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Objective To explore the clinical effect of the open and laparoscopic surgery in the treatment of ectopic pregnancy to retain the clinical efficacy of reproductive function analysis. Methods Four hundred and fifty-six patients with ectopic pregnancy were selected as our subjects. Two hundred and eleven cases were served as laparotomy group( open),and 245 cases were laparoscopic group( laparoscopic). The data of intraoperative blood loss,operative time,postoperative anal exhaust time,average hospital stay,tubal patency rate,intrauterine pregnancy rate and again repeat ectopic pregnancy rate were recorded. Results Patients in two groups were successfully completed surgery. The operative time,intraoperative blood loss,postoperative anal exhaust time,average hospitalization time were(55. 1 ± 13. 5)min,(63. 5 ± 18. 3)ml,(25. 7 ± 5. 6)h,(6. 1 ± 2. 0)d respectively in laparotomy group,and(41. 3 ± 15. 5)min,(41. 1 ± 13. 3)ml,(13. 5 ± 5. 1)h,(3. 6 ± 1. 4)d respectively in laparoscopic group,and the differences were significant( t =2. 045,2. 263,3. 131, 3. 152,P﹤0. 05). The tubal patency rate,intrauterine pregnancy,ectopic pregnancy rate in laparotomy group were 81. 0%( 171/211 ),59. 7%( 126/211 ) and 26. 5%( 56/211 ) respectively,and 75. 5%( 185/245 ), 53. 5%( 131/245 ) and 22. 9%( 56/245 ) respectively in laparoscopic group,and the differences were not significant(χ2 =2. 254,2. 130,1. 242;P ﹥0. 05 ). Conclusion Laparoscopic surgery in the treatment of ectopic pregnancy is superior to laparotomy in terms of small trauma,less bleeding,faster recovery,shorter hospitalization time,and postoperative tubal patency rate.
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Objective To study the expression of HPV、p16 and Her-2 in the squamous cell cervical carcinoma and its chnical significance. Methods Expression of HPV16/18、p16, and C-erbB-2 and the amplification of Her-2 gene were examined using situ hybridization technique,SP immunohistochemistry,and FISH imaging analysis system in 60 cases of cervical cancer, 61 cases of CIN, and 21 cases of normal cervical tissue,respectively.Results The positive rates of HPV16/18 and p16 in the normal tissue,CIN Ⅰ -Ⅱ,CINⅢ and the squamous cell cervical carcinoma were gradually increased, they wereo (0/21),9.68 ％ (3/31),46.67 ％ (14/30),71.67 ％ (43/60);0 (0/21),19.35 ％ (6/31),93.33 ％ (28/30),96.67 ％ (58/60),respectively,and there were significant differences among the groups (P＜0.05),but no significant difference was found between the normal tissue and the CIN Ⅰ - Ⅱ. The positive rates of Her-2 and Her-2 in the CIN Ⅲ and the carcinoma were 13.33 ％ (4/30),31.67 ％ (19/60),3.33 ％ (1/30),21.67 ％ (13/60),respectively,but in the normal group and the CIN Ⅰ - Ⅱ wereo,and the differences between the carcinoma group and the CIN group,the carcinoma group and the normal group were significant(P＜0.05).The expression of Her-2 and the amplification of Her-2 were closely related to the stage, degree of differentiation and metastasis of lymph node in the squamous cell cervical carcinoma (P＜0.05). Conclusion The infection of HPV is one of thetriggers for the squamous cell cervical carcinoma.The expression of p16 and the amplification of Her-2 may be closely correlated with tumor development and high expression of p16 and Her-2 indicates poor prognosis.
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ObjectiveTo study the expressions of Ki-67 and p53 in the surface cells and polygonal cells in pulmonary sclerosing hemangioma(PSH)and investigate the relation of cell proliferation index and biological behaviour of the tumor.MethodsDouble-staining immunohistochemistry was used to detect the expressions of Ki-67 and CK8/18 protein. Double immunofluorescence staining was used to detect the expressions of p53 and AE1/AE3 protein. ResultsThe positive signal of AE1/AE3 and CK8/18 were localized in cytomembrane of surface cells. The positive signal of Ki-67 and p53 were localized in cell nucleus of the two kinds of cells.The positive rate of Ki-67 was under 1％ in surface cells and 1％-10 ％ in polygonal cells. p53 protein was mainly expressed in polygonal cells (6/9, 33.3 ％) and only exsited in seldom surface cells.ConclusionThere are differences on cellular morphous and immunophenotype between the surface cells and polygonal cells.The proliferation index and gene mutation are all predominant in polygonal cells than in surface cells. The biological behaviour of PSH maybe mainly be decided by the polygonal cells.
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Objective To investigate the expressions of p16, cyclinD1 protein in esophageal squamous cell carcinoma and its clinic significance. Methods The expressions of p16 and cyclinD1 protein in 55 esophageal carcinoma cases were detected by immunohistochemical technique. Results The positive expression of p16 protein in 55 patients was 49.1%(27/55). The loss of p16 protein was significantly related to lymph node metastasis (P ＜0.05), and the positive expression of p16 had the higher five-year survival rate.Conversely, the positive expression of cyclinD1 in 55 patients was 74.5 % (41/55), and had the lower five-year survival rate compared to the negative expression cases. Conclusion Loss of p16 protein in human ESCC is a frequent event and correlates significantly with the lymph node metastasis. The loss of p16 and the over expression of cyclinD 1 in esophageal carcinoma may serve as a risk prognosis factors.
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Objective To analyse the expression of p16INK4A, CyclinD1, Ki-67 proteins and HPV16/18, 31/33 in invasive squamous cell carcinoma of cervix(ISCC)and to indicate the significance of them in the occurrence and development of ISCC. Methods Using tissue microarray,in Situ Hybridization (ISH) and immunohistochemical method detected the expression of HPVI6/18, 31/33 and investigated the expression of p16INK4A, CyclinD1, Ki-67 in ISCC, CIN and NCE. Results was analysed by SPSS vision 13.0. Results The positive expression rate of HPV16/18, CyelinD1, Ki-67 in ISCC was markedly higher than that in CIN and NCE. Significant relationship was observed between p16INK4A protein expression and histological grade of the cancer. No significant correlation was observed between CyclinD1 protein expression and every clinical pathological parameters of ISCC. Conclusion High-risk HPV takes an important role in the development in ISCC. p16INK4A gene might not act as a suppressor-gene only on the occurrence in ISCC. Ki-67 can be looked as a valuable clinic index of diagnosing benign and malignant tumor.
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Objective To investigate the relationship and clinicopathologic significance between the expression of CD95,CD44V6 and metastasis of axillary lymph node in breast cancer.Methods Immunohistochemistry was used to detect the expression of CD95 and CD44V6 in 101 cases of breast cancer, in which, 40 cases without metastasis in axillary lymph node were detected MCK expression by IHC. The results were analyzed statistically. Results 9 cases of breast cancer with lymph node micrometastasis were observed by IHC in 40 cases without metastasis in axillary lymph node by microscope. The expression of CD95, CD44V6 in lymph node metastasis group was similar as in lymph node micrometastasis group. There was significant difference of CD95 expression between those with lymph node metastasis and those without. The positive rate of CD95 and the high expression of CD44V6 in the cases that the tumor size was over 2 cm were significandy higher than in the cases that the tumor size was less than 2 cm (P<0.05). Conclusion Detection of the expression of CD95, CD44V6 in breast cancer may be helpful to predict the lymph node micrometastasis and provide more dependable evidence for judging prognosis and selecting treatment prescription clinically.
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Objective To explore expression and clinical value of VEGF-C and p63 in early esophageal carcinoma and intraepithelial neoplasia. Methods 146 cases were randomized into normal esophageal mucosa, low level intraepithelial tumor, high level intraepithelial tumor and early esophageal carcinoma. The expression of VEGF-C and p63 were detected by using the immunohistochemistry dyeing.Results The expression of VEGF-C immunohistochemistry dyeing had statistical differences among different levels(X~2= 47.455, P <0.001). Normal esophageal mucosa v.s. high level intraepithelial tumor (X~2=36.721, P <0.001), Normal esophageal mucosa v.s. early esophageal carcinoma (X~2=26.483, P <0.001), low level intraepithelial tumor v.s. high level intraepithelial tumor(X~2= 10.025, P<0.0083), low level intraepithelial tumor v.s. early esophageal carcinoma(X~2=16.734, P<0.001). There was a significant correlation between pathological classification and the expression amount of VEGF-C (r = 0.462, P <0.001). The expression of p63 had statistical differences among different levels(X~2=28.962, P <0.05). There was a significant difference on normal esophageal mucosa comparing with low level, high level intraepithelial tumor or early esophageal carcinoma (X~2=12.735, P =0.005, X~2=20.421, P<0.001, X~2=20.854, P<0.001). There was a significant correlation between pathological classification and the expression of p63 (r= 0.272, P<0.05). Conclusion There is a significant correlation in the express of either VEGF-C or p63 comparing with either intraepithelial tumor or early esophageal carcinoma. It may be an early warning indicator.
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BACKGROUND : After femoral neck fracture, incidences of ischemic necrosis and bone non-healing are closely related to biomechanical characteristics of internal fixation devices. Compression stress can improve fracture healing, tension force can delay fracture healing, and shear stress can inhibit fracture healing. How to relieve shear stress and expand compression stress is of significance for theories and clinical applications.OBJECTIVE: To compare the biomechanical characteristics of the two geometric configurations of three cannulated compression screws in the fixation for femoral neck fracture and to provide a theoretical foundation in the treatment of femoral neck fracture.DESIGN : Observational contrast study.SETTING: Department of Orthopaedics, the 251 Hospital of Chinese PLA; Department of Orthopaedics, the Third Hospital, Hebei Medical University.PARTICIPANTS: The experiment was carried out in the Hebei Orthopaedic Institute from November 2002 to March 2003. Five cadavers including 4 males and 1 female with similar bone mineral density (BMD) were provided by Department of Anatomy, Hebei Medical University. X-ray photographs proved that all the cadavers did not have rheumatism, tuberculosis, tumor, fracture or deformity.METHODS: Ten femurs were randomly divided into inverted and upright isosceles triangle with 5 in each group. Femur samples with femoral neck fracture were fixed with three cannulated screws and measured with the biomechanical machine (CSS-44020, made in Changchun Experimental Researching Institute, provided by Hebei Orthopaedics Institute). The compression strength, torsibility and the maximal vertical loading were compared between the two configurations of screws.MAIN OUTCOME MEASURES:①Displacement of femoral head at 600 N and 750 N during torsibility test; ②torque-moment at 2°and 4°during torsibility test;③load during maximal vertical loading test.CONCLUSION: The effect of three cannulated compression screws configured as an inverted isosceles triangle on the treatment of femoral neck fracture is superior to that of three cannulated compression screws as an upright isosceles triangle.
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OBJECTIVE To find out the main polluting bacteria in the medical establishments in Langfang city so as to direct the work of disinfecting and reduce the rate of the nosocomical infection in the medical establishments. METHODS The environment of the medical establishments was divided to five groups, including the air, the object surface , the medical workers hands, the using disinfectant and the medical equipment. RESULTS The main polluting bacteria in the air, on the object surface and the medical equipment were the Gram-positive cocci. The main polluting bacteria in the using disinfectant was the Gram-negative bacilli. The Gram-negative bacilli were more than the Gram-positive cocci on the hands of the medical worker. The main bacteria were Staphylococcus epidermidis, Escherichia coli and Acinetobacter. The using disinfectant was with the maximum qualified rate (98.8%), and with only 6 samples unqualified. The air was with the minimum qualified rate (58.22%). CONCLUSIONS No spores gemma which are difficult to be killed have been found and the unqualified samples in various environment are mainly due to the weak awareness of disinfection and the careless attitude.
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Objective To explore the value of Chinese ink in identifying sentinel lymph nodes(SLN) during radical resection of cervical carcinoma.Methods After sterilized Chinese ink(1ml) was infused in normal tissue at four points,extensive cervical resection and cleaning operation of pelvic lymph nodes were performed.Lymph nodes staining black in drainage field of pelvic lymph system were investigated.Results Lymph nodes staining black were found in 15 cases.The identifying rate was 100%(15/15).Positive lymph nodes were found in 2 cases with lymph node metastasis.The accurate rate of pelvic lymph nodes metastasis was 100%.Conclusion The effect is reliable by using Chinese ink as tracer of SLNs in cervical carcinoma.