胃癌KRT17表达及其对上皮间质转化的影响

目的:研究KRT17在胃癌组织、细胞的表达及其对上皮间质转化(epithelial mesenchymal transition,EMT)的作用。方法:利用RT-PCR法检测32对配对胃癌及癌旁组织KRT17的表达。用RT-PCR及Western印迹法检测胃癌细胞株与永生化胃黏膜上皮细胞KRT17的表达。免疫组织化学染色法评估227例胃癌组织芯片KRT17表达,结合临床病理资料进行初步分析。Transwell实验观察干扰KRT17的胃癌细胞与对照组细胞迁移、侵袭能力的差异。RT-PCR及Western印迹法检测EMT标志物E钙黏蛋白、波形蛋白的表达。结果 :KRT17在胃癌组织和细胞中表达显著增加,其表达高低与肿瘤组织分级(P=0.008),肿瘤浸润深度(T分期)(P=0.027),淋巴结转移(N分期)(P=0.03)密切相关。干扰KRT17后胃癌细胞迁移和侵袭能力明显下降,E钙黏蛋白的表达明显升高,波形蛋白的表达明显降低。结论:KRT17在胃癌组织中高表达,并与临床病理密切相关。KRT17下调后抑制细胞迁移与侵袭,通过抑制EMT的机制产生作用。     

癌胚抗原细胞黏附分子1和CD105对胃癌进展的作用

目的:研究癌胚抗原细胞黏附分子1(CEACAM1)、CD105及CD34标记的肿瘤微血管密度(MVD)在胃癌组织中的表达,探讨其对胃癌生长、浸润和转移的作用。方法:采用免疫组织化学SP法,检测60例胃癌组织和15例癌旁正常组织中CEACAM1、CD105的表达,计数CD34标记的MVD值。结果:CEACAM1在胃癌组织中表达强度明显高于癌旁正常组织(P0.05);CEACAM1在Ⅲ～Ⅳ期病例中表达明显升高,与Ⅰ～Ⅱ期相比差异有统计学意义(P0.05)。CD105在胃癌组织中的表达明显高于癌旁正常组织的表达(P0.05)。CD105在Ⅲ～Ⅳ期病例中表达明显高于Ⅰ～Ⅱ期(P0.01)。胃癌组织中MVD均值明显高于癌旁正常组织(P0.01)。MVD在不同病理分级G1、G2、G3组间两两比较,差异均有统计学意义(P0.05)。在不同临床分期比较,Ⅲ~Ⅳ期MVD值显著高于Ⅰ~Ⅱ期(P0.01)。CEACAM1与CD105在胃癌组织中的表达存在明显正相关(r=0.382,P0.01),CEACAM1与MVD的表达存在明显正相关(r=0.437,P0.01);CD105与MVD的表达存在明显正相关(r=0.336,P0.05)。结论:CEACAM1是一个肿瘤抑制因子,CEACAM1在胃癌组织中表达的升高促进了胃癌微血管的生成。CEACAM1可以作为抗肿瘤血管生成治疗的靶点之一。CEACAM1、CD105在胃癌组织中的表达与胃癌的临床分期密切相关,CEACAM1的表达与CD105呈正相关,两者表达水平越高,胃癌的浸润性越强,恶性程度越高。MVD与胃癌的病理分级和临床分期密切相关。MVD越高,肿瘤新生血管越丰富,胃癌恶性程度越高。     

过表达癌胚抗原相关黏附分子6抑制胃癌细胞的凋亡与失巢凋亡

目的:探讨过表达癌胚抗原相关黏附分子6(carcinoembryonic antigen-related cell adhesion molecule 6,CEACAM6)对胃癌细胞凋亡与失巢凋亡的影响。方法:构建CEACAM6真核过表达载体转染胃癌细胞SGC-7901和MKN-45,使其CEACAM6过表达,qRT-PCR、Western印迹验证过表达效果,免疫荧光定位CEACAM6;流式细胞仪检测过表达CEACAM6后胃癌细胞凋亡的变化,失巢凋亡检测其失巢凋亡的变化。结果:转染CEACAM6后,胃癌细胞SGC-7901和MKN-45的CEACAM6分别过表达了30 000倍和4 000倍;在胃癌细胞SGC-7901中凋亡与失巢凋亡分别下降了46.2%和53.8%,在MKN-45中凋亡与失巢凋亡分别下降了71.7%和74.6%。结论:过表达CEACAM6抑制胃癌细胞的凋亡和失巢凋亡,CEACAM6通过抑制胃癌细胞凋亡和失巢凋亡的途径参与胃癌细胞的恶性生长过程。     

TXNDC9在结肠直肠癌组织中的表达及其影响

目的:探讨TXNDC9基因在结肠直肠癌组织和细胞中的表达,以及沉默TXNDC9高表达后对细胞株SW1116增殖、迁移、侵袭能力的影响。方法:分别应用免疫组织化学技术、免疫印迹法观察TXNDC9在结肠直肠癌组织和细胞中的表达水平:应用小干扰RNA瞬时转染TXNDC9高表达的结肠癌细胞株SW1116,用实时PCR筛选最高效率的干扰片段,并用Western印迹法检测基因沉默效果:最后研究瞬时转染后SW1116细胞增殖、迁移、侵袭能力的变化。结果:结肠直肠癌组织中TXNDC9的表达明显高于对照的癌旁正常组织(P<0.01),细胞迁移和侵袭能力亦有明显下降(P<0.01)。结论:TXNDC9在结肠直肠癌组织中的表达显著高于癌旁正常黏膜上皮,并与肿瘤的大小和浸润深度相关,SW1116是TXNDC9基因高表达的细胞株之一,下调TXNDC9表达能显著抑制该细胞的增殖能力、细胞迁移和侵袭能力。TXNDC9基因对维持肿瘤细胞的增殖和运动能力有重要作用,并可能成为抑制肿瘤生长和转移的有效途径。     

长链非编码RNA POU6F2-AS2在人胃癌组织中的表达及临床意义

目的探讨长链非编码RNA POU6F2-AS2在人胃癌组织中的表达及临床意义。方法收集2017年5月至2018年5月期间川北医学院附属医院普外科收治的73例行胃癌根治手术患者的胃癌组织及其配对的距离癌组织5 cm处的癌旁胃黏膜组织标本,采用实时荧光定量聚合酶链反应方法检测胃癌组织及其相对应的癌旁组织中POU6F2-AS2表达水平,采用χ2检验分析其表达水平与胃癌患者临床病理特征的关系,通过Kaplan Meier Plotter数据库数据分析POU6F2-AS2的表达与胃癌患者总体生存率的关系。结果胃癌组织中POU6F2-AS2相对表达量明显高于其对应的癌旁组织(P0.050)。根据胃癌组织与其对应的癌旁组织中POU6F2-AS2表达水平将POU6F2-AS2在癌组织中高于其癌旁组织的病例归为高表达(43例),反之归为低表达组(30例)。分析POU6F2-AS2表达高低与胃癌患者临床病理特征的关系发现,POU6F2-AS2高表达与肿瘤浸润深度(P=0.022)和TNM分期(P=0.032)有关,而与胃癌患者的性别、年龄、是否吸烟、是否饮酒、肿瘤直径、分化程度、淋巴结转移、远处转移、脉管浸润、神经浸润、肝脏转移、有无腹水及脂肪结节是否转移均无关(P0.050)。通过Kaplan Meier Plotter数据库数据分析631例胃癌患者POU6F2-AS2表达水平与患者总体生存率的关系发现,POU6F2-AS2高表达组相对于其低表达组预后更差(P=0.001)。结论 POU6F2-AS2高表达与肿瘤浸润深度和TNM分期有关,其可能参与了调控胃癌的发生及发展,有希望作为潜在的胃癌基因诊断和治疗的重要靶点以及评估胃癌患者预后的生物标志物。     

胃癌组织中皮层肌动蛋白的表达及其对预后的影响

目的：探讨皮层肌动蛋白（CORTACTIN）在胃癌组织中的表达及其对预后的影响。 方法：采用免疫组化SP法检测56例胃癌及对应癌旁组织中CORTACTIN的表达,分析其与胃癌临床特征和预后的关系。 结果：CORTACTIN在胃癌组织中的阳性表达率显著高于对应的癌旁组织 (69.6% vs. 21.4%,P=0.000),CORTACTIN在胃癌中的阳性表达与肿瘤病理分化程度、淋巴结转移、TNM分期和浸润深度有关(P=0.009, P=0.014, P=0.019, P=0.021);CORTACTIN阳性表达是胃癌患者预后不良的独立影响因素。 结论：CORTACTIN在胃癌组织中表达升高,并且与患者预后相关,提示CORTACTIN可能在胃癌中发挥促进侵袭转移的作用。     

miR-301a在结肠直肠癌组织中的表达及其对结肠癌细胞侵袭、迁移能力的影响

目的:分析结肠直肠癌组织miR-301a的表达及其与结肠直肠癌病人临床病理特征的关系。探讨下调miR-301a表达对结肠癌细胞增殖、侵袭、迁移能力以及PTEN蛋白表达的影响。方法:应用实时定量PCR方法检测48对结肠直肠癌组织和癌旁组织以及5种结肠癌细胞株中miR-301a的表达。应用瞬时转染方法将miR-301a抑制剂转入结肠癌细胞株HCT116后,用细胞增殖实验(CCK-8法)、transwell侵袭实验检测细胞的增殖和侵袭力;采用transwell迁移实验和划痕实验检测细胞迁移能力;并用Western印迹技术检测下调miR-301a后其靶蛋白PTEN表达的变化。结果:PCR结果显示,miR-301a在有淋巴结转移的结肠直肠癌组织中表达较其对应的癌旁组织和无淋巴结转移的癌组织为高(P<0.05);5种结肠癌细胞中均有不同程度表达;transwell侵袭、迁移实验显示,miR-301a抑制剂转染后HCT116细胞侵袭、迁移能力明显降低(P<0.05);增殖实验显示,下调miR-301a对结肠癌细胞抑制作用明显(P<0.05)。划痕实验表明,miR-301a抑制剂转染组细胞迁移能力明显受到抑制。Western印迹法显示,miR-301a抑制剂转染组细胞PTEN蛋白表达增加。结论:miR-301a在有淋巴结转移的结肠直肠癌组织中表达较高;下调miR-301a的表达抑制HCT116细胞的增殖、侵袭和迁移能力,且PTEN蛋白表达增加。miR-301a对结肠癌细胞生物学功能的影响可能是通过PTEN信号通路实现的。     

整合素αvβ6在甲状腺乳头状癌中的表达

目的:探究整合素αvβ6在甲状腺乳头状癌中的表达及其对肿瘤生物学行为的影响。方法:选取2014年11月—2015年9月60例PTC肿瘤及相应癌旁组织标本,免疫组化法检测整合素αvβ6的表达情况;在PTC细胞系TPC-1及B-CPAP中利用siRNA干扰整合素αvβ6表达,CCK8实验及Transwell侵袭实验分别检测PTC细胞增殖能力及侵袭能力的变化。结果:整合素αvβ6在癌旁组织中几乎不表达,在肿瘤组织中表达显著,且在伴有周围侵犯的肿瘤组织中表达高于不伴有周围侵犯的肿瘤组织。体外干扰αvβ6表达后,肿瘤细胞增殖能力及侵袭能力受到显著抑制。结论:在PTC组织中整合素αvβ6表达显著上调,上调的整合素αvβ6与肿瘤的侵袭浸润显著相关,干扰整合素αvβ6的表达可以显著抑制PTC细胞的增殖能力与侵袭能力。     

沉默信息调节因子7在胃癌组织的表达及其与胃癌临床病理的关系

目的观察沉默信息调节因子7(SIRT7)在胃癌组织中的表达,分析其与胃癌临床病理特征的关系。方法收集195例胃癌病人的癌组织和癌旁正常组织,Western blot检测SIRT7在胃癌及癌旁组织中的表达水平,免疫组织化学方法检测不同病理特征的胃癌组织和癌旁组织中SIRT7的表达。结果胃癌组织中SIRT7阳性率(65. 64%)明显高于癌旁正常组织的阳性率(19. 49%),差异有统计学意义(P 0. 05)。SIRT7在胃癌组织中的表达与病人年龄、性别及肿瘤大小无明显相关(P 0. 05),而与胃癌淋巴结转移、浸润深度、TNM分期明显相关(P 0. 05)。结论SIRT7在胃癌组织中的表达高于癌旁正常组织,且与胃癌淋巴结转移、浸润深度、TNM分期密切相关,表明SIRT7在胃癌的侵袭过程中发挥重要作用。     

钙黏蛋白12在结肠癌细胞株与结肠直肠癌组织中的表达及其影响

目的：研究钙黏蛋白12（cadherin-12,CDH-12）在结肠癌细胞株与结肠直肠癌组织中的表达及其对结肠癌细胞株增殖、侵袭、迁移的影响。方法：应用实时PCR和Western印迹法在7株结肠癌细胞株中筛选CDH-12高表达细胞株;shRNA瞬转干扰高表达细胞株SW1116,Western印迹法验证干扰效果;CCK-8检测癌细胞增殖活性变化;transwell实验验证癌细胞迁移、侵袭能力的变化;组织芯片免疫组织化学技术检测CDH-12在结肠直肠癌组织中的表达。结果：实时PCR和Western印迹结果显示CDH-12在细胞株中表达,SW1116和LoVo两个细胞株高表达CDH-12,在成功下调SW1116细胞中CDH-12表达之后,SW1116结肠癌细胞株的增殖、迁移、侵袭能力较对照组明显下降;免疫组化染色结果显示,CDH-12在结肠直肠癌组织中的表达明显高于癌旁正常组织中的表达。结论：CDH-12在结肠直肠癌组织中的表达明显高于癌旁正常组织,证实了CDH-12为癌基因的可能性;下调CDH-12在结肠癌细胞株SW1116的表达可明显抑制细胞的增殖、迁移、侵袭能力,显示其在肿瘤细胞生长和转移中的重要作用。     

Presenteeism and Absenteeism Before and After Total Hip and Knee Arthroplasty

BackgroundAbsenteeism is costly, yet evidence suggests that presenteeism—illness-related reduced productivity at work—is costlier. We quantified employed patients’ presenteeism and absenteeism before and after total joint arthroplasty (TJA).MethodsWe measured presenteeism (0-100 scale, 100 full performance) and absenteeism using the World Health Organization’s Health and Work Performance Questionnaire before and after TJA among a convenience sample of employed patients. We captured detailed information about employment and job characteristics and evaluated how and among whom presenteeism and absenteeism improved.ResultsIn total, 636 primary, unilateral TJA patients responded to an enrollment email, confirmed employment, and completed a preoperative survey (mean age: 62.1 years, 55.3% women). Full at-work performance was reported by 19.7%. Among 520 (81.8%) who responded to a 1-year follow-up, 473 (91.0%) were still employed, and 461 (88.7%) had resumed working. Among patients reporting at baseline and 1 year, average at-work performance improved from 80.7 to 89.4. A Wilcoxon signed-rank test indicated that postoperative performance was significantly higher than preoperative performance (P < .0001). The percentage of patients who reported full at-work performance increased from 20.9% to 36.8% (delta = 15.9%, 95% confidence interval = [10.0%, 21.9%], P < .0001). Presenteeism gains were concentrated among patients who reported declining work performance leading up to surgery. Average changes in absences were relatively small. Combined, the average monthly value lost by employers to presenteeism declined from 15.3% to 8.3% and to absenteeism from 16.9% to 15.5% (ie, mitigated loss of 8.4% of monthly value).ConclusionAmong employed patients before TJA, presenteeism and absenteeism were similarly costly. After, employed patients reported increased performance, concentrated among those with declining performance leading up to surgery.     

The German emergency and disaster medicine and management systemdhistory and present

As well for optimized emergency management in individual cases as for optimized mass medicine in disaster management, the principle of the medical doctors approaching the patient directly and timely, even close to the site of the incident, is a long-standing marker for quality of care and patient survival in Germany. Professional rescue and emergency forces, including medical services, are the “Golden Standard” of emergency management systems. Regulative laws, proper organization of resources, equipment, training and adequate delivery of medical measures are key factors in systematic approaches to manage emergencies and disasters alike and thus save lives. During disasters command, communication, coordination and cooperation are essential to cope with extreme situations, even more so in a globalized world. In this article, we describe the major historical milestones, the current state of the German system in emergency and disaster management and its integration into the broader European approach.     

Differences in Osteocyte Density and Bone Histomorphometry Between Men and Women and Between Healthy and Osteoporotic Subjects

Bone defects related to osteoporosis develop with increasing age and differ between males and females. It is currently thought that the bone remodeling process is supervised by osteocytes in a strain-dependent manner. We have shown an altered response of osteocytes from osteoporotic patients to mechanical loading, and osteocyte density is reduced in osteoporotic patients, which might relate to imperfect bone remodeling, leading to lack of bone mass and strength. Hence, information on osteocyte density will contribute to a better understanding of bone biology in males and females and to the assessment of osteoporosis. Osteocyte density as well as conventional histomorphometric parameters of trabecular bone were determined in cancellous iliac crest bone of healthy postmenopausal women and men and of osteoporotic women and men. Osteocyte density was higher in healthy females than in healthy males and lower in osteoporotic females than in healthy females. Bone mass was reduced in osteoporotic patients, both male and female. In females, trabecular number was reduced, whereas in males, trabecular thickness was reduced and eroded surface was increased. There were no correlations between the parameter groups bone architecture, bone formation, bone resorption, and osteocyte density. These results are consistent with impaired osteoblast function in osteoporotic patients and with a different mechanism of bone loss between men and women, in which osteocyte density might play a role. The reduced osteocyte numbers in female osteoporotic patients might relate to imperfect bone remodeling leading to lack of bone mass and strength. M. G. Mullender and S. D. Tan contributed equally to this work.     

肝内胆管囊腺瘤和囊腺癌的CT、MRI及病理表现

目的探讨肝内胆管囊腺瘤和囊腺癌的CT、MRI和病理特点。方法回顾性分析经手术病理证实的6例肝内胆管囊腺瘤和2例肝内胆管囊腺癌的影像及临床病理资料，将病变的影像表现与其病理大体形态及组织学表现作对照分析。结果6例肝内胆管囊腺瘤，女4例、男2例；2例肝内胆管囊腺癌均为女性病人；8例病人平均年龄55岁。所有病灶均表现为多房囊性肿块，肿瘤囊腔各分房内常为多种液体成分，在CT上可表现为不同密度、在MRI上可表现为不同信号强度。囊内出现多发大小不等的壁结节在胆管囊腺癌内更常见，囊内有分隔但无壁结节只见于胆管囊腺瘤。在7例CT扫描中，4例胆管囊腺瘤和1例胆管囊腺癌可见囊壁或分隔上钙化，囊壁、囊内分隔及囊内结节均为轻、中度延迟增强。肿瘤中出现卵巢样间质见于3例胆管囊腺瘤和1例胆管囊腺癌，且均为女性病人。结论肝内胆管囊腺瘤和囊腺癌是肝脏不常见的囊性肿瘤，影像上多房、囊内有分隔且各分房囊内密度或信号不一致，高度提示肝内胆管囊腺瘤或囊腺癌的诊断，如囊内伴有多发大小不等的结节，则进一步提示囊腺癌的可能。但影像学表现不能区分肿瘤中有无卵巢样间质。