经导管肝动脉栓塞化疗术(TACE)对肝癌细胞凋亡相关蛋白fas,bax和bcl-xl表达影响的相关研究

目的　探讨经导管肝动脉栓塞化疗术 (TACE)对肝细胞癌 (HCC)细胞凋亡相关蛋白fas ,bax和bcl -xl表达的影响 ,评价TACE对肝细胞癌的疗效。方法　经病理证实的肝细胞癌 63例 ,包括单纯手术组 42例 ,TACE组 2 1例 (为TACE治疗后 2次有手术机会而行切除者 ) ;采用免疫组织化学SP法检测标本fas ,bax和bcl -xl的表达情况 ,将 2组结果进行对照分析。结果　TACE组fas表达阳性率为 47.62 % ( 10 / 2 1) ,单纯手术组fas表达阳性率为 2 1.43 % ( 9/ 42 ) ,二者之间有显著性差异 (Ρ <0 .0 5 ) ,TACE组明显高于单纯手术组 ;TACE组bcl -xl表达阳性率为 2 3 .81% ( 5 / 2 1) ,单纯手术组阳性率为 5 4.76% ( 2 3 / 42 ) ,二者之间亦有显著性差异 (Ρ <0 .0 5 ) ,TACE组明显低于单纯手术组 ;bax的表达阳性率在单纯手术组和TACE组无显著性差异 (Ρ >0 .0 5 )。结论　TACE治疗可以促进肝癌细胞fas表达增高 ,使bcl -xl表达降低 ,从而在总体上增加肝癌细胞凋亡率 ,促使肿瘤缩小。关于TACE治疗对bax的影响有待进一步研究     

CT导向肺活检标本端粒酶活性检测对肺癌的早期诊断价值

目的 研究肺活检标本端粒酶活性检测对肺癌的早期诊断价值。资料与方法 经X线平片与CT扫描疑诊为早期肺癌52例患者，分别进行纤维支气管镜活检与经皮针刺切割活检，并使用银染端粒酶重复序列扩增法（TRAP）检测活检标本端粒酶活性；而后将早期肺癌（T1NOM0）与非癌病变组对照研究。结果 经手术病理证实为早期肺癌患者22例，肺活检标本端粒酶活性表达率为86．4％（19／22）；经手术或随访2年以上证实为良性病变者24例（肺囊肿3例，结核6例，炎性假瘤5例，肺炎10例），端粒酶活性表达阳性率为4．2％（1／24）。两组有显著性差异（P＜．01）。结论 端粒酶可以作为肺癌定性的一个敏感的肿瘤标志物，结合病理学检查，有可能对肺癌作出早期诊断。     

周围型支气管肺癌HRCT界面影像不对称分布的病理基础

目的　研究周围型肺癌 (peripherallungcancer ,PLC)瘤—肺界面影像不对称分布的病理基础。方法　将病理证实的 2 5例周围型肺癌及 16例肺良性结节的病灶肺叶术后标本行Heitsman法固定 48～ 72h后HRCT扫描 ,再将标本制成含病灶肺全叶切片及病灶组织切片进行对照研究 ,观察瘤—肺界面HRCT表现的病理基础。结果　术后标本HRCT、大体病理切片的变化完全吻合。PLC近端边缘模糊 4例 (16% ) ,细毛刺 3例 (12 % ) ,远端分别为 18例 (72 % )、19例 (76% ) ,呈明显不对称分布 (Ρ <0 .0 1)。肺良性结节近端病灶边缘出现上述改变者各 3例 ,远端分别为 2例、3例 ,两者之间分布无差异 (Ρ >0 .0 5 )。远端瘤—肺界面显示不对称分布组织病理学主要表现为慢性阻塞性肺炎、肺间质纤维组织增生、淋巴管炎及癌细胞浸润。癌灶与支气管间的关系为支 (细 )气管腔完全阻塞 9例 ,管腔偏心性狭窄 >5 0 % 12例 ,管腔无明显变化但出现毛刺等变化 3例。良性病灶附近支 (细 )气管主要表现为受压、移位、绕行 ,管腔无明显狭窄或截断。病灶周边组织学变化主要为变性的纤维组织包膜及受病灶压迫萎陷的肺泡组织。结论　周围型肺癌界面影像改变不对称分布的病理基础是癌灶所致的支气管阻塞及导致癌结节远端与肺交界面的淋巴管回流障碍、     

CT引导下经皮肺穿刺活检物端粒酶活性检测

目的　研究CT引导下经皮肺肿块穿刺活检物端粒酶活性在肺癌诊断中的价值。方法　采用银染 TRAP法测定 43例肺肿块穿刺活检物端粒酶活性。结果　 43例肺肿块经病理确诊肺癌 32例、肺良性病变 11例 ;32例肺癌中端粒酶阳性率为 87.5 % (2 8/ 32 ) ,而 11例肺良性病变中端粒酶阳性率为 9.1% (1/ 11)。结论　CT引导下经皮肺穿刺活检物端粒酶活性测定 ,可作为诊断肺癌的有效指标 ,端粒酶可成为肺癌的肿瘤标志物     

肝细胞癌PCNA基因表达与肝亚段动脉化学栓塞疗效的相关性研究

目的　探讨肝细胞癌增殖细胞核抗原 (PCNA)基因表达水平与肝亚段动脉化学栓塞疗效的相关性。方法　 43例肝细胞癌患者在B型超声引导下行肝穿刺活检获取肝癌组织标本 ,并应用免疫组织化学方法以小鼠抗人PCNA单克隆抗体检测PCNA标记指数(PCNAlabelingindex ,PCNALI) ,观察肝癌组织PCNALI与肝亚段动脉化学栓塞疗效和预后的关系。采用的统计方法有方差分析 ,t检验 ,Kaplan -Meier法 ,Log -rank检验等 (SPSS 10 .0软件包 )。结果　肝亚段动脉栓塞治疗后 1～ 3年生存率分别为 86.0 5 %、65 .12 %、5 1.16% ,优于常规肝动脉化学栓塞治疗效果 (Ρ <0 .0 5 )。肝细胞癌穿刺组织平均PNCALI为 (68± 2 7) %。PCNALI随着Edmondson -Steiner分级级别的增加而表达水平增高。PCNA低表达患者生存率显著高于高表达者 (Ρ <0 .0 5 )。高分化肝细胞癌组织PCNALI与无瘤肝组织PCNALI比较无统计学意义。结论　肝亚段动脉栓塞治疗肝细胞癌副作用少 ,疗效优于常规化学栓塞治疗 ;肝细胞癌抗原PCNA是反映肝亚段动脉化学栓塞术预后的一个客观指标     

ABCG2在肺癌中的表达及意义

目的 ATP结合转运蛋白G超家族成员2(ABCG2)属膜转运体ABC超家族,参与肿瘤的耐药.本研究旨在探讨ABCG2在肺癌中的表达及意义.方法 选用83例(64例非小细胞肺癌和19例小细胞肺癌)肺癌患者手术及活检标本.这些患者在取组织标本前均未行化疗或放疗.采用免疫组化法检测83例肺癌组织中ABCG2的表达.分别设阳性和阴性对照.另外取5例正常肺组织作比较研究.结果 ABCG2阳性染色定位于癌细胞胞膜,部分病例胞浆也有分布.83例肺癌中,免疫组化显示非小细胞肺癌ABCG2阳性率71.88%(46/64),明显高于小细胞肺癌10.53%(2/19,P＜0.05).在非小细胞癌中ABCG2的表达与患者性别,肿瘤大小及病理类型无相关性(P＞0.05),但ABCG2在无淋巴结转移和有淋巴结转移的非小细胞癌中表达有显著性差异(P＜0.05).同时ABCG2表达与非小细胞癌分化程度也具有相关性(P＜0.05).而用于比较研究的5例正常肺组织未观察到ABCG2阳性染色.结论 ABCG2在非小细胞肺癌的发生、发展过程中可能起着重要作用,它有可能成为治疗非小细胞肺癌临床耐药的分子靶标.     

肺肿块穿刺标本癌基因蛋白检测

目的　研究流式细胞仪 (FCM)检测肺癌穿刺标本p5 3蛋白、增殖细胞核抗原 (PCNA)表达的价值。资料与方法　运用FCM检测 6 6例穿刺标本p5 3蛋白、PCNA表达。结果　 (1) 6 6例肺肿块中病理诊断恶性 5 3例 ,13例病理诊断及临床随防诊断为良性病变。 (2 ) 5 3例肺恶性病变p5 3蛋白表达阳性率为 6 2 .3% ,PCNA阳性率为4 5 .3% ;13例良性病变p5 3蛋白表达阳性率为 30 .8% ,PCNA阳性率为 7.7% ;两组p5 3蛋白、PCNA阳性表达有显著性差异 (P <0 .0 5 )。 (3) 5 3例肺恶性病变穿刺敏感性为 94 .3% ,13例肺良性病变穿刺特异性为 76 .9% ,6 6例穿刺诊断准确性为 90 .9% ,气胸发生率为 4 .6 %。结论　运用FCM可以检测肺癌穿刺标本p5 3蛋白、PCNA表达 ,为了解肺癌的分子生物学行为特性提供帮助。     

纵隔和肺门肿块的CT导向穿刺活检

目的　评价CT导向纵隔和肺门肿块穿刺活检的价值。方法　总结 1998-0 4～ 2 0 0 1-12经CT导向穿刺活检的 34例纵隔和肺门肿块病例。纵隔和纵隔旁肿块 19例 ,纵隔内上腔静脉旁和隆突下淋巴结 7例 ,肺门肿块 8例 ,纵隔内淋巴结肿大和肺门肿块病例纤支镜检查均为阴性。CT定位后以 18～ 2 0G切割针及抽吸针从前 ( 19例 )或后 ( 15例 )胸壁避开重要脏器进针 ,穿刺次数 1～ 3次作组织学或加抽吸细胞学检查。结果　 32例明确诊断 ,阳性率 94%。 4/34例 ( 12 % )有少量气胸 ,均自行吸收 ,2 /34例 ( 6% )肺内少量出血。本组纤支镜阴性的肺门和近纵隔肺癌以小细胞肺癌为主 ( 11/15 )。结论　CT导向穿刺活检对于纵隔和纤支镜检查阴性的肺门肿块有重要价值 ,安全可靠 ,胸腺部位抽吸活检有利于提高阳性率     

肺癌组织MDR1和GST-πmRNA水平测定及其临床意义

用RT-PCR方法对51例手术切除肺癌组织和相应的癌周正常肺组织进行MDR1和GST-πmRNA检测.结果表明:MDR1 mRAN在正常肺组织和肺癌组织中表达阳性率分别13.7%(7/51)和43.1%(22/51);而GST-πmRNA阳性率则分别为19.6%(10/51)和51.0%(26/51).MDR1或GST-πmRNA表达与肿瘤病理类型、组织分化、TNM分期等均无明显的相关性(P＞0.05).19例(37.3%)发生MDR1和GST-πmRNA共表达.上述表明肺组织细胞在恶变过程中MDR1和GST-πmRNA表达均有所增加.提示,二者在肺癌先天性耐药机制中均占有重要的作用,而且二者在肺癌中的表达基本是一致的.     

18F-FDG PET延迟显像鉴别诊断原发性肺癌

目的　探讨18F 脱氧葡萄糖 (FDG)PET延迟显像对原发性肺癌和肺结核的鉴别诊断价值。方法　 70例受检者分为原发性肺癌组 (2 5例 )、肺结核组 (16例 )和正常对照组 (2 9例 ) ,分别行18F FDGPET早期头部～盆腔显像和注射后 4h胸部延迟显像。计算 2次显像肺部病灶感兴趣区 (ROI)与同一平面对侧正常组织的放射性比值 (T/B)。结果　18F FDGPET显像示 2 5例原发性肺癌早期显像阳性 2 2例 ,阴性 3例 ,灵敏度、特异性和阳性预测值分别为 88 0 %、87 5 %和 91 7% ;延迟显像阳性2 3例 ,阴性 2例 ,灵敏度、特异性和阳性预测值分别为 92 0 %、93 8%和 95 8%。T/B与原发性肺癌不同组织学类型存在明显关系。肺结核组早期显像T/B为 3 6 7± 2 17,其中 2例发现FDG高摄取灶 ,假阳性率为 12 5 % ,延迟显像 1例FDG阳性 ,假阳性率为 6 3%。早期显像原发性肺癌组T/B (4 33± 3 0 0 )和肺结核组差异无显著性 (t=0 94 5 ,P =0 347) ,延迟显像原发性肺癌组T/B (7 91± 7 0 8)较早期显像增高 3 4 9± 2 6 6 ,明显高于肺结核组 (3 6 7± 1 86 ,t=4 173,P =0 0 0 0 )。肺结核组和对照组T/B (1 15± 0 31,1 0 5± 0 13)延迟与早期显像差异无显著性 (t=0 0 4 9、1 5 6 4 ,P =0 96 6、0 199)。结论延迟显像比早期显像更     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.