脑转移瘤中mtp53,二磷酸核苷激酶／nm23—H1的表达和临床 …

目的 探讨突变体ｐ５３蛋白（ｍｔｐ５３）和二磷酸核苷激酶（ＮＤＰＫ）／ｎｍ２３－Ｈ１在脑转移瘤中的表达和预后关系。方法 采用免疫组织化学卵白素－生物素复合物（ＡＢＣ）法检测ｍｔｐ５３和ＮＤＰＫ／ｎｍ２３－Ｈ１在３１例脑转移瘤中的表达。结果３１例中１９例（６１．３％）ｍｔｐ５３、４例（１２．９％）ＮＤＰＫ／ｎｍ２３－Ｈ１表达阳性细胞。ｍｔｐ５３与ＮＤＰＫ／ｎｍ２３－Ｈ１表达呈负相关。ｍｔｐ５３阳性     

青年期大肠癌nm23／NDPK蛋白的表达及意义（附30例报告）

目的：探讨青年期大肠癌中肿瘤转移抑制基因ｎｍ２３／ＮＤＰＫ蛋白的表达情况及其生物学特性的关系。方法：采用免疫组织化学Ｓ－Ｐ方法检测３０例青年期大肠癌癌组织中ｎｍ２３－Ｈ１基因产物／核苷二磷酸激酶（ｎｍ２３／ＮＤＰＫ）的表达,结果：青年期大肠癌ｎｍ２３／ＮＤＰＫ表达阳性率６３．３３％,在组织分化低、原发灶浸润程度（Ｔ３、Ｔ４）、淋巴结及远处转移,ＤｕｋｅｓＣ、Ｄ期和血清ＣＥＡ阳性的大肠癌中表达明显减     

bcl-2和Fas/FasL系统在肝癌细胞凋亡中的作用

目的 探讨ｂｃｌ－２和Ｆａｓ／ＦａｓＬ系统在肝癌细胞凋亡过程中的作用。方法 应用免疫组织化学方法检测３６例肝癌和４９例肝硬化组织中ｂｃｌ－２、Ｆａｓ和ＦａｓＬ的表达,用ＴＵＮＥＬ法检测肝中的细胞凋亡。结果 肝癌组织与肝硬化组织比较, 细胞明显减少;肝癌和肝硬化组织中ｂｃｌ－２的表达率分别为１６．６６％和６７．３４％;Ｆａｓ的表达率分别为５２．７７％和７３．４７％;ＦａｓＬ的表达率分别为７２．２２％     

胆囊病变时bcl-2和p16蛋白产物的表达和意义

以２５例胆囊粘膜异型增生和４０例胆囊腺癌标本用免疫组化方法观察ｂｃｌ－２和ｐ１６蛋白的表达,并与正常胆囊粘膜比较。结果;在正常胆囊粘膜中均未ｂｃｌ－２和ｐ１６表达,而胆囊粘膜上皮导型增生及胆囊腺癌组织中,两者的表达阳性率较正常组织明显增高,且ｂｃｌ－２和ｐ１６蛋白的阳笥率随着异型增生程度的增高而增加;ｐ１６的表达还与胆囊腺癌之浸润程度及淋巴结转移有关。     

nm23产物／NDPK表达与精原细胞瘤生物学行为

为了解ｎｍ２３在精原细胞瘤发生、进展过程中所起的作用，应用Ｓ－Ｐ免疫组织化学方法、兔抗ＮＤＰＫ多克隆抗体对精原细胞瘤及正常睾丸组织中ｎｍ２３产物／ＮＤＰＫ的表达进行了检测。结果：３８例肿瘤和５例正常睾丸生殖上皮组织中ｎｍ２３／ＮＤＰＫ均呈阳性表达。肿瘤组织中的表达强度明显高于正常生殖上皮组织，而与其组织病理类型无关，强表达缺失与肿瘤的转移行为有关。提示ｎｍ２３／ＮＤＰＫ在精原细胞瘤发生和转移抑制过程中可能起重要作用     

CD15抗原和bcl-2基因蛋白在甲状腺癌中的表达及相关性研究

目的 研究甲状腺癌组织中ＣＤ１５抗原和ｂｃｌ－２基因蛋白的表达与肿瘤发生和转移的关系,并探讨ＣＤ１５与ｂｃｌ－２基因蛋白表达的关系。方法 应用微波－ＬＳＡＢ免疫组织化学法检测５０例甲状腺癌、４５例甲状腺腺瘤和２０例癌旁正常甲状腺组织中ＣＤ１５和ｂｃｌ－２基因蛋白表达。结果 在甲状腺癌组织中ＣＤ１５和ｂｃｌ－２基因蛋白表达阳性率分别为６８．０％和４６．０％,均显著高于甲状腺腺瘤和癌旁正常甲状腺组织（     

凋亡相关基因bcl—2和bax蛋白在膀胱癌组织中的表达及临床意义

为探讨凋亡抑制基因ｂｃｌ－２和凋亡促进基因ｂａｘ表达产物在膀胱癌组织中的分布及意义,作者应用抗ｂｃｌ－２单克隆抗体和抗ｂａｘ多克隆抗体分别对３４例膀胱癌和９例正常膀胱粘膜组织的石蜡切片进行免疫组化染色。结果显示,９例正常膀胱粘膜有４例ｂｃｌ－２蛋白表达阳性（４４．４４％）,３４例膀胱癌有２８例ｂｃｌ－２蛋白表达阳性（８２．３５％）,两组间差异有显著意义（Ｐ＜０．０５）,随肿瘤分级的增加,阳性表达增强。９例正常膀胱粘膜有８例ｂａｘ蛋白表达阳性（８８．８９％）,３４例膀胱癌有１８例表达阳性（５２．９４％）,两组间差异有显著意义（Ｐ＜０．０５）。作者认为,ｂｃｌ－２和ｂａｘ蛋白在膀胱癌组织中的异常表达,参与了膀胱癌的发生及进展过程。     

胆囊癌组织中p21、p53及bcl-2癌基因蛋白的表达及意义

为探讨胆囊良恶性病变组织中ｐ２１,ｐ５３及ｂｃｌ－２癌基因蛋白的表达及其与胆囊癌预后的关系,以及在胆囊良恶性病变的鉴别诊断中的作用,采用免疫组织化学ＡＢＣ法,分别测定了４０例胆囊癌及８例胆囊腺瘤型息肉组织中ｐ２１,ｐ５３及ｂｃｌ－２癌基因蛋白的表达情况。结果;胆囊癌组织中ｐ２１,ｐ５３及ｂｃｌ－２癌基因蛋白表达阳性率分别为５２．５％,５２．５％和７０．０％,在胆囊腺瘤型息肉中３者分别为０％,０％和     

乳腺癌中bcl-2蛋白表达的意义

为探讨抑凋亡基因ｂｃｌ－２蛋白表达在乳腺癌中的意义,应用免疫组织化学的方法,对１２５例浸润性乳腺癌患者的石蜡包埋组织切片中ｂｃｌ－２,雌激素受体,孕激素受体及ｐ＾５３基因的表达产物进行检测。结果：ｂｃｌ－２蛋白在浸润性导管癌中的表达为６３．３％,而在浸润性小叶癌中为８８．９％,二者间菜显著性间谍;在浸润性导管癌中,ｂｃｌ－２蛋白的表达与原发癌大小及肿瘤分级呈负相关,与ＥＲ,ＰＲ的表达呈正相关,与ｐ     

NDPK／nm23在胆囊,胆管癌中的表达及临床意义

为探讨核苷二磷酸激酶／ｎｍ２３（ＮＤＰＫ／ｎｍ２３）在胆囊、胆管癌中的表达及临床意义，用免疫组化ＡＢＣ法对４１例胆囊癌、１２例胆管癌ＮＤＰＫ／ｎｍ２３表达进行了测定。结果发现：ｎｍ２３在恶性肿瘤中的表达率明显高于良性病变（Ｐ＜０．０５）。ＮＤＰＫ／ｎｍ２３表达与胆囊及胆管癌组织的分化、局部浸润及淋巴转移密切相关（Ｐ＜０．０５），提示：ｎｍ２３检测对正确估计肿瘤的侵袭性、淋巴转移潜能及预后有重要价值。     

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.     

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。     

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.