Smooth muscle distribution in the extrahepatic bile duct: histologic and immunohistochemical studies of 122 cases

The distribution of smooth muscle fibers in the extrahepatic bile duct (EBD) wall is not well characterized. We analyzed 101 consecutive Whipple's operation specimens and 21 autopsy specimens for the pattern of smooth muscle distribution in EBD using the Masson-trichrome stain and the desmin immunohistochemical stain. The patterns were categorized as continuous, interrupted, scattered, and no muscle layer. EBDs were divided into lower, middle, and upper portions, and the distribution pattern of smooth muscle fibers was analyzed separately in each portion. Because most surgically resected specimens contained the middle and lower EBDs with only a portion of the upper EBD, only the length of the middle and lower EBDs (common bile duct, CBD) was measured. The mean length of CBD in surgically resected specimens was 6.4 +/- 1.4 cm (men, 6.6 +/- 1.3 cm; women, 6.1 +/- 1.5 cm). The mean length of CBD in autopsy specimens was 6.8 +/- 1.0 cm. The predominant patterns of the lower third of the EBD were interrupted (49%) and continuous (43%). The predominant patterns of the middle third of the EBD were scattered (63%) and interrupted (23%). Those of the upper third of the EBD were no muscle fiber (58%) and scattered (39%). In conclusion, different patterns of smooth muscle distribution were observed in different portions of the EBD. Because scattered muscle fibers or no muscle fibers were the main features of the upper third of the EBD, understanding of this pattern may be helpful for assessment of the depth of invasion or staging of carcinoma of the upper third of the EBD.     

Peroxiredoxins in breast carcinoma.

PURPOSE: Peroxiredoxins (Prxs) are a novel group of peroxidases containing high antioxidant efficiency and some of them having also effects on cell differentiation and apoptosis. The mammalian Prx family has six distinct members located in various subcellular locations, including peroxisomes and mitochondria, places where oxidative stress is most evident. EXPERIMENTAL DESIGN: We examined immunohistochemically a large set of samples from patients with breast carcinoma and investigated associations with parameters such as tumor-node-metastasis classification, hormone receptor status, and patient survival. Three biopsies of healthy breast tissue were used as controls. RESULTS: Expression of peroxiredoxins I, III, IV, and V was found in >or=80% of cases, whereas the expression of Prx II and VI was less frequent. Increased expression of Prx III was found to associate with the presence of progesterone (P = 0.02) and estrogen (P = 0.03) receptors, and Prxs IV (P = 0.009) and VI (P = 0.04) were overexpressed in progesterone receptor positive cases. Prx V was the only isoform that associated with items of tumor-node-metastasis classification, it was connected to a larger tumor size (P = 0.05) and positive lymph node status (P = 0.04). Prx V positivity was also connected with shorter survival (P = 0.04), whereas Prxs III (P = 0.002) and IV (P = 0.02) were related to better prognosis, probably resulting from their connection with a positive hormone receptor status. CONCLUSIONS: In conclusion, we found that expression of peroxiredoxins, especially III, IV and V, is increased in breast malignancy, suggesting the induction of Prxs as response to increased production of reactive oxygen species in carcinomatous tissue.     

Phytosphingosine induces apoptotic cell death via caspase 8 activation and Bax translocation in human cancer cells.

PURPOSE: Sphingolipid metabolites, such as sphingosine and ceramide, are highly bioactive compounds and are involved in diverse cell processes, including cell-cell interaction, cell proliferation, differentiation, and apoptosis. However, the physiological roles of phytosphingosine are poorly understood. In this study, we report that phytosphingosine can potently induce apoptotic cell death in human cancer cells via caspase activation and caspase-independent cytochrome c release. EXPERIMENTAL DESIGN: Phytosphingosine-induced apoptosis was determined by Hoechst 33258 staining, flow cytometric analysis, and DNA fragmentation assay. Involvement of caspases was determined by immunoblot analysis and cell death detection assays after treatment with synthetic inhibitor z-Val-Ala-Asp-fluoromethyl ketone, z-DEVD-fmk, or z-IETD-fmk. Death receptor (DR) dependency was analyzed by examining expression of DRs (Fas, DR4, DR5, TNFR1, and R2), and interaction of Fas-associated death domain and caspase 8. Involvement of the mitochondria pathway was examined by monitoring of the mitochondria membrane potential, cytochrome c release, and Bax translocation. RESULTS: Phytosphingosine-treated cells displayed several features of apoptosis, including increase of sub-G(1) population, DNA fragmentation, and poly(ADP-ribose) polymerase cleavage. We observed that phytosphingosine cause activation of caspase 8 in a DR-independent fashion. Phytosphingosine also induced activation of caspase 9 and 3, loss of mitochondrial membrane potential, and the cytochrome c release from mitochondria. However, we failed to detect Bid cleavage. Moreover, caspase 8 inhibitor z-IETD-fmk did not affect phytosphingosine-induced cytochrome c release and caspase 9 activation, suggesting that phytosphingosine-induced cytochrome c release is caused by caspase 8-independent manner. Phytosphingosine induced mitochondrial translocation of Bax from the cytosol without changes in the protein levels of Bcl-2, Bcl-xL, and Bax. In addition, Bcl-2/Bax interaction was diminished after addition of phytosphingosine. CONCLUSION: These findings indicate that phytosphingosine induces apoptotic cell death in human cancer cells by direct activation of caspase 8, and by mitochondrial translocation of Bax and subsequent release of cytochrome c into cytoplasm, providing a potential mechanism for the anticancer activity of phytosphingosine.     

头孢哌酮/舒巴坦治疗急性脑血管病并发肺部感染的疗效

目的: 比较头孢哌酮/舒巴坦与环丙沙星治疗急性脑血管病并发肺部感染的疗效.方法: 急性脑血管病并发肺部感染90例,分为2组.头孢哌酮/舒巴坦治疗组42例,用量3g ivd bid,7～14 d为一疗程;环丙沙星对照组48例,用量200 mg ivd bid,7～14 d为一疗程.结果: 治疗组与对照组有效率分别为97.60%和72.90%,细菌清除率为90.48%和66.67%,两者均有统计学差异(P＜0.01);不良反应发生率,治疗组2.38%,对照组2.08%.结论: 头孢哌酮/舒巴坦治疗急性脑血管病并发肺部感染有显著的疗效.     

一种新的细胞凋亡相关基因——高同型半胱氨酸诱导基因HCY-2的功能初探

目的　探讨高同型半胱氨酸 (HCY)血症引起心血管病和出生性缺陷的作用机制。方法　采用诱导筛选方法克隆高同型半胱氨酸诱导基因 HCY- 2 ,以 Northern印迹分析检测 HCY- 2基因在大鼠不同组织中的表达 ,以免疫组化方法验证 HCY- 2蛋白在大鼠不同组织中的表达。结果　以诱导筛选方法从大鼠血管平滑肌细胞内克隆到一个新的全长 c DNA,即高同型半胱氨酸诱导基因 HCY- 2 ,它编码 142个氨基酸。Northern印迹分析和免疫组化检测表明 ,HCY- 2基因可在大鼠心、肾、脑、肝、肺等组织中广泛表达。在体外 ,将重组 HCY- 2基因转移至内皮细胞中 ,能够引起细胞凋亡和 DNA损伤 ;在体内 ,将 HCY- 2基因转移至鸡胚内 ,则诱发鸡胚细胞凋亡 ,并引起畸形。结论　 HCY- 2基因可能是一种新的凋亡基因 ,高同型半胱氨酸血症可能通过 HCY- 2基因诱发心血管病和出生性畸形。     

四格表数据Meta分析的简明统计方法

为临床医生进行循证医学研究时能更加方便地应用Meta分析,根据 "四格表"资料的Mantel-Haenszel法及Peto法的Meta分析,介绍一种简便的统计方法,其统计结果与原方法完全相同.这种简明的Meta分析的方法对临床医生在作多个研究资料的综合分析时具有良好的实用性,对促进临床医生开展循证医学的研究十分有益.     

Clinical study on the pattern of lymphnode metastasis in carcinoma of esophagus (an analysis of 200 cases)

Objective: To study the pattern of lymphnode metastasis in carcinoma of esophagus. Methods: 200 cases of resected esophageal cancer specimens were carefully examined pathologically. Lymphnode metastasis, its pathway and extent in relation to pathological changes were analyzed. Results: Lymphnode metastasis was mainly regional and extended vertically in both directions. Leaping-over metastasis was another feature. The deeper invasion by the tumor, the higher frequencies of metastasis development, and vice versa. However, leaping-over metastasis was more likely to occur where tumor invasion was less severe. Conclusion: Owing to the high frequency of lymphnode metastasis in the superior mediastinum and the widely spanned leaping-over metastasis, an operative approach by three incisions through right thoracotomy with excision of the whole segment of esophagus and anastomosis at cervical region was recommended, in order to dissect lymphnodes in the cervical, thoracic and abdominal regions and to leave less or no metastatic lymphnodes behind.     

乌龙丹治疗急性脑梗塞及对下丘脑—垂体—甲状腺轴内分泌激素变化的影响

目的 :通过对 66例急性脑梗塞住院患者进行了较系统的临床观察和有关下丘脑—垂体—甲状腺轴内分泌激素水平的检测 ,以探讨中药复方乌龙丹的临床疗效和有关机制。方法 :临床疗效评定采用计分法 ,治疗组 (3 5例 )用低分子右旋糖酐静脉滴注加乌龙丹口服。对照组 (3 1例 )用低分子右旋糖酐静脉滴注加尼莫通口服 ,疗程均为 4周 ,治疗前后采血用放免法检查 :三碘甲状腺原氨酸 (T3)、甲状腺素 (T4)、游离三碘甲状腺原氨酸 (FT3)、游离甲状腺素(FT4)、促甲状腺素 (TSH)。结果 :治疗组疗效优于对照组 ,疗效评分值增加 ;经 4周治疗用药后 ,治疗组的T3、FT3和TSH由治疗前的较低水平升高至正常范围 ,两组用药前后各指标变化差值比较 ,在T3、FT3、TSH有显著性差异 (P <0 0 1 )。结论 :本研究表明了中药乌龙丹在低分子右旋糖酐改善微循环作用的基础上发挥了更有效的治疗作用 ,对脑梗塞急性期下丘脑—垂体—靶腺轴功能紊乱、激素分泌异常有一定的调节作用 ,从而有助于维持内环境的相对稳定。     

蒙药广枣中3种黄酮类成分对离体心功能的影响

采用Langendorff灌流法,观察广枣中3种黄酮类成分对离体心功能的影响,为找到一种抗心律失常作用较强的主要化学单体或简单复合物打下基础.结果表明：样品1和样品2减慢心率作用在0.027g生药1/ml～0.22g生药/ml范围内,具有明显的浓度依赖性,当浓度大于0.22g生药/ml时,减慢心率作用反而随着剂量增加而减小;样品3减慢心率作用与剂量成反比.在0.027g生药1ml～1.72g生药/ml范围内,样品1、样品2和样品3使心肌收缩幅度的变化均无统计学意义.结论：广枣中3种黄酮类成分均可减慢心率,对心肌收缩力影响不明显.