MMP-3在大肠腺瘤及大肠癌中的表达与临床意义

为探讨基质金属蛋白酶3（MMP-3）在大肠腺瘤及大肠癌中的表达与临床病理参数间的相关性,应用免疫组织化学方法检测MMP-3在20例大肠腺瘤和60例大肠癌中的表达。结果显示,（1）MMP-3在20例大肠腺瘤及60例大肠癌中,阳性表达率分别为10％和41．7％（P=0．031）。（2）MMP-3的阳性表达与淋巴结转移（P=0．017）呈正相关,与预后呈负相关。结果表明,MMP-3的上调表达可能参与了大肠癌的发生、发展、浸润及转移,对临床上判断预后具有较大意义。     

T2WI肿瘤最大层面直方图分析鉴别腮腺多形性腺瘤与恶性肿瘤

目的探讨T2WI肿瘤最大层面直方图分析鉴别腮腺多形性腺瘤与恶性肿瘤的价值。方法回顾性分析经手术病理证实的41例腮腺多形性腺瘤及23例腮腺恶性肿瘤患者的MRI资料。采用MaZda软件在轴位最大肿瘤层面T2WI中勾画ROI,进行灰度直方图分析,获取9个特征参数(均值、方差、峰度、偏度、第1百分位数、第10百分位数、第50百分位数、第90百分位数及第99百分位数)进行统计分析,比较腮腺多形性腺瘤与恶性肿瘤间直方图特征参数的差异;绘制ROC曲线,评价以直方图特征参数鉴别腮腺多形性腺瘤与恶性肿瘤的效能。结果 9个特征参数中,第1百分位数及第10百分位数在腮腺多形性腺瘤与恶性肿瘤间差异有统计学意义(P均0.05),腮腺多形性腺瘤均高于恶性肿瘤。ROC曲线分析显示,第10百分位数最具鉴别诊断效能,AUC为0.70(P=0.01),最佳临界值为76.00,敏感度为66.70%,特异度为60.00%。第1百分位数的ROC曲线AUC、最佳临界值、敏感度及特异度分别为0.67(P=0.04)、46.50、63.90%及60.00%。结论 T2WI肿瘤最大层面直方图分析可作为术前鉴别腮腺多形性腺瘤与恶性肿瘤的重要手段,为临床提供有价值的参考信息。     

白藜芦醇抑制TXNIP/NLRP3信号通路改善脂多糖诱导的肾小管上皮细胞炎性损伤

[目的]观察白藜芦醇对脂多糖诱导的肾小管上皮细胞（HK-2）炎性损伤的保护作用,及其对TXNIP/NLRP3炎性通路的影响。[方法]采用脂多糖（LPS,1 mg/L）体外诱导HK-2细胞炎性损伤模型,将细胞分为正常对照组、LPS诱导组、LPS+低剂量（50 μmol/L）白藜芦醇组、LPS+中剂量（100 μmol/L）白藜芦醇组、LPS+高剂量（200 μmol/L）白藜芦醇组;CCK8法检测HK-2细胞相对存活率,酶联免疫吸附测定（ELISA）法检测炎性因子白介素-6（IL-6）、白介素-1β（IL-1β）及肿瘤坏死因子-α（TNF-α）水平,Western Blot方法分析诱导型一氧化氮合酶（iNOS）、环氧酶-2（COX-2）、人硫氧还蛋白互作蛋白（TXNIP）及人隐热蛋白（NLRP3）表达。[结果]与LPS诱导组比较,不同浓度白藜芦醇干预的HK-2细胞相对存活率明显升高（P<0.05）,细胞上清炎性因子IL-6、IL-1β及TNF-α水平明显降低（P<0.05）,细胞中炎性蛋白iNOS及COX-2表达水平显著降低（P<0.05）;细胞中TXNIP及NLRP3蛋白表达也显著降低（P<0.05）,并表现出剂量依赖性。[结论]白藜芦醇可以明显抑制LPS诱导的HK-2细胞炎症损伤,抑制炎症相关蛋白的表达,其作用机制可能与抑制TXNIP/NLRP3炎性通路活化相关。     

过量运动对健康大鼠肾脏结构与功能的影响

目的：观察过量运动对健康大鼠肾脏结构与功能的影响并探讨其可能机制。方法：将30只健康Sprauge-Dawley(SD)大鼠按照随机数字表随机分为安静对照组和过量运动组,每组15只。安静对照组在鼠笼内安静饲养,过量运动组进行16周高强度跑台力竭运动。实验后,测定24 h尿蛋白（UP）、血尿素氮（BUN）和血清肌酐（SCr）含量评价肾功能;分别行HE、Masson染色观察肾脏组织病理学改变,同时获取肾小球和肾小管损伤评分以及纤维化指数（FI）;免疫印迹测定转化生长因子-β1(TGF-β1)、基质金属蛋白酶-9(MMP-9)、α-平滑肌肌动蛋白（α-SMA）和E-钙黏蛋白（E-CA）蛋白表达量。结果：与安静对照组比较,过量运动组肾脏结构异常,肾小球损伤评分、肾小管损伤评分、FI、UP、BUN和SCr增加（t分别为-6.895、-7.365、-9.234、-4.964、-7.753、-16.444,均P<0.05）,MMP-9蛋白表达下调（t=5.077,P<0.05）,而TGF-β1、α-SMA和E-CA蛋白表达差异无统计学意义（t分别为-1.801、-1.129、1.585,...     

显微镜下经单鼻孔蝶窦入路切除垂体腺瘤

目的评价显微镜下经单鼻孔蝶窦入路切除垂体腺瘤的疗效. 方法采用经单鼻孔蝶窦入路行垂体腺瘤切除术20例,其中微腺瘤8例(<10 mm),小腺瘤8例(10～20 mm),中腺瘤3例(20～30 mm),大腺瘤1例(>30 mm);PRL腺瘤9例,GH腺瘤6例,ACTH腺瘤5例. 结果本组20例无并发症,平均随访5(2～10)个月,患者临床症状较术前均有不同程度改善,手术效果良好. 结论经单鼻孔蝶窦入路垂体瘤切除术效果好,术中损伤小,患者痛苦少,术后康复快,没有或较少出现并发症.     

止消通脉宁干预TGF-β1诱导的HK-2细胞VEGF mRNA的表达

目的:通过观察止消通脉宁药物血清干预转化生长因子-β1(TGF-β1)诱导的人肾小管上皮细胞(HK-2)血管内皮生长因子(VEGF)mRNA的表达,进一步探讨其在防治肾间质纤维化方面的作用。方法:将HK-2细胞用含10%胎牛血清的DMEM/F12(1∶1)培养基培养;实验分为6组:空白对照组、单纯TGF-β1诱导组(TGF-β110ng/ml)、空白血清对照组(TGF-β110ng/ml+10%空白血清)、干预1组(TGF-β110ng/ml+10%低剂量止消通脉宁药物血清)、干预2组(TGF-β110ng/ml+10%中剂量止消通脉宁药物血清)、干预3组(TGF-β110ng/ml+10%高剂量止消通脉宁药物血清)。药物干预24h后,荧光定量PCR检测VEGF mRNA的表达。结果:HK-2细胞经TGF-β1诱导后,VEGF mRNA的表达显著上升,与空白对照组相比差异有统计学意义(P<0.05),经止消通脉宁药物血清干预后,VEGFmRNA的表达逐步下降,与单纯TGF-β1诱导组相比差异有统计学意义(P<0.05)。结论:止消通脉宁在一定程度上能够抑制TGF-β1诱导的人肾小管上皮细胞纤维化,其机制的可能与调节纤维化细胞因子VEGF的mRNA表达有关。     

Absence of donor CD40 protects renal allograft epithelium and preserves renal function

Blocking the CD40‐CD154 pathway prevents allograft rejection and induces donor‐specific tolerance in various experimental models. However, the translation to clinical studies has been hampered by unexpected thromboembolic complications of CD154‐blocking antibodies. Thus, blocking CD40 instead is now considered as an alternative strategy. Here, we evaluated the role of donor CD40 in allospecific T‐cell responses in vitro and in an in vivo model for renal transplantation. Fully MHC‐mismatched allografts from CD40‐deficient donors displayed better renal function than wild type. These functional data correlated with a lower level of apoptosis in renal tubular epithelial cells and higher expression of PD‐L1, which is most probably because of a reduced Th17 response in recipients of a CD40‐deficient donor. This hypothesis was supported in vitro, where donor CD40 expression was important for the induction of direct allospecific T‐cell responses. Especially the induction of Th17 cells was critically dependent on donor CD40. IL‐17A in conjunction with interferon‐γ in turn rendered renal tubular epithelial cells to a more costimulatory state by upregulating CD40 and downregulating PD‐L1 expression. In conclusion, CD40 blockade not only reduces the allospecific T‐cell responses, but might also lead to protection of tubular epithelium from apoptosis and thereby preserve kidney allograft function.     

Multiregional sampling reveals a homogenous distribution of Ki-67 proliferation rate in pituitary adenomas

Summary. Ki-67 antigen is used as a marker of proliferative activity that is linked to growth rate, invasiveness and prognosis of pituitary adenomas. So far the distribution of Ki-67 index within an individual adenoma has not been investigated. If Ki-67 antigen expression differs significantly within an individual pituitary adenoma, a sampling error may result when assessing small fragments of adenoma tissue. Such a potential error would diminish the value of Ki-67 as a tool for postoperative patient management considerations. The aim of the present study was to assess Ki-67 proliferation rates in different regions of pituitary adenomas and to statistically analyse these data for potential regional differences within each tumor.Ki-67 proliferation index was assessed in smear preparations of 100 specimens of 26 consecutive patients operated on for pituitary adenoma in the Department of Neurosurgery, Medical University Vienna. Depending on the size and extent of the tumor, a mean of 4 tissue samples (range 2–8) was selected intraoperatively from each adenoma from endosellar, suprasellar, parasellar, and basal sellar dural locations.Overall mean cell proliferation rate measured by Ki-67 was 1.81±0.90% (range 0.33–3.43%). Histologically invasive adenomas had significantly higher mean Ki-67 proliferation index in all samples from the same tumor than non-invasive adenomas (2.01±0.91% vs. 1.11±0.59%; P=0.024). Multiregional sampling revealed a homogenous distribution of Ki-67 index throughout an individual adenoma with no significant differences between any two different regions on t-test.Our data confirm that location of a biopsy does not influence Ki-67 index. Therefore, Ki-67 index of a single biopsy is representative for the whole individual adenoma. Thus Ki-67 index can be considered a reliable parameter for assessment of cell proliferation rate in adenoma biopsies and may be used for postoperative patient management considerations.     

Umbilical endometriosis

Tumors of the papillary region are an unusual and heterogeneous group of neoplasms that arise from the major papilla, the ampulla of Vater, and the peripapillary duodenum. Benign adenomas of the papilla of Vater are an increasingly recognized condition in those with familial adenomatous polyposis syndromes as well as sporadic cases. Papillary adenoma is a recognized but rare cause of acute pancreatitis. We describe a patient who presented with acute recurrent pancreatitis that was attributed to an intrapapillary pedunculated villous adenoma. Following diagnosis by endoscopic needle knife sphincterotomy and endoscopic retrograde cholangiopancreatography, endoscopic snare resection of the adenoma resulted in symptomatic improvement.     

肾上腺皮质腺瘤与增生的神经内分泌分化特性

目的 :探讨肾上腺皮质腺瘤及增生有无神经内分泌性分化。方法 :通过免疫组化方法观察肾上腺皮质腺瘤 (n =39)、增生 (n =2 4)、正常组 (n =10 )的神经丝蛋白 (NF)、神经特异性烯化酶 (NSE)、突触素 (SY)的阳性表达。结果 :腺瘤组NF阳性率35 .89% ,NSE 6 6 .6 6 % ,SY 6 1.5 3%。肾上腺皮质增生的阳性率分别为NF 12 .5 % ,NSE 37.5 % ,SY 5 0 %。且所有阳性表达均发生于伴有结节性增生的病例。与正常组比较SY阳性表达有显著意义 (P <0 .0 5 ) ,与腺瘤组比较NSE阳性表达有显著意义 (P<0 .0 5 )。结论 :肾上腺皮质腺瘤与伴有结节增生的肾上腺皮质增生有神经内分泌分化