膀胱移行细胞癌组织中血管内皮生长因子表达

目的：探讨与膀胱移行细胞癌预后相关的新诊断指标及方法.方法：采用免疫组化S-P法,检侧68例原发性膀胱移行细胞癌（按WHO肿瘤病理分级：Ⅰ级17例、Ⅱ级29例、Ⅲ级22例;临床分期按UICC标准：Tis-T1期36例、T2-T4期32例;有淋巴结转移者26例,有血管浸润者14例）和10例正常膀胱组织标本血管内皮生长因子（VEGF）的表达,探讨其表达与患者预后的关系.结果：68例膀胱移行细胞癌组织中VEGF阳性表达率为45.6%（31/68）,与病理分级、临床分期、血管浸润、淋巴结是否转移有关（P＜0.01）;对照组10例癌旁正常膀胱黏膜组织VEGF表达均为阴性;VEGF表达阳性生存超过5 a者（39.3%）明显低于VEGF表达阴性者（93.7%）（P＜0.05）.结论：VEGF表达与膀胱移行细胞癌的恶性程度密切相关,检测VEGF表达对判断膀胱移行细胞癌预后有重要意义.     

缺氧诱导因子-1α和血管内皮生长因子在膀胱癌中的表达及其与微血管密度的关系

目的 研究膀胱癌及正常膀胱组织缺氧诱导因子-1α(HIF-1α)、血管内皮生长因子(VECF)的表达及微血管密度(MVD)在膀胱移行细胞癌血管生成及生物学行为的关系.方法 采用免疫组织化学方法检测40例膀胱移行细胞癌和10例正常膀胱组织的HIF-1α、VEGF表达及MVD.结果 膀胱移行细胞癌组织中HIF-1α阳性表达率为77.5%,VEGF阳性表达率为75%,MVD平均为(37.8±8.3),正常膀胱组织中仅1例可见VEGF表达.膀胱移行细胞癌组织HIF-1α及VEGF表达较正常膀胱组织明显增高(P<0.05);膀胱移行细胞癌组织MVD值显著高于正常组织;HIF-1α阳性表达程度与VEGF阳性表达率及MVD成正相关;膀胱移行细胞癌组织中HIF-1α表达与病理分级呈正相关(P<0.05).结论 HIF-1α、VEGF在膀胱移行细胞癌组织血管生成过程中起主要作用;HIF-1α与膀胱移行细胞癌的生物学行为有关,可作为膀胱癌生物学行为的标志.     

PTEN在膀胱移行细胞癌中的表达及意义

目的：探讨膀胱移行细胞癌中PTEN的表达及其临床意义。方法：应用免疫组织化学法对60例膀胱移行细胞癌组织和20例正常膀胱黏膜中PTEN蛋白的表达进行检测。结果：膀胱癌组织中PTEN蛋白阳性表达率为40%（24/60）,明显低于正常膀胱组织100.0%（20/20）,两组间的差异有统计学意义（P〈0.01）;且其表达水平在不同病理分级、临床分期间差异也有显著性差异（P〈0.01）。结论：PTEN蛋白表达的缺失可能在膀胱移行细胞癌的发生及进展过程中起着重要作用;检测PTEN蛋白表达水平有助于膀胱癌的诊断和预后的判断。     

p16、nm23-H1基因蛋白在膀胱癌的表达与临床意义

目的：探讨抑癌基因p16及肿瘤抑制基因nm23-H1在膀胱中的表达及临床意义。方法：应用免疫组织化学s-p法检测18例正常膀胱组织中及38例膀胱移行细胞癌组织中p16及nm23-H1的表达。结果：p16在正常组织、膀胱癌中阳性表达率分别为88．8％（16／18）、47．4％（18／38），两者间有显著差异性（P＜0．01）。nm23-H1在正常膀胱组织、膀胱癌中阳性表达率分别为83．3％（15／18），44．7％（17／38）。两者间有显著差异（P＜0．01）。提示，p16、nm23-H1阳性表达率与膀胱移行细胞癌的临床分期、临床分级、肿瘤大小及是否转移有密切关系。结论：p16、nm23-H1在膀胱癌中的阳性表达对抑制肿瘤生长，浸润和转移起重要作用，可作为膀胱癌患者预测转移和预后及判断膀胱移行细胞癌生物学行为的良好指标。     

膀胱移行细胞癌树突状细胞浸润和PCNA表达的临床意义

目的 探讨膀胱移行细胞癌组织中树突状细胞（DCs）浸润及增殖细胞核抗原（PCNA）的表达与其生物学行为的关系。方法 采用免疫组织化学SP法检测31例膀胱移行细胞癌术后组织标本中PCNA及DCs标志蛋白S-100的表达。结果 不同病理分级、临床分期及单发癌灶与多发癌灶的膀胱移行细胞癌，其DCs数量相互比较，差异均有显著性（P〈0．05）；原发与复发膀胱癌的DCs浸润数差异无显著性（P〉0．05）。不同病理分级膀胱移行细胞癌PCNA阳性表达细胞数比较差异有显著性（P〈0．05）。结论 膀胱癌DCs浸润数量随病理分级、临床分期的升高而降低，而PCNA随病理分级的升高而增高。DCs及PCNA可以作为预测膀胱癌生物行为的指标。     

nm23-H1基因在膀胱移行细胞癌中的表达及其临床意义

目的：探讨nm23-H1基因与膀胱移行细胞癌生物学行为之间的关系。方法：应用免疫组织化学方法检测50例膀胱移行细胞癌组织nm23-H1基因表达。结果nm23蛋白弥散于胞浆及胞膜，nm23-H1的表达与膀胱癌的分级、分期有密切关系，有转移性癌组织nm23-H1基因表达明显高于无转移癌组织（P＜0.01）。结论：nm23-H1基因表达是一个判断膀胱移行细胞癌恶性程度有价值的指标。     

VEGF及PD-ECGF在膀胱癌的表达及与肿瘤血管生成的关系

目的：研究膀胱移行细胞癌中血管内皮生长因子（VEGF），血小板源性内皮细胞生长因子（PD－ECGF）的表达及肿瘤血管形成的情况及意义。方法：采用免疫组化SP法分析68例原发性膀胱移行细胞部的VEGF，PDECGF的表达情况，检测CD34以计算微血管密度（MVD）。结果：膀胱癌中VEGF表达率为61．76％（42／68）；PDECGF表达率为54．41％（37／68）；二者共同阳性表达率为38．24％（26／68）。VEGF，PD－ECGF与膀胱癌的分级，分期和预后相关，并与MVD呈正相关（P＜0．05）。此外二者之间也有相关性（P＜0．05）。结论：VEGF，PD－ECGF能共同调节膀胱癌的血管形成，可用于判断膀胱癌的生物学行为。     

淋巴管密度和血管内皮生长因子在膀胱移行细胞癌中的表达及临床意义

目的：探讨膀胱移行细胞癌淋巴管密度（LVD）和血管内皮生长因子（VEGF）表达的关系及生物学意义。方法：应用免疫酶标组织化学二步法检测74例膀胱移行细胞癌、15例膀胱移行上皮不典型增生、15例正常移行上皮中D2-40和VEGF的表达,分析D2-40标记的LVD与VEGF表达的相关性及在不同病变组间的差异。结果：移行细胞癌组中VEGF阳性率和LVD高于正常移行上皮和不典型增生移行上皮组（P〈0.05）,浸润深度≥1/2肌层组VEGF阳性率和LVD高于浸润深度〈1/2肌层组（P〈0.05）;淋巴结转移组VEGF阳性率和LVD高于无淋巴结转移组（P〈0.05）,且移行细胞癌VEGF阳性组的LVD高于阴性组（P〈0.05）;移行细胞癌的VEGF阳性率和LVD与肿瘤细胞分化程度无关。结论：VEGF和LVD与膀胱移行细胞癌的生物学行为有关,VEGF可促进淋巴管生成。     

血管内皮生长因子和增殖细胞核抗原在膀胱癌中的表达及临床意义

目的：探讨血管内皮生长因子（VEGF）和增殖细胞核抗原（PCNA）在原发性膀胱移形细胞癌中的表达及其临床意义.方法： 应用免疫组织化学技术检测56例原发性膀胱移形细胞癌和10例正常膀胱组织中VEGF和PCNA的表达,并分析VEGF和PCNA与膀胱癌病理分级和临床分期的关系.结果： VEGF和PCNA在正常膀胱组织中不表达,而在膀胱癌组织中表达较强并与肿瘤的病理分级和临床分期密切相关.结论： VEGF和PCNA可促进膀胱癌的血管生成和细胞增殖.膀胱癌组织中VEGF和PCNA的测定有可能成为判断膀胱癌预后的一个指标.     

膀胱移行细胞癌微血管密度与组织学分级及预后的关系

为探讨肿瘤血管形成及其密度与膀胱移行细胞癌生物学行为的关系，应用免疫组化方法检测了67例膀胱移行细胞癌组织第Ⅷ因子相关抗原表达和肿瘤微血管的长度密度（LV）、结果显示，膀胱癌组织中微血管LV明显比正常膀优高（P＜0．01）。但高分化膀胱癌微血管LV与正常膀胱无显著性差异（P＞0.05）。膀胱癌分化越差，微血管LV越高；有肌层浸润组微血管LV明显高于无肌层浸润组（P＜0．01）；术后肿瘤复发组微血管LV显著高于未复发组（P＜0.01），5年死亡组微血管LV显著高于5年生存组（P＜0.01）。结果提示微血管LV与膀胱移行细胞癌的组织学分级和预后密切相关，其肿瘤是典型的血管依赖性病变，血管形成有利于肿瘤生长，浸润及复发。     

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…     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

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.