Overexpression/amplification of HER-2/neu is uncommon in hepatocellular carcinoma

BACKGROUND： Hepatocellular carcinoma （HCC） is one of the most prevalent fatal cancers in the world. Despite advances in early diagnosis and improvements in surgical techniques, the survival of patients with HCC even after resection is poor because of the high incidence of recurrences. Therefore, the identification of prognostic factors may be helpful in the development of new treatment protocols. AIMS： To investigate HER-2/neu status in HCC by immunohistochemistry （IHC） and fluorescence in situ hybridisation （FISH）, and to explore the possibility of using trastuzumab in the treatment of HCC. METH ODS： Eight hundred and sixty eight surgical samples from patients with primary HCC were examined for their HER-2/neu status. IHC for HER-2/neu was performed with the HercepTest kit; FISH analysis was performed with the PathVysion HER-2 DNA probe kit. The correlations between HER-2/neu overexpression and clinicopathological characteristics were analysed statistically. RESULTS： HER-2/neu overexpression was detected in 21 （2.42%） of the 868 primary HCCs. Only one specimen showed HER-2/neu gene amplification by FISH. No significant associations were found between HER-2/neu overexpression and the clinicopathological parameters. CONCLUSIONS： There is a low frequency of HER-2/neu overexpression/amplification in HCC. There appears to be no role for HER-2/neu as a prognostic marker and no benefit of anti-HER-2/neu trastuzumab treatment in patients with HCC.     

Amplification of the C-erbB-2(HER-2/neu) proto-oncogene in ovarian carcinomas.

C-erbB-2(HER-2 / neu) proto-oncogene is mainly expressed in epithelial tissue and activated due to its amplification. Amplification of the C-erbB-2 proto-oncogene has been associated with poor prognosis in human ovarian cancer. Our study was to examine whether amplification is more frequently observed in ovarian cancer, or it is associated with poor prognosis of human ovarian cancer in China. The DNA of ovarian cancers was extracted and consequently digested with restriction endonuclease EcoRI, electrophoresed in 0.8% agarose gels and blotted onto nitrocellulose filter with Southern transfering method. It was then hybridized with a 32P-labelled C-erbB-2 probe and subsequently underwent autoradiography. The result has shown that the C-erbB-2(HER-2 / neu) gene was amplified in 8 of 26 human ovarian cancers (30.8%). The clinical data showed that all of the 8 cases with the amplified C-erbB-2 were in their advanced stage (III-IV). Five of the patients died from 2 to 4 months after operation. These data sugge     

Overexpression/amplification of HER-2/neu is uncommon in hepatocellular carcinoma

Background： Hepatocellular carcinoma （HCC） is one of the most prevalent fatal cancers in the world. Despite advances in early diagnosis and improvements in surgical techniques, the survival of patients with HCC even after resection is poor because of the high incidence of recurrences. Therefore, the identification of prognostic factors may be helpful in the development of new treatment protocols. Aims： To investigate HER-2/neu status in HCC by immunohistochemistry （IHC） and fluorescence in situ hybridisation （FISH）, and to explore the possibility of using trastuzumab in the treatment of HCC. Methods.. Eight hundred and sixty eight surgical samples from patients with primary HCC were examined for their HER-2/neu status. IHC for HER-2/neu was performed with the HercepTest kit; FISH analysis was performed with the PathVysion HER-2 DNA probe kit. The correlations between HER-2/neu overexpression and clinicopathological characteristics were analysed statistically. Results： HER-2/neu overexpression was detected in 21 （2.42%） of the 868 primary HCCs. Only one specimen showed HER-2/neu gene amplification by FISH. No significant associations were found between HER-2/neu overexpression and the clinicopathological parameters. Conclusions： There is a low frequency of HER-2/neu overexpression/amplification in HCC. There appears to be no role for HER-2/neu as a prognostic marker and no benefit of anti-HER-2/neu trastuzumab treatment in patients with HCC.     

CD44v6在卵巢上皮性癌中的表达及意义

目的 探讨CD44v6在卵巢癌中的表达情况及其与卵巢癌临床病理特征之间的关系,进一步阐明CD44v6在卵巢癌侵袭和转移过程中的作用.方法 通过免疫组化SP法检测在CD44v6正常卵巢组织、卵巢良性、交界性、恶性肿瘤组织中的表达.结果 CD44v6在卵巢癌中的表达与肿瘤的分化程度、肿瘤的临床分期及有无淋巴结转移有关,差异有统计学意义,而与上皮性肿瘤中的不同组织学类型无关.结论 CD44v6在正常卵巢组织中不表达,在卵巢上皮性癌中呈高表达,并与临床分期、分级、淋巴结转移有关,提示CD44v6的表达可能与卵巢上皮性癌的发生、发展有关. Abstract： Objective To discuss the expressions of cell - surface adhesive molecules CD44v6 was investigated between the expressions and clinical patho - characteristic were also analyzed. To elucidate the effects of CD44v6 on invasion and metastasis of ovarian cancer, the correlation of CD44v6 was also analyzed. Methods The expression of CD44v6 in normal, benign, borderline and malignant cancer were detected by immunohistochemistry. Results There was significant difference between CD44v6 and degree of differentiation or clinical stage(P ＜ 0.05). Conclusions CD44v6 doesn't express in normal ovarian tissues, express highly in epithelial ovarian cancer and have relationship with clinical stage, clinical stage and lymph node metastasis. It suggests that the expressions of CD44v6 may have relationship with occurrence and development of epithelial ovarian cancer.     

卵巢上皮性癌患者血清中HER-2/neu自身抗体的表达及诊断价值

目的测定卵巢上皮性癌患者血清中HER-2/neu自身抗体的表达水平,探讨其作为卵巢上皮性癌血清学标志物的诊断价值。方法采用ELISA法检测2007年至2009年40例卵巢上皮性癌患者、20例良性上皮性卵巢肿瘤患者和20例正常对照女性的血清HER-2/neu自身抗体水平;采用统计学方法分析血清HER-2/neu自身抗体的诊断价值。结果卵巢上皮性癌患者血清HER-2/neu自身抗体水平显著高于良性上皮性卵巢肿瘤患者和正常女性(P<0.05)。ROC曲线分析显示HER-2/neu自身抗体用于卵巢上皮性癌诊断的灵敏度和特异性分别为47.5%和97.5%;联合CA125检测可提高诊断特异性至90%且不降低灵敏度。偏相关系数表明血清CA125与HER-2/neu自身抗体水平无相关性。结论血清HER-2/neu自身抗体水平与卵巢上皮性癌相关,有望成为卵巢上皮性癌诊断的一种新血清学标志物。     

MUC4和HER2/neu在卵巢上皮性癌中的表达及临床意义

目的:探讨MUC4和HER2/neu在卵巢上皮性癌中的表达及临床意义.方法:采用免疫组化法检测62例卵巢上皮性癌(卵巢癌组)、18例卵巢交界性肿瘤(交界组)、15例卵巢良性肿瘤(良性组)和11例正常卵巢(正常组)组织中MUC4和HER2/neu的表达.结果:卵巢癌组 MUC4和HER2/neu阳性表达率显著高于正常组、良性组、交界组(P<0.05),MUC4和HER2/neu阳性表达率在卵巢上皮性癌低分化组高于高-中分化组(P<0.05);HER2/neu阳性表达率在卵巢上皮性癌有淋巴结转移组高于无淋巴结转移组(P<0.05).卵巢上皮性癌中MUC4和HER2/neu的表达呈正相关(r=0.348,P<0.05).结论:MUC4和HER2/neu可能参与了卵巢上皮性癌的发生发展,二者在卵巢上皮性癌的发生发展中可能起协同作用.     

FAS和HER-2/neu蛋白在卵巢上皮性癌组织中的表达及其相关性研究

目的 研究脂肪酸合成酶（FAS）和人表皮生长因子受体2（HER-2/neu）在卵巢肿瘤组织中的表达及其相关性.方法 应用免疫组化SP法检测52例卵巢癌、10例交界性卵巢肿瘤、10例良性上皮性卵巢肿瘤组织中FAS和HER-2蛋白的表达情况.结果 （1）卵巢癌及交界性卵巢肿瘤组织中的FAS阳性表达率明显高于良性上皮性卵巢肿瘤组织（P =0.000）;卵巢癌组织中的HER-2阳性表达率明显高于卵巢良性上皮性肿瘤及卵巢交界性肿瘤组织（P=0.045）.（2）FAS蛋白表达与组织学类型有关（P =0.009）.（3）FAS、HER-2/neu蛋白阳性者的平均生存时间短于阴性者（P=0.024、0.005）.（4）FAS与HER-2/neu在卵巢癌中的表达正相关（r= 12.46,P=0.000）.结论 FAS、HER-2/neu蛋白的过表达可能在卵巢癌的发生和发展中起一定作用,可明显缩短患者术后生存时间,是卵巢上皮性癌患者的不良预后因素,两者在卵巢癌的发生、发展中可能有某种相互促进的作用.     

OVEREXPRESSION OF p53, EGFR,C-ERBB2 AND C-ERBB3 IN ENDOMETRIOID CARCINOMA OF THE OVARY

Objectives. To determine overexpression of p53, EGFR, e-erbD-2 and e-erbB-3 in endometrioid carcinoma of the ovary and to evaluate the prognostic signiFtcance of these resdts, especially, eoexlsting overexpression of p53 and one of the member of type I growth factor receptor family. Methods. Overexpressions of the p53, EGFR, e-erbB-2 and e-erbB-3 protein were studied by immunohlstochemistry in paraffin-embedded tumor tissue from 28 patients with endometrioid carcinoma of the ovary. Results. 11 (39.3%), 13 (46.4%), and 14 (50. 0%) were stained positively with p53, e-erbB-2 and c-erbB-3 monoclonal ant/bodies. 13 (46. 4%) was stained positively with EGFR polyclonal antibody.There were no relationship between p53, EGFR, C-erbB-2, c-erbB-3 and histologic grade, lymph node metastasis. The percentage of tumors with over expression of p53, EGFR, C-erbB-2 and c-erbB-3 was higher in those with stage Ⅰ～Ⅱ tumors compared with those with stage Ⅰ, in patients with residual tumor after initial surgery compared with those without. A high survival rate was observed in patients without p53, EGFR, c-erbB-2 and c-erbB-3 overexpression respectively than those with. A highest survival rate was observed in patients with both p53 and one of EGFR, c-erbB-2 and c-erbB-3 negative compared with those both positive or either of both positive. Concltrsion. Overexpression of p53, EGFR, c-erbB-2 and C-erbB-3 resulted in a poorer prognosis respectively. Overexpression of both p53 and one of the EGFR, c-erbB-2 and e-erbB-3 is a worse prognostic indicator in patients with endometrioid carcinoma of the ovary.     

Effect of retroperitoneal lymphadenectomy on prognosis of patients with epithelial ovarian cancer

Objective To evaluate prognostic factors which have an influence on overall survival and to assess the rational application of retroperitoneal lymphadenectomy in patients with epithelial ovarian cancer. Methods The data of 131 patients treated between January 1990 and December 1998 in Union Hospital and Tongji Hospital were analyzed retrospectively. Survival was calculated using the Kaplan-Meier method and comparisons were performed using Log-rank test. Independent prognostic factors were identified by the Cox proportional hazards regression model. Results Univariate analysis showed that age, general conditions, menopausal status, stage, pathological types, location of the tumor, residual tumor and retroperitoneal lymphadenectomy were prognostic factors. Multivariate analysis showed that age, stage, residual tumor, retroperitoneal lymphadenectomy and the number of courses of chemotherapy were the most important prognostic factors. The survival rate could not be improved through retroperitoneal lymphadenectomy in the patients in early stage, advanced stage with residual tumor &gt;2 cm or those with mucinous adenocarcinoma （P&gt;0.05). Among patients in advanced stage cancer with a residual tumor ≤2 cm, 5-year survival was 65% and 30% for patients who did and did not undergo lymphadenectomy, respectively （P&lt;0.01). Among patients with serous adenocarcinoma, 5-year survival was 61% and 31% for patients who did and did not undergo lymphadenectomy, respectively （P&lt;0.01). Conclusions The prognosis of the patients with epithelial ovarian cancer may be influenced by age, stage, residual tumor, retroperitoneal lymphadenectomy and the number of courses of chemotherapy. Although retroperitoneal lymphadenectomy could improve the survival rate, it should be carried out selectively.     

多西他赛与奥沙利铂联合治疗复发性上皮性卵巢癌疗效评价

目的 观察和评估多西他赛联合奥沙利铂方案治疗复发性上皮性卵巢癌的临床疗效及安全性.方法 对病理证实为复发性上皮性卵巢癌患者36例进行化疗.给药方案为:多西他赛75mg/m~2,静脉滴注1 h,第1天:奥沙利铂100mg/m~2,静脉滴注2h,第1天.每21 d重复,至少治疗2个周期.结果 接受治疗的36例患者均可评价疗效,完全缓解率为8.3%,部分缓解率为47.2%,总有效率55.6%.主要毒副反应为骨髓抑制和周围神经炎.结论 多西他赛联合奥沙利铂化疗方案治疗复发性上皮性卵巢癌有较好的疗效,毒副反应轻,耐受性好,值得进一步临床研究推广.

Abstract：

Objective To evaluate the efficacy and safety of docetaxel (Taxotere) (DTX) and oxaliplatin (OXA) for treatment of recurrent epithelial ovarian cancer. Methods Thirty-six patients with histologically confirmed recurrent epithelial ovarian cancer received chemotherapy with DTX and OXA. DTX at the dose of 75 mg/m2 was administered on day 1 by intravenous infusion in 60 min, followed by OXA at 100 mg/m~2 given by a 2 h infusion. The chemotherapy cycles were repeated every 21 days, and the patients received at least 2 cycles. Results All the patients were available for response evaluation, among whom 3 (8.3%) showed complete responses and 17 (47.2%) showed partial responses, with an overall response rate of 55.6%. The main adverse effects included hematological toxicities and peripheral neuropathy. Conclusion Combination of DTX and OXA produces good therapeutic effect with tolerable toxicity profile for treatment of recurrent epithelial ovarian cancer.     

促红素对Ⅲ期食管癌的放疗增敏作用

目的 评价促红素对Ⅲ期食管癌的放疗增敏作用及不良反应.方法 将62例欲接受根治性放疗的Ⅲ期食管癌患者随机分为试验组和对照组.试验组:在放疗前1周给予促红素3万U,皮下注射,每周1次,至放疗结束.放疗用6 MV X射线进行三维适行照射,DT 1.8～2.0 Gy/次,每周5次,中位剂量为DT 64 Gy.对照组行单纯三维适行照射,其设野和剂量同试验组,中位剂量为DT 65 Gy.结果 放疗DT 20 Gy时,试验组完全消退率(CR)为6.7%(2/30),对照组为6.7%(2/30),二者比较差异无统计学意义(χ2=0.2679,P=0.6048);放疗DT 40 Gy时,试验组CR为33.3%(10/30),对照组为16.7%(5/30),二者比较差异无统计学意义(χ2=2.2222,P=0.1360);放疗结束时,试验组CR为50.0%(15/30),对照组为26.7%(8/30),二者比较差异无统计学意义(χ2=3.4548,P=0.0631);放疗后1个月,试验组CR为63.3%(19/30),对照组为36.7%(11/30),二者比较差异有统计学意义(χ2=4.2667,P=0.0389);放疗后6个月,试验组CR为66.7%(20/30),对照组为40.0%(12/30),二者比较差异有统计学意义(χ2=4.2857,P=0.0384).两组在血液学毒性方面比较差异有统计学意义(χ2＝8.1481,P=0.0043).结论 促红素能明显提高Ⅲ期食管癌的放疗疗效,减轻放疗所致的血液学毒性,并可预见能延长患者的远期生存,值得临床上进一步试用推广. Abstract： Objective To study the radiosensitization effect of recombined human erythropoietin (RHEpo) on esophageal neoplasms with stage Ⅲ. Methods From March 2004 to May 2008, 62 patients diagnosed esophageal neoplasms with stage Ⅲ were randomly divided into the treatment group or the control group. In the treatment group, RHEpo was administered at 30 000 U weekly during the course of three dimensional conformal radiotherapy and one week before radiation. The control group was only given three dimensional conformal radiotherapy. Radiation was administered with 6MV X-rays, 1.8-2.0 Gy per day and 5 times per week. Total dose was 60-70 Gy over 6-7 weeks, and the median doses were 64 Gy and 65 Gy, respectively.Results At the end of DT 20 Gy, complete remission rate (CRR) in both groups were 6.7% (2/31) (χ2=0.2679,P=0.6048), while DT 40 Gy was over, the CRR was 33.3% (10/30) and 16.7%(5/30) (χ2=2.2222,P =0.1360) respectively, when the whole radiotherapy was finished, the CRR was 50.0% (15/30) and 26.7% (8/30) (χ2=3.4548,P=0.0631) respectively, and one month and six months after radiotherapy, the CRR were 63.3% (19/30) and 66.7% (20/30) in the trial group, and 36.7% (11/30) and 40.0% (12/30) in the control group respectively (χ2=4.2667,P=0.0389; χ2=4.2857,P=0.0384). The rates of acute hematological toxicity were different in two groups (χ2＝8.1481,P=0.0043). Conclusions RHEpo can improve the clinical effect of patients diagnosed esophageal neoplasms with stage III who received radiotherapy, and decrease acute hematological toxicity caused by radiotherapy, and may elongate life time of these patients.     

子宫内膜浆液性乳头状癌23例临床与病理分析

目的 通过对子宫内膜浆液性乳头状癌(UPSC)的临床及病理特征的分析,探讨其合理的治疗方法.方法 自2002年6月至2008年12月我院收治子宫内膜浆液性乳头状癌患者23例,对其临床病理、诊断方法、治疗方法及预后进行回顾性分析.结果 全部患者病例采用手术治疗,术后辅助放疗和(或)化疗者17例.Ⅲ、Ⅳ期患者占56.5%,52.2%的患者肌层浸润深度超过1/2肌层(12/23),52.2%有子宫外扩散(12/23),腹膜后淋巴结转移率为54.5%(6/11),86.6%患者雌孕激素受体阴性.预后差,随访期内12例死亡.结论 UPSC少见,临床诊断困难,依靠病理学检查可以确诊.子宫内膜浆液性乳头状癌有其独特的临床病理特征,与普通的子宫内膜癌明显不同,肿瘤高度恶性,预后差,合理的个体化综合治疗可延长生存期. Abstract： Objective To study the rational therapy for uterine papillary serous carcinoma (UPSC) and analyze its clinical and pathologic features. Methods A retrospective study was conducted on incidence, clinical characteristics,pathological feature,diagnosis and treatment,prognosis of 23 patients with UPSC,who was admitted in our hospital from January 2000 to June 2006.Results All the patients underwent operation, and 17 cases received postoperative radiotherapy and(or) chemotherapy. Among all the patients with UPSC,56.5% was stage Ⅲ and Ⅳ;52.2% with deep myometrial invasion;Estrogen or progestin receptors were negative in 86.6% cases.12 cases died during the follow ing up period, indicating poor prognosis.Conclusions UPSC is an uncommon tumor. It is difficult to make the diagnosis for clinicians.UPSC can be surely diagnosed with clinical pathology.The clinical and pathologic features of UPSC are different from the common endometrial carcinoma. Rational individu alized treatment can prolong survival time.     

儿童腺样体扁桃体切除前后血清炎性介质的动态变化

目的 观察阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患儿行腺样体扁桃体切除手术前、后血清中炎性因子的变化,并评估手术的影响.方法 将45例行扁桃体腺样体切除术的OSAHS患儿作为治疗组,另选45例性别和年龄等与治疗组相匹配的健康儿童为对照组.用超敏ELISA法检测血清α-肿瘤坏死因子(TNF-α)和白介素-6(IL-6),用胶乳增强免疫比浊法检测血清中超敏C-反应蛋白(hs-CRP).治疗组手术治疗后6个月复查上述指标.结果 治疗组术前血清TNF-α、IL-6和hs-CRP水平均高于对照组(P<0.01);经手术治疗后1年,上述指标均低于术前水平(P<0.01);TNF-α、IL-6和hs-CRP水平与AHI呈正相关,与LSaO2呈负相关.结论 手术治疗可有效逆转OSAHS患儿血中TNF-α、IL-6和Hs-CRP的水平,可以将其作为手术治疗效果的评价指标. Abstract： Objective To observe the changes of circulating tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) levels in children with obstructive sleep apnea-hypopnea syndrome (OSAHS) before and after operation,and to assess the effect of surgical treatment on the levels of these inflammatory factors. Methods Forty-five children with OSAHS underwent adenoidectomy and tonsillectomy were selected as OSAHS group and matched for age and sex to 45 health children control group. Serum levels of TNF-α and IL-6 were detected by high sensitivity ELISA. The hs-CRP was measured by latex-enhanced turbidometry. The serum levels of these factors in OSAHS group before operation were compared with those of the control group and OSAHS group 6 months after operation. Results Serum levels of TNF-α, IL-6, and hs-CRP in OSAHS group were higher than those in the control group (P<0.01), and the levels in OSAHS group 6 months after operation were significantly lower than those before operation (P<0.01). All the serum parameters were correlated positively with AHI, and negatively with LSaO2. Conclusions Operative treatment can effectively correct circulating serum levels of TNF-α,IL-6 and hs-CRP in children with OSAHS. The changes of TNF-α,IL-6 and hs-CRP levels can be a valuable measure in treatment follow-up.     

特应性皮炎小鼠中Th1/Th2类细胞因子失衡对神经生长因子表达的影响

目的 初步探讨特应性皮炎(AD)小鼠中Th1/Th2 类细胞因子失衡对脾淋巴细胞神经生长因子(NGF) mRNA 表达的影响.方法 用卵清蛋白经皮肤致敏建立小鼠AD模型, ELISA测定血清总IgE水平.分离脾淋巴细胞并培养.逆转录-聚合酶链反应(RT-PCR)半定量法测定细胞在刀豆素A(ConA)刺激下表达NGF mRNA的基础水平及γ-干扰素(IFN-γ)和白细胞介素-4(IL -4)干预后NGF mRNA表达改变.结果 ①AD小鼠脾淋巴细胞在基础状态下具有表达NGF mRNA的功能,在12、24、36、48 h时基础NGF mRNA表达量随着时间的延长逐渐升高,IL-4组(50 μg/L)随着时间的延长基础NGF mRNA表达量逐渐升高,并高于同时间空白对照组(P均<0.01). 相反, IFN-γ组(25 μg/L)的NGF mRNA水平随时间逐渐下降,并均低于同时间空白对照组(P均<0.01).②干预24 h时,随着IL-4干预浓度的增加,NGF mRNA的表达水平亦升高,并且分别与前一梯度低浓度干预组比较差异有统计学意义(P均<0.01),随着IFN-γ干预浓度的增加, NGF mRNA的表达水平却逐渐减低,分别比前一梯度低浓度干预组有显著降低(P均<0.01).结论 在特应性皮炎中Th2类细胞因子IL-4可上调淋巴细胞NGF mRNA表达,Th1类细胞因子IFN-γ可下调淋巴细胞NGF mRNA表达,两者均呈时间和浓度依赖性,Th1 / Th2类细胞因子免疫失衡可能通过调控NGF mRNA 表达间接促进其诱导神经源性炎症. Abstract： Objective To explore the effect of Th1 / Th2 cytokines on the expression of nerve growth factor (NGF) in splenic lymphocytes in atopic dermatitis mice.Methods Four AD mice were sensitized and challenged with ovalbumin to establish AD model, and serum IgE level was measured by ELISA.The mouse splenic lymphocytes were isolated and cultured with ConA. The expressions of NGF mRNA were detected by RT-PCR, and were observed after the lymphocytes were exogenously added with interferon -γ(IFN-γ) or interleukin-4 (IL-4). Results ①The lymphocytes of the AD model stimulated by ConA in vitro expressed NGF mRNA in a time-dependent manner. After the lymphocytes had been cultured with IL-4 for 12 h, 24 h, 36 h, and 48 h, 50μg/L IL-4 upregulated the expressions of NGF mRNA in a time-dependent manner and all the NGF mRNA expressions were significantly higher than the basal values at the same time (P all<0.01), however,25μg /L IFN-γ downregulated the expressions of NGF mRNA in a time-dependent manner and all the NGF mRNA expressions were significantly lower than the basal values at the same time (P all<0.01).②The lymphocytes of the AD model stimulated by ConA in vitro also expressed NGF mRNA in a dose-dependent manner.After 0,10, 25,50, and 100 μg /L IL-4 had been added for 24 h, IL-4 upregulated the expressions of NGF mRNA in a dose-dependent manner and the NGF mRNA expressions were all significantly higher than the values of the lower dose IL -4 (P all <0.01), however,after 0, 1, 10, 25,and 50μg /L IFN-γ had been added for 24 h, IFN-γ downregulated the expressions of NGFmRNA in a dose-dependent mannerand all the NGF mRNA expressions were significantly lower than the values of the lower IFN-γ dose (P all<0.01).Conclusions In the splenic lymphocytes of atopic dermatitis mice, IL -4, one of the Th2 cytokines, can upregulate the expressions of NGF, IFN-γ, one of the Th1 cytokines, can downregulate the expressions of NGF both in a time-dependent manner and in a dose-dependent manner. Th1 /Th2 cytokine immune imbalance may indirectly induce the skin neurogenic inflammation by regulating the NGF mRNA expression.     

EB病毒和巨细胞病毒感染与自身免疫性肝炎Ⅰ型的关系探讨

目的 探讨EB病毒(EBV)和巨细胞病毒(CMV)感染与Ⅰ型自身免疫性肝炎1型(AIH-I型)之间的关系.方法 采用酶联免疫吸附技术(ELISA)检测AIH-I型患者和对照组血清中EBV和CMV抗体IgG和IgM, CMV-IgM阳性者行聚合酶链反应(PCR)检测血清的CMV-DNA;EBV-IgM阳性者行肝组织活检免疫组织化学检测EBV抗原,再阳性者行原位杂交检测EBV特异基因,比较各对应组之间的差异.结果 在AIH-I型组和对照组之间,CMV-IgM、CMV-IgG、EBV-IgM和EBV-IgG比较差异均有统计学意义(P<0.05).AIH-I型组与对照组中CMV-IgM阳性者15例,其血清CMV-DNA均为阴性.AIH-I型组和对照组血清EBV-IgM阳性者21例,检测其肝组织中EBV抗原,阳性6例;对此6例原位杂交检测肝组织EBV基因(EBER),结果均为阴性.结论 自身免疫性肝炎患者CMV-IgG和EBV-IgG阳性率均比对照组高,推测AIH-I型患者既往感染该病毒;但IgM阳性率高于对照组并不能证明现症感染,提示IgM与自身免疫性肝炎患者某些自身抗原存在交叉免疫反应,并通过分子模拟机制诱发自身免疫性肝炎. Abstract： Objective The purpose of this study was to initially explore the relationship between the epstein-barr virus and cytomegalo virus infection and type I autoimmune hepatitis(type I AIH). Methods The IgG/IgM antibodies in EBV and CMV in serum between type I AIH group and the control group were detected by enzyme-labeled immunosorbent assay(ELISA). CMV-DNA was detected by polymerase chain reaction(PCR) in serum of CMV-IgM positive reaction. Immunohistochemistry was used to detect the EBV antigens in liver tissue which was obstained by liver biopsy.Situ hybridization was used to detect EBV -specific genes in liver tissue which also getted by liver biopsy.Then compared the differences in each other. Results Between the type I AIH group and the control group, there were significant difference in CMV-IgM, CMV-IgG, EBV-IgM and EBV-IgG (P<0.05). In the type Ⅰ AIH group and the control group, the serum CMV-DNA were negative in 15 cases CMV-IgM positive and 6 cases of 21 cases of serum EBV-IgM positive reaction in serum were positive by immunohistochemistry,but then negative by in situ hybridization.Conclusions CMV-IgG and EBV-IgG positive rate in type Ⅰ AIH group was higher than the control group, and it suggested that type Ⅰ AIH type patients had been infected with the virus.CMV-IgM and EBV-IgM positive rate in type Ⅰ AIH group was higher than the control group too, which could not prove present infection.These indicated that cross-immune response was existed between IgM antibodies of EBV and CMV in serum and certain self-antigen in patients with autoimmune hepatitis and suggested that autoimmune hepatitis may be induced by molecular simulation mechanism.     

绝经后2型糖尿病患者尿路感染的雌激素治疗

目的 研究雌激素治疗绝经后2型糖尿病患者尿路感染的疗效.方法 将83例绝经后2型糖尿病尿路感染患者随机分为两组,对照组(42例)根据药敏给予抗生素治疗配合胰岛素控制血糖,治疗组(41例)在对照组的基础上加用雌二醇凝胶.观察两组的临床疗效及细菌学疗效.结果 治疗组痊愈31例,有效7例,无效3例;对照组痊愈15例,有效14例,无效13例.两组临床疗效比较差异有统计学意义(P<0.05),两组治疗后细菌学疗效比较差异亦有统计学意义(P<0.05).结论 在抗生素治疗的基础上加用雌二醇,对绝经后2型糖尿病合并尿路感染患者疗效显著. Abstract： Objective To investigate the curative effect of estrogen therapy on urinary tract infection of type 2 diabetes mellitus in postmenopausal women. Methods Eithty-three postmenopausal women who had urinary tract infection of type 2 diabetes mellitus were enrolled and were randomly divided to receive antibiotic therapy(levofloxacin was used before obtaining of drug susceptibility results) alone (control group) or in combination with estradiol gel (treatment group). The clinical efficacy and bacteriological therapeutic effect in the two groups were evaluated. Results The treatment group was better than control group in both clinical efficacy and bacteriaological therapeutic effect. Conclusions Antibiotic therapy in combination with estradiol gel showed remarkable efficacy for patients with type 2 diabetes mellitus associated with urinary tract infection in postmenopusal women.     

脂蛋白相关磷脂酶A2与冠状动脉粥样硬化病变程度及斑块稳定性的关系

目的 探讨脂蛋白相关磷脂酶A2(Lp-PLA2)与冠状动脉粥样硬化病变程度及斑块稳定性的关系.方法 对160例可疑冠心病患者行冠状动脉造影,根据冠状动脉造影结果分为冠状动脉造影正常的对照组(34例)和冠心病组(126例),冠心病组根据临床类型分为急性冠状动脉综合征组(86例)和稳定型心绞痛组(40例).以病变支数和Gensini积分评价动脉粥样硬化病变程度,以临床类型评价斑块稳定性.检查所有患者血清Lp-PLA2水平、高敏C-反应蛋白(hs-CRP)等指标,分析Lp-PLA2、hs-CRP等与病变支数、Gensini积分、斑块稳定性的关系.结果 冠心病组Lp-PLA2水平显著高于对照组(P＜0.05),而且随着冠状动脉病变支数的增加和Gensini积分的增加而逐渐升高,在急性冠状动脉综合征组较稳定型心绞痛组升高.Lp-PLA2水平与hs-CRP无明显相关性.结论 冠心病患者血清Lp-PLA2水平与冠状动脉粥样硬化病变程度及斑块稳定性有关. Abstract： Objective To investigate the correlations between serum levels of lipoprotein -associated pospholipase A2 ( Lp - PLA2 ) and the severity and stability of coronary atherosclerosis. Methods Coronary angiography (CAG) was performed in 160 patients who were suspected as having coronary artery disease(CAD). According to the coronary artery chanrges and plaque characters in CAG, all patients were divided into control group( n =34) and CAD group( n = 126). According to the clinical types,the CAD patients were divided into acute coronary syndrome (ACS) group ( n = 86) and stable angina pectoris (SAP) group ( n = 40). The number of diseased coronary branches and Gensini' s score was used for evaluate the severity of atherosclerosis. The clinical types was used for evaluate the stability of plaque. Lp - PLA2 and hs - CRP were measured in all the patients. The correlation between serum LpPLA2 with hs - CRP and the number of diseased coronary branches, Gensini's score, clinical types were analyzed. Results Lp - PLA2 in CAD patients was significantly higher than that in control group ( P＜0.05) and increased with the increasing number of diseased coronary branches and Gensini's score.Lp -PLA2 in ACS group was higher than SAP group. Lp -PLA2 level had no correlated with hs -CRP.Conclusions CAD patients serum Lp - PLA2 level is correlated with the severity of atherosclerosis and the stability of plaque.     

血清孕酮及绒毛膜促性腺激素联合检测对妊娠早期结局预测的价值

目的 探讨在妊娠早期联合检测血清孕酮(P)及48 h绒毛膜促性腺激素(β-HCG)的上升情况对早期妊娠结局的预测价值.方法 采用ECL/RTA技术,将287例孕妇分为正常对照组、先兆流产组、难免流产组、异位妊娠组,研究血清孕酮、48 h β-HCG的上升情况与妊娠结局变化的关系.结果 正常对照组、先兆流产组血清孕酮及β-HCG值明显高于难免流产及异位妊娠组.血清孕酮>20 μg/L者,出现宫内妊娠结局不良及异位妊娠的比例较低;妊娠早期孕酮<10 μg/L者宫内妊娠结局不良及异位妊娠的比例高,组间比较差异有统计学意义(P＜0.05).48 h β-HCG上升理想组比上升不理想组宫内妊娠结局良好比例较高,宫内妊娠结局不良率和异位妊娠率相对较低,差异有统计学意义(P＜0.05).结论 在妊娠早期联合检测血清孕酮及48 h β-HCG上升情况对于妊娠结局的预测及指导治疗具有重要的临床价值. Abstract： Objective To investigate the predictive value of the combined detection of serum progesterone (P) and human chorionic gonadotropin (β-HCG) rise in 48 h on early pregnancy outcome.Methods Two hundred and eighty-seven cases of pregnant women were divided into normal control group,threatened abortion group,inevitable abortion group and ectopic pregnancy group. Using the ECL/RTA technology, the relationships of P and pregnancy outcome, β-HCG rise in 48 h and changes of pregnancy outcome were observed. Results P and β-HCG of the normal group and threatened abortion group were significantly higher than other groups. People whose P was greater than 20 μg/L appeared lower adverse intrauterine pregnancy outcome and ectopic pregnancy. People whose P was less than 10 μg/L during early pregnancy appeared higher rate of adverse intrauterine pregnancy outcome and ectopic pregnancy. The differences between the two groups were significant (P<0.05). The group whose 48 h β-HCG increased significantly had higher rate than the one whose 48hβ-HCG rise was not satisfactory in good intrauterine pregnancy outcome. Adverse outcomes of intrauterine pregnancy rate and ectopic pregnancy rate were relatively low. There were significant differences between the two groups (P<0.05) Conclusions During early pregnancy, the combined detection of P and 48 h β-HCG rise had important clinical value in predicting the pregnancy outcome and guiding therapy.     

Tomey超声测厚仪、Orbscan Ⅱ和Pentacam三种仪器测量中央角膜厚度的比较

目的 Tomey超声测厚仪、Orbscan Ⅱ和Pentacam三种仪器测量屈光不正患者术前角膜中央厚度(CCT)进行比较,分析Orbscan Ⅱ、Pentacam同Tomey超声测厚仪比较的差异和一致性.方法 在准分子激光室选取术前检查的近视患者90例(90只眼均为左眼),对每位患者分别用Tomey超声测厚仪、Orbscan Ⅱ、和Pentacam三种仪器测量角膜中央厚度,对三组角膜中央厚度值进行分析比较,分别采用配对t检验评价两种仪器与超声测厚仪测量角膜中央厚度间的差异、简单线性相关描述两种仪器与超声测厚仪测量角膜中央厚度间的相关关系和Bland Altman分析来比较两种仪器与超声测厚仪测量角膜中央厚度间的一致性.结果 Tomey、Orbscan Ⅱ(声速系数0.95)和Pentacam三种仪器测量角膜中央厚度平均值分别为(543.1±30.2)μm、(542.1±36.1)μm、和(544.7±28.5)μm.Tomey和Orbscan Ⅱ两种测量仪器之间的比较差异无统计学意义(P>0.05).Tomey和Pentacam比较相差(-2.8±11.0)μm,差异有统计学意义(P<0.01),线性相关显示Tomey和Orbscan Ⅱ、Pentacam三种设备存在正相关(P<0.01).Bland Altman分析显示Tomey与Orbscan Ⅱ、Pentacam两种仪器间有较好的一致性,95%一致性界限分别为-37.4～+39.3 μm、-24.4～+18.8 μm.结论 两种方法与超声相比较相关性高、一致性好,都可以用来测量角膜厚度,存在一定的相互参考. Abstract： Objective To compare the measure of the corneal central thickness(CCT) of the faulty refraction patients by the three instruments.Tomey ultrasonic thickness meter,Orbscan Ⅱ and Pentacam.Analyse the differences and consistence of the three instruments. Methods Ninety eyes(all were left eyes)of the myopia patients during the pre-operation examination in the laser treatment, measure the CCT of every patient in the three different instruments, compare the central cornea thickness numbers by the three equipments.Take the pared t-test and evaluate the differences of the two instuments and describe the relationship between the two instuments and the ultrasonic thickness meter by simple linear regression. And analyse and compare the consistency of the two instuments and the ultrasonic thickness meter by Bland Altman. Results The average number of the CCT of the Tomey,Orbscan Ⅱ(sound velocityratio:0.96)and Pentacam were (543.1±30.2)μm,(542.1±36.1)μm and (544.7±28.5)μm. There was no statistical significance between Tomey and Orbscan Ⅱ(P>0.05). The difference between Tomey and Pentacam was (-2.8±11.0)μm(P<0.01). Simple linear regression reveals that the three instruments were positive correlation(P<0.01). Bland Altman revealed that Tomey and Orbscan Ⅱ,Pentacam had good consistency. 95% of the consisitency boundary were -37.4/+39.3 μm and -24.4/+18.8 μm. Conclusions The two methods compared with the ultrasound reveals high relation and good consistency which can both be used to measure the cornea thickness and can make a cross reference.     

α-硫辛酸对颅脑创伤患者脑损害的影响

目的 研究α-硫辛酸对颅脑创伤患者脑损害的影响.方法 将50例行急诊手术的颅脑创伤患者随机分为对照组和治疗组,每组25例.治疗组在麻醉前静脉给予α-硫辛酸600 mg,每天1次, 连用5 d.对照组静脉滴注等量生理盐水.分别于麻醉前、手术结束时及术后1、3、5 d采集患者颈内静脉血,检测血清S100β蛋白和神经元特异性烯醇化酶(NSE)水平;3个月后行哥拉斯预后(GOS)评分.结果 治疗组相同时间点血清NSE和S100β含量明显低于对照组(P＜0.05),治疗组GOS评分明显好于对照组(P＜0.05).结论 α-硫辛酸能显著降低颅脑创伤患者血清S100β蛋白和NSE水平,改善预后,对脑损伤有保护作用. Abstract： Objective To investigate the efficacy of α-lipoicacid on cerebral neurologic injuries in traumatic brain injury patients. Methods Thirty-six patients undergoing operation were randomly divided into two groups, control group(25 cases) and experiment group(25 cases). In experiment group 600 mg α-lipoicacid was given by intravenous injection before anesthesia induction, qd for 5 days, while in control group only equivalent of normal saline was administration. Blood samples were taken from intrajugular vein for determination of serum levels of S100β protein, neuron-specific enolase(NSE) at five time-points: before anesthesia, at the end of operation and postoperation 1 d, 3 d, 5 d. Glasgow outcome scale(GOS) of all patients were determined after 3 months of therapy. Results Compared with the control group, serum levels of S100β and NSE in the experiment group were decreased significantly(P<0.05). The GOS were significantly better in experiment group versus control group.Conclusions α-lipoicacid can attenuate cerebral neurologic injury in traumatic brain injury patients,and improve their outcome probably.