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1.
目的 探讨Gli1、Gli3蛋白在肝细胞癌组织中的表达及临床意义.方法 免疫组化法检测36例肝细胞癌组织及其癌旁肝组织中Gli1、Gli3蛋白的表达,并与临床因素进行相关性分析.结果 在肝细胞癌组织及癌旁肝组织中Gli1的阳性表达率分别为75%和36.1%,Gli3的阳性表达率分别为58.3%和30.6%.Gli1和Gli3在肝细胞癌组织中的阳性表达率显著高于癌旁肝组织(P<0.05).Gli1和Gli3两种蛋白的表达呈正相关(r=0.423,P<0.05).Gli3的表达与临床指标(年龄、肿瘤大小、分化和淋巴结转移)无关.Gli1的表达与年龄、肿瘤大小无关,但与肿瘤分化程度和淋巴结转移相关(P<0.05).结论 Gli1、Gli3蛋白在肝细胞癌组织中有较高的阳性表达率且具有相关性,且Gli1的表达率与肿瘤分化程度和淋巴结转移相关.检测Gli1、Gli3蛋白表达有助于肝细胞癌的诊断,可能作为判断肝细胞癌恶性程度及预后的指标.  相似文献   

2.
肝细胞肝癌中HSP90α的表达及意义   总被引:1,自引:0,他引:1  
目的 研究热休克蛋白90α(HSP90α)在人肝细胞性肝癌(HCC)组织中的表达,并探讨其与肿瘤生物学行为及预后的关系。方法 采用免疫组织化学方法检测l0例正常肝组织、40例HCC组织及其癌旁组织中HSP90α的表达。结果 HSP90α在正常肝脏、癌旁组织及肝细胞性肝癌中的表达阳性率分别为l0.0%、52.5%及72.5%.在肝细胞性肝癌中的表达阳性率明显高于正常肝组织和癌旁组织(P<0.05)。HCC的HSP90α阳性表达与肿瘤的临床分期、分化程度、累及浆膜状况及淋巴结转移状况显著相关(P<0.05);而与肿瘤数目无关(P>0.05)。HSP90α阴性表达者的预后显著优于HSP90α阳性表达者,术后平均无瘤生存期前者为38.6个月,后者为25.5个月(P<0.05)。结论 HSP90α在肝细胞性肝癌中的表达明显增强,HSP90α表达与HCC的临床分期、肿瘤分化程度、累及浆膜状况及淋巴结转移状况有关.可作为判断颈后的指标之一。  相似文献   

3.
目的 探讨Bmi-1在胃癌组织中的表达及其与临床病理因素之间的关系.方法 采用RT-PCR和Western blot技术检测44例胃癌组织和癌旁正常组织中Bmi-1的表达.结果 胃癌组织Bmi-1mRNA阳性表达率为72.73%,显著高于癌旁正常组织(13.64%)(P<0.05);Bmi-1蛋白在胃癌组织中表达显著高于癌旁正常组织(P<0.05);在有淋巴结转移以及远处转移的患者中Bmi-1的表达显著高于无淋巴结转移和无远处转移阴性患者(P<0.05).但Bmi-1的表达与患者的性别、年龄、肿瘤大小及分化程度无关,该4因素的分组间差异无统计学意义(P>0.05).结论 Bmi-1的表达上升可能与胃癌的发生及浸润、转移有关.  相似文献   

4.
目的 探讨氨基肽酶N(CD13)在肝细胞癌中的表达水平及其临床意义.方法 应用免疫组织化学染色方法检测CD13在55例肝癌组织及其相应癌旁组织和13例正常肝组织中的表达水平.运用X2检验分析肿瘤组织中CD13表达与临床病理因素的关系.运用Kaplan-Meier法分析肿瘤组织CD13与患者术后总生存时间的关系.结果 CD13在肝癌组织中的阳性表达率为72.73%(40/55),在癌旁组织的阳性表达率为21.81%(12/55),在正常肝组织的阳性表达率为7.69%(1/13).与癌旁组织和正常组织比较,肝癌组织中CDI3的阳性表达率显著升高,差异有统计学意义(P<0.05).进一步分析显示CD13表达与肝癌的分化程度、包膜侵犯、淋巴结转移、门静脉癌栓形成、临床TNM分期等临床病理因素相关(P<0.05).K-M生存曲线提示肿瘤CD13阳性表达的病例较阴性表达者生存率降低,差异具有统计学意义(P<0.05).多因素COX逐步回归分析提示CDI3是影响总体生存率预后的独立危险因素.结论 CD13在肝癌的发生和发展中可能发挥重要的作用,可作为肝癌临床诊断和判断预后的一项重要指标.  相似文献   

5.
目的 探讨原发性肝细胞癌中EphA7 mRNA的表达及其临床意义.方法 应用逆转录-聚合酶链反应(RT-PCR)及实时荧光定量PCR法检测EphA7 mRNA在40例肝癌及相应的癌旁肝组织和10例正常肝组织中的表达,并分析其与肝癌临床病理因素之间的关系.结果 40例肝癌组织及相应的癌旁肝组织和10例正常肝组织中均有EphA7 mRNA的表达.实时荧光定量PCR分析显示EphA7 mRNA在肝癌组织(20.0711±32.0232)中的表达显著高于癌旁肝组织(4.5184±9.4738,P<0.05)和正常肝组织(4.1764±4.7193,P<0.05),而在癌旁肝组织和正常肝组织中的表达差异无统计学意义(P>0.05).EphA7 mRNA的过表达与肝癌细胞的分化程度、门静脉癌栓的形成及淋巴结转移等临床病理因素有关(P<0.05).结论 EphA7的过表达与原发性肝细胞癌的生物学行为密切相关,可能在肝癌的恶性转化、侵袭和转移过程中发挥作用.  相似文献   

6.
目的探讨纤黏连蛋白(fibronectin,FN)和张力蛋白同源基因蛋白(phosphatase and tensin homology deleted on chromosome ten,PTEN)在原发性肝细胞肝癌(hepatocellular carcinomas,HCC)组织中的表达及与其临床病理特征间的关系。方法采用Western blot及免疫组化方法检测83例HCC组织及其癌旁组织、47例肝硬变组织和11例正常肝组织中FN及PTEN的表达情况,并分析FN及PTEN的表达与HCC临床病理特征间的关系。结果 HCC癌组织中FN蛋白表达阳性率明显高于癌旁组织、正常肝组织及肝硬变组织(P0.05),而PTEN蛋白的表达结果与之相反(P0.05);癌旁组织中FN蛋白表达阳性率亦高于肝硬变组织及正常肝组织(P0.05),PTEN蛋白的表达结果与之相反(P0.05)。在合并癌栓、伴淋巴结转移、AFP阳性及肿瘤病灶多发的HCC癌组织中FN蛋白表达阳性率较高(P0.05),而FN蛋白在HCC癌组织中的表达与患者性别、年龄、HBs Ag状态、肿瘤分化程度及大小均无关(P0.05)。在高-中分化HCC、合并癌栓、AFP阳性、伴淋巴结转移和肿瘤直径≥2 cm的HCC癌组织中PTEN蛋白表达阳性率较低(P0.05),而PTEN蛋白在HCC癌组织中的表达与患者性别、年龄、Hbs Ag状态及肿瘤数目无关(P0.05)。结论 FN和PTEN在HCC癌组织中异常表达,其在HCC的发生、发展和侵袭转移中可能起一定的促进或抑制作用。两者异常表达可作为HCC恶性程度和侵袭转移的分子生物学标志物。  相似文献   

7.
目的 探讨Chemerin在肝细胞癌组织及人肝癌细胞株中的表达及预后价值.方法 采用免疫组化SABC法检测Chemerin蛋白在正常肝组织、肝癌及癌旁配对组织中的表达情况;采用RT-PCR方法检测肝癌组织、人肝癌细胞株以及永生化肝细胞株LO2中Chemerin mRNA的表达情况.结果 Chemerin在肝癌组织中、癌旁配对组织中、正常肝组织中表达阳性率分别为56.67%、90.00%、100%,差别具有统计学意义(P<0.05).RT-PCR结果显示,Chemerin mRNA在癌旁配对组织中的表达高于相应的肝癌组织(P<0.05).细胞检测结果发现,Chemerin mRNA在永生化的人肝细胞株LO2中高表达;在人肝癌细胞株中低表达.Chemerin蛋白的表达与患者性别、年龄、肿瘤大小、HBsAg状态、甲胎蛋白(AFP)水平无关,而与淋巴结转移、门静脉癌栓、肝癌分化程度以及TNM分期相关.结论 Chemerin的表达下调可能在肝癌的发生发展及侵袭转移中起重要作用,提示其可能是影响肝癌患者预后的分子标志.  相似文献   

8.
目的 探讨内皮细胞分化基因-1(EDG-1)、丝切蛋白-1(CFL-1)在原发性肝细胞癌(HCC)中的表达水平及其与临床病理特征和两者之间的相互关系.方法 采用免疫组织化学方法,检测EDG-1、CFL-1在57例原发性肝细胞癌组织(实验组)及15例癌旁组织(对照组)中的表达,并与临床病理资料进行比较分析.随访所有病例术后的生存时间,并进行生存分析.结果 EDG-1 、CFL-1阳性表达分别为54.4% (31/57)和66.7% (37/57),均明显高于正常肝组织的表达,差异有统计学意义(P<0.05),且呈正相关(P<0.05).EDG-1、CFL-1在肿瘤转移组及低分化组中的表达阳性率明显高于无肿瘤转移组及高+中分化组,差异有统计学意义(P<0.05).COX多因素回归分析的结果提示,肿瘤转移、癌栓、病理分型、EDG-1及CFL-1的表达为影响预后的独立因素.结论 EDG-1 、CFL-1可能作为判断HCC恶性程度的预测指标,其表达水平有助于评价肝细胞癌患者的预后.  相似文献   

9.
目的 探讨胰腺癌组织中CIP2A和c-Myc蛋白的表达及其临床意义.方法 采用免疫组织化学法检测42例胰腺癌组织及26例癌旁组织中CIP2A和c-Myc的表达情况,分析它们与临床病理参数的关系.结果 CIP2A在胰腺癌组织及癌旁组织中的阳性表达率分别为71.4%和7.7%;CIP2A在26例癌组织及配对癌旁组织中的阳性表达率比较,差异有统计学意义(P <0.05);c-Myc在胰腺癌组织及癌旁组织中的阳性表达率分别为64.3%和11.5%;c-Myc在26例癌组织及配对癌旁组织中的阳性表达率比较,差异有统计学意义(P<0.05).CIP2A在胰腺癌组织中的表达与分化程度、TNM分期及淋巴结转移明显相关(P<0.05),c-Myc在胰腺癌组织中的表达与分化程度、TNM分期及淋巴结转移明显相关(P<0.001).经Spearman等级相关性分析,CIP2A和c-Myc在胰腺癌组织中的表达呈正相关(r=0.689,P<0.001).结论 CIP2A和c-Myc过表达共同促进胰腺癌侵袭和转移,推测CIP2A与c-Myc在胰腺癌进展过程中发挥正反馈调节作用.  相似文献   

10.
目的 探讨酪氨酸蛋白激酶 EphA7 蛋白在原发性肝细胞癌中的表达及其临床意义.方法 应用免疫组化和 Western blot 方法检测 EphA7 蛋白在40例原发性肝细胞癌及相应的癌旁肝组 织和10例正常肝组织中的表达情况,并分析其与原发性肝细胞癌的临床病理因素之间的关系.结果 EphA7蛋白的表达主要位于原发性肝细胞癌细胞或肝细胞的胞质,以及纤维间隔内的血管内皮细胞.原发性肝细胞癌组织、癌旁肝组织及正常肝组织中均有EphA7蛋白的表达,Western blot分析结果显示EphA7蛋白在肝细胞癌组织(0.58±0.26)中的表达水平高于癌旁肝组织(0.40±0.22,P<0.05)和正常肝组织(0.32±0.16,P<0.05),而在癌旁肝组织和正常肝组织中的表达差异无统计学意义(P>0.05);EphA7蛋白的表达水平与原发性肝细胞癌细胞的分化程度、门静脉癌栓、淋巴结转移和甲胎蛋白水平等临床病理因素相关(P<0.05).结论 EphA7 蛋白的表达与原发性肝细胞癌的生物学行为密切相关,可能在原发性肝细胞癌的恶性转化、侵袭和转移过程中发挥重要作用.  相似文献   

11.
Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI2) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI2), TXB2 (stabile metabolite of thromboxane A2) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI2 release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB2 (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI2 release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A2, presumably contributing to hemodynamic stability within 30 min after MT.  相似文献   

12.
Don Dame 《Artificial organs》1996,20(5):613-617
Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.  相似文献   

13.
Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.  相似文献   

14.
Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.  相似文献   

15.
Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H2O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg−1 followed by 0.15 mg · kg−1 · h−1, n=8) or verapamil (0.1 mg · kg−1 followed by 0.3 mg · kg−1 · h−1, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.  相似文献   

16.
Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.  相似文献   

17.
Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.  相似文献   

18.
Background: It has been shown that the depressive effects of both propofol and midazolam on consciousness are synergistic with opioids, but the nature of their interactions on other physiological systems, e. g. respiration, has not been fully investigated. The present study examined the effect of propofol and midazolam alone and in combination with fentanyl on phrenic nerve activity (PNA) and whether such interactions are additive or synergistic. Methods: PNA was recorded in 27 anaesthetised and artificially ventilated rabbits. In three groups, propofol, fentanyl and midazolam were administered intravenously in incremental doses to construct dose-response curves for the depressant effects of each one on PNA. In another two groups, the effect of pretreatment with either fentanyl 1 μg · kg?1 i. v. or midazolam 0.05 mg · kg?1 i. v. on the effects of propofol and fentanyl respectively on PNA were studied. Results: Propofol and fentanyl caused a dose-dependent depression of PNA with complete abolition at the highest total doses of 16 mg · kg?1 i. v. and 32 μg · kg?1 i. v., respectively. In contrast, midazolam in incremental doses to a total of 0.8 mg · kg?1 reduced mean PNA by 63%, but approximately 12% of PNA remained at a total dose as high as 6.4 mg · kg?1. The mean ED50s, calculated from dose-response curves, were 5.4 mg · kg?1, 3.9 μg · kg?1 and 0.4 mg · kg?1 for propofol, fentanyl and midazolam, respectively. Initial doses of either fentanyl 1 μg · kg?1 i. v. or midazolam 0.05 mg · kg?1 i. v. acted synergistically with subsequent doses of either propofol or fentanyl to abolish PNA at total doses of 8 mg · kg?1 and 8 μg · kg?1, respectively. Conclusion: Fentanyl has a synergistic interaction with both propofol and midazolam on PNA and hence potentially on respiration.  相似文献   

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Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg?1 · min?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min?1 · m?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO2I) and oxygen consumption index (VO2I) were also significantly increased in the dopexamine group (DO2I: from 416±91 to 717±110 ml/m2 · m2; VO2I: from 98±25 to 157±22 ml/m2 · m2), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow.  相似文献   

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