Experimental reconstruction of dog's esophagus with biotype artificial esophagus

OBJECTIVE: At present, there are few materials available for esophagus reconstruction anywhere in the world. The reported survival rate in animals during the perioperative period is comparatively low. The present study assessed the feasibility of using a biotype artificial esophagus in the reconstruction of a dog's esophagus. METHODS: In 30 mongrel dogs, a portion of the thoracic esophagus was resected and an 8 cm section of artificial esophagus was transplanted to reconstruct the organ. The survival rate, food intake and process of healing were observed. RESULTS: Of the 30 dogs, 28 survived the peri­operative period (93.3% survival). Two dogs (6.7%) developed an anastomotic fistula; 19 dogs survived for 1 year, a survival rate of 79.2% (19/24) with the remaining six dogs were killed according to the experimental protocol. Detachment of the artificial esophagus occurred on average 28.8 days after operation and the dogs suffered from varying degrees of dysphagia 23?45 days after operation. Gradual remission occurred after 4 months. The histological study revealed that the regenerated esophagus was composed of fibrous and connective tissues and the luminal surface was covered with squamous epithelium in 3?6 months. CONCLUSION: The transplanted artificial esophagus detached after the surrounding ‘regenerated esophagus’ had formed, and the squamous epithelium gradually covered the luminal surface. Continuous remodeling of the ‘regenerated esophagus’ gradually relieved the stenosis. Whether detachment of the implant and the postoperative stenosis can be solved is the key problem restricting the use of the biotype artificial esophagus in clinical practice.     

结核分枝杆菌分泌蛋白Ag85B-ESAT6的融合表达及纯化

目的　融合表达结核分枝杆菌分泌蛋白Ag85B ESAT6 ,为结核病的预防提供有效亚单位疫苗。方法　设计含不同酶切位点的Ag85B和ESAT6引物 ,采用聚合酶链反应 (polymerasechainreaction ,PCR)的方法从结核分枝杆菌毒株H3 7Rv DNA中分别扩增出相应大小的DNA片段 ,将片段分别与PGEM T easy载体连接测序。将测序正确的Ag85B和ESAT6按照不同的酶切位点克隆入PPROEXHT表达载体 ,挑选出阳性克隆 ,将诱导的表达产物进行聚丙烯酰胺凝胶电泳 (SDS PAGE)分析 ,同时与含6个组氨酸 (histidine 6×his)的单克隆抗体 (monoclonalantibody ,mAb)进行固定化蛋白质免疫学测定(Western blot) ,将用含Ni 鳌合剂的Ni NTA亲合柱纯化的表达产物免疫小鼠 ,用结核分枝杆菌培养上清滤液蛋白 (culturefiltrateproteins ,CFP)作为抗原 ,酶联免疫吸附试验 (enzyme linkedimmunosorbentassay ,ELISA)测定免疫小鼠血清特异性抗体的滴度。结果　PCR获得的Ag85B和ESAT6序列与基因文库 (GenBank)报道的完全一致。两者在大肠杆菌DH5α株中融合表达的产物约为 370 0 0 ,与预计大小相吻合。Western blot结果显示 ,在相对分子量约 370 0 0处有表达产物与 6×hismAb特异性结合带。表达产物为包涵体 ,通过Ni NTA纯化系统 ,可得到纯化的目的蛋白。Ag8     

Genes in one megabase of the HLA class I region.

To define the gene content of the HLA class I region, cDNA selection was applied to three overlapping yeast artificial chromosomes (YACs) that spanned 1 megabase (Mb) of this region of the human major histocompatibility complex. These YACs extended from the region centromeric to HLA-E to the region telomeric to HLA-F. In addition to the recognized class I genes and pseudogenes and the anonymous non-class-I genes described recently by us and others, 20 additional anonymous cDNA clones were identified from this 1-Mb region. We also identified a long repetitive DNA element in the region between HLA-B and HLA-E. Homologues of this element were located at several sites in the human genome outside of the HLA complex. The portion of the HLA class I region represented by these YACs shows an average gene density as high as the class II and class III regions. Thus, the high gene density portion of the HLA complex is extended to more than 3 Mb.     

未接受抗病毒治疗的慢性乙型肝炎患者多聚酶P基因YMDD变异检测

目的 了解未经拉米夫定及干扰素抗病毒治疗的慢性乙型肝炎患者中HBV多聚酶YMDD变异情况。方法 应用错配PCR扩增方法检测病人血清HBV的YMDD位点，选择65例病史超过半年以上、肝功能异常、HBV DNA阳性的慢性乙型肝炎患者。结果 在65例患者中，YMDD变异阳性6例(9．07％)，阴性59例，6例变异中2例为YIDD阳性，其中1例为YMDD野毒株和变异株混合存在，4例为YYDD阳性，其中1例为YMDD野毒株和变异株混合存在。结论 本检测方法简便、实用，在未经抗病毒治疗的慢性乙型肝炎患者中可存在YMDD变异株，其与野生株一样是自然存在的。     

肾上腺素能β2受体基因多态性与慢性心力衰竭关系的研究

目的:在上海地区汉族人群中研究肾上腺素能β2受体(β2受体)基因多态性与慢性心力衰竭(心衰)的关系.方法:选取92例慢性心衰患者(心衰组)和80例健康人(正常对照组),进行外周静脉血的脱氧核糖核酸(DNA)抽提,通过多聚酶链式反应扩增后,进行β2受体基因的测序.结果:发现β2受体基因有4个多态性位点,分别为:16 Arg/Gly、27 Gln/Glu、87 Leu A/G、178 ArgA/C.其中27Gln/Glu位点在正常对照组中全部表现为C/C基因型,而在心衰组中有7例表现为G/C基因型,没有发现G/G基因型,两组间基因型和等位基因型的差异均有极显著的统计学意义(P＜0.01),而其它多态性位点两组间比较差异均无统计学意义(P＞0.05).结论:在上海地区汉族人群中β2受体基因多态性与心衰密切相关,其中27 Gln/Glu杂合子可能为心衰的易感基因,并且与心衰的严重程度、左心室收缩功能密切相关.     

CA19-9 as the most significant prognostic indicator of metastatic colorectal cancer

BACKGROUND/AIMS: Colorectal cancer is the third leading cause of cancer-related mortality in Taiwan. We became interested in searching for the factors predictive of survival. Serum CA19-9 (carbohydrate antigen 19-9) level has been reported as a factor predictive of survival in patients with colorectal cancer. A few articles have reported that patients with metastatic colorectal cancer who have normal (< or = 37 U/mL) serum CA19-9 levels survived significantly longer than those with higher serum CA19-9 levels. However, these reports are contradictory and lack definite conclusions. This study was carried out in an effort to evaluate the prognostic significance of serum CA19-9 levels in patients with metastatic colorectal cancer in Taiwan. METHODOLOGY: Between 1991 and 1994, a total of 128 patients with histologically confirmed metastatic colorectal cancers were evaluated retrospectively at Veterans General Hospital-Taipei. All patients had measurable metastatic lesions and life expectancies of more than 3 months. 5-Fluorouracil-based chemotherapy, either in a weekly bolus regimen or a monthly 5-day bolus schedule, were administered to all of them. Data on age, sex, performance status, location of primary tumor, extent of metastases, site of metastases, histological differentiation, serum CEA (carcinoembryonic antigen) and CA19-9 levels were analyzed before chemotherapy to determine their association with survival. Blood samples for CEA and CA19-9 measurement were analyzed using the radioimmunoassay method. Multivariate analysis by the Cox's proportional hazards regression model was performed to determine independent prognostic factors among all of the possible variables. RESULTS: By univariate analysis, serum CA19-9 levels (P < 0.001) and performance status of the patients (P = 0.022) were identified as prognostic factors, while age, sex, location of primary tumor, site of metastasis, histological differentiation, and pre-treatment serum CEA levels were not considered significant. By multivariate analysis, serum CA19-9 levels (P < 0.001) and performance status of the patients (P = 0.014) were still found as independent prognostic factors of these patients. CONCLUSIONS: The data from our study indicate that serum CA19-9 level is the most significant prognostic indicator of patients with metastatic colorectal cancer. It is recommended that stratification for further clinical trials for patients with metastatic colorectal cancer should be carried out according to serum CA19-9 levels.     

Heterogeneity in the response of vascular smooth muscle to heparin: altered signaling in heparin-resistant cells

OBJECTIVE: Vascular smooth muscle cells show phenotypic heterogeneity in vivo that affects the extent to which they respond to the antimitogenic effects of heparin. In vitro, heparin-resistant cells are readily selected. This study was undertaken to determine whether differences in the antiproliferative response to heparin involve differences in activity of heparin-sensitive signal transduction pathways. METHODS: Rat thoracic aorta smooth muscle cells (ASMC) at early passage together with two established vascular smooth muscle lines, PAC-1 and A10, were examined before and after selection for growth in the presence of heparin (10 micrograms/ml). Cells were rendered quiescent and then stimulated with serum. RESULTS: The three cell types showed different sensitivities to the antimitogenic effects of heparin. With respect to [3H]thymidine incorporation, A10 cells were insensitive to 1 microgram/ml heparin whereas PAC-1 cells responded down to 0.05 microgram/ml and ASMC were of intermediate sensitivity. ASMC and PAC-1 cells but not A10 showed a decrease in c-fos mRNA in response to 1 microgram/ml heparin, and a decrease in the c-Fos content of AP-1 DNA binding activity. None of the cells had decreased c-jun mRNA in the presence of heparin. Although induction of c-fos by serum is thought to signal through the Erk mitogen activated protein kinase family, Erk activity was decreased more by 1 microgram/ml heparin in A10 cells than in PAC-1 or ASMC. When cells were selected by growth in the presence of 10 micrograms/ml heparin, A10 cells were unaffected but PAC-1 and ASMC showed a blunted effect of heparin on serum stimulation. In contrast to A10 and their controls not exposed to continuous heparin, heparin-selected PAC-1 and ASMC showed a diminished ability to induce c-fos in response to serum. CONCLUSIONS: Smooth muscle cell lines show different responses to the antimitogenic effects of heparin that correlate with the heparin sensitivity of c-Fos/c-Jun expression. Although Erk is implicated in c-fos induction, cells comparatively resistant to heparin still show heparin-dependent inhibition of Erk activation, suggesting that other pathways may be more important for heparin resistance. Furthermore, cells selected for heparin resistance may develop c-fos-independent pathways for proliferation.     

Familial breast cancer in southern Taiwan

The purpose of this study is to evaluate whether there are pathobiologic differences and differences in overall rates survival between familial and non-familial breast cancer patients in Taiwan. A retrospective study was performed evaluating 76 familial breast cancer patients in 69 families, which included two BRCA1 related cases and six BRCA2 related cases. Patients were compared with 425 non-familial sporadic cases. Familial breast cancer patients had similar ages and stages as non-familial patients (mean, 46.6 years vs 48.9 years, p = 0.306). However, the familial breast cancer patients with BRCA1 and BRCA2 related cases presented at lower stages (p = 0.034) and younger ages than non-familial patients (mean, 45.1 years vs 48.9 years P = 0.042). The occurrence of infiltrating ductal carcinoma and lobular carcinoma in situ was not significantly different in the two groups. Mucinous carcinoma was represented with 6.7% (4/76) and 1.3% (1/76) medullary carcinoma. The overall grade of familial breast cancer, including BRCA1 and BRCA2 related cases in 8 infiltrating ductal carcinoma, was significantly higher than that of controls. The mean follow up was 4.5 years for familial breast cancers. Five- and 10-year overall survival rates were 69% and 61% for those with a family history, compared with 86% and 64% for those in the control group (p = 0.644). There were no statistically significant differences in disease-free survival rates between the two groups at 5 or 10 years (69% vs 78% in 5 years; 48% vs 58% in 10 years) (p = 0.862). Despite the younger ages and earlier stages at presentation in familial breast cancer patients with BRCA1 and BRCA2 related cases, the familial breast cancer patients had higher grade patholobiologic characteristics, but similar prognoses when compared with sporadic breast cancer patients. Owing to the limited number of familial cases in this study, more cases and longer follow up are needed.