The reflex effect of changes in renal perfusion on hindlimb vascular resistance in anaesthetized rabbits

This study was designed to characterise the response of the hindlimb vasculature to reduced renal perfusion in the anaesthetized rabbit and to elucidate whether the stimulus was dependent upon reduced renal perfusion pressure (RPP) or blood flow (RBF). Acute decreases in renal perfusion resulted in rapid and reversible increases in femoral perfusion (FPP). This vascular response was completely abolished following renal denervation indicating that the afferent component of the reflex is neurally mediated. Acute hindlimb responses to changes in renal perfusion pressure were present whether the limb was perfused with homologous blood or cross-perfused with blood from a donor rabbit, demonstrating that the efferent component of the response is also neurally mediated. There was a 28-s latency for initiation of the hindlimb vasoconstriction, which is consistent with recent evidence for renal autocoid stimulation of the afferent renal nerve receptors. Decreasing RPP indirectly, by altering flow, resulted in a hindlimb vasoconstriction below approximately 55 mm Hg (7.3 kPa) RPP or 15 ml/ min RBF. However, decreasing RPP by directly reducing pressure in graded steps resulted in increases in FPP, which reflected the changes in renal flow; thus during the autoregulatory phase, where flow did not change as pressure fell, FPP also remained stable. The results of these protocols suggest that a neurally mediated hindlimb vascular reflex is stimulated by decreased renal flow rather than pressure.     

CT模拟定位三维适形放射治疗食管癌的临床研究

目的探讨CT模拟定位三维适形放射治疗食管癌的疗效。方法1997年4月～2002年7月,经病理证实的食管鳞状细胞癌87例患者，其中男性56例，女性31例，年龄42～75岁，平均年龄62.5岁，随机分为2组，两组患者一般情况、性别、年龄及病变部位构成经统计学检验无统计学意义，一组为采用CT模拟定位进行三维适形放射治疗，另一组为常规模拟定位放射治疗，两组的剂量都为64～66Gy／32.33次／6.4～6.6周。结果采用Kaplan—Meier法计算生存率，并用Log—Rank检验其差异性。治疗计划各指标分析采用kolmogorowSmirnov法行正态分布检验，继而行t检验，以P〈0.05为差异有统计学意义。CT模拟定位三维适形放射治疗组和常规模拟定位放射治疗组1、2、3、4年生存率分别为70.1％、55.6％、40.4％、36.3％和65.4％、50.6％、30.6％、20.9％（p〉0.05）。但是对Ⅰ～Ⅱ期患者，CT模拟定位三维适形放射治疗组和常规模拟定位放射治疗组的生存率分别为81.2％、75.5％、67.3％、61.5％和80.1％、65.7％、54.9％、29.7％（P〈0，05），局部控制率分别为75.6％、71.7％、65.5％、59.0％和65.4％、50.6％、33.3％、25.6％（P〈0.05）。而对于Ⅲ～Ⅳ期的患者，两组之间的生存率和局部控制率差异无统计学意义。结论CT模拟定位三维适形放射治疗的疗效明显好于常规模拟定位放射治疗组。特别对Ⅰ-Ⅱ期早期食管癌患者两组之间差异有统计学意义，而对晚期患者差异无统计学意义。     

消化道肿瘤自身抗体检测

目的探讨消化道肿瘤患者针对肿瘤细胞的自身抗体的存在。方法收集肠癌患者及胃癌患者术前血清96份和健康体检人群血清62份，分组后采用Western印迹分析法定性检测消化道肿瘤患者术前血清中的自身抗体。结果正常健康人群和正常肝细胞株96％（212／220）的反应条无显色带，而97％（60／62）的肠癌患者肠癌细胞株、89％（39／44）的胃癌患者胃癌细胞株反应条均出现多个阳性带。结论健康人群体内很少产生针对肿瘤细胞的自身抗体，而大部分消化道肿瘤患者体内产生针对肿瘤相关抗原的自身抗体，这为消化道肿瘤的病因，早期诊断，预后监测及分子靶向治疗等研究提供了一个很好的线索。     

Stat5b/Survivin信号转导通路调控结肠癌细胞凋亡的机制

目的: 探讨Stat5b/Survivin信号转导通路调控结肠癌细胞凋亡的作用机制。方法: 用阳离子脂质体介导Stat5反义寡核苷酸转染人结肠癌HT29细胞，MTT法检测细胞增殖状态；流式细胞术检测细胞周期与凋亡；EMSA检测Stat5活性；Western blotting检测Stat5、p-Stat5、cyclin D1、Survivin与Bcl-2凋亡家族成员Bcl-2和Bcl-x_L的表达。结果: 转染Stat5反义寡核苷酸后HT29细胞增殖受抑制，凋亡细胞增多，Stat5、p-Stat5与Survivin表达下降，Bcl-2与Bcl-x_L变化不明显。结论: 阻断Stat5通路可以抑制靶基因Survivin表达并诱导结肠癌细胞凋亡。     

Diagnostic difficulties in the interpretation of needle aspiration material from large renal cysts

In recent years, fine-needle-aspiration biopsies (FNA) have been widely used in the evaluation of renal masses, with false-positive FNA data being very uncommon. We present a case report of a 76-yr-old man with a 16-cm renal cyst and what was interpreted as an isolated calcified mural nodule. Following drainage of the main cyst fluid, FNA biopsy showed atypical cell clusters thought to be positive for malignancy. Subsequent surgery failed to disclose either a residual mural nodule or evidence of malignancy. Immunoperoxidase studies performed on both the cell block and actual cyst wall suggested that the abnormal cells were histiocytes. The diagnostic pitfalls of this case, along with a review of pertinent literature, are discussed. Diagn Cytopathol 1994; 11:380–384. © 1994 Wiley-Liss, Inc.     

Histochemical demonstration of endogenous estrogen in breast carcinomas: Biochemical and clinical correlation

Summary In a study of 277 patients with breast carcinomas, the PAP immunoperoxidase method for demonstrating endogenous estrogen was correlated with the sucrose density gradient (SDG) assay and with histologic and clinical features. The results from the PAP method and SDG assay agreed in 59 of 84 patients (82.1%) on whom both methods were performed. Histologically, the PAP method was positive in 7 of 7 patients with non-invasive carcinomas, in 164 of 233 patients (70.4%) with common invasive ductal carcinoma, and in 21 of 22 of those with special histological types of invasive carcinomas not including Paget's disease, medullary or apocrine carcinoma, where only 5 of 14 were positive. Clinically, 15 of 18 patients with positive endogenous estrogen showed a response to endocrine therapy as opposed to 1 of 9 patients with a negative endogenous estrogen. The mean survival was 31.2 and 15.6 months, respectively for patients with positive and negative endogenous estrogen. Remission for longer than 2 years was seen more often in patients with positive endogenous estrogen. These results suggest a clinical utility of the present PAP method which, therefore, deserves a further trial as an alternative to histochemical methods aiming at the estrogen receptors.This work was supported by Grants-in Aid for Scientific Research from the Ministry of Education, Science, and Culture of Japan (No. 56480119).This paper was presented at the 72nd Annual Meeding of International Academy of Pathology (United States-Canadian Division), Atlanta, Georgia, March 1, 1983.     

头颈部鳞癌中抑癌基因PTEN的研究进展

The FTEN, having a dual specificity phosphatase activity, is the first tumor suppressor gene that possess phosphatase activity hitherto. Many researches have suggested that FTEN play a major role in the tumorgenesis. In clinical, the head and neck squamous cell carcinoma(HNSCC) is one of the most common ma-lignant tumors. In this review, advances in the research of FTEN and the relationship between the PTEN and HNSCC are discussed.     

特殊染色和免疫组织化学染色在肾上皮性肿瘤诊断中的应用

目的 探讨肾上皮性肿瘤的诊断及鉴别诊断。方法 对91例具有较完整病理资料的肾上皮性肿瘤进行了常规组织学观察,Mowy胶状铁染色及CD10、细胞角蛋白(CK)7、波形蛋白免疫组织化学染色。结果 91例肾上皮性肿瘤中肾透明细胞癌78例,占86％;肾乳头状癌8例,占9％;肾嫌色细胞癌4例,占4％;肾嗜酸细胞腺瘤1例,占1％。78例肾透明细胞癌中CD10、波形蛋白阳性分别为63例(81％)和69例(88％),主要表现为细胞膜阳性。74／78肾透明细胞癌CK7呈阴性,17／17 Mowy胶状铁染色阴性或呈灶状粗颗粒。肾嫌色细胞癌4例,CK7均呈胞膜阳性;Mowy胶状铁染色表现为胞质内蓝色细网状;4例CD10肿瘤细胞膜均阴性,波形蛋白阴性。肾嗜酸细胞腺癌1例CD10,CK7,波形蛋白,Mowy胶状铁染色均为阴性或不特异。结论 在常规诊断肾上皮性肿瘤有困难时免疫组织化学CD10,CK7,波形蛋白染色以及Mowy胶状铁染色对鉴别诊断有帮助。     

The mechanisms of fast renal compensation

Summary The changes in blood concentration which result in the adjustment of excretion when renal functioning mass is acutely reduced have been investigated by means of paired experiments on isolated dog kidneys. One kidney was perfused with undiluted blood; the other kidney was perfused with blood supplemented with an amount of water and solutes corresponding to the amount retained after the suppression of the contralateral kidney in situ; the response was evaluated from the difference in excretion between the two organs. The results may be summarized as follows: a) the adjustment of the excretion of water, sodium, potassium and urea results from small changes in blood concentration (haematocrit, plasma proteins and solutes), in the absence of specific stimuli of extrarenal origin; b) increased urea concentration is not the major determinant of the readjustment of sodium and water excretion; c) the response is potentiated by high arterial blood pressure; d) if the load of water exceeds the load of sodium, this ion is retained by the kidney even in the presence of an osmotic load of urea; e) the changes in the blood concentrations do not provide an adequate adjustment of the excretion of phosphate; f) increased excretion per nephron results from decreased fractional reabsorption without significant change in glomerular filtration rate.     

Serum creatinine concentration and renal interstitial volume

Summary Renal biopsies of 44 patients with endocapillary acute glomerulonephritis (gn) and 64 patients with moderately severe mesangioproliferative gn were investigated morphometrically (point-counting-method, tubulometry).In both gn's statistically significant positive correlations between relative interstitial volume and the concentration of serum creatinine at the time of biopsy were found.Despite severe glomerular lesions the serum creatinine concentration is not increased in most cases of endocapillary acute gn, providing the relative interstitial volume is not increased by more than 15%.Increased serum creatinine concentration without a markedly enlarged interstitium was found in 11 cases of endocapillary acute gn with clinically and morphologically proven acute renal failure. In these cases the glomerular function is probably impaired by the Thurau-mechanism.In all other patients, especially in those with moderately severe mesangioproliferative gn, the serum creatinine concentration rises with an enlargement of relative interstitial volume. This reduction of renal function may be explained by a decrease to the total cross-sectional area of postglomerular vessels, caused by interstitial fibrosis. That may possibly lead to diminished renal blood flow and glomerular filtration with an increase of the serum creatinine concentration.Supported by the Deutsche Forschungsgemeinschaft