孤立结节型肺黏液腺癌的CT表现与病理对照研究

目的探讨孤立结节型肺黏液腺癌CT影像成因、表现特点及其病理基础。方法回顾性分析16例经手术病理证实的孤立结节型肺黏液腺癌CT影像资料,其中12例病变部位作高分辨率CT(HRCT)薄层扫描及多平面容积重组(MPVR),另有9例行增强扫描,分析病灶分布、形态、密度特征并与之病理比较。结果 16例病例中,病灶分布在胸膜、叶间裂旁占81.3%(13/16)。原位腺癌(AIS)及微浸润腺癌(MIA)含空泡征100%(3/3),浸润性黏液腺癌(IMA)空泡征69.2%(9/13);AIS及MIA见肿瘤微血管征100%(3/3),IMA 46.2%(6/13);MIA出现灶周磨玻璃影50%(1/2),IMA出现46.2%(6/13);IMA有浅分叶38.5%(5/13),细短毛刺30.8%(4/13),"胸膜牵拉征"38.5%(5/13)。9例患者增强扫描呈轻中度强化,强化程度(21.7±15.2)HU。16例结节型黏液腺癌均无淋巴结和远处转移。结论孤立结节型肺黏液腺癌在胸膜、叶间裂旁多见,灶内空泡征及肿瘤微血管征在AIS、MIA出现率最高,灶周磨玻璃影也是肺黏液腺癌一个重要征象。     

非酒精性脂肪肝大鼠肝组织FGF21mRNA表达与脂质沉积、胰岛素抵抗的关系

目的观察非酒精性脂肪肝(NAFLD)大鼠肝组织成纤维细胞生长因子21(FGF21)mRNA表达,并探讨其与脂质沉积、胰岛素抵抗的关系。方法选择SD大鼠40只,随机分为对照组10只、高脂组30只。对照组给予基础饲料喂养,高脂组给予高脂饲料喂养。喂养8周,两组均取10只,评价NAFLD模型建立情况。高脂组剩余大鼠继续高脂饲料喂养,分别于12、24周各取10只,腹主动脉取血,检测血清空腹血糖(FPG)、空腹胰岛素(FINS)、ALT、AST、TC、TG、FGF21、FFA水平,计算胰岛素抵抗指数(HOMA-IR);处死大鼠取肝组织,制备石蜡切片,行HE染色,观察肝细胞形态学变化;制备肝组织匀浆液,检测TG含量;采用RT-PCR法检测肝组织FGF21 mRNA表达。结果喂养8周时,高脂组体质量、肝湿重及血清TG、TC水平均高于对照组(P均<0.05),肝组织呈大泡性脂肪变性并出现炎症细胞浸润及点状坏死,提示NAFLD模型建立成功。高脂组喂养12、24周时,血清FFA水平、肝组织TG含量、HOMA-IR明显高于喂养8周时,且喂养24周时均高于喂养12周时(P均<0.05);而血清FGF21水平、肝组织FGF21 mRNA表达则呈先升高再下降趋势(P均<0.05)。结论 NAFLD大鼠肝组织FGF21 mRNA表达、血清FGF21水平与肝组织TG含量有关,在NAFLD早期二者变化一致,胰岛素抵抗可间接抑制其表达。     

单采血小板采集2个治疗单位献血者筛选指标探讨

目的:探讨机采血小板采集2个治疗量献血者筛选指标。方法:对78例献血者分析其体重、体表面积和采前血小板(PLT)计数对血小板减少量的影响。结果:体重(W)≥55kg,体表面积(S)≥1.7,采前血PLT计数≥200×109/L者采集后血小板计数均≥100×109/L。对男性献血者来说W≥70或S≥1.9采集后血小板降低较少;对55≤W<65,1.7≤S积<1.8献血者来说,采后血小板降低较多。结论:机采血小板采集2个治疗单位献血者筛选时要求W≥55kg,S≥1.7,采前血PLT计数≥200×109/L。     

微动力负压护创治疗糖尿病患者足部溃疡的临床疗效及价值

目的 探讨微动力负压护创治疗糖尿病患者足部溃疡的临床疗效及价值.方法 选择糖尿病足部溃疡患者92例,根据患者意愿分为对照组(n = 55)与观察组(n = 37).两组患者均使用降糖药物控制血糖在正常范围,对照组患足进行普通纱布换药,观察组患足采用微动力负压护创.治疗前及治疗后1周、2周,采用VAS评分法评估患者疼痛情...     

水通道蛋白1在急性坏死性胰腺炎大鼠胰腺组织的表达及其意义

Objective To study the expression of aquaporin 1 ( AQP1 ) in pancreas and its pathogenic role in rats with experimental acute necrotizing pancreatitis (ANP). Methods Forty-eight male Sprague-Dawley rats were randomly divided into two groups : control group ( n = 24 ) and ANP group ( n = 24). Six rats in each group were sacrificed at 3,6,12 and 18 h after induction of experimental models. Quantity of ascites and levels of serum amylases were measured at each time point. Serum AQPI was determined by ELISA. Pathological changes of pancreatic tissues were examined. Capillary permeability in pancreatic tissues was tested by Evans Blue (EB) extravasation method. AQPI expression in pancreatic tissues was detected by immunohistochemieal staining, Western blot and fluorescence quantitative polymerase chain reaction (FQ-PCR). Results (1) Serum amylase level at 3,6,12, and 18 h in control group was (1308±759) ,(1077±508), (1325±761),(1328±762) U/L,and that in ANP group was (9102± 2199), (8799±1634), (9398±1473), (9484±862) U/L respectively. The concentration of EB in pancreatic tissues at each time point in control group was (205.61±32.99), (141.46±27.18 ), (96.94± 26.79), (61.43±24.82) mg/L, and that in ANP group was ( 273.59±23.47 ), ( 253.51±31.68 ), (221.15±73.68 ), (185.28±42.35) ,respectively. There was significandy difference between two groups. Serum AQP1 level in control group at each point was ( 74.08±11.80), (78.49±9.06 ), (75.77± 7.37 ), ( 72.75±13.87 ) mg/L, and that in AN P group was (73.29±9.61 ), ( 62.85±7.28 ), (62.07± 4.39 ), (46.33±11.91 ) mg/L, respectively ( P < 0.01 ). ( 2 ) Protein expression of AQPI in pancreatic tissues detected by immunohistochemical staining in control group at each time point was 114.13±7.92, 122.39±7.99,145.98±6.48,113.98±6.48, and that in ANP group was 80.07±14.89,110.54± 4.45,103.77±10.48,99.18±6.95;Protein expression of AQP1 in pancreatic tissues detected by Western blot in control group at each time point was 1.19±0.33,1.02±0.25,0.90±0.33,1.06±0.20,and that in ANP group was 0.83±0.11,0.96±0.21,0. 58±0.28,0.72±0.14, respectively ( P < 0.05 ). ( 3 ) The mRNA level of AQP1 gene expressed in pancreas in control group at each time point was 0.91±0.22,1.01±0.83,0.48±0.23,0.61±0.51,and that in ANP group was 2.13±0.63,2.02±1.40, 2.07±0.86,2.49±2.47,respectively (P<0.01).Condusion The expression of AQP1 wasdown-reg-ulated in pancreas in rats with ANP,which might could play an important role in the pathogenesis of capil-lary leak syndrome.     

下呼吸道多药耐药鲍氏不动杆菌感染患者的护理措施

鲍氏不动杆菌是不动杆菌属在下呼吸道的主要致病菌,是医院感染的重要病原菌,属非发酵菌.近年来由于广谱抗菌药物的滥用,造成该菌的分离率不断上升且耐药性日益严重,由于该菌的耐药性较强,表现出多药耐药性(MDR),给临床治疗带来很大困难.为此我们总结了脑梗死下呼吸道多药耐药鲍氏不动杆菌感染患者的治疗、护理等措施.     

PEA3蛋白在乳腺癌组织中的表达及其与Her-2/neu的关系

背景与目的:Ets转录因子家族成员多瘤病毒增强子激活因子3基因(polyomavirus enhancer activator 3,PEA3)与肿瘤的侵袭和转移密切相关,其在乳腺癌发生、发展中的作用有待探讨.本研究旨在探讨PEA3蛋白在乳腺癌组织中的表达及其与Her-2/neu和乳腺癌临床病理因素的关系.方法:采用免疫组化法检测80例乳腺癌组织中PEA3及Her-2/neu的表达,对Her-2/neu(++)的病例采用显色原位杂交(coloration in situ hybridization,CISH)检测Her-2基因扩增情况.结果:80例乳腺癌组织中PEA3的阳性率57.5％(46/80),高于正常乳腺组织及乳腺纤维腺瘤,与肿瘤大小、组织学分级及腋淋巴结转移均有一定的相关性,且与Her-2/neu的表达呈正相关.PEA3蛋白的阳性表达与乳腺癌患者5年生存率呈负相关.结论:PEA3与乳腺癌浸润转移及预后密切相关,有望作为乳腺癌预后的一个参考指标,其作用机制可能与Her-2/neu相关.     

扩散加权成像对不同病理类型乳腺癌的鉴别诊断价值

目的：探讨扩散加权成像（DWI）及ADC值（ADC）测量对不同病理类型乳腺癌的鉴别诊断价值。方法：回顾分析50例经病理证实的乳腺癌患者的MRI资料,DWI检查采用EPI技术,分别测量乳腺病灶及正常乳腺ADC值,对不同病理类型乳腺癌的ADC值进行单因素方差分析并进行两两比较。结果：50例中浸润性导管癌34例,黏液腺癌6例,乳头状癌4例,浸润性筛状癌4例和髓样癌2例。乳腺癌和正常组织的ADC值分别为（1.31±0.06）×10-3及（2.06±0.04）×10-3mm2/s。浸润性导管癌、黏液腺癌、乳头状癌及筛状癌之间ADC值差异有统计学意义（F=9.406,P〈0.05）,黏液腺癌与浸润性导管癌、乳头状癌及筛状癌之间ADC值差异有统计学意义（P〈0.01）,浸润性导管癌与乳头状癌及筛状癌间的ADC值差异无统计学意义（P值分别为0.671和0.333）。结论：不同类型乳腺癌因病理基础不同,ADC值变化存在一定差异,ADC值测量有助于部分病理类型乳腺癌的鉴别诊断。     

CD105和VEGF、TGF-β1在结直肠癌的表达及其与浸润、转移和血管生成的关系

目的 探讨结直肠癌中CD105和VEGF、TGF-β1的表达及与血管生成的关系.方法 应用免疫组化方法检测60例结直肠癌中CD105标记的微血管密度(MVD)和VEGF、TGF-β1的表达.结果 60例结直肠癌中CD105表达的MVD为36.50±9.43.VEGF、TGF-β1表达的阳性率为68.3%,75.0%.MVD和VEGF、TGF-β1表达与肿瘤浸润深度、淋巴结转移和Dukes分期密切相关(P＜0.05).VEGF、TGF-β1表达均与MVD呈正相关(P＜0.01),TGF-β1与VEGF也呈正相关(P＜0.05).结论 CD105、VEGF、TGF-β1关系密切,三者联合检测可作为结直肠癌新生血管和浸润转移的有价值的标志物.