血小板衍生生长因子受体-a在骨肉瘤中的表达及意义

目的:探讨血小板衍生生长因子受体-a(PDGFR-a)在骨肉瘤发病中的表达及与骨肉瘤临床病理、预后的关系。方法:采用免疫组织化学SP法,检测了60例骨肉瘤和10例骨瘤(对照组)中PDGFR-a的表达情况,分析PDGFR-a的表达与骨肉瘤病理分型、临床分型及预后之间的关系。结果:①PDGFR-a表达与病理分型无明显相关性,但与临床分期密切相关;②PDGFR-a在骨肉瘤中表达阳性率为61.7%(37/60),显著高于对照组(P<0.05);③PDGFR-a高表达组的术后生存时间显著低于PDGFR-a低表达组;④PDGFR-a表达高的易局部复发。结论:PDGFR-a在骨肉瘤中的表达与骨肉瘤的生物学行为有关,对评价患者的预后及指导临床治疗具有一定的参考价值。     

戊四氮点燃模型大鼠海马苔藓纤维出芽与Cdk5/p35表达的动态变化

目的：动态观察细胞周期素依赖性激酶5（cyclin-dependent kinase5，Cdk5）和调节亚基p35在戊四氮（pentylenetetrazole，PTZ）致痫大鼠海马各区的表达变化，及其与苔藓纤维出芽（mossy fiber sprouting，MFS）的关系，以探讨其在癫痫发病机制中的作用。方法：SD雄性成年大鼠120只，随机分为PTZ组和对照组；PTZ组分为PTZ第1次注射后3d、1周、2周、4周、6周共5个亚组，每亚组12只，对照组随机分为5个亚组，与眦组各时间点对应。以上各亚组再分2个小组，每小组6只大鼠，分别进行（1）免疫组织化学和原位杂交，检测各时间点Cdk5与p35蛋白和mRNA在海马CA1和CA3区、齿状回颗粒细胞层和门区的表达；（2）Timm染色并评分。结果：PTZ组大鼠上述各区Cdk5和p35mRNA在第3天时表达即有明显上调（P＜0．01），第4周仍维持在较高水平，第6周时基本恢复到对照组水平；各区Cdk5和p35蛋白表达从第3天起即上调（P＜0．01），第2周时最强，其后下调，至第6周接近或达到对照组水平。PTZ组CA3区在点燃前MFS评分1～4分，点燃后MFS评分4～5分。MFS的变化趋势与Cdk5和p35的表达一致。结论：海马Cdk5／p35的表达变化可能参与苔藓纤维出芽，从而促进癫痫的发生。     

PC-1基因K121Q多态性与2型糖尿病合并视网膜病变的相关性研究

目的探讨浆细胞膜糖蛋白(PC-1)基因K121Q多态性与2型糖尿病合并视网膜病变的相关性。方法应用聚合酶链反应-限制性酶切片段长度多态性分析(PCR-RFLP)技术,对2型糖尿病合并视网膜病变(DR组,n=48)、2型糖尿病未合并视网膜病变(NDR组,n=56)进行PC-1基因K121Q多态性分型及研究,并与正常组(对照组组,n=56)对照分析。结果 DR组和NDR组KQ基因型频率、K等位基因频率均显著高于对照组组,差异有统计学意义(P<0.05);DR组和NDR组比较,KK型与KQ型基因型构成频率和等位基因频率差异无统计学意义(P>0.05)。结论 PC-1基因K121Q多态性与2型糖尿病相关,但其可能不是糖尿病视网膜病变发生的主要原因。     

数字化放射成像与普通X线诊断肺内单发结节的ROC曲线评价

OBJECTIVE: To compare digital radiographs with conventional radiographs in the detection of solitary pulmonary nodules. METHODS: Thirty patients with solitary pulmonary nodule and 30 cases without pulmonary nodules were enrolled in the study. The existence of solitary pulmonary nodule was confirmed by chest computed tomography (CT) as well as biopsy. All patients examined by both digital radiography (group A) and conventional radiographs (group B) were reviewed by four experienced chest radiologists and four residents. Assessment was performed with receiver operating characteristic (ROC) analysis of the images in both groups. RESULTS: (1) Observer performance of the experienced radiologists in group B (Az=0.838) was superior to that in group A (Az=0.816) (P<0.05) in detection of solitary pulmonary nodule. For the residents, observer performance in group B (Az=0.842) was superior to that in group A (Az=0.712) (P<0.05). (2) There was no difference between the two groups (P=0.272), for the judgement of benign or malignant solitary pulmonary nodule. CONCLUSIONS: Digital radiographs is superior to conventional radiographs in detection of solitary pulmonary nodule. However, there was no significant differences in discrimination between benign and malignant solitary pulmonary nodules in the two groups.     

S100A4在食管鳞癌中的表达及与浸润转移的关系

目的 探讨S100A4在食管鳞癌发生发展及浸润转移中的作用.方法 采用免疫组化检测100例食管鳞癌组织中S100A4、MMP-2及E-cadherin蛋白的表达,采用RT-PCR及Western blot检测食管鳞癌细胞系EC-1和TE-1中S100A4基因的表达并采用Boyden小室检测EC-1和TE-1细胞的体外侵袭能力.结果 100例食管鳞癌组织中S100A4蛋白的表达(52.0%)明显高于食管正常黏膜(26.0%)(P<0.01),与肿瘤分化程度、浸润深度及淋巴结转移有关(P<0.05),且与MMP-2表达呈正相关(P<0.01),与E-cadherin表达呈负相关(P<0.05).食管鳞癌细胞EC-1中S100A4mRNA(0.894±0.021)、蛋白(0.897+0.053)表达及体外侵袭力(91.00+17.44)明显高于TE-1细胞(S100A4 mRNA:0.812±0.040,蛋白:0.645±0.089,体外侵袭力:61.80±11.10)(P<0.01).结论 S100A4基因在食管鳞癌组织以及高侵袭性食管鳞癌细胞EC-1中的高表达提示其可能参与了食管鳞癌的发生发展及浸润转移.     

被覆自体微粒皮的辐照氟银猪皮移植治疗深度烧伤15例报告

OBJECTIVE: To study the feasibility of using irradiated porcine skin impregnated with fluorine and silver covered by autogenous skin granule graft in the treatment of severe burn injury. METHODS: Autogenous split-thick skin grafts were cut into small pieces (<1 mm3), which were transferred onto the sheet of porcine skin mounted with a layer of Xinnaxing ointment (2 mm in thickness). After eschar removal, the burn wound was covered with the prepared porcine skin, sutured and fixed with small holes at the lower site for drainage. The growth of autogenous granule skin was then observed and the criteria for therapeutic effect evaluation drafted. RESULTS: The layer of Xinnaxing ointment on the the porcine skin improved the adhesion of the autogenous small skin grafts, therefore full use could be made of the donor skin source. In the 15 patients receiving this treatment, the graft-covered area was (12.3+/-3.5) % that of the wound, with the donor-recipient area ratio of 1: (11.0+/-2.7) and subsequent healing time of 27.5+/-5.5 d. Primary healing was achieved in 9 cases, and secondary healing in 6, demonstrating similar clinical effect to that of allo-skin grafting. CONCLUSION: The method is easy and economic, which saves autogenous skin source and produces satisfactory clinical effect.     

Protective effects of penehyclidine hydrochloride on acute lung injury caused by severe dichlorvos poisoning in swine

Background Organophosphate poisoning is an important health problem in developing countries which causes death mainly by inducing acute lung injury. In this study, we examined the effects of penehyclidine hydrochloride （PHC）, a selective M-receptor inhibitor, on dichlorvos-induced acute lung injury in swine. Methods Twenty-two female swines were randomly divided into control （n=5）, dichlorvos （n=6）, atropine （n=6）, and PHC （n=5） groups. Hemodynamic data, extravascular lung water index （EVLWI）, and pulmonary vascular permeability index （PVPI） were monitored; blood gas analysis and acetylcholinesterase （AchE） levels were measured. PaO2/FiO2, cardiac index （CI）, and pulmonary vascular resistance indices （PVRI） were calculated. At termination of the study, pulmonary tissue was collected for ATPase activity determination and wet to dry weight ratio （W/D） testing 6 hours post-poisoning. TUNEL assay, and Bax, Bcl-2, and caspase-3 expression were applied to pulmonary tissue, and histopathology was observed. Results After poisoning, PHC markedly decreased PVRI, increased CI more effectively than atropine. Anticholinergic treatment reduced W/D, apoptosis index （AI）, and mitigated injury to the structure of lung; however, PHC reduced AI and caspase-3 expression and improved Bcl-2/Bax more effectively than atropine. Atropine and PHC improved ATPase activities; a significant difference between groups was observed in Ca2＋-ATPase activity, but not Na＋-K＋-ATPase activity. Conclusions The PHC group showed mild impairment in pathology, less apoptotic cells, and little impact on cardiac function compared with the atropine group in dichlorvos-induced acute lung injury.     

重型β地中海贫血患者的心脏房室扩大及其影响因素

目的：观察重型β地中海贫血（TM）患者心脏房室扩大情况及其危险因素。方法：自2008年7月至2010年3月,对57例TM患者以心脏彩超测量其心脏房室大小,并记录一般情况、输血和去铁状况,测量血清铁蛋白浓度。 结果：57例患者中19例有心房和/或心室扩大。左心房、右心房、左心室、右心室扩大分别为14例（24.6%）、14例（24.6%）、10例（17.5%）、7例（12.3%）。相关分析表明,输血前血红蛋白浓度是影响心脏房室扩大的唯一独立因素。结论：TM患者中心脏房室改变较为普遍,需加强规范化输血治疗以维持输血前血红蛋白大于90g/L。     

芳香开窍法对大鼠脑缺血再灌注后血脑屏障超微结构损伤及AQP-4表达的影响

目的通过观察大鼠脑缺血再灌注后血脑屏障(BBB)超微结构损伤及AQP-4表达情况,探讨芳香开窍法对BBB的保护作用。方法建立大鼠局灶性脑缺血再灌注模型,电镜下观察BBB超微结构,分别用RT-PCR方法、免疫组化方法研究AQP-4 mRNA、AQP-4蛋白表达的变化。结果与模型组比较,麝香配伍冰片组AQP-4 mRNA表达量显著降低(P<0.01),冰片组AQP-4 mRNA表达量也较模型组下降(P<0.05)。麝香配伍冰片组AQP-4 mRNA表达量较麝香组低,差异有统计学意义(P<0.05)。麝香配伍冰片组AQP-4蛋白表达量较模型组下降明显,差异有统计学意义(P<0.05),冰片组AQP-4蛋白表达量也较模型组下降(P<0.05)。结论麝香配伍冰片可减轻缺血再灌注后BBB超微结构损伤,抑制脑组织AQP-4 mRNA和蛋白的表达而起到脑保护作用,这可能是其芳香开窍的作用原理之一。     

食管基底细胞样鳞形细胞癌临床病理研究

目的：进一步阐明少见的食管基底细胞样鳞形细胞癌（BSC）的临床病理学特征。方法：收集21例食管BSC分别作苏木精-伊红（H-E）染色及组织化学、免疫组化染色（S-P法），其中7例作电镜观察，并进行随访。结果：BSC最主要的组织学特征是基底细胞样癌呈实体小叶状、筛网状排列，癌巢中央见粉刺状坏死，并恒伴有鳞形细胞癌或癌巢内伴有小灶性鳞状成分，表面黏膜可伴有异型增生或原位癌。免疫组化染色，肿瘤内的基底样细胞示：细胞角蛋白（CK）14／16（＋），上皮膜抗原（EMA）15／16（＋），波形蛋白（Vimentin）14／16（＋），S-100蛋白7／16（＋），癌胚抗原（CEA）和平滑肌肌动蛋白（SMA）阴性。电镜下示基底样癌细胞分化差，细胞器少，细胞间有少量桥粒，癌细胞梁索间可见特征性的多层折叠或指纹状的基膜。15例获随访结果，其中13例Ⅱ期以上者有10例于手术后2年内死于肿瘤复发或转移。结论：食管BSC是一种新的独立的临床病理类型，因分化低、恶性程度高，预后较差．