EGFL7基因沉默对裸鼠胃癌血管生成的影响

Objective To investigate the effect of short hairpin RNA (shRNA) targeting at epidermal growth factor-1 ike domain 7 ( EGFL7 ) gene on angiogenesis of stomach carcinoma and its mechanism in nude mice.Methods shRNA targeting at EGFL7 gene was constructed and transfected into SGC-7901 cells (pshEGFL7 group), meanwhile, the cells transfected with vector plasmids were used as control group.Positive clones were selected and the transplanted tumor animal models were constructed in nude mice, and the growth and volume of tumors were observed.After 8 weeks, EGFL7 mRNA and protein in transplanted tumor tissues were detected.Moreover, Anti-CD34, VEGF and TSP1 were stained by the immuno- chemistry method, and MMP-2 and TIMP2 mRNA were detected by RT-PCR.Results EGFL7 mRNA was significantly down regulated in pshEGFL7 group.In psh EGFL7 group, the tumor volume was 1.86 ± 0.65 cm3,MVD was 20.84 ± 6.38, while in control group, the tumor volume was 4.86 ± 1.15 cm3, MVD was 39.48±9.01.In EGFL7 group, TSP1 protein presented positive, and VEGF protein presented weakly positive or negative.The expression of MMP-2 mRNA decreased, TIMP2 mRNA increased in pshEGFL7 group, and it was significantly different compared with control group( P ＜0.01 ).Conclusion RNA interference targeting at EGFL7 gene can balance TSP1/VEGF, through regulating the expression of MMP-2/TIMP2 to impair angiogenesis of stomach cancer in nude mice.     

Application of optical coherence tomography angiography in assessment of posterior scleral reinforcement for pathologic myopia

AIM: To investigate the effect of posterior scleral reinforcement (PSR) on circulation of pathologic myopia eyes with posterior staphyloma by optical coherence tomography angiography (OCTA). METHODS: The study included 30 pathologic myopia eyes with posterior staphyloma which underwent PSR (PSR group) for 6 to 18mo ago, and 30 age and myopia matched eyes without PSR surgery as control group. Macular, choriocapillaris and radial peripapillary capillary (RPC) flow density were measured by OCTA, and the measurements were compared between groups. RESULTS: OCTA found no significant differences in macular flow density between PSR and control groups. For the superficial flow, whole enface flow density (WED), fovea density (FD), and parafoveal density (PD) were 46.55%±5.19% vs 47.29%±4.12% (P=0.542), 31.45%±6.35% vs 31.17%±4.48% (P=0.841), and 48.82%±5.66% vs 49.21%±4.15% (P=0.756) in PSR and control groups, respectively. For the deep flow, WED, FD, and PD were 52.07%±5.78% vs 53.95%±4.62% (P=0.168), 29.62%±6.55% vs 29.50%±6.38% (P=0.940), and 56.93%±6.17% vs 58.15%±5.13% (P=0.407) in PSR and control groups, respectively. The choriocapillary flow density was 61.18±3.25% in PSR group vs 60.88%±2.56% in control group (P=0.692). Also, OCTA found no significant differences in RPCs flow density between PSR and control groups. The optic disc WED, inside disc flow density and peripapillary flow density were 48.47%±4.77% vs 48.11%±4.57% (P=0.813), 45.47%±11.44% vs 46.68%±9.02% (P=0.709), 54.32%±5.29% vs 52.47%±6.62% (P=0.349) in PSR and control groups, respectively. CONCLUSION: OCTA provides a non-invasive and quantitative approach for monitoring macular and papillary blood flow in pathologic myopia. PSR can not improve but may maintain the circulation of pathologic myopia eyes with posterior staphyloma.     

EGFL7基因沉默对裸鼠胃癌血管生成的影响

Objective To investigate the effect of short hairpin RNA (shRNA) targeting at epidermal growth factor-1 ike domain 7 ( EGFL7 ) gene on angiogenesis of stomach carcinoma and its mechanism in nude mice.Methods shRNA targeting at EGFL7 gene was constructed and transfected into SGC-7901 cells (pshEGFL7 group), meanwhile, the cells transfected with vector plasmids were used as control group.Positive clones were selected and the transplanted tumor animal models were constructed in nude mice, and the growth and volume of tumors were observed.After 8 weeks, EGFL7 mRNA and protein in transplanted tumor tissues were detected.Moreover, Anti-CD34, VEGF and TSP1 were stained by the immuno- chemistry method, and MMP-2 and TIMP2 mRNA were detected by RT-PCR.Results EGFL7 mRNA was significantly down regulated in pshEGFL7 group.In psh EGFL7 group, the tumor volume was 1.86 ± 0.65 cm3,MVD was 20.84 ± 6.38, while in control group, the tumor volume was 4.86 ± 1.15 cm3, MVD was 39.48±9.01.In EGFL7 group, TSP1 protein presented positive, and VEGF protein presented weakly positive or negative.The expression of MMP-2 mRNA decreased, TIMP2 mRNA increased in pshEGFL7 group, and it was significantly different compared with control group( P ＜0.01 ).Conclusion RNA interference targeting at EGFL7 gene can balance TSP1/VEGF, through regulating the expression of MMP-2/TIMP2 to impair angiogenesis of stomach cancer in nude mice.     

胃癌CT分期以及CT强化与肿瘤血管生成关系研究

目的:研究胃癌CT分期、CT强化表现与肿瘤血管生成关系,为临床治疗提供有用信息。方法:30例经手术和病理证实为胃癌的患者术前予腹部螺旋CT双期增强扫描,测定胃癌病变研究区域的CT强化值,术后采集这30例患者胃癌标本,对相应研究部位进行二步法CD34单克隆抗体和VEGF单克隆抗体免疫组化染色,并依据临床、CT、病理结果对其病变进行TNM分期以及CT分期,将CT强化值、CT分期、TNM分期、病理分级结果以及CD34、VEGF染色结果进行统计学研究。结果:30例患者胃癌TNM分期与CT分期符合率为90%,CT强化值与TNM分期、CT分期呈明显正相关。CT强化值与微血管密度(MVD)呈正直线相关,方程式Y=49.4125 0.5067X。VEGF高表达组与低表达组的CT强化值之间差异显著(P<0.05),病理分级与CT强化值之间无相关关系(P>0.05)。结论:依据CT表现可对胃癌进行术前分期,CT强化值可反映胃癌肿瘤血管的生成,CT强化值高低对胃癌病理分级无直接帮助。     

螺旋腺瘤临床病理分析

目的:对螺旋腺瘤的临床病理形态学特点、诊断和鉴别诊断、治疗及预后等进行初步探讨.方法:标本采用常规石蜡切片,HE染色.另对石蜡切片采用EnVision免疫组化二步法染色.结果:患者男性及女性各4例,发病年龄28～66岁,平均年龄40.1岁.8例肿瘤均表现为皮下小结节伴疼痛,结节大小0.3～1.5 cm.镜下见瘤细胞巢主要由两种类型的细胞构成:一型为基底样细胞,位于瘤细胞巢的周边;另一型为腺上皮样细胞,位于瘤细胞巢的中央.8例中有2例术后随访2～3年,均无复发.结论:螺旋腺瘤可见于全身各处皮下,常为单发性伴疼痛.肿瘤大多数为良性,免疫组化见瘤细胞巢周边的基底样细胞表达肌上皮标记阳性,中央的腺上皮样细胞表达腺上皮标记阳性.     

急性脑梗死散在和单一弥散加权成像病损与其供血动脉狭窄的关系

目的 探讨急性脑梗死弥散加权磁共振成像(DWI)上大脑中动脉(MCA)供血区散在性或单一性缺血性病损与其脑供血动脉狭窄或闭塞的关系.方法 回顾性分析73例连续积累的DWI显示一侧MCA供血区脑梗死的病例,入组病例均排除心源性栓塞性脑梗死,所有患者均在发病24 h内进行MRI和MRA等检查,7例患者并进行DSA.采用DWI急性缺血性病损分类方法 分为散在病损组和单一病损组,比较两组的病灶同侧MCA、颈内动脉(ICA)颅内段和颅外段狭窄或闭塞的发生率.结果 散在病损组42例,单一病损组31例.在病损同侧ICA颅外段和MCA闭塞或重度狭窄方面两组差异有统计学意义(28.6%与0,x2=10.6,P=0.001).在病损同侧ICA颅内段并MCA轻中度狭窄方面,两组间差异具有统计学意义(31.0%与9.7%,x2=4.717,P=0.03).散在病损与MCA和(或)ICA严重或多发狭窄呈正相关(OR值为13.7,95%CI:3.6～52.5).在MRA或DSA未发现颅内外大血管狭窄方面,两组间差异具有统计学意义(11.9%与32.3%,x2=4.526,P=0.033).散在病损组与无明显血管狭窄呈负相关(OR值为0.284,95%CI:0.09～0.94).结论 (1)脑梗死急性期DWI显示的MCA区散在性病损患者,MCA和ICA狭窄、甚至闭塞的可能性较大,以ICA颅外段闭塞较为常见;(2)DWI显示单一病损时提示脑供血动脉狭窄程度较轻,范围较局限,小血管病变的可能性相对较高,很少为严重的ICA颅外段狭窄或闭塞.

Abstract：

Objective To investigate the relationship between scattered or single lesion of acute cerebral infarction in middle cerebral artery territory on diffusion-weighted imaging (DWI) and stenosis of middle cerebral artery (MCA) or internal carotid artery (ICA). Methods With exclusion of cardioembolism, 73 consecutive patients with acute cerebral infarction of the unilateral MCA territory on DWI were analyzed. All patients got magnetic resonance imaging (MRI) and angiography (MRA) within 24 hours after onset, and 7 patients also had digital subtraction angiography (DSA). The patients were classified into single lesion group or scattered lesions group according to the DWI findings. The incidence of stenosis or occlusion of ipsolateral MCA, intracranial and extracranial ICA were compared between the two groups. Results 42 patients had scattered lesions and 31 patients had single lesion. The scattered-lesions group had a high incidence of ipsilateral extracranial ICA or MCA occlusion or severe stenosis ( 25.6%versus 0, x2 = 10.6, P = 0.001 ) and a high incidence of ipsilateral intracranial ICA or MCA moderate or mild stenosis (31.0% versus 9.7% ,x2 =4.717, P =0.03 ). A positive correlation was found between the scattered lesions and severe or multifocal stenosis of ipsilateral ICA and MCA ( OR: 13.7, 95% CI: 3.6 to 52.5). There was a low incidence of absence of extra- and intracranial stenosis on MRA or DSA in the scattered-lesions group ( 11.9% versus 32.3%, x2= 4.526, P = 0.033 ). A negative correlation was found between the scattered lesions and absence of large-artery stenosis ( OR: 0.284, 95% CI: 0.09 to 0.94).Conclusions ( 1 ) Patients with acute cerebral infarction and scattered lesions on DWI were more likely to suffer from stenosis or occlusion of ICA or MCA, especially over the extracranial ICA. (2) Patients with single lesion were less likely to have severe or multiple stenosis of MCA and ICA, indicating the relevance of small-vessel pathogenesis.     

股骨近端抗旋髓内钉固定结合骨水泥注入治疗股骨粗隆间转移癌性病理性骨折

目的探讨股骨近端抗旋髓内钉(PFNA)结合骨水泥注入治疗股骨粗隆间转移癌性病理性骨折的方法和疗效。方法 2009年3月～2011年3月我科应用PFNA结合骨水泥注入治疗股骨粗隆间转移癌性病理性骨折12例,骨折按Evans分型,Ⅰ型2例,Ⅱ型2例,Ⅲ型5例,Ⅳ型3例。均使用牵引床闭合复位PFNA内固定,同时股骨粗隆部病灶注入骨水泥治疗。结果本组手术时间40～75min,平均55min,术中失血量80～300ml,平均失血量180ml,住院时间3～13d,平均9d。其中1例术后因血压不稳定转入ICU病房,2d后死于多器官衰竭。11例获随访3个月～1年,平均8个月,3例死于术后3～6个月,4例死于术后6个月～1年,4例术后1年随访时健康状况较好。所有11例术后患肢疼痛减轻,便于护理,改善了生活质量。结论应用PFNA固定结合骨水泥注入治疗股骨粗隆间转移癌性病理性骨折,手术创伤小,手术时间短,减轻了患者痛苦,改善了生活质量,使癌症中晚期患者坚定了继续活下去的信心。     

老年人舒张性心力衰竭

随着人口老龄化的增加,舒张性心力衰竭（DHF）的患病率逐步上升,严重威胁老年人的生命,现有的诊断方法对DHF的诊断有一定局限性,不同国家的心衰指南对于DHF的诊断标准也不完全相同,现有的治疗方案对DHF患者的自然病程和预后改善欠佳,因此成为目前的研究热点。现对老年性DHF最新的发病机制及诊断治疗进展进行阐述。     

频域OCT在光动力疗法治疗病理性近视脉络膜新生血管中的应用

目的 评价频域光学相干断层扫描(optical coherence tomography,OCT)检查在光动力疗法(photodynamic therapy,PDT)治疗病理性近视所致的黄斑区脉络膜新生血管(choriodal neovascularization,CNV)中的临床应用价值.方法 对比分析21例26眼病理性近视患者PDT治疗前后频域OCT图像中黄斑中心凹层间厚度及外层高反射厚度,观察不同时期OCT的形态变化.结果 26眼CNV生长方式均属于Ⅱ型.PDT治疗后6个月18眼视网膜层间厚度恢复,视网膜下液吸收,CNV反光团逐渐缩小或纤维化,中心凹形态恢复.黄斑中心凹层间厚度治疗后1周(339.96±74.40)μm增加,治疗后1个月(267.78±33.39)μm开始下降,且差异均有统计学意义(均为P＜0.05).外层高反射厚度与术前(247.33±49.31)μm相比,从治疗后1个月(226.73±83.15)μm开始明显减少,但仅治疗后6个月(165.15±22.90)μm时差异有统计学意义(P=0.042).结论 频域OCT对病理性近视CNV行PDT治疗前后视网膜形态结构的连续观察具有重要意义,为临床治疗提供一种安全、无损伤的检测方法.     

喉癌颈部淋巴结转移的CT影像及其病理基础

目的探讨喉癌颈部淋巴结转移的CT影像及其病理基础,确立淋巴结转移的CT诊断标准。材料与方法20例声门上型喉癌患者,先行CT扫描,将手术切取的颈部廓清标本制成病理大切片,然后进行对照研究。分别以淋巴结短直径0.5、1.0及1.5cm为淋巴结转移的假设诊断标准,根据诊断试验计算CT诊断淋巴结移转移的准确度。结果共有22侧颈部转移,38个转移淋巴结,根据三种不同诊断标准,CT诊断的准确度分别为81％、90％及71％,喉癌颈部淋巴结转移分为四个阶段;转移早期,发展期,完全癌变期及破溃融合期。结论CT诊断淋巴结转移优于临床触诊,淋巴结转移的CT诊断标准以淋巴结短直径1.0cm较合理,CT影像有与转移淋巴结各期相对应的影像表现。