TURP联合经尿道膀胱颈切开术治疗小体积前列腺增生所致膀胱出口梗阻的疗效分析

目的:探讨经尿道前列腺电切术(TURP)联合经尿道膀胱颈切开术(TUIBN)治疗小体积前列腺增生(BPH)所致膀胱出口梗阻的疗效。方法:选择2009年1月~2013年12月我院收治的小体积BPH患者,其中单纯经尿道前列腺电切术(TURP组)48例,经尿道前列腺电切术联合经尿道膀胱颈切开术(TURP+TUIBN组)48例。比较两组的术前、术后国际前列腺症状评分(IPSS)、残余尿量(PVR)、最大尿流率(Qmax)等,以及术后并发症的发生情况。结果:TURP+TUIBN组术中出血量较TURP组明显增多(P0.05),两组手术时间、组织切除质量比较,差异均无统计学意义(P0.05);与TURP组比较,TURP+TUIBN组术后6个月IPSS评分、PVR明显下降,Qmax、膀胱压力明显上升(P0.05);TURP+TUIBN组并发症发生率为4.2%,显著低于TURP组16.7%(P0.05)。结论:TURP+TUIBN治疗小体积前BPH所致膀胱出口梗阻,可彻底切除增生腺体,消除小体积BPH的各种梗阻因素,减少术后膀胱颈挛缩的发生。     

Optical quantitative pathology of cervical intraepithelial neoplasia in human tissues using spatial frequency analysis

An optical quantitative histological method in human tissues using spatial frequencies is demonstrated. Optical spatial frequency spectra from different stages of human Cervical Intraepithelial Neoplasia (CIN) tissue are evaluated as a potential quantitative pathological tool. The degree of randomness of tissue structures from normal to different stages of CIN tissue can be recognized by spatial frequency analysis. The standard deviation, σ of human normal and CIN tissue, is obtained by assuming the spatial frequency spectra as a Gaussian distribution. A support vector machine classifier (SVM) is trained in the subspace of σ. Twenty‐eight normal and CIN samples of varying grades are examined and compared with current diagnostic outcomes. Our results suggest that an excellent accuracy for diagnostic purposes can be achieved. This approach offers a simple, efficient and objective way to supplement histopathology in recognizing alterations from normal to different stages of cervical pre‐cancer, which are reflected by spatial information contained within the aperiodic and random structures of the different types of tissue. (© 2015 WILEY‐VCH Verlag GmbH &Co. KGaA, Weinheim)     

Otoacoustic emissions,auditory evoked potentials and self-reported gender in people affected by disorders of sex development (DSD)

Both otoacoustic emissions (OAEs) and auditory evoked potentials (AEPs) are sexually dimorphic, and both are believed to be influenced by prenatal androgen exposure. OAEs and AEPs were collected from people affected by 1 of 3 categories of disorders of sex development (DSD) — (1) women with complete androgen insensitivity syndrome (CAIS); (2) women with congenital adrenal hyperplasia (CAH); and (3) individuals with 46,XY DSD including prenatal androgen exposure who developed a male gender despite initial rearing as females (men with DSD). Gender identity (GI) and role (GR) were measured both retrospectively and at the time of study participation, using standardized questionnaires. The main objective of this study was to determine if patterns of OAEs and AEPs correlate with gender in people affected by DSD and in controls. A second objective was to assess if OAE and AEP patterns differed according to degrees of prenatal androgen exposure across groups. Control males, men with DSD, and women with CAH produced fewer spontaneous OAEs (SOAEs) – the male-typical pattern – than control females and women with CAIS. Additionally, the number of SOAEs produced correlated with gender development across all groups tested. Although some sex differences in AEPs were observed between control males and females, AEP measures did not correlate with gender development, nor did they vary according to degrees of prenatal androgen exposure, among people with DSD. Thus, OAEs, but not AEPs, may prove useful as bioassays for assessing early brain exposure to androgens and predicting gender development in people with DSD.     

Validation of a total testosterone assay using high-turbulence liquid chromatography tandem mass spectrometry: Total and free testosterone reference ranges

Accurate measurement of testosterone concentration is of critical importance when diagnosing and treating male hypogonadism, congenital adrenal hyperplasia, premature or delayed puberty, and androgen excess in polycystic ovary syndrome or other virilizing conditions. However, some assays have inherent limitations and biases that affect measurement of low-testosterone values. Therefore, we developed a highly specific online mass spectrometry method. Sera were extracted online using high-turbulence flow liquid chromatography coupled to analytical HPLC and atmospheric pressure chemical ionization tandem mass spectrometry (HTLC-APCI-MS/MS). Analyte ions were monitored by multiple reaction monitoring (MRM). Total analysis time was 1.15 min per sample when using the multiplexing system. Testosterone concentrations were measured directly from 150 μL of serum or plasma without derivatization or liquid-liquid extraction. The lower limit of quantification was 0.3 ng/dL, and the assay was linear up to 2000 ng/dL. The method compared very well with an established RIA: y = 1.02x + 1.5, r² = 0.994. Comparison with a platform immunoassay confirmed the previously reported ICMA positive bias at low concentrations. Male and female adult and pediatric reference ranges were developed for this very sensitive and accurate high-throughput LC-MS/MS method. This method is suitable for measuring the expected low-testosterone concentrations seen in women, children, and hypogonadal males and for monitoring testosterone suppressive therapy in prostate cancer patients.     

Subtyping borderline nuclear changes: is it of value in predicting high-grade cervical intraepithelial neoplasia on histology?

The aim was to determine the association between the subtypes of borderline nuclear changes (BNC) in cervical smears and high-grade cervical intraepithelial neoplasia (HCIN). BNC was reported in 23236 smears received in our laboratory over a 7-year period, 3278 patients were referred for colposcopy. Analysis was restricted to 2007 cases, which fitted the criteria of: (1). consistent subtyping of borderline change and (2). cervical histology result within 12 months of the last abnormal smear. BNC was reported in six categories and correlated with histology. Atypia bordering on dyskaryosis, atypical metaplastic cells and endocervical atypia, were associated with HCIN in 25%, 25.4% and 23.8% of cases, respectively. Dyskeratosis and koilocytotic atypia were associated with HCIN in 19.2% and 13.7% of cases, respectively. Some subtypes of borderline change are more frequently associated with HCIN. The difference is not sufficient to dictate clinical management.     

Reaction-diffusion approach to modeling of the spread of early tumors along linear or tubular structures

We consider a system composed of a tubular sheet of early tumor cells, occupying the surface of a structure existing in the organism. We assume that the cells have a potential for proliferation in response to a growth factor. This model can be thought of as representing an early stage (pre-in situ) of tumor evolution. A biomedical example of such process might be the atypical adenomatous hyperplasia in the lung. Destabilization of the equilibrium in such system represents initial invasion of cancer. We are looking for a transition from a slightly perturbed equilibrium state to uncontrolled and irregular growth. We examine a mathematical model of a population of cells distributed over a linear or tubular structure. Growth of cells is regulated by a growth factor, which can diffuse over the structure. Aside from this, production of cells and of the growth factor is governed by a pair of ordinary differential equations. Equation for the cell number follows from an accepted model of cell cycle. Equation for the bounded receptor particle number follows from a time-continuous Markov process. We demonstrate existence of the solutions of the complete model, using the method of invariant rectangles. We find conditions under which diffusion causes destabilization of the spatially homogeneous steady state, leading to exponential growth and apparently chaotic spatial patterns, following a period of almost constancy. This phenomenon may serve as a mathematical explanation of "unexpected" rapid growth and invasion of temporarily stable structures composed of cancer cells.     

Cellular automaton simulation examining progenitor hierarchy structure effects on mammary ductal carcinoma in situ

A computer simulation is used to model ductal carcinoma in situ, a form of non-invasive breast cancer. The simulation uses known histological morphology, cell types, and stochastic cell proliferation to evolve tumorous growth within a duct. The ductal simulation is based on a hybrid cellular automaton design using genetic rules to determine each cell's behavior. The genetic rules are a mutable abstraction that demonstrate genetic heterogeneity in a population. Our goal was to examine the role (if any) that recently discovered mammary stem cell hierarchies play in genetic heterogeneity, DCIS initiation and aggressiveness. Results show that simpler progenitor hierarchies result in greater genetic heterogeneity and evolve DCIS significantly faster. However, the more complex progenitor hierarchy structure was able to sustain the rapid reproduction of a cancer cell population for longer periods of time.     

Copper deprivation in rats induces islet hyperplasia and hepatic metaplasia in the pancreas

BACKGROUND INFORMATION: Prolonged copper deprivation in rats followed by refeeding with a normal diet has previously been used to induce the appearance of hepatocyte-like cells in the pancreas, but the effects on islet size and morphology have not been determined. RESULTS: In the present study we investigated the distribution of pancreatic alpha- and beta-cells and of hepatocytes in adult rats fed a copper-deficient diet followed by refeeding with a normal diet. Immunohistochemical staining for insulin and glucagon showed that the islets of the copper-deficient group were up to 2.4 times larger in mass compared with controls. The islets were disorganized, with alpha-cells found in multiple layers at the periphery of the islet and sometimes deep in the core. Isolated alpha- and beta-cells were also found in increased numbers in the ductular system. Copper deprivation caused almost complete ablation of the acinar cells, and refeeding induced adipogenesis, acinar regeneration and hepatocyte-like cells. Ductular proliferation and nerve hyperplasia were also present. The hepatocytes tended to be associated with islets or with ducts, rather than with residual pancreatic exocrine tissue. CONCLUSIONS: These data show that copper deficiency in rats, as well as inducing the appearance of hepatocytes, is capable of causing islet hyperplasia.     

在子宫颈上皮内瘤变和鳞癌组织中CyclinE、Rb基因表达的研究

目的 探讨细胞周期素E（CyclinE）、视网膜母细胞瘤（Rb）基因与上皮内瘤变（CIN）和宫颈鳞癌的关系,及其在癌变过程中的意义。方法 应用免疫组化技术（S-P法）,检测CyclinE和Rb基因产物在各级别CIN77例和宫颈鳞癌40例中的表达状况,并以正常子宫颈鳞状上皮20例做对照。结果 在正常宫颈鳞状上皮、CINⅠ、CINⅡ、CINⅢ及宫颈鳞癌中,CyclinE的阳性表达率呈逐渐增强趋势,分别为：0．0％、30．0％、75．0％、65．0％、60．0％。正常宫颈鳞状上皮与各级别CIN和宫颈鳞癌之间差异均有显著性（P〈0．01或〈0．005）,CINⅠ与CINⅡ、CINⅢ、宫颈鳞癌组间差异均有显著性（P〈0．005或〈0．01）;Rb基因蛋白的表达率逐渐下调,分别为：100．0％、55．0％、20．0%、24．3%、23．5％,在正常宫颈鳞状上皮与各级别CIN和宫颈鳞癌组间差异均有显著性（P〈0．005）;CINI与CINHI、宫颈鳞癌组间差异有显著性（P〈O．005）。结论CyclinE在正常子宫颈鳞状上皮表达阴性,随着发生CIN从轻到重至宫颈鳞癌,表达呈逐渐增强趋势;表明CyclinE在子宫颈癌变过程中起到重要作用,CyclinE参与CIN的进展及子宫颈癌癌变机制。Rb基因蛋白在正常子宫颈鳞状上皮100％阳性,随着发生CIN从轻到重至宫颈鳞癌,表达呈逐渐下调趋势,甚至消失;表明Rb基因可能主要通过功能性失活参与宫颈鳞癌的发生,并且其在癌变过程中起重要作用。发现CyclinE表达增强和RB基因表达下调或消失,有助于宫颈鳞癌发生的判断及CIN程度和级别的确定。     

采用SM 22启动子调节荧光蛋白的策略分选和鉴定人前列腺平滑肌细胞与成纤维细胞

 平滑肌细胞的数量、表型以及在间质细胞中所占的比例在前列腺间质增生的发生和发展中占有重要的地位.获得纯的平滑肌细胞和成纤维细胞,研究它们基因表达的差异,有助于进一步揭示前列腺增生的分子病因学.构建不同长度的 SM 22启动子,测定荧光素酶活性.采用了基于启动子特异性激活红绿色荧光蛋白表达结合流式细胞分选的策略,体外分离纯的平滑肌细胞和成纤维细胞.启动子活性实验结果表明,1 396 bp的人SM22启动子具有平滑肌细胞特异性和较高的相对活性.构建了红绿荧光蛋白的表达载体pDual-color,在此载体中,RFP的表达受1 396bp的SM22启动子调控,GFP的组成型表达受CMV启动子控制.用流式细胞仪分选GFP+/RFP+和GFP+/RFP-细胞,提取总RNA,进行实时定量RT-PCR.结果显示,在分选获得的GFP+/RFP+细胞比GFP+/RFP-细胞的SM22和SMMHC表达水平高10倍以上.提示,基于启动子特异性可以在体外分离纯的平滑肌细胞和成纤维细胞.