大肠癌及各类大肠息肉流式细胞DNA定量研究

大肠息肉是一种常见的良性肿瘤,其中腺瘤性息肉与大肠癌的发生有密切关系。我们应用流式细胞计对不同病理类型的大肠息肉组织细胞ＤＮＡ进行定量分析,以探讨各类息肉、尤其是腺瘤性息肉,伴轻度及重度异型增生者与大肠癌组织细胞ＤＮＡ含量的变化规律及其生物学特性,为临床正确处理各类型息肉提供理论依据。一、材料和方法1材料来源:65例标本均为内镜下活检组织,其中正常大肠黏膜6例,炎性息肉10例,增生性息肉7例,腺瘤性息肉10例,腺瘤性息肉伴轻度异型增生10例,伴中重度异型增生12例,大肠癌10例。2方法:标本经10%甲醛溶液固定,石蜡包裹切片,常…     

YAP、TAZ在大肠息肉中的表达及临床意义

目的检测YAP、TAZ在大肠息肉中的表达并探讨其临床意义。方法分别选取28例大肠增生性息肉组织、28例大肠腺瘤性息肉组织、32例大肠癌组织及24例正常大肠黏膜组织,采用免疫组化Envision两步法检测两种蛋白在4种组织中的表达情况。结果 YAP、TAZ在正常大肠组织、大肠增生性息肉组织、大肠腺瘤性息肉组织及癌组织的表达率逐渐升高,差异有统计学意义(P0.05);二者的表达与大肠腺瘤性息肉有蒂无蒂及大小有关(P0.05);二者在大肠腺瘤性息肉组织中的表达呈正相关(r=7.582,P0.05)。结论 YAP、TAZ的表达率与大肠息肉的严重程度关系密切,检测大肠息肉组织中的YAP、TAZ蛋白的表达水平有助于早期发现大肠癌。     

老年人大肠息肉与大肠癌

为了解老年人大肠息肉和大肠癌的临床特点，更好地预防老年人大肠肿瘤的发生和早期诊断大肠癌，对２４８例老年人大肠息肉和大肠癌的临床及病理作一回顾性分析。结果老年人大肠息肉和大肠癌的检出率分别为３３．３％和２３．３％，并有以下特点：（１）大肠息肉和大肠癌是老年人便血的主要原因，炎性息肉、腺瘤性息肉及大肠癌三者的便血率依次增高；（２）息肉检出率显著高于普通人群息肉检出率，且腺瘤性息肉占７３．８％；（３）多发性息肉比例较高，并以腺瘤性息肉为主，占８０．７％，且多发生于不同的肠段；（４）老年人大肠癌低恶性程度者多；（５）大肠腺瘤性息肉常与大肠癌并存，二者多发生于不同肠段。因此，我们认为便血是老年人大肠镜检查的有力指征；大肠镜检查时不应满足于远端大肠病变的诊断，应尽可能检查全大肠；对老年人大肠息肉，尤其是多发性息肉及直径大于１．０ｃｍ者应积极切除。     

大肠癌和大肠腺瘤性息肉患者外周血中G-17表达及临床意义

目的探讨大肠癌和大肠腺瘤性息肉患者外周血中胃泌素17(gastrin-17,G-17)的表达及临床意义。方法以41例大肠癌患者、65例大肠息肉患者(其中大肠腺瘤性息肉组41例,大肠非腺瘤性息肉组24例)及33名肠镜检查阴性健康体检者为研究对象,采用酶联免疫吸附法(enzyme-linked immunosorbent assay,ELISA)检测各组研究者外周血中G-17表达水平,并进行组间两两比较。结果大肠癌组、大肠非腺瘤性息肉组、大肠腺瘤性息肉组外周血中G-17表达明显高于健康对照组,大肠癌组高于大肠非腺瘤性息肉组、大肠腺瘤性息肉组,差异有统计学意义(P0.05);大肠腺瘤性息肉组外周血中G-17表达水平明显高于大肠非腺瘤性息肉组和健康对照组,差异有统计学意义(P0.05);大肠非腺瘤性息肉外周血中G-17表达水平高于健康对照组,但差异无统计学意义(P0.05)。结论血清G-17与大肠癌和大肠息肉及其病理类型具有一定相关性,可能在结肠息肉与结肠癌的发生、发展过程中起一定作用。     

老年人大肠息肉与大肠癌

为了解老年人大肠息肉和大肠癌的临床特点，更好地预防老年人大肠肿瘤的发生和早期诊断大肠癌，对２４８例老年人大肠息肉和大肠癌的临床及病理作一回顾性分析，结果老年人大肠息肉和大肠癌的检出率分别为３３．３％和２３．３％，并有以下特点：（１）大肠息肉和大肠癌是老年人便血的主要原因，炎性息肉，腺瘤性息肉及大肠癌三者的便血率依次增高；（２）息肉检出率显著高于普通人群息肉检出率，且腺瘤性息肉占７３．８％（３）多发     

PTEN在大肠癌癌变过程中的表达及意义

目的探讨在大肠癌癌变过程中,即大肠正常组织、大肠增生性息肉、大肠腺瘤和大肠癌中PTEN的表达及意义。方法应用免疫组织化学SP法检测122例大肠组织标本中PTEN蛋白的表达,应用等级相关的秩和检验分析PTEN在大肠组织中表达的意义及其与临床病理特征间的关系。结果PTEN蛋白在正常大肠组织、大肠增生性息肉、大肠腺瘤、大肠癌中表达差异有明显统计学意义（P=0．000）。大肠癌中PTEN蛋白表达与肿瘤分化程度、临床肿瘤分期及性别无关（P〉0．05）,但与患者的年龄相关（P=0．002）。结论PTEN蛋白在大肠癌癌变过程中存在异常表达,PTEN蛋白的低表达与大肠癌的发生和浸润转移相关。     

MC_5抗原和CEA在大肠良、恶性病变表达的对比研究(摘要)

为了探讨大肠息肉与大肠癌之间的病因学关系,研究抗人大肠癌单克隆抗体MC_5在大肠癌早期诊断的价值,我们应用MC_5抗大肠癌及抗癌胚抗原(Carcinoembryonic antigen,CEA)两种单克隆抗体,通过抗生物素—生物素—酶复合物法(ABC法),对51例大肠癌、41例大肠腺瘤,9例炎性息肉,5例增生性息肉,5例幼年性息肉,16例慢性炎症性大肠粘膜及20例正常大肠粘膜进行MC_5抗原与CEA表达的对比研究.     

577例大肠癌相关危险因素的研究

目的 探讨惠州地区大肠癌发病的相关危险因素.方法 对惠州地区577例大肠癌患者进行大肠癌危险因素单因素条件Logistics回归分析,纳入多因素条件Logislic回归模型进行多因素分析,计算各危险因素与大肠癌的关联程度OR值及其95％可信区间.结果 对577例大肠癌患者进行单因素条件Logistics回归分析发现,糖尿病病史、既往有大肠腺瘤性息肉病史和一级亲属患大肠腺瘤或大肠癌家族史和大肠癌的发生有关(P＜0.05).根据单因素的分析结果,将有意义的变量引入到多因素条件Logistic回归模型进行分析,结果显示糖尿病病史、既往大肠腺瘤性息肉病史、一级亲属患大肠腺瘤或大肠癌家族史是大肠癌发生的危险因素(P均＜0.05,OR值均＞1).结论 糖尿病病史、既往有大肠腺瘤性息肉病史和一级亲属患大肠腺瘤性息肉或大肠癌家族史增加了患大肠癌的危险性.     

大肠息肉组织中端粒酶活性的检测及临床意义

目的探讨大肠息肉组织中端粒酶活性检测的临床意义。方法将经肠镜检查及病理证实为结直肠炎性息肉及增生性息肉、腺瘤性息肉（未癌变）、腺瘤性息肉癌变、大肠癌患者各30例,为研究组,以息肉旁正常肠黏膜组织30例为对照组。分别检测各息肉及息肉旁正常组织中端粒酶活性,将检测结果进行对比分析。结果其中增生性息肉组端粒酶检测阳性2例,腺瘤性息肉组端粒酶检测阳性11例,伴轻、中、重不典型增生分别为4例、3例、4例,而且随着不典型增生的加重,端粒酶相对活性值增加,腺瘤性息肉癌变组端粒酶检测阳性22例,大肠癌组粒酶检测全部阳性。结论端粒酶的检测对发现腺瘤样息肉是否癌变或癌变倾向有一定的临床意义。端粒酶可以作为消化道组织癌前病变的检测指标。     

异常隐窝病灶研究进展

近20多年来，世界上多数国家大肠癌的发病率呈上升趋势，我国大肠癌发病率上升趋势亦十分显著。一般认为绝大多数大肠癌的发生归咎于腺瘤的癌变，部分直接起源于大肠黏膜生发中心的干细胞，少数可由增生性息肉经锯齿状腺瘤癌变等。但是随着1987年Bird对变异隐窝病灶（aberrant crypt foci，ACF）的首次报道及近年来对ACF的深入研究，ACF被认为是结直肠癌发生过程中可在光镜下观察到的最小和最早期的大肠黏膜病变。     

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.