Runx3基因在肝细胞癌中甲基化状态分析及临床意义

目的通过检测肝细胞癌组织中Runx3基因启动子区域甲基化状态,探讨Runx3基因启动子区域异常甲基化在肝细胞癌发生、发展过程中的临床意义。方法采用DNA甲基化特异性聚合酶链反应（PCR）（MSP）技术对81例肝细胞癌患者肿瘤组织及其癌旁正常组织Runx3基因启动子区域甲基化状态进行检测。结果在肝细胞癌组织中,Runx3基因启动子区域甲基化率占43．2％（35／81）,而在相对应的癌旁正常组织中,Runx3基因启动子区域仅发现1例异常甲基化现象,其甲基化率占1．2％（1／81）（P〈0．01）;Runx3基因启动子区域甲基化状态与临床病理参数的关系差异均无统计学意义。结论Runx3基因启动子区域甲基化是导致Runx3基因失活的主要原因之一,与肝细胞癌发生早期密切相关,可作为肝细胞癌早期诊断的分子标记物及分子治疗的靶点。     

肾细胞癌患者组织中RASSF1A、hMLH1及ALU甲基化水平的分析

目的探讨错配修复基因(h MLH1)、RAS相关区域家族1A基因(RASSF1A)启动子区甲基化以及ALU基因甲基化水平与肾细胞癌(肾癌)的关系。方法巢式甲基化特异性PCR(n MSP)检测15例肾癌组织及其相应癌旁组织中h MLH1、RASSF1A基因启动子区的甲基化状态,联合亚硫酸氢钠限制酶分析方法(COBRA)分析ALU基因甲基化水平。结果 h MLH1基因在肾癌组织中的甲基化率(0.41±0.18)%高于癌旁组织(0.32±0.13)%,差异有统计学意义(t=2.52,P0.05);ALU基因在癌组织中的甲基化率(0.11±0.04)%低于癌旁组织(0.12±0.03)%,差异有统计学意义(t=3.82,P0.05)。而RASSF1A基因在肾癌组织和癌旁组织中的甲基化率分别为(0.75±0.11)%和(0.69±0.12)%,差异无统计学意义(t=1.35,P0.05)。结论 h MLH1基因启动子区甲基化以及ALU基因甲基化可能与肾癌的发病有关,RASSF1A基因启动子区甲基化与肾癌发病无关。     

应用BSP克隆测序检测肝细胞癌组织中Dynamin 3基因启动子区域甲基化水平

目的检测原发性肝细胞癌组织Dynamin 3(DNM3)基因启动子区域36个CpG的甲基化水平,分析其与肝细胞癌患者临床病理特征的关系,探讨DNM3基因甲基化在肝癌形成过程中的作用。方法提取30对患者肝细胞癌组织和癌旁组织DNA,经亚硫酸氢盐处理后,进行巢式PCR并联合克隆测序检测DNM3基因的甲基化水平。结果肝细胞癌患者的甲基化事件发生率为83.3%(25/30)。癌组织的DNM3基因启动子区域平均甲基化率为37.8%,癌旁组织为12.0%,两者比较差异有统计学意义(P0.05)。DNM3基因甲基化诊断肝癌的受试者工作特征曲线(ROC)曲线下面积(AUC)为0.831,对肝癌有较好的诊断价值。结论 DNM3作为肝细胞癌的一种抑癌基因,其启动子区域高度甲基化可能会促进肝细胞癌的形成。     

白血病细胞系中抑癌基因PTEN启动子区甲基化状态检测及其去甲基化研究

目的 探讨抑癌基因PTEN表达沉默的机制及诱导PTEN表达对白血病细胞的作用.方法 应用甲基化特异性聚合酶链反应(Methylation specific PCR,MSP)检测白血病细胞系HL-60、Nalm-6、Raji、KG-1a、U937、NB4、K562中PTEN基因启动子区域甲基化状态;用甲基化转移酶抑制剂5-氮-2'-脱氧胞苷(5-Aza-CdR)处理白血病细胞,MSP检测甲基化状态的改变、RT-PCR检测PTEN mRNA水平的改变、瑞特染色观察细胞形态学改变、膜联蛋白V/碘化丙锭(Annexin V/PI)标记染色检测细胞凋亡.结果 检测的白血病细胞系中HL-60、Nalm-6、Raji、KG-1a、U937细胞PTEN基因显示超甲基化状态,而NB4和K562细胞显示低甲基化状态;5-Aza-CdR处理HL-60和Nalm-6细胞后,PTEN基因甲基化降低、mRNA表达水平则逐渐增高,并呈剂量依赖性,细胞出现凋亡现象.结论PTEN基因启动子区异常甲基化可能导致该基因转录表达失活或沉默,甲基化抑制剂可以诱导PTEN表达,并引起白血病细胞凋亡.     

死亡相关蛋白激酶1基因启动子甲基化在宫颈癌中的临床意义

目的研究死亡相关蛋白激酶1(DAPK1)基因启动子甲基化在宫颈癌中的临床意义。方法应用甲基化特异性聚合酶链反应(PCR)检测宫颈癌癌组织和癌旁正常组织中DAPK1基因启动子甲基化,比较在二者间的差异及其与临床病理因素之间的关系。结果宫颈癌组织中DAPK1基因启动子甲基化率为62.5%,癌旁组织中甲基化率为5.0%,宫颈癌组织中DAPK1基因启动子甲基化率显著高于宫颈癌癌旁组织,差异有统计学意义(P<0.05)。宫颈癌癌组织DAPK1基因启动子甲基化率在组织学分级、肿瘤最大径、淋巴结转移、器官转移、FIGO分期中的差异有统计学意义(P<0.05)。结论 DAPK1基因启动子在宫颈癌中呈高甲基化状态,可作为宫颈癌的病情和预后评估的生物学标志物。     

骨肉瘤中WIF-1甲基化及WIF-1、β-catenin蛋白表达的研究

目的检测骨肉瘤中WIF-1基因启动子区甲基化状态及WIF-1蛋白、β-catenin蛋白表达情况,探讨它们之间的相关性及其与骨肉瘤发生发展的关系,为骨肉瘤的分子靶向治疗提供理论依据。方法收集青岛大学2008年1月至2013年6月骨肉瘤组织50例,并取骨软骨瘤组织30例作为对照,应用甲基化PCR和免疫组化两种方法,检测骨肉瘤组及对照组WIF-1基因启动子区甲基化状态及WIF-1蛋白、β-catenin蛋白表达情况。结果骨肉瘤和骨软骨瘤组织的WIF-1启动子甲基化阳性率分别为70.0%和20.0%,差异具有统计学意义(P<0.01)。WIF-1启动子甲基化阳性率随着骨肉瘤分期的增加而升高。骨肉瘤和骨软骨瘤组织中WIF-1蛋白表达率分别为42.0%和70.0%,两者之间差异有统计学意义(P<0.05),且WIF-1启动子甲基化阳性与WIF-1蛋白表达呈明显负相关(P<0.05)。骨肉瘤和骨软骨瘤组织中β-catenin蛋白表达率分别为70.0%和43.3%,两者之间差异有统计学意义(P<0.05),WIF-1启动子甲基化与β-catenin蛋白表达呈正相关(P<0.05)。结论 WIF-1基因甲基化状态可能抑制了WIF-1蛋白的表达,从而引起β-catenin蛋白在在胞质中异常积聚表达,从而使经典Wnt信号转导通路过度激活,参与细胞的生长、增殖,导致骨肉瘤的发生发展。     

甲基化特异性PCR联合结合重亚硫酸盐限制性内切酶法在胃癌抑癌基因甲基化检测中的应用

目的探讨甲基化特异性PCR(MSP)方法检测胃癌组织中抑癌基因甲基化的准确性,联合应用MSP方法与结合重亚硫酸盐限制性内切酶法(COBRA)检测抑癌基因甲基化状态的意义。方法采用MSP检测胃癌组织抑癌基因Runx3启动子区甲基化的状态,随后再采用COBRA检测胃癌组织标本的甲基化状态。分析两种方法检测结果的关系。结果经MSP方法检测54例肿瘤组织中共有30例标本发生Runx3基因启动子区异常甲基化,甲基化阳性率为55.6%。经COBRA方法检测54例肿瘤组织中有27例出现酶切条带即存在甲基化,甲基化阳性率为50.0%。经COBRA方法检测,在MSP方法检测的30例阳性标本中有3例未出现酶切条带即为假阳性。在MSP方法检测Runx3基因甲基化阴性的24例标本中,经COBRA方法检测,Runx3基因甲基化阴性的标本亦为24例。两种检测方法检测结果的阳性率差异无统计学意义(P>0.05)。结论甲基化特异性PCR方法在检测胃癌抑癌基因甲基化状态的研究中具有较高的灵敏度,COBRA方法可以检测出MSP方法中的假阳性标本,联合应用两种方法检测胃癌组织中抑癌基因的甲基化状态会使实验结果更可靠、准确。     

抑癌基因PTEN和P53在骨肉瘤组织中的表达及对预后的影响

目的:研究骨肉瘤组织中抑癌基因PTEN和P53的表达情况,及其在骨肉瘤的发生、发展中的可能作用。方法:收集中国医科大学附属第一医院1995-05/2002-11骨肉瘤标本38个及骨软骨瘤标本20个。用免疫组织化学SP法检测PTEN及P53在38个骨肉瘤及20个骨软骨瘤石蜡标本中的表达情况。结果:PTEN蛋白在骨肉瘤中表达阳性率为55%(21/38),在对照组骨软骨瘤中为90%18/20),骨肉瘤与骨软骨瘤相比差异有显著性意义((χ2=4.62,P<0.05)。P53在骨肉瘤中表达阳性率为66%(25/38),在对照组骨软骨瘤中为5%(1/20),骨肉瘤与骨软骨瘤相比差异有非常显著性意义(χ2=19.58,P<0.01)。结论:抑癌基因PTEN和P53在骨肉瘤组织中表达下调,可能与骨肉瘤的恶性进展有关。     

肝癌中Sall3基因甲基化的研究

目的:检测Sall3基因在肝癌细胞系和肝癌组织中的甲基化状况及其表达水平。方法:对7株肝癌细胞系、142对肝癌组织和6例正常肝组织进行Sall3基因启动子区域甲基化检测。甲基化研究使用甲基化特异性聚合酶链反应(methylation specific polymerase chain reaction,MSP),基因表达水平研究采用实时定量反转录PCR(real-time RT-PCR)。结果:MSP结果显示,7株肝癌细胞株中有6株Sall3基因的启动子区域为纯合甲基化,1株为纯合去甲基化;在6例正常肝组织中Sall3均为纯合去甲基化;在142对肝癌组织标本中,癌旁组织Sall3基因启动子区域甲基化率为18.31%,在癌组织中为64.79%。real-time RT-PCR结果显示,肝癌肿瘤细胞系Sall3mRNA的表达水平明显低于去甲基化的正常肝组织。结论:Sall3基因启动子甲基化在正常肝组织、肝癌组织(和肝癌细胞系)中有明显差异。     

Runx3基因启动子区甲基化与胃癌的关系

目的通过检测胃癌Runx3基因启动子区域甲基化状态，来探讨Runx3基因启动子区域甲基化在胃癌发生和发展过程中的临床意义。方法采用DNA甲基化特异性PCR（MSP）技术对37例胃癌患者手术切除肿瘤组织及其癌旁组织Runx3基因启动子区域甲基化进行检测。结果Runx3基因在37例胃癌及其癌旁组织中甲基化率分别为40．5％（15／37）和8％（3／37）。结论Runx3基因启动子区甲基化可能是肿瘤特异性的（P＜0．05），可作为胃癌早期诊断的分子标记物。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Modified micro-superior percutaneously-assisted total hip: early experiences & case reports

Because of the extensile nature and familiarity of the standard posterior-lateral approach to the hip, a family of "micro-posterior" approaches has been developed. This family includes the Percutaneously-Assisted Total Hip (PATH) approach, the Supercapsular (SuperCap) approach and a newer hybrid approach, the Supercapsular Percutaneously-Assisted Total Hip (SuperPATH) approach. Such approaches should ideally provide a continuum for the surgeon: from a "micro" (external rotator sparing) posterior approach, to a "mini" (external rotator sacrificing) posterior approach, to a standard posterior approach. This could keep a surgeon within his comfort zone during the learning curve of the procedure, while leaving options for complicated reconstructions for the more practiced micro-posterior surgeons. This paper details one author's experiences utilizing this combined approach, as well as permutations of this entire micro-posterior family of approaches as applied to more complex hip reconstructions.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.