Fascin蛋白在非小细胞肺癌组织中的表达及临床意义

目的分析Fascin蛋白在人非小细胞肺癌(NSCLC)组织中的表达及与患者临床病理特征的关系。方法选取73例NSCLC手术后组织标本(NSCLC组)及30例癌旁组织标本,采用免疫组化法对两种组织标本进行染色和半定量检测,分析Fascin蛋白在NSCLC组织中的表达及与患者临床病理特征的关系。结果 NSCLC组织中,Fascin蛋白16例强(+),17例(+),18例弱(+),22例(-),阳性率为69.9%;癌旁组26例(-),4例弱(+),阳性率13.3%;NSCLC组织中Fascin蛋白的阳性率显著高于癌旁组织,差异显著(P0.05)。NSCLC组织中的Fascin蛋白阳性表达与患者的年龄、性别、吸烟史、肿瘤最大径、组织学类型无关(P0.05);与患者的TNM分期、淋巴结转移、组织学分化程度具有显著的关系(P0.05)。结论 NSCLC组织中Fascin蛋白高表达,并且与NSCLC的分期、分化及淋巴结转移有关。     

GRB2和Ki-67蛋白表达水平变化与结直肠癌发病相关性分析及其意义

目的探讨生长因子受体结合蛋白2(GRB2)、仅存在于增生细胞中的核蛋白(Ki-67)在结直肠癌患者中的变化及其临床意义。方法选取确诊的结直肠癌患者组织标本100例(病灶组)、癌旁组织标本50例(癌旁组),健康对象50例(对照组)进行回顾性研究,收集时间2015年2月至2017年7月。检测病灶组和癌旁组标本中的GRB2与癌症患者与健康对象血清中Ki-67蛋白水平,并分析其与临床病理学特征的关系及在临床治疗中的意义。结果结直肠癌组织中胞浆GRB2的表达显著高于癌旁组织(P0.05),而结肠癌组织、癌旁组织中胞核GRB2中的表达水平差异无统计学意义(P0.05);胞浆GRB2的表达情况与清扫淋巴结个数有关(P0.05);病灶组Ki-67蛋白阳性表达率是82%,高于对照组阳性率,有淋巴结转移者比无淋巴结转移的阳性表达率明显增高(P0.05)。结论 GRB2、Ki-67蛋白在结直肠癌组织中高表达,并且与肿瘤的发生发展关系密切。     

肝癌组织中血管内皮生长因子的表达水平及影响因素分析

目的探讨肝癌组织血管内皮生长因子(VEGF)表达水平及其影响因素。方法 80例原发性肝癌组织标本,40例癌旁组织标本,均采用免疫组化法测定组织VEGF表达情况,分析VEGF与肝癌临床病理参数的关系。结果肝癌组织VEGF表达阳性率高于癌旁组织,且中度阳性、强阳性率比例高于癌旁组织,弱阳性比例低于癌旁组织(P0.05);不同分化程度、不同TNM分期、不同肝功能分级、是否合并淋巴结转移患者VEGF阳性率比较差异均有统计学意义(P0.05);肝癌组织VEGF表达情况与肿瘤分化程度呈负相关,与TNM分期、肝功能分级、淋巴结转移呈正相关(P0.05)。结论肝癌癌组织VEGF呈高表达,且受肿瘤分化程度、TNM分期、淋巴结转移及肝功能分级的影响。     

uH2B在原发性结肠腺癌中的表达及其与临床病理参数的关系

目的探讨原发性结肠腺癌组织中组蛋白H2B单素泛化(uH2B)的表达水平及与患者临床病理参数的关系。方法选取2013年1月—2016年1月本院胃肠外科手术切除的83例结肠腺癌组织标本、癌旁组织,既往收集的20例正常结肠组织,采用免疫组化染色观察各组组织标本中uH2B蛋白的表达程度,并分析与原发性结肠腺癌患者临床病理参数的关系。结果结肠癌组织标本中uH2B蛋白的阳性表达率46.99%,低于癌旁组织的83.13%、正常结肠黏膜组织的90.00%,差异均具有统计学意义(P0.05);癌旁组织和正常结肠黏膜组织中uH2B蛋白的阳性表达率差异无统计学意义(P0.05);结肠癌组织标本中uH2B蛋白的阳性表达率与肿瘤的TNM分期、分化程度、淋巴结转移相关(P0.05),与患者的年龄、性别、肿瘤浸润深度、肿瘤最大径的关系不显著(P0.05)。结论结肠癌组织标本中uH2B蛋白表达率降低,并且与患者的肿瘤的TNM分期、分化程度、淋巴结转移具有相关性。     

结肠癌组织中PUMA和C-myb表达及其临床病理意义

目的研究结肠癌及其癌旁组织中PUMA和C-myb表达水平及其临床病理意义。方法 54例结肠癌和30例癌旁组织手术切除标本常规制作石蜡包埋切片,PUMA和C-myb染色方法为免疫组化法。结果结肠癌PUMA和C-myb表达阳性率及其评分明显高于癌旁组织（P〈0.01）。PUMA和（或）C-myb表达阳性的癌旁组织呈中至重度不典型增生。无淋巴结转移、未侵犯浆膜层及临床分期A＋B的病例PUMA和C-myb表达阳性率明显低于低分化、淋巴结转移和侵犯浆膜层及临床分期C＋D的病例（P〈0.05或P〈0.01）;高分化腺癌PUMA表达阳性率及其评分明显低于中分化或低分化腺癌（P〈0.05）;结肠癌中PUMA和C-myb表达水平呈正相关（r=0.59,P=0.000）。结论 PUMA和C-myb表达与结肠腺癌发生、临床生物学行为有密切关系。     

Ezrin、IGF1R蛋白表达情况与原发性胆囊癌的相关性研究

目的探讨原发性胆囊癌组织中埃兹蛋白(Ezrin)、胰岛素样生长因子受体1(IGF1R)蛋白的表达情况及其与胆囊癌病理学特征的关系。方法回顾性选取湖北理工学院附属医院病理科收集的80例胆囊癌组织标本、40例癌旁组织标本,收治时间2013年1月至2016年7月。应用免疫组织化学染色法检测两组标本中的Ezrin、IGF1R蛋白表达情况,并探讨二者与患者的年龄、性别、肿瘤分化程度、Nevin分期、肝脏侵犯等指标的关系。结果胆囊癌组织中的Ezrin蛋白阳性表达率53. 75%,IGF1R蛋白阳性表达率为51. 25%均显著高于胆囊癌癌旁组织中的5. 00%、10. 00%,差异均具有统计学意义(P 0. 05)。低分化、Ⅲ期和Ⅳ期、发生肝脏侵犯、发生淋巴结转移的胆囊癌患者的Ezrin蛋白阳性表达率显著高于高分化和中分化、Ⅰ期和Ⅱ期、未发生肝脏侵犯、未发生淋巴结转移的胆囊癌患者(P 0. 05)。低分化、Ⅲ期和Ⅳ期、发生淋巴结转移的胆囊癌患者的IGF1R蛋白阳性表达率显著的高于高分化和中分化、Ⅰ期和Ⅱ期、未发生淋巴结转移的胆囊癌患者(P 0. 05)。结论胆囊癌组织总Ezrin、IGF1R蛋白呈显著高表达,并且Ezrin、IGF1R蛋白表达与胆囊癌的病理学特征存在一定的相关性。     

Bcl-2、Bax蛋白在皮肤鳞状细胞癌组织中的表达水平变化及与病理学特征的关系

目的研究Bcl-2、Bax蛋白在鳞状细胞癌组织中的表达水平变化及与病理学特征的关系。方法选取我院2015年1月-2017年10月确诊的鳞状细胞癌组织标本120例为病灶组、癌旁组织标本60例为对照组,检测病灶组和癌旁组标本中的Bcl-2、Bax蛋白表达水平并分析各蛋白表达与患者临床病理参数、预后情况的关系。结果 Bcl-2蛋白在鳞状细胞癌组织中的表达水平明显高于对照组(P0.05);Bax在鳞状细胞癌组织中的表达水平明显低于对照组(P0.05);Bcl-2蛋白的表达与患者肿瘤的组织学分化程度、临床病理学分期、肿瘤的浸润深度及淋巴结转移情况有关(P0.05);Bax蛋白的表达与肿瘤的组织学分化程度有关(P0.05)。结论 Bcl-2蛋白在鳞状细胞癌组织中的表达水平升高,Bax在鳞状细胞癌组织中表达降低,并且与鳞状细胞癌的病理学特征有一定的相关性。     

甲状腺癌患者CXCR4和Ki-67表达及其与预后的相关性

目的探讨甲状腺癌患者趋化因子受体4(CXCR4)和增殖细胞核抗原Ki-67表达及其与预后的相关性。方法收集该院甲状腺癌组织标本82例(甲状腺癌组)、甲状腺癌旁组织标本82例(癌旁组织组)及甲状腺良性病变标本82例(对照组),采用免疫组化染色法检测各组标本中CXCR4、Ki-67的阳性表达情况,并分析甲状腺癌组织CXCR4、Ki-67表达与临床病理特征及预后的关系。结果甲状腺癌组CXCR4、Ki-67蛋白的阳性表达率显著高于癌旁组织组、对照组(P0.05)。甲状腺癌组织中CXCR4阳性率与病理分期、淋巴结转移有关(P0.05);Ki-67阳性率与病理分期、淋巴结转移、包膜侵犯有关(P0.05)。甲状腺癌患者的中位疾病进展时间(TTP)为37.92个月(95%CI:27.89～43.31),CXCR4、Ki-67阳性者的TTP显著高于阴性表达者(P0.05)。结论甲状腺癌患者CXCR4、Ki-67呈高表达状态,且表达水平与其临床病理特征相关,共同影响患者术后复发转移。     

Ezrin及其相关蛋白在乳腺癌组织中的表达及临床意义

目的:研究乳腺癌组织中Ezrin、CD44v6及E-cadherin蛋白的表达及其临床病理意义。方法:应用免疫组化SP法,检测56例乳腺癌组织、30例癌旁正常乳腺组织组织标本中Ezrin、CD44v6、E-cadherin的表达情况。结果:(1)乳腺癌组织中Ezrin、CD44v6和E-cadherin的表达率分别为62.50%、76.79%和26.79%,与正常乳腺组织相比差异有统计学意义(P0.05)。(2)Ezrin、CD44v6的表达与乳腺癌的原发肿瘤大小、组织学分级、临床TNM分期和淋巴结转移有关(P0.05);E-cadherin的下调表达与乳腺癌的组织学分级、临床TNM分期和淋巴结转移有关(P0.05)。(3)在浸润性导管癌中Ezrin与CD44v6表达水平呈显著正相关(P0.05),而与E-cadherin表达水平呈显著负相关(P0.05)。结论:联合检测Ezrin、CD44v6和E-cadherin的表达有助于预测乳腺癌的恶性程度和转移潜能。     

Shh在散发性甲状腺髓样癌中的表达及其临床意义研究

目的 通过检测Sonic Hedgehog信号通路关键分子Shh在散发性甲状腺髓样癌表达情况,探讨其与散发性甲状腺髓样癌临床病理特征的关系及临床意义.方法 应用免疫组织化学方法检测11例甲状腺髓样癌患者癌组织及其癌旁组织病理蜡块标本中Shh的表达情况,分析其与临床病理特征的关系.结果 Shh蛋白主要表达于细胞膜与细胞质中.甲状腺髓样癌组织中Shh阳性表达率72.7％ (8/11)明显高于癌旁组织的9.1％(1/11).癌组织中Shh的表达与患者性别及年龄均无关(P＞0.05),而与肿瘤的TNM分期有关(P＜0.05).Shh在肿瘤直径≥1 cm和直径＜1 cm的表达阳性率分别为100％和20％,差异有统计学意义(P＜0.01).Shh在有淋巴结转移的肿瘤组织中和无淋巴结转移的肿瘤组织中的表达阳性率分别为100％和40％,差异有统计学意义(P＜0.05).结论 Shh信号通路的主要配体Shh蛋白在散发性甲状腺髓样癌中表达升高,并与肿瘤发生、分期及淋巴结转移有关,提示Shh信号通路的异常激活在散发性甲状腺髓样癌中发挥一定的作用,Shh蛋白为散发性甲状腺髓样癌预后判断指标及潜在的治疗靶点.     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Modified micro-superior percutaneously-assisted total hip: early experiences & case reports

Because of the extensile nature and familiarity of the standard posterior-lateral approach to the hip, a family of "micro-posterior" approaches has been developed. This family includes the Percutaneously-Assisted Total Hip (PATH) approach, the Supercapsular (SuperCap) approach and a newer hybrid approach, the Supercapsular Percutaneously-Assisted Total Hip (SuperPATH) approach. Such approaches should ideally provide a continuum for the surgeon: from a "micro" (external rotator sparing) posterior approach, to a "mini" (external rotator sacrificing) posterior approach, to a standard posterior approach. This could keep a surgeon within his comfort zone during the learning curve of the procedure, while leaving options for complicated reconstructions for the more practiced micro-posterior surgeons. This paper details one author's experiences utilizing this combined approach, as well as permutations of this entire micro-posterior family of approaches as applied to more complex hip reconstructions.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Structure and function of "metalloantibiotics"

Although most antibiotics do not need metal ions for their biological activities, there are a number of antibiotics that require metal ions to function properly, such as bleomycin (BLM), streptonigrin (SN), and bacitracin. The coordinated metal ions in these antibiotics play an important role in maintaining proper structure and/or function of these antibiotics. Removal of the metal ions from these antibiotics can cause changes in structure and/or function of these antibiotics. Similar to the case of "metalloproteins," these antibiotics are dubbed "metalloantibiotics" which are the title subjects of this review. Metalloantibiotics can interact with several different kinds of biomolecules, including DNA, RNA, proteins, receptors, and lipids, rendering their unique and specific bioactivities. In addition to the microbial-originated metalloantibiotics, many metalloantibiotic derivatives and metal complexes of synthetic ligands also show antibacterial, antiviral, and anti-neoplastic activities which are also briefly discussed to provide a broad sense of the term "metalloantibiotics."