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1.
目的探讨血管内皮生长因子(VEGF)、Flt-1和KDR的表达与原发性胆囊癌临床病理特征的关系。方法对21例原发性胆囊癌和10例胆囊腺瘤样息肉新鲜组织标本采用逆转录-聚合酶链反应(RT-PCR)和免疫组织化学染色在mRNA和蛋白水平检测VEGF、Flt-1和KDR在原发性胆囊癌和胆囊腺瘤样息肉的表达情况,并分析VEGF、Flt-1和KDR免疫组织化学阳性表达的病例与胆囊癌肝浸润、淋巴转移、病理分级和Nevin分期等临床病理特征的相关性。结果在胆囊癌和胆囊腺瘤样息肉组织中VEGF mRNA阳性表达率为90.47%(19/21)和20%(2/10);Flt-1mRNA阳性表达率为71.42%(15/21)和0%(0/10);KDR mRNA阳性表达率为85.71%(18/21)和10%(1/10);两组差异有统计学意义(P〈0.05)。免疫组织化学染色VEGF蛋白检测阳性表达率为80.95%(17/21)和20%(2/10);Flt-1蛋白阳性表达率为60.90%(13/21)和10%(1/10);KDR蛋白阳性表达率为76.19%(16/21)和10%(1/10),两组差异有统计学意义(P〈0.05)。VEGF、Flt-1和KDR蛋白的阳性表达率在胆囊癌肝浸润、淋巴转移和NevinⅣ、Ⅴ期组明显高于无肝浸润、无淋巴转移和NevinⅠ、Ⅱ、Ⅲ期组(P〈0.05),而在高、中和低分化组三者的阳性表达率无统计学意义(P〉0.05)。结论原发性胆囊癌组织中VEGF、Flt-1和KDR在mRNA和蛋白水平均存在高表达,VEGF、Flt-1和KDR蛋白的阳性表达同胆囊癌肝浸润、淋巴转移和Nevin分期明显相关,但与病理分级无明显相关。  相似文献   

2.
Survivin在胆囊癌中的表达及其与p53相关性研究   总被引:1,自引:0,他引:1  
目的检测胆囊癌中凋亡抑制因子Survivin的表达,研究其与胆囊癌f临床特征的关系,并探讨其与p53的相关性。方法采用免疫组织化学技术检测45例胆囊癌组织、20例胆囊息肉、20例胆囊炎及10例正常胆囊组织中Survivin和p53表达。结果45例胆囊癌组织中40例表达Survivin蛋白,34例表达p53蛋白,表达p53的病例中,31例表达Survivin阳性。而在胆囊息肉、胆囊炎及正常胆囊组织中不表达。且Survivin的表达与胆囊癌病人性别、年龄、肿瘤大小、病理分级、Nevin分期、淋巴结转移无关(P〉0.05),而p53与淋巴结转移密切相关(P〈0.01)。结论Survivin在胆囊癌中的高表达提示其可能与肿瘤的发生有关,Survivin和p53突变对凋亡抑制的协同作用在胆囊癌的发生发展过程中起重要作用。  相似文献   

3.
nm23-H1和E-Cadherin基因蛋白在胆囊癌组织中的表达   总被引:15,自引:3,他引:12  
目的:探讨nm23-H1和E-cadherin(E-Cad)基因蛋白在胆囊癌组织中的表达与组织类型,病理分级和转移的关系。及nm23-H1和E-Cad基因蛋白表达的相关性。方法:应用催化信号放大系统免疫组化方法,检测52例胆囊腺癌,20例胆囊腺瘤和10例慢性胆囊炎组织中nm23-H1和E-Cad表达水平。结果:在胆囊癌中nm23-H1和E-Cad阳性表达率分别为51.9%和42.3%,均明显低于胆囊腺瘤和慢性胆囊炎(P<0.05),nm23-H1和E-Cad表达与胆囊癌的组织类型,病理分级和转移密切相关(P<0.05),两基因蛋白表达在胆囊癌组织中呈正相关(P<0.05),结论:nm23-H1和E-Cad基因与胆囊癌的转移密切相关,对临床判断胆囊癌预后有一定指导意义。  相似文献   

4.
目的:观察乳腺浸润性导管癌组织中BRCA1、Ki-67及p53的表达及其与临床病理特征之间的关系。方法采用EliVisionTMplus两步免疫组化方法,检测BRCA1、Ki-67及P53在60例乳腺浸润性导管癌组织的表达情况。结果①60例乳腺浸润性导管癌组织中,BRCA1的阳性率为60.0%(36/60),Ki-67及 p53的阳性率分别为56.67%(34/60)、48.33%(29/60);②BRCA1蛋白表达与患者发病年龄、临床分期、伴有腋淋巴结转移以及组织学分级有关(P<0.05),而与肿瘤大小无关(P>0.05);Ki-67表达与临床分期、淋巴结转移、组织学分级有关(P<0.05),与发病年龄、肿瘤大小无关(P>0.05);p53表达与肿瘤大小、临床分期、淋巴结转移、组织学分级相关(P<0.05),与发病年龄无关(P>0.05);③BRCA1表达与 Ki-67、p53均呈负相关(r1=-0.577,P<0.05,r2=-0.504,P <0.05),Ki-67与p53的表达呈正相关(r =0.375,P<0.05)。结论联合检测BRCA1、Ki-67及p53对乳腺癌的早期诊断、恶性程度判定和预后监测有重要意义,可为乳腺癌的个体化治疗提供有效的指针。  相似文献   

5.
目的:探讨p16,Rb基因在原发性胆囊癌中的表达及其与病理生物学行为和预后的关系。方法:采用免疫组化(SP)法对56例胆囊癌进行p16和Rb蛋白的定位观察。结果:p16和Rb基因在原发性胆囊癌中的表达阳性率分别为46.3%和71.4%,显著低于在胆囊良性病变中的表达(P<0.05),Rb表达与胆囊癌的病理组织学分级,组织类型,浸润,转移和预后无明显关系(P>0.05),而p16与胆囊癌的浸润,转移和预后有明显相关性(P<0.05),p16和Rb基因蛋白表达存在着明显的互补性。结论:p16和Rb基因蛋白丢失是胆囊癌发生,发展中的重要分子事件,与细胞周期G1-S期的负反馈调节环路中断关系密切,p16蛋白表达可作为评估胆囊癌病理生物学行为及预后的参考指标。  相似文献   

6.
目的探讨环氧化酶-2(COX-2)和Ki-67在乳腺浸润性导管癌组织中的表达情况及其临床意义。方法采用免疫组织化学sP方法检测82例乳腺浸润性导管癌组织和相应癌旁正常组织中COX.2和Ki.67蛋白表达,并分析二者表达的相关性以及其表达与乳腺浸润性导管癌患者临床病理特征的关系。结果①在82例乳腺浸润性导管癌组织中COX-2和Ki.67蛋白表达阳性率均分别明显高于其在相应癌旁正常组织中的表达阳性率[COX.2:71.95%(59/82)比8.54%(7/82),z。=68.56,P〈0.001;Ki-67:64.63%(53/82)比13.42%(11/82)。X2=45.20,P〈0.001]。②COX.2和Ki.67蛋白阳性表达与肿瘤TNM分期(cox.2:rs=O.349,P〈0.05;Ki.67:rs=0.305,P〈0.05)、淋巴结转移(cOx-2:rs=0.336,P〈0.05;Ki-67:rs=0.419,P〈0.01)、脉管侵犯(cOx-2:rs=0.235,P〈0.05 ki-67:rs=0.461,P〈0.01)及组织学分级(cox-2:rs=0.434,P〈0.01;Ki-67:rs=0.378,P〈0.05)均呈正相关;Ki.67蛋白阳性表达与肿瘤直径呈正相关(rs=0.365,P〈0.01),而COX.2蛋白阳性表达与此无关(rs=0.135,P〉0.05);COX-2和Ki-67蛋白阳性表达皆与患者是否绝经无关(cox-2:rs=O.172,P〉0.05;Ki.67:rs=0.163,P〉0.05)。③在浸润性导管癌组织中COX.2和幻.67蛋白阳性表达呈正相关性(rs=0.475,P〈0.01)。结论在乳腺浸润性导管癌组织中COX.2和Ki.67的表达均增高,两者与乳腺浸润性导管癌临床病理特征密切相关,对两者进行联合检测可反映乳腺浸润性导管癌的生物学行为,COX-2有可能成为乳腺癌治疗的一个新靶点。  相似文献   

7.
目的:研究Ki-67和CD34在胃癌组织中的表达,探讨其与胃癌临床病理相关因素的关系。方法:采用免疫组织化学SP法检测80例胃癌组织Ki-67的表达,并以CD34抗体标记血管内皮细胞,结果用微血管密度(MVD)表示。结果:Ki-67表达与胃癌分化程度、淋巴结转移、浸润深度以及肿瘤大小密切相关(P〈O.05),与年龄、性别无关(P〉0.05)。Ki-67与MVD在胃癌组织中呈正相关(P〈0.05)。MVD与胃癌分化程度、淋巴结转移、浸润深度密切相关(P〈0.05),而与年龄、性别、肿瘤大小无关(P〉0.05)。结论:Ki-67及CD34与胃癌的分化程度、浸润深度、淋巴结转移方面明显相关,而与年龄、性别、肿瘤大小无关。检测胃癌组织中Ki-67及CD34的表达对临床有-定的指导意义。  相似文献   

8.
目的:探讨血管内皮生长因子(Vascular endothelial growth factor,VEGF)与F-钙粘蛋白(E-Cad)在胆囊癌组织中的表达及与胆囊癌发生发展的关系。方法:应用免疫组织化学法检测14例胆囊腺癌和41例胆囊癌组织中VEGF、E-Cad的表达。结果:VEGF阳性表达率胆囊腺瘤中为42.86%,胆囊癌组织中为80.49%,二者差异有显著意义(P<0.05),E-Cad在胆囊腺瘤中仅1例表达减弱,而在胆囊癌组织中表达减弱或不表达占68.29%(28/41),差异有非常显著意义(P<0.01)。胆囊癌直径≥2cm及侵及浆膜组VEGF表达升高,而E-Cad表达率明显降低,E-Cad表达率在远处转移组也明显降低。两者表达与肿瘤Nevin分期、组织学分级及有无淋巴结转移无关。结论:VEGF与E-Cad在胆囊癌发生和浸润转移过程中发挥重要作用,两者表达率的高低可作为预示胆囊癌进展及判断预后的指标。  相似文献   

9.
目的:检测肝门部胆管癌中凋亡抑制因子Survivin蛋白的表达,研究其与肝门部胆管癌的临床特征的关系,并探讨其与p53的相关性。方法:采用免疫组织化学方法检测86例肝门部胆管癌组织、10例癌旁组织(距肿瘤边缘约1.0cm)及10例正常胆管组织中Survivin蛋白和p53蛋白的表达,结合临床病理学资料进行统计学分析。结果:86例肝门部胆管癌组织中,Survivin蛋白阳性率为82.6%(71/86),p53蛋白阳性率为76.7%(66,86),Survivin与p53在癌旁组织和正常胆管组织中均呈阴性表达,与癌组织相比差异有统计学意义(P〈O.05);Survivin表达与肝门部胆管癌病理分级、Bismuth分型、患者的性别及年龄和肿瘤大小均无关(P〉0.05),但淋巴结转移阳性组Survivin蛋白表达水平明显高于淋巴结转移阴性组,差异有统计学意义(P〈0.05);p53蛋白在肝门部胆管癌中与肿瘤组织病理分级、淋巴结有无转移相关(P〈0.05),与其他病理学特征无关(P〉O.05)。71例Survivin阳性表达者中同时表达p53阳性者58例,15例阴性表达者中表达p53阳性者8例,两者差异有统计学意义(P〈0.05)。结论:肝门部胆管癌组织中Survivin和p53的表达显著高于癌旁组织和正常胆管组织,其在肝门部胆管癌的发展、转移过程中可能具有重要作用。  相似文献   

10.
细胞周期素E在胆囊癌中的表达及意义   总被引:1,自引:1,他引:0  
目的:探讨cyclinE与胆囊癌发生发展的关系。方法:应用S-P免疫组织化学技术,对35例原发性胆囊癌、10例胆囊腺瘤及10例慢性胆囊炎行cyclinE多克隆抗体的免疫组化标记。结果:胆囊癌cyclinE的阳性率为48.57%,与胆囊腺瘤、胆囊炎(阳性率均为10%)比较差异有显著性(P<0.05)。cyclinE阳性表达率在病理组织学分级中有显著性差异(P<0.05),伴淋巴结及远处转移者cyclinE可反映细胞的增殖状态,是判断胆囊癌发生发展的重要生物学标志。  相似文献   

11.
Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI2) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI2), TXB2 (stabile metabolite of thromboxane A2) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI2 release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB2 (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI2 release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A2, presumably contributing to hemodynamic stability within 30 min after MT.  相似文献   

12.
Don Dame 《Artificial organs》1996,20(5):613-617
Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.  相似文献   

13.
Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H2O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg−1 followed by 0.15 mg · kg−1 · h−1, n=8) or verapamil (0.1 mg · kg−1 followed by 0.3 mg · kg−1 · h−1, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.  相似文献   

14.
Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.  相似文献   

15.
Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.  相似文献   

16.
Abstract Immunoadsorption (1A) therapy with tryptophan (TR-350) or phenylalanine (PH-350) adsorbents has been used to reduce the concentration of serum antibodies in human lymphocyte antigen (HLA)-immunized patients. Other forms of plasma purification have been reported to reduce the level of fibrinogen, which affects the blood properties. In this study we investigated the effects of IA therapy using both adsorbents on plasma fibrinogen and immunoglobulins G and M in 13 patients (8 patients were treated with TR-350, and 5 patients were treated with PH-350). During each session 1 plasma volume (2.8 ± 0.4 L of plasma) was processed through the immunocolumn and then returned to the patient together with the blood cells. Compared with the pretreatment values, the plasma fibrinogen, IgG, and IgM concentrations were significantly reduced after IA therapy (p < 0.01 for TR-350; p < 0.04 for PH-350). There was a positive correlation between the degree of reduction of plasma proteins and the number of IA treatments given. A nonpara-metric test (Wilcoxon's signed-rank test or the Mann-Whitney test) was used for statistical analysis. We conclude from our study that IA therapy effectively lowers the plasma levels of fibrinogen, IgG, and IgM and thus can be considered a valuable alternative to other blood purification methods.  相似文献   

17.
Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.  相似文献   

18.
Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.  相似文献   

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Abstract: Photopheresis is a technique in which peripheral blood mononuclear cells, in the presence of a photoacti-vatable compound, are exposed extracorporeally to ultraviolet A light and reinfused, inducing a host autoregula-tory immune response. Experimental work and ongoing clinical studies are helping to define the role of this novel, safe, and non-toxic immunomodulating technology in the field of transplantation.  相似文献   

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