Overexpression of p53 in hepatocellular carcinomas: A clinicopathological and prognostic correlation

Abstract Overexpression of the p53 tumour suppressor gene is one of the most common abnormalities in primary human cancers and appears to be a result of point mutation within a highly conserved region of the gene with subsequent encoding for a mutant, more stable protein. In this study, 71 surgically resected hepatocellular carcinomas (HCC) were examined to study the expression of the p53 gene, its relation with clinicopathological parameters and its prognostic significance. Using immunohistochemical detection for mutant p53 protein with monoclonal antibody PAb1801, p53 overexpression was found in 22 tumours (31%) but in none of the non-tumorous liver specimens. Overexpression of p53 was more frequent in tumours with poor cellular differentiation ( P = 0.01), in tumours > 5 cm in diameter ( P = 0.05), and in those with giant cells present ( P = 0.03) and, less significantly, of massive type of Eggel's classification ( P = 0.06). It did not have any significant correlation with hepatitis B or C status, background liver disease or serum α-fetoprotein levels, nor was it related to tumour invasiveness (venous permeation, direct liver invasion and tumour microsatellite formation). In addition, the presence of p53 mutant protein did not influence tumour recurrence or patients' survival rates. The data suggested that p53 mutation in HCC was associated with a later stage of oncogenesis. However, it was not apparently related to tumour invasiveness/aggressiveness and prognosis.     

Anticonvulsant Activity of Extracts of Diospyros Fischeri Stem Bark

Evaluation of extracts of Diospyros fischeri Gurke (Ebenaceae), which is used traditionally for the treatment of epilepsy shows that the aqueous extract of the tem bark has no effect againstpicrotoxin induced convulsions in mice. However, an 80% ethanol extract of the bark caused dose-dependent suppression of convulsions induced by 10 mg/kg body wt picrotoxin, at doses between 100–3200 mg/kg body wt. Petroleum ether, 1:1 dichloromethane:methanol, and methanol extracts also suppressed picrotoxin-induced convulsions, but had a slightly lower inhibitory effect. The petroleum ether extract was the most active, but all were less active than the ethanol extract. Unlike phenobarbitone, which at 50 mg/kg body wt completely suppressed convulsions induced by 10 mg/kg body wt picrotoxin, none of the plant extracts completely suppressed convulsions in the mice. These results support the traditional uses of D.fischeri for the treatment of epilepsy. Given the seemingly innocuous nature of the extracts more work is suggested to ascertain their clinical application.     

胰胆管十二指肠乳头X线解剖与胆囊切除后胆源性腹痛

为研究胆管十二指肠乳头部的Ｘ线解剖与胆囊切除后胆源性腹痛发生间的关系，回顾性研究胆囊切除后胆源性腹痛连续ＥＲＣＲ检查７６例，术前病变为胆囊结石，慢性胆囊炎，胆管胰腺未发现病变。     

综合重症监护病房院内感染因素分析

收集综合重症监护病房（综合ＩＣＵ）１８１例患者的临床资料，分析综合ＩＣＵ院内感染的发生率及影响因素，并探讨预防综合ＩＣＵ院内感染的有效措施。患者均为入院（科）前或入院（科）４８ｈ内无感染病例，院内感染率为１５．５％（２８例），其中胸、腹部外伤及手术后发生率高（分别占各自的５３．８％和４５．５％），其次为多发伤（２６．１％）、脑部病变、外伤、手术后（１７．９％）及心肺复苏后（１４．３％），心脏手术后最少（２．５％）。病原菌以Ｇ￣－杆菌为主，绿脓杆茵最多。综合分析多种因素，作者认为：综合ＩＣＵ院内感染的主要因素是患者年龄、病情严重程度及住院和应用机械通气、留置导尿的时间，而患者本身的咳嗽和排痰能力亦不容忽视。鉴于综合ＩＣＵ病种杂，作者认为更应重视室内空气、仪器设备的消毒，有感染的患者的隔离及医务人员积极采取消毒隔离措施，以防交叉感染。     

Ranitidine 300 mg twice daily and 150 mg four-times daily are effective in healing erosive oesophagitis.

BACKGROUND: Ranitidine 150 mg q.d.s. is the currently recommended dosage in the United States for the treatment of erosive oesophagitis. To determine whether a higher dose of ranitidine administered less frequently would also be effective in healing erosive oesophagitis, we compared ranitidine 300 mg b.d. with ranitidine 150 mg q.d.s. in the treatment of erosive oesophagitis. METHODS: This multicentre, double- blind, randomized, placebo-controlled study conducted in the United States compared two dosages of ranitidine in 772 patients with endoscopically diagnosed erosive oesophagitis. Patients were treated with ranitidine 300 mg b.d., ranitidine 150 mg q.d.s. or placebo for up to 12 weeks. Endoscopies were repeated after 4, 8 and 12 weeks of treatment. RESULTS: Ranitidine 300 mg b.d. was significantly more effective than placebo in healing erosive oesophagitis at weeks 8 and 12 (51 vs. 36% and 66 vs. 52%, respectively; P < or = 0.004). Significantly higher healing rates were also achieved with ranitidine 150 mg q.d.s. compared with placebo at 4, 8 and 12 weeks (37 vs. 21%, 62 vs. 36% and 77 vs. 52%, respectively; P < 0.001). Healing rates were significantly higher with ranitidine 150 mg q.d.s. than with ranitidine 300 mg b.d. at all scheduled endoscopies (P < or = 0.041). CONCLUSIONS: Ranitidine 300 mg b.d. is effective in healing erosive oesophagitis and may be appropriate as an alternative dosage regimen to ranitidine 150 mg q.d.s. in some patients with erosive oesophagitis.