非小细胞肺癌中VEGF-C及其受体mRNA的表达与临床意义

目的：研究肺癌组织及癌旁组织中血管内皮生长因子C(vascular endothelial growth factor C,VEGF-C)及其受体mRNA的表达,分析其在肿瘤转移中的作用。方法：采用RT-PCR法分析36例新鲜肺癌组织及癌旁组织标本中VEGF-C／KDR／Fit-4mRNA的表达,并统计分析它与临床病理特点之间的关系。结果：癌旁组织(PT)中VEGF-C mRNA表达与Flt-4mRNA的表达呈显著正相关(r=0．523,P=0．0055)。肿瘤组织及癌旁组织中单一的VEGF-C、KDR或Flt-4 mRNA表达与肿瘤转移无明显相关;COMVEGF-C-3与淋巴结转移(r=0．5805,P=0．0008)及临床病理分期(r=0．5057,P=0．0064)呈明显正相关。结论：VEGF-C及其受体在肺癌组织及瘤旁组织中高表达,在肿瘤转移尤其是淋巴转移中起重要作用,COMVEGF-C-3是反映患者淋巴转移和预后的良好指标。     

VEGF-C与PDGF-BB在结肠癌组织中的表达

目的探讨结肠癌组织中血小板衍生生长因子BB（PDGF-BB）、血管内皮生长因子C（VEGF-C）的表达,及其与肿瘤临床病理参数之间的关系;分析在结肠原发癌与相应淋巴结转移癌中VEGF-C、PDGF-BB表达是否存在差异。方法收集结肠癌组织50例、淋巴结转移癌30例及癌旁正常组织15例,应用免疫组化SP法检测VEGF-C,PDGF-BB在癌旁正常组织、结肠癌和淋巴结转移癌中的表达。结果结肠癌组织中VEGF-C阳性表达率显著高于癌旁正常组织（P〈0.05）;VEGF-C的表达与结肠癌的浸润深度、淋巴结转移有关（均P〈0.05）,与病人性别、肿瘤大小及分化程度无关（P〉0.05）。PDGF-BB在结肠癌组织中的阳性表达率显著高于癌旁正常组织（P〈0.05）;PDGF-BB的表达与肿瘤的浸润深度有关（P〈0.05）,与病人的性别、肿瘤的大小、分化程度及淋巴结转移无关（P〉0.05）。PDGF-BB、VEGF-C2者之间的表达呈显著正相关（r=0.572,P〈0.05）。PDGF-BB、VEGF-C在淋巴结转移癌中的表达率均高于其相应的原发癌组织,但无统计学意义（均P〉0.05）。结论VEGF-C表达与结肠癌的浸润及淋巴结转移有关;PDGF-BB的表达与结肠癌浸润有关。PDGF-BB、VEGF-C在结肠癌中的表达呈正相关。肿瘤原发癌与淋巴结转移癌中VEGF-C、PDGF-BB的表达无异质性。     

EphA2/EphrinA1在胃癌组织中的表达及与血管生成的关系

目的探讨EphA2与其配体EphrinA1在胃癌组织中的表达及与肿瘤血管生成的关系。方法利用免疫组织化学法检测82例胃癌手术切除标本中癌组织、癌旁组织及正常胃黏膜中EphA2、EphrinA1的表达,并采用CD34抗体标记微血管内皮细胞,计算微血管密度（MVD）。分析EphA2、EphrinA1的表达与MVD之间的相关性及其与胃癌临床病理特征的关系。结果胃癌组织中EphA2、EphrinA1的表达及MVD显著高于癌旁组织及正常胃黏膜（P〈0.01）;EphA2、Eph-rinA1表达水平及MVD值与胃癌的分化程度、浸润深度及淋巴结转移有关（P〈0.05）,MVD值还与肿瘤直径有关（P〈0.05）;Spearman等级相关分析表明,EphA2、EphrinA1表达分别与MVD呈显著正相关（r=0.485,P〈0.01;r=0.512,P〈0.01）。结论EphA2及其配体EphrinA1在胃癌组织中特异性高表达,可能参与肿瘤血管的生成,在胃癌的发病及恶性进展中发挥重要作用。     

CXCR4和VEGF—C在胃癌淋巴结转移中的作用及相关性

目的探讨CXCR4和VEGF—C在胃癌淋巴结转移中的作用及两者的相关性。方法应用免疫组化法及RT—PCR检测CXCR4及VEGF—C在人胃癌组织中的表达水平,并分析其与胃癌淋巴结转移的关系。结果CXCR4及VEGF—C蛋白在癌旁组织中无阳性表达,在胃癌组织中均呈阳性表达。胃癌组织中CXCR4及VEGF—C蛋白阳性表达率均明显高于癌旁组织（P〈005或0．01）,且No组织、N、＋N2组织、N3组织中CXCR4及VEGF—C蛋白阳性表达率两两比较差异均有统计学意义（P〈005或001）。不同胃癌组织中CXCR4mRNA及VEGF—CmRNA的表达明显不同,差异均有统计学意义（P〈005或001）。胃癌组织中CXCR4表达与VEGF-C表达呈显著正相关（r=0．355,P〈001）。结论胃癌中CXCR4和VEGF—C的表达呈正相关,两者的协同作用与胃癌患者淋巴结转移密切相关,进一步研究两者的作用机制可能对预测淋巴结转移及判断预后有重要临床价值。     

KISS-1、Ezrin蛋白在胃癌组织中的表达及临床意义

目的探讨KISS-1、Ezrin蛋白在正常胃黏膜、不典型增生胃黏膜及胃癌组织中的表达及其临床意义。方法采用免疫组化法分别对21例正常胃黏膜组织、23例癌旁不典型增生组织、45例胃癌组织中KISS-1、Ezrin蛋白的表达进行检测。结果正常胃黏膜、癌旁非典型增生和胃癌组织中KISS-1蛋白的阳性表达率依次递减,经两两相比,差异均有统计学意义（P〈0.05）;正常胃黏膜、癌旁非典型增生和胃癌组织中Ezrin蛋白的阳性表达率依次递增,且两两相比,差异均有统计学意义（P〈0.05）;相关性分析发现KISS-1、Ezrin蛋白在胃癌中的表达具有显著的负相关性（r=-0.537,P〈0.01）。结论 KISS-1、Ezrin蛋白参与胃癌的发生发展过程,且可能起协同作用。     

胃癌组织中KiSS-1 mRNA及蛋白的表达

目的探讨胃癌组织中KiSS-1 mRNA及蛋白的表达情况。方法分别采用原位杂交方法和免疫组织化学SP法对40例胃癌组织、22例癌旁不典型增生组织及40例正常胃黏膜组织进行KiSS-1 mRNA和蛋白的检测。结果胃癌组织、癌旁不典型增生组织及正常胃黏膜组织中KiSS-1 mRNA的阳性表达率分别为57.5%（23/40）、77.3%（17/22）、97.5%（39/40）,依次升高（X2=18.323,P〈0.01）;KiSS-1蛋白的阳性表达率分别为52.5%（21/40）、81.8%（18/22）、95.0%（38/40）,依次增高（X2=20.131,P〈0.01）;胃癌组织中KiSS-1 mRNA及蛋白表达与胃癌分化程度无关（P〉0.05）,与浸润深度、淋巴结转移有关（P〈0.05）;胃癌组织中KiSS-1 mRNA与蛋白的表达呈正相关（rs=0.702,P〈0.05）。结论 KiSS-1表达缺失与胃癌的发生、转移有关;KiSS-1有望成为胃癌早期诊断和判断预后的辅助指标。     

胃癌相关易感基因W41的原位表达分析

目的：进一步分析人胃癌相关易感基因W41在胃癌组织的表达情况。方法：利用循环引物介导原位标记（C-PRINS）技术，检测胃癌标本的W41mRNA表达，并采用生物素连接辣根过氧化物酶标记，DAB显色法，以提高石蜡切片检测mRNA表达的敏感性。用Image-Pro Plus图象分析软件计算每个细胞胞浆中阳性染色信号的单位面积光密度值（IOD），每例标本IOD的平均值代表W41表达水平。结果：W41在胃癌、有肠化癌旁组织、无肠化癌旁组织和正常胃黏膜中表达结果经，检验有显著性差异（F=8．810，P=0．001）。组间比较结果示胃癌组织表达高于正常组织（P〈0．05），癌旁肠化组织和无癌旁肠化组织的表达亦高于正常组织（P〈0．05），而癌与癌旁肠化组织和无癌旁肠化组织之间的表达没有差异（P〉0．05）。W41在腺癌和印戒细胞癌的表达经t检验无显著性差异（t=1．304，P=0．029）。结论：W41在胃癌及癌旁组织中表达高于正常胃黏膜，在肠化组织有明显表达，提示W41表达水平与胃黏膜癌变有关；C-PRINS法在信号强度、操作便利和时间上明显优于经典原位杂交。     

Runx3和Smad4在胃癌中的表达及其临床意义

目的：研究Runx3、Smad4蛋白在胃癌及正常胃黏膜组织中的表达差异及其与胃癌生物学行为的关系。方法：应用免疫组织化学法检测Runx3、Smad4蛋白在56例胃癌组织及40例癌旁组织中Runx3、Smad4的表达。结果（：1）胃癌组织中Runx3和Smad4阳性表达率分别为37.5%和44.6%,在癌旁组织分别为92.5%和87.5%。两种蛋白在胃癌组织表达差异具有显著性（P〈0.05）。Smad4的表达与胃癌不同分化程度、浸润深度、淋巴结转移及临床分期相关（P〈0.05）;Runx3的表达与胃癌不同分化程度、浸润深度、淋巴结转移（P〈0.05）相关,与临床分期无关（P〉0.05）。（2）Runx3与Smad4在胃癌组织中的表达呈正相关（P〈0.05,r=0.4264）。结论：Runx3、Smad4的低表达与胃癌的浸润和转移有密切的关系,在胃癌的发生、发展中起着不同程度的作用。     

HIF-1α在宫颈鳞癌组织中的表达及其与淋巴道转移的关系

目的：研究HIF-1α在宫颈鳞癌中的表达及与淋巴道转移的关系。方法：采用免疫组化法检测10例正常宫颈、55例宫颈上皮内瘤变（CIN）及75例宫颈鳞癌组织中HIF-1α及VEGF-C的表达,采用VEGFR-3免疫组织化学法标记组织标本中的淋巴管并测定微淋巴管密度（LMVD）,并分析其与临床病理特征的关系。结果：HIF-1α及VEGF-C在宫颈鳞癌组织中的表达水平明显高于正常宫颈及CIN（P〈0.05）;微淋巴管主要集中在癌周组织,LMVD的高低与淋巴结转移相关（P〈0.05）;HIF-1α的表达水平与VEGF-C表达水平及癌周组织LMVD呈正相关（r=0.269,P〈0.05;r=0.407,P〈0.05）,VEGF-C的表达与癌周组织LMVD呈正相关（r=0.431,P〈0.05）。结论：HIF-1α在宫颈鳞癌组织中的表达与淋巴结转移显著相关。HIF-1α可能通过上调VEGF-C的表达影响微淋巴管的形成,从而参与宫颈癌的淋巴道转移过程。     

缺氧诱导因子-1α和CD105与胃癌的关系研究

目的探讨缺氧诱导因子（HIF-1α）和CD105在胃癌发展过程中的意义及其对肿瘤血管生成的影响。方法应用组织芯片技术和免疫组织化学方法检测HIF-1α和CD105在70例胃癌组织、14例癌旁组织和15例正常组织中的表达,并计数CD105标记癌组织的微血管密度（MVD）。结果 HIF-1α和CD105在胃癌组织中的表达明显高于正常组织及癌旁组织（P〈0.05）;HIF-1α和CD105的表达均与胃癌的浸润深度、临床分期及局部淋巴结转移之间存在相关性（P〈0.05）;HIF-1α和CD105表达阳性组的MVD均高于各自的阴性组（P〈0.05）;HIF-1α和CD105在胃癌中表达存在正相关性（r=0.285,P〈0.05）。结论 HIF-1α和CD105在胃癌的发展和转移过程中具有重要意义;联合检测两者的表达可用于评价胃癌的恶性生物学行为。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.