人脑胶质瘤组织中EGFR、MMP-9、Ki-67的表达与肿瘤病理分级的关系

目的探讨人脑胶质瘤组织中EGFR、MMP-9、K i-67的表达与肿瘤病理分级的关系。方法取102例脑胶质瘤患者的胶质瘤组织标本,病理分级Ⅰ级7例,Ⅱ级49例,Ⅲ级27例,Ⅳ级19例。采用免疫组化方法检测其中的EGFR、MMP-9、K i-67。结果本组62例（60.78%）EGFR阳性,Ⅰ、Ⅱ、Ⅲ、Ⅳ级瘤组织中EGFR阳性表达率分别为28.3%（2/7）、40.8%（20/49）、81.5%（22/27）、94.7%（18/19）,EGFR阳性表达率与胶质瘤病理级别呈正相关（r=0.48,P〈0.01）。本组66例（64.71%）MMP-9阳性表达,Ⅰ、Ⅱ、Ⅲ、Ⅳ级瘤组织中EGFR阳性表达率分别为28.3%（2/7）、85.2%（23/49）、85.2%（23/27）、94.7%（18/19）,脑胶质瘤中MMP-9表达与病理级别呈正相关（r=0.46,P〈0.01）。本组均可见K i-67的表达,Ⅰ、Ⅱ、Ⅲ、Ⅳ级瘤组织的K i-67表达量分别为9.00±1.00、14.20±1.30、41.80±2.38、56.20±1.31,脑胶质瘤PI与病理分级有关（F=1.00,P〈0.01）。胶质瘤组织中EGFR表达与MMP-9、K i-67表达均呈正相关（r分别为0.75、0.98,P均〈0.01）。结论 人脑胶质瘤组织中的EGFR、MMP-9、K i-67与肿瘤病理分级均有关。     

人脑胶质瘤组织中高迁移率族蛋白B1的表达及其与病理分级的关系

目的探讨人脑胶质瘤组织中高迁移率族蛋白(HMG)B1的表达及其与病理分级的关系。方法选取外科手术治疗后经病理证实的脑胶质瘤标本80例为研究组,另外选择同期25例行开颅减压手术的脑外伤患者的正常脑组织为对照组。采用RT-PCR法和免疫组化法检测人脑胶质瘤组织和正常脑组织中的HMGB1表达,分析表达差异性与病理级别的关系。结果实验组HMGB1基因表达量(25.371±2.837)明显高于对照组(6.074±3.309)(P0.05);HMGB1蛋白阳性表达率为75.00%,高于正常脑组织中的20.00%(P0.05);在病理分级中,实验组的Ⅲ~Ⅳ级胶质瘤组HMGB1 mRNA表达量(29.835±3.942)显著高于Ⅰ~Ⅱ级(21.332±2.253)(P0.05),Ⅲ~Ⅳ级胶质瘤组HMGB1蛋白阳性表达率(76.92%)高于Ⅰ~Ⅱ级(70.73%)(P0.05)。结论 HMGB1在人脑胶质瘤的临床治疗中具有重要指导意义。     

胶质瘤组织中EGFR、p27^kip1的表达变化及意义

目的观察胶质瘤组织中表皮生长因子受体（EGFR）和p27kip1的表达变化,并探讨其临床意义。方法采用免疫组化SP法检测60例胶质瘤组织、5例正常脑组织中EGFR和p27kip1。结果 60例胶质瘤患者中有39例表达EGFR,20例表达p27kip1。EGFR在正常脑组织中无表达,在Ⅱ、Ⅲ、Ⅳ级胶质瘤中阳性表达率分别为52.4%、60.9%、87.5%（P〈0.05）;p27kip1在正常脑组织中表达率为80.0%,在Ⅱ、Ⅲ、Ⅳ级胶质瘤中阳性表达率分别为57.1%、26.1%、12.5%（P〈0.05）。EGFR表达与胶质瘤病理分级呈正相关（r=0.426,P〈0.05）,p27kip1表达与胶质瘤病理分级呈负相关（r=-0.325,P〈0.05）。结论 EGFR、p27kip1表达与胶质瘤的恶性程度有关,其表达异常可能在肿瘤形成中起促进作用。     

整合素β1在脑神经胶质瘤的表达及其与Ki-67的关系

目的探讨整合素β1及Ki-67抗原在神经胶质瘤细胞增殖、侵袭中的作用,以便为临床判断神经胶质瘤的恶性程度、选择治疗措施及评价预后提供依据。方法采用免疫组化法检测5例正常脑组织及40例不同级别神经胶质瘤中整合素β1的表达情况,分析其病理指数(PI)及其与Ki-67表达的关系。结果正常脑组织中整合素β1及Ki-67抗原均不表达。在脑神经胶质瘤中整合素β1表达于瘤细胞的胞质、胞膜及肿瘤血管的内皮细胞,且主要表达于肿瘤侵袭边缘的瘤细胞及血管基底膜的内皮细胞,其表达是在细胞质、胞膜及肿瘤血管的内皮细胞出现棕色或棕黄色染色;在脑神经胶质瘤中Ki-67表达于瘤细胞的胞核,其表达是在胞核出现棕色或棕黄色染色。在Ⅰ、Ⅱ级神经胶质瘤标本23例中阳性3例、弱阳6例,阳性表达率为39.13%(9/23),PI值为6.52±7.42,在Ⅲ、Ⅳ级神经胶质瘤标本17例中强阳性3例、阳性7例、弱阳4例,阳性表达率为82.35%(14/17),PI值为26.41±25.12,Ⅰ、Ⅱ级与Ⅲ、Ⅳ级间差异显著(P<0.05)。在神经胶质瘤中的Ki-67 LI范围为2%～30%,Ⅰ、Ⅱ级与Ⅲ、Ⅳ级神经胶质瘤的Ki-67 LI分别为12.09%±8.10%及19.12%±8.89%,Ⅰ、Ⅱ级与Ⅲ、Ⅳ级间差异显著(P<0.05)。经直线相关分析,整合素β1与Ki-67抗原的阳性细胞表达率呈正相关(P<0.05)。结论整合素β1及Ki-67抗原的表达在Ⅰ、Ⅱ级神经胶质瘤组明显低于Ⅲ、Ⅳ级,与神经胶质瘤增殖及侵袭性呈正相关,可作为判断神经胶质瘤病理分级的重要指标。     

解旋酶RECQ1和细胞核相关抗原Ki-67在脑胶质瘤组织中的表达及相关性

目的分析解旋酶RECQ1和细胞核相关抗原Ki-67在脑胶质瘤组织中的表达及其相关性。方法选取该院神经外科收治的脑胶质瘤手术治疗患者80例,根据病理学分级分为Ⅰ~Ⅱ级44例,Ⅲ~Ⅳ级36例,另外选取正常脑组织20例,利用免疫组化法检测RECQ1、Ki-67的表达情况,计算RECQ1、Ki-67表达的相关性。结果 1RECQ1、Ki-67在正常脑组织中表达呈阴性,在胶质瘤组织表达呈阳性;RECQ1、Ki-67在Ⅰ~Ⅱ级胶质瘤组织中多为低表达,在Ⅲ~Ⅳ级胶质瘤组织中多为高表达;2RECQ1在正常脑组织中无表达,Ⅰ~Ⅱ级胶质瘤组织RECQ1表达率与Ⅲ~Ⅳ级胶质瘤组织比较明显降低(P0.05);3Ki-67在正常脑组织组织中无表达,Ⅰ~Ⅱ级胶质瘤组织RECQ1表达率为75%,与Ⅲ~Ⅳ级胶质瘤组织比较明显降低(P0.05);4胶质瘤组织中RECQ1和Ki-67表达均为阳性的有57例(71.3%),均为阴性的有14例(17.5%)。RECQ1阳性但Ki-67阴性的有4例(5%),RECQ1阴性但Ki-67阳性的有5例(6.2%),RECQ1和Ki-67表达呈正相关(r=0.768,P0.01)。结论 RECQ1和Ki-67的表达随着脑胶质瘤组织恶性程度的增高而升高,且两者正相关。     

survivin与PTEN在星形细胞瘤患者脑中的表达及临床意义

目的探讨survivin、VFEN在人脑星形细胞瘤组织标本中的表达及其与病理分级和预后的关系。方法设实验组和正常对照组。实验组为人脑星形细胞瘤组织标本,Ⅰ级组20例、Ⅱ级组30例、Ⅲ-Ⅳ级组30例;对照组为正常人脑组织标本10例。采用免疫组化S-P法检测survivin、PTEN的表达并分析二者之间的相互关系。结果从Ⅰ级组到Ⅲ～Ⅳ级组,survivin阳性表达率呈明显递增趋势,PTEN的阳性表达率呈递减趋势,二者呈负相关（rs=-0.668,P〈0．05）。结论survivin基因和PTEN蛋白表达与人脑星形细胞瘤的临床病理级别和生物学行为特征有密切关系,联合检测survivin和PTEN对判断人脑星形细胞瘤的恶性程度及预后有一定参考价值。     

人脑胶质瘤组织中耐药相关基因蛋白MGMT、Topo-Ⅱ、GST-π、P-gp的表达变化及意义

目的观察人脑胶质瘤组织中耐药相关基因蛋白O6-甲基鸟嘌呤-DNA-甲基转移酶（MGMT）、拓扑异构酶（Topo-Ⅱ）、谷胱甘肽转移酶（GST-π）、P-糖蛋白（P-gp）的表达变化,并探讨其临床意义。方法采用免疫组化法检测330例人脑胶质瘤组织及20例正常脑组织中的MGMT、Topo-Ⅱ、GST-π、P-gp蛋白。结果正常脑组织中MGMT、Topo-Ⅱ、GST-π、P-gp均无表达,人脑胶质瘤组织中MGMT、Topo-Ⅱ、GST-π、P-gp的阳性表达率分别为43.9%、24.3%、49.8%、48.2%;MGMT的表达与胶质瘤病理分级无关（P〉0.05）,Topo-Ⅱ、GST-π、P-gp的表达与胶质瘤病理分级有关（P均〈0.05）。结论人脑胶质瘤组织中不同程度地表达耐药相关基因蛋白MGMT、Topo-Ⅱ、GST-π、P-gp,可据此制订个体化的胶质瘤化疗方案。     

抗CD34单克隆抗体标记血管生成在人脑胶质瘤组织中的表达及临床意义

应用免疫单抗标记的组织化学技术检测63例人脑胶质瘤组织中CD34的表达情况，根据CD34阳性的血管内皮细胞计数来测定肿瘤微血管密度（MVD）。结果发现，Ⅲ、Ⅳ级胶质瘤MVD显著高于Ⅰ、Ⅱ级（P＜0．05） ；术后18个月内复发和生存期＜3年者MVD显著高于术后18个月内无复发和生存期≥3年者（P＜0．10）；MVD与患者的性别、年龄、肿瘤生长部位无明显相关（P＞0．05）。认为人脑胶质瘤组织中血管形成与病理分级、术后复发及生存密切相关。可作为一项有意义的预后指标。     

cyclinA和p27kip1在脑胶质瘤中的表达变化及意义

目的探讨cyclinA和p27kip1在脑胶质瘤中的表达及意义。方法采用S-P免疫组织化学法检测10例正常脑组织、80例人脑胶质瘤组织中cyclinA和p27kip1的表达。结果 10例正常脑组织中未出现cyclinA阳性染色,cyclinA、p27kip1在Ⅲ、Ⅳ级胶质瘤组织中的表达明显高于其在Ⅰ、Ⅱ级胶质瘤组织中的表达(P均<0.05)。cyclinA和p27kip1在人脑胶质瘤中的表达呈负相关(r=-0.298,P<0.05)。结论 cyclinA和p27kip1在脑胶质瘤的发生中可能起重要作用,二者与胶质瘤的恶性程度相关。     

SOX2在脑胶质瘤组织中的表达及其临床意义

目的分析SOX2在脑胶质瘤组织中的表达及其临床意义。方法收集安康市人民医院神经外科2012年1月—2015年1月收治的65例脑胶质瘤患者的脑组织标本及13例因颅脑损伤行颅内减压术患者的脑组织标本,采用免疫组化法检测SOX2蛋白表达情况,采用反转录聚合酶链式反应(RT-PCR)检测SOX2 mRNA表达情况,分析SOX2蛋白表达与脑胶质瘤患者临床特征的关系。结果Ⅰ级脑胶质瘤组织中SOX2蛋白阳性表达率高于正常脑组织,Ⅱ级脑胶质瘤组织中SOX2蛋白阳性表达率高于Ⅰ级脑胶质瘤组织及正常脑组织,Ⅲ级脑胶质瘤组织中SOX2蛋白阳性表达率高于Ⅰ级、Ⅱ级脑胶质瘤组织及正常脑组织,Ⅳ级脑胶质瘤组织中SOX2蛋白阳性表达率高于Ⅰ级、Ⅱ级、Ⅲ级脑胶质瘤组织及正常脑组织(P0.05)。不同性别、年龄脑胶质瘤患者脑胶质瘤组织中SOX2蛋白表达情况比较,差异无统计学意义(P0.05);不同肿瘤直径、病理分级脑胶质瘤患者脑胶质瘤组织中SOX2蛋白表达情况比较,差异有统计学意义(P0.05)。Ⅰ级脑胶质瘤组织中SOX2 mRNA相对表达量高于正常脑组织,Ⅱ级脑胶质瘤组织中SOX2 mRNA相对表达量高于Ⅰ级脑胶质瘤组织及正常脑组织,Ⅲ级脑胶质瘤组织中SOX2 mRNA相对表达量高于Ⅰ级、Ⅱ级脑胶质瘤组织及正常脑组织,Ⅳ级脑胶质瘤组织中SOX2 mRNA相对表达量高于Ⅰ级、Ⅱ级、Ⅲ级脑胶质瘤组织及正常脑组织(P0.05)。结论 SOX2在脑胶质瘤组织内呈高表达,且其表达水平随着肿瘤恶性程度的加重而升高,提示SOX2在脑胶质瘤的发生和发展过程中起重要作用。     

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.     

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.     

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.     

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.