尿脱落细胞吖啶橙染色检查在膀胱癌诊断中的应用价值

目的 探讨尿脱落细胞吖啶橙荧光染色(AO-F)检查在膀胱癌诊断中的应用价值.方法 回顾性分析1016例膀胱癌患者资料,按临床分期、病理分级、肿瘤大小、数目、部位,手术治疗方式及有无血尿症状,分别计算AO-F阳性率,并进行统计学分析.结果 1016例患者尿样AO-F阳性率78.05%(793/1016),表浅癌和浸润癌患者阳性率分别为74.69%(611/818)和91.92%(182/198);病理分级≤Ⅱ级和Ⅲ级患者阳性率分别为67.24%(351/522)和90.37%(413/457);有无血尿症状患者阳性率分别为80.30%(750/934)和52.44%(43/82);肿瘤直径≥2 cm和<2 cm患者阳性率分别为79.87%(710/889)和65.35%(83/127);多发和单发肿瘤患者阳性率分别为83.07%(363/437)和74.27%(430/579);肿瘤累及膀胱三角区或膀胱颈部者阳性率为77.21%(105/136),累及其他部位者为78.07%(687/880);治疗方法TURBt、膀胱部分切除和膀胱全切除患者阳性率分别为69.68%(393/564),87.87%(268/305)和91.74%(100/109).AO-F阳性率与膀胱癌临床分期、病理分级、手术治疗方式、肿瘤大小、数目及有无血尿症状等因素有明显相关性,且与其临床分期、病理分级间存在正相关(r值分别为0.99和0.97);患者性别及肿瘤发生部位等因素与AO-F阳性率之间无相关性.结论 尿脱落细胞AO-F榆查诊断膀胱癌阳性率高,且简便、无创、经济、准确性高,可反复进行,可提高膀胱癌患者的早期诊断率,值得临床推广应用.     

Distress and affective dysregulation in patients with borderline personality disorder: a psychophysiological ambulatory monitoring study

Borderline personality disorder (BPD) is characterized by enduring psychological distress and affective dysregulation. Several models have linked both phenomena, but are lacking empirical support. To investigate the relation between psychological distress and components of affective dysregulation (especially inability to label emotions, conflictive emotions, and physiological hyperarousal), we repeatedly assessed these components using a 24-hour ambulatory monitoring approach in a group of 50 BPD patients and 50 healthy controls. Hierarchical linear model analyses identified a clear relation between inability to label emotions and distress in the BPD group (p = 0.0009) but not across all subjects (p = 0.6492). Conflictive emotions were related to psychological distress in both groups (p < 0.0001). This relation is, however, most pertinent to the BPD group who experienced conflicting emotions more frequently. Physiological arousal (heart rate) was related to distress in both groups. Our empirical findings emphasize training in labeling emotions and distress tolerance interventions in treatment for BPD.     

The CyberKnife stereotactic radiosurgery system: description, installation, and an initial evaluation of use and functionality

The CyberKnife Stereotactic Radiosurgery System is manufactured by Accuray, Inc. (570 Del Rey Avenue, Sunnyvale, CA 94085; telephone 1-888/522-3740 or 1-408/522-3740; http://www.accuray.com). It is currently available for purchase (capital cost of US $3.2 million plus US $0.5 to 0.75 million for site setup), or in a revenue-sharing plan (US $0.5 to 0.75 million setup cost). [Figure: see text].     

Exendin-4 treatment expands graft beta-cell mass in diabetic mice transplanted with a marginal number of fresh islets

Exendin-4 stimulates insulin secretion, suppresses glucagons secretion, increases beta-cell replication and neogenesis, and reduces beta-cell apoptosis. However, it has been shown that posttransplant exendin-4 treatment did not improve glucose homeostasis in diabetic mice transplanted with a large number of freshly isolated islets. The aim of this study was to test if exendin-4 is beneficial for hyperglycemic recipients with a marginal number of fresh islets. We transplanted 150 C57BL/6 mouse islets under the kidney capsule of inbred streptozotocin-diabetic mice, and then treated the recipients with and without exendin-4 for 6 weeks. Before and after transplantation, recipients' blood glucose, body weight, and intraperitoneal glucose tolerance test were measured. At 6 weeks, the grafts were removed to determine beta-cell mass. Blood glucose levels in both groups decreased progressively after transplantation, and the exendin-4-treated group had had lower blood glucose than controls since day 3. By 6 weeks, euglycemia was achieved more in mice treated with exendin-4 than in controls (100% vs. 62.5%, p = 0.018). The time to obtain normoglycemia was shorter in the exendin-4-treated group than in controls (12 +/- 8 vs. 29 +/- 13 days, p < 0.001). Blood glucose at 6 weeks was 123 +/- 18 and 170 +/- 62 mg/dl in the exendin-4-treated group and controls, respectively (p = 0.008). Additionally, the exendin-4-treated group had better glucose tolerance than controls at 2 and 4 weeks (p <0.02). However, both groups exhibited increased body weight over time, and weight changes did not significantly differ between the two groups throughout the study period. At 6 weeks after transplantation, grafts in the exendin-4-treated group were more prominent and contained more insulin-stained cells than those of controls. They had 2.3-fold beta-cell mass of the graft compared with controls (0.30 +/- 0.11 vs. 0.13 +/- 0.03 mg, p = 0.012). These results indicate posttransplant exendin-4 treatment in the diabetic recipient with a marginal number of fresh islets expands graft beta-cell mass and improves transplantation outcome.     

Intravenous iron exacerbates oxidative DNA damage in peripheral blood lymphocytes in chronic hemodialysis patients

Patients undergoing maintenance hemodialysis have elevated markers of oxidative stress, but the reasons for this are not fully understood. Intravenous administration of iron, which many of these patients receive, may provoke the generation of bioactive iron, which enhances oxidative stress and lipid peroxidation. In this study, 110 hemodialysis patients were randomly assigned to five groups that were administered single intravenous doses of iron sucrose, ranging from 20 to 500 mg. A time- and dosage-dependent rise in lymphocyte 8-hydroxy-2'-deoxyguanosine (8-OHdG) levels in lymphocyte DNA, a marker of oxidative DNA damage, with a significant increase at 2 h after intravenous iron of > or = 200 mg (P < 0.05). Four weeks later, patients were randomly assigned to weekly iron sucrose (100 mg of elemental iron) or saline for 12 wk, and 89 patients completed the study. Mean lymphocyte 8-OHdG content was significantly higher in patients receiving intravenous iron compared with control subjects (P < 0.05), especially in those with ferritin levels > 500 microg/L. In addition, flow cytometric techniques revealed increased production of reactive oxygen species in lymphocytes among those treated with intravenous iron. Treatment with intravenous iron but not saline was also associated with decreased plasma ascorbate and alpha-tocopherol levels and increased oxidized glutathione/reduced glutathione ratio (P < 0.05). In summary, intravenous iron sucrose provokes oxidative damage to peripheral blood lymphocyte DNA in hemodialysis patients, especially among those with high levels of ferritin.     

Stress Fracture of the Ulna in a Break-Dancer

Break dancing is a popular activity in teenagers and is associated with severe trauma to bones and tissues. We report the first known case of a break dancer with an ulnar stress fracture. Such injuries occur in a variety of sports due to substantial stress on the ulna and repetitive excessive rotation of the forearm. In this study we describe a patient who experienced an ulnar stress fracture during break dancing training. The diagnosis was established by history and physical examination. Initial radiographic findings were negative. However, radiographs taken 3 months after initial presented revealed callus formation over the ulnar shaft. This suggested that readjustment is required in break dancing training protocols. It is important to increase awareness of this injury among physicians to expedite the diagnosis and to prevent the possibility of conversion to an overt fracture in the future.

Key points

• Stress fractures should not be ignored when the patient changes exercise loading.
• A thoroughly detailed clinical history, physical examination, and plain radiographs were used diagnostically in this clinical case.
• The best methods for the treatment of stress fractures include readjustment training protocols to prevent conversion to overt fractures.

Key words: Sports injuries, ulna fractures, stress fractures, magnetic resonance imaging     

A nanoemulsion of an anti-oxidant synergy formulation reduces tumor growth rate in neuroblastoma-bearing nude mice

Neuroblastoma, the most common form of childhood cancer, may arise from a biochemical block of cellular differentiation and a resultant continuation of a proliferative state. Neuroblastoma often spontaneously reverts by undergoing partial differentiation and ultimate degeneration and may be associated with the generation of reactive oxygen species (ROS). We have recently reported in neuroblastoma cell culture studies that an anti-oxidant synergy formulation (ASF) can induce differentiation and buffer neuronal degeneration and oxidative stress in cultured cortical neurons and in central nervous system tissue of apolipoprotein E-deficient mice. The objective of the present study was to investigate whether a subcutaneous injection and/or transdermal application of a nanoemulsion preparation of ASF would reduce tumor growth rate in a neuroblastoma xenograph mouse model. The results indicate that whereas suspensions of ASF were ineffective in decreasing tumor growth rate in the neuroblastoma mouse model, tumor growth rate was similarly reduced an average 65% by either subcutaneous injection or transdermal application of an ASF nanoemulsion preparation to the tumor. In conclusion, the data suggest that subcutaneous and/or transdermal application of an ASF nanoemulsion preparation is effective in reducing tumor growth rate in this neuroblastoma mouse model.