肝细胞肝癌中p15、p16基因表达的关系

目的 探讨ｐ１５,ｐ１６基因在肝细胞肝癌（ＨＣＣ）的表达情况,相互关系及其临床病理意义。方法 用免疫组织化学方法（ＳＡＢＣ法）检测了ｐ１５,ｐ１６基因在３０例ＨＣＣ标本中的表达。结果 ｐ１６,ｐ１５基因在ＨＣＣ的阳性表达率在肿瘤分级及及临床分期的差异中均有显著意义。结论ｐ１５,ｐ１６基因的异常表达在ＨＣＣ中的发生,发展过程中起重要作用,二者在ＨＣＣ中的表达具有不均衡性。     

Combined use of cytology,p16 immunostaining and genotyping for triage of women positive for high-risk human papillomavirus at primary screening

Human papillomavirus (HPV) testing is very sensitive for primary cervical screening but has low specificity. Triage tests that improve specificity but maintain high sensitivity are needed. Women enrolled in the experimental arm of Phase 2 of the New Technologies for Cervical Cancer randomized controlled cervical screening trial were tested for high-risk HPV (hrHPV) and referred to colposcopy if positive. hrHPV-positive women also had HPV genotyping (by polymerase chain reaction with GP5+/GP6+ primers and reverse line blotting), immunostaining for p16 overexpression and cytology. We computed sensitivity, specificity and positive predictive value (PPV) for different combinations of tests and determined potential hierarchical ordering of triage tests. A number of 1,091 HPV-positive women had valid tests for cytology, p16 and genotyping. Ninety-two of them had cervical intraepithelial neoplasia grade 2+ (CIN2+) histology and 40 of them had CIN grade 3+ (CIN3+) histology. The PPV for CIN2+ was >10% in hrHPV-positive women with positive high-grade squamous intraepithelial lesion (61.3%), positive low-grade squamous intraepithelial lesion (LSIL+) (18.3%) and positive atypical squamous cells of undetermined significance (14.8%) cytology, p16 positive (16.7%) and, hierarchically, for infections by HPV33, 16, 35, 59, 31 and 52 (in decreasing order). Referral of women positive for either p16 or LSIL+ cytology had 97.8% sensitivity for CIN2+ and women negative for both of these had a 3-year CIN3+ risk of 0.2%. Similar results were seen for women being either p16 or HPV16/33 positive. hrHPV-positive women who were negative for p16 and cytology (LSIL threshold) had a very low CIN3+ rate in the following 3 years. Recalling them after that interval and referring those positive for either test to immediate colposcopy seem to be an efficient triage strategy. The same applies to p16 and HPV16.     

补阳还五汤对脑缺血大鼠nNOS免疫阳性神经元的影响

目的探讨补阳还五汤对大鼠持续性局灶性脑缺血后脑组织内神经元型一氧化氮合酶(nNOS)免疫阳性神经元表达的影响。方法动物分为正常对照组,模型对照缺血1、4、10h组,补阳还五汤预处理缺血1、4、10h组。局灶性脑缺血模型由线栓法阻塞大鼠大脑中动脉(MCAO)制成,免疫组化SABC法测定大鼠脑缺血后,不同脑区在不同时间段的nNOS免疫阳性神经元表达的变化。结果缺血侧各脑区内nNOS免疫阳性神经元表达较正常对照组升高(P<0.05),随时间延长而递增,在大脑皮层纹状区与尾壳核表达增加程度最高。补阳还五汤预处理缺血4、10h组大脑皮层纹状区nNOS免疫阳性神经元表达(170.80±21.71、189.20±18.53)比模型组同时段表达(244.60±12.44、363.00±24.82)显著性降低(P<0.05);补阳还五汤预处理缺血1、4、10h组尾壳核nNOS免疫阳性神经元表达(127.33±19.83、215.20±38.80、191.20±22.39)比模型组同时段表达(138.67±13.99、266.40±29.25、373.20±31.55)显著性降低(P<0.05)。早期即起效,并随缺血时间延长而递增。结论提示补阳还五汤能抑制缺血后脑组织内早期nNOS活性的升高,对缺血后脑组织具有早期保护作用。     

A sensitive LC/MS/MS bioanalysis assay of orally administered lipoic acid in rat blood and brain tissue

A sensitive liquid chromatography tandem mass spectrometry (LC/MS/MS) bioanalytical method was developed and validated to analyze lipoic acid (LA) in rat blood and brain samples. Ten mobile phase combinations were investigated during method development. Mobile phase combination of 0.1% acetic acid (pH 4 adjusted with ammonia solution)/acetonitrile was most optimum in terms of sensitivity and peak shape of LA and the internal standard, valproic acid. Sample extraction method was explored using liquid–liquid extraction and protein precipitation methods. Protein precipitation yielded the highest recovery of the analytes from blood and brain ranging from 92 to 115%. The lower limit of quantitation (LLOQ) of LA was 0.1 ng/mL (0.485 nM) in both blood and brain while on-column lower limit of detection (LLOD) was 0.03 pg. The precision (% R.S.D.) ranged from 1.49 to 26.39% and 1.49 to 10.89% for intra- and inter-day assays, respectively. The accuracy ranged from 91.2 to 116.17% for intra-day assay and 102.68 to 114.33% for inter-day assay.     

输卵管栓塞术在IVF-ET前治疗输卵管积水的临床应用

输卵管积水的患者行体外受精胚胎移植（IVF-ET）将影响治疗结果,患者的胚胎植入率和临床妊娠率降低,流产率增加。检索有关IVF—ET前对输卵管积水预处理方法的文献,分析对比常用的4种方法（输卵管切除术、结扎术,开窗术、抽吸术）的不足之处,着重介绍输卵管栓塞术的介入治疗。结论：IVF-ET前应用输卵管栓塞术对输卵管积水进行预处理,是一种创新性方法。其简便、安全、经济,对卵巢功能无影响,可显著增加临床妊娠率,并能杜绝输卵管妊娠的发生。