显微图像分析在基础医学研究中发挥着重要作用,兰州大学基础医学院实验教学中心在医学形态学实验课程中设置了相关内容.基于课时和授课对象的先修知基础等情况,该课题设计了有针对性的教学方案.方案总体着重于对基本原理的宏观和直观介绍,并通过案例实践熟悉基本操作方法从而更进一步体会、理解基本原理.这种教学设计,使学生在较短时间内掌握显微图像分析的基本原理和操作方法,满足医学生创新科研的现实需求,同时也为今后更深层次的图像分析学习奠定基础.

目的 探讨虚拟仿真实验项目与CBL及TBL相结合的混合式教学方法在“医学形态学实验”教学中的应用效果.方法 以2016级和2017级选课学生为研究对象,随机分为对照组和实验组,对照组采用传统教学方法,实验组采用混合式教学方法,分别进行“医学形态学实验”教学;课程结束后,对学生进行问卷调查及综合考核,比较两种方法的教学效果.结果 实验组学生的综合考核成绩显著高于对照组(P＜0.05);问卷调查显示,实验组学生对混合式教学方法满意度较高(P＜0.05).结论 在“医学形态学实验”教学中,混合式教学的教学效果明显优于传统教学方法.

为提高医学生在基础课程学习阶段的系统性,激发学生的创新精神,培养出“双一流”建设中的各类型人才,在实验教学改革过程中,对医学专业本科生开设“医学形态学综合性实验”课程.通过设置科研进展指导的全新实验内容、每位学生全程操作的实验安排、多途径的教学手段、学生设计创新性实验的考核方式、课后问卷调查的教学效果评价等,对形态学实验教学进行了一系列探索和改革.通过综合性实验新课程的开设,锻炼了学生的科学思维,提高了操作能力,培养了探索精神,取得了良好的教学效果.

Aim:Prepared a new kind of Al (OH)3 adjuvant which has obviously absorbability on ovalbumin,and applied in establishing a rat model with objective clinical characteristics of allergic rhinitis (AR).Methods:Firstly,a new kind of Al (OH)3 adjuvant with obvious adsorption on ovalbumin (OVA) had been prepared by controlling the reaction conditions,then,was used in building AR rat model.The model group was treated by ovalbumin and Al (OH) 3 to complete basic sensitization;followed by nasal challenge with 2％ ovalbumin saline.The control group used normal saline instead ofAl (OH)3 adjuvant.By the passive cutaneous anaphylaxis,the behavioral score,Luna staining,Hematoxylin-eosin staining,the model was comprehensively evaluated.Results:1) the results of OVA absorption experiments showed our Al (OH)3 could absorb OVA obviously.2) the model group:passive cutaneous anaphylaxis (+) proved the production of allergen specific IgE;behavioral score was greater than 5;Luna staining and Hematoxylin-eosin staining showed the nasal mucosa eosinophilia infiltration.The control group had no such changes.Conclusion:Based on the preparation of Al (OH)3 adjuvant with obvious adsorption on ovalbumin,we had successfully established the rat model with allergen specific IgE (+) and nasal mucosa eosinophilia infiltration two objective clinical characteristics of allergic rhinitis.

Objective To establish a rat model of allergic rhinitis (AR) which is consistent with the clinical objective features.Methods 21 Wistar rats were randomly divided into model group (n=9) and control group (n=9),and another 3 normal rats were used for passive cutaneous anaphylaxis (PCA).The model group used ovalbumin (OVA) as an allergen to complet basic sensitization;followed by 5％ OVA saline nasal challenge.The control group used normal saline instead of OVA.By the PCA test,the behavioral score,Luna staining,HE staining,the model was comprehensively evaluated.Results For the model group,PCA (+) proved the production of allergen specific IgE after the completion of the basic sensitization phase;each rat behavioral score was greater than 5,appearing the typical symptoms such as sneezing,nasal itching,rhinorrhea after the completion of nasal challenge;Luna staining showed the nasal septum mucosa eosinophilia infiltration;HE staining showed the nasal mucosal eosinophilia,goblet cells increased,part of epithelial shedding.The control group had no such changes.Conclusion This study has successfully established the AR rat model which had the characteristics of the two differential diagnosis:the production of allergen specific IgE and eosinophilia and was in accordance with the onset of clinical symptoms of human AR.

目的 对牦牛、迁饲黄牛及低海拔黄牛颈动脉体(CB)形态及CB中低氧相关因子的表达进行比较,探讨高原土生或迁饲动物CB适应慢性低氧的模式.方法 采集青海地区海拔3000 ～4000m的9头牦牛、2500m的9头高山迁饲黄牛及甘肃平原海拔1300米的12头低海拔黄牛的CB,固定、切片、染色后行光学显微镜和电子显微镜比较观察,并对CB中低氧诱导因子-1α(HIF-1α)、一氧化氮合酶(NOS)、瘦素受体(LEPR)、促红细胞生成素(EPO)等低氧相关因子的表达进行免疫组织化学观察.结果 相比黄牛,牦牛CB体积较小,不同海拔牦牛的CB大小、形态及主细胞数量差异无显著性,而迁饲黄牛CB体积较低海拔黄牛大.牦牛CB主细胞中明细胞、暗细胞和固缩细胞的数量百分比比例为67.1％∶28.2％∶4.7％,迁饲黄牛为78.5％∶18.6％∶2.9％,低海拔黄牛为87.3％∶10.2％∶2.5％;与低海拔黄牛相似,牦牛CB少部分明细胞胞质透亮,暗细胞胞核染色质较致密并呈粗颗粒状,而迁饲黄牛CB大部分明细胞胞质透亮,暗细胞胞核染色质致密,颗粒稀少.3种牛支持细胞形态差异无显著性.与低海拔黄牛相比,迁饲黄牛CB主细胞的少数核异染色质增多,个别形态异常,胞质内多数细胞器肿胀溶解,残留少量细胞器和致密核心囊泡.3种牛CB中均有不同程度的HIF-1a、NOS、LEPR、EPO的蛋白表达,其中牦牛CB中EPO蛋白表达阳性率较低海拔黄牛明显降低(P＜0.05).结论 海拔高度不是影响牦牛颈动脉体大小和主细胞数量的主要因素.迁饲黄牛CB主细胞中细胞类型的比例与牦牛有趋同性改变,但缺氧时行使功能的I型细胞功能系统受损,尚处于低氧环境下的习服阶段.慢性低氧可能主要影响牦牛和迁饲黄牛CB中EPO蛋白表达.

目的:对牦牛和迁饲黄牛及低海拔黄牛肺动脉干与肺组织形态进行比较研究,获得高原土生或迁饲动物慢性低氧时适应进化的模式.方法:采集青海地区海拔3 000～4 000 m的牦牛、2 500m的高山迁饲黄牛及甘肃平凉1 300m的低海拔黄牛的肺动脉干及肺组织,固定、切片、染色后行光镜和电镜比较观察.结果:55％的迁饲黄牛和98％牦牛肺动脉干中膜以弹性纤维及胶原纤维为主,而45％的迁饲黄牛和100％低海拔黄牛以弹性纤维及平滑肌增多为主,且平滑肌增多成团分布.牦牛和迁饲黄牛肺浆膜结构致密,间皮下以弹性纤维为主,而低海拔黄牛肺浆膜结构疏松,间皮下以胶原纤维为主.相比于迁饲黄牛,牦牛和低海拔黄牛肺终末细支气管黏膜纵行皱襞更明显,牦牛肺呼吸性细支气管黏膜上皮为单层或假复层柱状上皮,多数细胞可见到纤毛,并且黏膜仍有皱襞形成;而黄牛主要为单层柱状上皮,部分细胞可见纤毛.迁饲黄牛肺内小动脉血管壁和微动脉管壁厚度增加,与牦牛及低海拔黄牛比较差异有统计学意义.结论:牦牛肺动脉干和肺组织形态与结构有适应高原的独特形式,迁饲黄牛在适应高原时发生了与牦牛一样的趋同性改变,同时又兼具低海拔黄牛的特点.

目的 分析甲状腺良性和恶性结节的超声特征,探讨临床特征和辅助检查对判断甲状腺结节性质的价值,筛选鉴别良、恶性结节的敏感指标,提高恶性甲状腺结节的诊断率,避免不必要的检查和手术.方法 回顾性分析我院2006年1月至2010年6月接受手术治疗的甲状腺结节患者520人,根据病理结果将患者分为良性组和恶性组,分别观察两组患者性别、年龄、临床症状、体征、甲状腺功能及其结节的大小、钙化、回声、边界、彩色多普勒血流显像特征等,结合病理学诊断进行对照分析.结果 恶性结节中微钙化出现较多、边界欠清或不清、内部回声不均匀、包膜不明显、血流信号增强者发生率明显高于良性结节.同一病理类型的甲状腺肿瘤可有不同的超声表现,不同病理类型的肿瘤又有类似的超声图像.结论 彩超特征有助于区分甲状腺结节的良、恶性,但应与临床表现以及其他医学检查密切结合,才能提高诊断的准确性.

Objective To study the role of oncogene C-met in the process of tumor angiogenesis of thyroid neoplasm and their clinical significance.Methods Immunochemical technique was used to examine C-met and CD34 expression in 53 cases of thyroid neoplasm tissues.Results The positive expression of C-met oncogene protein in thyroid carcinoma was 92.5%,while it was 22.7%in thyroid adenoma,and it was negative in normal thyroid tissue(P0.01).Microvessel density was significantly higher in C-met positive group than in C-met negative group(P0.05). The microvessel density value of thyroid carcinoma significantly correlated with histologic classification, differentiation degree,lymph node metastasis and the stage of the tumor(P0.05)and it did not correlate with gender,age and size of tumor.Conclusion Oncogene C-met may be involved in the genesis and development of endometrial adenocarcinoma.It may prompt cellular proliferation and induce tumor angiogenesis and correlate with poor prognosis.

Objective To investigate the characteristics of distribution and density of lymphatic vessel and the correlation with its clinicopathological factors in breast cancer and analyse the possible mechanism of lymph node metastasis in breast carcinoma.Methods Making use of immunohistochemistry to research the expression of D2-40 in 50 cases of breast carcinoma and the normal tissues near the tumor borderline,which microlymphatic density was counted.Results The MLD in breast carcinoma was significant higher than that in the normal tissue adjacent carcinoma(P<0.01) and it was not the same in different aeras of carcinoma.The MLD in tumor borderline was higher than that in the normal tissues and tumor center tissues(P<0.01)and There was no correlation in the tumor center and the normal tissue(P>0.05).The MLD in the borderline had positive relation to the clinical stage,and lymph node metastasis(P<0.01),but it had no significant difference from age,tumor diameter,histologic types,progestoger and estrogen receptor condition(P>0.05).Conclusions 1.The lymphatic vessel appears in the breast carcinoma.It mainly distributes in the tumor borderline.The MLD in the tumor borderline has correlation with clinical stage,lymph node metastasis.The increase of MLD may be related to the invasion and metastasis of breast carcinoma in the tumor borderline.2.The detection of MLD in the tissue of breast carcinoma can be a important affiliated markers to evaluate the lymph node metastasis.It also can measure the prognosis of breast carcinoma and provide experimental and theoretical foundation to confirm the clinical treatment methods.

[目的]研究疏肝化脂胶囊治疗脂肪肝的临床疗效。[方法]280例脂肪肝患者随机分为治疗组200例和对照组80例。治疗组给予疏肝化脂胶囊(每粒含生药量0.5 g)4粒/次,3次/d,对照组给予血脂康胶囊(每粒含血脂康药量0.3 g),2粒/次,3次/d。总疗程18周,并测定血脂、血黏度、肝功能(ALT、γ-GT、ALP)及肝纤维化指标(HA、LN、PⅢP、CⅣ)。[结果]治疗组总有效率为94.0%,对照组为75.0%(P<0.01);疏肝化脂胶囊能显著降低血脂、血黏度,改善肝功能及降解肝纤维化指标(P<0.05,<0.01)[结论]疏肝化脂胶囊具有良好的保肝降脂功能及治疗脂肪肝作用。

侵袭和转移是恶性肿瘤的基本特征,也是肿瘤致死的主要原因.近年发现肿瘤淋巴管生成对肿瘤血的淋巴道转移起至关重要的作用.血管内皮生长因子(VEGF-C/ VEGF-D)与淋巴管生成密切相关,现就淋巴管生成与肿瘤转移的研究作一综述.

Objective Through observing the effect of SHGHZ capsule based on morphological changes of the fatty liver rats we want to get the experimental case for the clinical therapy of fatty liver. Methods The ideal model of fatty liver was constructed by feeding rats on high fat diet. The rats were is divided into normal control group, model group, high dose SHGHZ group, low dose SHGHZ group and Xuezhikang group. All the treatment group were intervend by its own medicine. Liver tissue of each group rat was extracted and made HE staining, then observed through optical microscope and analyzed the system picture, dealed with was the medical statistics analysis. Results As for the model group, hepatic cell was arranged for upsed and hepatic plasma was full of different morphological fat vacuoles and even evoloved into fat sac, and appeared serious steatosis. The structure of rat's liver lobule and liver sinusoid were obvious in the therapy group, hepatic cells were not obviously found the fat vacuoles. Comparing with the positive group there is remarkable difference (P0.01). Conclusion SHGHZ capsule can effectively improve therapy of the experimental rat's pathological changes of fatty liver and has significantly effects on treating fatty liver.

DPC4/Smad4 is a tumor suppressor gene identified recently,and the peptide encoded by DPC4/Smad4 gene is a cytoplasmic mediator fellowed the binding between the ligand and receptor in TGF-β signaling pathway.The downstream target genes regulated by DPC4/Smad4 are p21 WAF1,uPA,PAI-1,VEGF and TSP-1.TGF-β signaling transcription pathway including the ligand,receptor,cytoplasmic signaling transcription factor DPC4/Smad4 and the downstream target gene forms a growth inhibition regulation of tumor,and any abnormality of the elements can cause disorder in the pathway leading to tumorigenesis.

脊髓海绵状血管瘤(Cavernous angioma)发病率很低,随着MRI的应用,近来报道也有逐渐增多的趋势.但文献更多集中于临床特征、临床经过和治疗等方面,而对其病理方面则少有深入探讨.本文综合近年来相关文献,对其发生发展规律进行病理学分析,以便更好理解进而指导临床治疗.

为探讨TGF-β1信号通路异常和DNA含量在直肠癌恶性演进过程中的关系与预后的意义,应用免疫组化检测正常直肠黏膜、直肠腺上皮不典型增生、直肠癌中TGF-β1,TβRⅡ,Smad4,VEGF蛋白的表达;核酸Feulgen染色测定直肠癌DNA含量.TGF-β1在低分化(72.4%)、中分化(73.9%)和高分化组(70.0%)中的阳性表达明显高于不典型增生组(23.1%)(P＜0.05),且与淋巴结侵犯、TNM分期明显相关.TβRⅡ在正常直肠黏膜(70.0%)及不典型增生组(69.2%)中的阳性表达明显高于低分化(14.8%)、中分化(13.5%)、高分化组(11.1%)(P＜0.05).73.9%低分化、72.2%中分化腺癌有Smad4的缺失表达,与高分化(35.0%)、不典型增生组(23.1%)及正常直肠黏膜(25.0%)的缺失表达相比有显著性差异(P＜0.05).VEGF在低分化(66.6%)和中分化组(65.2%)中的阳性表达明显高于高分化(25.0%)及不典型增生组(23.0%)(P＜0.05),且与腹水明显相关.DI值与直肠癌淋巴结转移相关,TNM分期中DI值Ⅳ期＞Ⅲ期＞Ⅱ期＞Ⅰ期,Ⅳ期、Ⅲ期和Ⅱ期、Ⅰ期差异有统计学意义(P＜0.05).TGF-β1与VEGF的表达(x2=5.94,r=0.364)、Smad4和TβRⅡ的表达(x2=4.14,r=0.256)均呈正相关,Smad4与VEGF的表达(x2=4.68,r=-0.322)呈负相关.Kaplan-Meier曲线显示TGF-β1,VEGF的阳性表达组与Smad4,TβRⅡ的阴性表达组的预后较正常对照组差.Cox回归分析显示TGF-β1和Smad4与预后相关,Smad4对预后是保护性因素,TGF-β1对预后风险最大.TGF-β1信号通路的关键元件的异常和直肠癌的高增殖活性与直肠癌恶性演进及预后密切相关.

OBJECTIVE:To evaluate the relationship between inactivation of TGF β 1 signaling pathway and pathogenesis of rectal cancer.METHODS:Twenty specimens of normal rectal adenoepithelium,thirteen specimens of rectal atypical hyperplasia and sixty specimens of different differentiated rectal cancers were tested by immunohistochemical techniques for expression of TGF β 1,TβRⅡ,Smad4 and VEGF.RESULTS:The expression of TGF β 1 was significantly higher in poorly differentiated adenocarcinoma (13/18),medium differentiated adenocarcinoma(17/23) and well differentiated adenocarcinoma (11/20) than that in group of atypical hyperplasia (21 5%), P 0 05,and had a significant relevance with regional node metastasis, P 0 01.The positive staining of TβRⅡ was higher in groups of normal rectal adenoepithelium(15/20) and atypical hyperplasia (7/13) than that was in poorly differentiated adenocarcinoma (3/18), medium differentiated adenocarcinoma (4/23) and well differentiated adenocarcinoma (4/20), P 0 05.The loss expressions of Smad4 in groups of of poorly and medium differentiated adenocarcinoma were observed in (13/18) and (16/23),respectively,and were significant higher than those were in groups of well differentiated adenocarcinoma (7/20),atypical hyperplasia (4/13) and normal rectal adenoepithelium (6/20), P 0 05.The expression of VEGF was significant higher in groups of poorly differentiated adenocarcinoma (12/18) and medium differentiated adenocarcinoma (16/23) than that was in well differentiated adenocarcinoma (5/20) and atypical hyperplasia (3/13), P 0 05.Expressions of TGF β 1 and VEGF were positively correlated,expressions of Smad4 and TβRⅡ were positively correlated and expressions of Smad4 and VEGF were negatively correlated.Kaplan Meier analyses revealed an impact on survival by TGF β 1,TβRⅡ,Smad4 and VEGF.CONCLUSIONS:The abnormal TGF β 1 signaling pathway and pathogenesis of rectal cancer are positively correlated.

甲状腺癌是最常见的内分泌癌瘤,由于病理类型较多,故其生物学行为的差异性较大.甲状腺肿瘤的良恶性鉴别是临床医生的诊断难点之一,国内外不少学者对其作过探讨[1].随着免疫组织化学的发展,寻找新的肿瘤标志物是帮助解决这些难点的一种方向.近年来,癌基因和抑癌基因在肿瘤上的研究已成为热点,目前普遍认为肿瘤的发生与多种癌基因异常有关.本文采用S-P免疫组化法,对癌基因产物P53和NM23表达特点及意义进行探讨.寻找甲状腺癌诊断和预后的免疫组化指标.

随着在分子和蛋白水平上对甲状腺癌研究的不断进展,现已发现许多基因与甲状腺癌的发生、发展、转归有联系.肿瘤的发生是一个涉及多基因、多阶段的演变过程.甲状腺滤泡细胞癌,包括由缓慢发展的高分化癌到高度恶性的未分化癌的多种病变,而不同表现型的甲状腺滤泡细胞癌,其发生常与某一特定癌基因密切相关[1].

用随机对照法评估硫酸妥布霉素在单纯胆囊切除术后的使用价值,选用第三代头孢菌素类及青霉素类抗生素为对照.结果,三类药物在切口感染、继发胆道感染、耳肾毒性方面,经统计学比较无显著性差异;在过敏反应方面,经统计学比较,硫酸妥布霉素注射液及第三代头孢菌素明显优于青霉素类抗生素.提示:硫酸妥布霉素注射液用于单纯胆囊切除术后是一种安全、有效、低毒的抗生素,值得推广.