前列腺增生组织中间质细胞增殖和表型转化与雌激素受体α表达的关系

目的 比较人正常前列腺(NP)和前列腺增生(BPH)中间质细胞标记蛋白、增殖细胞核抗原(PCNA)和雌激素受体α(ERα)的表达差异,并检测BPH组织间质细胞标记蛋白与PCNA或ERα同时呈阳性染色的细胞.方法 对4例NP和8例BPH连续切片应用免疫组织化学方法,观察波形蛋白(vimentin)、α-平滑肌肌动蛋白(α-SMA)、肌球蛋白(myosin)、PCNA和ERa的表达定位.结果 与NP相比在BPH中,α-SMA阳性染色细胞显著增加;波形蛋白在间质中阳性染色细胞有所增加,在腺泡基底层及临近腺泡外层间质中阳性染色细胞明显增加;在临近腺泡外的数层间质细胞中肌球蛋白和ERα由部分阳性变为完全阴性染色,而在远离腺泡的间质中其阳性染色细胞由散在斑块状分布变为簇状密集排列;PCNA在间质中阳性染色细胞有所增加,在基底细胞层中阳性染色细胞显著增加.连续切片免疫组织化学染色显示,在腺泡上皮基底层存在PCNA与波形蛋白、ERα共定位的细胞;在间质中存在肌球蛋白与ERα共定位的细胞.结论 与NP相比,BPH间质细胞表型发生明显变化,且其增殖和表型转化与ERα表达定位的改变密切相关.     

雌激素受体α、β亚型在子宫平滑肌瘤中的表达特征

目的：探讨雌激素受体(ER)α、β亚型的表达量在子宫平滑肌瘤发病中的意义。方法：取自愿手术的子宫肌瘤患者30例为研究对象,应用非放射性原位杂交技术方法测定平滑肌瘤组织中ER和ERβmRNA的表达,并与正常的平滑肌组织相比较。结果：ERαmRNA和ERβmRNA主要在平滑肌细胞中表达。子宫肌瘤和正常的平滑肌组织中ERαmRNA的表达量高于ERβmRNA;ERαmRNA在子宫肌瘤中的表达明显高于正常的平滑肌组织,而ERβmRNA的表达仅呈下降趋势。结论：子宫肌瘤的发生发展可能与ERαmRNA的高表达有关,亦可能与ERβmRNA减少趋势有关。     

激素受体及CgA表达与去势抵抗性前列腺癌的关系

目的探讨嗜铬粒蛋白A(chromogranin A, CgA)、AR、ER、PR表达与前列腺癌(prostate cancer, PCa)去势抵抗的关系。方法收集行TURP术有临床随访资料的63例PCa标本,采用免疫组化SP法检测CgA、AR、ER、PR在PCa组织中的表达情况,并分析去势抵抗与PCa各临床病理特征、CgA、AR、ER、PR的关系,以及CgA与PCa各临床病理特征、AR、ER、PR的关系。结果去势抵抗性PCa的发生与PCa PSA≥20 ng/mL、Gleason评分8～10、CgA阳性、AR阴性具有相关性,CgA阳性与PCa PSA≥20 ng/mL、Gleason评分8～10、AR阴性具有相关性。ER、PR表达与去势抵抗性PCa的发生及CgA表达无相关性。多因素Logistic回归分析结果显示Gleason评分是进展为去势抵抗性PCa的独立危险因素,AR是CgA的独立危险因素。结论 CgA表达与前列腺的恶性程度呈正相关,AR表达与前列腺的恶性程度呈负相关。Gleason评分、CgA及AR与PCa去势抵抗密切相关,监测CgA与AR的表达情况,结合Gleason评分对PCa的治疗方案选择和预后判断有一定的临床指导意义。     

雌激素受体不同亚型在卵巢子宫内膜异位症在位内膜与异位内膜中的表达及其意义

目的 研究雌激素受体(ER)不同亚型在子宫内膜异位症的在位和异位内膜中的表达,以寻找其在不同病灶中的分布规律,探讨子宫内膜异位症的发病机制.方法 收集解放军总医院2004年1月-2006年12月行手术治疗的卵巢子宫内膜异位症石蜡标本,包括卵巢子宫内膜异位囊肿60例及其在位内膜60例(增生期各30例、分泌期各30例)以及正常子宫内膜30例(增生期和分泌期各15例).采用免疫组织化学(EnVision)方法检测上述组织中ERα和ERβ的表达.染色结果半定量化,并分析比较各种组织间的表达差异.结果 各组中,ERα和ERβ在腺上皮的表达与它们在间质细胞中的表达呈正相关.ERα蛋白在不同部位的表达:在位内膜ERα的表达(腺上皮和间质细胞阳性率分别为73.3%和76.7%)高于卵巢子宫内膜异位囊肿(腺上皮和问质细胞阳性率分别为43.4%和46.7%)和正常内膜的表达(腺上皮和间质细胞阳性率分别为56.7%和50.0%),均P<0.05.ERβ蛋白在不同部位的表达:卵巢子宫内膜异位囊肿(腺上皮和间质细胞阳性率分别为90.0%和76.7%)高于在位子宫内膜的表达(腺上皮和间质细胞阳性率分别为68.0%和63.3%),后者又高于正常子宫内膜(腺上皮和间质细胞阳性率分别为36.7%和26.7%),P均<0.05.在位内膜的ERα和ERβ蛋白表达在增殖期均高于分泌期,P均<0.05;异位内膜增殖期和分泌期的表达差异无统计学意义.ERα和ERβ蛋白在不同部位表达的比较:在正常内膜中ERα的表达略高于ERβ,但差异无统计学意义,P>0.05;卵巢子宫内膜异位囊肿中ERβ的表达高于ERα,P<0.05;而在位内膜中两种亚型表达差异无统计学意义.结论 子宫内膜异位症患者在位子宫内膜及异位内膜均有ERα和ERβ的表达,但与正常子宫内膜相比,在卵巢子宫内膜异位囊肿中ERβ表达占优势,而ERα表达受限.ERα和ERβ在不同组织中的分布及表达水平与子宫内膜异位症的发生和发展有着密切关系.     

ERα、ERβ、pS2蛋白在子宫平滑肌肉瘤组织中的表达及意义

目的研究ERα、ERβ、pS2蛋白在子宫平滑肌肉瘤组织中的表达及意义。方法选取1997年1月~2004年5月间,青岛大学医学院,青岛市第三人民医院,第八人民医院,收治的子宫肌瘤和平滑肌肉瘤患者128例的石蜡块,用免疫组化法测定ERα、ERβ、pS2表达。结果子宫平滑肌肉瘤中,ERα阳性率(36.1%),子宫肌瘤中ERα阳性率(83.6%),两者比较有显著性差异(P<0.01);其强度亦有显著性差异(P<0.01);平滑肌肉瘤ERβ阳性率(18.0%)子宫肌瘤中ERβ阳性率(59.7%),两者比较有显著性差异(P<0.01);其强度亦有显著性差异(P<0.01)。平滑肌肉瘤pS2阳性率(41.0%)子宫肌瘤pS2率(23.9%),两者比较有显著性差异(P<0.05);pS2在子宫平滑肌肉瘤中的表达强度比在子宫肌瘤中高,两者比较有显著性差异(P<0.05)。随着子宫肉瘤临床分期的增加,ERα、pS2的阳性表达率降低,差异有显著性(P<0.05);ERα、ERβ、pS2在绝经前比在绝经后高,各指标在绝经前后比较都有显著性差异P<0.01。结论ERα、ERβ、pS2与子宫平滑肌肉瘤的发病机制有关,与子宫平滑肌肉瘤的预后有关。     

良、恶性前列腺组织中S100P与Ki-67的表达

目的观察人良、恶性前列腺组织中S100P与Ki-67的表达及二者的相关性。方法应用免疫组化SP法检测15例正常前列腺组织、30例前列腺增生(prostatic hyperplasia,BPH)及30例前列腺癌(prostate cancer,PCa)组织中S100P与Ki-67的表达,并分析二者在PCa组织中的表达有无相关性。结果 (1)S100P蛋白在正常前列腺组织及BPH组织中的阳性率(93.33%、90.00%)明显高于前列腺癌组(20.00%)(χ2=38.953,P<0.01);S100P蛋白在高、中、低分化PCa组织中阳性率差异无统计学意义(P>0.05)。(2)Ki-67在PCa组织中阳性率(63.33%)明显高于BPH(13.33%)及正常对照组(6.67%)(χ2=22.763,P<0.01);低分化PCa组Ki-67阳性率比高、中分化组明显增高(P<0.05)。(3)PCa组织中S100P和Ki-67二者表达呈负相关关系,但无统计学意义(r=-0.077,P=0.689)。结论前列腺发生癌变后S100P与Ki-67表达分别会发生下调与升高,可能预示肿瘤更具增殖能力和侵袭性,联合检测二者有助于判断PCa的发展趋势及预后评估。     

雌激素α、β受体在雌性大鼠眼葡萄膜组织中的表达

目的 探讨雌激素α、β受体（ERα、ERβ）在雌性大鼠眼葡萄膜组织的表达。方法 选择青春期SD雌性大鼠22只,采用颈椎脱臼处死大鼠, 取眼球作常规石蜡包埋,连续切片, SP免疫组织化学方法显示ERα、ERβ在葡萄膜组织的表达;采用Tanaka记分法对ERα、ERβ进行定量分析,并设正常大鼠子宫作阳性对照;PBS代替一抗作阴性对照。同时采用放射免疫分析方法检测大鼠血清雌二醇的浓度。结果 ERβ在虹膜基质细胞、虹膜前后两层色素上皮细胞、睫状体非色素上皮和色素上皮、脉络膜各层血管内皮的表达水平主要呈中表达或高表达;ERα则表达不明显。ERβ阳性表达率明显高于ERα,经统计学分析两者间有显著性差异（P＜0.05）。ERα、ERβ免疫阳性反应物呈颗粒状,定位在细胞质或细胞核。正常大鼠血清雌二醇水平经检测含量为(22.13±3.54)ng/L。结论 大鼠葡萄膜组织以ERβ表达为主,雌激素主要通过ERβ信号转导途径对这些组织的功能起调控作用。     

前列腺相关疾病谱系中Glypican-1的表达及临床意义

目的 检测前列腺增生(prostatic hyperplasia, BPH)、前列腺上皮内瘤(prostatic intraepithelial neoplasia, PIN)和前列腺癌(prostate cancer, PCa)中磷脂酰肌醇聚糖-1(Glypican-1)的表达水平。方法 采用免疫组化、ELISA法检测Glypican-1在40例BPH、60例PIN及60例PCa中的表达,并复习相关文献。结果 Glypican-1在BPH和低级别前列腺上皮内瘤(low-grade prostatic intraepithelial neoplasia, LGPIN)中呈低表达,在高级别前列腺上皮内瘤(high-grade prostatic intraepithelial neoplasia, HGPIN)及PCa中呈高表达,平均秩次为46.10(BPH)、55.23(LGPIN)、89.75(HGPIN)、117.20(PCa),差异有统计学意义(P<0.001)。PCa组中血清学Glypican-1水平明显高于PIN组和BPH组(P<0.001),血清学Glypica...     

绝经妇女外周血单个核细胞骨代谢调控因子表达变化

目的:探讨绝经妇女雌激素水平下降所致免疫细胞骨代谢调控因子变化。方法:纳入绝经妇女、未绝经妇女各30例,电化学发光法检测血清雌二醇(E2)水平;RT-PCR法检测外周血单个核细胞(PBMC)中雌激素受体(ERα、ERβ)、白细胞IL-6、TNFα-。核因子κB受体活化因子配基(RANKL)、核因子κB受体活化因子(RANK)mRNA表达;ELISA检测血清IL-6、TNFα-蛋白含量;双能X线骨密度仪检测腰椎2~4(L2-4)前后位骨密度(BMD)。结果:与未绝经组比较,绝经妇女E2水平明显下降,腰椎BMD显著降低(P<0.05),外周血单个核细胞ERα、ERβmRNA表达明显降低(P<0.05),IL-6、TNFα-、RANKL、RANKmRNA表达明显升高(P<0.05),IL-6及TNFα-血清蛋白含量明显升高(P<0.05)。相关性分析显示PBMC中ERα、ERβmRNA表达与血清E2水平、腰椎BMD呈显著正相关性(P<0.05),PBMC中IL-6、TNFα-、RANKL、RANKmRNA表达与血清E2水平、腰椎BMD呈显著负相关性(P<0.05)。结论:绝经后妇女雌激素水平下降伴随着外周血免疫细胞雌激素受体转录水平下降,同时,炎性骨吸收调控因子和溶骨性细胞因子表达升高,这种变化可能在绝经后骨丢失中发挥重要作用。     

子宫肌瘤雌激素受体亚型mRNA的表达

目的　探讨雌激素受体亚型的表达与子宫平滑肌瘤发生、发展的关系。方法　将60例子宫肌瘤患者分为AB两组, A组32例<48岁,B组28例>48岁,应用原位杂交技术测定平滑肌瘤组织中雌激素两种受体亚型mRNA的表达,取肿瘤周 围正常的平滑肌作对照。结果　子宫肌瘤组织中ERαmRNA的表达明显高于正常的平滑肌组织,而ERβmRNA的表达降 低;B组ERαmRNA在子宫平滑肌瘤组织中的表达较A组呈下降趋势,而ERβmRNA的表达呈上升趋势。结论　子宫肌瘤的 发生发展与ERαmRNA的高表达有关,亦与ERβmRNA表达减少有关。肌瘤的萎缩可能与ERβmRNA表达的升高趋势及 ERαmRNA表达的下降趋势均相关。     

Pain and Effusion and Quadriceps Activation and Strength

Context:

Quadriceps dysfunction is a common consequence of knee joint injury and disease, yet its causes remain elusive.

Objective:

To determine the effects of pain on quadriceps strength and activation and to learn if simultaneous pain and knee joint effusion affect the magnitude of quadriceps dysfunction.

Design:

Crossover study.

Setting:

University research laboratory.

Patients or Other Participants:

Fourteen (8 men, 6 women; age = 23.6 ± 4.8 years, height = 170.3 ± 9.16 cm, mass = 72.9 ± 11.84 kg) healthy volunteers.

Intervention(s):

All participants were tested under 4 randomized conditions: normal knee, effused knee, painful knee, and effused and painful knee.

Main Outcome Measure(s):

Quadriceps strength (Nm/kg) and activation (central activation ratio) were assessed after each condition was induced.

Results:

Quadriceps strength and activation were highest under the normal knee condition and differed from the 3 experimental knee conditions (P < .05). No differences were noted among the 3 experimental knee conditions for either variable (P > .05).

Conclusions:

Both pain and effusion led to quadriceps dysfunction, but the interaction of the 2 stimuli did not increase the magnitude of the strength or activation deficits. Therefore, pain and effusion can be considered equally potent in eliciting quadriceps inhibition. Given that pain and effusion accompany numerous knee conditions, the prevalence of quadriceps dysfunction is likely high.Key Words: arthrogenic muscle inhibition, central activation failure, voluntary activation, muscles

Key Points

• Knee pain and effusion resulted in arthrogenic muscle inhibition and weakness of the quadriceps.
• The simultaneous presence of pain and effusion did not increase the magnitude of quadriceps dysfunction.
• To reduce arthrogenic muscle inhibition and improve muscle strength, clinicians should employ interventions that target removing both pain and effusion.

Quadriceps weakness is a common consequence of traumatic knee joint injury^1,2 and chronic degenerative knee joint conditions.^3,4 Arthrogenic muscle inhibition (AMI), a neurologic decline in muscle activation, results in quadriceps weakness and hinders rehabilitation by preventing gains in strength.⁵ The inability to reverse AMI and restore muscle function can lead to decreased physical abilities,⁶ biomechanical deficits,⁷ and possibly reinjury.⁵ Furthermore, researchers^8,9 have suggested that quadriceps weakness resulting from AMI may place patients at risk for developing osteoarthritis in the knee. In light of the substantial influence of quadriceps AMI on these clinically relevant outcomes, we need to improve our understanding of the factors that contribute to this neurologic decline in muscle activity so efforts to target and reverse it can be implemented and gains in strength can be achieved more easily.Joint injury and disease are accompanied by numerous sequelae (ie, pain, swelling, tissue damage, inflammation), so ascertaining which one ultimately leads to neurologic muscle dysfunction is difficult. Whereas a joint effusion can result in AMI,^10–12 the effects of pain are less understood despite many clinicians attributing AMI to pain. Using techniques that introduce knee pain without accompanying injury may provide insights into the role of pain in eliciting AMI.The degree of knee joint damage may play a role in the quantity of AMI that manifests. Hurley et al^13,14 demonstrated that quadriceps AMI, measured using an interpolated-twitch technique, was greater in patients with extensive traumatic knee injury (eg, fractured tibial plateau, ruptured medial collateral ligament, and medial meniscectomy) than patients with isolated joint trauma (ie, isolated anterior cruciate ligament [ACL] rupture). Similarly, patients with more knee joint symptoms (ie, greater number of symptoms and increased severity of symptoms) may present with greater magnitudes of quadriceps inhibition. Recently, investigators¹⁵ have suggested that patients with more pain display less quadriceps strength, supporting this tenet. Given that effusion and pain often present simultaneously with joint injuries and diseases, such as ACL injury and osteoarthritis, examining both the isolated and cumulative effects of these sequelae appears warranted to determine if they influence the magnitude of muscle inhibition.Experimental joint-effusion and pain models are safe and effective experimental methods that allow for the isolated examination of their effects on muscle function. The effusion model, whereby sterile saline is injected directly into the knee joint capsule,⁷ produces a clinically relevant magnitude of the joint effusion that may be present with traumatic injury. Effusion is thought to activate group II afferents responding to stretch or pressure,^16–18 which in turn may facilitate group Ib interneurons and result in quadriceps AMI.⁵ The pain model involves injecting hypertonic saline into the infrapatellar fat pad to produce anteromedial knee pain similar to that described in patients with patellofemoral pain syndrome.¹⁹ Pain is considered to initiate AMI through activation of group III and IV afferents that act as nocioceptors to signal damage or potential damage to joint structures.^16–18 The firing of these afferents then may lead to facilitation of group Ib interneurons, the flexion reflex, or the gamma loop, ultimately resulting in quadriceps inhibition.²⁰ Thus, these models allow us to create symptoms that are associated with knee injury and have the added benefit of providing a way to examine their effects in isolation.Therefore, the purpose of our study was to determine the effects of pain on quadriceps strength and activation and to learn if simultaneous pain and knee joint effusion would affect the magnitude of quadriceps dysfunction. We hypothesized that pain alone would result in quadriceps inhibition and that the magnitude of inhibition would be greater when effusion and pain were present simultaneously.     

即早基因c-fos与脑血管病及学习记忆

即早基因c-fos是广泛存在于原核细胞和真核细胞的高度保守基因.在正常情况下,c-fos基因参与细胞生长、分化、信息传递、学习和记忆等生理过程,而在病理情况下c-fos基因表达及调控变化与多种疾病的发生和发展有关.C-fos在中枢神经系统的某些部位可有基础水平的表达,但表达很低,当受到如脑缺血、脑出血、痫性发作、应激等刺激后,其在数十分钟内做出反应,在对外界刺激-转录耦联的信忠传递过程中起着核内第三信使的重要作用.     

自主创新学习与问题探究教学改革的探索与实践

<正>人体解剖学与组织学胚胎学是高职护理及助产专业的学生接触最早而又重要的医学基础核心课程。鉴于目前高职护理及助产专业的教学内容多,课时少等难题,教与学的矛盾日益突出。因此,如何在有限的时间内既保证教学体系的完整性,又能解决时间与内容冲突的矛盾,从而使医学生对所学内容真正达到"必须、够用",是授课教师面临的严峻挑战。同时,顺应医学终身教育发展的需求,提高医学生自主学习的能力,