E钙黏蛋白、c-Src蛋白在胃癌中的表达及其与侵袭转移的关系

目的 通过检测E钙黏蛋白(E-cadherin,E cad)和c Src蛋白在胃癌中的表达,探讨其在肿瘤转移和侵袭过程中的作用.方法 采取胃癌组织50例,正常胃黏膜10例;应用免疫组织化学链霉素抗生物素-过氧化酶连接(SP)法检测E-cad、c-Src蛋白的表达.结果 ①胃癌组织中E cad的阳性表达率为46.0％(23/50),显著低于正常黏膜100％(10/10)(P＜0.01).转移组E-cad阳性表达率35.3％(12/34)明显低于非转移组68.8％(11/16)(P＜0.05).与临床分期、浸润分级的关系显示,Ⅲ～Ⅳ期和T3～T4级癌组织中E-cad表达分别明显低于Ⅰ～Ⅱ期和T1～～T2级(均P＜0.05).E cad表达还与组织学分级相关,胃癌分化程度低,其阳性表达率也低,分化程度高,阳性表达率也高(P＜0.05).②c-Src蛋白在Ⅲ～Ⅳ期的表达明显高于Ⅰ～Ⅱ期(P＜0.05);T3～T4级c-Src蛋白表达高于T1～T2级(P＜0.05).结论 c-Src蛋白在胃癌中均呈高表达,而E-cad则反之.E cad表达减弱与胃癌侵袭转移潜能相关,可作为胃癌侵袭转移的生物学标志之一.     

抑癌基因PTEN和FHIT在胃癌中的表达及临床意义

目的:探讨胃癌组织中PTEN及FHIT蛋白的表达.方法:采用免疫组织化学SP法检测52例胃癌组织、30例正常胃黏膜组织中PTEN及FHIT蛋白的表达.结果:PTEN、FHIT蛋白在胃癌组织中的阳性表达远低于正常胃黏膜(P＜0.05);PTEN蛋白表达与胃癌的分化程度、淋巴结转移有显著相关性(P＜0.05);FHIT蛋白表达与胃癌的分化程度有关(P＜0.05).结论:PTEN和FHIT在胃癌组织与正常胃黏膜组织中呈差异表达,提示二者可能参与了胃癌的发生发展过程,值得进一步研究.     

生存素与葡萄糖转运蛋白1在胃癌组织中的表达及临床意义

目的 探讨生存素(Survivin)与葡萄糖转运蛋白1(Glut 1)在胃癌组织中的表达及其临床意义.方法 采用免疫组织化学染色法检测Survivin与Glut 1蛋白在78例胃癌组织和20例正常胃黏膜组织中的表达,分析二者与胃癌临床病理特征的关系.结果 Survivin与Glut 1蛋白在胃癌组织中的表达率分别为75.64％(59/78)和78.21％ (61/78),均显著高于正常胃黏膜组织的10.00％ (2/20)和5.00％ (1/20),差异均有统计学意义(X2值分别为4.265、4.158,P均＜0.01);Survivin在胃癌中的表达与性别、年龄无关(P均＞0.05),但与肿瘤的分化程度、浆膜侵犯、淋巴结转移、TNM分期之间的差异均有统计学意义(x2值分别为4.143、4.247、11.813、7.542,P均＜0.05);Glut 1在胃癌中的表达与性别、年龄、分化程度、浆膜侵犯等因素无关(P均＞0.05),但与淋巴转移、TNM分期之间的差异均有统计学意义(x2值分别为6.230、4.083,P均＜0.05);胃癌组织中Survivin和Glut 1蛋白表达呈正相关性,差异具有统计学意义(x2 =7.145,r =0.342,P＜0.05).结论 Survivin与Glut 1在胃癌组织中高表达,可能在胃癌发生发展中起重要作用,二者在胃癌中表达呈正相关.联合检测Survivin与Glut 1可作为反映胃癌生物学行为和判断预后的有效指标之一.     

COX-2与Fas蛋白在胃癌组织中的表达及意义

目的探讨COX-2和Fas蛋白在胃癌组织中的表达相互关系及意义。方法应用免疫组化方法检测了30例正常胃黏膜及82例胃癌组织中COX-2和Fas的表达情况。结果COX-2蛋白在胃癌组织中阳性表达率为63．4％,而在正常对照的胃黏膜组织中阳性率为13．3％,胃癌组织中COX-2蛋白阳性率显著高于正常胃黏膜(P＜0．001)。Fas在胃癌组织中阳性率为39．1％,在30例正常胃黏膜组阳性率为93．3％,正常胃黏膜组中Fas阳性率显著高于胃癌组织(P＜0．001)。COX-2与Fas的阳性表达在各性别组和各年龄组之间无显著差异,COX-2在有淋巴结转移和无淋巴结转移胃癌组间,低分化和高、中分化胃癌组间、TNM分期之间表达有显著差异。Fas在高、中分化胃癌组阳性表达率显著高于低分化胃癌组(P＜0．05)。而在TNM分期之间,有淋巴结转移和无淋巴结转移胃癌组间表达无显著性差异(P＞0．05)。胃癌组织中COX-2与Fas表达具有显著负相关(r_φ=-0．559,P＜0．001)。结论胃癌组织中存在COX-2的高表达与Fas低表达,且两者之间的表达强度具有显著等级负相关。     

胃黏膜癌变过程中p53表达变化和幽门螺杆菌感染情况

目的 探讨p53表达和幽门螺旋杆菌(H.pylori,Hp)感染在慢性胃炎、胃黏膜异型增生及胃癌中的变化,分析两者的相关性及其在胃癌发生的可能关系.方法 采用链霉菌抗生物素蛋白—过氧化物酶连接法(SP)免疫组化法检测p53蛋白在胃黏膜慢性炎症(40例)、胃黏膜异型增生(59例)和胃腺癌(68例)组织中的表达.采用亚甲蓝染色检测上述标本中Hp感染.分析P53表达与Hp感染的相关关系及其在胃癌发生发展中的可能意义.结果 p53在慢性炎症组中偶见个别细胞呈阳性表达(2/40,5.0％),异型增生组和胃腺癌组中p53阳性表达率分别28.8％(17/59)和51.5％(35/68),从慢性炎症组、胃黏膜异型增生到胃腺癌,呈逐渐增高趋势;Hp在慢性炎症组中的检出率为32.5％(13/40),在异型增生组和胃腺癌组中检出率分别为72.9％(43/59)和58.8％(40/68),均明显高于慢性炎症组(P＜0.05).在异型增生组和胃腺癌组,p53阳性表达率在Hp感染阳性组明显高于Hp阴性组,p53阳性表达与Hp感染均呈正相关(r=0.304、0.383,均P＜0.05).结论 胃黏膜异型增生和胃腺癌组织p53表达与Hp感染密切相关,p53和Hp在胃腺癌的发生中可能发挥重要作用.     

Kiss-1和基质金属蛋白酶-9蛋白在胃癌中的表达及意义

目的 检测Kiss-1及基质金属蛋白酶-9(MMP-9)蛋白在胃癌中的表达,探讨二者在胃癌发生发展及转移中的作用.方法 以54例胃癌标本作为研究对象,11例正常胃黏膜组织作为对照,采用流式细胞术分析,检测Kiss-1和MMP-9蛋白的表达在不同指标及临床病理特征之间的关系.结果 胃癌组织中Kiss-1的表达量低于正常胃黏膜组织[(0.7864 ±0.1149)与(1.0000 ±0.1105),t=5.66,P＜0.01],MMP-9的表达量高于正常胃黏膜组织[(1.1789±0.1271)与(1.0000±0.1215),t=4.28,P＜0.01],Kiss-1及MMP-9在胃癌中的表达均与浸润深度及淋巴结转移密切相关,二者在胃癌中的表达呈负相关(r=-0.4911,P＜0.05).结论 Kiss-1和MMP-9蛋白可能在胃癌发生、发展中起一定促进作用,检测Kiss-1和MMP-9有望成为与胃癌预后相关的重要指标.     

胃癌中FHIT基因外显子5、8纯合性缺失及其蛋白表达的研究

目的:探讨FHIT基因外显子5、8纯合性缺失与蛋白表达的关系及其在胃癌发病机制中的作用.方法:应用PCR及免疫组化SP法检测30例胃癌组织、18例正常胃组织中FHIT基因外显子5、8的纯合性缺失和FHIT蛋白的表达.结果:FHIT蛋白阴性表达率及外显子5、8纯合性缺失率在胃癌组织中均高于正常胃组织(P＜0.05).FHIT蛋白表达与胃癌的分化程度有关(P＜0.05):胃癌组织中FHIT基因外显子5、8纯合性缺失与FHIT蛋白阴性表达有显著相关性(r=0.59,P＜0.05).结论:胃癌组织中FHIT基因外显子5、8纯合性缺失可能是引起FHIT蛋白表达降低并进而导致胃癌发生的重要机制.     

P27mRNA及蛋白在甲状腺癌组织中的表达及意义

目的 观察P27mRNA及蛋白在甲状腺癌组织中的表达变化,探讨P27基因在甲状腺癌发病过程中的作用.方法 逆转录聚合酶链反应(RT-PCR)法和Western blot方法检测31例甲状腺癌、48例甲状腺腺瘤、11例正常甲状腺组织中P27mRNA、蛋白的表达.结果 P27mRNA在甲状腺癌组织的表达量为0.740±0.029,明显低于甲状腺腺瘤0.892±0.027及正常甲状腺组织0.922±0.024,3组间比较差异具有统计学意义(F=4.731,P＜0.05).P27蛋白在甲状腺癌组织的表达量为0.340 ±0.019,明显低于甲状腺腺瘤0.532±0.023及正常甲状腺组织0.735±0.036,差异具有统计学意义(F =3.350,P＜0.05).结论 P27mRNA及蛋白降低可能与甲状腺癌的发生、发展有关.     

KAI1/CD82和MMP-9蛋白表达与胃癌浸润转移的关系

目的:探讨胃癌组织中KAI1/CD82和MMP-9蛋白的表达及其与胃癌浸润转移的关系.方法:采用免疫组织化学SP法检测52例胃癌组织、30例正常胃黏膜组织中KAI1/CD82及MMP-9蛋白的表达.结果:胃癌组织中KAI1/CD82及MMP-9蛋白阳性表达率分别为53.8%、65.4%;进展期病例分组KAI1/CD82及MMP-9蛋白的阳性表达率均高于其早期病例分组(P＜0.05);淋巴结转移组KAI1/CD82及MMP-9蛋白阳性表达率分别为68.8%、78.1%,无淋巴结转移组分别为30%、45%,两组之间对比差异有显著性(P＜0.05);高分化、中分化及低分化胃癌组织中KAI1/CD82蛋白的阳性表达率分别为23.1%、61.1%、66.7%(P＜0.05).结论:KAI1/CD82及MMP-9蛋白的异常表达可能在胃癌的发生、发展及浸润转移过程中发挥重要作用.     

POSTN蛋白在胃黏膜癌变过程中的表达及意义

目的观察胃癌相关蛋白质POSTN在胃黏膜癌变过程中的表达与意义,为胃癌的早期诊断、病理分型与评估预后提供有价值的实验依据。方法收集正常胃黏膜、癌旁及胃癌组织标本8例,采用Western blotting检测POSTN蛋白在上述组织中的表达;其次利用免疫组化染色观察POSTN蛋白在正常胃黏膜、癌旁及胃癌组织中的表达,并分析其在胃黏膜癌变过程中表达的意义。结果 Western blotting结果显示,胃癌组织中POSTN蛋白表达明显高于正常胃黏膜和癌旁组织(P0.01),同时癌旁组织中的表达高于正常胃黏膜组织(P0.01)。免疫组化结果显示,正常胃黏膜、癌旁和胃癌组织中POSTN蛋白表达的阳性率分别为14.71%、46.15%和77.48%,而胃高、中和低分化腺癌中表达的阳性率分别为60%、70.6%和81.4%。POSTN蛋白表达与胃癌组织的分化程度相关,即组织分化降低,其表达增强(P0.01)。结论胃癌组织中POSTN蛋白表达高于正常胃黏膜和癌旁组织,癌旁组织中的表达高于正常胃黏膜组织,该蛋白表达与胃癌组织的发生和分化程度有关。     

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.     

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.     

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.     

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.     

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.     

Structure and function of "metalloantibiotics"

Although most antibiotics do not need metal ions for their biological activities, there are a number of antibiotics that require metal ions to function properly, such as bleomycin (BLM), streptonigrin (SN), and bacitracin. The coordinated metal ions in these antibiotics play an important role in maintaining proper structure and/or function of these antibiotics. Removal of the metal ions from these antibiotics can cause changes in structure and/or function of these antibiotics. Similar to the case of "metalloproteins," these antibiotics are dubbed "metalloantibiotics" which are the title subjects of this review. Metalloantibiotics can interact with several different kinds of biomolecules, including DNA, RNA, proteins, receptors, and lipids, rendering their unique and specific bioactivities. In addition to the microbial-originated metalloantibiotics, many metalloantibiotic derivatives and metal complexes of synthetic ligands also show antibacterial, antiviral, and anti-neoplastic activities which are also briefly discussed to provide a broad sense of the term "metalloantibiotics."