阻抑素在胃肠癌中的表达情况及其临床意义

目的检测阻抑素(PHB)在胃肠癌中的表达情况,探讨PHB对胃肠肿瘤诊断的价值。方法采用免疫组织化学法检测PHB在胃肠癌癌组织和癌旁组织中的表达情况。结果PHB在胃肠癌组织的表达量明显高于其相应癌旁组织的表达量,差异有极显著性(P<0.01);PHB在低分化胃癌、肠癌组织中的表达量明显高于中分化癌组织,差异有极显著性(P<0.01)。结论PHB在胃肠癌中特异性高表达,检测胃癌、肠癌组织中PHB的表达对胃癌、肠癌及其分化程度具有潜在诊断价值,为胃肠癌的临床诊断和治疗奠定了实验基础。     

乳腺癌组织中LncRNA ADAMTS9-AS1与miR-513a-5p的表达及临床意义

目的研究乳腺癌组织中长链非编码RNA(LncRNA)ADAMTS9-AS1、miR-513a-5p的表达,并分析二者的关系及临床意义。方法选取2015年8月—2017年8月诊治的乳腺癌患者83例为研究对象。应用实时定量PCR检测乳腺癌及癌旁组织中LncRNA ADAMTS9-AS1、miR-513a-5p的表达。Pearson相关分析二者的相关性,在线生物信息学软件分析二者的相互作用位点,Kaplan-Meier生存分析二者表达对乳腺癌患者预后的影响,多因素Cox回归分析影响患者预后的危险因素。结果与癌旁组织比较,乳腺癌组织中LncRNA ADAMTS9-AS1表达降低,miR-513a-5p表达升高(P0.01)。乳腺癌组织中LncRNA ADAMTS9-AS1与miR-513a-5p表达呈明显负相关(P0.01),且二者存在潜在的结合位点。乳腺癌组织中LncRNA ADAMTS9-AS1、miR-513a-5p表达与肿瘤分期及淋巴结转移有相关性(P0.05,P0.01)。Kaplan-Meier生存分析结果LncRNA ADAMTS9-AS1低表达及miR-513a-5p高表达乳腺癌患者的3年总体生存率较低(P0.01)。乳腺癌组织中LncRNA ADAMTS9-AS1低表达、miR-513a-5p高表达、高肿瘤分期及伴有淋巴结转移是影响乳腺癌患者预后的独立危险因素(P0.05,P0.01)。结论乳腺癌组织中LncRNA ADAMTS9-AS1表达下调,而miR-513a-5p表达上调,二者表达与乳腺癌患者肿瘤分期及不良预后有关,可作为乳腺癌的肿瘤标志物。     

基于高通量多组学数据分析ESYT3在乳腺癌中的表达及临床意义

目的基于高通量数据库分析扩展突触结合蛋白3(ESYT3)在乳腺癌中的表达及临床意义。方法使用TCGA数据库和基因表达数据库(GEO)的门户网站(c Bio Portal和Oncomine)以及癌症多组学和临床数据库Linked Omics分析ESYT3在乳腺癌中的变化及其与临床预后的关系;分别采用Kaplan-Meier法分析ESYT3变异与乳腺癌患者生存之间的关系,非参数检验分析正常乳腺组织和浸润性乳腺癌组织中ESYT3的表达差异,Spearman非参数检验分析浸润性乳腺癌中ESYT3 m RNA水平与临床各指标的相关性以及基因拷贝数变化和甲基化水平对m RNA表达的影响。结果 c Bio Portal分析结果显示1 098例浸润性乳腺癌患者中,122例发生了ESYT3 m RNA的改变(包括突变、拷贝数变化和m RNA水平上调),其中,ESYT3 m RNA水平上调超过默认阈值(EXP≥2)的占10%,且不利于患者预后(P0.05);Oncomine分析结果显示,浸润性乳腺癌组织中ESYT3m RNA水平明显高于癌旁组织(P0.01);Linked Omics分析结果显示,浸润性乳腺癌中ESYT3 m RNA水平分别受雌激素受体、孕激素受体、PAM50分型、组织学类型、年龄以及肿瘤纯度的影响(P0.01);ESYT3 m RNA水平与其基因拷贝数呈正相关(P0.01),而与其DNA甲基化呈负相关(P0.01)。结论 ESYT3拷贝数增加和低甲基化促进其表达,且ESYT3高表达不利于乳腺癌患者预后,可作为预后的候选标志物。     

HER-2、Ki-67及CD147在乳腺癌中的表达及对病情进展和预后生存的评估

目的分析人类表皮生长因子受体-2(HER-2)、原癌基因增殖细胞核抗原Ki-67和细胞外基质金属蛋白酶诱导因子CD147表达对乳腺癌病情进展、预后生存的评估价值。方法选取2014年7月—2017年6月诊治的乳腺癌101例,收集乳腺癌组织及癌旁正常组织(距离癌组织5 cm以上),分别作为乳腺癌组和癌旁组织组。比较两组HER-2、Ki-67及CD147的表达,观察三者与临床病理参数的关系。记录所有患者在随访时间内存活及死亡情况,采用多因素Logistic回归分析影响乳腺癌患者预后生存的危险因素。结果 HER-2、Ki-67及CD147在乳腺癌组中阳性表达率均高于癌旁组织组(P0.01)。乳腺癌患者HER-2、Ki-67及CD147表达水平与组织分化类型、TNM分期、脉管侵袭和淋巴结侵袭具有显著相关性(P0.05,P0.01)。截至随访结束,101例乳腺癌患者生存65例,死亡36例,病死率为35.64%。组织中低分化、TNM分期为Ⅲ+Ⅳ期、脉管侵袭、淋巴结侵袭、HER-2、Ki-67及CD147表达阳性是影响乳腺癌患者预后生存的独立危险因素(P0.05,P0.01)。结论 HER-2、Ki-67及CD147在乳腺癌组织中表达异常,且与患者病情进展及预后生存密切相关,或可作为预测乳腺癌患者预后生存的分子标志物和肿瘤治疗的潜在靶点。     

血浆长链非编码RNA H19对乳腺癌的潜在诊断价值

目的探讨长链非编码RNA(lncRNA)H19在乳腺癌患者血浆中的表达水平及其对乳腺癌的潜在诊断价值。方法采用定量-逆转录PCR(qRT-PCR)检测24例乳腺癌患者癌组织及其癌旁组织,以及97例乳腺癌患者、30例乳腺良性疾病患者和86例体检健康者血浆中H19的表达水平,分析血浆H19表达量与乳腺癌临床病理参数的相关性;采用电化学发光免疫分析法(ECLI)检测血浆中CA153和CEA的水平,对血浆H19、CA153和CEA进行多元Logistic回归分析,绘制受试者工作特征曲线(ROC曲线)以评估血浆H19对乳腺癌的诊断效能。结果与癌旁组织相比,H19在乳腺癌组织中表达明显增高(Z=-2.371,P=0.018);乳腺癌组血浆H19水平明显高于良性病变组(U=411,P0.01)和体检健康组(U=2 138,P0.01);乳腺癌患者血浆中H19表达水平与雌激素受体(ER)、孕激素受体(PR)、c-erb B-2以及淋巴结转移相关(P均0.05);血浆H19单独诊断乳腺癌的ROC曲线下面积(AUC~(ROC))为0.827,敏感性和特异性分别为57.7%和86.4%,其对乳腺癌诊断效能明显高于CA153(AUC~(ROC)=0.661)和CEA(AUC~(ROC)=0.524),且H19、CA153和CEA联合诊断价值(AUC~(ROC)=0.853)亦高于单独检测。结论血浆中高表达的H19可能为乳腺癌诊断的一个潜在的生物学标志物。     

乳腺癌淋巴转移与Galectin-3、CA19-9表达的相关性研究

目的通过检测乳腺癌组织中半乳凝素-3(Galectin-3)、CA19-9的表达,探讨Galectin-3、CA19-9与乳腺癌淋巴结转移的相关性研究。方法对85例乳腺癌患者手术切除的癌组织:(1)进行常规连续切片HE染色病理诊断、分期。(2)应用免疫组织化学方法检测癌组织中及癌旁组织Galectin-3、CA19-9的表达水平;(3)结合淋巴结转移情况进行分析对比。结果 (1)有淋巴结转移组的癌组织Galectin-3和CA19-9表达与无淋巴结转移组癌组织中的表达有差异性改变(P0.05)。(2)有淋巴结转移组癌旁组织Galectin-3、CA19-9表达与无淋巴结转移组的癌旁组织中的表达亦呈差异性改变(P0.05)。结论乳腺癌的侵袭及淋巴结转移可能与Galectin-3与CA19-9的表达呈正相关性改变。     

乳腺癌组织中ELMO3,FOXK1的表达及其临床意义

目的:检测乳腺癌组织中吞噬和运动蛋白3(engulfment and cell mobility 3,ELMO3)、叉头框转录因子1(forkhead box k1,FOXK1)的表达情况,并探讨两者在乳腺癌组织中表达的相关性及与乳腺癌患者临床病理参数、预后的关系。方法:收集2013年1月至2018年1月惠州市第三人民医院乳腺癌患者手术标本80例,应用实时荧光定量PCR(quantitative real-time polymerase chain reaction,qRT-PCR)和免疫组织化学检测乳腺癌组织及癌旁组织中ELMO3与FOXK1的表达情况;并分析乳腺癌组织中ELMO3与FOXK1表达的相关性,及其的表达与乳腺癌患者临床病理参数、预后的关系。结果:qRT-PCR检测ELMO3mRNA,FOXK1mRNA在乳腺癌组织中表达分别为1.16±0.48,1.34±0.60,在癌旁组织中表达分别为0.81±0.36,0.95±0.49;乳腺癌组织中ELMO3与FOXK1表达水平均高于癌旁组织(均P0.05),且乳腺癌组织中ELMO3与FOXK1的表达呈正相关(r=0.423,P=0.037)。免疫组织化学检测EL MO3与FOX K1在乳腺癌组织中阳性表达分别为58例(72.52%),6 2例(7 7. 5 0%),在癌旁组织中阳性表达分别为2 8例(3 5. 0 0%), 2 9例(3 6. 2 5%),乳腺癌组织中ELMO3与FOXK1阳性表达率均高于癌旁组织(均P0.05)。ELMO3与肿瘤TNM分期、淋巴结转移显著相关,FOXK1与肿瘤组织TNM分期、淋巴结转移和组织分级显著相关(均P0.05)。KaplanMeier生存曲线分析显示乳腺癌组织中ELMO3与FOXK1高表达患者生存期较短。结论:乳腺癌组织中ELMO3与FOXK1呈高表达,并与肿瘤发生发展及预后有关。ELMO3与FOXK1在乳腺癌组织中表达呈正相关,可能协同参与了乳腺癌的发生发展。ELMO3与FOXK1具有作为乳腺癌新的标志物、治疗靶标及评估预后的潜在价值。     

miR-21和miR-93表达水平与三阴性乳腺癌发生发展的相关性研究

目的探讨miR-21和miR-93的表达水平与三阴性乳腺癌(TNBC)发生发展的相关性。方法选择行乳腺癌根治术的女性患者86例,收集癌组织与正常乳腺组织,采用逆转录聚合酶链反应(RT-PCR)检测miR-21和miR-93的相对表达量,并分析其与临床病理特征的相关性。结果 miR-21和miR-93在TNBC组织中相对表达量高于癌旁组织;TNBC组织中,miR21高表达54例,占62.79%,miR-93高表达50例,占58.14%;miR-21和miR-93在肿瘤直径5 cm、临床分期为Ⅲ~Ⅳ期以及淋巴结转移的患者中高表达率显著增高(P0.01);miR-21和miR-93的表达水平与患者年龄、月经状态、病理分级无明显相关性。癌组织中miR-21与miR-93表达水平呈显著正相关(r=0.761,P0.01)。结论 miR-21与miR-93在TNBC中表达异常增高,且与肿瘤直径、临床分期、淋巴结转移有关,可作为TNBC诊断及判断预后的辅助指标。     

5脂氧化酶在乳腺癌中的表达及临床意义

目的 探讨5脂氧化酶(5-LOX)在乳腺癌组织中的表达及临床意义.方法 采用免疫组化方法检测74例乳腺癌(乳腺癌组)、24例癌旁组织(癌旁组)及18例正常乳腺组织(对照组)中5-LOX蛋白的表达;并分析其与临床病理特征的相关性.结果 乳腺癌组74例中5-LOX阳性表达64例,明显高于癌旁组24例中阳性表达4例及正常乳腺组织18例中阳性表达2例(86.5％、16.7％及11.1％,x2=70.029,P＜0.01);5-LOX表达与肿瘤大小(Rs =0.375,P＜0.001)、组织学分级(Rs=0.236,P＜0.05)、临床分期(Rs=0.249,P＜0.05)、淋巴结转移(Rs =0.355,P＜0.01)呈正相关,与患者年龄、雌激素及孕激素受体情况无关.结论 5-LOX蛋白与乳腺癌的发生、发展和转移有关,有可能作为独立指标判断乳腺癌预后.     

葡萄糖神经酰胺合成酶在乳腺癌中的表达及与乳腺癌临床病理特征的相关性分析

目的探讨葡萄糖神经酰胺合成酶(GCS)在乳腺癌中的表达及与乳腺癌临床病理特征的相关性。方法选取乳腺癌组织标本87例,同时选取癌旁组织作为对照,观察乳腺癌和癌旁组织中GCS表达情况,分析GCS表达与乳腺癌临床病理特征相关性。结果 87例乳腺癌组织GCS阳性表达63例(72.41%),癌旁组织GCS阳性表达40例(45.98%),GCS阳性表达率乳腺癌组织明显高于癌旁组织,差异有统计学意义(P0.05)。GCS表达与乳腺癌患者年龄、TNM分期、雌性激素受体(ER)、人类表皮生长因子受体2(HER-2)及表皮生长因子受体(EGFR)相关(P0.05)。多因素相关性分析结果显示乳腺癌患者GCS表达与年龄、TNM分期、ER及EGFR呈正相关,与HER-2呈负相关。结论 GCS在乳腺癌组织中呈高表达,与ER和HER-2有一定关系,可能与乳腺癌癌细胞分裂、增殖、扩散和转移密切相关,能反映病情进展程度。     

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.