Objective To investigate the association between proliferation cell nucleus antigen (PCNA) and bcl 2,P 16 ,P 53 cell apoptosis gene expression in endometrial atypical hyperplasia (EAH) and endometrial carcinoma (EC).Methods The PCNA,bcl 2,P 16 and P 53 gene expression was examined ,analysedand compared in 33 cases with EC,35 cases with EAH and 30 cases with endometrial simple hyperplasia (ESH) by immunohistochemical method.Results There expression of PCNA and bcl 2 in EC and EAH showed positive,from moderate to strong,with no significant difference between the two groups but significantly higher than that in ESH(P0.01).The P 16 gene expression decreased with the decrease of cell differentiation.The positive rate in ESH,EAH,EC was 93.33%,74.28%,63.64% respectively.The positive rate in ESH was significantly higher than that in EAH (P0.05) and EC (P0.01),but no significant difference between the latter two groups.The P 16 gene expression was detected in cellular plasm in ESH,but in cellular nucleus and/or cellular plasm in EAH and EC.The P 53 gene expression rate in ESH,EAH,EC was 0%,22.86%,54.55% respectively.There was a significant difference between the latter two groups (P0.01).Conclusion The expression of PCNA,bcl 2,P 53 increases graduallyin endometrial hyperplasia disease and cell maligant transformation,but P 16 decreases.This indicates the out of balance between cell over proliferation and proliferation/apoptosis gene plays an important role in endometrial maligant transformation.The abnormal expression could help to diagnose the endometrial proliferation diseases and predict their biological behavior.
目的探讨增殖细胞核抗原(PCNA)及细胞凋亡相关基因k1-2,P16,P53在子宫内膜不典型增生(EAH)与内膜癌变(EC)组织中表达的相关性.方法应用免疫组织化学技术分别对33例子宫内膜癌,35例子宫内膜不典型增生,30例单纯性子宫内膜增生(ESH)组织进行PCNA和bcl-2,P16,P53基因蛋白定位、表达程度、对比差异,分析它们之间的关系.结果EC组和EAH组PCNA,bcl-2均有阳性表达,两组间差异无显著性,其表达强度由中到强阳性,但这两种在EC和EAH组中表达与其在ESH组比较,差异有显著性(P＜0.01).P16基因随细胞分化程度下降,ESH组阳性率93.33%,EAH和EC组分别为74.28%,63.64%,ESH组明显高于EAH组(P＜0.05)与EC组(P＜0.01),而后两者差异无显著性,其定位ESH组基因表达均在细胞浆,而EAH和EC组基因表达见于细胞核或核浆共同表达.P53基因在ESH组无阳性表达,EAH组阳性率22.86%,EC组阳性率54.55%,两组比较差异有显著性(P＜0.01).结论PCNA,bcl-2,P53表达在子宫内膜增殖性病变、细胞恶性转化的进程中呈递增趋势,而P16趋于递减,提示细胞的过度增殖和增殖/凋亡相关基因的表达失衡在子宫内膜恶性转化过程中起重要作用,其异常表达可作为子宫增生性疾病不同发展阶段的诊断及预测其生物学行为的参考指标.
Objective To investigate the expression of LN in rectal carcinoma.Methods The LN in rectal carcinoma of 31 cases and in rectal adenoma of 5 cases was examined with immunohistochemistry,and analysis was done to find out the relationship between its expression and clinical or pathological data.Results The rectal adenoma of 5 cases had complete expression of LN while only 16 in 31 rectal carcinoma cases had complete or part expression of LN.Therefore,there was a significant difference between them(P0.05).The expression of LN caused a significant difference in terms of invasive extent(P0.05),but no significant difference in terms of age,sex,the shape of tumor,lymphatic metastasis and distant metastasis,histological type and pathological grade(P0.05).Conclusion The expression of LN in rectal carcinoma,which is closely related to its invasive depth,can be regarded as an important factor for the prognosis of rectal carcinoma.
Objective To investigate the microsurgical anatomy of the anterior inferior cerebellar artery (AICA) in CPA.Methods The anterior inferior cerebellar artery were studied on 44 side of 22 adult head specimens with surgical microscope.Results ① There were 41 anterior inferior cerebellar arteries on 44 sides.The basilar artery can be divided into three equal segments from cranial to caudal.The number of AICA originating from the middle and inferior segment of the basilar artery were 34 and 77 respectively.② The number of AICAs which were posterior and medial to the abducent nerve were 34 and 5 respectively and 2 AICAs ran across the abducent nerve.③ Among 41 AICAs,16 were posterior to Ⅶ and Ⅷ and 19 ran across Ⅶ and Ⅷ.④The number of artery loops postolateral and posterior to the trigeminal nerve root were 15 and 9 respectively while only 2 artery loops were clorsal to the trigeminal nerve.Conclusion AICA is anatomically closely related to the abducent nerve,facial nerve,trigeminal nerve and vestibular nerve in CPA,which means nerves and blood vessels might compress each other ,leading to diseases.
目的观察慢性再生障碍性贫血(CAA)患者骨髓CD34+细胞凋亡状况,探讨CAA可能的发病机制.方法采用单克隆抗体-免疫磁珠分离系统(MACS)分离纯化39例CAA患者的骨髓CD34+细胞,用DNA末端原位标(TUNEL)技术分析骨髓CD34+细胞原位凋亡状况.结果CAA患者骨髓细胞的凋亡率为(39.24±12.70)%,健康对照组为(8.50±2.30)%,组间比较差异有显著性(P＜0.01).凋亡细胞可见核染色质皱缩、凝聚,但未见到核碎裂现象及典型的凋亡小体.结论CAA患者骨髓CD34+细胞的过度凋亡是其质或/和量缺陷的原因之一.
患者,女,55岁,退休工人.20年前无明显诱因及原因出现腰背部疼痛不适,以晨起时为著,时有大关节疼痛不适.1月前患者自觉腰背部疼痛加剧,遂来我院就诊.
目的探讨颈椎骨折合并颈髓损伤胫骨前肌急性失神经支配时肌纤维形态与酶组织化学变化.方法颈椎骨折合并颈髓损伤病人和对照组胫骨前肌标本做冰冻切片,HE、琥珀酸脱氢酶(SDH)、乳酸脱氢酶(LDH)和三磷酸腺苷(ATP)酶染色,计算机图像分析系统测量肌纤维形态与酶染色光密度.结果琥珀酸脱氢酶和乳酸脱氢酶将胫骨前肌分为三型,三磷酸腺苷酶将肌纤维分为两型;急性颈髓损伤早期肌纤维形态、琥珀酸脱氢酶和乳酸脱氢酶活性无变化,三磷酸腺苷酶活性增高.结论骨骼肌纤维急性去神经支配时,三磷酸腺苷酶活性增高,检测该酶活性可提供诊断依据.
目的探讨修复圆形或椭圆形皮肤缺损的有效方法.方法通过在缺损的一侧边缘切线上设计一个小于创面约20%的易位皮瓣,进行转移修复创面.结果临床应用63例,皮瓣全部成活,修复部位外观良好.结论切线位易位皮瓣是修复圆形或椭圆形皮肤缺损的有效方法.
导尿术是临床护理工作中的一项常用的基础护理技术操作,也是一项损伤性操作,操作中的无菌技术是预防泌尿系感染的关键.正确掌握置尿管的时机,可减轻病人痛苦,减少尿道损伤,因此,对产科实施剖宫产术的160例初产妇术前留置双腔气囊导尿管的时机进行研究,现报告如下:
目的研究补肾活血方药对慢性再生障碍性贫血(CAA)患者骨髓细胞体外增殖的影响,探讨其治疗CAA的机制.方法采用细胞培养,光镜下观察补肾活血中药作用于CAA患者骨髓细胞后的形态学;3H-TdR掺入和液体闪烁技术方法,检测补肾活血中药对CAA患者骨髓细胞的增殖变化.结果加入补肾活血中药组,CAA患者骨髓细胞培养第48小时见细胞丛明显增多,72h见大量集落形成;3H-TdR掺入法显示,补肾活血中药组骨髓细胞的增殖,以每孔75g/L最有效.在50～100g/L范围内,与对照组比较差异有显著性(P＜0.01);25g/L和125g/L组与对照组比较差异无显著性(P＜O.05).结论补肾活血方药在体外有促进CAA患者骨髓细胞增殖的作用,为补肾活血中药治疗CAA提供了实验与理论依据.
本院对65岁以上同时并发多种疾病的高龄病人施行髋关节置换术18例,均使用硬膜外阻滞麻醉,对心血管系统干扰较大,在麻醉处理中有一定困难,现就麻醉中的问题总结报告如下:
目的总结采用改进心肺脑复苏的方法,抢救心脏骤停病人的临床经验.方法改变原有的ABC模式为CAB模式,首先进行胸外心脏按压,必要时胸腹交替挤压,及早除颤.大剂量应用肾上腺素和肾上腺皮质激素,同时早期注意保护脑细胞等措施.结果抢救成功的心脏骤停病人30例脑功能恢复时间1h内11例,最长达54h.结论CBA心肺脑复苏术能够提高心脏骤停的抢救成功率,适宜在临床上广泛应用.
目的调查了解医护人员术后痛和术后止痛的认识和态度.方法用问卷式调查表采取面对面方式调查了本院130名医护人员.结果①128人(98.5%)完成答卷.②绝大多数认为应控制术后痛,但约40%不知道术后痛可致并发症.③有20%～50%的人对术后止痛有误解.④仅半数人了解术后止痛用药现状.⑤认为术后止痛应主要由外科医师和麻醉医师负责者分别占55.5%和35.9%.⑥绝大多数认为术后止痛宣传力度不够.⑦对本院术后镇痛工作评价良好.⑧非手术科室人员在某些方面不如手术科室更了解.结论医护人员术后止痛意识较好,但仍有许多不足之处.有必要进一步加强医护人员术后止痛意识的教育.
目的探讨剖宫产术中大出血(出血量≥800ml)的原因及有效治疗方法.方法对1996年～2000年间58例剖宫产术中大出血患者的临床资料进行回顾分析.结果①剖宫产3462例,剖宫产率逐年上升,平均为26.21%,术中大出血58例,发生率1.67%.②术中大出血的原因以宫缩乏力多见(43.1%),其次为前置胎盘(37.93%)、植入胎盘(15.52%)和凝血功能障碍(3.45%).③58例均给予宫缩剂等药物治疗,同时行保守、手术治疗,Ⅰ组(24例)行双侧子宫动脉结扎或"8"字缝扎止血,Ⅱ组(34例)采用子宫腔纱条填塞止血,58例中6例保守治疗无效行全子宫或次全子宫切除术.Ⅰ组与Ⅱ组的术中出血量及术中、术后输血量比较差异有显著性(P＜0.01).结论子宫腔纱条填塞止血法可用于剖宫产术中大出血的早期或晚期,是一种安全、快速、有效的止血方法.
目的研究乌司他丁(Ulinastatin,UTI)对缺血性脑水肿的防治作用及其机制.方法应用沙土鼠全脑缺血再灌注模型,随机分为4组:假手术组(Ⅰ组)、缺血组(Ⅱ组)、预防组(Ⅲ组)和治疗组(Ⅳ组),每组6只.称重法测定脑含水量.测定脑组织一氧化氮(NO)含量及一氧化氮合酶(NOS)活性.焦油紫染色光镜观察海马CA1区神经元显微结构.结果Ⅱ组脑组织含水量明显升高(P＜0.05,vs Ⅰ组);脑组织NO含量明显上升,NOS活性增加(P＜0.01,vs Ⅰ组);焦油紫染色光镜显示:海马CA1区细胞肿胀,细胞间隙增大,部分细胞核呈不规则固缩、深染.Ⅲ组、Ⅳ组同Ⅱ组相比脑组织含水量明显降低(P＜0.05),脑组织NO含量减少,NOS活性降低(P＜0.01);光镜显示:海马CA1区细胞间隙稍有增大,只有个别细胞核固缩;Ⅲ组和Ⅳ组无明显差别.结论乌司他丁具有防治缺血性脑水肿、保护脑细胞的作用,作用机制可能与其抑制NOS活性,减少NO的生成有关.
目的探讨米索前列醇(米索)对高危妊娠产妇产后出血的预防作用.方法将高危妊娠100例随机分为实验组及对照组,每组50例,均为手术产妇,在剖宫取胎之后,实验组给产妇口服米索前列醇400c,宫体注射催产素10u;对照组,在剖宫取胎之后,立即宫体注射催产素10u,且静脉推注20u,观察两组产妇在胎儿娩出至产后2h的出血量.结果实验组产后2h出血量212.5±81.4ml,对照组369.2±107.8ml(P＜0.01).结论米索联合催产素促宫缩作用明显强于单用催产素,且米索口服给药方便,吸收迅速,兼有降低血压作用,尤其适应于妊高征患者,是目前最理想的适应于高危产妇的促宫缩药物.
目前在输血工作中,血型判定错误或配血不合的原因很多,笔者发现1例骨髓增生异常综合征(MDS)患者自身凝集,其红细胞与A,B,O,AB各型血型也发生凝集.说明患者有病理性抗体,现报告如下:
