脑星形细胞瘤Cyclin D1和Survivin的表达与其恶性程度关系探讨

[摘要] 目的 检测Cyclin D1和Survivin在脑星形细胞瘤中的表达情况，探讨其与肿瘤恶性程度的关系。方法 采用ElivisionTMplus免疫组化技术，检测10例正常脑组织、60例脑星形细胞瘤中Cyclin D1和Survivin的表达，计算阳性细胞百分率，用统计学方法分析Cyclin D1和Survivin的表达与肿瘤病理分级的关系。结果 （1）Cyclin D1在正常脑组织、Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级脑星形细胞瘤中的阳性表达率分别为：20％（2/10），25％（4/16），44％(7/16)；50％(7/14)，71％(10/14)。（2）Survivin在正常脑组织、Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级脑星形细胞瘤中的阳性表达率分别为：0（0/10），56％(9/16)，65％(11/16)；93％(13/14)，100％(14/14)。（3）二者在不同级别星形细胞瘤中的阳性表达率有明显差异，并具有显著性(P值分别为<0.05, <0.005)。（4）Spearman等级相关分析示：Cyclin D1和Survivin在星形细胞瘤中表达强度与病理分级呈正相关（rs＝0.357，P＝0.005<0.01；rs＝0.539，P＝<0.01）， Cyclin D1和Survivin二者呈正相关（rs＝0.652，P<0.01）。结论 脑星形细胞瘤中Cyclin D1和Survivin的表达与肿瘤恶性程度相关；Cyclin D1和Survivin表达两者之间具有相关性； CyclinD1、Survivin的过表达可能在脑星形细胞瘤的发生发展中起协同作用。 [关键词] 脑星形细胞瘤；Cyclin D1﹑P21WAF1/CIP1和Survivin；免疫组化     

乳腺癌中p16,Cyclin D1基因蛋白的表达及意义

目的：探讨细胞周期调控因子p16及Cyclin D1蛋白的表达与乳腺癌发生发展的关系。方法：采用免疫组织化学染色检测49例乳腺癌及14例癌旁组织中p16及CyclinD1蛋白表达。结果：Cyclin D1在乳腺癌中有较高表达，过表达率为49％（24／49），明显高于癌旁正常组织（P＜0．05）；p16在乳腺癌中过表达率（40．8％）低于癌旁正常组织（阳性率为92．8％，P＜0．05）；淋巴结转移组的p16蛋白表达明显低于淋巴结无转移组（P＜0．05）；p16的低表达与CyclinD1的高表达有关。结论：Cyclin D1过表达及p16蛋白的失表达参与乳腺癌的发生；p16蛋白的表达异常可能参与乳腺癌的转移。     

周期蛋白A、D1和增殖细胞核抗原在肺癌中的表达及临床意义

目的观察细胞周期蛋白A、D1（Cyclin A、D1）和增殖细胞核抗原（PCNA）在肺癌中的表达及其临床意义。方法采用免疫组化和RT-PCR方法观察94例肺癌组织和10例假瘤炎性肺组织（对照组）中Cyclin A、D1和PCNA的表达。结果在94例肺癌中，Cyclin A蛋白表达阳性率为84.0%；Cyclin D1蛋白表达阳性率为63．8％;PCNA蛋白表达阳性率为68．1％；肺癌的分期与Cyclin A和PCNA蛋白的表达相关（P〈0．05）。在小细胞癌、鳞癌中Cyclin A、D1的mRNA表达较对照组均存非常显著的提高（P〈0.01）;在腺癌中Cyclin A、D1的mRNA表达较对照组也有明照增强（P〈0．05）。结论肺癌中Cyclin A和PCNA蛋白表达有显著升高，Cyclin A和PCNA蛋白的过表达与肺癌的分期相关。     

星形细胞瘤中FHIT、PCNA蛋白表达及意义

目的研究人脑星形细胞瘤中FHIT、PCNA蛋白的差异表达，探讨它们之间、它们与病理分级及复发之间的关系。方法应用免疫组化SP法检测了50例星形细胞瘤中不同级别的FHIT、、PCNA蛋白的表达水平，以10例非肿瘤脑组织作对照。结果非肿瘤脑组织FHIT、PCNA蛋白阳性表达率分别为100％、0，星形细胞瘤中FHIT、PCNA蛋白阳性表达率分别为40％、86％；尽管在星形细胞瘤中FHIT、PCNA蛋白表达总体差异有显著性（P〈0．05），Ⅱ级与Ⅲ级、Ⅱ级与Ⅳ级间比较差异有显著性（P〈0．05），但Ⅲ级与Ⅳ级比较差异无显著性（P〉0．05）；经统计学分析FHIT、PCNA蛋白呈皿著负相关（P〈0．01）；8例复发病例中复发前后FHIT、PCNA蛋白表达差异有显著性（P〈0．05）。结论星形细胞瘤中FHIT、PCNA蛋白表达之间的显著负相关，提示FHIT、蛋白可能对细胞增殖具有负性调控作用。FHIT、PCNA蛋白的表达水平可能与星形细胞瘤的病理分级和复发有关，推测FHIT、PCNA蛋白的表达可能与星形细胞瘤的肿瘤侵袭性相关。     

星形细胞瘤中端粒酶和P53蛋白的表达与意义

目的：研究星形细胞瘤中端粒酶基因与P53蛋白的表达，探讨其在星形细胞瘤诊断和预后中的临床意义。方法：收集经手术切除及病理证实的星形细胞瘤86例标本，8例正常脑组织作对照。用端粒酶原位杂交检测试剂盒检测组织标本端粒酶基因。用SABC法检测P53蛋白的表达。结果：星形细胞瘤中端粒酶基因和P53蛋白的阳性检出率分别为44．2％（38／86）和62．8％（54／86），且随着肿瘤恶性程度的增加，端粒酶基因表达强度升高（P＜0．01），端粒酶表达与P53蛋白表达强度无明显相关性（P＞0．05）。正常组织中未检测出端粒酶基因。结论：端粒酶基因与星形细胞瘤的分化程度有关，可作为星形细胞瘤恶性程度的重要标记物，而P53蛋白可能对端粒酶基因的表达无直接影响。     

Cyclin D1蛋白和P16蛋白在子宫内膜癌中的表达及其相关性研究

目的 了解细胞周期调控蛋白Cyclin D1,P16在子宫内膜癌中的表达及与临床特征的关系,并探讨两者表达的相关性。方法 用免疫组化SP法检测64例子宫内膜癌标本中Cyclin D1蛋白中和P16蛋白的表达。结果 Cyclin D1蛋白的阳性表达率为54．68％,其表达与FIGO分期有关;P16蛋白的阳性表达率为53．13％,其表达与年龄、组织学分级和FIGO分期有关;Cyclin D1蛋白和P16蛋白的表达有相关性（r＝－0．4007）。结论 细胞周期调控基因相关蛋白Cyclin D1和P16与子宫内膜癌的发生和发展有关,且两者间存在协同作用。     

CD44粘附分子及p53蛋白与星形细胞瘤的预后

目的：探讨CD44粘附分子、p53蛋白在星形细胞瘤中的表达与肿瘤病理分级和预后间的关系。方法：采用免疫组化SABC法检测65例确诊并有随访的星形细胞瘤患者的病理切片中CD44粘附分子和p53蛋白的表达。结果：CD44粘附分子及p53蛋白阳性表达率分别为72％（47／65例）和38％（25／65例），在不同病理级别的肿瘤中有显著差异（P＜0．01）。65例星形细胞瘤中CD44和p53均阳性表达的有20例（31％），这20例病例与13例CD44粘附分子、p53蛋白表达均阴性病例32例CD44粘附分子或p53蛋白单一阳性表达的病例的1a和3a存活率均有显著差异（P＜0．01）。结论：CD44粘附分子和p53蛋白阳性检出率有助于判断星形细胞瘤恶性程度及预测肿瘤预后。     

p16蛋白在人脑星形细胞瘤中的表达及意义

目的：研究p16蛋白在人脑星形细胞瘤发病和预后的关系。方法：用SP免疫组化法观察星形细胞瘤中p16蛋白的表达情况。结果：p16在39例星形细胞瘤中表达的缺失率为71．8％，并且缺失率随星形细胞瘤恶性程度的增加而升高。术后各观察期内复发病例中p16蛋白缺失率明显高于未复发病例（P＜0．05）。结论：p16蛋白表达的缺失与星形细胞瘤的发生有较密切的关系，在一定程度上可以提示它的恶性程度及预后。     

星形细胞肿瘤中RCASl的mRNA及蛋白表达的临床意义

目的：探讨RCASl在人星形细胞肿瘤中的基因及蛋白表达，及其与肿瘤发生、发展的关系。方法：RT-PCR法检测59例新鲜星形细胞肿瘤组织及6例正常脑组织中RCASl的mRNA表达。免疫组织化学法检测71例星形细胞肿瘤及6例正常脑组织病理切片中RCASl的蛋白表达。结果：弥漫型星形细胞瘤（GradeⅡ）和间变型星形细胞瘤之间（GradeⅢ）、间变型星形细胞瘤和胶质母细胞瘤（GradeIV）之间RCASlmRNA的表达有统计学差异（P〈0．05），而RCASl蛋白表达仅在间变型星形细胞瘤和胶质母细胞瘤之间存在统计学差异（P〈0．01），RCASl蛋白表达与肿瘤级别呈正相关（r=0．573，P〈0．001）。在正常脑组织中未检测到RCASl蛋白。结论：RCASl的表达与星形细胞肿瘤的病理分级有关。星形细胞肿瘤中RCASl的表达在转录和转录后水平受到调节。[第一段]     

抑癌基因p16蛋白在脑星形细胞瘤中的表达和意义

目的：探讨p16蛋白与人脑星形细胞瘤组织学级别间的关系。方法：运用柠檬酸－SP－高压加热免疫组化技术检测，P16蛋白在60例脑星形细胞瘤中的表达情况；结果：60例脑星形细胞瘤中P16蛋白的表达与组织学级别呈负相关，有显著性意义（P＜0．05），结论：P16蛋白缺失的细胞周期调控失调与星形细胞瘤的发生，发展的关系密切。     

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.