原发性小肠腺癌中钙粘蛋白基因异常甲基化及蛋白表达的研究

目的 探讨原发性小肠腺癌中钙粘蛋白(E-cad)基因甲基化状态和蛋白表达的特点,及其与小肠腺癌I临床病理特征的关系.方法 分别采用甲基化特异性PCR(MSP)和免疫组化SP法检测36例原发性小肠腺癌及相应癌旁组织中E-cad基因甲基化状态及蛋白表达水平,并结合临床资料进行分析.结果 小肠腺癌和癌旁组织中E-cad甲基化率分别为38.9%(14/36)和8.3%(3/36),差异有统计学意义(P＜0.01).小肠腺癌和癌旁组织中E-cad蛋白的阳性率分别为41.7%(15/36)和97.2%(35/36),差异有统计学意义(P＜0.01).E-cad蛋白缺失的21例标本中有12例发生甲基化,与蛋白缺失相关(P＜0.01).E-cad甲基化率及蛋白表达率与患者性别、年龄、肿瘤大小、发生部位无关(P＞0.05),与肿瘤浸润深度、分化程度及淋巴结转移密切相关(P＜0.05).结论 E-cad基因的异常甲基化可影响蛋白表达,与小肠腺癌浸润深度、分化程度及淋巴结转移有关.     

小肠肿瘤组织中E-cad蛋白表达及其基因甲基化状态观察

目的 检测上皮型钙黏附素(E-cad)在小肠肿瘤组织中的表达情况及其甲基化状态,并探讨其与临床病理特征的关系.方法 42例小肠腺癌、16例小肠腺瘤及21例癌旁正常组织的石蜡标本,分别采用免疫组化SP法和甲基化特异性PCR法检测E-cad表达情况及甲基化状态,并结合临床病理资料进行分析.结果 小肠腺癌、腺瘤、癌旁正常组织中E-cad蛋白的阳性表达率分别为38.1％(16/42)、87.5％ (14/16)、90.4％(19/21),E-cad基因甲基化率分别为45.2％ (19/42)、12.5％ (2/16)、9.5％(2/21);小肠腺癌组织中E-cad蛋白阳性表达率、甲基化率与小肠腺瘤、癌旁正常组织比较,P均＜0.01.小肠腺癌组织中E-cad蛋白表达和E-cad基因甲基化呈负相关(r=-0.523,P＜0.01).E-cad蛋白表达及甲基化与患者的性别、年龄、肿瘤大小及发生部位无关(P均＞0.05),但与肿瘤分化程度及淋巴结转移密切相关(P均＜0.01).结论 E-cad基因甲基化可引起E-cad蛋白的失表达,其可能参与小肠腺癌的发生、发展;E-cad失表达可作为判断小肠腺癌转移的一个潜在重要指标,对其治疗及预后有重要临床意义.     

胃癌组织中NPRL2蛋白的表达变化

目的观察胃癌组织中NPRL2蛋白的表达变化。方法采用免疫组化SP法检测60例胃腺癌组织及其癌旁正常组织中的NPRL2蛋白。结果 NPRL2蛋白在癌旁正常组织中的阳性率为86.7%,明显高于癌正常组织中的26.7%,P〈0.05。NPRL2蛋白表达与胃癌分化程度、有无淋巴结转移、肿瘤浸润深度、临床分期及患者的年龄、性别均无关（P均〉0.05）。结论胃癌组织中NPRL2蛋白表达降低。     

原发性肝细胞癌组织中NF-κB p65蛋白的表达变化及意义

目的观察原发性肝细胞癌（HCC）组织中核转录因子κB（NF-κB）p65蛋白的表达变化,并探讨其临床意义。方法采用免疫组化SP法检测42例HCC组织、癌旁肝组织及6例正常肝组织中的NF-κB p65蛋白。结果 HCC组织中NF-κB p65蛋白阳性率（73.8%）明显高于癌周肝组织及正常肝组织中的30.9%、16.7%,P均〈0.05。NF-κB p65蛋白表达与HCC分化程度、术前AFP水平、肿瘤直径、合并HbsAg阳性及有无门静脉浸润有关（P均〈0.05）。NF-κB p65蛋白阳性者生存时间为（27.7±8.5）个月,阴性者为（39.6±10.2）个月,两者比较,P〈0.05。结论 HCC组织中NF-κB p65蛋白高表达,其在HCC的侵袭、转移及预后判断中具有一定作用。     

肝细胞癌组织HSP70、p53和PCNA的表达及其意义

目的探讨热休克蛋白70（HSP70）、p53和增殖细胞核抗原（PCNA）在肝细胞癌（HCC）组织中的表达及其意义。方法采用免疫组化法检测正常人、慢性乙型肝炎、肝硬化和HCC肝或癌组织HSP70、p53和PCNA的表达情况。结果 HCC组织HSP70、p53和PCNA表达阳性率明显高于非癌组织（x1^2=27.16x2^2=67.6,x3^2=40.6,P〈0.01）;HSP70在正常人、慢性乙型肝炎、肝硬化和HCC中的表达逐步增强;HSP70和p53在分化较好的HCC中的阳性率明显低于分化不良者（x1^2=6.8,P1〈0.01x2^2=6.1,P2〈0.05）,而PCNA表达与HCC组织分化程度无关（x2=2.4,P〉0.05）;HSP70表达强度与p53和PCNA表达关系密切（x1^2=41.3,x2^2=41.4,P〈0.01）。结论 HCC是HSP70高表达肿瘤。HSP70表达与p53和PCNA表达密切相关,因而在HCC发生和发展中起重要作用。     

胃癌组织p21基因表达及基因改变的研究

目的研究胃癌组织P21蛋白表达和p21基因改变的意义．方法32例胃癌石蜡标本，其中乳头状腺癌6例，管状腺癌9例，粘液腺癌8例，低分化腺癌7例，未分化癌2例，存在淋巴结转移的标本23例，32例癌旁正常胃粘膜组织作对照．应用ABC免疫组化方法检测P21蛋白表达，单链构象多态性分析（SSCP）检测p21基因改变．参照文献确定p21蛋白表达的阳性标准及SSCCP检测p21基因异常标准，并对结果进行统计学分析．结果胃癌组织P21蛋白表达阳性率56．3％（18／32），其中管状腺癌77．8％（7／9），乳头状腺癌83．3％（5／6），粘液腺癌37．5％（3／8），低分化腺癌42．9％（3／7），未分化癌0％（0／2），存在淋巴结转移组为43．5％（10／23），无淋巴结转移组为88．9％（8／9），癌旁组织为90．6％（29／32）．P21蛋白表达阳性率胃癌组织较癌旁组织明显降低（P＜0．05），与胃癌伴淋巴结转移呈负相关（P＜0．05），不同病理类型间未见差异显著（P＞0．05）．PCR－SSCR分析18．8％（6／32）胃癌组织存在p21基因改变．结论p21基因以异常表达及基因改变的方式参与胃癌发生、发展．     

增殖细胞核抗原与胃癌组织类型的关系

目的观察胃癌组织PCNA的表达．方法60例胃癌切除标本，用免疫组织化学染色检测PCNA．39岁以下青年组30例，70岁以上老年组30例以WHO组织分类，青年组高分化腺癌5例，未分化癌15例，粘液癌2例，印戒细胞癌8例，老年组高分化腺癌20例，分化癌6例，粘液癌4例，未见印戒细胞癌．结果PCNA阳性率青年组粘膜固有层和粘膜下层分别为28．90％±22．59％与23．40％±24．08％，老年组分别为28．32％±15．48％与26．02％±14．71％，两组之间无明显差异．青年组粘膜固有层内，分化型腺癌PCNA明显高于未分化癌；印戒细胞癌PCNA明显低于分化型癌，也低于未分化癌，以上P值均＜0．05．老年组在癌的浸润部位乳头状腺癌PCNA阳性率显著高于管状腺癌（P＜0．05），亦高于青年组的未分化癌（P＜0．05）．两组合并后，印戒细胞癌PCNA阳性率明显低于其他类型癌．从整体上看，粘膜固有层PCNA阳性率比粘膜下层高，分化型腺癌比未分化型腺癌高，但二者之间无显著性差异．结论①胃癌粘膜固有层和粘膜下层PCNA阳性率青年组与老年组两组之间无明显差异．②印戒细胞癌PCNA明显低于分化型癌，也低于未分化癌．③不管胃癌组织类型分化程度如何，不同区域PCNA数量和分布是异质性     

胰腺癌p57~(kip2)、视网膜母细胞瘤蛋白和增殖细胞核抗原的表达及与临床病理的关系

目的 探讨细胞周期蛋白依赖性激酶抑制因子p57~(kip2),视网膜母细胞瘤蛋白(Rb)和增殖细胞核抗原(PCNA)在胰腺癌发生发展中的作用。方法 应用免疫组化技术,对32例胰腺癌及癌旁组织中p57~(kip2)蛋白和PCNA表达进行检测。结果 p57~(kip2)蛋白阳性表达率在胰腺癌组织中为46.9％,显著低于癌旁胰腺组织的75.0％(x~2=5.317,P<0.05),并与胰腺癌组织分化程度有关(P<0.05),而与淋巴结转移无关(P>0.05)。Rb蛋白阳性表达率在胰腺癌组织中为50％,显著低于癌旁胰腺组织的78.1％(x~2=5.497,P<0.05)。PCNA阳性表达率在胰腺癌组织中为71.9％,显著高于癌旁胰腺组织的43.8％(x~2=5.189,P<0.05),并与胰腺癌组织分化程度和淋巴结转移均有关(P<0.05)。p57~(kip2)蛋白阳性表达组Rb蛋白阳性表达率为53.3％;p57~(kip2)蛋白阴性表达组Rb蛋白阳性表达率为47.1％,两组间无相关性(γ=0.16507,P>0.05)。结论 P57~(kip2)、Rb蛋白低表达和PCNA蛋白过度表达与胰腺癌的发生发展有关。     

c—erbB-2、p53和nm23H1蛋白在肝外胆管癌组织中的表达及临床意义

目的探讨c—erbB-2、p53和nm23H1基因在肝外胆管癌发生与发展中的作用。方法用免疫组化法检测72份肝外胆管癌组织、43份癌旁胆管组织和11份正常胆管组织中c—erbB-2、p53和nm23H1蛋白表达情况,并分析三项指标与肝外胆管癌临床病理特征的相关性。结果p53蛋白表达阳性率胆管癌组织〉癌旁组织〉正常胆管组织（P〈0．05、0．01）,且低分化者表达阳性率显著高于高分化和中分化者,Ⅲ～Ⅳ期者表达阳性率显著高于Ⅰ～Ⅱ期者,有转移者阳性表达率显著高于无转移者,生存时间≤18个月者显著高于〉18个月者（P〈0．05）;c—erbB-2蛋白表达阳性率胆管癌组织〉癌旁组织〉正常胆管组织（P〈0．05、0．01）,其中低分化者显著高于高分化及中分化者,有转移者明显高于无转移者（P〈0．05）;nm23H1蛋白表达阳性率胆管癌组织〈癌旁组织〈正常胆管组织（P〈0．05、0．01）,且低分化者显著低于高、中分化者,Ⅲ～Ⅳ期者表达阳性率显著低于Ⅰ～Ⅱ期者,生存时间≤18月者显著低于〉18月者。结论c—erbB-2、p53、nm23H1在胆管癌发生、发展中起重要作用,其中p53、nm23H1蛋白表达可反映胆管癌生物学行为和恶性程度,c-erbB-2蛋白过度表达与胆管癌分化程度有关。     

胰腺癌p57kip2、视网膜母细胞瘤蛋白和增殖细胞核抗原的表达及与临床病理的关系

目的探讨细胞周期蛋白依赖性激酶抑制因子p57kip2,视网膜母细胞瘤蛋白(Rb)和增殖细胞核抗原(PCNA)在胰腺癌发生发展中的作用.方法应用免疫组化技术,对32例胰腺癌及癌旁组织中p57kip2、Rb蛋白和PCNA表达进行检测.结果 p57kip2蛋白阳性表达率在胰腺癌组织中为46.9%,显著低于癌旁胰腺组织的75.0%(χ2=5.317,P < 0.05),并与胰腺癌组织分化程度有关(P < 0.05),而与淋巴结转移无关(P > 0.05).Rb蛋白阳性表达率在胰腺癌组织中为50%,显著低于癌旁胰腺组织的78.1%(χ2=5.497, P < 0.05).PCNA阳性表达率在胰腺癌组织中为71.9%,显著高于癌旁胰腺组织的43.8%(χ2=5.189, P < 0.05),并与胰腺癌组织分化程度和淋巴结转移均有关(P < 0.05) .p57kip2蛋白阳性表达组Rb蛋白阳性表达率为53.3%;p57kip2蛋白阴性表达组Rb蛋白阳性表达率为47.1%,两组间无相关性(γ=0.16507, P ＞ 0.05).结论 p57kip2、Rb蛋白低表达和PCNA蛋白过度表达与胰腺癌的发生发展有关.     

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.     

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.     

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.     

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.