P—糖蛋白，GST—π，TOPOⅡ在胃癌组中的表达及其临床意义

目的；探讨P—gp、GST—π，TOPOⅡ在胃癌组织中的表达及意义。方法：采用免疫组织化学方法研究了P—gp、GST—π，TOPOⅡ在胃癌组织中的表达情况。结果；P—gp,GST—π在胃癌组织中的表达升高，表达率分别为58．2％和72．84，P—gp的高表达与淋巴结转移、癌肿浸润深度有关(P＜0．05)。GST—π，的高表达与细胞分化程度有关(P＜0．05)。TOPOⅡ在周癌组织中的表达降低，表达率为61．73%,TOPOⅡ的表达降低与临床病理参数无关（P＞0．05)。结论：胃癌组织中存在着P—pg、GST—π，TOPOⅡ表达水平的变化，临床检测P—gp、GST—π，TOPOⅡ对胃癌化疗方案的制定、判断预后有重要的指导意义。     

谷胱甘肽S—转移酶及同工酶在原发性肝癌中的表达

应用免疫组化方法，对３２例人肝细胞肝癌的谷胱甘肽Ｓ－转移酶（ＧＳＴｓ）及同工酶进行原位检测，并以γ－谷氨酰转肽酶（γ－ＧＴ）作为对照，同时检测１１例肝硬化组织的ＧＳＴｓ酸性同工酶ＧＳＴ－π。结果显示，人肝细胞肝癌的ＧＳＴ－π阳性检出率高于肝硬化组织，尤其在高分化肝细胞肝癌中呈过量表达（８５％）；同时，肝细胞肝癌组织的ＧＳＴ－π阳性率显著高于γ－ＧＴ阳性率。提示ＧＳＴ－π有望成为人肝细胞肝癌的一种新的标志酶。     

胎盘型谷胱甘肽S转移酶在胃癌中表达的意义

目的：探讨胎盘型谷胱甘肽S转移酶（glutathione s—transfarase，GSTπ）在胃癌中表达的临床意义。方法：利用SP免疫组织化学方法，检测58例胃癌和40例慢性萎缩性胃炎患者组织中的阳性率。结果：GSTπ在胃癌和胃炎组织中的阳性率分别为74．14％（43／58）和37．50％（15／40）。两者差异显著（P〈0.05）。GSTπ在胃癌低分化组阳性率偏高，但无统计学意义（P〉0.05）。淋巴结转移组阳性率高于无淋巴结转移组（P〈0．05）。结论：GSTπ在胃癌组织中有较高表达，检测GSTπ对提示预后及指导化疗方案选择有指导意义。     

Wnt信号通路对肝细胞肝癌的影响

目的：探讨Wnt信号通路Wnt5a和β－catenin的表达与肝细胞肝癌的关系及临床意义。方法选取肝细胞肝癌患者癌组织及其癌旁组织各82例,采用免疫组织化学法检测β－catenin与Wnt5a的水平,分析两者与肝细胞肝癌患者临床病理参数间的关系及两者的相关性。结果肝细胞肝癌组织与癌旁组织Wnt5a的阳性表达率分别为35．0％和71．7％,β－catenin的阳性表达率分别为65．9％和23．2％,两者相比差异均有统计学意义（P＜0．01）。在肝细胞肝癌组织内Wnt5的表达与TMN分期和血清 AFP水平相关（P＜0．05）,而与患者年龄、性别、肿瘤分化程度以及有无肝硬化无明显相关（P＞0．05）;β－catenin的表达与TMN分期和肿瘤分化程度及是否有肝硬化有相关性（P＜0．05）,而与患者年龄、性别、血清AFP水平无明显相关（P＞0．05）。在肝细胞肝癌组织中,Wnt5a与β－catenin的表达呈负相关（r＝－0．418,P＜0．05）。结论 Wnt信号通路Wnt5a与β－catenin的表达与肝细胞肝癌的发生、发展具有密切的关系,可为临床治疗肝细胞肝癌提供一定理论基础。     

人胎盘型谷胱甘肽S转移酶在胃癌组织中的表达与基因甲基化关系的研究

应用S—P法检测116例胃癌和53例胃癌前病变的GST－π表达和限制性内切酶及PCR、Southern印迹方法检测14例胃癌及其相应正常胃粘膜GST－πDNA5'端调控区CCGG特定位点的甲基化水平。GST－π阳性率：正常胃粘膜10％（4／39），胃癌77％（89／116），肠上皮化生76％（19／25），不典型增生89％（25／28）。GST－π在胃癌及癌前病变中的表达较正常胃粘膜增高（P＜0．01）。胃癌组织中GST－π基因较正常胃粘膜呈现高度去甲基化（P＜0．01），胃癌GST-π基因5'端调控区低甲基化与其GST－π表达增加里相关性（P＜0．05）。GST－π在胃癌及癌前病变中的表达与胃癌的发生、发展密切相关。GST－π可作为胃癌的肿瘤相关抗原；GST－π基因5'端调控区低甲基化可能是GST－π高表达的分子机制。     

肝硬化、肝癌患者血清转化生长因子β1和干扰素γ的测定及临床意义

目的：探讨转化生长因子β1(TGF-β1)和干扰素γ(IFN-γ)在肝硬化、肝癌中的表达及临床意义。方法：采用酶联免疫吸附试验法(ELISA)测定了48例肝硬化、40例原发性肝癌、6例转移性肝癌及20例正常对照者血清中TGF-β1和IFN-γ含量。结果：原发性肝癌患者血清TGF-β1水平显著高于肝硬化组和正食对照组，血清IFN-γ水平明显低于肝硬化组和正好对照组(P均＜0．05)。原发性肝癌组的血清TGF-β1水平显著高于转移性肝癌组(P＜0．05)，而两组IFN-γ水平无显著性差异(P＞0．05)。肝硬化及转移性肝癌患者血清TGF-β1和IFN-γ水平无显著性差异(P均＞0．05)。肿块数目≥3个，直径≥3cM和AFP≤20ng/ml的原发性肝癌患者血清TGF-β1水平明显增高，血清IFN-γ水平显著降低(P均＜0．05)。20例原发性肝癌患者经介入或手术治疗后血清TGF-β1水平明显下降，IFN-γ水平明显上升(P＜0．05)。结论：血清TGF-β1和IFN-γ可作为新的血清学标志应用于原发性肝癌的鉴别诊断和近期疗效的判断。     

胃粘膜肠化中π类谷胱甘肽转移酶的表达及其与幽门螺杆菌感染的相关性

目的 探讨π类谷胱甘肽转移酶（GST－π）在胃癌发生过程中的表达,及在肠化阶段以GST－π为代表的人体对致癌物解毒系统与幽螺杆菌（Hp)致毒作用间的相互作用。方法 利用S－P法对219例胃粘膜活检标本进行GST－π单克隆抗体的检测;利用HID－ABpH2.5-PAS粘蛋白组织化学技术对171例肠化粘膜进行分型;利用HE及Hp-DNA PCR及ELISA方法对正常胃粘膜和肠化粘膜进行Hp的检测。对80例Hp阳性患者进行Hp根除治疗,停药3个月后进行Hp、GST－π的检测。结果 正常胃粘膜未见GST-π的表达,肠化粘膜GST－π阳性率为69．6％,胃癌GST－π阳性率为44．4％,高于正常胃粘膜（P＜0．01）,低于肠化粘膜（P＜0．05）。Hp阴性组GST－π阳性率高于Hp阳性组（P＜0．05）。Hp根除治疗后,根除组GST－π表达高于未根除组（P＜0．05）。正常胃粘膜→肠化粘膜→胃癌组织中GST－π表达由无→高→低,GST－π弱阳性或阴性的Ⅲ型肠化与胃癌关系密切;肠化粘膜中GST－π弱阳性或阴性表达又合并Hp感染者,胃癌发生的危险性增加。结论 在胃粘膜上皮肠化阶段Hp的致毒作用与GS－π解毒作用彼此相互拮抗。     

卵巢肿瘤组织谷胱甘肽S转移酶—π的表达及其临床意义

目的：研究卵巢肿瘤组织中谷胱甘肽S转移酶－π（GST－π）的表达及其临床意义,方法：用免疫组化链霉菌素样生物素过氧化酶法（S－P）测定10人良性卵巢肿瘤,40例恶性肿瘤组织中GST－π的表, 其与组织学类型,病理分级,临床分期前化疗的关系,结果：10例良性肿瘤GST－π无阳性表达,40例恶笥肿瘤阳性表达26例（65％）,GST－π的表达与组织学类型和术前化疗无关系（P＞0．05）,GST－π阳性表达在低分化癌中占85．71％,高于高,中分化癌（33．33％,P＜0．01）,在上皮性肿瘤I－II期中占20％,III－IV期占71．4％,有随着期升高而升高的趋势,GST－π阳性者缓解期短,易近期内复发,结论：免疫组化测定GST－π在卵巢恶性肿瘤中的表达对化疗疗效,克服耐药,估计预后具有一定的临床价值,GST－π阳性者属非P－糖蛋白耐药,化疗疗效及预后差。     

血清GPDA,γ-GT与ALP联合检测在原发性肝癌诊断中的价值

目的：探讨联合检测甘氨酰脯氨酸二肽酶（GPDA）、γ-谷氨酰转肽酶（γ-GT）与碱性磷酸酶（ALP）血清水平，提高原发性肝癌（PHC）诊断价值。方法：GPDA，γ-GT与ALP均采用连续监测法，检测肿瘤患者328例。结善：肝癌组三项酶活性与胃癌组、肺癌组、直肠癌组及对照组比较均高于其他各组，均具有统计学意义。（P〈0．01，P〈0．05）。肝癌组三项阳性率与其他肿瘤组比较差异具有统计学意义（P〈0．01）。结论：联合检测GPDA．γ-GT与ALP可提高对PHC定性诊断水平．在疗效监测方面可为临康提供有价值的资料．     

β-连环蛋白在原发性肝细胞癌中的表达及其临床意义

目的：研究β－连环蛋白在原发性肝细胞癌中的表达及其与原发性肝细胞癌分化、侵袭转移和预后的关系。方法：应用免疫应运地63例原发性肝细胞癌石蜡包埋标本进行β－连环蛋白半定量检测。结果：有49例（78％）原发性肝细胞癌β－连环蛋白阳性表达，低分化癌的β－连环蛋白阳性率明显高于高分化癌（P＜0．05）。β－连环蛋白阳性表达率在AFP高表达肝癌组高于AFP低表达组（P＜0．05）。β－连环蛋白阳性表达率在有淋巴结转移肝癌组织高于无淋巴结转移组（P＜0．05）。β＝连环蛋白阳性表达患者2a生存率（11％）显著低于阴性表达者（32％，P＜0．05）。结论：β－连环蛋白表达与肝癌组织的分化程度、有无淋巴结转移、患者的AFP水平呈正相关，β－连环蛋白表达与患者预后相关，可以作为判断原发性肝细胞癌预后的生物学指标。     

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.     

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.     

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.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.