A risk-based approach to identifying oligometastatic disease on imaging

Recognition of <3 metastases in <2 organs, particularly in cancers with a known predisposition to oligometastatic disease (OMD) (colorectal, prostate, renal, sarcoma and lung), offers the opportunity to focally treat the lesions identified and confers a survival advantage. The reliability with which OMD is identified depends on the sensitivity of the imaging technique used for detection and may be predicted from phenotypic and genetic factors of the primary tumour, which determine metastatic risk. Whole-body or organ-specific imaging to identify oligometastases requires optimization to achieve maximal sensitivity. Metastatic lesions at multiple locations may require a variety of imaging modalities for best visualisation because the optimal image contrast is determined by tumour biology. Newer imaging techniques used for this purpose require validation. Additionally, rationalisation of imaging strategies is needed, particularly with regard to timing of imaging and follow-up studies. This article reviews the current evidence for the use of imaging for recognising OMD and proposes a risk-based roadmap for identifying patients with true OMD, or at risk of metastatic disease likely to be OM.     

系膜细胞α-平滑肌肌动蛋白表达与细胞表型的关系

目的：探讨增殖性肾小球肾炎大鼠动物模型中系膜细胞α－平滑肌肌动蛋白（α－SMA）表达与细胞表型的关系。方法：应用单克隆抗体1－22－3（MoAb1-22-3)及Habu蛇毒素分别诱导大鼠增殖性肾小球肾炎动物模型。用免疫组化技术并结合计算机图像分析，检测两个不同诱因引起模型的各个阶段的系膜细胞内α－平滑肌肌动蛋白，SMeb的表达程度，系膜细胞增殖和细胞外基质（ECM）分泌的情况。结果：在MoAb1-22-3模型，随着系膜细胞增殖程度的加理，ECM积聚增多，α－SMA的表达程度也增加，三者平行变化并具有高度相关性，而Habu模型则系膜细胞增殖和ECM增加的同时α－SMA，SMemb表达不增加。结论：α－SMA不是系膜细胞被激活并处于增殖／分泌表型唯一标志。     

转化人关节软骨细胞的Ⅱ型胶原表型诱导

目的 用离心管聚集体培养（Aggregate culture)诱导转化人关节细胞的Ⅱ型胶原。方法 将体外长期培养的第30，40，50代转化软骨细胞消化后进行离心管培养，比较细胞在单层培养，离心管聚集体培养，以及在普通培养基，RAI诱导培养基下[2型骨形态发生蛋白（BMP－2）＋抗坏血酸盐（Ascorbate) 胰岛素（insulin)]，Ⅰ，Ⅱ，Ⅲ型胶原的表达和胞外基质发生情况。结果 在单层培养条件下，转化软骨细胞只表达Ⅰ型胶原，而在BAI诱导培养基及离心管聚集体培养下转化软有细胞表达的Ⅱ型胶原和大量胞外基质。结论 离心管聚集体培养是诱导转化软骨细胞Ⅱ型胶原的有效方式。     

大粒车前子中苯乙醇苷类化合物对树突状细胞的调控研究

目的:探讨大粒车前子中苯乙醇苷类化合物对小鼠骨髓来源树突状细胞(DCs)功能调节的影响,为进一步阐明大粒车前子的免疫调节活性提供依据.方法:采用细胞因子诱导法,从Balb/cj小鼠骨髓细胞贴壁分离获得单核细胞,加入含10%胎牛血清、10μg·L~(-1)重组小鼠粒细胞巨噬细胞集落刺激因子(rmGM-CSF)及重组小鼠白细胞介素_4(rmIL-4)的RPMI1640完全培养基培养,在培养第6天,实验组加入车前子苯乙醇苷类化合物(10,50,100 mg·L(-1)),对照组加入RPMI 1640或LPS(1mg·L~(-1)),流式细胞仪检测DCs表面分子CD11c,CD86,MHC Ⅱ和CD80的表达以及各组DCs吞噬功能的变化.结果:车前子毛蕊花苷和异毛蕊花苷能够提高DCs表面分子CD11c,CD86,MHC Ⅱ和CD80的表达;空白组DCs的吞噬功能很强(45.39%),车前子毛蕊花苷和异毛蕊花苷组DCs吞噬功能都明显下降(分别为37.27%,30.40%,33.45%和40.15%,37.59%,31.07%).结论:车前子苯乙醇苷类化合物能促进小鼠骨髓来源的DCs表型及功能的成熟.     

慢性乙型病毒性肝炎患者外周血T淋巴细胞亚群CD27和CD28的表达

目的分析慢性乙型病毒性肝炎患者外周血T淋巴细胞亚群CD27和CD28的表达,初步探讨其分化表型。方法采集分离健康人和慢性乙型病毒性肝炎患者外周血单个核细胞(PBMC),利用多种荧光标记抗体标记细胞表面分子,再用流式细胞仪检测CD8 和CD4 T淋巴细胞表面CD27和CD28分子的表达。结果31例慢性乙型病毒性肝炎患者CD8 CD27 CD28 T细胞占CD8 T细胞(41.13±24.89)%,低于28例健康对照组的(71.93±14.47)%(P<0.05)。而CD8 CD27-CD28-T细胞占CD8 T细胞(42.16±10.98)%,显著高于健康对照组的(9.16±5.24)%(P<0.01)。慢性乙型病毒性肝炎患者CD4 CD27 CD28 T细胞(80.89±7.93)%和健康对照组(83.17±8.31)%比较,差异无统计学意义。结论健康人外周血T淋巴细胞以CD27 CD28 早期分化表型为主。而慢性乙型病毒性肝炎患者外周血中不同的亚群分化特征又有所不同,CD4 T淋巴细胞的分化表型仍然以CD27 CD28 早期分化表型为主,而CD8 T淋巴细胞中早期分化表型明显减少,晚期分化表型(CD27-CD28-)显著增加。     

脐血LAK细胞生物学特性影响因素的研究

采集２３名产妇的脐带血和８名正常成人的外周血制备ＬＡＫ细胞，随机分为４组，在培养第３，５，７，１４天，分别利用ＭＴＴ法和＾１２５Ｉ－ＵｄＲ释放法对４组ＬＡＫ细胞的增殖力和杀伤活性进行了测定，同时用细胞毒方法测定培养７天的ＬＡＫ细胞的免疫表型。结果发现，在不同培养时间，脐血来源的ＬＡＫ细胞增殖力显著高于成人血ＬＡＫ细胞（Ｐ〈０．０５或Ｐ〈０．０１），成人血清组，脐血血清组，红细胞组ＬＡＫ细胞增殖力有     

The clinical phenotypes of juvenile bipolar disorder: toward a validation of the episodic-chronic-distinction.

BACKGROUND: Recent research has addressed the issue of subtyping juvenile bipolar disorder (JBD). Accordingly, we set out to find out, in a naturalistic sample of bipolar children and adolescents with mania and mixed mania, whether the most useful subtyping should be based on clinical features (elated vs. irritable) or course (episodic vs. chronic). METHODS: We studied 136 patients, 81 male patients (59.6%) and 55 female patients (40.4%), mean age 13.5 +/- 2.9 years, meeting the DSM-IV diagnosis of bipolar disorder, assessed by a structured clinical interview (Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version [K-SADS-PL]). RESULTS: Regarding course, 77 patients (56.6%) had an episodic course and 59 patients (43.4%) had a chronic course. Patients with chronic course were significantly younger, had an earlier onset of JBD, and presented a more frequent comorbidity with disruptive behavior disorders. According to the prevalent mood disturbance, 75 patients (55.1%) showed an elated and 61 patients (44.9%) showed an irritable mood. Elated mood was more frequent in patients with episodic course, whereas irritable mood was more frequent in the patients with chronic course. CONCLUSIONS: These findings suggest that chronic versus episodic course may be a putative differential feature. Further validation of such a distinction would require prospective studies, temperament evaluation, gender and neurobiologic approaches, and differential psychopharmacologic assignment and response.     

胰岛素对大鼠血管平滑肌细胞表型转化的影响

目的:探讨胰岛素对体外培养的血管平滑肌细胞(vascular smooth muscle cell,VSMC)表型转化的影响.方法:用酶消化法分离大鼠VSMC,采用免疫组织化学法检测胰岛素作用后VSMC肌动蛋白(α-SM actin),RT-PCR 检测胰岛素作用后VSMC中bFGF、TGF-β、PDGF、matrix Gla和OPN各目的基因mRNA相对表达水平.结果:胰岛素组VSMC的3H-TdR掺入值比对照组升高47％(P<0.01), VSMC α- SM actin免疫组化结果显示对照组的α-SM actin比胰岛素组染色深.而matrix Gla和OPN在培养的VSMC中mRNA的表达量,胰岛素组明显高于对照组(P<0.05),同时bFGF、TGF-β、PDGF的表达胰岛素组也明显高于对照组(P<0.05).并可明显见到细胞骨架F-actin、G-actin重新分布.结论:在合成表型的matrix Gla和OPN表达量明显高于收缩表型,而合成表型的α- SM actin表达量明显低于收缩表型.提示胰岛素对VSMC的表型转化起了一定作用.胰岛素在促进了VSMC增殖的同时,伴有VSMC由收缩型转变为合成型及细胞骨架F-actin、G-actin重新分布.