DNA异倍体联合C-12检测在良恶性腹水中的诊断价值

目的:评价检测腹水细胞的DNA异倍体及肿瘤标志物表达鉴别良恶性腹水的价值.方法:68例有明确诊断的腹水患者, 分为良性组31例, 恶性组37例. 每位患者除常规腹水脱落细胞学检查外, 还分别进行FCM-DNA倍体分析和使用C-12多肿瘤标志物蛋白芯片检测肿瘤标志物.结果:良恶性腹水DI、增值指数有显著差别( P<0.01). FCM-DNA倍体检测对恶性腹水的敏感性为72.97%, 特异性为93.54%, 准确性为82.35%. C-12检测恶性腹水的敏感性为94.59%, 特异性为54.84%, 准确性为76.47%.两者联合检测敏感性达94.59%, 特异性达96.77%, 准确性为82.35%.结论:FCM-DNA倍体检测与C-12多肿瘤标志物联合检测可以提高诊断的敏感性和特异性,对良恶性腹水的鉴别诊断具有较大的价值, 易于临床应用.     

检测DNA异倍体对恶性胸腔积液的诊断价值

目的 探讨流式细胞检测DNA异倍体对恶性胸腔积液的诊断价值。方法 恶性胸积液41例均经临床与病理证实结核性胸腔积液40例为对照组。各例均作流式细胞DNA异倍体检测与癌胚抗原测定。结果 肿瘤组中33例胸水流式细胞DNA异倍体呈阳性。8例呈阴性,假阴性率为19.5%,30例胸水CEA呈阳性,11例呈阴性,假阴性率为26.8%。结核组中36例胸水流式细胞DNA异倍体呈阴性。4例呈阳性,假阳性率为11.1%。34例胸水CEA阴性,6例阳性,假阳性率为17.6%,胸水流式细胞DNA异倍体诊断的敏感性为80.5%、特异性90%、准确性85.2% ;胸水CEA诊断的敏感性为732%、特异性85%、准确性79%;两项检测联合应用诊断的敏感性为927%、特异性100%、准确性96.3%。结论 流式细胞DNA异倍体检测对于诊断恶性胸腔积液具有良好的临床价值。其诊断敏感性、特异性和准确性均高于胸水CEA的诊断,若联合两项检测方法诊断恶性胸腔积液则具有更好的临床价值。     

脱落细胞学、DNA异倍体和肿瘤标志物检查联合诊断恶性胸腹水的价值探讨

目的：评价脱落细胞学、DNA异倍体、肿瘤标志物检查联合诊断恶性胸腹水的应用价值。方法：贝克曼公司RS-6500流式细胞分析仪,观察DNA异倍体,以DNA异倍体≥10%作为阳性标准;涂片染色,镜下观察细胞形态特征;肿瘤标志物检查使用Combas 6000电化学发光仪测定。结果：39例恶性肿瘤,DNA异倍体分析有21例阳性,阳性率53.9%,70例良性肿瘤仅1例阳性,阳性率1.4%;细胞学检查,39例恶性胸腹水以找到癌细胞为阳性,阳性16例,阳性率41.0%,70例良性胸腹水中,未找到癌细胞;肿瘤标志物（SF、CEA、NSE、CA-125）检查,恶性阳性率为74.4%,61.5%,64.4%,72.0%,良性阳性率为15.8%,21.4%,12.5%,5.6%,差异有统计学意义（P〈0.01）,4项联合检测,以任意一项阳性指标作为阳性判断,可将敏感度提高到92.3%。细胞学、DNA异倍体与肿瘤标志物联合检测,其联合灵敏度为87.0%,联合特异度为77.7%,灵敏度明显提高。结论：脱落细胞学、DNA异倍体、肿瘤标志物联合检测,可大大提高恶性胸腹水的诊断阳性率。     

细胞DNA倍体分析及CYFRA21-1、CEA、CA125水平检测在老年良恶性胸腔积液诊断中的价值

目的探讨胸腔积液中细胞DNA倍体分析与联合检测CYFRA21-1、CEA、CA125在其良恶性鉴别诊断方面的应用价值。方法选取80例恶性及70例良性胸腔积液患者,平均年龄(64±3)岁,分别行CYFRA21-1、CEA、CA125检测及细胞DNA倍体分析。结果恶性胸腔积液组CYFRA21-1、CEA、CA125的含量明显高于良性胸腔积液组(P<0.05);细胞DNA倍体分析法联合CYFRA21-1、CEA、CA125检测的灵敏性及特异性均高于CYFRA21-1、CEA、CA125的测定(P<0.05)。结论在胸腔积液良恶性的鉴别诊断方面,细胞DNA倍体分析联合CYFRA21-1、CEA、CA125检测法具有更好的诊断价值。     

流式细胞仪DNA倍体测定鉴别良恶性胸腔积液的诊断价值

目的通过流式细胞仪(FCM)技术测定胸水脱落细胞细胞核的脱氧核糖核酸(DNA)含量,并将此方法与传统的病理学方法,肿瘤标记物癌胚抗原(CEA)的检测相比较,以鉴别胸水的良恶、性。方法病例选自2003-03~2004-03苏州大学附属第二医院呼吸内科的住院患者,留取新鲜的胸腔积液标本,以肝素抗凝,荧光染料染色后,用流式细胞仪检测细胞核DNA倍体,分析细胞的增殖能力。结果根据临床检查将胸水分为良性和恶性两组,在恶性胸腔积液组中,87·5%的标本可以检测到DNA异倍体,在良性胸腔积液中,90%的标本表现为两倍体。结论流式细胞仪DNA倍体测定使得病理诊断有了可依据的客观指标,是病理学检查的有益补充,与CEA联合测定可以提高恶性胸腔积液的检出率。     

免疫细胞化学和形态学分析对良恶性胸腹水鉴别诊断的作用

目的探讨免疫细胞化学和形态学分析在胸腹水细胞学鉴别诊断中的意义。方法选取河北北方学院附属第一医院消化内科,呼吸内科的良、恶性胸腹水患者各30例,应用免疫细胞化学SP法检测癌胚抗原(CEA)、上皮膜抗原(EMA)、波形蛋白的表达,同时应用计算机图像分析系统定量测定其脱落细胞的核面积、质面积、核质比、细胞周长、平均直径、圆度和形状因子。结果 1恶性胸腹水中腺癌细胞(B组)CEA表达均阳性,EMA部分阳性,波形蛋白均阴性;增生性间皮细胞(A组)EMA和波形蛋白部分阳性,CEA均阴性。CEA单独诊断的敏感性、特异性、阳性预测值、阴性预测值均最好,联合检测EMA+波形蛋白组合的敏感性和特异性较好。2良恶性标本的细胞形态学测量结果显示:良性组标本的面积、周长等效直径、长径、短径与恶性标本间存在明显差异,良性组明显低于恶性组(P0.05);变异系数在两组间比较显示良性组标本的面积、周长等效直径、长径、短径与恶性标本间存在明显差异,良性组明显低于恶性组(P0.05)。结论 1免疫细胞化学在良恶性胸腹水鉴别诊断中有重要作用,CEA单独诊断以及EMA+波形蛋白联合检测均可获得较好的敏感性、特异性;2形态学定量分析可为鉴别诊断提供参考,二者综合分析是提高胸腹水细胞学阳性诊断率的有效途径之一。     

印片细胞学及DNA倍体分析对乳腺疾病的诊断价值

目的 探讨组织印片细胞学与DNA倍体分析对乳腺疾病良恶性的诊断价值.方法 通过组织印片细胞学及DNA倍体全自动图像分析仪分别对80例乳腺疾病的良恶性作出诊断,与常规石蜡切片病理诊断及免疫组化结果进行比较.结果 组织印片细胞学对乳腺疾病良恶性诊断的特异性为92.7%,敏感性72%,准确率86.25%;DNA倍体分析的特异性为100%,敏感性92%,准确率97.5%.结论 组织印片细胞学和DNA倍体分析对乳腺疾病良恶性的诊断具有较高的价值.     

腹水端粒酶、DNA倍体、CEA、CA19-9和血清-腹水白蛋白梯度对良恶性腹水的鉴别诊断意义

背景:确定腹水的良恶性在临床上具有重要意义,但恶性腹水的早期诊断相对困难,临床常规检测手段的漏诊率较高,且阴性结果不能排除肿瘤。目的:探讨腹水端粒酶、DNA倍体、CEA、CA19-9和血清-腹水白蛋白梯度(SAAG)对鉴别诊断良恶性腹水的意义。方法:纳入77例腹水患者(恶性腹水组41例,良性腹水组36例),分别检测腹水端粒酶、DNA倍体、CEA、CA19-9、白蛋白和血清白蛋白含量。结果:恶性腹水组腹水端粒酶、DNA异倍体比例、CEA、CA19-9明显高于良性腹水组,SAAG明显低于良性腹水组,差异均有统计学意义(P0.01)。腹水端粒酶和CEA的鉴别诊断准确性较高,5项指标联合检测的敏感性显著高于各指标单独检测(P0.05)。结论:腹水端粒酶、DNA倍体、CEA、CA19-9和SAAG可用于鉴别诊断良恶性腹水,联合检测可提高诊断敏感性。     

骨髓细胞嗜银蛋白染色的方法及实用价值

AgNOR染色是一种较新的染色技术,主要应用于恶性肿瘤细胞学诊断。近年来,各国学者在这方面进行了大量研究工作,特别是在痰徐片、胸腹水、宫颈刮片、各种肿块穿刺物涂片等,应用AgNOR染色,鉴别肿瘤的良恶性、肿瘤的分型、癌前病变的检测和预后等,具有一定的诊断价值。近1年里,我们对正常骨髓细胞及急性、慢性白血病患者的骨细胞进行了AgNOR染色,并进行了分析,现报告如下。     

细胞DNA定量分析法在浆膜腔积液鉴别诊断中的应用

目的探讨细胞DNA定量分析法在良恶性浆膜腔积液鉴别诊断中的应用价值。方法将297例份浆膜腔积液（胸水、腹水、心包积液）分别制成4张薄层细胞涂片,2张做巴氏染色、行常规细胞学检查,2张经Feulgen染色、行细胞DNA定量分析。结果297例份标本,常规细胞学检查发现138例（44.5%）异常,DNA定量分析发现131例（44.1%）异常;常规细胞学检查诊断为癌及可疑癌细胞的84例中均出现DNA异倍体,常规细胞学检查发现异型细胞的54中47例（87%）出现DNA异倍体。结论细胞DNA定量分析可进一步认证常规细胞学检查结果并弥补其不足,二者联合应用可鉴别浆膜腔积液的性质。     

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.