Indeterminate pulmonary nodules in colorectal cancer

AIM:To investigate the clinicopathologic parameters of pulmonary metastasis in colorectal cancer(CRC) patients after lung operation of indeterminate pulmonary nodules(IPNs).METHODS:From a prospective database of CRCpatients,40 cases that underwent lung operation between November 2008 and December 2012 for suspicious metastatic pulmonary nodules on chest computed tomography(CT)were enrolled.The decision to perform a lung operation was made if the patient met the following criteria:(1)completely resected or resectable primary CRC;(2)completely resectable IPNs;(3)controlled or controllable extrapulmonary metastasis;and(4)adequate general condition and pulmonary function to tolerate pulmonary operation.Lung operation was performed by a thoracic surgeon without CT-guided biopsy for pathologic confirmation.RESULTS:A total of 40 cases of lung resection was performed in 29 patients.Five patients underwent repeated lung resection.The final pathology result showed metastasis from the CRC in 30 cases(75%)and benign pathology in 10 cases(25%).The primary tumor site was the rectum in 26/30(86.6%)cases with pulmonary metastasis,but only 3/10(30%)cases in the benign group had a primary rectal cancer(P=0.001).Positron emission tomography(PET)-CT was performed for 22/30(73.4%)patients in the lung metastasis group and for 6/10(60.0%)patients in the benign group.PET-CT revealed hot uptake of18fluorine 2-fluoro-2-deoxy-D-glucose with all IPNs in both groups.The group with pulmonary metastasis had a higher incidence of primary rectal cancer(P=0.001),a more advanced tumor stage(P=0.011),and more frequent lymphatic invasion of tumor cells(P=0.005).Six cases with previous liver metastasectomy were present in the lung metastasis group.Serum carcinoembryonic antigen levels before lung operation were not elevated in any of the patients.CONCLUSION:The stage and location of the primary tumor and tumor cell infiltration of lymphatics provide useful indicators for deciding on lung resection of IPNs in CRC.     

Carcinogenicity of 1,2-dimethylhydrazine dihydrochloride in BALB/c mice

Summary The carcinogenicity of 1,2-dimethylhydrazine dihydrochloride (DMH) by oral, intragastric and subcutaneous administration was examined in 339 BALB/c mice. Subcutaneous injection of DMH induced intestinal tumors in the lower colon of all mice. After oral administration it induced a high incidence of vascular tumors in the liver and soft tissues, but colon tumors were found in only 2 mice when given at a high dosage. On intragastric administration, it induced a fairly high incidence both of colon and vascular tumors. The sites and incidences of vascular tumors and squamous cell carcinomas of the perianal glands were also described.This work was supported in part by a Grant-in Aid for Cancer Research from the Ministry of Education, Japan.     

正丁醇提取的低分子量宫颈癌细胞表面抗原

本实验采用正丁醇提取方法以研究甲基胆蒽诱发的小鼠宫颈癌(U_(14))细胞表面抗原。用2.5%正丁醇溶液对U_(14)细胞进行提取所获得的正丁醇粗提物(CBE),经Lowry法测得其蛋白含量为147微克/毫升;在SDS-PAGE中显出8条区带,分子量为18-70kD;用ELISA检测表明CBE与抗宫颈癌单克隆抗体(AU_(14-1))和多克隆抗体均呈阳性反应。结果证明CBE系低分子量的宫颈癌细胞表面抗原,其中含有能够与AU_(14-1)发生免疫反应的肿瘤抗原决定簇。     

改良构建大鼠单侧输尿管梗阻肾间质纤维化模型

文题释义：肾盂积液：输尿管完全或不完全梗阻时,由于尿液无法正常排出体外而导致肾盂积液。慢性肾盂积液引起的肾脏损伤是不可逆的,可由多种上尿路梗阻性疾病诱发,导致肾盂肾盏扩大,肾小管与肾小球结构与功能丧失,进而肾组织萎缩。 肾间质纤维化：是各种慢性肾病发展至终末期的共同病理特征,以肾小管间质瘢痕硬化为特征,最终导致肾脏组织功能完全丧失。该过程受到转化生长因子β、成纤维细胞生长因子、内分泌等信号通路的调控,肾间质纤维化动物模型是研究相关药物药理机制的重要模型。 背景：传统的大鼠单侧输尿管梗阻手术方法,可以在较短的时间内(一两周)导致动物梗阻侧肾脏发生肾间质纤维化,但具有术后并发症较多、死亡率较高的缺点。 目的：优化并改良大鼠单侧输尿管梗阻手术操作,降低动物术后的并发症发生率,提高存活率,检测改良单侧输尿管梗阻方法建模大鼠的病理生理指标,为功能药理学基础研究提供背景数据支持。 方法：①取20只雄性SD大鼠,随机分为4组,分别进行传统单侧输尿管梗阻方法结扎、改良单侧输尿管梗阻方法结扎、不游离输尿管结扎、开腹腔但不结扎输尿管(假手术组)操作,术后14 d时比较组间大鼠肾间质纤维化成模率、死亡率、术后并发症发生率的差异;②另取28只SD大鼠,雌雄各半,随机分为改良组与假手术组,采用尿液分析、血细胞分析、血液生化分析方法,检测两组大鼠的生理指标,并通过苏木精-伊红染色与Masson染色法,观察改良组大鼠术后14,21 d时的肾脏组织病理学结果。 结果与结论：①与不游离输尿管结扎组大鼠相比,传统单侧输尿管梗阻组和改良单侧输尿管梗阻组大鼠的成模率高;②在单侧输尿管梗阻手术操作过程中,采用输尿管中段双结扎、中间不剪断的改良方法与传统方法相比,操作更简便易行,手术开创更小,肾间质纤维化成模快、成模率较高,动物术后死亡率与并发症发生率均低;③改良组与假手术组相比,术后14 d时的尿素氮、谷草转氨酶、白蛋白等血液生化指标差异有显著性意义(P < 0.05),其梗阻侧肾脏的组织病理切片苏木精-伊红染色与Masson染色结果均可见典型的肾间质纤维化病理特征。 ORCID: 0000-0001-7823-2897(孙杰) 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

钬激光治疗输尿管结石患者的护理

目的探讨钬激光治疗输尿管结石的护理。方法总结钬激光治疗87例输尿管结石患者的临床资料,分析患者在治疗过程中所采用的护理措施。结果87例患者单次碎石率为96.6%(84/87),平均结石排尽时间为19.5日,平均住院2.5日。除1例输尿管穿孔外,无其他并发症。结论针对患者特点,术前加强心理护理,术后严密观察各引流管情况和并发症的发生,是手术成功的重要环节。     

FHL2在大肠癌组织中的表达及其作用

目的:探讨FHL2基因在大肠癌中的表达及其临床意义.方法:用免疫组织化学方法检测35例大肠癌组织、15例大肠息肉组织和15例正常结肠黏膜组织中FHL2蛋白的表达情况,并分析其与相关临床病理因素的关系.结果:FHL2蛋白表达阳性率在大肠癌组织中显著高于正常大肠黏膜组织和大肠息肉组织.结论:FHL2蛋白在大肠癌组织中高度表达,但表达程度与癌症病理分级无明显相关性.     

胰腺肿瘤伴血糖异常对肿瘤标志物的影响

目的 探讨血糖异常对胰腺肿瘤标志物在胰腺疾病诊断中的影响作用及其临床应用价值.方法 以59例胰腺恶性肿瘤为研究对象,其中包括46例胰腺癌、13例胰腺其他恶性肿瘤,以27例良性疾病患者为对照,采集肿瘤患者术前静脉血,常规离心分离血清进行检测.利用美国雅培公司酶免发光分析仪器及配套试剂进行检测,诊断标准以CA199＞37 kU/L、CA 125＞35 kU/L、癌胚抗原(CEA)＞10 μg/L为阳性.结果 (1)单项检测指标以CA199诊断准确性最高,两两联合检测以CA199+CEA准确性最高,优于单项检测和三者联合,且经x2检验差异具有统计学意义(x2=26.131,P＜0.05).三者联合诊断胰腺肿瘤,只会增加医疗费用,并不能提高诊断的准确性.(2)胰腺肿瘤组各指标平均秩次均高于胰腺良性疾病组,2组之间非参数检验结果如下:CA199(Z=4.682,P=0.000)、CA125(Z=1.866,P=0.062)、CEA(Z=2.573,P=0.010);提示对于鉴别胰腺良恶性疾病,CA199、CEA等指标差异有统计学意义(Z=3.232,P＜0.05;Z=2.573,P=0.010).(3)胰腺肿瘤患者中,血糖异常组与血糖正常组相比,非参数检验结果为CA199(Z=2.265,P=0.024)、CA125(Z=0.736,P=0.462)、CEA(Z=1.536,P=0.125),血糖异常只对CA199影响,差异有统计学意义(Z=2.265,P＜0.05).而在胰腺良性疾病组患者中,差异均无统计学意义(分别为Z=4.214,P＞0.05;Z=3.224,P＞0.05;Z=3.154,P＞0.05).结论 对于胰腺肿瘤的诊断,三种肿瘤指标联合诊断,并不能提高诊断的准确性,只会增加医疗费用;以CA199+CEA联合检测准确性最高;单项检测指标以CA199诊断准确性最高.CA199在对伴有血糖异常的胰腺良恶性疾病的鉴别时,须考虑血糖的影响作用,通过ROC曲线设置不同的CA199调定点,有望达到更优的诊断效能.

Abstract：

Objective To investigate the effect of pathoglycemia on the tumor biomarker expression in pancreatic tumor and assess its influence on the diagnostic value of these biomarkers.Methods We recruited 59 patients with malignant pancreatic tumor in total into this study,including 46 cases with pancreatic carcinoma and 13 cases with other pancreatic malignancies.Twenty-seven patients with benign pancreatic diseases were selected as control.All subjects were extracted venous blood and serum samples were separated by centrifugation.Serum levels of CA199,CA125 and CEA were measured by chemiluminescent microparticle immunoassay(CMIA).The positive expression criteria were designated as ＞37 kU/L for CA199;＞35 kU/L for CA125;＞10 μg/L for CEA.Results (1) CA199 showed the highest diagnostic accuracy when the tumor biomarker was used alone.CA199 plus CEA showed the highest diagnostic accuracy when the biomarkers were used pairwisely,even better than three biomarkers used in combination(x2=26.131,P＜0.05).(2)The average rank of all tumor biomarkers were higher in all malignant pancreatic tumor than benign pancreatic diseases,and some of the differences reached statistically significance(CA199,Z=4.682,P=0.000;CA125,Z=1.866,P=0.062;CEA,Z=2.573,P=0.010).(3)When the malignant pancreatic tumor group were further divided into two groups according to their blood sugar level,we found that CA199 were significantly higher in pathoglycemia group than euglycemia group(Z=2.265,P=0.024),while no significant differences were observed in patients with benign pancreatic diseases when compared between patients with different blood sugar levels(Z=4.214,3.224,3.154,Ps＞0.05).Conclusion The combination use of three tumor biomarkers showed no improvements in the diagnosis of pancreatic neoplasm,but with disadvantage of elevated medical expense.CA199 showed the highest diagnostic accuracy when used alone.CA199 plus CEA showed the highest diagnostic accuracy when the biomarkers were used pairwisely.The blood sugar level should be considered when using CA199 in the differential diagnosis of pancreatic neoplasm from benign pancreatic lesions;a new set-point of CA199 should be set by studying the ROC curve and other statistic index to improve the overall accuracy.     

Livin异构体基因转染对肺腺癌A549细胞生长及放化疗敏感性的影响

目的研究转染Livin α、β两种异构体基因对肺腺癌A549细胞生长及放、化疗敏感性的影响。方法基因转染获得稳定表达Livinα和β的A549细胞克隆，逆转录一聚合酶链反应及免疫荧光化学法了解Livin α、β在转染细胞中基因水平和蛋白水平的表达情况；用平板克隆形成实验研究细胞生长情况；甲基偶氮唑蓝法研究细胞对放、化疗的敏感性；细胞周期分析法了解细胞凋亡情况。结果与转染前比较，基因转染后，阳性细胞尤其是表达Livin α的A549细胞克隆形成能力提高约20％、倍增时间缩短5～6h（P〈0．05），对多种化疗药物和放射线敏感性降低（P〈0．01），10Gy放射线照射下仅有0．2％细胞发生凋亡。结论Livin尤其是Livin α参与肺癌的发生发展，是肺癌细胞对放、化疗耐受的重要机制之一。     

乳腺癌高频超声声像图分析

目的：研究乳腺癌高频超声表现，提高诊断准确性。方法：回顾分析390例病理证实的乳腺癌超声资料。结果：乳腺癌超声声像图表现复杂。有形态不规则、毛刺样改变、高回声晕环、簇状钙化斑、回声衰减、纵横比大于1等表现的乳腺癌超声诊断正确率较高，形态规则、边界清晰、后方回声增强、囊实性、肿块小于10mm及中、高回声的乳腺癌超声诊断正确率较低。结论：充分认识乳腺癌各种超声表现，有助于乳腺癌的超声诊断。