痰标本涂片检查与培养结果分析

目的：探讨痰标本涂片检查在细菌培养以及临床治疗中的意义。方法：送检标本首先直接涂片革兰染色镜检,同时将合格痰标本划分为以阴性杆菌、阳性球菌、霉菌为主和普通标本四大类。再对合格痰标本行细菌学培养及药物敏感测定。结果：314份痰标本合格率为62．4％(196／314)。196份合格痰标本共检出145株病原菌,培养阳性率74．0％。涂片以阴性杆菌、阳性球菌、霉菌为主的标本与培养结果符合率分别为93．1％、68．4％和41．2％。结论：痰培养结果的准确性受痰标本是否合格、病原菌的生长速度以及是否使用过大剂量抗生素等因素直接影响。临床医生必须依据临床症状及涂片结果判断作出何种为真正的病原菌。     

MMP-2 VEGF在肺腺癌细胞中的表达及其意义

目的研究探讨基质金属蛋白酶2(MMP-2)及血管内皮生长因子(VEGF)在胸腔积液、痰液中肺腺癌细胞的不同表达及二者在肺癌细胞侵袭转移过程中的相互关系。方法选择胸腔积液、痰液共计264例癌性及异型增生细胞标本经免疫细胞化学方法分别检测MMP-2 VEGF的表达情况。结果免疫细胞化学结果显示:MMP-2在胸腔积液中腺癌细胞、异型增生上皮细胞的表达率分别为71.7%(99/138)、16.7%(6/36),在胸膜炎和结核病变典型良性胸腔积液增生上皮细胞中不表达;在痰腺癌细胞中的表达率为39.1%(27/69),统计结果显示MMP-2在恶性胸腔积液腺癌细胞中的表达率明显高于在异型增生的上皮、增生的上皮及痰腺癌细胞的表达率(P均0.05)。VEGF在胸腔积液中腺癌细胞、异型增生上皮细胞的表达率分别为89.1%(123/138)、33.3%(12/36),在胸膜炎和结核病变典型良性胸腔积液增生上皮细胞中不表达;在痰腺癌细胞中的表达率为47.8%(33/69),VEGF在恶性胸腔积液腺癌细胞中表达率明显高于在异型增生的上皮细胞、增生的上皮细胞及痰腺癌细胞的表达率(P均0.05),且MMP-2同VEGF总阳性表达率之间成正相关(r=0.867,P=0.049)。结果 MMP-2 VEGF在胸水腺癌细胞中高表达,可能与肺腺癌的转移、侵袭有关;两者联合做免疫细胞化学检查对肺腺癌细胞病理诊断有辅助意义。     

Bacteriological follow-up of pulmonary tuberculosis treatment: a study with a simple colorimetric assay

The viability of Mycobacterium tuberculosis (MTB) in serial sputum specimens from persistently smear positive patients was evaluated. The assay was based on oxidation-reduction of Alamar Blue and Malachite Green dyes that change their color in response to MTB growth. A total of 280 sputum specimens from 40 persistently smear positive TB patients and 40 sputa from non-tuberculosis patients were digested, decontaminated and examined microscopically. To check the MTB viability, the sediments from decontaminated samples were inoculated into three culture media: Lowenstein-Jensen (LJ) slants, Alamar Blue and Malachite Green culture tubes. We found that out of 280 smear positive specimens, the LJ culture was positive in 124 (44%). The numbers of correctly identified S+/C+ cases by Alamar Blue and Malachite Green were 118 (95%) and 116 (93%), respectively. The mean time required for reporting the positive signal in Alamar Blue culture tubes was 9 versus 11 days by Malachite Green culture tubes. In the standard LJ culture media the average detection time was 27 days (P < 0.05). The sensitivity of LJ was 99%, Alamar Blue 95% and Malachite Green 93%. The specificity was 100%, 92% and 93%, respectively. The oxidation-reduction method is rapid, sensitive and inexpensive in monitoring the treatment response of patients with pulmonary TB. Thus, using this method can be of paramount importance, particularly in resource-constrained areas.     

Somatostatin inhibition of phosphoinositides turnover in isolated rat acinar pancreatic cells: interaction with bombesin.

The effects of somatostatin-14 and bombesin on [3H]inositol phosphate accumulation were studied in 24 h myo-[3H]inositol-prelabeled cultured rat acinar cells. Bombesin, 10 nM, stimulated basal formation of phosphatidyl monophosphate (InsP1), phosphatidyl 4,5-biphosphate (InsP2) and inositol 1,4,5-triphosphate (InsP3) by 128 +/- 5.2%, 147 +/- 10% and 155 +/- 5%, respectively. At 5 s, the ED50 value for InsP3 stimulation was 0.70 +/- 0.2 nM. This stimulation was partly blocked (64 +/- 0.04% inhibition) by 10 ng/ml Bordetella pertussis toxin. In contrast to bombesin, somatostatin, 10 nM, inhibited basal InsP1, InsP2 and InsP3 formation. At 5 s, the inhibition degree for InsP3 was 18 +/- 2.5% and the IC50s values 1 +/- 0.09 nM, 1 +/- 0.12 nM and 0.07 +/- 0.005 nM for InsP1, InsP2 and InsP3, respectively. Bombesin-stimulated InsP3 formation was also inhibited by somatostatin. At 5 s, the inhibition degree was 85 +/- 3.5% at 10 nM and the IC50 value, 0.10 +/- 0.05 nM. Furthermore, somatostatin inhibition of bombesin stimulation was partly blocked (66 +/- 4% inhibition) by Bordetella pertussis toxin. These data therefore suggest that the acinar pancreatic cells contain a somatostatin receptor exerting a negative control on basal and bombesin receptor-stimulated phosphatidyl inositol turnover.     

The role of thrombocyte prostanoids and products secreted by dense granules in the platelet attachment, spreading and aggregation on collagen substrates

The role of platelet prostanoids and substances released from dense bodies (ADP and serotonin) in the initial attachment, spreading and aggregation of platelets on surfaces coated with I, III, IV and V genetic types of collagen was investigated. A positive linear correlation was found to exist between thrombi-like aggregate formation on collagen substrates and platelet prostanoid synthesis. No correlation was established between platelet aggregate formation and 14C-serotonin release. The cyclooxygenase inhibitor indomethacin and the antagonists of PG endoperoxides and TXA2 (13-APA and BM 13.177) completely block thrombi-like aggregate formation. Neither 13-APA nor BM 13.177 affect platelet spreading, while indomethacin inhibits this process by 25%. The ADP-scavenger CP/CPK inhibits platelet aggregation and spreading by 25-30%. The inhibitors of cyclooxygenase and CP/CPK do not influence the initial attachment of platelets. The data obtained suggest that thrombi-like aggregate formation on collagen substrates is mediated by the synthesis of PG endoperoxides and TXA2; however, in platelet spreading this synthesis plays a limited role. Spreading and aggregation of platelets on collagen substrates is only partly mediated by ADP and serotonin. Initial attachment of platelets does not depend on ADP and serotonin release and PG endoperoxide/TXA2 synthesis.     

Comparison of ELISA with shell vial cell culture method for the detection of human rotavirus in fecal specimens

The aim of the study was to compare an enzyme immunoassay method with shell vial cell culture method for detection of rotavirus in fecal specimens. In addition, the correlation between laboratory results and clinical scores of patients with gastroenteritis was evaluated. A total of 219 fecal specimens from children (ages 3 weeks to 5 years) with acute gastroenteritis submitted to pediatric emergency room were evaluated by both ELISA and shell vial cell culture. A Vesikari score was used for assessing the severity of the illness. Among 219 stool samples tested, 107 (48.9%) were determined to be positive. Two specimens were positive by shell vial cell culture method while they were ELISA negative. According to these results the calculated sensitivity, specificity, PPV, and NPV of ELISA were 98.1%, 100%, 100%, and 98.2%, respectively. The mean severity score for the 107 episodes of rotavirus diarrhoea was 11.0 +/- 3.6 compared to 4.5 +/- 1.9 for the 112 episodes of non-rotavirus diarrhea in the same population. Our study indicates that ELISA, which is easier to perform, faster and cheaper than cell culture methods may be suitable for routine diagnosis of rotavirus infections. The severity of rotavirus positive gastroenteritis was significantly higher than that of rotavirus negative patients.     

Crystals occurring in pulmonary cytology specimens. Association with Aspergillus infection

Birefringent needlelike crystals in rosette or wheat-sheaf-like arrangements were found in pulmonary cytology specimens from 11 of 65 patients who had either sputum cultures positive for Aspergillus or histologically confirmed pulmonary aspergilloma. No crystals were found in specimens from 60 control patients with and without known fungal disease. The crystals were most often associated with A. niger infection (45.4%), followed by A. flavus (16%). Crystals were also observed in one case of A. fumigatus infection and in one case in which the species was not determined. In two cases, crystals were found more than one year before sputum cultures became positive; in one of these patients, a fungus ball was not identified by X ray until five years after the first appearance of the crystals in the sputum. Sixty-four percent of the patients with crystals also showed moderate to severe cytologic atypia. The crystals are thought to be calcium oxalate. We conclude that the presence of birefringent needlelike crystals with rosette or wheat-sheaf-like arrangements in pulmonary cytology specimens is a reliable marker for the presence of Aspergillus infection, which may be detected before cultures are positive or a fungus ball is evident on X ray.     

Quantitative assessment of protein-bound tyrosine nitration in airway secretions from patients with inflammatory airway disease

Because reactive nitrogen species (RNS) have potent inflammatory activity, they may be involved in the inflammatory process in pulmonary diseases. We recently reported increased numbers of 3-nitrotyrosine immunopositive cells, which are evidences of RNS production, in the sputum of patients with chronic obstructive pulmonary disease (COPD) and patients with asthma compared with healthy subjects. In the present study, we attempted to quantify this protein nitration in the airways by means of high-performance liquid chromatography (HPLC) used together with an electrochemical detection system that we developed. Sputum samples were obtained from 15 stable COPD patients, 9 asthmatic patients and 7 healthy subjects by using hypertonic saline inhalation. The values for the molar ratio of protein-bound 3-nitrotyrosine/tyrosine in patients with asthma (4.31 +/- 1.13 x 10(-6), p < 0.05) and patients with COPD (3.04 +/- 0.36 x 10(-6), p < 0.01) were significantly higher than those in healthy subjects (1.37 +/- 0.19 x 10(-6)). The levels of protein-bound 3-nitrotyrosine in the airways were not significantly different in asthmatic patients and COPD patients. A significant negative correlation was found between values for protein-bound 3-nitrotyrosine/tyrosine and % FEV1 values in patients with COPD (r = -0.53, p < 0.05) but not in patients with asthma. These results suggest that our HPLC-electrochemical method is useful for quantifying RNS production in human airways. More importantly, they show that increased RNS production in the airways seems to contribute in a critical way to the pathogenesis of COPD, and that the effects of RNS in airways may differ in asthma and COPD.     

Immunohistochemical localization and correlation of p53 and PCNA expression in breast carcinoma

The object of the present study is to detect the p53 tumour suppressor gene and proliferation cell nuclear antigen (PCNA) expression in breast carcinoma by immunohistochemistry and correlate them with the prognostic parameters. Total 35 cases of primary breast carcinoma were studied and classified histologically. Paraffin sections were stained by using monoclonal antibody D07 for p53 protein and PC-10 for PCNA. Out of 35 cases, 16 (45.7%) were p53 positive and 25 (71.4%) were PCNA positive. The mean PCNA labelling index (PCNA LI +/- SD) was 58.97 +/- 22.72 in tumors positive for both p53+ and PCNA+ while cases negative for p53- and positive for PCNA+ has higher PCNA LI +/- SD (59.24 +/- 18.97). The difference in the two groups was not significant. Most cases were positive for both p53+ and PCNA+ in the age group < 30 with higher mean PCNA LI +/- SD (62.20 +/- 27.13) than in the group > 30 (57.88 +/- 18.47). In the pre-menopausal group 57.1% cases were positive for p53+ with higher PCNA LI +/- SD (59.94 +/- 24.22). Maximum p53 and PCNA positivity was observed in grade III tumors (63.2% and 84.2%). The mean PCNA LI +/- SD was also highest in grade III carcinomas (66.83 +/- 13.97). No significant correlation was found between p53 and PCNA status with morphological type and tumour size except that logistic regression showed a positive correlation with tumour grade. Therefore the present study suggests that both p53 expression and PCNA are markers of poor differentiation in breast cancer.     

Cytologic diagnosis of laryngeal and hypopharyngeal squamous cell carcinoma in sputum

A prospective study of the value of sputum cytology in the diagnosis of squamous cell carcinoma of the larynx and hypopharynx is reported. Sputum cytology established the diagnosis in 63.5% of the patients with laryngeal lesions and in 77.4% of the patients with hypopharyngeal lesions. In laryngeal cancer, a positive diagnosis by sputum cytology was related to clinical T factors (according to the TNM classification): while only 29.4% of T1 lesions were positively detected by sputum cytology, 63.3% of T2 lesions, 69.7% of T3 lesions and 79.2% of T4 lesions were so detected. In hypopharyngeal cancer, there was no discernible relationship between sputum cytodiagnosis and clinical T factors. Generally, there was only a small number of cancer cells present in the sputum in these cases. Some of the squamous cancer cells were not very conspicuous and would require careful screening of the sputum specimens to be detected.     

中国人前列腺癌VEGF—C mRNA、VEGFR-3和CD31表达与肿瘤转移的关系

The expressions of VEGF-C mRNA, VEGFR-3 and CD31 were studied in order to investigate the correlation between them and neoangiogenesis, hyperplasia of micro-lymphatics and tumor metastases. 34 cases of prostate cancer tissue and 12 cases of adjacent nontumorous tissue specimens were tested. They were marked by VEGFR-3 and CD31 with immunohistochemistic staining and analyzed with image, the micro-lymphatics count (MLC) and microvessel density (MVD) were counted using Weidner's highest vessel density count method; the expression of VEGF-C mRNA was inspected in situ hybridization. The expression of VEGF-C mRNA was 44.12% positive in 34 cases of prostate cancer, the MLC (8.26 +/- 2.73)mm2 and MVD (74.82 +/- 11.76)mm2 in prostate cancer were significantly higher than those in adjacent nontumorous tissue (MLC, 4.82 +/- 3.48/mm2; MVD, 32.86 +/- 5.41/mm2). In addition, there was a correlation between the expression of VEGF-C mRNA and micro-lymphatics metastases and there was a positive correlation between the expression of VEGFR-3 and CD31. The expressions of VEGF-C mRNA , MLC, MVD in stage III and IV and those who have lymph metastasis were higher than those in stage I and II and those who have no lymph metastasis; the expressions of VEGFR-3 and CD31 in VEGF-C mRNA positive groups were significantly higher than those in negative groups. The difference of histopathologic grading in prostate cancer had no statistical significance. VEGF-C could accelerate the hyperplasia of micro-lymphatics and neoangiogenesis induced by tumor and play an important role in tumor lymph metastases. There was a close correlation between the expressions of VEGFR-3, CD31 and tumor metastases. The increase of MLC and MVD on prostate cancer indicated the hyperplasia of new micro-lymphatics and neoangiogenesis in the tumor tissue, which could also be a signal to determine the tumor metastases in clinic.     

Association of current smoking with airway inflammation in chronic obstructive pulmonary disease and asymptomatic smokers

Background

Inflammation in the airways and lung parenchyma underlies fixed airway obstruction in chronic obstructive pulmonary disease. The exact role of smoking as promoting factor of inflammation in chronic obstructive pulmonary disease is not clear, partly because studies often do not distinguish between current and ex-smokers.

Methods

We investigated airway inflammation in sputum and bronchial biopsies of 34 smokers with chronic obstructive pulmonary disease (9 Global initiative for Chronic Obstructive Lung Disease stage 0, 9 stage I, 10 stage II and 6 stage III) and 26 asymptomatic smokers, and its relationship with past and present smoking habits and airway obstruction.

Results

Neutrophil percentage, interleukin-8 and eosinophilic-cationic-protein levels in sputum were higher in chronic obstructive pulmonary disease (stage I-III) than asymptomatic smokers. Inflammatory cell numbers in bronchial biopsies were similar in both groups. Current smoking correlated positively with macrophages: in bronchial biopsies in both groups, and in sputum in chronic obstructive pulmonary disease. Pack-years smoking correlated positively with biopsy macrophages only in chronic obstructive pulmonary disease.

Conclusion

Inflammatory effects of current smoking may mask the underlying ongoing inflammatory process pertinent to chronic obstructive pulmonary disease. This may have implications for future studies, which should avoid including mixed populations of smokers and ex-smokers.     

Myeloperoxidase and protein oxidation in cystic fibrosis

Cystic fibrosis (CF) is associated with chronic pulmonary inflammation and progressive lung dysfunction, possibly associated with the formation of neutrophil myeloperoxidase (MPO)-derived oxidants. Expectorated sputum specimens from adult CF patients were analyzed for MPO characteristic protein modifications and found to contain large amounts of active MPO as well as high levels of protein-associated 3-chlorotyrosine and 3,3'-dityrosine, products that result from MPO activity, compared with expectorated sputum from non-CF subjects. Sputum levels of nitrite (NO(2)(-)) and nitrate (NO(3)(-)), indicating local production of nitric oxide (NO. ), were not elevated but in fact were slightly reduced in CF. However, there was a slight increase in protein-associated 3-nitrotyrosine in CF sputum compared with controls, reflecting the formation of reactive nitrogen intermediates, possibly through MPO-catalyzed oxidation of NO(2)(-). CF sputum MPO was found to contribute to oxidant-mediated cytotoxicity toward cultured tracheobronchial epithelial cells; however, peroxidase-dependent protein oxidation occurred primarily within sputum proteins, suggesting scavenging of MPO-derived oxidants by CF mucus and perhaps formation of secondary cytotoxic products within CF sputum. Our findings demonstrate the formation of MPO-derived oxidizing and possibly nitrating species within the respiratory tract of subjects with CF, which collectively may contribute to bronchial injury and respiratory failure in CF.     

前列腺癌nm23H1mRNA、TGF-β1mRNA表达及其与肿瘤转移、生存率的相关性研究

应用原位杂交法检测42例前列腺癌组织nm23H1mRNA、TGF-β1mRNA表达,并以CD31抗体为标记,经EnVision~(TM)免疫组织化学及Leica-Qwin计算机图像分析,用Weidner最高血管密度计数法,计数阳性MVD,研究前列腺癌组织nm23H1mRNA、TGF-β1mRNA和CD31的表达与前列腺癌中的新生血管的生成、肿瘤血道转移和调查患者术后的生存率关系。前列腺癌nm23H1mRNA阳性表达66．67%(28例),nm23H1mRNA阳性表达与前列腺癌骨转移、TNM分期、MVD呈负相关(P＜0．05)：TGF-β1mRNA阳性表达78．75%(33例),其与前列腺癌骨转移、TNM分期、MVD呈正相关(P＜0．05),与癌周组织的nm23H1mRNA和TGF-β1mRNA阳性表达比较,具有显著性差异(P＜0．01或P＜0．05)。前列腺癌组织的MVD(78．51±10．29/mm~2)显著高于癌周组织(34．19±9．27/mm~2),两者比较具有显著性差异(P＜0．05)。在根治术后5年内死亡的42．86%(18例)患者中MVD(92．41±15．42/ mm~2),高于5年内生存的患者(62．79±13．58/mm~2),两组间有显著性差异(P＜0．05);在不同的肿瘤病理学分级中,nm23H1mRNA在前列腺癌未、低分化型中阳性表达率高,高、中分化型中阳性表达率低,两组间有显著性差异(P＜0．05)。当nm23H1mRNA阳性表达率高时,肿瘤骨转移率低,生存率高,故认为nm23H1基因具有抑制前列腺癌发生和转移作用。当TGF-β1mRNA阳性表达率高时,肿瘤骨转移率高,生存率低。故认为TGF-β1基因具有促进前列腺癌发生和转移作用。前列腺癌组织中的MVD与肿瘤骨转移密切相关,前列腺癌组织MVD的显著增高,提示肿瘤组织有新血管的生成。TGF-β1促进了肿瘤诱导的血管新生,在前列腺癌的骨转移中起重要作用。     

The association between distance to water pipes and water bodies positive for anopheline mosquitoes (Diptera: Culicidae) in the urban community of Malindi, Kenya.

The increasing risk of mosquito-borne diseases in African urban environments has been partly attributed to failed planning and resource underdevelopment. Though engineered systems may reduce mosquito proliferation, there are few studies describing this relationship. This study investigates how engineered systems such as roads and piped water systems affect the odds of anopheline immatures (i.e., larvae and pupae) occurring in water bodies located in Malindi, Kenya. Anopheles gambiae s.s. (Giles), An. arabiensis (Patton), and An. merus (Dointz) were identified in urban Malindi, with Anopheles gambiae s.s. being the predominant species identified. The Breslow-Day test was used to explore interactions among independent variables. Logistic regression was used to test whether water bodies positive for anopheline immatures are associated with engineered systems, while controlling for potential confounding and interaction effects associated with urban water body characteristics. Water bodies more than 100 m from water pipes were 13 times more likely to have anopheline immatures present, compared to water bodies that were less than 100 m from water pipes (OR = 13.54, 95% CI: 3.15-58.23). Roads were not significantly associated with water bodies positive for anopheline immatures. Statistical interaction was detected between water body substrate type and distance to water pipes. This study provides insight into how water pipes influence the distribution of water bodies positive with immature anophelines in urban environments.     

The sensitivity of detection of asbestos bodies in sputa and bronchial washings

While asbestos bodies (ABs) in sputum and/or bronchial washings are highly specific markers for significant asbestos exposure, comparison of the sensitivity between sputum cytology and bronchial washing cytology for the detection of ABs had not been documented. Review of the files of the Cytopathology Laboratory, Methodist Hospital, Houston, Texas, for the period 1973 to 1984 identified 11 patients with slides available for review who (1) had been examined by both sputum cytology and bronchial washing cytology and (2) had at least one specimen positive for ABs. Of the 11 evaluable cases, all had ABs in the bronchial washings but ony 6 had ABs in the sputum. In addition, iron stain (e.g., the Prussian blue stain) was found to be more sensitive than the Papanicolaou stain for the detection of ABs in these cases. These findings indicate that iron-stained bronchial washing specimens should be preferred for the cytologic detection of asbestos exposure.     

Unfractionated heparin reduces the elasticity of sputum from patients with cystic fibrosis

Mucus obstruction of the airway in patients with cystic fibrosis (CF) reduces lung function, invites infection, and limits delivery of inhaled drugs including gene therapy vectors to target cells. Not all patients respond to presently available mucolytics, and new approaches are needed. Our objectives were to investigate the in vitro effects of unfractionated heparin (UFH) on the morphology and rheology of sputum and the effect of UFH on diffusion of 200-nm nanospheres through sputum from adult CF patients. Confocal laser scanning microscopy was used to image fluorescently stained actin and DNA components of CF sputum, and atomic force microscopy was used to image isolated DNA networks. The viscoelasticity of CF sputum was measured using dynamic oscillatory rheometry. Nanosphere diffusion was measured through CF sputum using a Boyden chamber-based assay. Actin-DNA bundles in CF sputum were disaggregated by UFH at concentrations of 0.1-10 mg/ml, and UFH enhanced the endonuclease activity in sputum from patients on dornase alfa therapy. UFH significantly reduced the elasticity and yield stress, but not the viscosity, of CF sputum from patients not receiving dornase alfa therapy. Heparin dose-dependently significantly increased the diffusion of nanospheres through CF sputum from patients not on dornase alfa therapy from 10.5 +/- 2.5% at baseline to 36.9 +/- 4.4% at 10 mg/ml but was more potent, with maximal effect at 0.1 mg/ml, in patients who were on dornase alfa therapy. Thus the mucoactive properties of UFH indicate its potential as a new therapeutic approach in patients with cystic fibrosis.     

胃癌nm23H1 mRNA、VEGF-C mRNA表达及其与淋巴转移、生存率的相关性研究

研究胃癌组织nm23H1 mRNA、VEGF-C mRNA和VEGFR-3的表达与胃癌中的新生淋巴管的生成、肿瘤淋巴道转移和生存率关系,为临床治疗及预后提供实验依据。用胃癌与癌周组织作对照,应用原位杂交法检测78例胃癌组织nm23H1 mRNA、VEGF-C mRNA表达,并以VEGFR-3抗体为标记,经EnVisionTM免疫组织化学及Leica-Qwin计算机图像分析,用Weidner最高血管密度计数法,计数阳性淋巴管数(MLC),以及调查患者术后的生存率。胃癌nm23H1 mRNA阳性表达 69．23％(54例)、nm23H1 mRNA阳性表达与胃癌淋巴结转移、TNM分期、MLC呈负相关(P<0．01), VEGF-C mRNA阳性表达46．15％(36例),其与胃癌淋巴结转移、TNM分期、MLC呈正相关(P<0．01 或P<0．05)．与癌周组织的nm23H1 mRNA和VEGF-C mRNA表达比较,具有显著性差异(P<0．01 或P<0．05)。nm23H1 mRNA在Ⅰ、Ⅱ期胃癌中呈高表达,在Ⅲ、Ⅳ期患者中呈低或无表达。胃癌组织的MLC(8．37±2．29/mm2)显著高于癌周组织(4．51±2．64/mm2),两者比较具有显著性差异(P<0．05)。 nm23H1 mRNA与VEGFR-3表达之间存在负相关(P<0．05,r=0．8479);VEGF-C mRNA与VEG- FR-3表达之间存在正相关(P<0．05,r=0．8362)。在根治术5年内死亡的61．54％(48例)患者中 MLC(10.82±2．51/mm2)高于5年内生存的患者(6．53±2．09/mm2),两组间有显著性差异(P<0．05);在不同的肿瘤病理学分级中,胃癌未、低分化型与高、中分化型的nm23H1 mRNA阳性表达,有显著性差异(P<0．05),当nm23H1 mRNA高表达时,肿瘤淋巴转移率低,生存率高,故认为nm23H1基因具有抑制胃癌发生和淋巴道转移作用;当VEGF-C mRNA高表达时,肿瘤淋巴转移率高,生存率低。胃癌组织中的VEGFR-3表达水平与肿瘤的淋巴转移密切相关,胃癌组织MLC的显著增高,提示肿瘤组织有新淋巴管的生成。VEGF-C促进了肿瘤诱导的淋巴管新生,在胃癌的淋巴道转移中起重要作用。     

The assessment of host and bacterial proteins in sputum from active pulmonary tuberculosis

Pulmonary tuberculosis (TB) is caused by Mycobacterium tuberculosis. The protein composition of sputum may reflect the immune status of the lung. This study aimed to evaluate the protein profiles in spontaneous sputum samples from patients with active pulmonary TB. Sputum samples were collected from patients with pulmonary TB and healthy controls. Western blotting was used to analyze the amount of interleukin 10 (IL-10), interferon-gamma (IFN-γ), IL-25, IL-17, perforin-1, urease, albumin, transferrin, lactoferrin, adenosine deaminase (also known as adenosine aminohydrolase, or ADA), ADA-2, granzyme B, granulysin, and caspase-1 in sputum. Results of detection of IL-10, IFN-γ, perforin-1, urease, ADA2, and caspase-1, showed relatively high specificity in distinguishing patients with TB from healthy controls, although sensitivities varied from 13.3% to 66.1%. By defining a positive result as the detection of any two proteins in sputum samples, combined use of transferrin and urease as markers increased sensitivity to 73.2% and specificity to 71.1%. Furthermore, we observed that the concentration of transferrin was proportional to the number of acid-fast bacilli detected in sputum specimens. Detection of sputum transferrin and urease was highly associated with pulmonary TB infection. In addition, a high concentration of transferrin detected in sputum might correlate with active TB infection. This data on sputum proteins in patients with TB may aid in the development of biomarkers to assess the severity of pulmonary TB.     

Examination of Induced Sputum In the Diagnosis of Pneumocystis Carinii Pneumonia

The results of the examination of sputum induced by the inhalation of nebulized hypertonic saline in the diagnosis of Pneumocystis carinii pneumonia (PCP) are presented. In suspected cases of PCP in patients who were either HIV antibody positive or were receiving immunosuppressive therapy, 46 induced sputum specimens were stained using both Grocott's modified Gomori methenamine silver nitrate (GMS) and immunofluorescence staining. In 12 specimens P. carinii cysts were detected by both methods, in four specimens by GMS staining only and in five specimens by immunofluorescence only. The sensitivity of induced sputum examination in the detection of P. carinii cysts was increased by using both of these staining methods on each sputum specimen and the need for more invasive methods of diagnosis was reduced.