MTA1、MMP-9和TIMP-1蛋白与神经母细胞瘤侵袭转移相关性研究

目的探讨MTA1、MMP-9和TIMP-1蛋白与小儿神经母细胞瘤生物学行为之间的关系。方法运用免疫组化S—P法检测56例神经母细胞瘤组织中MTA1、MMP-9、TIMP—1蛋白的表达。结果56例神经母细胞瘤组织中37例MTA1阳性表达,阳性率为66．1％,MTA1高表达与神经母细胞瘤临床分期和转移关系密切（P〈0．05）;39例MMP-9蛋白阳性表达,阳性率为69．6％,MMP-9高表达与神经母细胞瘤临床分期和转移关系密切（P〈0．05）;27例TIMP—1蛋白阳性表达,阳性率为48．2％,TIMP-1低表达与神经母细胞瘤临床分期和转移关系密切（P〈0．05）;神经母细胞瘤组织中MMP-9,TIMP-1蛋白表达呈负相关（P〈0．05）。结论MTA1、MMP-9和TIMP-1蛋白表达与神经母细胞瘤恶性程度、转移和预后关系密切,可作为判断预后的指标,并有望为肿瘤靶向治疗提供理论依据。     

Ezrin蛋白、CD44、 E-钙粘素与神经母细胞瘤转移的关系

目的 探讨Ezrin蛋白、CD44、E-钙粘素在神经母细胞瘤中的表达及其与神经母细胞瘤转移的关系.方法 应用免疫组织化学二步法检测40例神经母细胞瘤标本中Ezrin蛋白、CD44、E-钙粘素的表达情况,并应用统计学方法比较其在局灶期、进展期的病例、FH型(组织结构良好型)和UFH型(组织结构不良型)及不同年龄性别病例中的表达程度.结论 Ezrin蛋白在进展期患儿中的表达为20例,明显高于局灶期病例的15例,且有统计学意义(H=6.124,P=0.013).而在进展期病例中CD44的表达为6例,明显低于局灶期的12例,E-钙粘素的表达5例则明显低于局灶期的11例,并且均有统计学意义(H=4.950,P=0.026;H=5.455,P=0.020).Ezrin蛋白和CD44在FH型和UFH型表达的差异具有统计学意义(H=5.182,P=0.023;H=4.496,P=0.034).而 E-钙粘素在FH 中表达为阳性的有11例.在UFH型中为5例,经统计学检验两者之间差异无明显统计学意义(H=2.754,P=0.097).Ezrin蛋白在不同年龄组中的差异具有统计学意义,而CD44和E-钙粘素没有,三者在不同性别组中的表达无明显统计学差异.经统计学分析Ezrin蛋白的表达与CD44的表达呈负相关(χ2=4.675,P=0.031,r=-0.323).Ezrin蛋白的表达与E-钙粘素蛋白的表达呈负相关(χ2=6.077,P=0.014,r=-0.123).E-钙粘素蛋白的表达与CD44的表达呈正相关(χ2=6.077,P=0.014,r=-0.363).结论 Ezrin蛋白、CD44和E-钙粘素的表达与NB的转移有关,其中Ezrin蛋白可促进肿瘤的转移,而CD44、E-钙粘素则对肿瘤的转移有抑制作用.年龄是影响Ezrin蛋白表达的因素之一,但不影响CD44和E-钙粘素的表达,而性别对Ezrin蛋白、CD44和E-钙粘素的表达没有影响.在NB的发生、发展过程中Ezrin蛋白与CD44之间,Ezrin蛋白与E-钙粘素之间可能存在负协同效应,而CD44与E-钙粘素之间可能存在正协同效应.

Abstract：

Objective To study Ezrin protein,CD44 and E-cadherin expressions and their association to metastasis of neuroblastoma(NB).Methods The expressions of Ezrin Protein,CD44 and E-cadherin in 40 NB patients were detected by two-step immunohistochemistry staining,and the expression levels of these proteins were analyzed according to local stage and advanced stage,favor able histology(FH) and the unfavorable histology(UFH),age and gender.Results Strong expression of Ezrin Protein was detected only in 15 patients in local stage tumors,and in 20 advanced stage tumors(compared local stage tumors,H=6.124,P=0.013).Strong CD44 staining was found in 12 in local stage tumors,and in 6 advanced stage tumors(H=4.950,P=0.026).Strong E-cadherin staining was found in11 local stage tumors,and in 5 advanced stage tumors(H=5.455,P=0.020).The difference between Ezrin Protein expression in the type of FH and UFH type was significant(H=5.182,P=0.023),and so did the CD44(H=4.496,P=0.034).The expression of Ezrin protein was related to the age.There was negative correlation between the expression of Ezrin and the CD44(χ2=4.675,P=0.031,r=-0.323),and the expression of Ezrin and the E-cadherin(χ2=6.077,P=0.014,r=-0.123).While positive correlation between the CD44 and E-cadherin(χ2=6.077,P=0.014,r=-0.363) was noted.Conclusions Ezrin Protein,CD44 and E-cadherin expressions may be related to metastasis and progression of NB.While Ezrin protein can stimulate tumor metastasis,CD44 and E-cadherin may have an inhibitory effect.Age is one of factors influence the expression of Ezrin protein in neuroblastoma.     

小儿输尿管囊肿的外科治疗

目的评价小儿输尿管囊肿手术方法及其疗效。方法对52例小儿输尿管囊肿治疗方法进行分析,根据手术方法不同分为两组,囊肿切除组22例,膀胱输尿管再植组30例。结合术后随访情况对两组疗效进行分析。结果经随访时间24～38个月,45例患者肾积水及输尿管扩张减轻,术后囊肿切除组4例膀胱输尿管返流合并泌尿系感染,1例单纯泌尿系感染;膀胱输尿管再植组术后2例膀胱输尿管返流合并泌尿系感染。结论膀胱输尿管再植术和输尿管囊肿切除术是治疗小儿输尿管囊肿的有效方法 。     

血清淀粉样蛋白A和C-反应蛋白在新生儿坏死性结肠炎患儿水平变化及临床意义

目的 探讨分析血清淀粉样蛋白A(serum amyloid A,SAA)、C反应蛋白(C-reactive protein,CRP)在新生儿坏死性结肠炎(NEC)诊断的应用价值.方法 收集自2019年2月至2020年2月于河南省人民医院小儿外科、新生儿重症监护室90例患儿依据修正的Bell分期方法将其分为Ⅲ /Ⅱ 期(...     

珠黄散治疗带状疱疹62例

以珠黄散外敷配合六神丸内服治疗带状疱疹６２例，除１例用药后局部皮肤出现过敏被迫停药外，其余６１例均治愈。     

非肿瘤细胞凋亡引起肿瘤机体血清细胞色素C增高

Background  Neuroblastoma (NB) is one of the most common malignant solid tumors of childhood. It is still not clear whether the apoptosis of tumor cells or the non-tumor cells contributes to the increase of concentration of cytochrome c (Cyt c) in the serum of the cancer patients. The aim of this research was to identify the source of the Cyt c in the serum when the tumor grows up by subcutaneous inoculation of human NB cells into nude mice.

Methods  We subcutaneously inoculated human NB cells (KP-N-NS) into nude mice and collected the sera of tumor-bearing mice (n=14) and control mice (n=25) 4 weeks later in order to screen for and identify differentially expressed proteins in the serum. Differentially expressed proteins in the serum were screened by surface-enhanced laser desorption/ionization-time-of-flight (SELDI-TOF) mass spectrometry.

Results  The relative intensity of a protein having a mass-to-charge ratio (m/z) of 11 609 was 3338.37±3410.85 in the tumor group and 59.84±40.74 in the control group, indicating that the expression level of this protein in the tumor group was 55.8 times higher than that in the control group. Serum proteins were separated and purified by high-performance liquid chromatography (HPLC). Liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) was performed to produce peptide mass fingerprints (PMFs). Spectrum analysis and a database search revealed that the highly expressed protein (m/z=11 605.4) from the serum of tumor-bearing mice was the mouse Cyt c.

Conclusions  Increased concentration of Cyt c in the serum of tumor-bearing nude mice might be partially attributed to the secretion of this protein by non-tumor cells.

     

儿童Castleman病临床病理和治疗分析

目的:探讨儿童Castleman病的临床特点、病理表型、治疗和预后。方法:回顾性分析2010年5月至2019年10月在河南省人民医院和郑州大学第一附属医院确诊为Castleman病的15例患儿的临床特点、实验室检查及组织病理学资料。结果:15例Castleman病患儿中男12例、女3例,就诊年龄12（10,15）岁,发...     

腹腔镜辅助与小切口肾盂成形术治疗婴儿期先天性肾积水临床疗效比较

目的探讨腹腔镜辅助体外肾盂成形术与小切口肾盂成形术治疗婴儿期先天性肾积水的临床疗效。方法回顾性分析67例婴儿期先天性肾积水手术治疗患儿的临床资料,其中腹腔镜辅助体外肾盂成形手术31例为腹腔镜辅助组,小切口肾盂成形术36例为小切口手术组。比较2组手术时间、术中出血量、术后肠道恢复时间、术后住院时间、术后并发症发生率、肾盂分离减少值和肾小球滤过率增加值。结果腹腔镜辅助组手术时间[(78±12)min]较小切口手术组[(70±10)min]长(P<0.05),术后住院时间[(7.5±1.2)d]、术后肠道恢复时间[(1.2±0.2)d]均短于小切口手术组[(8.5±1.3)d、(1.5±0.5)d](P<0.05),术中出血量[(10.1±2.2)mL]少于小切口手术组[(12.6±3.2)mL](P<0.05);腹腔镜辅助组术后并发症发生率(9.6%)、肾盂分离减少值[(16.4±9.6)mm]、肾小球滤过率增加值[(10.3±2.7)mL/min]与小切口手术组[8.3%、(17.3±8.2)mm、(9.6±3.6)mL/min]比较差异无统计学意义(P>0.05)。结论腹腔镜辅助体外肾盂成形术治疗婴儿期先天性肾积水可达到与小切口肾盂成形术相同效果,患儿术后恢复快、住院时间短。     

平阳霉素局部注射与口服普萘洛尔治疗颜面部血管瘤疗效比较

目的：探讨平阳霉素局部注射与口服普萘洛尔治疗颜面部血管瘤的疗效。方法选择婴幼儿体表增生期血管瘤患儿共156例,分为两组,平阳霉素组75例,采用平阳霉素局部注射治疗,普萘洛尔组81例,采用口服普萘洛尔治疗。两组分别随诊6个月。结果随访1个月,平阳霉素组有效率达26.7%,显著高于普萘洛尔组（6.2%）,两组间差异有统计学意义（ P 〈0.05）;随访6个月,平阳霉素组瘤体减少体积（ ml）、血管密度减少（n/ cm^2）、有效率、治愈率分别为（6.3±4.2）ml、（4.0 ± 2.3）n/ cm^2、78.6%及70.6%,均显著低于普萘洛尔组的（8.5±3.6）ml、（5.2 ± 2.1）n/ cm^2、95.1%及90.1%,两组比较差异有统计学意义（P 〈0.05）,各组均未出现严重并发症。结论平阳霉素作用快,尤其适合体积较小且表浅的血管瘤,口服普萘洛尔治疗婴幼儿头面部增生期血管瘤方法简单、疗效可靠、副作用小,可作为婴幼儿血管瘤增生期的临床一线治疗方法。     

改良小儿直肠前庭瘘经肛修补术的应用

目的介绍自制肛门环状拉钩在小儿后天性直肠前庭瘘经肛修补术的应用经验。方法小儿直肠前庭瘘23例(其中直肠舟状窝瘘18例、直肠阴唇瘘4例、直肠阴道瘘1例),年龄6月～13岁,扩肛后肛门一周缝6～8根牵引线缝合固定于自制肛门环状拉钩上,可充分显露肛管及瘘内口,横梭形切开瘘口黏膜,切除瘘口内黏膜及瘢痕组织,缝闭瘘道,扇形游离瘘口近端黏膜与瘘口远端黏膜对位缝合。结果一期治愈19例,1例术后复发,3例失访,平均出院时间为术后3.5d,随访无肛门狭窄、大便失禁,效果良好。结论应用自制肛门环状拉钩可明显增加肛管、直肠显露,提高疗效。