卵巢伴微浸润的浆液性交界性肿瘤临床病理学特征分析

目的探讨卵巢伴微浸润的浆液性交界性肿瘤(SBTM)临床病理特征。 方法回顾性分析明确诊断的10例卵巢SBTM患者临床资料,观察卵巢SBTM的病理形态特点及免疫表型。 结果患者年龄范围22～68岁;10例卵巢SBTM的上皮细胞均呈轻-中度非典型增生,其中8例形成乳头结构,2例可见微乳头结构,肿瘤间质内均出现单个细胞或多个细胞组成的细胞簇,细胞质呈嗜酸性,10例卵巢SBTM肿瘤细胞均CK7和CAM5.2弥漫阳性,CA125和WT1部分肿瘤细胞阳性。 结论卵巢SBTM是一种具有低度恶性潜能的肿瘤,微浸润病变较小时,诊断时容易漏诊;由于有复发可能,建议密切随访。     

Influence of β-lactamase inhibitors on the activity of oxacillin against methicillin-resistant Staphylococcus aureus

We studied the in vitro susceptibility to oxacillin of 46 isolates of methicillin-resistant Staphylococcus aureus (MRSA) isolates with a minimum inhibitory concentration (MIC) >8 μg/ml of oxacillin, with and without adding clavulanic acid, sulbactam, or tazobactam in three different concentrations (2, 4, and 8 μg/ml). All 46 strains were found by the rapid chromogenic cephalosporin method to be β-lactamase producers. For those strains with low-level resistance (MIC of 16 or 32 μg/ml), the MICs of oxacillin decreased four- to 32-fold and two- to 32-fold after adding sulbactam and tazobactam, respectively. For those with high-level resistance (MIC of ⩾64 μg/ml), the MICs either did not change or decreased only two-fold after we added one of three β-lactamase inhibitors. The results suggest that β-lactamase production probably plays a role in resistance to oxacillin in those MRSA strains of low-level oxacillin resistance.     

Influence of inflammatory status in the acute phase of stroke on post-stroke depression

BackgroundThirty percent of stroke patients will suffer from post-stroke depression (PSD). Recent data suggest that inflammation accounts for a substantial amount of depression. Our primary objective was to assess the association between standard inflammation biomarkers in the acute phase of stroke and PSD at three months. The secondary objective was to elaborate a predictive model of PSD from clinical, biological and radiological data.MethodsWe performed a retrospective analysis of a single-centre cohort of stroke patients with a three-month follow-up. Serum levels of C-reactive protein (CRP), fibrinogen, leukocyte count and neutrophil to lymphocyte ratio (NLR) were tested at admission and at peak. Mood was assessed at three months using the depression sub-scale of the Hospital Anxiety and Depression Scale (HADS). Association between inflammation biomarkers and HADS was evaluated with multi-linear regression adjusted on clinical and radiological parameters. Logistic predictive models of PSD at three months, with and without inflammation biomarkers, were compared.ResultsThree hundred and forty-eight patients were included, of whom 20.06% developed PSD. Baseline and peak values of all inflammatory markers were associated with the severity of PSD at three months. Area under the curve for the receiver operating characteristic curve of PSD prediction was 0.746 (CI 95% 0.592–0.803) with selected inflammation biomarkers and 0.744 (CI 95% 0.587–0.799) without.ConclusionMost inflammation biomarkers are weakly associated with PSD, adding negligible value to predictive models. While they suggest the implication of inflammation in PSD pathogenesis, they are useless for the prediction of PSD, underscoring the need for more specific biomarkers.     

Eltrombopag or Intravenous Immunoglobulin as a Bridge to Splenectomy in Adults With Chronic Idiopathic Thrombocytopenic Purpura: A Canadian Economic Analysis

BackgroundChronic idiopathic thrombocytopenia purpura (ITP) in adults is a potentially serious disorder affecting 6000 to 7000 Canadians. Initial treatment consisting of corticosteroids usually begins when the platelet count is persistently below 20 × 10⁹/L or if the patient has bleeding complications. In cases in which corticosteroid resistance develops or in which they are contraindicated, splenectomy is the recommended second-line therapy. In many of these patients, intravenous immunoglobulin (IVIG; 1 g/kg/day for 2 days then 1 g/kg/day monthly) is often used as a bridge to surgery. Eltrombopag is a new orally administered agent that activates the thrombopoietic receptor and stimulates human megakaryocytes. Clinical trials have demonstrated that eltrombopag is safe and effective in the treatment of adults with chronic ITP. Therefore, it represents an attractive option to IVIG for use as a bridge to splenectomy. In this study, a cost-minimization analysis was conducted to test the hypothesis that eltrombopag is a cost-effective alternative to IVIG for this indication.Patients and MethodsThe economic analysis was conducted from the Canadian societal perspective using a 4-month time horizon. Estimates for direct medical costs in these patients were obtained from 6 hematologists from across Canada. The base case analysis considered direct costs for drug therapy, outpatient pharmacy fees, medical consultations and visits, laboratory and diagnostic procedures, as well as costs for secondary pharmacotherapy in cases in which the primary agent had to be discontinued because of side effects. For IVIG, the analysis also included visits to the infusion clinic, chair time to receive the infusion, nursing time, pharmacy preparation, as well as indirect costs (eg, time off work, patient travel). A 1-way sensitivity analysis was then undertaken on the key cost drivers to test the stability of the primary findings.ResultsTotal direct and indirect costs for IVIG were $24,134 for 4 months of therapy with drug cost contributing to 84% of the total. In contrast, total costs for eltrombopag were approximately $14,651 for an overall savings of $9,543 per patient. The sensitivity analysis suggested that the base case findings were stable and were only modestly affected by variations in drug cost and duration of therapy.ConclusionGiven its oral route of administration and cost-saving potential, eltrombopag would be an economically attractive alternative to IVIG when the intent of therapy is to create a bridge to surgery.     

基质金属蛋白酶-7在非小细胞肺癌中表达的意义

目的探讨基质金属蛋白酶-7(MMP-7)在非小细胞肺癌的发生、浸润及转移过程中的作用。方法采用免疫组织化学SP法,检测原发性非小细胞肺癌石蜡包埋组织80例、正常肺组织40例中MMP-7的表达水平,分析其与非小细胞肺癌的病理分化程度、手术-病理分期、淋巴结转移的相关性。结果非小细胞肺癌组MMP-7阳性率高于正常肺组织组(P=0.000)。非小细胞肺癌组TNM分期中Ⅰ、Ⅱ期合并后和Ⅲ、Ⅳ期合并后MMP-7的阳性率比较,差异有统计学意义(P=0.022);低分化癌的MMP-7的阳性率与高、中分化癌相比,差异无统计学意义(P=0.073);淋巴结转移组MMP-7的表达与无淋巴结转移组差异有统计学意义(P=0.003)。结论 MMP-7可能参与了非小细胞肺癌的发生和演进的过程;MMP-7检测可能成为判断非小细胞肺癌发生发展和评价预后的有效参考指标之一,对于非小细胞肺癌的早期预测可能具有重要的临床意义。     

泰安市某高校大学生痤疮患病情况及多种影响因素Logistic分析

目的了解大学生痤疮的患病情况,从多方面对大学生痤疮发病的影响因素进行调查分析,为痤疮的预防和治疗提供依据。方法整群随机抽取泰安市某高校一至四年级学生1416名,使用《自编基本情况问卷》和《青少年生活事件量表》进行问卷调查。结果大学生痤疮患病率为44.07%,其中男性患病率为39.85%,女性为46.61%,两性间患病率差异有统计学意义(P<0.05)。非条件Logistic回归分析显示,油性皮肤、痛经(女性)、睡眠时间少、喜食油炸或肥腻食物、阳性家族史、就业压力、学习压力、健康适应因子等因素为痤疮发病的危险因素。结论痤疮是好发于青少年的常见疾病,其发生受到生物、心理、社会等因素的影响,预防与治疗应综合考虑。     

低温保存的嗅鞘细胞移植治疗脊髓损伤的实验研究

目的:观察低温保存复苏后嗅鞘细胞(OECs)局部移植治疗脊髓损伤(SCI)的疗效,探讨低温保存对嗅鞘细胞活性的影响。方法:建立大鼠T10节段脊髓半切损伤模型56只,随机分为四组,每组12只:新鲜OECs移植组(A组),冻存OECs移植组(B组),D/F12培养液移植组(C组)和空白对照组(D组)。A组损失伤局部行新鲜OECs移植,B组将处于对数生长期的OECs冻存3个月,复苏后(用双苯亚甲胺标记)移植到脊髓半切模型大鼠脊髓损伤区。术后第1天、1、2、3、4、6、8及10周时进行联合行为学(CBS)综合评分,术后5周和10周时取材观察移植细胞存活及迁移情况;HE染色及嗜银染色观察脊髓组织病理及轴突情况;NGFRp75免疫组织化学染色情况。结果:术后第1天,2、10周时CBS评分,A组分别为85.78±1.07、58.80±5.00、6.52±2.37;B组分别为86.12±1.29、60.06±6.51、8.15±2.26;C组分别为86.4±1.03、66.28±7.00、30.65±5.60;D组分别为86.75±1.37、69.85±6.61、34.13±5.38。A、B两组间无明显差别(P>0.05);C组与D组间比较无差异(P>0.05);A组及B组较C组和D组在2周后各时段差别有显著意义(P<0.05)。组织学方面,HE染色和嗜银染色A、B两组在术后5周可见多量突起经近侧断端向损伤区域生长,10周时可见神经纤维跨越损伤区域,而C、D组未见有神经纤维跨越损伤区;NGFRp75免疫组化染色,无论5周还是10周,A、B两组在损伤部位均可见阳性染色区域,C、D组未见有阳性着色。术后5周时A、B两组可检测到荧光标记细胞,且可见细胞发生迁移。结论:低温保存的OECs脊髓局部移植治疗SCI与新鲜OECs移植治疗效果无差别。     

端粒酶逆转录酶反义寡核苷酸对乳腺癌细胞生物学特性及干细胞富集的影响

目的探讨人端粒酶逆转录酶反义寡核苷酸(hTERT ASODN)对乳腺癌MCF-7细胞系干细胞微球体富集及其生物学特性的影响。方法以人端粒酶逆转录酶(hTERT)基因编码区为靶点合成反义寡核苷酸,脂质体介导转染,以正义序列转染作为对照。实验分设转染组(ASODN组),正义序列转染的对照组(SODN组)及空白对照组。采用无血清悬浮培养法观察转染对MCF-7干细胞微球体富集的影响。Western blot检测各组干性标记物CD44及ALDH1的表达。RT-PCR检测各组ABCG2、MDR1 mRNA的表达。采用单因素方差分析对各组数据进行统计学处理。结果 ASODN组干细胞微球体生长速率及球体体积明显差于两对照组。与空白对照及SODN组比较,Western blot检测发现CD44与ALDH1在ASODN组细胞表达降低,差异有统计学意义(P<0.01)。RT-PCR检测发现,在ASODN组细胞ABCG2及MDR1 mRNA的表达量均显著降低,差异有统计学意义(P<0.01)。而空白对照组及SODN组两者比较差异无统计学意义(P>0.05)。结论 hTERT ASODN在抑制乳腺癌干细胞微球体的富集、降低乳腺癌细胞干性表达及其耐药性方面具有重要作用。     

A prospective evaluation of the diagnostic value of video capsule endoscopy in patients initially classified as irritable bowel syndrome

BackgroundIrritable bowel syndrome (IBS) is characterized by chronic gastrointestinal dysfunction in the absence of detectable organic disease. The recently developed technique, video capsule endoscopy (CE), has been shown to be much more sensitive than traditional enterography in detecting mucosal changes in the small intestine. This study was performed to see if any earlier, not detectable by other standard methods, mucosal changes could be found in the small intestine in patients diagnosed as having IBS.MethodsAll consecutive women who, over the past five years, had received a well-founded diagnosis of IBS at the Department of Medicine were identified. Twenty-eight women, mean age 36 ± 12 years were willing to participate in the study. They underwent a CE after a pre-test with a dummy capsule. The actual IBS activity was estimated by the validated Gastrointestinal Symptom Rating Scale (GSRS) and Psychological General Well-Being (PGWB) Index questionnaires.ResultsThe duration of the IBS symptoms was a mean of 10 years (range 3–25). Symptoms were present, according to the scores of the GSRS and the PGWB index, at the time the patients underwent the CE. In the majority, 24 of 27 IBS patients examined, no specific small intestinal lesions were seen on CE. In two patients, CE revealed multiple small intestinal lesions such as ulcerations and/or erosions, and in one patient a duodenal ulceration.ConclusionIn the vast majority of patients who fulfil the symptom criteria of IBS, no pathological mucosal lesions can be found by CE explaining the symptomatology. However, a subgroup of these patients may benefit from investigation by CE to reconsider the diagnosis.     

Synergistic effects of ginseng stem and leaf-extracted ginsenoside and choline on improving learning and memory in rats☆ Association verification experiment in animals with multiple learning and memory disorders

BACKGROUND： Ginsenoside extracted from the stem and leaf of ginseng （GSL） and choline have both been shown to improve learning and memory functions; however, further studies are needed to understand the synergistic effects of a combination of both. OBJECTIVE： To verify the combined improved synergistic effects of GSL and choline on learning and memory disorders in rats. DESIGN： Control observation.
SETTING： Taishan Medical College.
MATERIALS： A total of 150 male Kunming mice weighing （204-2） g and 40 healthy male Wistar rats weighing （2204-20） g were provided by the Experimental Animal Department of Jilin University. Animal experimentation received confirmed consent from the local ethic committee. GSL was provided by the Department of Chemistry, Norman Bethune Medical University, and choline was provided by the Third Experiment Factory, Shanghai.
METHODS： This study was performed at the Life Science Institute, Taishan Medical College from October 2006 to February 2007. ① Scopolamine-induced learning and memory disorders in rats： Forty rats were randomly divided into control group, model group, combination group （400 mg/kg GSL ＋ 200 mg/kg choline）, GSL （400 mg/kg） group, and choline （200 mg/kg） group, 8 rats/group. Rats were perfused and administrated in the morning, once a day for 14 successive days. Rats in the control group and model group were perfused with 20 mL/kg distilled water and underwent Morris water maze spatial resolution test 1 hour after perfusion on the 10m, 11m, and 12m days after administration. Rats also underwent passive step-down avoidance test 1 hour after reperfusion on the 13m and 14m days after administration. Thirty minutes prior to experimentation, rats in the remaining three groups were intraperitoneally （i.p） injected with 2 mg/kg scopolamine, and rats in the control group were i.p. injected with 2 mL/kg saline. ② Scopolamine-induced learning disorder and memory acquired disorder in mice： Fifty mice were randomly divided into con