目的 对甲状腺微小乳头状癌(PTMC)患者的临床病理特征与中央区淋巴结转移(CLNM)相关性进行分析,旨在为临床实施精准化、科学化治疗提供参考依据.方法 回顾性分析经手术治疗的440例PT-MC患者病历资料,应用χ2检验及Logistic多因素回归模型对入选患者性别、年龄、肿瘤大小、多灶性、双侧癌、包膜侵犯及BRAFV600E突变、中性粒细胞/淋巴细胞计数比值(NLR)、血小板/淋巴细胞计数比值(PLR)水平与CLNM相关性进行单因素及多因素分析.结果 单因素相关性分析结果显示,患者性别、年龄与CLNM发生无明显相关性(P>0.05);肿瘤直径≥5 mm、肿瘤多灶性、双侧癌、包膜侵犯、NLR≥2.5、PLR≥175及BRAFV600E突变与CLNM发生风险明显相关(P<0.05),是CLNM的独立危险因素.Logistic多因素分析结果显示:肿瘤大小、肿瘤多灶性、包膜侵犯、BRAFV600E突变、NLR以及PLR是CLNM的独立危险因素(P<0.05).性别、年龄、双侧癌与CLNM无明显相关(P>0.05).肿瘤直径≥5 mm、肿瘤多灶性、包膜侵犯、BRAFV600E突变、NLR≥2.5及PLR≥175的患者发生CLNM的风险更高.其中,BRAFV600E突变及NLR≥2.5是影响CLNM最重要的两个独立危险因素.结论 肿瘤直径≥5 mm、肿瘤多灶性、包膜侵犯及BRAFV600E突变、NLR≥2.5、PLR≥175均为PTMC发生CLNM的独立危险因素;对于存在包膜侵犯、BRAFV600E突变及NLR值≥2.5的患者应着重考虑行预防性中央区淋巴结清扫(pCLND).

Objective: To investigate the correlation between neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and central lymph node metastasis (CLNM) in patients with cN0 papillary thyroid microcarcinoma (PTMC). Methods: The clinicopathological data of PTMC patients confirmed by surgery and pathology in the 81st Military Hospital of People's Liberation Army from 2016 to 2019 were collected, and the relationship between preoperative NLR, PLR levels and postoperative PTMC CLNM were analyzed. Logistic regression analysis was used for multivariate analysis. Receiver operating characteristic (ROC) curve was used to determine the cutoff value of NLR and PLR. The interaction relative excess risk was used to analyze the relationship between NLR, PLR and CLNM. Results: Among 220 patients with cN0 stage PTMC, 92 were CLNM. The ROC curve showed that when the cutoff value of NLR was 2.5 and the cutoff value of PLR was 175, the highest Youden index was 0.318 and 0.264, respectively. NLR and PLR were both related to CLNM (P<0.05). The tumor long diameter, multifocality, NLR≥2.5 and PLR≥175 were independent impact factors of CLNM (P<0.05). The results of the interaction showed that the relative excess risk of the interaction was 5.531 (95%CI: 0.160, 10.901, P=0.016), the attribution ratio was 0.512 (95%CI: 0.230, 0.794, P=0.009), and the synergy index was 2.294 (95%CI: 1.492, 4.579, P=0.022), suggested that NLR and PLR had an interactive effect, and these two synergistically promoted CLNM. Conclusions: NLR and PLR are independent risk factors for cN0 stage PTMC CLNM. When NLR≥2.5 and PLR≥175, preventive central lymph node dissection should be routinely performed.

甲状腺癌(thyroid carcinoma,TC)是头颈部最常见的内分泌系统实体恶性肿瘤之一,发病率近年呈快速增长趋势.根据美国国立癌症研究所(SEER)数据库统计,2018年全球新发TC约为567000例,位列所有常见癌症发病率的第9位,并以每年5.1％的速度持续增长[1].甲状腺乳头状癌(papillary thyro id carcinoma,PTC)是TC中最常见的病理分型,占全部甲状腺恶性肿瘤的90％以上[2].也是30岁以下女性发病率最高的恶性肿瘤,男女发病比例为1:2.7[3].我国近十年间PTC发病率涨幅显著,2013年以来90％以上的新增TC患者为PTC[4].肿瘤常继发于慢性炎症和基因突变,而慢性炎症又可导致机体内微环境改变、诱导基因突变、诱发肿瘤.BRAFV600E突变是目前PTC中最常见的遗传学事件,是促进PTC侵袭和转移的分子基础之一[5].PTC虽然是多种因素共同作用的结果,预后亦受多种因素影响,但是炎症、BRAFV600E突变和PTC三者之间联系十分密切,结合文献分析如下.

目的 研究BRAFV600E突变与中性粒细胞/淋巴细胞计数比值(NLR)的相关性及其对甲状腺微小乳头状癌(PTMC)中央区淋巴结转移(CLNM)的影响.方法 150例cN0期PTMC患者术中均行预防性中央区淋巴结清扫术;根据术前外周静脉血血常规计算NLR,Ventana免疫组化检测术后病理标本BRAFV600E突变情况;采用交互作用相对超额危险度、归因比以及协同指数分析BRAFV600E突变和炎症指标间的交互作用.结果 不存在BRAFV600E突变且NLR<2.5的PTMC患者CLNM转移比例最低(P<0.05);而存在BRAFV600E突变且NLR≥2.5的PTMC患者CLNM比例明显高于仅存在BRAFV600E突变或NLR≥2.5及不存在BRAFV600E突变且NLR<2.5的患者(P<0.05).BRAFV600E和NLR交互作用分析显示RERI=4.987(0.159～11.011),AP=0.497(0.199～0.802),SI=2.313(1.502～4.605).结论 BRAFV600E突变和NLR具有明显交互作用,两者具有协同作用,促进了PTMC患者CLNM.

Objective:To observe the effect of sorafenib on ferroptosis in thyroid cancer TPC-1 cells, and to provide a new strategy for the treatment of thyroid cancer.Methods:Thyroid cancer TPC-1 cells were cultured in vitro, treated and divided into sorafenib group and negative control group, and cell counting kit-8 (CCK-8) assay was used to detect cell viability; Dichlorofluorescein (DCFH-DA) probe was used to detect reactive oxygen species (ROS) production; Western blotting experiment was used to detect the protein expression levels of ACSL4, SLC7A11 and GPX4; Malondialdehyde (MDA) kit was used to detect the content of MDA in thyroid cancer cells. Analysis of variance was used for the mean comparison between multiple groups, and t-test was used for the comparison between the two groups. Results:The cell absorbance value of sorafenib intervention group (1.29±0.17) was significantly lower than that of control group (1.86±0.23, t=2.695, P<0.05); The fluorescence intensity of ROS in TPC-1 cells treated with sorafenib (1.833±0.293) was significantly higher than that in the control group (0.825±0.186, t=2.801, P<0.05); Western blotting experiments showed that the expression level of ACSl4 protein (0.954±0.091) after sorafenib intervention was higher than that in the control group (0.442±0.132, t=5.314, P<0.05), and the protein expression level of SLC7A11 (0.293±0.087) was significantly lower than that in the control group (0.897±0.098, t=7.916, P<0.05), the protein expression level of GPx4 (0.325±0.051) was also lower than that of control cells (0.893±0.069, t=9.325, P<0.05). The results of MDA detection showed that the expression level of MDA in sorafenib intervention group (30.661±3.192) was significantly higher than that in control group (19.285±1.406, t=5.901, P<0.05). Conclusion:Sorafenib can promote the ferroptosis process of thyroid cancer cells and accelerate the death of thyroid cancer cells.

Objective:To observe the effect of microRNA (miR)-204 on the expression of zinc finger E-box binding protein 1 (ZEB1) in papillary thyroid carcinoma (PTC) cells, as well as the effect on epithelial-mesenchymal transition (EMT) and cell invasion ability.Methods:Real-time polymerase chain reaction (PCR) method was used to detect the expression level of miR-204 in papillary thyroid carcinoma and its adjacent tissues. The miR-204 mimics were transfected into thyroid papillary carcinoma cells-1 (TPC-1) cells of papillary thyroid carcinoma, the expression levels of ZEB1, E-cadherin, N-cadherin and vimentin were detected by real-time PCR, and the regulatory effect of miR-204 on ZEB1 gene was observed by double luciferase reporter gene assay. The miR-204 mimics and plasmid overexpressing ZEB1 were co-transfected into TPC-1 cells. Transwell cell invasion assay was used to observe the effect of miR-204 and ZEB1 expression on the invasion of thyroid cancer cells.Results:Real-time PCR results found that the expression level of miR-204 in papillary thyroid carcinoma (1.14±0.08) was significantly lower than that in adjacent tissues (3.52±0.07, t=13.250, P<0.05). The number of invasive cells in the miR-204 mimics transfection group was significantly less than in the control group (149.4±20.2 vs. 268.6±30.2, t=3.402, P<0.05). The expression level of E-cadherin in miR-204 mimics transfected cells was significantly higher than that in control cells (0.98±0.17 vs. 0.35±0.12, t=2.903, P<0.05), and the expression of N-cadherin and vimentin was significantly lower (0.29±0.11 vs. 0.89±0.10, t=2.974, P<0.05; 0.30±0.13 vs. 0.93±0.15, t=2.859, P<0.05). The relative luciferase activity of ZEB1 in the miR-204 mimics transfection group was significantly lower than that in the control group (0.23±0.06 vs. 1.12±0.04, t=12.460, P<0.05). The expression level of ZEB1 in thyroid cancer papillary carcinoma TPC-1 cells transfected with miR-204 mimics was significantly lower than that in the control group (0.41±0.06 vs. 1.10±0.07, t=6.783, P<0.05). After co-transfection with ZEB1-overexpressed plasmids, the number of invasive cells in thyroid cancer cells was not significantly different from that in the control group (224.4±23.5 vs. 230.0±28.5, t=1.140, P>0.05). Conclusion:MiR-204 can inhibit EMT and invasion of papillary thyroid carcinoma cells by targeting ZEB1 expression.

Thyroid cancer is one of the most common malignant tumors in the head, neck and endocrine system. The incidence of thyroid cancer has been increasing year by year. Although the diagnosis and treatment methods are constantly improving and the overall mortality rate is not significantly increasing, the continuous emergence of new cases has attracted the attention of the global medical community. The cause of thyroid cancer is not very clear. The occurrence, development and prognosis of thyroid cancer are affected by many factors: age, gender, psychomental factor, environmental factor, genetic factor, histopathological type, lymph node metastasis, clinical stage, immunohistochemical factor, molecular biological factor, and so on. It is of great significance to find out the factors that may affect the prognosis of thyroid cancer for guiding treatment and judging prognosis. According to the different prognostic factors, we can choose the appropriate individualized comprehensive treatment plan in order to maximize the benefits of patients. Key words: Thyroid neoplasms; Immunohistochemistry; Molecular biology; Genic mutation; Prognosis; Review

目的 探讨BRAFV600E突变在cN0期甲状腺微小乳头状癌(PTMC)颈中央区淋巴结转移(CLNM)的临床意义及预测价值.方法 回顾性分析2017年1月至2020年1月经手术治疗、病理证实的222例cN0期PTMC患者的临床资料,分析BRAFV600E突变阳性与PTMC患者CLNM的相关性.应用SPSS 23.0统计软件分析数据,单因素分析采用χ2检验分析,多因素分析采用Logistic回归分析;P<0.05为差异有统计学意义.结果 222例PTMC患者94例(42.3％)存在CLNM;肿瘤大小、肿瘤多灶性、包膜侵犯、BRAFV600E突变是CLNM的独立危险因素(P<0.05),发生CLNM的风险更高;BRAFV600E突变(OR=2.445,95％CI:1.557～3.840)是影响CLNM最重要的独立危险因素.结论 PTMC具有较高的CLNM,BRAFV600E突变阳性时应常规行预防性中央区淋巴结清扫术;BRAFV600E突变可有效预测cN0期PTMC患者是否存在CLNM.

Objective: To explore the relationship between different types of female reproductive system dysplasia and age of visit, clinical manifestations, common types of combined malformations and endometriosis. Methods: The patient's medical records in the Second Hospital of Hebei Medical University from December 2002 to June 2016 were collected and retrospectively analyzed. Results: Among 924 cases of genital tract dysplasia, uterine dysplasia (65.3%, 824/1 261) was the most common, followed by vaginal dysplasia (28.3%, 357/1 261), hymen atresia and urogenital fistula (3.7%, 47/1 261), and cervical dysplasia (2.6%, 33/1 261). (1) The youngest age was in patients with hymen atresia and urogenital fistula, with a median of 14.5 years old, while the older age were in patients with uterine, vaginal and cervical dysplasia, with median age of 25.0, 24.0 and 23.0 years old, respectively. (2) The clinical manifestations were lack of specificity, mainly abnormal findings of physical examination or accessory examination, primary amenorrhea, lower abdominal pain, infertility, adverse pregnancy history. (3) About other systemic malformations, urological malformations were the most common (4.8%, 44/924), followed by spinal malformations (0.5%, 5/924), inguinal hernia (0.4%, 4/924), heart malformations (0.2%, 2/924), cleft lip and palate (0.2%, 2/924). Oblique vaginal septal syndrome and MRKH syndrome were the most likely to be associated with other system malformations. (4) About combination with endometriosis, there was no significant difference between obstructive genital tract malformations (2.3%, 9/385) and non obstructive genital tract malformations (1.7%, 9/539; P=0.469). Conclusions: Female reproductive system dysplasia is the most common in uterine dysplasia, followed by vaginal dysplasia, hymen atresia and urogenital fistula, and cervical dysplasia. The age of visit is generally older, often found by abnormal findings of physical examination or accessory examination, primary amenorrhea, lower abdominal pain, infertility, adverse pregnancy history;and could be combined with a variety of other system malformations, most seen by urinary system malformations,there is also the risk of endometriosis.

Objective To study expression and significance of Wnt inhibitory factor-1(WIF-1),β-catenin and chclin D1 in Wnt/β-catenin signal transduction pathway in papillary thyroid cancer(PTC).Methods Sixty cases of PTC were selected and the specimens of cancerous foci and adjacent tissues were taken.The expression of WIF-1,β-catenin and cyclin D1 mRNA and protein were detected,and the correlation between WIF-1 mRNA and β-catenin,cyclin D1 mRNA was analyzed.Results The expression levels of WIF-1 mRNA and positive rates of WIF-1 protein expression in PTC tissues were significantly lower than those in paracancerous tissues(P<0.05),while expression levels of β-catenin,cyclin D1 mRNA and protein in PTC tissues were on the contrary(P<0.05).And the expression levels of WIF-1 mRNA and protein in PTC lymph node metastasis group was lower than those without lymph node metastasis,but the expression levels of β-catenin,cyclin D1 mRNA and protein in PTC lymph node metastasis group were on the contrary(P<0.05).There were no statistically significant differences in the expression levels of WIF-1,β-catenin,cyclin D1 mRNA and positive rates of protein in PTC tissues in different sex,age,tumor diameter,number of lesions and whether or not the capsule was invaded(P>0.05).Expression levels of β-catenin,cyclin D1 mRNA were negatively correlated with those of WIF-1 mRNA(P<0.05).Conclusion The down regulation mechanism of WIF-1 gene in PTC tissues promoted the accumulation of β-catenin protein in the cytoplasm,which resulted in over activation of target gene cyclin D1.The WIF-1 down regulation or β-catenin and cyclin D1 up regulation mechanism may play an auxo-action role in the occurrence and metastasis in PTC.

目的 探讨miR-221在甲状腺疾病穿刺细胞活检组织及外周血中的定量表达及意义.方法 51例甲状腺结节患者采用超声引导下粗针穿刺细胞活检法获取标本,术前抽取外周血标本,采用定量PCR法检测组织及血浆中miR-221的表达水平.结果 miR-221在甲状腺良性结节组织中的表达与周围正常组织差异无统计学意义(P＞0.05),miR-221在甲状腺癌组织中的表达明显高于穿刺病灶周围正常组织(P＜0.05);miR-221在不同甲状腺癌肿瘤病理分期及有无淋巴结转移方面表达差异有统计学意义(P＜0.05).甲状腺癌组外周血miR-221水平显著高于健康对照组和甲状腺良性病变组(P＜0.05).结论 miR-221高表达与甲状腺癌的恶化过程关系密切,可为甲状腺癌术前诊断和个体化治疗提供新的思路.

目的:探讨多灶甲状腺微小乳头状癌(PTMC)的临床病理特征.方法:回顾性分析2013年5月-2016年4月297例手术治疗并经病理证实的PTMC患者临床资料.结果:297例PTMC患者中,多灶PTMC 70例(23.6％).与单灶PTMC患者比较,多灶PTMC患者肿瘤直径小(0.54 cm vs.0.69 cm)、包膜侵犯率高(18.6％vs.8.8％)、行甲状腺全切比例高(87.1％vs.41.4％),差异均有统计学意义(均P＜0.05).癌灶数≥3多灶PTMC患者与癌灶数=2的PTMC患者比较,前者合并双侧癌的比例增高(88.2％vs.44.4％)、中央区淋巴结转移的比例增高(47.1％vs.22.2％),差异均有统计学意义(均P＜0.05).结论:多灶PTMC的病灶更为微小且更易出现包膜侵犯;多灶PTMC的病灶数越多合并双侧癌和中央区淋巴结转移的风险就越大;多灶PTMC应常规行预防性中央区淋巴结清扫.

目的 探讨甲状腺全切术后血钙、血镁、血磷和血清甲状旁腺激素(parathyroid hormone,PTH)水平的变化及意义.方法 选取甲状腺全切术患者129例(甲状腺乳头状癌82例,结节性甲状腺肿和甲状腺腺瘤47例),监测所有患者术前和术后30 min、1d、3d的血钙、血镁、血磷和血PTH水平;并分析患者性别、年龄、术前促甲状腺激素(thyroid stimulating hormone,TSH)水平、术中识别甲状旁腺数和病理类型与术后甲状旁腺损伤所致低钙血症间的关系.结果 不同甲状腺全切术组术后血钙、血镁和PTH水平均呈下降趋势,且血钙和血镁水平以术后1d下降最为明显,PTH水平在术后30 min即出现明显下降.血钙水平在不同甲状腺全切术组组间、不同时点间差异有统计学意义(P＜0.05),在组间·不同时点间交互作用差异无统计学意义(P＞0.05).血镁和PTH水平在不同甲状腺全切术组组间、不同时点间以及组间·不同时点间交互作用差异均有统计学意义(P＜0.05).血磷在不同甲状腺全切术组组间、不同时点间以及组间·不同时点间交互作用差异均无统计学意义(P＞0.05).129例甲状腺全切术患者中又分为血钙正常亚组77例(59.7％),低钙血症无症状亚组31例(24.0％),低钙血症有症状亚组21例(16.3％).低钙血症有症状亚组和低钙血症无症状亚组乳头状癌检出率高于血钙正常亚组(P＜0.05).血钙正常亚组、低钙血症有症状亚组和低钙血症无症状亚组性别、年龄、术前TSH水平以及术中识别甲状旁腺数差异无统计学意义(P＞0.05).结论 手术范围和甲状腺癌可能是术后甲状旁腺损伤的影响因素.甲状腺术后血PTH监测较血钙更敏感.甲状腺术后低钙血症多合并低镁血症,补钙同时应补镁.

目的 观察磷酸化腺苷酸活化蛋白激酶(phosphorylated AMP-activated protein kinase,pAMPK)和磷酸化乙酰辅酶A羧化酶(phosphorylated acetyl-CoA carboxylase,pACC)在甲状腺乳头状癌(papillary thyroid carcinoma,PTC)组织中的表达情况,探讨AMPK-ACC信号通路在PTC中的表达及意义.方法 采用免疫组织化学法和Western blot法分别检测60例PTC和20例结节性甲状腺肿组织中pAMPK和pACC的表达情况,分析其与性别、年龄、肿瘤大小、双侧癌、多灶、包膜侵犯、中央区淋巴结转移和侧颈部淋巴结转移等临床病理因素的关系.结果 pAMPK和pACC在PTC和结节性甲状腺肿组织中均有表达,pAMPK和pACC在PTC组织中阳性表达率均显著高于结节性甲状腺肿(P＜0.05).pAMPK和pACC在PTC中央区淋巴结转移组中的阳性表达率均显著高于PTC中央区淋巴结未转移组(P＜0.05).pAMPK和pACC在PTC侧颈部淋巴结转移组中的阳性表达率均显著高于PTC侧颈部淋巴结未转移组(P＜0.05).pAMPK和pACC的表达程度与PTC患者的性别、年龄、肿瘤大小、双侧癌、多灶和包膜侵犯等差异均无统计学意义(P＞0.05).Western blot法检测显示PTC组织中pAMPK和pACC的表达均显著高于结节性甲状腺肿组(P＜0.05).结论 pAMPK和pACC在PTC组织中表达增强,并与颈部淋巴结转移密切相关;AMPK-ACC信号通路的激活在PTC发生和转移中可能发挥了促进作用.

Objective:To study 3% sodium bicarbonate solution and saline in the prevention of oral fungal infection in patients after liver transplantation . Methods:Randomly divided 112 cases of patients after liver transplantation into control group and observation group .The control group used saline solution for oral care; observation group was treated with 3% sodium bicarbonate solution for oral care.Oral fungal infection occurred after operation in two groups were compared.Results:The oral fungal infection rate of observation group was lower than that of the control group (P<0.05).Conclusion:Oral nursing with 3% sodium bicarbonate solution can effectively prevent oral fungal infection after liver transplantation .

Objective To observe the expression patterns of sodium/iodide symporter (NIS) in thyroid tissues,discuss the correlation between the expression of NIS in differentiated thyroid cancer and its ability of uptaking iodine,and provide a theoretical basis for 131I radiation therapy.Methods 187 cases of surgcal resection of patients with thyroid tissue were selected as experimental group,and 30 cases of pericarcinomatous normal thyroid tissues served as control group.The streptavidin-perosidase (SP) method was used to detect the expression of NIS in different thyroid tissues.Results The positive expression rate of NIS in differentiated thyroid cancer,thyroid adenoma,thyroid tissue adjacent to thyroid cancer and primary hyperthyroidism was 12.69％,30.43％,46.67％ and 100.00％ respectivrely.The staining intensity of NIS in the primary hyperthyroidism was higher than thyroid adenoma and thyroid tissues adjacent to thyroid cancer,and that in the thyroid adenoma and thyroid tissues adjacent to thyroid cancer was higher than in differentiated thyroid cancer.Conclusion The NIS proteins were expressed diversely in cell membrane of differentiated thyroid cancer.This study provides a theoretical basis for individualized 131I radiation therapy.The positive expression level of NIS protein in cell membrane of differentiated thyroid cancer may indirectly predict the ability of uptaking iodine and the effect of 131I radiotherapy for differentiated thyroid cancer.

Objective To investigate the risk factors of central lymph node metastasis in papillary thyroid microcarcinoma (PTMC) patients.Methods We retrospectively reviewed 203 PTMC patients who underwent prophylactic central lymph node dissection.Results Sixty-six of 203 (32.5％) patients had central lymph node metastasis,among which there were 48 patients (72.7％) in tumor size ≥7 mm,14 patients (21.2％) in capsular invasion,21 patients (31.8％) in multifocal and 16 patients (24.2％) in bilateral.There was significant difference in tumor size ≥7 mm,capsular invasion,multifocal and bilateral lesions between the two groups (P ＜ 0.05).Non-conditional logistic regression analysis revealed that tumor size ≥7 mm was significantly correlated with central lymph node metastasis (P ＜ 0.05).The central lymph node dissection didn' t increase the rate of hypocalcemia and recurrent laryngeal nerve injury.Conclusion Tumor size ≥7 mm was the main influencing factor contributing to central lymph node metastasis.Capsular invasion,multifocal and bilateral lesions were secondary factors contributing to the central lymph node metastasis.PTMC has high central lymph transfer rate and routine prophylactic central lymph node dissection is necessary.

Objective To observe the pathophysiological change of acute lung injury in rats with severe acute pancreatitis(SAP),and to explore its pathogenesis mechanism .Methods The 240 healthy male SD(Sprague-Dawley) rats from January 2008 to 2009 January were enrolled in the study , these rats were randomly divided into 8 groups according to random digits table,7 observation groups and control group ,the observation groups included 7 different time points of SAP ,ie. 1h group,3h group,6h group,9h group,12h group,18h group,24h group and control group ,with 30 rats in each group.The changes of serum amylase , the ratio of lung tissue wet/dry weight , lung myeloperoxidase ( MPO ) activity and the lungs permeability index were detected and compared among the 8 groups.Results The lung injury score,the ratio of lung tissue wet/dry weight and lung MPO levels in observation groups were gradually increased ,as compared with those in control group , moreover,which in 7 time points were significantly higher than those in control group ( P <0.05).The lung permeability index in observation groups was gradually decreased ,as compared with that in control group ( P <0.05).The MPO levels in lung tissue were positively correlated to lung injury score ( r =0.946, P <0.01),and the ratio of lung tissue wet/dry weight was positively correlated to lung injury score ( r =0.879, P <0.01),however,lungs permeability index was negatively correlated to lung injury score( r =0.859, P <00.1 ).Conclu sion The lung injury degree of rats with SAP is gradually increased with prolongation of course of disease ,moreover ,the MPO levels in lung tissue are continually increased .

目的：研究S期激酶相关蛋白（Skp）2和细胞周期抑制蛋白p27在甲状腺癌癌组织中的表达及临床意义。方法首次就诊的老年甲状腺癌患者85例、甲状腺腺瘤老年患者40例和结节性甲状腺肿老年患者40例，采用免疫组织化学法检测甲状腺癌、甲状腺腺瘤和甲状腺肿组织中Skp2和p27蛋白的表达情况。结果（1）甲状腺癌组织Skp2蛋白阳性表达率显著高于甲状腺腺瘤组织和甲状腺肿组织（P＜0．001），甲状腺腺瘤组织和甲状腺肿组织Skp2蛋白阳性表达率差异无统计学意义（P＞0．05）；（2）甲状腺癌组织p27蛋白阳性表达率显著低于甲状腺腺瘤组织和甲状腺肿组织（ P＜0．001），甲状腺腺瘤组织和甲状腺肿组织p27蛋白阳性表达率差异无统计学意义（ P＞0．05）；（3） Skp2蛋白的表达与肿瘤分期、周围组织侵犯情况及淋巴结转移有关（P＜0．05或P＜0．01），而与性别和肿瘤大小无关（P＞0．05）；（4）p27蛋白的表达与肿瘤分期、周围组织侵犯情况及淋巴结转移有关（P＜0．05或P＜0．01），而与性别和肿瘤大小无关（P＞0．05）；（5）甲状腺癌组织中 Skp2与 p27蛋白表达评分呈负相关（r＝－0．657，P＝0．016）。结论 Skp2和p27蛋白分别在甲状腺癌组织的表达呈负相关，两者参与了甲状腺癌的发生和发展。

Objective To observe the change of serum and urine biochemical indexes in kidney damage rats with severe acute pancreatitis (SAP).Methods A total of 240 healthy male Sprague-Dawley rats were selected as the research obj ects,and the rats were randomly divided into eight groups (each group,n=30)by random number table,named as SAP different time group (SAP 1h,3h,6h,9h,12h,18h,24h group)and the control group.The serum amylase (AMY),serum creatinine (SCr),blood urea nitrogen (BUN)and blood uric acid (UA),the urine creatinine (UCr),renal injury molecules (KIM)-1 andβ-N-acetyl amino glycosidase enzymes (NAG)of different groups were compared.Results The levels of SCr,BUN and UA of SAP 1h, 3h,6h,9h,12h,18h,24h group were higher than those of the control group,the differences were statistically significant (P<0.05).The UCr levels of SAP 1h,3h,6h,9h,12h group were lower than those of the control group,the levels of KIM-1 and NAG were higher than those of the control group,the differences were statistically significant (P<0.05).Conclusion In SAP kidney damage,the renal tubular inj ury is earlier than the capillary damage.The KIM-1 and NAG are the&nbsp;renal tubular damage j udge indexes,the sensitivity and specificity were better than Cr,BUN and UA for early diagnosis of SAP kidney damage.