KAI1蛋白在甲状腺乳头状癌及滤泡癌组织中的表达及临床意义

目的 探讨KAI1蛋白在甲状腺乳头状癌(PTC)和滤泡癌组织中表达及其在PTC浸润和转移中的作用.方法 回顾性分析2006年1月至2009年8月收治的58例PTC患者(PTC组)、17例甲状腺滤泡癌患者(滤泡癌组)和30例甲状腺良性肿瘤患者(对照组)的临床资料,采用免疫组织化学方法测定PTC组织、甲状腺滤泡癌组织和甲状腺良性肿瘤组织中KAI1蛋白的表达.结果 KAI1蛋白在PTC组阳性表达率为48.3％(28/58),滤泡癌组为47.1％(8/17),对照组为86.7％(26/30),PTC组、滤泡癌组与对照组比较差异有统计学意义(P＜0.01),而PTC组与滤泡癌组比较差异无统计学意义(P＞0.05).PTC组KAI1蛋白表达在患者性别、年龄及原发病灶直径之间比较差异无统计学意义(P＞0.05).KAI1蛋白在肿瘤的TNM分期Ⅰ期的阳性表达率为88.9％(8/9)、Ⅱ期为60.9％(14/23)、Ⅲ～Ⅳ期为23.1％(6/26),不同TNM分期的KAI1蛋白阳性表达率比较差异有统计学意义(P＜0.01);KAI1蛋白在有淋巴结转移的PTC组织中和无淋巴结转移的PTC组织中的阳性表达率分别为32.3％(10/31)和66.7％(18/27),两者比较差异有统计学意义(P＜0.05).结论 KAI1蛋白表达可反映PTC的转移能力以及临床演进程度,KAI1蛋白可能对PTC的浸润和转移有抑制作用.     

凋亡抑制基因Survivin与高危型-人乳头瘤病毒在宫颈癌及癌前病变中的表达及其临床意义

目的 研究宫颈癌及癌前病变中凋亡抑制基因Survivin的表达及高危型-人乳头瘤病毒(HR-HPV)的感染情况,探讨两者在宫颈癌发病机制中的作用.方法 入选宫颈上皮内瘤变(CIN)Ⅰ 25例、CINⅡ～Ⅲ23例及宫颈癌34例,另取20例正常宫颈作为对照.采用免疫组织化学SP法检测Survivin的表达,以聚合酶链反应技术检测HR-HPV感染情况.结果 Survivin阳性表达率和HR-HPV感染率均为宫颈癌[85.3％(29/34)和88.2％ (30/34)]高于CIN [52.1％(25/48)和54.2％(26/48) ](P＜ 0.05),CIN高于正常宫颈[0和10.0％(2/20)](P＜0.05),CINⅡ～Ⅲ[65.2％(15/23)和73.9％(17/23)]高于CIN I[32.0％(8/25)和28.0％(7/25)](P＜ 0.05).在宫颈癌中Survivin阳性表达与组织学分级相关(P＜0.05),而与年龄、临床分期及病理分型无关(P＞0.05).HR-HPV感染与年龄、临床分期、组织学分级及病理分型均无关(P＞0.05).在宫颈癌中Survivin阳性表达与HR-HPV感染呈正相关(r=0.403,P＜ 0.05).结论 Survivin阳性表达及HR-HPV感染可能与宫颈癌的发生、发展密切相关.两者在宫颈癌的发病机制中可能起着协同作用.     

磷脂酰肌醇3激酶和蛋白激酶B在上皮性卵巢癌组织中的表达及临床意义

目的 研究磷脂酰肌醇3激酶(PI3K)和蛋白激酶B(Akt)在上皮性卵巢癌(EOC)组织中的表达和临床意义.方法 运用Western Blot和免疫组化法检测41例EOC(EOC组)、20例正常卵巢(NO,NO组)和20例良性卵巢上皮性肿瘤(BEOT,BEOT组)组织中PI3K和Akt蛋白的表达.结果 PI3K在EOC组中阳性表达率为70.7％(29/41),显著高于NO组和BEOT组[10.0％(2/20)、20.0％(4/20)],差异有统计学意义(P＜ 0.01);Akt在EOC组中阳性表达率为73.2％(30/41),显著高于NO组和BEOT组[10.0％(2/20)、30.0％(6/20)],差异有统计学意义(P＜0.01).在EOC患者中,临床分期Ⅰ～Ⅱ期PI3K和Akt蛋白的表达与Ⅲ～Ⅳ期比较差异有统计学意义(P＜0.05);浆液性囊腺癌中PI3K和Akt蛋白的表达与黏液性囊腺癌比较差异无统计学意义(P＞0.05).结论 PI3K和Akt蛋白在EOC组织中表达显著增强,它们在EOC发生、发展中起到～定的作用,PI3K/Akt通路有望作为抗肿瘤治疗的有效新靶点.     

COX-2蛋白质在宫颈病变中的表达及意义

[目的]探讨正常宫颈组织、慢性宫颈炎、CIN Ⅰ～Ⅱ、CINⅢ和宫颈浸润性鳞癌组织中COX-2(环氧合酶-2)表达及意义. [方法]采用免疫组化Envision法检测正常宫颈组织15例、慢性宫颈炎23例、CIN Ⅰ～Ⅱ25例、CINⅢ 26例及宫颈癌组织42例中COX-2蛋白质的表达. [结果]COX-2蛋白的表达阳性率随着宫颈病变的加重而增高.正常宫颈组织中的COX-2不表达,在慢性宫颈炎、CINⅠ～Ⅱ、CINⅢ和浸润性宫颈癌的阳性表达率分别为56.5%、52.0%、73.1%和90.5%,正常宫颈组织与各组织COX-2的表达差异有统计学意义(P＜0.01).COX-2表达在慢性宫颈炎与CIN Ⅰ～Ⅱ和CINⅢ差异无统计学意义(P＞0.05);与浸润性宫颈瘤之间差异有统计学意义(X2=8.229,P＜0.01).COX-2表达在CIN Ⅰ～Ⅱ与浸润性宫颈癌(X2=12.763,P＜0.01)差异有统计学意义,CINⅢ与浸润性宫颈癌之间的(X2＝2.417,P＞0.05)两组之间差异无统计学意义. [结论]COX-2蛋白的表达随着宫颈病变的加重而阳性率增高.其在慢性宫颈炎中的异常表达.对宫颈癌的早期诊断有一定价值. OX-2的表达差异有统计学意义(P＜0.01).COX-2表达在慢性宫颈炎与CIN Ⅰ-Ⅱ和CINⅢ差异无统计学意义(P＞0.05);与浸润性宫颈瘤之间差异有统计学意义(X2=8.229,P＜0.01).COX-2表达在CIN Ⅰ～Ⅱ与浸润性宫颈癌(X2=12.763,P＜0.01)差异有统计学意义,CINⅢ与浸润性宫颈癌之间的(X2＝2.417,P＞0.05)两组之间差异无统计学意义. [结论]COX-2蛋白的表达随着宫颈病变的加重而阳性率增高.其在慢性宫颈炎中的异常表达.对宫颈癌的早期诊断有一定 值. OX-2的表达差异有统计学意义(P＜0.01).COX-2表达在慢性宫颈炎与CIN Ⅰ-Ⅱ和CINⅢ差异无     

鼻内镜治疗鼻腔和鼻窦内翻性乳头状瘤的临床疗效观察

目的 探讨鼻内镜治疗鼻腔和鼻窦内翻性乳头状瘤(NIP)的临床效果.方法 选择40例应用鼻内镜治疗的NIP患者(鼻内镜组)和40例应用鼻外侧切开手术治疗的NIP患者(鼻侧切开组),比较两组的手术时间、住院时间、复发率和并发症发生情况.结果 鼻内镜组手术时间和住院时间分别为(50.5±13.6) min和(3.5±1.0)d,鼻侧切开组分别为(72.9±18.8) min和(5.5±1.5)d,两组比较差异有统计学意义(P＜0.05).鼻内镜组和鼻侧切开组术后并发症发生率分别为15.0％( 6/40)和20.0％ (8/40),两组比较差异无统计学意义(P＞0.05);但是在Ⅲ级肿瘤中鼻内镜组术后并发症发生率明显低于鼻侧切开组[14.3％ (2/14)比41.7％(5/12)],Ⅳ级肿瘤中术后鼻内镜组并发症发生率则明显高于鼻侧切开组[50.0％( 2/4)比0],差异有统计学意义(P＜0.05).鼻内镜组和鼻侧切开组术后复发率分别为20.0％(8/40)和32.5％(13/40),两组比较差异无统计学意义(P＞0.05),但是在Ⅲ级肿瘤中鼻内镜组术后复发率明显低于鼻侧切开组[14.3％(2/14)比41.7％(5/12)],Ⅳ级肿瘤中鼻侧切开组术后复发率则低于鼻内镜组[40.0％(2/5)比75.0％( 3/4)],差异均有统计学意义(P＜0.05).结论 鼻内镜治疗NIP具有切实可行的意义,同时对于不同分级肿瘤则应该与鼻侧切开手术互相补充以提高手术切除率,降低复发率及恶变风险.     

绝经后女性高尿酸血症与颈动脉硬化关系的研究

目的 探讨绝经后女性高尿酸血症与颈动脉硬化的关系.方法 在196例自然绝经后女性患者中,经彩色多普勒超声诊断为颈动脉粥样硬化、斑块形成者156例为观察组,40例无颈动脉粥样硬化者为对照组,比较两组的年龄、体质指数(BMI)、雌二醇(E2)和高尿酸血症、高胆固醇血症、高三酰甘油血症、缺血性脑病家族史比率.结果 两组年龄、BMI和E2水平比较差异无统计学意义(P＞0.05).观察组高尿酸血症比率[39.74％(62/156)]明显高于对照组[17.50％(7/40)],差异有统计学意义(P＜0.01),高胆固醇血症比率[21.15％(33/156)]明显高于对照组[15.00％(6/40)] (P＜0.05).两组缺血性脑病家族史、高三酰甘油血症比率比较差异无统计学意义(P＞0.05).结论 绝经后女性颈动脉粥样硬化的发生与尿酸水平密切相关.     

Smac和Livin的表达与宫颈癌的发生发展相关性分析

目的 探讨凋亡相关蛋白Smac、Livin在宫颈癌组织中的表达及临床意义.方法 选取2014年3月至2015年3月汕头市中心医院妇产科宫颈鳞状细胞癌24例(宫颈癌组),宫颈上皮内瘤变(CIN)Ⅰ 15例(CIN Ⅰ组),CIN Ⅱ13例(CIN Ⅱ组),CIN Ⅲ13例(CIN Ⅲ组),正常宫颈组织15例作为正常对照(对照组),采用免疫组化法检测各组的Smac和Livin表达情况.结果 宫颈癌组Smac阳性比例为83.33％,明显高于对照组,差异比较有统计学意义(x2=25.658,P＜0.05);宫颈癌组、CIN Ⅱ组和CIN Ⅲ组Smac阳性比例比较差异无统计学意义(x2=2.204,P＞0.05);宫颈癌组、CIN Ⅱ组和CIN Ⅲ组Livin阳性比例分别为79.17％、76.92％和84.62％,明显高于对照组(x2值分别为19.420、17.279、14.412,均P＜0.05);CIN Ⅰ组与对照组Smac和Livin阳性比例比较差异无统计学意义(x2值分别为0.536、0.000,均P＞0.05);CIN Ⅰ组Smac和Livin阳性比例明显低于CINⅡ组、CINⅢ组和宫颈癌组(x2值分别为20.843、22.611,均P＜0.05);低分化患者Smac阳性比例为42.86％,明显低于高中分化患者(x2=11.657,P＜0.05);宫颈鳞状细胞癌中Smac和Livin的表达呈正相关(r=0.872,P＜0.05).结论 Smac和Livin在宫颈鳞状细胞癌的发生发展中起协同作用.     

陈旧性心肌梗死碎裂QRS波及碎裂QRS时限与室性心律失常的关系

目的 通过分析陈旧性心肌梗死(OMI)伴碎裂QRS波(fQRS)患者和不伴fQRS患者以及不同fQRS时限患者发生室性心律失常的情况,探讨OMI患者fQRS、fQRS时限与室性心律失常的关系.方法 选择321例OMI患者进行常规心电图检查,根据心电图有无fQRS分为OMI伴fQRS组(A组,167例)和OMI不伴fQRS组(B组,154例).A组将出现fQRS的导联加长描记50mm/s心电图,连续测量3个fQRS时限,取其平均值,根据fQRS时限的数值分为≤0.100 8组(X组,96例)、0.101～0.119 s组(Y组,54例)、≥0.120 s组(Z组,17例).所有患者均进行24h动态心电图检查,统计分析室性心律失常的发生情况.结果 A组室性心律失常发生率为78.4％(131/167),B组为63.6％(98/154),两组比较差异有统计学意义(P＜0.01);A组室性期前收缩＞720个/24h发生率为28.7％ (48/1 67),B组为17.5％(27/154),两组比较差异有统计学意义(P＜0.05);A组多形性室性期前收缩、成对室性期前收缩、非持续性室性心动过速、室性期前收缩Lown分级3～5级发生率分另为16.2％(27/167)、33.5％(56/167)、12.0％( 20/167)、34.1％(57/167),B组分别为7.8％(12/154)、21.4％(33/154)、4.5％(7/154)、23.4％( 36/154),两组比较差异有统计学意义(P＜0.05).Z组室性心律失常发生率[ 100.0％(17/17)]显著高于Y组[79.6％(43/54)]和X组[74.0％(71/96)],差异均有统计学意义(P＜0.05).Z组室性期前收缩Lown分级3～5级发生率[70.6％(12/17)]显著高于Y组[ 42.6％( 23/54)]和X组[22.9％(22/96)],Y组显著高于X组,差异均有统计学意义(P＜0.05).结论 OMI伴fQRS患者较OMI不伴fQRS患者的室性心律失常发生率增加且较严重,并且随着fQRS时限的增宽,室性期前收缩的发生次数明显增加,室性期前收缩Lown分级3～5级发生率也明显增加.所以fQRS是高危心肌梗死患者预警的心电图新指标,fQRS时限对预测OMI患者心脏事件的发生具有明确的价值.     

肠病毒71型感染重症手足口病脑脊液细胞学改变与临床症状分析

目的 探讨肠病毒71型(EV71)感染重症手足口病患儿脑脊液细胞学改变与临床症状的关系,为临床诊治提供依据.方法 选择2012年3月至7月本院隔离病区住院EV71感染手足口病重症患儿86例.入院后行腰椎穿刺术,收集脑脊液检验结果,比较脑脊液细胞学变化,结合临床症状进行分析.结果 手足口病重症患儿脑脊液细胞学计数≥500×106/L组患儿[占70.9％(61/86)],其呕吐、嗜睡、肢体抖动、进展至第3期及脑干脑炎发生率高于＜500×106/L组[占29.1％(25/86)],差异均有统计学意义(x2 =6.8～10.62,P＜0.05,P＜0.01),而发热、易惊及下肢无力发生率两组比较差异均无统计学意义(P＞0.05)；脑脊液细胞学以多核细胞为主者[占25.6％ (22/86)],其嗜睡、肢体抖动、下肢无力、进展至第3期及脑干脑炎发生率高于单核细胞为主者[占74.4％ (64/86)],差异均有统计学意义(x2=6.40～12.30,P＜0.05,P＜0.01),而发热、易惊及呕吐症状比较差异均无统计学意义(P＞0.05).结论 脑脊液白细胞计数异常增多或以多核细胞为主的手足口病重症患儿病情较重,脑干脑炎的发生率高,脑脊液细胞学的检测对手足口病早期诊断及病情判别有帮助.     

大骨瓣开颅血肿清除术治疗高血压性脑出血的临床研究

目的 探讨大骨瓣开颅血肿清除术治疗高血压性脑出血的临床效果及安全性.方法 将162例高血压性脑出血患者按手术方法不同分为观察组(80例)和对照组(82例),对照组给予单纯开颅血肿清除术治疗,观察组给予大骨瓣开颅血肿清除术治疗.计算术前和术后1、3、7d脑血肿量,术后随访3个月评价两组患者的疗效,观察并发症发生情况.结果 两组术前血肿量比较差异无统计学意义(t=2.981,P＞ 0.05);两组术后1、3、7d血肿量与术前比较均显著下降,且观察组较对照组下降更显著,两组比较差异有统计学意义(t=5.224、5.448、5.415,P＜ 0.05).观察组有效率[92.5％(74/80)]明显高于对照组[57.3％(47/82)],差异有统计学意义(x2=4.020,P＜0.05);病死率[2.5％(2/80)]明显低于对照组[ 11.0％(9/82)],差异有统计学意义(x2=10.937,P＜ 0.05).观察组肺部感染发生率为28.8％(23/80),明显低于对照组的65.9％( 54/82),差异有统计学意义(x2=5.706,P＜ 0.05);观察组再发脑出血和消化道出血发生率分别为3.8％(3/80)、12.5％(10/80),对照组分别为4.9 ％(4/82)、13.4％(11/82),两组比较差异无统计学意义(x2=2.841、2.674,P＞0.05).结论 大骨瓣开颅血肿清除术治疗高血压性脑出血疗效肯定,可以降低病死率和减少并发症的发生.     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.