胃癌活组织c—erb—B2过度表达与预后的关系

探讨胃癌活检组织ｃ－ｅｒｂ－Ｂ２过度表达与预后的关系。用免疫组化法检测１０３例胃癌胃镜活检组织及术后１５１个转移淋巴结ｃ－ｅｒｂ－Ｂ２表达。结果：１８．４％胃癌活检组织出现阳性表达，进展期胃癌、乳头状腺癌及伴淋巴与肝转移者阳性率增高（Ｐ均＜０．０５）；阳性表达更多见于高中分化胃癌（但Ｐ＞０．０５）；转移淋巴结表达阳性率高于胃癌原发病灶（Ｐ＜０．０５）。高中分化胃癌ｃ－ｅｒｂ－Ｂ２过度表达者５年生存率低于阴性者（Ｐ＜０．０１）。以上结果提示ｃ－ｅｒｂ－Ｂ２过度表达与否有助于胃癌预后的估计。     

胃癌组织中肝素酶和血管内皮生长因子-C的表达及其临床意义

目的探讨胃癌组织中肝素酶和血管内皮生长因子（VEGF）-C蛋白表达及其临床意义。方法采用免疫组化S-P法检测97例原发性胃癌组织、癌旁组织及20例正常胃黏膜组织中肝素酶和VEGFC蛋白的表达，并分析其与临床病理特征和预后的关系。结果胃癌组织肝素酶和VEGF—C蛋白表达阳性率分别为61．9％和66．0％，显著高于癌旁组织的7．2％和5．0％，正常胃组织的8．3％和5．0％（P值均〈0．01）；肝素酶表达与肿瘤分化程度无关，但与肿瘤直径、淋巴结转移、静脉侵犯、淋巴管侵犯、远处转移、浆膜面受累和TNM分期等密切相关；VEGF—C表达与肿瘤直径、分化程度、静脉侵犯及远处转移等无关，但与淋巴结转移、淋巴管侵犯、浆膜面受累和TNM分期等密切相关；肝素酶和VEGF—C阳性表达组术后生存率明显低于阴性组；在胃癌中肝素酶和VEGF—C阳性表达呈正相关。结论肝素酶及VEGF-C蛋白的阳性表达，可作为胃癌预后不良的参考指标。     

nm23-H1蛋白在胃癌中的表达

目的ｎｍ２３Ｈ１基因被认为是肿瘤转移抑制基因．本研究旨在探讨此基因的蛋白表达与胃癌转移之间的关系．方法使用抗人ｎｍ２３Ｈ１单克隆抗体，采用抗生蛋白链菌素—生物素标记的免疫组织化学染色方法，检测ｎｍ２３Ｈ１蛋白在５２例手术切除的胃癌及其淋巴结转移癌中的表达．结果ｎｍ２３Ｈ１蛋白表达与性别、年龄及胃癌的组织学类型无关．原发癌中ｎｍ２３Ｈ１表达阳性率（３６５％）明显高于转移癌（１２５％，Ｐ＜００１）．无淋巴结转移者及浆膜累及者，ｎｍ２３Ｈ１表达的阳性率（６６７％，６００％）明显高于有淋巴结转移者及浆膜累及者（２７５％，２７０％，Ｐ＜００５）．结论本研究结果表明ｎｍ２３Ｈ１蛋白在抑制胃癌浸润及淋巴结转移中发挥重要作用．     

差别PCR技术检测胃癌C一erbB-2癌基因扩增的临床意义

目的探讨胃癌Ｃ－ｅｒｂＢ－２癌基因扩增的临床意义。方法应用差别ＰＣＲ技术检测Ｃ－ｅｒｂＢ－２在８３例胃癌及１０１个转移淋巴结扩增情况。结果２８．９％（２４／８３）的胃癌存在该基因扩增，进展期胃癌及伴淋巴结转移者扩增阳性率增高（Ｐ＜０．０５及Ｐ＜０．０１）；转移淋巴结扩增阳性率明显高于胄癌原发灶（Ｐ＜０．０５）。早期胃癌及高中分化胃癌伴Ｃ－ｅｒｂＢ－２扩增者５年生存率低于不扩增者（Ｐ＜０．０５）。用Ｓｏｕｔｈｅｒｎｂｌｏｔ分子杂交及免疫组化ＡＢＣ法检测原胃癌样本基因扩增及过度表达，扩增及过度表达率分别为１５．７％及１８．１％，均明显低于上述扩增阳性率。结论差别ＰＣＲ技术检测Ｃ－ｅｒｂＢ－２扩增是一种快速方便、可靠、独立的方法，对胃癌预后及转移潜力是一种良好的判断指标。     

胃癌幽门螺杆菌感染中c-met基因表达与增殖的关系及其预后

目的 研究c-met基因蛋白及增殖细胞核抗原（PCNA）在幽门螺杆菌（Hp)感染的胃黏膜病变演进中的表达及关系，探讨Hp感染对胃癌预后的意义。方法 采用免疫组织化学法检测145例经病理证实不同胃黏膜病变的c-met和PCNA基因表达，Warthin-Starry法检测Hp感染。结果 在浅表性胃炎（CSG）、萎缩肠化性胃炎、异型增生（DYS）、早期胃癌和进展期胃癌中，c-met和PCNA2种基因在萎缩肠化性胃炎、DYS、胃癌均显著高于CSG（P＜0．05）。对胃黏膜增殖程度与c-met和PCNA阳性表达强度的密切关系分析，表明两者有显著关联（P＜0．01）。c-met和PCNA阳性表达与胃癌组织类型、浆膜浸润和淋巴结转移密切相关，而且Borrmann Ⅳ明显高于早期胃癌（P＜0．05）。c-met－LI和PCNA－LI在胃癌中等级相关表达有极显著的相关性（P＜0．001）。c-met阳性表达与肠型胃癌Hp感染有关。萎缩肠化性胃炎、DYS和胃癌组c-met阳性表达中Hp感染者明显高于阴性者。Hp阳性者5年生存期显著短于Hp阴性者。结论 c-met和PCNA基因表达与胃黏膜增殖和恶化有关，c-met基因可能成为评估胃癌恶化和预后的1项新的重要指标。Hp感染和c-met表达与胃黏膜增殖和恶化有关，Hp感染与胃癌预后有关。     

血管内皮生长因子表达在胃癌浸润转移中的作用

目的探讨血管内皮生长因子（VEGF）在胃癌组织中表达及其与临床特征之间的关系。方法材料取自瑞金医院外科1988年～1991年间手术切除标本，共128例。研究方法按LSAB法免疫组织化学操作技术常规进行，抗人VEGF单克隆抗体及抗人因子Ⅷ相关抗原单克隆抗体分别用于检测肿瘤组织内的VEGF蛋白和微血管数（MVC）。结果128例胃癌组织中，VEGF表达阳性率为6O．9％（78／128）。VEGF表达阳性肿瘤的MVC明显高于阴性者（P＜0．005）.高水平的VEGF表达与肿瘤的浸润性生长、浆膜浸润、淋巴结转移和肝转移具有明显相关关系。此外，VEGF表达阳性者的复发率高于阴性者，阳性者的预后明显较阴性者差。多因素分析表明，VEGF表达是胃癌的一个独立预后因子。结论VEGF可能通过刺激新生血管形成，与胃癌的恶性进程和不良预后有密切关系。     

胃癌组织nm23和c-erbB_2癌基因蛋白表达与根治术后再发癌的关系

目的探讨ｎｍ２３和ｃｅｒｂＢ２癌基因蛋白表达与胃癌根治术后再发癌发生的关系．方法采用免疫组化ＳＰ法检测６４例胃癌中ｎｍ２３和ｃｅｒｂＢ２的表达，并结合内镜及随访资料进行分析．结果胃癌ｎｍ２３低表达率及ｃｅｒｂＢ２阳性率在淋巴结转移组及术后３ａ内有再发癌组明显增高，ｎｍ２３低表达率及ｃｅｒｂＢ２阳性率：有淋巴结转移组为６８９％（３１／４５）和４２２％（１９／４５）；无淋巴结转移组为３６８％（７／１９）和１５８％（３／１９）；术后３ａ内再发癌组为８１０％（１７／２１）和５２４％（１１／２１）；术后３ａ以上无再发癌组为４８８％（２１／４３）和２２６％（１１／４３）（Ｐ＜００５）．而且ｎｍ２３低表达与肿瘤浸润程度有关，浸至浆膜及周围脏器组ｎｍ２３低表达率为７８６％（２２／２８）；浸至粘膜及粘膜下组者为４００％（６／１５）（Ｐ＜００５）．结论胃癌ｎｍ２３低表达和ｃｅｒｂＢ２阳性表达者具有较强的浸润、转移能力，且术后易发生再发癌，二者的表达变化对判断胃癌术后再发癌的发生及预后有重要意义     

胃癌组织中生长抑素与表皮生长因子受体表达的相关性及意义

目的观察胃癌组织中生长抑素（ＳＳ）表达与表皮生长因子受体（ＥＧＦＲ）表达的相互关系，探讨其抑癌的可能机制．方法应用免疫组化ＬＳＡＢ法及即用型ＳＰ法，对１４７例各种组织学类型胃癌中ＳＳ及ＥＧＦＲ的表达进行观察比较，并对其中１２７例患者进行预后随访．结果胃癌中ＳＳ阳性表达率为２５７％．ＥＧＦＲ阳性表达率５４３％．ＳＳ阳性及ＳＳ阴性两组胃癌ＥＧＦＲ的表达有明显差异（Ｐ＜００１）．ＳＳ阳性胃癌组ＥＧＦＲ的表达明显减少；ＳＳ阴性胃癌组ＥＧＦＲ的表达增多．ＳＳ阳性胃癌较ＳＳ阴性胃癌生存期长，预后好（Ｐ＜００１）．相反，ＥＧＦＲ阳性胃癌较ＥＧＦＲ阴性胃癌生存期短，预后差（Ｐ＜００１）．尤其是伴有ＳＳ阴性表达的ＥＧＦＲ阳性胃癌预后更差．结论ＳＳ及ＥＧＦＲ在人体胃癌组织中的表达有一定拮抗性．ＳＳ阴性的ＥＧＦＲ阳性胃癌预后更差．ＳＳ的抑癌机制之一可能是干扰了生长因子的合成，影响了细胞内调节细胞生长信号的传递，从而抑制肿瘤生长     

上皮生长因子家族在老年人肠型胃癌发生中的变化

目的　探讨上皮生长因子（ＥＧＦ）家族在老年人胃癌发生中的作用。　方法　采用免疫组化ＬＳＡＢ法观察ＥＧＦ、转化生长因子－α（ＴＧＦ－α）、上皮生长因子受体（ＥＧＦＲ）在老年人肠型胃癌发生不同阶段的表达情况。　结果　ＥＧＦ在正常组织无表达,在胃癌表达最高（７０．８％ ）。ＴＧＦ－α、ＥＧＦＲ在不典型增生组织的表达（分别为７２．２％ 及８３．３％ ）最高;ＴＧＦ－α／ＥＧＦ＋ ＥＧＦＲ共同表达亦以不典型增生组织为最高。ＴＧＦ－α、ＥＧＦＲ在癌周正常组织的表达（分别为５５．６％ 及６１．１％ ）明显高于非癌正常组织（Ｐ＜ ０．０１）;且ＥＧＦ与胃癌的淋巴结转移、浆膜外侵呈正相关（Ｐ＜ ０．０５）。ＥＧＦ家族阳性胃癌粘膜的增殖细胞核抗原（ＰＣＮＡ）标记指数明显高于阴性组（Ｐ＜ ０．０１）,共同表达ＴＧＦ－α／ＥＧＦ＋ＥＧＦＲ胃粘膜的ＰＣＮＡ标记指数也明显高于单独表达ＥＧＦ、ＴＧＦ－α或ＥＧＦＲ组（Ｐ＜ ０．０５）。　结论　ＴＧＦ－α、ＥＧＦＲ与胃癌发生的早期事件关系密切,二者共同表达是癌前病变有意义的标志。ＥＧＦ与进展期癌有关,是判断预后的指标     

胃癌nm23和P53蛋白表达及癌浸润转移的关系

目的探讨胃癌淋巴结增生转移与Ｐ５３,ｎｍ２３蛋白表达的关系．方法应用ＳＰ免疫组织化学方法,检测８７例伴有淋巴结反应性增生和（或）癌转移的胃癌进行Ｐ５３,ｎｍ２３蛋白表达．结果Ｐ５３蛋白阳性表达５２９％,淋巴结反应性增生比淋巴结伴有癌转移者阳性表达率低,差异有显著性（Ｐ＜００１）．ｎｍ２３蛋白阳性表达７７％,淋巴结反应性增生者比淋巴结伴有癌转移者阳性表达率高,差异有显著性（Ｐ＜００１）．结论Ｐ５３和ｎｍ２３蛋白阳性表达均与胃癌的淋巴结增生有关,多有相反的阳性表达,呈显著的负相关关系     

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.     

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.     

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.     

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.