PTEN基因变异与人脑胶质瘤预后的关系研究

目的探讨PTEN基因变异与人脑胶质瘤病理级别、生存期及病人年龄、性别、肿瘤生长部位的关系。方法应用聚合酶链反应-单链构象多态性电泳分析（PCR-SSCP）结合银染技术和双重PCR技术．检测80例胶质瘤PTEN基因9个外显子点突变与基因缺失情况。结果15例（18．8％）发生基因点突变。27例（33．8％）存在基因缺失。PTEN基因失活与星形细胞瘤病理分级显著性相关（P〈0．05）。其中高度恶性胶质瘤（Ⅲ～Ⅳ级）的突变率（31．3％）和缺失率（52．1％）明显高于低度恶性者（Ⅰ～Ⅱ级）（P〈0．05）；与病人性别、年龄及肿瘤生长部位无关。PTEN基因第5、6和8外显子是胶质瘤病人的热点基因突变区。PTEN基因失活的胶质瘤病人生存期明显低于基因正常者。结论人脑胶质瘤PTEN基因与病理分级和生存期关系密切。可作为一项独立的预后指标。     

人脑胶质瘤细胞多药耐药性的形成及其耐药特性的研究

目的探讨人脑胶质瘤细胞多药耐药性（ＭＤＲ）的形成规律及其耐药特性。方法采用长春新碱（ＶＣＲ）在体外对人脑胶质瘤ＢＴ３２５细胞持续诱导获得了表现为ＭＤＲ特征的人脑胶质瘤细胞模型．以ＭＴＴ法测定胶质瘤细胞增殖，透射电镜行超微结构研究，通过流式细胞仪，检测培养的胶质瘤细胞与３２例术后胶质瘤新鲜组织标本中Ｐ－糖蛋白的表达。结果耐药的胶质瘤细胞ＢＴ３２５／ＶＣＲ对长春新碱的耐受程度为其亲本细胞的２４倍，对阿霉素、威猛交叉耐药，对５－氟脲嘧啶敏感。透射电镜下见ＢＴ３２５／ＶＣＲ细胞常染色质明显，线粒体丰富，粗面内质网增多。研究表明ＢＴ３２５／ＶＣＲ表现为Ｐ－糖蛋白介导的典型ＭＤＲ。胶质瘤新鲜组织标本中，Ｐ－糖蛋白表达阳性率为３７５％（１２／３２），同肿瘤的恶性程度呈正相关（Ｐ＜０．０１）。结论长春新碱能够诱导人脑胶质瘤细胞产生Ｐ－糖蛋白介导的典型ＭＤＲ。胶质瘤中多药耐药基因产物Ｐ－糖蛋白表达的阳性率同肿瘤的恶性程度呈正相关。应用流式细胞仅能早期发现耐药细胞，具有临床推广价值。     

儿童恶性脑胶质瘤P53与细胞增殖核抗原表达的预后价值

目的探讨Ｐ５３与细胞增殖核抗原（ＰＣＮＡ）在儿童恶性脑胶质瘤表达的预后价值。方法采用ＡＢＣ免疫组化方法对３３例儿童恶性脑胶质瘤Ｐ５３与ＰＣＮＡ表达进行回顾性研究。结果３３例儿童恶性脑胶质瘤中Ｐ５３表达阳性１５例（４５％），ＰＣＮＡ表达阳性２９例（８８％）。间变性星形细胞瘤、胶质母细胞瘤及髓母细胞瘤Ｐ５３蛋白表达的阳性比例分别为５／１２、９／１６、１／５，肿瘤Ｐ５３蛋白阴性者其细胞增殖活性均较阴性者高（Ｐ＜００５）；ＰＣＮＡ标记指数与肿瘤的恶性程度呈正相关（Ｐｅａｒｓｏｎ列联系数＝０．５６，Ｐ＜００１）。Ｐ５３或ＰＣＮＡ表达阳性者存活率分别显著低于Ｐ５３或ＰＣＮＡ表达阴性者（Ｐ＜００５，Ｐ＜００１）。结论Ｐ５３基因突变以及由此导致的细胞异常增殖与儿童恶性脑胶质瘤的发生和发展有关；ＰＣＮＡ能较好地反映胶质瘤的恶性程度，其表达检测对临床预后判定有重要参考价值。     

nestin基因表达与胶质瘤恶性进展及预后相关性的初步研究

目的研究神经干细胞标志物巢蛋白（nestin）基因在不同恶性程度人脑胶质瘤中的表达状况，分析其表达与临床病理及预后的相关性。方法采用实时荧光定量PCR方法检测80例人脑胶质瘤标本及4例正常脑组织中的nestin基因表达状况，并对其与临床病理及预后的相关性进行统计分析。结果在人脑胶质瘤组织中存在nestin基因表达，其表达水平与病理级别呈正相关（r=0．625，P〈0．05），与病人生存时间呈负相关（r=-0．312，P〈0．05），而在不同性别、年龄及肿瘤部位中表达水平的差异无统计学意义（P〉0．05）。结论不同恶性程度胶质瘤中均可检出nestin基因表达，其表达水平与胶质瘤病理级别、病人生存时间之间存在显著关联．提示不同恶性程度胶质瘤中均存在胶质瘤干细胞，nestin表达水平可能与预后相关。     

胶质细胞瘤的分子病理学特征与个体综合治疗决策

在胶质瘤的临床治疗实践中,我们多有这样的经验,同样是低级别胶质瘤(WHO I、II级),尽管治疗措施相同,一类患者术后较长时间肿瘤不复发,甚至可达到治愈;而另一类患者术后短时间肿瘤即复发,复发的胶质瘤则大多转变为恶性胶质瘤,但也有的肿瘤复发时病理级别并没有升高.而高度恶性的胶质母细胞瘤,多数治疗效果很差,平均生存期不到一年,但也有少数患者在同样的治疗条件下可存活5年,甚至更长时间.为什么相同病理级别胶质瘤,对相同治疗临床疗效存在很大差异.     

PET在颅内恶性胶质瘤治疗后疗效观察及预后评价中的作用

目的　探讨正电子发射断层扫描（ＰＥＴ）在恶性胶质瘤治疗后疗效观察及预后评价中的作用。方法　观察３２ 例手术加放疗后追加立体定向放射外科治疗的颅内恶性胶质瘤患者的ＣＴ、ＭＲ及ＰＥＴ影像改变,并经手术病理及随访来分析ＰＥＴ 显像与肿瘤治疗后疗效及预后的关系。结果　ＰＥＴ所显示病灶区的ＦＤＧ代谢与肿瘤复发密切相关,代谢越高,复发的可能越大。ＦＤＧ－ＰＥＴ指数（肿瘤／白质）与生存期呈正相关。结论　ＰＥＴ可以帮助区分恶性胶质瘤治疗后的放射性坏死与复发,并可较准确地评价预后。     

抑癌基因p16蛋白在脑胶质瘤中的缺失及意义

目的 研究ｐ１６蛋白的缺失率与脑胶质瘤性程度的关系。方法 应用ＳＰ免疫级化检测７２例人脑胶质瘤，４个人脑体外恶性胶质瘤细胞系及１０例正常脑组织中抑癌基因ｐ１６蛋白的表达，结果 正常脑组织、Ｉ级、ＩＩ级、ＩＩＩ级、ＩＶ级、ＣＬ中ｐ１６蛋白的缺失率分别为０．１０％，３１．８％，６３．２％，７１．４％，１００％，脑胶质瘤细胞系，高恶度脑胶质瘤（ＷＨＯ，ＩＩＩ级～ＩＶ级）与低恶度脑胶质瘤（ＷＨＯ，Ｉ级～Ｉ级）之间差异显（Ｐ〈０．０５），结论 ｐ１６蛋白的缺失率与脑胶质瘤的汪事分极和恶性程度密切相关，提示ｐ１６基因在脑胶质瘤的发生，发展过程中起重要作用。     

人脑胶质瘤中表皮生长因子受体表达的研究

目的：探讨表皮生长因子受体（ＥＧＦＲ）基因表达与胶质瘤恶性程度的关系。方法：采用Ｎｏｒｔｈｅｒｎ印迹杂交及免疫组织化学技术从ｍＲＮＡ及蛋白水平检测了５０例人脑胶质瘤、４个体外恶性胶质瘤细胞系及８例正常脑组织的ＥＧＦＲ的基因表达。结果：免疫组化检测高恶度胶质瘤（ＷＨＯⅢ－Ⅳ级）ＥＧＦＲ表达６９％（２０／２９），而低恶度胶质瘤（ＷＨＯⅠ－Ⅱ级）表达率为３３％（７／２１），差异显著（Ｐ＜０．０１）；４例细胞系阳性表达１００％；８例正常脑组织无ＥＧＦＲ蛋白表达。ＷＨＯ分级与ＥＧＦＲ蛋白表达呈正相关（ｒ＝０．５５９７，Ｐ＜０．００１）。对５０例胶质瘤进行Ｎｏｒｔｈｅｒｎ印迹杂交，其结果与免疫组化检测结果一致，ＥＧＦＲｍＲＮＡ也随胶质瘤恶性程度的增加而表达增高。结论：ＥＧＦＲ可能在恶性胶质瘤的发生发展中起重要作用，ＥＧＦＲ过表达与胶质瘤分级相关性为从分子水平评估肿瘤的恶性程度及选择基因治疗的靶基因提供了参考。     

P16基因改变与脑胶质瘤生物学特性相关性的研究

目的 研究Ｐ１６基因改变与脑胶质瘤恶性程度分级及肿瘤细胞增殖活性之间的关系。方法 检测４１例不同级别脑胶质瘤标本和７例正常脑组织Ｐ１６基因改变和ＰＣＮＡ蛋白表达情况。结果 实验组Ｐ１６基因缺失和突变２２例（５４％），ｍＲＮＡ和蛋白表达缺失分别为２３例（５６％）和２７例（６６％），三者改变非一对一关系。Ｐ１６基因改变和ＰＣＮＡ指数随脑胶质瘤恶性程度级别增高呈上升趋势（Ｐ〈０．０５）。Ｐ１６基因改变与     

腺病毒介导的HSV—tk基因治疗大鼠脑胶质瘤实验研究

目的：带有ＨＳＶ－ｔｋ基因的重组腺病毒（ＡｄＨＣＭＶ－ｔｋ）结合核苷类似物（ＮＡ）治疗大鼠Ｃ６脑胶质瘤。方法：用Ｘ－ｇａｌ染色测定ＡｄＨＣＭＶ－ｌａｃＺ转染大鼠Ｃ６胶质瘤细胞的效率。用ＡｄＨＣＭＶ－ｔｋ／ＡＣＶ、ＧＣＶ离体及活体治疗大鼠Ｃ６胶质瘤。结果：ＡｄＨＣＭＶ－ｌａｃＺ感染Ｃ６细胞效率达１００％，ＡｄＨＣＭＶ－ｔｋ感染Ｃ６细胞，在病毒感染复数为１０００时，ＧＣＶ和ＡＣＶ半致死剂量分别为３μｇ／ｍｌ和２０μｇ／ｍｌ，Ａｄ－ＨＣＭＶ－ｔｋ／ＡＣＶ治疗大鼠Ｃ６胶质瘤模型，大鼠生存期超过９０天，而对照组分别为１７．０±１．６天（生理盐水组）、１４．５±１．３天（ＡｄＨＣＭＶ－ｌａｃＺ组），Ｐ＜０．００１。结论：重组腺病毒对靶细胞感染效率可达１００％，ＡｄＨＣＭＶ－ｔｋ用ＧＣＶ的杀伤Ｃ６胶质瘤细胞比ＡＣＶ强，而ＨＳＶ－ｔｋ／ＡＣＶ用腺病毒介导治疗大鼠脑肿瘤疗效显著。     

Physical and Sexual Abuse and Neglect and Eating Disorder Symptoms

For eating-disordered patients with a history of post-traumatic stress, childhood abuse and neglect, and dissociative disorder, eating behavior symptoms may function as a rational response to unmetabolized traumatic experiences. This paper will review trauma-based theory, dissociation, abreactive, and ego-states therapy as they apply to eating disorder patients.     

Efficacy and Effectiveness of Child and Adolescent Psychotherapy and Pharmacotherapy

Decades of intervention research have produced a rich body of evidence on the effects of psychotherapies and pharmacotherapies with children and adolescents. Here we summarize and critique that evidence. We review findings bearing on the efficacy of psychosocial treatments and medications under controlled experimental conditions. We also report evidence, where available, on the effectiveness of both classes of treatment with clinically referred youth treated in real-world clinical contexts. In general, the large body of evidence on efficacy contrasts sharply with the small base of evidence on effectiveness. Addressing this gap through an enriched research agenda could contribute importantly to linking scientific inquiry and clinical practice—to the benefit of both ventures. This is one element of a multifaceted agenda for future research and for synthesis of research, which will require the interplay of multiple disciplines related to child and adolescent mental health.     

Presence and severity of anorexia and bulimia among male and female Omani and non-Omani adolescents

OBJECTIVE: The population of Oman is a heterogeneous mix of nationalities providing a natural setting for studying the cross-cultural differences in the presence and severity of eating disorders as well as an opportunity for evaluating the performance of measurement instruments for these disorders. METHOD: Disordered eating screening instruments (the Eating Attitude Test and the Bulimic Investigatory Test) were administered to Omani teenagers, non-Omani teenagers, and Omani adults. RESULTS: On the Eating Attitude Test, 33% of Omani teenagers (29.4% females and 36.4% males) and 9% of non-Omani teenagers (7.5% of males and 10.6% females) showed a propensity for anorexic-like behavior. On the Bulimic Investigatory Test, 12.3% of Omani teenagers showed a propensity for binge eating or bulimia (13.7% females and 10.9% males). Among the non-Omani teenagers, 18.4% showed a tendency toward bulimia, with females showing a slightly greater tendency than males. In contrast, barely 2% of Omani adults showed either a presence of or a severity of disorderly behavior with food. CONCLUSION: Omani teenagers scored significantly higher than other ethnic groups and Omani adults. This finding is discussed in the light of emerging evidence from many parts of the world suggesting that cultural transition, compounded by demographic constraints, plays a significant role in abnormal eating attitudes.     

Physical and Sexual Abuse and Neglect and Eating Disorder Symptoms

Abstract

For eating-disordered patients with a history of post-traumatic stress, childhood abuse and neglect, and dissociative disorder, eating behavior symptoms may function as a rational response to unmetabolized traumatic experiences. This paper will review trauma-based theory, dissociation, abreactive, and ego-states therapy as they apply to eating disorder patients.     

Micro-affirmations and Recovery for Persons with Mental Health and Alcohol and Drug Problems: User and Professional Experience-Based Practice and Knowledge

Recurrent factors contributing to a recovery process from co-occurring mental health and addiction problems mentioned by users and professionals have been analyzed as part of working alliances and helpful relationships. Still, we lack knowledge about how helpful relationships are developed in daily practice. In this article, we focus on the concrete construction of professional helpful relationships. Forty persons in recovery and fifteen professionals were interviewed. The interviews were analyzed according to thematic analysis, resulting in three themes presented as paradoxes (1) My own decision, but with the help of others; (2) The need for structures and going beyond them; and (3) Small trivial things of great importance. Micro-affirmations have a central role in creating helpful relationships by confirming the individuals involved as more than solely users or professionals. More attention and appreciation should be paid to practices involving micro-affirmations.

     

Opiate and digitalis receptor assays distinguish between neuroexcitant and inactive organochlorines and between anesthetics and convulsants

Specific binding of [3H]naloxone to rat brain tissue in vitro was inhibited by the excitant organochlorinated insecticides (OCI), by ether (E) and octanol (OCT), and by the convulsant indoklon (IND) and its anesthetic isomer, isoindoklon (ISO). In the presence of 100 mM NaCl the inhibition of naloxone binding by E, OCT and ISO was greatly potentiated, whereas that by OCI and IND was attenuated. KCl (100 mM) was equally effective as NaCl on the action of anesthetics, but the effect of the excitant drugs was, in contrast to NaCl, unaffected by KCl. Specific binding of [3H]ouabain in the absence of Na, was depressed by anesthetics and enhanced by neuroexcitants. In the presence of NaCl, which by itself inhibits ouabain binding to brain, both anesthetics and excitants enhanced ouabain binding. DDE, a non-insecticidal analog of DDT, and the dimethyl derivative of the OCI, lindane, were inactive in the receptor assays. These observations point to a unique isolated system which responds consistently to anesthetic agents as a class and, in a different way, to neuroexcitant compounds.