肝细胞肝癌中PED/PEA-15 mRNA及蛋白表达的临床意义

目的:探讨PED/PEA-15 mRNA及蛋白在肝癌组织、癌旁组织及正常肝组织中的表达情况及其临床意义.方法:应用半定量逆转录.聚合酶链反应检测40例肝细胞肝癌、相应癌旁组织和12例正常肝组织中PED/PEA.15基因的相对表达量.并通过免疫组化检测PED/PEA-15蛋白的表达.结果:半定量RT-PCR显示,PED/PEA-15基因在肝癌组织中均呈高表达,癌旁组织及正常肝组织呈低表达或不表达,相对表达量分别为1.201±0.301、0.64±0.101和0.565±0.077,PED/PEA-15 mRNA在肝癌组织中表达较癌旁组织、正常肝组织显著升高(P<0.01).免疫组织化学显示,肝癌组织、癌旁组织及正常肝组织中PED/PEA-15蛋白的表达率分别为72.5%、32.5%和16.7%.肝癌组织中PED/PEA-15蛋白表达较癌旁组织及正常肝组织显著升高(P<0.01).且PED/PEA-15 mRNA及蛋白的表达与肝癌病理分级、临床分期有关(P<0.05),而与发病年龄、性别、肿瘤大小、肿瘤数目差异无显著性(P>0.05).结论:PED/PEA-15 mRNA及蛋白在肝癌组织中表达水平明显升高,可能在肝癌的发生及发展过程中发挥重要作用.     

Akt2、Livin蛋白表达情况与胃癌发病相关性及与临床病理学特征的关系

目的探讨丝氨酸/苏氨酸蛋白激酶2 (Akt2)、Livin蛋白在胃癌患者中的表达情况及其与临床病理学特征的关系,讨论其在临床上应用的意义。方法选取我院确诊的胃癌患者组织标本125例(病灶组)、癌旁组织标本60例(癌旁组),收集时间2015年1月-2017年5月,免疫组化法检测病灶组和癌旁组标本中的Akt2、Livin蛋白表达情况并分析其与临床病理学特征的关系。结果胃癌组织Akt2、Livin蛋白表达明显高于癌旁组织(P0.05),Akt2与淋巴结转移、分化程度、不同浸润深度、不同临床分期有关(P0.05);Livin蛋白与淋巴结转移、分化程度有关(P0.05);与性别、年龄、不同浸润深度、不同临床分期间无关(P0.05)。结论 Akt2、Livin蛋白在胃癌中高表达,并且与肿瘤的发生发展关系密切。     

胃癌组织中Podoplanin、血管内皮生长因子-C表达水平及临床意义

目的探讨胃癌癌组织中Podoplanin、血管内皮生长因子(VEGF)-C表达水平及临床意义。方法 127例胃癌患者,取手术切除胃癌组织(127例)及距肿瘤5～10 mm处癌旁组织(50例)石蜡标本,采用免疫组化法检测Podoplanin、VEGFC表达水平,观察Podoplanin、VEGF-C与临床病理参数的关系。结果胃癌组织中Podoplanin、VEGF-C表达水平均高于癌旁组织(P 0. 05)。不同年龄、性别、肿瘤大小的胃癌患者癌组织中Podoplanin表达水平差异无统计学意义(P 0. 05),临床分期高、分化程度低、存在浆膜浸润及淋巴结转移的患者Podoplanin表达水平较高(P 0. 05)。不同年龄、性别、肿瘤大小、分化程度的胃癌患者癌组织中VEGF-C表达阳性率差异无统计学意义(P 0. 05),临床分期高、存在浆膜浸润及淋巴结转移患者VEGF-C表达阳性率较高(P 0. 05)。结论胃癌癌组织中Podoplanin、VEGF-C表达水平较高,其中Podoplanin高表达可能与肿瘤临床分期、分化程度、浆膜浸润及淋巴结转移有关,VEGF-C表达阳性率可能与肿瘤临床分期、浆膜浸润及淋巴结转移有关。     

FBXW7及c-Myc蛋白在人胃癌组织中的表达及其与胃癌临床病理特征的相关性分析

目的分析F框/WD-40域蛋白7(FBXW7)及c-Myc蛋白在人胃癌组织中的表达及其与胃癌临床病理特征的相关性。方法回顾性收集102例胃癌临床手术标本,每份标本均取其正常胃黏膜组织(A组)、癌旁组织(B组)与癌组织(C组)。通过免疫组织化学法对三种组织FBXW7及c-Myc蛋白的表达水平进行检测,进而分析其与胃癌临床病理特征的相关性。结果相比A组与B组,C组中的FBXW7蛋白表达水平显著降低(P0.05),而c-Myc蛋白的表达水平明显升高(P0.05);而B组中的FBXW7、c-Myc蛋白表达水平均显著低于A组(P0.05)。FBXW7、c-Myc蛋白的表达水平与患者年龄、性别及肿瘤部位均无显著相关性(P0.05),但与胃癌分化程度、肿瘤浸润深度、淋巴结转移及TNM分期均显著相关(P0.01)。结论胃癌患者中FBXW7蛋白表达水平明显降低,而cMyc蛋白表达明显升高,二者表达水平可能与肿瘤分化程度、浸润深度及发生淋巴结转移等存在密切联系,FBXW7与c-Myc可能成为早期诊断与评估胃癌浸润及淋巴结转移的重要生物学指标。     

GOLPH3、Livin蛋白表达水平与胃癌患者临床病理特征的相关性研究

[目的]探讨胃癌组织中高尔基体磷酸化蛋白3(GOLPH3)、Livin蛋白表达水平及与患者临床病理学特征的关系.[方法]选取两院病理科收集的80例胃癌术后组织学标本、40例胃癌癌旁组织标本,采用免疫组化染色方法检测胃癌组织及癌旁组织中的GOLPH3蛋白、Livin蛋白表达水平,并按照肿瘤病灶直径、TNM分期、浸润程度、...     

hGC-1在胃癌组织中的表达及其与胃癌发生、发展过程的相关性研究

目的研究粒细胞集落刺激因子1(h GC-1)在胃癌组织和正常及良性病变胃黏膜组织中的表达及其与临床病理学特征之间的关系,进一步探讨h GC-1表达改变与胃癌发生、发展过程的相关性。方法应用免疫组织化学SP方法检测组织芯片中70例胃癌标本和5例正常及炎性病变胃组织标本中h GC-1的表达情况,并结合胃癌病理分级、TNM分期、肿瘤浸润的深度、患者的性别构成比、年龄以及是否存在淋巴结转移等临床病理参数进行分析。结果胃癌组织中h GC-1的表达水平明显高于正常及炎性病变胃黏膜组织。70例胃癌组织中h GC-1表达上调41例,总上调率达58.6%,而在5例正常及炎性病变胃黏膜组织中有4例表达为阴性,仅1例标本表达上调。h GC-1的表达上调率与胃癌细胞的病理分级、TNM分期以及肿瘤浸润深度存在相关性,且随着胃癌细胞恶性程度的增高,h GC-1的表达也呈逐渐减少趋势,差异具有统计学意义(P0.05)。h GC-1的表达与患者的性别构成比、年龄、肿瘤淋巴结是否转移则无明显相关(P0.05)。结论 h GC-1表达上调与胃癌的发生、发展过程相关,因此可作为反映胃癌恶性生物学行为的新型标志物。     

P53和Ki67在胃癌中的表达及其临床意义

目的了解P53和Ki67在胃癌中的表达形式及其临床意义。方法采用免疫组化PV-9000法检查60例患者胃癌组织中P53和Ki67蛋白的表达。结果 P53和Ki67能表达蛋白组织核细胞的特征。60例患者胃癌组织中P53和Ki67蛋白表达阳性率分别为31.67%、68.33%;21例慢性胃炎患者组织中P53和Ki67蛋白表达阳性率为4.77%、38.10%。P53的蛋白组织临床分期、浸润深度、淋巴转移三项阳性表达比较差异有统计学意义(P<0.05),分化程度比较差异未见统计学意义(P>0.05);Ki67蛋白表达的临床分期、浸润深度比较差异有统计学意义(P<0.05),淋巴结转移与分化程度比较差异未见统计学意义(P>0.05)。P53和Ki67在胃癌组织中表达呈显著相关性。结论应用P53和Ki67表达形式的检查结果,可作为胃癌的诊断及预后恢复情况的重要依据。     

己糖激酶-Ⅱ在胃癌组织中的表达及其临床意义

目的探讨己糖激酶-Ⅱ(HK-Ⅱ)在人体胃癌组织中的表达情况及其临床意义,分析HK-Ⅱ与临床病理特征之间的关系。方法选取2013年3—9月在东南大学医学院附属江阴医院确诊的胃癌病患100例,切除标本,运用免疫组化及RTPCR方法检测胃癌组织及正常胃黏膜组织中HK-Ⅱ的表达情况,并分析其与性别、年龄、浸润深度、TNM分期、分化程度、淋巴结转移、脉管侵犯、肿瘤大小等的关系。结果 HK-Ⅱ在胃癌组织中的阳性表达率为68.00%,显著高于正常胃黏膜组织(P0.05)。HK-Ⅱ表达与性别、年龄、浸润深度无关(P0.05);与TNM分期、分化程度、淋巴结转移、脉管侵犯、肿瘤大小有关(P0.05)。胃癌组织HK-ⅡmRNA阳性率显著高于正常胃黏膜组织(P0.01)。结论 HK-Ⅱ在胃癌组织中高表达,可作为胃癌的恶性预后指标和临床治疗靶点。     

MTSS1在胃癌中的表达及临床意义

目的:探讨MTSS1在胃癌中的表达及其与临床病理关系.方法:用免疫组化方法及Western Blot方法检测MTSS1在胃癌及癌旁正常组织中的表达,并分析其与胃癌临床及病理参数的相关性.结果:通过对50例胃癌及癌旁正常组织的免疫组化染色表明,MTSS1在胃癌组织中39例呈阳性表达,但在正常组织中仅12例阳性表达.Western Blot结果显示50组肿瘤与正常组织的蛋白表达水平对比中有35组病例肿瘤中MTSS1表达水平明显高于正常组织.统计分析表明MTSS1在胃癌中的表达较正常组织明显增高(P=0.000),MTSS1的表达与胃癌的TNM分期、淋巴结转移、远处转移及肿瘤的浸润深度有关,而与患者的性别、年龄,肿瘤的部位、尺寸、分化程度无关.结论:MTSS1可能在胃癌的发生、发展中发挥着重要作用.     

胃癌组织中MIF与miR-451的表达及其临床意义

目的研究胃癌组织中MIF与miR-451的表达及临床意义。方法选取60例胃癌患者的肿瘤组织(观察组)及其癌旁组织标本(对照组),采用RT-PCR方法检测胃癌组织和癌旁组织中MIF和miR-451的表达水平,并分析其与临床病理的关系。结果 RT-PCR结果显示,胃癌患者的肿瘤组织标本中MIF表达水平显著高于对照组患者,差异具有统计学意义(P0.05);miR-451表达水平显著低于对照组患者,差异具有统计学意义(P0.05)。比较胃癌中MIF与miR-451的表达与临床病理因素关系可知,MIF与miR-451的表达与患者的性别、年龄及远处转移无关(P0.05),而与肿瘤分化程度、TNM分期、浸润深度、淋巴结转移有关(P0.05)。经Spearman等级相关分析发现胃癌组MIF与miR-451表达具有显著负相关性(r=-0.697,P=0.012)。结论胃癌组织中MIF的表达显著升高,而miR-451的表达显著下降,且具有明显的相关性,可以作为重要的辅助指标对临床胃癌的诊断、治疗和预后判断进行指导。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.