胃癌血管内皮生长因子和一氧化氮合酶的表达与胃癌血管生成及临床病理的关系

目的研究血管内皮生长因子(VEGF)、诱导型一氧化氮合酶(iNOS)和内皮型一氧化氮合酶(eNOS)在人胃癌中表达的相关性;探讨3者与人胃癌血管生成和临床病理特征的关系;研究一氧化氮(NO)和VEGF的相互作用及NO在VEGF促肿瘤生长中的作用机制。方法应用免疫组织化学方法检测34例人胃癌手术切除标本VEGF、iNOS和eNOS的表达,第Ⅷ因子相关抗原(FⅧRAg)血管内皮细胞特异性染色计数肿瘤微血管密度(MVD)。结果(1)31例胃癌组织表达VEGF,25例表达iNOS,28例表达eNOS;(2)VEGF与iNOS的表达正相关,与eNOS的表达无相关;(3)VEGF、iNOS的表达与胃癌MVD呈正相关,表达与不表达eNOS其胃癌MVD的差异无显著性意义;(4)VEGF的表达与胃癌淋巴结转移和肿瘤浸润深度呈正相关,与肿瘤分化程度无关;iNOS表达与胃癌的浸润深度呈正相关,与胃癌分化程度及有无淋巴结转移无关;eNOS表达与胃癌浸润深度、分化程度及有无淋巴结转移均无关。结论(1)iNOS对VEGF的生成和发挥作用的过程有重要影响;(2)MVD随着VEGF和iNOS表达的增强而增加,说明两者对胃癌血管生成具有促进作用。     

胃癌组织NOS和VEGF表达与癌细胞增殖相关性的研究

目的:研究人胃癌组织血管内皮生长因子(VEGF)、诱导型一氧化氮合酶(iNOS)、内皮型一氧化氮合酶(eNOS)的表达与癌细胞增殖的相关性。方法:应用免疫组化方法检测34例胃癌手术切除标本VEGF、iNOS、eNOS和增殖细胞核抗原(PCNA)的分布及表达。结果:①31例胃癌组织表达VEGF,25例(73.5%)表达iNOS,28例(82.4%)表达eNOS;②VEGF与iNOS的表达具有明显相关性,VEGF与eNOS的表达无明显相关性;③表达VEGF的胃癌PCNA标记指数(PLI)明显高于不表达VEGF的胃癌,表达iNOS的胃癌PLI明显高于不表达iNOS的胃癌,表达eNOS的胃癌PLI与不表达eNOS的胃癌无显著性差异(P<0.05)。结论:①VEGF与iNOS的表达具有明显相关性,说明iNOS在VEGF的生成和发挥作用过程中起重要作用;②PLI随着VEGF和iNOS表达的增加而增加,说明二者对胃癌细胞增殖具有促进作用。     

胃癌中微血管密度及一氧化氮合酶表达与肿瘤浸润、转移的相关性分析

目的研究胃癌组织中微血管密度(MVD)的高低,一氧化氮合酶(NOS)的表达及与肿瘤病理特征间的关系,探讨MVD、NOS在胃癌浸润、转移中的意义及其间的相关性。方法应用免疫组化SP法检测56例手术切除胃癌组织石蜡包埋标本的iNOS、eNOS、nNOS的蛋白表达,对肿瘤微血管以CD34抗体染色并检测MVD。结果56例胃癌组织MVD平均为(36.25±6.32);i-NOS、eNOS、nNOS的阳性表达率分别为75.0%、80.4%、83.9%;不同浸润深度、淋巴结转移程度及TNM分期的胃癌中MVD值的差异有统计学意义(P<0.01);iNOS、eNOS、nNOS的表达随胃癌浸润深度的加深,淋巴结转移程度的提高而上调(P<0.01);iNOS阳性表达胃癌组织中的MVD值为(44.76±4.16),明显高于阴性表达者的(32.14±4.89)(P<0.01)。结论随着胃癌浸润,转移程度进展,肿瘤MVD值增高,NOS的表达上调;胃癌中iNOS的表达与肿瘤MVD有关,提示iNOS在胃癌生长,浸润及转移中促进肿瘤新生血管形成。     

一氧化氮合酶在膀胱癌中的表达及与肿瘤血管形成的关系

目的　探讨一氧化氮 (NO)在膀胱肿瘤中的作用及与肿瘤血管形成的关系。　方法　采用免疫组化方法对 5 8例膀胱移行细胞癌及 14例正常膀胱粘膜标本进行一氧化氮合酶 (NOS)抗体染色和微血管密度 (MVD)计数 ,观察表达结果与肿瘤生物学特性及与肿瘤血管形成的相关性。　结果　诱导型NOS(iNOS)在正常膀胱组织中无表达 ,而在膀胱癌组织中的阳性表达率为 81% ( 47/5 8) ,表达程度与肿瘤分级、分期无关 (P >0 .0 5 ) ;iNOS表达阳性组和阴性组的MVD分别为 ( 3 9.3± 19.5 )和( 2 9.3± 10 .5 ) /HP ,即iNOS的表达程度与肿瘤MVD成正比 (P <0 .0 1) ;内皮型NOS(eNOS)在膀胱肿瘤和正常膀胱粘膜的血管内皮细胞都有明显表达 ,而移行上皮细胞中未见表达。　结论　iNOS在膀胱移行细胞癌血管形成中有重要作用     

一氧化氮合酶和血管内皮生长因子在结肠癌的表达及其在肿瘤血管生成中的作用

目的探讨诱导型一氧化氮合酶(iNOS)和血管内皮生长因子(VEGF)在结肠癌中的表达特点及其与临床病理的关系。方法采用免疫组织化学SP法检测结肠腺癌iNOS、VEGF、Ⅳ型胶原及FⅧAg的表达情况。结果45例结肠癌iNOS和VEGF蛋白的阳性率分别为76%和80%。两者呈正相关共同作用于肿瘤间质血管,致微血管密度(MVD)增多。结肠癌iNOS阳性的MVD值为37.0±5.7;阴性的则为30.5±4.9。结肠癌VEGF阳性的MVD值为39.5±8.5;阴性的则为30.7±4.4。VEGF的表达与肿瘤的侵袭、分化程度及淋巴结转移有关,但与患者的年龄、性别和组织分型无关。结论iNOS和VEGF的表达与结肠癌的血管生成和侵袭转移密切相关。     

肝细胞癌中iNOS和P53蛋白的表达及其与肿瘤血管形成的关系

目的　研究诱导型一氧化氮合酶 (iNOS)和p5 3蛋白在肝细胞癌中的表达及其与肿瘤血管形成的关系。方法　采用免疫组化和图像分析技术检测 5 9例肝细胞癌患者肿瘤组织中iNOS和p5 3蛋白的表达 ,CD34单克隆抗体免疫组化染色检测肿瘤组织微血管密度 (MVD)。结果　①iNOS和p5 3蛋白在肝细胞癌组织中表达阳性率分别为 81.4 % ( 4 8/ 5 9)和 6 4 .4 % ( 38/ 5 9) ,表达强度 (IOD值 )分别为 5 6 35± 12 87和 335 2± 873。②MVD为 32 .5± 2 .73,以肿瘤边缘和癌旁组织微血管较密集。③iNOS的表达与p5 3蛋白表达呈显著正相关 (r=0 .6 5 ,P<0 .0 5 ) ;iNOS的表达与MVD呈显著正相关 (r=0 .75 ,P<0 .0 5 ) ;p5 3蛋白的表达与MVD呈显著正相关 (r=0 .72 ,P<0 .0 5 )。结论　肝细胞癌组织中存在iNOS和p5 3蛋白的高表达 ;iNOS和p5 3可促进肝癌血管形成     

抑癌基因PTEN/MMAC1/TEP1编码蛋白和血管内皮生长因子在胃癌组织表达的相关性及其意义

目的 探讨胃癌组织中抑癌基因PTEN/MMAC1/TEP1(以下简称PTEN)蛋白与血管内皮生长因子(VEGF)的表达关系及其在胃癌生物学行为和血管生成的作用。方法 应用免疫组织化学SP法检测35例胃癌及8例慢性胃炎组织中PTEN和VEGF蛋白的表达水平及CD_(34)标记的微血管密度(MVD)。结果 (1)与慢性胃炎组比较,胃癌组PTEN蛋白表达呈显著下降(t=2.45,P<0.05)而VEGF与MVD表达均显著增强(t=2.21,2.30,P<0.05);进展期胃癌PTEN蛋白表达显著下调(t=1.85,P<0.05),而VEGF表达呈明显上调(t=1.46,P>0.05),但差异无显著性;(2)PTEN蛋白表达下调主要与胃癌淋巴结转移(t=2.92,P<0.05)、浸润深度(t=1.85,P<0.05)、年龄(t=2.26,P<0.05)、TNM分期(t=1.77,P<0.10)有较密切的关系;PTEN蛋白阴性表达者MVD较阳性者显著增加(t=2.60,P<0.05),且两者呈显著负相关(γ=-0.363,P<0.05)。(3)VEGF表达与胃癌浆膜浸润、淋巴结转移及TNM分期均显著正相关(t=4.38、2.28、2.27,P<0.01、0.05、0.05),VEGF阳性表达者MVD显著增加(t=3.35,P=0.02),且两者呈显著正相关(γ=0.512,P<0.05);(4)胃癌PTEN蛋白阴性表达者VEGF表达较阳性者显著上调(t=-1.99,P=0.055),两者呈显著负相关(γ=-0.403,P<0.05)。结论 胃癌PTEN基因编码蛋白失表达可能通过上调VEGF表达途径,增强     

骨肉瘤肺转移与血管内皮生长因子和微血管密度的关系

目的 探讨骨肉瘤盱市转移与血管内皮生长因子(VEGF)和微血管密度(MVD)的关系.方法 用免疫组织化学法检测30例骨肉瘤组织中VEGF的表达和MVD.结果 VEGF在骨肉瘤中的阳性率表达分别为70.00%(21/30),其中有肺转移的病例阳性率为92.31%(12/13).无肺转移病例的阳性率为52.94%(9/17),差异有统计学意义(P<0:05).骨肉瘤组织中VEGF阳性表达与骨肉瘤的组织学分型无明显相关(P>0.05).骨肉瘤中VEGF表达强度与MVD呈正相关(r=0.799,P<0.01);有肺转移的骨肉瘤患者其瘤组织中MVD与无肺转移的骨肉瘤患者其瘤组织中MVD差异有统计学意义(P<0.05),有肺转移的明显高于无肺转移的病例.结论 VEGF是促进微血管生成的主要细胞因子,检测VEGF表达与MVD值可作为判断肿瘤预后的重要指标.     

胃癌组织中核因子-κBp65 的表达及其与血管内皮生长因子的关系

目的　研究胃癌组织中核因子 κBp6 5 (NF κBp6 5 )的表达及其与血管内皮生长因子 (VEGF)的关系。方法　应用免疫组化SP法 ,对 5 6例胃癌组织检测NF κBp6 5和VEGF的表达 ,并与良性组织作对照研究。 结果　胃癌组织中NF κBp6 5和VEGF的表达阳性率分别为 6 2 .5 %和 76 .8% ,显著高于胃粘膜不典型增生表达阳性率的 33.3%和 4 4 .4 % (P<0 .0 5 )及正常胃粘膜表达阳性率的 0和 8.3% (P<0 .0 1)。NF κBp6 5的表达与胃癌临床分期、浸润深度和淋巴结转移有关 (P<0 .0 5 ) ,与病理类型无关 (P>0 .0 5 )。NF κBp6 5表达与VEGF呈正相关 (r =0 .36 ,P<0 .0 1)。结论　NF κBp6 5可能通过上调VEGF的表达 ,在胃癌的发生、发展中发挥重要作用。     

胃癌组织中p53和血管内皮生长因子的表达与血管生成的关系及其意义

目的　探讨胃癌组织中p53与血管内皮生长因子(VEGF)表达和血管生成的关系。方法　应用免疫组织化学技术对60例胃癌组织进行p53、VEGF表达和肿瘤组织微血管密度MVD检测。结果　MVD以及p53和VEGF的表达与胃癌病灶的大小(P＜0.05)、浸润深度(P＜0.01)、淋巴结转移(P＜0.01)和TNM分期(P＜0.01)密切相关。p53的表达与VEGF的表达显著相关（χ     

Body composition assessment and methodology in nonathletic and athletic adolescent and adult males and females

The purpose of this review is to outline methodology for assessing body composition utilizing anthropometric and densitometric techniques. The objective of body composition assessment is to measure body fat and lean body mass. The quantity of these components varies due to growth, physical activity, dietary regimens, and aging. Anthropometric techniques incorporate selected skinfolds, circumferences, skeletal widths, or other variables to estimate body composition within k2.0-4.0%. These techniques are adequate for field testing of groups or individuals, but are population specific. Densitometry measures body volume irrespective of physique, sex, or age. This laboratory technique estimates body composition within 1.0-2.0%, is more difficult to administer, but is not population specific. Some limitation exists with any present technique due to biological variability and incomplete research of reference body composition in children, females, and the aged. J Orthop Sports Phys Ther 1984;5(6):336-347.     

Perioperative and long-term morbidity and mortality after above-knee and below-knee amputations in diabetics and nondiabetics

We performed a retrospective review of a vascular surgery quality assurance database to evaluate the perioperative and long-term morbidity and mortality of above-knee amputations (AKA, n = 234) and below-knee amputations (BKA, n = 720) and to examine the effect of diabetes mellitus (DM) (181 of AKA and 606 of BKA patients). All patients in the database who had AKA or BKA from 1990 to May 2001 were included in the study. Perioperative 30-day cardiac morbidity and mortality and 3-yr and 10-yr mortality after AKA or BKA were assessed. The effect of DM on 30-day cardiac outcome was assessed by multivariate logistic regression and the effect on long-term survival was assessed by Cox regression analysis. The perioperative cardiac event rate (cardiac death or nonfatal myocardial infarction) was at least 6.8% after AKA and at most 3.6% after BKA. Median survival was significantly less after AKA (20 mo) than BKA (52 mo) (P < 0.001). DM was not a significant predictor of perioperative 30-day mortality (odds ratio, 0.76 [0.39-1.49]; P = 0.43) or 3-yr survival (Hazard ratio, 1.03 [0.86-1.24]; P = 0.72) but predicted 10-yr mortality (Hazard ratio, 1.34 [1.04-1.73]; P = 0.026). Significant predictors of the 30-day perioperative mortality were the site of amputation (odds ratio, 4.35 [2.56-7.14]; P < 0.001) and history of renal insufficiency (odds ratio, 2.15 [1.13-4.08]; P = 0.019). AKA should be triaged as a high-risk surgery while BKA is an intermediate-risk surgery. Long-term survival after AKA or BKA is poor, regardless of the presence of DM.     

Postoperative nausea and vomiting and opioid-induced nausea and vomiting: guidelines for prevention and treatment

Postoperative nausea and vomiting (PONV) causes patient discomfort, lowers patient satisfaction, and increases care requirements. Opioid-induced nausea and vomiting (OINV) may also occur if opioids are used to treat postoperative pain. These guidelines aim to provide recommendations for the prevention and treatment of both problems. A working group was established in accordance with the charter of the Sociedad Espa?ola de Anestesiología y Reanimación. The group undertook the critical appraisal of articles relevant to the management of PONV and OINV in adults and children early and late in the perioperative period. Discussions led to recommendations, summarized as follows: 1) Risk for PONV should be assessed in all patients undergoing surgery; 2 easy-to-use scales are useful for risk assessment: the Apfel scale for adults and the Eberhart scale for children. 2) Measures to reduce baseline risk should be used for adults at moderate or high risk and all children. 3) Pharmacologic prophylaxis with 1 drug is useful for patients at low risk (Apfel or Eberhart 1) who are to receive general anesthesia; patients with higher levels of risk should receive prophylaxis with 2 or more drugs and baseline risk should be reduced (multimodal approach). 4) Dexamethasone, droperidol, and ondansetron (or other setrons) have similar levels of efficacy; drug choice should be made based on individual patient factors. 5) The drug prescribed for treating PONV should preferably be different from the one used for prophylaxis; ondansetron is the most effective drug for treating PONV. 6) Risk for PONV should be assessed before discharge after outpatient surgery or on the ward for hospitalized patients; there is no evidence that late preventive strategies are effective. 7) The drug of choice for preventing OINV is droperidol.