男性泌尿生殖层的层面解剖及其临床意义研究

目的 观察并描述男性泌尿生殖层的层面解剖学形态,探讨该层面在结直肠手术中的临床意义。
方法 采用层面解剖学方法解剖10具男性尸体躯干与20具盆腔标本,系统地描述泌尿生殖层的解剖形态,并与相应腹腔镜下解剖结构相比较。结果 男性泌尿生殖层为泌尿生殖筋膜包被,整体结构可分3段--腹段、盆段和精索段。泌尿生殖层腹段头侧由泌尿生殖筋膜紧密愈着于膈下筋膜,外侧与腹横筋膜间形成侧锥筋膜,其腹侧为原始体腔膜形成的后腹膜以及后腹膜与腹内脏器固有筋膜形成的融合筋膜,背侧为腰肌筋膜;腹段在肠系膜下动脉以下,形成位于腹主动脉与下腔静脉前方的独立层面,在盆腔入口处延续为位于中央的盆段和位于两侧的精索段。精索段外侧界为精索血管,内侧界为输尿管,前界为输精管,外被泌尿生殖筋膜,形似三角,经由内环外出至腹股沟管,延伸至睾丸。盆段入盆后包绕在直肠周围下行,直肠后方的泌尿生殖层约在骶4椎体前方融汇于直肠固有筋膜,其内走行腹下神经;直肠侧方泌尿生殖层内为下腹下神经丛以及输尿管、输精管走行,泌尿生殖筋膜脏层覆盖其内侧表面,行向直肠前方,终于精囊腺-前列腺交界,泌尿生殖筋膜壁层覆盖于下腹下神经、输尿管背侧及外侧,下行与膀胱固有筋膜融汇。结论 泌尿生殖层各段构成结肠、直肠周围毗邻层面,该解剖结构对于结直肠手术具有重要的指导意义。     

原发性肝细胞癌微血管侵犯的术前预测模型构建及临床意义

目的构建原发性肝细胞癌(HCC)微血管侵犯(MVI)的术前预测模型并验证其准确性。方法回顾性分析2017年1月至2019年6月行肝切除术的160例HCC患者的临床病理资料,观察患者MVI情况。采用SPSS20.0软件对数据进行处理分析,计数资料采用χ^2检验;计量资料采用t检验;采用单因素和多因素Logistic回归分析影响MVI的独立危险因素,并构建HCC患者MVI的术前预测模型,通过描绘受试者工作特征曲线(ROC)并计算曲线下面积(AUC)从而来评估模型的预测能力,并以术后病理诊断结果为金标准对预测模型进行验证。结果在160例患者中,有MVI者86例,无MVI者74例。对单因素分析有统计学意义的资料进行Logistic多因素分析,结果显示:肿瘤直径、瘤周低回声晕环、甲胎蛋白(AFP)水平、血小板与淋巴细胞比值(PLR)水平、循环肿瘤DNA(ctDNA)浓度是HCC的MVI独立危险因素。根据Logistic回归分析各变量的回归系数构建预测模型,通过绘制ROC曲线,计算出AUC值为0.914(95%CI 0.820~0.962),当最佳临界值为0.069时对HCC患者MVI具有预测价值,灵敏度为86.5%,特异度为87.9%,约登指数为0.74。以术后病理诊断为金标准,验证预测模型,灵敏度为88.4%,特异度为93.2%,两者灵敏度和特异度无统计学差异(P>0.05)。结论基于Logistic多因素回归分析建立预测模型具有较高的灵敏度和特异性,对HCC微血管侵犯的患者具有较高的预测价值,可为HCC患者的术前治疗方案、手术规划提供参考。     

考马斯亮蓝微盘比色法测定蛋白质含量

目的 建立快速、灵敏的测定蛋白质的方法。方法 以考马斯亮蓝作为显色剂,用酶联免疫测定仪微盘比色测定牛血清白蛋白和小鼠肝组织匀浆的蛋白含量,并与常量比色法进行了比较,结果 考马斯亮蓝微盘比色法与常量法相比,对样品的测定结果相近,而前者样品用量少（只需几微升）,简便、快速、检测极限低（0.63ug)。结论 考马斯亮蓝微盘比色法是一种简单、快速、灵敏的蛋白质测定方法,尤其适用于大批量、微量样品的蛋白质含量测定。     

多肿瘤标志物蛋白芯片检测系统的临床应用

目的探讨多种肿瘤标志物联合检测在肝癌、肠癌、肺癌、前列腺癌、卵巢癌等5种肿瘤的临床应用价值.方法采用多肿瘤标志物蛋白芯片法（C-12系统）检测205例肿瘤病人,100例良性疾病患者和150例健康人.结果恶性肿瘤组灵敏度（70.7%）、显著高于良性疾病组（38%）和健康组（16.6%）（P〈0.01）,在肺癌组中ROC曲线面积大于单项标志物.结论采用蛋白芯片系统检测多种肿瘤标志物可提高恶性肿瘤诊断的敏感性,同时有较好的特异性,其临床应用效果好于单项肿瘤标志物.     

肺耐药蛋白表达与食管鳞癌临床病理特征的关系

目的　研究肺耐药蛋白(LRP)在食管鳞癌组织中的表达情况及其与临床病理特征和预后的关系。方法　应用Elivision二步免疫组织化学法观察51例食管鳞癌组织和18例癌旁正常粘膜组织(距离癌组织>2cm)中LRP的表达情况,结合临床病理指标包括患者年龄、肿瘤大小、临床分期和淋巴结转移以及生存情况进行统计学分析。结果　肿瘤大于5cm者LRP的阳性率明显高于5cm以下者(P<0. 05),食管鳞癌中LRP表达阳性率高于癌旁正常食管鳞状上皮,高年龄组的LRP阳性率较低年龄组高,有淋巴结转移者LRP阳性率高于无转移者,生存期短者( <3年)的阳性率高于生存期长者( >3年),但P均>0. 05。结论　LRP表达与食管鳞癌肿瘤大小之间存在显著相关性,临床检测LRP阳性不能作为判断食管鳞癌转移和预后的独立指标,但提示LRP表达阳性患者可能有预后差的趋势。     

Difference of Gene Expression Profiles between Barrett’s Esophagus and Cardia Intestinal Metaplasia by Gene Chip

Theincidenceofadenocarcinomaintheesoph agusandgastroesophagealjunction(GEJ)isin creasingforthetwodecadesinNorthAmericaandEurope[1].Barrett'sesophagus(BE)isthoughttobeapremalignantconditionforesophagealadeno carcinomaandmostofadenocarcinomasatGEJ[2].Recentlythepresenceofcardiaintestinalmetapla sia(CIM)insomenormalappearingGEJhasbeendescribed[3].TherelationofthisconditiontoBEhasnotyetbeeninvestigated.Inthisexperiment,wehadperformedoura nalysisonthree4096chipsinordertoacquirethedifference…     

细胞核DNA图像分析及PSA检测在前列腺癌诊断中的应用

目的:探讨DNA图像分析技术及血清前列腺特异性抗原(PSA)水平检测在前列腺癌(PC)诊断中的应用价值。方法:应用计算机图像分析技术测定5例正常前列腺(NP)和30例PC的标本DNA倍体;应用ELISA方法检测30例PC患者血清中PSA。结果:5例NP中均为整倍体(2C和3-4C),30例PC中有23例出现非整倍体,并且随着PC分级的增高,其倍体率也增大;25例前列腺癌患者血清PSA值高于正常值。7例整倍体患者6例血清PSA不正常,5例PSA正常者中4例为非整倍体。结论:细胞核DNA含量和倍体及血清PSA的测定是反映前列腺癌细胞增殖分化能力的重要生物学指标,为正确诊断恶性肿瘤提供依据。     

Expert opinion on thyroid complications of new anti-cancer therapies: Tyrosine kinase inhibitors

Thyroid pathology is the most frequent form of endocrinopathy during tyrosine kinase inhibitor (TKI) treatment. Dysthyroidism occurs in 10% to 80% of cases, depending on diagnostic criteria. In patients with intact thyroid gland prior to TKI treatment, incidence of dysthyroidism is 30–40%, with subclinical presentation in half of cases. It mainly involves hypothyroidism, preceded in 20–40% of cases by transient thyrotoxicosis that may go overlooked. The pathophysiological mechanism is “vascular” thyroiditis induced by the anti-angiogenic action of TKIs. Between 20% and 60% of patients receiving levothyroxine ahead of TKI treatment show increased levothyroxine requirements. TKIs should not be discontinued because of onset of thyroid dysfunction. Treatment is symptomatic in case of thyrotoxicosis, and levothyroxine replacement therapy is initiated in case of symptomatic hypothyroidism or TSH > 10 mIU/L. During TKI treatment, TSH should be assayed monthly, or at end of off-period (i.e., day 1 of new cycle after interruption), for the first 6 months, then every 2–3 months or in case of clinical signs of dysthyroidism. In patients already treated for hypothyroidism, TSH should be assayed monthly for 3 months, then every 3 months throughout treatment. At TKI termination, remission of hypothyroidism is possible but unpredictable, and progressive discontinuation of levothyroxine may be considered under monitoring. Teamwork between oncologists and endocrinologists improves screening and treatment of thyroid dysfunction, enabling the patient to be better accompanied during treatment.     

Differential ligand regulation of PlexB signaling in motor neuron axon guidance in Drosophila

Plexins (Plexs) are a large family of phylogenetically conserved guidance receptors that bind specifically to semaphorins (Semas), another large family of guidance molecules. In the Drosophila embryonic central nervous system (CNS), the secreted semaphorins Sema-2a and Sema-2b both act as ligands for PlexB, but mediate mutually independent and opposite functions (repulsive and attractive guidance, respectively). PlexB is also known to regulate motor axon guidance in the embryonic peripheral nervous system (PNS). However, it is unclear whether the mechanisms of ligand regulation of PlexB seen in the CNS are similar or the same as those that exist in PNS motor axon guidance. Here, we find that two distinct modes of ligand regulation underlie differential roles of PlexB in PNS motor axon pathfinding during embryonic development. Epistasis analyses in the intersegmental nerve b (ISNb) pathway suggest that PlexB serves as a receptor for both Sema-2a and Sema-2b and integrates their mutually dependent but opposite guidance functions. Furthermore, we present evidence that PlexB mediates not only Sema-2a/2b-dependent guidance functions, but also Sema-2a/2b-independent target recognition in establishing the segmental nerve a (SNa) motor axon pathway. These results demonstrate that a single guidance receptor can elicit diverse effects on the establishment of neuronal connectivity via regulation of its ligands themselves.     

益肾健脾化瘀汤辅助防己黄芪汤治疗慢性肾炎的效果及作用机制

目的探讨益肾健脾化瘀汤联合防己黄芪汤治疗慢性肾炎的效果及作用机制。方法选取我院收治的140例慢性肾炎患者为研究对象,采用随机数字表将其分为对照组和研究组,各70例。对照组行防己黄芪汤治疗,研究组在对照组基础上加用益肾健脾化瘀汤治疗。比较两组患者的治疗效果。结果治疗后,两组患者的各项中医症状评分、24 h尿蛋白定量、SCr和BUN水平均显著低于治疗前,且研究组低于对照组(P<0.05)。治疗后,两组患者的SF-36和KDTA评分均显著高于治疗前,且研究组高于对照组(P<0.05)。结论益肾健脾化瘀汤联合防己黄芪汤治疗慢性肾炎效果显著,有助于患者肾功能和生活质量的改善,值得临床推广应用。