组织因子途径抑制物-2在非小细胞肺癌中的表达及其临床意义

目的 研究组织因子途径抑制物-2(TFPI-2)在非小细胞肺癌中的表达及其临床意义.方法 应用免疫组织化学SP法检测56例手术切除的肺癌石蜡标本及12例肺部良性病变的肺正常组织中的TFPI-2的蛋白表达情况.结果 ①TFPI-2在非小细胞肺癌中的表达阳性率为21.4％,低于正常肺组织(75.0％,P＜0.05);②TFPI-2在鳞癌中的蛋白表达阳性率低于腺癌(9.4％ vs 37.5％,P＜0.05),Ⅰ+Ⅱ期非小细胞肺癌组织TFPI-2表达阳性率高于Ⅲ+Ⅳ期非小细胞肺癌组织(31.3％ vs 8.3％,P＜0.05),而组织分化程度对TFPI-2表达阳性率的影响无统计学差异;③吸烟指数≥400的肺癌患者TFPI-2表达阳性率低于吸烟指数＜400(包括不吸烟者)的患者(8.6％ vs 42.9％,P＜0.05);④56例非小细胞肺癌组织中,TFPI-2表达阳性患者的肿瘤最大直径均小于5 cm,在肿瘤最大直径大于5 cm的患者肺癌组织中,TFPI-2基本不表达.结论 TFPI-2的低表达可能在非小细胞肺癌的发生、发展过程中起重要作用,TFPI-2的表达与非小细胞肺癌的病理类型、临床分期、吸烟指数、肿瘤直径是否小于5 cm密切相关,与组织的分化程度无关.     

非小细胞肺癌组织中WWOX蛋白表达及意义

目的观察非小细胞肺癌中包含氧化还原酶的ww域（WWOX）蛋白的表达,探讨其与临床病理参数的关系。方法采用免疫组化法检测79例非小细胞肺癌组织以及30例癌旁组织中WWOX蛋白,并分析其与非小细胞肺癌各临床病理参数的关系。结果WWOX蛋白在非小细胞肺癌组织的阳性率为16.4%（13/79）,较癌旁肺组织的90%（27/30）显著减低（P〈0.05）。WWOX蛋白表达与是否有淋巴结转移显著相关（P〈0.01）。结论WWOX蛋白表达在肺癌组织中表达减少或缺失,可能与肺癌的发生发展有关。     

Survivin和Livin蛋白在非小细胞肺癌中的表达及临床意义

目的 研究Survivin和Livin蛋白在非小细胞肺癌(NSCLC)组织中的表达及其临床意义,并分析两者的相关性.方法 用免疫组织化学SP法检测50例NSCLC组织、21例癌旁正常肺组织中Survivin和Livin蛋白的表达水平,并分析其与临床病理特征的关系.结果 Survivin蛋白在NSCLC中的阳性表达率显著高于癌旁正常肺组织(P＜0.05),Livin蛋白在NSCLC中的阳性表达率显著高于癌旁正常肺组织(P＜0.05).Survivin蛋白表达的阳性率与分化程度相关(P＜0.05),Livin蛋白表达的阳性率与淋巴结转移相关(P＜0.05).Survivin和Livin蛋白表达无相关性.结论 Survivin、Livin在NSCLC的发生、发展过程中起着重要的作用,联合检测可为NSCLC的的早期诊断、进一步治疗提供必要的理论依据.     

DCLK1和A20在非小细胞肺癌中的表达及意义

目的探讨肿瘤相关因子双肾上腺样激酶1(DCLK1)和肿瘤坏死因子α诱导蛋白3(A20)在非小细胞肺癌(NSCLC)组织中的表达情况及临床意义。方法用免疫组织化学方法检测DCLK1和A20在61例肺癌和22例癌旁肺组织中的表达。结果 (1)非小细胞肺癌原发灶组织和癌旁肺组织中A20的表达阳性率分别为59.0%(36/61)和18.2%(4/22),两组之间差异有统计学意义(P0.05);非小细胞肺癌原发灶组织和癌旁肺组织中DCLK1表达阳性率分别为21.3%(13/61)和27.3%(6/22),两组间差异无统计学意义(P0.05);(2)A20蛋白阳性水平与淋巴结转移显著相关(P0.05),与NSCLC病理组织类型、肿瘤组织分化程度无相关性(P0.05)。DCLK1蛋白阳性水平与肿瘤组织分化程度、临床分期及淋巴结转移均无相关性(P0.05)。结论 A20在非小细胞肺癌组织中的表达明显高于癌旁组织,其表达情况与淋巴结转移相关,可能参与了非小细胞肺癌的发生和发展,DCLK1与非小细胞肺癌的进展无明显关系。     

凋亡抑制基因XIAP和PED/PEA-15与老年肺癌发生、发展的关系

目的 探讨凋亡抑制基因XIAP和PED/PEA-15在肺癌发生、发展中的表达及其临床意义.方法 应用RT-PCR和免疫组化Wax Envision多聚复合物酶标法检测66例人非小细胞肺癌(NSCLC)中XIAP和PED/PEA-15 mRNA和蛋白的表达,并结合临床病理特征进行分析.结果 肺癌组织中XIAP和FED/PEA-15 mRNA表达和蛋白阳性表达率均明显高于正常肺组织和癌旁组织(P均＜0.05);XIAP和PED/PEA-15蛋白阳性表达率在不同年龄、性别、是否吸烟、肿瘤大小、组织学类型间无显著性差异(P均＞0.05),在不同分化程度、TNM分期、淋巴结转移与否组间有显著性差异(P＜0.05);生存3年以上者肺癌组织中XIAP和PED/PEA-15蛋白阳性表达率均明显低于生存3年以下者(P＜0.05).结论 凋亡抑制基因XIAP和PED/PEA-15在肺癌中呈高表达,可作为判断人肺癌生物学行为及患者预后的参考指标且有望成为肺癌靶向基因治疗的新靶点.     

TMPRSS4在非小细胞肺癌中的表达及临床意义

目的通过观察上皮细胞-间质转型(EMT)通路相关蛋白跨膜丝氨酸蛋白酶TMPRSS4(transmembrane protease serine 4,TMPRSS4)在非小细胞肺癌患者手术切除的肺癌组织、癌旁组织中的表达,探讨TMPRSS4蛋白水平表达与非小细胞肺癌的临床关系。方法应用免疫组织化学SP法检测45例非小细胞肺癌及其配对癌旁组织中TMPRSS4蛋白的表达情况。结果非小细胞肺癌组织中TMPRSS4蛋白阳性表达率为60.00%,癌旁组织中TMPRSS4阳性表达率为4.44%;癌组织中TMPRSS4蛋白阳性表达率明显高于癌旁正常肺组织(χ2=29.31,P0.01)。TMPRSS4蛋白表达与非小细胞肺癌淋巴结转移、临床分期相关(P0.05)。结论 TMPRSS4在非小细胞肺癌中的表达与肿瘤发生、转移密切相关,高表达的TMPRSS4蛋白提示肺癌有转移风险更高及预后更差的可能,TMPRSS4可能成为非小细胞肺癌中一个新的研究方向。     

非小细胞肺癌中WWOX蛋白、Ki67的表达及其意义

目的 探讨WWOX(WW domain-containing oxidoreductase)基因在非小细胞肺癌(NSCLC)组织中的表达及其临床意义.方法 用免疫组化方法检测50例鳞癌,31例腺癌及20例癌旁正常组织中WWOX基因蛋白的表达,并分析其与各临床病理指标、细胞增殖之间的关系.结果 WWOX基因在72.8%的NSCLC中失表达或表达减少,而在相邻正常肺组织中有80.0%正常表达.WWOX基因的表达与组织类型、腺癌细胞分化程度密切相关(r=0.262,r=0.457,P＜0.05),在鳞癌和低分化腺癌中WWOX基因失表达或表达减少.细胞增殖指数越高,WWOX基因表达越少,二者呈负相关(r=-0.252,P＜0.05).Ki67的表达与吸烟、组织分化、临床分期、淋巴结转移密切相关(均P＜0.05);与WWOX蛋白表达呈负相关(r=-0.252,P＜0.05).结论 WWOX蛋白在NSCLC组织中呈低表达,其表达的缺失可能在不同类型NSCLC的形成中发挥了不同的作用,而且与肿瘤的恶性程度及侵袭有关.Ki67蛋白的高表达提示预后不佳.     

转移抑制基因nm23在肺癌中的表达与预后关系的研究

目的 探讨人非小细胞肺癌中nm23的表达水平与肺癌的转移及预后关系。方法 应用免疫组织化学法对146例人非细胞肺癌中nm23的表达水平进行研究。结果 肺癌中nm23表达水平明显低于癌旁肺组织和正常肺组织（P＜0.05）,肺癌中nm23表达水平与肺癌细胞分化程度,是否存在转移有密切关系（P＜0.05）,癌旁组织与正常肺组织之间无显著性差异（P＞0.05）。结论 nm23在非小细胞肺癌中起转移抑制基因的作用,它们的表达水平降低可能是肺癌转移的重要原因。     

LKB1蛋白在非小细胞肺癌中的表达及临床意义

目的探讨LKB1蛋白在非小细胞肺癌中的表达情况及临床意义。方法应用免疫组化方法检测76例非小细胞肺癌中LKB1蛋白的表达情况。结果 LKB1蛋白在肺癌组织及癌旁正常肺组织中均有表达,LKB1在正常肺组织的阳性表达率显著高于癌组织(90.78%vs 65.79%,P<0.01)。LKB1蛋白在肺鳞癌和腺癌组织中的表达无显著性差异。LKB1蛋白在高分化肿瘤中的表达阳性率明显高于中-低分化肿瘤(81.82%vs53.49%,P<0.05)。LKB1蛋白在无淋巴结转移组的阳性表达率明显高于淋巴结转移阳性组(89.29%vs 52.08%,P<0.01)。结论 LKB1蛋白的低表达与肺癌的发生有关,并且影响肿瘤的分化及淋巴结转移,可能影响肺癌的预后。     

NSCLC中WWOX蛋白、erbB2蛋白的表达及其与细胞增殖之间的关系

目的探讨WWOX蛋白、erbB2蛋白在非小细胞肺癌(NSCLC)组织中的表达及与肿瘤细胞增殖之间的关系。方法免疫组化方法检测50例鳞癌,31例腺癌及20例癌旁正常组织中WWOX蛋白、erbB2蛋白的表达,分析其与临床病理指标、肿瘤细胞增殖之间的关系。结果 WWOX蛋白在72.8%的NSCLC中失表达或表达降低,而相邻正常肺组织中有80.0%正常表达。WWOX蛋白的表达与组织类型、腺癌细胞分化程度密切相关(r=0.262,0.457,P0.05),在鳞癌和低分化腺癌中WWOX蛋白失表达或表达降低。肺癌中erbB2蛋白的过度表达与肺癌的临床分期、淋巴结转移相关,WWOX蛋白阳性表达与erbB2负相关(r=-0.239,P0.05),与肿瘤细胞增殖指数也呈负相关(r=-0.252,P0.05)。结论 WWOX蛋白的低表达与erbB2的过表达可以协同判断NSCLC的预后。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

N-acetyl-L-cysteine combined with mesalamine in the treatment of ulcerative colitis： Randomized,placebo-controlled pilot study

AIM： To evaluate the effectiveness and safety of oral N-acetyl-L-cysteine （NAC） co-administration with mesalamine in ulcerative colitis （UC） patients.
METHODS： Thirty seven patients with mild to moderate UC were randomized to receive a four-wk course of oral mesalamine （2.4 g/d） plus N-acetyl-L-cysteine （0.8 g/d） （group A） or mesalamine plus placebo （group B）. Patients were monitored using the Modified Truelove-Witts Severity Index （MTWSI）. The primary endpoint was clinical remission （MTWSI ≤ 2） at 4 wk. Secondary endpoints were clinical response （defined as a reduction from baseline in the MTWSI of ≥ 2 points） and drug safety. The serum TNF-α, interleukin-6, interleukin-8 and MCP-1 were evaluated at baseline and at 4 wk of treatment. RESULTS： Analysis per-protocol criteria showed clinical remission rates of 63% and 50% after 4 wk treatment with mesalamine plus N-acetyl-L-cysteine （group A） and mesalamine plus placebo （group B） respectively （OR = 1.71; 95% CI： 0.46 to 6.36; P = 0.19; NNT = 7.7）. Analysis of variance （ANOVA） of data indicated a significant reduction of MTWSI in group A （P = 0.046） with respect to basal condition without significant changes in the group B （P = 0.735） during treatment. Clinical responses were 66% （group A） vs 44% （group B） after 4 wk of treatment （OR = 2.5; 95% CI： 0.64 to 9.65; P = 0.11; NNT = 4.5）. Clinical improvement in group A correlated with a decrease of IL-8 and MCP-1. Rates of adverse events did not differ significantly between both groups.
CONCLUSION： In group A （oral NAC combined with mesalamine） contrarily to group B （mesalamine alone）, the clinical improvement correlates with a decrease of chemokines such as MCP-1 and IL-8. NAC addition not produced any side effects.     

Delorme's transrectal excision for internal rectal prolapse

Surgical therapy of functional outlet obstruction in patients with internal rectal intussusception may include abdominal, perineal, or transrectal procedures. Because abdominal procedures often result in significant physiologic impact but unrelieved constipation, the authors have elected Delorme's transrectal excision for management of these patients. Since a short-term placebo effect attends many therapies, this report describes results of transrectal excision only after a threeyear postoperative period. Delorme's transrectal excision of internal intussusception accomplished sustained symptomatic relief in over 70 percent of otherwise refractory constipated patients. The association of internal intussusception with other abnormalities underscores the importance of defining both anatomic and functional components when selecting patients whose constipation may require surgical therapy. Critical technical elements, surgical pitfalls, and potential complications of the procedure are discussed.Poster presentation at the meeting of The American Society of Colon and Rectal Surgeons, Toronto, Canada, June 11 to 16, 1989.     

The oral glucose tolerance test: A comparison of the time points on the basis of limit values,normal dispersion,and reproducibility

Summary Time points in the glucose tolerance test (GTT) are compared on the basis of limit values, dispersion within a reference population, and reproducibility. We suggest using the distance between a limit value and the median reference value as a measure of the magnitude of abnormality. The distance between 140 mg/100 ml and the median fasting plasma glucose value is chosen as a standard distance and limits for other points in the GTT are calculated to equal this standard distance of abnormality. We suggest that the probability of correctly interpreting an inividual result is directly related to the reproducibility of the test and inversely related to the percentage of the total range of values which is dispersed among the normal population. The ratio of reproducibility to percentage normal dispersion is proposed as an index of the probability of correctly interpreting an individual result. According to this index, the probability of correct interpretation varies in order: fasting plasma glucose concentration>3-h>2-h>0.5-h>1-h plasma glucose concentration.