Abnormal expression of Col X, PTHrP, TGF-β, bFGF, and VEGF in cartilage with Kashin–Beck disease

The purpose of the current study was to investigate the abnormal expression of Col X, PTHrP, TGF-β, bFGF, and VEGF in cartilage from patients with Kashin–Beck disease (KBD) to understand the pathogenesis of chondronecrosis in KBD. Articular cartilage and growth plate cartilage collected were divided into four groups: control children (8 samples, 5 cases), KBD children (19 samples, 9 cases), control adults (8 samples, 6 cases), and KBD adults (16 samples, 15 cases). The presence of PTHrP, TGF-β₁, bFGF, VEGF, and collagen X in articular cartilage and in growth plate cartilage was analyzed by immunohistochemistry. Articular cartilage and growth plate were each divided in three zones, and the rate of positive cells was counted by light microscope for cytoplasmic and pericellular staining. Results showed that (1) in KBD children, Col X expression was lower in the deep zone of growth plate cartilage than in normal children; in articular cartilage of KBD adults, however, collagen X expression was higher in the middle zone compared to the controls; (2) staining for bFGF, PTHrP, TGF-β₁, and VEGF in KBD adult patients was prominent in the chondrocyte clusters and the eroded surface of articular cartilage, and the percentage of chondrocyte staining was significantly higher than in control samples (t = 3.64–10.34, df = 12 for children and 19 for adults, P = 0.002–0.0001); and (3) the enhanced PTHrP, TGF-β₁, and VEGF staining in the deep and middle zone of KBD articular cartilage correlated with the high incidence of chondronecrosis in the middle zone (48.5% ± 10.2%) and deep zone (70.6% ± 27.0%) of adult KBD cartilage. In conclusion, Col X expression was reduced in areas of chondrocyte necrosis in the deep zone of KBD articular cartilage, indicating changes in terminal chondrocyte differentiation. PTHrP, TGF-β₁, and VEGF expression was significantly altered and indicated degenerative changes in KBD cartilage, which initially resemble those occurring in osteoarthritis, but lead eventually to chondronecrosis, an event not observed in osteoarthritis.     

宫颈合并阴道高级别上皮内病变的诊断与处理

目的 总结宫颈合并阴道上皮内病变诊断与处理的临床经验.方法 对1例宫颈冷刀锥切(cold knifeconization,CKC)术后反复新柏氏液基细胞学技术(thinprep cytologic test,TCT)异常患者进行多次阴道镜下宫颈及阴道壁活检,发现高级别上皮内病变,对此患者诊断过程和治疗方法进行总结分析.结果 本例54岁女性,因高级别宫颈上皮内病变行CKC手术,术后仍提示反复TCT异常,高危型人乳头瘤病毒(high-risk humanpapilomavirus,HR-HPV)持续感染,阴道镜活检发现宫颈合并阴道高级别上皮内病变,阴道病变广泛延伸至阴道上1/3,随行腹腔镜下筋膜外全子宫切除术+双附件切除术+部分阴道切除术,术后发现仍有阴道高级别上皮内病变残留,故继续补充阴道腔内放疗.结论 对于宫颈上皮内病变患者,建议常规行阴道镜下阴道壁全面检查,对可疑病变部分活检,尤其高级别宫颈上皮内病变患者.对于宫颈合并阴道高级别上皮内病变患者,尽量行全子宫切除时同时切除阴道病变,减少阴道上皮内病变残留.     

P2X7受体在非小细胞肺癌中的表达及其临床意义*

的?探讨非小细胞肺癌（NSCLC）患者癌组织中P2X7R的表达及其临床意义。方法?回顾性分析2012年1月—2014年1月华中科技大学同济医学院附属武汉中心医院收治的NSCLC患者118例癌组织标本。采用免疫组织化学法检测NSCLC组织标本中P2X7R的表达,根据免疫组织化学结果将患者分为P2X7R高、低表达组。采用Kaplan-Meier曲线和Log-rank χ2检验比较P2X7R高、低表达组无瘤生存率和总生存率的差异;采用Cox比例风险模型分析影响NSCLC患者无瘤生存率和总生存率的独立危险因素。 结果?72例（61.0%）患者癌组织中P2X7R高表达。不同TNM分期和有无淋巴结转移患者的P2X7R蛋白高表达率比较,差异有统计学意义（P?<0.05）。P2X7R高表达组5年无瘤生存率低于P2X7R低表达组（18.1% VS 25.1%）（P?<0.05）;P2X7R高表达组5年总生存率低于P2X7R低表达组（23.3% VS 30.1%）（P?<0.05）。单因素Cox比例风险模型分析显示,P2X7R表达、TNM分期及淋巴结转移是影响NSCLC患者无瘤生存率的危险因素（P?<0.05）。多因素Cox比例风险模型分析表明,P2X7R表达[OlR=2.082（95% CI：1.079,3.747）,P?=0.001]及TNM分期[OlR=3.210（95% CI：0.587,6.448）,P?=0.028]是影响NSCLC患者无瘤生存率的危险因素。单因素Cox比例风险模型回归分析显示,P2X7R表达、TNM分期和淋巴结转移是影响NSCLC患者总生存率的危险因素（P?<0.05）。多因素Cox比例风险模型回归分析表明,P2X7R表达[OlR=2.893（95%CI：1.582,4.562）,P?=0.002]及TNM分期[OlR=1.910（95%CI：0.587,2.449）,P?=0.038]是影响NSCLC患者总生存率的危险因素。结论?P2X7R表达可作为影响NSCLC预后的新分子标志物。     

散发型克雅氏病临床诊断标志物研究进展

散发型克雅氏病(sporadic Creutzfeldt-Jakob disease, sCJD)是一类以快速进展性痴呆为突出表现的致死性神经系统变性疾病,由脑内致病性朊蛋白沉积所致。其核心病理特征为海绵状变性、胶质增生及神经元丢失。sCJD的诊断主要以其特征性的临床表现、脑脊液、脑电图及影像学等标志物为依据,但因其各亚型临床异质性大和部分标志物在疾病早期敏感度低等原因,使其早期诊断仍较困难。该综述系统总结了sCJD诊断标准的更新,并对各种标志物在不同分子亚型诊断中的优劣性及研究进展进行系统阐述。     

案例式立体教学结合SP在胃肠外科临床见习教学中的应用

目的:探讨案例式立体教学法结合标准化病人[案例式立体教学（case-three-dimensional teaching method,CTTM）+标准化病人（standardized patient,SP）]在胃肠外科见习教学改革中的应用价值。方法:选取120名在滨州医学院附属医院胃肠外科进行见习的临床专业学生,将之...     

内镜鼻窦手术后局部应用Merogel对促进术腔黏膜上皮化的临床效果观察

目的　观察使用美国Xomed公司生产的Merogel(透明质酸 )作为内镜鼻窦手术后的术腔填塞物对促进术腔上皮化的作用。方法　对 16例 (32侧 )经鼻内镜全鼻窦开放术患者进行同体对照观察 ,左侧为Merogel观察组 ,右侧为空白对照组 ,连续内镜随访 12周 ,观察双侧术腔上皮化过程。结果　Merogel侧治愈 93 75 % ,好转 6 2 5 % ,平均上皮化时间 3 4周 ;对照侧治愈 87 5 0 % ,好转12 5 0 % ,平均上皮化时间 8 3周。表明使用Merogel侧术腔上皮化时间比对照组明显缩短。结论　内镜鼻窦手术后局部使用Merogel ,可以促进术腔上皮化过程     

直肠充盈对直肠壁CT影像组学特征的影响

目的：探讨直肠充盈对直肠壁CT影像组学特征的影响。方法：收集95例宫颈癌后装治疗定位CT扫描图像,患者在直肠填充苦参凝胶前后分别进行CT扫描,手动勾画直肠壁,计算提取7类共计851个特征,包括形态、统计、灰度相关矩阵、灰度游程矩阵、灰度共生矩阵、灰度区域矩阵及邻域灰度差分矩阵特征,采用一致性相关系数评估特征稳定性,威尔科克森符号秩检验分析直肠充盈对直肠壁CT影像组学特征的影响。结果：直肠充盈前后较稳定（一致性相关系数值小于0.8）的特征占总数的13%(113/851),有显著性差异（P<0.05）的特征占总数的92%(782/851)。结论：直肠充盈对直肠壁CT影像组学特征影响较大,应予以关注。     

慢性鼻窦炎鼻息肉围手术前期处理对术中出血影响的观察

OBJECTIVE: To explore the method of reducing bleeding during endoscopic sinus surgery for chronic sinusitis and nasal polyp. METHODS: Bleeding during surgery and the effective rate of two groups patients with chronic sinusitis and nasal polyp were compared (68 cases in group A with preoperative treatment, 30 cases in group B without preoperative treatment). RESULTS: The effective rate between group A(91.2%) and group B (80%) is of significant difference (F = 8.617, P = 0.026); The volume of bleeding during surgery between group A that is (53.2 +/- 41.8) ml and group B that is (97.2 +/- 59.0) ml is of significant difference (F = 27.946, P = 0.002). CONCLUSIONS: Controlling the inflammatory reaction of chronic sinusitis and nasal polyp by preoperative treatment is the most important factor to reduce bleeding while undergoing endoscopic sinus surgery. However, the followings are also important factors to reduce bleeding in endoscopic sinus surgery, such as adequate use of vasoconstrictor in the middle nasal meatus during surgery, the use of deliberate hypotension during surgery, controlling the high risk factors by preoperative treatment and reducing trauma during surgery, etc.     

近5年中药治疗重型颅脑创伤的研究进展

本文查阅了近五年中国知网数据库115篇文献,综述了中药治疗TBI的研究进展,从中医辨证分型、中药成方、单味中药、中药注射液等四个方面进行了分析。