幽门螺杆菌重组粘附素rHpaA生物学活性及免疫原性的体外评价

目的：体外评价幽门螺杆菌（Hp)重组粘附素rHpaA的生物学活性及免疫原性,探讨其在Hp疫苗应用中的可行性。方法：流式细胞术和光镜定量计数法检测rHpaA及其抗体对Hp与胃上皮细胞粘附的影响;ELISA法测定Hp感染者血清中抗HpaA抗体,^3H-TDR掺入法测定人外周血淋巴细胞（PBL）对rHpaA的增殖反应,评价rHpaA对体液和细胞免疫的细胞;流式细胞术检测rHpaA对T辅助细胞（Th）表型的选择作用,探讨rHpaA可能的免疫机制。结果rHpaA和抗rHpaA抗血清均能部分阻断Hp与胃上皮细胞系的粘附;ELISA法能检测出Hp阳性患者血清中存在抗HpaA抗体,检测出率与Hp超声破碎抗原（HpSON)包被下的检出率相近（50%vs54%,P＞0．05）;不论培养基中是否加入IL－2,rHpaA均可刺激Hp PBL的增殖（P＜0．05）;Hp阳性或阴性PBL细胞与rHpaA孵育后均能显著提高IL－4阳性T细胞比例（P＜0．05）。结论HpaA是具有免疫原性的Hp菌体成分,且能选择性增加Th2细胞比例,有望成为Hp疫苗研制中一种有效的新抗原。     

双歧杆菌对实验性大肠癌的预防及诱导细胞凋亡的作用

目的　探讨青春型双歧杆菌对实验性大肠癌的预防作用及其防瘤机制。方法　以裸鼠大肠癌移植瘤为动物模型,预先用双歧杆菌注射于裸鼠腹腔,观察移植瘤的生长速度,同时利用透射电镜、原位末端标记技术及免疫组化技术观察大肠癌裸鼠移植瘤的超微结构、凋亡细胞密度以及ｂｃｌ２、ｂａｘ 蛋白表达率及其阳性细胞密度。结果　双歧杆菌预防组大肠癌移植瘤的生长速度显著慢于对照组; 此外双歧杆菌预防组移植瘤组织中可见多量处于不同凋亡时期的瘤细胞,其凋亡细胞密度、ｂａｘ 蛋白表达率以及阳性细胞密度均显著高于肿瘤对照组,而ｂｃｌ２ 蛋白的表达情况则相反。结论　青春型双歧杆菌能显著预防大肠癌的发生与发展,并能诱导其细胞凋亡。     

双歧杆菌对实验性大肠癌化bcl-2及bax基因表达的影响

目的 通过观察大肠癌裸鼠移植瘤bcl-2及bax基因的蛋白表达水平,探讨双歧杆菌的抑瘤途径及机制.方法 采用免疫组化SP法检测了40只裸鼠大肠癌移植瘤bcl-2及bax基因的蛋白表达率及表达强度.结果 双歧杆菌注射组大肠癌移植瘤bcl-2蛋白表达率及阳性细胞密度均低于肿瘤对照组,bax基因的表达情况则相反.结论 双歧杆菌可使大肠癌裸鼠移植瘤的bcl-2基因表达下调,bax基因表达增强,最终诱导肿瘤细胞凋亡,实现其抗瘤目的.     

Usefulness of a Three‐Dimensional‐Printed Model in the Treatment of Irreducible Atlantoaxial Dislocation with Transoral Atlantoaxial Reduction Plate

ObjectiveTo evaluate the usefulness of a 3D‐printed model for transoral atlantoaxial reduction plate (TARP) surgery in the treatment of irreducible atlantoaxial dislocation (IAAD).MethodsA retrospective review was conducted of 23 patients (13 men, 10 women; mean age 58.17 ± 5.27 years) with IAAD who underwent TARP from January 2015 to July 2017. Patients were divided into a 3D group (12 patients) and a non‐3D group (11 patients). A preoperative simulation process was undertaken for the patients in the 3D group, with preselection of the TARP system using a 3D‐printed 1:1 scale model, while only imaging data was used for the non‐3D group. Complications, clinical outcomes (Japanese Orthopaedic Association [JOA] and visual analogue score [VAS]), and image measurements (atlas–dens interval [ADI], cervicomedullary angle [CMA], and clivus‐canal angle [CCA]) were noted preoperatively and at the last follow up.ResultsA total of 23 patients with a follow‐up time of 16.26 ± 4.27 months were included in the present study. The surgery duration, intraoperative blood loss, and fluoroscopy times in the 3D group were found to be shorter than those in non‐3D group, with statistical significance. The surgery duration was 3.29 ± 0.45 h in the 3D group and 4.68 ± 0.90 h in the non‐3D group, and the estimated intraoperative blood loss was 131.67 ± 43.03 mL in the 3D group and 185.45 ± 42.28 mL in the non‐3D group. No patients received blood transfusions. The intraoperative fluoroscopy times were 5.67 ± 0.89 in the 3D group and 7.91 ± 1.45 in the non‐3D group. Preoperatively and at last follow up, JOA and VAS scores and ADI, CCA, and CMA were improved significantly within the two groups. However, no statistical difference was observed between the two groups. However, surgical site infection occurred in 1 patient in the 3D group, who underwent an emergency revision operation of the removal of TARP device and posterior occipitocervical fixation; the patient recovered 2 weeks after the surgery. In 2 patients in the traditional group, a mistake occurred in the placement of screws, with no neurological symptoms related to the misplacement.ConclusionPreoperative surgical simulation using a 3D‐printed real‐size model is an intuitive and effective aid for TARP surgery for treating IAAD. The 3D‐printed biomodel precisely replicated patient‐specific anatomy for use in complicated craniovertebral junction surgery. The information was more useful than that available with 3D reconstructed images.     

S100P as a marker for poor survival and advanced stage in gallbladder carcinoma

AimsGallbladder carcinomas usually present in advanced stages and has a dismal prognosis despite modern imaging techniques and aggressive surgical intervention. Identification of biologic markers for early diagnosis and improved therapeutic strategies is thus of paramount importance. S100P has been identified in a variety of malignant neoplasms of the gastrointestinal and pancreaticobiliary systems, but it is not yet known if S100P expression is associated with clinically-relevant characteristics of gall bladder carcinoma. The aims of the present study were: 1) to investigate the relationship between S100P expression and histological type, grade, tumor-node-metastasis stage, presence of vascular invasion, perineural invasion and necrosis; and 2) to evaluate for any S100P-defined difference in the risk for tumor recurrence or death.MethodImmunostains for S100P were performed on 4 tissue microarray blocks containing 91 cases of gall bladder carcinoma.ResultThe intensity of S100P staining was significantly associated with pathological T stage 4 (p = 0. 0238). Staining intensity ≥3 in ≥25% tumor cells was associated with pathological T stage 4 (p = 0.0005). A higher S100P immunoreactivity score (IRS) was significantly associated with higher TNM stage (p = 0.0341). Age (p = 0.0485), presence of vascular invasion (p = 0.0359), pathological T stage (p = 0.0291) and TNM stage (p = 0.0153) were significantly associated with tumor recurrence. Intense S100P reactivity was associated with decreased overall survival [hazard ratio = 9.614; 95% confidence interval (CI), 1.873–49.338; p = 0.0067].ConclusionOur findings indicate that S100P over-expression is a potential prognostic marker for gall bladder carcinoma and is significantly associated with advanced tumor stage and poorer survival.