凋亡抑制蛋白Survivin和血管内皮生长因子在肝细胞癌中的表达及其临床意义

目的 探讨肝细胞癌(HCC)组织中凋亡抑制蛋白Survivin与血管内皮生长因子(VEGF)表达的相关性及其临床意义.方法 应用免疫组织化学方法检测50例HCC组织和20例正常肝组织中Survivin、VEGF蛋白的表达,并将检测结果与临床病理特征进行综合分析.结果 (1)50例HCC组织中Survlvin、VEGF蛋白的阳性表达率分别为64.0％(32/50)、68.0％(34/50),在正常肝组织中的表达率分别为0％(0/20)、10％(2/20),差异有显著性(P<0.05);(2)Survivin、VEGF蛋白表达与患者的性别、年龄、肿瘤大小、分化程度、AFP值均无相关性(P0.05),而与f临床分期及转移相关(P<0.05);(3)Survivin、vEGF蛋白表达呈正相关关系(x2=6.69,P<0.05).结论 Survivin和VEGF蛋白在HCC中表达率较高,为肝癌的分子靶向治疗提供了新的靶点;Survivin和VEGF在HCC中的表达关系密切,测定HCC中Survivin、VEGF蛋白的表达,有助于临床判断病人预后.     

肝细胞肝癌VEGF与p53的表达及其意义

目的研究血管内皮生长因子(VEGF)和p53蛋白表达与原发性肝细胞肝癌(HCC)的关系。方法用免疫组织化学SP法,检测49例HCC组织、21例癌旁组织、10例正常肝组织VEGF及p53蛋白的表达情况,并与临床病理指标比较分析。结果49例HCC中VEGF、p53蛋白阳性表达分别为63.2%和53.1%;VEGF和p53蛋白表达有相关性(P<0.05)。21例癌旁组织中VEGF和p53蛋白阳性表达分别为19.0%和9.5%。肝癌组织和癌旁组织VEGF和p53蛋白表达差异有显著性(P<0.01)。10例正常肝组织无VEGF和p53蛋白表达。HCC组织中VEGF、p53蛋白阳性表达与血管侵犯和转移倾向明显相关(P<0.05)。结论HCC组织中VEGF、p53蛋白过表达,通过促进HCC肿瘤血管的生成而促进HCC的生长和浸润转移,p53和VEGF可作为反应HCC生物学行为的重要指标。     

KiSS-1及VEGF在肝细胞癌组织中的表达及临床意义

目的探讨KiSS-1蛋白和血管内皮生长因子(VEGF)在肝细胞癌中的表达及临床意义。方法采用免疫组化法检测33例HCC组织,25例癌旁组织和20例正常肝组织中KiSS-1蛋白和VEGF蛋白的表达情况。结果 HCC组织中的KiSS-1蛋白和VEGF的阳性表达率分别为27.27%(9/33)、81.82%(27/33);在癌旁组织及正常肝组织中则分别为的72.00%(18/25)、52.00%(9/25)和85.00%(17/20)、45.00%(9/20),差异均具有统计学意义(P<0.05);肝细胞癌中KiSS-1蛋白和VEGF的表达均与肿瘤分化程度、临床分期及淋巴结转移有密切联系,二者在HCC中的表达呈负相关(r=-0.770,P<0.05)。结论 KiSS-1蛋白在肝细胞癌中的表达明显下调,VEGF蛋白在肝细胞癌中的表达增多,二者表达呈现负相关性,可能参与促进了肿瘤的发生、侵袭和转移。     

HIF-1α与VEGF在肝细胞肝癌中的表达及其临床意义

目的:研究低氧诱导因子-1α(HIF-1α) 、血管内皮生长因子(VEGF)在肝细胞肝癌(HCC)中的表达及其意义.方法:采用免疫组织化学SABC法检测54例HCC组织及14例正常肝组织中HIF-1α、VEGF的表达情况,研究这2个因子与HCC临床病理学资料及生物学行为的关系.结果:HIF-1α、VEGF蛋白在HCC组织及正常肝组织中阳性表达率比较,差异有显著性(P＜0.05).HCC组织中HIF-1α蛋白与VEGF 蛋白的表达呈正相关(P＜0.05).HIF-1α、VEGF的表达与HCC、病理学分级、AFP无明显关系(P＞0.05).而与肿瘤的侵袭转移能力密切相关(P＜0.05).结论:HCC组织中HIF-1α、VEGF呈过量表达.肝癌组织中HIF-1α、VEGF表达可反映肝癌的生物学行为,可作为预测肝癌浸润转移的一项重要指标.     

原发性肝细胞癌组织中Livin和Smac蛋白的表达

目的:探讨原发性肝细胞癌(HCC)组织中Livin和Smac蛋白的表达.方法:采用免疫组织化学法检测50例HCC组织、25例癌旁组织和15例正常肝组织中Livin和Smac蛋白的表达情况.结果:HCC组织、癌旁组织和正常肝组织中Livin阳性率分别为84.0%(42/50)、32.0%(8/25)和0,与非肝癌组织比较,HCC组织中Livin阳性率较高(χ2=27.840,P<0.01).HCC组织、癌旁组织和正常肝组织中Smac的阳性率分别48.0%(24/50)、88.0%(22/25)、100%(15/15),与非肝癌组织比较,HCC组织中Smac阳性率较低(χ2=28.373,P<0.01).Livin和Smac蛋白的表达均与HCC组织的分化程度无关(P>0.05).HCC组织中Livin和Smac蛋白的表达呈负相关(rs=-0.236,P<0.05).结论:Smac和Livin蛋白可能是肝癌细胞凋亡信号传导网络中的重要一环.     

PTEN在肝硬化、肝细胞性肝癌组织中的表达及临床意义

目的探讨抑癌基因PTEN在肝硬化、肝癌组织中的表达及临床意义.方法用S-P免疫组织化学方法分别检测62例肝细胞性肝癌(HCC)15例肝硬化及10例正常肝脏PTEN蛋白表达状况.结果 10例正常肝组织中PTEN蛋白均为阳性表达. HCC中PTEN 蛋白的阳性率69.4%(43/62),明显低于肝硬化组(93.3%)及正常肝组织组(100%)(P<0.01).PTEN蛋白在高分化、中分化、低分化肝细胞性肝癌中的阳性率分别为75.1%(21/28)、71.4%(15/21)和53.8%(7/13),肝细胞性肝癌中PTEN蛋白阳性表达率与肿瘤的组织分化及其它临床病理因素无关(P＞0.05).肝癌PTEN蛋白阳性表达率与有无合并肝硬化无关(P＞0.05).结论 PTEN表达缺失在肝细胞性肝癌的发生和发展过程中发挥重要作用,检测PTEN蛋白表达有助于肝细胞性肝癌的诊断.     

肝细胞肝癌组织中survivin基因的表达及与p53、Bcl-2表达的关系

目的 探讨survivin基因在肝细胞肝癌(HCC)组织中的表达、定位及临床意义,以及与p53和Bcl-2表达的关系.方法 应用SABC免疫组织化学染色技术对87例HCC组织及其50例癌旁组织、4种肝癌细胞系和27例非肝癌肝组织进行survivin蛋白检测,对其中的30例HCC组织进行突变型p53和Bcl-2蛋白检测;应用Western blot和real time-PCR等技术对8例HCC组织及其癌旁组织、4种肝癌细胞系进行survivin蛋白和mRNA进行检测;对74例HCC患者的临床分期、病理分级、瘤块大小等与survivin蛋白表达情况进行相关性分析.结果 ①HCC组织、癌旁组织和非肝癌肝组织中,survivin蛋白阳性表达率分别为59.77%(52/87),26.00%(13/50)和0(0/27),HCC组织中survivin蛋白表达与癌旁组织和非肝癌肝组织比较差异均有统计学意义(P<0.01),且与患者年龄、性别、瘤块大小、有否转移、临床分期和病理分级等均无相关关系(P>0.05).②survivin mRNA在HCC组织、癌旁组织中阳性表达率分别为37.5%(3/8)和0(0/8);survivin蛋白和mRNA在4种肝癌细胞系(SMMC-7721,HHCC,HCC-9724 和HepG2)中,除HepG2外均呈高表达.③survivin蛋白表达与突变型p53表达存在明显正相关(χ2=4.693,P=0.030),与Bcl-2表达无明显相关(χ2=0.25,P=0.617).结论 survivin基因可能成为肿瘤基因治疗的靶点;survivin基因与p53基因在抑制肿瘤细胞凋亡方面可能具有某种协同作用;检测survivin表达水平对判断HCC恶性程度和预后可能无临床价值.     

肝细胞性肝癌组织中Thrombin和VEGF的表达水平及其临床意义

目的:研究凝血酶(Thrombin)和血管内皮生长因子(VEGF)在人肝细胞性肝癌(HCC)组织中的表达情况,分析其与HCC临床病理特征的关系.方法:应用Western blot检测55例HCC组织及其癌旁肝组织中Thrombin和VEGF蛋白的表达.结果:HCC组织中Thrombin和VEGF蛋白的表达水平明显高于癌旁肝组织(P＜0.05),而且Thrombin和VEGF表达呈显著正相关(r =0.333,P＜0.05).HCC组织中Thrombin的表达与有无门静脉癌栓有关(P＜0.05),VEGF的表达与包膜完整性有关(P＜0.05).Thrombin高表达患者中位生存时间显著低于低表达患者(P＜0.05).结论:Thrombin和VEGF在HCC组织中的表达水平明显升高,且两者的表达水平呈正相关,提示两者在HCC的发生发展过程中有着密切关系.     

肝细胞癌中血管内皮生长因子的表达与肿瘤进展的关系研究

目的 评估血管内皮生长因子(VEGF)的表达与肿瘤临床病理特点及复发的关系.方法 应用免疫组织化学法检测原发性肝癌组织(27例)、转移性肝癌组织(11例)及癌旁正常组织(38例)中VEGF蛋白表达情况;应用聚合酶链反应(PCR)技术检测上述3组肝组织中VEGF mRNA的表达水平;分析VEGF在肿瘤组织中的表达与临床病理特点及复发之间的关系.结果 原发性肝癌患者肝组织VEGF mRNA表达水平显著高于正常肝组织,差异有统计学意义(P＜0.05);原发性肝癌患者肝组织中VEGF蛋白表达阳性率(77.8%)显著高于正常肝组织(15.8%),差异有统计学意义(P＜0.01),而转移性肝癌组织VEGF蛋白表达阳性率(36.4%)与正常肝组织比较差异无统计学意义(P＞0.05).原发性肝癌患者中,肿瘤直径≥5 cm者VEGF表达升高者所占比例(85.7%)显著高于肿瘤直径＜5 cm者;2年内复发者肝组织VEGF表达升高者所占比例(87.5%)显著高于1年内复发者,差异均有统计学意义(P＜0.05).结论 原发性肝癌组织中VEGF的表达明显高于正常肝组织,且VEGF的表达与肿瘤大小及复发有关.     

Sonic Hedgehog信号通路分子Shh和Smo在肝细胞肝癌中表达与意义

目的:探讨Sonic Hedgehog(SHH)信号通路分子Shh和Smo在肝细胞肝癌(Hepatocellular carcinoma,HCC)中的表达及其意义?方法:用RT-PCR方法检测10例HCC组织及相应癌旁组织和肝癌细胞系HepG2?Huh7中Shh?Smo mRNA的表达?采用免疫组化方法检测30例肝癌组织及10例正常肝组织中Shh?Smo蛋白的表达?结果:RT-PCR结果显示HCC组织中Shh?Smo mRNA的表达率显著高于癌旁组织(P < 0.05);Shh?Smo mRNA在Huh7中的表达强度高于HepG2,但两者间无显著性差异(P > 0.05)?免疫组化结果显示Shh?Smo蛋白在HCC组织中阳性率分别为63.3%(19/30)?76.7%(23/30);Smo蛋白的表达与肿瘤大小相关(P < 0.05)?Shh?Smo蛋白在正常肝组织中均无表达?结论:Shh和Smo在肝癌中高表达,表明SHH信号通路可能参与肝癌的发生,为肝癌防治提供新的依据?     

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…     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.