Dual-colour chromogenic in-situ hybridization is a potential alternative to fluorescence in-situ hybridization in HER2 testing

Hwang C‐C, Pintye M, Chang L‐C, Chen H‐Y, Yeh K‐Y, Chein H‐P, Lee N & Chen J‐R
(2011) Histopathology 59 , 984–992 Dual‐colour chromogenic in‐situ hybridization is a potential alternative to fluorescence in‐situ hybridization in HER2 testing Aim: Dual‐colour chromogenic in‐situ hybridization (dc‐CISH) is an emerging methodology for characterizing genomic alterations. This study was aimed at evaluating the performance of a dc‐CISH kit (ZytoVision) in determining human epidermal growth factor receptor 2 (HER2) status in breast cancer. Methods and results: Two hundred and twenty‐eight invasive breast carcinomas arranged in tissue microarrays were analysed in parallel with dc‐CISH, fluorescence in‐situ hybridization (FISH), and immunohistochemistry. Of 227 tumours with available FISH and dc‐CISH results, HER2 amplification and non‐amplification were detected in 49 (21.6%) and 178 (78.4%) tumours, respectively, by both assays. The concordance between dc‐CISH and FISH results showed 100% agreement (κ‐coefficient = 1.00). Immunohistochemically, 162 (71%), 25 (11.0%) and 41 (18%) tumours were scored 0/1+, 2+, and 3+, respectively. The corresponding results with both FISH and dc‐CISH demonstrated HER2 amplification in two (3.2%), nine (36%) and 38 (93%) tumours, respectively. Complete consensus among these three methods was observed in 197 cases, representing 98% of all 3+ and 0/1+ tumours (κ‐coefficient = 0.92). Confirmatory testing of 25 2+ tumours showed complete consensus between FISH and dc‐CISH. Conclusions: dc‐CISH is a promising alternative to FISH in HER2 testing, and the single‐institute incidence of HER2 amplification in breast cancer in Taiwan is 21.2%.     

茵白汤对α-萘异硫氰酸酯所致小鼠黄疸模型的退黄降酶作用研究

目的：观察茵陈、白茅根、紫草等对α-萘异硫氰酸酯（ANIT）所致小鼠急性黄疸模型的退黄降酶作用。方法：将小鼠随机分为正常组、模型组、阳性药物对照组（茵栀黄注射液）和提取液大、中、小给药组。各治疗组连续灌胃给药7d后,ANIT诱发黄疸模型,48h后摘眼球取血,分离血清,以血清肝功能指标以及肝脏组织病理学的改变为观察指标。结果：与模型组比较,茵栀黄组、提取液小剂量给药组的ALT、AST、ALP、TBIL、IBIL,均显著下降（P〈0.05）;与茵栀黄组比较,提取液小剂量给药组ALT、AST、ALP、TBIL、IBIL,均无差异（P〉0.05）肝脏病理组织学检查表明,提取液能明显减轻肝细胞变性、坏死和肝小胆管增生。结论：提取液具有降低实验性胆汁淤积小鼠血清胆红素、转氨酶和改善肝脏组织损伤的作用。     

Keeping CSF valve function with urokinase in children with intra-ventricular haemorrhage and CSF shunts

Background  Intra-ventricular haemorrhage (IVH) can occur spontaneously or during the surgical revision of ventricular cerebrospinal fluid (CSF) shunts. Aim  The aim of the study was to report the safety and efficacy of an original method for treatment of IVH that may occur at the time of valve revision aimed at maintaining the function of previously implanted CSF shunts. Patients and methods  We reviewed the medical records of six patients who experienced an IVH in the presence of a previously placed ventriculoperitoneal (VP) shunt. Five of the haemorrhages occurred during ventricular catheter replacement and the remaining one in a child given a VP shunt who sustained a spontaneous intra-cerebral haemorrhage. We inserted an external ventricular drainage without removing the original shunt. Urokinase was administered via the ventricular drain during several days until blood clearance in the CSF. Disappearance of the ventricular clots was checked by a cranial computerised tomography scan, while CSF shunt function was verified by the children’s evolution and/or by a reservoir tap. Results  Follow-up evaluation of the six patients demonstrated that the existing VP shunts were functioning appropriately and that the treatment was safe. Conclusions  Patients with IVH complicating ventricular catheter replacement and patients with spontaneous bleeding who harbour a VP shunt can be treated by intra-ventricular urokinase to avoid the removal of the initial shunt. The technique has proven to be safe and utilises the ventricular drain placed for the acute management of the IVH. Shunt replacement will always be possible in case of failure of the technique we are reporting.     

Extended daily access to cocaine results in distinct alterations in Homer 1b/c and NMDA receptor subunit expression within the medial prefrontal cortex

Human cocaine addicts show altered function within the basal ganglia and the medial prefrontal cortex (mPFC) and altered glutamate function within these areas is postulated to be critical for cocaine addiction. The present project utilized a highly valid animal model of cocaine addiction, to test whether excessive use of cocaine alters glutamate function within these brain areas. Rats were trained to lever‐press for i.v. saline vehicle or cocaine (0.25 mg/infusion) over seven 1‐h daily sessions, after which, saline controls and half of cocaine self‐administering animals (brief access condition) received 10 more 1‐h daily sessions, whereas the remaining cocaine animals received 10 additional 6‐h daily sessions (extended access condition). One, 14, or 60 days after the last self‐administration session, animals were sacrificed. Tissue samples from the ventral tegmental area (VTA), nucleus accumbens (N.Acc) core and shell, and mPFC were analyzed by immunoblotting for expression of Homer1b/c, Homer2a/b, mGluR1, mGluR5, NR2a, and NR2b subunits of the NMDA receptor. Brief and extended access to cocaine failed to alter protein levels within the VTA, and produced transient and similar changes in N.Acc protein expression, which were more pronounced in the core subregion. In contrast, extended access to cocaine resulted in distinct and long lasting alterations of protein expression within the mPFC that included: increased levels of Homer1b/c at 1 day, NR2b at 14 days, and NR2a at 60 days, of withdrawal. These data support the notion that altered NMDA function within the mPFC may contribute, in part, to the transition to excessive uncontrolled consumption of cocaine. Synapse 63:598–609, 2009. © 2009 Wiley‐Liss, Inc.     

Ex vivo [11C]‐(+)‐PHNO binding is unchanged in animal models displaying increased high‐affinity states of the D2 receptor in vitro

Dopamine (DA) D₂ receptor supersensitivity has been linked to an increase in the density of the D₂ high‐affinity state as measured in vitro. The two‐ affinity‐state model of the D₂ receptor predicts that the ex vivo specific binding of [¹¹C]‐(+)‐PHNO, an agonist radiotracer thought to bind selectively to the high‐affinity state in vivo, should be increased in animal models that display in vitro increases in the proportion of receptors in the D₂ high‐affinity state. Here, we test this hypotheses by comparing the ex vivo SBR of [¹¹C]‐(+)‐PHNO with that of the antagonist radiotracer [³H]‐raclopride in three dopaminergically supersensitive rat models—AMPH‐sensitized rats, rats withdrawn from chronic ethanol, and unilaterally 6‐OHDA‐lesioned rats—using ex vivo dual‐radiotracer biodistribution studies. We find that in AMPH‐sensitized rats and rats withdrawn from chronic ethanol treatment, models that exhibited ～4‐fold increases in the D₂ high‐affinity state in vitro, the SBRs of [¹¹C]‐(+)‐PHNO and [³H]‐raclopride are unchanged relative to control rats. In unilaterally 6‐OHDA‐lesioned rats, we find that the increase in [¹¹C]‐(+)‐PHNO SBR is no different than that observed for the antagonist radiotracer [³H]‐raclopride (54% ± 16% and 52% ± 14%, respectively). In addition, the effect of acute AMPH pretreatment (4 mg/kg, i.v.) on the SBRs of [¹¹C]‐(+)‐PHNO and [³H]‐raclopride is equivalent in AMPH‐sensitized (?38% ± 12% and ?36% ± 8%, respectively) and in control rats (?40% ± 11% and ?38% ± 7%). These data emphasize a significant discrepancy between in vitro and in vivo measures of D₂ agonist binding, indicating that the two‐affinity‐state model of the D₂ receptor may not apply veridically to living systems. The potential implications of this discrepancy are discussed. Synapse 63:998–1009, 2009. © 2009 Wiley‐Liss, Inc.     

全膝关节置换术中飞溅散落物的细菌学分析

目的探讨全膝关节置换（TKA）术中飞溅散落物细菌培养和药敏结果特点,分析引起术后感染的相关因素,提出预防感染管理措施。方法对2000年1月至2008年12月本组开展的342例TKA术中的45例,术中飞溅物散落于手术无菌区和术者有菌区的270点散落物进行细菌培养和药敏结果分析。结果22例未佩戴无菌防护面罩组细菌培养结果无菌区出现1点阳性结果,阳性率1.45%,有菌区共3点阳性,阳性率4.35%,无菌区及有菌区总阳性率2.90%;而佩戴无菌防护面罩组细菌培养结果全部为阴性。结论术者自身携带的含菌量可能是引起TKA术后感染的危险因素之一,应采取改变护理模式,严格规章制度,保证在层流的清洁环境中进行无菌操作,重视人工关节置换术围手术期和手术过程中每个环节,建立完善的防止TKA术后感染的手术室护理管理措施。     

腹腔镜结合腹腔药物灌注治疗慢性盆腔炎的临床分析

目的:总结腹腔镜结合腹腔灌注α-糜蛋白酶、地塞米松治疗慢性盆腔炎的疗效。方法:随机将200例患者分为观察组和对照组,每组100例。观察组行腹腔镜盆腔粘连松解术,病灶清除后腹腔灌注α-糜蛋白酶、地塞米松。对照组仅行腹腔镜盆腔粘连松解术。术后两组均予以抗生素、中药治疗及理疗。观察患者症状、体征好转情况。结果:观察组治愈率明显高于对照组(P<0.01)。结论:腹腔镜手术可使多数慢性盆腔炎患者盆腔解剖位置恢复正常,病灶清除。结合腹腔灌注α-糜蛋白酶、地塞米松可防止盆腔分离创面再粘连,提高了治愈率。疗效明显,值得临床推广应用。     

椎管内应用阿片类药物研究进展

椎管内应用阿片类药物因为其诸多优点近年来在临床上应用广泛.新的药物和给药方法层出不穷.然而,对于阿片类药物在椎管内的作用机制、分布、头向移动、最佳剂量及长期给药的优缺点均尚存争议.     

逍遥丸对口服铁剂服药依从性的观察

目的观察患者对口服铁剂的依从性。方法选择缺铁性贫血患者120例,随机分为2组,对照组60人,常规口服右旋糖酐铁、维生素c;观察组60例,在对照组治疗基础上加服逍遥丸,每次8粒,3次／d,观察用药后不良反应。结果对照组依从性好者为88．33％,观察组依从性好者为98．33％,2组问经统计学处理差异有统计学意义（P〈0．05）。结论观察组服药依从性比对照组服药依从性明显提高。     

综合性大学医学实践教学模式的探索

建立统一管理的,包括公共教学、基础医学教学、临床技能教学及医学专业教学在内的医学实验教学大平台,为推进基础和临床实践教学内容的有机整合提供了基础。该模式的探索为综合性大学体制下医学实验教学建设和管理提供了借鉴和参考。