增殖细胞核抗原表达在肾细胞癌侵袭和转移性评估中的价值

侵袭和转移是影响肾细胞癌预后的重要因素 ,我们采用免疫组织化学技术检测 10 2例肾癌患者的癌细胞增殖细胞核抗原 (ＰＣＮＡ)表达 ,探讨其在肾癌侵袭和转移能力评估中的价值。1.资料和方法 :10 2例肾癌患者经根治术 ,取其肾癌标本 10 2份 ,根据是否存在浸润或转移 ,分为浸润转移组与非浸润转移组。远隔脏器转移 ,肾包膜外、肾外脏器浸润或肾、腔静脉癌栓依据术前影像学及术中探查、术后病理诊断 ;肾门淋巴结、镜下癌周组织及微静脉浸润由病理组织学检查 (图 1～ 3)确认 ,方法见李泉林等[1] 报道。应用标准过氧化物酶 链霉卵白素 (ＳＰ)免疫…     

增殖细胞核抗原在肝细胞癌中的表达及其临床意义

目的 探讨增殖细胞核抗原(PCNA)在肝细胞肝癌的发生发展中的作用及作用机制.方法 采用逆转录-聚合酶链反应(RT-PCR)和免疫组织化学法检测PCNA在肝细胞癌、相应癌旁组织和正常肝组织中mRNA和蛋白质的表达,正常肝组织、癌旁组织、肝细胞癌组织中的阳性表达率分别为20.0％、46.2％和85.7％;结合患者的年龄、性别、肿瘤大小、分化程度、有无淋巴结转移等临床病理学资料进行统计学分析,其表达与组织分化程度和淋巴结转移呈明显相关(P＜0.05).结果 PCNA在正常肝组织、癌旁组织、肝细胞癌组织中的阳性表达率分别为20.0％、46.2％和85.7％,在肝细胞癌中的阳性表达率显著高于正常肝组织和癌旁肝组织(P＜0.05);RT-PCR检测结果也证实PCNA mRNA在肝细胞癌中的表达明显高于正常肝组织和癌旁肝组织(P＜0.05).PCNA的表达与患者年龄、性别、肿瘤大小等因素无明显相关(P＞0.05),与组织分化程度和淋巴结转移呈明显相关(P＜0.05).结论 PCNA在肝细胞癌组织中的表达高于正常肝组织和癌旁肝组织,并且与肿瘤的恶性程度密切相关.     

肾盂癌增殖细胞核抗原表达的临床意义

采用免疫组化技术检测３１例肾盂癌和９例慢性能盂炎组织中增殖细胞核抗原（ＰＣＮＡ）的表达。发现肾盂癌ＰＣＮＡ阳性细胞数明显高于炎症组，随肿瘤病理分级和分期的上升而增加，且分化差的染色对肾盂良性病变的鉴别和肾盂癌生物学行为的评估具有重要意义。对肾盂癌ＰＣＮＡ阳性细胞数大于７５％得术后应定期复查膀胱镜，并行必要的膀胱灌注治疗。     

胆管癌胆囊癌增殖细胞核抗原表达及其临床意义

应用免疫组织化学方法研究胆管癌、胆囊癌及其良性病变ＰＣＮＡ蛋白的表达，结果妻现“胆管癌、胆囊癌ＰＣＮＡ蛋白阳性反应率为８３．５％和８５％，与良性病变比较差异有显著性意义，表明癌变组织有较经强增殖活性。     

增殖细胞核抗原在胃肠道平滑肌肿瘤中表达的临床意义

探讨增殖细胞核抗原表达与胃肠道平滑肌肿瘤的关系。方法 采用免疫组化Ｓ－Ｐ法检测８６例ＧＩＳＭＴ中ＰＣＮＡ的表达情况。结果 ＰＣＮＡ表达按正常胃肠道平滑肌组织，平滑肌瘤，平滑肌肉瘤Ⅰ，Ⅱ，Ⅲ级的依次明显递增，同时，ＰＣＮＡ的表达与肿瘤的性质，大小，中心有无坏死有明显关系。     

增殖细胞核抗原在大肠肿瘤中表达的临床意义

目的：探讨大肠肿瘤生物学特性及预后同增殖细胞核抗原（ＰＣＮＡ）表达的关系,方法,免疫组织化学方法。结果,ＰＣＮＡ表达状况同肿瘤的浸润深度,淋巴结转移相关,并同组织学分级呈正相关,ＤukesAB同ＤukesCD期间增殖指数有显著性差异,不同生存组间明显不同,结论,ＰＣＮＡ增殖状况是肿瘤侵裘和转移的重要特征,可以独立的预测大肠肿瘤患者的预后。     

细胞核增殖抗原与E-钙黏蛋白在膀胱移行细胞癌中的表达及临床意义

目的 探讨细胞核增殖抗原(Ki-67)、E-钙黏蛋白(E-cadherin)在膀胱移行细胞癌中的表达及其临床意义.方法 采用免疫组织化学方法检测Ki-67、E-cadherin在48例膀胱移行细胞癌组织中的表达,统计分析其表达与膀胱移行细胞癌临床病理、分期之间的关系.结果 Ki-67、E-cadherin在膀胱移行细胞癌中的阳性表达率分别是83.3％和47.9％,两者呈负相关(P＜0.05).两者表达水平与肿瘤临床分期及病理分级明显相关(P＜0.05).结论 检测Ki-67与E-cadherin有助于判断膀胱移行细胞癌侵袭和转移能力.     

肝细胞癌增殖细胞核抗原表达的图像定量分析

目的 探讨原发性肝细胞癌(简称肝癌)增殖细胞核抗原(PCNA)的表达情况及其意义.方法 采用免疫组化ABC法极测了PCNA蛋白在41例人肝癌组织和人肝癌细胞系HCC-9204的表达情况,并用图像分析仪定量分析了其表达水平与肝癌病理分级之间的关系.结果 癌旁非肿瘤性肝细胞不表达PCNA或只有微弱的表达,而各级肝癌组织的癌细胞均有不同程度的较强的PCNA表达,并且随着肝癌组织分化程度的下降PCNA表达的平均光密度和积分光密度均呈升高趋势,在不同病理分级的肝癌组织之间具有显著性差异(P<0.05).PCNA在培养的HCC-9204细胞中表达的阳性率为86.4%.结论 PCNA可作为肝癌发生和发展过程中的一个与其恶性程度密切相关的标志物,可能在肝癌细胞的增殖过程中具有重要的作用.     

胰腺癌组织中增殖细胞核抗原的表达及临床意义

目的 为了探讨增殖细胞核抗原（PCNA）的表达与胰腺癌组织生物学行为及预后的关系。方法 采用LABC法免疫组化染色检测32例胰腺癌和14例慢性胰腺炎组织中的PCNA表达。结果 PCNA在胰腺癌组织中的表达率为100％,胰腺癌组织中的PI明显高于慢性胰腺炎组织（P＜0．01）。PI 值与随肿瘤进展而逐渐增加的趋势,且PCNA表达与胰腺癌的预后呈负相关（P＜0．01）。结论ＰＣＮＡ表达能反映胰腺癌组织的增殖活性,分化程度越低,PCNA表达强度越高,它可作为预测胰腺癌病程和预后的一个有用指标。     

Reduction of Plasma Fibrinogen, Immunoglobulin G, and Immunoglobulin M Concentrations by Immunoadsorption Therapy with Tryptophan and Phenylalanine Adsorbents

Abstract Immunoadsorption (1A) therapy with tryptophan (TR-350) or phenylalanine (PH-350) adsorbents has been used to reduce the concentration of serum antibodies in human lymphocyte antigen (HLA)-immunized patients. Other forms of plasma purification have been reported to reduce the level of fibrinogen, which affects the blood properties. In this study we investigated the effects of IA therapy using both adsorbents on plasma fibrinogen and immunoglobulins G and M in 13 patients (8 patients were treated with TR-350, and 5 patients were treated with PH-350). During each session 1 plasma volume (2.8 ± 0.4 L of plasma) was processed through the immunocolumn and then returned to the patient together with the blood cells. Compared with the pretreatment values, the plasma fibrinogen, IgG, and IgM concentrations were significantly reduced after IA therapy (p < 0.01 for TR-350; p < 0.04 for PH-350). There was a positive correlation between the degree of reduction of plasma proteins and the number of IA treatments given. A nonpara-metric test (Wilcoxon's signed-rank test or the Mann-Whitney test) was used for statistical analysis. We conclude from our study that IA therapy effectively lowers the plasma levels of fibrinogen, IgG, and IgM and thus can be considered a valuable alternative to other blood purification methods.     

A comparison of the inhibitory effects of four volatile anaesthetics on the metabolism of chlorzoxazone, a substrate for CYP2E1, in rabbits

Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.     

The multiply injured child

Blunt trauma is the principal cause of childhood death in many developed countries. This review outlines the differences between adults and children with respect to resuscitation and treatment of orthopaedic injuries in a child with polytrauma. Recent advances in techniques of fracture stabilization are reported.     

Intrathecal administration of sameridine to patients subjected to arthroscopic knee joint surgery

Background: Sameridine, a new substance with both local anesthetic and opioid effects, was administered intrathecally for the first time to humans, i. e. in patients subjected to arthroscopic knee joint surgery.
Method: A dose-escalating (10, 15, 20 and 25 mg), open study was performed in 33 patients. Only two patients were included in the 25 mg group.
Results: Sameridine provided good quality of surgical anesthesia in all patients except those receiving 10 mg. The maximum level of sensory block, Th5–Th7, was reached within 30 min with a median duration of 3.6–3.9 h. The motor block was more profound with increasing dose, but never lasted longer than the sensory block. The influence on heart rate and blood pressure was minor and atropine and ephedrine were needed in four patients. No clinically significant ECG-changes were detected and no arrhythmias were recorded. Oxygen saturation and respiratory rate did not decrease in a clinically significant way and were not affected by concomitant morphine given i. v. postoperatively. There were few side-effects, the most frequent being mild pruritus (10/33).
Conclusion: Sameridine provided clinically adequate anesthesia for the patients receiving the doses of 15, 20 and 25 mg. Further studies are needed to evaluate the substance and it is of great interest to clinically investigate the opioid component with respect to postoperative analgesia.     

Anesthésie du patient épileptique

Although surgery of brain tumors and epilepsy are restricted to few specialized centers, anaesthesia for a patient with epilepsy is commonly encountered. Surgical treatments of epilepsy are currently soaring due to the lack of significant progress about effectiveness of antiepileptic drugs (AEDs). Theoretical principles for the anaesthesiologist are quite complex, involving interactions between physiological and pharmacological anaesthesia and AEDs, such as enzyme induction with the first generation molecules mainly (phenytoin, carbamazepin, phenobarbital). The latest generation AEDs (levetiracetam, lamotrigine, gabapentin, oxcarbazepin, vigabatrin, lacosamide...) are better tolerated and induce fewer drug interactions. Practically, the risk of severe perioperative complications is low, provided that the administration of AEDs is kept as close as possible to its usual dosage, and that metabolic disturbances are prevented. The main anaesthetic drugs to avoid are alfentanil, remifentanil and sevoflurane, although their contraindication are only relative, since the clinical benefit might be clear and the doses should remain moderate.     

Development of Selective Low-Density Lipoprotein (LDL) Apheresis System: Immobilized Polyanion as LDL-Specific Adsorption for LDL Apheresis System

Abstract: Low-density lipoprotein (LDL) is widely recognized as one of the major risk factors for developing coronary heart diseases. Despite intensive development of LDL-lowering drugs, there still exist those patients with refractory hyperlipidemia whose plasma LDL levels are not sufficiently lowered by drugs. LDL apheresis, direct removal of plasma LDL from circulating blood, is thought to be the most promising treatment for such refractory patients. Various techniques, such as the use of an im-munoadsorbent utilizing an anti-LDL antibody, have been used in an attempt to achieve the selective removal of LDL. However, none were widely used because of complications, poor selectivity, and so forth. To establish a safe and effective LDL apheresis system, we chose a synthetic affinity adsorbent as the LDL-removing device. Synthetic polyanion compounds were used as the affinity ligands for LDL adsorbent to simulate the anion-rich sequence of LDL binding sites in the human LDL receptor. Among various polyanion compounds, those polyanions with sulfate or sulfonate groups and hydrophilic backbone were found to have strong affinity for LDL. In contrast, polyanions with carboxyl groups showed poor affinity. Dextran sulfate (DS) was selected as the affinity ligand of LDL adsorbent for its high affinity and low toxicity. The influence of its charge density and molecular weight on its affinity for LDL was suitable. The affinity rapidly increased as the charge density increased, then, reached a constant value. Little affinity was found for either the DS monomer (glucose sulfate) or DS with a molecular weight higher than 10⁴ daltons whereas DS with molecular weights in the midrange showed strong affinity. DS with a midrange molecular weight was immobilized on cellulose hard gel to give LDL adsorbent clinical application. The adsorbent demonstrated an excellent selectivity for LDL and very low density lipoprotein (VLDL) in vitro. Adsorption of high-density lipoprotein and major plasma proteins was almost negligible. Additional study of the LDL-binding mechanism revealed that DS directly interacts with positively charged sites on LDL, which demonstrates that the nature of the interaction is the same as that of LDL receptor. An LDL adsorption column (Liposorber) packed with an LDL adsorbent and polysulfone hollow-fiber plasma separator (Sulflux) was developed as an efficient LDL apheresis system. Clinical investigation proved that this system is capable of intensively lowering the plasma LDL level without affecting major plasma components.     

Artificial organs 2010: a year in review

In this Editor's Review, articles published in 2010 are organized by category and briefly summarized. As the official journal of The International Federation for Artificial Organs, The International Faculty for Artificial Organs, and the International Society for Rotary Blood Pumps, Artificial Organs continues in the original mission of its founders "to foster communications in the field of artificial organs on an international level."Artificial Organs continues to publish developments and clinical applications of artificial organ technologies in this broad and expanding field of organ Replacement, Recovery, and Regeneration from all over the world. We take this time also to express our gratitude to our authors for offering their work to this journal. We offer our very special thanks to our reviewers who give so generously of time and expertise to review, critique, and especially provide such meaningful suggestions to the author's work whether eventually accepted or rejected and especially to those whose native tongue is not English. Without these excellent and dedicated reviewers the quality expected from such a journal could not be possible. We also express our special thanks to our Publisher, Wiley-Blackwell, for their expert attention and support in the production and marketing of Artificial Organs. In this Editor's Review, that historically has been widely received by our readership, we aim to provide a brief reflection of the currently available worldwide knowledge that is intended to advance and better human life while providing insight for continued application of technologies and methods of organ Replacement, Recovery, and Regeneration. We look forward to recording further advances in the coming years.