连环蛋白P120在肝细胞癌中的表达及其意义

目的检测肝细胞性肝癌(hepatocellular carcinoma,HCC)中连环蛋白P120(P120catenin,P120ctn)的表达,分析其与临床病理特点之间的关系。方法用免疫组化技术检测58例HCC、17例癌旁肝硬化及8例正常肝组织中P120ctn的表达。结果58例HCC组织中有34例P120ctn(58.6%)膜表达弱阳性或缺失,30例(51.7%)胞质表达,异常表达总比例为65.5%(38/58);17例癌旁肝硬化组织中有6例(35.3%)膜表达弱阳性,8例(47.1%)胞质表达,异常表达总比例为47.1%(8/17);8例正常肝组织全部表现为胞膜正常表达,无胞质表达。P120ctn的异常表达与HCC的包膜形成、淋巴浸润、有无卫星灶、肿瘤分化等相关(P<0.05),而与性别、年龄、瘤体积大小、分期等无关(P>0.05)。结论HCC中存在较高比例的P120ctn异常表达,主要表现为胞膜表达缺失伴胞质异常染色,P120ctn可以作为预测HCC转移潜能和预后状况的有价值的指标。     

膀胱炎性肌纤维母细胞瘤2例报告并文献复习

目的：探讨膀胱炎性肌纤维母细胞瘤的临床、病理、组织生化特性和诊治方法及预后。方法：报告2例肉眼血尿伴重度贫血的膀胱炎性肌纤维母细胞瘤患者的诊治资料,并结合文献进行探讨。结果：膀胱炎性肌纤维母细胞瘤以肉眼血尿和尿痛为最常见症状,肿瘤好发于膀胱底部、顶壁、侧壁;组织学由具有平滑肌细胞和纤维母细胞特征的梭形细胞、大量慢性炎性细胞及血管样黏液构成。1例随访3年,1例随访6个月,均无瘤存活。结论：膀胱炎性肌纤维母细胞瘤为低度恶性肿瘤,罕见。确诊依据病理学检查,应与平滑肌肉瘤、横纹肌肉瘤、梭形细胞癌等鉴别;治疗原则以切除肿瘤、保留膀胱功能为主,TUPKBT、TURBT或膀胱部分切除术,术后辅以化疗药物膀胱灌注,效果佳。     

复方苦参洗剂外用对皮肤毒性的实验研究

为观察复方苦参洗剂对家兔及豚鼠皮肤的毒性作用,本研究用家兔进行皮肤急性毒性实验和皮肤刺激性实验,用豚鼠进行皮肤过敏性实验。结果显示,用复方苦参洗剂外涂于家兔完整皮肤和破损皮肤均未发生急性毒性反应和刺激反应。豚鼠皮肤也未发生过敏性反应。结果表明,复方苦参洗剂是安全的外用制剂,可在临床上推广应用。     

改良DCF 方案一线治疗晚期胃癌患者的临床观察

目的：观察改良DCF方案（多西紫杉醇+顺铂+5-氟尿嘧啶）一线治疗晚期胃癌的疗效及不良反应。 方法：对2008年6月—2011年6月收治的48例初治晚期胃癌患者,采用改良DCF方案化疗,即多西紫杉醇75 mg/m2静脉滴注（第1天）,顺铂20 mg/m2静脉滴注（第1~3天）,5-氟尿嘧啶750 mg/m2持续静脉滴注24 h（第1~5天）。21 d为1周期,至少2周期后进行疗效评价。 结果：随访日期截止2013年2月,无失访病例。全组患者总有效率（ORR）为29.2%（14/48）,疾病控制率（DCR）为87.5%（42/48）,其中完全缓解（CR）1例（2.1%）,部分缓解（PR）13例（27.1%）,病情稳定（SD）28例（58.3%）,病情进展（PD）6例（12.5%）;中位疾病进展时间（TTP）为6.9个月,中位总生存期（OS）为12.5个月;不良反应为主要为骨髓抑制、消化道反应和脱发,粒细胞减低发生率为66.7%（32/48）,其中III~IV度占21.8%（7/32）,血小板减低发生率为20.8%（10/48）,无III~IV度发生者;无严重感染、出血等治疗相关死亡。化疗后KPS评分是独立的预后影响指标。 结论：改良DCF方案一线治疗晚期胃癌疗效确切,耐受性好。     

Leucine‐rich glioma inactivated 3 promotes HaCaT keratinocyte migration

Our finding that human skin expresses leucine‐rich glioma inactivated 3 (LGI3) raises the question of the function of this cytokine in keratinocytes. We have shown that LGI3 stimulates human HaCaT keratinocyte migration without affecting viability or proliferation. Western blot analysis showed that LGI3 induced focal adhesion kinase activation, Akt phosphorylation, and glycogen synthase kinase 3β (GSK3β) phosphorylation in these cells. Using the scratch wound assay and a modified Boyden chamber, we found that LY294002, a selective phosphatidylinositol 3‐kinase inhibitor, and LiCl, a selective GSK3β inhibitor, abolished LGI3‐induced cell migration. We tested β‐catenin levels after LGI3 treatment because the Akt‐GSK3β pathway regulates β‐catenin accumulation, and β‐catenin promotes cell migration. LGI3 treatment increased β‐catenin protein and nuclear localization, whereas LY294002 prevented LGI3‐induced focal adhesion kinase and Akt activation as well as β‐catenin accumulation. Overall, these data suggest that LGI3 stimulates HaCaT cell migration following β‐catenin accumulation through the Akt pathway.     

重症急性胰腺炎的治疗与预后临床分析

目的探讨重症急性胰腺炎（severe acute pancreatitis，SAP）的治疗方法与预后的关系。方法回顾性分析收治的164例SAP的临床特征、治疗方法、并发症、病死率等资料。结果非手术治疗54例；手术治疗110例，其中早期手术69例，延期手术41例。早期手术的并发症发生率和病死率分别为81．2％和30．4％，明显高于非手术及延期手术治疗患者。结论SAP治疗方法是影响疗效的重要因素，早期采用非手术为主的综合治疗能有效降低并发症发生率和病死率，但对有早期手术或延期手术指征的患者，应及时手术治疗。     

Limited Wegener＇s granulomatosis of the epididymis and testis

A case is presented of Wegener＇s granulomatosis limited to the testis and epididymis, simultaneously, in a 69-year-old man. Orchiectomy was carried out through an inguinal incision under the presumptive diagnosis of a right testicular tumor. A hard, irregular mass occupied the upper testicle and a portion of the epididymal head was visualized. Histopathologic examination of the specimen showed granulomatous inflammation of the testis and epididymis with prominent angiocentric granulomata in the walls of arteries, veins and foci of fibrinoid necrosis, surrounded by palisading inflammatory cells with a few giant cells. The diagnosis of limited Wegener＇s granulomatosis was considered, although antineutrophil cytoplasmic antibody （c-ANCA） test was negative 2 weeks after orchiectomy. The patient showed an excellent response after local complete excision. He remains free of disease 18 months after orchiectomy.     

Sentinel node biopsy using dye and isotope double tracers in early gastric cancer

Background The results of sentinel node (SN) biopsy have been improved by the use of dye and isotope double tracers in melanoma and breast cancer. However, the usefulness of this double tracer technique has not been determined in gastric cancer. The aim of this study was to investigate the possibility of improving SN biopsy results by using double tracers in gastric cancer.Methods Sixty-four gastric adenocarcinoma patients preoperatively diagnosed as cT1N0, were enrolled in the study. ^99mTc tin colloid was injected by preoperative endoscopy, and lymphoscintigraphy was performed prior to operation. After laparotomy, isosulfan blue was intraoperatively injected using an endoscope. Blue-stained or radioactive nodes were identified and defined as SNs. Gastrectomy with D2 lymphadenectomy was performed in all patients. All dissected lymph nodes were evaluated for metastasis by hematoxylin and eosin staining and immunohistochemistry.Results SN detection rates using dye, isotope, or both tracers were 95.3%, 84.4%, and 96.9%, respectively, and their corresponding sensitivities were 52.9%, 52.9%, and 70.6%. In the pT1 subset, the sensitivity of the double tracer was 87.5%; and in a subset of tumors with diameter <4.5 cm, this was also 87.5%.Conclusions These findings confirm that SN biopsy results are improved by using double tracers in gastric cancer and suggest that SN biopsy is suitable in cases of small-sized early gastric cancer.