目的：探討單純腦白質疏松癥(LA)以及LA合并腦梗死及其MRI影像學嚴重程度與年齡、性別、高血壓、糖尿病相關性初步分析。方法：根據郭氏等2003年制定的LA診斷標準納入168例腦白質疏松癥患者，分為A、B兩組：A組95例為單純腦白質疏松(LA)，B組73例為LA合并腦梗死(LA+CI)。兩組患者均行頭MRI檢查。根據Kinkel等的方法將T2WI顯示腦室周圍高信號范圍及程度分為5型.結果：年齡與腦白質疏松的嚴重程度呈線性相關性(Plt;0.05)，男性與女性間比較腦白質疏松的發生率無顯著差異(Pgt;0.05)，LA以及LA+CI患者，其高血壓及糖尿病伴發率較高，而且LA+CI組高于LA組(高血壓Plt;0.01，糖尿病Plt;0.01)，LA患者MRI表現以1型為主，LA+CI患者表現以2型為主，Plt;0.01)。結論：腦白質疏松癥的嚴重程度與年齡密切相關，LA的發生率在男女性別間無明顯差異。高血壓、糖尿病可能是LA的危險因素。LA+CI組與單純LA組相比，其高血壓、糖尿病伴發率更高且MRI表現程度更重。
目的 探討上皮細胞鈣黏蛋白（E-Cadherin）、尿激酶型纖溶酶原激活劑（uPA）表達與乳腺癌的浸潤、淋巴結轉移的關系。 方法 采用免疫組織化學鏈霉菌抗生物素蛋白-過氧化物酶連接法對乳腺纖維腺瘤、乳腺腺病和乳腺癌各40例蠟塊中E-Cadherin、uPA表達進行研究。 結果 乳腺纖維腺瘤、腺病和乳腺癌中E-Cadherin陽性率分別為85.0%、82.5%和20.0%，三者差異有統計學意義（P＜0.05）；E-Cadherin表達陰性患者淋巴結轉移率（90.6%）高于E-Cadherin表達陽性者（25.0%），差異有統計學意義（P＜0.01）。uPA在乳腺纖維腺瘤、腺病均呈陰性表達，在乳腺癌中的陽性率為60.0%，三者差異有統計學意義（P＜0.05）；uPA表達陽性患者淋巴結轉移率（88.5%）顯著高于陰性者（50.0%），兩者的表達差異有統計學意義（P＜0.05）。 結論 E-Cadherin和uPA的表達與乳腺癌的浸潤轉移密切相關，同步檢測其在乳腺癌組織中的表達并綜合分析二者之間的關系，對評價乳腺癌細胞的侵襲轉移能力及預后判斷具有一定價值。uPA在乳腺癌中表達率較高，而且和乳腺癌的生物學特性有關，它對提示預后和開展靶向治療有指導意義。
Objective To introduce a method of preoperative three-dimensional measurement by echocardiography to guide the surgical resection of hypertrophic obstructive cardiomyopathy (HOCM) and its long-term follow-up effect. MethodsBefore operation, each patient underwent transthoracic echocardiography to measure the length, width and thickness of diastolic ventricular septum hypertrophy on the long axis, short axis and four chamber sections, in order to establish three-dimensional measurement data of myocardial hypertrophy, and quantitatively estimate the location, depth and range of myocardium to be removed between 2014 and 2022 in our hospital. According to the quantitative data during operation, the hypertrophic myocardium of ventricular septum was resected to dredge the left ventricular outflow tract. ResultsForty-three patients were recruited, including 22 males and 21 females, aged 18-78 (49.2±5.1) years. Eighteen patietns underwent mitral valve surgery at the same time. All patients were satisfied with the relief of left ventricular outflow tract obstruction. Postoperative transesophageal echocardiography showed that the left ventricular outflow tract pressure gradient decreased significantly (94.2±28.1 mm Hg vs. 6.7±4.7 mm Hg, P<0.05). There was no ventricular septal perforation or complete atrioventricular block during the operation, and no one needed a secondary aorta-clamp for re-operation to remove hypertrophic myocardium again. Postoperative echocardiography showed that the mitral valve closed well or only had mild regurgitation, and the mitral systolic anterior motion sign basically disappeared. After 1.0-8.5 years of follow-up, the average pressure difference of left ventricular outflow tract remained below 10 mm Hg, and the clinical symptoms disappeared or improved significantly. Conclusion The quantitative prediction of the resection range of hypertrophic myocardium by three-dimensional measurement of preoperative echocardiography can accurately guide the surgical range of HOCM, avoid multiple blocking of aorta during operation, relieve left ventricular outflow tract obstruction to the greatest extent, and obtain better long-term results.
Objective To investigate the clinicopathological features, postoperative survival and prognostic influencing factors of male patients with hepatocellular carcinoma （HCC）. Methods The clinicopathological features and the follow-up data of 155 male HCC patients who received hepatectomy from Jan. 1995 to Dec. 2002 were retrospectively analyzed and the prognostic influencing factors were defined by uni- and multi-variate analysis. Results Compared with 24 female patients at the same period, males were about six-year older and both of their hepatitis B surface antigen (HBsAg) and liver cirrhosis positive rates were higher (P＜0.05)， but there were no significant differences of the other clinicopathological parameters between the male group and the female group. Multivariate analysis showed that Edmondson-Steiner grade and portal vein tumor thrombosis (PVTT) were two independent prognostic influencing factors of both the overall survival and the tumor-free postoperative survival of male patients with HCC, while satellite nodule and tumor size only influenced the overall survival. Conclusion The main clinicopathological features and the postoperative survival of male HCC patients were similar than those of female’s. Tumor differentiation and biological behaviors were major factors affecting postoperative survival of male patients with HCC.