DNA甲基转移酶1在子宫颈病变组织和子宫颈癌细胞中的异常表达及其意义

 目的　探讨DNA甲基转移酶1（DNMT1）在子宫颈病变组织和子宫颈癌细胞中的异常表达及其意义。方法　选择经病理学确诊的子宫颈鳞状细胞癌（SCC）患者80例、子宫颈上皮内瘤样变（CIN）患者105例（CINⅠ 52例,CINⅡ／Ⅲ 53例）和子宫颈正常（NC）者53名,收集其手术或活组织检查子宫颈组织标本。选择子宫颈癌Caski细胞（HPV16阳性）和C33A细胞（HPV阴性）进行体外实验。分别采用Western blot和实时荧光聚合酶链反应（qRT-PCR）法检测子宫颈组织和细胞中DNMT1蛋白和mRNA的表达。结果　DNMT1蛋白和mRNA的表达水平在CIN及SCC组织中均较NC组织高,差异均有统计学意义（F＝110.57,P＜0.001;F＝2.68,P＝0.048）;随着子宫颈病变程度的加重,DNMT1蛋白表达水平呈逐渐上升趋势（χ2趋势＝50.80,P＜0.001）,但DNMT1 mRNA的表达在调整子宫颈癌相关因素后,未显示相同趋势（χ2趋势＝3.63,P＞0.05）。Caski 细胞DNMT1蛋白和mRNA的表达水平均较C33A细胞高,特别是mRNA的表达水平差异有统计学意义（t＝7.134,P＝0.002）。结论　DNMT1蛋白和mRNA高表达均是导致子宫颈癌和癌前病变发生的危险因素,HPV16感染与DNMT1转录功能异常对子宫颈癌的发生可能有协同效应。     

浅谈医学研究生教育的趋势

我国研究生教育的规模的不断扩大,为我国社会经济的快速发展做出了巨大的贡献.医学研究生教育在教育改革大潮中的发展如何呢?本文尝试从两个发面讨论医学研究生教育的发展趋势和前景:医学研究生的课程规划,即结果导向教育和医学教育一体化概念的引入;新的教学手段的应用,即模拟装置的应用和网络的广泛采用.医学院校应准确把握高等医学教育发展趋势,了解高等医学教育发展动态,深入探索教学改革,从而提高医学院校办学质量,提升办学综合实力.     

高脂饮食大鼠肾组织中细胞凋亡及Bcl-2和Bax的表达

目的 观察Bcl-2和Bax高脂饮食大鼠肾组织中Bcl2和Bax表达及细胞凋亡,探讨脂质肾毒性损伤的机制.方法 将10只雄性SD大鼠随机均分为对照组和高脂饮食组,喂养6周,检测血清学指标;用HE染色观察肾脏组织学改变;采用TUNEL法榆测细胞凋亡情况;免疫组化方法检测Bcl-2和Bax表达.结果 高脂饮食组血清甘油三酯(TG)、总胆固醇(TC)水平明显高于对照组,而高密度脂蚩白胆固醇(HDL-C)水平明显下降(P＜0.05);高脂饮食组肾组织凋亡细胞数高于对照组(高倍镜视野15.45±5.07vs 3.57±1.38,P＜0.05),且肾小管的凋亡细胞明显多于肾小球;高脂饮食组Bax平均光密度高于对照组(0.276 3±0.091 2vs0.150 6±0.333 4,P＜0.05),Bcl-2平均光密度低于对照组(0.245 0±0.021 6vs0.294 1±0.020 4,P＜0.05).结论 高脂饮食可导致大鼠肾组织中凋亡细胞增多,且Bcl-2、Bax的表达及Bcl-2/Bax影响着肾脏组织细胞凋亡的发生.     

凝血抗凝异常与反复妊娠丢失的相关性

目的:探讨凝血抗凝异常与不明原因反复妊娠丢失相关性。方法:选择78例(除外口服避孕药)不明原因反复妊娠丢失(RPL)患者及健康妇女60例,分别检测血浆凝血因子FⅡ、FⅤ、FⅧ、FⅨ、D-二聚体(D-D)水平及抗凝血酶(AT)、蛋白C(PC)活性。结果:RPL患者和对照组FⅧ活性水平分别为142.1%±59.8%、103.0%±25.7%,P=0.0001。FⅧ∶C水平大于150%,RPL危险增加4.2倍;FⅧ∶C水平大于130%,RPL危险增加3.3倍。RPL患者和对照组D-D水平分别为(0.38±0.29)mg/L、(0.19±0.12)mg/L,P=0.0001,胎死宫内患者升高尤其显著[(0.40±0.32)mg/L]。RPL患者FⅡ、FⅤ、FⅨ及AT、PC活性与对照组比较无统计学差异。结论:FⅧ活性升高和D-D水平升高是反复妊娠丢失的高危因素,尤其使胎死宫内的危险性显著升高。     

MMP-2/TIMP-2在胎膜早破中的表达及意义

目的:探讨基质金属蛋白酶-2(MMP-2)及其抑制因子-2(TIMP-2)的表达与胎膜早破发病的关系。方法:通过免疫组织化学方法检测胎膜早破组和正常对照组胎膜中MMP-2及TIMP-2的表达情况。结果:基质金属蛋白酶-2在胎膜早破组胎膜中的表达水平为(137.1333±17.83010),在正常对照组胎膜中的表达水平为(179.3667±16.07200),差异有统计学意义(P<0.01);基质金属蛋白酶抑制因子2在胎膜早破组胎膜中的表达水平为(166.7667±16.86597),在正常对照组胎膜中的表达水平为(173.9000±13.73229),差异无统计学意义(P>0.05)。结论:胎膜中基质金属蛋白酶-2蛋白的高表达可能是胎膜早破的病因之一。     

网络直报对综合性医院传染病疫情报告的影响

目的探讨网络直报对传染病疫情报告及质量的影响。方法随机抽取医院2001年-2003年和2005年-2007年的传染病卡片，分别统计并比较完整率、正确率、迟报率、漏报率和发现率。结果2001年-2003年的传染病卡片完整率和正确率分别为85．61％和87．78％，传染病迟报率、漏报率和发现率分别为17．92％、7．03％和0．32％。2005—2007年的传染病卡片完整率和正确率分别为100％和99．51％，传染病迟报率、漏报率和发现率分别为5．20％、0．75％和0．55％。结论网络直报有利于传染病疫情报告及质量提高，卡片完整率、正确率显著上升，迟报率、漏报率降低，传染病发现率提高。     

胃癌术后腹腔内温热蒸馏水灌洗化疗的临床应用

1996～ 2 0 0 0年 ,我院对胃癌术后患者进行腹腔内温热蒸馏水灌洗化疗 ,现报告如下。1　资料与方法1 .1　一般资料　全组 64例 ,其中男 42例 ,女 2 2例 ;年龄 1 7～ 93岁 ,平均 55岁。患者均经病理检查确诊 ,随机分为腹腔化疗组 (ip) 31例和静脉化疗组 (iv) 33例 ,其中未分化腺癌 2 1例 ,低分化腺癌 1 9例 ,印戒细胞癌 7例 ,粘液腺癌 9例 ,高分化腺癌 8例。1 .2　化疗方法　 1 ip组 :术后 7～ 1 0天开始腹腔灌注化疗 ,将 5- Fu 1 .5g稀释于生理盐水 1 0 0 0～1 50 0 ml内 ,经 40 %～ 43%预热后于腹腔置管滴入 ,然后嘱患者改变体位 ,使化疗…     

地震灾区环境与女性生殖道感染

四川省汶川大地震后,随着灾区应急状态的基本结束和灾区重建工作的启动,包括都江堰市、什邡市等在内的地震重灾区的社会秩序逐渐进入了常态.因而,有关地震灾区的公共卫生策略也应随着常态的进人而进行若干调整.女性生殖道感染(reproductive tract infection,RTI)是妇科常见病,若不及时治疗,可降低生活质量、影响妊娠结局、降低出生人口质量、增加疾病负担等,极大地影响女性的生活质量和健康水平.     

子宫内膜异位症患者盆腔粘连与疼痛的相关性

Objective To study the incidence of pelvic adhesions in endometriosis(EM) and the relationship between pelvic adhesions and pain symptoms. Methods The incidence of pelvic adhesions, dysmenorrhea, chronic pelvic pain, dyspareunia, dyschizia in 480 patients with EM were studied retrospectively to evaluate the correlation between pelvic adhesions and the degree of pain symptoms. In accordance with the revised American Fertility Society classification (r-AFS), it was observed that 155 cases were in Stage Ⅰ,33 cases were in stage Ⅱ,108 cases were in stage Ⅲ and 184 were cases in stage Ⅳ. Results (1) Among 480 cases with EM, 72.3% (347/480) of patients have pelvic adhesions simultaneously, of which 25.2% (39/155) patients were in Stage Ⅰ, 78.8% (26/33) patients were in Stage Ⅱ, 90.7% (98/108) patients were in Stage Ⅲ and 100.0% (184/184) patients were in Stage Ⅳ. It was found that positive correlation existed between the degree of pelvic adhesions and clinical staging of EM(rs=0.870,P<0.01).(2) 61.0%(293/480) of patients presented dysmenorrhoea, of which the percentages of mild, moderate and severe dysmenorrhea were 52.2%(153/293), 26.6%(78/293), 21.2% (62/293), respectively. The rate of patients presenting chronic pelvic pain (CPP), dyspareunia and dyschezia were 23.8% (114/480), 15.4% (74/480) and 7.1% (34/480), respectively. (3) Ovarian adhesions was positively correlated with dysmenorrhea and CPP(rs=0.367 and 0.267,P<0.01). Adhesion of the bottom and posterior wall of uterus was positively correlated with dysmenorrhea and CPP (rs=0.336, 0.164,P<0.01); adhesions of fallopian tubes were positively correlated with dysmenorrhea, CPP and dyschezia (rs=0.283, 0.225 and 0.159, P<0.01). Adhesions of rectum was positively correlated with dysmenorrhea (rs=0.101,P<0.05). In addition to dyspareunia, the degree of pelvic adhesions was positively correlated with dysmenorrhea, CPP and dyschezia (rs=0.470, 0.273, 0.132, P<0.01). Conclusion Pelvic adhesions are characteristic lesions of endometriosis, the site and degree pelvic adhesions are closely correlated with pain symptoms.     

子宫内膜异位症患者盆腔粘连与疼痛的相关性

Objective To study the incidence of pelvic adhesions in endometriosis(EM) and the relationship between pelvic adhesions and pain symptoms. Methods The incidence of pelvic adhesions, dysmenorrhea, chronic pelvic pain, dyspareunia, dyschizia in 480 patients with EM were studied retrospectively to evaluate the correlation between pelvic adhesions and the degree of pain symptoms. In accordance with the revised American Fertility Society classification (r-AFS), it was observed that 155 cases were in Stage Ⅰ,33 cases were in stage Ⅱ,108 cases were in stage Ⅲ and 184 were cases in stage Ⅳ. Results (1) Among 480 cases with EM, 72.3% (347/480) of patients have pelvic adhesions simultaneously, of which 25.2% (39/155) patients were in Stage Ⅰ, 78.8% (26/33) patients were in Stage Ⅱ, 90.7% (98/108) patients were in Stage Ⅲ and 100.0% (184/184) patients were in Stage Ⅳ. It was found that positive correlation existed between the degree of pelvic adhesions and clinical staging of EM(rs=0.870,P<0.01).(2) 61.0%(293/480) of patients presented dysmenorrhoea, of which the percentages of mild, moderate and severe dysmenorrhea were 52.2%(153/293), 26.6%(78/293), 21.2% (62/293), respectively. The rate of patients presenting chronic pelvic pain (CPP), dyspareunia and dyschezia were 23.8% (114/480), 15.4% (74/480) and 7.1% (34/480), respectively. (3) Ovarian adhesions was positively correlated with dysmenorrhea and CPP(rs=0.367 and 0.267,P<0.01). Adhesion of the bottom and posterior wall of uterus was positively correlated with dysmenorrhea and CPP (rs=0.336, 0.164,P<0.01); adhesions of fallopian tubes were positively correlated with dysmenorrhea, CPP and dyschezia (rs=0.283, 0.225 and 0.159, P<0.01). Adhesions of rectum was positively correlated with dysmenorrhea (rs=0.101,P<0.05). In addition to dyspareunia, the degree of pelvic adhesions was positively correlated with dysmenorrhea, CPP and dyschezia (rs=0.470, 0.273, 0.132, P<0.01). Conclusion Pelvic adhesions are characteristic lesions of endometriosis, the site and degree pelvic adhesions are closely correlated with pain symptoms.