食管癌间质炎性细胞SDF-1与肿瘤细胞CXCR4的表达及对预后的影响

目的探讨基质衍生因子1（SDF-1）在食管癌组织间质中髓来源的炎性细胞中及CXC族趋化因子受体4（CXCR4）在食管癌肿瘤细胞中的表达情况,分析其对预后的影响。方法应用免疫组织化学SP染色技术检测116例食管癌组织中SDF-1在间质中髓来源的炎性细胞中及CXCR4在肿瘤细胞中的阳性表达情况,分析阳性表达率与预后的关系。结果本组病例3 a总生存率63.79%,间质中SDF-1阳性表达率与食管癌预后无明显相关（P〉0.05）。肿瘤细胞中CXCR4阳性表达率与食管癌预后呈明显负相关（P〈0.05）。CXCR4阳性表达率与淋巴结转移、肿瘤浸润深度、病理分期有关（P〈0.05）。SDF-1阳性表达率与病理分期有关（P〈0.05）。多因素分析显示,pTNM分期及CX-CR4的表达是影响食管癌患者术后预后的独立因素（P〈0.05）。SDF-1与CXCR4的表达无明显相关性。结论食管癌组织中CXCR4的表达是影响食管癌患者预后的独立因素,而SDF-1与食管癌预后无明显相关性。     

人脑胶质瘤中CXCR4、hTERT的表达及意义

目的 探讨趋化因子受体4(CXCR4)和端粒酶逆转录酶(hTERT)在胶质瘤恶性转变中表达的变化及意义.方法 用免疫组织化学、原位杂交技术检测60例胶质瘤手术切除患者标本中CXCR4、hTERT的表达,6例正常脑组织作对照.结果 60例胶质瘤中有35例表达CXCR4(58.3%),36(60.0%)例表达hTERT,随着胶质瘤级别的升高,CXCR4、hTERT表达增强(P＜0.05).正常脑组织均不表达CXCR4、hTERT.CXCR4与hTERT表达呈正相关(r=0.6358,P＜0.05).结论 CXCR4、hTERT的表达与胶质瘤的分级有关,联合检测CXCR4、hTERT有助于胶质瘤恶性程度的判断.     

miR-126表达水平与CXCR4及直肠癌患者临床病理特征之间的相关性

目的探究微小RNA(miR)-126的表达水平与CXCR4及直肠癌患者临床病理特征之间的相关性。方法 92例直肠癌手术病人切除标本及距切缘远端5 cm以外正常组织标本,所有组织采用手术分离并在术后立即置于液氮中保存。qRT-PCR法检测CXCR4 mRNA表达,Western印迹法检测miR-126、CXCR4蛋白表达,对待测标本进行免疫组化染色,使用多因素回归分析直肠癌患者预后的影响因素。结果直肠癌组织中miR-126蛋白表达明显低于癌旁组织(P0.05),CXCR4 mRNA表达明显高于癌旁组织(P0.05)。直肠癌组织中CXCR4蛋白表达明显高于癌旁组织,CXCR4在直肠癌组织细胞质中大量表达,而在正常的直肠组织中呈不表达或弱阳性表达状态。miR-126、CXCR4表达与直肠癌患者性别、年龄无关,与直肠癌患者肿瘤体积、病理分期、分化程度、淋巴结转移、远处转移情况有关,肿瘤体积较大、Ⅲ+Ⅳ期、分化程度较低、淋巴结转移、远处转移阳性的患者miR-126表达明显降低,CXCR4表达明显升高(P0.05)。肿瘤体积、miR-126、CXCR4表达、病理分期、分化程度、淋巴结转移及远处转移等为直肠癌患者预后的影响因素,其中miR-126、CXCR4表达为直肠癌患者预后的独立预测因素。结论 miR-126在直肠癌中呈异常低表达、CXCR4蛋白在直肠癌中呈异常高表达,且与直肠癌病理特征具有一定相关性,是直肠癌患者预后的独立预测因素。     

人脑胶质瘤不同病理分级标本中神经丛素1与细胞增殖抗原的阳性表达及临床意义

目的探讨人脑胶质瘤不同病理分级标本中神经丛素A1(plexin A1)和细胞增殖抗原(Ki-67)的阳性表达及临床意义。方法选取50例脑胶质瘤患者本行常规苏木精-伊红染色(HE染色)。根据病理分级Ki-67分为A、B两组,其中A组21例(Ⅰ~Ⅱ级),B组29例(Ⅲ~Ⅳ级)。采用免疫组织化学法对标本中神经丛素A1及Ki-67抗原的阳性表达情况进行检测。结果神经丛素A1在A组中的阳性表达率为23.81%(5/21),低于B组72.41%(21/29)(P0.05);Ki-67在A组中的阳性表达率为14.29%(3/21),低于B组55.17%(16/29)(P0.05);神经丛素A1及Ki-67在人脑胶质瘤组织中的表达呈正相关性(P0.05)。结论对脑胶质瘤组织中神经丛素A1进行检测有利于评估患者的预后。人脑胶质瘤的发生及发展过程中Ki-67和神经丛素A1可能起到协同作用。     

整合素β1在脑神经胶质瘤的表达及其与Ki-67的关系

目的探讨整合素β1及Ki-67抗原在神经胶质瘤细胞增殖、侵袭中的作用,以便为临床判断神经胶质瘤的恶性程度、选择治疗措施及评价预后提供依据。方法采用免疫组化法检测5例正常脑组织及40例不同级别神经胶质瘤中整合素β1的表达情况,分析其病理指数(PI)及其与Ki-67表达的关系。结果正常脑组织中整合素β1及Ki-67抗原均不表达。在脑神经胶质瘤中整合素β1表达于瘤细胞的胞质、胞膜及肿瘤血管的内皮细胞,且主要表达于肿瘤侵袭边缘的瘤细胞及血管基底膜的内皮细胞,其表达是在细胞质、胞膜及肿瘤血管的内皮细胞出现棕色或棕黄色染色;在脑神经胶质瘤中Ki-67表达于瘤细胞的胞核,其表达是在胞核出现棕色或棕黄色染色。在Ⅰ、Ⅱ级神经胶质瘤标本23例中阳性3例、弱阳6例,阳性表达率为39.13%(9/23),PI值为6.52±7.42,在Ⅲ、Ⅳ级神经胶质瘤标本17例中强阳性3例、阳性7例、弱阳4例,阳性表达率为82.35%(14/17),PI值为26.41±25.12,Ⅰ、Ⅱ级与Ⅲ、Ⅳ级间差异显著(P<0.05)。在神经胶质瘤中的Ki-67 LI范围为2%～30%,Ⅰ、Ⅱ级与Ⅲ、Ⅳ级神经胶质瘤的Ki-67 LI分别为12.09%±8.10%及19.12%±8.89%,Ⅰ、Ⅱ级与Ⅲ、Ⅳ级间差异显著(P<0.05)。经直线相关分析,整合素β1与Ki-67抗原的阳性细胞表达率呈正相关(P<0.05)。结论整合素β1及Ki-67抗原的表达在Ⅰ、Ⅱ级神经胶质瘤组明显低于Ⅲ、Ⅳ级,与神经胶质瘤增殖及侵袭性呈正相关,可作为判断神经胶质瘤病理分级的重要指标。     

脑胶质瘤组织中Kiss-1与FAK的表达及意义

目的观察肿瘤转移抑制基因1（Kiss-1）及黏着斑激酶（FAK）蛋白在脑胶质瘤组织中的表达情况,探讨两者在脑胶质瘤发病中的相关性及临床意义。方法选择脑胶质瘤患者的胶质瘤组织标本132例份,采用免疫组化三步法检测其Kiss-1及FAK蛋白表达,计算病理级别为低级别（Ⅰ～Ⅱ级）、高级别（Ⅲ～Ⅳ级）胶质瘤组织中Kiss-1与FAK蛋白的阳性表达率,分析Kiss-1与FAK蛋白表达的相关性,比较Kiss-1与FAK蛋白阳性患者术后3年复发率,分析Kiss-1、FAK蛋白表达与无进展生存期（DFS）及总生存期（OS）的关系。结果低级别、高级别脑胶质瘤组织中Kiss-1蛋白的阳性表达率分别为50%、25.93%,低级别脑胶质瘤组织Kiss-1的阳性表达率高于高级别组织（P〈0.05）。低级别、高级别脑胶质瘤组织中FAK蛋白的阳性表达率分别为60.26%、81.48%,低级别脑胶质瘤组织FAK的阳性表达率低于高级别组织（P〈0.05）。Kiss-1与FAK蛋白表达呈负相关（P〈0.05）,Kiss-1阳性＋FAK阴性、Kiss-1阴性＋FAK阴性、Kiss-1阳性＋FAK阳性、Kiss-1阴性＋FAK阳性患者脑胶质瘤3年复发率分别为26.67%、54.55%、52.17%、85.29%,Kiss-1阴性＋FAK阳性患者复发率高于其他三种组合,Kiss-1阴性者＋FAK阴性者、Kiss-1阳性＋FAK阳性者高于Kiss-1阳性＋FAK阴性者（P均〈0.05）。Kiss-1、FAK是脑胶质瘤患者DFS、OS的独立影响因素（P均〈0.05）。结论脑胶质瘤组织Kiss-1表达降低、FAK表达增高,Kiss-1与FAK在脑胶质瘤中表达呈负相关关系,Kiss-1表达减弱、FAK表达增强与脑胶质瘤复发及预后不良有关。     

转化生长因子-β受体Ⅲ在胶质瘤组织中的表达及意义

目的探讨转化生长因子-β受体Ⅲ(TβRⅢ)在胶质瘤发生发展中的作用。方法采用免疫组化法检测TβRⅢ在3例正常脑组织、13例低级别(Ⅰ、Ⅱ级)胶质瘤和27例高级别(Ⅲ、Ⅳ级)胶质瘤中的表达,Western Blot法进一步验证各级别不同病理类型中TβRⅢ表达。结果正常脑组织中TβRⅢ阳性表达率为100%(3/3),低级别胶质瘤阳性表达率为84.6%(11/13),高级别胶质瘤阳性表达率为48.1%(13/27),高、低级别间比较,P<0.05;Ⅱ、Ⅲ级肿瘤中,星形细胞瘤和含少突成分的胶质瘤间TβRⅢ的表达无显著差异。结论高级别胶质瘤中TβRⅢ表达降低;TβRⅢ可能参与了胶质瘤的恶变过程,其低表达可促进肿瘤的侵袭和迁移。     

整合素β1、FN与CD34在脑胶质瘤中的表达及与预后的关系

目的 检测整合素β1、纤维连接蛋白(FN)、血管生成因子CD34在脑胶质瘤中的表达,并探讨它们与胶质瘤患者术后生存率的关系.方法 采用免疫组织化学SP法检测各组病例脑组织中整合素β1、FN和CD34的表达.结果 整合素β1、FN在胶质瘤中表达的总阳性率分别为61.4%、54.3%,二者在不同级别胶质瘤中的表达差异有统计学意义(P均<0.05),并与胶质瘤病理分级呈正相关(P均<0.01);胶质瘤患者CD34标记的肿瘤内平均微血管密度(MVD)为34.7±6.3,其在不同级别胶质瘤中的表达有统计学差异(P<0.01),与胶质瘤病理分级呈正相关(P<0.01);胶质瘤中整合素β1蛋白、FN蛋白以及MVD值3者间两两呈正相关(P均<0.05);随着胶质瘤病理分级的升高及整合素β1、FN、MVD表达的增强,术后生存率下降(P均<0.05).结论 整合素β1、FN和MVD的高表达与胶质瘤的发生及恶性程度有关,联合检测有助于评估预后.     

胃癌和癌旁组织内IL-9、CXCR1表达情况与患者病情和生存预后的相关性

目的探讨胃癌及癌旁组织内白细胞介素-9(interleukin-9,IL-9)、CXC家族趋化因子受体(CXC chemokine receptor 1,CXCR1)表达水平及其与患者病情和生存预后的相关性。方法选取79例在徐州医科大学附属医院进行诊治的胃癌患者,采取免疫组织化学SP法检测胃癌组织及癌旁组织标本IL-9、CXCR1表达,分析IL-9、CXCR1表达与患者病情及预后生存的相关性。结果共收集有效癌症组织标本79例、癌旁组织标本79例,胃癌组织内IL-9、CXCR1阳性表达明显高于癌旁组织,差异有统计学意义(P0.05)。在胃癌组织中IL-9与CXCR1表达具有相关性(P0.05)。在胃癌组织内IL-9阳性表达与浸润深度、TNM分期及淋巴结转移相关(P0.05),而CXCR1阳性表达与TNM分期及淋巴结转移相关(P0.05)。胃癌患者IL-9、CXCR1阳性表达者预后生存期明显低于阴性者,差异有统计学意义(P0.05)。将预后相关因素进行Cox多因素分析显示,淋巴结转移、TNM分期、IL-9表达、CXCR1表达是胃癌患者预后的独立影响因素(P0.05)。结论胃癌组织中IL-9、CXCR1阳性表达明显升高,IL-9、CXCR1表达与胃癌患者病情及预后相关,IL-9、CXCR1阳性表达是影响胃癌患者预后生存期的独立因素。     

SENP1蛋白在老年脑胶质瘤中的表达及其与预后的相关性

目的探讨SUMO特异性蛋白酶(SENP-1)蛋白在老年脑胶质瘤中的表达及其与预后的相关性。方法 145例老年脑胶质瘤患者,选取脑胶质瘤癌灶旁未见明显组织学改变的组织区域正常脑组织为对照组。根据免疫组织化学法检测SENP1蛋白在老年胶质瘤及正常脑组织中表达的结果,比较SENP1蛋白在两组中的阳性表达率。分析脑胶质瘤组织中SENP1蛋白的阳性表达与临床病理特征的关系,应用Kaplan-Meier法分析SENP1蛋白表达与脑胶质瘤预后的关系。结果 SENP1在脑胶质瘤组织中的阳性表达率高于正常脑组织(P<0.05)。SENP1在临床分期为Ⅲ和Ⅳ期的脑胶质瘤组织中的阳性表达显著高于Ⅰ和Ⅱ期,在淋巴结转移组织的表达显著高于无淋巴结转移者,大病灶组织中SENP1的阳性表达显著高于小病灶组(P<0.05),在不同性别患者中,不同分化程度中的表达差异均无统计学意义(P>0.05)。提示SENP1的表达与脑胶质瘤的临床分期、淋巴结转移和脑胶质瘤的病灶大小相关。SENP1阴性表达组的中位生存期显著高于阳性表达组(P<0.05)。结论 SENP1在脑胶质瘤组织中的阳性表达显著增强,且与老年患者的预后密切相关,SENP1阴性表达的老年脑胶质瘤患者具有更长的生存期。     

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.