c－met基因表达与胃癌增殖在幽门螺杆菌感染中的关系

目的 研究c-met基因蛋白及增殖细胞核抗原（PCNA）在幽门螺杆菌（H.pylori)感染的胃粘膜病变演进中的表达及关系。方法 145例经病理证实不同胃粘膜病变，采用免疫组化法检测c-met和PCNA基因表达，Warthin-starry法检测H.pylori感染。结果 在浅表性胃炎（CSG）、萎缩肠化性胃炎（CAG＋IM）、异型增生（ATP）、早期胃癌和进展期胃癌中，两种基因CAG＋IM、ATP、胃癌均显高于CSG（P＜0．05）。胃粘膜增殖程度与c-met和PCNA阳性表达强度有显关联（P＜0．01）。c-met和PCNA阳性表达与胃癌组织类型、浆膜浸润和淋巴结转移密切相关。c-met和PCNA－LI在胃癌中等级相关表达有极其显的相关性（P＜0．001）。c-met阳性表达与肠型胃癌H.pylori感染有关。CAG＋IM、ATP和GC组c-met阳性表达中H.pylori感染明显高于阴性。结论 c-met和PCNA基因表达与胃粘膜增殖和恶化有关。c-met基因可能成为评估胃癌恶化的一项新的重要指标。H.pylori感染和c-met表达与胃粘膜增殖和进展有关。     

Hp、p53在胃癌和癌前病变中的表达及相关性研究

目的:探讨Hp、p53在胃癌及癌前病变中的表达及相互关系.方法:采用特殊染色方法和免疫组化方法,检测130例不同胃粘膜病变石蜡包埋标本.结果:1.慢性浅表性胃炎(CSG)、慢性萎缩性胃炎(CAG)、非典型增生(DYS)和胃癌(GC)Hp阳性率分别为40%、60%、70%和72.5%,GC与CSG比较有显著差异(P<0.05).2.p53基因蛋白在CSG、 CAG、 DYS、 GC中的表达率分别为5%、 25%、 50%、 62.5%,其中GC与CAG、CSG 相比有明显差异(P<0.01).3.在80例胃癌标本中,Hp阳性组p53阳性表达率明显高于Hp阴性组(P<0.05). 结论: 1. Hp感染在胃粘膜病变的演变过程中起着重要作用. 2.突变型p53与胃癌的发生有关.3.p53的突变与Hp感染有密切关系.     

胃癌和癌前病变患者细胞间隙连接改变与幽门螺杆菌感染的关系

目的:观察胃癌(gastric cancer,GC)和癌前病变(precancerous lesion,PL)患者胃上皮细胞间隙连接超微结构改变,探讨其与幽门螺杆菌(Helicobacter priori,H.pylori)感染的关系.方法:对70例GC,88例PL,33例慢性浅表性胃炎(chronic superficial gastritis,CSG)患者,进行快速尿素酶试验、碱性品红染色和14C尿素呼气实验以检测H.priori,聚合酶链式反应(polymerase chain reaction,PCR)法检测H.py-lorii CagA基因,并以透射电镜观察胃上皮细胞间隙连接超微结构改变.结果:PL患者胃上皮细胞单位周长连接长度小于CSG患者,细胞间隙最小宽度大于CSG患者.GC患者细胞连接数、单位周长连接数与单位周长连接长度小于CSG与PL患者,细胞间隙最小宽度大于CSG;CasA H.pylori感染者细胞连接数、单位周长连接数与单位周长连接长度均小于CagA-日.pylori感染者,细胞间隙最小宽度大于CasA-H.pylori感染者.PL患者H.pylori根除者胃上皮细胞间隙缩小,细胞连接长度增加,其单位周长连接长度大于未根除者,细胞间隙最小宽度小于未根除者.结论:GC和PL患者胃上皮细胞间隙连接改变与H.pylori感染,特别是与CagA H.pylori感染有关,H.pylori根除可促进细胞间隙连接形成.     

小儿幽门螺杆菌感染与胃粘膜上皮细胞凋亡

目的　探讨幽门螺杆菌 (H .pylori)相关性小儿慢性胃炎胃粘膜上皮细胞凋亡和相关基因 Fas的变化 .方法　采用 TUNEL技术和 Envision免疫组化方法检测 19例 H .py-lori阴性慢性胃炎和 17例 H.pylori阳性慢性胃炎患儿 H.pylori清除前后胃粘膜上皮细胞凋亡和相关基因 Fas的变化 .结果　 19例 H.pylori阴性小儿胃炎胃粘膜上皮细胞凋亡指数和 Fas指数分别为 (2 .7± 0 .8) %和 (11.7± 9.0 ) % ;17例 H.pylori阳性小儿慢性胃炎胃粘膜凋亡指数和 Fas指数分别为 (8.5± 1.8) %和 (31.3± 1.9) % ;H.pylori阳性组凋亡指数和 Fas指数明显高于 H .pylori阴性组 P<0 .0 1. H .py-lori清除后胃粘膜上皮凋亡指数和 Fas指数均明显减少(P<0 .0 1) ,治疗前凋亡指数和 Fas指数分别为 (8.6± 2 .3) %和 (32 .6± 12 .7) % ;清除 H.pylori后 ,凋亡和 Fas指数分别为 (3.6± 1.8) %和 (13.3± 6 .4) % .结论　 H .pylori感染促进胃粘膜上皮细胞的凋亡 ;Fas基因过度表达可能是 H.py-lori诱导胃粘膜上皮细胞凋亡增加的机制之一 .     

慢性胃炎胃粘膜上皮细胞中bax、fas、p16基因的表达

目的:探讨bax、fas和p16在胃粘膜病变发生发展过程中的作用及意义.方法:应用免疫组织化学方法,检测慢性浅表性胃炎(CSG)和轻、中、重度慢性萎缩性胃炎(CAG)患者胃粘膜上皮细胞中bax、fas(促凋亡基因)和p16(增殖负调控基因)基因蛋白的表达情况.结果:CSG和轻、中、重度CAG胃粘膜中bax的表达率分别为41.75%、72.41%和78.26%,fas的表达率分别为39.81%、65.52%和78.26%,p16的表达率分别为9.71%、24.14%和30.43%.轻、中、重度CAG与CSG比较,bax、fas、p16的表达差异有显著性意义P<0.05～0.01.轻、中、重度CAG间比较,差异无显著性意义.结论:bax、fas和p16的高表达,使得细胞增殖/凋亡的比例失衡,在胃粘膜病变的发生发展中可能有重要意义.     

不同胃黏膜病变中TFF3表达与幽门螺杆菌的关系

目的 观察三叶因子3 (trefoil factor 3,TFF3)在胃癌前病变及胃癌的表达,及其与幽门螺杆菌(Helicobacter pylori,H.pylori)感染的相关性,探讨H.pylori感染与胃癌发生的关系.方法 收集慢性浅表性胃炎(chronic superficial gastritis,CSG),慢性萎缩性胃炎伴中、重度肠上皮化生(intestinal metaplasia,IM),慢性萎缩性胃炎伴中、重度不典型增生(dysplasia,Dys)各30例,胃癌(gastric cancer,GC)40例,采用免疫组织化学SP法检测TFF3蛋白的表达.采用warthin-starry银染法及尿素酶试验检测胃黏膜H.pylori感染.结果 CSG、IM、Dys、GC组织中H.pylori感染的胃黏膜组织中,TFF3的表达高于无H.pylori感染的患者(P<0.05).结论 H.pylori感染可能通过上调TFF3的表达,在胃癌发生、发展过程中发挥重要作用.     

突变型p53、PCNA表达和幽门螺杆菌感染与胃黏膜病变

目的　研究突变型 p5 3、增殖细胞核抗原 (PCNA)和幽门螺杆菌 (Hp)感染与胃黏膜良、恶性病变之间的关系。　方法　采用免疫组织化学S -P法 ,对慢性浅表性胃炎 (CSG )、慢性萎缩性胃炎(CAG)、不典型增生 (GED)及胃癌 (GCA)共 115例胃镜活检标本进行突变型 p5 3、PCNA和幽门螺杆菌感染进行检测。　结果　突变型p5 3在CSG及CAG表达均为阴性 ,在GED表达阳性 2 4% ,在GCA表达阳性 5 5 % ,差异有显著性 (P <0 .0 1)。PCNA反映细胞增殖活性 ,在CSG、CAG、GED、GCA的表达有显著递增性 (P <0 .0 5 ) ;幽门螺杆菌感染在CSG检出率为 36 %、CAG为 48% ,GED为 72、GCA为 80 % ,与 2 0例正常胃黏膜Hp检测率 2 0 %作对照 ,除了CSG外 ,其余几组均有显著性差异 (P <0 .0 5 )。Hp感染与PCNA表达强级 (阳性细胞 >5 0 % ) ,与 p5 3阳性病例均有显著相关性 (P <0 .0 1)。 　结论　突变型 p5 3、PCNA及幽门螺杆菌感染在胃黏膜不典型增生、胃癌的发生、发展中有一定作用 ;Hp感染对胃黏膜上皮细胞过度增殖可能起促进作用     

HP、hTERT在胃癌及癌前病变中的表达及相关性研究

目的:探讨幽门螺杆菌(HP)、端粒酶基因(hTERT)在胃癌及癌前病变中的表达及相互关系。方法:采用特殊染色方法和原位杂交方法分别检测130例石蜡包埋标本中HP感染和hTERTmRNA的表达情况。结果:HP感染在慢性浅表性胃炎(CSG)、慢性萎缩性胃炎(CAG)、非典型增生(DYS)和胃癌(GC)中表达率分别为40%、60%、70%和72.5%。GC与对照组(CSG)相比有显著性差异(P<0.05);hTERTmRNA在CSG、CAG、DYS及GC中表达率分别是0、10%、30%、78.75%。GC与CSG、CAG、DYS分别相比有显著性差异(P<0.05);HP感染阳性的胃癌组hTERTmRNA阳性的表达明显高于HP阴性的胃癌组(P<0.01)。结论:HP感染在CSG→CAG→DYS→GC这一演变过程中起着重要作用;胃癌的发生与端粒酶活性有密切关系;HP感染与端粒酶活性呈正相关。     

胃癌高危人群胃粘膜组织中突变型P53蛋白、Runx3蛋白的表达及HP感染的研究

目的:探讨胃癌高危人群胃粘膜组织中的突变型P53蛋白、Runx3蛋白和幽门螺杆菌感染率与胃癌的关系。方法:利用免疫组化法(S-P)检测178例胃癌高危人群胃粘膜活检标本及63例胃癌胃粘膜组织中突变型P53蛋白、Runx3蛋白的表达情况,并用HE染色和特殊染色检测其中的HP感染情况。结果:1突变型P53蛋白在CSG中的表达率最低,胃癌中表达率最高,随着病变的进展阳性表达率呈递增趋势,其中GC与CAG、CSG之间差异有显著性意义。2Runx3蛋白在CSG中的表达率最高,在胃癌中表达率最低,随着病变的进展表达率呈递减趋势。GC与CSG,CAG相比有显著性差异,GC与伴IM相比有统计学意义,GC与伴DYS相比无统计学意义。3高危人群中HP在CSG、CAG、伴IM和伴DYS的感染率随着病变的进展而升高。4在高危人群HP感染的阳性组和阴性组中,阳性组P53蛋白的表达率明显高于HP阴性组,阳性组Runx3蛋白的表达率明显低于HP阴性组。结论:胃癌的发生可能与HP感染、突变型P53蛋白和Runx3蛋白等多种因素及其相互作用有关;在胃癌高危人群的追踪观察中,进行HP感染、P53蛋白、Runx3蛋白的联合检测,对发现胃癌前病变和胃癌及探讨癌变机制是有一定科学意义的。     

胃癌变过程中Hp感染与凋亡基因Bcl-2表达相关性研究

目的 研究胃癌变过程中幽门螺杆菌(Hp)感染与凋亡基因Bcl-2表达、细胞凋亡和临床意义.方法 用快速尿素酶法、W-S银染法和美蓝法联合检测62例慢性浅表性胃炎(CSG)、55例慢性萎缩性胃炎(CAG)、52例肠化生(IM)、46例不典型增生(AH)、65例胃癌(GC)组织中Hp的感染,并采用免疫组化及TUNEL法分别检测Bcl-2蛋白的表达及细胞凋亡水平.结果 Hp感染率、Bcl-2蛋白阳性表达率均随着胃癌形成中病变恶性程度的加重而明显上升.Hp感染率CAG、IM、AH和AC组较CSG,GC组较CAG组均明显升高 (P＜0.05);IM、AH、GC组阳性表达率明显高于CSG组(P＜0.01,P＜0.05);GC组的阳性表达率明显高于IM组(P＜0.01);AH、GC组Hp阳性患者Bcl-2蛋白表达率均高于Hp阴性患者(P＜0.05);IM、AH、GC组中Bcl-2阳性者凋亡指数均低于Bcl-2阴性者;Hp感染阳性胃癌患者组织中Bcl-2蛋白表达与组织分化程度有明显关系,低未分化胃癌Bcl-2蛋白表达明显高于高中分化胃癌(P＜0.01).结论 在胃黏膜癌变过程中,Hp感染可能通过逐渐上调Bcl-2基因的表达,抑制细胞凋亡和分化发挥致癌作用.     

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…     

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.     

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.