非霍奇金淋巴瘤患者血清血管内皮生长因子水平的检测及临床意义

目的检测非霍奇金淋巴瘤(non-Hodgkin’s lymphoma,NHL)患者血清血管内皮生长因子(vascular endothelial growthfactor,VEGF)表达水平探索其临床意义。方法采用酶联免疫吸附法(ELISA)对NHL患者及正常健康对照组血清VEGF表达水平进行检测。结果49例初诊NHL患者的血清VEGF为(215.26±109.83)pg/mL,明显高于正常对照组(98.46±24.67)pg/mL,P<0.05。31例患者取得缓解或部分缓解,治疗前VEGF水平(205.79±112.47)pg/mL,缓解后VEGF水平(95.79±52.47)pg/mL,治疗前、缓解后比较差异有统计学意义(P<0.05)。9例缓解后复发时VEGF水平(225.41±97.35)pg/mL,与初诊者血清VEGF水平水平比较差异无统计学意义(P>0.05),与正常对照组比较差异有统计学意义(P<0.05)。结论VEGF与NHL发生发展密切相关,它对NHL治疗、病情监测及预后判断等具有指导意义。     

存活蛋白和NF-κB在外周T细胞性淋巴瘤中的表达和意义

本研究旨在探讨存活蛋白和NF-κB在外周T细胞性淋巴瘤中的表达及意义。应用免疫组织化学法检测26例外周T细胞性淋巴瘤组织中存活蛋白和NF-κB的表达,30例良性淋巴组织反应增生被选作对照组。结果发现,外周T细胞性淋巴瘤患者中有21例存活蛋白表达阳性,阳性率为80.8%;17例NF-κB表达阳性,阳性率为65.4%。与对照组相比,具有显著性差异(p<0.01)。实验组中,存活蛋白阳性率与NF-κB阳性率呈正相关。结论:存活蛋白和NF-κB在外周T细胞性淋巴瘤组织中广泛表达,对肿瘤细胞的促增殖和抑凋亡发挥着重要的作用。     

NF-κB、VEGF对涎腺腺样囊性癌血管生成的影响及意义

[目的]探讨真核细胞核转录因子B （NF-κB）对于涎腺腺样囊性癌（SACC）血管生成的影响及临床意义.[方法]采用免疫组织化学SP法检测28例正常唾液腺组织、32例多形性腺瘤（pleomorphic adenoma,PA）和34例SACC中NF-κB和血管内皮细胞生长因子（VEGF）的表达,CD34标记微血管计数（MVD）,采用SPSS16.0软件统计分析.[结果]正常唾液腺组织、PA和SACC中NF-κB、VEGF的表达和MVD计数逐步升高,组间相比较差异均有显著性（P＜0.05）,MVD计数随着NF-κB表达的增强而升高（P＜0.05）;NF-κB和VEGF、VEGF和CD34的表达成正相关（P均＜0.05）.NF-κB的表达与SACC的神经侵犯和远处转移有关联,组间比较差异均具有显著性（P＜0.05）,实体型SACC中NF-κB的表达高于筛孔型和腺管型,NF-κB的表达与SACC的部位、大小、淋巴结转移差异不具有统计学意义.[结论]NF-κB的表达与SACC的血管生成呈正相关,在SACC噬神经性、远处侵袭性和恶性程度方面起重要作用,故推测NF-κB可以作为抗血管治疗SACC的潜在的靶向目标.     

内毒素对大鼠淋巴细胞表达TLR4及NF-κB与分泌IL-6的影响

目的研究内毒素干预离体大鼠淋巴细胞后TLR4 mRNA、NF-κB mRNA的表达及IL-6分泌的变化,探讨淋巴细胞在全身炎症反应综合征(SIRS)发生及进展中的作用机制。方法制备健康雄性Wistar大鼠脾脏淋巴细胞,培养至对数期,随机分为对照组和实验组。对照组不做处理。实验组加入不等量内毒素,调整浓度为低浓度组(10 ng/ml)、高浓度组(100 ng/ml),培养3、6、12 h。RT-PCR技术检测TLR4及NF-κB的mRNA表达水平,ELISA技术测定IL-6的分泌量。结果干预3 h后,低浓度组:TLR4及NF-κB的mRNA表达与对照组比较无显著差异(P>0.05),IL-6的分泌与对照相比差异有统计学意义(P<0.05)。高浓度组:TLR4 mRNA的表达及IL-6的分泌与对照组比较差异有统计学意义(P<0.05),NF-κB的mRNA表达与对照组比较无显著差异(P>0.05)。干预6、12 h后,低、高浓度组:TLR4及NF-κB的mRNA表达与IL-6的分泌分别与对照组比较差异均有统计学意义(P<0.05)。此外,TLR4及NF-κB的mRNA表达水平及IL-6的分泌量随时间延长增加。结论内毒素能刺激大鼠淋巴细胞高表达TLR4、NF-κB及分泌包括IL-6在内的各种细胞因子与炎症介质,促进SIRS的发生及发展。     

核因子κB在肝癌组织中的表达及其与细胞增殖和凋亡关系

目的研究肝细胞癌(hepatocellular carcinoma,HCC)组织中核因子κB(NF-κB)表达水平的变化,分析NF-κB表达与肝癌细胞增殖和凋亡间的相关关系,探讨其表达在临床病理学中的意义。方法应用免疫组织化学法(SP)检测44例HCC组织、25例癌旁相应组织、9例正常肝组织中NF-κB、Ki-67蛋白的表达情况,采用末端脱氧核苷酸转移酶介导的dUTP缺口标记(terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling,TUNEL)法检测细胞凋亡,并计算其增殖指数(PI)和凋亡指数(AI)。结果NF-κB蛋白在HCC组织、癌旁组织中的阳性表达率分别为81.8%(36/44)、28.0%(7/25),9例正常肝组织未见表达,3组比较差异有统计学意义(P<0.01)。在HCC组织中NF-κB表达与组织学分级有关,Ⅲ、Ⅳ级NF-κB表达率显著高于Ⅰ、Ⅱ级(P<0.05),与其他临床病理特征无关。HCC标本中NF-κB阳性表达病例平均PI(29.9±13.7)%,阴性表达者的平均PI(24.2±10.9)%(P>0.05)。HCC标本NF-κB阳性表达者平均AI(2.9±1.4)%,明显低于阴性表达者平均AI(4.9±2.0)%(P<0.05)。结论NF-κB在HCC中高表达,与HCC患者预后相关。NF-κB通过抑制细胞凋亡的方式影响肝癌的生物学特性,而对肝癌的细胞增殖无显著影响。     

核因子κB在多脏器功能障碍综合征发病机制及预后评估中的作用

目的 检测多脏器功能障碍综合征(MODS)患者外周血单核细胞(PBMC)中核因子κB(NF-κB)mRNA及NF-κB抑制因子(IκBα)mRNA的表达.探讨NF-κB的活性在评估MODS患者病情及预后中的作用.方法 收集30例MODS患者,按疾病的转归分为死亡和存活组.同期选取10例健康体检者作为对照组.应用逆转录-聚合酶链式反应法(RT-PCR)检测PBMC中NF-κB mRNA及IκBα mRNA的表达.结果 死亡组、存活组和对照组PBMC中NF-κB mRNA相对表达量分别为1.179±0.508、1.247±0.512和0.738±0.238,差异有统计学意义(P＜0.05).死亡组、存活组和对照组PBMC中IκBα mRNA相对表达量分别为0.875±0.451、1.372±0.743和1.966±0.666,差异有统计学意义(P＜0.05或＜0.01).结论 活化的NF-κB参与了MODS的发生发展,而且其活化程度与患者的预后密切相关,NF-κB活性越高,患者预后越差.     

白癜风患者外周血单个核细胞中TLR7、TLR9、NF-κB的表达及意义研究

目的探究白癜风患者外周血单个核细胞(PBMC)中Toll样受体7(TLR7)、Toll样受体9(TLR9)、核因子-κB(NF-κB)的表达情况及其意义。方法前瞻性选取2017年4月至2018年4月沈阳市第七人民医院收治的33例白癜风患者作为观察组,33例同期健康体检者为对照组。使用流式细胞仪检测两组PBMC中的TLR7、TLR9表达情况,采用逆转录-聚合酶链反应(RT-PCR)检测两组PBMC中的NF-κB表达情况。结果流式细胞仪结果显示,观察组患者PBMC中的TLR7表达量为(94.65±3.931)%,高于对照组的(92.84±3.52)%,但差异无统计学意义(P0.05);而观察组患者PBMC中的TLR9表达量为(86.68±11.01)%,低于对照组的(90.75±5.74)%,但差异无统计学意义(P 0.05); PCR反应结果显示,观察组患者PBMC中的NF-κB mRNA表达量为(0.96±1.52),高于对照组的(0.24±0.35),差异具有统计学意义(P 0.05)。结论白癜风患者PBMC中TLR7表达过量,TLR9则低表达,但与正常健康者的表达情况未见较大差异,而该信号通路的信号分子NF-κB表达量远高于正常健康者,推测TLR7、TLR9、NF-κB的表达与白癜风可能存在一定的关系,但具体机制需进一步探寻。     

核转录因子NF-κB和血管内皮生长因子在不同病程尖锐湿疣中的表达及其意义

目的:探讨核转录因子NF-κB和血管内皮生长因子(vascular endothelial growth factor,VEGF)在不同病程尖锐湿疣(CA)中的表达情况及其临床意义.方法:将确诊的尖锐湿疣患者40例分为短病程组20例、长病程组20例,同时以20例正常人包皮组织为对照组,用RT-PCR和Western Blot的方法分别检测不同病程CA以及正常皮肤组织中的核转录因子NF-κB和VEGF的mRNA及蛋白表达.结果:(1)短病程组CA疣体中NBκB mRNA、YEGFmRNA的表达水平分别为1.16±0.17、1.01±0.11,长病程组中NF-κB mRNA、VEGF mRNA的表达水平分别为0.75±0.10、1.11±0.10,均明显高于对照组的0.47±0.11和0.61±0.12(均P＜0.05);同时短病程组CA疣体中NF-κB mRNA、VEGF mRNA的表达水平与长病程组比较差异有显著性(P＜0.05).(2)短病程组CA疣体中NF-κB蛋白、VEGF蛋白表达水平分别为0.78±0.12、0.81±0.12,长病程组中NF-κB蛋白、VEGF蛋白表达水平分别为0.66±0.11、0.91±0.11,显著高于对照组的0.31±0.08和0.29±0.09(均P＜0.05).NF-κB蛋白以短病程组表达最高,且短病程组与长病程组比较差异有显著性(P＜0.05).结论:核转录因子NF-κB和血管内皮生长因子在尖锐湿疣疣体中高表达并与病程相关,可能共同参与了CA的发病以及转归.     

三阴性乳腺癌中COX-2、NF-κB及VEGF表达的临床研究

目的研究环氧酶(COX-2)、核因子-κB(NF-κB)及血管内皮生长因子(VEGF)在三阴性乳腺癌中的表达及临床意义。方法选取2010年1月至2014年12月于该院进行乳腺癌治疗的100例患者为研究对象,其中三阴性乳腺癌50例,非三阴性乳腺癌50例,采用免疫组织化学法检测100例患者乳腺癌组织中COX-2、NF-κB及VEGF的表达,并应用D2-40标记检测淋巴管浸润和淋巴管密度,对相关的临床病理资料进行统计分析。结果 COX-2在三阴性与非三阴性乳腺癌中的表达分别为76%、70%,差异无统计学意义(P0.05),VEGF在三阴性乳腺癌病变和非三阴性乳腺癌病变中阳性表达率分别为60%和36%,差异有统计意义(P0.05)。NF-κB在三阴性乳腺癌病变和非三阴性乳腺癌病变中阳性表达率分别为66%和32%,差异有统计意义(P0.05)。三阴性乳腺癌组织中乳腺癌中NF-κB与VEGF,COX-2与VEGF表达呈正相关。结论放化疗是三阴性乳腺癌术后治疗的主要手段,而抑制NF-κB、VEGF和COX-2的表达有望成为治疗三阴性乳腺癌的新靶点,值得研究探索。     

弥漫大B细胞淋巴瘤组织中Bcl-2、NF-κB、C-myc蛋白表达及临床意义

目的探讨弥漫大B细胞淋巴瘤(DLBCL)组织中Bcl-2、核因子κB(NF-κB)、C-myc蛋白表达及其临床意义。方法选取67例DLBCL患者淋巴瘤组织作为观察组,选取同期21例淋巴结反应性增生(RH)患者淋巴结组织作为对照组,采用免疫组织化学(S-P)方法检测组织中Bcl-2、NF-κB、C-myc蛋白表达水平,分析三者与DLBCL临床病理特征之间的关系。结果Bcl-2、NF-κB、C-myc蛋白在DLBCL组织中的阳性表达率分别为58.21%、62.69%、77.61%,在RH组织中的阳性表达率分别为0.00%、19.05%、23.81%,差异均有统计学意义(P0.05)。Bcl-2蛋白表达与DLBCL患者年龄、性别、发病部位、血清乳酸脱氢酶(LDH)水平及结外部位等无显著相关性(P0.05),与患者临床分期、IPI分级显著相关(P0.05);NF-κB蛋白表达与DLBCL患者年龄、性别无显著相关性(P0.05),与患者发病部位、临床分期、IPI分级以及血清LDH水平显著相关(P0.05);C-myc蛋白表达与DLBCL患者年龄、性别、发病部位、血清LDH水平以及结外部位等无显著相关性(P0.05),与患者临床分期、IPI分级显著相关(P0.05)。Bcl-2与NF-κB在DLBCL组织中表达呈较强正相关(r=0.671,P0.05),而与C-myc无相关性(P0.05),NF-κB与C-myc在DLBCL组织中表达呈较弱正相关(r=0.293,P0.05)。结论 Bcl-2、NF-κB、C-myc表达与DLBCL临床分期、IPI分级密切相关,三者可作为评价DLBCL预后的参考指标。     

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.     

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.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.     

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.     

Clinical Trial Updates and Hotline Sessions presented at the European Society of Cardiology Congress 2007

This article provides information and commentaries on trials which were presented at the Hotline and Clinical Trial Update Sessions at the European Society of Cardiology Congress 2007 in Vienna. The key presentations were performed by leading experts in the field with relevant positions in the trials or registries. It is important to note that unpublished reports should be considered as preliminary data, as the analysis may change in the final publications. The comprehensive summaries have been generated from the oral presentation and the webcasts of the European Society of Cardiology and should provide the readers with the most comprehensive information of relevant publications.     

Balance and Boundaries in Grief Counseling: An Intervention Framework for Volunteer Training

Volunteers or paraprofessional counselors are commonly used to provide supportive care to the bereaved. These counselors generally are trained in basic listening skills, providing a generic, nonspecific approach to intervention that remains to be proven effective. The present paper outlines a framework that provides paraprofessionals with a broader model for intervention with the bereaved. Attention to boundaries as a helper and balance in the grief recovery are central to the model. Interventions are described that provide the paraprofessional counselor with more options for tailoring their counseling strategy to the individual. These include techniques that are presumed to be more specific to the enhancement of grief recovery.     

A new method for the simultaneous analysis of unmodified and modified urinary nucleosides and nucleobases by high performance liquid chromatography

Details are given of a new, rapid and simple pre-fractionation method and an isocratic high performance liquid chromatography system suitable for parallel analysis of nucleosides and nucleobases from urine and other biological fluids. The quantitative recovery and excellent reproducibility of the method is demonstrated by analysis of representative standard RNA catabolites. The advantage of this new method for application to biological samples is discussed.     

Adsorption of Charged Non-albumin Bound Drugs by Amorphous Silica

We investigated the in vitro drug adsorption of PQ 10150 sodium silicate gel (AIS, Santa Clara, CA) with particle size of 230 um and surface area of 400 nr/g. We observed 99% to 88% adsorption of gentamicin; a mean 91 % of disopyramide; a mean 89% of quinidine at low concentration, falling to 75% at higher concentration. Insulin was 88% adsorbed at low concentrations but less so (65%) at higher concentrations. We observed a mean 83 % adsorption of procainamide, a mean 84% of N-acetyl procainamide, 74% oflidocaine, 73% of amitriptyline; and 44% of desipramine. We found an average 14% reduction of total digoxin concentration when serum containing digoxin (2 to 33 ng/mL) was exposed to sodium silicate, while the reduction in free digoxin concentration was 16%. Five percent ethosuximide was also removed. The adsorption of theophylline, phenobarbital, acetaminophen, phenytoin, ethylene glycol, methotrexate, salicylate, thiocyanate and diazepam was minimal and not significant. We conclude that significant amounts of charged, non-albumin bound drugs can be removed by PQ 10150 sodium silicate gel.