检测 GPC3和 GP73两种方法的比较及与临床的相关性

采用 ELISA 法检测70例标本(肝癌组39例、肝硬化组31例)血清中磷脂酰肌醇蛋白聚糖3(GPC3)和高尔基体蛋白73(GP73)的水平,qRT-PCR 法检测相同标本外周血单个核细胞(PBMC)中 GPC3 mRNA 和 GP73 mRNA 的相对表达量。结果显示肝癌组血清中 GPC3和 GP73表达量显著高于肝硬化组(P <0．0001);两组间 PBMC 中 GPC3 mRNA 和GP73 mRNA 水平差异无统计学意义;相关性分析结果显示,肝硬化组和肝癌组血清中 GPC3、GP73含量均有正相关性(P <0．01)。血清中 GPC3和 GP73的水平均能预测原发性肝癌,且 GPC3和 GP73的水平具有一定的相关性;PBMC 中GPC3 mRNA 和 GP73 mRNA 的表达水平不能很好的区分肝癌组与肝硬化组,提示 ELISA 法检测血清中 GPC3和 GP73的表达水平是临床预测原发性肝癌的首选方法。     

肝癌组织GP73过表达及血GP73异常对肝癌的诊断价值

目的：分析肝癌（HCC）组织及外周血高尔基体糖蛋白-73（GP73）表达对肝癌的诊断价值。方法：以Western Blot法检测肝癌组织GP73表达;收集肝病患者外周血标本,以酶联免疫吸附法检测GP73水平。结果：肝癌、癌旁组织GP73均有表达,但癌组织GP73蛋白条带灰度均值为480.7,明显高于癌旁（209.0,t=6.453,P〈0.001）。外周血GP73水平,正常对照组（28.83±21.00）ng/mL,慢性肝炎组（49.86±40.46）ng/mL,肝硬化组（62.30±56.30）ng/mL和肝癌组（87.25±78.41）ng/mL,肝癌组明显高于对照组和良性肝病各组（P〈0.05）;肝癌患者血GP73表达与HBV感染、伴肝外转移密切相关（P〈0.05）,与血AFP呈显著正相关（r=0.961,P〈0.05）;经临床综合评价,受试者工作特征曲线下面积AFP为0.877,GP73为0.931,且两者对肝癌具有互补诊断价值。结论：GP73过表达与肝癌发展密切相关,它的定量检测有助于肝癌的诊断与鉴别。     

血清GP73,GPC3,AFU,CA19-9联合检测在原发性 肝癌诊断中的价值

目的 探讨血清GP73,GPC3,AFU,CA19-9联合检测在原发性肝癌诊断中的价值.方法 方便选取2016年1月—2017年1月包头医学院第一附属医院肿瘤外科收治的49例原发性肝癌(PHC)患者,50例肝炎肝硬化患者和50名健康体检者作为研究对象,检测各组受试者血清中GP73,GPC3,AFU及CA19-9水平.结果 PHC组患者的GP73值(284.65±85.63)ng/mL,GPC3值(116.94±31.88)μg/L,AFU值(154.69±38.78)U/L及CA19-9值(76.31±30.53)U/mL与肝炎肝硬化组比较GP73值(90.12±48.07)ng/mL,GPC3值(50.63±19.72)μg/L,AFU值(70.86±21.72)U/L及CA19-9值(51.29±25.17)U/mL均显著升高(P<0.05);PHC组与正常对照组GP73值(58.66±20.39)ng/mL,GPC3值(8.95±3.36)μg/L,AFU值(29.64±7.55)U/L及CA19-9值(20.81±9.55)U/mL比较上述各指标显著升高(P<0.05);PHC组联合检测敏感度可高达93.88%,各指标单独检测敏感度在40%~60%左右,肝炎肝硬化组联合检测敏感度为38.00%,各指标单独检测敏感度在10%~20%左右,两组联合检测与各指标单独检测比较敏感度均有显著提升(P<0.05).结论 血清GP73,GPC3,AFU及CA19-9均为原发性肝癌的敏感指标,四者联合检测对PHC的早期诊断有重要意义.     

GP73在肝癌中的诊断价值

目的分析血清中高尔基糖蛋白73(GP73)在原发性肝癌诊断中的临床价值。方法选取经临床病理确诊的原发性肝癌患者67例(肝癌组)、肝硬化患者60例(肝硬化组)及体检正常人群60例(正常组),分别检测三组研究对象的血清GP73水平并进行比较分析,并分析不同临床病理特征的肝癌患者血清GP73水平的差异,同时以临床病理诊断结果作为金标准,评估GP73鉴别诊断肝癌与肝硬化患者的效能。结果肝癌组的血清GP73水平为(280.95±139.40)ng/ml,显著高于肝硬化组的(93.56±61.35)ng/ml和正常组的(24.97±12.63)ng/ml,且差异均有统计学意义(P0.05);不同年龄、性别、肿瘤大小肝癌组患者血清GP73水平差异无统计学意义(P0.05);发生远处转移、血管浸润、Ⅲ+Ⅳ期的肝癌患者的GP73显著高于未发生生远处转移、未血管浸润、Ⅰ+Ⅳ期的肝癌患者(P0.05)。血清GP73诊断肝癌的灵敏度为65.67%,特异度为85.00%,漏诊率为34.33%,误诊率为15.00%,阳性预测值83.02%,阴性预测值68.92%,ROC曲线下面积AUC=0.780。结论 GP73在原发性肝癌的中高表达,在诊断肝癌中具有一定的临床价值。     

外周血磷脂酰肌醇蛋白聚糖-3检测在原发性肝癌诊断中的意义

目的 探讨外周血磷脂酰肌醇蛋白聚糖-3(GPC3)检测在原发性肝癌诊断中的意义.方法 应用酶联免疫吸附试验检测80例原发性肝癌患者、78例肝内良性占位病变患者和40例健康对照者外周血GPC3蛋白水平,了解GPC3蛋白在各组中的阳性率,探讨GPC3蛋白诊断原发性肝癌的敏感性和特异性.结果 健康对照组血清GPC3蛋白水平为(196.76±112.24)pg/mL,肝内良性占位组为(248.56±123.35)pg/mL,原发性肝癌组为(678.23±325.22)pg/mL.原发性肝癌组血清GPC3蛋白水平高于肝内良性占位组和正常对照组(F=18.76,P＜0.01).根据ROC曲线,若外周血GPC3蛋白诊断原发性肝癌的界值为412.6 prdmL,则敏感度为63.2%,特异度为89.3%,健康对照者GPC3蛋白阳性率为2.50%,肝内良性占住病变组阳性率为14.1%.原发性肝癌组阳性率为65.0%.各组间血清GPC3蛋白阳性率统计学差异有显著性意义(χ2=40.28,P＜0.01).若AFP诊断肝癌的截止值为400 ng/mL,AFP的阳性率为46.3%,联合检测AFP和GPC3的阳性率提高至77.5%. 结论GPC3蛋白可作为原发性肝癌诊断及鉴别诊断的重要指标之一.联合检测GPC3和AFP可能提高原发性肝癌的诊断敏感性.     

GP73在慢性乙型肝炎、肝硬化、原发性肝癌血清及组织中的表达

目的探讨在慢性乙型肝炎、乙肝病毒相关性肝硬化、原发性肝癌血清及组织中高尔基体蛋白73(G P73)的表达.方法 (1)通过应用双抗体夹心ELISA方法测定慢性乙型肝炎、乙肝病毒相关性肝硬化、原发性肝癌患者及正常对照组血清及组织中GP73的水平;(2)通过免疫组织化学染色SP法检测慢性乙型肝炎、乙肝病毒相关性肝硬、原发性肝癌患者、正常人的上述4组人群肝组织中GP73的表达水平.结果发现4组中血清、组织中GP73的浓度表达强弱与性别年龄无关;在慢性乙型肝炎、乙肝病毒相关性肝硬化肝癌中表达逐渐增高,GP73与慢性肝病的进展有关,慢性乙型肝炎感染相关肝病者,血清、组织中GP73的浓度与AFP、HBV-DNA有一定相关性,并且与ALP相关性较高.结论 GP73在肝癌患者呈现高表达,有助于推测肝脏良、恶性疾病的鉴别,可能成为一种有潜在价值的肝癌标志物.     

免疫组织化学二步法检测原发性肝癌组织GP 73蛋白表达的结果分析

目的：分析原发性肝癌组织GP73蛋白表达的结果。方法选取手术切除原发性肝癌组织的患者35例,采用免疫组织化学二步法检测31例原发性肝癌组织、28例癌旁组织、10例肝硬化肝组织和11例正常肝组织的GP 73蛋白的表达。结果 GP 73蛋白表达主要位于肝癌组织、癌旁组织、肝硬化肝组织的细胞中,其细胞质会出现黄色、棕黄色、黄褐色的着色颗粒。在肝癌组织中,GP 73阳性率为93.5%(29/31);在癌旁组织中,GP 73阳性率为92.9%(26/28);在肝硬化肝组织中,GP 73阳性率为40.0%(4/10);在正常肝组织中,GP 73阳性率为27.2%(3/11)。在GP 73蛋白阳性表达率方面,肝硬化肝组织与正常肝组织差异无统计学意义;肝癌组织相比与癌旁组织差异无统计学意义;与肝硬化肝组织和正常肝组织相比,肝癌组织和癌旁组织的GP 73蛋白的阳性表达率更高,差异有统计学意义(P<0.05)。结论 GP 73蛋白是肝癌组织病理标志物,可以作为肝癌诊断的标记蛋白。     

新的HCC血清标志物GP73在HCC中的表达及临床价值研究

目的 研究新的原发性肝细胞癌(HCC)血清标志物高尔基体蛋白73( GP73)在HCC血清中的表达及临床价值.方法 选取确诊为HCC者40例为HCC组;肝炎患者及肝硬化患者120例为肝病组;健康体检者120例为健康组.用双抗体夹心ELISA法检测三组血清GP73浓度;同时检测甲胎蛋白(AFP)及α-L-岩藻糖苷酶(AFU)作对比研究.结果 HCC组血清中GP73的表达水平为(399.17 ±264.43) ng/ml,显著高于肝病组的(105.12±67.79) ng/ml和健康组的( 66.51 ±46.2) ng/ml,差异均有统计学意义(P＜0.05).GP73、AFP、AFU诊断HCC的敏感性分别为89.28％、62.5％和80.7％;特异性分别为87.1％、78.5％和68.7％,GP73敏感性及特异性均高于AFP和AFU.结论 GP73是继AFP、AFU之后另一个新的优秀的诊断HCC血清标志物,具有重要临床价值.     

血清GP73作为原发性肝癌肿瘤标志物的来源探究

目的探究血清GP73作为原发性肝癌的肿瘤标志物的可行性。方法采用SYBR Green qPCR法对103例原发性肝癌（PHC）、13例肝硬化、49例肝炎和50例健康人群外周血单核细胞GP73 mRNA的相对表达量进行检测,同时检测分析8份正常肝组织和8份肝癌组织的GP73 mRNA相对表达水平。对7例病理确诊为PHC的肝组织和1例正常肝组织、1例肝硬化肝组织中GP73的表达进行免疫组化分析。采用ELISA法检测血清GP73水平和利用电化学发光法血清中AFP水平。结果外周血有核细胞GP73 mRNA含量四组间差异无统计学意义（F=3.013,P=0.055）。肝癌组织GP73mRNA表达量（12.64）显著高于正常肝组织（1.00）。GP73免疫组化结果显示,正常肝组织中GP73少量在肝实质细胞胆小管处表达。肝硬化组织中GP73在肝细胞胞浆中弱阳性表达,但在肝细胞胞浆的两侧靠近胆小管位置呈颗粒状浓集;胆管柱状上皮也呈强阳性着色。PHC患者肝组织GP73在肿瘤细胞胞浆呈强阳性着色,且在胆管上皮细胞靠近腔缘一侧呈深棕色颗粒状分布。肝癌组中血清GP73水平显著高于肝炎组及健康对照组（χ^2=62.541,P=0.000）。通过ROC曲线确定诊断肝癌的GP73临界值为113.2μg/L,和AFP的临界值为13.3μg/L时,GP73和AFP单项检测的敏感度分别为68.0%和56.3%,特异度分别为94.8%和91.8%。结论 PHC患者血清高表达的GP73可能是在癌变的肝细胞胞浆中合成随后分泌入血。血清GP73在诊断PHC时阳性检出率显著高于AFP,且ROC曲线提示灵敏度和特异度均优于AFP。     

高尔基体蛋白73联合甲胎蛋白异质体在原发性肝癌诊断中的价值

目的探讨高尔基体蛋白73(GP73)与甲胎蛋白异质体(AFP-L3)联合检测在乙型肝炎病毒相关性肝癌诊断中的价值。方法收集132例血清,其中原发性肝癌(PHC)56例、肝硬化33例,慢乙肝患者23例,健康对照20例,酶联免疫吸附法(ELISA)检测各组GP73的表达情况;应用甲胎蛋白异质体亲和吸附离心管洗脱获得AFP-L3,同时化学发光法检测原始血清中总AFP和AFP-L3,计算AFP-L3在总AFP中的比率。结果 PHC组、肝硬化组、肝炎组及健康对照组血清GP73水平分别为247.05(228.35～287.72)、176.83(159.51～183.98)、152.58(135.19～162.85)、43.00(37.96～52.64)ng/mL,AFP-L3%分别为14.52(12.33～15.28)%、5.68(4.32～7.74)%、4.31(3.57～6.45)%、3.29(2.60～4.25)%。PHC组GP73和AFP-L3%均明显高于其他组(P均<0.01);GP73和AFP-L3%用于诊断PHC的ROC曲线下面积分别为0.825、0.828,最佳截取值分别为187.60 ng/mL、9.98%,此时的敏感度分别为69.6%、64.3%,特异度分别为86.8%、96.1%。二者联合诊断PHC的敏感度为82.1%,特异度为85.5%。结论 GP73和AFP-L3%均可作为诊断PHC的血清标记物,二者联合检测具有更高的灵敏度,可提高PHC的诊断率。     

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…     

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.     

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.     

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.     

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.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…