nm23、ki67在恶性淋巴瘤中的表达及意义

采用免疫组化SP法检测60例淋巴瘤、20例反应性淋巴结炎和20例正常淋巴结组织中的nm23、ki67，并分析两者与临床病理参数的关系。结果在正常淋巴组织中nm23、ki67呈低水平表达。随淋巴瘤恶性程度的提高nm23和ki67的表达均增强（P〈0．01）。Nm23、ki67的高表达与患者年龄大、恶性程度高、临床分期高、结外累计部位数多及乳酸脱氢酶（LDH）增高有关（P均〈0．01）。两者的表达水平呈正相关（r=0．756，P〈0．01）。认为恶性淋巴瘤组织中nm23、ki67表达升高，其表达水平可反映淋巴瘤的恶性程度。     

非霍奇金淋巴瘤中肺耐药相关蛋白的表达及意义

目的 研究非霍奇金淋巴瘸（NHL）中肺耐药相关蛋白（LRP）的表达及其临床意义。方法 应用免疫组化S-P法检测43例NHL患者（其中初治病例32例，复发病例11例）和10例坏死增生性淋巴结炎患者组织中的LRP水平。结果 LRP在NHL患者中表达明显高于坏死增生性淋巴结炎患者（P〈0．05），而且NHL复发组高于初治组（P〈0．05）。12例随访患者中LRP阴性者治疗效果优于LRP阳性者。结论 LRP过度表达与NHL临床耐药及疗效相关。     

Ezrin和Akt在非霍奇金淋巴瘤组织中的表达及意义

采用免疫组化SP方法检测66例非霍奇金淋巴瘤（NHL）及10例淋巴结良性病变（LNBC）组织中Ezrin、Akt表达情况，分析其相关性及与NHL组织学类型的关系。结果Ezrin在NHL组织中的阳性表达率明显低于LNBC组织（P〈0．01）；Akt在NHL组织中的表达显著高于LNBC组织（P〈0．05）；惰性NHL组织Ezrin和Akt表达水平略高于侵袭性NHL组织，但均无统计学意义；NHL组织中Ezrin与Akt表达水平呈正相关（r=0．383，P〈0．01）。认为Ezrin和Akt表达异常与NHL发生有关，此可能与Ezrin和Akt之间存在某种分子联系有关。     

PCNA在非霍奇金淋巴瘤中的表达及意义

目的探讨增殖细胞核抗原（PCNA）在非霍奇金淋巴瘤中（NHL）的表达及临床意义。方法采用免疫组化SP方法检测52例NHL及12例淋巴结反应性增生（RH）患者PCNA的表达情况。结果PCNA在RH患者中的阳性表达率明显低于NHL患者；侵袭性NHL患者表达水平明显高于惰性NHL患者。乳酸脱氢酶（LDH）〈250U／L的NHL患者PCNA阳性表达率明显低于LDH〉250U／L者。PCNA阳性表达率〉25％NHL患者平均生存期较阳性表达率〈25％者短。结论PCNA与NHL的发生发展有关，并可对预后判断提供参考依据。     

NHL患者放疗效果及与肿瘤细胞MDM2基因表达、血清LDH水平的相关性

目的探讨非霍奇金淋巴瘤（NHL）的放疗效果及与肿瘤细胞分子生物学指标的相关性。方法对33例Ⅰ期NHL患者（NHL组）行局部放疗,观察缓解时间;采用免疫组化SP法检测NHL及良性淋巴结增生性疾病患者（对照组）细胞内MDM2表达、血清乳酸脱氢酶（LDH）水平,对两者与缓解时间的相关性进行分析。结果NHL组肿瘤细胞内MDM2基因表达、患者血清LDH水平均显著高于对照组,MDM2基因表达阳性者缓解期维持时间明显长于阴性者、血清LDH水平显著高于阴性者（P均〈0．001）;NHL组MDM2基因表达水平与血清LDH水平呈正相关、与患者缓解期维持时间呈负相关。结论Ⅰ期NHL患者行放疗效果确切;肿瘤细胞MDM2基因表达及血清LDH水平与患者缓解期维持时间呈负相关,可作为病情监测指标。     

黏膜成熟T细胞和NK细胞淋巴瘤组织中TIMP-2与MMP-9表达及意义

采用免疫组化S-P法检测59例黏膜成熟T细胞和NK细胞淋巴瘤（以下称淋巴瘤）患者瘤组织（淋巴瘤组）与31例鼻咽黏膜淋巴组织反应性增生患者（增生组）增生组织中基质金属蛋白酶抑制剂-2（TIMP-2）和基质金属蛋白酶-9（MMP-9）表达情况。结果淋巴瘤组TIMP-2和MMP-9阳性率分别为81．36％、83．05％,增生组阳率分别为100％、32．26％,TIMP-2和MMP-9表达率与临床分期、血管侵犯和生存期均无显著性关系。两组TIMP-2和MMP-9表达均无明显相关性（r=-0．007,P〉0．05）。提示TIMP-2和MMP-9表达异常在淋巴瘤发生中可能起重要作用,MMP-9可作为鉴别淋巴瘤性质的标志物。     

Ki-67与Bcl-2在非霍奇金淋巴瘤中的表达及其临床意义

目的：探讨增殖相关抗原Ki-67和抗凋亡蛋白Bcl-2的检测,观察其在非霍奇金淋巴瘤（NHL）中的表达及临床意义。方法：用免疫组织化学染色的方法,对35例NHL外科活检石蜡包埋组织切片进行Ki-67抗原和Bcl-2蛋白的检测。结果：（1）Ki-67在低度恶性NHL组中的表达低于高度恶性组（P＜0．01）,而Bcl-2在低度恶性NHL组中的表达高于高度恶性组（P＜0．01）。（2）B细胞性NHL中Bcl-2的表达高于T细胞性NHL（P＜0．02）,而Ki-67表达差异差异无显著性（P＞0．1）。（3）首次化疗缓解组中的Bcl-2表达低于未缓解组（P＜0．01）,而Ki-67表达差异无显著性。（4）高Ki-67表达组的生存期比低表达组短（P＜0．05）,而Bcl-2的表达在两组之间无差异。结论：增殖相关抗原Ki-67和抗凋亡蛋白Bcl-2的表达与NHL的恶性程度和预后密切相关,是了解肿瘤发生和判断NHL预后的有效指标。     

食管癌组织HPV16E6蛋白表达变化及其对CyclinD蛋白表达的影响

目的观察食管癌组织中HPVl6E6蛋白表达变化,探讨其对食管癌组织细胞周期蛋白（CyclinDl）表达的影响。方法用免疫组化sP法检测40例食管鳞癌患者肿瘤组织（鳞癌组）、癌旁正常食管组织（对照组）及10例食管不典型增生患者病变组织（增生组）中的HPVl6E6蛋白表达;采用WesternNot法检测HPVl6E6阳性及阴性食管鳞癌患者肿瘤组织中的CyclinDl蛋白表达。结果鳞癌组、增生组、对照组HPVl6E6蛋白阳性表达率分别为55％（22／40）、20％（2／10）、12．5％（5／40）,鳞癌组HPVl6E6蛋白阳性表达率高于增生组和对照组（P均〈0．05）。HPVl6E6蛋白阳性、阴性者癌组织中CyclinDl蛋白表达量分别为0．892±0．057、0．327±0．02;HPVl6E6蛋白表达阳性者肿瘤组织CyclinDl蛋白表达量高于HPVl6E6蛋白阴性者（P〈0．05）。结论食管癌组织中HPVl6E6蛋白表达升高,并与CyclinDl蛋白表达有关。     

凋亡调控蛋白在B细胞非霍奇金淋巴瘤的表达及其与细胞凋亡的关系

目的探讨髓细胞白血病基因1（MCL-1）、Survivin在B细胞非霍奇金淋巴瘤（B-NHL）表达及其与细胞凋亡的关系。方法应用末端脱氧核苷酸转移酶介导的dUTP缺口末端标记技术和免疫组织化学SP法检测43例B-NHL和10例反应性增生（RH）淋巴组织细胞凋亡率和MCL-1、Survivin的表达水平。结果MCL-1和Survivin在43例B-NHL中阳性表达率分别为58．1％（25／43）和69．8％（30／43）,而MCL-1在RH淋巴组织阴性表达,Survivin在RH淋巴组织低表达10．0％（1／10）,MCL-1在侵袭性B-NHL表达的频率和强度明显高于惰性B-NHL（70．0％,30．8％,P〈0．05）,Survivin在侵袭性B-NHL中表达的阳性率明显高于惰性B-NHL（80．0％,46．2％,P〈0．05）;MCL-1阳性表达组与凋亡指数（AI）无相关,Survivin阳性表达组与AI正相关（r=0．429,P〈0．01）,此外,两者表达呈显著正相关（r=0．598,P〈0．001）。结论MCL-1对B-NHL细胞凋亡作用不如Survivin明显,后者可能参与了B-NHL细胞凋亡调节,二者在B-NHL的共表达与其发生发展有关。     

皮肤鳞癌组织中FHIT基因表达及其意义

应用免疫组织化学S-P法检测脆性组氨酸三联体（FHIT）在27例皮肤鳞癌患者（SCC组）癌组织及11例正常人（对照组）皮肤组织中的表达。结果SCC组FHIT蛋白阳性表达率（44．4％）显著低于对照组（90．9％），P〈0．05。高中分化SCC患者FHIT蛋白阳性表达率（50．0％）显著高于低分化者（38．5％），P〈0．05；有淋巴结转移者FHIT蛋白阳性表达率（42．1％）显著低于无淋巴转移者（50．0％），P〈0．05。提示FHIT基因在SCC的发生、发展中起重要作用，其水平可作为SCC发生及转移能力的一项客观指标。     

Three layer functional model and energy exchange concept of aging process

Relying on a certain degree of abstraction, we can propose that no particular distinction exists between animate or living matter and inanimate matter. While focusing attention on some specifics, the dividing line between the two can be drawn. The most apparent distinction is in the level of structural and functional organization with the dissimilar streams of ‘energy flow’ between the observed entity and the surrounding environment. In essence, living matter is created from inanimate matter which is organized to contain internal intense energy processes and maintain lower intensity energy exchange processes with the environment. Taking internal and external energy processes into account, we contend in this paper that living matter can be referred to as matter of dissipative structure, with this structure assumed to be a common quality of all living creatures and living matter in general. Interruption of internal energy conversion processes and terminating the controlled energy exchange with the environment leads to degeneration of dissipative structure and reduction of the same to inanimate matter, (gas, liquid and/or solid inanimate substances), and ultimately what can be called ‘death.’ This concept of what we call dissipative nature can be extended from living organisms to social groups of animals, to mankind. An analogy based on the organization of matter provides a basis for a functional model of living entities. The models relies on the parallels among the three central structures of any cell (nucleus, cytoplasm and outer membrane) and the human body (central organs, body fluids along with the connective tissues, and external skin integument). This three-part structural organization may be observed almost universally in nature. It can be observed from the atomic structure to the planetary and intergalactic organizations. This similarity is corroborated by the membrane theory applied to living organisms. According to the energy nature of living matter and the proposed functional model, the decreased integrity of a human body's external envelope membrane is a first cause of the structural degradation and aging of the entire organism. The aging process than progresses externally to internally, as in single cell organisms, suggesting that much of the efforts towards the restoration and maintenance of the mechanisms responsible for structural development should be focused accordingly, on the membrane, i.e., the skin. Numerous reports indicate that all parts of the human body, like: bones, blood with blood vessels, muscles, skin, and so on, have some ability for restoration. Therefore, actual revival of not only aging tissue of the human body's membrane, but the entire human body enclosed within, with all internal organs, might be expected. We assess several aging theories within the context of our model and provide suggestions on how to activate the body's own anti-aging mechanisms and increase longevity. This paper presents some analogies and some distinctions that exist between the living dissipative structure matter and inanimate matter, discusses the aging process and proposes certain aging reversal solutions.     

Unusual responses of nocturnal pineal melatonin synthesis and secretion to swimming: Attempts to define mechanisms

Abstract: The effect of swimming at night on rat pineal melatonin synthesis was compared with that of light exposure at night. Rats were forced to swim at 0030 hr (lights out at 2000 hr) and sacrificed by decapitation 15 and 30 min later, immediately after swimming. Other groups of animals were exposed to white light (650μW/cm²) for 15 and 30 min at same time. Swimming caused a rapid and highly significant drop in the melatonin content in the pineal gland; however, the activity of N-acetyltransferase (NAT), the supposed rate limiting enzyme in the melatonin production, was not changed. Despite the drop in pineal melatonin levels, serum concentrations of the indole remained elevated in the rats that swam. In contrast, melatonin levels in the pineal and serum of light exposed rats fell precipitously, accompanied by a significant suppression of NAT activity. Since we anticipated that the strenuous exercise associated with swimming may induce release of artrial natriuretic peptide (ANP) from the heart, which in turn could cause the release of pineal melatonin, in a second study we injected physiological saline intravenously to stretch the cardiac muscle and release ANP. Three milliliters of normal saline was injected during the day into the jugular vein of anesthetized rats that were pretreated with isoproterenol to stimulate pineal melatonin production. Animals were killed 15 min after the saline injection, and pineal NAT activity and pineal melatonin levels were measured. The saline injections caused no alteration in the elevated levels of either NAT or melatonin. These data suggest that the disparity in pineal NAT activity (which was high) and pineal melatonin (which was low), in animals swum at night, may not be caused by ANP which is released during strenuous exercise such as swimming.     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Melatonin and photoperiodic time measurement: Seasonal breeding in the sheep

Abstract: Well-established circadian physiology supports the view that photoperiodic time measurement utilizes the coincidence between the presence of light and a photosensitive phase of a 'biological clock' to alter reproductive status—the so-called external coincidence model of seasonal breeding. In this review, we examine the mechanism whereby photoperiod interacts with presumed suprachiasmatic nuclei activity to allow endogenous melatonin to normally synchronize reproductive activity to the optimal time of year. The Romney Marsh sheep is particularly explored as an experimental model. It is suggested that the on/off activity of seasonal reproduction may be a robust mechanism able to be predictably manipulated by the judicious use of the light/dark cycle and exogenous melatonin, but firmly based on circadian principles.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Language of CTO interventions – Focus on hardware

The knowledge of variety of chronic total occlusion (CTO) hardware and the ability to use them represents the key to success of any CTO interventions. However, the multiplicity of CTO hardware and their physical character and the terminology used by experts create confusion in the mind of an average interventional cardiologist, particularly a beginner in this field. This knowledge is available but is scattered. We aim to classify and compare the currently used devices based on their properties focusing on how physical character of each device can be utilized in a specific situation, thus clarifying and simplifying the technical discourse.