食管癌化疗前后AgNORs颗粒数变化与疗效的关系

本文对２２例食管鳞癌患者联合化疗前后活检或手术标本进行核仁形成区染色，比较同一患者化疗前后部细胞ＡｇＮＯＲｓ颗粒数，分析颗粒数变化与临床化疗的关系。结果显示１２例化疗有效者ＡｇＮＯＲｓ颗粒数均明显减少，化疗无效者颗粒都无明显变化。     

AgNORs在胃镜活检小标本中的应用

采用嗜银染技术对胃镜活检的１０例正常食管粘膜、２０例食管癌、１０例正常胃粘膜和２０例胃癌的小标本的核仁组成区相关蛋白（ＡｇＮＯＲｓ）进行了研究。结果发现：食管癌和胃癌细胞的ＡｇＮＯＲｓ／核均数明显高于正常食管和胃粘膜的上皮细胞（Ｐ＜０．０１）。随着食管癌和胃癌细胞分化程度的降低，ＡｇＮＯＲｓ／核均数升高（Ｐ＜０．０５，或Ｐ＜０．０１）。我们认为ＡｇＮＯＲｓ技术有助于区别食管和胃的正常与恶性细胞，也有助于恶性细胞的组织学分级。将ＡｇＮＯＲｓ技术应用到胃镜活检的小标本中可以提高病理诊断的准确性。     

幽门螺杆菌清除前后胃粘膜增殖状态的变化

本研究以流式细胞技术对幽门螺杆菌（ＨＰ）阳性和阴性患者胃粘膜细胞周期进行对比分析，并通过银染技术对ＨＰ清除前后胃粘膜细胞核仁组成区嗜银蛋白（ＡｇＮＯＲｓ）的变化进行随访观察。结果表明，ＨＰ阳性胃粘膜Ｓ期细胞比率和增殖指数均显著高于ＨＰ阴性胃粘膜，ＡｇＮＯＲｓ数量与胃粘膜增殖指数呈显著正相关。经治疗ＨＰ转阴者其胃粘膜细胞ＡｇＮＯＲｓ数量显著下降（Ｐ＜０．０１），而ＨＰ仍为阳性者ＡｓＮＯＲｓ数量则无显著变化（Ｐ＞０．０５）。ＨＰ清除后胃粘膜炎症明显好转。结果提示ＨＰ感染的胃粘膜处于高增殖状态，ＨＰ感染可能通过刺激胃粘膜细胞的增殖加速，从而增加患胃癌的危险性。     

慢性肝病,肝细胞癌及其癌旁肝组织核仁组成区嗜银蛋白的研究

采用嗜银染色技术研究正常肝、慢性肝病、肝细胞癌及其癌旁肝组织核仁组成区嗜银蛋白（Ａｇ－ＮＯＲ）的变化。正常肝组织ＡｇＮＯＲ数低于慢性肝病和癌旁肝组织（Ｐ〈０．０５），后二者低于肝细胞癌ＡｇＮＯＲ数（Ｐ〈０．０１）。不同分化程度癌组织ＡｇＮＯＲ数无差异（Ｐ〉０．０５）。１年内死亡者与生存１年以上者癌组织ＡｇＮＯＲ计数无统计学差异。结果提示，ＡｇＮＯＲ计数有助于鉴别良恶性肝病，对肝癌预后的判断无意义。     

核仁组成区相关嗜银蛋白对白血病分型诊断价值的探讨

本文选用骨髓片４４６例、血片１７４例，其中急性白血病２１２例，慢性白血病３７例，其它白血病２２例，骨髓增生异常综合征５２例，非白血病８０例，正常人４３例。应用ＰＬＯＴＯＮ及本室改良法，检测核仁组成区相关嗜银蛋白（ＡｇＮＯＲｓ），ＡｇＮＯＲｓ颗粒／核及特殊鼻常嗜银染色区百分率及内外颗粒总合，代替检测１００个有核细胞ＡｇＮＯＲｓ嗜银颗粒面积（ＧＡ），并测定１００个有核细胞核面积（ＮＡ）、ＧＡ和Ｇ／Ａ（嗜银颗粒／有核细胞核面积）的比值三项指标，结果表明急性白血病ＡｇＮＯＲｓ颗粒／核为４．４３±０．９８，特殊异常嗜银染色区占１９．８％；期余ＡｇＮＯＲｓ颗粒／核分别为：慢性白血病为３．０３±０．８２，其它白血病为４．３５±１．４９，骨髓增生异常综合征为４．３１±１．３８，非白血病为２．８５±０．９５；正常人为１．４９±０．３７。     

幽门螺杆菌阳性胃粘膜病变AgNOR和rasp21的表达

目的研究幽门螺杆菌阳性（Ｈｐ＋）不同胃粘膜病变的ＡｇＮＯＲ数量及ｒａｓｐ２１阳性表达率，探讨其生物学行为及Ｈｐ在此过程中可能的作用．方法经内窥镜病理检查证实胃粘膜病变（慢性浅表性胃炎、慢性萎缩性胃炎、肠上皮化生、异型增生、胃癌）共计２７８例．通过Ｈｐ检测（ＣＬＯｔｅｓｔ结合ＷａｒｔｈｉｎＳｔａｒｙ染色）证实其中１４６例阳性，１３２例阴性．分别对其粘膜标本作了ＡｇＮＯＲ定量及ｒａｓｐ２１表达的研究，比较不同胃粘膜病变中Ｈｐ阳性和阴性组间ＡｇＮＯＲ数目和ｒａｓｐ２１阳性表达率．结果除慢性浅表性胃炎外各病变中Ｈｐ＋组的ＡｇＮＯＲ数量均显著高于Ｈｐ－组（Ｐ＜００５或Ｐ＜００１）；除慢性浅表性胃炎及慢性萎缩性胃炎外各病变中Ｈｐ＋组的ｒａｓｐ２１阳性表达率均显著高于Ｈｐ－组（Ｐ＜００５）．结论Ｈｐ＋胃粘膜病变具有更多的肿瘤生物学行为，该菌可能刺激胃上皮细胞的过度增殖而启动恶性变．     

肝血管瘤中VEGF的表达及其与AgNOR定量的关系

本文用肝血管瘤石蜡切片作血管内皮生长因子（ＶＥＧＦ）链霉亲和素－生物素－过氧化物酶免疫组织化学染色（妈ＳＡＢＣ法）和核仁组成区相关嗜银蛋白（ＡｇＮＯＲ）计数方法，研究ＶＥＧＦ在肝血管瘤成因中的地位。结果显示：４８例肝血管瘤标本中，ＶＥＧＦ阳性表达率为７５．０％，其中（＋）者９例，（＋＋）者１１例（＋＋＋）者１６例，且ＶＥＧＦ表达强度在不同的组别间ＡｇＮＯＲ计数差异显著（Ｐ〈０．０１）。提示ＶＥＧＦ     

食管癌细胞核AgNOR的定量研究

本文对３４例新近切除的食管癌组织和２２例术后随访病人（生存５年以上及半年内复发死亡各１１例）的标本进行ＡｇＮＯＲ染色，以正常食管上皮细胞作对照。结果食管癌细胞核ＡｇＮＯＲ均数显著高于正常食管上皮（Ｐ〈０．００１），３４例新近切除组织的ＡｇＮＯＲ均数随细胞分化等级的增加而增加。术后生存５年以上病人的ＡｇＮＯＲ均数显著低于术后半年内复发死亡者（Ｐ〈０．０１），提示ＡｇＮＯＲ均数与食管癌恶性程度和预后有     

AgNOR变化对地方性甲状腺肿的诊断学意义

对７０例地方性甲状腺肿病变化细胞核内ＡｇＮＯＲ进行研究。结果表明，乳头状增生结节滤泡上细胞核内ＡｇＮＯＲ颗粒均数分别与胚胎型、胎儿型、胶质潴留型结节和滤泡型结节的均数比较，均存在显著性差异（Ｐ〈０．０１）。因此，作者认为ＡｇＮＯＲ染色方法对地方性甲状腺肿各结节类型的区别和预后判断有重要意义。     

用流式细胞仪和RNA原位杂交技术联合检测白血病患者的多药耐药

为研究多药耐药（ＭＤＲ）在白血病中临床意义，以及环孢霉素Ａ（ＣｓＡ）对ＭＤＲ体外逆转效果，对２６例白血病患者采用流式细胞仪测定治疗前白血病细胞内柔红霉素（ＤＮＲ）浓度及应用原位杂交技术检测ＭＤＲ１表达水平，并与加入ＣｓＡ后细胞内ＤＮＲ浓度变化比较。结果显示，初治完全缓解组，ＭＤＲ１阳性细胞内ＤＮＲ平均浓度（８０．０１％±２．１０％）明显高于难治、复发组（４４．８０％±７．７４％）（Ｐ＜０．０１），ＣｓＡ对难治组、复发组中ＭＤＲ１阳性者逆转效果好（Ｐ＜０．０１）。提示两种方法联合检测ＭＤＲ可指导临床化疗方案设计，ＣｓＡ对体外白血病耐药细胞有明显逆转效果     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.