胃癌血管内皮生长因子的表达与微血管密度的关系及其临床意义

目的探讨胃癌组织中血管内皮生长因子（VEGF）的表达和微血管密度（MVD）的关系,以及这两项指标与临床病理特征和预后之间的关系。方法观察分析116例胃癌组织中VEGF的表达和计算微血管密度(MVD),分析VEGF的表达与MVD间的关系及它们与临床病理因素和预后的关系。结果116例胃癌组织中,VEGF的阳性率为60.34%。VEGF阳性组中的MVD值明显高于VEGF阴性组（分别为26.16±8.50和19.22±8.20,P<0.01)。在淋巴结转移组中VEGF表达的阳性率明显高于无淋巴结转移组(P<0.05)。在肿瘤分期晚的病人中,其VEGF表达的阳性率也明显高于分期早的(P<0.05)。MVD与胃癌的淋巴结转移及腹腔内转移有关(P均<0.01),且随TNM分期而增加(P<0.01)。VEGF表达阴性组和低MVD组(MVD<23)的5年生存率均明显高于VEGF表达阳性组和高MVD组(MVD≥23)(均P<0.01)。多因素分析表明,MVD和VEGF的表达均是独立的预后因素。结论胃癌组织中VEGF的表达和MVD能反映胃癌的恶性程度,是判断预后和指导辅助治疗的有效指标。     

踝关节骨折的手术治疗

目的 探讨手术治疗踝关节骨折的疗效.方法 回顾性分析2000年1月至2008年4月手术治疗且有完整随访资料的92例踝父节骨折患者的疗效.评价指标包括美国足踝机会踝与后足功能评分(AOFAS评分)、骨折部位的疼痛评估(VAS评分)、患者满意度、踝关节活动度.并对踝关节健侧与患侧的关节活动度差异,以及不同AO分型之间、骨折累及不同部位(单踝、双踝、三踝骨折)之间、不同随访时限之间这二种情况下的踝关节屈伸活动度及AOFAS评分的差异进行统计学分析.结果 平均随访55个月,所有患者骨折均愈合;AOFAS评分平均为93.6分,优良率100%;VAS评分平均为0.17分,患者满意度评分平均为9.62分.健、患侧踝关节活动度差异有统计学意义(P<0.05),不同AO分型之间、骨折累及小同部位之问、不同随访时限之问的踝关节屈伸活动度和AOFAS评分差异无统计学意义(P>0.05).结论 手术治疗踝关节骨折可取得满意的临床疗效.     

高位腰椎间盘突出症

目的：通过147例高位腰椎间盘突出症的回顾性研究,旨在提高对本症的认识,减少漏诊,误诊,方法：回顾性分析报告147例高位腰椎间盘突出,结果：治疗腰1,210例,腰2。3 32例,腰3,4 105例,其中双间隙突出34例,跳跃性突出27例,伴椎管狭窄31例。瘫痪3例,非手术治疗34例,手术113例,优47例,良8例,差92例,重点讨论了高位腰椎及椎间盘和神经根的解剖特点和临床三大特征及诊断治疗,提出对不同程度的病人用不同治疗方式以及手术中需要注意的六个问题。     

Misdiagnosis of eosinophilic ulcer of oral mucosa as squamous cell carcinoma in old patients

ＥＤｅｐａｒｔｍｅｎｔｏｆＯｒａｌＭｅｄｉｃｉｎｅ,ＳｔｏｍａｔｏｌｏｇｉｃａｌＨｏｓｐｉｔａｌ,ＴｉａｎｊｉｎＭｅｄｉｃａｌＵｎｉｖｅｒｓｉｔｙ,Ｔｉａｎｊｉｎ300070,Ｃｈｉｎａ(ＧａｏＳ,ＬｉｕＮ,ＬｉＣＦ,ＬｉＳＬａｎｄＤｕＪ)ｏｓｉｎｏｐｈｉｌｉｃｕｌｃｅｒｏｆｏｒａｌｍｕｃｏｓａ(ＥＵＯＭ)ｉｓａｎｏｎｓｐｅｃｉｆｉｃｃｌｉｎｉｃａｌａｐｐｅａｒａｎｃｅ,ｗｈｉｃｈａｐｐｅａｒｓｔｏｂｅｆｒｅｑｕｅｎｔｌｙｕｎｒｅｃｏｇｎｉｚｅｄｏｒｍｉｓｄｉａｇｎｏｓｅｄｕｓｕａｌｌｙａｓｓｑｕａｍｏｕｓｃｅｌ…     

Application of inferior major bone flap craniotomy decompression in brain injury

ｆｔｅｒｂｒａｉｎｉｎｊｕｒｙ ,ｏｐｅｒａｔｉｖｅｓｕｒｇｅｒｙｉｓａｃｏｍｍｏｎａｎｄｅｆｆｅｃｔｉｖｅｗａｙｔｏｒｅｌｉｅｖｅｐａｔｉｅｎｔｓ ｐａｉｎｓ .Ｉｍｐｏｒｔａｎｔｌｙ ,ｏｐｅｒａｔｉｖｅｍｏｄｅａｎｄｔｅｃｈｎｉｑｕｅｅｓｐｅｃｉａｌｌｙｔｈｅｄｉｍｅｎｓｉｏｎｏｆｔｈｅｂｏｎｅｆｌａｐａｒｅｃｒｕｃｉａｌｆｏｒｏｂｔａｉｎｉｎｇａｐｅｒｆｅｃｔｒｅｓｕｌｔ .Ｉｎｔｈｉｓｓｔｕｄｙ ,ｗｅｈａｖｅｒｅｐｏｒｔｅｄｔｈｅｇｏｏｄｒｅｓｕｌｔｓｏｆｔｈｅｉｎｆｅｒｉｏｒｍａｊｏｒｂｏｎ…     

Biosynthetic response and mechanical properties of articular cartilage after injurious compression.

Traumatic joint injury is known to produce osteoarthritic degeneration of articular cartilage. To study the effects of injurious compression on the degradation and repair of cartilage in vitro, we developed a model that allows strain and strain rate-controlled loading of cartilage explants. The influence of strain rate on both cartilage matrix biosynthesis and mechanical properties was assessed after single injurious compressions. Loading with a strain rate of 0.01 s(-1) to a final strain of 50% resulted in no measured effect on the cells or on the extracellular matrix, although peak stresses reached levels of about 12 MPa. However, compression with strain rates of 0.1 and 1 s(-1) caused peak stresses of approximately 18 and 24 MPa, respectively, and resulted in significant decreases in both proteoglycan and total protein biosynthesis. The mechanical properties of the explants (compressive and shear stiffness) were also reduced with increasing strain rate. Additionally, cell viability decreased with increasing strain rate, and the remaining viable cells lost their ability to exhibit an increase in biosynthesis in response to low-amplitude dynamic mechanical stimulation. This latter decrease in reparative response was most dramatic in the tissue compressed at the highest strain rates. We conclude that strain rate (like peak stress or strain) is an important parameter in defining mechanical injury, and that cartilage injuriously compressed at high strain rates can lose its characteristic anabolic response to low-amplitude cyclic mechanical loading.     

Analysis of Hurthle cell neoplasms of the thyroid by interphase fluorescence in situ hybridization.

Recent studies have indicated that numerical chromosomal abnormalities including changes in p53 and cyclin D1 may be involved in Hurthle cell tumorigenesis. We analyzed a series of Hurthle cell neoplasms of the thyroid to evaluate the diagnostic and prognostic utility of numerical anomalies by DNA fluorescent probes for cyclin D1 and p53 gene loci and chromosomes 5, 7, 11, 12, 17, and 22. Interphase fluorescence in situ hybridization (FISH) analysis was performed on paraffin-embedded tissue sections from 10 Hurthle cell adenomas, 19 Hurthle cell carcinomas, and 7 normal thyroid tissues used as controls. Directly labeled fluorescent DNA probes for the centromere region of chromosomes 7, 11, 12, and 17 and locus-specific probes for chromosomes 5 and 22, cyclin D1, and p53 were utilized for dual-probe hybridizations. Sixty percent (6 of 10) Hurthle cell adenomas and 63% (12 of 19) Hurthle cell carcinomas showed chromosome gains. Twenty percent (2 of 10) Hurthle cell adenomas and 26% (5 of 19) Hurthle cell carcinomas showed chromosome losses. Normal thyroid tissues used as controls showed no chromosomal abnormalities. Among Hurthle cell tumors with chromosomal abnormalities, adenomas averaged 2.7 gains and 0.3 losses per case, and carcinomas averaged 3.3 gains and 0.6 losses per case. The two adenomas with chromosome losses each showed loss of one chromosome, whereas the five carcinomas with losses averaged 1.8 losses per case. Chromosome 22 was the most common loss identified, occurring in three of the 11 patients who died of disease. These results indicate that chromosomal imbalances as gains are common in both benign and malignant Hurthle cell neoplasms, but Hurthle cell carcinomas tend to have more chromosome losses than adenomas. Among Hurthle cell carcinomas in this study, chromosome losses were identified only from patients who died of disease. The loss of chromosome 22 may have prognostic value in Hurthle cell carcinoma of the thyroid.     

乳腺癌近癌和远癌组织基因突变的临床病理研究

目的：通过观察乳腺癌周组织癌基因与抑癌基因表达,为科学确定乳腺癌局部切除范围提供一定的理论参考依据。方法：通过光镜和免疫组化方法观察104例乳腺癌手术后标本近癌和远癌组织的癌浸润,c-erbB-2,P53的表达情况。结果：104例乳腺癌术后标本中,“近癌区”和“远癌区”癌浸润率分别为21．2％,5．78％,c-erbB-2在阳性癌组织的近,远癌组织中的表达率分别为53．6％,16．3％,c-erbB-2在癌周的阳性表达与肿瘤大小无关。P53阳性癌组织的近、远癌组织中P53均为阴性。结论：乳腺癌局部切除范围除应考虑形态学的改变外还应考虑基因学上已有“突变”的乳腺组织。     

ET与CEF新辅助化疗方案的临床疗效比较

目的比较ET与CEF两种不同新辅助化疗方案治疗乳腺癌的疗效及不良反应。方法收集130例Ⅱa-Ⅲc期乳腺癌患者,分为两组,分别接受ET组（多西紫杉醇加表阿霉素）和CEF组（环磷酰胺加表阿霉素加5-Fu）化疗方案治疗。其中ET组64例,CEF组66例,化疗21天为1个周期。所有的患者均完成2—4个周期新辅助化疗后评价疗效。结果乳腺癌新辅助化疗总有效率（ORR）ET组为85．9％（57／64）,CEF组为71．2％（47／66）。主要不良反应是脱发、乏力、恶心、呕吐、腹泻,两组间不良反应无显著性差异。ET组3度以上粒细胞缺乏、粒细胞缺乏性发热、外周性水肿、关节痛、肌痛、神经感觉异常发生率较CEF组高（P〈0．05）,但不良反应均可耐受。结论两组新辅助化疗方案对乳腺癌的原发肿瘤均有效。ET组的疗效及不良反应均高于CEF组。     

猴下颌角截骨术后咬肌变化的影像学与肌电功能研究

目的:研究下颌角截骨术后咬肌形态与功能的变化情况。方法:12只成年雌性恒河猴分为3组,每组4只。各组经口内随机行一侧下颌角截骨术,做自身前后对照。术前及术后3、6、12个月时以CT和肌电仪动态检测术侧咬肌的厚度、横截面积和肌电电压峰值。结果:术后咬肌厚度、横截面积和肌电峰值均减小,这些变化在术后3个月最为明显,术后6个月开始恢复,但在术后12个月时仍与正常组有显著差异。结论:下颌角截除术使咬肌的形态与功能产生一定程度的萎缩与减弱,但随着时间的推移,有逐渐恢复的趋势。