部分睡眠剥夺对大鼠糖代谢的影响

1材料和方法 1.1材料血糖仪(Accu-CHEK Softclix(R)2 LANCING DEVICE)及大平台水箱由第四军医大学教学实验中心提供.小平台水箱由第四军医大学航天航空医学系心理教研室提供.INS试剂盒,购自中国人民解放军总医院科技开发中心放免研究所.     

Prognosis of papillary serous, clear cell, and grade 3 stage I carcinoma of the endometrium

OBJECTIVE: The purpose of this study was to evaluate patients with uterine papillary serous carcinoma (UPSC), clear cell (CC), and grade 3 endometrioid (G3) surgically stage I endometrial cancer. METHODS: The 25th Annual Report (AR) of FIGO was used to identify patients with endometrial cancers who were surgically staged. For comparison, all cancers reported were evaluated with particular interest in patients with stage I UPSC, CC, and G3. Incidence, substage, post-surgical treatment, and survival were identified. RESULTS: Of 5694 endometrial cancer patients reported to the AR, 3996 (70%) were surgically stage I. There were 148 UPSC, 59 CC, and 325 with G3 lesions. UPSC and CC represent 5.2% of all stage I cancers while 8.1% are G3. Although there were greater number of UPSC, CC, and G3 with extrauterine disease, about 50% of UPSC and CC were stage I. This compares to 81% for G1, 68% for G2, and only 42% for G3. There were more IA cancers with UPSC and CC than G3 (22%, 33%, and 17%, respectively). Survival (5 years) for UPSC and CC was 72% and 81%, respectively, compared to 76% for G3 lesions. Postoperative radiation improved survival somewhat (6-8%) but the difference was not significant. CONCLUSION: UPSC and CC histotypes when diagnosed as stage I have a better survival than commonly perceived and equal to G3 endometrioid cancers. Postoperative radiation improves survival but not significantly so. The role of chemotherapy has not been defined.     

History of the FIGO cancer staging system

The main objectives of any good staging system - essential to an evidence-based approach to cancer - are: to aid the clinician in planning treatment; to provide indication of prognosis; to assist the physician in evaluating the results of treatment; to facilitate the exchange of information between treatment centers, thus disseminating knowledge; and to contribute to continuing investigations into human malignancies. A good staging system must have 3 basic characteristics: it must be valid, reliable, and practical. The first staging system for gynecological cancers appeared around the turn of the 20th century and applied to the carcinoma of the cervix uteri-the most common cancer affecting women in high income countries at that time. The classification and staging of the other gynecological malignancies was not put forward until the 1950s. Over the years, these staging classifications - with the exception of cervical cancer and gestational trophoblastic neoplasia - have shifted from a clinical to a surgical-pathological basis. This paper reviews the history of the International Federation of Gynecology and Obstetrics (FIGO) cancer staging system, how it was developed, and why.     

Primary lung cancer: biodistribution and dosimetry of two In-111- labeled monoclonal antibodies

This study was undertaken to measure the biokinetics and organ dosimetry of indium-111-labeled monoclonal antibodies (MoAbs) with a whole-body gamma camera imaging technique. Twenty patients with primary lung cancer were studied with two different MoAb agents (anti-carcinoembryonic antigen ZCEO25 and antiadenocarcinoma LA20207). Imaging was performed at 1, 24, 72, and 144 hours after injection. Scintigraphic whole-body retention was verified by means of comparison with the results from in vitro counting of excreta. Organ retention was verified in an abdominal phantom. The MoAb cleared slowly from the heart and lungs, the brain and spleen showed no clearance, and the liver showed increased activity over the 6-day period. Dosimetry for ZCE025 showed a dose to the liver of 1.3 rad/mCi (0.36 mGy/MBq); heart, 1.5 rad/mCi (0.40 mGy/MBq); spleen, 1.1 rad/mCi (0.29 mGy/MBq); total body, 0.49 rad/mCi (0.13 mGy/MBq); and testes, 0.39 rad/mCi (0.11 mGy/MBq). The dosimetry for LA20207 was similar.     

Bronchial responsiveness to histamine: relationship to diurnal variation of peak flow rate, improvement after bronchodilator, and airway calibre

Features of asthma include increases in both bronchial responsiveness and variability of airflow rates. We examined the relationship between bronchial responsiveness to histamine and the variation of peak expiratory flow rate (PFR) during the day and in response to salbutamol (200 μg), and the initial FEV₁ at the time of the histamine test and FEV₁ response to salbutamol. Bronchial responsiveness to histamine was expressed as the provocation concentration causing a fall in FEV₁ of 20% (PC₂₀). PC₂₀ ranged between 13·9 and 130 mg/ml in nonasthmatic subjects, between 10·5 and 59·9 mg/ml in five asymptomatic asthmatics, and between 0·03 and 20·8 mg/ml in 27 asthmatics with symptoms controlled by medication. The lower the PC₂₀ (the greater the bronchial responsiveness) the lower the morning PFR (r = 0·79), the greater the increase in PFR after salbutamol (morning r = −0·75, evening r = −0·80), and the greater the difference between the highest and lowest PFR each day (r = −0·81). Measurements of PFR were abnormal, compared with those in nonasthmatic subjects, in all subjects with a PC₂₀ less than 2 mg/ml—that is, moderate or severe increase in nonspecific bronchial responsiveness—and in none with a PC₂₀ greater than 21 mg/ml—that is, normal responsiveness; five of nine asthmatics with controlled symptoms had abnormal PFR measurements when PC₂₀ was between 2 and 21 mg/ml—that is, mild hyperresponsiveness. In contrast, FEV₁ at the time of the histamine test was greater than 80% predicted in all subjects with a PC₂₀ greater than 2 mg/ml and was not less than this in 10 of 18 subjects with a PC₂₀ less than 2 mg/ml. When improvement in FEV₁ was 20% or more after salbutamol, the PC₂₀ was usually moderately or severely increased (less than 0·4 mg/ml). The results identify a close relationship between nonspecific bronchial responsiveness to histamine and the variability in flow rates which occurs spontaneously and after bronchodilator. In addition, they raise the possibility that increased airflow obstruction in asthma may be a consequence of increased responsiveness.     

Interdisciplinary treatment of necrotizing enterocolitis and spontaneous intestinal perforations in preterm infants

From January 1986 to December 1992, 13 patients with necrotizing enterocolitis (NEC) (Grade II-III; Bell) were treated. The incidence was highest in the very immature infants with birth weight < 1000 g: 6/148 (4%). From onset, NEC was associated with clinical symptoms such as abdominal distension, bloody stools, retained gastric contents and septicemia. Indications of inflammation were seen in only 6 out of 13 patients at the time of diagnosis. No complications were seen in 10 patients during the acute phase. Two infants developed a bowel perforation and another one a gangrene. Immediate surgery was performed. In three other infants, elective surgery was performed because of colonic strictures. Twelve (92%) patients survived NEC. Five other VLBW infants developed spontaneous perforations of the bowel. The clinical presentation, laboratory and radiological findings differed greatly from those with NEC. Four infants survived. A primarily conservative therapeutic regime with close cooperation between the surgeon and pediatrician may be an alternative to early surgical intervention in NEC.     

The human corpus luteum: reduction in macrophages during simulated maternal recognition of pregnancy

It has been shown that immune cells, particularly macrophages, accumulate in the corpus luteum during luteolysis. This study aimed to investigate the effect of maternal recognition of pregnancy on the localization and numbers of macrophages in the human corpus luteum. Corpora lutea (n = 12) were obtained from normally cycling women at the time of hysterectomy and were dated on the basis of serial urinary luteinizing hormone (LH) estimation. In addition, corpora lutea (n = 4) were collected from women who had received daily doubling doses of human chorionic gonadotrophin (HCG) to mimic the hormonal changes of early pregnancy. Macrophages were localized by immunohistochemistry using an anti-CD68 antibody. Steroidogenic cells, steroidogenic cells of thecal origin and endothelial cells were identified on serial sections by immunohistochemistry for 3beta-hydroxysteroid dehydrogenase, 17alpha-hydroxylase and von Willebrand factor, respectively. The luteal cells capable of responding directly to HCG were identified by isotopic in-situ hybridization for messenger RNA encoding LH/HCG receptors. Macrophages were localized primarily to the vascular connective tissue and theca-lutein areas of the corpus luteum, although some were found in the granulosa-lutein cell layer. Macrophage numbers increased throughout the luteal phase to a maximum in the late- luteal phase (P < 0.05). Luteal 'rescue' with HCG was associated with a marked reduction in the numbers of tissue macrophages when compared with those of the late-luteal phase (P < 0.001). One of the effects of HCG during maternal recognition of pregnancy is to prevent the normal influx of macrophages into the corpus luteum. As LH/HCG receptors localized to the steroidogenic cells, this implies a fundamental role for steroidogenic cell products in the control of macrophage influx into the human corpus luteum.