髓内钉固定与微创经皮钢板内固定对胫腓骨骨折患者血小板活化及血清转化生长因子-β1和骨形态发生蛋白-2影响的比较

目的:探讨髓内钉固定(intramedullary nail fixation,IMN)与微创经皮钢板内固定(minimally invasive percutaneous plate internal fixation,MIPPO)技术应用于胫腓骨骨折的效果及对患者血小板活化及血清转化生长因子-β1(transforming growth factor-β1,TGF-β1)、骨形态发生蛋白-2(bone morphogenetic protein-2,BMP-2)影响。方法:选取2019年2月至2020年2月胫腓骨骨折患者105例,分为MIPPO组53例和IMN组52例。其中MIPPO组男29例,女24例,年龄(41.74±6.05)岁;IMN组男31例,女21例,年龄(40.59±5.26)岁。比较两组围术期手术指标,术后并发症,术后12个月踝关节功能恢复情况,术前及术后3、7 d血小板活化指标,术前及术后4、8周血清TGF-β1、BMP-2水平。结果:MIPPO组手术时间、骨折愈合时间短于IMN组(P<0.05);与术前相比,两组术后3、7 d的GMP-140、PAC-1、CD63、CD61水平均提高,但MIPPO组低于IMN组(P<0.05);两组术后4、8周血清TGF-β1、BMP-2水平均较术前提高,且MIPPO组提高幅度大于IMN组(P<0.05);MIPPO组术后并发症发生率低于IMN组(P<0.05)。两组术后随访12个月,踝关节功能Mazur评分比较,差异无统计学意义(P>0.05)。结论:髓内钉固定与MIPO技术治疗胫腓骨骨折均可改善踝关节功能,但后者具有手术时间短、骨折愈合快、并发症少的优势,且血小板活化轻,血清TGF-β1、BMP-2水平改善快。     

下肢骨折病人术后35天内深静脉血栓的发生情况及危险因素分析

目的 探讨下肢骨折病人出院后35 d内深静脉血栓形成（deep vein thrombosis, DVT）的发生率及危险因素。方法 回顾性分析2014年7月至2017年7月西安交通大学医学院附属红会医院创伤骨科收治的402例住院期间未发生DVT的下肢骨折病人的临床资料。所有病人术前、术后都常规用物理方法和药物抗凝预防DVT,嘱咐病人出院后口服利伐沙班抗凝至术后35 d,记录术后35 d复查时双下肢DVT的发生情况。根据术后35 d门诊复查双下肢超声结果将病人分为DVT组和非DVT组,分析比较两组病人的性别、年龄、骨折部位、身体质量指数、合并其他骨折、合并内科疾病、术后的实验室检查（D-二聚体）、术后住院时间的差异,对上诉结果中差异有统计学意义的变量进一步采用多因素Logistic回归分析,分析病人出院后DVT的危险因素。结果 402例下肢骨折病人出院后发生DVT的有56例（13.9%）,其中2例（0.50%）发生肺栓塞,2例均合并有小腿肌间静脉血栓,1例发生在术后3周,1例在术后4周发生致死性肺栓塞。周围型52例,单纯中央型0例,混合型4例。膝关节以近的骨折病人DVT发生率为15.5%（36/232）,膝关节周围骨折病人DVT发生率为13.8%（8/58）,膝关节以远骨折病人DVT发生率10.7%（12/112）。两组间年龄、合并其他骨折、术后住院时间、冠心病、术后1 d D-二聚体、出院时D-二聚体的差异有统计学意义（P＜0.05）,多因素Logistic回归分析显示年龄＞60岁［OR=3.207,95% CI（2.007,8.553）,P=0.009］、合并其他骨折［OR=7.111,95% CI（2.297,22.011）,P＜0.001］、术后住院时间＜7 d［OR=1.448,95% CI（1.225,1.718）,P=0.020］、出院时D-二聚体偏高［OR=1.355,95% CI（0.892,12.626）,P=0.027］是出院后DVT的独立危险因素。结论 虽然出院前常规使用物理方法和药物抗凝预防DVT,出院后嘱咐病人口服利伐沙班35 d,但是出院时没有DVT的下肢骨折病人术后35 d仍有发生DVT的可能（13.9%）,严重者还会发生肺栓塞,年龄、合并其他骨折、术后住院时间较短、出院时D-二聚体是出院后DVT发生的独立危险因素。     

膝关节置换术后深静脉血栓栓塞影响因素及血清NETs及sVCAM-1水平变化意义

目的: 探究膝关节置换术后血清中性粒细胞胞外陷阱(neutrophil extracellular traps,NETs)及可溶性血管细胞黏附分子(soluble vascular cell adhesion molecule-1,sVCAM-1)水平变化情况与深静脉血栓栓塞的关系及其影响因素。方法: 回顾性选取2017年5月至2020年4月30例行膝关节置换术后出现深静脉血栓栓塞患者作为观察组,另自同期住院的膝关节置换术后未出现深静脉血栓栓塞患者中随机抽取60例作为对照组。对比两组临床资料,术前,术后1、3、5 d血清NETs、sVCAM-1水平,采用Logistic多因素回归模型分析膝关节置换术后深静脉血栓栓塞影响因素;采用Pearson相关性分析血清NETs、sVCAM-1水平的关系;绘制受试者工作特征曲线(receiver operating characteristic curve,ROC)得到曲线下面积(areas under the curve,AUC),分析血清NETs、sVCAM-1水平对膝关节置换术后深静脉血栓栓塞的诊断价值。结果: 两组年龄、体质量指数、术后膝关节抬高屈曲位比例比较,差异有统计学意义(P<0.05)。观察组术后1、3 d血清NETs、sVCAM-1水平均高于对照组(P<0.05)。Logistic回归分析结果显示年龄,体质量指数,术后膝关节抬高屈曲位,术后1、3 d血清NETs、sVCAM-1水平均为膝关节置换术后深静脉血栓栓塞影响因素(P<0.05);Pearson相关性分析可知,膝关节置换术后深静脉血栓栓塞患者术后1、3 d血清NETs、sVCAM-1水平均呈正相关关系(P<0.05);绘制术后1、3 d血清NETs、sVCAM-1水平预测膝关节置换术后深静脉血栓栓塞ROC曲线,结果显示术后1 d血清NETs、sVCAM-1水平AUC均大于术后3 d,具有良好预测效能。结论: 膝关节置换术后深静脉血栓栓塞影响因素为年龄,体质量指数,术后膝关节抬高屈曲位,术后血清NETs、sVCAM-1水平,尤其是术后血清NETs、sVCAM-1水平变化可作为预测术后深静脉血栓栓塞的潜在生物学标记物,临床需加以重视。     

胫骨骨折患者术后血清小凹蛋白-1蛋白含量与延迟愈合关系的探究

目的:探讨胫骨骨折患者切开复位内固定手术后血清小凹蛋白-1(caveolin-1)蛋白含量与延迟愈合的关系。方法:自2018年4月至2020年6月收治接受切开复位内固定手术的134例胫骨骨折患者,根据骨折愈合情况分为延迟愈合组和正常愈合组。比较两组患者术前及术后1、4、8、12周时血清caveolin-1蛋白含量,采用Logistic回归模型分析骨折延迟愈合的影响因素,采用受试者工作特征(receiver operating characteristic,ROC)曲线分析血清caveolin-1蛋白对骨折延迟愈合的预测价值。结果:骨折后4个月时随访评估愈合情况,正常愈合93例,延迟愈合41例。术后1、4、8、12周时,延迟愈合组血清caveolin-1蛋白含量均低于正常愈合组(P<0.05);延迟愈合组与正常愈合组在吸烟、糖尿病、开放性骨折、Gustlio分型Ⅲ型方面比较差异有统计学意义(P<0.05);经Logistic回归分析,吸烟、糖尿病、开放性骨折、Gustlio Ⅲ型骨折及术后4、8周时血清caveolin-1蛋白含量降低是骨折延迟愈合的危险因素(P<0.05);经ROC曲线分析,术后4、8周时血清caveolin-1蛋白含量对骨折延迟愈合具有预测价值,预测的最佳截断值分别为12.45、12.52 ng/ml,对应的灵敏度为45.34%、43.90%,特异性为80.65%、87.10%(P<0.05)。结论:胫骨骨折患者切开复位内固定术后4、8周时血清caveolin-1蛋白含量降低与延迟愈合有关,术后4、8周时检测血清caveolin-1蛋白含量对延迟愈合具有预测价值。     

miR-143调控基质金属蛋白酶-13表达对骨肉瘤细胞迁移及侵袭的影响

目的:探究miR-143对基质金属蛋白酶-13(matrix metalloproteinase,MMP-13)表达的调节作用及其对骨肉瘤细胞迁移及侵袭能力的影响。方法:采用96孔板培养小鼠骨肉瘤细胞系143B细胞,设立空白组、阴性组、阳性组、干预组。空白组不做特殊处理,阳性组加入50 μg miR-143 mimic,阴性组加入等量mimic NC(miR-143 mimic的对照序列),干预组加入50 μg miR-143 mimic及10 μg MMP-13蛋白,继续培养3~6 h,最后吸出血清处理0.5 h。分别采用荧光定量PCR和Western-blot测定各组miR-143和MMP-13蛋白表达,采用Transwell、划痕实验测定细胞的侵袭与迁移能力。结果:阳性组及干预组MMP-13蛋白表达量明显低于空白组,阳性组低于干预组(P<0.05);空白组、阴性组、阳性组及干预组每个视野的侵袭细胞数均值分别为(1 000.01±44.77)、(959.25±46.32)、(245.04±4.33)、(634.06±33.78)个;阳性组及干预组划痕愈合率均明显低于空白组,阳性组低于干预组(P<0.05)。结论:MMP-13是miR-143作用的一个靶点,可以通过抑制MMP-13表达降低骨肉瘤细胞的迁移及侵袭能力。     

术中间歇性充气加压系统联合3M升温仪预防股骨近端抗旋髓内钉手术患者下肢深静脉血栓

目的: 探索股骨转子间骨折患者行新型股骨近端防旋髓内钉(proximal femoral nail antirotation,PFNA)手术过程中,双下肢间歇性充气加压装置(intermittent pneumatic compression,IPC)联合3M升温仪对预防下肢深静脉血栓形成(deep venous thrombosis,DVT)的效果。方法: 回顾性分析2016年3月至2019年8月行PFNA手术治疗的127例股骨转子间骨折患者,按术中不同血栓防治方法分为两组,A组63例不使用IPC及3M升温仪;B组64例使用IPC联合3M升温仪。应用彩色多普勒超声动态监测围手术期下肢DVT及变化情况,分别在术毕0、24、72 h以及>72 h(以后每3 d复查1次直至出院)进行下肢静脉血栓形成情况进行监测。结果: 两组PFNA手术后患者下肢DVT发生情况:B组5例(7.8%),而A组20例(31.7%),两组比较差异有统计学意义(P=0.001);术后0、72 h及>72 h两组下肢DVT比较差异均无统计学意义(P>0.05),但术后24 h时A组DVT形成率明显高于B组(P=0.049);A组患者右下肢及双下肢DVT形成与B组比较差异均无统计学意义(P均>0.05);但A组左下肢DVT形成明显高于B组(P=0.012)。结论: 术中IPC联合3M升温仪治疗可有效预防行PFNA手术患者下肢DVT形成。     

血清CTRP3及PGC-1α表达与创伤性骨折愈合的相关性分析

目的: 探讨创伤性骨折患者血清C1q/TNF相关蛋白3(C1q/tumor necrosis factor-related protein-3,CTRP3),过氧化物酶体增殖物激活受体γ共激活因子-1α(peroxisome proliferator-activated receptor γ coactivator-1α,PGC-1α)表达水平对骨折愈合的预测价值。方法: 2019年1月至2020年1月收治80例创伤性胫骨平台骨折患者,采用膝关节后侧入路支撑钢板内固定手术治疗,术后随访12个月,根据骨折延迟愈合判定标准将患者分为两组:骨折愈合组54例,男24例,女30例,年龄29~75(52.36±13.17)岁;延迟愈合组26例,男13例,女13例,年龄29~75(53.82±13.52)岁。采用酶联免疫吸附(enzyme linked immunosorbent assay,ELISA)法检测创伤性骨折患者血清CTRP3、PGC-1α及25-羟维生素D3[25(OH)D3]水平;采用全自动生化分析仪检测血磷、血钙水平,计算钙磷乘积;采用Pearson法分析延迟愈合患者术后1周血清CTRP3、PGC-1α与骨生化相关指标的相关性;采用受试者工作特征曲线(receiver operator characteristic curve,ROC)分析血清CTRP3、PGC-1α水平对创伤性骨折愈合的预测价值。结果: 骨折愈合组术后1、4周血清CTRP3、PGC-1α、钙磷乘积、25(OH)D3水平高于延迟愈合组(P<0.05)。延迟愈合患者术后1周血清CTRP3与PGC-1α呈正相关(r=0.637,P<0.05),且二者与钙磷乘积、25(OH)D3均呈正相关(P<0.05)。血清CTRP3、PGC-1α水平预测创伤性骨折愈合的曲线下面积(area under curve,AUC)分别为0.845、0.855,截断值分别为188.678、2.697 ng/ml,特异性分别为96.2%、80.8%,敏感度分别为53.7%、77.8%;二者联合预测的AUC为0.904,特异性为88.5%,敏感度为81.5%。结论: 创伤性骨折延迟愈合患者术后1、4周血清CTRP3、PGC-1α水平均低于正常愈合患者,其表达水平对预测患者骨折愈合状况有一定的参考价值。     

高龄髋部骨折患者术后发生脑卒中危险因素分析

目的: 探讨高龄髋部骨折患者术后发生脑卒中的危险因素。方法: 自2012年3月至2017年6月接受髋关节置换术的高龄髋部骨折的500例患者,男286例,女214例;年龄60~76(68.49±11.85)岁。根据术后2周内是否发生急性脑卒中分为卒中组30例及对照组470例。比较两组患者一般资料及血清细胞因子白细胞介素(interleukin,IL)-1,IL-6,IL-10,肿瘤坏死因子-α(tumer necrosis factors,TNF-α)的含量,随访两组患者的总体生存情况。结果: 卒中组患者的性别、年龄、麻醉方式、手术时间、术中失血量、及术前IL-1、IL-6、IL-10、TNF-α含量与对照组比较差异无统计学意义(P>0.05),高血压、糖尿病、房颤的患病率、术中低血压的发生率以及术后1、3 d时的血清IL-1、IL-6、IL-10、TNF-α含量均明显高于对照组(P<0.05)。截止至随访日期,卒中组患者的累积生存率明显低于对照组(P<0.05)。经Logistic回归分析:房颤,术中低血压,术后1、3 d时血清IL-1及TNF-α含量升高是术后急性脑卒中的危险因素。结论: 高龄髋部骨折患者手术后脑卒中的发生影响疾病预后,术后炎症细胞因子IL-1、TNF-α的增多是脑卒中发生的独立危险因素。     

基于Caprini风险评估模型的干预策略及应用于预防全髋关节置换术后深静脉血栓的效果分析

目的:分析应用Caprini血栓风险评估模型的干预策略对预防全髋关节置换术(total hip replacement,THR)后深静脉血栓(deep vein thrombosis,DVT)的效果。方法:选取自2018年1月至2021年12月收治的197例THR患者作为回顾性队列研究对象,男114例,女83例;年龄45~80(66.81±10.34)岁。以2019年5月引进Caprini血栓风险评估模型为界分为两组,94例行传统常规干预策略(对照组),103例行基于Caprini血栓风险评估模型的干预策略(观察组)。统计分析两组DVT发生率,疼痛视觉模拟评分(visual analogue scale,VAS),患肢周径差值,血清D-二聚体(D-D)水平及髋关节功能Harris评分。结果:197例获得随访,时间1~3(2.57±0.31)个月。观察组DVT发生率为1.94%(2例),对照组DVT发生率为11.70%(11例),两组比较差异有统计意义(χ²=6.642,P=0.010)。两组患者术后VAS均逐渐降低(P<0.001),两组患者术后1、2、3、7 d VAS评分比较差异有统计意义(P<0.05),但两组术后10 d VAS比较差异无统计意义(P>0.05)。两组术后患肢周径差值均逐渐缩小(P<0.001),两组术后1、2、3、7、10 d患肢周径差值比较差异有统计意义(P<0.05)。两组术后血清D-D水平均逐渐降低(P<0.05),两组术后8、24、48、72 h血清D-D水平相比差异有统计意义(P<0.05)。两组患者术后疼痛评分和Harris总评分均随时间逐渐升高(P<0.001),两组患者术后出院3个月疼痛评分比较差异有统计学意义(P<0.05),两组患者术后出院即刻、出院后1和3个月Harris总评分比较差异有统计学意义(P<0.001)。结论:基于Caprini血栓风险评估模型的干预策略有助于降低THR患者DVT发生率,改善术后疼痛和患肢肿胀,促进髋关节功能恢复。     

全髋关节置换术后假体周围发生骨折的列线图预测模型构建和评估

目的:构建评估行全髋关节置换术(total hip arthroplasty,THA)患者术后假体周围发生骨折的列线图预测模型。方法:选取2013年4月至2019年2月行THA患者538例为研究对象,男318例,女220例,年龄40~60(50.79±6.37)岁。根据对所有行THA患者跟踪随访3年的结果,将其分为无骨折组506例和骨折组32例。单因素和多因素Logistic回归分析行THA患者术后假体周围发生骨折的影响因素;构建行THA患者术后假体周围发生骨折的列线图预测模型,评估该预测模型的有效性、区分度。结果:骨折组行THA患者中存在骨质疏松状态、有外伤史、有髋关节翻修占比高于无骨折组(P<0.05),骨水泥型假体占比低于无骨折组(P<0.05)。骨质疏松状态[OR=4.177,95%CI(1.815,9.617),P<0.05],外伤史[OR=7.481,95%CI(3.104,18.031),P<0.05],髋关节翻修[OR=11.371,95%CI(3.220,40.153),P<0.05]是影响行THA患者术后假体周围发生骨折的独立危险因素,骨水泥型假体[OR=0.067,95%CI(0.019,0.236),P<0.05]是影响行THA患者术后假体周围发生骨折的独立保护因素。Hosmer-Lemeshow拟合优度检验显示, χ²=7.864,P=0.325。受试者工作特征(receiver operating characteristic curve,ROC)曲线评估行THA患者术后假体周围发生骨折的曲线下面积(area under curve,AUC)为0.892,敏感度为87.5%,特异性为77.7%。结论:本研究构建的行THA患者术后假体周围发生骨折的列线图预测模型区分度较好,有益于临床预测行THA患者假体周围是否发生骨折,为进行个体化预防骨折提供便利。     

基质金属蛋白酶家族在骨关节炎软骨组织中表达的研究

[目的]观察骨关节炎关节软骨中MMP-7、MMP-9、MMP-13和TIMP-1的表达,探讨其与软骨退变的关系及可能的作用机制。[方法]选取20例因骨关节炎行关节置换的软骨组织,常规HE染色观察其组织学形态,ABC免疫组化法观察关节软骨MMP-7、MMP-9、MMP-13和TIMP-1的表达,2例因意外受伤截肢患者的正常膝关节软骨标本作为对照。统计采用Mann-Whitney U非参数检验及相关分析。[结果]骨关节炎关节软骨出现裂隙、纤维化,软骨细胞增多、排列紊乱,并出现大量簇聚软骨细胞和肥大软骨细胞。MMP-7和MMP-13在正常软骨全层均呈低表达,但在退变软骨中的表达则明显增多,光密度值行U检验,两组差异有显著性(P<0.01)。在正常与OA软骨的浅层,MMP-9和TIMP-1的表达无显著性差异(P>0.05);但在深层软骨中,OA软骨MMP-9和TIMP-1的表达较正常软骨明显增多,两组差异有显著性(P<0.01)。[结论]MMP-7,13在OA软骨全层表达均多于正常软骨;MMP-9,13仅在OA软骨深层出现过多表达。MMPs与TIMPs的失衡是导致关节软骨发生组织学退变的原因之一。     

大肠癌组织中MMP-2、MMP-7的基因表达

目的:观察MMP-2和MMP-7在大肠癌组织与正常组织中表达的差异.方法:取28例大肠癌组织及肿瘤周围正常组织,用RT-PCR方法检测肿瘤组织及正常组织中MMP-2和MMP-7的表达.结果:MMP-2和MMP-7在大肠癌组织中的表达率和表达水平高于周围的正常组织(P＜0.05).结论:MMP-2和MMP-7可能在大肠癌的进展中起重要作用.     

Detection and analysis of MMP-2 and MMP-9 in seminal plasma

BackgroundThe aim of this study was to explore the association between semen parameters and matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) expression in human seminal plasma samples.MethodsConventional semen analysis was performed on semen samples (n = 64). MMP-2 and MMP-9 expression in seminal plasma was determined using gelatin zymography.ResultsCompared to semen samples with a normal sperm count, semen samples with a low sperm count (≤ 19 × 10⁶/ml) showed reduced sperm viability, a reduced percentage of Grade A sperm, a reduced percentage of morphologically-normal sperm, and lower proMMP-9 and MMP-9 but higher proMMP-2 and MMP-2 levels (P < 0.05). There were correlations between MMP-2 and MMP-9 expression and the percentage of Grade A sperm and morphologically-normal sperm (P < 0.05).ConclusionsMMP-2 and MMP-9 are both present in human semen, and low-concentration semen samples have increased MMP-2 and decreased MMP-9. We also observed relationships between MMP-2, MMP-9 and seminal parameters.     

Matrix metalloproteinases as diagnostic (MMP-13) and prognostic (MMP-2, MMP-9) markers of prostate cancer

Previous studies have detected high levels of matrix metalloproteinases (MMPs) in metastatic prostate cancer. In this study, we recruited 40 patients with prostate cancer (PCa): 20 presented organ-confined carcinoma and 20 had metastatic cancer. We also recruited 40 subjects for control groups, 20 with benign prostate hyperplasia (BPH) and 20 healthy males with similar characteristics. All of the patients were monitored at the beginning (time 0) and after 90 days. We analyzed the plasma concentrations of MMP-2, MMP-9, MMP-13, TIMP-1 and the enzyme activity of MMP-2 and MMP-9,using specific ELISA tests. The plasma concentrations of MMP-2, MMP-9 and MMP-13 were higher in PCa patients with metastasis than in the other groups, and in these patients decreased markedly after therapy began. For MMP-2 and MMP-9, greater differences were observed in enzyme activity than in plasma concentrations. TIMP-1 was reduced in PCa patients with metastasis, even if the intergroup differences were not statistically significant. Our results suggest that the plasma concentration and activity of MMPs, in association with PSA determination, could play a role in diagnosis, monitoring therapy and evaluating malignant progression in PCa.     

Clinical significance of MMP-2 and MMP-9 in patients with oral cancer

BACKGROUND: Factors that represent the potential for invasion and metastasis, such as matrix metalloproteinases (MMPs), could predict prognosis of cancer. Therefore, the authors studied plasma and tissue levels of MMP-2 and MMP-9 in oral cancer, the leading malignancy in India. METHODS: Enzyme-linked immunosorbent assay and gelatin zymography were used for the MMP analysis from plasma and tissue samples, respectively. RESULTS: Latent, active, and total forms and activation ratio of MMP-2 and MMP-9 were significantly elevated in malignant tissues as compared with adjacent normal tissues. Activation of MMP-2 was higher than MMP-9 in malignant tissues. Activation ratio was significantly higher in malignant tissues of the patients with lymph node metastasis as compared with those without lymph node metastasis (p = .005). Plasma MMP-9 levels were significantly lower in responders as compared with pretreatment levels (p = .002). CONCLUSION: The data indicate that MMP-2 and MMP-9 can be useful to identify metastatic phenotype as well as for treatment monitoring in oral cancer.     

The role of MMP-2 and MMP-9 polymorphisms in sporadic intracranial aneurysms

OBJECT: Matrix metalloproteinases (MMPs) are a family of endopeptidases that mediate vascular remodeling by degrading extracellular matrix components, such as collagen and elastin. On the basis of accumulating evidence that implicates increased MMP-2 (gelatinase A) and MMP-9 (gelatinase B) amounts and activity in the pathogenesis of aneurysms, the authors investigated the genetic association between polymorphisms in MMP-2 and MMP-9 and sporadic intracranial aneurysms. METHODS: Eight polymorphisms located in MMP-2 and MMP-9 were genotyped, and the association of these variations with disease was assessed in a Caucasian population consisting of 125 patients with intracranial aneurysms and 234 ethnically matched healthy volunteers. Polymorphisms in the MMP-2 gene and the haplotypes generated from these polymorphisms were not associated with the occurrence of intracranial aneurysms. However, a polymorphism located in the 3' untranslated region of MMP-9 showed a significant association with disease in the study population, with individuals carrying the TT genotype at increased risk for developing intracranial aneurysms (odds ratio 1.91, p = 0.005). Haplotypes containing the T allele of this polymorphism also showed a comparable association with disease. Similar results were obtained in an analysis of these polymorphisms in a subgroup of patients who presented with ruptured aneurysms. CONCLUSIONS: The study findings support a role for MMP-9, but not MMP-2, in the pathogenesis of intracranial aneurysms.     

MMP-2、MMP-9在胃肠道间质瘤中的表达及其临床意义

目的：探讨基质金属蛋白酶（MMP）-2、MMP-9在胃肠道间质瘤（GIST）中的表达及其与预后的关系.方法：采用免疫组化方法检测54例GIST组织中的MMP-2、MMP-9的表达,分析与各病理参数的关系.结果：肿瘤组织中的MMP-2、MMP-9阳性率分别为85.2%、83.3%,并随着GIST恶性程度的增高,其表达均出现递增趋势,差异有显著性意义（P＜0.05）;与肿瘤良恶性、生长方式、肿瘤大小、肿瘤中心有无坏死亦有明显关系（P＜0.01）.单因素分析MMP-2、MMP-9阳性表达的患者有较高的5年生存率,多因素分析发现MMP-2、MMP-9共表达能独立预测患者的5年生存率.结论：MMP-2、MMP-9在GIST中的表达率可以作为判断GIST性质、恶性程度、转移及预后的客观指标.     

The expression of MMP-2, MMP-7, MMP-9, and TIMP-1 in chronic rhinosinusitis and nasal polyposis

OBJECTIVES: To investigate the expression and clinical significance of MMP-2, MMP-7, MMP-9, and TIMP-1 in patients with nasal polyposis (NP) and chronic rhinosinusitis (CRS). STUDY DESIGN: Prospective study. SUBJECTS AND METHODS: This study involved 54 patients. There were three groups: nasal polyposis group, chronic rhinosinusitis group, and control group. Specimens were collected during endoscopic sinus surgery. Each sample was immunohistochemically examined. RESULTS: Expression of MMP-2 was found significantly increased in NP, whereas MMP-7 expression was found significantly increased in CRS (P < 0.001). TIMP-1 was significantly high in control group compared to CRS and NP (P < 0.001 and P = 0.002, respectively). CONCLUSIONS: Different regulation type of activation of MMPs has been found in these two diseases. If MMP-2 expression is intense in the mucosa, then this ends with polyp formation; if MMP-7 expression is intense, it ends with CRS or stays as CRS.