应警惕免疫检查点抑制剂潜在的促进非酒精性脂肪性肝病相关肝细胞癌进展的风险

原发性肝癌(primary liver cancer,PLC)严重危害人类健康,根据世界卫生组织公布数据显示,2020年全球PLC新发及死亡病例分别为91 万例及83 万例[1].PLC主要包括肝细胞癌(hepatocellular carcinoma,HCC)及肝内胆管细胞癌,其中HCC约占PLC患者的80％～85％...     

哺乳动物雷帕霉素靶蛋白与C-Jun信号通路在原发性肝癌中的作用及其相关性研究进展

原发性肝癌(primary liver cancer,简称肝癌)是原发于肝细胞或肝内胆管上皮细胞的恶性肿瘤之一,包括肝细胞癌(hepatocellular carcinoma,HCC)、胆管细胞癌和混合性肝癌,在我国HCC约占90％以上[1].HCC与慢性肝炎病毒感染密切相关,其发病率和死亡率分别占全球恶性肿瘤的第5位和第3位,占我国恶性肿瘤的第3位和第2位,在全球每年新增的60余万病例中我国病例占50％以上.     

介入栓塞和手术再切除治疗原发性肝癌术后复发患者的疗效

原发性肝癌(PLC)是常见的恶性肿瘤,简称为肝癌,其中包括肝细胞癌(HCC)、肝内胆管细胞癌等不同病理类型。手术治疗仍然是HCC的首选方法,但是术后患者复发率较高〔1,2〕。对于术后复发的PLC患者,如何有效延长患者生存时间是PLC外科治疗的目标。本文就我院收治的PLC术后复发患者采取介入栓塞和手术再切除治疗,对比疗效,旨在探讨治疗复发性肝癌的有效方法。     

肝细胞癌非手术治疗若干进展

肝细胞癌(HCC)是全球最常见的第5位癌,由其所致死亡率居第3位,每年HCC的总发病人数超过50万.HCC是我国最常见的恶性肿瘤之一,年发病率超过37例/10万人,居全球之首.     

免疫联合治疗肝细胞癌研究进展

原发性肝癌(PLC)为常见并严重危害生命健康的恶性肿瘤之一。由于乙型肝炎病毒(hepatitis B virus,HBV)感染,我国肝癌发病形势依然严峻,发病率居恶性肿瘤的第4位,每年新发病例约39.3万,占全球的50%以上,死亡率居第3位[1]。肝细胞癌(hepatocellular carcinoma,HCC)是PLC的主要类型,约占75%~85%。手术治疗(包括肝移植)为首选且唯一可能根治的方法,但在明确诊断时大多HCC患者已为中晚期,治疗效果差,手术切除率较低,切除后肿瘤复发率高。经动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)、射频消融(radiofrequency ablation,RFA)、立体定向放疗(stereotactic body radiation therapy,SBRT)等局部治疗也仅是缓解症状、减轻痛苦、改善生活质量的姑息手段。     

肝细胞癌自发消退的机制研究

恶性肿瘤的自发消退(SRC)是一种罕见现象,1956年首次报道[1],较常见于恶性黑色素瘤、神经母细胞瘤、乳腺癌、肾细胞癌等.肝细胞癌(HCC)是最常见的恶性肿瘤之一,其发病率居世界第6位,病死率居世界第3位[2].HCC自发消退的发生率约0.406％[3].HCC自发消退的机制目前仍不明确,可能的机制分为两类:一是肿...     

肝细胞癌中微小RNA的功能及临床研究进展

正肝细胞癌(hepatocellular carcinoma,HCC)是发病率最高的恶性肿瘤之一,在全球范围内造成了十分严重的卫生和社会负担~([1])。在中国,由于慢性乙型肝炎病毒及丙型肝炎病毒感染的广泛流行,HCC的发病率一直居高不下~([2])。与其他恶性肿瘤类似,HCC的致病机制十分复杂,慢性肝炎病毒感染、遗传、酒精、药物等因素的共同作用导致了HCC的发生。微小RNA(micro-RNA,miRNA)属于不具备蛋白质翻译功能的非编码     

肝癌细胞对星状细胞活化的调控作用

肝细胞癌(hepatocellular carcinama,HCC)是全球癌症相关性死亡的主要原因之一,占恶性肿瘤死亡原因的第4位,占男性恶性肿瘤死亡原因的第3位。在亚洲某些高发区如中国,其年发病率高达34人/10万人口。每年全世界有25万人死于HCC。我国因HCC死亡者约占其中的40％。由于HCC是多因素疾病,其发病过程较为复杂,近年有关HCC发病机制的研究出现许多热点。如有关癌基因的研究认为HCC形成的分子机制在于癌基因的激活和抑癌基因的失活。研究较多者包括ras,c-myc,cerbB-2,p53,p21和p16等基因及其在HCC发生和发展中的作用。此外,微卫星不稳定性、端粒酶与肝癌的关系亦受到重视,bcl-2是抑     

原发性肝脏罕见恶性肿瘤的诊断

近年来,除常见的原发性肝细胞癌(HCC),肝胆管细胞癌外,其它种原发性肝恶性肿瘤的报告也日见增多,这就是临床所谓罕见非肝细胞癌(HCC)的其它种肝恶性肿瘤.按肿瘤细胞的大体起源情况,临床上     

miRNA与肝细胞肝癌的关系

肝细胞癌(hepatocellularcar cinoma,HCC)作为全球高发的恶性肿瘤之一,发病机理不详,早期症状不典型,临床缺乏有效的检测及治疗手段,预后差,死亡率高.据统计全球每年有600000人死于肝癌,肝癌病人5年生存率小于5％[1].研究结果表明miRNA与肝细胞癌的发生发展关系密切,这可能有助于肝癌的早期诊断、治疗及预后判断.本文仅就miRNA与肝细胞癌的发生机制作如下介绍.     

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.     

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.     

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.     

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.