Survivin在原发性肝细胞癌中的表达及意义

目的　Survivin是凋亡抑制蛋白中的一种 ,选择性地表达于恶性肿瘤组织。该文研究Sur vivin基因在原发性肝细胞癌中的表达及生物学意义。方法　收集 2株肝细胞癌细胞株 ,4 0例原发性肝癌组织标本及相应的癌旁组织 ,以Westernblotting法检测Survivin蛋白表达 ;半定量RT PCR法检测SurvivinmRNA表达 ;肝癌细胞凋亡指数采用原位末端标记法检测。结果　 2株肝癌细胞株和 85 % (34例 )的肝癌组织表达Survivin蛋白和mRNA ,而癌旁组织内无一例阳性表达。Survivin蛋白表达的阳性率在肝内转移组为 93.5 % ,显著高于肝内无转移组 (5 5 .6 % ,P <0 .0 5 ) ;在门静脉癌栓浸润组为 92 .8% ,显著高于无门静脉癌栓浸润组 (6 6 .7% ,P <0 .0 5 )。RT PCR显示 ,2株肝癌细胞株和 85 .0 % (34例 )的肝癌组织表达SurvivinmRNA ,与Westernblotting的结果一致 ,SurvivinmRNA的表达水平在肝内转移组 (1.10 5± 0 .396 )和门静脉癌栓浸润组 (1.137± 0 .4 0 4 )中 ,显著高于肝内无转移组 (0 .5 72± 0 .0 82 )和无门静脉癌栓浸润组 (0 .6 2 7± 0 .12 2 ,P <0 .0 5 )。所有肝癌组织标本中均可检测到凋亡细胞 ,但Survivin表达阳性组的凋亡指数 (1.15 2 %± 0 .32 6 % )显著低于Survivin表达阴性组 (4.5 0 2 %± 0 .830 % ,P <0 .0 5     

E-CD和CD44V6在肾细胞癌中的表达及临床意义

应用免疫组化方法检测61例肾细胞癌（RCC）组织和12例正常肾组织中上皮钙黏附素（E-CD）和CD44基因含V6外显子变异体（CD44V6）的表达情况。结果正常肾组织中E-CD、CD44V6均呈阳性表达。RCC组织中E-CD、CD44V6保留表达率在不同细胞类型中无显著差异,不同分级和分期中有显著差异,E-CD在转移组和无转移组、脉管浸润组和无脉管浸润组之间有显著差异,CD44V6在转移组和无转移组、脉管浸润组和无脉管浸润组之间无显著差异。认为E-CD在RCC组织中的保留表达率和分级、分期、转移及浸润呈负相关,CD44V6在RCC组织中的保留表达率和分级、分期呈正相关。     

膀胱移行细胞癌组织中CD44v6的表达及意义

采用免疫组化SABC法检测64例膀胱移行细胞癌和癌旁膀胱组织中的CD4v6。结果显示,64例膀胱移行细胞癌组织中CD44v6阳性表达率为56.3%,癌旁膀胱组织中未见CD44v6蛋白表达;CD44v6表达水平与膀胱移行细胞癌组织学分级、临床分期及复发有关。认为CD44v6可作为判断膀胱移行细胞癌的恶性程度和复发的参考依据。     

其它肝脏疾病/肝硬化

Pinl在肝硬化和肝癌组织中的表达及其与乙型肝炎病毒X蛋白的关系——杨盛力等（湖北武汉华中科技大学同济医学院附属同济医院肝脏外科中心430030）；《腹部外科》2007，20（4）：240—242[目的：通过检测Pinl在肝硬化组织和肝癌原发灶及门静脉癌栓中的表达，     

原发性肝癌合并门静脉癌栓的外科治疗

肝癌是常见恶性肿瘤之一，其发病率和病死率居我国恶性肿瘤第二位。门静脉侵犯是肝癌重要的生物学特性。肝癌倾向于侵袭门静脉，并继而形成癌栓。临床报道肝癌门静脉癌栓（PVTT）发生率为44．0％～62．2％。肝癌侵袭门静脉是肝内播散及根治性切除术后早期复发的根源。此外，癌栓阻塞门静脉，门静脉高压加剧，继而引发食道胃底静脉破裂出血，甚至导致肝功能衰竭。因此，肝癌合并PVTT患者总体预后差，中位生存时间仅2．7个月。     

Ezrin蛋白和CD44-V6蛋白在结肠腺癌中的表达及其意义

目的 探讨结肠腺癌组织中Ezrin及CD44-V6蛋白的表达及意义.方法 应用免疫组化SP法检测Ezrin及CD44 -V6蛋白在80例结肠腺癌和20例癌旁肠组织中的表达情况.结果 Ezrin及CD44-V6蛋白在癌旁肠组织中阳性表达率分别为35.0％ 、25.0％,而在结肠腺癌组织中的阳性表达率明显增高,分别为83.75％ 、82.5％,Ezrin及CD44-V6蛋白在癌旁肠组织组与结肠腺癌组相比,差异有统计学意义(P＜0.01);Ezrin及CD44-V6蛋白表达与肿瘤组织分化程度、浸润深度、淋巴结转移及分期有关(P＜0.01);Ezrin及CD44-V6蛋白在结肠癌组织中的表达呈显著正相关,差异有显著性(P＜0.01);在Ezrin及CD44-V6蛋白同时阳性表达组中,淋巴结转移率高达65％显著高于两者均为阴性表达组淋巴结转移率14.29％,差异有统计学意义(P＜0.05).结论 Ezrin及CD44-V6蛋白过表达可能与结肠癌患者的侵袭及淋巴结转移具有显著相关性,联合检测Ezrin及CD44-V6蛋白有助于预测结肠腺癌的恶性程度和转移潜能.     

甲状腺乳头状癌组织中ZNF703、CD44v6的表达及与临床病理参数的相关性

目的检测ZNF703和CD44v6蛋白在甲状腺乳头状癌组织中的表达水平及其临床意义。方法采用免疫组织化学法检测73例甲状腺乳头状癌和配对癌旁组织、50例结节性甲状腺瘤组织中ZNF703、CD44v6蛋白的表达,并分析ZNF703和CD44v6)与癌组织临床病理参数的关系,采用Spearman等级相关分析两指标的相关性。结果甲状腺乳头状组织中,ZNF703和CD44v6蛋白的阳性表达率(69. 86%、78. 08%)均分别高于癌旁组组织(12. 32%、21. 92%)和结节性甲状腺癌组织(24. 00%、36. 00%),差异均有统计学意义(P<0. 05)。ZNF703和CD44v6在甲状腺乳头状癌组织的表达阳性率均与年龄、性别无关(P>0. 05),与肿瘤直径、临床分期、淋巴结转移有关(P<0. 05); ZNF703和CD44v6在甲状腺乳头状癌组织中的表达水平呈正相关(r=0. 722,P=0. 00)。结论 ZNF703和CD44v6蛋白在甲状腺乳头状癌组织中高表达,且其表达均与肿瘤大小、临床分期及淋巴结转移有关,ZNF703和CD44v6可能协同参与了甲状腺乳头状癌的发生、发展,联合检测可为甲状腺肿瘤良、恶性鉴别及预后评估提供参考。     

非小细胞肺癌DNA含量与转移相关基因表达的相关性研究

目的　探讨转移相关基因CD82、CD44和Fas在肺癌中的表达与DNA含量的关系。方法　应用流式细胞仪对45例肺癌患者手术切除的新鲜癌标本中CD82、CD44、Fas蛋白及DNA含量进行检测,并与癌旁对照组(30例)和肺部良性病变组(20例)对照。结果　肺癌组CD82和Fas表达低于癌旁对照组和良性病变组,CD44表达和DI值高于癌旁组和良性病变组。CD82、CD44、Fas表达和DNA含量与肺癌的分期和分级相关。CD82和Fas表达与DI值均呈负相关(r=-0. 674,r=-0. 881,P<0. 01),CD44表达与DI值呈正相关(r=0. 542,P<0. 01),CD82和Fas表达水平与CD44蛋白的表达水平均呈负相关(r=-0. 926,r=-0. 653,P<0. 01)。结论　CD82、CD44、Fas表达及DNA含量在肺癌发生、发展和转移过程中起着不同但又相互调控的作用,联合检测这些指标对预测肿瘤的生长和转移潜能具有一定的指导意义。     

非小细胞肺癌组织中CD44s、CD44v6、Fas的表达及意义

目的 探讨非小细胞肺癌组织中CD44s、CD44v6、Fas的表达及临床意义.方法 采用SP免疫组化法检测CD44s、CD44v6及Fas基因蛋白在58例非小细胞肺癌、18例癌旁正常组织中的表达变化,分析其表达与肿瘤TNM分期、分化程度及淋巴结转移关系.结果 Fas基因蛋白在非小细胞肺癌组织中的表达低于癌旁肺组织,CD44s和CD44v6在癌旁正常肺组织未见表达;CD44s在鳞癌和腺癌中的表达阳性率分别为83.3％及45.5％,CD44v6,在鳞癌和腺癌的表达阳性率分别为86.1％及40.9％,CD44s、CD44v6在鳞癌中的表达均高于腺癌（P均＜0.05）.Fas、CD44s和CD44v6的表达均与肿瘤TNM分期、分化程度及淋巴结转移相关.结论 非小细胞肺癌通过CD44分子的构型改变,降低Fas表达,逃逸Fas-FasL介导的细胞凋亡.非小细胞肺癌CD44s、CD44v6及Fas蛋白的检测可能为评价肿瘤预后的重要指标,也为非小细胞肺癌的治疗提供新的靶点.     

Fas/FasL在肝癌免疫逃避中作用的探讨

应用免疫组织化学法及脱氧核糖核酸末端转移酶介导的缺口末端标记 (Tunel)技术 ,对 41例肝癌组织中Fas、FasL表达及肝细胞凋亡进行观察和比较。结果显示 ,肝癌中Fas阳性率为 31 .71 % ,癌旁肝硬化Fas阳性率 80 .0 0 % ,癌细胞Fas表达较癌旁显著减小 ,肝癌及癌旁肝硬化FasL阳性率分别为 41 .46 %、65 .0 0 % ;FasL表达在二者间无显著差异。肝癌组织Fas、FasL表达与性别、肿瘤大小、组织分级无关。Fas表达与门静脉癌栓发生率呈负相关 ,FasL表达则与其无关。Fas抗原表达阳性的肝癌组织细胞凋亡指数明显高于Fas抗原表达阴性组。表明Fas/FasL系统在原发性肝癌肿瘤免疫逃避中起重要作用 ,Fas抗原表达在原发性肝癌门静脉癌栓形成中的作用值得进一步研究     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

124例耐多药结核分枝杆菌基因突变特征分析

目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

Assessment of quality of life of parents of children with juvenile chronic arthritis

The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low. Received: 26 September 2001 / Accepted: 8 February 2002     

Numerical Simulation of the Effect of Rate of Change of Glucose on Measurement Error of Continuous Glucose Monitors

Background

A 5-day in-patient study designed to assess the accuracy of the FreeStyle Navigator® Continuous Glucose Monitoring System revealed that the level of accuracy of the continuous sensor measurements was dependent on the rate of glucose change. When the absolute rate of change was less than 1 mg•dl⁻¹•min⁻¹ (75% of the time), the median absolute relative difference (ARD) was 8.5%, with 85% of all points falling within the A zone of the Clarke error grid. When the absolute rate of change was greater than 2 mg•dl⁻¹•min⁻¹ (8% of the time), the median ARD was 17.5%, with 59% of all points falling within the Clarke A zone.

Method

Numerical simulations were performed to investigate effects of the rate of change of glucose on sensor measurement error. This approach enabled physiologically relevant distributions of glucose values to be reordered to explore the effect of different glucose rate-of-change distributions on apparent sensor accuracy.

Results

The physiological lag between blood and interstitial fluid glucose levels is sufficient to account for the observed difference in sensor accuracy between periods of stable glucose and periods of rapidly changing glucose.

Conclusions

The role of physiological lag on the apparent decrease in sensor accuracy at high glucose rates of change has implications for clinical study design, regulatory review of continuous glucose sensors, and development of performance standards for this new technology. This work demonstrates the difficulty in comparing accuracy measures between different clinical studies and highlights the need for studies to include both relevant glucose distributions and relevant glucose rate-of-change distributions.     

Angiographic diagnosis of the degree of serosal invasion of carcinoma of the colon

Angiography using Prostaglandin El^® was performed on 38 patients with carcinoma of the colon in order to diagnose the degree of serosal cancer invasion. The findings at angiography were classified into four groups:1) AG-S3, abnormal change (irregularity and/or encasement) up to marginal vessels; 2) AG-S2, abnormality up to vasa recta; 3) AG-S1, abnormality of penetrating branches of vasa recta within the wall of the colon; and 4) AG-S0, no distinct findings of abovementioned vessels. These angiographic findings were compared with both macroscopic and microscopic serosal cancer invasion. Angiographic diagnosis is in accord with the macroscopic findings in 84.2 percent of cases. Angiographic diagnosis is in accord with the microscopic findings in 32.4 percent of cases. Macroscopic findings confirm the angiographic diagnosis precisely but the conflict with microscopic findings should not be overlooked. This may be the result of inflammatory change, adhesion, and fibrosis around carcinoma of the colon.