非小细胞肺癌中FGF-2、VEGF的表达及意义

【目的】探讨碱性成纤维细胞生长因子（FGF-2）、血管内皮生长因子（VEGF）在非小细胞肺癌（NSCLC）组织的表达及与临床病理学参数间的关系。【方法】用免疫组化SP法检测71例NSCLC组织中的FGF-2、VEGF的表达及肿瘤微血管密度（MVD）。【结果】FGF2、VEGF表达与TNM分期、淋巴结转移和MVD有关（P〈0．05）,两者共表达与MVD有关（P〈0．05）。相关分析显示FGF-2与VEGF的表达呈正相关（r=0．268,P〈0．05）。【结论】NSCLC中FGF2和VEGF的表达与肿瘤微血管形成和肿瘤转移有关;FGF-2和VEGF可作为临床判断NSCLC转移和预后的指标。     

垂体腺瘤VEGF、bFGF和内皮抑素mRNA表达与血管生成的关系

【目的】检测垂体腺瘤组织中的血管内皮细胞生长因子（VEGF）、碱性成纤维细胞生长因子（bFGF）和内皮抑素mRNA的表达，探讨其与垂体腺瘤血管生成的关系及临床意义。【方法】应用逆转录PCR（RT—PCR）方法检测30例垂体腺瘤组织标本中VEGF、bFGF和内皮抑素mRNA的表达，以Ⅷ因子相关抗原（FⅧ-Rag）血管内皮细胞标记法作为MVD计数的方法，分析上述血管生成相关因子与垂体腺瘤血管生成的关系。【结果】VEGF、bFGF mRNA表达与MVD之间呈显著正相关（r=0．36，r=0．45，均P〈0．05），内皮抑素表达和MVD之间无显著相关性（r=-0．17，P〉0．05）。【结论】垂体腺瘤血管生成与促血管生成因子VEGF、bFGF基因水平表达的上调有关。     

Ang-2、VEGF在子宫肌瘤组织中的表达及相互作用

【目的】研究血管生成素-2（Ang-2）、血管内皮生长因子（VEGF）在子宫肌瘤组织中的表达及其相关性，探讨二者在子宫肌瘤发生发展中的作用。【方法】采用免疫组化的SP法，检测50例子宫肌瘤及肌瘤周围正常组织Ang-2及VEGF的表达，并用图像分析法测定二者的表达强度。【结果】50例子宫肌瘤组织中Ang-2及VEGF的表达阳性率分别为82％及78％，其表达均高于相应的瘤旁正常组织（P〈0．01）；相关性分析表明，Ang-2及VEGF表达之间存在明显正相关（P〈0．01）。【结论】子宫肌瘤组织中Ang-2及VEGF均高表达，说明二者均参与子宫肌瘤的发生发展。二者表达呈正相关，推测Ang-2及VEGF在子宫肌瘤的发生发展中有协同作用。     

肾细胞癌与良性肾肿瘤组织微血管密度和血管内皮细胞生长因子表达的对比研究

目的：通过检测肾细胞癌、肾脏良性肿瘤标本中的微血管密度（MVD）及血管内皮细胞生长因子（VEGF）表达情况,研究不同性质肾脏肿瘤血管生成的差异。方法：肾细胞癌标本39例,良性肾脏肿瘤标本12例。采用“热点（hotpoint）”法计数MVD,VEGF的定量标准为VEGF染色强度与阳性细胞百分比分值的乘积。结果：MVD、VEGF在肾细胞癌和良性肾脏肿瘤均有表达。肾细胞癌组织MVD（18．3±6．9）计数／视野,VEGF乘积值3．63±2．5（×400）,转移者MVD和VEGF乘积值分别为（26．2±7．8）计数／视野、5．83±2．4,未转移者MVD和VEGF乘积值分别为（14．4±4．6）计数／视野、2．06±2．7;12例良性肾脏肿瘤MVD为（2．5±1．3）计数／视野,VEGF乘积值为0．32±0．2。肾细胞癌组织MVD和VEGF表达显著高于良性肾肿瘤（P〈0．01）,转移组肾细胞癌MVD和VEGF表达显著高于未转移组（P〈0．01）;肾细胞癌组织MVD与VEGF统计学上呈正相关（r=0．684,P〈0．001）。结论：肾细胞癌MVD及VEGF表达均显著高于良性肾脏肿瘤,提示不同性质的肾脏肿瘤其血管生成情况不同．转移肾细胞癌血管生成水平亦高于未转移肾细胞癌,提示血管生成与肾细胞癌转移相关,肾细胞癌组织MVD和VEGF表达水平呈正相关     

胃癌彩色多普勒血流分级与微血管密度、血管内皮生长因子的表达及其相关性研究

目的探讨彩色多普勒超声检测胃癌血流分级与病理微血管密度（MVD）和血管内皮生长因子（VEGF）表达的临床病理关系。方法术前测定60例各期胃癌患者肿瘤区域和正常胃壁的彩色多普勒血流显像（CDFI）,根据血流显示情况进行血流分级;术后免疫组化技术检测相对应标本内MVD、VEGF的表达。结果随着胃癌病灶区域内血流信号增多,血流分级增高,病理MVD计数和VEGF表达呈上升趋势（P=0．000）;胃癌癌组织血流分级和MVD计数均高于癌旁正常组织（P〈0．05）,进展期高于早期（P〈0．05）;VEGF表达水平癌组织则低于癌旁正常组织（P=0．000）,进展期高于早期（P=0．000）;MVD值同VEGF表达密切相关（P〈0．05）,而胃癌癌旁正常组织进展期与早期血流分级、MVD值和VEGF表达比较差异均无统计学意义（P〉0．05）。结论彩色多普勒超声所检测的胃癌内血流信号与病理MVD测值和VEGF表达有较好的相关性,胃癌术前CDFI血流检测可间接评价肿瘤组织内的血管生成状态,为胃癌的预后评估提供有益的信息。     

原发性肝癌患者血清血管内皮生长因子水平及其意义

【目的】探讨原发性肝细胞癌（HCC）患者血清血管内皮生长因子（vascular endothelial growthfactor,VEGF）水平及其临床意义。【方法】选择HCC患者60例（HCC组）和正常对照组60例（对照组）,采用酶联免疫吸附法（ELISA）检测两组入选对象血清中VEGF的含量,比较两组血清VEGF水平并分析其与临床病理特征的关系。【结果】HCC组患者血清VEGF水平（368．8±172．6）pg／mL显著高于对照组血清VEGF（158．8士60．2）pg／mL（P〈0．01）;HCC组血清VEGF水平与肿瘤大小呈正相关（P〈0．01）,有转移与复发的患者血清VEGF水平显著高于无转移与复发的患者,TNMⅢ、Ⅳ期患者血清VEGF浓度显著高于TNMI、Ⅱ期患者,有门脉癌栓与肝内外转移的患者血清VEGF水平显著高于无静脉癌栓及无肝内转移患者,合并肝硬化的患者VEGF水平明显高于无肝硬化患者,其差异均有显著性（P〈0．01）。【结论】血清VEGF水平可作为HCC诊断、判断恶性程度及是否转移和估计预后的有效指标。     

肾癌旁组织高表达内皮祖细胞与肿瘤浸润相关

目的检测肾癌旁组织中CD34＋／Flk-1＋内皮祖细胞（EPCs）表达水平。探讨其与肾癌浸润性生长的相关性。方法首先建立裸鼠原位肾癌模型,建模成功后第7、12、17、21天分别处死8只裸鼠,收取癌旁组织,对照组同时间收取相应部位肾组织。采用流式细胞术检测癌旁组织中EPCs占单个核细胞的比例,RT-PCR、Westernblot方法检测血管内皮细胞生长因子（VEGF）及其配体Flk-1表达强度,免疫组织化学方法检测癌旁组织平均微血管密度（MVD）。结果肿瘤形成12、17、21d,癌旁EPCs表达均明显高于对照组（P〈0．05）,整体呈现上升趋势（P〈0．01）。各时间段癌旁VEGF表达递增（P〈0．01）,但均低于对照组（P〈0．01）。Flk-1表达强度呈现下降趋势（P〈0．01）。癌旁MVD表达与VEGF一致,整体低于对照组（P〈0．01）。结论EPCs在肾癌旁组织中表达水平升高,参与癌旁血管新生,可能与肾癌的浸润性生长相关。     

VEGF及其受体Flt、KDR表达与胃癌临床病理特征的关系

【目的】4g讨血管内皮生长因子（VEGF）及其受体Fit、KDR的表达与胃癌临床病理特征的关系。【方法】选取本院手术切除的胃癌标本112例及癌旁组织作为对照,采用免疫组织化学方法检测VEGF及其受体Flt、KDR表达。【结果】胃癌组织VEGF、Fh和KDR阳性表达率分别为70．54％、59．82％和64．29％,均高于癌旁组织的16．07％、25．89％和22．32％,且差异有显著性（P〈0．05）;有淋巴转移纽VEGF、Fit和KDR阳性表达率高于无淋巴转移组（P〈0．05）;浸润程度超过肌层组的EGF、Flt和KDR阳性表达率高于未超过肌层组（P〈0．05）。在不同性别、年龄、肿瘤分化程度、组织类型中VEGF、Flt和KDR表达差异无显著性（P〉0．05）;VEGF表达与Flt和KDR表达呈一定的正相关关系（rs=0．233和O．418,P〈0．05）,Fit和KDR表达同样呈正相关关系（rs=0．263和P〈0．05）。【结论】胃癌中广泛表达VEGF及其受体Fit、KDR,且与胃癌淋巴结转移和浸润程度有一定关系。     

肝脾双介入对原发性肝癌血清sIL-2R和VEGF水平的影响

【目的】研究原发性肝细胞癌（HCC）患者行肝动脉灌注化疗（TAcE）联合脾动脉化疗药物灌注治疗前后血清可溶性白细胞介素2受体（slL-2R）和血管内皮细胞生长因子（VEGF）水平变化及其临床意义。【方法】30例HCC患者行单纯肝动脉化疗栓塞（TACE）,45例行TACE联合脾动脉化疗药物灌注治疗,分别于治疗前后测定slL-2R和VEGF,并与30名健康体检者比较。【结果】HCC患者sIL-2R及VEGF水平明显高于对照组（P〈0．01）;治疗后sIL-2R和VEGFR水平均较治疗前明显下降（P〈0．01）;肝脾双介入治疗后sIL-2R和VEGFR水平下降更显著（P〈0．05）。【结论】HCC患者TACE联合脾动脉化疗药物灌注治疗疗效明显,优于单纯TACE治疗。     

血管内皮生长因子在乳腺浸润性导管癌中的表达及意义

目的 检测乳腺浸润性导管癌中血管内皮生长因子（VEGF）的表达水平及肿瘤微血管密度（MVD）值，探讨VEGF、MVD水平及与临床病理学特征之间的相关性。方法 采用免疫组化染色法（SP法）分别检测88例乳腺癌患者术后标本中VEGF的表达水平、MVD值以及C-erbB-2表达情况。结果 88例标本中VEGF阳性62例，阳性率为70．45％；淋巴结转移组中VEGF表达水平高于未转移组（P〈0．05）；相对中晚期组（Ⅱb-Ⅲ）中VEGF表达水平高于相对早期组（Ⅰ-Ⅱa）（P〈0．05）；C-erbB-2阳性组中VEGF表达水平高于阴性组（P〈0．05）；随着癌组织学分级的升高，VEGF表达水平也有逐渐升高趋势（P〈0，05）。随着癌组织学分级的升高，MVD值也呈现出逐渐增高趋势（P〈0．01）；MVD值随着VEGF表达水平增高而增高（P〈0．01）。结论 VEGF在乳腺浸润性导管癌的肿瘤血管生成及转移过程中可能发挥重要的调控作用。VEGF和MVD值可作为反映乳腺癌生物学行为的指标之一。以VEGF为靶点的抗血管生成治疗策略有望成为治疗C-erbB-2阳性患者的一条新的途径。     

儿童遗传性心律失常的诊治进展

回顾在遗传性心律失常领域最新发表的相关研究,主要关注与儿童心源性猝死关系密切的离子通道病,包括长QT综合征（LQTS）、短QT综合征（SQTS）、Brugada综合征（BrS）和儿茶酚胺敏感性多形性室性心动过速（CPVT）,总结它们在发病机制及诊治方面的进展。     

The acoustic characteristics of the skull

Many investigators have stated that the difficulties of imaging with acoustical energy through the skull result from the marked attenuation of the energy by the skull. In the literature measurements of total attenuation have been confused with those for absorption.Measurements made by us show that absorption by compact bone varies between 2–3 dB cm^?1 MHz^?1 and, in the low megaHertz region appears to be directly proportional to frequency.It has also between shown that the convoluted inner surface of the ivory bone of the inner table of the skull may degrade the collimation and directionality of the beam by refraction.Cancellous bone, such as is present in the dipole of the skull, greatly attenuates the energy. It is postulated that this largely results from scattering. It is also postulated that the energy propagates through cancellous bone as two components, one in the soft tissues and the other partly in the bony spicules. Observations suggest that attenuation due to scattering much more markedly affects the latter of these components and scatters more greatly the higher frequencies in a pulse of broad bandwidth.The energy in each component has varying propagation paths so that the later cycles in the pulse of each component are subject to increasing interference as a result of the variations in propagation times. The two components moreover may have different propagation times so that interference may occur between the pulses of each component as well.All of these phenomena degrade the collimation, coherence, directionality, beam width, pulse length, frequency and other properties of the ultrasonic energy upon which imaging through the skull depends.The interference effects described above are least for the first cycle in the pulse which usually is not the cycle of highest amplitude. Since, in the free field, most of the energy is concentrated around the beam axis, most of the energy in the field which is deflected from its normal propagation path is deflected away from the beam axis. Thus the directionality of the beam is least degraded in the beam axis. The effects of the skull in degrading the properties of the ultrasonic pulse would therefore be lessened if the amplitude of the first cycle of the pulse and the directionality of its energy could be used for imaging.     

Organ Preservation: Current Concepts and New Strategies for the Next Decade

SUMMARY: Organ transplantation has developed over the past 50 years to reach the sophisticated and integrated clinical service of today through several advances in science. One of the most important of these has been the ability to apply organ preservation protocols to deliver donor organs of high quality, via a network of organ exchange to match the most suitable recipient patient to the best available organ, capable of rapid resumption of life-sustaining function in the recipient patient. This has only been possible by amassing a good understanding of the potential effects of hypoxic injury on donated organs, and how to prevent these by applying organ preservation. This review sets out the history of organ preservation, how applications of hypothermia have become central to the process, and what the current status is for the range of solid organs commonly transplanted. The science of organ preservation is constantly being updated with new knowledge and ideas, and the review also discusses what innovations are coming close to clinical reality to meet the growing demands for high quality organs in transplantation over the next few years.     

2017年呼吸疾病主要进展

2017年,国内外学者在呼吸系统疾病的临床和基础领域均进行了深入研究,不仅对相关指南进行了更新,并且针对一些临床热点、难点问题达成专家共识,现就2017年呼吸疾病相关进展作一简单介绍。     

家族性噬血细胞性淋巴组织细胞增生症1例并文献复习

目的加强对家族性噬血细胞性淋巴组织细胞增生症（familially hemophagocytic lymphohistiocytosis,FHL）的认识。方法报道确诊为FHL的新病例1例,结合国内外报道的FHL的病例,对该病的临床特点进行汇总分析。结果FHL2常与PRF1基因突变相关,约20%~40%的患者存在穿孔素基因突变。结论对于有阳性家族史,基因诊断明确,应尽早行化疗或者造血干细胞移植。若无家族史,未发现与继发性HLH相关的原发病因,可考虑行基因筛查以明确是否存在FHL的可能。     

COVID‐19 and COVID‐19 vaccine‐related dermatological reactions: An interesting case series with a narrative review of the potential critical and non‐critical mucocutaneous adverse effects related to virus,therapy, and the vaccination

This narrative review article was conducted to lay out a summarized but exhaustive review of current literature over mucocutaneous manifestations in 4 dimensions of SARS‐CoV‐2 pandemic: virus itself, treatment‐related, vaccine‐induced, and alteration of chronic dermatologic diseases following infection. Virus and vaccine‐related were mainly self‐limited and non‐severe. Treatment‐related reactions could be life‐threatening.     

Burkitt's lymphoma of maxillary gingiva: A case report

Burkitt's lymphoma(BL) is an aggressive form of nonHodgkin's B-cell lymphoma with three variants namely endemic, sporadic, and immunodeficiency-associated types. It is endemic in Africa and sporadic in other parts of the world. While the endemic form is widely reported to occur in early childhood and commonly involves the jaw bones, the sporadic form typically presents as an abdominal mass. This presentation reports a rare case of sporadic form of BL clinically manifesting as a generalized gingival enlargement in an immunocompetent adult male which demonstrated an aggressive behavior. The patient reported with a prominent anterior gingival swelling of 6 mo duration which slowly enlarged in size and associated with multiple lymph node involvement. Microscopic examination of the lesion using H, E and immunohistochemical diagnosis confirmed the diagnosis as BL. The patient succumbed to the disease before any therapy could be instituted. Since a wide array of causes can be attributed to gingival enlargements, it is necessary to consider malignancies as one of the important differential diagnosis so as to facilitate the need for appropriate diagnosis and prompt treatment.     

Real‐life effectiveness of biological therapies on symptoms in severe asthma with comorbid CRSwNP

BackgroundWe aimed to evaluate the effectiveness of different antibody therapies on nasal polyp symptoms in patients treated for severe asthma.MethodsWe performed a retrospective analysis of patients with severe asthma and comorbid CRSwNP who were treated with anti‐IgE, anti‐IL‐5/R or anti‐IL‐4R. CRSwNP symptom burden was evaluated before and after 6 months of therapy.ResultsFifty patients were included hereof treated with anti‐IgE: 9, anti‐IL‐5/R: 26 and anti‐IL‐4R: 15 patients. At baseline median SNOT‐20 was similar among groups (anti‐IgE: 55, anti‐IL‐5/R: 52 and anti‐IL‐4R: 56, p = 0.76), median visual analogue scale (VAS) for nasal symptoms was 4, 7 and 8 (p = 0.14) and VAS for total symptoms was higher in the anti‐IL‐4R group (4, 5 and 8, p = 0.002). After 6 months SNOT‐20 improved significantly in all patient groups with median improvement of anti‐IgE: −8 (p < 0.01), anti‐IL‐5/R: −13 (p < 0.001) and anti‐IL‐4R: −18 (p < 0.001), with larger improvement in the anti‐IL‐4R group than in anti‐IgE (p < 0.001) and anti‐IL‐5/R (p < 0.001) groups. VAS nasal symptoms improved by median anti‐IgE: 0 (n.s.), anti‐IL‐5/R: −1 (p < 0.01) and anti‐IL‐4R: −3 (p < 0.001), VAS total symptoms by anti‐IgE: −1 (n.s.), anti‐IL‐5/R: −2 (p < 0.001) and anti‐IL‐4R: −2 (p < 0.001).ConclusionsTreatment by all antibodies showed effectiveness in reducing symptoms of CRSwNP in patients with severe asthma, with the largest reduction observed in anti‐IL‐4R‐treated patients.     

经颅黑质超声诊断帕金森病的临床评价

目的 通过对帕金森病患者及正常对照组进行经颅超声(transcranial sonography,TCS)检查,结合帕金森病患者的Hoehn Yahr（H Y）分级及帕金森病统一评分量表评分结果,了解我国大陆地区帕金森病患者有无黑质(substantia nigra, SN)回声增强表现。方法 对入选对象进行TCS检查,并对检查结果进行评价。结果 帕金森病患者 SN阳性率明显高于正常对照者（P＜0.05）。帕金森病SN异常组 H Y 分期明显高于帕金森病SN正常组(P＜0.05),表明帕金森病患者SN高回声面积与H Y分期相关。TCS检查对帕金森病的敏感性为80.5%,特异性为79.9%。结论 我国帕金森病患者SN强回声检出率显著高于对照组,说明我国帕金森病患者也存在SN回声增强这一现象,与国内外报道相一致。TCS检查对帕金森病的诊断具有一定的意义,敏感性及特异性较高。