40例深部浸润型子宫内膜异位症的临床特点、MRI影像表现及治疗效果分析

[目的]探讨深部浸润型子宫内膜异位症(DIE)临床特点、MRI影像表现及治疗效果.[方法]回顾性分析2014年2月至2016年2月确诊的85例子宫内膜异位症患者临床、MRI影像学及治疗相关资料,通过与非DIE人群比较总结DIE临床特点,观察DIE患者MRI影像学表现及治疗效果.[结果]85例患者中病理证实DIE 40例,DIE组重度痛经、性交痛、附件囊肿活动度、宫骶韧带结节发生率分别为92.5%、65.0%、72.5%、67.5%显著高于非DIE组(n=45)的33.3%、11.1%、42.2%、17.8%,差异有统计学意义(P<0.05),DIE组阴道直肠隔结节5例,后穹窿蓝色结节15例,而非DIE组无.MRI显示DIE患者累及子宫宫骶韧带27例(子宫骶骨韧带增厚、两侧不对称或韧带内结节);T1WI、T2WI序列多以高信号为主.治疗总有效率90.6%;术后6个月患者临床症状评分、CA125水平较术前均明显下降(P<0.05).[结论]DIE患者以重度痛经、性交痛为其典型临床症状,阴道直肠隔结节、后穹窿蓝色结节为DIE判断敏感表现;MRI对DIE病变范围准确显示,在DIE术前诊断中有重要作用;根据临床症状及MRI检查结果采取相应的治疗方法效果良好.     

趋化因子受体 CXCR7在原发性肝细胞肝癌中的表达及意义

【目的】探讨趋化因子受体 CXCR7在原发性肝细胞肝癌（PHC）中的表达情况及其临床意义。【方法】应用组织芯片和免疫组化法检测35对肝癌、癌旁组织和6例正常肝组织中 CXCR7的表达,并分析其表达与肝癌临床病理特征及预后的相关性。【结果】CXCR7在 35例 PHC 患者组织中的阳性表达率为88．6％（31／35）,显著高于配对癌旁肝组织37．14％（13／35）以及正常肝组织0（0／6）;CXCR7的高表达与 PHC 组织学分型、临床分期、淋巴结转移和血清 AFP 含量呈正相关（ P ＜0．05）,与其他临床指标无相关性（ P ＞0．05）;CXCR7阳性表达患者的中位生存时间相对于阴性表达患者均较短,且差异具有统计学意义（ P ＝0．001）。【结论】CXCR7在 PHC 患者中的阳性表达情况与临床预后密切相关,并且可分别作为独立的预测 PHC 患者预后的指标。     

BDNF在甲状腺乳头状癌中的表达及临床意义

【目的】观察脑源性神经营养因子（brain derived neurotrophic factor ,BDNF）在甲状腺乳头状癌（Papillary thyroid carcinoma ,PTC）中的表达,探讨其与PTC发生及临床病理特征的关系。【方法】对56例P T C、22例甲状腺腺瘤、10例正常甲状腺组织,采用免疫组化链霉素抗生物素蛋白‐过氧化物酶法（S P法）检测BDNF的表达。【结果】BDNF在PTC、甲状腺腺瘤中的表达明显高于正常甲状腺组织（ P ＜0．05）;BDNF的表达水平与PTC肿块大小、有无淋巴结转移有关（ P ＜0．05）;BDNF表达水平与 PTC发病年龄、性别、临床分期无明显相关性（ P ＞0．05）;BDNF的表达水平与PTC的分化程度呈负相关（ r ＝－0．482,P＜0．05）。【结论】BDNF过表达可能与甲状腺腺瘤、PTC发生有关;BDNF表达水平为临床上判断PTC分化程度、淋巴结转移可能性提供有效参考,对指导PTC手术方式及辅助治疗具有实用价值。     

PARP-1与HMGA2在乳腺癌分子分型中的表达及临床意义

【目的】通过免疫组化法实验观察PARP‐1和 HMGA2在乳腺癌不同分子分型中的表达,探讨其在乳腺癌中表达的意义及其与临床特点的相关性。【方法】采用免疫组化法检测240例乳腺癌术后肿瘤标本和60例乳腺良性肿瘤组织中PARP‐1与 HMGA2蛋白的表达情况。分析 PARP‐1和 HMGA2在不同分子类型乳腺癌组织中的表达差异;分析两者在不同分子类型表达的相关性及其与原发肿瘤直径、腋窝淋巴结转移等病理特征相关性。【结果】在乳腺癌中 PARP‐1阳性表达率为65．4％显著高于癌旁组织中的22．4％;HMGA2阳性表达率为58．8％高于癌旁组织中的36．4％,PARP‐1及 HMGA2在乳腺癌各分子分型中的阳性表达与腋窝淋巴结转移情况具有相关性（ P ＜0．05）,HMGA2的阳性表达在luminal A型及luminal B型中与原发肿瘤大小存在相关性（ P ＜0．05）,而在 H ER‐2过表达型及三阴性乳腺癌中不存在相关性（ P ＞0．05）。【结论】PARP‐1与HMGA2在乳腺癌的浸润、转移过程中相互作用,是反映乳腺癌进展的生物学指标。PARP‐1与HMGA2高表达的患者易发生淋巴结转移,预后不良。     

CD147和MMP-2在胆囊癌组织中的表达及意义

【目的】探讨细胞外基质金属蛋白酶诱导因子（CD147）和基质金属蛋白酶2（MMP‐2）在胆囊癌组织中的表达及意义。【方法】采用免疫组织化学法检测30例慢性胆囊炎和21例胆囊癌患者组织中CD147和M M P‐2的表达,并分析其临床意义。【结果】21例胆囊癌组织中 CD147和 M M P‐2的阳性表达率分别为71．4％（15／21）和76．2％（16／21）,显著高于慢性胆囊炎组织中的表达13．3％（4／30）和23．3％（7／30）（ P ＜0．01）;CD147和M M P‐2的阳性表达与胆囊癌的临床分期和淋巴结转移显著相关（ P ＜0．05）,且胆囊癌中CD147与MMP‐2的阳性表达呈正相关（ r ＝0．631,P ＝0．002）。【结论】CD147和MMP‐2在胆囊癌组织中的阳性表达与其临床分期和淋巴结转移相关,CD147可能通过与M M P‐2的相互作用共同参与调控胆囊癌的进展与转移。     

HIF-1α mRNA在寻常型银屑病及脂溢角化病皮损表皮中的表达及意义

[目的]研究低氧诱导因子-1α（HIF-1α） mRNA在寻常型银屑病及脂溢性角化病皮损表皮中的表达,探讨其在银屑病及脂溢性角化病中的作用机制.[方法]应用原位杂交法检测HIF-1α mRNA在寻常型银屑病、脂溢性角化病及正常皮肤组织各25例皮损表皮中的表达和分布.[结果]在25例寻常型银屑病皮损表皮的中下层可见HIF-1α mRNA阳性表达,在25例脂溢性角化病皮损表皮的全层可见HIF-1α mRNA阳性表达,在正常皮肤的表皮未见HIF-1α mRNA的表达;银屑病、脂溢性角化病皮损表皮中HIF-1α mRNA的表达阳性率均为100%（25/25）,均显著高于正常对照组,其差异有统计学意义（P〈0.01）.[结论]HIF-1α mRNA在寻常型银屑病及脂溢性角化病皮损的表皮中表达均增高.     

肺鳞癌患者血清miRNA-181a的表达及其对肺癌细胞功能的影响

【目的】探讨肺鳞癌患者血清中microRNA-181a（miR-181a）水平的变化及其对人肺鳞癌细胞生物学功能的影响。【方法】选择56例肺鳞癌患者和50名健康成人,采用stem-[oop定量PCR的方法检测其血清中miR-181a的表达变化;体外实验采用CCK8和Transwell小室实验检测miR-181a对人肺鳞癌细胞株NCI-H226增殖、侵袭和迁移能力的影响。【结果】miR-181a在肺鳞癌患者血清中表达较健康成人显著降低（P〈0．05）;miR181a可明显抑制肺鳞癌细胞NCI—H226的增殖、侵袭和迁移。【结论】在肺鳞癌患者miR-181a是一种保护性的微小RNA,具有较好的诊断和治疗前景。     

n-HA／PA66义眼台钻孔及栓钉置入术疗效观察

目的观察n-HA／PA66义眼台植入术后钻孔及栓钉置入效果和并发症。方法18只新西兰兔分成A1、A2、A3、B1、B2、B3六组,A组行眼球内容物剜除加义眼台植入术,B组行眼球摘除加义眼台植入术,均植入n-HA／PA66义眼台,术后3mm行义眼台钻孔及栓钉植入术,1组钻孔深度7mm,2组9mm,3组11mm,观察6mm。结果B3组1只眼术后发生感染,经治疗后痊愈,其余17只动物均顺利完成义眼台钻孔、安置栓钉。结论n-HA／PA66义眼台可以顺利完成钻孔、安置栓钉。     

The effect of 12-month participation in osteogenic and non-osteogenic sports on bone development in adolescent male athletes. The PRO-BONE study

Objectives

Research investigating the longitudinal effects of the most popular sports on bone development in adolescent males is scarce. The aim is to investigate the effect of 12-month participation in osteogenic and non-osteogenic sports on bone development.

Guidelines for hospital privileges in vascular surgery and endovascular interventions: Recommendations of the Society for Vascular Surgery

The Hospital Privileges Practice Guideline Writing Group of the Society for Vascular Surgery is making the following five recommendations concerning guidelines for hospital privileges for vascular surgery and endovascular therapy. Advanced endovascular procedures are currently entrenched in the everyday practice of specialized vascular interventionalists, including vascular surgeons, but open vascular surgery remains uniquely essential to the specialty. First, we endorse the Residency Review Committee for Surgery recommendations regarding open and endovascular cases during vascular residency and fellowship training. Second, applicants for new hospital privileges wishing to perform vascular surgery should have completed an Accreditation Council for Graduate Medical Education-accredited vascular surgery residency or fellowship or American Osteopathic Association-accredited training program before 2020 and should obtain American Board of Surgery certification in vascular surgery or American Osteopathic Association certification within 7 years of completion of their training. Third, we recommend that applicants for renewal of hospital privileges in vascular surgery include physicians who are board certified in vascular surgery, general surgery, or cardiothoracic surgery. These physicians with an established practice in vascular surgery should participate in Maintenance of Certification programs as established by the American Board of Surgery and maintain their respective board certification. Fourth, we provide recommendations concerning guidelines for endovascular procedures for vascular surgeons and other vascular interventionalists who are applying for new or renewed hospital privileges. All physicians performing open or endovascular procedures should track outcomes using nationally validated registries, ideally by the Vascular Quality Initiative. Fifth, we endorse the Intersocietal Accreditation Commission recommendations for noninvasive vascular laboratory interpretations and examinations to become a Registered Physician in Vascular Interpretation, which is included in the requirements for board eligibility in vascular surgery, but recommend that only physicians with demonstrated clinical experience in the diagnosis and management of vascular disease be allowed to interpret these studies.