多药耐药相关蛋白和肺耐药蛋白在胃癌中的表达

目的：检测多药耐药相关蛋白（MRP）和肺耐药蛋白（LRP）在胃癌组织中的表达，并探讨其与临床病理特征的关系。方法：采用免疫组织化学法，检测52例患者胃癌组织和30例慢性胃炎组织中MRP及LRP的表达。结果：在52例胃癌组织和30例胃炎组织中，MRP的阳性表达率分别为32.69%（17例）、10％（3例），LRP的阳性表达率分别为63.46%（33例）、33.33%（10例），差异均有显著性意义（P＜0.05）。MRP的表达与胃癌病理分期和分化程度相关（P＜0.05）；LRP的表达与淋巴结转移相关（P＜0.05）。两蛋白在胃癌中的表达呈正相关（P＜0.05）。结论：MRP和LRP在胃癌组织中均有较高的表达，两者均可能是胃癌原发性多药耐药（MDR）的一种重要机制，且两者可能具有协同作用；临床上检测该两蛋白的表达，有利于为胃癌患者制定更加合理的综合治疗方案。     

P-糖蛋白、多药耐药相关蛋白在胃癌的表达与化疗敏感性的相关性研究

目的：探讨胃癌组织中P-糖蛋白（P-glycoprotein，P-gP）、多药耐药相关蛋白（muhidrug resistance-associated protein，MRP）的表达及对胃癌原代细胞培养体外化疗药物敏感性的影响。方法：应用免疫组化法检测P-gP及MRP在48例胃癌及癌旁组织的表达，同时通过胃癌原代细胞培养MTT药敏试验，检测胃癌对7种临床常用化疗药物的敏感性及耐药性，进一步分析药敏试验结果与P-gp、MRP表达的相关性。结果：在48例胃癌中，P-gP及MRP阳性率分别为41．7％、29．2％，共同表达率为25．0％。癌旁组织与癌组织的P-gP、MRP阳性表达率无显著差异。在顺铂（DDP）、丝裂霉素（MMC）、阿霉素（ADM）、鬼臼乙叉甙（VP-16）、5-氟尿嘧啶（5-FU）、羟基喜树碱（HCVF）、甲氨蝶呤（MTX）中，ADM、VP-16、HCVF耐药组P-gP、MRP阳性表达及共表达率较敏感组显著升高。结论：胃癌组织P-gp、MRP表达可导致胃癌原发性耐药。P-gP、MRP介导的MDR是ADM、VP-16、HCPT耐药的重要因素．     

急性白血病多药耐药相关蛋白的检测及临床意义

目的：探讨多药耐药相关蛋白（MRP）的表达与临床耐药的关系。方法：以免疫组化ABC法检测了53例急性白血病AL患者和15例对照组骨髓单个核细胞MRP的表达情况,并同时检测了P－170的表达。结果：（1）40例化疗后患者,MRP阳性表达23例,其中疗效差18例,疗效佳5例。MRP阴性表达17例,其中疗效差7例,疗效佳10例。MRP阳性组疗铲显著差于阴性组（P＜0．05）,（2）40例化疗后患者,P－170阳性组疗效显著差于阴性组（P＜0．01）,（3）化疗后患者MRP与P－170表达具有一定的一致性（Kappa系数－0．367,P＜0．01）,且两者与临床疗效有关。结论：MRP的过高表达是多药耐药（MDR（）产生机制中又一因素;（2）MRP与P－170表达有一定的一致性,且与临床疗效有一定关系;（3）MDR采用多项指标检测有助于AL疗效判断及预后预测。     

胃癌前组织和胃癌中Fas基因表达及其与细胞凋亡的关系

目的 探讨胃癌组织及胃癌中Fas基因表达状况及其与细胞凋亡的关系。方法 应用原位杂交和免疫组织化学技术检测10例正常胃粘膜、72例慢性胃炎和53例胃癌中Fas基因的表达,并采用凋亡细胞原位检测方法对组织切片中的凋亡细胞进行观察和比较。结果 正常胃粘膜无Fas基因表达。Fas mRNA在肠化生组织中的表达率为75．00％,显著高于萎缩性胃炎（37．50％,P＜0．01）和胃癌（52．83％,P＜0．05）。Fas蛋白在肠化生组织中的表达率为80．56％,显著高于萎缩性胃炎（37．50％,P＜0．01）、异型增生（55．00％,P＜0．05）和胃癌（45．28％,P＜0．01）。X^2检验表明两种方法检测阳性率差异无显著性。凋亡细胞原位检测结果显示,Fas蛋白表达阳性萎缩性胃炎、肠化生和胃癌组织中的凋亡细胞指数显著高于Fas蛋白阴性组（P＜0．05及P＜0．01）,Fas蛋白表达状态与细胞凋亡指数呈正相关（r=0．393,P＜0．01）。结论 Fas基因对胃癌前组织及胃癌细胞凋亡具有促进性调控作用,细胞凋亡调控异常在胃癌发病中可能起重要作用。     

Cdk2及其抑制因子p27Kip1在胃癌中的表达和意义

目的：探讨细胞周期素依赖性激酶2（Cdk2)及其抑制因子p27^Kipl与胃癌生物学行为的关系。方法：采用免疫组织化学S－P法对60例胃癌组织原发灶和淋巴结转移灶进行Cdk2，p27^Kipl免疫组化染色，腹水或腹腔冲洗液先脱落细胞学检查。结果：Cdk2阳性表达率56．67％（34／60），阳性细胞定位于细胞核和细胞浆，以Ⅲ，Ⅳ期表达率较高（P＜0．01），与胃癌大体类型及浆膜分型关系密切（P＜0．01）；p27^Kipl阳性表达率为43．33％（26／60），阳性细胞定位于细胞浆，在高分化及Ⅰ、Ⅱ期胃癌高表达（P＜0．05），且与淋巴细胞转移密切相关（P＜0．01），Cdk2，p27^Kipl同时阳性表达19例，占31．67％（19／600。结论：Cdk2与胃癌浸润深度，淋巴结转移呈正相关，p27^Kipl表达与胃癌浸润深度，淋巴结转移呈负相关。     

上皮钙粘素在胃癌中的表达及意义

目的：探讨上皮钙粘素（E－cadherin,E-CD）在慢性胃炎、胃粘膜异型增生及胃癌组织中的表达及与胃癌生物学行为的关系。方法：应用免疫组织化学SP法研究20例慢性胃炎、20例胃粘膜异型增生及50例胃癌组织中E－CD的表达。结果：慢性胃炎、胃粘膜异型增生及胃癌的阳性表达率分别为95．0％（19／20例）、85．0％（17／20例）、42．0％（21／50例）。慢性胃炎及胃粘膜异型增生组的阳性表达率显高于胃癌组（P＜0．01），同时E－CD在胃癌组织中的表达与胃癌的分化程度、淋巴结转移、浸润深度及临床分期等有相关关系（P＜0．05，P＜0．01）。结论：E－CD参与了肿瘤的发生、发展、浸润及转移。     

多药耐药相关蛋白、谷胱甘肽-S-转移酶π、拓扑异构酶Ⅱα及环氧合酶-2在卵巢癌组织中的表达及其与卵巢癌患者耐药和预后的关系

目的 探讨多药耐药相关蛋白（MRP）、谷胱甘肽-S-转移酶π（GST-π）、DNA拓扑异构酶Ⅱα（TopoⅡα）及环氧合酶-2（COX-2）在卵巢癌组织中的表达情况,及其与耐药及预后的关系。方法选择北京协和医院2000至2004年间收治的上皮性卵巢癌患者60例,肿瘤细胞减灭术后经铂类和紫杉醇一线化疗6-9个疗程,随诊资料完整。其中浆乳癌35例,黏液性囊腺癌2例,透明细胞癌11例,移行细胞癌4例,子宫内膜样癌8例,患者平均年龄51．2岁。采用免疫组化法检测卵巢癌标本中MRP、GST-π、TopoⅡα及COX-2的表达情况,并分析其表达与卵巢癌患者耐药和预后的关系。结果MRP,GST-π,Topoπ和COX-2在卵巢癌标本中的阳性表达率分别为26．7％、93．3％、61．7％和78．3％。透明细胞癌组织中MRP的阳性表达率显著高于非透明细胞癌（54．5％V820．4％,P〈0．05）;Ⅲ-Ⅳ期组织中Topoπ的阳性率显著低于Ⅰ～Ⅱ期（56．6％V878．6％,P〈0．05）。将MRP阳性、GST-π强阳性、TopoⅡα阴性和COX-2强阳性表达作为4个与复发、耐药及预后不良有关的危险因素。复发组具有≥2个危险因素者显著多于未复发组（81．6％V854．5％,P〈0．05）。化疗耐药组中具有≥2个危险因素者显著多于化疗敏感组（100％V855．6％,P〈0．01）。具有≥2个危险因素者和危险因素不足2个者的3年生存率分别为69．9％和91．7％（P〉0．05）。结论MRP、GST-π、TopoⅡα及COX-2在卵巢癌组织中呈中等到高等程度的表达。具有MRP阳性、GST-π强阳性、TopoⅡα阴性和COX-2强阳性中的2个以上危险因素可作为预测卵巢癌患者复发和耐药的重要指标。     

胃癌中 MCM5蛋白的表达及临床病理意义

目的：探讨胃癌中微小染色体维持蛋白5（MCM5）的表达情况及临床病理意义。方法采用免疫组化SP法检测60例胃原发癌组织及20例正常胃黏膜组织（取自癌旁正常胃黏膜）中MCM5蛋白的表达情况,并结合临床病理参数进行综合分析。结果 MCM5在60例胃癌组织中阳性率为80．6％;在20例正常胃黏膜组织中阳性率为30％。胃癌组显著高于正常组（ P＜0．01）。 MCM5在胃癌组中的表达与病理分级和浸润深度（T分期）有关（P＜0．01;P＜0．05）。结论 MCM5参与了胃癌的发生发展并可能作用于胃癌的早期阶段,其表达水平可能与胃癌病理分级、分期有关,检测其表达水平对胃癌的治疗选择和评估预后可能有重要的参考意义。     

ATP-TCA药敏试验测定的胃癌耐药性与MDR1 mRNA和P-gp表达的关系

目的评价三磷酸腺苷-肿瘤体外药敏试验（ATP—TCA）测定的原发性胃癌耐药性与耐药基因以及蛋白表达的关系。方法选择2009—2011年间收治的胃癌患者52例，采用ATP-TCA检测胃癌患者对5-氟尿嘧啶、丝裂霉素、顺铂、5-氟尿嘧啶＋阿霉素＋丝裂霉素、奥沙利铂＋20倍5-氟尿嘧啶5种方案的体外药物敏感性，采用逆转录PCR以及荧光定量PCR检测胃癌患者组织中耐药基因MDR1的表达，采用流式细胞仪检测胃癌患者血中P-糖蛋白（P—gp）表达，采用X^2检验分析ATP—TCA检测结果与MDR1和P—gp表达之间的相关性。结果①5-氟尿嘧啶、丝裂霉素、顺铂、5-氟尿嘧啶＋阿霉素＋丝裂霉素、奥沙利铂＋20倍5一氟尿嘧啶5种方案与临床疗效明显相关（P〈0．01），其中奥沙利铂＋20倍5一氟尿嘧啶方案的ATP—TCA检测结果与临床疗效的符合率最高，达84．6％（44／52）。②ATP—TCA检测化疗敏感和耐药患者MDR1mRNA的表达水平分别为（0．673±0．143）和（1．436±0．594），两者比较差异有统计学意义（P=0．008）。⑧用流式细胞仪检测52例胃癌患者P—gP表达量，其中阳性20例，阳性率达38．4％，P—gP的表达与ATP—TCA药敏试验有明显相关（P〈0．01）。结论ATP—TCA检测耐药结果与MDR1mRNA和P—gp表达之间存在明显的相关性，临床检测MDR1mRNA和P—gp表达可有效预测临床化疗敏感性，指导胃癌的个体化治疗。     

P53，rasP21及C—met癌基因蛋白在胃癌中的表达及分布特征

应用免疫组化SP方法检测了60例胃癌标本P53，rasP21及C－met癌基因蛋白，其阳性结果分别为51．7％、40．0％、70．0％；胃癌旁正常粘膜上皮的阳性率分别为1．6％、13．3％、16．7％，与肿瘤区相比较有显著差异（P＜0．01），P53阳性细胞的染色部位在细胞核内，P21及C－met阳性细胞的染色部位在胞浆及／或胞膜，P21在肿瘤区与肿瘤移行区，癌旁正常粘膜区染色强度比较有差异（P＜0．05），C-met表达有显著性差异（P＜0．01）。P53阳性表达与肿瘤的分化程度有关，即分化越差，其阳性表达越高。     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

A preliminary screening study on the associated proteins in human psoriasis vulgaris by serum proteomics technologies

Objective：To investigate the optimum screening conditions of associated proteins in human psoriasis vulgaris by serum proteomics technique, and to screen the different expression proteins related with psoriasis vulgaris. Methods：Serum samples of peripheral blood were collected from newly diagnosed psoriasis vulgaris patients in the clinic, and 20 matched healthy persons. Serum albumin IgG was removed by filtering with ProteoExtract Albumin/IgG. After comparative proteomics analysis the different protein spots were identified using 2-DE and MS. Results ：Electrophoresis figures with high resolution and reproducibility were obtained. Three different expression proteins were found only in the serum from psoriasis vulgaris patients, while nine other different proteins expressing from healthy volunteers. Conclusion：The protein expression was different in the serum between the psoriasis vulgaris patients and healthy volunteers. It was hoped that we could find the biomarkers related to psoriasis vulgaris by using proteomics.     

A CASE OF HUGE GASTRIC DISOPYROBEZOAR

PYTOBEZOARS are common bezoars in gastrontestinal tract, commonly seen in stomach and mall intestine,1but huge disopyrobezoars are     

Acupuncture Treatment of Chest Bi Syndrome

CASE HISTORY A male,a retired officer of 61 years old,paid his first visit on May 12,2006.The patient stated that 2 weeks before he suddenly got paroxysmal precordial choking pain,with irregular attacks.Each attack would last several seconds to several minutes.The attack was accompanied with heavy oppressed sensation in the precordial region,palpitation,lassitude,and in severe cases,sweating,which was once diagnosed by a hospital as'coronary heart disease'.Recalling the case history,the patient said that several days before he got angry with others because of some affairs in work,and he was not so used to the life pattern since he had just retired from his busy working post.At usual times,he was quick tempered and peevish.In recent days,he had poor appetite,and loose stool.     

Instructions to Contributors

The English edition of Chinese Journal of Integrative Medicine is edited and published by the Chinese Journal of Integrated Traditional and Western Medicine Press.Original scientific papers of advanced clinical and experimental medicine in the field of complementary/alternative medicine or integrative medicine are expected.