Expression and alteration of insulin-like growth factor II-messenger RNA in hepatoma tissues and peripheral blood of patients with hepatocellular carcinoma

AIM: To investigate the clinical values of serum free insulin-like growth factor Ⅱ (IGF-Ⅱ) levels and IGF-Ⅱ mRNA in hepatocellular carcinoma (HCC) tissues and peripheral blood for diagnosis of HCC and monitoring of extrahepatic metastasis.METHODS: Total RNAs were extracted from HCC tissues or peripheral blood mononuclear cells from patients with HCC, liver diseases devoid of cancer, non-hepatic tumors,and healthy controls, respectively. IGF-Ⅱ cDNAs were synthesized through random primers and reversetranscriptase, amplified by polymerase chain reaction (PCR), and confirmed by DNA sequencing analysis. Serum free IGF-Ⅱ levels in patients with different liver diseases were analyzed by an enzyme-linked immunosorbent assay.RESULTS: The amplified fragments of IGF-Ⅱ mRNA by RT-PCR were identical to originally designed ones with a size of 170 bp and confirmed by sequencing analysis.The dilution experiments revealed that the lowest sensitivity of our system was 2 ng/L of total RNA. The positive frequencies of IGF-Ⅱ mRNA were 100% in HCC tissues,53.3% in para-cancerous tissues, and 0% in non-cancerous tissues, respectively. The serum free IGF-Ⅱ levels were significantly higher in HCC than those in chronic hepatitis or liver cirrhosis. The positive frequency of circulating IGF-Ⅱ mRNA was 34.2% in HCC, no amplified fragment was found in other liver diseases, extrahepatic tumors,and normal controls, respectively. The circulating IGF-Ⅱ mRNA correlated with the stage of HCC, and its positive rate was 100% in HCC with extrahepatic metastasis and 35.5% in HCC with AFP-negative. No significant correlation was found between tumor sizes and circulating IGF-Ⅱ mRNA fragment.CONCLUSION: The abnormal expressions of free IGF-Ⅱ and IGF-Ⅱ mRNA are useful tumor markers for HCC diagnosis, differentiation of extrahepatic metastasis and monitoring postoperative recurrence.

Dynamic alteration of telomerase expression and its diagnostic significance in liver or peripheral blood for hepatocellular carcinoma

瞄准：在肝纸巾或外部血在肝细胞癌(HCC ) 和它的诊断含意的开发期间调查 telomerase 表示的动态改变为 HCC 的单音的原子房间。方法：肝 telomerase 的动态表情在 hepatocytes 的恶意的转变期间被观察在(SD ) Sprague-Dawly，老鼠用 0.05% 2-fluoenyacetamide (2-FAA ) 喂了。全部的 RNA 和 telomerase 从老鼠或人的肝纸巾被提取。在肝并且在传播的血的 telomerase 活动被 telomeric 重复扩大 protocol-enzyme-linked 免疫吸着剂试金(TRAP-ELISA ) 检测，并且它的诊断价值与良性或恶意的肝疾病在病人被调查。结果：肝细胞瘤模型在 HCC 开发期间显示了肝的 telomerase 的动态表示。telomerase 活动与肝总数 RNA 层次一致(r = 0.83， P【0.01 ) 在 hepatocytes 的退化，初癌状态，和癌化的阶段。在 HCC 病人，在 HCC 纸巾的 telomerase 层次比在他们的邻近的非癌的纸巾，而是肝全部的 RNA 铺平显著地高比在后者在前者是更低的。尽管 HCC 病人的传播 telomerase 反常地与长期的肝疾病在病人之中被表示，因为发生在正常控制是15.7%， telomerase 活动是为 HCC 诊断的一个非特定的标记，25%在长期的肝炎，45.9%在肝肝硬化，并且85.2%在 HCC ，分别地吸收度什么时候 telomerase 活动珍视，是超过 0.2 。如果价值是超过 0.6，发生在 HCC 组是 60% 并且 0% 在除了在有肝的二种情况中的其它(P【0.01 ) 的任何东西肝硬化。然而，有浆液 alpha-fetoprotein 水平的传播 telomerase 的联合能增加积极的率和精确性(92.6% ， 135 中的 125 个) HCC 诊断。结论：过去 telomerase 的表示在肝纸巾与 HCC 开发，和它的反常被联系或在外设，血能是为 HCC 的诊断和预后的一个有用标记。

The Assessment of the Clinical Effect of the Drug Compatibility and Course of Treatment to the Brucellar Spondylitis

Objective: To evaluate five drug treatment regimens in the treatment of Brucella spondylitis. Methods: Patients with clinical symptoms compatible and diagnostic test consistent with Brucella spondylitis were randomly assigned to five drug treatment regimens. Results: Combination therapy with doxycycline, rifampin and sulfamethoxazole for 56 consecutive days showed the highest cure rate of 20% after a single course and of 85% after a double course with affectivity rates of 55% and 95%. Cure rate and affectivity rate was significant better (P 0.05) than for patients receiving doxycycline, rifampin and streptomycin for the same period and regimens containing doxycycline were significant better than regimens without this drug. Conclusion: Combination therapy of doxycycline, rifampin and sulfamethoxazole for 8 weeks using one or two full courses should be recommended for Brucella spondylitis.

前路或前后路联合手术治疗颈椎布鲁杆菌性脊柱炎的临床疗效观察

目的探讨颈椎布鲁杆菌性脊柱炎的手术选择及治疗效果。方法回顾性分析2007年8月—2017年8月河北北方学院附属第一医院标准化抗布鲁杆菌性脊柱炎药物治疗前提下行一期前路或者前后路联合手术治疗的42例颈椎布鲁杆菌性脊柱炎患者的临床资料。其中累及颈椎3个相邻椎体7例,2个相邻椎体23例,单椎体12例,合并有颈椎管狭窄患者5例,均存在不同程度的神经功能损害。进行实验室检查包括C反应蛋白(CRP)、血沉(ESR)、虎红平板凝集试验、血清试管凝集试验。以美国脊髓损伤协会(ASIA)分级、日本骨科学会(JOA)、颈部疼痛视觉模拟VAS评分判定临床效果。术前应用磺胺甲基异恶唑、强力霉素和利福平治疗14 d以上,待ESR呈下降趋势或持续处于某一数值时进行手术治疗。根据脊髓神经受压和病灶累及椎体的情况选择颈椎前路或前后路联合入路进行手术。手术后继续进行标准化抗布鲁杆菌病药物治疗。结果患者未出现病情加重情况,末次随访优良率为100%。术后12个月复查颈椎X射线片及MRI未发现复发。术后末次随访颈部VAS评分较术前降低(P<0.05);术后末次随访JOA评分较术前升高(P<0.05);术后末次随访ASIA分级中D级7例,E级35例,神经功能恢复较术前明显(P<0.05)。结论在术前规范化药物治疗前提下,根据感染累及椎体及椎管的情况采取一期病灶清除联合植骨融合内固定手术,能够极大减少患者的痛苦及致残的概率,有效地控制病情进展,恢复颈椎稳定性,挽救神经功能,临床疗效值得肯定,术后继续标准化药物治疗是防止布鲁杆菌性脊柱炎复发的关键。