大肠正常组织和癌组织自体荧光差异病理学基础

目的：比较胶原Ⅰ、Ⅲ、Ⅳ型在大肠正常组织和癌组织的分布差异,分析组织癌变后胶原的改变对自体荧光产生的影响。方法：采用免疫组化技术,半定量计分分析Ⅰ、Ⅲ、Ⅳ型胶原亚型在２６例病人正常和腺癌组织中的分布差异。结果：正常组织的基底膜呈现很强的Ⅳ型胶原抗体阳性反应,在基底膜形成较粗的环形染色带;Ⅰ型和Ⅲ型胶原抗体反应在细胞外基质呈连续的细丝纤维样,紧贴基底膜,间质中染色较基底膜稍深。癌组织Ⅳ型胶原抗体反应在癌巢周边为阴性,或仅在残存的基底膜有片断的阳性反应;Ⅰ型和Ⅲ型胶原在癌巢周边的反应呈阴性或不连续性的阳性,但癌间质的阳性反应较正常间质内明显。癌细胞浸润深肌层后癌巢周边间质内三种胶原抗体反应均呈阴性。Ⅰ型、Ⅲ型和Ⅳ型在正常组织和癌组织中的分布存在十分显著性差异（Ｐ〈０．００１）,但在不同分化程度腺癌的分布上无明显差异     

Ⅰ、Ⅲ、Ⅳ、Ⅴ型胶原和层连蛋白在人肝硬化和肝细胞癌中的分布

正常肝脏肝窦壁Ⅳ型胶原和层连蛋白染色阳性,说明存在基底膜结构,是为功能性基底膜。肝硬化时肝窦毛细血管化,使功能性基底膜破坏。肝硬化时各种细胞外基质成分显著增多,以Ⅰ型胶原为最多。由于各成分增多程度不一致,使细胞外基质的构成发生了改变,原发性肝细胞性肝癌组织中细胞外基质的分布与含量与癌组织的分化程度密切相关,分化程度高,细胞外基质沿癌组织小梁间的血窦壁排列成连续或断续线状;分化程度低,癌组织的细胞外基质仅见于血管壁。     

Ⅰ、Ⅲ、Ⅳ、Ⅴ型胶原和层连蛋白在人肝硬化和肝细胞癌中的分布

正常肝脏肝窦壁Ⅳ型胶原和层连蛋白染色阳性,说明存在基底膜结构,是为功能性基底膜.肝硬化时肝窦毛细血管化,使功能性基底膜破坏,肝硬化时各种细胞外基质成分显著增多,以Ⅰ型胶原为最多.由于各成分增多程度不一致,使细胞外基质的构成发生了改变.原发性肝细胞性肝癌组织中细胞外基质的分布与含量与癌组织的分化程度密切相关.分化程度高,细胞外基质沿癌组织小梁间的血窦壁排列成连续或断续线状;分化程度低,癌组织的细胞外基质仅见于血管壁.     

胶原和层连蛋白在人肝硬化和肝细胞癌中的分布

正常肝脏肝窦壁Ⅳ型胶原和层连蛋白染色阳性,说明存在基底膜结构,是为功能性基底膜.肝硬化时肝窦毛细血管化,使功能性基底膜破坏.肝硬化时各种细胞外基质成分显着增多,以Ⅰ型胶原为最多.由于各成分增多程度不一致,使细胞外基质的构成发生了改变.原发性肝细胞性肝癌组织中细胞外基质的分布与含量与癌组织的分化程度密切相关.分化程度高,细咆外基质措癌组织小梁间的血窦壁排列成连续或断续线状;分化程度低,癌组织的细胞外基质仅见于血管壁.     

Smoothened蛋白及mRNA在子宫颈鳞状细胞癌组织中的表达及意义

目的探讨Smoothened(Smo)蛋白及mRNA在子宫颈鳞状细胞癌组织中的表达及意义。方法应用免疫组织化学方法及原位杂交法检测70例子宫颈鳞状细胞癌组织、48例子宫颈上皮内瘤变(CIN)组织及65例正常子宫颈黏膜组织中Smo蛋白及mRNA的表达水平,分析Smo基因与子宫颈鳞状细胞癌病理特征的联系。结果 Smo蛋白及mRNA在正常宫颈黏膜组织中呈阴性或弱阳性表达,在CIN和子宫颈鳞状细胞癌组织中呈强阳性,其表达率显著高于正常宫颈黏膜组织(P<0. 05); Smo蛋白的阳性表达率与子宫颈鳞状细胞癌浸润深度、病理学分级、有无淋巴结转移呈正相关(P<0. 05)。结论子宫颈鳞状细胞癌的发生、发展及浸润转移或与Smo蛋白阳性表达率升高有关,有望成为宫颈癌生物治疗的新靶点。     

子宫颈鳞状细胞癌组织中SIAH2、CARM1的表达与意义

目的：探讨子宫颈鳞状细胞癌组织中SIAH2、CARM1的表达及与临床特征间的关系。方法：前瞻性选取2020年5月至2022年5月漳浦县医院收治的120例子宫颈鳞状细胞癌患者为研究对象，于患者入院后检测癌组织与配对癌旁组织中SIAH2、CARM1相关蛋白的表达水平，分析上述指标与临床病理特征的相关性。结果：子宫颈鳞状细胞癌组织中SIAH2、CARM1的阳性表达率明显较子宫颈鳞状细胞癌旁组织高（P＜0.05）；SIAH2、CARM1通路相关蛋白阳性表达与年龄、肿瘤直径无关（P＞0.05），但可能与分化程度、肌层浸润深度、FIGO分期、淋巴结转移有关（P＜0.05）；Logistic回归分析结果得出，子宫颈鳞状细胞癌组织SIAH2、CARM1通路相关蛋白表达阳性率在低分化、肌层浸润深度≥1/2、FIGO分期为Ⅲ~Ⅳ期、淋巴结转移的患者中较高（OR＞1，P＜0.05）。结论：SIAH2、CARM1在子宫颈鳞状细胞癌组织中的阳性表达率较癌旁组织高，且与临床病理特征（分化程度、肌层浸润深度、FIGO分期、淋巴结转移）有一定关系。     

恶性肿瘤患者血清层粘连蛋白的测定及意义

层粘连蛋白(Laminin, LN)是细胞外间质中非胶原糖蛋白的主要成分,它广泛分布于基底膜的透明层中,与Ⅳ型胶原结合,形成基底膜的骨架,参与影响并调节细胞的粘附、运动、生长和分化。正常情况下血清中LN含量较低,在肿瘤或慢性疾病等因素刺激下,出现基底膜的破损改变或机体合成加强,使血清中含量明显上升。为此,我们对我院一年来收治的84例恶性肿瘤患者进行了血清LN的检测,以探讨其变化及临床意义,现报告如下。     

表皮钙黏蛋白和层黏连蛋白在喉癌及下咽鳞状细胞癌中表达及意义

目的探讨表皮钙黏蛋白(epithelial cadherin,E-cad)和层黏连蛋白(laminin,LN)在喉癌、下咽鳞状细胞癌中表达及意义。方法应用免疫组织化学SP法检测35例喉癌和15例下咽鳞状细胞癌患者手术组织标本,不同分化程度及颈淋巴结转移者E-cad和LN表达情况。结果高分化癌者E-cad和LN阳性表达率高于中、低分化癌者(P<0.05);颈淋巴结转移者E-cad和LN阳性表达率低于未转移者(P<0.01)。结论 E-cad和LN可作为判断喉癌、下咽鳞状细胞癌分化及转移的重要指标。     

TGF—β1，VEGF抗体等与2型糖尿病肾病患者并发高血压肾间质纤维化指标变化的相关性研究

目的 探讨转化生长因子(TGF-β1)、血管内皮生长因子(VEGF)抗体、肿瘤坏死因子(TNF-α)、透明质酸(HA)、纤维连接蛋白(FN)、层黏连蛋白(LN)、Ⅳ型胶原(CⅣ)、Ⅱ型前胶原(PCⅡ)在2型糖尿病肾病患者并发高血压肾间质纤维化的发病机理及病程进展中表达的相关性.方法 选择经诊断为2型糖尿病肾病并发高血压患者146例;同时选择40例健康正常人作对照组.应用酶联免疫分析法(ELISA)时TGF-β1,VEGF抗体,TNF-α进行检测,用化学发光分析法对HA,FN,LN,CⅣ,PCⅡ进行检测.结果 2型糖尿病肾病并发高血压肾间质纤雏化患者的TGF-β1,VEGF,VEGF抗体,TNF-α,FN,LN,CⅣ,PCⅡ表达显著上调(P＜0.01),校正常对照组差异有统计学显著性意义(P＜0.01),且与病情的进展呈正相关;而HA表达明显下调,较正常对照组差异有统计学显著性意义(P＜0.01),且与病情的进程呈负相关.结论 生长因子(PEDF)是有效的血管生成抑制剂,对保持正常组织透明无血管的状态有重要作用,TGF-β1是促进纤维化的重要细胞因子,调节肌成纤雏细胞分化和胶原合成,在肾纤维化发生发展中起着重要的作用.而VEGF是血管和淋巴内皮细胞的生长和分化及正常争异常血管新生的重要的调节因子,在生理和病理性血管新生中起重要作用.三者同时表达异常,可能提示肾间质纤维化患者免疫病理机理中的细胞活化模式,对肾间质纤维化惠者的免疫机制和指导治疗有指导意义.     

MUC1、MUC2在宫颈癌中的表达及其临床意义

目的探讨MUC1、MUC2两种粘蛋白在宫颈鳞状细胞癌中的表达及其临床意义。方法 30例宫颈鳞状细胞癌的组织样本(实验组)和10例轻度慢性宫颈炎的组织标本(对照组),应用免疫组织化学及Western blot技术检测组织内MUC1、MUC2两种粘蛋白在宫颈鳞状细胞癌中的表达。结果 MUC1蛋白在宫颈鳞状细胞癌中的表达明显高于对照组(P<0.05),且浸润深度>3mm的癌组织的表达明显高于浸润深度≤3mm(P<0.05);而与发病人群的年龄、浸润范围、宫颈癌组织的分化及有无淋巴结转移无明显相关性;MUC2蛋白在宫颈鳞状细胞癌中无明显表达。结论 MUC1蛋白与子宫颈鳞状细胞癌的发生发展有关。     

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.     

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.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.     

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.     

Clinical Trial Updates and Hotline Sessions presented at the European Society of Cardiology Congress 2007

This article provides information and commentaries on trials which were presented at the Hotline and Clinical Trial Update Sessions at the European Society of Cardiology Congress 2007 in Vienna. The key presentations were performed by leading experts in the field with relevant positions in the trials or registries. It is important to note that unpublished reports should be considered as preliminary data, as the analysis may change in the final publications. The comprehensive summaries have been generated from the oral presentation and the webcasts of the European Society of Cardiology and should provide the readers with the most comprehensive information of relevant publications.     

Balance and Boundaries in Grief Counseling: An Intervention Framework for Volunteer Training

Volunteers or paraprofessional counselors are commonly used to provide supportive care to the bereaved. These counselors generally are trained in basic listening skills, providing a generic, nonspecific approach to intervention that remains to be proven effective. The present paper outlines a framework that provides paraprofessionals with a broader model for intervention with the bereaved. Attention to boundaries as a helper and balance in the grief recovery are central to the model. Interventions are described that provide the paraprofessional counselor with more options for tailoring their counseling strategy to the individual. These include techniques that are presumed to be more specific to the enhancement of grief recovery.     

A new method for the simultaneous analysis of unmodified and modified urinary nucleosides and nucleobases by high performance liquid chromatography

Details are given of a new, rapid and simple pre-fractionation method and an isocratic high performance liquid chromatography system suitable for parallel analysis of nucleosides and nucleobases from urine and other biological fluids. The quantitative recovery and excellent reproducibility of the method is demonstrated by analysis of representative standard RNA catabolites. The advantage of this new method for application to biological samples is discussed.     

Adsorption of Charged Non-albumin Bound Drugs by Amorphous Silica

We investigated the in vitro drug adsorption of PQ 10150 sodium silicate gel (AIS, Santa Clara, CA) with particle size of 230 um and surface area of 400 nr/g. We observed 99% to 88% adsorption of gentamicin; a mean 91 % of disopyramide; a mean 89% of quinidine at low concentration, falling to 75% at higher concentration. Insulin was 88% adsorbed at low concentrations but less so (65%) at higher concentrations. We observed a mean 83 % adsorption of procainamide, a mean 84% of N-acetyl procainamide, 74% oflidocaine, 73% of amitriptyline; and 44% of desipramine. We found an average 14% reduction of total digoxin concentration when serum containing digoxin (2 to 33 ng/mL) was exposed to sodium silicate, while the reduction in free digoxin concentration was 16%. Five percent ethosuximide was also removed. The adsorption of theophylline, phenobarbital, acetaminophen, phenytoin, ethylene glycol, methotrexate, salicylate, thiocyanate and diazepam was minimal and not significant. We conclude that significant amounts of charged, non-albumin bound drugs can be removed by PQ 10150 sodium silicate gel.