血清TSGF、CA242、CA19-9对老年胰腺癌患者诊断作用的临床研究

目的 评价血清中肿瘤标志物恶性肿瘤相关物质(TSGF)、糖类抗原CA242和CAl9-9对老年胰腺癌患者的诊断作用。方法 采用生化比色法与酶免法分别检测200例健康人、52例胰腺炎及96例胰腺癌患者的TSGF、CA242和CAl9-9含量。结果 TSGF、CA242和CAl9-9阳性似然比依次为5．4、12．6和6．3，阴性似然比依次为0．10、0．19和0．17。单项肿瘤标志物对胰腺癌诊断：TSGF敏感性高达91．6％，CA242特异性高达93．5％。以3项均为阳性诊断胰腺癌：敏感性为77．1％，特异性和阳性预测值皆为100．0％。胰头癌TSGF与CA242水平显著高于胰体癌、胰尾癌及全胰癌，而CAl9-9的表达与其部位无相关性。TSGF、CA242与CAl9-9随着临床分期的进展而敏感性增加，Ⅰ期者TSGF的敏感性显著高于CA242与CAl9-9，因此TSGF可以作为胰腺癌早期筛选的肿瘤标志物。结论 应用TSGF、CA242和CAl9-9联合诊断胰腺癌可以提高特异性，其表达对胰腺癌的不同组织分型起到重要作用，3项标志物联合检测可助早期诊断胰腺癌。     

日本血吸虫重组信号蛋白14-3-3的纯化及抗体制备

目的制备日本血吸虫(中国大陆株)信号蛋白Sj14-3-3的多克隆抗体与单克隆抗体。方法将合Sj14-3-3重组蛋白的凝胶条带冻干磨粉,免疫家兔,制备抗Sj14-3-3多克隆抗血请;用电洗脱纯化的Sj14-3-3免疫BALB/c小鼠,用杂交瘤技术制备抗Sj14-3-3单克隆抗体。测定所得抗体效价及特异性鉴定。结果获得大量纯化的表达产物;制备的多克隆抗血清双扩效价达1:8～1:64。获得1株能稳定分泌抗Sj14-3-3单抗的杂交瘤细胞株4D9,单抗亚类为IgG1。此株单抗能与重组Sj14-3-3蛋白发生特异性反应。结论获得了高度敏感、特异的抗Sj14-3-3多克隆抗血清及稳定分泌抗Sj14-3-3单抗的杂交瘤细胞。     

CA72-4联合AFP、CEA、CA19-9检测在胃肠道疾病中的临床应用价值研究

目的探讨糖类抗原72-4(CA72-4)联合甲胎蛋白(AFP)、癌胚抗原(CEA)、糖类抗原19-9(CA19-9)检测在胃肠道良、恶性疾病中的临床价值。方法收集2017-2018年该院就诊的胃癌(55例)、胃肠道其他癌(71例)、胃肠道良性疾病(556例)患者的临床资料与血清AFP、CEA、CA72-4、CA19-9检查结果,分析肿瘤标志物在不同疾病组间的表达差异。结果(1)血清CA72-4水平在胃癌组与良性疾病组、胃癌组与其他癌组比较,差异有统计学意义(P<0.05)。血清CA72-4在胃癌组的阳性率(30.91%)明显高于其他癌组(18.84%)及良性疾病组(17.99%)。(2)血清CA72-4在胃溃疡、胃息肉、慢性胃炎、急性胃肠炎、十二指肠溃疡、肠息肉等良性疾病的阳性率分别为15.00%、19.12%、11.02%、25.53%、24.07%、19.58%,各组间CA72-4水平及阳性率比较差异无统计学意义(P>0.05);(3)CEA单项检测用于胃癌诊断的灵敏度为23.64%,CA72-4+CEA+CA19-9联合检测用于胃癌诊断的灵敏度为47.27%;CA19-9单项检测用于胃肠道其他癌诊断的灵敏度为24.64%,AFP+CEA+CA19-9联合检测用于胃肠道其他癌诊断的灵敏度为66.20%,差异有统计学意义(P<0.05)。结论血清CA72-4联合CEA、CA19-9检测,可更好地识别胃癌;血清AFP联合CEA、CA19-9检测,可更好地识别胃肠道其他恶性肿瘤。     

Expression of Hsp70-2 in unilateral cryptorchid testis of rhesus monkey during germ cell apoptosis

We investigated the possible role of Hsp70-2 in germ cell apoptosis induced by heat stress in monkey unilateral cryptorchid testis. The study focused on in situ analysis of the testicular cell DNA fragmentation and on the possible relationship between Hsp70-2 expression and germ cell apoptosis. The TUNEL result showed that most of the germ cells were labeled in the cryptorchid testis on d 5 after induction of cryptorchidism; that with most of the apoptotic germ cells depleted, only a few germ cells were labeled on d 10; and that almost no apoptotic signal was observed in the cryptorchid testis on d 15 and thereafter. This indicates that the increasing germ cell degeneration in cryptorchid testis may take the form of apoptosis. Using in situ hybridization, immunohistochemistry, and Northern blot, we examined the changes of Hsp70-2 expression in the monkey cryptorchid testis. The level of Hsp70-2 mRNA decreased slightly, while the expression of HSP70-2 protein was almost unchanged at the early stage of germ cell apoptosis in the cryptorchid testis on d 5 and dropped dramatically along with the loss of apoptotic germ cells in the cryptorchid testis on d 10 after operation. It is therefore suggested that Hsp70-2 might not take part in inhibiting the apoptosis of germ cells at the early stage during operation-induced cryptorchid testis, and that Hsp70-2 gene does not belong to the immediate early related gene responsible for germ cell apoptosis induced by heat stress.     

Glucose and fat metabolism in adipose tissue of acetyl-CoA carboxylase 2 knockout mice

Acc2-/- mutant mice, when fed a high-fat/high-carbohydrate (HF/HC) diet, were protected against diet-induced obesity and diabetes. To investigate the role of acetyl-CoA carboxylase 2 (ACC2) in the regulation of energy metabolism in adipose tissues, we studied fatty acid and glucose oxidation in primary cultures of adipocytes isolated from wild-type and Acc2-/- mutant mice fed either normal chow or a HF/HC diet. When fed normal chow, oxidation of [14C]palmitate in adipocytes of Acc2-/- mutant mice was approximately 80% higher than in adipocytes of WT mice, and it remained significantly higher in the presence of insulin. Interestingly, in addition to increased fatty acid oxidation, we also observed increased glucose oxidation in adipocytes of Acc2-/- mutant mice compared with that of WT mice. When fed a HF/HC diet for 4-5 months, adipocytes of Acc2-/- mutant mice maintained a 25% higher palmitate oxidation and a 2-fold higher glucose oxidation than WT mice. The mRNA level of glucose transporter 4 (GLUT4) decreased several fold in the adipose tissue of WT mice fed a HF/HC diet; however, in the adipose tissue of Acc2-/- mutant mice, it was 7-fold higher. Moreover, lipolysis activity was higher in adipocytes of Acc2-/- mutant mice compared with that in WT mice. These findings suggest that continuous fatty acid oxidation in the adipocytes of Acc2-/- mutant mice, combined with a higher level of glucose oxidation and a higher rate of lipolysis, are major factors leading to efficient maintenance of insulin sensitivity and leaner Acc2-/- mutant mice.     

探讨肿瘤标志物在结直肠癌患者中的诊断价值

目的 探讨肿瘤标志物癌胚抗原（carcinoembryonic antigen,CEA）、糖类抗原（carbohydrateantigen,CA）19-9、CA724在结直肠癌中的诊断价值.方法 收集2011年1月-2012年5月期间在我院确诊为结直肠癌的患者153例为患者组,同期选择67例健康体检者作为对照组,检测其血清CEA、CA19-9、CA724水平,按检测结果将患者组分为肿标阳性组和肿标阴性组,并对检测结果进行统计学分析.结果 三项肿瘤标志物检测水平在肿标阳性组、肿标阴性组及对照组间差异均有统计学意义（P均＜ 0.05）,肿标阳性组三项肿瘤标志物水平均高于肿标阴性组及对照组,且差异均有统计学意义（P均＜0.05）.三项肿瘤标志物诊断结直肠癌患者的阳性率分别为32.09％、14.18％、11.94％,三项联合检测的阳性率为43.28％.肿标阳性组、肿标阴性组患者手术前后血清CEA水平差异均有统计学意义（P均＜0.05）,而CA19-9水平在两组患者手术前后差异均无统计学意义（P均＞0.05）,血清CA724水平在肿标阳性组患者手术前后差异有统计学意义（P＜0.05）,而在肿标阴性组患者手术前后差异无统计学意义（P＞ 0.05）.处于不同Dukes分期的结直肠癌患者血清CEA、CA19-9、CA724水平差异均无统计学意义（P均＞ 0.05）.在不同Dukes分期患者中,三项肿瘤标志物联合检测的阳性率均在40％左右.结论 三项肿瘤标志物在结直肠癌中的诊断阳性率均较低,建议临床高度怀疑结直肠癌的患者,即使在各肿瘤标志物均为阴性的情况下,也应及早接受肠镜检查,以免贻误病情.对于已手术的患者,定期监测肿瘤标志物可作为其术后评估指标.     

胃癌变过程中幽门螺杆菌感染与Ki67和P27蛋白表达的意义

目的探讨胃癌变过程中胃黏膜上皮细胞幽门螺杆菌（Hp）感染与细胞增生及抑癌基因P27蛋白表达的意义。方法用快速尿素酶法、美蓝法及免疫组化法联合检测312例胃镜活检标本Hp感染率,其中慢性浅表性胃炎（CSG）112例、慢性萎缩性胃炎（CAG）100例、胃癌（GC）100例。并采用免疫组化技术分别检测标本中Ki67和P27蛋白的表达,观察Hp感染对Ki-67和P27蛋白表达的影响。结果运用三种方法联合检测,所有病例、CSG、CAG和GC中Hp感染率分别为49．0％（158／312）、25．9％（29／112）、53．0％（53／100）、71．0％（71／100）。CAG组明显高于CSG组（P〈0．05）;GC组明显高于CAG组和CSG组P〈0．05,P〈0．01）。所有病例中均能检测到Ki=67和P27蛋白的表达,Ki67在CSG、CAG、GC中的阳性表达率为35．7％（40／112）,58．0％（58／100）,64．0％（64／100）。且GC组明显高于CSG组（P〈0．05）;P27在CSG、CAG、GC中的表达率为36．6％（41／112）,32．0％（32／100）,29．0％（29／100）。随着病变进展,P27的表达逐渐下降,但差异无统计学意义（P〉0．05）。结论Hp在癌组织阳性率明显高于非癌组织,胃癌可能是Hp长期感染与其他因素共同作用的结果。Hp感染可诱导胃黏膜Ki-67和P27的表达异常,使抑制上皮生长与调节细胞凋亡信号传导的转化因子受体数目减少,引起胃黏膜上皮细胞的过度增生,同时也与抑癌基因P27的失活有关。     

静脉药物配置中心新护士岗前培训模式的构建及效果评价

目的 探讨规范化静脉药物配置中心新护士岗前培训模式的实施效果.方法 制订培训计划和培训内容,选拔带教教师,采用多种形式带教和培训考核.结果 新护士独立上岗时间缩短1个月,对整体教学满意度提高（P＜0.05）,独立工作第1年差错频次和绩效考核未达标频次减少（P＜0.01）.结论 静脉药物配置中心岗前培训模式使新护士培训更加规范、有效,值得推广.     

PTEN与P27kipl在膀胱移行细胞癌中的表达及相关性研究

目的：探讨PTEN与P27^kipl在膀胱移行细胞癌（BTCC）组织中的表达情况、相关性及其与病理分级、临床分期的关系。方法：应用免疫组化技术（SP法）检测58例BTCC和13例正常膀胱黏膜标本中FrEN与P27kipl蛋白的表达情况。结果：BTCC中PTEN与P27^kipl蛋白表达明显低于正常膀胱黏膜中两者的表达（P〈0．05）；在BTCC中PTEN与P27^kipl蛋白表达均与肿瘤病理分级和临床分期密切相关（P〈0．05）；在BTCC中PTEN与P27州表达呈正相关（r=0．447，P〈0．05）。结论：PTEN、P27^kipl在BTCC的发生发展中可能发挥了重要作用，两者的联合检测有助于BTCC的早期诊断和预后判断。[著者文摘]     

Calcitriol-Mediated Hypercalcaemia and Increased Interleukins in a Patient with Sarcoid Myopathy

In this report we describe a patient with Sjo¨gren’s syndrome (SS) and calcitriol-mediated hypercalcaemia. Initially, there was no clinical evidence of sarcoidosis. The patient had hypercalcaemia associated with increased calcitriol serum levels; circulating interleukin-6 and tumour necrosis factor alpha levels were also elevated. At the beginning, therapy with clodronate was effective in decreasing the serum calcium levels. However, the serum calcitriol decreased only after chloroquine treatment was added. After 2 years of therapy, the patient developed progressive and extensive muscle weakness. A muscle biopsy revealed a very prominent non-caseating granulomatous myopathy. Corticosteroid therapy was then instituted. Although both chloroquine and corticosteroid therapy were associated with decreased serum interleukin and calcitriol levels, only corticosteroid therapy was effective in treating the sarcoid myopathy. The role of cytokines in calcitriol mediated hypercalcaemia is discussed. Received: 1 February 1999 / Accepted: 2 June 1999