Participation of epididymal cysteine-rich secretory proteins in sperm-egg fusion and their potential use for male fertility regulation

Rat protein DE is an androgen-dependent cysteine-rich secretory protein （CRISP） synthesized by proximal epididymal regions. DE, also known as CRISP-1, is localized on the equatorial segment of acrosome-reacted spermatozoa and participates in gamete fusion through binding to egg complementary sites. Immunization of rats with DE inhibits fertility and sperm fusion ability, suggesting that DE represents a good epididymal contraceptive target. Recombinant DE fragments and synthetic peptides revealed that DE binds to the egg via a 12-amino acid region of an evolutionarily conserved motif, Signature 2 （S2）. The ability of other CRISP to bind to the rat egg was correlated with their S2 amino acid sequences. Although testicular protein Tpx- 1 （CRISP-2） was capable of binding to rodent eggs, human epididymal AEG-related protein （ARP） and helothermine （from lizard saliva） were not. The S2 region presented only two substitutions in Tpx-1 and four in ARP and helothermine, compared with the DE S2, suggesting that this amino acid sequence was relevant for egg interaction. Studies with Tpx- 1 and anti-Tpx- 1 revealed the participation of this protein in gamete fusion through binding to complementary sites in the egg. In competition studies, DE reduced binding of Tpx- 1 dose-dependently, indicating that both CRISP share the egg complementary sites. That anti-DE and anti-Tpx-1 inhibit sperm-egg fusion while recognizing only the corresponding proteins, suggests functional cooperation between these homologous CRISP to ensure fertilization success. These results increase our understanding of the molecular mechanisms of gamete fusion and contribute to the development of new and safer fertility regulating methods. （Asian J Androl 2007 July; 9： 528-532）

Expression of serum human epididymal secretory protein E4 at low grade and high grade serous carcinomas

Objective:To investigate the value of serum human epididymis protein 4(HE4) in differential diagnosis of patients with low-grade serous(LGSC) and high-grade serous carcinoma(HGSC) serous ovarian cancer.Methods:LGSC and HGSC serous ovarian cancer were diagnosed by the two-tier grade system,serum levels of HE4 and carbohydrate antigen 12S(CA125) were measured by ELBA and radioisotope method,respectively in 60 serous ovarian cancer patients. HE4 and TPS3 protein in cancer tissue were measured by immunohistochemical method. Results:The difference in density of HE4 and TP53 protein was significant between LGSC and HGSC tissue,while serum CA12S did not show significant difference between different serum samples.There was significant difference in serum HE4 levels between LGSC and HGSC and the result was different within FIGO(Ⅰ+Ⅱ) stage,suggesting HE4 was not a reliable biomarker for the discrimination between LGSC and HCSC.HE4 had potential as a biomarker for the discrimination between LGSC and HGSC but the role in early diagnosis was limited.Conclusions:HE4 may be a reliable marker for differential diagnosis of LGSC and HGSC.But its role in early diagnosis of LGSC and HGSC need to be confirmed from the perspective of two-tier grade system.

Influence of reproductive tract obstruction on expression ）f epididymal proteins and their restoration after patency

Vasectomy is a simple and reliable method of male contraception. A growing number of men after vasectomy request vasectomy reversal due to various reasons. The pregnancy rate is lower than the patency rate after vasovasostomy and the pregnancy rate is time dependent. In this study, we evaluated the influence of reproductive tract obstruction on expression of epididymal proteins and their restoration after patency. Adult male Wistar rats were studied 30, 60 and 120 days after vasectomy, 30 days after vasovasostomy or after sham operations. Two-dimensional gel electrophoresis, mass-spectrometric technique, multidatabase search, Western blotting and real-time PCR were used to analyze the expression regulation of epididymal proteins. Total integrated intensity and total spot area of autoradiograms showed a consistent downward trend with time after obstruction, and this trend remained after patency. The intensity of the autoradiographic spots in three patency groups showed three trends： a downward trend, similar intensity and an upward trend compared with the correspondent obstruction group, respectively. Further verified experiments on human epididymis 2 （HE2）, fertilization antigen-1 （FA-1）, clusterin and PH20 demonstrated that compared with the correspondent obstruction group, the translation levels of HE2 and the mRNA transcription levels of HE2 showed an upward trend in patency groups, especially in the groups of obstruction for 60 days where the expression levels of HE2 were significantly upregulated after patency （P〈O.05）. Reproductive tract obstruction provokes a disregulation of gene expression in the epididymis and this disregulation remained after patency. Successful reversal may recover some proteins and the recovery is time dependent, Obstruction differentially alters mRNA transcription of different proteins and the content of proteins seemed to be easier to be influenced than the gene transcription.

Structure and function of epididymal protein cysteine-rich secretory protein-1

Cysteine-rich secretory protein-1 （CRISP-1） is a glycoprotein secreted by the epididymal epithelium. It is a member of a large family of proteins characterized by two conserved domains and a set of 16 conserved cysteine residues. In mammals, CRISP-1 inhibits sperm-egg fusion and can suppress sperm capacitation. The molecular mechanism of action of the mammalian CRISP proteins remains unknown, but certain non-mammalian CRISP proteins can block ion channels. In the rat, CRISP-1 comprises two forms referred to as Proteins D and E. Recent work in our laboratory demonstrates that the D form of CRISP-1 associates transiently with the sperm surface, whereas the E form binds tightly. When the spermatozoa are washed, the E form of CRISP-1 persists on the sperm surface after all D form has dissociated. Cross-linking studies demonstrate different protein-protein interaction patterns for D and E, although no binding partners for either protein have yet been identified. Mass spectrometric analyses revealed a potential post-translational modification on the E form that is not present on the D form. This is the only discernable difference between Proteins D and E, and presumably is responsible for the difference in behavior of these two forms of rat CRISP- 1. These studies demonstrate that the more abundant D form interacts with spermatozoa transiently, possibly with a specific receptor on the sperm surface, consistent with a capacitation-suppressing function during sperm transit and storage in the epididymis, and also confirm a tightly bound population of the E form that could act in the female reproductive tract. （Asian J Androl 2007 July; 9： 508-514）

Paracrine and endocrine actions of bone——the functions of secretory proteins from osteoblasts, osteocytes, and osteoclasts

The skeleton is a dynamic organ that is constantly remodeled. Proteins secreted from bone cells, namely osteoblasts, osteocytes,and osteoclasts exert regulation on osteoblastogenesis, osteclastogenesis, and angiogenesis in a paracrine manner. Osteoblasts secrete a range of different molecules including RANKL/OPG, M-CSF, SEMA3A, WNT5A, and WNT16 that regulate osteoclastogenesis. Osteoblasts also produce VEGFA that stimulates osteoblastogenesis and angiogenesis. Osteocytes produce sclerostin（SOST） that inhibits osteoblast differentiation and promotes osteoclast differentiation. Osteoclasts secrete factors including BMP6, CTHRC1, EFNB2, S1P, WNT10B, SEMA4D, and CT-1 that act on osteoblasts and osteocytes, and thereby influencea A osteogenesis. Osteoclast precursors produce the angiogenic factor PDGF-BB to promote the formation of Type H vessels, which then stimulate osteoblastogenesis. Besides, the evidences over the past decades show that at least three hormones or ＂osteokines＂from bone cells have endocrine functions. FGF23 is produced by osteoblasts and osteocytes and can regulate phosphate metabolism. Osteocalcin（OCN） secreted by osteoblasts regulates systemic glucose and energy metabolism, reproduction, and cognition. Lipocalin-2（LCN2） is secreted by osteoblasts and can influence energy metabolism by suppressing appetite in the brain.We review the recent progresses in the paracrine and endocrine functions of the secretory proteins of osteoblasts, osteocytes, and osteoclasts, revealing connections of the skeleton with other tissues and providing added insights into the pathogenesis of degenerative diseases affecting multiple organs and the drug discovery process.

Research advances of secretory proteins in malignant tumors

Secretory proteins in tumor tissues are important components of the tumor microenvironment.Secretory proteins act on tumor cells or stromal cells or mediate interactions between tumor cells and stromal cells,thereby affecting tumor progression and clinical treatment efficacy.In this paper,recent research advances in secretory proteins in malignant tumors are reviewed.

SsdchA is a novel secretory cellobiohydrolase driving pathogenicity in Sclerotinia sclerotiorum

The necrotrophic fungus, Sclerotinia sclerotiorum, employs an array of cell wall-degrading enzymes(CWDEs), including cellulase, to dismantle host cell walls. However, the molecular mechanisms through which S. sclerotiorum degrades cellulose remain elusive. Here, we unveil a novel secretory cellobiohydrolase, SsdchA, characterized by a signal peptide and a Glyco_hydro_7(GH7) domain. SsdchA exhibits a robust expression of during early infection stages. Interestingly, colony morphology and growth rates remain unaffected across the wild-type, SsdchA deletion strains and SsdchA overexpression strains on potato dextrose agar(PDA) medium. Nevertheless, the pathogenicity and cellobiohydrolase activity decreased in the SsdchA deletion strains, but enhanced in the SsdchA overexpression strains. Moreover,the heterologous expression of SsdchA in Arabidopsis thaliana leads to reduced cellulose content and heightened susceptibility to S. sclerotiorum. Collectively, our data underscore the pivotal role of the novel cellobiohydrolase SsdchA in the pathogenicity of S. sclerotiorum.

Correlation of serum mesothelin and human epididymis secretory protein 4 contents with cellular infiltrative growth in patients with ovarian cancer

Objective: To study the correlation of serum mesothelin and human epididymis secretory protein 4 contents with cellular infiltrative growth in patients with ovarian cancer. Methods:Patients with ovarian cancer who underwent surgical resection in West Coast Medical Center of the Affiliated Hospital of Qingdao University between June 2013 and December 2016 were selected as the ovarian cancer group of the study, and healthy women who received physical examination in China University of Petroleum (East China) Hospital during the same period were selected as the control group of the study. Serum was collected from two groups of subjects to detect serum mesothelin and human epididymis secretory protein 4 contents, and the ovarian cancer lesions and adjacent lesions were collected from ovarian cancer group to detect the expression of proliferation, apoptosis and invasion genes. Results: Serum mesothelin and human epididymis secretory protein 4 contents of ovarian cancer group were significantly higher than those of control group;FUNDC1, LSD1, TNFAIP8, CXCR4, β-catenin, CD44, PELP1, Slug, ZEB1 and Snail mRNA expression in ovarian cancer lesions were significantly higher than those in adjacent lesions and positively correlated with serum mesothelin and human epididymis secretory protein 4 contents while MFN2, PTEN, FN14 and E-cadherin mRNA expression were significantly lower than those in adjacent lesions and negatively correlated with serum mesothelin and human epididymis secretory protein 4 contents. Conclusion: Serum mesothelin and human epididymis secretory protein 4 contents abnormally increase in patients with ovarian cancer and are associated with the infiltrative growth of cancer cells.

Human ribonuclease 9,a member of ribonuclease A superfamily,specifically expressed in epididymis,is a novel sperm-binding protein

To explore the functions of human ribonuclease 9(RNase 9),we constructed a mammalian fusion expression vector pcDNA-hRNase9,prepared recombinant human RNase 9-His fusion protein from HEK293T cells and determined its N-terminal amino acid sequences.According to the determined mature protein,recombinant human RNase 9 was prepared in E.coli.Ribonucleolytic activity and antibacterial activity of recombinant human RNase 9 were detected,and the distribution of human RNase 9 on tissues and ejaculated spermatozoa and in vitro capacitated spermatozoa were analyzed via indirect immunofluorescence assay.The results showed that recombinant human RNase 9 did not exhibit detectable ribonucleolytic activity against yeast tRNA,but exhibited antibacterial activity,in a concentration/time dependent manner,against E.coli.Immunofluorescent analyses showed that the predicted human RNase 9 was present throughout the epididymis,but not present in other tissues examined,and human RNase 9 was also present on the entire head and neck regions of human ejaculated spermatozoa and in vitro capacitated spermatozoa.These results suggest that human RNase 9 may play roles in host defense of male reproductive tract.

Computational Analysis of Signal Peptide-Dependent Secreted Proteins in Saccharomyces cerevisiae

Computer based software such as the SignalP v3.0, TargetP v1.01, big-PI predictor and TMHMM v2.0 were combined to predict the signal peptides, and the signal peptide-dependent secreted proteins among the 6 700 ORFs in genome of Saccharomyces cerevisiae. The results showed that 163 proteins were the secreted ones containing signal peptides, and they were secreted via Sec pathway. Among the 163 predicted secreted proteins, the signal peptides of 47 secreted proteins included only the H-domain and C-domain, without N-domain, but the signal peptides of other 116 secreted proteins included all the three domains. There were differences in the constitution of signal peptides between the secreted proteins of S. cerevisiae and of Candida albicans, but the length and amino acids types of their signal peptides were similar in general. Few of the same signal peptides occurred in the secreted proteins of S. cerevisiae genome, and the homology could be compared among the secreted proteins with the same signal peptides. The BLAST 2 SEQUENECES and CLUSTAL W were used to align the two protein sequences and multi-protein sequences, respectively. The alignment result indicated that homology of these sequences with the same signal peptide was very highly conservative in amino acid of complete gene. The effect of the signal peptides in S. cerevisia on expression of foreign eukaryotic secreted proteins is discussed in this paper.

Secretory Transactivating Transcription-apoptin fusion protein induces apoptosis in hepatocellular carcinoma HepG2 cells

AIM:To determine whether SP-TAT-apoptin induces apoptosis and also maintains its tumor cell specificity. METHODS:In this study,we designed a secretory protein by adding a secretory signal peptide(SP) to the N terminus of Transactivating Transcription(TAT)-apoptin(SP-TAT-apoptin),to test the hypothesis that it gains an additive bystander effect as an anti-cancer therapy. We used an artificial human secretory SP whose amino acid sequence and corresponding cDNA sequence were generated by the SP hidden Markov model. RESULTS:In human liver carcinoma HepG2 cells,SP-TAT-apoptin expression showed a diffuse pattern in the early phase after transfection. After 48 h,however,it translocated into the nuclear compartment and caused massive apoptotic cell death,as determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide(MTT) assay and annexin-V binding assay. SP-TAT-apoptin did not,however,cause any cell death in non-malignant human umbilical vein endothelial cells(HUVECs). Most importantly,the conditioned medium from Chinese hamster ovary(CHO) cells transfected with SP-TAT-apoptin also induced significant cell deathin HepG2 cells,but not in HUVECs. CONCLUSION:The data demonstrated that SP-TAT-apoptin induces apoptosis only in malignant cells,and its secretory property might greatly increase its potency once it is delivered in vivo for cancer therapy.

Quantitative Screening of Secretory Protein Genes in <i>Candidatus</i>Liberibacter Asiaticus

Huanglongbing (HLB) is the most destructive disease of citrus worldwide. The disease is caused by Candidatus Liberibacter spp., which is vectored by the psyllids Diaphorina citri Kuwayama and Trioza erytreae. Secretory proteins are important in bacterial pathogenesis and structure components. Some of them are expressed at a high level. To obtain the highly-expressed secretory protein genes (SPGs) for antiserum preparation, six candidate SPGs were chosen from Candidatus Liberibacter asiaticus by bioinformatic analysis and were further tested by qPCR and RT-qPCR methods, respectively. The result showed that two SPGs, 408 and pap (both are Flp pilus assembly protein genes), have relative high amounts of DNA and RNA transcripts of early HLB-infected green orange leaves. The 408 and pap genes were further constructed into the plant expression vector pCAMBIA1300 (GV1300: GFP) and expressed in tobacco leaf epidermal cells for subcellular localization analysis. The transient expression results indicated that the 408 protein is located in the nuclei and cytoplasm of tobacco leaf cells. However, the pap protein is located in the cytoplasm of tobacco leaf cells, which may help the pathogen invade into plant cells. This research is an important foundation for the preparation of the antiserum against Candidatus Liberibacter asiaticus and the early detection of HLB disease.

PnSCR82,a small cysteine-rich secretory protein of Phytophthora nicotianae,can enhance defense responses in plants

A number of plant pathogenic species of Phytophthora are known to produce different classes of secretory proteins during interactions with their hosts.Although several small cysteine-rich(SCR)secretory proteins,conserved in oomycete pathogens,have been identified in Phytophthora,their specific involvement in these interactions remains unknown.In this study,an SCR effector encoded by Pn SCR82 in P.nicotianae was identified and shown to have similarities to P.cactorum phytotoxic protein,Pc F(Phytophthora cactorum Fragaria).Agroinfection with potato virus X vector,Pn SCR82,was capable of inducing plant hypersensitive cell death in Nicotiana benthamiana and Solanum lycopersicum.Real-time PCR results indicated that transiently expressed Pn SCR82 in N.benthamiana leaves activated the jasmonate,salicylic acid and ethylene signaling pathways.Transient expression of Pn SCR82 enhanced plant resisitance to P.capsici.In summary,our results demonstrated that P.nicotianae Pn SCR82 elicits defensive responses in N.benthamiana and may potentially play a significant role in future crop protection programs.

Distribution of secretory inhibitor of platelet microbicidal protein among anaerobic bacteria isolated from stool of children with diarrhea

AIM: To study the secretory inhibitor of platelet microbicidal protein (SIPMP) phenotypes of faecal anaerobic isolates from patients with diarrhea. METHODS: Faecal isolates of anaerobic bacteria (B. fragilis, n = 42; B. longum, n = 70; A. israelii, n = 21; E. lentum, n = 12) from children with diarrhea were tested. SIPMP production was tested by inhibition of platelet microbicidal protein (PMP) bioactivity against B. subtilis and was expressed as percentage of inhibition of PMP bactericidal activity. RESULTS: Among anaerobic isolates 80% of B. longum strains, 85.7% of A. israelii strains, 50% of E. lentum strains and 92.86% of B. fragilis strains were SIPMP-positive. The isolated anaerobic organisms demonstrated SIPMP production at a mean level of 13.8% ± 0.7%, 14.7% ± 1.8%, 3.9% ± 0.9% (P < 0.05) and 26.8% ± 7.5% (P < 0.05) for bifidobacteria, A. israelii, E. lentum and B. fragilis, respectively. CONCLUSION: Data from the present study may have significant implications in understanding the pathogenesis of microecological disorders in the intestine, as well as for future improvement in the prevention and therapy of anaerobe-associated infections.

冠心病患者血清VCAM-1、miR-145、Gal-3、SFRP5水平变化

目的探讨冠心病患者血清血管细胞黏附分子-1(VCAM-1)、miR-145、半乳糖凝集素-3(Gal-3)、分泌型卷曲蛋白5(SFRP5)水平变化及意义。方法选取冠心病患者80例为冠心病组,另收集健康志愿者40名为健康对照组。采集清晨空腹肘静脉血,酶联免疫吸附法测定血清VCAM-1、Gal-3、SFRP5浓度;RT-PCR检测血清miR-145表达水平。根据冠脉造影检查诊断的病变支数分为单支病变、双支病变、多支病变。收集两组受试者人口学特征及冠心病患者实验室指标;进行1 a随访,记录不良预后发生情况(病情加重再入院、死亡)。结果冠心病组患者血清VCAM-1、Gal-3水平明显高于健康对照组,miR-145、SFRP5水平明显低于健康对照组(均P<0.01)。急性心肌梗死组患者血清VCAM-1、Gal-3水平明显高于不稳定型心绞痛组、稳定型心绞痛组患者,血清miR-145、SFRP5水平明显低于不稳定型心绞痛组、稳定型心绞痛组患者(均P<0.05)。多支病变患者血清VCAM-1、Gal-3水平明显高于双支病变和单支病变患者,血清miR-145、SFRP5水平明显低于双支病变和单支病变患者(均P<0.05)。预后不良组患者血清VCAM-1、Gal-3水平明显高于预后良好组患者,miR-145、SFRP5水平明显低于预后良好组患者(均P<0.01)。VCAM-1、miR-145、Gal-3、SFRP5水平是冠心病患者预后的独立影响因素;ROC曲线分析显示,血清VCAM-1、miR-145、Gal-3、SFRP5水平联合检测对冠心病患者预后具有较高的预测价值(AUC=0.928)。结论冠心病患者血清VCAM-1、Gal-3水平高表达,miR-145、SFRP5水平低表达,且与冠心病分类、冠脉病变支数密切相关,联合检测对预后具有较高的预测价值。

血清SDC-1、HDAC6、CC16水平联合检测对慢性阻塞性肺疾病患者预后不良的预测价值

目的:探讨血清多配体蛋白聚糖1(SDC-1)、组蛋白去乙酰化酶6(HDAC6)、克拉拉细胞分泌蛋白16(CC16)水平联合检测对慢性阻塞性肺疾病(COPD)患者预后不良的预测价值。方法:选取2020年11月至2023年11月该院收治的147例COPD患者进行横断面研究,设为研究组;选取同期于该院体检的147名健康者设为对照组。比较两组、不同COPD病情程度患者、不同预后COPD患者血清SDC-1、HDAC6、CC16水平;采用受试者工作特征(ROC)曲线分析入院时血清SDC-1、HDAC6、CC16水平单项及联合检测预测COPD患者预后不良的价值。结果:研究组血清SDC-1、HDAC6水平均高于对照组,血清CC16水平低于对照组,差异有统计学意义(P<0.05)。重度COPD患者血清SDC-1、HDAC6水平高于中重度、中度、轻度患者,且中重度高于中度、轻度患者,中度高于轻度患者;重度COPD患者血清CC16水平低于中重度、中度、轻度患者,且中重度低于中度、轻度患者,中度低于轻度患者,差异均有统计学意义(P<0.05)。预后不良COPD患者入院时血清SDC-1、HDAC6水平高于预后良好患者,血清CC16水平低于预后良好患者,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,入院时血清SDC-1、HDAC6、CC16水平联合检测预测COPD患者预后不良的曲线下面积(AUC)为0.938,高于三者单项检测诊断(AUC=0.774、0.771、0.716)。结论:入院时血清SDC-1、HDAC6、CC16水平联合检测预测COPD患者预后不良的价值高于三者单项检测。

尼拉帕利联合贝伐珠单抗治疗晚期卵巢癌效果及对外周血T淋巴细胞亚群、凋亡因子的影响

目的探究尼拉帕利联合贝伐珠单抗治疗晚期卵巢癌的效果。方法选取2020年9月—2023年9月就诊的80例晚期卵巢癌,采用随机数字表法分为观察组和对照组各40例,观察组在TP化疗基础上给予贝伐珠单抗联合尼拉帕利治疗,对照组在TP化疗基础上给予贝伐珠单抗治疗,均治疗4个周期。对比2组疗效及治疗前后血清癌抗原(CA)125、CA153、人附睾蛋白4(HE4)、缺氧诱导因子-1α(HIF-1α)、血管生成素-2(Ang-2)、血管内皮生长因子(VEGF)、B淋巴细胞瘤-2(Bcl-2)、B细胞CLL/淋巴瘤2关联凋亡基因-1(Bag-1)、CD3+、CD4+、CD4+/CD8+,以及毒副反应发生率。结果观察组总有效率为90.00%(36/40)高于对照组的72.50%(29/40)(P<0.05);随着治疗时间的延长CA153、HE4、CA125、VEGF、Ang-2、HIF-1α、VEGF、Ang-2、HIF-1α水平逐渐降低(P<0.05),随着治疗时间的延长观察组CD3+、CD4+、CD4+/CD8+先降低后趋于稳定,对照组呈持续降低趋势(P<0.05)。治疗2个、4个周期后,观察组CA153、HE4、CA125、VEGF、Ang-2、HIF-1α、Bag-1、Bcl-2均低于对照组,观察组CD3+、CD4+、CD4+/CD8+均较对照组高(P<0.05)。2组毒副反应发生率比较差异无统计学意义(P>0.05)。结论尼拉帕利联合贝伐珠单抗治疗可调控晚期卵巢癌患者细胞凋亡因子及血管生成因子水平,缓解免疫损伤,抑制肿瘤标志物水平,提升治疗效果。

卵巢-附件影像报告和数据系统分类联合血清学检查对卵巢-附件肿瘤的诊断价值

目的探讨卵巢-附件影像报告和数据系统(O-RADS)分类联合血清糖类抗原125(CA125)及人附睾分泌蛋白4(HE4)对卵巢-附件肿瘤的诊断价值。方法回顾性分析安徽医科大学附属亳州医院(亳州市人民医院)收治并病理确诊的卵巢-附件肿瘤患者90例,以病理结果为金标准,分析超声O-RADS分类、血清CA125、HE4对卵巢-附件恶性肿瘤的检出率。运用受试者工作特征(ROC)曲线分析O-RADS分类、CA125、HE4及三者联合应用对卵巢-附件肿瘤的诊断效能。结果90例卵巢-附件肿瘤中,良性61例,恶性29例。O-RADS分类中2、3、4、5类对恶性肿瘤的检出率依次增高,与良性肿瘤比较,差异有统计学意义(P<0.001),血清CA125、HE4对恶性肿瘤的检出率分别为72.00%、70.37%,与良性肿瘤比较,差异有统计学意义(P均<0.001)。O-RADS分类、CA125、HE4及三者联合诊断卵巢-附件肿瘤的曲线下面积(AUC)分别为0.783、0.753、0.762、0.909,联合诊断AUC高于任一单独诊断技术(P均<0.05)。结论超声O-RADS分类联合血清CA125、HE4有助于提高卵巢-附件肿瘤的诊断效能。

膝骨关节炎患者SFRP与玻璃酸钠治疗效果的关系

目的探讨膝骨关节炎(knee osteoarthritis,KOA)患者分泌型卷曲相关蛋白(secretory curl related protein,SFRP)水平与玻璃酸钠治疗效果的关系。方法选取2021年5月至2023年6月温州市中医院收治的KOA患者89例纳入观察组,所有患者均采用玻璃酸钠治疗,根据治疗效果分为显效/好转组和效果差组;同期选取67名健康体检者纳入对照组。采用酶联免疫吸附试验测定各组纳入者的SFRP1、SFRP2和SFRP5水平,并对KOA患者玻璃酸钠治疗效果进行多因素Logistic回归分析;绘制受试者操作特征曲线(receiver operating characteristic curve,ROC曲线),分析SFRP水平在KOA患者治疗效果中的评价效能。结果观察组患者的SFRP1、SFRP2及SFRP5水平低于对照组(P<0.05);89例KOA患者经玻璃酸钠治疗后,67例治疗效果良好(75.28%),显效/好转组患者的SFRP1、SFRP2及SFRP5水平高于效果差组(P<0.05);多因素分析结果表明,SFRP1、SFRP2、SFRP5水平及西安大略和麦克马斯特大学骨关节炎指数均为KOA患者治疗效果的影响因素(P<0.05);ROC曲线结果表明,SFRP1、SFRP2联合SFRP5对KOA患者治疗效果评价的敏感度和特异性高于单一指标(P<0.05)。结论SFRP1、SFRP2和SFRP5在KOA患者中呈低表达,其表达水平与患者玻璃酸钠治疗效果存在紧密联系,不同指标联合测定可提高预测的敏感度和特异性。

DCE-MRI联合ADC及CA125、HE4对卵巢上皮性肿瘤良恶性鉴别的价值

目的通过研究动态对比增强磁共振成像(dynamic contrast-enhanced magnetic resonance imaging,DCE-MRI)、表观扩散系数(apparent diffusion coefficient,ADC)、血清糖类抗原125(CA125)、人附睾分泌蛋白(HE4)及其联合应用对卵巢上皮性肿瘤良恶性的鉴别诊断效能,探讨运用于卵巢上皮性肿瘤诊断的最佳方法。方法回顾性分析我院2022年1月至2022年12月收治的76例卵巢上皮性肿瘤患者为研究对象,病理证实良性36例,恶性40例。分别记录良、恶性肿瘤患者的DCE-MRI定量参数K^(trans),DWI扫描自动生成的ADC图上勾画ROI(感兴趣区)获得ADC值,并通过LIS系统调取其CA125及HE4指标并进行统计,同时以病理诊断结果为金标准,计算不同检查方法及联合应用对诊断卵巢上皮性肿瘤良恶性诊断的灵敏度、特异度。结果K^(trans)、ADC、CA125及HE4指标对卵巢上皮性肿瘤良恶性诊断的灵敏度分别为92.5%、80.0%、72.5%,特异度分别为86.1%、75.0%、88.8%;恶性组患者CA125及HE4水平明显高于良性组;联合应用对良性、恶性卵巢上皮性肿瘤诊断的敏感性及特异性高于单一检查,具有统计学差异(P<0.05)。结论DCE-MRI联合ADC及CA125、HE4对卵巢上皮性肿瘤良恶性鉴别诊断的效能优于单一检查,可提高术前对卵巢上皮性肿瘤良恶性鉴别诊断的价值。