消化道恶性肿瘤淋巴管生成的研究进展

消化道恶性肿瘤的发病率日益增高,而肿瘤的淋巴道转移是导致患者最终死亡的重要因素之一．在某些恶性肿瘤中已经证实有淋巴管生成,被称为淋巴管生成因子的VEGF-C、 VEGF-D及其受体VEGFR-3能够诱导淋巴管的生成．恶性肿瘤中的淋巴管生成因子不但能够促进肿瘤淋巴管的生成,而且与淋巴道转移密切相关．近年来对于消化道恶性肿瘤的淋巴管生成以及淋巴道转移的研究正在开展,本文将对消化道恶性肿瘤淋巴管生成机制,淋巴管生成与肿瘤淋巴道转移的关系,最新研究进展以及此项研究的临床意义加以综述．     

淋巴管新生与肿瘤淋巴道转移的相关性

在实体恶性肿瘤中,淋巴道是肿瘤细胞转移的主要途径,淋巴管生成在肿瘤的淋巴转移过程中起重要作用。随着淋巴管内皮特异标记物和淋巴管生长因子的发现,肿瘤诱发淋巴管生成的分子机制和以抑制肿瘤淋巴管生成作为抗肿瘤转移靶点的研究引起临床关注。现将淋巴管生成于肿瘤淋巴道转移相关性的研究进展综述如下。     

老年子宫颈癌中Tiaml表达与淋巴管生成关系的研究

肿瘤淋巴转移往往是导致治疗困难,患者死亡的重要原因,而肿瘤淋巴管生成在肿瘤转移中起不容忽视的作用.最近研究表明肿瘤淋巴转移与肿瘤边缘区微淋巴管密度显著相关[1].宫颈癌是妇产科临床常见的恶性肿瘤之一,淋巴结转移是其发生侵袭转移的重要途径,同时也是影响患者预后的重要因素.     

消化道肿瘤淋巴管生成的临床研究进展

肿瘤淋巴管生成与淋巴转移的关系是近年肿瘤转移机制的一大研究热点，此文简要综述近年消化道恶性肿瘤淋巴管生成与淋巴管分布、临床病理指标及预后、生存等的关系。     

淋巴管与消化系恶性肿瘤相关研究

肿瘤淋巴管形成与抑制在消化系恶性肿瘤转移中的作用逐渐受到重视,阻断淋巴管生成是抑制肿瘤淋巴道转移的有效途径,有关恶性肿瘤淋巴管生成机制的研究不断深入。此文综述了肿瘤淋巴管内皮细胞的分子标志物及针对上述靶点的抗肿瘤淋巴管生成的治疗方法。     

消化道肿瘤淋巴管生成的临床研究进展

肿瘤淋巴管生成与淋巴转移的关系是近年肿瘤转移机制的一大研究热点 ,此文简要综述近年消化道恶性肿瘤淋巴管生成与淋巴管分布、临床病理指标及预后、生存等的关系。     

恶性肿瘤淋巴转移分子标记物及转移机制研究进展

血行转移和淋巴转移是恶性肿瘤主要的转移方式，是影响患者选择治疗方案、手术治疗效果及术后生存时间和生存质量的重要因素。相对于血行转移，淋巴转移的机制研究较少，主要原因是缺乏特异性较高的新生淋巴管内皮标记物。近年来，随着淋巴管内皮特异性标记物和淋巴管生成相关因子的发现，肿瘤的淋巴转移机制成为研究的热点。     

结直肠癌淋巴管生成与淋巴结转移相关检测的临床研究进展

结直肠癌是人类常见的可经淋巴道转移的恶性肿瘤,其淋巴管生成与转移过程中牵涉了多种生物标志物表达水平的改变,检测这些相关生物标志物可为结直肠癌的诊断、治疗和预后情况提供重大参考价值．本文主要综述近年来与结直肠癌淋巴管生成与淋巴结转移相关检测的临床研究进展．     

肿瘤淋巴管生成的调控

侵袭和转移是恶性肿瘤的基本特征,淋巴管是恶性肿瘤侵袭转移到局部淋巴结或远处器官的主要途径之一.近年来,越来越多的研究表明肿瘤中存在活跃的淋巴管生成,新生的淋巴管对肿瘤的转移起着重要作用.淋巴管的生成是一个由多种因子参与的复杂过程,除趋化因子、黏附分子和细胞外基质等作用外,淋巴管内皮细胞特异性转录因子和受体等发挥着关键性作用.明确淋巴管生成的调控机制对肿瘤的治疗有重要意义.     

血管内皮生长因子比值在胃癌及转移中的变化及意义

胃癌转移早期以淋巴系统转移为主,淋巴结转移的程度和范围是决定其预后的重要因素.血管内皮生长因子(vascular endothelial growth factor,VEGF)-C和VEGFD是特异性淋巴管生成调节因子,以往研究较多关注胃癌中VEGF-C、VEGF-D各自的表达情况,但对于VEGF- C/VEGF-D比值在胃癌及转移灶中的情况及其与淋巴道转移的相关性还不十分清楚,国内外鲜见报道.因此,深入探讨VEGF-C/VEGF-D比值与胃癌淋巴系统转移的关系,将有助于早期发现胃癌淋巴结转移和胃癌预后评估指标.     

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.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

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.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.