中国实用医刊杂志   部级期刊

摘要：目的 探讨Smac和XIAP基因在肾细胞癌组织中的表达及其临床意义.方法 采用免疫组织化学法检测95例肾癌标本不同分型、分级、分期及10例正常肾组织中Smac和XIAP的表达,分析其表达与肾癌分级、分期的关系及二者表达相关性.结果 Smac在各型肾细胞癌中随分期、分级的增加表达减低,XIAP在各型肾细胞癌中随分期、分级的增加表达增高,二者的表达呈负相关.结论 Smac和XIAP表达与肾细胞癌分期、分级关系密切,共同参与了肾癌的发生发展. Abstract： Objective To study the expression and significance of Smac and XIAP in renal cell carcinoma(RCC). Methods The expressions of Smac and XIAP were detected using SP immunohistochemical technique in 95 cases of RCC and 10 cases of normal renal tissue. Results The postitive expressions of Smac were statistically significant differences in different clinical statges. The postitive expressions of XIAP were higher in RCC related to the lower histological grade. Smac protein and XIAP protein expression had negative correlation. Conclusions It indicate that Smac and XIAP may play an important role in RCC. The expression of Smac and XIAP are statistically significant associated with tumor grade and clinical stage.

摘要：目的 总结全腔静脉肺动脉连接术治疗复杂先天性心脏病的经验,并对心内隧道和心外管道两种全腔静脉肺动脉连接术术式进行比较.方法 全组32例复杂先天性心脏病,12例行心内隧道全腔静脉肺动脉连接术,20例行心外管道全腔静脉肺动脉连接术.结果 全组患者死亡2例,发生低心排出量综合征8例,10例出现胸腔积液(均治愈),血流动力学满意,术后随访心功能Ⅰ～Ⅱ级,紫绀消失,无心律失常发生.结论 全腔静脉肺动脉连接术是治疗复杂先天性心脏病的一种有效方法,临床效果好,优于传统的Fontan手术;心外管道全腔静脉肺动脉连接术较心内隧道全腔静脉肺动脉连接术操作更简单. Abstract： Objective To summary the experience of total cavopulmonary connection (TCPC) with different methods and study the operative indication, design and therapeutic efficacy. Methods Thirty-two cases of complex cyanotic congenital heart disease were reviewed: 12 cases underwent lateral tunnel and 20 cases extra-cardiac conduit TCPC.Results Two cases were died, and low heart output syndrome occurred in 8 cases, pleural effusion in 10 cases were cured at last. Cyanosis were abscised in all patients and no arrhythmogenesis occured and the heart function improved too. Conclusions The surgical procedures of TPCP is a modus operandi to treat the complex cyanotic congenital heart disease and outweigh the orthodox Fontan procedure. The operating performance of extra-cardiac conduit TCPC is reducing to the lateral tunnel.

摘要：目的 通过16层螺旋CT分析肺孤立性结节与胸膜的关系,以提高对孤立性肺结节的诊断和鉴别诊断.方法 回顾性分析56例已被手术或临床回访证实的肺孤立性结节与邻近胸膜关系的影像学资料.结果 56例中肺癌29例,炎性结节11例,结核球8例,错构瘤4例,转移瘤2例,硬化性血管瘤1例,腺瘤1例.肺孤立性结节与邻近胸膜的改变主要包括胸膜增厚、粘连及胸膜凹陷,其中肺癌病例中有典型胸膜凹陷12例,胸膜呈大范围增厚5例,小范围增厚6例,小范围增厚并有多处粘连6例.11例炎性结节中典型胸膜凹陷2例,胸膜呈大范围增厚5例,小范围增厚并有胸膜粘连4例.结核球有胸膜粘连8例,胸膜小范围增厚1例,1例无胸膜改变.错构瘤、转移瘤、硬化性血管瘤及腺瘤邻近胸膜均无改变.结论 MSCT多层面重建显示肺孤立性结节与胸膜关系对孤立性肺结节诊断和鉴别诊断有很大临床应用价值. Abstract： Objective To analyse the relationship between solitary pulmonary nodules and pleural relationship by 16-slice spiral CT,and to improve the diagnosis of solitary pulmonary nodules and differential diagnosis. Methods A retrospective analysis of 56 cases had been confirmed by surgery or clinical returning to isolate peripheral lung nodules and pleura between adjacent image data. Results In 56 cases, lung cancer of 29 cases, inflammatory nodules of 11 cases, 8 cases of tuberculoma, 4 cases of hamartoma, metastatic tumors, 2 cases of sclerosing hemangioma of a tumor, adenoma in 1 case. Solitary pulmonary nodules and adjacent pleural changes include pleural thickening, adhesions, and pleural indentation. Which lung cancer cases with typical pleural indentation in 12 cases, showed a wide range of pleural thickening in 5 cases,small-scale thickening in 6 cases, small-scale thickening and multiple adhesions in 6 cases. Eleven cases of inflammatory nodules typical pleural indentation, 2 cases showed extensive pleural thickening in 5

摘要：目的 探讨螺旋CT动态增强扫描对肺孤立性结节病变的良、恶性鉴别诊断价值.方法 经病理证实的62例肺孤立性结节,平扫后,以2 ml/s速率注入造影剂后1、2、3、4、5 min薄层扫描.分析强化值、时间-密度曲线及强化形态对良、恶性结节的鉴别价值.结果 恶性结节的强化值(49±15)Hu明显高于良性结节(18±16)Hu(P＜0.01).周围型肺癌的主要强化形态是完全性强化及周围性强化.恶性结节增强后CT值立即升高,2 min形成强化高峰,然后逐渐下降,而良性结节特别是结核球增强后CT值缓慢上升,无明显峰值出现.结核球的主要强化形态是无强化及包膜样强化,占92.3%.结论 强化值≤15 Hu提示良性结节;强化值＞20 Hu考虑恶性结节.动态增强CT对周围型肺癌与结核球的鉴别有较高价值. Abstract： Objective To analyze the feature of the solitary pulmonary nodules at dynamic contrast-enhanced spiral CT. Methods Sixty-two patients with solitary pulmonary nodules proved by pathology were studied. Thin-section CT scans were obtained before and after enhancement 1,2,3,4 and 5 minutes. Results Malignant nodules enhanced (49±15)Hu significantly more than benign nodules (18±16)Hu. The major enhancement pattern of peripheral lung carcinoma was complete enhancement, a little show peripheral enhancement. Tuberculoma show capsular enhancement or non enhancement. Conclusions Absence of significant lung noldue enhancement (≤15 Hu) at CT is strongly predictive of benignity.Malignant nodules enhanced significantly more than benign nodules. Dynamic contrast enhanced CT is useful in the differential diagnosis of lung carcinoma and tuberculoma.