应用组织芯片技术研究Delta-like 4在胃癌组织中的表达及意义

目的:研究Delta-like 4(DLL4)在胃癌中的表达及其与血管生成的关系.方法:采用免疫组化EnVision法检测胃癌组织芯片中DLL4的表达,用CD34进行微血管内皮细胞染色,计算微血管密度(MVD),分析其相关性.结果:DLL4在胃癌中的表达明显高于正常胃黏膜(85.9% vs 35.3%.P＜0.01).DLL4的高表达与胃癌的转移(r=0.612,P＜0.01)和胃壁浸润深度(r=0.482,P＜0.01)呈正相关,与胃癌的组织病理及Borrmann分型无关.胃癌组织MVD明显高于正常胃黏膜组织(66.5±18.6 vs 34.2±16.4.P＜0.01).MVD值与胃癌的组织病理分型(r=0.506,P＜0.01)和转移有关(r=0.426,P＜0.01),与胃癌胃壁浸润深度和Borrmann分型无明显相关性.DLL4表达阳性组的MVD指数明显高于DLL4表达阴性组(70.5±16.2 vs 32.5±10.4,P7＜0.01),DLL4表达与MVD呈正相关(r=0.521.P＜0.01).结论:DLL4表达促进血管分化,对胃癌的转移、浸润起重要作用.     

食管癌组织环氧化酶-2的表达与血管生成的关系

目的:探讨环氧化酶-2(COX-2)在食管癌组织的表达及其与肿瘤血管生成的关系．方法:免疫组化法检测食管鳞癌手术切除标本90例和癌旁正常黏膜34例中COX-2表达,采用抗CD34抗体标记微血管内皮细胞,计算微血管密度(MVD)．分析COX-2表达与MVD及其与食管癌主要临床病理特征的相关性．结果:食管癌组织COX-2阳性表达率为84．4％显著高于癌旁正常黏膜的20．6％(x2=45．47,P =0．00)．COX-2表达与肿瘤细胞分化程度、临床TNM分期和淋巴结转移密切相关,TNM分期中Ⅲ Ⅳ期的食管鳞癌组织中COX-2表达率为92．9％,显著高于Ⅰ Ⅱ期的70．6％(x2= 7．99,P=0．005)．高、中分化的食管鳞癌组织中COX-2表达率为92．9％,显著高于低分化的 70．6％(x2=7．99,P=0．005)．伴有淋巴结转移的食管鳞癌组织中COX-2表达率为94．3％,显著高于无淋巴结转移的70．3％(x2=9．61,P= 0．002)．食管癌组织MVD值为29．68±3．81, 显著高于癌旁正常黏膜的15．12±2．80(t= 20．28,P=0．00)．MVD与肿瘤的TNM分期和淋巴结转移密切相关,TNM分期中Ⅲ Ⅳ期的食管鳞癌组织中MVD值为31．46±3．52,显著高于Ⅰ Ⅱ期的26．74±2．06(t=-7．09,P=0．00)．伴有淋巴结转移的食管鳞癌组织中MVD为 31．72±3．43,显著高于无淋巴结转移的26．76 ±2．01(f=-7．90,P=0．00)．Spearman等级相关分析表明,MVD与COX-2表达呈显著正相关(r =0．607．P=0．00)．结论:COX-2异常表达及其诱导的血管生成在食管癌的侵袭和淋巴结转移中起重要作用．     

胃癌发生和演进中maspin和Kail表达的临床病理意义

目的观察maspin和Kail在胃癌及癌前病变中的表达,并探讨他们在胃癌发生和演进中的作用.方法采用免疫组化方法检测maspin和Kail在正常胃黏膜(n=182)、胃异型增生(n=69)和胃癌(n=113)中的表达,比较他们表达与胃癌临床病理特征的关系,并探讨maspin和Kail表达的关系.结果Maspin在正常胃黏膜、胃异型增生和胃癌中的阳性率分别为79.8%(145/182)、75.4%(52/69)和50.4%(57/113),Kail在相应组织中的阳性率分别81.9%(149/182)、65.2%(49/69)、58.4%(66/113).正常胃黏膜和胃异型增生中maspin表达高于胃癌(P＜0.01),正常胃黏膜中Kail表达高于胃异型增生和胃癌(P＜0.01).maspin表达与胃癌浸润深度(P=0.003＜0.01)、转移(P=0.027＜0.05)、Lauren分型(P=0.015＜0.05)和组织学分型相关(P=0.024＜0.05),而与肿块大小、Borrmann分型、生长方式和TNM分期无关(P＞0.05).Kail表达与浸润深度(P=0.043＜0.05)、转移(P=0.005＜0.01)、生长模式(P=0.034＜0.05)、Lauren(P=0.000＜0.01)和组织学分型相关(P＜0.05),而与肿块大小、Borrmann分型和TNM分期无关(P＞0.05).值得注意的是胃癌中maspin和Kail表达显著一致(P=0.008＜0.05).结论maspin和Kail表达下调在胃癌发生中起重要作用,maspin和Kail的表达可能对胃癌的浸润和转移具有抑制作用,可作为反应胃癌病理生物学行为的有效的客观指标.     

一氧化氮合酶和微血管生成与胃癌发展的关系

目的　研究诱导型一氧化氮合酶 (iNOS)在人胃癌组织中的表达及其与胃癌微血管形成、淋巴结转移及临床分期的关系。方法　采用免疫组化S P法检测 50例原发性胃癌组织、癌周组织及 2 0例正常胃黏膜组织中iNOS的表达 ,同时检测微血管密度 (MVD) ,以抗CD3 4标记血管内皮细胞 ,并分析其与肿瘤行为之间的关系。结果　 50例胃癌组织中iNOS阳性表达率为 70 .0 % ,MVD均值为 2 2 .0± 9 .8,显著高于癌周组织 (16.2 % ,6.1± 3 .4)和正常胃组织 (15.0 % ,5.5± 2 .6;P <0 .0 1)。按TNM分期 ,Ⅳ期胃癌组织iNOS阳性表达率为 93 .8% ,MVD为 42 .3± 3 .7,两者显著高于Ⅰ、Ⅱ、Ⅲ期 ,差异有显著性 (P <0 .0 1)。有淋巴结转移组iNOS的阳性表达率为 84.6% ,MVD均值为 2 7.4± 6.5;无淋巴结转移组iNOS阳性表达率为 54.2 % ,MVD均值为 15.3± 4.7,两组差异有显著性 (P <0 .0 5)。iNOS阳性表达组及高MVD值 (≥ 2 2 .0 )组的 3年生存率均显著低于iNOS阴性表达组及低MVD值 (<2 2 .0 )组 ,差异有显著性 (P <0 .0 5)。结论　胃癌组织中iNOS高阳性表达 ,随着iNOS阳性表达的增强 ,MVD值也增加 ,两者呈正相关。iNOS的表达及MVD与胃癌TNM分期、淋巴结转移及预后有密切关系。iNOS的表达及MVD值可作为判断胃癌预后的重要指标     

胃癌组织中PTEN,MMP-9和Caspase-3表达的关系

目的:研究PTEN,MMP-9和Caspase-3在胃癌及正常胃组织中的表达,探讨他们在胃癌的发生、发展、浸润和转移中的作用．方法:选择临床病理资料齐全的胃癌蜡块标本54例,另取正常胃黏膜标本15例作对照．采用SP免疫组化方法检测PTEN,MMP-9和 Caspase-3在其中的表达．结果:胃癌中PTEN低表达(28/54,51．9％),且肿瘤浸润深(P=0．004)、有淋巴(P=0．003) 和远隔转移(P=0．01 5)、临床分期高(P= 0．001)、病理分化低(P=0．008)时降低．胃癌中MMP-9高表达(41／54,75．9％),且肿瘤浸润深(P=0．040)、有淋巴转移(P=0．025)、临床分期高(P=0．039)、病理分化低(P=0．009)时增高．胃癌中Caspase-3低表达(12／54,22．2％), 且有淋巴转移(P=0．045)、临床分期高(P= 0．015)、病理分化低(P=0．035)时降低．胃癌中PTEN与MMP-9(r=-0．543,P=0．001), Caspase-3与MMP-9的表达负相关(r=0．741, P=0.001),PTEN与Caspase-3的表达正相关(r =0．515,P=0．001)．结论:胃癌中PTEN,Caspase-3低表达,MMP-9 高表达;PTEN、MMP-9和Caspase-3可作为胃癌诊断和预后判断的指标．     

DLL4在胰腺癌组织中的表达及其与肿瘤血管生成的关系

目的 检测delta-like ligand 4(DLL4)在胰腺癌中的表达,分析其与肿瘤血管生成及临床病理特征的关系.方法 采用免疫组化SP法检测60例胰腺癌组织及20例癌旁正常胰腺组织中DLL4的表达;观察微血管内皮细胞CD34表达,计算微血管密度(MVD);分析DLL4表达、MVD与胰腺癌临床病理特征之间的关系以及两者的相关性.结果 DLL4在胰腺癌组织中的表达明显高于正常胰腺组织(68.3％比20.0％,P＜0.01);胰腺癌组织DLL4的高表达与肿瘤分化程度、TNM分型、肿瘤转移及浸润等呈正相关(P值均＜0.05),而与肿瘤部位、大小、组织病理分型无关.胰腺癌组织MVD明显高于正常胰腺组织(34.9±13.2比18.9±2.2,P＜0.01);胰腺癌的MVD与肿瘤分化程度、TNM分期、肿瘤转移及浸润有关(P值均＜0.05),而与肿瘤部位、大小、组织病理分型等无明显相关性.DLL4表达阳性的胰腺癌组织MVD明显高于DLL4表达阴性者(38.8±10.7比29.0±15.2,P＜0.05),且DLL4表达与MVD呈显著正相关(r=0.669,P＜0.05).结论 DLL4表达可促进肿瘤血管生成,且与胰腺癌的转移、浸润相关.     

结肠癌COX-2mRNA表达与微血管密度关系的临床意义

目的通过观察结肠癌组织COX-2mRNA及CD34的表达，结合结肠癌组织中微血管密度（microvessel density，MVD）所见，探讨COX-2与肿瘤血管形成及病理特征的关系，为结肠癌生物治疗提供理论基础。方法 选择62例结肠癌、22例结肠腺瘤和22例正常结肠黏膜标本，采用原位分子杂交法检测COX-2mRNA并用MaxVisionTM快捷免疫组化法检测CD34表达，光镜下记数MVD。结果结肠癌、结肠腺瘤组织COX-2mRNA的阳性率明显高于正常黏膜，且有统计学意义（74．19％：36．36％，P=0．001；72．73％：36．36％，P=0．015）；结肠癌组平均MVD值高于腺瘤组和正常组，三组比较，有统计学意义（F=19．628，P=0．000）。在62例结肠癌组织中，高分化组COX-2mRNA阳性率高于低分化组（X^2=4．215、P=0．040）；进展期癌组的MVD高于早期癌组（t=3．079，P：0．003）；淋巴结有转移组MVD高于无转移组（t=3．180，P=0．002）；有血管侵犯组高于无血管侵犯组（t=2．093，P=0．041）；COX-2mRNA阳性组MVD高于阴性组，COX-2mRNA高表达组MVD高于低表达组，但差异均无统计学意义（P〉0．05）。结论MVD记数可作为判断肿瘤预后的有效评价指标，COX-2与肿瘤细胞的增殖和凋亡密切相关，与肿瘤血管生成无直接相关性。     

胃癌组织中THBS2基因水平与MVD、MMP-2表达的相关性

目的探讨胃癌组织中血小板反应蛋白2(THBS2)基因表达水平微血管密度(MVD)、基质金属蛋白酶(MMP)-2表达的相关性。方法应用免疫组化EnVision二步法染色检测MMP-2表达水平。应用CD34免疫组化染色评价MVD的表达。通过PCR技术定量分析80例胃癌组织和30例正常胃黏膜组织中THBS2基因的表达,分析胃癌组织中THBS2基因的表达与MVD、MMP-2表达的相关性。结果胃癌组织中THBS2基因表达为(-1.2±0.05),正常的胃黏膜组中为(-1.82±0.12),两组之间的差异显著(P<0.05)。THBS2基因高表达与低表达与MMP-2蛋白表达具有密切的关系(P<0.05);胃癌组织中MVD 45.34±12.35,与THBS2基因水平呈正相关(r=0.432,P=0.001)。结论胃癌组织中THBS2基因的表达水平于MVD、MMP-2表达存在一定的相关关系,THBS2基因的变化可能是通过促进MVD、MMP-2表达实现的。     

胃癌组织中环氧化酶-2的表达及临床意义

应用免疫组织化学方法检测环氧化酶-2（COX-2）在胃癌患者癌组织、癌旁组织及正常胃黏膜组织中的表述。结果正常胃黏膜组织中无COX-2表达或弱表达；COX-2表达阳性率胃癌组织明显高于癌旁组织（P〈0．05）；COX-2表达与胃癌组织TNM分期、淋巴结转移、周围组织浸润有关（P〈0．05）。认为COX-2在胃癌发生、发展中起重要作用。     

胃癌组织中KAI1、nm23及P53的表达及其临床意义

目的:探讨正常胃黏膜、不典型增生胃黏膜及癌组织中KAI1、nm23及P53蛋白的表达．方法:应用SP法免疫组化检测22例正常胃黏膜,65例不典型增生胃黏膜及74N胃癌组织中的KAI1、nm23及P53蛋白的表达．结果:正常胃黏膜、不典型增生胃黏膜及胃癌组织中,KAI1和nm23阳性率呈降低趋势,组间差异性有统计学意义(x2=20．885, P<0．001;x2=29．133,P<0．05):P53蛋白阳性表达率呈增加趋势,组间差异性有统计学意义(x2=21．954,P<0．001)．Fisher精确概率检验显示:在胃癌组中不同的浸润深度、有无淋巴结转移和脉管侵犯组内KAI1、nm23及 P53组阳性表达率的差异性有统计学意义(x2 =20．885,P<0．001;x2=29．133,P<0．05;x2= 21．954,P<0．001);而在年龄、性别组间的差异性无统计学意义．Spearman等级相关分析显示 KAI1与nm23表达呈正相关(r=0．859,P<0．05); KAI1与P53表达呈负相关(r=-0．859,P<0．05), nm23与P53表达呈负相关(r=-0．874,P<0．05) 结论:抑癌基因KAI1与nm23的缺失以及P53 蛋白的过表达可能是胃癌发生、发展及浸润和转移的重要原因之一．     

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.