Ang-2在食管鳞癌中表达及与血管生成的研究

目的探讨血管生成素-2（Ang-2）在食管鳞癌组织中的表达及在肿瘤血管生成中的作用。方法应用RT-PCR和免疫组化法检测Ang-2mRNA、血管内皮生长因子（VEGF）、CD34在80例食管鳞癌及癌旁食管黏膜组织中的表达,根据CD34染色情况计算出食管鳞癌组织的微血管密度（MVD）。结果食管鳞癌组织中的Ang-2mRNA表达水平显著高于癌旁食管黏膜（P〈0.01）。食管鳞癌中Ang-2mRNA表达与肿瘤浸润深度及淋巴结转移有关（P〈0.01）。食管鳞癌Ang-2mRNA表达水平高于癌旁食管黏膜组织51例中,其癌组织中Ang-2mRNA的表达水平与MVD呈正相关（r=0.94,P〈0.01） 同时,VEGF阳性表达者的MVD明显高于VEGF阴性表达者（P〈0.01）,即当VEGF过度表达时,Ang-2促进血管生成。食管鳞癌Ang-2mRNA表达水平低于癌旁组织29例中,其癌组织Ang-2mRNA的表达水平与MVD呈负相关（r=-0.41,P〈0.05）,VEGF的阳性表达与阴性表达间MVD差异无统计学意义（P〉0.05）,即当VEGF相对缺乏时,Ang-2抑制血管生成。结论Ang-2mRNA在食管鳞癌组织中过度表达,与食管鳞癌的侵袭转移相关。Ang-2对食管鳞癌血管生成具有双向调节作用。     

食管鳞癌组织中葡萄糖转运蛋白1、血管内皮生长因子和环氧合酶-2蛋白检测

目的:检测人食管鳞癌组织中葡萄糖转运蛋白1(GLUT1)、血管内皮生长因子(VEGF)和环氧合酶-2(COX-2)蛋白的表达水平变化.方法:应用免疫组化SP法检测60例食管鳞癌、34例癌旁不典型增生组织及60例正常食管黏膜组织中GLUT1、VEGF和COX-2蛋白的表达.结果:GLUT1阳性染色定位于细胞膜,VEGF和COX-2蛋白阳性染色定位于细胞浆.食管鳞癌组织、癌旁不典型增生组织及正常食管黏膜组织中GLUT1的阳性表达率分别为91.7%、58.8%、20.0%,3组间差异有统计学意义(χ2=29.74,P＜0.05);VEGF蛋白阳性表达率分别为 95.0%、70.6%,8.3%,3组间差异有统计学意义(χ2=14.62,P＜0.05);COX-2蛋白阳性表达率分别为93.3%、73.5%和18.3%,3组间差异有统计学意义(χ2=16.11,P＜0.05).在各类组织中,GLUT1 、VEGF和 COX-2的表达呈正相关.结论:GLUT1、VEGF和COX-2蛋白的过表达可能共同参与了食管癌的发生发展.     

三叶因子1与食管鳞癌新生血管形成的关系

),食管癌MVD水平高于癌旁组织(P＜0.01).结论 TFF1可能通过上调VEGF表达促进食管鳞癌新生血管的形成.     

术前间质化学治疗对口腔鳞状细胞癌环氧酶2、血管内皮生长因子表达及微血管密度的影响

[目的]探讨术前间质化学治疗对口腔鳞状细胞癌环氧酶2(COX-2)、血管内皮生长因子(VEGF)表达及微血管密度(MVD)的影响.[方法]选择2001年—2009年间接受治疗的高分化口腔鳞状细胞癌患者30例,分为术前静脉化学治疗组(15例)和间质化学治疗组(15例),采用免疫组织化学法检测两组COX-2,VEGF表达水平和MVD值变化.[结果]术前间质化学治疗组COX-2,VEGF表达水平及MVD值明显低于术前静脉化学治疗组(P<0.05),COX-2,VEGF阴性组MVD值明显低于COX-2,VEGF阳性组(P<0.05).[结论]术前间质化学治疗和静脉化学治疗均可能通过抑制COX-2,VEGF及MVD表达从而起到减少肿瘤新生血管生成的作用,间质化学治疗较静脉化学治疗作用更为明显.     

血管内皮生长因子和环氧合酶在结直肠癌组织中的表达及其意义

目的 探讨血管内皮生长因子(VEGF)和环氧合酶-2(COX-2)在结直肠癌组织中的表达及其临床意义.方法 采用免疫组化SP法检测56例患者结直肠癌组织、20例癌旁组织VEGF和COX-2的表达及微血管密度(MVD),并结合病理及临床资料进行分析.结果 结直肠癌组织中的VEGF和COX-2的表达阳性率明显高于癌旁组织和正常黏膜组织,与正常黏膜比较差异有显著性(P<0.05).VEGF和COX-2阳性者MVD值显著高于阴性者(P<0.05),VEGF和COX表达及MVD与淋巴结转移、肝转移及Dukes分期有密切关系.结论 VEGF和COX-2在结直癌组织中呈共同表达,并可能通过促进血管形成从而对结直肠癌的发生、发展起重要作用.     

食管鳞癌组织中乏氧诱导因子-1α、血管内皮生长因子及微血管密度测定

目的:探讨食管鳞癌组织中乏氧诱导因子(HIF-1α的表达与血管生成的关系.方法:采用免疫组织化学SP技术检测46例食管鳞癌及26例癌旁正常组织中HIF-1α、血管内皮细胞生长因子(VEGF蛋白的表达,用CD34抗体标记肿瘤组织血管内皮细胞,计算微血管密度(MVD).结果:食管鳞癌组织中HIF-1α、VEGF的阳性率分别为41.31%(19/46)、58.70%(27/46),MVD为46.12±7.64;均高于癌旁正常组织(P＜0.05).HIF-1α、VEGF的表达与食管鳞癌组织学分级和TNM分期无关(P＞0.05),与淋巴结转移及浸润深度有关(P＜0.05).食管鳞癌组织中HIF-1α的表达与VEGF表达及MVD均呈正相关(P＜0.05).结论:HIF-1α与食管癌新生血管形成有关.     

食管鳞癌组织中COX-2的表达

目的:探讨COX-2在食管鳞癌发生、转移及血管形成过程中的作用。方法:采用免疫组织化学方法检测20例正常食管黏膜,6例轻中度、6例重度不典型增生组织及41例食管鳞癌组织中COX-2蛋白的表达,同时对食管鳞癌组织行微血管密度(MVD)测定。结果:正常食管黏膜组织中COX-2不表达;轻中度不典型增生组织,重度不典型增生组织及食管鳞癌组织中COX-2的阳性表达率分别为1/6,3/6,22/41,依次增加(P<0.05)。不同分化程度和浸润深度食管鳞癌组织中,COX-2阳性表达率差异无统计学意义,但有淋巴结转移组的阳性表达率(73.7%)高于无淋巴结转移组(36.4%)(P<0.05)。COX-2阳性食管鳞癌组织中MVD值(39.27±14.80)高于阴性者(22.21±7.97)(t=4.467,P<0.05)。结论:COX-2表达可能是食管鳞癌发生过程中的早期事件,与淋巴结转移和肿瘤组织新生血管的形成有关,与细胞分化程度和浸润深度无关。     

环氧合酶-2与胃癌新生血管形成的关系

目的：观察环氧合酶-2（cyclooxygenase-2,COX-2）和血管内皮生长因子（vascular endothelial growth factor,VEGF）在正常胃黏膜组织、癌旁组织和胃癌组织中的表达,探讨COX-2与胃癌发生发展过程中新生血管形成的关系。方法：采用SP免疫组化方法检测42例正常组织、66例癌旁组织和66例胃癌组织中COX-2和VEGF的表达,以CD34标记血管内皮,测定微血管密度（microvessel density,MVD）。结果：正常胃黏膜组织→癌旁组织→胃癌组织中,COX-2、VEGF的表达和MVD呈逐渐上升趋势,差异具有统计学意义（P〈0．01）,三者的表达具有一致性。MVD值与COX-2的表达呈正相关。结论：COX-2在胃癌发生发展过程中促进新生血管的生成。     

COX-2基因在非小细胞肺癌中的表达及其与VEGF、CD105的关系

目的探讨环氧化酶-2(cyclooxygenase-2,COX-2)基因在非小细胞肺癌(NSCLC)中的表达及其与血管内皮生长因子(VEGF)和CD105的关系。方法逆转录聚合酶链反应(RT-PCR)方法检测64例NSCLC组织及相对应的正常组织中COX-2mRNA的表达,免疫组织化学法检测VEGF、CD105蛋白的表达,以CD105计数微血管密度(MVD)。结果NSCLC组织COX-2mRNA表达阳性率为67.2%,相应正常组织则为14.1%(P<0.01);NSCLC组织COX-2mRNA表达强度高于相应正常组织(P<0.01)。COX-2mR-NA的表达与VEGF的表达显著相关(P<0.01),COX-2阳性癌组织的MVD高于COX-2阴性表达者(P<0.05)。结论NSCLC组织中COX-2表达上调且微血管被激活,COX-2可能通过诱导VEGF表达或与VEGF、CD105协同作用而促进肿瘤血管形成。     

中性粒细胞淋巴细胞比、环氧合酶-2及核转录因子-κB在食管鳞状细胞癌中表达的意义

目的探讨中性粒细胞淋巴细胞比(NLR)、环氧化酶-2(COX-2)、核转录因子-κB(NF-κB)在食管鳞状细胞癌中的表达及相互之间的关系。方法选取新乡医学院第一附属医院经病理诊断为食管鳞状细胞癌的患者60例(鳞癌组),另选择同期健康体检者42例(对照组),分别检测2组受试者外周血常规并计算NLR,比较2组受试者NLR的差异,并进一步分析NLR与食管鳞状细胞癌病理特点的关系。采用免疫组织化学方法检测食管鳞状细胞癌患者癌组织及癌旁组织中COX-2、NF-κB的表达。鳞癌组患者以NLR中位值3.0为节点分为低NLR组(NLR<3.0)和高NLR组(NLR≥3.0),分析2组患者癌组织中COX-2、NF-κB表达的差异。采用Spearman等级相关分析COX-2与NF-κB表达的相关性。结果鳞癌组和对照组受试者NLR分别为1.79±0.77、3.75±2.22,鳞癌组受试者NLR显著高于对照组(P<0.05)。NLR与患者的性别、年龄、肿瘤大小、肿瘤位置无明显相关性(P>0.05),与浸润深度、淋巴结转移、远处转移、病理分级、临床分期有相关性(P<0.05)。COX-2和NF-κB在食管鳞状细胞癌组织中的阳性表达率分别为81.7%(49/60)和56.7%(34/60),在癌旁组织中的阳性表达率分别为58.9%(35/60)和36.7%(22/60),COX-2和NF-κB在食管鳞状细胞癌组织中的阳性表达率均显著高于癌旁组织(P<0.05)。COX-2表达与肿瘤大小及浸润深度相关(P<0.05),与年龄、肿瘤部位、淋巴结转移、远处转移及病理分级无关(P>0.05)。NF-κB表达与肿瘤浸润深度、淋巴结转移、远处转移有关(P<0.05),与年龄、肿瘤大小、肿瘤部位、病理分级无关(P>0.05)。COX-2和NF-κB在食管鳞状细胞癌组织中表达呈正相关(P<0.05)。高NLR组患者癌组织中COX-2和NF-κB阳性表达率分别为94.1%(32/34)和73.5%(25/34),显著高于低NLR组的65.4%(17/26)和34.6%(9/26)(P<0.05)。结论NLR可能是评价食管鳞状细胞癌恶性生物学行为的指标;COX-2、NF-κB可能通过促进慢性炎症的过程参与食管鳞状细胞癌的发生、发展。     

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…     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.