Thymectomy by partial sternotomy for the treatment of myasthenia gravis

BACKGROUND: Myasthenia gravis is an autoimmune disease characterized by weakness and fatigue of voluntary muscles. Surgical treatment of choice for myasthenia gravis has been thymectomy. However, thymectomy indications and surgical approach are still controversial. The purpose of this study is to evaluate the efficacy of partial median sternotomy approach to the thymus. METHODS: From 1973 to 1999, 478 patients with myasthenia gravis underwent thymectomy through a partial median sternotomy. RESULTS: Sixty-one patients (12.7%) had complete remission of symptoms, 299 (62.5%) had a significant improvement, and 83 (17.4%), a mild improvement; whereas 35 patients (7.4%) had no improvement of clinical symptoms. CONCLUSIONS: Partial median sternotomy has shown to be a useful surgical approach to the thymus, as demonstrated by the good functional and aesthetic results, associated with low morbidity and no mortality.     

Mediastinal synovial sarcoma: report of two cases with molecular genetic analysis

Synovial sarcoma occurs predominantly in the paraarticular regions of the extremities. Synovial sarcoma of the mediastinum is an exceedingly rare neoplasm that has overlapping histologic and immunophenotypic features with other tumors in the differential diagnosis. We describe two cases. One is a 67-year-old patient who presented with chest pain and shortness of breath. Diagnostic imaging revealed a mediastinal mass extending over the cardiac apex. Histopathology, immunohistochemistry, and molecular genetic analysis confirmed the diagnosis of synovial sarcoma. The patient underwent surgical resection and postoperative radiation therapy. He is alive and well 18 months after diagnosis. This case illustrates the importance of proper procurement of frozen tissue for molecular genetic analysis for the identification of the t(X;18), characteristic of synovial sarcoma. Detection of this translocation is of paramount importance to confirm this diagnosis, particularly when this neoplasm arises in atypical locations outside the extremities.     

MMP-2、TIMP-2、VEGF和bFGF在血管瘤增生及消退过程中的变化

目的 探讨基质金属蛋白酶-2（MMP-2）及其抑制剂（TIMP-2）、血管内皮生长因子（VEGF）和碱性成纤维细胞生长因子（bFGF）在血管瘤增生、消退过程中的变化。方法 采用免疫组织化学链霉亲和素-过氧化酶（SP）法，检测增生期血管瘤32例、消退期血管瘤10例、血管畸形17例及小儿正常皮肤10例标本中MMP-2、TIMP-2、VEGF及bFGF的表达。结果 MMP-2、VEGF及bFGF在增生期血管瘤中的表达明显高于消退期血管瘤、血管畸形和正常皮肤，其差异有统计学意义；TIMP-2在消退期血管瘤中的表达明显高于增生期血管瘤、血管畸形和正常皮肤，其差异有统计学意义。结论 MMP-2、VEGF及bFGF可能促进血管瘤血管生成，从而促进血管瘤增生，而TIMP-2可能促进血管瘤消退。     

基质金属蛋白酶-13在退变腰椎间盘髓核组织中的表达及其意义

目的观察基质金属蛋白酶(MMPs)-13在退变腰椎间盘髓核组织中的表达及其临床意义。方法应用原位分子杂交(ISH)和免疫组织化学检测30例(男23例,女7例)退变腰椎间盘和8例(男6例,女2例)创伤腰椎间盘髓核组织中MMP-13信使核糖核酸(mRNA)和蛋白的表达。图像平均灰度值作为测定指标,两样本t检验进行统计学分析。结果:MMP-13在退变腰椎间盘髓核中表达明显增加。在退变组及创伤组中,MMP-13 mRNA表达的平均灰度值分别为101.17±10.96、153.37±15.24(t=11.01,P<0.01);MMP-13蛋白表达的平均灰度值分别为148.24±21.50、105.23±15.69(t=6.37,P<0.01)。结论髓核中MMP-13的表达增强可能是腰椎间盘退变的重要因素之一。     

Intra‐articular injection of hyaluronan restores the aberrant expression of matrix metalloproteinase‐13 in osteoarthritic subchondral bone

Subchondral bone is a candidate for treatment of osteoarthritis (OA). We investigated the effects of intra‐articular injection of hyaluronan (IAI‐HA) on subchondral bone in rabbit OA model. OA was induced by anterior cruciate ligament transection, with some rabbits receiving IAI‐HA. OA was graded morphologically, and expression of mRNA was assessed by real‐time RT‐PCR. Tissue sections were stained with hyaluronan‐binding protein, and penetration of fluorescent hyaluronan was assessed. The in vitro inhibitory effect of hyaluronan on MMP‐13 was analyzed in human osteoarthritic subchondral bone osteoblasts (OA Ob) by real‐time RT‐PCR and ELISA. Binding of hyaluronan to OA Ob via CD44 was assessed by immunofluorescence cytochemistry. Expression of MMP‐13 and IL‐6 mRNA in cartilage and subchondral bone, and morphological OA grade, increased over time. IAI‐HA ameliorated the OA grade and selectively suppressed MMP‐13 mRNA in subchondral bone. IAI‐HA enhanced the hyaluronan staining of subchondral bone marrow cells and osteocyte lacunae. Fluorescence was observed in the subchondral bone marrow space. In OA Ob, hyaluronan reduced the expression and production of MMP‐13, and anti‐CD44 antibody blocked hyaluronan binding to OA Ob. These findings indicate that regulation of MMP‐13 in subchondral bone may be a critical mechanism during IAI‐HA. © 2010 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 29:354–360, 2011     

反义RhoC基因对胆管癌QBC939细胞株基质金属蛋白酶－2的抑制作用

目的 观察反义RhoC基因对胆管癌QBC939细胞株的基质金属蛋白酶-2(MMP-2)表达的影响.方法 将反义RhoC真核表达载体转染人胆管癌细胞株QBC939,逆转录－聚合酶链反应(RT-PCR)和Western blot检测MMP-2在QBC939细胞、转染空载体的QBC939细胞(QBC939-V)、转染反义RhoC的QBC939细胞(QBC939-AS)的mRNA和蛋白相对表达量.结果 QBC939细胞MMP－2 mRNA吸光度相对值为0.588±0.074,QBC939-V细胞为0.629±0.061,两者差异无统计学意义(P＞0.05),QBC939-AS细胞MMP-2 mRNA吸光度相对值为0.286±0.097;与QBC939及QBC939－V比较,差异有统计学意义(P＜0.05).结论 反义RhoC基因能够抑制QBC939细胞株的MMP-2表达.     

MMP-9和CyclinE在膀胱尿路上皮癌中的表达及其临床意义

目的：探讨和CyclinE在膀胱癌组织和正常膀胱黏膜组织中的表达,并结合ll缶床病理特征进行分析。结果：MMP一9在膀胱癌组织中的阳性表达率为70．9％,显著高于正常膀胱黏膜中的阳性表达率11．1％,差异有统计学意义（P〈0．05）。MMP一9的表达与膀胱癌患者性别和年龄无关（P〉0．05）,与膀胱癌患者肿瘤的大小、肿瘤的多少以及肿瘤的恶性程度密切相关（P〈O．05）。CyclinE在膀胱癌组织和正常膀胱黏膜中的阳性表达率分别为64．6％和16．7％,差异有统计学意义（P〈O．05）。CyclinE的表达与膀胱癌的大小、肿瘤的多少以及肿瘤的病理分级和临床分期密切相关（P〈0．05）,与膀胱癌患者的年龄和性别无关（P〉0．05）。结论：MMP一9和CyclinE在膀胱癌组织中的表达均升高,提示它们共同参与了膀胱癌的发生和发展,MMP一9和CyclinE有协同表达关系。同时检测膀胱癌组织中MMP一9和CyclinE的表达对判断预后和指导治疗有一定意义。     

Vasculature-targeted tumor necrosis factor-alpha increases the therapeutic index of doxorubicin against prostate cancer

BACKGROUND: Poor penetration and uneven distribution of doxorubicin in tumors limits the efficacy of this drug in patients with prostate cancer (PC). Aim of the study was to investigate whether pre-treatment with NGR-TNF, a tumor necrosis factor-alpha derivative able to target tumor vessels and alter vessel permeability, increases the penetration and the efficacy of doxorubicin in pre-clinical models of PC. METHODS: Wild type C57BL/6 mice bearing androgen-independent TRAMP-C1 PC and transgenic adenocarcinoma of the mouse prostate (TRAMP) mice, which spontaneously develop PC and metastasis, were treated with repeated cycles of doxorubicin, administered either alone or following NGR-TNF. Tumor growth and drug uptake by cancer cells was evaluated. RESULTS: Doxorubicin as a single agent blocked the growth of TRAMP-C1 cells in vitro but not in vivo. Pre-treatment of mice bearing subcutaneous TRAMP-C1 tumors with NGR-TNF favored doxorubicin penetration into the tumor mass, and in both TRAMP-C1 and TRAMP models significantly delayed tumor growth without increasing drug-related toxicity. CONCLUSIONS: Pre-treatment with NGR-TNF significantly expanded the therapeutic index of doxorubicin in mouse models of hormone-dependent and -independent PC.     

FAK和MMP-9蛋白在结直肠癌组织中的表达及相关性研究

目的 探讨斑激酶(focal adhesion kinase , FAK)和基质金属蛋白酶-9(matrix metalloproteinase,MMP-9)在结直肠癌中的表达.方法 采用免疫组化法检测了67例结直肠癌和癌旁组织以及51例正常结直肠黏膜组织中FAK和MMP-9的表达,并比较了不同临床病理参数下FAK和MMP-9的表达情况.结果 结直肠癌组织FAK阳性表达(77.6%,52/67)高于癌旁组织(50.8%,34/67)和正常结直肠黏膜组织(37.3%,19/51),结直肠癌组织中MMP-9染色阳性率(73.1%,49/67)高于癌旁组织(49.3%,33/67)和正常结直肠黏膜组织(31.4%,16/51),不同肿瘤分化、局部分期以及有无淋巴结转移者FAK和MMP-9表达水平存在差异(P<0. 05).结论 FAK和MMP-9在结直肠癌组织高表达,且FAK和MMP-9表达呈正相关,可能成为判断结直肠癌预后的指标之一.     

17β-雌二醇对子宫内膜异位症患者在位子宫内膜间质细胞β-catenin mRNA和蛋白表达的影响

目的研究17β-雌二醇(17β-E2)对子宫内膜异位症(内异症)患者在位子宫内膜间质细胞β-catenin mRNA和蛋白表达的影响,探讨Wnt/β-catenin信号通路在介导雌激素促进内异症发生发展的作用。方法体外分离培养内异症患者在位子宫内膜间质细胞。用不同浓度17β-E2处理子宫内膜间质细胞48 h;此后选用10-10mol/L 17β-E2处理子宫内膜间质细胞12、24和48 h,逆转录聚合酶链反应(RT-PCR)和免疫印迹法(Western blotting)检测17β-E2处理前后子宫内膜间质细胞β-catenin mRNA和蛋白的表达水平。同法分析雌激素受体拮抗剂ICI182,780(10-6mol/L)对17β-E2促进β-catenin mRNA和蛋白表达的影响。免疫组织化学染色观察17β-E2作用后β-catenin在子宫内膜间质细胞中的定位。结果17β-E2能明显促进内异症患者在位子宫内膜间质细胞β-catenin mRNA和蛋白的表达,并呈剂量和时间依赖性,于10-10mol/L作用48 h最明显。雌激素受体拮抗剂ICI182,780能明显抑制17β-E2对子宫内膜间质细胞β-catenin mRNA和蛋白的表达。免疫组织化学染色发现17β-E2能促进β-catenin在子宫内膜间质细胞核内的表达。结论雌激素可能通过激活Wnt/β-catenin信号通路促进内异症在位子宫内膜的异位种植。