膜型基质金属蛋白酶-1在肝癌组织中的表达及意义

[目的]比较膜型基质金属蛋白酶-1(membrane type-1 matrix metalloproteinase,MT1-MMP)在大肝癌(瘤体直径＞3 cm)及小肝癌(单肿瘤结节且瘤体直径≤3 ca)组织中的表达差异,并探讨其在肝癌肿瘤细胞浸润、转移过程中的作用.[方法]应用半定量RT-PCR方法检测MT1-MMP mRNA在22例大肝癌及12例小肝癌组织中的表达;应用免疫组化方法检测MT1-MMP蛋白在53例大肝癌及40例小肝癌组织中的表达,并分析MT1-MMP蛋白表达水平与肝癌浸润、转移之间的关系.[结果]MT1-MMP蛋白在大、小肝癌组织中的表达差异显著(P=-0.007),但其mRNA水平的差异无统计学意义(P=0.693);MT1-MMP蛋白表达水平与肝癌浸润及转移之间均呈正相关关系(P=0.021;P=-0.001).[结论]调控MT1-MMP蛋白在肝癌组织中异常表达的关键环节可能是在转录后水平进行,大肝癌肿瘤细胞的侵袭能力较小肝癌强与其高表达MT1-MMP蛋白有关.     

MT1-MMP 在乳腺癌中表达的研究

目的：探讨膜型基质金属蛋白酶-1（MT1-MMP）表达与乳腺癌临床病理因素的关系。方法用免疫组化法检测69例乳腺癌组织及27例正常乳腺组织中MT1-MMP的表达水平,分析其与乳腺癌临床分期、淋巴结转移和器官转移的相关性。结果MT1-MMP蛋白在69例乳腺癌组织中阳性表达61例（88．4％）,在27例正常乳腺组织中无一例阳性表达（P＜0．01）;在T1＋T2与T3＋T4两组阳性表达为24例（77．4％）和37例（97．4％）（P＜0．05）;在N0＋N1与N2＋N3两组阳性表达为14例（70％）和47例（95．9％）（P＜0．01）;在M0与M1两组阳性表达为39例（82．98％）和22例（100％）（P＜0．05）。结论MT1-MMP蛋白参与了乳腺癌的浸润生长和扩散转移过程,是乳腺癌发生发展中的重要生物学事件。     

血清外泌体MT1-MMP mRNA在胃癌患者中的表达及其与预后的关系

探讨血清外泌体膜1型基质金属蛋白酶(MT1-MMP)mRNA在胃癌患者中的表达及其与预后的关系。方法 选取2016年3月—2018年7月我院行胃癌切除术的98例患者为研究对象。采用实时荧光定量PCR（RT-PCR）测定患者癌组织、癌旁正常组织中MT1-MMP mRNA表达量,分析患者临床病理参数与胃癌组织中MT1-MMP mRNA表达量的关系;对98例患者进行随访,统计术后3年内存活率,比较存活亚组(n=62)与死亡亚组(n=36)患者入组时的胃癌组织与癌旁组织中MT1-MMP mRNA表达水平,运用受试者工作曲线(ROC)分析MT1-MMP mRNA表达水平对术后3年内生存状态的预测效能。结果 98例患者胃癌组织中MT1-MMP mRNA表达水平(0.96±0.12)显著高于癌旁组织(0.80±0.09)(P＜0.05);患者胃癌组织中MT1-MMP mRNA表达量与淋巴结转移、浸润程度、TNM分期有关(P＜0.05),与性别、年龄、肿瘤位置、肿瘤直径大小及分化程度无关(P＞0.05);98例患者术后3年存活亚组入组时的胃癌组织及癌旁组织中MT1-MMP mRNA表达水平显著高于死亡亚组(P＜0.05);ROC曲线分析显示,胃癌组织、癌旁组织MT1-MMP mRNA表达水平对患者术后3年生存状态的预测效能有一定局限性(AUC=0.760、0.691),胃癌组织与癌旁组织联合检验的预测效能明显高于单一检测(AUC=0.813)。结论 胃癌组织中MT1-MMP mRNA表达与肿瘤的淋巴转移、TNM分期及浸润程度相关,可一定程度上指导预后     

膜型基质金属蛋白酶1及其诱导因子在结直肠癌中表达与预后的相关性

目的 探讨基质金属蛋白酶诱导因子(EMMPRIN)及膜型基质金属蛋白酶1(MT1-MMP)在结直肠癌组织中的表达与肿瘤的侵袭、转移及预后的关系.方法 采用逆转录聚合酶链反应(RT-PCR)检测48例结直肠癌组织及其癌旁正常组织中EMMPRIN及MT1-MMP mRNA的表达,并用免疫组化SABC法检测上述组织中EMMPRIN及MT1-MMP蛋白的表达.结果 48例肿瘤组织中35例(72.9%)有EMMPRIN mRNA的表达,30例(62.5%)有MT1-MMP mRNA的表达.免疫组化染色分别有31例(64.6%)EMMPRIN和25例(52.1%)MT1-MMP呈阳性反应,但在癌旁正常组织中均未检测到EMMPRIN和MT1-MMP mRNA及蛋白的表达.EMMPRIN与MT1-MMP mRNA的相对表达强度与患者年龄、性别、肿瘤大小、浸润深度以及肿瘤类型和分化程度无关(均P＞0.05),但与Duke's分期、区域淋巴结转移和远处转移情况呈显著相关(均P＜0.01),且EMMPRIN和MT1-MMP的mRNA表达呈显著正相关(r=0.728,P＜0.01).EMMPRIN mRNA阳性表达的患者平均生存期为(37.8±14.6)月,阴性患者为(54.7±11.3)月,5年生存率前者为41.2%,显著低于阴性患者的70.4%(P＜0.01),EMMPRIN和MT1-MMP mRNA的阳性表达同患者的总生存率显著相关(P＜0.01,P＜0.05).结论 MT1-MMP及其诱导因子EMMPRIN与结直肠癌的侵袭与转移密切相关,有可能作为判断结直肠癌侵袭性的有效指标,高表达EMMPRIN和MT1-MMP可能预示着结直肠癌患者不良的预后.     

原发性肝癌组织中LASP-1 mRNA和HPA-1 mRNA表达水平及其临床意义

目的定量检测LIM和SH3蛋白1（LASP-1）mRNA和乙酰肝素酶-1（HPA-1）mRNA在原发性肝癌组织中的表达水平,探讨二者与肝癌发生、侵袭和转移的关系。方法利用实时荧光定量PCR检测法分别检测62例原发性肝癌癌组织、配对癌旁组织（距癌2cm）和正常肝脏组织（距癌大于5cm）中LASP-1mRNA和HPA．1mRNA的表达水平,并分析二者与肝癌临床病理特征的关系。结果肝癌组织、癌旁组织、正常肝组织中HPA-1mRNA表达水平分别为47．25±16．65、23．15±14．89、7．56±5．15,LASP-1mRNA的表达水平分别为51．66±20．12、35．73±15．07、10．17±8．29。HPA-1mRNA及LASP-1mRNA在癌组织中的表达高于癌旁组织和正常组织（P均〈0．05）。HPA-1及LASP-1的表达与肿瘤分化程度、浸润深度、淋巴结转移及TNM分期密切相关（P〈0．05,P〈0．01）,与患者年龄、性别及肿瘤大小无关（P均〉0．05）。Spearman等级相关分析显示LASP-1mRNA和HPA-1mRNA的表达呈正相关（OR=0．421,P〈0．05）。结论肝癌组织中LASP-1mRNA与HPA-1mRNA的表达与肿瘤浸润深度、分化程度、淋巴结转移及TNM分期等密切相关。二者联合表达水平的增加可能促进肝癌的侵袭转移。     

CYR61/CCN1在肝细胞肝癌中的原位表达及其临床意义

目的：观察Cyr61在肝细胞肝癌中表达的意义．方法：采用免疫组化法和RT—PCR共检测65例肝细胞肝癌中Cyr61蛋白和mRNA表达水平，分析其表达与肝癌的临床病理学特征的关系．结果：高分化HCC组织的Cyr61蛋白表达水平高于低分化HCC组织（P〈0．01）；镜下存在静脉浸润、多结节的HCC组织中Cyr61蛋白表达高于无静脉浸润、单结节的HCC组织（P〈0．05）．30例肝癌组织Cyr61mRNA表达均为阳性，86．67％（26／30）癌组织Cyr61mRNA表达低于相应癌旁组织（P〈0．05）．结论：Cyr61可能在肝癌的发生早期发挥重要作用，并与肝癌进程中的间质重建和侵袭转移有关．     

非小细胞肺癌血管内皮生长因子-C和Survivin蛋白的表达及其对患者预后的影响

【目的】研究血管内皮生长因子-C（VEGF-C）和survivin蛋白在非小细胞肺癌（NSCLC）组织中的表达及其与肺癌生物学行为的关系。【方法】应用免疫组化方法检测77例NSCLC组织中VEGF—C和survivin蛋白的表达，分析其与肿瘤大小、肿瘤淋巴管密度（LVD）、组织类型、分化程度、淋巴结转移、临床复发情况和患者术后生存时间的关系。【结果】77例NSCLC组织中，有45例VEGF-C蛋白表达呈阳性（58．4％1；有41例survivin蛋白表达呈阳性（53．2％）。VEGF-C蛋白的阳性表达组肿瘤大小和LVD均高于阴性组（P〈0．05），VEGF-C蛋白的表达与患者术后生存时间呈负相关（P〈0．05）。Survivin蛋白的阳性表达组的LVD高于阴性组（P〈0．05）．survivin蛋白的表达与NSCLC淋巴结转移（r=0．324，P〈0．05）和临床复发呈正相关（r=0．233，P〈0．05），与患者术后生存时间呈负相关（P〈0．05）。VEGF-C和survivin蛋白在NSCLC组织中的表达之间呈正相关性f，=0．266．P〈0．05）。【结论】VEGF—C和survivin蛋白的表达与非小细胞肺癌的生物学行为具有相关性．它们的高表达提示非小细胞肺癌患者预后不良。     

基质金属蛋白酶-1和膜型1基质金属蛋白酶在胆囊癌血管生成拟态中的表达及临床意义

目的 探讨基质金属蛋白酶-1 （MMP-1）和膜型1基质金属蛋白酶（MT1-MMP）在胆囊癌血管生成拟态中的表达及临床意义.方法 收集手术病理确诊的原发性胆囊癌74例和胆囊腺瘤、慢性胆囊炎各10例的石蜡标本及相关临床资料,应用免疫组化测定上述病变组织的MMP-1、MT1-MMP表达.应用Kaplan-Meier生存比较、Cox风险模型分析与胆囊癌血管生成拟态（VM）的相关性和临床意义.结果 ①胆囊癌MMP-1、MT1-MMP表达明显高于胆囊腺瘤、胆囊炎（P＜0.000 1）;VM（＋）胆囊癌MT1-MMP表达明显高于VM（-）胆囊癌（P=0.003 9）,而MMP-1则无差别.②MMP-1表达与VM（-）胆囊癌的Nevin分期（P=0.003 6）、分化程度（P=0.010）、肝转移（P=0.003）和淋巴结转移（P=0.002）正相关;MT1-MMP表达与VM（-）或VM（＋）胆囊癌的Nevin分期（P=0.013或P=0.033）、浸润深度（P=0.045或P=0.035）、淋巴结转移（P=0.046或P=0.025）和肝转移（P=0.030或P=0.027）正相关;MMP-1、MT1-MMP表达与VM（-）胆囊癌正相关.③VM（＋）胆囊癌MT1-MMP表达在Nevin S3-s5期（P =0.000 1）、侵犯浆膜（P=0.001）、淋巴结转移（P =0.000 2）和肝转移（P=0.004）同样分组条件下分别明显高于VM（-）胆囊癌;MMP-1仅在肝转移组,VM（＋）胆囊癌表达显著高于VM（-）（P=0.038）.④无论在MMP-1、MT1-MMP单独表达阳性或二者均阳性,VM（＋）胆囊癌患者术后5年生存期都明显短于VM（-）组（P=0.025 1或P=0.022 5或P=0.025 0）.Cox多因素分析表明,VM、浸润深度、淋巴结转移、肝转移、手术方式是影响胆囊癌患者预后的独立因素.结论 胆囊癌MMP-1、MT1-MMP高表达,MT1-MMP表达与胆囊癌VM相关,MMP-1则与胆囊癌VM无关.MMP-1,MT1-MMP可作为评判胆囊癌Nevin分期、浸润深度、淋巴结或肝转移及判断预后的重要指标;而MT1-MMP还可作为判断胆囊癌否存在VM和VM胆囊癌预后的重要指标.     

吗啡依赖和戒断小鼠海马MT1、MT2基因表达的变化

【目的】探讨吗啡依赖和戒断小鼠海马金属硫蛋白（metallothionein，MT）MT1、MT2 mRNA表达的变化。【方法】剂量递增法皮下注射吗啡建立吗啡依赖小鼠模型，腹腔注射盐酸纳络酮诱发戒断症状。根据小鼠戒断反应中出现的跳跃次数、体重下降等指标评定戒断反应的强度。采用半定量逆转录一聚合酶链反应（RT—PCR）方法，观察实验小鼠海马MT1、MT2 mRNA的变化情况。【结果】吗啡依赖组MT1、MT2 mRNA表达水平高于对照组和吗啡戒断组（P〈0．05），吗啡戒断组MT1、MT2 mRNA表达水平高于对照组（P〈0．05）。【结论】吗啡依赖小鼠海马MT1、MT2 mRNA表达增加，纳络酮戒断能够抑制吗啡依赖引起的MT1、MT2表达增加，表明海马MT的表达变化参与了吗啡依赖和戒断过程。     

影响肝癌生物学行为及预后的相关因子研究

【目的】研究原发性肝细胞癌组织中Ki67、Fas及survivin蛋白的表达及其与肝癌的生物学行为及预后的关系。【方法】应用免疫组织化学方法对83例肝癌组织中Ki67、Fas及survivin蛋白的表达情况进行检测，结合临床病理资料分析。【结果】Ki67、Fas及survivin蛋白表达水平与肝癌患者术后生存率关系密切；survivin与Ki67的表达呈显著正相关（P〈0．01）；survivin与Ki67的表达均与Fas表达呈显著负相关（P〈0．05），与癌栓形成及肿瘤转移呈显著正相关（P〈0．01）；Fas的表达与癌栓形成及肿瘤转移呈显著负相关（P〈0．01）。【结论】Ki67、Fas与survivin的表达可能与肝癌的生物学行为及预后密切相关，有可能作为预测肝癌患者预后的指标。     

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…     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

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.