ABSTRACT. We examined the serum concentration of human epididymis protein (HE4) in patients with benign gynecological diseases complicated with chronic renal deficiency and its significance in the differential diagnosis of benign and malignant gynecological diseases. Serum HE4 and cancer antigen 125 concentrations were detected by chemiluminescence. Clinically or pathologically confirmed gynecological diseases were grouped and retrospectively analyzed, including 50 cases of gynecological benign diseases, 35 cases of non-mucinous epithelial ovarian carcinoma, 36 cases of endometrial adenocarcinoma, 15 cases of gynecological benign diseases patients complicated with chronic renal deficiency, 15 cases of gynecological diseases without chronic renal deficiency, and 30 normal controls. Serum HE4 values in the ovarian cancer group, endometrial cancer group, gynecological benign diseases with chronic renal deficiency group, and chronic renal deficiency group were significantly increased compared with the benign gynecological diseases and normal control groups, showing a significant difference (P < 0.001). A comparison of 4 groups with high HE4 showed that the HE4 level in the 2 groups 2157 HE4 in benign gynecology with renal insufficiency ©FUNPEC-RP www.funpecrp.com.br Genetics and Molecular Research 14 (1): 2156-2161 (2015) with renal deficiency were higher than those in the ovarian cancer and endometrial cancer groups, but the difference was not significant (P > 0.05); there was no significant difference between 2 groups with renal deficiency (P > 0.05). Serum concentration of HE4 was high in patients with chronic renal deficiency, which should be distinguished during differential diagnosis of gynecological benign and malignant tumors in patients with chronic renal deficiency to avoid misdiagnosis.

Our objective was to study the effects of type I insulin-like growth factor receptor (IGF-IR) on human cord blood lymphocyte (CBL) functions. First, we used RT-PCR to determine the expression of IGF-IR at the mRNA level in CBL. We then inhibited the expression of IGF-IR in CBL by the antisense oligonucleotide for the IGF-IR gene. We measured the changes in interleukin (IL)-2, -4 and interferon-γ (IFNγ) at mRNA levels by RT-PCR, immunoglobulin M (IgM) production by CBL with an ELISA and lymphocyte proliferation by a 3 H-thymidine uptake technique. Our results showed that IGF-IR mRNA was detected in both non-activated and activated CBL, but the expression levels in the activated CBL were higher than those in the non-activated CBL. After being exposed to the antisense oligonucleotide, a 50% reduction in the amount of IGF-IR mRNA occurred. Accordingly, the proliferation of CBL to mitogen was significantly reduced about 50%, and the production of IgM from CBL was also markedly decreased. In the phytohemagglutinin-stimulated CBL culture system, when the IGF-IR antisense oligonucleotide existed, the mRNA levels of IFNγ and IL-2 decreased 30-50% and IL-4 decreased 20-30%. We concluded that IGF-IR is most likely involved in the process of CBL proliferation and production of immunoglobulin and cytokines. It might therefore play an important role in the modulation of the immune functions.

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Keto acids is widely used in dialysis patients with end-stage renal disease, which can effectively correct hypocalcemia, reduce blood PTH as well as blood phosphorus, and elevate blood albumin. Keto acids have a very low incidence of side effects. So far, no cases of Keto acids-induced severe hypercalcemia had been reported. The authors here present a case of continuous ambulatory peritoneal dialysis (CAPD) patient who repeatedly developed severe hypercalcemia accompanied by consciousness disturbance due to daily low-dose keto acids administration. In this case, common causes of hypercalcemia were excluded by thorough physical examination and investigations. The blood calcium concentration of this patient had reached 3.83 mmol/L, belonging to severe hypercalcemia, and the clinical manifestations of cognitive disorder required urgent treatment. After the suspension of keto acids, the serum calcium concentration returned to normal, and the peritoneal dialysis scheme resumed as normal after discharge, which could still maintain the normal calcium concentration. When the patient took the medicine again, severe hypercalcemia occurred as expected. After drug withdrawal, blood calcium backed to normal level, and blood phosphorus increased, which further confirmed that calcium and phosphorus metabolism disorder was closely related to the use of keto acids. This case here indicate that close monitoring of blood calcium, phosphorus and other indicators are needed, in order to prevent potential risk of hypercalcemia which would endanger the safety of patient's life.