上皮性卵巢肿瘤组织中YKL-40的表达及临床意义

目的 探讨甲壳质酶蛋白40(YKL-40)在上皮性卵巢肿瘤中的表达及临床意义.方法 采用免疫组织化学法检测YKL-40在正常卵巢组织、上皮性良性卵巢肿瘤、交界性卵巢肿瘤及卵巢癌组织中的表达情况.结果 YKL-40在上皮性卵巢癌组的阳性表达率高于正常组、良性组(P<0.01);在交界卵巢肿瘤组与卵巢癌组无差异(P>0.05),但卵巢癌组YKL-40染色强度高于交界组(P<0.05);早期卵巢癌(Ⅰ、Ⅱ期) 组织中阳性表达率低于晚期卵巢癌(Ⅲ、Ⅳ期)组织中阳性表达率(P<0.05),YKL-40在上皮性卵巢癌组织中表达水平与FIGO分期呈正相关.结论 YKL-40蛋白可能参与了上皮性卵巢肿瘤的发生发展.     

EGFR及Ki67在上皮性卵巢癌中的表达及意义

目的探讨表皮生长因子受体(EGFR)和Ki67在上皮性卵巢癌中的表达及临床意义。方法采用免疫组化SP法检测EGFR和Ki67在上皮性卵巢癌、卵巢良性肿瘤和正常卵巢组织的表达情况。结果 EGFR和Ki67在上皮性卵巢癌组织与正常卵巢和卵巢良性肿瘤组织阳性的表达率有统计学差异(P<0.05)。EGFR和Ki67表达在肿瘤的组织学分级、临床分期和有无淋巴结转移中具有统计学差异(P<0.05)。结论 EGFR和Ki67在上皮性卵巢癌的发生、发展过程中起着重要的作用。     

COX-2、VEGF、Ki67在卵巢上皮性癌中的表达及意义

目的探讨环氧合酶-2(COX-2)、血管内皮生长因子(VEGF)和增殖细胞相关抗原(Ki67)在卵巢上皮性癌发生、发展中的作用.方法采用免疫组化Envision法检测30例囊腺瘤、60例囊腺癌组织中COX-2、VEGF及Ki67的表达.结果卵巢囊腺癌组织中COX-2、VEGF及Ki67的表达明显高于囊腺瘤组织(P<0.01);COX-2的高表达与临床分期及分化程度无关(P>0.05);VEGF的高表达与临床分期、及分化程度有关(P<0.05);Ki67的高表达与临床分期及分化程度有关(P<0.05).COX-2与VEGF和Ki67的表达间存在正相关(r=0.359,P<0.01;r=0.444,P<0.01).结论 COX-2、VEGF、Ki67与卵巢上皮性癌的发生和发展相关,COX-2可通过使VEGF和Ki67高表达,增加细胞增殖活性促进卵巢上皮性癌的发生、发展.     

MMP-9、Survivin、COX-2、Ki67在胃癌组织中的表达及临床意义

目的:探讨MMP-9、Survivin、COX-2及Ki67在人胃癌组织中的表达及临床意义.方法:采用免疫组化S-P法.检测58例患者胃癌组织和正常胃黏膜组织中MMP-9、Survivin、COX-2及Ki67的表达情况.结果:MMP-9、Survivin和COX-2在胃癌组织中的阳性表达率均显著高于正常胃黏膜组织(P<0.01);MMP-9、Survivin和COX-2的阳性表迭率与患者的性别、年龄及癌灶的部位和大小无关(P>0.05),而与胃癌的浸润深度、淋巴结转移及TNM分期有关(P<0.05),MMP-9的阳性表达率又与胃癌分化程度有关(P<0.05);而且三者之间均有相关性(P<0.05).在胃癌组织中MMP-9、Survivin、COX-2表达阳性组与阴性组比较,Ki67LI表达有显著性差异(P均<0.01).结论:MMP-9、Survivin、COX-2及Ki67在胃癌的发生、发展中起着重要作用,可做为判断胃癌生物学行为和预后的重要指标.     

Ki67及C-erbB-2在原发性输卵管腺癌中的表达及意义

目的探讨Ki67及C-erbB-2在原发性输卵管腺癌中的表达及意义。方法采用免疫组织化学S-P法测定21例原发性输卵管腺癌组织中Ki67及C-erbB-2的表达。结果Ki67及C-erbB-2在输卵管腺癌组织中的表达明显高于正常输卵管组织（P〈0.01）,且临床分期Ⅲ-Ⅳ期显著高于Ⅰ-Ⅱ期（P〈0.01）,组织学分级G3级高于G1、G2级（P〈0.05）。结论Ki67及C-erbB-2的异常表达可能在原发性输卵管腺癌的发生、发展过程中起重要作用。     

p27蛋白、细胞周期素E和增殖细胞核抗原在上皮性卵巢肿瘤的表达及其临床意义

目的探讨p27、细胞周期素E(CyclinE)和增殖细胞核抗原(proliferating cell nuclear antigen,PCNA)在上皮性卵巢肿瘤组织中的表达及其与上皮性卵巢癌的临床分期、分化程度和病理类型的关系。方法应用流式细胞技术检测64例上皮性卵巢肿瘤组织中p27、CyclinE和PCNA的表达,并进行对比分析。结果p27在卵巢癌组织中呈低表达(P<0.01),而CyclinE和PCNA在卵巢癌组织中呈高表达(P<0.01,P<0.05);在Ⅲ~Ⅳ期和低分化患者中p27表达下降,而CyclinE和PCNA表达升高。p27与CyclinE和PCNA表达呈负相关(r=-0.532,P<0.01,r=-0.564,P<0.01),CyclinE和PCNA表达呈正相关(r=0.556,P<0.05)。结论p27、CyclinE和PCNA的表达与上皮性卵巢肿瘤的临床分期和病理分级有关,而与病理类型无关。     

卵巢肿瘤中p27和CyclinE的表达及意义

目的研究p27和CyclinE在卵巢肿瘤中的表达及与临床意义和预后的关系。方法应用免疫组化S-P法检测p27和CyclinE在55例卵巢组织(包括正常的卵巢组织、良性、恶性卵巢肿瘤)中的表达情况,分析其与临床病理参数和预后的关系及两指标间的相关性。结果与正常卵巢组织和良性卵巢肿瘤比较,在卵巢癌中p27降低而CyclinE的表达明显升高(P<0.01),p27和CyclinE在卵巢癌中的表达呈明显负相关性(P<0.01)。结论p27和CyclinE的表达水平与卵巢肿瘤的发生、发展及恶性程度密切相关,可能成为卵巢癌恶性程度及预后判定的重要指标。     

Ki67、Fas系统在卵巢肿瘤组织中的表达及临床意义

目的：通过检测卵巢肿瘤组织Ki67,Fas系统的表达，探讨其与卵巢细胞增殖与凋亡的关系。方法：用流式细胞术检测Ki67,Fas,FasL抗原在52例卵巢肿瘤组织中的表达。结果：（1）卵巢癌组织中Ki67表达显著高于卵巢良性肿瘤（P＜0．01），Fas表达下调（P＜0．01），FasL表达增高（P＜0．01），（2）Ki67随组织学分级（P＜0．01），临床分期（P＜0．05）的升高而增加，与卵巢癌组织大小呈正相关（r=0.499,P=0.006)，与淋巴结转移无关，Fas与组织学分级，临床分期，淋巴结转移及组织大小无关（P＞0．05），FasL的表达与临床分期无关，但随组织学分级的升高而增加（P＜0．05），有淋巴结转移者FasL的表达高于无淋巴结转移者（P＜0．05），结论：Ki67与卵巢癌的组织学分级，临床分期及肿瘤大小有关，卵巢癌组织中存在Fas表达的下调及FasL表达增加，这与肿瘤的免疫逃逸有关。     

上皮性卵巢癌组织中Ki67和PCNA的表达及有丝分裂指数

目的 分析不同的增殖指标与上皮性卵巢癌临床病理指标的相关性,并探讨其对个体化治疗的指导意义.方法 应用免疫组织化学二步法检测109例上皮性卵巢癌组织(其中73例有转移灶),20例交界性、28例良性上皮性卵巢瘤及20例正常卵巢上皮组织中Ki67、PCNA的蛋白核表达并观察计算有丝分裂指数(MI);同时应用原位杂交法检测其中74例卵巢上皮组织(上皮性卵巢癌37例、交界性卵巢瘤14例、良性卵巢瘤11例、正常卵巢上皮组织12例)中Ki67、PCNA的mRNA表达.结合临床病理指标,进行统计学分析处理.结果 ①上皮性卵巢癌中Ki67的mRNA和蛋白的阳性表达率及过表达率高于其他组织(P<0.05).PCNA的mRNA和蛋白的阳性表达率及过表达率在四组之间差异无统计学意义(P>0.05).两个指标的mRNA和蛋白表达呈正相关(r=0.449,P=0.025;r=0.484,P=0.014).②Ki67在低分化、Ⅲ-Ⅳ期病例中阳性表达率高,在浆液性卵巢癌中呈过表达,而在其他类型(黏液性、恶性苗勒氏混合瘤、移行细胞癌伴鳞癌分化等)中呈低表达或表达缺失,在其他临床病理指标方面差异无统计学意义.PCNA在上皮性卵巢癌FIGO分期、分化程度,组织学类型及其他临床病理指标的阳性表达率差异均无统计学意义.有丝分裂呈高指数者共72例(66.1%).低分化、临床晚期病例较高分化和临床早期病例MI高指数者比例高(P<0.05).③Ki67过表达同时MI高指数卵巢癌患者共有57例,与另外52例非同时Ki67过表达及MI高指数患者比较在临床分期、分化程度及组织学类型之间差异有统计学意义(P<0.05).④在73例既有原发灶又有转移灶的病例中:原发灶中三者的表达分别为:Ki67蛋白58.9%、PCNA蛋白91.8%、高指数者占61.6%.在转移灶中(腹膜/大网膜)三者的阳性表达率分别为:Ki67蛋白41.1%、PCNA蛋白74.0%、高指数者占38.4%.原发灶中三种指标明显高于转移灶(P<0.05).Ki67蛋白在原发灶中的阳性表达强度高于转移灶(P=0.040),而PCNA蛋白在原发灶和转移灶中的阳性表达强度无明显差异(P=0.514).结论 联合检测Ki67和计算MI可评估上皮性卵巢癌的增殖状态,而PCNA不能作为卵巢癌增殖程度和良恶性鉴别的良好指标.     

Ki67、P53蛋白在人喉组织中的表达及临床意义

目的 探讨Ki67和P53蛋白表达在人喉癌发生、发展及预后中的作用.方法 采用免疫组织化学Envision法检测182例喉不同病变组织标本(喉癌141例,喉癌前病变18例,声带息肉15例和癌周正常喉组织8例)中Ki67和P53蛋白的表达.结果 Ki67、P53在人喉癌组织中表达阳性率均显著高于喉癌前病变、声带息肉组织及癌周正常喉组织(P＜0.01);中晚期(Ⅲ～Ⅳ期)、伴颈淋巴结转移及术后3年或5年死亡的喉癌组织中PD4、Ki67阳性表达率均显著高于早期(Ⅰ～Ⅱ期)、无颈淋巴结转移及3年或5年存活病例(P＜0.01或0.05);Ki67和P53蛋白在人喉癌组织中联合表达阳性率显著高于喉其他不同病变组织中联合表达阳性率(P＜0.01).结论 Ki67和P53联合表达与人喉癌的发生、发展及预后有一定的相关性.     

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.     

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.     

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.