HPA蛋白的表达与食管鳞癌血管生成、浸润、转移的关系

目的 探讨HPA蛋白在食管鳞癌中的表达及其与食管鳞癌血管生成、浸润、转移的关系.方法 应用免疫组化法(Immunohistochmeistry,IHC)检测70例食管鳞癌组织和23例切缘正常组织中HPA、CD34蛋白的表达.结果 癌组织中HPA蛋白的表达(65.7%)显著高于切缘正常组织(0.0%)(P＜0.05).有淋巴结转移的食管鳞癌组织中HPA蛋白的阳性表达率90.9%(30/33)高于无淋巴结转移组43.2%(16/37)(P＜0.05);有纤维膜浸润的食管鳞癌组织中HPA蛋白的阳性表达率92.9%(39/42)高于无纤维膜浸润组25.0%(7/28)(P＜0.05).HPA蛋白阳性表达的食管鳞癌组织中的微血管密度(Mean Miciovessel Density,MVD)值(44.85±12.74)显著高于HPA蛋白阴性者的MVD值(33.05±7.32)(P＜0.05).结论 HPA蛋白阳性表达与食管鳞癌的发生、血管生成、浸润深度、淋巴结转移有关.     

胃腺癌组织中缺氧诱导因子-1α的表达及其与细胞增殖和血管形成的关系

目的:探讨缺氧诱导因子1α(HIF1α)在胃腺癌组织中的表达及其与细胞增殖、血管形成的关系。方法:应用免疫组织化学SP法检测64例胃腺癌组织及20例癌旁正常组织中HIF1α、细胞核增殖抗原(Ki67)表达及微血管密度(MVD),并分析HIF1α表达与Ki67、MVD的相关性。结果:HIF1α蛋白在正常胃组织中不表达,在胃腺癌中的阳性表达率为70.3%(45/64),其阳性表达与胃腺癌淋巴结转移、临床病理分期有关,其阳性表达率淋巴结转移组88.6%(31/35)显著高于无淋巴结转移组48.3%(14/29)(P<0.01),临床Ⅲ+Ⅳ期阳性表达率94.1%(32/34)显著高于临床Ⅰ+Ⅱ期43.3%(13/30)(P<0.01)。HIF1α表达与Ki67、MVD呈正相关(r=0.439,P<0.01和r=0.582,P<0.05)。结论:HIF1α在胃腺癌组织中表达明显升高,并与肿瘤细胞增殖和血管形成密切相关,提示它可能在胃癌的发生发展及恶性演进过程中起重要作用。     

P53、P21 ras、Ki-67 蛋白的表达及微血管密度与甲状腺癌转移关系的研究

目的探讨甲状腺癌中P53、P21ras、Ki-67基因的表达及微血管密度(MVD)与甲状腺癌转移的关系.方法用免疫组化SP法,检测45例甲状腺癌中P53、P21ras、Ki-67及血管标记物CD34蛋白的表达情况,并分析其与临床病理因素的关系.结果 45例甲状腺癌中P53和P21r~的阳性表达率分别为22.2%和35.5%,差异无统计学意义;在发生淋巴结转移的13例甲状腺癌中P53蛋白阳性表达率为46.2%,明显高于无转移者的12.5%(χ2=5.77,P＜0.05),其Ki-67分级指数有9例分布在Ⅱ～Ⅲ级;在复发病例中P53蛋白的阳性表达率为75%,明显高于未复发病例的10%(χ2=5.92,P＜0.05),复发病例的Ki-67分级指数均在Ⅱ级.微血管密度计数在滤泡癌中为79.1±18.4,明显高于乳头状癌的35.4±12.1(t=2.412,P＜0.05).结论P53蛋白阳性表达的甲状腺癌患者易发生淋巴结转移及复发,P21ras及Ki-67的高表达则提示甲状腺癌可能发生淋巴结转移,甲状腺癌组织中的微血管密度与癌组织学类型有关,而与淋巴结转移无关.     

端粒酶及nm23的表达与胃腺癌预后的关系探讨

目的 :探讨端粒酶和nm2 3癌基因蛋白表达与胃癌根治术后复发及预后的关系。方法 :采用端粒酶原位分子杂交技术及免疫组化S P法分别对 4 5例原发性胃腺癌组织中端粒酶的活性及nm2 3进行检测 ,并结合内镜及随访资料进行分析。结果 :胃腺癌端粒酶阳性表达率及nm2 3低表达率在有淋巴结转移组显著高于无淋巴结转移组 ;在术后 5年内复发者中显著高于无复发者。虽然随着胃腺癌分化程度的降低及浸润深度的增加 ,端粒酶活性及nm2 3低表达呈增强趋势 ,但其差异无统计学意义。结论 :胃腺癌组织中端粒酶的活性表达及nm2 3的低表达与淋巴结转移及术后复发显著相关 ,两者的表达变化对判断胃癌术后复发及预后判断有重要临床意义     

胃腺癌组织中Ets-1及微血管密度检测

目的:研究转录调节因子Ets-1(E26 transformation specific-1)及微血管密度(MVD)在胃腺癌组织中的表达及意义.方法:采用免疫组织化学SP法检测Ets-1和MVD在28例正常胃黏膜、40例不典型增生胃黏膜及70例胃腺癌组织中的表达.结果:胃腺癌组织中Ets-1阳性表达率(87.1%)明显高于癌旁病变组织(57.5%)和正常胃黏膜(32.1%)(P均<0.05);CDl05标记的MVD均值(30.16±3.92)明显高于癌旁病变组织(12.98 ±1.62)和正常胃黏膜(11.29 ±1.08)(P均<0.05).胃腺癌组织中Ets-1的表达和MVD均值与胃腺癌浸润深度、淋巴结转移及临床分期有关(P均<0.05).与年龄和性别无关(P均>0.05).胃腺癌组织中MVD值随着Ets-1表达增强而增高(P<0.05).结论:高表达的Ets-1参与胃腺癌浸润和淋巴道转移,并与胃腺癌组织中微血管生成有关,Ets-1可作为判断胃腺癌恶性行为的重要生物学标记物之一.     

微血管密度在胃腺癌中的表达及临床预后意义

目的：探讨微血管密度(Vascular endothelial growth factor,MVD)在判断胃腺癌中的转移和判断预后中的作用。方法：应用免疫组织化学S—P法检测76例胃腺癌组织和10例正常胃组织中MVD的表达水平,随访生存时间,比较MVD的不同表达程度与生存率的关系。结果：MVD阳性较正常组织显著增高,并与Bomnann分型、分化程度、浸润深度、肿块大小、淋巴结转移程度比较相关显著(P＜0.05),MVD阳性表达者的生存时间较阴性者短(P＜0.05)。结论：MVD与血管发生密切相关,可作为判断胃腺癌转移和预后的重要指标之一。     

食管鳞状细胞癌组织中RECK蛋白的表达与微血管密度检测

目的:检测食管鳞状细胞癌组织中RECK蛋白的表达及微血管密度(MVD).方法:应用免疫组织化学SP法检测62例食管鳞状细胞癌组织、31例癌旁不典型增生组织及62例正常食管黏膜组织中RECK蛋白的表达与MVD.结果:食管鳞状细胞癌组织、癌旁不典型增生组织及正常黏膜组织中RECK蛋白的阳性表达率依次增高,分别为59.7%(37/62)、71.0%(22/31)、85.5%(53/62),3组间比较差异有统计学意义(P＜0.05);RECK蛋白的表达与食管鳞状细胞癌的组织学分级、浸润深度及淋巴结转移密切相关(P＜0.05).MVD与食管鳞状细胞癌的浸润深度及淋巴结转移密切相关(P＜0.05).结论:RECK和MVD在食管鳞状细胞癌的黏膜上皮癌变及浸润、转移中起重要作用,2者联合检测可望成为食管鳞状细胞癌早期诊断和预后判断的分子指标之一.     

非小细胞肺癌组织中PTEN、P53蛋白及微血管密度检测

目的:检测非小细胞肺癌(NSCLC)组织中微血管密度(MVD)、PTEN、P53的表达.方法:采用免疫组化SP法分别检测75例NSCLC组织中PTEN、P53的表达及MVD.75例NSCLC患者中男55例,女20例;鳞癌50例,腺癌25例;高分化18例,中分化34例,低分化23例;Ⅰ Ⅱ期50例,Ⅲ Ⅳ期25例;有淋巴结转移45例,无淋巴结转移30例.结果:肺腺癌组织MVD高于鳞癌组织,Ⅲ～Ⅳ期肺癌组织中MVD高于Ⅰ～Ⅱ期肺癌组织,有淋巴结转移肺癌组织中MVD高于无淋巴结转移者(P均＜0.05);PTEN阳性肺癌组织中MVD低于PTEN阴性者,P53阳性组肺癌组织中MVD高于P53阴性组(P均＜0.05).结论:NSCLC组织中PTEN表达的减低、突变型P53表达的升高可促使新生血管生成,MVD增加,提示预后不良.     

PINCH蛋白在食管鳞状细胞癌中的表达意义及与血管生成的关系

目的 探讨PINCH(particularly interesting new cysteinehistindine rich protein,PINCH)蛋白在食管鳞状细胞癌中的表达意义及与血管生成的关系.方法 采用免疫组织化学ABC法检测21例正常食管黏膜组织和43例食管鳞状细胞癌组织中PINCH蛋白的表达及CD31标记的肿瘤内微血管密度(microvessel density,MVD),并探讨PINCH蛋白表达与肿瘤血管牛成之间的关系.结果 PINCH蛋白在食管鳞状细胞癌组织相关间质中呈异质性表达,其阳性率为60.47%(26/43),明显高于止常食管黏膜组织的4.76%(1/21),差异有统计学意义(P<0.05),而且在肿瘤浸润边缘阳性更明显.PINCH蛋白表达与患者性别,年龄及病理分期无相关性;淋巴结转移组鳞状细胞癌组织中PINCH蛋白阳性表达率为90.90%(10/11),未转移组鳞状细胞癌病例中阳性率为40.63%(13/32),二者相比差异有统计学意义(P<0.05);高分化组鳞状细胞癌组织中PINCH蛋白阳性表达率为53.33%(8/15),中分化组鳞状细胞癌组织中PINCH蛋白阳性表达率为73.68%(14/19).低分化组鳞状细胞癌组织中PINCH蛋白阳性表达率为100%(9/9),三者相比差异有统计学意义(P<0.05).PINCH蛋白表达与MVD无关,MVD与食管鳞状细胞癌患者的性别、年龄、分化程度、病理分期、淋巴结转移均无关.结论 PINCH蛋白可作为一个肿瘤相关间质的标志物来预测肿瘤浸润、分化程度及淋巴结转移的能力,PINCH蛋白表达与MVD无明显相关性.     

食管癌血管生成与淋巴结转移的关系

目的 探讨食管因管生成与淋巴结转移的关系,方法 采用免疫组织化学的方法检测了1994－1995年手术切除的50例食管癌病人石蜡标本中微血管密度和血管内皮生长因子及受体蛋白的表达。其中有食管旁淋巴结转移者18例,胃左动脉旁淋巴结转移15例。光镜下行MVD、VEGF、Flt、KDR蛋白表达细胞的计数。结果 食管旁和胃左动脉旁淋巴结转移组的微血管密度（MVD）、血管内皮生长因子（VEGF）、血管同皮生长因子受体（Flt、KDR）蛋白表达均高于未转移组,结论 食管癌中MVD、VEGF、Flt、KDR蛋白表达与肿瘤转移行为密切相关,有可能作为判定肿瘤生物学行为、转移潜能及预后的指标。     

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…