胃癌组织中MACC1基因的表达及意义

摘要:目的：探讨胃癌组织中结肠癌转移相关基因（MACC1）的表达,评价其在胃癌进展、侵袭和转移中的作用。 方法：用RT-PCR检测60例胃癌患者癌组织和癌旁组织中MACC1 mRNA的表达情况,分析其与临床病理参数的相关性。 结果：MACC1 mRNA在胃癌组织中阳性率为70.0%(42/60),显著高于癌旁组织［13.3%(8/60),χ²=37.34,P＜0.01］,和正常胃黏膜组织［0%(0/20),χ²=26.73,P＜0.01］。MACC1 mRNA表达与胃癌浸润深度、TNM分期、分化程度及有无淋巴结转移呈正相关(P均＜0.05),而与年龄、性别、肿瘤大小无关。 结论: MACC1 mRNA高表达与胃癌进展、侵袭及转移相关,可作为胃癌诊断和预后评估的分子标志物。     

蛋白质磷酸酶2A癌性抑制因子在CML患者外周血单个核细胞中的表达及意义

摘要:目的：观察蛋白质磷酸酶2A癌性抑制因子（CIP2A）在慢性髓细胞白血病（CML）患者外周血单个核细胞中的表达及意义。 方法：收集不同临床分期［CML-CP(慢性期)、CML-AP/BP（加速/急变期）］的41例CML患者和35例体检健康者外周血标本,分离单个核细胞,用RT-PCR检测CIP2A mRNA的表达,并对CML患者进行随访。 结果：CML-CP患者CIP2A mRNA阳性率为63.6％（14/22）,CML-AP/BP患者阳性率为68.4％（13/19）,两组差异无统计学意义（χ²=0.104,P>0.05）;健康人对照组CIP2A mRNA均为阴性。32例随访患者中,CIP2A mRNA阳性患者的死亡率为47.4％（9/19）,阴性患者死亡率为7.7％（1/13）,差异有统计学意义（χ²=3.960,P<0.05）。 结论: CML患者外周血单个核细胞中CIP2A呈高表达状态,可能CML发生相关。     

细胞周期素H在食管癌中的表达及临床意义

摘要：目的：探讨细胞周期素H（CCN H)在食管癌中的表达及临床意义。 方法：用western blot检测8例配对的食管癌和癌旁组织中CCN H蛋白表达水平;免疫组化检测98例食管癌石蜡切片中CCN H蛋白表达情况;Kaplan-meier生存曲线分析患者的生存率;Cox模型多因素分析CCN H的表达与患者临床预后的相关性。 结果：western blot结果表明,CCN H在食管癌细胞核中的表达显著高于癌旁组织（P<0.05）;免疫组化结果表明,CCN H在低分化的食管癌细胞核中表达较高,且与分化程度有关（χ²=25.10,P<0.05）;生存曲线分析显示,CCN H高表达与食管癌患者生存率相关（χ²=11.61,P＜0.05）,但CCN H不能作为独立的食管癌预后指标（P>0.05）。 结论：CCN H在食管癌中表达上调,且与食管癌的发生、发展密切相关。     

IGFBP6在结直肠癌组织中的表达及其意义

摘要：目的：探讨胰岛素样生长因子结合蛋白6（IGFBP6）在结直肠癌（CRC）组织中的表达水平及其在CRC中的临床意义。 方法：实时荧光定量PCR(qRT-PCR)检测CRC患者癌组织及其相应癌旁组织中IGFBP6 mRNA的表达水平;免疫组织化学法（IHC）检测CRC患者癌组织及癌旁组织石蜡切片中IGFBP6蛋白的表达;分析其与CRC患者临床病理参数及预后关系。 结果：CRC患者癌组织中IGFBP6 mRNA表达水平（0.26±0.39）低于癌旁组织（1.22±0.75）,差异有统计学意义（t=8.288,P＜0.01）;CRC患者癌组织中IGFBP6蛋白阳性率（38.1%）低于癌旁组织(61.9%),且与TNM分期相关（P均＜0.01）。生存曲线分析显示,IGFBP6低表达的CRC患者生存时间明显缩短。 结论：低表达的IGFBP6可作为CRC诊断及预后判断潜在的生物学标志物。     

结直肠癌组织Rab27A的表达及意义

目的： 在基因和蛋白水平检测结直肠癌组织及相应的癌旁组织中Rab27A表达情况，并探讨其与结直肠癌患者临床特点的相关性及临床意义。方法： 回顾性分析2005年1月至2019年1月在上海市浦东新区人民医院普通外科和上海交通大学医学院附属仁济医院胃肠外科接受手术治疗的125例结直肠癌患者的结直肠癌病理标本及其临床病理资料。采用实时定量聚合酶链反应（qRT-PCR）和Western印迹法分别检测其中32对和8对结直肠癌患者的肿瘤组织和相应的癌旁组织（距癌组织边缘>5 cm）中Rab27A mRNA和蛋白表达情况。免疫组织化学检测125例结直肠癌组织中Rab27A表达情况，计算Rab27A染色强度，并分析其与临床特点之间的关系。结果： 在32对结直肠癌肿瘤组织和癌旁组织中，肿瘤组织中Rab27A mRNA表达水平明显高于癌旁正常临床组织（P=0.001）。在8对结直肠癌肿瘤组织和癌旁组织中，肿瘤组织中蛋白表达水平明显高于癌旁正常组织。肿瘤大小和临床分期在Rab27A蛋白高表达组和低表达组差异有统计学意义（P=0.037、0.017）。生存分析结果显示，Rab27A表达水平越高，结直肠癌患者预后越差。同时，多因素分析表明，Rab27A在结直肠癌患者中可作为独立的预后分子标志物。结论： Rab27A在结直肠癌的发生发展中起重要作用，可作为反映结直肠癌生物学行为的潜在有效指标。     

宫颈癌组织中Slug基因及其蛋白质的表达与意义

摘要：目的：检测Slug基因在宫颈癌和慢性宫颈炎症组织中的表达,探讨其与宫颈癌发生、发展的相关性及在宫颈癌诊疗中的意义。 方法：收集31例宫颈癌组织和17例慢性宫颈炎症组织标本,用RT-PCR、实时定量PCR检测Slug mRNA的表达;用western blot分析Slug蛋白的表达水平,并分析Slug mRNA在宫颈癌中的表达水平与临床病理因素及高危型HPV病毒载量的相关性。 结果：宫颈癌组织中SlugmRNA表达阳性率及相对表达水平均显著高于慢性宫颈炎症组织（χ²=9.872;U=140,P均<0.01）;western blot也证实Slug蛋白表达水平高于慢性宫颈炎症组织（U=98,P<0.01）。在宫颈癌组织中,Slug的阳性表达与国际妇产科学联盟（International Federation of Gynecology and Obstetrics, FIGO）肿瘤分期相关,Ⅱ期阳性率高于Ⅰ期（χ²=4.037,P<0.05）,与年龄、肿瘤大小、分化程度、淋巴细胞转移和病理类型无关;而Slug基因相对表达水平与高危型HPV病毒载量呈正相关（r=0.554,P<0.01）。 结论:宫颈癌组织中Slug的表达上调,且与宫颈癌的FIGO分期相关,在宫颈癌的发生机制中,可能存在Slug和高危型HPV的协同作用。     

Twist、Slug基因在宫颈癌中的表达及与预后的关系

摘要:目的：探讨Twist、Slug基因在宫颈癌中的表达水平及与临床预后的关系。 方法：用实时定量PCR检测56例宫颈癌患者、120例宫颈上皮内瘤变(CIN)患者组织和血浆中Twist、Slug mRNA的表达,以35例正常宫颈及慢性宫颈炎组织和血浆作为对照。免疫组化染色检测Twist、Slug蛋白在宫颈癌组织中的表达,并分析其与宫颈癌复发的关系。 结果：对照组、CIN组、宫颈癌组组织中Twist mRNA表达水平分别为(1.98±0.48)×10^-3、(3.89±0.86)×10^-3、(6.53±1.25)×10^-3,血浆中Twist mRNA表达水平分别为(1.62±0.55)×10^-4、(1.76±0.68)×10^-4、(2.08±0.90) ×10^-4;3组组织中Slug mRNA表达水平分别为(1.33±0.32)×10^-2、(3.02±0.95)×10^-2、(4.69±1.02)×10^-2,血浆中Slug mRNA表达水平分别为(2.08±0.75)×10^-3、(2.30±0.78)×10^-3、(3.09±1.02)×10^-3;宫颈癌组、CIN组组织中Twist、SlugmRNA表达水平均高于对照组（F分别为46.69、55.30,P<0.01);宫颈癌组血浆中Twist、SlugmRNA 相对表达水平最高（F分别为10.56、17.97,P<0.01),且术前血浆中Twist、Slug相对表达水平高于术后2周的水平（t分别为2.12、2.03,P<0.05)。宫颈癌组Twist mRNA与SlugmRNA呈正相关（r=0.483, P<0.01）;免疫组化结果表明,宫颈癌组织Twist、Slug蛋白表达阳性率(55.4%、78.6%)高于对照组的表达阳性率(8.6%、37.1%)（χ²分别为20.15、15.80,P<0.01)。宫颈癌组Twist蛋白阳性者复发率高于Twist蛋白阴性者（29.0% vs 4.0%,χ²=5.91,P<0.05)。 结论:Twist、Slug基因在宫颈癌组织和血浆中表达上调,Twist阳性表达与宫颈癌的复发关系密切。     

3D动脉自旋标记、弥散张量成像联合常规MRI鉴别诊断颅内血管外皮细胞瘤与血管瘤型脑膜瘤

目的 观察3D动脉自旋标记（3D ASL）、弥散张量成像（DTI）联合常规MRI鉴别诊断颅内血管外皮细胞瘤（HPC）与血管瘤型脑膜瘤（AM）的价值。方法 回顾性分析经手术病理证实的15例HPC（HPC组）与11例AM（AM组），分析2组临床表现、MRI（包括平扫、增强、DTI、3D ASL）征象及功能成像参数差异。结果 HPC组平均脑血流量（CBF）及各向异性分数（FA）均低于AM组（t=-8.99，P<0.01；t=-3.66，P<0.01），表观弥散系数（ADC）高于AM组（t=2.61，P=0.02）；HPC组高灌注区和低灌注区CBF均低于AM组（t=-15.13，P<0.01；t=-8.30，P<0.01）；HPC组平均发病年龄低于AM组（t=-2.39，P=0.02），性别差异无统计学意义（χ²=1.69，P=0.19）；相比AM组，HPC组更易出现分叶征（χ²=9.09，P<0.01）及囊变坏死（χ²=9.38，P<0.01），HPC病灶T1WI以等高信号为主（χ²=27.78，P<0.01）、T2WI以等低信号为主（χ²=16.33，P<0.01），瘤周水肿程度轻（χ²=19.25，P<0.01），血管流空影更常见且更粗大（χ²=9.02，P=0.01），多与硬脑膜多为窄基底相连（χ²=28.54，P<0.01）而脑膜尾征少见（χ²=25.00，P<0.01）。结论 HPC与AM的MRI征象及各功能成像参数值存在一定差异，可为鉴别诊断提供参考。     

低强度脉冲超声保护MPP+诱导的N2a细胞损伤的实验研究

目的 观察低强度脉冲超声（LIPUS）能否减弱1-甲基-4-苯基吡啶离子（MPP⁺）诱导的N2a细胞毒性，对帕金森病（PD）细胞模型发挥保护作用。方法 以MPP⁺作用于N2a细胞24 h，建立PD细胞模型，并对N2a细胞进行超声辐照（1 MHz，50 mW/cm²，脉冲重复频率1 kHz，辐照10 min）。将细胞分为对照组、超声对照（LIPUS）组、MPP⁺组和超声处理（MPP⁺+LIPUS）组，并给予相应处理。采用CCK8法测定细胞活力，DCFH-DA染色法检测细胞内活性氧簇（ROS）水平，JC-1染色法检测线粒体膜电位变化，Annexin V-FITC/PI双染法检测细胞凋亡情况；以实时荧光定量PCR检测瞬时受体电位M7（TRPM7）的mRNA表达水平。结果 与对照组相比，MPP⁺组细胞存活率及线粒体膜电位显著降低，细胞内ROS水平和细胞凋亡明显增加（P均<0.01）；LIPUS辐照后，经MPP⁺诱导的细胞存活率和线粒体膜电位显著上升，细胞内ROS水平及细胞凋亡明显降低（P均<0.01）。MPP⁺组TRPM7的mRNA表达下降，MPP⁺+LIPUS组TRPM7表达显著升高（P均<0.01）。结论 LIPUS可增加MPP⁺诱导的N2a细胞存活率，减少线粒体膜电位损伤和ROS生成，抑制细胞凋亡，对MPP⁺的神经细胞毒性具有保护作用。     

TF-FⅦa复合物影响人卵巢癌细胞尿激酶型纤溶酶原激活物受体mRNA表达的研究

目的克隆人组织因子(TF),研究组织因子-活化凝血因子Ⅶ复合物(TF-FⅦa)对人卵巢癌细胞内尿激酶型纤溶酶原激活物(u-PA)及其受体(u-PAR)mRNA表达的影响,探讨该复合物在肿瘤浸润、转移中的作用机制.方法采用分子克隆技术构建人TF真核表达载体pcDNA3-TFcDNA;以脂质体介导转染人卵巢癌细胞系A2780,筛选稳定表达的转染细胞A2780-TF.以FⅦa分别刺激A2780细胞和A2780-TF细胞,采用RT-PCR方法检测细胞内u-PA及u-PAR mRNA水平变化.结果①构建产物经基因测序证实为pcDNA3-TFcDNA重组体;②转染细胞A2780-TF内TF-mRNA水平显著增高转染细胞为3.91±0.28,未转染细胞为0.97±0.23(P<0.01);转染细胞表面TF表达显著增高转染细胞为(48.56±9.53)%,未转染细胞为(2.73±1.15)%(P<0.01);③FⅦa刺激对A2780细胞内u-PA、u-PAR mRNA水平均无显著影响;④FⅦa呈浓度依赖性诱导A2780-TF细胞内u-PAR mRMA水平增高,而不影响u-PA mRNA水平;FⅦa刺激A2780-TF细胞内u-PAR mRNA水平增高的作用具有一定的时相性;⑤抗TF单抗可阻断FⅦa诱导A2780-TF细胞内u-PAR mRNA转录的作用.结论 TF通过与FⅦa形成复合物而上调人卵巢癌细胞内u-PAR mRNA的表达,可能藉此增强肿瘤侵袭及转移作用.     

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.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

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.     

Modified micro-superior percutaneously-assisted total hip: early experiences & case reports

Because of the extensile nature and familiarity of the standard posterior-lateral approach to the hip, a family of "micro-posterior" approaches has been developed. This family includes the Percutaneously-Assisted Total Hip (PATH) approach, the Supercapsular (SuperCap) approach and a newer hybrid approach, the Supercapsular Percutaneously-Assisted Total Hip (SuperPATH) approach. Such approaches should ideally provide a continuum for the surgeon: from a "micro" (external rotator sparing) posterior approach, to a "mini" (external rotator sacrificing) posterior approach, to a standard posterior approach. This could keep a surgeon within his comfort zone during the learning curve of the procedure, while leaving options for complicated reconstructions for the more practiced micro-posterior surgeons. This paper details one author's experiences utilizing this combined approach, as well as permutations of this entire micro-posterior family of approaches as applied to more complex hip reconstructions.     

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.     

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.