彩色多普勒血流显像与彩色多普勒能量图在恶性滋养细胞肿瘤的应用

目的探讨彩色多普勒血流显像(CDFI)及彩色多普勒能量图(CDE)在恶性滋养细胞肿瘤(GTD)早期诊断及化疗监测中的应用价值.方法对20例GTD进行CDFI、CDE检测,观察其血流情况及用PD检测病变区血流速度,测算RI值.结果CDFI显示病变区血流异常丰富,CDE显示更丰富的血流信号.PD检测出低阻血流,RI=0.41±0.07,化疗前后相比CDFI、CDE和PD改变明显,RI值差异有非常显著性意义(p<0.01).结论CDFI、CDE对恶性滋养细胞肿瘤诊断及观察疗效均有十分重要的价值.     

血绒毛膜促性腺激素与彩色多普勒血流显像在恶性滋养细胞肿瘤…

用彩色多普勒血流显像(CDFI)与放射免疫分析(RIA)技术检测绒毛膜促性腺激素(β-HCG)均为近年来应用于临床的检测手段.我院将两者联合应用于恶性滋养细胞肿瘤的诊断及化疗后的疗效观察,旨在探讨其在鉴别良、恶性滋养细胞肿瘤的价值以及化疗后的疗效评价. 资料与方法 1 一般情况 选自1995年1月至1998年6月我院住院恶性滋养细胞肿瘤患者共32例作为观察组(以下简称观察组),其中侵蚀性葡萄胎20例,绒癌12例.年龄19～45岁.所有病例均在入院后及每次化疗后测血β-HCG并作CDFI检查.以同期住院的20例良性葡萄胎作为对照.     

彩色多普勒血流显像诊断膀胱癌

膀胱肿瘤是泌尿系统最常见的肿瘤之一,男性多于女性.临床症状多为无痛性血尿,早期诊断较困难,晚期出现尿频、尿急、尿痛和排尿困难.笔者报道应用彩色多普勒血流显像（color Doppler flow imaging,CDFI）检测膀胱癌血流信号,以便为临床早期诊断提供依据.     

经直肠彩色多普勒血流显像诊断前列腺纤维化的价值

1　资料与方法1.1　一般资料112例来自我院 1997年 3月至 2 0 0 2年 9月门诊或住院的患者。前列腺增生患者共 6 9例 ,均有夜尿增多、尿频、尿急、尿末滴沥、排尿费力或困难、尿不尽等不同程度临床症状 ,病程 5～ 35年不等。经肛门指检 ,其中 5 5例〔年龄 38～ 80岁 ,平均 (5 9.4 5±7.76 )岁〕前列腺增大明显 ;另 14例〔年龄 4 4～ 71岁 ,平均 (5 4.79± 6 .4 0 )岁〕前列腺大小基本正常 ,拟诊前列腺纤维化 (后经超声引导下会阴部穿刺活检证实 )。 4 3例正常对照组病例〔年龄 2 5～ 5 9岁 ,平均(4 0 .87± 8.31)岁〕随机选取无前列腺疾病自…     

彩色多普勒能量图检测子宫内膜血流评价IVF-ET结局研究进展

子宫内膜的容受性抑制是辅助生育技术方面的研究热点。既往采用检测雌激素、孕激素以及部分已知与子宫内膜容受性相关因子来评价,但是这类检测方式有创且耗时长,评价IVF-ET结局价值有限。彩色多普勒能量图是一种高敏感度的彩色超声,可高质量的实现器官组织血流灌注的彩色显像。本次研究在分析子宫内膜容受性的基础上,对彩色多普勒能量图检测子宫内膜血流评价IVF-ET结局的相关研究进行综述,旨在为IVF-ET结局的改善提供一定参考。     

胎儿心脏三尖瓣返流的彩色多普勒血流显像检测

目的 探讨胎心三尖瓣返流的原因与临床价值。方法 应用彩色多普勒血流显像对21例胎心三尖瓣返流进行了检测，观察胎心结构、返流信号分布、测量最大返流速度。结果 21例胎心三尖瓣返流的原因为：先心病组6例，均显示心内结构异常；非先心病组15例，4例表现右心扩大，无心内结构畸形；两组返流速度无显差异（P＞0．05）。结论 先心病引导的三尖瓣返流是因心脏结构异常所致，非先心病性三尖瓣返流主要由于胎心右室功能不良引起。当检出三尖瓣返流时，应进一步追踪扫查心内结构有无畸形，在排除先心病之后即应提示心脏负荷增加，若伴有右心腔扩大则是发生心力衰竭的佐证。     

彩色多普勒和三维能量血流成像在原发肝癌中的应用价值

探讨彩色多普勒及三维能量血流成像在原发生肝癌中的应用价值。方法 42例原发肝癌肿瘤血供特征进行了检测，23例进行了选择性肝动脉造影。结果：彩色能量多普勒（CDE）显示肿瘤血流明显高于彩色多普勒（CDFI），三维能量血流成像（3DCPA）能显示立体血流分布图，与肝动脉造影有相同的血流分布特征和意义。结论 彩色多普勒及三维能量血流成像能直观地表现肝癌肿瘤血流分布状态，且灵敏度高，重复性好，值得临床推广应用。     

胎儿心脏三尖瓣返流的彩色多普勒血流显像检测

目的　探讨胎心三尖瓣返流的原因与临床价值。方法　应用彩色多普勒血流显像对 2 1例胎心三尖瓣返流进行了检测 ,观察胎心结构、返流信号分布、测量最大返流速度。结果　 2 1例胎心三尖瓣返流的原因为 :先心病组 6例 ,均显示心内结构异常 ;非先心病组 15例 ,4例表现右心扩大 ,无心内结构畸形 ;两组返流速度无显著差异 (P >0 .0 5 )。结论　先心病引导的三尖瓣返流是因心脏结构异常所致 ,非先心病性三尖瓣返流主要由于胎心右室功能不良引起。当检出三尖瓣返流时 ,应进一步追踪扫查心内结构有无畸形 ,在排除先心病之后即应提示心脏负荷增加 ,若伴有右心腔扩大则是发生心力衰竭的佐证     

彩色多普勒和三维能量血流成像在原发肝癌中的应用价值

探讨彩色多普勒及三维能量血流成像在原发性肝癌中的应用价值。方法　 42例原发肝癌肿瘤血供特征进行了检测 ,2 3例进行了选择性肝动脉造影。结果 :彩色能量多普勒 (CDE)显示肿瘤血流明显高于彩色多普勒 (CDFI) ,三维能量血流成像 (3DCPA)能显示立体血流分布图 ,与肝动脉造影有相同的血流分布特征和意义。结论　彩色多普勒及三维能量血流成像能直观地表现肝癌肿瘤血流分布状态 ,且灵敏度高 ,重复性好 ,值得临床推广应用。     

Fas-Fas Ligand System-Induced Apoptosis in Human Placenta and Gestational Trophoblastic Disease

PROBLEM: Previous studies demonstrated that unique tissue-specific antigens expressed on vascular endothelial cells can serve as immunogens, and the apparent association between transplant rejection and antiendothelial cell (EC) antibodies is well established. A common feature of some placentas from women with recurrent pregnancy loss is the diffuse formation of microthrombi associated with changes in thromboresistant properties of endothelial cells, similar to the findings in rejected organs. Therefore, the prevalence of anti-EC antibodies in patients with recurrent pregnancy loss and the role of these antibodies in cultured human endothelial cells from umbilical cord vein were studied. METHOD OF STUDY: To evaluate the frequency of anti-EC antibodies, sera from 160 nonpregnant patients with recurrent pregnancy loss after absorption with pooled platelets and pooled leukocytes were tested using cultured human umbilical cord vein endothelial cells (HUVEC) by flow cytometry. To study the role of anti-EC antibodies, purified anti-EC IgGs were added to HUVEC cultures and hemostatic, fibrinolytic, and anticoagulation pathway markers (tissue factor, tissue plasminogen activator, palsminogen-activator inhibitor, thrombomodulin, heparan-sulfate proteoglican, antithrombin III, von Willebrand factor, CD54, human leukocyte antigens-DR, and transferin receptor) were detected by specific antibodies and flow cytometry. Immunoblotting analyses were done by using purified anti-EC IgGs against cell membrane proteins from endothelial cells and leukocytes extracted by detergent solubilization. RESULTS: Thirty-nine (24%) of the patients were positive for EC antibodies. Antipaternal lymphocyte antibodies were tested as well and were found in 37 (23%) of the patients as 25 sera (15.6%) showed reactivity with both EC and lymphocytes. Certain patient sera were reactive with HUVEC lines from some but not other umbilical cords, which suggests allotype Sera from 70 normal healthy male and nonpregnant female controls did not react with any of the individual HUVEC lines used. The purified anti-EC immunoglobulin G (IgGs) recognized bands, from HUVEC surface membrane protein preparations, with molecular weights of 120 kDa. Both hemostatic and fibrinolytic pathway markers were found activated in the presence of anti-EC IgGs, suggesting an altered endothelial cell surface activation state. CONCLUSIONS: The results indicate that anti-EC antibody is another marker for a subset of recurrent spontaneous aborters who may have activation of hemostasis and fibrinolysis as a mechanism involved in their losses.     

彩色多普勒超声在男性乳腺疾病中的应用价值

目的探讨高频彩色多普勒超声在男性乳腺疾病中的应用价值。方法回顾性分析经手术病理证实的3例男性乳腺癌、20例男性乳腺增生患者的二维及CDFI超声图像。结果 3例乳腺癌表现为乳腺内实性肿块,质硬,边界不清,2例可见微钙化,3例周边或内部可探及血流信号,为Ⅱ级;20例男性乳腺发育表现为乳晕下方低回声,质软,与周围腺体相延续,2例周边可探及血流信号,为Ⅰ级。结论高频彩色多普勒超声在男性乳腺疾病诊断及鉴别诊断中具有重要实用价值。     

p21-Activated Kinase-1 Promotes Aggressive Phenotype,Cell Proliferation,and Invasion in Gestational Trophoblastic Disease

Gestational trophoblastic disease (GTD) includes hydatidiform mole (HM), which can develop persistent gestational trophoblastic neoplasia requiring chemotherapy; choriocarcinoma, which is a frankly malignant tumor; placental site trophoblastic tumor; and epithelioid trophoblastic tumor. p21-Activated kinases (PAKs) promote malignant tumor progression. Therefore, this study investigated PAK1, PAK2, and p-PAK2 Ser²⁰ in the pathogenesis of GTD. By real-time PCR, PAK1 mRNA was significantly higher in HMs, particularly metastatic HMs (P = 0.046) and HMs that developed persistent disease (P = 0.011), when compared with normal placentas. By immunohistochemistry, significantly increased cytoplasmic PAK1 immunoreactivity in cytotrophoblasts was also detected in HMs (P = 0.042) and choriocarcinomas (P = 0.003). In addition, HMs that developed persistent disease displayed higher PAK1 immunoreactivity than those that regressed (P = 0.016), and elevated PAK1 immunoreactivity was observed in placental site trophoblastic tumors. Indeed, there was significant positive correlation between PAK1 expression and the proliferative indices Ki-67 (P = 0.016) and MCM7 (P = 0.026). Moreover, higher PAK1 mRNA and protein expression was confirmed in the choriocarcinoma cell-lines JEG-3 and JAR; however, PAK2 mRNA and p-PAK2 immunoreactivity showed a similar expression pattern in normal first trimester placentas and GTD. Knockdown of PAK1 in JEG-3 and JAR reduced cell proliferation, migration, and invasion ability, up-regulated p16, and down-regulated vascular endothelial growth factor and MT1-MMP expression. This is the first report revealing the involvement of PAK1 in the pathogenesis and clinical progress of GTD.Gestational trophoblastic disease (GTD) is a disease of the placenta resulting from abnormal trophoblastic proliferation. It encompasses hydatidiform mole (HM), choriocarcinoma (CCA), placental site trophoblastic tumor (PSTT), and epithelioid trophoblastic tumor. The latter three are malignant tumors, whereas HMs are nonneoplastic lesions with an increased risk of malignant transformation. Furthermore, 8% to 30% of HMs may persist after suction evacuation and develop gestational trophoblastic neoplasia (GTN), hence requiring chemotherapy. Although the response of GTD to chemotherapy is in general very good, chemoresistant cases still exist despite advances in chemotherapy. While there is growing understanding in the molecular biology of GTD, the precise molecular pathways of its development should be further explored.^1,2,3p21-Activated kinases (PAKs) were initially discovered as effector molecules of Rho GTPases, Rac, and CDC42,⁴ and are increasingly recognized as important mediators for a wide variety of cellular functions, including cell morphogenesis, motility, mitosis, apoptosis, and angiogenesis.^5,6 PAKs have been divided into group I (PAKs1-3) and group II (PAKs4-6), bases on structural organization and mode of regulation.⁵ In group I PAKs, the p21-binding domain in the N-terminal domain binds small GTPases Rac and CDC42 to cause autophosphorylation of certain sites in the N-terminal inhibitory domain, leading to conformational change that releases the auto-inhibition and activates the kinase activity.⁵ Phosphorylation of PAK1 at Ser²¹ regulates the binding of PAK1 to Nck, resulting in PAK1 cycling between membrane and cytosol and finally facilitates cell migration.^7,8 Its corresponding phosphorylation site at PAK2 is Ser²⁰.Overexpression of PAK1 has been observed in various human cancers,⁶ such as breast, colorectal, and ovarian cancers.⁹ PAK1 was found to regulate the invasiveness of breast cancer cells and the malignant progression of colorectal carcinomas to metastasis.^10,11 PAK2 has also been found to be involved in Rac3-mediated breast cancer cell proliferation.¹² The recent development of kinase inhibitors for the PAK family molecules^13,14 is intriguing since they may be explored as potential therapeutic targets in chemoresistant GTD.In this study, we investigated the expression and localization of PAK1, PAK2, and p-PAK2 Ser²⁰ in normal human placenta and in GTD to determine whether PAK1 or PAK2 are involved in development and malignant progression of GTD. We also correlated their expression with clinical outcome and examined the in vitro effects and potential downstream targets of PAK1 on CCA cells.     

脉动流下超声血流彩色声像与声谱图的模拟研究

我们以颈动脉分支为例,采用血流动力学计算机模拟方法,根据可信的血管轮廓、血流脉动数据及体内情况,仿真出血流彩色声像图和某处脉冲多普勒声谱图.模拟结果对流场的各参数和分布描述更加准确,对仪器测量是有效的验证和有益补充.本研究的方法可用以血管血流异常的计算机辅助诊断,也为相关仪器开发提供了详细、接近真实的数据源.     

The HL-A and ABO Antigens in Trophoblastic Disease

No statistically significant deviations in phenotype frequencies of the 25 HL-A antigens or the ABO antigens were seen when 111 Caucasian patients with trophoblastic disease were compared with 1,259 healthy Caucasian controls. However, an increasein the incidence of HL-A11 was found in 39 patients who currently had the disease, but not in 72 who had recovered from the disease. Further, an increase in the frequency of W18 was observed among 18 patients who currently had 'invasive' disease (choriocarcinoma or invasive mole), but not in 44 who had recovered from such disease. If valid for larger patient population, these increases may suggest association of HL-A11 and W18 with the 'morbidity' of the trophoblastic disease. No increase in histocompatibility was seen in 45 patient-couples over 67 control-couples in terms of decrease in the number of male spouse's HL-A incompatibilities, and no significant difference was seen in the distribution of pregnancies in the two groups. No significant difference was observed in the incidence of different male-female combinations of ABO blood groups between 95 patient-couples and an equal number of control-couples. Lymphocytotoxic antibodies were found in 64 patients (158 sera) or 36% of the 178 patients (413 sera) examined. HL-A specific antibodies were found in 30 or 17% patients (39 sera). Of these 30, 24 patients had molar pregnancies and six had choriocarcinoma. Whether these antibodies have a role in the destruction of neoplastic tissue remains to be determined.     

Detection of Early Pregnancy Factor-Like Activity in Women With Gestational Trophoblastic Tumors

ABSTRACT: The presence of immunosuppressive early pregnancy factor (EPF) in the maternal serum has so far been associated with gestation. Its presence in the serum of women with gestational trophoblastic tumors was investigated. The results indicate that while EPF activity was detected in the serum of women with choriocarcinoma, no such activity was detected in the serum of women with hydatidiform mole, leading to the novel use of EPF as a marker to distinguish these two clinical situations. Results of the experiments also suggest that EPF moiety present in the maternal serum during pregnancy may be of different molecular entity than that present in the serum of women with choriocarcinoma.     

乳腺病的彩色多普勒超声研究

目的：观察和探讨彩色多普勒超声在乳腺病诊断中的应用价值。方法按年龄将所有患者分成三组，并分析三组患者之间出现不同乳腺病的概率。结果不同年龄层的女性患乳腺疾病的种类不同，其中20~29岁的女性患乳腺纤维腺瘤的发病率较高，而30~39岁的女性乳腺增生症的发病率明显高于其他年龄层。结论彩色多普勒超声诊断乳腺病患者价值明显，并且其在鉴别良恶性肿瘤方面有其显著的优势，所以值得在临床上推广应用。