Diagnostic potential of urinary monocyte chemoattractant protein-1 for Alzheimer's disease and amnestic mild cognitive impairment.

BACKGROUND AND PURPOSE: The chemokine monocyte chemoattractant protein-1 (MCP-1) is involved in the pathogenesis of Alzheimer's disease (AD). This study aimed to investigate whether urinary MCP-1 can distinguish patients with AD, patients with amnestic mild cognitive impairment (aMCI) and cognitively normal (CN) subjects. METHODS: A total of 754 participants, including 97 patients with AD, 50 patients with aMCI and 84 age- and sex-matched CN controls as well as a cohort of 523 CN subjects of different ages, were enrolled from five hospitals located in different areas of China. Urinary MCP-1 levels were determined using enzyme-linked immunosorbent assays. The correlations between urinary MCP-1 levels and cognition test scores or age were analysed. The optimal diagnostic sensitivity and specificity were determined using receiver operating characteristic curve analysis. RESULTS: In the cohort of CN subjects of different ages, urinary MCP-1 levels increased with ageing and were correlated with age. The urinary MCP-1 levels were higher in females than in males. In the cohort composed of patients with AD, aMCI and age- and sex-matched CN controls, urinary MCP-1 levels were significantly higher in patients with AD and aMCI than in CN controls. There were no differences in urine MCP-1 levels between the AD group and the aMCI group. The urinary MCP-1 levels were correlated with the Mini-Mental State Examination scores and age, and were able to differentiate patients with AD and aMCI from CN subjects. CONCLUSIONS: Urinary MCP-1 is a potential biomarker for the diagnosis of AD and aMCI.

[Preoperative C-reactive protein/albumin ratio predicts the prognosis of patients with resectable pancreatic cancer].

Objective: To evaluate the clinical significance of C-reactive protein/albumin ratio in predicting the postoperative prognosis of pancreatic cancer patients. Methods: The clinical date of 97 patients with resectable pancreatic cancers who treated at Department of Hepatobiliary and Pancreatic Surgery, the third Affiliated Hospital of Soochow University from January 2005 to December 2015 were analyzed retrospectively. The cut-off value of CRP/Alb ratio was determined by the receiver operating characteristic(ROC) curve. According to the CRP/Alb ratio, patients were respectively divided into two groups: the high group(CRP/Alb ratio≥0.109) and the low group(CRP/Alb<0.109). The relationships between CRP/Alb ratio and clinical characteristics were analyzed by χ(2) test. Median survival and 1-year overall survival rate(OS) was calculated by Kaplan-Meier method.The risk factors of patients with poor prognosis were analyzed by univariate and multivariate Cox regression analysis model. Results: Tumor TNM stage(χ(2)=4.280, P=0.039) and differentiation(χ(2)=6.635, P=0.010) had significant relationship with CRP/Alb ratio. The median survival of higher CRP/Alb ratio group and lower CRP/Alb ratio group was 15 months and 23 months respectively. Compared with lower CRP/Alb ratio group, the 1-year OS of higher CRP/Alb ratio group decreased remarkablely, and the difference was statistically(χ(2)=10.207, P=0.001). Moreover, median survival and OS were decreased in patients with advanced age(≥65 years old: χ(2) =5.338, P=0.021), high TNM stage(ⅡB-Ⅲ: χ(2) =10.529, P=0.001), poor tumor differentiation(χ(2)=5.380, P=0.020), vascular invasion(χ(2) =7.856, P=0.005) and positive surgical margin(χ(2)=9.059, P=0.003). A high CRP/Alb ratio was identified as an independent risk factor of poor prognosis for patients with pancreatic cancer(HR=1.832, 95% CI: 1.067-3.144, P=0.028). Besides, old age(HR=1.684, P=0.014), high TNM stage(HR=1.666, P=0.031), vascular invasion(HR=1.834, P=0.024) and positive surgical margin(HR=2.205, P=0.023) were also included. Conclusion: Preoperative CRP/Alb ratio can be an important clinical factor for assessing the prognosis of patients with resectable pancreatic cancers, and high CRP/Alb ratio suggests poor prognosis.

Malignant pheochromocytoma: diagnosis and treatment in fifteen cases.

This study reviews the diagnosis and treatment of 15 patients with malignant pheochromocytoma (MP) between 1958 and 1986 in Shanghai Rui-jin Hospital. The main clinical features consisted of sustained elevation of arterial blood pressure, obviously increased catecholamine secretion and a sustained positive phentolamine test. Out of 15 patients only seven survived, two of whom suffered from paraplegia due to metastatic cordal compression. Compared with some earlier results, the prognosis was unsatisfactory. There were several factors which may have been responsible: (1) late diagnosis; (2) incomplete operation, and (3) no regular post-operative assessment of urinary biochemical changes. Because MP is a tumour with a low degree of malignancy, noting the above three factors and using 131I-MIBG to obtain accurate diagnosis and effective treatment enables a better prognosis of this disease.

Aspirin resistance: clinical significance and genetic polymorphism.

OBJECTIVE: To determine the prevalence, clinical implications and underlying mechanism of aspirin resistance in Chinese patients. METHODS: Platelet aggregation was determined by light transmission aggregometry (LTA) using four different inducers. Patients were divided into aspirin-resistant (AR), aspirin semi responder (ASR) and aspirin-sensitive (AS) groups, according to their LTA results. Aspirin resistance was assessed by thrombo elastography (TEG, with arachidonic acid [AA] or adenosine diphosphate as inducers), serum/urinary 11-dehydrothromboxane B2 (11-DH-TXB2) assay, platelet function analyser-100 assay and P-selectin assay. Polymorphisms in the prostaglandin endoperoxide synthase 1 (PTGS1) gene (A842G, C50T, C22T, G128A, C644A and C714A), the PTGS2 gene (G765C) and the integrin ß3 (ITGB3) gene (C196T) were examined. RESULTS: The study included 360 aspirin-treated patients and 314 healthy controls. AS patients had significantly lower levels of 11-DH-TXB2 than AR and ASR patients, and significantly lower levels of P-selectin than AR patients. TEG-AA was more sensitive, specific and consistent than P-selectin in detecting aspirin resistance. The frequency of the PTGS2 G765C mutation was significantly higher in the AR/ASR groups versus the AS group. CONCLUSIONS: TEG-AA was more sensitive, specific and consistent than the P-selectin assay for detecting aspirin resistance, and the PTGS2 G765C mutation may be related to aspirin resistance.

The murine amelogenin promoter: developmentally regulated expression in transgenic animals.

We are interested in understanding hierarchical regulation pathways that control gene expression in developing teeth. In pursuit of the molecular basis for the regulated expression of amelogenin by developing ameloblasts during tooth formation, we isolated the murine amelogenin promoter. Analysis of this promoter will provide additional details towards the identification of signals generated through instructive-, dissimilar-germ layer interactions that are for responsible for temporal- and spatial-regulation for amelogenin gene expression. Using transgenic mice we demonstrate that a 2263 nucleotide stretch of the murine amelogenin promoter conveys appropriate temporal- and spatial-regulation for amelogenin gene expression in response to instructive-signals. These transgenic animals are useful reagents to further dissect signaling pathways responsible for regulated gene expression by terminally differentiated ameloblasts.