Skp2、p27和Ki-67在乳腺癌中的表达及意义

目的检测乳腺癌中Skp2、p27和Ki-67的表达情况,探讨三者在乳腺癌中表达的意义及相互关系。方法制作80例乳腺癌肿瘤组织芯片,其中浸润性导管癌,非特殊型42例,浸润性小叶癌12例,特殊类型浸润性癌14例(黏液癌7例,小管癌4例,实性乳头状癌3例),导管原位癌8例,小叶原位癌4例。腋窝淋巴结阳性43例,阴性37例。采用组织芯片技术和免疫组织化学方法检测乳腺癌中Skp2、p27和Ki-67的表达。结果 80例乳腺癌中Skp2、p27的阳性率分别为46.3%、45.0%,Ki-67指数高表达率56.3%(45/80)。p27与Skp2同时阳性表达7例,p27阴性者中Skp2阳性30例(P0.01)。37例Skp2阳性者中Ki-67高表达29例,43例Skp2阴性者中Ki-67仅16例高表达(P0.01)。36例p27阳性者中Ki-67高表达仅7例,44例p27阴性者中Ki-67高表达38例(P0.01)。结论 Skp2高表达、p27失表达和Ki-67指数增高共同参与了乳腺癌的发生和发展过程,并与腋窝淋巴结转移密切相关。乳腺癌组织中Skp2的表达与p27呈负相关,与Ki-67的表达呈正相关,p27与Ki-67的表达呈负相关。     

HIF－1αE－cadherin在乳腺中的表达及意义

目的：探讨缺氧诱导因子－1α（ hypoxia inducible factor－1 alpha, HIF－1α）及E－钙粘蛋白（ E－cadherin,E－cad）在乳腺癌发生、发展过程中的作用及其关系。方法：采用免疫组织化学SP 法检测30例癌旁正常乳腺组织、40例乳腺增生组织及60例乳腺癌组织中HIF－1α及E－cad 蛋白表达。结果：HIF－1α在正常乳腺组织及乳腺增生组织中不表达,在乳腺癌组织中主要表达在胞核,少量表达于胞浆,阳性表达率为63．3％（38／60）,癌组织中的表达高于正常及增生组织,差异有统计学意义（P＜0．05）;其表达与组织病理学分级、TNM分期有关（ P＜0．05）,与年龄无关。 E－cad主要表达在细胞膜,少量表达于胞浆,在乳腺正常、增生及癌组织中的阳性表达率分别为93．3％（28／30）,80．0％（31／40）,55．0％（33／60）;E－cad阳性表达率在正常与增生组织间无差别（P＞0．05）,但在癌组织中显著低于正常及增生组织（P＜0．05）。其表达与组织病理学分级、TNM分期有关（P＜0．05）,与年龄无关。 HIF－1a与E－cad在乳腺癌组织中的表达呈负相关（ r＝－0．433,P＜0．01）。结论：HIF－1α与E－cad表达异常可能是乳腺癌的早期事件,两者在乳腺癌的发生、发展过程中起作用,联合检测在判断乳腺疾病的恶性度,从而判断预后方面有重要价值。     

FGFR1在乳腺浸润性小叶癌中的表达及意义

目的探讨FGFR1在乳腺浸润性小叶癌中的表达及意义。方法采用免疫组织化学染色检测FGFR1在45例乳腺浸润性小叶癌、40例乳腺浸润性导管癌中的表达,比较FGFR1在浸润性小叶癌和浸润性导管癌中表达的差异,分析浸润性小叶癌FGFR1的表达与临床病理参数的关系。结果 FGFR1在乳腺癌癌旁组织中均阴性表达。浸润性小叶癌FGFR1的阳性表达率比浸润性导管癌高(P=0.048),其染色强度也比浸润性导管癌强(P=0.044)。FGFR1的表达强度与乳腺浸润性小叶癌的肿块大小(P=0.021)和TNM分期相关(P=0.041)。结论初步推测FGFR1的过表达参与乳腺浸润性小叶癌的发生、发展。     

应用组织芯片检测Ral-A在乳腺癌中的表达及意义

[摘要] 目的：检测Ral-A在乳腺癌中的表达及意义。方法 应用免疫组化检测组织芯片中68例乳腺癌（导管原位癌8例,浸润性导管癌54例,浸润性小叶癌6例）及癌旁正常乳腺组织中RalA的表达差异及其与临床病理各项指标的关系。结果：Ral-A表达于细胞浆和细胞膜。导管原位癌与癌旁正常组织比较,没有显著性差异;浸润性导管癌及浸润性小叶癌与癌旁正常组织比较均有统计学意义,P值均小于0.05;浸润性导管癌级浸润性小叶癌表达均低于导管原位癌,比较有统计学意义,P值均小于0.05。浸润性乳腺癌中Ral-A表达与年龄、肿瘤大小、分期、淋巴结转移无关,与肿瘤分级有关（P＜0.05）。结论：Ral-A在浸润性乳腺癌中表达下调,其表达水平与分级有关,提示Ral-A在乳腺癌的演进有重要作用。     

CD44v6表达与浸润性乳腺癌的关系

目的：研究CD44v6蛋白表达在乳腺癌侵袭、转移和预后中的作用。方法：用免疫组化S—P法检测104例浸润性乳腺癌石蜡切片中肿瘤细胞CD44v6的表达，结合临床和病理资料作分析。结果：CD44v6主要定位于细胞质。CD44v6蛋白表达与浸润性乳腺癌的组织学类型无关(P＞0．05)，与患者年龄大小无关(P＞0．05)，CD44v6在髓样癌、浸润性小叶癌、管状癌、浸润性导管癌、管内为主的浸润性导管癌的阳性率分别为69．2％、71．4％、79．2％、0％、72．8％在年龄＞50岁和年龄≤50岁患者的表达为66．7％、74．3％。CD44v6与乳腺癌的组织学分级有关(P＜0．05)。Ⅰ级阳性表达率为64．5％，Ⅱ级为94．1％，Ⅲ级87．5％。CD44v6蛋白表达与乳腺癌浸润程度、腋窝淋巴结转移、存活时间有关(P＜0．05)，且随着肿瘤组织浸润程度的增加，表达强度增大(P＜0．05)。CD44v6在组织浸润Ⅰ级、Ⅱ级、Ⅲ级的表达阳性率分别为55．8％、87．5％、95．2％。在腋窝淋巴结转移为(-)、( )、( )的乳腺癌标本中，CD44v6蛋白表达的阳性率分别为27．3％、68．8％、89．7％表明CD44v6蛋白表达与腋窝淋巴结转移有关(P＜0．05)。结论：黏附分子CD44v6的表达与浸润性乳腺癌的浸润、转移、预后有关，CD44v6可作为一个与乳腺癌预后密切相关的指标。     

乳腺癌组织中C-erbB-2基因蛋白的表达及其意义

目的：探讨癌基因蛋白C—erbB-2与乳腺癌组织学分型、淋巴结转移、雌激素受体（ER）和孕激素受体（PR）的关系。方法：对179例乳腺癌患者采用免疫组化法检测C-erbB-2蛋白在乳腺癌组织中的表达。结果：179例乳腺癌组织中C-erbB-2表达的阳性率为29．6％，在导管原位癌中C—erbB-2表达率为52．9％，其它病理类型中C—erbB-2表达均较低（〈45％），导管原位癌C—erbB-2蛋白表达率与浸润性导管癌、浸润性小叶癌比较差异有统计学意义，C—erbB-2蛋白阳性表达组患者的淋巴结转移率明显高于阴性组（P〈0．05），并与雌、孕激素受体呈负相关关系。结论：C—erbB-2表达与乳腺癌组织学分型、淋巴结转移有关，可作为乳腺癌预后判断的指标之一。     

FGFR1在乳腺浸润性小叶癌中的表达及其与脉管生成的关系

目的：探讨成纤维细胞生长因子Ⅰ型受体（FGFR1）在乳腺浸润性小叶癌中的表达情况和对血管及淋巴管生成的影响。方法：采用免疫组织化学染色检测FGFR1在45例乳腺浸润性小叶癌、40例乳腺浸润性导管癌中的表达,同时采用CD34和D2-40双标免疫组织化学染色分别标记血管和淋巴管,检测乳腺浸润性小叶癌的微血管密度和微淋巴管密度。结果：乳腺浸润性小叶癌的RGRR1表达阳性率比乳腺浸润性导管癌高,其染色强度也比乳腺浸润性导管癌强,差异均具有统计学意义（P〈0．05）;FG—FR1在乳腺浸润性小叶癌中的阳性表达与微血管密度相关（P〈0．05）,而与微淋巴管密度无关（P〉0．05）。结论：初步推测FGFR1的过表达与乳腺浸润性小叶癌的发生有关,FGFR1的过表达能促进癌组织中的血管生成。     

双侧原发性乳腺癌雌激素与孕激素受体的表达及病理分析

目的 探讨双侧原发性乳腺癌中临床特点与病理学特征的关系及了解双侧原发性乳腺癌中雌激素受体(Estrogan receptor，ER)、孕激素受体(Progestin recetor，PR)表达情况。方法 回顾性分析了29例双侧原发性乳腺癌ER、PR表达情况，分析其病理学特征及临床特点。结果 双侧乳腺癌发生率为3．2％，单侧乳腺癌ER、PR阳性表达分别为53．2％和41．2％，双侧乳腺癌中第一原发癌中ER、PR阳性表达分别为69％和5l％，第二原发癌中分别为65％，和48％，浸润性小叶癌在单侧乳腺癌中占11．6%，在双侧乳腺癌第一、二原发癌中分别占34．4％和41．3％，单侧乳腺癌与双侧乳腺癌第一原发癌腋淋巴结状况相似。结论 双侧原发性乳腺癌有较高的ER表达，浸润性小叶癌与双原发癌发生有明显相关。淋巴结状况与双侧乳腺癌发生无关。     

丝切蛋白-1在乳腺导管癌中的表达及意义

目的探讨丝切蛋白-1（eofilin-1,CFL-1）在乳腺导管癌中的表达及意义。方法应用高通量组织芯片技术建立组织芯片,采用免疫组织化学SP法检测69例乳腺癌旁组织、24例乳腺导管内癌组织、69例乳腺浸润性导管癌组织中CFL-1蛋白的表达情况。结果CFL-1蛋白在乳腺癌旁组织、乳腺导管内癌组织及乳腺浸润性导管癌组织中的阳性表达率逐渐升高,其阳性表达率依次为26．09％、62．50％、82．61％,差异有统计学意义（P〈0．05）。在乳腺浸润性导管癌中,CFL-1蛋白高表达与肿瘤TNM分期和淋巴结转移有关（P〈0．05）,与患者年龄、肿瘤大小、病理分级无关（P〉0．05）。结论CFL-1表达增高可能在乳腺浸润性导管癌的发生、发展、侵袭和转移过程中起重要作用。     

上皮钙黏附素在肺癌组织中的表达及意义

目的 探讨上皮钙黏附素（E—cadherin，E—cad）在肺癌组织中的表达及其与肿瘤生物学行为的关系。方法 应用免疫组织化学Picture两步法检测65例肺鳞癌组织中E—cad的表达。结果 肺鳞癌组织中E—cad的异常表达率为61．5％（40／65），良性病变的异常表达率为0，两者间有显著差异（P〈0．05）。伴淋巴结转移的异常表达率为78．4％（29／37），在无淋巴结转移的异常表达率为39．2％（11／28），二者之间有显著性差异（P〈0．05）。结论 E—cad对肺鳞癌的浸润和转移有促进作用，可作为反映肺鳞癌生物学行为的指标。     

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…     

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.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.