子宫颈癌中c-myc和hMLH1表达与HPV16感染的关系

目的探讨子宫颈病变中c-myc与hMLH1和HPV16表达的关系。方法应用免疫组化SP法检测c-myc与hM-LH1在慢性子宫颈炎、子宫颈上皮内瘤变(cervical intraepi-thelial neoplasia,CIN)和子宫颈癌患者中的表达水平;PCR技术检测相应标本中HPV16感染的情况。结果 c-myc在慢性子宫颈炎、CIN、子宫颈癌中的阳性率分别为26.7%(8/30))、50%(30/60)、69.2%(36/52),差异有统计学意义(P<0.05),hMLH1阳性率依次为66.7%(20/30)、56.7%(34/60)、30.7%(16/52),差异有统计学意义(P<0.05)。在子宫颈癌组织中,c-myc蛋白与肿瘤分化程度、临床分期以及有无淋巴结转移相关;hMLH1蛋白表达下调与子宫颈癌分化程度及是否有淋巴结转移密切相关,表达差异均有统计学意义(P<0.05);HPV16与c-myc蛋白表达呈正相关;与hM-LH1蛋白表达呈负相关。结论 HPV16可能是通过影响c-myc与hMLH1蛋白表达而在子宫颈癌的发生、发展中发挥作用。     

HPV E6/E7 mRNA联合HPV L1衣壳蛋白在子宫颈癌前病变诊断中的价值

目的探讨HPV E6/E7 mRNA联合HPV L1衣壳蛋白检测在子宫颈癌前病变诊断中的价值。方法采用分支链DNA信号放大技术检测156例子宫颈活检不同病变组织中HPV E6/E7 mRNA的表达,并应用免疫组化En Vision法检测HPV L1衣壳蛋白的表达。结果与正常组织相比,子宫颈低级别上皮内病变(low-grade squamous intraepithelial lesion,LSIL)、子宫颈高级别上皮内病变(high-grade squamous intraepithelial lesion,HSIL)和子宫颈鳞癌组织中HPV E6/E7mRNA的阳性率增高(P 0. 05),且HSIL和子宫颈癌中HPV E6/E7 mRNA的阳性率高于LSIL(P 0. 05),但HSIL和子宫颈癌组织中HPV E6/E7 mRNA的阳性率差异无显著性(P 0. 05); HPV L1衣壳蛋白在LSIL中的阳性率明显高于HSIL(P 0. 05)。结论通过对子宫颈不同病变标本进行HPV E6/E7 mRNA和HPV L1衣壳蛋白联合检测,了解不同病变子宫颈组织中HPV E6/E7 mRNA和HPV L1衣壳蛋白的表达趋势,可预测子宫颈上皮内病变的发展趋势,指导临床医师进行合理治疗。     

人乳头瘤病毒L1壳蛋白在子宫颈活检组织中的表达及意义

目的探讨人乳头瘤病毒(human papilloma virus, HPV)L1壳蛋白在HPV阳性子宫颈活检组织中的表达与子宫颈鳞状上皮内病变(squamous intraepithelial lesion, SIL)程度的相关性及其应用价值。方法收集2017年1～9月上海市第一妇婴保健院因HPV阳性行子宫颈活检患者966例,以非同位素标记核酸分子杂交技术和免疫组化技术为基础行HPV L1壳蛋白检测。结果 966例中HPV L1壳蛋白的总阳性率为14.8%(143/966),其中慢性子宫颈炎、低级别鳞状上皮内病变(low grade squamous intraepithelial lesion, LSIL)、高级别鳞状上皮内病变(high grade squamous intraepithelial lesion, HSIL)和子宫颈浸润性鳞状细胞癌中HPV L1壳蛋白的阳性率分别为0.2%(1/513)、37.9%(121/319)、15.9%(21/132)和0(0/2)。LSIL中HPV L1壳蛋白率高于慢性子宫颈炎、HSIL和子宫颈浸润性鳞状细胞癌。结论 HPV L1壳蛋白在子宫颈活检组织中的表达与宫颈鳞状上皮病变程度呈负相关性。HPV L1在帮助了解子宫颈鳞状上皮病变程度,预测子宫颈鳞状上皮病变的发展趋势、转归、预后及选择临床处理方案中有一定参考价值。     

常见HR-HPV各型在子宫颈组织中致癌能力的评估

目的探讨高危型人乳头状瘤病毒(high-risk human papilloma viruses,HR-HPV)各型与子宫颈病变进展的关系。方法对135例诊断结果为45例非子宫颈上皮内瘤变(non-squamous intraepithelial lesions,NSIL)、42例低级别鳞状上皮内病变(low-grade squamous intraepithelial lesions,LSIL)、40例高级别鳞状上皮内病变(high-grade squamous intraepithelial lesions,HSIL)、8例子宫颈癌(squamous cervical cancer,SCC)的子宫颈活检组织蜡块进行HPV及E6/E7 mRNA的检测,分别应用PCR-反向杂交法、支链DNA技术(Quantivirus冷光仪)检测。结果 HPV 16在NSIL、LSIL、HSIL、SCC中感染率依次22.22%、21.43%、47.50%、62.50%,呈逐渐递增趋势(P=0.007);单一感染时,HPV 16的E6/E7 mRNA拷贝数依次是1 425.76、3 747.25、1 325.98、86 015.36,与子宫颈病变严重程度具有相关性(P=0.028);多重感染时,HPV 16伴其它HPV感染组在NSIL、LSIL、HSIL、SCC中的E6/E7 mRNA拷贝数呈递增趋势,差异有统计学意义(P=0.040),而其它HPV(不包括HPV 16)感染组表达的mRNA拷贝数与病变严重程度呈负相关性(P=0.044)。结论 HPV 16与子宫颈病变进展的关系最为紧密;在所有HR-HPV中HPV 16的致癌能力最强。     

子宫颈低级别鳞状上皮内病变与HR-HPV的关系

目的探讨高危型人乳头状瘤病毒(high risk human papillomavirus,HR-HPV)在子宫颈低级别鳞状上皮内病变(low-grade squamous intraepithelial lesion,LSIL)中的分布特点及感染方式,并分析其在LSIL中的作用。方法应用实时荧光定量PCR和HPV原位杂交技术对328例诊断结果为168例LSIL、160例高级别鳞状上皮内病变(high-grade squamous intraepithelial lesions,HSIL)的子宫颈组织蜡块进行HPV分型检测。结果 HE染色结果显示,LSIL的病变细胞集中在子宫颈鳞状上皮表层,HSIL的病变细胞主要集中在上皮下层。168例LSIL患者中HR-HPV阳性率95.2%;LSIL、HSIL中HPV 16、18阳性率分别为26.2%、57.5%,其他型HR-HPV(不包括HPV 16、18)的阳性率分别为80.9%、55.0%,差异均有统计学意义(P0.001)。在原位杂交检测组中,HR-HPV的阳性率为70.2%,HR-HPV阳性LSIL中,棕黄色阳性细胞位于子宫颈鳞状上皮表层、中层,基底层未见阳性细胞。结论 HR-HPV感染与LSIL的发生、发展密切相关,尤其是其他型HR-HPV(不包括HPV 16、18);LSIL患者中HR-HPV的感染开始于子宫颈鳞状上皮表层。     

子宫颈癌中Gli蛋白过表达的临床病理学意义

目的 研究Gli蛋白检测在子宫颈癌及其癌前病变中的临床病理学意义,并分析Gli蛋白表达与HPV16型感染的关系.方法 32例正常子宫颈上皮、71例子宫颈上皮内瘤变(CIN);其中CIN1 28例、CIN2 18例、CIN3 25例和80例子宫颈鳞状上皮癌(SCC)共183例存档蜡块选自延边大学医院、延边妇幼保健院和延边肿瘤医院病理科.应用PCR技术检测上述组织中HPV16型的感染,并用免疫组化方法在子宫颈病变组织芯片中检测Gli-1、Gli-2、Gli-3蛋白的表达情况.结果 Gli-1和Gli-2蛋白呈胞质和胞核染色,Gli-3蛋白多数呈胞质染色.在子宫颈癌和癌前病变(CIN2/3)中,Gli-1~3呈强阳性,其阳性表达率均显著高于正常子宫颈黏膜上皮.80例子宫颈癌标本中HPV16阳性率是77.5%.在子宫颈癌组织中HPV16阳性组的Gli-1蛋白的胞质阳性率(85.5%,53/62)与强阳性率(85.5%,53/62)以及Gli-2蛋白的胞质阳性率(100%)与胞核强阳性率(100%)均高于HPV16阴性组(Gli-1胞质阳性率与强阳性率均为0,Gli-2胞质阳性率和胞核强阳性率分别为0和50%),差异具有统计学意义(P均<0.05);而3种蛋白表达率与患者的年龄、淋巴结转移、肿瘤学分期和临床分期均无关.结论 Gli-1、Gli-2、Gli-3蛋白过表达可以作为子宫颈癌及其癌前病变的早期辅助诊断指标,Gli蛋白的表达水平与HPV16感染密切相关,且有望成为子宫颈癌靶向治疗的新靶点.     

子宫颈鳞状细胞癌中PHLPP表达与肿瘤转移的关系

目的探讨PHLPP表达与子宫颈鳞状细胞癌(cervix squamous cell carcinoma,CSCC)临床病理特征的关系及与肿瘤转移的生物学意义。方法应用免疫组化SP法检测78例CSCC组织(其中淋巴结转移38例、无淋巴结转移40例),低、高级别上皮内病变各40例,20例正常子宫颈组织中PHLPP和p-AKT表达,分析PHLPP表达与不同子宫颈病变组织、淋巴结转移的相关性。结果 PHLPP在正常子宫颈、低、高级别上皮内病变、CSCC中的阳性率逐渐减少,各组间差异有统计学意义(P0.05);但低级别上皮内病变与高级别上皮内病变组间差异无统计学意义(P0.05);组织学分级各组间差异无统计学意义(P0.05)。淋巴结转移组与无淋巴结转移组相比,差异有统计学意义(P0.05)。pAKT在正常子宫颈、低、高级别上皮内病变、CSCC中的阳性率逐渐增加,各组间差异均有统计学意义(P0.05);但低、高级别上皮内病变与CSCC组间差异无统计学意义(P0.05)。组织学分级各组间差异均有统计学意义(P0.05)。淋巴结转移组与无淋巴结转移组间差异有统计学意义(P0.05)。PHLPP表达与p-AKT表达呈负相关(r=-0.964,P0.05)。结论 PHLPP在CSCC中低表达可能与肿瘤的发生、发展及转移密切相关,可作为判断子宫颈癌患者预后的参考指标。     

宫颈鳞状细胞癌和癌前病变中Skp2表达及其与HPV16/18感染的关系

目的 探讨skp2在宫颈鳞状细胞癌和癌前病变中的表达规律及其与人乳头状瘤病毒(HPV)感染之间的关系.方法 采用免疫组织化学(ABC法)和原位杂交检测Skp2蛋白和HPV16/18 DNA在30例正常宫颈鳞状上皮、29例宫颈低级别上皮内瘤变、31例高级别上皮内瘤变和31例宫颈鳞状细胞癌中的表达.结果 Skp2在正常宫颈鳞状上皮中呈阴性,与宫颈低级别上皮内瘤变(阳性表达率为13.8%,4/29)之间差异无统计学意义(P>0.05).随着上皮病变级别升高,表达也逐渐增强,在宫颈鳞状细胞癌中表达更强;HPV16/18 DNA在四组中的阳性表达率,除高级别上皮内瘤变和宫颈鳞状细胞癌两组间差异无统计学意义外(均为96.8%),其余各组之间差异均有统计学意义(P<0.01);在宫颈低级别上皮内瘤变中skp2蛋白表达和HPV感染相关无统计学意义,但在高级别上皮内瘤变和宫颈鳞状细胞癌两组中均呈正相关(γ高级别=0.373,γ癌 =0.416,P<0.05).结论 Skp2过表达主要在宫颈鳞状细胞癌形成的中晚期起作用,可作为一个早期诊断恶性的指标,且可能与HPV16/18感染有协同作用.E7-skp2-Rb可能是HPV感染诱导宫颈鳞状细胞癌形成的一条新致癌途径.     

子宫颈病变组织中低分子量蛋白酶体表达与HPV16感染的关系

目的观察低分子量蛋白酶体(low molecular-weight protein,LMP)在子宫颈病变组织中的mRNA和蛋白表达,探讨其与HPV16感染的关系。方法以152例新疆维吾尔族妇女正常子宫颈上皮、子宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)和子宫颈鳞癌(cervical squamous cell carcinoma,CSCC)患者为研究对象,采用RT-PCR和免疫组化法鉴定LMP2和LMP7mRNA及蛋白表达水平;采用PCR技术检测相应标本HPV16感染情况。结果 (1)LMP2、LMP7随着子宫颈病变的加重其蛋白表达逐渐降低,且mRNA表达水平与蛋白表达趋势相一致。在CIN中LMP2、LMP7蛋白表达下调和缺失率分别为25.0%/15.6%、29.7%/23.4%;在子宫颈癌中LMP2、LMP7蛋白的表达下调和缺失率分别为17.5%/34.9%、23.8%/41.3%。临床病理参数进行分析发现LMP2、LMP7与子宫颈癌分化程度及淋巴结转移密切相关(P<0.05)。(2)PCR结果显示,HPV16的检出率随着子宫颈病变的进展而增加,在慢性子宫颈炎、CIN和子宫颈癌组织中阳性率分别为8%(2/25)、67.2%(43/64)和77.8%(49/63),且随着肿瘤恶性程度的增加其阳性表达率增加,各组间阳性表达差异有统计学意义(P<0.05)。在CIN中LMP7表达下调与HPV16感染有关(P<0.05),子宫颈癌中LMP2和LMP7表达下调与HPV16感染有关(P<0.05)。结论 LMP基因的转录表达下调或蛋白质表达缺失与维吾尔族妇女子宫颈癌病变进程密切相关,其中HPV16感染可能是重要原因之一。     

Association of the expression of the low molecular-weight protein with HPV16 infection in cervical lesions

目的 观察低分子量蛋白酶体(low molecular-weight protein,LMP)在子宫颈病变组织中的mRNA和蛋白表达,探讨其与HPV16感染的关系.方法 以152例新疆维吾尔族妇女正常子宫颈上皮、子宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)和子宫颈鳞癌(cervical squamous cell carcinoma,CSCC)患者为研究对象,采用RT-PCR和免疫组化法鉴定LMP2和LMP7 mRNA及蛋白表达水平;采用PCR技术检测相应标本HPV16感染情况.结果 (1)LMP2、LMP7随着子宫颈病变的加重其蛋白表达逐渐降低,且mRNA表达水平与蛋白表达趋势相一致.在CIN中LMP2、LMP7蛋白表达下调和缺失率分别为25.0%/15.6%、29.7%/23.4%;在子宫颈癌中LMP2、LMP7蛋白的表达下调和缺失率分别为17.5%/34.9%、23.8%/41.3%.临床病理参数进行分析发现LMP2、LMP7与子宫颈癌分化程度及淋巴结转移密切相关(P<0.05).(2)PCR结果显示,HPV16的检出率随着子宫颈病变的进展而增加,在慢性子宫颈炎、CIN和子宫颈癌组织中阳性率分别为8%(2/25)、67.2%(43/64)和77.8%(49/63),且随着肿瘤恶性程度的增加其阳性表达率增加,各组间阳性表达差异有统计学意义(P<0.05).在CIN中LMP7表达下调与HPV16感染有关(P<0.05),子宫颈癌中LMP2和LMP7表达下调与HPV16感染有关(P<0.05).结论 LMP基因的转录表达下调或蛋白质表达缺失与维吾尔族妇女子宫颈癌病变进程密切相关,其中HPV16感染可能是重要原因之一.     

颈神经根槽和颈椎间孔的应用解剖

目的：为颈椎病的病因、诊断和治疗提供补充的定量数据。方法：在干燥的颈椎椎骨标本和福尔马林固定的颈椎标本上，测量颈神经根槽和颈椎椎间孔。结果：内侧区的平均长度，内侧区前缘中点到椎体中线的距离从C3～C7逐渐增加。C3内侧区的宽度较大，C7上、下关节突及峡部高度之和的后中点到颈神经根槽后壁的前后距离最小。结论：研究结果为影像诊断和外科手术提供了相关的应用解剖数据。     

Prevalence and genotype distribution of human papillomavirus in non-neoplastic cervical tissue lesion: cervical erosion

Human papillomavirus (HPV) infection is the commonest sexually transmitted infection, which is associated with various clinical conditions, ranging from asymptomatic infection to malignant disease of the cervix. The aim of this study was to evaluate the prevalence and genotypic distribution of HPV in women with cervical erosion and to compare the results with those in women with a clinically normal cervix. A further aim was to establish the association between HPV infection and cervical cytology results in women with and without cervical erosion. Cervical samples were collected by liquid-based method and consecutively evaluated for the presence of HPV DNA and for cervical cytology. HPV DNA was tested by a nested polymerase chain reaction (PCR) and typed by reverse dot blot genotyping. Cytological classification was made according to Bethesda 2001 criteria. The overall HPV prevalence was 16.9%; HPV DNA was positive in 20.2% of women with cervical erosion and 12.8% in women with normal cervix (P < 0.05). Multiple infections were found in 34.1% of the HPV-positive women. Commonest types were HPV 18 (32.9%), HPV 16 (29.5%), HPV 54 (20.5%), and HPV 6 (17%). Cervical cytology results were abnormal for 5.2% of women with cervical erosion and for 1.3% with clinically normal cervix (P < 0.05). This study detected a high prevalence of HPV infection in women with cervical erosion compared to women with a normal cervix. This data may contribute to the HPV epidemiology in the southeastern Turkey. It is recommended that women with cervical erosion should be given priority in HPV screening programs.     

E-Cadherin在子宫颈上皮内瘤变及子宫颈鳞癌中的表达

目的：了解E-Cadherin在子宫颈上皮内瘤变及子宫颈鳞癌的表达及其临床意义。方法：采用S-P免疫组化方法对20例慢性子宫颈炎，40例子宫颈上皮内瘤变及71例浸润性子宫颈鳞癌进行E-Cadherin检测。结果：慢性子宫颈炎、CIN I、CINⅡ、CINⅢ、浸润性子宫颈鳞癌、癌旁组织E-Cadherin的异常表达率分别为40.0%、23.1%、16.7%、60.0%、95.8%及53.8%。子宫颈鳞癌E-Cadherin的异常表达率明显高于子宫颈上皮内瘤变及癌旁组织。结论：CINⅢ、浸润型子宫颈鳞癌E-Cadherin表达下调或缺失。     

人工颈椎间盘置换术后颈椎活动与稳定性的评价

目的:评价人工颈椎间盘置换术对颈椎活动与维持手术节段稳定性的作用及临床效果。方法:18例非手术治疗无效的颈椎病(脊髓型、神经根型或/和混合型)行前路颈椎间盘切除后置入Bryan人工颈椎间盘,按计划进行定期随访(6～20个月,平均14个月),根据手术前后颈椎的动力位X线片分析手术节段的稳定性。并结合病人神经症状和体征的改善情况评价其临床效果。结果:手术效果优9例,良5例,一般3例,差1例。手术前平均JOA评分为12分,术后平均为15.5分;手术节段前屈后伸术前运动范围12.8°±5.7°,术后11.2°±5.4°;邻近间隙术前屈伸运动范围11.9°±5.8°,术后11.4°±4.9°。术前后比较无统计学差异(P>0.05)。未发现假体松动和移位。结论:人工颈椎间盘置换术安全可靠,病人恢复快,既可保持手术节段颈椎稳定,又可维持颈椎的生理活动度。     

Prevalence of alpha-papillomavirus genotypes in cervical squamous intraepithelial lesions and invasive cervical carcinoma in the Italian population

The aim of the present investigation was to define the spectrum of mucosotropic human papillomaviruses among 414 Italian women with normal cervices (n = 183), low- and high-grade cervical squamous intraepithelial lesions (n = 101 and 65, respectively), and invasive squamous cervical carcinomas (n = 65). Human papillomaviruses were detected by broad spectrum consensus-primer-pairs MY09/MY11 and GP5+/GP6+-based polymerase chain reaction using three amplification methods and were characterized by nucleotide sequence analysis. The prevalence rates of HPV infections was 19.7%, 63.4%, 80%, and 81.5% in patients with normal cervices, low-grade, and high-grade squamous intraepithelial lesions, and cervical carcinomas, respectively. Among the 205 HPV-positive patients, a total of 31 mucosal HPV genotypes were identified of which 16 types, epidemiological classified as high-risk viruses (HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 66, 68, 73, and 82), have been found in 16.9%, 50.1%, 69.2%, and 78.5% of normal cervix, low-, and high-grade cervical squamous intraepithelial lesions, and cervical carcinoma groups, respectively. As expected, the HPV16 was the most represented viral type in all groups examined with frequency rates ranging from 8.7% in normal subjects to 58.5% in invasive carcinoma patients. Ten epidemiologically defined low-risk HPV types (HPV6, 11, 42, 54, 61, 70, 71, 72, 81, 83) were detected in 2.7%, 7.9%, and 6.1% of normal cervix, low-, and high-grade cervical squamous intraepithelial lesions, respectively, and in none of invasive carcinomas. Furthermore, five unknown risk viruses were detected in 3% of low-grade cervical squamous intraepithelial lesions (HPV30, 32, 67), in 3.1% of high-grade cervical squamous intraepithelial lesions (HPV62, 90), and in 1.5% of cervical carcinomas (HPV62). Larger epidemiological screening studies, with PCR amplification and followed by either hybridization-based procedures against sequence targets of all known HPV types or sequence analysis studies, are needed in order to assess the epidemiological risk of less represented HPV types, to identify unknown viruses, and to monitor the future eventual spread of unusual viral types related to vaccination programs and/or population mobility.     

前路减压联合后路内镜手术在 “钳夹式”颈椎病治疗中的应用

目的 探讨颈椎前路减压植骨融合内固定(ACDF)联合后路内镜手术治疗“钳夹式”颈椎病的疗效。方法 回顾性分析。纳入2015年3月-2017年5月河北医科大学第三医院脊柱外科影像学及随访资料完整的28例“钳夹式”颈椎病患者,其中男15例、女13例,年龄33~71(52.214±8.234)岁。接受ACDF的15例患者纳入ACDF组。接受ACDF联合后路内镜手术的13例患者纳入联合手术组。对两组患者术后1年时的颈项部疼痛视觉模拟评分(VAS)及日本骨科协会(JOA)评分、颈椎曲度(Cobb角)、黄韧带面积、椎管矢状径、椎管面积、脊髓面积、椎间隙高度、轴性症状等临床及影像学指标进行比较。结果 两组患者性别、年龄、病程、术前临床表现(颈椎功能障碍指数)、手术节段等基线资料比较,差异均无统计学意义(P值均＞0.05)。两组患者术后各时间点VAS和JOA评分与术前相比,差异均有统计学意义(P值均＜0.01)。联合手术组与ACDF组术后1年Cobb角(10.85°±2.79°、9.33°±3.48°)比较差异无统计学意义(t=-1.255, P＞0.05)。两组患者术后1年时黄韧带面积、椎管矢状径、椎管面积及脊髓面积组间比较差异均有统计学意义(t=9.403、-2.855、-8.007、-2.447, P值均＜0.05),且组内手术前后比较差异均有统计学意义(P值均＜0.01)。术后1年椎间隙高度两组间比较差异无统计学意义(t=-0.534, P＞0.05),但组内手术前后比较差异均有统计学意义(P值均＜0.01)。随访满1年时,两组患者术后轴性症状发生率差异无统计学意义(P=0.705)。结论 联合手术较传统颈椎前路手术,减压更加彻底,更加有利于脊髓功能的恢复,并有效避免了传统后路手术对颈后部软组织的损伤。     

Telomerase and human papillomavirus as diagnostic adjuncts for cervical dysplasia and carcinoma

Telomerase and human papillomavirus (HPV) DNA were evaluated as potential markers of high-grade dysplasia in cervical cytological specimens. Cytology specimens were collected from patients at the time of colposcopic evaluation for management of a previous abnormal cytology test result. Telomerase activity was evaluated by the telomeric repeat amplification protocol (TRAP), and HPV DNA was detected by polymerase chain reaction with L1 consensus-sequence primers and filter hybridization genotyping. Telomerase was detected in 8 of 97 (8.2%) cases with normal cytology or benign cellular changes, in 7 of 98 (7.1%) cases of atypical squamous cells of undetermined significance (ASCUS), in 3 of 95 (3.2%) cases of low-grade squamous intraepithelial lesion (LSIL), and in 17 of 48 (35.4%) cases with high-grade squamous intraepithelial lesion (HSIL). High-risk HPVs were detected in 23 of 97 (23.7%) cases with normal/reactive cellular changes (RCC) cytology, in 28 of 98 (28.6%) cases of ASCUS, in 69 of 95 (72.6%) cases of LSIL, and in 35 of 48 (72.9%) cases of HSIL. Telomerase expression did not correlate with the detection of high-risk HPVs in any cytological diagnostic categories. Telomerase and HPV test results of cytological specimens were correlated with the histological diagnoses of concurrent cervical biopsy specimens. Telomerase showed a sensitivity of 29.9% and a specificity of 94.0% for biopsy-confirmed cervical intraepithelial neoplasia (CIN) II/III. In contrast, high-risk HPVs were detected in 70.1% of cases with underlying CIN II/III, with a specificity of 62.5%. A relatively high proportion of normal/RCC or ASCUS cases with telomerase-positive test results had underlying high-grade dysplasia on cervical biopsy. Thus, technical and practical limitations of the TRAP assay in cervical cytology specimens limit the practical application of telomerase as a diagnostic adjunct in cervical cytopathology.     

上颈性眩晕发生的颈交感神经及第2颈神经的解剖学因素观察

目的 明确颈上神经节（superior cervical ganglion,SCG）与第2颈神经及椎动脉的解剖关系,为临床诊治上颈性眩晕提供形态学基础。 方法 解剖15具（30侧）成人尸体标本,观察颈上神经节与C2的交通支及至椎动脉的分支。 结果 5侧未见SCG与C2之间存在神经连接;25侧存在神经连接,其中18侧存在迷走神经参与,7侧可见SCG分支支配椎动脉。SCG分支与C2前支汇合后,交感神经纤维分别至C2前、后支及椎动脉。 结论 SCG与C2的交通支及其对椎动脉的支配关系,可为阐明上颈性眩晕发病机理及建立有效治疗方案提供重要解剖学依据。     

颈椎棘突的形态学特征及在颈部推拿中的临床意义

目的：探讨颈椎棘突分叉的规律性及其对颈部推拿的指导意义。方法：64具（套）汉族男性干燥颈椎骨骼标本上对颈椎棘突的分叉情况进行大体解剖学观测。结果：C2棘突分叉的出现率最高（94．4％），而在C7几乎所有标本的棘突都没有分叉（96．9％）；颈椎中段（C3－C6）棘突的分叉分别为82．8％，81．3％、78．1％和60％，各节段之间的分叉率差异显著（P＜0．05）。结论：C2和C7可分别作为颈部推拿的定位标志，在应用手法之前必须要分清是由先天颈椎棘突分叉所致棘突偏丕还是由颈椎偏移所引起的棘突偏歪。