胃癌及癌前病变中肝肠钙黏蛋白的表达及其意义

目的 研究胃癌及肠化生组织中肝肠钙黏蛋白(liver-intestine cadherin. LI-cadherin)的表达,探讨胃黏膜癌前病变及癌变的分子机制. 方法应用SP免疫组化方法检测244例不同胃组织中(包括正常胃黏膜28例、慢性浅表性胃炎30例、慢性萎缩性胃炎42例、肠化生胃黏膜58例、胃腺癌46例、癌旁组织30例、胃间质瘤10例) LI-cadherin蛋白的表达.结果 LI-cadherin蛋白在正常胃黏膜、慢性胃炎、癌旁组织及胃间质瘤组织中不表达;在肠化生组织中阳性表达率为83%,在胃腺癌组织中阳性表达率为65%.按Laurien分型,肠型胃癌中LI-cadherin蛋白阳性表达率(78%)高于弥漫型胃癌(35%),两者之间差异有统计学意义(P<0.05).LI-cadherin与淋巴结转移及临床分期明显正相关(P<0.01). 结论LI-cadherin的异常表达与肠化生及胃腺癌的发生有关;LI-cadherin高表达者淋巴结转移率高.有助于判断胃癌恶性程度及预后.     

胃粘膜病变中人端粒酶催化亚单位、c-myc蛋白的表达及其相互关系

目的探讨胃粘膜病变中人端粒酶催化亚单位(humantelomerasecatalyticsubunit,hTERT)的表达状况及其与c-myc蛋白表达的关系。方法应用免疫组织化学技术检测45例慢性胃炎和19例胃癌中hTERT和c-myc蛋白的表达。结果hTERT蛋白的表达率在胃癌组织中显著高于不典型增生、肠化生和萎缩性胃炎组织(P<0.05);在不典型增生组织中显著高于肠化生和萎缩性胃炎组织(P<0.05);在肠化生组织中显著高于萎缩性胃炎组织(P<0.05)。c-myc蛋白的表达率在胃癌组织中显著高于不典型增生、肠化生和萎缩性胃炎组织(P<0.05);在不典型增生组织中显著高于肠化生和萎缩性胃炎组织(P<0.05);在肠化生组织中显著高于萎缩性胃炎组织(P<0.05)。hTERT蛋白表达率在c-myc蛋白阳性患者中显著高于c-myc蛋白阴性患者(P<0.01)。结论在胃癌和胃癌前病变阶段,端粒酶(telomerase)与c-myc均可能发挥重要作用,促进了胃癌的发生、发展;c-myc表达增加可能是胃粘膜上皮细胞端粒酶激活的主要机制之一。     

CDX-2和COX-2在胃癌中的表达及临床意义

目的:探讨尾型同盒转录子-2(CDX-2)和环氧合酶-2(COX-2)在胃癌组织中的表达及临床意义.方法:采用免疫组织化学EnVision两步法检测CDX-2和COX-2在75例胃癌组织和30例癌旁组织中的表达,分析其与胃癌临床病理特征的关系以及两者的相关性.结果:CDX-2和COX-2在胃癌组织中的阳性表达率分别为53.3%和65.3%,高癌旁组织30.0%(P<0.05)和33.3%(P<0.01).在胃癌组织中表达呈明显负相关(P<0.01).结论:CDX-2和COX-2均参与了胃癌的发生、发展,CDX-2主要在肠型胃癌中表达,CDX-2的低表达与COX-2的高表达有助预测胃癌病情进展的情况.     

胃粘膜病变中人端粒酶催化亚单位、c—myc蛋白的表达及其相互关系

目的探讨胃粘膜病变中人端粒酶催化亚单位（human telomerase catalytic subunit，hTERT）的表达状况及其与c—myc蛋白表达的关系。方法应用免疫组织化学技术检测45例慢性胃炎和19例胃癌中hTERT和c—myc蛋白的表达。结果hTERT蛋白的表达率在胃癌组织中显著高于不典型增生、肠化生和萎缩性胃炎组织（P〈0．05）；在不典型增生组织中显著高于肠化生和萎缩性胃炎组织（P〈0．05）；在肠化生组织中显著高于萎缩性胃炎组织（P〈0．05）。c—myc蛋白的表达率在胃癌组织中显著高于不典型增生、肠化生和萎缩性胃炎组织（P〈0．05）；在不典型增生组织中显著高于肠化生和萎缩性胃炎组织（P〈0．05）；在肠化生组织中显著高于萎缩性胃炎组织（P〈0．05）。hTERT蛋白表达率在c—myc蛋白阳性患者中显著高于c-myc蛋白阴性患者（P〈0．01）。结论在胃癌和胃癌前病变阶段，端粒酶（telomerase）与c—myc均可能发挥重要作用，促进了胃癌的发生、发展;c-myc表达增加可能是胃粘膜上皮细胞端粒酶激活的主要机制之一。     

尾型同源盒转录因子2和NF-κB P65蛋白在胃印戒细胞癌组织中的表达及意义

目的观察尾型同源盒转录因子2(CDX2)和核转录因子(NF)-κBP65蛋白在胃印戒细胞癌组织中的表达。方法以癌旁正常胃黏膜和胃黏膜肠上皮化生作为对照,用免疫组织化学SABC法检测CDX2和NF-κBP65蛋白在胃印戒细胞癌组织中的表达情况。结果CDX2在正常胃黏膜中无表达,在肠上皮化生中表达明显增高,在胃印戒细胞癌组织中有CDX2的表达但水平低于肠上皮化生;胃印戒细胞癌组织中NF-κBP65则明显高于癌旁正常胃黏膜;胃印戒细胞癌中CDX2和NF-κBP65表达与肿瘤浸润深度有相关性。结论CDX2与NF-κBP65是胃印戒细胞癌重要的分子标志物。     

胃癌及癌前病变组织中幽门螺杆菌感染与NOD2和TLR9蛋白表达的相关性

目的 研究NOD2和TLR9蛋白在胃癌及癌前病变组织中的表达情况以及幽门螺杆菌(Hp)感染对该蛋白表达的影响.方法 用C13呼气试验和快速尿素酶试验确定感染情况,用免疫组化法测定40例慢性浅表性胃炎,84例慢性萎缩性胃炎,48例胃溃疡,80例胃腺癌组织中NOD2和TLR9蛋白的表达情况.结果 在慢性浅表性胃炎、慢性萎缩性胃炎、胃溃疡、胃腺癌中NOD2阳性表达率分别为35%、21%、33%、40%.TLR9阳性表达率分别为15%、12%、21%、22%.在同一病变中Hp阳性组NOD2及TLPO表达强于Hp阴性组,其中Hp阳性的慢性浅表性胃炎、胃溃疡、肠上皮化生、中重度不典型增生和胃癌组织中NOD2表达与Hp阴件组比较差异有统计学意义(P<0.05).结论 胃腺癌、癌前病变以及幽门螺杆菌感染能增强胃上皮细胞中NOD2和TLPO蛋白的表达,提示二者在胃黏膜天然免疫过程中可能起到重要作用.     

CDX1在胃癌中的表达及临床意义

目的:研究CDX1在胃癌以及胃炎组织中的表达。方法:应用组织芯片免疫组织化学技术检测CDX1在胃癌以及胃炎组织中的表达。结果:CDX1在胃癌组织的表达率为89%,明显高于癌旁胃炎组织的41%。肿瘤组织中CDX1表达与肿瘤细胞分化程度明显相关,随着肿瘤分化程度的降低,CDX1的表达率增高。CDX1表达也与肿瘤直径相关,随着肿瘤的增大,CDX1的表达阳性率增高。在癌旁组织中,具有慢性胃炎伴肠上皮化生和(或)异型增生的组织中CDX1表达明显上调。结论:胃癌以及胃炎组织中的CDX1表达量升高,表明CDX1在胃上皮分化障碍中起重要的作用。这一发现对于胃癌有了进一步的认识,对癌症的治疗具有提示作用。     

E2F-1蛋白在胃癌中的表达及意义

目的探讨E2F-1蛋白在胃癌及正常胃黏膜组织中的表达与意义。方法采用免疫组化技术对80例原发性胃癌癌组织与癌旁黏膜中E2F-1的表达进行检测，同时对40例正常胃黏膜组织进行对照性研究，并进行统计学分析。结果E2F-1在癌组织与癌旁黏膜中的阳性表达率为72．5％（58／80）和30．0％（24／80），在正常胃黏膜组织中的阳性表达率为22．5％（9／40），差异有非常显著性（P〈0．001）。癌组织、癌旁黏膜中E2F-1的表达在不同的临床病理特征之间差异无显著性（P〉0．05）。结论E2F-1蛋白在胃癌组织中超表达，E2F-1的反常表达与胃癌的发生有关。     

采用组织芯片技术检测胃黏膜病变中缺氧诱导因子-1α的表达

目的　研究缺氧诱导因子 -1α (HIF 1α)在胃黏膜病变中的表达及其意义。方法　采用组织芯片技术制作 12 0例各类胃黏膜病变的组织芯片 ,免疫组织化学方法检测HIF 1α的表达。结果　 12 0例各类胃黏膜病变中HIF 1α阳性率为 2 8.3 %。慢性浅表性胃炎、伴肠化生慢性萎缩性胃炎、伴异型增生慢性萎缩性胃炎和肠型胃癌中HIF 1α的阳性率分别为 0 .0 % ,10 .0 % ,40 .0 %和 63 .3 %。肠型胃癌和伴异型增生慢性萎缩性胃炎中HIF 1α的阳性率均显著高于慢性浅表性胃炎和伴肠化生慢性萎缩性胃炎 (P <0 .0 5 )。结论　HIF 1α可以作为一种较好的胃癌前病变标志物。应用组织芯片大规模检测临床组织样本是可行的 ,具有高效、快速、方便、经济、准确的特点。     

泛素特异性肽酶22在胃癌中的表达及其临床意义

目的 探讨泛素特异性肽酶22 (USP22)在胃癌组织中的表达及意义.方法 采用免疫组织化学SABC法检测100例胃癌、46例癌旁正常组织中USP22的表达情况.结果 USP22在胃癌组织中阳性率为80.0％,明显高于正常组织(P＜0.05).胃癌病理分期越高,USP22蛋白阳性表达率越高(P＜0.05).胃癌分化程度...     

Body composition assessment and methodology in nonathletic and athletic adolescent and adult males and females

The purpose of this review is to outline methodology for assessing body composition utilizing anthropometric and densitometric techniques. The objective of body composition assessment is to measure body fat and lean body mass. The quantity of these components varies due to growth, physical activity, dietary regimens, and aging. Anthropometric techniques incorporate selected skinfolds, circumferences, skeletal widths, or other variables to estimate body composition within k2.0-4.0%. These techniques are adequate for field testing of groups or individuals, but are population specific. Densitometry measures body volume irrespective of physique, sex, or age. This laboratory technique estimates body composition within 1.0-2.0%, is more difficult to administer, but is not population specific. Some limitation exists with any present technique due to biological variability and incomplete research of reference body composition in children, females, and the aged. J Orthop Sports Phys Ther 1984;5(6):336-347.     

Perioperative and long-term morbidity and mortality after above-knee and below-knee amputations in diabetics and nondiabetics

We performed a retrospective review of a vascular surgery quality assurance database to evaluate the perioperative and long-term morbidity and mortality of above-knee amputations (AKA, n = 234) and below-knee amputations (BKA, n = 720) and to examine the effect of diabetes mellitus (DM) (181 of AKA and 606 of BKA patients). All patients in the database who had AKA or BKA from 1990 to May 2001 were included in the study. Perioperative 30-day cardiac morbidity and mortality and 3-yr and 10-yr mortality after AKA or BKA were assessed. The effect of DM on 30-day cardiac outcome was assessed by multivariate logistic regression and the effect on long-term survival was assessed by Cox regression analysis. The perioperative cardiac event rate (cardiac death or nonfatal myocardial infarction) was at least 6.8% after AKA and at most 3.6% after BKA. Median survival was significantly less after AKA (20 mo) than BKA (52 mo) (P < 0.001). DM was not a significant predictor of perioperative 30-day mortality (odds ratio, 0.76 [0.39-1.49]; P = 0.43) or 3-yr survival (Hazard ratio, 1.03 [0.86-1.24]; P = 0.72) but predicted 10-yr mortality (Hazard ratio, 1.34 [1.04-1.73]; P = 0.026). Significant predictors of the 30-day perioperative mortality were the site of amputation (odds ratio, 4.35 [2.56-7.14]; P < 0.001) and history of renal insufficiency (odds ratio, 2.15 [1.13-4.08]; P = 0.019). AKA should be triaged as a high-risk surgery while BKA is an intermediate-risk surgery. Long-term survival after AKA or BKA is poor, regardless of the presence of DM.     

Postoperative nausea and vomiting and opioid-induced nausea and vomiting: guidelines for prevention and treatment

Postoperative nausea and vomiting (PONV) causes patient discomfort, lowers patient satisfaction, and increases care requirements. Opioid-induced nausea and vomiting (OINV) may also occur if opioids are used to treat postoperative pain. These guidelines aim to provide recommendations for the prevention and treatment of both problems. A working group was established in accordance with the charter of the Sociedad Espa?ola de Anestesiología y Reanimación. The group undertook the critical appraisal of articles relevant to the management of PONV and OINV in adults and children early and late in the perioperative period. Discussions led to recommendations, summarized as follows: 1) Risk for PONV should be assessed in all patients undergoing surgery; 2 easy-to-use scales are useful for risk assessment: the Apfel scale for adults and the Eberhart scale for children. 2) Measures to reduce baseline risk should be used for adults at moderate or high risk and all children. 3) Pharmacologic prophylaxis with 1 drug is useful for patients at low risk (Apfel or Eberhart 1) who are to receive general anesthesia; patients with higher levels of risk should receive prophylaxis with 2 or more drugs and baseline risk should be reduced (multimodal approach). 4) Dexamethasone, droperidol, and ondansetron (or other setrons) have similar levels of efficacy; drug choice should be made based on individual patient factors. 5) The drug prescribed for treating PONV should preferably be different from the one used for prophylaxis; ondansetron is the most effective drug for treating PONV. 6) Risk for PONV should be assessed before discharge after outpatient surgery or on the ward for hospitalized patients; there is no evidence that late preventive strategies are effective. 7) The drug of choice for preventing OINV is droperidol.