原发性肝癌组织癌基因ras和抑癌基因P^53点突变研究

应用多聚酶链延伸反应－限制性片段长度多态性分析法（ＰＣＲ－ＲＦＬＰ）对４３例福尔马林固定、石蜡包埋肝癌组织癌基因ｒａｓ和抑癌基因Ｐ＾５３点突变进行分析。结果表明，ｒａｓ基因总突变率为４１．９（１８／４３），其中Ｎ－ｒａｓ第１２位密码子突变率为３７．２％（１６／４３），ｃ－Ｋｉ－ｒａｓ第１２位密码子突变率为６．９％（３／４３），ｃ－Ｋｉ－ｒａｓ第１３位、ｃ－Ｈａ－ｒａｓ第１２和６１位密码子未发现有突     

白血病中N－ras基因点突变的研究

Ｎ－ｒａｓ基因是ｒａｓ基因族其中一种，主要以点突变的方式激活。分子生物学研究提示，Ｎ－ｒａｓ的激活与白血病的发生存在一定程度的相关。此项工作取材９例急性髓细胞性白血病（ＡＭＬ）患者，以７例正常体检者为对照进行了Ｎ－ｒａｓ基因点突变的初步研究。研究样本均取自北京的三级医院，所有患者均被所在医院确诊为ＡＭＬ，其中男性４例，女性５例，平均年龄３７岁。点突变的探测方法采用等位基因特异寡核苷酸探针（ＡＳＯ）斑点杂交方法，人工合成ＡＳＯ探针４种，长度均为２０ｍｅｒ。探测对象为Ｎ－ｒａｓ基因第１２，１３位密码子Ｇ→Ａ的点突变。为验证方法的可靠性，对一例阳性发现者进行了ＤＮＡ序列分析。研究发现在９例ＡＭＬ患者中，３例发现有Ｎ－ｒａｓ第１２位密码子Ｇ→Ａ的点突变。对照中未发现相同的点突变但有１例发现携有Ｎ－ｒａｓ第１３位Ｇ→Ａ的点突变。研究结果提示，Ｎ－ｒａｓ基因点突变，尤其是第１２位密码子的点突变，与白血病病因存在一定相关性。Ｎ－ｒａｓ在正常人中的突变情况及其意义尚需进一步探索。     

PCR方法检测微量残留白血病细胞

以Ｎ－ｒａｓ癌基因突变作为急性髓细胞白血病的分子标志，用ＰＣＲ技术研究该病的微量残留白血病细胞。１２例缓解期患者中检测到４例有Ｎ－ｒａｓ癌基因突变，对１０列患者作动态观察发现２例突变一直存在，２例在病程中发生突变。因此，Ｎ－ｒａｓ癌基因突变可用于检测ＭＲＬＣ。     

多发性骨髓瘤患者中N-ras基因突变的检测及其意义

目的：了解多发性骨髓瘤（ｍｕｌｔｉｐｌｅ ｍｙｅｌｏｍａ,ＭＭ）患者中Ｎ－ｒａｓ基因突变率及临床意义,方法采用聚合酶链反应－单链构象多态性银染法检测ＭＭ患者的Ｎ－ｒａｓ基因突变,并结合临床分析。结果１４例ＭＭ患者中,４例在Ｎ－ｒａｓ第６１密码子,１例在第１２、１３密码子处发生突变,突变率为３５．７％。突变者中４例已死亡,其中２例检测突变时已处于疾病终末期。结论Ｎ－ｒａｓ基因在ＭＭ中有较高的突变率,     

结直肠癌病人粪便及组织中Ki—ras基因突变的研究

作者采用ＰＣＲ－ＲＦＬＰ方法研究了中国人结直肠癌ｒａｓ基国突变的背景，并在病人粪便ＤＮＡ中检测该突变基因。３５例癌组织中发现Ｋｉ－ｒａｓ１２位密码子突变１１例（３１．４％），６１痊密码子１例（２．９％），没有发现西方结直肠癌中较为常见的１３位密码子突变。１８例病人粪便ＤＮＡ中６例有突变ｒａｓ基因，并与癌肿细胞的检测结果完全吻合。作者认为从粪便ＤＮＡ检测ｒａｓ基因突变，对早期发现结直肠肿瘤具有实际应     

新疆地区食管癌组织ras基因突变的研究

目的：探讨新疆哈萨克族食管癌组织ｒａｓ基因的变化及临床意义。方法：采用ＲＦＬＰ和ＳＳＣＰ法对４８例原发性食管癌组织进行Ｈａ－ｒａｓ,Ｋｉ－ｒａｓ基因突变的检测。结果：４８例食管癌中,Ｈａ－ｒａｓ基因外显子的第１２ 位密码子点突变有１０ 例,哈萨克族、汉族和维吾尔族的突变分别为４／２２、５／２１ 和１／５,而未发现Ｋｉ－ｒａｓ基因的突变。结论：Ｈａ－ｒａｓ 癌基因突变是食管癌组织的一种标志物。实验结果进一步支持在食管癌的发生、发展中有多种基因的改变。     

结直肠癌病人粪便及组织中Ki－ras基因突变的研究

作者采用ＰＣＲ－ＲＦＬＰ方法研究了中国人结直肠癌ｒａｓ基国突变的背景，并在病人粪便ＤＮＡ中检测该突变基因。３５例癌组织中发现Ｋｉ－ｒａｓ１２位密码子突变１１例（３１．４％），６１位密码子１例（２．９％），没有发现西方结直肠癌中较为常见的１３位密码子突变。１８例病人粪便ＤＮＡ中６例有突变ｒａｓ基因，并与癌肿组织的检测结果完全吻合。作者认为从粪便ＤＮＡ检测ｒａｓ基因突变，对早期发现结直肠肿瘤具有实际应用前景。     

骨髓增生异常综合征患者N－ras原癌基因突变的研究

应用ＰＣＲ－ＳＳＣＰ及直接测序法研究ＭＤＳ患者Ｎ－ｒａｓ原癌基因点突变。检测２６例（２８例次），发现Ｎ－ｒａｓ原癌基因第１外显子突变者１４例（５０％），统计表明Ｎ－ｒａｓ原癌基因突变与ＭＤＳ白血病转化及患者生存期缩短均有相关性（Ｐ＜０．０５），对预测ＲＡ、ＲＡＳ转化白血病有参考价值。对１例发现突变的标本进行直接测序证实为１２密码子第２碱基的Ｇ→Ａ转换。     

骨髓增生异常综合征患者N—ras原癌基因突变的研究

应用ＰＣＲ－ＳＳＣＰ及直接测序法研究ＭＤＳ患者Ｎ－ｒａｓ原癌基因点突变。检测２６例（２８例次），发现Ｎ－ｒａｓ原癌基因第１外显子突变者１４例（５０％），统计表明Ｎ－ｒａｓ原癌基因突变与ＭＤＳ白血病转化及患者自下而上期缩短均有相关性（Ｐ〈０．０５），对预测ＲＡ、ＲＡＳ转化白血病有参考价值。对１例发现突变的标本进行直接测序证实为１２密码子第２碱基的Ｇ→Ａ转换。     

胃癌组织中多种癌基因变异的观察

目的 探索胃癌癌变过程中多种癌基因和抑癌基因变异的规律。方法用Ｓｏｕｔｈｅｒｎ杂交、ＰＣＲ／ＳＳＣＰ和ＤＮＡ测序技术，检测３３例胃癌手术标本中原癌基因ｃ－ｍｅｔ、ＥＧＦＲ、ｃ－Ｈａ－ｒａｓ、ｃ－ｅｒｂＢ－２、ＡＫＴ-２的扩增和重排，以及抑癌基因ｐ５３、ｐ１６、ｎｍ２３－Ｈ１的突变和缺失。结果大多数胃癌组织（７０％）存在１个或１个以上的基因改变。不同个体基因异常的种类和方式不同。其中ｃ－ｍｅｔ基因重排２／３３例（６％），扩增８／３３例（２４％）。ｃ－ｅｒｂＢ－２扩增１／３３（３％），ＡＫＴ－２扩增２／１８例（１１％）。抑癌基因ｐ１６的纯合性缺失６／３３例（１８％），ｎｍ２３－Ｈ１和ｐ５３的杂合性缺失分别是５／１７例（２９％）和２／１３例（１６％）。ｐ５３第５～８外显子点突变的检出率为２０／３３例（６１％）。癌基因的扩增和重排多发生于胃癌进展期，而ｐ５３基因的点突变可发生于癌变各期。结论胃癌癌变是多基因异常累积所引起的渐进性过程，基因改变的数目、种类及方式与肿瘤的恶性表型密切相关。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.