Notch1/DLL4信号通路与VEGF在胃癌浸润和转移中的作用及其相关性

目的：探讨Notch1和其配体DLL4蛋白在胃癌组织中的表达及其与肿瘤血管转移之间的关系。
方法：采用免疫组织化学SP法检测45例胃癌及25例癌旁正常组织中Notch1,DLL4,VEGF的表达情况,并分析它们与各临床病理参数的关系。
结果：Notch1,DLL4,VEGF蛋白在胃癌中表达的阳性率均明显高于正常胃黏膜组织,差异均有统计学意义（P＜0.01）。Notch1蛋白在胃癌中表达与肿瘤浸润深度、淋巴结转移（P＜0.01）及远处转移（P＜0.05）有关;DLL4蛋白在胃癌中表达与肿瘤浸润深度（P＜0.01）,淋巴结转移及临床分期（P＜0.05）有关;VEGF蛋白在胃癌中表达与浸润深度（P＜0.01）、淋巴结转移、远处转移及TNM分期（P＜0.05）有关,上述各因素分组间差异有统计学意义。Notch1,DLL4,VEGF蛋白的表达三者两两间均呈正相关关系（rs=0.355,rs=0.367,rs=0.334;均P＜0.05）。
结论：Notch1/DLL4受体通路在胃癌组织中的表达上调与血管内皮生长因子有关,它们可能共同调控肿瘤新生血管形成,参与胃癌的侵袭和转移。     

Notch1/DLL4信号通路与VEGF在胃癌浸润和转移中的作用及其相关性

目的探讨Notch1和其配体DLL4蛋白在胃癌组织中的表达及其与肿瘤血管转移之间的关系。方法采用免疫组织化学SP法检测45例胃癌及25例癌旁正常组织中Notch1,DLL4,VEGF的表达情况,并分析它们与各临床病理参数的关系。结果Notch1,DLL4,VEGF蛋白在胃癌中表达的阳性率均明显高于正常胃黏膜组织,差异均有统计学意义(P<0.01)。Notch1蛋白在胃癌中表达与肿瘤浸润深度、淋巴结转移(P<0.01)及远处转移(P<0.05)有关;DLL4蛋白在胃癌中表达与肿瘤浸润深度(P<0.01),淋巴结转移及临床分期(P<0.05)有关;VEGF蛋白在胃癌中表达与浸润深度(P<0.01)、淋巴结转移、远处转移及TNM分期(P<0.05)有关,上述各因素分组间差异有统计学意义。Notch1,DLL4,VEGF蛋白的表达三者两两间均呈正相关关系(rs=0.355,rs=0.367,rs=0.334;均P<0.05)。结论Notch1/DLL4受体通路在胃癌组织中的表达上调与血管内皮生长因子有关,它们可能共同调控肿瘤新生血管形成,参与胃癌的侵袭和转移。     

EphA2和E-cadherin在胃癌中的表达及其意义

目的:探讨EphA2与E-cadherin在胃癌组织中的表达及其意义。方法:采用免疫组织化学SP法检测EphA2与E-cadherin蛋白在胃癌组织、癌旁组织和远癌胃组织中的表达情况，分析它们与胃癌临床病理特征之间的关系及两种蛋白间的相关性。结果:EphA2在胃癌组织中呈高表达(P＜0.01)，其高表达与胃癌的浸润深度、肿瘤TNM分期以及淋巴结转移有关(P＜0.05);E-cadherin在胃癌组织中呈低表达(P＜0.01)，其低表达与胃癌的浸润深度、肿瘤分化程度、肿瘤TNM分期以及淋巴结转移有关(P＜0.05);胃癌组织中EphA2和E-cadherin蛋白表达呈负相关(r=-0.602，P＜0.001)。结论:EphA2的高表达和E-cadherin的低表达与胃癌的发展和转移密切相关，EphA2可望作为胃癌治疗的新靶点。     

细胞间粘附分子-1在胃癌组织中的表达及临床意义

目的:探讨细胞间粘附分子-1(ICAM-1)在胃癌中的表达及其临床意义。方法:采用免疫组织化学法检测胃癌组织中ICAM-1的表达情况,并与临床病理参数作相关分析。结果:58例胃癌组织中,ICAM-1的阳性表达率为34.5%,其表达率与肿瘤浸润深度、肝转移及血管侵犯无明显相关(P＞0.05);ICAM-1表达阳性率在肠型胃癌显著高于弥漫型胃癌(P＜0.01),淋巴结转移者显著低于无淋巴结转移者(P＜0.01);随肿瘤TNM分期的增高,ICAM-1的阳性表达率也逐渐下降(P＜0.05)。结论:胃癌组织中ICAM-1表达与淋巴结转移和肿瘤分期密切相关。     

Bmi-1在胃癌中的表达及其意义

目的 探讨Bmi-1在胃癌组织中的表达及其与临床病理因素之间的关系.方法 采用RT-PCR和Western blot技术检测44例胃癌组织和癌旁正常组织中Bmi-1的表达.结果 胃癌组织Bmi-1mRNA阳性表达率为72.73％,显著高于癌旁正常组织(13.64％)(P＜0.05);Bmi-1蛋白在胃癌组织中表达显著高于癌旁正常组织(P＜0.05);在有淋巴结转移以及远处转移的患者中Bmi-1的表达显著高于无淋巴结转移和无远处转移阴性患者(P＜0.05).但Bmi-1的表达与患者的性别、年龄、肿瘤大小及分化程度无关,该4因素的分组间差异无统计学意义(P＞0.05).结论 Bmi-1的表达上升可能与胃癌的发生及浸润、转移有关.     

S100A4和血管内皮生长因子C、D在胃癌组织中的表达及其与淋巴结转移和预后的关系

目的 观察人胃癌S100A4和血管内皮生长因子(VEGF)-C、VEGF-D的表达,探讨其与临床病理特征及预后的关系.方法 应用免疫组织化学方法检测108例人胃癌及20例癌旁组织中S100A4和VEGF-C、VEGF-D的表达.分析S100A4和VEGF-C、VEGF-D表达与患者年龄、性别、肿瘤大小、病理类型、浸润深度、淋巴结转移和肿瘤TNM分期的关系,并作预后分析.结果 S100A4和VEGF-C、VEGF-D在胃癌组织中的阳性率明显高于癌旁组织(P＜0.05).S100A4的表达与肿瘤大小和淋巴结转移有关(P＜0.05),VEGF-C的表达与淋巴结转移和TNM分期有关(P＜0.05),VEGF-D的表达与淋巴结转移和TNM分期无明显相关(P＞0.05),肿瘤组织内S100A4和VEGF-C两者表达呈正相关(P＜0.05).S100A4和VEGF-C、VEGF-D阳性胃癌患者5年生存率分别低于阴性患者,差异无统计学意义(P＞0.05).结论 S100A4和VEGF-C的表达与胃癌的淋巴结转移有关,S100A4可能参与VEGF-C淋巴管生成通路,在胃癌的淋巴结转移中发挥重要作用.     

miR-21和PDCD4mRNA在大肠癌组织中的表达及其临床意义

目的 探讨miR-21和PDCD4mRNA在大肠癌组织中的表达及与其临床病理特征的关系,并阐明在大肠癌活体组织中miR-21与其靶基因PDCD4表达的关系.方法 用荧光定量PCR技术检测43对大肠癌组织及其对应的正常黏膜组织中的miR-21和PDCD4 mRNA表达量;免疫组化SP法检测PDCD4蛋白的表达.结果 大肠癌组织中miR-21的表达升高(P＜0.05),而PDCD4mRNA的表达降低(P＜0.05).miR-21的表达与大肠癌的淋巴结转移、临床分期(Ⅰ+Ⅱ、Ⅲ+Ⅳ)有关(P＜0.05),而与患者的性别、肿瘤位置、肿瘤大小、浸润深度、远处转移、临床分期(Ⅰ、Ⅱ)无关(P＞0.05);PDCD4mRNA的表达与大肠癌的浸润深度、临床分期(Ⅰ、Ⅱ)有关(P＜0.05),而与患者的性别、肿瘤位置、肿瘤大小、淋巴结转移、远处转移、临床分期(Ⅰ+Ⅱ、Ⅲ+Ⅳ)无关(P＞0.05).miR-21的表达与PDCD4蛋白的核表达、核与浆表达之和存在负相关(P＜0.05),而与PDCD4mRNA、PDCD4蛋白的浆表达无相关性(P＞0.05).结论 miR-21和PDCD4mRNA在大肠癌中的异常表达与大肠癌的预后有关;在大肠癌活体组织中,miR-21通过与PDCD4mRNA的3’非编码区结合抑制PDCD4mRNA翻译成蛋白质.     

Cyclin E在胃癌组织中的表达及其临床意义

目的探讨Cyclin E蛋白在胃癌组织中的表达及其与临床病理和生存时间的关系。方法采用免疫组化过氧化物酶标记链霉卵白素法（SP法）检测胃癌及正常胃黏膜组织100例、胃癌转移淋巴结组织66例中Cyclin E蛋白的表达,分析其与患者的年龄、性别、肿瘤大小、浸润深度、分化程度、淋巴结转移和远处转移等临床病理因素的相关关系。结果 Cyclin E蛋白在胃癌组织、正常胃黏膜组织及转移淋巴组织中均有表达,三者之间阳性表达率差异有统计学意义（P〈0.01）。Cyclin E蛋白表达与癌发部位、肿瘤大小、组织类型及有无淋巴结转移有显著的相关性（P〈0.05）,与患者的性别、年龄、远处转移、浸润深度及TNM分期无相关关系。结论 Cyclin E蛋白表达与胃癌患者发生淋巴结转移及肿瘤组织分化程度、大小有相关关系,可作为胃癌诊断及判断预后的一项新指标。     

整合素β3与Fas蛋白在胃癌组织中的表达及其意义

目的 探讨整合素β3(Integin-β3)和Fas蛋白在胃癌组织中的表达、相互关系及意义.方法 应用免疫组织化学方法 检测48例胃癌组织及12例正常胃黏膜中Integrin-β3和Fas蛋白的表达.结果 胃癌组织中Integrin-β3阳性率显著高于正常胃黏膜(72.9%比25.0%,P＜0.01);正常胃黏膜中Fas蛋白阳性率显著高于胃癌组织(83.3%比33.3%,P＜0.01);Integin-β3阳性率与淋巴结转移、TNM分期显著相关(P＜0.01),而与肿瘤细胞分化程度无相关性(P＞0.05);Fas蛋白阳性率与淋巴结转移、TNM分期及肿瘤细胞分化程度均无相关性(P均＞0.05).胃癌组织中Integrin-β3与Fas表达具有显著等级负相关(r=-0.429,P＜0.01).结论 htegrin-β3的表达与胃癌细胞的浸润与转移密切相关.     

结直肠癌组织中miR-142-3p及RAC1基因的表达及其意义

目的 研究结直肠癌组织中miR-142-3p、RAC1基因及蛋白的表达与临床病理特征的关系,并探讨miR-142-3p及RAC1二者表达的相关性.方法 用实时荧光定量PCR技术测定50例结直肠癌组织及其对应的正常黏膜组织中miR-142-3p和RAC1mRNA的表达;用免疫组化SP法检测RAC1蛋白的表达.结果 结直肠癌组织中miR-142-3p的表达低于对应的癌旁组织[-(0.714±2.876)比-(2.116±3.179),Z=-2.882,P=0.004];RAC1 mRNA表达显著高于癌旁组织[(8.973±1.940)比(10.093±2.069),Z=-4.204,P=0.000].miR-142-3p的表达与结直肠癌的淋巴结转移和临床分期有关(均P＜0.05),而与患者的性别、年龄、肿瘤大小、肿瘤位置、浸润深度、组织分化程度、有无远处转移等无关(均P ＞0.05);RAC1 mRNA的表达与结直肠癌患者的分化程度、淋巴结转移、远处转移及临床分期有关(均P ＜0.05),而与性别、年龄、肿瘤位置、肿瘤大小、浸润深度无关(均P＞0.05);RAC1蛋白的表达与肿瘤的分化程度、淋巴结转移、远处转移及临床分期有关(P＜0.05),而与其他临床病理特征无关.miR-142-3p的表达与RAC1 mRNA的表达无相关性(P＞0.05),而与RAC1蛋白的表达存在负相关(P＜0.05).结论 在结直肠癌组织中RAC1mRNA及RAC1蛋白高表达和miR-142-3p的低表达可能与其预后有关.     

Perioperative and long-term morbidity and mortality after above-knee and below-knee amputations in diabetics and nondiabetics

We performed a retrospective review of a vascular surgery quality assurance database to evaluate the perioperative and long-term morbidity and mortality of above-knee amputations (AKA, n = 234) and below-knee amputations (BKA, n = 720) and to examine the effect of diabetes mellitus (DM) (181 of AKA and 606 of BKA patients). All patients in the database who had AKA or BKA from 1990 to May 2001 were included in the study. Perioperative 30-day cardiac morbidity and mortality and 3-yr and 10-yr mortality after AKA or BKA were assessed. The effect of DM on 30-day cardiac outcome was assessed by multivariate logistic regression and the effect on long-term survival was assessed by Cox regression analysis. The perioperative cardiac event rate (cardiac death or nonfatal myocardial infarction) was at least 6.8% after AKA and at most 3.6% after BKA. Median survival was significantly less after AKA (20 mo) than BKA (52 mo) (P < 0.001). DM was not a significant predictor of perioperative 30-day mortality (odds ratio, 0.76 [0.39-1.49]; P = 0.43) or 3-yr survival (Hazard ratio, 1.03 [0.86-1.24]; P = 0.72) but predicted 10-yr mortality (Hazard ratio, 1.34 [1.04-1.73]; P = 0.026). Significant predictors of the 30-day perioperative mortality were the site of amputation (odds ratio, 4.35 [2.56-7.14]; P < 0.001) and history of renal insufficiency (odds ratio, 2.15 [1.13-4.08]; P = 0.019). AKA should be triaged as a high-risk surgery while BKA is an intermediate-risk surgery. Long-term survival after AKA or BKA is poor, regardless of the presence of DM.     

Body composition assessment and methodology in nonathletic and athletic adolescent and adult males and females

The purpose of this review is to outline methodology for assessing body composition utilizing anthropometric and densitometric techniques. The objective of body composition assessment is to measure body fat and lean body mass. The quantity of these components varies due to growth, physical activity, dietary regimens, and aging. Anthropometric techniques incorporate selected skinfolds, circumferences, skeletal widths, or other variables to estimate body composition within k2.0-4.0%. These techniques are adequate for field testing of groups or individuals, but are population specific. Densitometry measures body volume irrespective of physique, sex, or age. This laboratory technique estimates body composition within 1.0-2.0%, is more difficult to administer, but is not population specific. Some limitation exists with any present technique due to biological variability and incomplete research of reference body composition in children, females, and the aged. J Orthop Sports Phys Ther 1984;5(6):336-347.     

Postoperative nausea and vomiting and opioid-induced nausea and vomiting: guidelines for prevention and treatment

Postoperative nausea and vomiting (PONV) causes patient discomfort, lowers patient satisfaction, and increases care requirements. Opioid-induced nausea and vomiting (OINV) may also occur if opioids are used to treat postoperative pain. These guidelines aim to provide recommendations for the prevention and treatment of both problems. A working group was established in accordance with the charter of the Sociedad Espa?ola de Anestesiología y Reanimación. The group undertook the critical appraisal of articles relevant to the management of PONV and OINV in adults and children early and late in the perioperative period. Discussions led to recommendations, summarized as follows: 1) Risk for PONV should be assessed in all patients undergoing surgery; 2 easy-to-use scales are useful for risk assessment: the Apfel scale for adults and the Eberhart scale for children. 2) Measures to reduce baseline risk should be used for adults at moderate or high risk and all children. 3) Pharmacologic prophylaxis with 1 drug is useful for patients at low risk (Apfel or Eberhart 1) who are to receive general anesthesia; patients with higher levels of risk should receive prophylaxis with 2 or more drugs and baseline risk should be reduced (multimodal approach). 4) Dexamethasone, droperidol, and ondansetron (or other setrons) have similar levels of efficacy; drug choice should be made based on individual patient factors. 5) The drug prescribed for treating PONV should preferably be different from the one used for prophylaxis; ondansetron is the most effective drug for treating PONV. 6) Risk for PONV should be assessed before discharge after outpatient surgery or on the ward for hospitalized patients; there is no evidence that late preventive strategies are effective. 7) The drug of choice for preventing OINV is droperidol.     

Similarities and differences between female and male sexual functions and dysfunctions

Men and women have 23 pairs of chromosomes. They share 22 of them. In physiologic conditions they differ systematically in only one pair, the sexual one. Females (normally) have what is called an “XX” on the 23rd pair of chromosomes, whereas males have an “XY” pair. The striking sexual differences –anatomic, functional, reproductive, psychological and sociocultural - between men and women depends on or derive from the difference in one critical chromosome out of 46, which contains on average 2% of all the genetic code. Biochemical, neuroendocrine, hormonal, vascular, nervous, and metabolic similarities that both sexes share, based on the common 45 chromosomes and related biologically determined similarities contributing to the secret sexual symmetry between genders, is reviewed. Furthermore the role of the genetically determined brain and somatic gender dymorphism, contributing to gender sexual differences is analyzed. Neuroplasticity and psychoplasticity are praised as basic mechanisms that bridge together and re-shape the individual biological and psychological world through the continuous interaction with the environment. Enhancement of sexual differences in behaviour, meaning of, and motivation to sex by cultural constructs, by religious and social dynamics, and the continuous interaction of each person with a usually role-polarized society during the whole life span will be finally acknowledged. To contribute to a better understanding of the shared biological sexual similarities between genders and their dialectic and continuous relation with biological and socioculturally related sexual differences is the ultimate goal of this introductory article and the following papers of the series.