青春期乳房肥大症乳腺组织中芳香化酶P450 mRNA的表达

Objective To investigate the expression status of the P450arom mRNA in breast tissue of pubertal mammary hypertrophy and then explore the possible etiology of pubertal mammary hypertrophy. Methods 15 patients were selected for pubertal mammary hypertrophy group. Breast hypertrophy tissue specimens were collected from the gland excised during reduction mammaplasty. 15 patients with pathologically simple fibroadenoma were used as another control group. Patient approval of participation in this study was obtained preoperatively. The expression of P450arom mRNA was detected by RT-PCR in all the cases above. Results There was no significant difference between the pubertal mammary hypertrophy groups and normal groups on the expression rates of P450arom mRNA. But among the positive cases, the expression of P450arom mRNA within breast tissue were 0.202±0.048 in pubertal mammary hypertrophy group; and 0.159±0.068 in normal group. There was significant difference between the pubertal mammary hypertrophy and normal groups (P < 0.05). Conclusion The expression of P450arom mBNA in pubertal mammary hypertrophy are significantly higher than in normal mammary glandular tissue. The pubertal mammary hypertrophy may be related to the expression status of P450arom mRNA within breast tissue.     

增生性瘢痕组织中褪黑素受体的表达

Objective To investigate the expression and its significance of melatonin receptor in human hypertrophic scarring. Methods The expression of melatonin receptor GPR50 was detected with immunohistochemistiy and the melatonin receptors( MT1 、MT2)mRNA were assessed with RT-PCR method in 10 cases of human hypertrophic scar and normal skin. The positive production was sequenced with auto sequencing instrument. Results Positive signals of melatonin receptor could be found in the cell membrane and cytoplasm. The melatonin receptor GPR50 was located in the epithelial basal cells, sweat gland cells and hair follicle in both hypertrophic scar and normal skin. The melatonin receptor GPR50 was extensively expressed in fibroblasts of hypertrophic scar, but not in fibroblasts in normal skin. RT-PCR showed that the expression of melatonin receptor( MT1, MT2 ) mRNA in hypertrophic scar was significantly higher than that in normal skin( P <0. 05). In normal skin and hypertrophic scar group, the expression of MT1 mRNA was higher than MT2 mRNA ( P < 0. 05 ) . In normal skin and hypertrophic scar group, the expression of MT1 mRNA was 0.99081 ±0.26485 and 1.16584 ±0.21829 copy number/μl cDNA, respectively;the expression of MT2 mRNA was 0. 77083 ±0. 15927and 0. 99550 ±0. 14624 copy number/ μl cDNA, respectively. Sequencing results indicated that the positive product coincided with cDNA of human melatonin receptor in GeneBank. Conclusions Positive expression of melatonin receptor can be found in human hypertrophic scar and normal skin, but it is higher in scar. The over expression of melatonin receptor in hypertrophic scar may be related to the development of hypertrophic scar.     

增生性瘢痕组织中褪黑素受体的表达

Objective To investigate the expression and its significance of melatonin receptor in human hypertrophic scarring. Methods The expression of melatonin receptor GPR50 was detected with immunohistochemistiy and the melatonin receptors( MT1 、MT2)mRNA were assessed with RT-PCR method in 10 cases of human hypertrophic scar and normal skin. The positive production was sequenced with auto sequencing instrument. Results Positive signals of melatonin receptor could be found in the cell membrane and cytoplasm. The melatonin receptor GPR50 was located in the epithelial basal cells, sweat gland cells and hair follicle in both hypertrophic scar and normal skin. The melatonin receptor GPR50 was extensively expressed in fibroblasts of hypertrophic scar, but not in fibroblasts in normal skin. RT-PCR showed that the expression of melatonin receptor( MT1, MT2 ) mRNA in hypertrophic scar was significantly higher than that in normal skin( P <0. 05). In normal skin and hypertrophic scar group, the expression of MT1 mRNA was higher than MT2 mRNA ( P < 0. 05 ) . In normal skin and hypertrophic scar group, the expression of MT1 mRNA was 0.99081 ±0.26485 and 1.16584 ±0.21829 copy number/μl cDNA, respectively;the expression of MT2 mRNA was 0. 77083 ±0. 15927and 0. 99550 ±0. 14624 copy number/ μl cDNA, respectively. Sequencing results indicated that the positive product coincided with cDNA of human melatonin receptor in GeneBank. Conclusions Positive expression of melatonin receptor can be found in human hypertrophic scar and normal skin, but it is higher in scar. The over expression of melatonin receptor in hypertrophic scar may be related to the development of hypertrophic scar.     

CT尿路成像和IVU检查诊断泌尿系统疾病的比较研究

Objective The purpose of this study was to evaluate computed tomography urography (CTU) and compared with conventional intravenous urography (IVU) in diagnosis of urological disease. Methods One hundred and sixty-five patients with 111 males and 54 females underwent CTU urography including 78 cases underwent IVU were reviewed in this study. There were 12 cases underwent retrograde pyelography. There were 75 cases of nephrolithiasis and ureterolithiasis, 30 cases of ureteropelvic junction obstruction (UPJO), 30 cases of bladder cancer, 15 cases of pyelogenic cyst and parapelvic cyst, 9 cases of megaloureter and 6 cases of cancer in pelvis and ureter. Results The accuracy of diagnosis was 94.5% (156/165) in CTU group and 46.7% (42/90) in IVU group.The accuracy of diagnosis was 100.0% (75/75)of nephrolithiasis and ureterolith in CTU group and 78. 6%(33/42)in IVU group, 90.0% (27/30) of UPJO in CTU group, 100.0% (30/30) of bladder cancer in CTU group and 75.0%(9/12)in IVU group, 80.0%(12/15)of pyelogenic cyst and parapelvic cyst in CTU group, 100.0% (9/9)of megaloureter in CTU group, 100.0% (6/6)of cancer in pelvis and ureter in CT group. The displayed rate of the distal end of stenosis and obstruction was 79.4%(81/102)in CTU group and 25.0%(15/60)in IVU group. The examination time was (18.9±8.4)min in CTU group and (67.1±26.7)min in IVU group. Conclusion The CTU can provide more information than conventional IVU and can replace the IVU as routine examination in most cases.     

A型肉毒毒素局部应用对兔耳增生性瘢痕创面愈合和瘢痕增生的影响

Objective To investigate the effect of botulinum toxin type A (Botox A) injection on hypertrophic scar in rabbit ear model. Methods The hypertrophic scar model was established in 16 Japanese rabbits' ears. These wounds were divided into two groups as group T(treated with Botox A, n =48) and group S (not treated, n = 48). The wounds healing times and scar hypertrophy were observed with 8 specimen of normal skin at the rabbit ears as sham group B. HE stain was used to assess the hypertrophic index(HI). The expression of collagen Ⅰ and Ⅲ was tested by western-blot. The cell cycle of fibroblasts was studied by flow cytometry. Results The [] was significantly lower in group T than in group S(P < 0.01). The expression of collagen Ⅰ and Ⅲ, as well as the ratio of Ⅰ to Ⅲ, was markedly stronger in group S than in group T(P < 0.01). Compared with group T, more fibroblasts were in G2-M in gToup S and fewer in G0-G1 (P <0.05). Conclusions Local injection of Botox A can inhibite the formation of hypertrophic scar and the activity of fibroblasts in rabbit ear model. It can significantly decrease the expression of collagen Ⅰ and Ⅲ in hypertrophic scar, as well as the ratio of collagen Ⅰ to Ⅲ. It serves as the basis for the treatment of hypertrophic scar with Botox A.     

肉毒毒素A对大鼠皮肤及创面组织中SP、CGRP、TGF-β1和α-SMA的影响

Objective To investigate the effect of botulinum toxin type A (Botox A) injection on hypertrophic scar in rabbit ear model. Methods The hypertrophic scar model was established in 16 Japanese rabbits' ears. These wounds were divided into two groups as group T(treated with Botox A, n =48) and group S (not treated, n = 48). The wounds healing times and scar hypertrophy were observed with 8 specimen of normal skin at the rabbit ears as sham group B. HE stain was used to assess the hypertrophic index(HI). The expression of collagen Ⅰ and Ⅲ was tested by western-blot. The cell cycle of fibroblasts was studied by flow cytometry. Results The [] was significantly lower in group T than in group S(P < 0.01). The expression of collagen Ⅰ and Ⅲ, as well as the ratio of Ⅰ to Ⅲ, was markedly stronger in group S than in group T(P < 0.01). Compared with group T, more fibroblasts were in G2-M in gToup S and fewer in G0-G1 (P <0.05). Conclusions Local injection of Botox A can inhibite the formation of hypertrophic scar and the activity of fibroblasts in rabbit ear model. It can significantly decrease the expression of collagen Ⅰ and Ⅲ in hypertrophic scar, as well as the ratio of collagen Ⅰ to Ⅲ. It serves as the basis for the treatment of hypertrophic scar with Botox A.     

A型肉毒毒素局部应用对兔耳增生性瘢痕创面愈合和瘢痕增生的影响

Objective To investigate the effect of botulinum toxin type A (Botox A) injection on hypertrophic scar in rabbit ear model. Methods The hypertrophic scar model was established in 16 Japanese rabbits' ears. These wounds were divided into two groups as group T(treated with Botox A, n =48) and group S (not treated, n = 48). The wounds healing times and scar hypertrophy were observed with 8 specimen of normal skin at the rabbit ears as sham group B. HE stain was used to assess the hypertrophic index(HI). The expression of collagen Ⅰ and Ⅲ was tested by western-blot. The cell cycle of fibroblasts was studied by flow cytometry. Results The [] was significantly lower in group T than in group S(P < 0.01). The expression of collagen Ⅰ and Ⅲ, as well as the ratio of Ⅰ to Ⅲ, was markedly stronger in group S than in group T(P < 0.01). Compared with group T, more fibroblasts were in G2-M in gToup S and fewer in G0-G1 (P <0.05). Conclusions Local injection of Botox A can inhibite the formation of hypertrophic scar and the activity of fibroblasts in rabbit ear model. It can significantly decrease the expression of collagen Ⅰ and Ⅲ in hypertrophic scar, as well as the ratio of collagen Ⅰ to Ⅲ. It serves as the basis for the treatment of hypertrophic scar with Botox A.     

芳香化酶P450在肥大乳房乳腺组织中的表达

目的 探讨芳香化酶P450在肥大乳房乳腺组织中的表达情况.方法 采用免疫组织化学sP法,检测28例肥大乳房和12例正常体积乳房乳腺组织中芳香化酶P450的表达情况.并应用SPSS 13.0统计软件进行统计分析,组间比较采用Fisher精确概率检验.结果 在肥大乳房组28例患者中有11例呈芳香化酶阳性表达,阳性表达率39.29%;在正常体积乳房组12例患者中无芳香DOI:10.3760/cma.j.issn.1009-4598.2009.02.017化酶阳性表达,组间比较差异有统计学意义(P<0.05).腺性肥大组与脂性肥大组的芳香化酶阳性表达率比较差异无统计学意义(P>0.05).在分别按哺乳史和乳房肥大及下垂的程度的分组中,芳香化酶阳性表达率比较差异均无统计学意义(P>0.05).结论 芳香化酶P450在肥大乳房乳腺组织中存在过表达,可能参与肥大乳房的形成.     

雌激素受体亚型在肥大乳房乳腺组织中的表达及意义

目的:研究雌激素受体亚型α和β(ERα和ERβ)在肥大乳房乳腺组织中和正常体积乳房乳腺组织中的表达,探讨其在乳房肥大发病机制中的作用和意义.方法:采用免疫组织化学EnVision二步法,测定38例肥大乳房和17例正常体积乳房中ERα和ERβ的表达情况.结果:ERα在肥大乳房和正常体积乳房中的阳性表达率分别为97.37%和76.47%,两者比较差异具有统计学意义(P<0.05).ERβ在肥大乳房和正常体积乳房中的阳性表达率分别为89.47%和100%,两者比较差异无统计学意义(P>0.05).结论:乳房肥大的发生可能与乳腺组织中ERα含量升高有关,与ERβ无明显相关性.     

CyclinD1和P21在肥大乳房腺体组织中的表达及意义

目的：探讨肥大乳房中Cycl i nD1和P21的表达级意义。方法：采用免疫组化SP法,分别测定了34例腺性肥大乳房和30例正常体积乳房腺体中Cycl i nD1和P21的表达。结果：Cycl i nD1在34例肥大乳房中,阳性18例,阳性率52.94%;30例正常对照组中,全部表达阴性,阳性率0,两组间比较具有统计学意义（P〈0.05）。P21在34例肥大乳房中,3例阳性,阳性率8.82%;正常对照组30例,阳性9例,阳性率30.00%。两组间比较具有统计学意义（P〈0.05）。结论：乳房肥大的形成可能与Cycl i nD1增多和P21减少有关。     

乳腺癌组织AKIP1和P65的表达及其临床意义

【摘要】 目的 探讨乳腺癌组织中AKIP1和P65的表达及其临床意义。方法〓选择89例乳腺癌组织标本及60份癌旁组织,采用SP法免疫组化染色检测乳腺癌组织和癌旁组织的AKIP1和P65蛋白的表达;分析AKIP1和P65蛋白表达与乳腺癌组织生物学行为的相关性及乳腺癌组织中AKIP1和P65表达的相关性。结果〓乳腺癌组织中AKIP1的阳性表达率(56.2%)低于癌旁组织(93.3%,P<0.01),P65的阳性表达率(85.4%)高于癌旁组织(55.0%,P<0.01),乳腺癌组织中AKIP1和P65的表达呈现负相关关系(r=-0.704,P<0.01),不同病理分化和淋巴结转移乳腺癌组织中AKIP1和P65的表达存在明显差异(P<0.01)。结论〓乳腺癌组织中AKIP1失表达及P65过表达可能与乳腺癌的发生早及恶性高有关。     

COX-2、VEGF和E-cad在乳腺癌组织中的表达及临床病理意义

目的：探讨环氧化酶-2（COX-2）、血管内皮生长因子（VEGF）和E-钙黏附蛋白（E-cad）在乳腺癌组织中的表达及与临床病理特征之间的关系。方法：应用免疫组化S-P法检测30例乳腺单纯性增生、30例乳腺导管内癌、70例乳腺浸润性导管癌组织中COX-2、VEGF和E-cad的表达情况。结果：COX-2在乳腺单纯性增生、乳腺导管内癌、乳腺浸润性导管癌组织中的表达率分别为10.0%、46.6%、72.8%,乳腺单纯性增生与乳腺导管内癌、乳腺浸润性导管癌差异均有统计学意义（P〈0.01）;乳腺导管内癌与乳腺浸润性导管癌差异有统计学意义（P〈0.05）。VEGF在乳腺单纯性增生、乳腺导管内癌、乳腺浸润性导管癌组织中的表达率分别为3.3%、50.0%、65.7%,乳腺单纯性增生与乳腺导管内癌、乳腺浸润性导管癌相比差异均有统计学意义（P〈0.01）;乳腺导管内癌与乳腺浸润性导管癌差异无统计学意义（P〉0.05）。E-cad在乳腺单纯性增生、乳腺导管内癌、乳腺浸润性导管癌组织中的表达率分别为93.3%、43.30%、32.8%,乳腺单纯性增生与乳腺导管内癌、乳腺浸润性导管癌差异均有统计学意义（P〈0.01）;乳腺导管内癌与乳腺浸润性导管癌差异无统计学意义（P〉0.05）。COX-2在乳腺浸润性导管癌的阳性表达与淋巴结转移有关（P〈0.05）,与年龄、肿瘤大小、组织学分级无关（P〉0.05）。VEGF、E-cad在乳腺浸润性导管癌的阳性表达与组织学分级、淋巴结转移密切相关,与年龄、肿瘤大小无关。COX-2、VEGF在乳腺浸润性导管癌中的表达呈正相关（R=0.44,P〈0.01）,COX-2在乳腺浸润性导管癌中的表达与E-cad的表达呈负相关（R=-0.26,P〈0.05）。结论：COX-2、VEGF的高表达及E-cad的低表达在乳腺癌的发生发展过程中起重要的作用,检测其表达异常对判断临床进展、推测预后以及制定针对性的治疗方案有一定的参考价值。     

丘状小乳症的临床治疗探讨

目的:探讨丘状小乳症的病因及手术治疗方法。方法:对我科近一年来4例采用乳房假体矫正丘状小乳的病案进行总结,比较假体置入时同期行乳腺后放射状切开、梯田状切开及乳晕双环法缩小后的治疗效果。结果:单纯假体隆乳术后双乳呈葫芦状,形态不佳;假体置入同时行腺体后放射状切开的1例患者术后乳房仍呈葫芦形,程度较轻;假体置入同时行乳腺后梯田状切开的1例患者术后疗效与放射状切开相似;2例假体置入同时行乳晕旁双环法上提的患者获得满意的疗效。结论:丘状小乳症是比较少见的乳房畸形,此类患者未生育前乳腺覆盖胸壁的面积小(远小于正常乳房基底面积),生育时哺乳期乳腺增生、增大导致乳头、乳晕四周皮肤小面积被牵张,又因哺乳导致乳头、乳晕及四周皮肤小面积松弛下垂,这样就导致乳晕及其旁侧的皮肤松弛度大于基底轮廓线外的胸壁皮肤。此类患者最佳的手术治疗方法是行乳房假体置入的同时用双环法矫正乳晕四周的皮肤松弛畸形。     

保留薄层乳腺组织的巨乳矫治术

目的:寻找一种更适合增生性巨乳症矫治的手术方法。方法:按下蒂法作术前设计,术中切除90%的乳腺组织,仅保留近下蒂组织瓣侧的薄层乳腺组织,保全了乳腺被膜层的血管网,使组织瓣血运更有保证。结果:临床效果良好,乳房外观满意,乳头感觉良好,无明显并发症。结论:此方法是治疗中重度伴有增生或要求行全乳腺切除的巨乳症的首选方法。     

内窥镜双平面假体隆乳术的临床应用

目的：探讨应用内窥镜技术进行双平面假体隆乳术的优缺点及可行性。方法：自2010年6月至2011年5月,应用内窥镜开展双平面隆乳21例,6例为未婚女性,15例为哺乳后乳腺萎缩,其中6例伴轻度或中度的乳腺松垂。结果：21例就医者术后随访1～11个月,除1例乳房轻度欠对称外,其余就医者术后乳房形态良好,手感及动感好,无包膜挛缩,无血肿及感染。结论：采用内窥镜微创技术,可通过腋窝切口完成双平面隆乳手术,切口隐蔽,手术在直视下进行,安全性高,手术创伤小,恢复较快,就医者术后疼痛减轻,包膜挛缩发生率降低。由于结合了乳腺后及胸大肌下两个平面的优势,乳房形态更加自然,手感及动感逼真。适用于大多数需要隆乳者,尤其适用于哺乳后乳腺一定程度松垂的就医者。     

乳腺及乳腺周围组织易位技术即刻修复乳腺癌保乳术后局部缺损：附87例报告

目的：探讨利用乳腺及乳腺周围组织易位技术即刻修复保乳术后局部缺损的临床应用价值。 方法：回顾2009年1月—2012年1月应用乳腺及乳腺周围组织易位技术即刻修复保乳术后局部缺损的87例的临床资料,分析该术式的特点及临床适用情况,并评估其术后并发症及美观效果。 结果：87例患者修复手术均取得成功,其中周围腺体组织瓣成形术61例,侧胸筋膜结缔组织皮瓣成形术12例,部分背阔肌皮瓣成形术14例。全组无严重并发症发生。术后经12~27个月随访,患者未出现局部复发,术后美观效果：优、良75例（86.1%）,一般12例（13.7%）;修复后乳房形态自然对称,手感良好。 结论：利用乳腺及乳腺周围组织易位技术即刻修复保乳术后局部缺损,可避免乳房严重变形,能较好保持乳房外观及形态,是一种简单易行、安全可靠的术式,有较高的应用价值。     

乳房外下皱襞切口皮下腺体切除后假体植入术

目的：改善乳房残缺造成的不良外形和心理障碍，对因原位癌等疾病需作乳房皮下切除的患者探索一种既便于腺体完整切除和胸大肌后植入乳房假体，瘢痕又比较隐蔽，术后并发症较少的手术方法。方法：取乳房外下皱襞切口切除乳房腺体，经胸大肌外下缘进入胸大肌后间隙分离假体腔，植八注入式盐水乳房假体。结果：本方法切除接近腋窝的腺体尾部较下皱襞切口方便，比经胸大肌进入胸大肌后间隙的方法损伤少。用此方法切除腺体并隆乳50余侧，随访33侧隆乳术后2-7年的乳房，无一例发现腺体残留而发生乳腺疾病，假体植入后无一例发生血肿、乳房硬化等并发症，仅有一侧乳房假体轻度活动性移位：结论：乳房皮下腺体切除后同时重建乳房，能保持患者乳房良好的外形和曲线美，避免乳房残缺造成的心理障碍；本组患者大多为中年女性，重建后的乳房不宜过于丰满挺立，以免日后产生新的心理问题；外下皱襞切口较常用的下皱襞切口更能完整切除腺体，方便胸大肌后植入乳房假体，且并发症少。