目的 探讨单核细胞趋化蛋白-1(monocyte chemotactic protein-1,MCP-1)及脂蛋白(a)[lipoprotein(a),LP(a)]与梅尼埃病的关系.方法 选取30只健康SD大鼠,分成正常组、对照组及实验组,每组10只,实验组腹腔注射醋酸去氨加压素(4μg·kg-1·d-1连续注射7 d后改为6μg·kg-1·d-1连续注射3 d)行膜迷路积水造模,对照组腹腔注射等量生理盐水,正常组不作处理,停药7 d后对三组动物行ABR检测,取耳蜗中阶横截面积(SM)/(中阶+前庭阶横截面积)(SM+SV)比值评价膜迷路积水情况.造模成功后通过免疫组化染色检测耳蜗组织中MCP-1的表达,通过酶联免疫吸附实验(ELISA)法检测血清中LP(a)的水平,对LP(a)水平与内耳积水程度及大鼠ABR各指标进行相关性分析.结果 实验组波 Ⅱ 阈值升高、波 Ⅱ 、Ⅴ 潜伏期及 Ⅲ-Ⅴ 波间期较正常组和对照组均延长,差异有统计学意义(P<0.05).实验组、对照组、正常组SM/(SM+SV)比值分别为0.45±0.04、0.34±0.02、0.35±0.01,前者显著大于后两者(P<0.05).实验组M C P-1在耳蜗螺旋器、血管纹螺旋韧带及神经节细胞组织表达明显,前庭膜上也有表达,其它两组无表达.实验组、对照组、正常组L P(a)水平分别为4.07±0.20、1.36±0.12、1.38±0.14 mg/L,前者显著高于后两者(P<0.001),LP(a)表达水平与膜迷路积水程度及ABR各指标间均呈正相关(P<0.001).结论 膜迷路积水模型大鼠耳蜗组织中MCP-1表达明显,血清LP(a)水平明显升高,且LP(a)水平与膜迷路积水程度及大鼠听力下降呈正相关,提示MCP-1和LP(a)可能与梅尼埃病的发生有关.

Objective To investigate the relationship between programmed death 1 (PD-1) and programmed death ligand 1(PD-L1) with clinicopathological characteristics in the patients with laryngeal carcinoma.Methods The expression levels of PD-1 and PD-L1 in 45 samples of laryngeal carcinoma tissue(laryngeal carcinoma group) and 37 samples of vocal cord polyp tissues(polyp group) were detected by using the immunohistochemical method.Then the relationship between PD-1 and PD-L1 with clinicopathological characteristics in the patients with laryngeal carcinoma was analyzed.Results The positive expression rates of PD-1 and PD-L1 in the laryngeal carcinoma group were 57.78％ and 66.67 ％ respectively.PD-1,PD-L1 mainly located in cytoplasm or cell membrane of laryngeal carcinoma cells or interstitial lymphocyte.The positive expression rates of PD-1 and PD-L1 in the polyp group were 8.11％ and 13.51％ respectively.The positive expression rates of PD-1 and PD-L1 in the laryngeal carcinoma group were significantly higher than those in the polyp group(P＜0.01).The expression of PD-1 and PD-L1 in laryngeal carcinoma tissue had a correlation.The positive expression rates of PD-1 and PD-L1 in the laryngeal carcinoma tissue of stage Ⅲ and Ⅳ were significantly higher than those of stage Ⅰ and Ⅱ (P＜0.05).The positive expression rates of PD-1 and PD-L1 in highly differentiated laryngeal carcinoma tissue were significantly higher than those in moderately and lowly differentiated carcinoma tissue(P＜0.05).Conclusion PD-1 and PD-L1 play an important role in the occurrence and development of laryngeal carcinoma.The expression of PD-1 and PD-L1 is closely correlated to the clinical stage and differentiation degree of laryngeal carcinoma.

目的:研究SOX9在喉鳞癌组织中的表达以及S期组分(S phase fraction,SPF)的变化,探讨与肿瘤发生发展的关系.方法:采用免疫组织化学方法检测60例喉鳞癌(喉癌组)与32例正常喉黏膜组织(对照组)中SOX9蛋白表达变化,应用图像分析技术检测SOX9阳性表达产物的面密度及积分光密度值变化,同时采用流式细胞术检测喉癌组与对照组组织中SPF变化.结果:喉癌组面密度及积分光密度值较对照组升高,两组比较差异有显著性(P＜0.01).喉鳞癌组织中SOX9蛋白表达升高,喉鳞癌组织中SOX9蛋白表达与对照组比较差异有显著性(P＜0.01).喉癌组SPF高于对照组,二者差异有统计学意义(P＜0.01).结论:SOX9蛋白异常表达及SPF变化可能在喉鳞癌发生发展中发挥重要作用.

目的 探析尾型同源盒转录因子-2(Caudal type homeobox transcription factor-2,CDX2)在喉癌(laryngeal carcinoma,LC)组织中的表达及其作用.方法 采用免疫组织化学方法(Immunohistochemistry,IHC)检测两种组织中CDX2蛋白的表达,比较喉癌与声带息肉组织中CDX2面密度值及其积分光密度值的变化.结果 CDX2蛋白呈棕黄色颗粒,主要表达位于细胞核.对照组CDX2的表达无论在强度或细胞数量上均高于实验组,二组间差异有统计学意义(P＜0.01).结论 CDX2在喉癌组织中表达异常,CDX2异常表达可能在喉癌发生发展过程中发挥重要作用.

目的:探讨微创手术治疗声门型早期喉癌及癌前病变的临床疗效.方法:选择于2012年12月~2013年12月在我院治疗的声门型早期喉癌及癌前病变患者100例,随机分为观察组和对照组,每组50例,观察组采用低温等离子射频消融术治疗,对照组采用传统口切开手术治疗,比较两组近期疗效及复发情况.结果:①术后,观察组患者的黏膜恢复情况明显好于对照组,组间差异具统计学意义(P<0.05);②1年后,观察组复发率为0.0%(0/50),对照组复发率为8.0%(4/50),组间差异具统计学意义(P<0.05).结论:微创手术治疗声门型早期喉癌及癌前病变具有术后恢复好,复发率低的优点,值得推广应用.

目的 探讨婴幼儿反复肺炎的临床特点及其治疗和转归。方法 婴幼儿反复肺炎76例入院后经验性选择抗感染药物及对症处理,重症即喘憋较重患儿给予短程激素止喘药物,有基础病史的给予支持治疗,积极治疗原发病。结果 11月至来年的2月寒冷季节发生率高,为88.9％(160/180例次)。6例患儿治疗时间为7～21 d;治愈出院74例,死亡2例,1例为复杂性先心病患儿,1例为Ⅱ度营养不良患儿。结论 寒冷是婴幼儿肺炎反复发生的诱因,而基础疾病的存在是患儿肺炎反复发生的主要原因,故对于存在基础疾病患儿应在抗炎治疗同时积极治疗原发病。