目的：探讨单纯脑白质疏松症(LA)以及LA合并脑梗死及其MRI影像学严重程度与年龄、性别、高血压、糖尿病相关性初步分析。方法：根据郭氏等2003年制定的LA诊断标准纳入168例脑白质疏松症患者，分为A、B两组：A组95例为单纯脑白质疏松(LA)，B组73例为LA合并脑梗死(LA+CI)。两组患者均行头MRI检查。根据Kinkel等的方法将T2WI显示脑室周围高信号范围及程度分为5型.结果：年龄与脑白质疏松的严重程度呈线性相关性(Plt;0.05)，男性与女性间比较脑白质疏松的发生率无显著差异(Pgt;0.05)，LA以及LA+CI患者，其高血压及糖尿病伴发率较高，而且LA+CI组高于LA组(高血压Plt;0.01，糖尿病Plt;0.01)，LA患者MRI表现以1型为主，LA+CI患者表现以2型为主，Plt;0.01)。结论：脑白质疏松症的严重程度与年龄密切相关，LA的发生率在男女性别间无明显差异。高血压、糖尿病可能是LA的危险因素。LA+CI组与单纯LA组相比，其高血压、糖尿病伴发率更高且MRI表现程度更重。
目的 探讨上皮细胞钙黏蛋白（E-Cadherin）、尿激酶型纤溶酶原激活剂（uPA）表达与乳腺癌的浸润、淋巴结转移的关系。 方法 采用免疫组织化学链霉菌抗生物素蛋白-过氧化物酶连接法对乳腺纤维腺瘤、乳腺腺病和乳腺癌各40例蜡块中E-Cadherin、uPA表达进行研究。 结果 乳腺纤维腺瘤、腺病和乳腺癌中E-Cadherin阳性率分别为85.0%、82.5%和20.0%，三者差异有统计学意义（P＜0.05）；E-Cadherin表达阴性患者淋巴结转移率（90.6%）高于E-Cadherin表达阳性者（25.0%），差异有统计学意义（P＜0.01）。uPA在乳腺纤维腺瘤、腺病均呈阴性表达，在乳腺癌中的阳性率为60.0%，三者差异有统计学意义（P＜0.05）；uPA表达阳性患者淋巴结转移率（88.5%）显著高于阴性者（50.0%），两者的表达差异有统计学意义（P＜0.05）。 结论 E-Cadherin和uPA的表达与乳腺癌的浸润转移密切相关，同步检测其在乳腺癌组织中的表达并综合分析二者之间的关系，对评价乳腺癌细胞的侵袭转移能力及预后判断具有一定价值。uPA在乳腺癌中表达率较高，而且和乳腺癌的生物学特性有关，它对提示预后和开展靶向治疗有指导意义。
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.