S-甲基异硫脲对大鼠门脉高压症食管静脉曲张的影响

目的观察诱导型一氧化氮合酶抑制剂SMT对大鼠门脉高压症食管静脉曲张的影响。方法健康雄性SD大鼠60只随机分为5组,假手术组、模型组、低剂量组、中剂量组和高剂量组。假手术组仅分离门静脉、左肾上腺静脉关腹,其余组门脉缩窄两步法加左肾上腺静脉结扎,建立门脉高压症食管静脉曲张模型。假手术组与模型组手术后给予腹腔注射生理盐水,其余3组手术后给予腹腔注射不同浓度SMT。手术后21 d,检测大鼠门脉血中TNOS、iNOS的活性及NO的浓度,免疫组化CD34标记食管血管内皮,测量每组大鼠食管横切面黏膜下血管的数目、面积。结果模型组大鼠门脉血中TNOS活性与iNOS活性以及NO浓度和食管黏膜下血管数目,血管平均截面积,血管总面积均较假手术组显著升高（P〈0.01）。中、高剂量组大鼠门脉血中TNOS活性与iNOS活性以及NO浓度和食管黏膜下血管的数目、血管平均面积、血管总面积较模型组均显著下调（P≤0.01）。结论大鼠门脉高压食管静脉曲张的发病机制中有NO参与,门脉缩窄型门脉高压食管静脉曲张病中NO主要由iNOS生成,SMT对大鼠门脉高压食管静脉曲张可能具有一定保护作用。     

Differentiation-associated genes regulated by TPA-induced c-Jun expression via a PKC/JNK pathway in KYSE450 cells

A group of potential differentiation-associated genes had been identified by microarray analysis as c-Jun/AP-1 target genes essential for epithelial differentiation program. Our previous study showed that c-Jun/AP-1 could bind and activate these gene promoters in vivo using chromatin immunoprecipitation. To further understand how the mitogen-activated protein kinase signaling pathways regulate AP-1 activity and expression of c-Jun target genes, our strategy was based on the use of 12-o-tetradecanoylophorbol-13-acetate (TPA) and pharmacological reagents to induce or block c-Jun expression. The mRNA and protein expression of these genes increased in response to TPA-induced c-Jun/AP-1 expression. Inhibitors of JNK (SP600125) and PKC (GF109203X) mainly blocked expression and phosphorylation of c-Jun, while inhibition of MEK-ERK activity with PD98059 (an inhibitor of MEK) had little effect. Expression of involucrin and keratin 4 in response to TPA was attenuated by pretreatments with GF109203X and SP600125, but not PD98059, suggesting involvement of PKC and JNK in this response. Taken together, these results suggested that differentiation-associated genes were regulated by TPA-induced c-Jun/AP-1 mainly via a PKC/JNK pathway in esophageal cancer cell line KYSE450.     

Monitoring the wall mechanics during stent deployment in a vessel

Clinical trials have reported different restenosis rates for various stent designs. It is speculated that stent-induced strain concentrations on the arterial wall lead to tissue injury, which initiates restenosis. This hypothesis needs further investigations including better quantifications of non-uniform strain distribution on the artery following stent implantation. A non-contact surface strain measurement method for the stented artery is presented in this work. ARAMIS stereo optical surface strain measurement system uses two optical high speed cameras to capture the motion of each reference point, and resolve three dimensional strains over the deforming surface. As a mesh stent is deployed into a latex vessel with a random contrasting pattern sprayed or drawn on its outer surface, the surface strain is recorded at every instant of the deformation. The calculated strain distributions can then be used to understand the local lesion response, validate the computational models, and formulate hypotheses for further in vivo study.     

小型猪冠脉支架模型中即刻OCT检查评价支架贴壁不良的安全性和有效性

目的评价中华小型猪冠状动脉支架植入术后即刻行光学相干断层成像扫描（OCT）的安全性和有效性。方法健康中华小型猪22只,经股动脉途径行右冠状动脉西罗莫司药物洗脱支架植入术,术后即刻行OCT检查评价支架贴壁不良情况,同时记录OCT检查时间和相关并发症。结果 OCT共检查25段支架,失败3例（1例指引导丝断裂于支架内,2例发生冠脉痉挛导致阻断球囊送入困难未能成像）,OCT检查并发症包括一过性ST段抬高（5例）和室颤（3例）,死亡1例,平均手术时间49.7±12.9 min,其中OCT检查耗时17.9±4.9 min,OCT共检测522 mm支架,定量测量4514个支架丝,其中66个存在贴壁不良,即刻支架贴壁不良率1.46%。结论利用冠脉内OCT技术可以有效评价支架术后即刻贴壁不良情况,安全性良好。     

血管生成拟态和E-cad在食管鳞状细胞癌中的表达及临床意义

目的 探讨血管生成拟态( vasculogenic mimicry,VM)与E-钙粘蛋白(E-cadherin,E-cad))在食管鳞癌(esophageal squamous cell carcinoma)组织中的表达及意义.方法 收集食管鳞状细胞癌术后标本100例和30例癌旁正常食管黏膜,应用免疫组化法和组织化学法检测食管鳞状细胞癌和正常食管黏膜组织中VM和E-cad的表达情况.结果 在食管鳞状细胞癌组织和正常食管黏膜组织中,VM和E-cad的阳性表达率分别为47.0％、48.0％和0％、70.0％,差异有统计学意义(P＜0.05);VM及E-cad的表达与食管鳞癌的组织学分级、临床分期及淋巴结转移(P＜0.05);VM与E-cad在食管鳞癌中的表达呈负相关(r=-0.865,P=0.000).多因素分析:PTNM分期、淋巴结转移、VM和E-cad的表达是影响食管鳞癌根治术后患者预后的独立因素(P＜0.05);VM阳性组与阴性组的5年生存率分别为4.3％和64.2％,,差异有统计学意义(P=0.000);E-cad阳性组与阴性组5年生存率分别为60.4％和15.4％,差异有统计学意义(P=0.000).结论 具有VM结构的食管鳞状细胞癌的分化程度低,恶性度高,预后差,VM和E-cad表达的程度与食管鳞状细胞癌的进展和预后密切相关.     

Pokemon、P14ARF 蛋白在食管鳞状细胞癌中的表达及临床意义

目的:探讨食管鳞癌(esophageal squamous cell cacinoma,ESCC)组织中Pokemon和P14ARF表达的关系及其对ESCC临床病理特征和预后的判定价值。方法:应用SP免疫组织化学方法检测Pokemon和P14ARF二种蛋白在96例ESCC组织及20例癌旁正常组织中的表达,分析它们与ESCC病理学特征的关系,以及Pokemon和P14ARF的相关性,并结合随访资料观察上述蛋白表达对ESCC长期预后的影响。结果:癌旁正常组织中未见Pokemon蛋白表达,P14ARF蛋白阳性表达率为90.0%;在ESCC组织中Pokemon和P14ARF阳性表达率分别为75.0%和30.2%。Pokemon表达与P14ARF表达呈负相关(r=-0.458,P=0.000)。Pokemon和P14ARF的表达与TNM分期和淋巴结转移相关(P<0.05)。Pokemon表达阳性组的5年生存率分别为20.8%,显著低于阴性组(P=0.004);P14ARF表达阳性组的5年生存率为41.4%,显著高于阴性组(P=0.011)。结论:Pokemon蛋白的高表达和P14ARF蛋白低表达可能与ESCC的发生、发展关系密切,它们对于ESCC预后评估有一定的临床意义。     

三氧化二砷对食管癌细胞增殖和热休克蛋白70表达的影响

目的：研究三氧化二砷（As2O3）对食管癌细胞增殖和热休克蛋白70（HSP70）表达的影响。方法：通过相差显微镜、流式细胞术、免疫细胞化学染色和免疫印迹分析等方法观察As2O3对人食管癌细胞株EC1的作用效果和作用机制。结果：与对照组相比,经2μmol/L和5μmol/Las2O3作用的细胞出现明显的生长抑制,G2/M期细胞比例增加;2μmol/Las2O3作用48h后经Ecl细胞HSP70（heat shock protein70）及HSC70(heat shock cognate protein70)表达均增加。结论：As2O3诱导食管癌细胞G2/M期阻滞抑制细胞增殖和生长;HSP70的升高是细胞对As2O3作用后出现的应激反应,并与细胞周期阻滞相关。     

食管鳞癌人乳头状瘤病毒感染的原位杂交检测和观察

目的 :检测食管鳞癌中人乳头状瘤病毒 (HPV)的感染情况 ,探讨 HPV与食管癌发病的关系。方法 :用原位杂交技术及免疫组化方法对 33例食管鳞癌手术切除标本进行 HPV检测。结果 :用原位杂交方法检测食管鳞癌中 HPV DNA检出率为 4 5 .5 % (15 / 33)。HPV DNA阳性与食管鳞癌肿瘤细胞的分化程度无关 (P>0 .0 5 )。HPV衣壳蛋白的免疫组化检测均为阴性。结论 :HPV感染可能是引起食管上皮癌变的原因之一 ,与食管鳞癌的发生有关。即使在存在 HPV DNA的病例中 ,HPV衣壳蛋白亦可以不表达     

广东食管癌中Epstein-Barr病毒感染与细胞增殖p53的关系

目的 :研究食管癌中 EB病毒感染情况 ,探讨其与肿瘤细胞增殖及抑癌基因 p5 3的关系。方法 :应用聚合酶链反应技术 (PCR)检测食管癌中 EB病毒 DNA的感染。用免疫组化方法检测其中 p5 3的表达及肿瘤细胞增殖。结果 :2 4例食管癌中 ,EB病毒 DNA阳性率为 95 .8% (2 3/2 4)。 2 3例阳性病例中存在 p5 3蛋白积聚者为 16例 ,积聚率为 6 9.6 % (16 /2 3) ;1例 EB病毒 DNA阴性者 ,p5 3蛋白染色阴性。 p5 3蛋白积聚与增殖细胞核抗原的表达密切相关 (P<0 .0 5 )。结论 :广东食管癌中普遍存在 EB病毒的感染。有 EB病毒感染的病例 ,亦存在 p5 3蛋白积聚。 EB病毒可能与 p5 3的改变有关 ,从而导致细胞增殖。     

Metabolic syndrome in relation to Barrett⿿s esophagus and esophageal adenocarcinoma: Results from a large population-based case-control study in the Clinical Practice Research Datalink

Gastroesophageal reflux disease (GERD) causes local chronic inflammation that increases risks of Barrett⿿s esophagus (BE) and esophageal adenocarcinoma (EA), yet symptomatic GERD is absent in approximately half of all such patients. Obesity exacerbates GERD and is also a component of metabolic syndrome (MetS). We evaluated the hypothesis that MetS is a GERD-independent mechanism by which obesity is associated with increased risks of BE and EA using data from the UK Clinical Practice Research Datalink. BE cases (n = 10,215) and EA cases (n = 592) were each individually matched to five population controls based on age, sex, and general practice. MetS was defined as occurrence of at least three of the following: obesity, type 2 diabetes, hypertension, and high cholesterol. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using conditional logistic regression. MetS was marginally associated with BE (OR = 1.12, 95%CI 1.00⿿1.25). Similar effects were found for the individual component factors of obesity, hypertension, and high cholesterol. History of GERD modified the association (P-_{effect modification} <1E⿿5), with the MetS-BE association confined to patients without a history of GERD (OR = 1.33, 95%CI 1.12⿿1.58). No association between MetS and risk of EA was detected in the main or stratified analyses. In this large population-based case-control study, individuals with MetS had a marginally increased risk of BE in the absence of GERD. The systemic inflammatory state (MetS) may represent a reflux-independent inflammatory pathway that increases the risk of BE. MetS did not increase risk of EA in this study population.