Combined use of positive and negative immunomagnetic isolation followed by real-time RT-PCR for detection of the circulating tumor cells in patients with colorectal cancers

To establish a novel molecular diagnostic method of detecting circulating tumor cells (CTCs) LS174T colon cancer cells were serially diluted with normal blood. Additional peripheral blood samples were collected from 25 patients with colorectal carcinoma. Mononuclear cells (MNCs) were collected, equally divided into four parts, and then cancer cells were enriched by four methods: method A, nonimmunobead method; method B, negative immunobead method: CD45 immunomagnetic beads were used to deplete the leukocytes; method C, positive immunobead method: Ber-EP4 immunomagnetic beads were used to enrich cancer cells; method D, negative-and-positive immunobead method: CD45 immunomagnetic beads were first used to deplete the leukocytes from MNC and then Ber-EP4 immunomagnetic beads were used to enrich cancer cells. Finally, real-time quantitative RT-PCR was used to monitor mRNA expression of ₂-mircoglobulin (2M) and carcinoembryonic antigen (CEA). The relative CEA mRNA values were corrected with reference to 2M mRNA, to CEA mRNA/2M mRNA ratios according to a CEA mRNA external standards prepared with tenfold serial dilutions (1–10⁴ IS174T cells) of cDNA and 2M mRNA external standards prepared with tenfold serial dilutions (10²–10⁷ leukocytes) of cDNA. In recovery experiments a significant correlation between the number of cancer cells and CEA mRNA expression was found when CD45 or Ber-EP4 immunomagnetic beads were used alone. A highly significant correlation was found when CD45 and Ber-EP4 immunomagnetic beads were used successively. The sensitivity of method D was one cancer cell per milliliter of blood. Circulating cancer cells were detected in 19 of 25 patients with colorectal cancers. The relative CEA mRNA value obtained by method D was the smallest. The positive detection rate of circulating cancer cells in patients at Dukes B, C, and D stages were 25.0% (1/4), 83.3% (10/12), and 88.9% (8/9). Combinative use of immunomagnetic isolation followed by real-time RT-PCR is a useful technique to detect circulating tumor cells in patients with colorectal carcinomas. Applying negative and positive immunomagnetic beads successively yields the highest correlation with amount of tumor cells.     

高糖对体外培养Schwann细胞生长及细胞外信号调节激酶1／2磷酸化的影响

目的:探讨高糖对体外培养Schwann细胞生长及细胞外信号调节激酶(ERK)磷酸化的影响.方法:按照培养液中葡萄糖浓度的小同,分为对照组与高糖组.用MTT法检测Schwann细胞生长情况;用ELISA法检测对照组与高糖组ERK1/2磷酸化的程度,以及加入神经源性一氧化氮合成酶(nNOS)抑制剂后ERK1/2磷酸化的程度.结果:高糖浓度下,细胞虽有增殖但幅度及时程明显低于对照组,高糖抑制Schwann细胞生长;随着精浓度的升高.ERK1/2磷酸化的程度逐渐增加,并与加入nNOS抑制剂有相似的表现.结论:高糖抑制Schwann细胞生长,并且降低nNOS的量,减弱一氧化氮(NO)对ERK1/2的抑制作用,导致ERK1/2磷酸化水平升高.     

DICOM数据的三维重建与协同可视化系统的开发

复杂手术常需多科医生协商制定综合性治疗方案,网络协同三维可视化软件可使方案制定直观而精确。我们采用VTK工具包对DICOM格式CT图像数据进行三维重建并作网格简化,将结果所得多边形网格模型无缝集成到用HOOPS/3DAF所开发的图形系统进行显示,并用HOOPS/Stream工具包转成适合网络传输的HSF无损压缩流文件,再用HOOPS/NET工具包实现基于Client/Server架构的协同三维交互可视化系统。所得三维重建结果清晰,协同三维可视化操作实时度高。本研究实现了一个协同手术仿真开发平台,该架构易于进一步添加模拟手术操作与修复体设计功能。     

表皮细胞体外培养及临床应用

用手术切除阴茎包皮，制成单细胞悬液，经体外培养和传代培养，达到扩大增殖面积目的。将培养的单层表皮细胞薄膜，移植１００例深二度烧伤创面及肉芽创面，（最大移植面积３００ｃｍ２，最小面积２８ｃｍ２）均获得满意效果。因此，用阴茎包皮作为培养皮肤的细胞来源，具有实用价值和发展前景。     

143例晚期喉癌患者的临床特征及生存分析

目的 总结143例晚期喉癌患者的临床特征,分析预后的影响因素。方法 回顾性分析2010年1月-2016年12月经中国人民解放军总医院治疗的143例晚期喉癌患者的临床资料。其中,男135例(94.4%),女8例(5.6%);年龄35~79岁,中位年龄58岁。依据患者治疗方案不同分为2组:手术联合术后放化疗组106例和非手术综合治疗组37例。收集患者基本临床情况、治疗、随访及生存情况;生存率及单因素生存分析采用Kaplan-Meier法和log-rank检验,多因素生存分析采用Cox比例风险回归模型。结果 143例晚期喉癌患者的5年总体生存率为67.9%。单因素分析显示,影响晚期喉癌患者预后的临床因素有年龄、临床分期、T分期及肿瘤分化程度等(P值均<0.05);Cox模型多因素分析显示,患者年龄、临床分期、肿瘤分化程度及治疗方式是影响预后的独立危险因素(P值均<0.05)。T₄期、临床Ⅳ期患者采用手术联合术后放化疗5年生存率分别为62.2%和59.5%,明显好于非手术综合治疗的18.2%和41.4%,差异均有统计学意义(P值均<0.05)。结论 晚期喉癌患者预后相对较差,影响患者预后的因素包括患者年龄、临床分期、肿瘤分化程度及治疗方式等。对于临床Ⅳ期、尤其是T₄期患者,采取手术联合术后放化疗可以获得相对较好的预后。     

The effect of automated landmark identification on morphometric analyses

Morphometric analysis of anatomical landmarks allows researchers to identify specific morphological differences between natural populations or experimental groups, but manually identifying landmarks is time‐consuming. We compare manually and automatically generated adult mouse skull landmarks and subsequent morphometric analyses to elucidate how switching from manual to automated landmarking will impact morphometric analysis results for large mouse (Mus musculus) samples (n = 1205) that represent a wide range of ‘normal’ phenotypic variation (62 genotypes). Other studies have suggested that the use of automated landmarking methods is feasible, but this study is the first to compare the utility of current automated approaches to manual landmarking for a large dataset that allows the quantification of intra‐ and inter‐strain variation. With this unique sample, we investigated how switching to a non‐linear image registration‐based automated landmarking method impacts estimated differences in genotype mean shape and shape variance‐covariance structure. In addition, we tested whether an initial registration of specimen images to genotype‐specific averages improves automatic landmark identification accuracy. Our results indicated that automated landmark placement was significantly different than manual landmark placement but that estimated skull shape covariation was correlated across methods. The addition of a preliminary genotype‐specific registration step as part of a two‐level procedure did not substantially improve on the accuracy of one‐level automatic landmark placement. The landmarks with the lowest automatic landmark accuracy are found in locations with poor image registration alignment. The most serious outliers within morphometric analysis of automated landmarks displayed instances of stochastic image registration error that are likely representative of errors common when applying image registration methods to micro‐computed tomography datasets that were initially collected with manual landmarking in mind. Additional efforts during specimen preparation and image acquisition can help reduce the number of registration errors and improve registration results. A reduction in skull shape variance estimates were noted for automated landmarking methods compared with manual landmarking. This partially reflects an underestimation of more extreme genotype shapes and loss of biological signal, but largely represents the fact that automated methods do not suffer from intra‐observer landmarking error. For appropriate samples and research questions, our image registration‐based automated landmarking method can eliminate the time required for manual landmarking and have a similar power to identify shape differences between inbred mouse genotypes.     

Atypical squamous epithelium in cytologic specimens from the pancreas: cytological differential diagnosis and clinical implications

Atypical squamous epithelium is an uncommon finding in cytologic specimens obtained from pancreatic lesions. A variety of pathologic conditions can result in the presence of these cells, including primary or metastatic carcinomas, chronic pancreatitis, and squamous metaplasia related to pancreatic or biliary duct stent placement. Primary adenosquamous and squamous-cell carcinomas of the pancreas are rare, representing 3.4% and 1.4 % of pancreatic carcinomas, respectively. Cytologic separation of these malignancies from less ominous metaplasias has immense clinical importance. We reviewed Indiana University Hospital's and Duke University's experiences with atypical squamous epithelium occurring within pancreatic aspirates. Study cases were identified using a computer to search the cytology records of these two institutions. Nine cases with a diagnosis of squamous-cell carcinoma, adenosquamous carcinoma, or atypical squamous epithelium were retrieved from the two institutions' Department of Pathology files. One case of pure squamous-cell carcinoma occurred in a patient with a known pulmonary primary; a single case of adenosquamous carcinoma was diagnosed in a patient with a coexistent endometrial primary; a single sample of adenocarcinoma with squamous differentiation was diagnosed in a patient without other known disease; and four primary squamous-cell carcinomas of the pancreas were detected. In addition, a single case of atypical squamous metaplasia associated with a stent was identified, and one case of atypical squamous epithelium associated with chronic pancreatitis was diagnosed. Despite the reactive atypia present in the examples of metaplastic squamous epithelium, separation of these cases from true squamous-cell carcinoma and adenosquamous carcinoma was achievable by cytologic evaluation. No cytologic criteria aided in separating primary pancreatic carcinomas with squamous differentiation from metastatic lesions. In this study, we report our findings in a series of nine cases where cytology disclosed atypical squamous epithelium in the aspirates derived from pancreatic lesions.     

Development and validation of a gamma interferon ELISPOT assay for quantitation of cellular immune responses to varicella-zoster virus

Cell-mediated immunity appears to be critical for the prevention and control of varicella-zoster virus (VZV) infection and complications arising from zoster. Current assays of VZV-specific cell-mediated immunity are cumbersome or lack sensitivity. We have developed a gamma interferon ELISPOT assay that provides a direct measure of the number of T cells secreting a cytokine following stimulation with antigen. This assay is extremely sensitive and specific, with the ability to detect gamma interferon spot-forming cells (SFC) in the range of 10 to 1,000 SFC per million peripheral blood mononuclear cells (PBMCs). This assay has been validated by demonstrating the following: (i) the response detected is mediated almost entirely by CD4+ T cells, (ii) ELISPOT responses from fresh-frozen PBMCs are equivalent to those from freshly isolated cells, (iii) frozen PBMCs can be shipped on dry ice for up to 48 h without loss of activity, (iv) frozen PBMC samples can be stored in liquid nitrogen over long periods (>22 months) without any significant change in response, and (v) the numbers of ELISPOTs counted using a computer-based imaging system are equivalent to those counted by humans but have lower variability. The ability to use frozen cells is facilitated by the use of a recombinant nuclease (Benzonase) that can prevent cell clumping when samples are thawed. Frozen PBMC samples can be cycled through multiple changes in storage between liquid nitrogen and dry ice without any change in response being detected. This facilitates collection of samples at one site and testing performed at a remote location. This VZV ELISPOT assay provides a new versatile tool for monitoring cellular immune responses either during a herpes zoster disease outbreak or following vaccination.     

Bilateral diffuse nephroblastomatosis, pancortical type. A case report with immunohistochemical investigations

A variation of Perlman's syndrome of the pancortical type is reported in a male neonate whose parents were cousins. The patient was the product of a 35-week pregnancy, the Apgar score was 3, and the patient died of respiratory failure one hour and 12 minutes after delivery. Autopsy revealed bilateral diffuse nephroblastomatosis, pancortical type, associated with malformations (usually facial), congenital anomalies of the heart, hepatosplenomegaly, pancreatic islet cell hyperplasia, bilateral cryptorchidism, and hyperflexibility of the left knee joint. Renal immunohistochemical investigations revealed positive bindings with peanut and soybean agglutinins and epithelial membrane antigen along the luminal surface of the epithelium in the moderately differentiated tubules, but not in blastoma or primitive epithelium.