抑癌基因P53和癌基因MDM2在肾透明细胞癌中的表达及意义

目的 探讨抑癌基因P53蛋白、癌基因MDM2蛋白在肾透明细胞癌中的表达及发生、发展中的意义.方法 采用免疫组织化学法检测60例肾透明细胞癌、20例正常肾组织中抑癌基因P53、癌基因MDM2蛋白的表达情况.结果 60例肾透明细胞癌组织中P53阳性表达率为41.66%(25/60),显著高于正常肾组织的10%(2/20),差异有统计学意义(P＜0.05);60例肾透明细胞癌组织中MDM2阳性表达率为53.33%(32/60),显著高于正常肾组织的0%(0/20),差异有统计学意义(P＜0.05);P53和MDM2二者有一致性(χ2=2.9,P＝0.09).结论 P53与MDM2共同参与肾透明细胞癌的发生、发展,P53与MDM2可作为评价肾透明细胞癌的生物学指标.     

SLIT 2在肾透明细胞癌组织中的表达及意义

目的：探讨神经迁移蛋白SLIT2蛋白在肾癌中的表达及其临床意义。方法应用免疫组织化学方法检测80例肾透明细胞癌及对应的癌旁2cm肾组织中SLIT2蛋白的表达情况,结合临床病例资料分析其临床病理意义。结果（1）在肾透明细胞癌组织及对应的癌旁2cm肾组织中,SLIT2蛋白的阳性表达率分别为28.8%（23/80）和76.3%（61/80）,组间差异有统计学意义（P＜0.01）;（2）SLIT 2蛋白的表达与肾透明细胞癌组织分级、肿瘤TNM分期及有无淋巴结转移有关（P＜0.05）,而与肾癌患者的性别、年龄,肿瘤大小无关。结论研究结果支持SLIT2在肾癌的发生、发展过程中发挥了一定作用,检测SLIT 2蛋白的表达有助于判定肾透明细胞癌的生物学行为。     

甲状腺乳头状癌中PBX3和PTEN的表达及其临床意义

目的探讨前B细胞白血病同源盒基因3（PBX3）和第10号染色体缺失的磷酸酶和张力蛋白同源物基因（PTEN）在甲状腺乳头状癌（PTC）中的表达及其临床意义。方法选取2017年1月至2018年1月在台州市中心医院（台州学院附属医院）住院行手术切除和石蜡包埋的PTC标本80例,选取癌旁正常甲状腺组织（距离肿瘤≥2cm）30例作为对照。应用免疫组化EnVision二步法检测PTC和癌旁组织中PBX3和PTEN蛋白的表达情况,分析PTC不同临床病理特征与PBX3和PTEN表达的关系及两者蛋白表达的相关性。结果PTC组织中PBX3阳性表达率为73.75%,高于癌旁组织的16.67%,差异有统计学意义（P＜0.05）;PTC组织中PTEN阳性表达率为35.00%,低于癌旁组织的83.33%,差异有统计学意义（P＜0.05）。包膜侵犯、淋巴结转移和Ⅲ~Ⅳ期的PTC组织中PBX3阳性表达率分别高于无包膜侵犯、无淋巴结转移和Ⅰ~Ⅱ期的PTC组织,差异均有统计学意义（均P＜0.05）。包膜侵犯、淋巴结转移和Ⅲ~Ⅳ期的PTC组织中PTEN阳性表达率分别低于无包膜侵犯、无淋巴结转移和Ⅰ~Ⅱ期的PTC组织,差异均有统计学意义（均P＜0.05）。PTC组织中PBX3、PTEN蛋白表达呈负相关（r=-0.337,P＜0.05）。结论PTC组织中PBX3高表达,而PTEN低表达,两者表达呈负相关,且与PTC的包膜侵犯、淋巴结转移和临床分期密切相关,表明PBX3和PTEN异常表达可能在PTC发生、侵袭、转移的过程中起作用。     

抑癌基因Pdcd4在肾透明细胞癌中的表达及生物学意义

目的研究Pdcd4 mRNA及蛋白在肾透明细胞癌中的表达及探讨其与肾肿瘤分期分级的关系。方法采用逆转录-聚合酶链反应（半定量RT-PCR）及免疫组织化学方法同时检测肾脏透明细胞癌及癌旁正常组织Pdcd4 mRNA及蛋白的表达情况。结果 Pdcd4 mRNA在肾癌及癌旁正常组织中均有表达,透明细胞癌中的表达低于癌旁正常组织。肾透明细胞癌Pdcd4蛋白表达阳性率为37.5%（15/40）,显著低于癌旁正常肾脏组织阳性表达率90%（18/20）,G1~G2期Pdcd4蛋白表达阳性率为56.5%（13/23）高于G3~G4期Pdcd4蛋白表达阳性率为11.7%（2/17）,两者差异有显著性（P〈0.05）。结论 Pdcd4基因在肾透明细胞癌中呈低表达,与肾癌的发生及恶性分化程度相关,作为抑癌基因,Pdcd4蛋白表达可作为判定肾透明细胞癌生物学行为的客观指标。     

人白细胞抗原-G 在肾透明细胞癌中的表达及意义

目的：研究肾透明细胞癌患者组织及外周血中人白细胞抗原-G（ HLA-G）的表达情况,并探讨其在肾透明细胞癌发病机制中的作用。方法用免疫组化法检测肾透明细胞癌组织中HLA-G的表达情况,并分析其与患者临床参数间的关系。用ELISA法检测肾透明细胞癌患者外周血中HLA-G的浓度,并分析其与患者临床参数间的关系。结果 HLA-G在肾透明细胞癌组织中的阳性表达率为71.7％,明显高于癌旁正常组织（0.04％）,差异有统计学意义（P＜0.01）;HLA-G的表达与患者的性别、年龄、淋巴结转移等无明显相关性（P＞0.05）,但临床分期、分级越高,HLA-G的阳性率也越高,差异有统计学意义（P＜0.05）。与健康体检者相比,肾透明细胞癌患者血清中HLA-G水平明显升高（ P＜0.01）;HLA-G的水平随着患者临床分期、分级的增高而上升（P＜0.05）,与其他临床参数无明显相关性（P＞0.05）。结论肾透明细胞癌患者组织和血清中HLA-G的表达均发生了明显的变化,HLA-G在肾透明细胞癌的发生发展中可能发挥了一定的作用。     

EZH2和PTEN蛋白联合检测与肾透明细胞癌的相关性研究

目的 研究EZH2和PTEN蛋白在肾透明细胞癌中的表达及其相关性,并探讨与肾透明细胞癌临床分期及病理分级的关系.方法 采用免疫组织化学SABC法对58例肾透明细胞癌标本和8例正常肾脏组织标本中EZH2和PTEN的表达进行检测.结果 正常肾脏组织与肾透明细胞癌标本EZH2蛋白表达率分别为12.5%(1/8)和74.1%(43/58)(P<0.05).且EZH2的表达随肾癌的临床分期升高而增加,但EZH2的表达与肾癌的病理分级无明显统计学意义;正常肾脏组织与肾透明细胞癌标本PTEN蛋白表达率分别为100%(8/8)和43.1%(25/58)(P<0.05),且PTEN的表达随肾癌的病理分级及临床分期升高而降低;EZH2和PTEN在肾癌中的表达存在负相关(rs=-0.775,P<0.05).结论 PTEN和EZH2有负相关性,可能在肾透明细胞癌的发生发展过程中起关键作用,并可作为判定肾透明细胞癌恶性程度及进程参考的指标.     

PTEN和LIVIN在肾透明细胞癌中的表达及临床意义

目的:研究双特异磷酸酶活性的磷酸脂酶基因(PTEN)和黑色素瘤凋亡抑制蛋白或肾凋亡抑制蛋白(LIVIN)在肾透明细胞癌中的表达及其相关性。探讨与肾透明细胞癌临床分期及病理分级关系。方法:应用免疫组化SP法检测50例肾脏透明细胞癌、25例癌旁组织(距肿瘤边缘>1 cm)及10例正常肾组织中PTEN及LIVIN的表达。结果:PTEN在肾透明细胞癌中的阳性率明显低于癌旁及正常肾组织,差异有统计学意义(P<0.01);LIVIN在正常肾组织及癌旁组织无表达,而在肾透明细胞癌中高表达,差异有统计学意义(P<0.01)。在不同临床分期的肾透明细胞癌组织中PTEN和LIVIN的表达有显著差异性(P<0.01);并且两因子的表达呈显著负相关(r=-0.547,P<0.01)。结论:PTEN和LIVIN呈负相关性,在肾透明细胞癌的发生发展中起重要的作用,两个因子联合检测可作为判定肾透明细胞癌恶性程度的重要指标。     

CD70在肾透明细胞癌组织中的表达及意义

目的探讨肾细胞癌（简称肾癌）中淋巴细胞活化抗原CD70的表达状况及其临床意义,为肾癌干细胞研究筛选适当的表面标志物。方法采用免疫组织化学法检测20例正常肾组织、62例肾癌组织及癌旁组织中CD70蛋白表达状况。结果 CD70在正常肾组织、癌旁组织、透明细胞癌、乳头状细胞癌、嫌色细胞癌中的阳性表达率分别为0.00%（0/20）、6.82%（3/44）、90.91%（40/44）、27.27%（3/11）、14.29%（1/7）。在肾癌组织中CD70表达水平高于正常肾组织和癌旁组织（P〈0.01）,CD70表达水平在肾透明细胞癌中随其分化程度降低而增强,但与临床分期无相关性。结论 CD70的表达与肾透明细胞癌的恶性程度有相关性,可作为肾透明细胞癌的新型特异性肿瘤标志物,用于对尚未确定组织学分类的肾肿瘤进行鉴别诊断,并有望成为肾透明细胞癌预后判断的指标及治疗的靶标。     

细胞凋亡相关因子Caspase-3、Caspase-9和增殖细胞核抗原在人肾透明细胞癌中的表达

目的 检测人肾透明细胞癌组织中细胞凋亡相关重要因子Caspase-3、Caspase-9和增殖细胞核抗原(proliferating cell nuclear antigen,PCNA)表达的变化,研究这些因子的表达与肾癌的关系.方法 标本离体后分成3组,①肾癌细胞组;②癌旁组织组;③正常肾组织组.均用10%福尔马林固定48 h,常规石蜡包埋、切片5 μm,应用免疫组织化学方法进行观察.结果 PCNA免疫组织化学染色结果,正常肾组织内的细胞核有弱的阳性表达,癌旁组织阳性表达增加,高于正常肾组织;肾癌组织阳性表达明显增强, 明显高于癌旁组织.Caspase-3与 Caspase-9均在正常肾组织中有弱的阳性反应,癌旁组织阳性表达增加,肾癌组织表达明显减少.3组之间两两比较差异均有统计学意义(P<0.01).肾癌4个期之间比较差异无统计学意义(P＞0.05).结论 癌旁组织Caspase-3和Caspase-9蛋白表达明显高于正常肾组织及癌组织,癌组织表达最少;癌组织中Caspase-3和Caspase-9表达下降,说明细胞凋亡减少;PCNA在正常肾组织组、癌旁组织组、肾癌组织组的表达呈明显加强趋势,癌组织细胞增殖旺盛,是肿瘤形成的重要机制.Caspase-3、Caspase-9和PCNA于肾透明细胞癌的表达在肿瘤分期间差异无统计学意义.Caspase-3与Caspase-9蛋白表达呈正相关.     

肾细胞癌内皮抑素的表达与微血管密度相关性研究

目的探讨内皮抑素表达与肾细胞癌微血管密度及预后的关系。方法采用免疫组化的方法检测45例原发性肾细胞癌组织及35例癌旁正常肾组织中的Endostatin及CD34,并观察Endostatin的表达同MVD的关系。结果肾细胞癌组织中Endostatin阳性表达率为77.8%,癌旁正常肾组织为31.4%,差异有统计学意义(P0.01),在Ⅲ～Ⅳ期病例中的表达显著强于Ⅰ～Ⅱ期(P0.01)。肾细胞癌的MVD(32.89±9.42)明显高于癌旁正常肾脏组织(16.20±8.31)(P0.01);Ⅲ～Ⅳ期MVD(43.86±9.11)显著高于Ⅰ～Ⅱ期(28.71±8.04)(P0.01),且与Endostatin表达具有相关性(P0.05);MVD在组织学分级之间差异有统计学意义(P0.05)。结论 Endostatin在肾癌中表达显著高于癌旁的正常肾组织,且与MVD显著相关。MVD与肾癌的临床分期、病理分级密切相关。     

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.     

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.     

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…     

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.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.