目的 探讨TAP水平与乳腺癌分子亚型及临床病理参数之间的相关性。方法 以2021年3月—2025年1月期间收治的150例乳腺癌病例为样本,采用静脉采血方式测定TAP凝聚物表面积指标,通过免疫组织化学EnVision双步染色技术,对雌激素受体(ER)、雄激素受体(AR)、孕激素受体(PR)、Ki-67及p53等表达水平进行分析,采用荧光原位杂交(FISH)对人表皮生长因子受体2(HER2)基因扩增状态进行检测。结果 150例患者中,TAP强阳性131例,TAP弱阳性15例,TAP阴性4例,TAP阳性率97.33%。免疫表型:ER阴性43例,ER阳性107例;AR阳性133例,AR阴性17例;PR阴性60例,PR阳性90例;p53阳性73例,p53阴性77例;HER2强阳性41例,HER2弱阳性89例,HER2阴性20例;Ki-67增殖指数≥20% 116例,Ki-67增殖指数<20% 34例。FISH对65例免疫组织化学检测结果为HER2(2+ )的乳腺癌病例进行基因扩增状态分析,其中阳性7例,阴性58例。Ki-67高增殖组TAP表达水平显著高于低增殖组(P<0.05);不同临床分期患者TAP表达水平存在差异(P<0.05);三阴型、HER2阳性型、Luminal A型和Luminal B型的患者之间的TAP表达水平存在差异(P<0.05),各分子分型(HER2阳性型、三阴型、Luminal A型和Luminal B型)与其对应非分型组的TAP表达均无统计学差异(均P>0.05)。结论 TAP在乳腺癌中广泛表达,且与Ki-67增殖指数、临床分期呈正相关。虽然不同分子分型间TAP表达存在总体差异,但具体亚型对比未显示显著性,后期需扩大样本量验证。
Objective To explore the relationship between tumor abnormal protein(TAP)level and molecular typing and clinicopathological features of breast cancer.Methods A total of 150 breast cancer cases admitted from March 2021 to January 2025 were enrolled in this study.The surface area of TAP condensates was measured using venous blood samples.The expression levels of estrogen receptor(ER),androgen receptor(AR),progesterone receptor(PR),Ki-67,and P53 were analyzed via immunohistochemistry(IHC)using the EnVision two-step staining technique.The amplification status of the human epidermal growth factor receptor 2(HER2+)gene was determined using fluorescence in situ hybridization(FISH).Results Among 150 patients,131 cases were strongly positive,15 cases were weakly positive and 4 cases were negative,with a positive rate of 97.33%.Immunophenotype:ER positive in 107 cases and ER negative in 43 cases,133 cases were positive for AR and 17 cases were negative,PR was positive in 90 cases and negative in 60 cases,73 cases were positive for p53 and 77 cases were negative.HER2 is strongly positive in 41 cases,weakly positive in 89 cases and negative in 20 cases.There were 116 cases with Ki-67 proliferation index ≥ 20% and 34 cases with Ki-67 proliferation index < 20%.Sixty-five cases of breast cancer HER2(2 )were detected in the later stage.by FISH,of which 7 cases were positive and 58 cases were negative.The expression level of TAP in patients with high Ki-67 proliferation index was higher than that in patients with low Ki-67 proliferation index(P<0.05).The expression level of TAP in patients with different clinical stages was different(P<0.05).There were differences in TAP expression levels among patients with triple negative type,HER2 positive type,Luminal A type and Luminal B type(P<0.05).There was no statistical difference in TAP expression between each molecular type(triple negative type,HER2 positive type,Luminal A type and Luminal B type)and its corresponding non-typing group(all P>0.05).Conclusions TAP is widely expressed in breast cancer,and it is positively correlated with Ki-67 proliferation index and clinical stage.Although there is a general difference in TAP expression among different molecular typing,the comparison of specific subtypes shows no significance,and it needs to be verified by expanding the sample size
目的 探讨男性人乳头瘤病毒(HPV)基因分型感染情况。方法 收集采用聚合酶链式反应反向斑点杂交法进行28种HPV基因分型检测的1 137例男性检查结果,进行回顾性分析。结果 1 137例男性患者中阳性441例,阳性率为38.79%,感染率居前5位的亚型依次为HPV6(11.35%)、HPV11(7.92%)、HPV16(5.10%)、HPV52(3.52%)、HPV43(2.64%);就诊人群以20~39岁为主,感染人数也最多,各年龄组间阳性率比较差异无统计学意义(P>0.05),≥50岁组HPV52型阳性率高于20~29岁组(P<0.05)和30~39岁组(P<0.05)。单一感染占67.35%,多重感染占32.65%,单一感染中低危型占比最多(41.27%),多重感染中,二重感染占比最多(19.50%),高低危混合感染为各种类型感染之首(15.87%)。结论 1 137例样本中HPV阳性率为38.79%,感染亚型以HPV6、HPV11、HPV16、HPV52、HPV43为主,单一低危型感染较为常见,各年龄组间阳性率相近。
Objective To investigate the genotypes of human papillomavirus(HPV)infection.Methods A total of 1 137 male patients’ diagnoses were collected and analyzed retrospectively,which came from the detections using polymerase chain reaction reverse dot blot hybridization to genotype 28 HPV.Results Among 1 137 male patients,441 were HPV positive,with a positive rate of 38.79%,the infections of top five HPV types were HPV6(11.35%),HPV11(7.92%),HPV16(5.10%),HPV52(3.52%),HPV43(2.64%).The majority of the patients were the 20-39 age group,and the number of infections was also the highest.There was no statistical significance on the difference in the positive rate among different age groups(P>0.05).The positive rate of HPV52 in ≥50 years old group was higher than the groups of aged 20~29(P<0.05)and 30~39(P<0.05).The single and multiple infections accounted for 67.35% and 32.65%.The low-risk HPV accounted for the highest proportion(41.27%)in single infections,while in patients with multiple infections,the proportion of dual infections was the largest(19.50%)and the high- and low-risk HPV mixed infections was the maximum of the infection types(15.87%).Conclusions The detection rate of positive HPV in 1 137 male patients was 38.79%,mainly were type 6,type 11,type 16,type 52 and type 43,and the single low-risk HPV infected was common.Positive rates were similar among different age groups.
目的 本研究对广州地区5家教学医院的鲍曼不动杆菌进行分子流行病学分析。方法 5家教学医院共采集138株鲍曼不动杆菌,利用多位点序列分型(multilocus sequence typing,MLST)及eBURST算法评价菌株之间的遗传关系。结果 MLST将138株鲍曼不动杆菌分为8个已有序列类型(STs),分别为ST195、ST208、ST457、ST136、ST254、ST548、ST445和ST53,还发现17个新STs。其中ST195的数量最多,占所有分离株的35.5%(49/138),其次为ST208,占所有分离株的21.0%(29/138)。eBURST算法分析显示以ST195为预测祖先型的克隆复合体(clonal complex, CC) 195在医院环境中广泛传播。结论 鲍曼不动杆菌CC195是广州地区的流行克隆,各家医疗机构应根据其自身实际制定感染防控策略。
Objective We analyzed the molecular epidemiology of A.baumannii isolated from 5 teaching hospitals in Guangzhou to identify the epidemic clone in this area. Methods A total of 138 strains of A.baumannii were collected from 5 teaching hospitals, and the genetic relationship was evaluated by multilocus sequence typing (MLST) and eBURST algorithm. Results MLST divided 138 strains of A.baumannii into 8 existing sequence types (STs), namely ST195, ST208, ST457, ST136, ST254, ST548, ST445 and ST53, and 17 new STs. Among them, ST195 had the largest number, accounting for 35.5% (49/138) of all isolates, followed by ST208, accounting for 21.0% (29/138) of all isolates. eBURST algorithm showed that the clonal complex (CC) 195, the predicted founder ST195, was widely spread in the hospital environment. Conclusion A.baumannii CC195 was an epidemic clone in Guangzhou area. Medical institution should develop infection prevention and control strategies according to its own actual conditions.
目的 利用新的分型方法指导现有的微创技术下内固定的选择,提示预后,帮助制定术后康复计划。方法 将200例患者随机分成两组,一组为旧Evans分型组,另一组为改良Evans分型组,通过多层螺旋三维CT重建引导下改良Evans分型,对三个重点区域(股骨内距、头颈部及粗隆外侧入针点部位)的CT成像,利用多平面重组(MPR)、表面遮盖显示(SSD)及容积再现(VR)等多种后处理,分析骨折线走形、局部的微骨折、骨小梁分布、骨皮质厚度的骨折部内环境变化。简化整合到Evans分型中。来实现完善影像分型,有效地指导微创手术。对比两组患者的疗效。结果 新Evans分型组98例患者愈合良好,时间为9~17周,中位数为11.2周。其中伤口感染3例,髋关节内翻畸形3例,骨骨头坏死3例,按照髋关节治疗标准评分,优53例,良31例,可9例,差7例。优良率(包括优和良)为84%。旧Evans分型组80例患者愈合良好,时间为9~18周,中位数为11.8周。其中伤口感染10例,髋关节内翻畸形5例,股骨头坏死8例,按照髋关节治疗标准评分,优48例,良26例,可10例,差16例。优良率(包括优和良)为74%。两组对比,新Evans分型组优良率明显高于旧Evans分型组,差异有统计学意义。P<0.05。结论 多层螺旋三维CT重建引导下的改良Evans分型对老年脆骨性粗隆间骨折的微创治疗有重要的临床指导意义。
通过文献检索,对2001—2016年我国学者在国内发表的有关人工髋关节置换后假体周围骨折的Vancouver分型及其治疗方法进行汇总、归纳和分析, 总结分析国内初次生物型人工髋关节术后假体周围骨折病例的Vancouver分型及其不同治疗方法的优良率,为临床决策中选择适合的手术方法提供一定的参考借鉴。共有 117 篇文献入选,统计结果显示入选病例数前三位的省份分别是河南220例占13.3%,上海173例占10.5%,江苏163例占9.9%;Vancouver分型中A型骨折201例占12.2%,B型骨折1226例占74.4%,C型骨折221例占13.4%。AG型骨折行记忆合金环抱器或钢丝环扎+植骨治疗,AL型骨折行翻修+锁定钢板+钢丝或翻修+锁定钢板+植骨治疗,疗效显著;B1、B2、B3型骨折分别采用加压钢板+植骨、翻修+钢板+钢丝+植骨、翻修+记忆合金环抱器+植骨治疗,术后平均优良率可达100%;C 型骨折治疗方法较多,如LISS钢板+植骨、锁定钢板+钢丝、股骨髁钢板+钢缆+植骨、动力髋钢板+钢丝,疗效均较满意。我国人工髋关节置换术地区间开展不平衡,应根据Vancouver 分型,综合考虑患者骨折类型、骨折位置、假体稳定性、骨量丢失情况等提出个体化的治疗方案,提高临床疗效。
目的 探讨白癜风初诊患者外周血细胞因子水平与临床分型、皮损面积的相关性。方法 收集我院2009年7月—2013年7月4年间收治的初诊白癜风患者78例及健康志愿者37例,用ELISA检测外周血血清IL-6、IL-2, IFN-γ、TNF-α浓度并判断其与白癜风分型、皮损程度的相关性。结果 与对照组相比,白癜风各分型组的IL-6、IL-2水平均升高,其中,散在性的升高幅度最为明显。IL-6及IL-2与皮损面积呈正相关,其相关系数分别为0.664及0.483,P值分别为0.021及0.014。结论 IL-2及IL-6在白癜风的发病过程中起重要作用,且在不同的分型中的表达存在差异,并与皮损面积呈正相关。
Objective To evaluate the correlation of cytokine level of peripheral blood cells, clinical classification and skin lesion in preliminary diagnosis of vitiligo. Methods A total of 78 patients with vitiligo of preliminary diagnosis and 37 health volunteers were collected from July 2009 to July 2013. The peripheral blood were collected for ELISA measurement of IL-6, IL-2, IFN-γand TNF-α, and evaluated whether the cytokines concentration was correlated to clinical classification and skin lesion. Results Compared to control group, IL-6 and IL-2 in all of classification of vitiligo was higher, and the most increase was observed in scattered group. Both IL-6 and IL-2 showed the positive correlation with skin lesion (CI: 0.664 and 0.483, P=0.021 and 0.014). Conclusion IL-2 and IL-6 maybe play a key role in vitiligo etiology, and showed different level in different classification of vitiligo. Besides, they showed a positive correlation with skin lesion.
目的 探讨CYP2C19不同基因分型对急性冠状动脉综合征(ACS)患者服用氯吡格雷后血小板聚集率的影响。方法 选取2015年1月—2016年3月入住心内科的ACS患者258例为研究对象。入院时及服用氯吡格雷三日后分别抽取静脉血检测血小板聚集率及CYP2C19基因型。结果 快代谢型组(extensive metabolisers, EM)和中代谢型组(intermediate metabolisers, IM)服药前后血小板最大聚集率分别为(58.76±15.45)% vs(35.17±10.26)%和(59.35±11.58)% vs(47.66±12.59)%(P<0.05), 而慢代谢型组(poor metabolisers, PM)的血小板最大聚集率无明显降低。快代谢型组的最大血小板聚集率的降低幅度比慢代谢型组大(23.58±12.39% vs 11.65±13.56%,P<0.05)。 共有33例(12.79%)患者为氯吡格雷抵抗, 其中快代谢型组中氯吡格雷抵抗者2例(1.67%), 中代谢型组中氯吡格雷抵抗者3例(2.80%), 慢代谢型组中氯吡格雷抵抗者28例(90.32%) (三组比较P=0.038)。结论 ACS患者CYP2C19基因分型与服用氯吡格雷后血小板最大聚集率有关,与氯吡格雷抵抗有关。
Objective To explore the relationship between platelet aggregation rate and CYP2C19 gene polymorphisms. Methods A total of 258 cases diagnosed as acute coronary syndrome (ACS) from January 2015 to March 2016. The platelet aggregation rate was tested before and 3 days after taking clopidogrel. CYP2C19 gene polymorphisms was tested by Gene chip hybridization technique. Results The platelet aggregation rate before and after taking clopidogrel was(58.76±15.45)% vs(35.17±10.26)% and(59.35±11.58)% vs(47.66±12.59)%(P<0.05)in EM group and IM group. But there was no change in PM group. The PM group were associated with a significant increase risk of clopidogrel resistance compared with EM group and IM group. Conclusion CYP2C19 gene polymorphisms influence the rate of platelet aggregation rate after taking clopidogrel and are associated with clopidogrel resistance in ACS patients.