胃癌组织survivin mRNA的表达及其与预后的关系

目的探讨生存素(Survivin)mRNA在胃癌组织中的表达与临床病理及其预后的关系。方法应用逆转录聚合酶链反应(RT-PCR)检测41例胃癌患者与9例良性胃疾病患者手术标本中的Survivin mRNA表达并随访3年,将其表达及表达强度与临床病理特征进行相关分析。结果胃癌组织中Surviving mRNA的阳性率(70.7%)均高于癌旁正常组织(17.1%)和良性胃疾病患者组织Survivin mRNA表达的阳性率(1/9)(P<0.005)癌旁正常组织与良性胃疾病组织Survivin mRNA表达的阳性率差异无显著性(P>0.05);Survivin mRNA在胃癌组织的表达及表达强度与年龄、性别、病理分型、分期、解剖部位及淋巴结和(或)远处转移均无明显关系(P>0.05),但与预后有明显关系(P=0.001 8)。结论胃癌组织检测Survivin mRNA表达可以作为胃癌诊断的特异性分子标志物之一,且可独立作为预测肿瘤的预后。     

锌指蛋白A20在胃癌组织中的表达及其与胃癌病理分期和转移的相关性研究

目的探讨锌指蛋白A20在胃癌组织中的表达及其与临床病理分期和远处转移的关系。方法收集2009年1—10月在我院手术切除的42例胃癌及癌旁组织标本,用RT-PCR和Western blotting法分别检测标本中锌指蛋白A20的表达情况。结果胃癌组织中锌指蛋白A20的表达低于癌旁正常组织,Ⅲ期+Ⅳ期胃癌组织锌指蛋白A20的表达显著低于Ⅰ期+Ⅱ期胃癌组织(P<0.05)。肿瘤细胞的分化程度与锌指蛋白A20的表达水平呈负相关,有远处转移的胃癌组织中锌指蛋白A20的表达显著低于无远处转移的组织(P<0.05),有淋巴转移的胃癌组织中锌指蛋白A20的表达显著低于无转移的组织(P<0.05)。但是锌指蛋白A20的表达水平与患者的年龄、性别没有相关性。结论锌指蛋白A20在胃癌组织中表达降低,A20的表达水平与胃癌细胞的恶性程度、分期、远处转移、淋巴转移有关。     

非小细胞肺癌Bim和Caspase-3蛋白表达检测及临床意义

目的探讨Bim和Caspase-3蛋白在非小细胞肺癌(NSCLC)中的表达及临床意义。方法应用免疫组织化学技术检测89例NSCLC组织中Bim和Caspase-3蛋白的表达,并进行肿瘤临床特征分析。结果在NSCLC组织中,Bim蛋白表达率为65.2%(58/89),其表达与NSCLC临床分期、淋巴结转移和肿瘤分化程度密切相关(χ2=7.949～22.698,P<0.01);Caspase-3蛋白表达率为67.4%(60/89),其表达与NSCLC临床分期及淋巴结转移密切相关(χ2=5.098～5.408,P<0.05);在NSCLC组织中,Bim蛋白表达与Caspase-3蛋白表达呈正相关(r=0.649,P=0.000)。结论Bim蛋白表达与NSCLC转移及患者临床分期负相关。     

CT影像学及临床病理学相关因素对胃癌旁肿瘤沉积的预测价值

目的:探讨CT影像学及临床病理学相关因素对胃癌旁肿瘤沉积(TDs)的预测价值。方法:回顾性分析经手术病理证实的126例胃癌患者,根据病理诊断分为TDs阳性组(35例)和TDs阴性组(91例)。分析两组患者CT影像学及临床病理学对胃癌旁TDs的预测价值。通过单因素及多因素Logistic回归分析,比较两组各项参数值的差异并分析差异有统计学意义的变量的诊断效能。结果:单因素分析显示,影像学T分期、静脉期肿瘤强化不均匀、术前CEA、病理学N分期及脉管侵犯与胃癌旁TDs有关(P<0.05)。多因素Logistic回归分析显示影像学T分期(OR值=5.196)、病理学N分期(OR值=5.259)及脉管侵犯(OR值=3.991)是胃癌旁TDs的独立预测因素(P<0.05)。ROC分析结果显示,影像学T分期、病理学N分期及脉管侵犯预测TDs的AUC为0.682、0.721及0.731。结论:综合CT影像学及临床病理学相关因素,有助于预测胃癌旁TDs的存在。     

胰腺导管腺癌TPAP基因的表达及其与临床病理和预后的关系

目的 探讨胰腺导管腺癌组织中TPAP基因表达与患者临床特征及预后之间的关系.方法 采用实时定量RT-PCR方法检测40例胰腺导管腺癌、相应的癌旁胰腺组织及5例尸检获得的正常胰腺组织中TPAP mRNA的表达情况,并分析TPAP基因检测结果与临床病理参数和预后之间的关系.结果 TPAP在胰腺癌组织中的相对表达量[0.012(0.004, 0.018)]明显低于癌旁组织[0.018(0.009, 0.081)]及正常胰腺组织[0.740(0.457, 0.891),P<0.01],后两者之间表达也有明显差异(P<0.001).癌组织中TPAP mRNA的相对表达量与远处转移呈负相关(r=-0.342, P=0.031),与高分化呈正相关(r=0.371, P=0.018),但肿瘤部位和大小、血清CA19-9浓度、血清CEA浓度、临床分期、淋巴转移、患者的性别和年龄均对TPAP表达无明显影响(P>0.05).随访发现TPAP阴性为生存期的危险因素,阳性表达为生存期的保护因素.结论 TPAP对胰腺癌的发生、发展可能具有抑制作用,其高表达可作为胰腺癌生存期长的良性预测指标.     

RLIP76和CD44在胃癌患者血清和组织中表达及其临床意义

目的 探讨RLIP76和CD44在胃癌患者血清和组织中的表达及其临床意义。方法 收集2014年3月—2016年5月于成都市第五人民医院行手术治疗的82例胃癌患者的临床资料,所有患者手术前后均留取外周血标本,采用酶联免疫法测定患者血清RLIP76及CD44水平的变化;术中留取癌组织及癌旁组织标本,采用免疫组化法测定胃癌组织RLIP76、CD44表达情况,分析RLIP76、CD44表达与胃癌生物学特点及预后的关系。结果 术后2周,胃癌患者血清RLIP76、CD44表达水平降低,与术前3 d比较差异有统计学意义（t=18.390,26.291;均P<0.05）;胃癌患者癌组织RLIP76阳性率为50.00%,CD44阳性率为58.54%,患者癌组织RLIP76、CD44阳性率均高于癌旁组织（χ2=48.681,65.063;均P<0.05）;组织分化程度为低分化、临床分期为Ⅲ-Ⅳ期、伴淋巴结转移的胃癌患者RLIP76阳性率、CD44阳性率高于组织分化程度为高、中分化、临床分期Ⅰ-Ⅱ期及不伴淋巴结转移的胃癌患者（P<0.05）;RLIP76阳性、CD44阳性胃癌患者生存时间短于阴性者,但Log-Rank检验差异无统计学意义（χ2=2.057,P=0.151;χ2=0.452,P=0.501）;Cox分析显示淋巴结转移、临床分期、RLIP76阳性、CD44阳性均为影响胃癌预后的独立危险因素（P<0.05）。结论 胃癌患者血清及癌组织RLIP76、CD44水平呈异常高表达,且与胃癌组织分化程度、临床分期及淋巴结转移有关,是导致患者不良预后的独立危险因素。     

CyclinD1、p21WAF1、p53及Ki-67在肝细胞癌中的表达及与预后的关系

目的探讨肝细胞癌(HCC)中cyclin D1、p21、p53及Ki-67蛋白的表达及其与HCC预后的关系。方法选择2000年1月-2005年1月在解放军总医院行手术切除的80例HCC患者的肝组织标本,采用EliVision法进行cyclin D1、p21WAF1、p53及Ki-67免疫组化染色,分析其表达水平与HCC病理特征的关系,并进行生存分析。结果 Cyclin D1、p21WAF1、p53及Ki-67在HCC中的阳性表达率分别为38.8%、40.5%、65.4%及80.0%,均明显高于癌旁肝组织(分别为19.0%、11.5%、0.0%、6.3%,P<0.005)。相关分析显示,cyclin D1阳性表达与核分级呈正相关(P=0.041),p21WAF1及p53阳性表达与肿瘤分化程度(P=0.032、P=0.031)和血管浸润(P=0.036、P=0.011)呈正相关,Ki-67阳性表达与肿瘤分化程度(P=0.004)、核分级(P=0.045)和血管浸润(P=0.001)呈正相关。生存分析显示,cyclin D1及Ki-67高表达者预后较差。Ki-67阳性表达与p53(P=0.000)及p21WAF1(P=0.047)阳性表达有明显相关性,其他各蛋白之间表达无明显相关。Cox回归模型分析显示,肿瘤大小(P=0.042)、肿瘤数目(P=0.004)及血管浸润(P=0.000)为HCC的独立预后因素。结论 Cyclin D1、p21WAF1、p53及Ki-67可能参与了HCC的生物学进程;cyclin D1及Ki-67阳性表达对HCC预后的判断有一定价值。     

大肠癌P~(53)蛋白测定与临床生物学意义的相关研究

目的　探讨P53 蛋白表达与大肠癌的关系及临床生物学意义。方法　采用免疫组织化学技术对 32例大肠癌组织及 16例正常大肠组织中的p53 蛋白的表达进行观察和比较。结果　P53 在正常大肠组织中表达阴性 ,P53 蛋白在大肠癌组织中表达阳性率为 5 3 13%。P53 蛋白在大肠癌组织中的表达与患者的性别、年龄、肿瘤大小、部位、大体分型、浸润深度、组织学类型、Ducks’分期及局部淋巴结转移无明显关系 (P >0 .0 5 )。P53 蛋白表达与大肠癌伴肝转移相关 (P <0 .0 5 )。结论　P53 蛋白在大肠癌组织中表达阳性 ,尤以伴肝转移者为著。p53 蛋白过度表达提示预后不良。     

IRX2基因在原发性肝癌中表达的初步研究

目的 检测易洛魁族同源盒基因(IRX2)在原发性肝癌(HCC)组织中的表达及其临床意义.方法 收集手术切除的HCC组织标本及癌旁组织标本,采用实时荧光定量PCR和Western blotting检测IRX2在肝癌组织及相应癌旁组织的表达情况.采用免疫组化法分析IRX2蛋白在肝癌组织和癌旁组织中的表达及定位.比较高、中、低分化肝癌组织中IRX2蛋白表达与肝癌临床病理分期之间的关系.结果 80％(16/20)的肝癌组织中,IRX2 mRNA的表达量低于癌旁组织(P=0.04);IRX2蛋白在肝癌组织中的相对表达量(0.866)低于癌旁组织(1.803,P=0.009).随着肝癌分化程度的降低,IRX2蛋白表达量也随之降低,差异有统计学意义(P=0.001).进一步研究发现,高分化与低分化肝癌组织,中分化与低分化肝癌组织中IRX2蛋白的表达差异有统计学意义(P=0.006,P=0.001),而中分化与高分化组织IRX2蛋白表达差异无统计学意义(P=0.539).结论 HCC组织中IRX2的表达水平低于癌旁组织,IRX2的异常表达与HCC的分化程度有关.     

HER-2、Syk在胃癌中的表达及其临床意义

 目的 探讨人表皮生长因子受体2(human epidermal growth factor receptor 2, HER-2)、脾酪氨酸激酶(spleen tyrosine kinase, Syk)在胃癌中的表达及与胃癌的相关关系.方法 采用反转录-聚合酶链反应(RT-PCR)和SP免疫组化技术,检测62例胃癌及癌旁组织中HER-2、Syk表达状况,与胃癌临床病理检测结果进行相关性统计分析.结果 胃癌组织中HER-2 mRNA、HER-2蛋白阳性率分别是11.29%和30.65%,均高于癌旁组织(P＜0.05);Syk mRNA、Syk蛋白阳性率分别为27.42%和22.58%,均低于癌旁组织(P＜0.05).淋巴结转移的胃癌组织中,HER-2 mRNA、HER-2蛋白阳性表达率均高于无淋巴结转移组(P＜0.05),Syk mRNA、Syk蛋白阳性表达率均低于无淋巴结转移组(P＜0.05).HER-2表达与胃癌患病年龄、性别、肿瘤大小、部位均无相关性(P＞0.05),与肿瘤浸润深度、病理分期相关(P＜0.05),Syk表达与胃癌上述临床病理结果均无相关性(P＞0.05).HER-2蛋白与Syk蛋白在胃癌组织中的表达呈负相关.结论 胃癌发生和转移与HER-2表达和Syk表达密切相关.检测HER-2、Syk对胃癌的治疗及其预后评估具有指导意义.     

Mistakes in the diagnosis and treatment of the complete dislocation and fractures of the acromial end of the clavicle

The analysis of the mistakes in the operative treatment of the sick with such a trauma was conducted. Two typical examples were given. The mistakes were stipulated non-diagnosis of the simultaneous break of the coracoclavicular ligament and not taking measures for its recovery. The radiodiagnosis based on N. Z. Shmidt's method is considered to be inevitable for this category of the sick. After the confirmation of the diagnosis the operation of choice can be the operation of Yotkins-Leochuk for the sick with the complete dislocation of the acromial end of the clavicle, and the operation of Yotkins for the sick with fractures of the acromial end of the clavicle with the break of the coracoclavicular ligament. By means of these methods 43 sick men with the dislocation and 7 sick men with fractures of the acromial end of the clavicle have been operated since 1973. No cases had complications, relapses or unsatisfactory results.     

Quantitative evaluation of the echo intensity of the median nerve and flexor muscles of the forearm in the young and the elderly

Objectives

Musculoskeletal structures often appear brighter on imaging in the elderly, which makes it difficult to accurately delineate a peripheral nerve during ultrasound-guided regional anaesthetic procedures. The echo intensity of skeletal muscles is significantly increased in the elderly. However, there are no data comparing the echo intensity of peripheral nerves in the young and the elderly, which this study was designed to evaluate.

Methods

13 healthy, young volunteers (aged <30 years) and 11 elderly patients (aged >60 years) who were scheduled to undergo orthopaedic lower limb surgery were recruited. The settings of the ultrasound system were standardised and a high-frequency linear array transducer was used for the scan. A transverse scan of the median nerve (MN) and the flexor muscles (FMs) at the left mid-forearm was performed and three video loops of the ultrasound scan were recorded for each subject. Still images were captured from the video loops and normalised. Computer-assisted greyscale analysis was then performed on these images to determine the echo intensity of the MN and the FMs of the forearm.

Results

The echo intensity of the MN and FMs of the mid-forearm was significantly increased in the elderly (p<0.005). There was also a reduction in contrast between the MN and the adjoining FM in the elderly (p=0.04).

Conclusion

Under the conditions of this study, the MN and the FMs in the forearm appeared significantly brighter than those in the young, and there was a loss of contrast between these structures in sonograms of the elderly.Recently, there has been an increase in interest in the use of ultrasound to guide peripheral nerve blocks [1-3]. We have observed during such procedures that musculoskeletal structures often appear significantly brighter and that there is loss of contrast between the nerve and its adjoining muscles in the elderly, which often makes it difficult to accurately delineate a peripheral nerve using ultrasound in this age group. There are published data showing that the echo intensity (EI) of skeletal muscles is significantly increased in the elderly [4]. However, there are no data comparing the EI of a peripheral nerve in the young and the elderly, which this study was designed to evaluate.     

Sonography of the wrist and the hand

Sonographic examination of the hand requires high-frequency linear transducers. As the relevant structures are located very close to the surface, water stand-off pads are mandatory. Owing to the high sensitivity of sonography in the detection of fluid, exudative synovitis, tenosynovitis and ganglia can be easily diagnosed. Sonographic information on muscle atrophy and alterations of the shape and echogenicity of the median nerve in patients with carpal tunnel syndrome may be useful in evaluating the extent of disease. Further indications for the sonographic examination of the hand include suspected tumors, foreign bodies and synovial proliferation. Osseous destruction can be visualized in patients with rheumatoid disease, but the precise extent is hard to determine.     

Aspects of the venous drainage of the pons and the mesencephalon

Summary After a brief resumé of the morphology of the pontomesencephalic veins, the authors demonstrate the drainage dynamics of these veins in normal and pathlogical vertebral angio-seriograms. The repercussions of drainage impairment are illustrated.

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Untersuchungen über die Venen-Drainage von Pons und Mesencephalon

Zusammenfassung Nach kurzer Beschreibung der Morphologie der pontomesencephalen Venen wird die Drainagedynamik dieser Venen anhand normaler und pathologischer Vertebralisangiogramme demonstriert. Die unterschiedlichen Mechanismen einer Drainagebehinderung werden erläutert.

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A propos du drainage veineux du pont et du mésencéphale

Résumé Après un bref résumé de la morphologie des veines ponto-mésencéphalques, les auteurs décrivent les modalités de drainage de ces veines en sérioangiographie vertébrale normale et pathologique. Ils illustrent les répercussions de drainage défectueux.

     

高原彝汉成年人血红蛋白、红细胞值调查分析

目的了解高原地区彝汉成年人血红蛋白、红细胞及相关指标的基础水平，探讨其与国家参考值指标是否存在差异。方法选择健康成人规范采集静脉血，用美国COULTERAC·Tdiff2血球分析仪检测，对数据进行统计学处理。结果川西南高原彝汉成人的血红蛋白、红细胞水平及相关指标与国家参考值比较差异有非常显著的意义，P〈0．001；当地彝汉民族比较差异无显著意义，P〉0．05。结论有必要制定高原地区成人血红蛋白、红细胞及相关指标的正常参考值，为临床提供更科学实际的参考依据。     

MR imaging of the major nerves about the elbow: cadaveric study examining the effect of flexion and extension of the elbow and pronation and supination of the forearm

Magnetic resonance (MR) imaging provides useful information in the evaluation of peripheral nerves. Recent advances in MR imaging allow for detailed depiction of the soft tissue structures of the elbow joint. Three major nerves are present about the elbow. Six cadaveric elbows were imaged to depict the normal anatomy of these nerves and to determine the best plane and position of the elbow for optimal visualization of each nerve. Axial images of the elbow in full extension with the forearm in supination allow identification of all major nerves. Axial images with the elbow in full flexion allow accurate assessment of the cubital tunnel and the ulner nerve. Axial images of the elbow in full extension with the forearm in pronation are helpful for assessment of the median and radial nerves in the forearm.