胃腺癌微淋巴管检测的临床意义

采用微淋巴管特异标记D2-40对60例胃癌的中心癌组织、癌边缘区组织及其相应正常组织进行免疫组织化学染色检测微淋巴管密度,与CD34标记血管作对比.结果 胃癌中心未见明显微淋巴管,边缘区微淋巴管明显增多;胃癌边缘区淋巴管密度较正常胃组织显著性增高（P＜0.01）.胃癌边缘区微淋巴管密度与胃腺癌分化程度及淋巴结转移密切相关（P＜0.01）.     

新生淋巴管在胰腺导管腺癌周围神经丛微转移过程中的机制研究

目的 研究新生淋巴管在胰腺导管腺癌周围神经丛微转移过程中的作用与机制.方法 收集2005年9月至2006年10月长海医院行胰腺癌扩大根治术的30例胰腺导管腺癌患者的临床资料,术中采集胰腺肿瘤、癌旁、胆管下段、胰尾、肠系膜上动脉(SMA)旁组织(含胰周神经丛)以及区域淋巴结标本.常规病理检查,采用双重免疫组化方法检测毛细淋巴管,计算淋巴管密度(LVD).结果 胰内和(或)胰周神经丛浸润25例(83.3%),其中胰内合并胰周神经丛浸润20例,单纯胰内神经浸润5例,无单纯胰周神经丛浸润病例.神经浸润与患者年龄、性别、淋巴结转移、肿瘤大小、肿瘤部位无明显相关性(P>0.05),但与JPS临床分期相关(P<0.05).癌组织内的平均LVD为每视野(4.2±3.4)个,显著少于癌旁的(11.3±6.9)个及正常胰腺组织的(10.8±4.4)个(P<0.01),正常胰腺组织与癌旁组织平均LVD值差异无统计学意义.18例胰腺癌患者在非癌组织清晰可见肿瘤浸润淋巴管,而且胰周神经丛浸润与淋巴管肿瘤浸润间亦有明显相关性(P<0.05).结论 胰腺导管腺癌周围神经丛浸润的发生率较高,神经浸润与JPS临床分期、淋巴管浸润有明显相关性,提示胰腺导管腺癌存在通过新生淋巴管途径扩散转移的可能性.     

乳腺癌组织中微淋巴管分布及密度与腋窝淋巴结转移的相关性

目的探讨乳腺癌及相应癌旁组织中微淋巴管的分布、密度与腋窝淋巴结转移之间的相关性。方法应用免疫组化PV-9000二步法检测62例浸润性乳腺癌组织中D2-40的表达,并分别计数其微淋巴管密度(MLD)。结果乳腺癌转移例数与未转移例数的LMVD相比较,两者差异有统计学意义(P=0.004 4)。结论乳腺癌腋淋巴结转移状态不同,其癌周组织中微淋巴管密度差异有显著性;乳腺癌癌周微淋巴管密度越高,腋窝淋巴结转移的可能性越大。     

淋巴管内皮细胞透明质酸受体-1在胃癌组织中的表达及意义

目的:探讨淋巴管内皮细胞透明质酸受体-1(LYVE-1)在胃癌组织中的表达及临床意义．方法:采用组织芯片技术和免疫组化方法对85例胃癌组织和40例正常胃组织中LYVE-1的表达及淋巴管密度(LVD)进行检测．结果:LYVE-1的阳性产物表达于淋巴管内皮细胞胞质中,呈棕黄色染色．胃癌组织中LYVE-1阳性LVD显著高于正常胃组织(7．89±2．14 vs 1．15±1．62,P<0．01);瘤周的LYVE-1阳性LVD明显高于瘤内组织(9．28±1．18 vs 4．75±1．19,P<0．01);低分化(9．21±2．32)、Ⅲ-Ⅳ期(9．46±2．45)、有淋巴结转移(9．37±3．39)和远处转移(9．55±3．50)的胃癌组织中LYVE-1阳性LVD分别比高中分化(7．56±2．24)、Ⅰ-Ⅱ期(7．58±2．36)、无淋巴结转移(7．23±2．74)和远处转移(7．35±2．25)的明显增高(P<0．01, P<0．05)．结论:胃癌组织内及瘤周的LYVE-1阳性LVD明显增高,提示胃癌组织内的新生淋巴管主要位于瘤周,从而促进了肿瘤淋巴道转移．应用组织芯片大规模高效检测临床组织标本是可行的,具有快速、方便、经济、准确的特点．     

CD133、Ki-67在胃癌的表达及临床病理意义

目的:研究CDl33和Ki-67在胃癌中的表达,并探讨其与肿瘤生物学特征及患者术后生存时间的关系.方法:应用组织芯片技术,采用PV6000二步法检测有完整随访资料的336例胃癌及60例癌旁正常组织是CD133和Ki-67表达的差异.结果:胃癌CDl33和Ki-67的阳性率为57.4%.5[8]3%.CD133和Ki-67的表达均与肿瘤大小、分化程度、浸润深度、淋巴结转移数目、TNM分期和出现腹腔及远处转移相关(均P<0.05).CD133和Ki-67阳性组患者的5年生存率均低于阴性组(均P<0.05).CD133和Ki-67在胃癌的表达呈正相关(r=0.188,P<0.05).CD133和Ki-67在胃癌组织中的表达显著高于在癌旁正常组织中的表达(57.4% VS 28.6%.58.3% VS 18.6%,均P<0.05).CDl33和Ki-67均是患者术后生存时间的独立预后因子.结论:CD133和Ki-67在胃癌的发生、发展、转移及预后中发挥重要作用,可考虑作为胃癌临床评价肿瘤生物学行为及评估预后的指标.     

早期胃癌组织MMP-9、MLVD表达及临床意义

目的 探讨基质金属蛋白溶解酶-9(MMP-9)和淋巴管特异性抗体D2-40标记的微淋巴管密度(MLVD)在胃癌发生、发展中的作用.方法 免疫组化法检测74例早期胃癌组织及相应癌旁正常胃黏膜组织中MMP-9表达和D2-40标记的MLVD,分析两者与胃癌临床病理参数的关系及两者的相关性.结果 胃癌组织中MMP-9阳性表达率及MLVD均明显高于正常胃黏膜组织(P均＜0.01);胃癌组织中MMP-9阳性者的MLVD明显高于MM-9阴性者(P＜0.05).MMP-9阳性表达率及MLVD与胃癌的分化程度(P＜0.01)、淋巴结转移密切相关(P＜0.05);MMP-9的表达程度与MLVD呈正相关(P＜0.01).结论 MMP-9及MLVD在早期胃癌中高与其分化程度、淋巴结转移有关,两者联合检测可以作为早期胃癌的预后与转移的重要指标.     

胃癌组织VEGF-C和CXCR4的表达与淋巴结转移的关系

目的:探讨胃癌组织VEGF-C和CXCR4的表达与淋巴道转移的关系以及两者的相关性.方法:用半定量RT-PCR方法检测50例胃癌组织和相应癌旁组织中VEGF-C和CXCR4的表达水平.结果:在淋巴结转移阴性组(pN_0)胃癌组织(n =12)中VEGF-C的表达指数为0.28±0.09,与pN_1组(0.34±0.08,n=35)比较差别有显著意义(P<0.05);VEGF-C和CXCR4在pN_1组中的表达指数(0.34±0.08,0.3 1±0.08)与pN_2 pN_3组(0.40±0.10,0.43±0.14)比较差别均有显著意义(P<0.05、P<0.01);在淋巴结转移阳性的胃癌组织(n=38)中VEGF-C和CXCR4的表达指数(0.36±0.10,0.35±0.12)高于无淋巴结转pN。组(0.28±0.09,0.26±0.09,n=12),差别有显著意义(P<0.01,P<0.05).VEGF-C和CXCR4在pN_0组中的表达指数(0.28±0.09,0.26±0.09)与相应癌旁组织比较(0.21±0.12,0.20±0.11)差别均无显著意义.经Spearman等级相关分析VEGF-C和CXCR4在胃癌组织中表达之间存在显著相关性(r_s=0.34l,P<0.05).结论:VEGF-C和CXCR4的表达指数随胃癌淋巴结转移的增加而增加,两者之间存在一定相关性,对预测淋巴结转移有重要的临床价值.     

D2-40在肝细胞癌组织中的表达及其在淋巴转移中的作用

目的探讨D2-40在肝细胞癌组织中的表达及其在淋巴转移中的作用。方法选择35例肝细胞癌患者的手术标本,其中伴淋巴结转移9例、无转移24例。分别取癌组织(肝癌组)、癌边缘组织(癌边缘组)及癌以远(距肿瘤边缘10 cm以上)正常组织(对照组),采用SP免疫组化两步法检测三组D2-40表达,计数微淋巴管密度。结果 D2-40的阳性表达主要分布于癌边缘组织内淋巴管生长密集区。癌边缘组发生转移者D2-40阳性表达率高于无转移者(P<0.05)。肝癌组未见明显微淋巴管,微淋巴管主要分布于癌边缘组及对照组。癌边缘组淋巴结转移者微淋巴管密度高于未转移者(P<0.05)。结论 D2-40可促进肝细胞癌转移,其机制为促进微淋巴管形成。D2-40表达可作为预测肝细胞癌淋巴结转移的标记物。     

瘦素受体在胃癌组织中的表达及意义

采用免疫组化方法检测60例胃癌组织和20例癌旁组织中Leptin受体(Ob-R)、Ki-67及CD105的表达,并计算肿瘤细胞增殖指数及微血管密度(MVD)。结果胃癌组织中Ob-R表达强度明显高于癌旁组织,与Ki-67指数、MVD均呈正相关,并与胃癌的病理组织学分级、临床分期及淋巴结转移有关(P<0.01)。提示胃癌组织中的Ob-R激活后可通过促进肿瘤细胞增殖和血管形成在胃癌发生、发展过程中发挥作用。     

胰腺癌组织中COX-2、VEGF-C表达和淋巴管密度

目的 检测胰腺癌及癌旁组织中COX-2、VEGF-C的表达与淋巴管密度(LVD),探讨它们之间的关系.方法 应用组织芯片技术和免疫组化方法检测40例胰腺癌及相应癌旁组织和12例远处正常胰腺组织中COX-2、VEGF-C的表达及LVD,分析它们之间的关系,以及与临床病理指标的关系.结果 胰腺癌组织COX-2、VEGF-C表达阳性率分别为70.0%(28/40)和67.5%(27/40),显著高于癌旁组织的42.5%(17/40)和35.O%(14/40,P＜0.01),也显著高于正常胰腺的8.3%(1/12)和25.0%(3/12).癌、癌旁及正常胰腺的LVD分别为4.75±2.77、15.20±4.70和1.67±1.15,以癌旁组织最高(P＜0.01).癌组织COX-2表达与肿瘤分化程度、淋巴结转移相关;VEGF-C的表达与淋巴结转移相关.癌旁组织LVD与肿瘤分化程度、淋巴结转移有关,并与癌组织COX-2、VEGF-C表达存在一定相关性.结论 胰腺癌新生淋巴管主要存在于癌旁,淋巴管的形成可能有COX-2及VEGF-C的参与.     

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.     

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.     

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.     

Serological survey of HIV and syphilis in pregnant women in Madagascar

Objectives Peripartal transmission of human immunodeficiency virus (HIV) and Treponema pallidum, the causative agent of syphilis, leads to severe consequences for newborns. Preventive measures require awareness of the maternal infection. Although HIV and syphilis testing in Madagascar could be theoretically carried out within the framework of the national pregnancy follow‐up scheme, the required test kits are rarely available at peripheral health centres. In this study, we screened blood samples of pregnant Madagascan women for HIV and syphilis seroprevalence to estimate the demand for systemic screening in pregnancy. Methods Retrospective anonymous serological analysis for HIV and syphilis was performed in plasma samples from 1232 pregnant women that were taken between May and July 2010 in Ambositra, Ifanadiana, Manakara, Mananjary, Moramanga and Tsiroanomandidy (Madagascar) during pregnancy follow‐up. Screening was based on Treponema pallidum haemagglutination tests for syphilis and rapid tests for HIV, with confirmation of positive screening results on line assays. Results Out of 1232 pregnant women, none were seropositive for HIV and 37 (3%) were seropositive for Treponema pallidum. Conclusions Our findings are in line with previous studies that describe considerable syphilis prevalence in the rural Madagascan population. The results suggest a need for screening to prevent peripartal Treponema pallidum transmission, while HIV is still rare. If they are known, Treponema pallidum infections can be easily, safely and inexpensively treated even in pregnancy to reduce the risk of transmission.     

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.     

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.