p16基因在消化系肿瘤的研究进展

ｐ１６基因又称多重肿瘤抑制基因１（ＭＴＳ１）、细胞周期素依赖激酶４的抑制物（ｃｙｃｌｉｎｄｅｐｅｎｄｅｎｔｋｉｎａｓｅ４ｉｎｈｉｂｉｔｏｒ,ＣＤＫ４Ｉ）或ＣＤＫＮ２,是新近发现的一个重要抑癌基因,与许多肿瘤的发生、发展关系密切．与ｐ５３基因相比,它具有突变率高、分子量小,易于标定的特点,因而很快成为肿瘤分子生物学、分子遗传学等学科的研究热点．目前,人们已从基础及临床诊治等多个角度对ｐ１６基因进行了研究．本文旨在综述ｐ１６基因与消化系肿瘤发生、发展的关系及ｐ１６基因治疗情况．１　ｐ１６基因的作用及…     

Neurocritical care of patients with central nervous system infections

Bacterial meningitis and viral encephalitis are life-threatening infections with high mortality rates. Patients who survive these infections often remain permanently disabled. Potential neurologic complications requiring careful attention include impaired consciousness, elevated intracranial pressure, hydrocephalus, stroke, and seizures. Systemic complications are also common and are frequently the immediate cause of death. Critical care of these patients should focus not only on treatment of the underlying infection and its immediate complications but also on minimizing secondary brain injury. Given the increasing complexity of the diagnostic and therapeutic modalities available in managing central nervous system infections, the involvement of neurocritical care units and neurointensivists may be particularly helpful in improving outcomes.     

Hyphal forms in the central nervous system of patients with coccidioidomycosis.

Coccidioides immitis is a dimorphic fungus that grows as a filamentous mold in soil and as a spherule at human body temperature. The hyphal or soil form is found rarely in human tissue. We report 5 cases of coccidioidomycosis in which hyphae were found in brain tissue or spinal fluid. The presence of central nervous system plastic devices appears to be associated with morphological reversion to the saprophytic form. This reversion has implications for diagnosis and therapy and may increase the risk of obstruction of the device(s).     

Prognosis of the central nervous system involvement in patients with hemophagocytic lymphohistiocytosis

正Objective To investigate the characteristics and prognostic factor of central nervous system(CNS)involvement in patients with hemophagocytic lymphohistiocytosis(HLH).Methods From January 2006 to October 2015,152 patients with HLH,88 patients had CNS involvement,their clinical data were collected,and surviv-     

Telomerase activity in Malaysian patients with central nervous system tumors

Telomerase, the enzyme that stabilizes telomere length is reactivated with almost all cancer types, and may be a useful diagnostic marker for malignancy. Telomerase activity has been detected in germ line cells and most cancer cells, whereas most normal somatic cells have no clearly detectable telomerase activity. In our study, we aim to detect telomerase activity in 20 human central nervous system tumors from Malaysian patients. Telomerase activity was detected based on a highly sensitive procedure consisting of a CHAPS detergent-based extraction from frozen tissues and a PCR-based telomeric repeat amplification protocol (TRAP) using a TRAPEZE Telomerase Detection Kit (Intergen, Co). Telomerase activity was considered positive when a ladder of products was observed starting at 50bp, with 6bp increments. The activity was detected in 30% of the samples analysed, included glioblastoma multiforme, meduloblastoma, paraganglioma and oligodendroglioma. The result of Fisher's exact test indicated that there was a significant association between telomerase activity status with tumor grade (p=0.003). These results suggest that telomerase activity may be an important marker for tumor malignancy.     

The complication with tuberculosis of the central nervous system in patients with miliary tuberculosis

The complication with tuberculosis of the central nervous system (CNS) were studied in 16 patients with miliary tuberculosis who were admitted to our hospital during a period of two years from April, 1997 to March, 1999, and were examined by head MRI. Twelve cases (75%) were diagnosed as having tuberculosis of CNS. Six cases had tuberculosis of CNS which was found during the screening of miliary tuberculosis cases, and all had only cerebral tuberculoma. Meningeal irritative symptoms led to the discovery of tuberculosis of CNS in the remaining six cases, in which cerebral tuberculoma was complicated with tuberculous meningitis. Of these cases of meningitis, three cases showing disturbance of consciousness died, but no cases of death was found in cases by the screening. The length of time from the onset of symptoms to the diagnosis of tuberculosis was long in many of the cases complicated with tuberculosis of CNS compared with the cases without such a complication. In the cases of miliary tuberculosis, the rate of complication with tuberculosis of CNS is high, and the possibility of patients developing serious symptoms suddenly even when they were asymptomatic at the time of diagnosis and the paradoxical expansion that becomes intensified after initiation of treatment have been reported. Therefore, it is necessary to make a close checkup of CNS when the diagnosis of miliary tuberculosis has been made.     

Functional disorders of the central nervous system in patients with pulmonary tuberculosis]

Two groups of pulmonary tuberculosis patients were followed up to reveal the relation between the lipid peroxidation (LPO) processes and the function of the central nervous system (CNS) in pulmonary tuberculosis. Group 1 (n = 76) included subjects with normal baseline electroencephalographic findings; group 2 (n = 41) consisted of those with profound changes in the electroencephalogram. The findings of LPO processes were assessed by the blood levels of malonic dialdehyde and alpha-tocopherol. Group 2 showed a direct relationship between the progression of neurotic symptoms and the abnormal changes in the values of LPO processes. It is concluded that it is expedient to use antioxidants in the combined treatment of pulmonary tuberculosis patients to eliminate the baseline CNS changes caused by the specific process.     

Influence of blood transfusion on development of infection in patients with malignant neoplasms of the digestive system

BACKGROUND: Anemia affects up to 90% of cancer patients, with more than 60% requiring blood transfusion during or after treatment. AIM: To determine the influence of the allogeneic blood transfusion as a possible related factor to infection in patients with malignant neoplasms of the gastrointestinal system. PATIENTS AND METHOD: Charts of 400 oncological patients were randomly selected and divided into two groups: group 1 (n = 200)--patients submitted to allogeneic blood transfusion and group 2 (n = 200)--non transfused patients. Both groups were evaluated and compared according to the presence and type of infection and a possible association with age, sex, types of tumors and therapeutics approach. RESULTS: The relation between infection and blood transfusion, as well as age, sex, management and type of presented tumors were not significant. There was no difference in the incidence of infection between the non transfused patients (28) and those submitted to allogeneic blood transfusion (31). CONCLUSIONS: In the present investigation allogeneic blood transfusion was apparently not related to development of infection in patients with malignant gastrointestinal tumors.     

消化系统肿瘤的分子靶向治疗

消化系统肿瘤发病率在全球范围内位于恶性肿瘤首位,亦是全球癌症导致死亡的主要原因,且其总体仍处于姑息治疗水平.随着肿瘤分子生物学深入研究和认识,尤其阐明了分子信号通路对肿瘤细胞增殖和生长的作用机制,继而为其特异性靶点而设计的分子靶向药物的开发,开创了临床肿瘤治疗的新领域,在消化系统肿瘤治疗中取得了实质性疗效,成为肿瘤治疗的发展方向.本文对消化系统肿瘤分子靶向治疗药物的最新研究进展作一综述.     

HIV/AIDS合并中枢神经系统机会性感染73例临床分析

目的 探讨HIV感染及AIDS患者群(HIV/AIDS)的各种中枢神经系统机会性感染(opportunistic infections,OIs)情况,以提高诊断水平及临床治愈率,改善预后.方法 统计73例HIV/AIDS中枢神经系统OIs的临床数据,分析其临床表现、实验室检查结果和头颅影像学表现,评价其疗效及预后.结果...     

Low-grade primary central nervous system lymphoma in immunocompetent patients

Primary central nervous system lymphomas (PCNSL) are usually diffuse large B-cell non-Hodgkin's lymphomas (NHL). Here we characterize the clinical presentation, course and outcome of patients with low-grade PCNSL. Records of 332 patients screened for inclusion in three multicentre prospective trials were reviewed. Ten patients (3%) with a median age of 59 years and a median Karnofsky performance status of 70% were identified. Seven patients had B-cell and three had T-cell lymphoma. The median growth fraction was 4%. The radiological morphology was unusual for PCNSL in eight patients. Three patients underwent complete tumour resection, combined with chemotherapy in one patient and with chemotherapy plus local radiotherapy in another. Four patients received chemotherapy and three received chemotherapy plus whole-brain irradiation, resulting in four complete remissions, two no-change situations and one progressive disease. Patients had an overall survival (OAS) of 2-58+ months with a 2-year OAS of 67%. Low-grade PCNSL may differ from classical high-grade PCNSL in its clinical features and radiological morphology. The clinical course may be variable and frequently more indolent than in classical PCNSL.     

Regeneration in the central nervous system

Unlike neonatal axons, mammalian adult axons of the CNS do not regenerate after injury. This developmental loss of regenerative capacity, is correlated with the onset of myelination. Likewise, myelin, or myelin-associated components such as Nogo-A and myelin-associated glycoprotein (MAG) inhibit regeneration from older but not younger neurons. Identification of the molecular events responsible for this developmental loss of regenerative capacity is central to devise strategies to encourage regeneration in adults after injury. Endogenous levels of the cyclic nucleotides cAMP and cGMP have been suggested to determine the neuronal responsiveness to various axonal guidance factors. Elevating cAMP concentrations block Nogo-A or MAG induced inhibition of neurite outgrowth in older neurons, whereas suppressing cAMP levels in young neurons renders them susceptible to Nogo-A and MAG. Interestingly, elevated cAMP levels abrogated the Nogo-A and MAG mediated activation of RhoA and down regulation of Rac1 in adult neurons. In contrast, elevation of cAMP leads to the inactivation of RhoA and prevents activation of downstream effector proteins, while Rac is activated. We therefore conclude that the endogenous neuronal cAMP levels determine the neuronal responsiveness to myelin-associated neurite growth inhibitors by regulating rho GTPase activities.