宫颈癌患者外周血T淋巴细胞亚群及血VEGF水平的临床意义

目的探讨宫颈癌患者外周血T淋巴细胞亚群及血VEGF水平的临床意义。方法采用流式细胞仪(FCM)对34例宫颈癌患者外周血T淋巴细胞亚群进行检测,同时应用ELISA法检测血VEGF水平。随机抽取健康女性20例为对照组,比较两组T淋巴细胞亚群及VEGF。结果宫颈癌患者外周血CD4+、CD4+/CD8+比值较对照组均明显下降(P<0.05),而CD8+水平、IL-6、VEGF显著升高。IFN-γ水平与对照组无明显差异性。肿瘤期别越晚,CD4+/CD8+比值越低,CD8+、IL-6、VEGF水平越高,IFN-γ水平则无明显差异性。结论宫颈癌患者T淋巴细胞亚群改变导致细胞免疫功能降低,肿瘤细胞发生免疫逃逸,促进宫颈癌的发生、发展;VEGF诱导肿瘤血管形成,促进宫颈癌的侵袭、转移。     

川芎嗪对人脐静脉内皮细胞缺氧相关因子表达的影响

目的 观察川芎嗪(TMP)对人脐静脉内皮细胞(HUVECs)缺氧相关因子表达的影响.方法 体外培养HUVECs,取2～5代细胞进行实验.将HUVECs分为对照组、氯化钴(CoCl2)缺氧组及50、100、200 μmol/L TMP药物处理组.对照组不作任何处理.CoCl2缺氧组利用150 μmol/L的CoCl2干预HUVECs 4 h;50、100、200 μmol/L TMP药物处理组在CoCl2干预HUVECs 4 h后,再加入不同浓度TMP继续培养8h.分别提取各组细胞RNA和总蛋白,采用实时荧光定量聚合酶链反应(RT-PCR)和蛋白免疫印迹法(Western blot)检测脯氨酰羟化酶2(PHD2)、缺氧诱导因子-1α(HIF-1α)、血管内皮生长因子(VEGF)mRNA和蛋白的表达.结果 实时RT-PCR检测结果显示,与对照组比较,CoCl2缺氧组PHD2mRNA表达下降(t=3.734),HIF-1α和VEGF mRNA表达升高(t=4.589、3.926),差异均有统计学意义(P＜0.05).50、100、200 μmol/L TMP药物处理组分别与CoCl2缺氧组比较,PHD2 mRNA表达均升高(t=3.286、3.617、3.886),差异有统计学意义(P＜0.05);HIF-1α mRNA表达均无明显变化(t=1.025、0.726、-1.386),差异无统计学意义(P＞0.05);VEGF mRNA表达均有所下降,但50 μmol/L TMP药物处理组与之差异无统计学意义(t=1.696,P＞0.05),100、200 μmol/L TMP药物处理组与之差异有统计学意义(t=2.974、3.492,P＜0.05).Western blot检测结果显示,与对照组比较,CoCl2缺氧组PHD2蛋白表达下降,差异有统计学意义(t=3.122,P＜0.05);HIF-1α及VEGF蛋白表达均有不同程度升高,差异有统计学意义(t=3.778、3.257,P＜0.05).50、100、200 μmol/L TMP药物处理组分别与CoCl2缺氧组比较,PHD2蛋白表达均升高(t=2.813、3.026、3.078),差异有统计学意义(P＜0.05);HIF-1α、VEGF蛋白表达均有所下降,但50 μmol/L TMP药物处理组与之差异无统计学意义(t=2.056、1.986,P＞0.05),100 μmol/L TMP药物处理组(t=3.058、2.976)及200 μmol/L TMP药物处理组(t=3.828、3.136)与之差异有统计学意义(P＜0.05).结论 TMP能上调缺氧HUVECs中PHD2 mRNA和蛋白的表达,下调HIF-1α蛋白、VEGF mRNA和蛋白的表达.     

亲属活体儿童肾移植围手术期护理

本文通过探讨亲属活体儿童肾移植中供受体的围手术期护理特点,得出结论亲属活体供肾的儿童肾移植具有特殊性,应加强对供受体的术前评估及心理支持;供体术后需警惕外科并发症,并注意肾功能恢复情况。受体术后需注意维持体液平衡、协助医师评价患儿依从性及观察治疗执行情况等。术后尽早使供受体病房交流有利于双方心理恢复。长期随访要注意观察药物副作用对患儿美容、心理等的影响,并对患儿进行必要的心理辅导。     

手法复位夹板固定联合双柏散外敷治疗Cooney Ⅰ～Ⅲ型Colles骨折的临床效果观察

目的 观察手法复位夹板固定联合双柏散外敷治疗CooneyⅠ～Ⅲ型Colles骨折的临床效果。方法 选取2017年1月—2022年12月在东莞市沙田医院接受治疗的CooneyⅠ～Ⅲ型Colles骨折患者80例,依据随机数表法将其分为对照组和观察组,各40例。对照组采用手法复位夹板固定治疗,观察组在此基础上联合双柏散外敷治疗。对比两组治疗效果,观察治疗前后两组患者的骨折部位疼痛程度、肿胀程度及腕关节功能变化情况,并比较并发症发生情况。结果观察组总优良率高于对照组（P<0.05）。观察组患者治疗4 d、7 d后的视觉模拟评分及骨折部位肿胀评分均低于对照组（P<0.05）。治疗3个月后,观察组患者的腕关节功能评分高于对照组（P<0.05）,但两组患者的掌倾角、尺偏角比较,差异无统计学意义（P>0.05）。观察组并发症发生率低于对照组（P<0.05）。结论 手法复位夹板固定联合双柏散外敷治疗CooneyⅠ～Ⅲ型Colles骨折疗效确切,可有效缓解患者疼痛,减轻患者腕关节肿胀程度,促进腕关节功能恢复,并可减少相关并发症的发生。     

重组腺相关病毒-色素上皮衍生因子抑制氧诱导小鼠视网膜新生血管的作用

Objective To investigate the effects of recombinant adeno-associated virus type-2 (rAAV2) mediated delivery of pigment epithelium-derived factor (PEDF) on oxygen-induced retinal neovascularization (OIRNV) in mice. Methods A total of 22 C57/BL6 mice at the age of 3 days received intravitreal injections of 1 μl rAAV2-PEDF and rAAV2-EGFP into the left eyes (experimental group) and the right eyes (control group). All mice were put into the oxygen box right after the injection to induce the OIRNV model. 4 mice were sacrificed and PEDF protein in retina was measured by western blot at postnatal days 13 (P13). Twelve mice underwent retinal angiography with high molecular weight fluorescein-dextran,and another 6 mice were sacrificed for retinal lectin immunohistochemistry staining at P17. Absolute and relative non-perfusion areas of retinal neovascularization were analyzed by Image-Pro Plus 5.1 software.Results The expression level of PEDF protein was higher in the experimental group than that in the control group. The absolute non-perfusion area was (0. 96 + 0.22) mm2 in the experimental group and (1.96±0. 34) mm2 in the control group; the difference between the two groups was significant (t = -8. 554, P<0.01). The relative non-perfusion area was (8. 64 ± 1.52) % in the experimental group and (17. 27 ± 2. 98)% in the control group with a significant difference between the two groups (t = -8. 97, P<0. 01). The absolute area of retinal neovascularization was (0. 37 ± 0. 11) mm2 in the experimental group which was obviously higher than (1.26±0. 38) mm2 in the control group (t=-7. 8, P<0. 01); the relative areas in experimental and control groups was (3. 96 ± 0. 66) % and ( 11.45 ± 2. 06) %, respectively, whose difference is apparently (t=-8. 51, P<0. 01). The areas of retina neovascularization were (0. 11±0. 003)mm2 and (0.41±0.02)mm2 in the experimental and control groups, respectively, and the differencebetween the two groups was significant (t =- 5.14, P< 0. 01). Conclusions PEDF protein can stably express in the mice retina after rAAV2-PEDF transfetion, rAAV2-PEDF can decrease the retinal nonperfusion areas and inhibit the retinal neovascularization in OIRNV mice.     

视网膜电流图振荡电位的计算机处理及临床应

目的研究视网膜电流图(electroretinogram,ERG)振荡电位(oscillatory potentials, OPs)的提取和分析方法及其临床应用。方法测试了40只(40例)正常对照眼、33只(33例)糖尿病视网膜病变(diabetic retinopathy,DR)患眼、9只视网膜中央静脉阻塞(central retinal vein occlusion,CRVO)患眼和9只视网膜分支静脉阻塞(branch retinal vein occlusion,BRVO)患眼的振荡电位。用快速傅里叶变换计算OPs的10～290Hz频谱,计算频谱的功率总和以及最大功率。通过快速傅里叶逆变换用110～250Hz频谱成分重构时域的OPs。测量重构的OPs4个子波的潜伏期、振幅和振幅总和。结果与正常对照组比较,早期DR患眼140～210Hz振幅谱、功率总和以及最大功率下降,4个子波的潜伏期延长,振幅和振幅总和下降;CRVO患眼150～180Hz振幅谱、功率总和以及最大功率下降,第1到第3个子波的潜伏期延长,振幅和振幅总和下降;BRVO患眼功率总和以及最大功率下降,第2和第3个子波的潜伏期延长、第1到第3个子波的振幅和振幅总和下降。结论该文阐述的OPs分析方法可为DR、CRVO和BRVO的诊断提供有效的客观指标。     

性行为与宫颈癌——病例对照研究

国外流行病学调查研究表明,宫颈癌的发生与性行为关系密切,国内对此研究尚未深入。本文报告是基于人群的病例对照研究,分析宫颈癌与性行为之间的关系。 研究对象与方法 一、研究对象 选择靖安县六轮宫颈癌普查经病理确诊、且在本调查时还存活的266例作为病例     

重组腺相关病毒-色素上皮衍生因子抑制氧诱导小鼠视网膜新生血管的作用

Objective To investigate the effects of recombinant adeno-associated virus type-2 (rAAV2) mediated delivery of pigment epithelium-derived factor (PEDF) on oxygen-induced retinal neovascularization (OIRNV) in mice. Methods A total of 22 C57/BL6 mice at the age of 3 days received intravitreal injections of 1 μl rAAV2-PEDF and rAAV2-EGFP into the left eyes (experimental group) and the right eyes (control group). All mice were put into the oxygen box right after the injection to induce the OIRNV model. 4 mice were sacrificed and PEDF protein in retina was measured by western blot at postnatal days 13 (P13). Twelve mice underwent retinal angiography with high molecular weight fluorescein-dextran,and another 6 mice were sacrificed for retinal lectin immunohistochemistry staining at P17. Absolute and relative non-perfusion areas of retinal neovascularization were analyzed by Image-Pro Plus 5.1 software.Results The expression level of PEDF protein was higher in the experimental group than that in the control group. The absolute non-perfusion area was (0. 96 + 0.22) mm2 in the experimental group and (1.96±0. 34) mm2 in the control group; the difference between the two groups was significant (t = -8. 554, P<0.01). The relative non-perfusion area was (8. 64 ± 1.52) % in the experimental group and (17. 27 ± 2. 98)% in the control group with a significant difference between the two groups (t = -8. 97, P<0. 01). The absolute area of retinal neovascularization was (0. 37 ± 0. 11) mm2 in the experimental group which was obviously higher than (1.26±0. 38) mm2 in the control group (t=-7. 8, P<0. 01); the relative areas in experimental and control groups was (3. 96 ± 0. 66) % and ( 11.45 ± 2. 06) %, respectively, whose difference is apparently (t=-8. 51, P<0. 01). The areas of retina neovascularization were (0. 11±0. 003)mm2 and (0.41±0.02)mm2 in the experimental and control groups, respectively, and the differencebetween the two groups was significant (t =- 5.14, P< 0. 01). Conclusions PEDF protein can stably express in the mice retina after rAAV2-PEDF transfetion, rAAV2-PEDF can decrease the retinal nonperfusion areas and inhibit the retinal neovascularization in OIRNV mice.     

重组腺相关病毒-色素上皮衍生因子抑制氧诱导小鼠视网膜新生血管的作用

目的 观察重组腺相关病毒-色素上皮衍生因子(rAAV2-PEDF)对氧诱导小鼠视网膜新生血管(RNV)的作用.方法 选择3日龄C57/BL6小鼠22只,左眼为实验服,右眼为对照眼,微量注射器玻璃体腔分别注射rAAV2-PEDF和rAAV2-绿色荧光蛋白1μl.注射后立即将小鼠放入氧箱,建立氧诱导血管增生性视网膜病变模型.取13日龄小鼠4只提取视网膜总蛋白,蛋白质免疫印迹法(Western blot)检测色素上皮衍生因子(PEDF)蛋白表达.17日龄小鼠12只,荧光素心脏灌注视网膜铺片观察血管形态和分布.17日龄小鼠6只,视网膜冰冻切片外源凝集素标记后染色观察血管形态和分布.Image-Pro Plus5.1软件测量分析无荧光素灌注区和RNV的绝对面积和相对面积.结果 实验眼PEDF蛋白表达显著高于对照眼.视网膜铺片定量结果显示,实验眼和对照跟绝对无灌注区面积分别为(0.96±0.22)、(1.96±0.34)mm2,差异有统计学意义(t=-8.554,P<0.01);相对无灌注区面积分别为(8.64±1.52)%、(17.27±2.98)%,差异有统计学意义(t=-8.97,P<0.01).实验眼和对照眼绝对新生血管面积分别为(0.37±0.11)、(1.26±0.38)mm2,差异有统计学意义(t=-7.8,P<0.01);相对新生血管面积分别为(3.96±0.66)%、(11.45±2.06)%,差异有统计学意义(t=-8.51,P<0.01).外源凝集素标记定量结果显示,实验眼和对照眼RNV面积分别为(0.11±0.003)、(0.41 4-0.02)mm2,差异有统计学意义(t=-5.14,P<0.01).结论 rAAV2-PEDF可成功转染小鼠视网膜组织并稳定表达PEDF蛋白,不仅可以减少氧诱导血管增生性视网膜病变小鼠视网膜无灌注面积,而且可显著抑制RNV生成.     

睑板部分切除联合脱细胞真皮植入矫正瘢痕性上睑内翻临床观察

目的 评估睑板部分切除联合脱细胞真皮植入矫正瘢痕性上睑内翻的临床疗效.方法 对严重眼化学伤或热烧伤致瘢痕性上睑内翻的病人11例(13只眼睑),均行睑板部分切除联合脱细胞真皮植入术.术后随访5～20个月(平均10个月).结果 11只眼睑内翻获得成功矫正.有2只眼睑内翻复发,再次手术后睑内翻获得成功矫正.荧光素染色试验显示术后所有患者角膜上皮缺损明显减少.术前泪膜破裂时间(BUT)为(4.46±1.20)s,术后3个月延长至(6.92±1.32)s,差异具有统计学意义(P＜0.01);术后泪液分泌量(Schirmer I试验)与术前相比较差异无统计学意义(P＞0.05).结论 用睑板部分切除联合脱细胞真皮植入术来治疗由眼部化学伤或热烧伤引起的伴有眼睑变形的瘢痕性上睑内翻是一种安全有效的方法.