癌-睾丸抗原SSX2在肝细胞癌中的表达研究

目的：检测癌-睾丸抗原SSX2在肝细胞癌组织中的表达。方法应用RT-PCR技术,对40例肝细胞癌的癌组织及相应癌旁组织进行SSX2基因的mRNA检测。结果肝细胞癌组织中SSX2 mRNA表达阳性率为27.5%（11/40）,而相应的癌旁组织无SSX2 mRNA表达阳性率为0（0/40）,两组比较差异有统计学意义（P〈0.001）。统计学分析显示SSX2表达与AFP阳性率、HbsAg阳性率、病理分级、肝细胞癌肿瘤大小、肝细胞癌是否伴有肝硬化的情况等相关的临床指标均无关（P〉0.05）。结论 SSX2在HCC中呈低频率的表达。     

紧密连接蛋白1与重症急性胰腺炎大鼠胰腺微血管损伤关系的实验研究

目的研究重症急性胰腺炎（severe acute pancreatitis,SAP）大鼠紧密连接蛋白1（ZO-1）随时间的变化及其与SAP微血管损伤和胰腺组织病理学评分的关系。方法将48只Wistar大鼠随机均分为假手术组（SO组）和SAP组。SO组大鼠开腹后仅翻动胰腺;SAP组大鼠开腹后,以逆行胰胆管微泵注射5%牛磺胆酸钠法制备SAP模型。2组大鼠分别于手术后6、12及24 h各处死8只大鼠,取腹主动脉血测定外周血中淀粉酶、胰蛋白酶、白介素-8（IL-8）、肿瘤坏死因子-α（TNF-α）及ZO-1蛋白水平;取胰腺组织行HE染色,观察其病理学变化并评分;同时行免疫组化染色检测ZO-1蛋白的表达情况。结果同时点与SO组比较,各时点SAP组的血清淀粉酶、胰蛋白酶、IL-8、TNF-α及ZO-1蛋白水平均较高（P〈0.05）。SAP-6 h组和12 h组的血清淀粉酶水平均低于24 h组（P〈0.05）;SAP组内大鼠的胰蛋白酶、IL-8和ZO-1蛋白水平均随时点延长逐渐升高,各时点组间两两比较差异均有统计学意义（P〈0.05）;SAP组内3个时点组间TNF-α水平的差异无统计学意义（P〉0.05）。多重线性回归模型结果显示,SAP组血清ZO-1蛋白水平与胰腺组织病理学评分（b=0.96,P〈0.05）、血清淀粉酶水平（b=0.87,P〈0.05）、胰蛋白酶水平（b=0.72,P〈0.05）及IL-8水平（b=0.69,P〈0.05）均呈正相关,而与TNF-α水平的关系无统计学意义（P〉0.05）。HE染色结果显示,各时点SAP组大鼠的胰腺组织损伤程度重于SO组,且随时间延长,SAP大鼠胰腺组织的病理学损伤加重;SAP-12 h组和24 h组的胰腺组织病理学评分均高于6 h组（P〈0.05）。SP免疫组化染色结果显示,随时间延长,SAP组大鼠胰腺腺泡细胞间及毛细血管壁的ZO-1蛋白颗粒数量减少,且在毛细血管中的表达不连续。结论在SAP的进程中,血清中ZO-1蛋白的水平上升,同时其在胰腺组织中的表达呈下调趋势,表明其与SAP时的胰腺微血管损伤有关。     

Evaluation of Myocardial Viability after Myocardial Infarction with Intravenous Real-time Myocardial Contrast Echocardiography

The myocardial viability after myocardial infarction was evaluated by intravenous myocardial contrast echocardiography. Intravenous real-time myocardial contrast echocardiography was performed on 18 patients with myocardial infarction before coronary revascularization. Follow-up echocardiography was performed 3 months after coronary revascularization. Segmental wall motion was assessed using 18-segment LV model and classified as normal, hypokinesis, akinesis and dyskinesis. Viable myocardium was defined by evident improvement of segmental wall motion 3 months after coronary revascularization. Myocardial perfusion was assessed by visual interpretation and divided into 3 conditions： homogeneous opacification; partial or reduced opaciflcation or subendocardial contrast defect; contrast defect. The former two conditions were used as the standard to define the viable myocardium. The results showed that 109 abnormal wall motion segments were detected among 18 patients with myocardial infarction, including 47 segments of hypokinesis, 56 segments of akinesis and 6 segments of dyskinesis. The wall motion of 2 segments with hypokinesis before coronary revascularization which showed homogeneous opacification, 14 of 24 segments with hypokinese and 20 of 24 segments with akinese before coronary revascularization which showed partial or reduced opaciflcation or subendocardial contrast defect was improved 3 months after coronary revascularization. In our study, the sensitivity and specificity of evaluation of myocardial viability after myocardial infarction by intravenous real-time myocardial contrast echocardiography were 94.7% and 78.9%, respectively. It was concluded that intravenous real-time myocardial contrast echocardiography could accurately evaluate myocardial viability after myocardial infarction.     

Value of Quantitative Tissue Velocity Imaging in the Detection of Regional Myocardial Function in Dogs with Acute Subendocardial Ischemia

This study evaluated the application of quantitative tissue velocity imaging （QTVI） in assessing regional myocardial systolic and diastolic functions in dogs with acute subendocardial ischemia. Animal models of subendocardial ischemia were established by injecting microspheres （about 300 μm in diameter） into the proximal end of left circumflex coronary artery in 11 hybrid dogs through cannulation. Before and after embolization, two-dimensional echocardiography, QTVI and real-time myocardial contrast echocardiography （RT-MCE） via intravenous infusion of self-made microbubbles,were performed, respectively. The systolic segmental wall thickening and subendocardial myocardial longitudinal velocities of risk segments before and after embolization were compared by using paired t analysis. The regional myocardial video intensity versus contrast time could be fitted to an exponential function： y=A·（1-exp-β·t）, in which the product of A and β provides a measure of myocardial blood flow. RT-MCE showed that subendocardial normalized A·β was decreased markedly from 0.99±0.19 to 0.35±0.11 （P〈0.05） in 28 left ventricular （LV） myocardial segments after embolization, including 6 basal and 9 middle segments of lateral wall （LW）, 8 middle segments of posterior wall （PW） and 5 middle segments of inferior wall （IW）. However, there was no statistically significant difference in subepicardial layer before and after embolization. Accordingly, the ratio of A·β of subendocardial myocardium to subepicardial myocardium in these segments was significantly decreased from 1.10±0.10 to 0.31±0.07 （P〈0.05）. Although the systolic wall thickening did not change 5 min after the embolization in these ischemic segments （29%±3% vs 31%±5%, P〉0.05）, the longitudinal peak systolic velocities （Vs） and early-diastolic peak velocities （Ve） recorded by QTVI were declined significantly （P〈0.05）. Moreover, the subendocardial velocity curves during isovolumic relaxation predominant     

碘酊烧灼联合氟康唑与消朦片治疗真菌性角膜溃疡30例临床观察

真菌性角膜溃疡是一种致盲率较高、治疗极棘手的感染性眼病.我国作为农业大国,从事农业生产的人口众多,农业性眼外伤,尤其是以植物性眼外伤多见.农药及化肥的广泛使用,使土壤中的腐生寄生菌的拮抗菌减少,从而使镰刀菌等真菌大量滋生.此外,滥用糖皮质激素和广谱抗生素,使机体菌群失衡,也会增加真菌感染的机会.如何最大限度地保留患者宝贵的视力,是我们目前的研究课题.我科自2004年11月～2007年10月应用碘酊烧灼联合氟康唑与消朦片治疗真菌性角膜溃疡30例,取得了满意效果.     

射频消融联合经导管肝动脉栓塞化疗治疗肝癌疗效分析

目的 分析射频消融(RFA)联合经导管肝动脉栓塞化疗(TACE)治疗原发性肝癌的近期和远期疗效.方法 回顾性分析中山大学肿瘤防治中心肝胆外科2000年9月至2007年8月临床诊断为原发性肝细胞性肝癌114例,并行射频消融联合导管肝动脉栓塞化疗,对其进行生存分析.结果 全部病例1、2、3、4、5年总体生存率分别为90.4%、82.6%、73.2%、63.5%、49.1%、1、2、3、4、5年肿瘤无进展生存率分别为:77.1%、64.6%、54.6%、46.8%、36.4%.其中,病灶最大直径≤5 cm和5.1～7cm的1、2、3、4、5年生存率分别为95.5%、84.6%、73.1%、61.5%、50.6%及80.2%、64.9%、56.3%、45.3%、39.5%(P=0.041),单个病灶和多个(不多于3个病灶)病灶的1、2、3、4、5年生存率分另4为95.8%、89.1%、78.1%、67.1%、56.7%及80.0%、60.6%、46.6%、33.4%、21.5%(P=0.001).结论 RFA联合TACE是一种治疗肝癌的有效方法,直径≤5 cm、单个病灶的肝癌效果明显好于直径5.1～7 cm、多个病灶的肝癌.白蛋白水平、甲胎蛋白水平、肿瘤病灶边界是否清楚及病灶数目是影响联合治疗疗效的预后因素.     

止血器灼烙巩膜瓣联合透明质酸钠在小梁切除术中应用的临床观察

目的:在小梁切除术中应用止血器灼烙巩膜瓣联合透明质酸钠,观察术后前房,眼压的恢复和控制情况.方法:通过对我院近3年因各类青光眼而首次接受小梁切除术的病例30例共38共只眼,术中应用止血器灼烙巩膜瓣,手术将结束时,前房注入透明质酸钠.结果:术后仅3例前房形成不好,2例眼压控制不满意.绝大部分的眼压控制在较低水平.结论:术中应用止血器灼烙巩膜瓣联合透明质酸钠,可提高青光眼滤过手术的成功率和安全性,减少术后早期并发症的发生.     

超声引导下穿刺注药治疗未破裂型异位妊娠

由于超声诊断技术的广泛运用,临床上越来越多的异位妊娠(ectopic pregnancy,EP)病例可得到早期诊断,从而为异位妊娠的早期非手术治疗提供了可能[1-3]。我院自2004年5月以来,在超声引导下经腹经阴道穿刺治疗未破裂型异位妊娠共9例,现报告如下。资料与方法一、研究对象患者共9例。年龄26~39岁,平均年龄32.1岁。至穿刺时停经天数为41~77d,平均54.7d。腹痛6例,程度轻。阴道出血2~28d,平均9d,量少,点滴状,咖啡色或暗红色,淋漓不尽。均有流产史,其中人流史7例(有人流史者中1例有右侧输卵管妊娠史,右侧输卵管已切除),药流史1例,自然流产史1例。包…     

二维斑点追踪与组织多普勒测量左室收缩期扭转的对比研究

目的初步评价二维斑点追踪、组织多普勒测量左室收缩期扭转的一致性和可靠性。方法获取48例健康成人左室基底和心尖短轴图像,采用二维斑点追踪及组织多普勒2种方法测量收缩期左室基底部及心尖部旋转角度及左室扭转角度。结果2种方法基底部、心尖部旋转角度、达峰时间、左室扭转角度、扭转达峰时间的测值差异无统计学意义,二维斑点追踪观察者内变异系数更小。结论二维斑点追踪和组织多普勒健康人左室扭转测值无差异,但二维斑点追踪观察者内变异系数更小,可重复性更高。