原发性开角型青光眼视网膜神经纤维层厚度和视野平均缺损的相关性分析

目的 比较原发性开角型青光眼患者GDx VCC各参数和自动视野平均缺损(MD)的相关性.方法 用GDx VCC和Octopus1-2-3自动视野检测97例(191眼)原发性开角型青光眼患者.采用方差分析、Pearson相关分析和回归分析GDx各参数和自动视野平均缺损(mean defect,MD)之间的关系.结果 GDx各参数与视野的MD均呈负相关,相关性依次为:SA(-0.58)、TSNIT(-0.52)、IA(-0.52)、NFI(-0.48)和IES(-0.33),差异有统计学意义.上半野视野与GDx下象限RNFL厚度参数一致性为-0.61,下半野视野与GDx上象限RNFL厚度参数的一致性为-0.59.结论 GDx参数和自动视野的平均缺损呈中度相关.GDx可用于青光眼的随诊.

Abstract：

Objective To establish whether the structural parameters provided by GDx can be used to reflect functional damage in the mean defect of visual field. Methods 97 ( 191 eyes) patients with primary open angle glaucoma underwent examination with GDx and Octopus 1-2-3 automatic perimeter. The relationship between the retinal nerve fiber layer parameters and mean defect of visual field was analysed by ANOVA, Pearson's correlation (r), scatter plot and linear regression. Results The parameters of GDx decreased with increasing mean defect of visual field, measured both globally and regionally; r: SA=- 0.58, TSNIT =-0.52, IA=-0.52, NFI=-0.48 and IES=-0.33. All parameters were negative correlation with mean defect of visual field and there was significant correlation among these parameters,except IES(P＜0.05). The superior mean defect of visual field increased with decreasing inferior RNFL (r=-0.61), inferior visual field mean defect increased with decreasing superior RNFL (r=-0.59).There were significant correlation among these parameters. Conclusion Quantitative measures of the retinal nerve fiber layer using GDx were correlated with mean defect of visual field in patients with glaucoma. GDx can be used for follow up.     

弱激光联合阿托品疗法对屈光不正性弱视的疗效

目的 观察弱激光联合阿托品疗法对屈光不正性弱视的疗效.方法 120例(240只弱视眼)患儿随机分为治疗组(弱激光联合阿托品疗法)和对照组(传统治疗),比较两种方法对视力的提升效果及双眼视功能的改善情况.结果 弱激光联合阿托品疗法使弱视眼视力进步有效率及立体视锐度与对照组比较差异有统计学意义(t=2.24,P<0.05).结论 弱激光联合阿托品疗法更有利于患儿视力提升、双眼视力恢复. Abstract： Objective To observe the therapeutic effect of low level laser combined with atropine in treatment of ametropic amblyopia. Methods One hundred and twenty children (240 eyes with ametropic amblyopia) were grouped randomly, and the improvement of visual acuity and visual function between the two methods were compared. Results The differences in binocularvision improvement and stereopsis visual acuity of the two methods were significant(t=2.24,P<0.05).Conclusions Low level laser combined with atropine therapy seems to be superio to traditional treatment in binocularvision improvement and recovery.     

鼠神经生长因子治疗视神经萎缩的临床观察

目的 探讨鼠神经生长因子(nerve growth factor,NGF)在眼科治疗中对视神经萎缩的修复作用.方法 随机抽取视神经萎缩病例80例(120只眼),随机分成2组,其中对照组采用传统治疗,治疗组在传统治疗方法基础上加用鼠NGF注射液.观察2组治疗前后视力、视野及荧光跟底血管造影(FFA)乳头荧光充盈时间,对2组临床疗效进行比较分析.结果 治疗组较对照组治疗后视力显著上升(P<0.05),中心视野灰度显著下降(P<0.05),乳头荧光充盈迟缓时间显著下降(P<0.05);治疗组总有效率为81.7%,明显高于对照组(30.0%)(P<0.05).结论 鼠NGF可有效改善视神经萎缩患者的视力及中心视野缺损,缩短乳头荧光充盈时间,疗效肯定,无明显副作用.     

人神经生长因子治疗血管性痴呆疗效观察

目的：探讨神经生长因子治疗血管性痴呆的疗效。方法：明确诊断血管性痴呆患者47例，随机分为观察组和对照组，观察组24例应用神经生长因子治疗，对照组23例应用普通药物治疗，3疗程后观察结果。结果：观察组患者智力及认知能力均明显高于对照组，有效率达87.5％。结论：与其它治疗方法相比，应用神经生长因子治疗血管性痴呆有显著疗效。，Objective:To explore the curative effect of human nerve growth factors(NGF) on vascular dementia. Methods:Forty seven cases with vascular dementia were randomly divided into twogroups: the control group and the test group. Twenty four cases in thetest group were treated with NGF while the others in the control group were treated with ordinary medicines and after 3 courses of treatment, results were observed. Results: The intelligenceand cognitive ability in the test group were much higher than those in the control group(effectual rate,87.5％). Conclusion:Compared with other methods, NGF has a markable, curativeeffect.     

The exact estimation of visual acuity by VEP technology: A report of 726 cases of eye injury

This study explored the accuracy of using visual evoked potentials(VEP)technology for visual acuity estimation.The enrolled 726 patients with post-traumatic unilateral decrease in visual acuity included the injured eyes served as the experimental group,and the healthy eyes as the control group.The least signal visual angle(LSVA),and amplitude and latency of P100 were chosen as test indexes.The results under different experimental conditions were recorded by PRVEP technology.All data collected were processed...     

Dan Zhi Xiao Yao Yin Combined With Auricular-Point-Pressing for Treatment of Optic Atrophy-A Clinical Observation of 51 Cases

To evaluate the therapeutic effect of Dan Zhi Xiao Yao Yin (丹栀消遥饮 Decoction of Moutan Bark and Capejasmine) combined with auricular-point- pressing therapy for treatment of optic atrophy. The visual acuity and visual field was observed in the 51 cases (58 eyes) from the treatment group that were treated with Dan Zhi Xiao Yao Yin combined with auricular-point-pressing therapy and the 43 cases (49 eyes)from the control group that were treated with routine western drugs at the end of the trial (60 days). The effective rates of increase in visual acuity obtained in the treatment and the control groups were 79.3% and 44.89% respectively and enlargement in visual field were 61.9% and 22.6% respectively. Statistical analysis showed that there were significant differences between two groups (P＜0.05). The therapeutic effect of Dan Zhi Xiao Yao Yin combined with auricular-point -pressing therapy in increasing the visual acuity and enlarging the visual field was superior to that of the routine western drugs.     

Ahmed青光眼房水引流阀治疗新生血管性青光眼与其他难治性青光眼疗效对比研究

Background Neovascular glaucoma is a refractory disease, and difficult to manage. The aim of this study was to evaluate the clinical outcomes of Ahmed glaucoma valve implantation （AGVI） in neovascular glaucoma （NVG） and non- NVG patients. Methods This prospective, non-randomized study included 55 eyes of 55 patients with refractory glaucoma; 27 had NVG （NVG group） and 28 had non-NVG （non-NVG group）. All of the patients underwent AGVI. The NVG group was adjunctively injected with intravitreal ranibizumab/bevacizumab （IVR/IVB） before AGVI. Intraocular pressure （lOP） was the primary outcome measure in this study. Surgical success rate, number of antiglaucoma medications used, best corrected visual acuity （BCVA）, and postoperative complications were analyzed between the groups. Results All of the patients completed the study （follow-up of 12 months）. Kaplan-Meier survival curve analysis indicated that the qualified success rates in the NVG and non-NVG groups at 12 months were 70.5% and 92.9%, respectively; this difference was significant （P=-0.036）. The complete success rates in the NVG and non-NVG groups at 12 months were 66.7% and 89.3%, respectively （P=0.049）. Compared with preoperative examinations, the postoperative mean lOP and use of medications were significantly lower at all follow-up time points in both groups （all P 〈0.05）. There were significant differences in BCVA between the two groups at the 12-month follow-up （X2=9.86, P=0.020）. Cox proportional hazards regression showed NVG as a risk factor for surgical failure （RR=15.08, P=0.033）. Postoperative complications were similar between the two groups. Conclusions AGVI is a safe and effective procedure in refractory glaucoma, but the success rate of surgery was related to the type of refractory glaucoma. The complete and qualified success rates of NVG patient adjunctive anti-vascular endothelial growth factor treatment are still lower than those of non-NVG patients.     

Cross-sectional investigation of visual impairing diseases in Shanghai blind children school

Background  The control of blindness in children is a high priority within the VISION 2020 initiative. To determine the causes of severe visual impairment and blindness in children from Shanghai Blind Children School (SBCS) can provide useful information on childhood blindness in Shanghai.

Methods  A cross-sectional investigation of students in SBCS was conducted in May 2010. The World Health Organization/Prevention of Blindness (WHO/PBL) eye examination record system for children with low vision and blindness was used. The results were further compared with the findings of two previous investigation studies conducted in 1986 and 2004, respectively in SBCS.

Results  Of the 146 children observed, 80 children (54.8%) were blind (best corrected best visual acuity less than 0.05), 27 children (18.5%) had severe visual impairment (best corrected visual acuity less than 0.1 but better than or equal to 0.05), and 34 children (23.3%) had moderate visual impairment (best corrected visual acuity less than 0.3 but better than or equal to 0.1). The major affected anatomic sites in the 107 children with severe visual impairment and blindness (SVI/BL) were retina (47.7%), whole globe (16.8%), optic nerve (13.1%) and lens (9.3%). The leading causes of SVI/BL were retinopathy of prematurity (ROP, 25.2%), followed by retinal dystrophy (15.9%), optic nerve atrophy (9.3%) and microphthalmos (9.3%). The two leading etiologic categories of SVI/BL were perinatal/neonatal (36.4%) and congenital/hereditary groups (29.0%). The leading cause of moderate visual impairment was aphakia after cataract surgery (congenital cataract, 44.1%). Compared with the findings in two previous investigations in SBCS, the proportion of ROP in visual impairing diseases increased, while the proportion of disorders of the lens (cataract and aphakia) significantly decreased.

Conclusions  The leading cause of childhood blindness in SBCS nowadays is ROP. It is projected that without improvement in perinatal medical care that ROP will continue to be a major cause of childhood blindness.

     

Effect of Human Cytomegalovirus Infection on Nerve Growth Factor Expression in Human Glioma U251 Cells

Objective To explore the change of endogenic nerve growth factor （NGF） expression in human glioma cells infected with human cytomegalovirus （HCMV）. Methods U251 cells were cultured in RPMI 1640 culture medium and infected with HCMV AD 169 strain in vitro to establish a cell model of viral infection. Morphologic changes of U251 cells were observed under inverted microscope before and after infection with HCMV. Expression of NGF gene and protein of cells was detected by RT-PCR and Western blotting before and after infection with HCMV. Results The cytopathic effects of HCMV-infected cells appeared on day 5 after infection. However, differential NGF expression was evident on day 7. NGF expression was decreased significantly in U251 cells on day 7 after infection in comparison with control group （P〈0.05）. Conclusion HCMV can down-regulate endogenous NGF levels in human glioma cell line U251.     

近视眼Q值调整对视觉质量的影响

目的 研究角膜前表面非球面形状,观察传统准分子激光原位角膜磨镶术(LASIK)手术组与Q值引导LASIK(Q-LASIK)手术组视觉质量的差异.为个性化屈光手术的改进提供依据.方法 收集2008年10月至2009年4月期间近视眼100眼,均为左眼,分为标准组即无Q值引导LASIK手术组50眼,Q值调整组50眼,对术前、术后3个月6项指标做对照观察(视力和屈光度、对比敏感度,波前像差变化,角膜非球面性和视觉相关生活质量调查表);采用SPSS 12.0统计软件对资料进行分析.结果 LASIK手术前后Q值比较差异有统计学意义(t=31.26,P<0.01);目标Q值引导手术组术后和传统手术组术后3个月视力>5.0相比较, 用χ2检验, 差异无统计学意义(χ2 =0.195,P>0.05);两组术后角膜非球面性Q值均向正值方向发展,但Q值引导手术组低于传统手术组,两组比较差异有统计学意义(t=11.86,P<0.01);球差在两组术后均增高,但Q值引导手术组球差较无Q值引导手术组低,差异有统计学意义(t=21.34,P<0.01);主观评估上像差与对比敏感度上,术后3个月Q值引导手术组暗视下低频和离焦、球差均为负相关;Q值引导手术术后3个月傍晚视力、夜驾驶视力、眩光、夜晚驾驶不适方面优于无Q值引导手术组,差异有统计学意义(P<0.05,P<0.01,P<0.01,P<0.01).结论 传统LASIK手术前后角膜非球面形状的Q值变化明显;Q值引导LASIK术后Q值改变相对较少,能保持角膜相对的长椭圆形,即角膜非球面性,提高视觉质量.提示减少Q值的改变能提高和改善视觉质量. Abstract： Objective To investigate the conformation of cornea asphericity.To observe the difference visual acuity between operation with Q value-guide and traditional LASIK and to provide data for improving individuation refractive surgery. Methods One hundred myopic eyes(all left eyes)were divided into two groups, 50 eyes received operation with Q value-guide LASIK and 50 eyes received traditional LASIK since October 2008 to April 2009. To observe visual acuity,refractive error,contrast sensitivity,wavefront aberration, coraea asphericity and vision quality before and after three months of operation. Using the SPSS 12.0 to analyse the data. Results There were significant difference of Q value before and after no Q value guiding LASIK operation(t=31.26,P<0.01).To compare visual acuit (P>0.05) of after operation for Q value guiding LASIK with no Q value guiding LASIK, There was not statistic difference of visual acuity of two groups(χ2 =0.195,P>0.05);The Q value of two groups was higher after operation, But the Q value guiding operation group was lower than the traditional operation groups,there was statistical difference(t=11.86,P<0.01). The spherical aberration was all increased in two groups,but Q value guiding operation group was lower than the standard group,there was statistical difference(t=21.34,P<0.01). Q value group guiding operation was better than the standard group in halo,in glare,night visual acuity,night driving after operation three months,there was statistical difference(P<0.05, P<0.01,P<0.01,P<0.01). Conclusions There are significant differences in Q value after no Q value guide operation;there are less change of Q values after Q value guide operation, it can maintain long-spherical shape of cornea after Q value guide operation, and then raise the visual quality. It indicate that Q value change reduction can enhance and improve the visual quality.     

特应性皮炎小鼠中Th1/Th2类细胞因子失衡对神经生长因子表达的影响

目的 初步探讨特应性皮炎(AD)小鼠中Th1/Th2 类细胞因子失衡对脾淋巴细胞神经生长因子(NGF) mRNA 表达的影响.方法 用卵清蛋白经皮肤致敏建立小鼠AD模型, ELISA测定血清总IgE水平.分离脾淋巴细胞并培养.逆转录-聚合酶链反应(RT-PCR)半定量法测定细胞在刀豆素A(ConA)刺激下表达NGF mRNA的基础水平及γ-干扰素(IFN-γ)和白细胞介素-4(IL -4)干预后NGF mRNA表达改变.结果 ①AD小鼠脾淋巴细胞在基础状态下具有表达NGF mRNA的功能,在12、24、36、48 h时基础NGF mRNA表达量随着时间的延长逐渐升高,IL-4组(50 μg/L)随着时间的延长基础NGF mRNA表达量逐渐升高,并高于同时间空白对照组(P均<0.01). 相反, IFN-γ组(25 μg/L)的NGF mRNA水平随时间逐渐下降,并均低于同时间空白对照组(P均<0.01).②干预24 h时,随着IL-4干预浓度的增加,NGF mRNA的表达水平亦升高,并且分别与前一梯度低浓度干预组比较差异有统计学意义(P均<0.01),随着IFN-γ干预浓度的增加, NGF mRNA的表达水平却逐渐减低,分别比前一梯度低浓度干预组有显著降低(P均<0.01).结论 在特应性皮炎中Th2类细胞因子IL-4可上调淋巴细胞NGF mRNA表达,Th1类细胞因子IFN-γ可下调淋巴细胞NGF mRNA表达,两者均呈时间和浓度依赖性,Th1 / Th2类细胞因子免疫失衡可能通过调控NGF mRNA 表达间接促进其诱导神经源性炎症. Abstract： Objective To explore the effect of Th1 / Th2 cytokines on the expression of nerve growth factor (NGF) in splenic lymphocytes in atopic dermatitis mice.Methods Four AD mice were sensitized and challenged with ovalbumin to establish AD model, and serum IgE level was measured by ELISA.The mouse splenic lymphocytes were isolated and cultured with ConA. The expressions of NGF mRNA were detected by RT-PCR, and were observed after the lymphocytes were exogenously added with interferon -γ(IFN-γ) or interleukin-4 (IL-4). Results ①The lymphocytes of the AD model stimulated by ConA in vitro expressed NGF mRNA in a time-dependent manner. After the lymphocytes had been cultured with IL-4 for 12 h, 24 h, 36 h, and 48 h, 50μg/L IL-4 upregulated the expressions of NGF mRNA in a time-dependent manner and all the NGF mRNA expressions were significantly higher than the basal values at the same time (P all<0.01), however,25μg /L IFN-γ downregulated the expressions of NGF mRNA in a time-dependent manner and all the NGF mRNA expressions were significantly lower than the basal values at the same time (P all<0.01).②The lymphocytes of the AD model stimulated by ConA in vitro also expressed NGF mRNA in a dose-dependent manner.After 0,10, 25,50, and 100 μg /L IL-4 had been added for 24 h, IL-4 upregulated the expressions of NGF mRNA in a dose-dependent manner and the NGF mRNA expressions were all significantly higher than the values of the lower dose IL -4 (P all <0.01), however,after 0, 1, 10, 25,and 50μg /L IFN-γ had been added for 24 h, IFN-γ downregulated the expressions of NGFmRNA in a dose-dependent mannerand all the NGF mRNA expressions were significantly lower than the values of the lower IFN-γ dose (P all<0.01).Conclusions In the splenic lymphocytes of atopic dermatitis mice, IL -4, one of the Th2 cytokines, can upregulate the expressions of NGF, IFN-γ, one of the Th1 cytokines, can downregulate the expressions of NGF both in a time-dependent manner and in a dose-dependent manner. Th1 /Th2 cytokine immune imbalance may indirectly induce the skin neurogenic inflammation by regulating the NGF mRNA expression.     

人骨髓间充质干细胞向血管内皮细胞诱导的研究

目的 研究人骨髓间充质干细胞(HBMCs)的体外培养和向血管内皮细胞的诱导分化.方法 利用密度梯度离心法将HBMCs从人骨髓中分离出来,体外扩增.将第三代的细胞以含VEGF,bFGF的培养基定向诱导,使其向内皮细胞方向分化.利用免疫细胞化学和流式细胞学检测诱导后的细胞表型.结果 原代未经诱导的骨髓干细胞,培养3周后细胞形态呈梭形,诱导后第7天的细胞呈椭圆形或不规则形,第14天细胞大致呈铺路石样改变.免疫细胞化学显示CD31、CD34、vWF因子呈阳性,流式细胞仪测定CD31、vWF因子阳性率分别为87.5%、82.6%,双阳性率为71.2%.结论 骨髓间充质干细胞在内皮细胞生长因子和碱性成纤维细胞因子的诱导下向血管内皮细胞方向分化. Abstract： Objective To study the culture methods of human bone marrow mesenchymal stem cells(MSCs) and differentiation into vascular endothelial cells in vitro. Methods Bone marrow mesenchymal stem cells were isolated and cultivated by density gradient centrifugation method. Induce the third generation to vascular endothelial cells with vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF). Immunophenotypes of cells were detected by flow cytometry techniques and immunocyte chemistry after the transfection. Results After three weeks of primary culture of MSCs, the cell showed on fusiform shape. After 7 days induction, the cell showed on ellipse and irregular shape. After two weeks transfection, the cell exhibited a Cobblestone-like morphology. The cell expressed CD34,CD31,vWF after transfection by immunocyte chemistry. The positive rates of CD31 vWF were 87.5% and 82.6%, and the double positive rate was 71.2%. Conclusions Bone marrow mesenchymal stem cells can differentiate into vascular endothelial cells by treating with vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF).     

增生性糖尿病视网膜病变眼内组织型纤溶酶原激活物及其抑制物的表达与血管内皮生长因子表达的相关性

目的 探讨增生性糖尿病视网膜病变(PDR)中组织型纤溶酶原激活物(t-PA)及纤溶酶原激活物抑制剂(PAI)的表达及其与血管内皮生长因子(VEGF)表达的相关性.方法 在玻璃体手术中采集PDR 35眼玻璃体,同时采集因黄斑裂孔行玻璃体手术20眼玻璃体作为对照组,采用酶联免疫吸附法检测t-PA和PAI的表达浓度,并与VEGF的表达进行相关性分析.结果 PDR眼玻璃体中VEGF、t-PA及PAI的表达浓度与对照眼玻璃体中的表达浓度比较差异有统计学意义(P＜0.01).t-PA及PAI的表达与VEGF的表达经统计学分析,差异有统计学意义(P＜0.01).结论 在PDR眼内视网膜新生血管的发生过程中不但有VEGF,还可能同时有多种生物活性物质的参与. Abstract： Objective To evaluate the correlation between the expression of tissue plasminogen activator(t -PA)and plasminogen activator inhibitor(PAI)with vascular endothelial growth factor (VEGF)expression in proliferative diabetic retinopathy(PDR).Methods Vitreous samples were taken from 35 eyes with PDR and analyzed with enzyme linked immunosorbent assay(ELISA)for the expression of VEGF, t - PA and PAI.Control samples were from 20 eyes with idiopathic macular hole and analyzed in the same way.The correlation between VEGF expression and the expression of t - PA and PAI in proliferative diabetic retinopathy were studied.Results VEGF, t - PA and PAI were significantly expressed as compared with those in control subjects(P ＜0.01).The expression of t- PA and PAI were highly correlated with that of VEGF in proliferative diabetic retinopathy(P ＜ 0.01).Conclusions It is suggest that a number of bioactive substances may be involved in the pathogenesis of angiogenesis in PDR.The expression of t - PA may beupregulated by the activation of VEGF, which may further facilitate the process of angiogenesis in PDR.Meanwhile, the correlated expression of PAI may suggest the presence of an endogenous angiogenesis mechanism accompanying the activities of VEGF.     

靶向性血小板衍生生长因子siRNA表达质粒的构建及鉴定

目的 构建靶向性血小板衍生生长因子(PDGF)B链的小分子干扰RNA(siRNA)表达质粒,为进一步研究PDGF基因功能奠定基础.方法 根据PDGF-B链序列设计合成含靶向PDGF基因siRNA转录模板的茎环结构,与两端分别有Bam HI、HindIII酶切位点的pSilencer3.1-Hlhygro质粒连接,转化大肠杆菌,扩增、纯化得到所需质粒,通过琼脂糖凝胶电泳及基因测序鉴定其分子量及插入片段的序列.结果 PCR扩增片段与预期结果相符,双酶切证实PDGF siRNA表达载体克隆构建成功,插入片段测序结果与合成的siRNA结果一致.结论 成功构建了靶向性PDGF基因的siRNAs表达质粒. Abstract： Objective To construct the small interfering RNA (siRNA) expressing plasmids targeting platelet-derived growth factor(PDGF)and study the function of PDGF with RNA interference technology. Methods Two complementary 63-nt oligonucleotides targeting PDGF were synthesized with 5 single-stranded over-hangs according to the PDGF-B gene sequence in the Genebank and the kit manual,which were ligated with the linearized pSilencer3.1-Hlhygro.The plasmids were transformed into DH5α bacteria to amplify and then purified.The purified plasmids were identified by gel electrophoresis and sequencing.Results PDGF siRNA expression vectors were successfully constructed and identified by double endonuclease digestion.Sequence analysis of inserted fragment revealed the same sequence as synthesized siRNA oligonucleotides.Conclusions siRNA expression plasmids targeting PDGF have been successfully constructed.     

高迁移率蛋白B1和血管内皮生长因子在人食管鳞状细胞癌组织中的表达及意义

目的 探讨高迁移率蛋白B1(HMGB1)和血管内皮生长因子(VEGF)在人食管鳞状细胞癌组织中的表达及临床意义.方法 选择51例食管鳞状细胞癌标本,应用SP免疫组织化学染色法,检测HMGB1和VEGF在人食管鳞状细胞癌组织中的表达,并与临床病理参数的关系进行统计学分析.结果 食管鳞状细胞癌组织中HMGB1、VEGF的表达显著高于正常组织(P<0.05),且与淋巴转移相关(P<0.05),与肿瘤大小、分化程度等无相关性,食管鳞癌中HMGB1与VEGF的表达呈正相关(r=0.476,P<0.05).结论 HMGB1和VEGF的表达与食管癌患者的淋巴结转移相关,可作为判断预后的观测指标. Abstract： Objective To investigate the expression and clinicopathological significance of high mobility group box 1 (HMGB1) and vascular endothelial growth factor (VEGF) in esophagus squamous cell carcinoma. Methods The immunohistochemical S-P method was used to detect the expressions of HMGB1 and VEGF in 51 esophagus squamous cell carcinoma tissues and 12 normal tissues, and to study the significance of expression of HMGB1 and VEGF protein.Results HMGB1 and VEGF expressions were closely correlated with lymph node metastasis(P<0.05),but not with tumor size,The expression of HMB1 was related with VEGF (r=0.476,P<0.05).Conclusions HMGB1 and VEGF are closely correlated with lymph node metastasis,the expression may become predictor to the prognosis of esophagus squamous cell carcinoma.     

环氧化酶-2与血管内皮生长因子D在乳腺癌中的表达及临床意义

目的 探讨环氧化酶-2(COX-2) 和血管内皮生长因子D(VEGF-D)在乳腺癌中的表达及临床意义.方法 用免疫组化SP法检测59例乳腺癌及59例乳腺小叶增生病理组织中COX-2 和VEGF-D的表达,分析二者的表达情况与乳腺癌临床病理因素的关系.COX-2与VEGF-D在乳腺癌中的表达同年龄、肿块大小的关系用Wilcoxon秩和检验分析,COX-2与VEGF-D在乳腺癌中的表达同淋巴结转移及雌激素受体(ER)的关系用普通四格表卡方检验分析,COX-2与VEGF-D在乳腺癌中表达的相关性采用McNemar 配对χ2检验分析.结果 COX-2在乳腺癌和乳腺小叶增生组织中阳性表达率分别为61.0%(36/59)和11.9%(7/59),VEGF-D在乳腺癌和增生组织中的阳性表达率分别为74.6%(44/59)和8.5%(5/59),COX-2 和VEGF-D在乳腺癌及乳腺小叶增生组织中的表达比较差异有统计学意义(P<0.05).在乳腺癌组织中,COX-2 和VEGF-D的表达呈正相关(P<0.05);COX-2的表达同淋巴结转移呈正相关(P<0.05),同ER表达呈负相关(P<0.05);VEGF-D的表达同淋巴结转移呈正相关(P<0.05).结论 COX-2和VEGF-D高表达是乳腺癌侵袭转移的重要生物学标志. Abstract： Objective To investigate the expression of cyclooxygenase-2(COX-2)and vascular endothelial growth factor -D(VEGF-D) in human breast carcinoma and to investigate the relationships of COX-2 and VEGF-D with clinical and pathological characteristics.Methods The expression of COX-2 and VEGF-D were detected by immunohistochemistry SP technique in 59 cases of breast cancer and 59 cases of hyperplasia tissue.The relationship between the expression of COX-2,VEGF-D in breast cancer and the age, the volume was analyzed with Wilcoxon rank sum test.The relationship between the expression of COX-2, VEGF-D in breast cancer and the expression of estrogen receptor(ER) and lymph node metastasis was analyzed with Chi-square test. The relationship between the expression of COX-2 and VEGF-D in breast cancer was analyzed with Matching fourfold table.Results The positive expression rates of COX-2 were 61.0%(36/59) in breast cancer,and 11.9% (7/59) in hyperplasia.The positive expression rates of VEGF-D were 74.6%(44/59) in breast cancer,and 8.5%(15/59)in hyperplasia.The expression of COX-2 and VEGF-D in two groups had statistical differences(P<0.05). A significant positive correlation was found between the expression of VEGF-D and COX-2 in breast cancer(P<0.05). The expression of COX-2 in breast cancer was positively correlated with lymph node metastasis and negatively with the expression of ER (P<0.05). The expression of VEGF-D was positively correlated with lymph node metastasis(P<0.05). Conclusions COX-2 and VEGF-D are important biological markers for invasion and metastasis in breast cancer.     

胸水四项肿瘤标志物联检对恶性胸腔积液的诊断价值

目的 探讨联合检测胸水中的肿瘤标志物糖链抗原125(CA125)、糖链抗原19-9(CA199)、癌胚抗原(CEA)、肿瘤特异性生长因子(TSGF)对良、恶性胸腔积液的诊断价值.方法 采用酶联免疫吸附法(ELISA)和化学比色法检测胸水中的CA125、CA199、CEA、TSGF水平,并单项及联合计算四项肿瘤标志物的敏感性和特异性,并分析其在恶性胸腔积液诊断中的价值.结果 恶性组胸水中的CA125、CA199、CEA、TSGF的值均显著高于良性组(P<0.01),胸水四项联合检测可使恶性胸腔积液组的敏感性提高到95.8%,与胸水中单项肿瘤标志物的敏感性相比较,P<0.01,差异有统计学意义.特异性为82.3%,与单项检测的各组特异性相比,无明显下降,P＞0.05,差异无统计学意义.结论 联合检测胸水中的四项肿瘤标志物CA125、CA199、CEA、TSGF可提高对恶性胸腔积液诊断的敏感性,而特异性无明显下降.上述四项肿瘤标志物可作为良、恶性胸腔积液鉴别诊断的辅助指标. Abstract： Objective To study the role of co-detections of four tumor markers CA125,CA199,CEA and TSGF in differential diagnosis of benign and malignant pleural effusion.Methods The levels of CA125, CA199, CEA and TSGF in pleural effusion were detected by ELISA and colorimetry,the sensitivity and the specifity of the the single tumor marker and tumor markers combined assay were counted. Tle diagnostic value of combined assay of these four tumor markers was evaluated. Results Pleural fluid levels of CA125 ,CA199 ,CEA and TSGF in patients with malignant effusion were significantly higher than those patients in benign pleural effusions(P<0.01). Four tumor markers in pleural effusion increased the diagnostic sensitivity to 95.8% ,contrast with the sensitivity of the single tumor marker(P<0.01). While the specifity of those was 82.3%, not declining significantly (P＞0.05), compared with the specifity of the single tumor marker. Conclusions The combined assay of four tumor markers CA125, CA199, CEA and TSGF in pleural effusion increased the diagnostic sensitivity, while the specifity of those have no decrease significantly. The co-detections of four tumor markers in pleural effusion show great values in diagnosis and differential diagnosis for malignant and benign pleural effusion.     

转化生长因子-β1、基质金属蛋白酶组织抑制物-1、基质金属蛋白酶-1在绝经后盆腔器官脱垂患者阴道壁组织中表达的研究

目的 探讨绝经后女性盆腔器官脱垂(POP)患者阴道壁组织中转化生长因子-β1(TGF-β1)、基质金属蛋白酶组织抑制物-1(TIMP1)和基质金属蛋白酶-1(MMP1)的表达与POP的关系.方法 选取30例绝经后盆腔器官脱垂患者(POP 组),并选择同期20例非卵巢功能性肿瘤和宫颈上皮内瘤变患者作为对照(对照组),采用免疫组化SP二步法检测患者阴道壁组织中TGF-β1、TIMP1、MMP1的表达,两组患者阴道壁组织中TGF-β1、TIMP1和MMP1含量的表达以阳性区平均积分光密度为标准.结果 TGF-β1和TIMP1在POP组的表达显著低于对照组,差异有统计学意义(P<0.01).MMP1在POP组的表达显著高于对照组,差异有统计学意义(P<0.01).结论 绝经后POP的发生可能与组织中表达的TGF-β1、TIMP1减少和MMP1增多有关. Abstract： Objective To explore the relationship between transforming growth factor-β1 (TGF-β1) and tissue inhibitors of metalloproteinase-1 (TIMP1) and matrix metalloproteinase-1 (MMP1) with the occurrence of pelvic organ prolapse (POP) through analysis on TGF - β1 and TIMP1 and MMP1 in paries anterior vaginase of postmenopausal female pelvic organ prolapse. Methods The biopsy specimens in paries anterior vaginase were obtained from 50 subjects undergoing hysterectomia, tension-free vagina tape(TVT), burch procedures, who were assigned in the control, pelvic organ prolapse groups. TGF-β1 and TIMP1 and MMP1 in paries anterior vaginase was evaluated by immunohistochemical staining. Results TGF-β1 positive staining luminance and TIMP1 positive staining luminance were significantly lower in POP group than that in control group (P<0.01),MMP1 positive staining luminance was significantly higher in POP group than that in control group (P<0.01). Conclusions There is close relationship between degeneration of pelvic support construction and deficiency in TGF-β1 and TIMP1 declines in paries anterior vaginase of POP patient,and there is also close relationship between degeneration of pelvic support construction and accrescence in MMP1 of POP patient.     

血管内皮生长因子-C和sonic hedgehog在食管鳞状细胞癌中的表达

目的 探讨血管内皮生长因子-C(VEGF-C)和sonic hedgehog(SHH)在食管鳞状细胞癌(ESCC)组织中的表达及其与淋巴结转移的关系.方法 应用免疫组织化学法检测40例ESCC组织和30例癌旁正常黏膜组织中VEGF-C及SHH的表达.结果 40例ESCC组织中25例(62.5%)出现VEGF-C阳性,24例(60.0%)出现SHH阳性;癌旁正常食管黏膜组织30例中仅5例(16.7%)出现VEGF-C阳性,8例(26.7%)出现SHH阳性,其差异均有统计学意义(P＜0.05).在VEGF-C阳性的25例ESCC组织中19例出现淋巴结转移,而在VEGF-C阴性的15例ESCC组织中仅2例出现淋巴结转移,其差异有统计学意义(P＜0.05);SHH表达阳性的24例ESCC中18例有淋巴结转移,而SHH表达阴性的16例ESCC中7例有淋巴结转移,其差异有统计学意义(P＜0.05).结论 VEGF-C和SHH参与了ECSS的发生发展,且与其淋巴结转移的发生有关.对于VEGF-C及SHH表达阳性的ESCC患者,术前和术中应分别加强对淋巴结转移的评估及清扫,以提高其生存率. Abstract： Objective To study the expression of vascular endothelial growth factor-C(VEGF-C)and sonic hedgehog(SHH) in esophageal squamous cell carcinoma(ESSC)and explore the relationship between lymph node metastasis of ESCC and them.Methods The expression of VEGF-C and SHH was detectde using immunohistochemical method on 40 specimens from patients with ESSC and 30 cases of non-cancerous esophageal tissues. Results In the 40 specimens from patients with ESSC, 25 cases(62.5%) were VEGF-C positive,24 cases(60.0%)were SHH positive. In 30 cases of non-cancerous esophageal tissues,only 5 cases(16.7%)were VEGF-C positive,8 cases(26.7%)were SHH positive,there were both significant differences between the 2 types of tissues (P＜0.05).There were 19 cases had lymph node metastasis in the 25 cases whose VEGF-C were positive,while only 2 cases had lymph node metastasis in the 15 cases whose VEGF-C were negative (P＜0.05). There were 18 cases had lymph node metastasis in the 24 cases whose SHH were positive,while only 7 cases had lymph node metastasis in the 16 cases whose SHH were negative (P＜0.05). Conclusions VEGF-C and SHH play roles in development of ECSS,and had something to do with lymph node metastasis.For patients with ECSS whose VEGF-C and SHH positive,lymph node metastasis must be evaluated before and during operation in order to increase their survival rate.     

桡神经第二掌背支携筋膜蒂逆行岛状皮瓣修复指背骨外露

目的 探讨桡神经第二掌背支携筋膜蒂逆行岛状皮瓣修复指背骨外露的临床效果.方法 以桡神经第二掌背支携筋膜蒂逆行岛状皮瓣修复食指和中指中节指背骨外露患者共3例,观察皮瓣的成活率、质地、色泽.结果 随访3～24个月,平均18个月.3例皮瓣全部顺利成活,指端创面均获得覆盖;供区创面顺利愈合;皮瓣质地、弹性均正常,皮色与受区一致,无溃疡发生.结论 桡神经第二掌背支携筋膜蒂逆行岛状皮瓣修复指背骨外露具有操作相对简单、安全,皮瓣质地、色泽与受区一致等优点. Abstract： Objective To explore the clinical effect of reparing the bone exposure of finger back with a reverse island flap of the second metacarpal dorsal nerve of superficial radial nerve together with fascial pedicle.Methods Three cases with the bone exposure of finger back were repaired with a reverse island flap of the second metacarpal dorsal nerve of superficial radial nerve together with fascial pedicle.Then the survival rate, texture, and colour of the flaps were observed.Results All cases were followed up from 3 to 24 months (with the mean of 18 months).The flaps totally survivied in 3 cases, the bone exposure were repaired excellently.The raw surface of donor site were repaired.The flaps possessed good texture and flexibility.The flaps possess good quality and their colour match the recipient site.Conclusions The reverse island flap of the second metacarpal dorsal nerve of superficial radial nerve together with fascial pedicle is alternative to repair the bone exposure of finger back.The operation is easy and safe.