外周性面神经麻痹病例的残存神经纤维数目与预后

作者对三例面神经麻痹病例在行面神经减压术时取面神经颞骨外耳郭神经制成病理标本,在光学显微镜400倍下观察时,于目镜筒中放入5×5mm的圆板,计算此面积内神经纤维的数目,正常者之横断面平均190根,纵断面平均25根。面神经麻痹的临床评价按面部表情的十种动作评分,每项正常者4分,不全麻痹者2分,重度麻痹者0分。例1左侧贝尔氏麻痹之15岁男孩,临床评价为0分。病后2个月行面神经减压术:面神经水平部到茎乳孔之间神经鞘膜增厚,纵行切开鞘膜,看到出血,内部的神经束呈少量稀糊感。取耳郭神经制成标本,横断面上在鞘膜附近有散在     

膝状神经节切除与否与面神经再生关系的实验性研究

目前，有关面神经损伤后，副交感纤维和味觉系统的再生情况，以及它们的再生是否影响运动纤维再生，尚无研究证明。为探讨面神经损伤后再生与膝状神经节切除与否的相关性，该作者进行了动物实验研究。 方法：将23只新西兰成年白化病兔子(性别不限，体重2.5～3.2kg)，随机分为2组。所有动物均切除2mm面神经鼓室段，移植耳大神经衔接断端。组1(10……     

膝状神经节切除与否与面神经再生关系的实验性研究

目前 ,有关面神经损伤后 ,副交感纤维和味觉系统的再生情况 ,以及它们的再生是否影响运动纤维再生 ,尚无研究证明。为探讨面神经损伤后再生与膝状神经节切除与否的相关性 ,该作者进行了动物实验研究。方法 :将 2 3只新西兰成年白化病兔子 (性别不限 ,体重 2 .5～ 3.2 kg) ,随机分为 2组。所有动物均切除2 mm面神经鼓室段 ,移植耳大神经衔接断端。组 1(10只兔子 )保留膝状神经节 ,组 2 (13只兔子 )切除膝状神经节。 3个月后取面神经乳突段和颞外段进行组织学检查。结果 :正常面神经有髓纤维均匀分布 ,髓鞘厚度与轴索直径保持一定比例。平均纤…     

面神经电图与致瘫疾病和病程的关系

面神经电图 (ｅｌｅｃｔｒｏｎｅｕｒｏｇｒａｐｈｙ,ＥＮｏＧ)是一种客观评价面神经功能的方法 ,对面瘫早期的功能测试及评估预后有帮助。一、对象和方法总结 1993年 6月～ 1998年 4月面瘫患者 80例所作ＥＮｏＧ的结果。其中男5 5例 ,女 2 5例 ;年龄 6～ 80岁 ,青壮年(2 1～ 4 0岁 )共 3 8例 ,占总数的 4 8%。面瘫 2周内来诊者占 5 6%。致瘫疾病中Ｂｅｌｌ麻痹 3 5例 ,耳带状疱疹 2 1例 ,头外伤 16例 ,中耳炎 4例 ,中耳癌 3例 ,先天性胆脂瘤 1例。使用ＤａｎｔｅｃＥｖｏｍａｔｉｃ80 0 0型电生理仪测试 ,患者平卧 ,采用针电极 ,正极置鼻唇…     

面神经乳突段修复术后再生纤维三维构筑特点与功能恢复的关系

目的:研究端-端吻合术和耳大神经移植术修复面神经乳突段后再生纤维三维构筑特点与功能恢复的关系。方法:新西兰大白兔30只,随机分为端-端吻合组和耳大神经移植组,每组15只。对2组动物左侧耳分别实施面神经乳突段端-端吻合术或耳大神经移植术后30d、90d和120d检测肌电图,取双侧面神经乳突段及周围颞骨,脱钙,石蜡包埋,制作6μm连续切片后,利用Mimics 12.0软件重建显示再生神经的空间构筑。结果:2组动物比较再生纤维只有30d时差异有统计学意义,肌电图振幅30d和90d差异有统计学意义,三维重建结果显示随时间延长再生神经纤维髓鞘逐渐增厚、上下对接增多并聚集成簇。结论:不同修复术后面神经乳突段再生纤维三维构筑特点与功能逐渐恢复的趋势在时间上相应,但又不是完全一致。     

黑猩猩动物模型的鼻中隔切除与颅面发育:与腭裂手术的关系

关于鼻中隔软骨对面中部发育的作用,人们曾作过大量动物研究,多数均认为,当行腭裂重建术时应避免切除软骨,否则将继发面部发育迟缓。但过去皆用非灵长类做动物模型,而用与人接近的狒狒作实验,得出了下列结论:①象非灵长类那样,早期(3～4月龄)完全切除中隔软骨可致切牙骨发育明显迟缓;②狒狒完成面部发育比鼠、兔要经过更长时间(7年),这就让软骨得以再生,另外因还保留一个相当长的生长期,使动物在几年中又恢复了面部的正常生长速度。过去主张对生长期病人作中隔手术持保守态度,主要是根据非灵长类的实验结果。作者们认     

缝隙连接蛋白43和E-钙黏附素表达与喉癌生物学行为关系的研究

目的　研究缝隙连接蛋白基因 4 3(connexin4 3,Cx4 3)和E 钙黏附素 (E cadherin ,E cad)在喉癌组织中的表达与其生物学行为的关系 ,探讨喉癌发生、发展的机制。方法　应用免疫组织化学PicTureTM二步法 ,检测有 5年以上随访资料的 6 0例喉癌组织和 10例癌周正常喉组织中Cx4 3和E cad的表达 ,结果进行统计学处理。结果　Cx4 3和E cad蛋白主要定位于细胞膜上 ,10例癌周正常喉黏膜组织均呈阳性表达。 6 0例喉癌患者中 ,70 0 % (4 2 / 6 0例 )的喉癌Cx4 3呈阳性表达 ,按喉癌的临床分期、颈部淋巴结转移、喉癌复发情况分组差异有显著性意义 (χ2 =5 11、6 4 1、3 86 ,P值均 <0 0 5 ) ,与喉癌的组织学分级差异有极显著性 (χ2 =15 0 9,P <0 0 1) ,与喉癌患者的生存期无统计学意义 (χ2 =2 6 5 ,P >0 0 5 ) ;4 1 7% (2 5 / 6 0例 )的喉癌组织中E cad表达减低 ,按喉癌的临床分期、喉癌复发情况分组及生存期分组差异有显著性意义 (χ2 =6 0 9、5 35、5 14 ,P值均 <0 0 5 ) ,与喉癌的组织学分级、颈部淋巴结转移差异有极显著性意义 (χ2 =15 0 7、6 6 5 ,P均值 <0 0 1)。同一标本中Cx4 3和E cad基因表达有显著的相关性和一致性 (r=0 6 3,P <0 0 0 0 1)。结论　喉癌存在Cx4 3和E cad基因的失活及蛋     

缝隙连接蛋白43和E-钙黏附素表达与喉癌生物学行为关系的研究

OBJECTIVE: To investigate expression of connexin43 (Cx43) and E-cadherin (E-cad) and its relationship with the biological behavior in Laryngeal carcinomas. METHODS: Immunohistochemistry staining (PicTure two steps method) was used to detect connexin 43 and E-cadherin expression in 60 paraffin-embedded laryngeal carcinomas and 10 normal epithelia around tumors. All the patients were followed up more than five years. RESULTS: Cx43 and E-cad were expressed by normal epithelia with typical membranous staining 10 normal epithelia strongly expressed Cx43 and E-cad. The reduction rate of Cx43 expression in laryngeal carcinomas was 30.0%. The significant relationship was observed between low Cx43 expression and differentiation, lymph node metastasis and recurrence (chi2 = 15.09, 6.41, 3.86, P < 0.01, 0.05, 0.05), but there was no significance between low Cx43 expression and prognosis (chi2 = 2.65, P > 0.05). 41.7% laryngeal carcinoma showed reduced or no expression of E-cad. Tumor cell dedifferentiation correlated with reduced expression for E-cad (chi2 = 15.07, P < 0.01). Absent or low E-cad expression was observed more frequently in patients with local recurrence and lymph node metastasis and with less than 5-year survival period (chi2 = 5.35, 6.65, 5.14; P < 0.05, 0.01, 0.05). There was a positive relationship between the expression of Cx43 and E-cad in same sample (r = 0.63, P < 0.0001). CONCLUSIONS: Laryngeal cancer presented inactivation of Cx43 gene and E-cad gene and down regulation of Cx43 and E-cad proteins. The level of Cx43 and E-cad may be a sensitive predictor of differentiation, invasion, lymph node metastasis and recurrence. E-cad is also a prognostic factor for patients with laryngeal cancer.     

应用组织芯片探讨纤维连接蛋白和抑癌基因p53以及Ezrin表达与喉癌生物学行为的关系

目的探讨纤维连接蛋白(fibronectin,Fn)、抑癌基因p53和p81(Ezrin蛋白)在喉癌中表达,及其与喉癌流行病史、病理学分级、临床TNM分期和预后等生物学行为的关系. 方法应用组织芯片技术进行免疫组织化学链霉抗生物素蛋白-过氧化物酶连接法(streptavidin-peroxidase conjugated method,SP法)染色检测1992～2000年中手术治疗的85例喉鳞状细胞癌中FN、p53和p81等因子的表达,结合临床相关因素进行统计分析. 结果 85例中6例的组织芯片样本中肿瘤细胞较少或无肿瘤细胞.Fn染色70例中38例为阴性或低度阳性,32例为强阳性,在肿瘤T分级中Fn表达有统计学差异(P<0.05),患者吸烟、性别、年龄、肿瘤组织学分级、肿瘤临床分期、淋巴结转移、生存率等Fn表达无统计学差异.p81阳性细胞比率范0%-100%?～100%,平均53.7%,中位数58.7%,87.3%(69/79)有阳性表达.以中位数为界分为p81高、低表达组,两组T分级、临床早晚期、生存率有统计学差异(P<0.05),但与患者吸烟、性别、年龄、肿瘤组织学分级及淋巴结转移的差异无显著性(P>0.05).p53染色79例中37例阳性(46.8%),平均染色比率为21.6%,范围0～90.3%,中位数为5.9%.p53蛋白阳性表达与患者吸烟、性别、年龄、肿瘤组织学分级、淋巴节转移及生存率差异均无显著性(P>0.05). 结论组织微阵列是一种高效率的实验方法,具有快速、高通量、节约资源等特点.p81、FN表达与肿瘤的生长分化可能有关,进一步扩大样本验证后可作为临床预测预后重要参考指标.     

应用组织芯片探讨纤维连接蛋白和抑癌基因p53以及Ezrin表达与喉癌生物学行为的关系

OBJECTIVE: To evaluate the predictive role of fibronectin, p81 (Ezrin protein) and p53 gene in primary laryngeal carcinoma, it's relationship with epidemiology(smoking), histological grading, surgical treatment, TNM stage and prognosis were studied by the tissuechip technology. METHODS: The expression of fibronectin, p53 gene and p81 (Ezrin protein) on a series of 85 primary laryngeal carcinoma patients treated in our hospital between 1992 and 2000 was studied with tissuechip technology. The correlation of each score according to the intensity and percentage of labeled cells or intercellular substance with relevant clinical dada was statistically analyzed. RESULTS: Some cases were lost or boasted no tumor tissue in our tissuechip. Among the 70 cases available, 45.71% (32/70) of the specimens' basal membrane and extracellular matrix were strongly stained with fibronectin; there is statistical significance (P < 0.05) between primary tumor grading groups. Ezrin protein expressing rate is 87.3%, and the average percentage of its labeled cells is 53.68% (ranging from 0% to 100%, median is 58. 69%). There were significant difference between tumor grading groups, clinical early and late stages and 3-year survival rates (P < 0.05) after chi-square test. But no relation with smoking, gender, age and histological classes (P > 0.05). The average percentage of p53 positive cells is 21.6% (ranging from 0% to 90.3%, median is 5.85%) and 46.8% showed positive stains in our research. There was no statistical prominence in p53 protein demonstration between TNM stages, lymph node metastasis, 3-year survival rate, smoking, gender, age and histological classes (P > 0.05). CONCLUSIONS: The tissue microarray technique spent shorter time and less expense, and showed higher consistency in our essays. And the present study suggests fibronectin and p81 (Ezrin protein) could be the clinical discriminators in laryngeal carcinoma.