p53和nm23在大肠癌中的表达及其生物学意义

①目的探讨大肠癌组织中ｐ５３及ｎｍ２３的表达与浸润转移的关系。②方法应用免疫组织化学ＬＳＡＢ法检测７５例大肠癌中ｐ５３及ｎｍ２３的表达。③结果大肠癌组织中ｐ５３，ｎｍ２３的阳性率分别为５３．３％和６５．３％．ｐ５３过表达和ｎｍ２３低表达均与大肠癌的浸润深度及淋巴结转移有关。ｐ５３在低分化癌中的表达明显高于高分化癌（χ２＝１０．０８，Ｐ＜０．０１），而ｎｍ２３表达与大肠癌分化程度无关（χ２＝３．３９，Ｐ＞０．０５）。④结论ｐ５３高表达和ｎｍ２３低表达在大肠癌的浸润转移中起重要作用，大肠癌淋巴结转移可能与多基因异常有关     

食管癌组织中p16蛋白表达及其临床意义

应用免疫组化ＳＡＢＣ法检测４９ 例食管鳞癌、１２ 例食管腺癌和２０ 例食管正常组织。结果显示,２８ 例食管鳞癌（５７．１％ ,２８／４９）４ 例食管腺癌（３３．３％ ,４／１２）和１８ 例食管正常组织（９０％ ,１８／２０）ｐ１６ 蛋白表达阳性（Ｐ＜ ０．０１）,伴有淋巴结转移的食管鳞癌ｐ１６ 蛋白表达阳性率（３９．３％ ）显著低于无淋巴结转移者（８１．０％ ,Ｐ＜ ０．０１）,中低分化食管癌ｐ１６ 蛋白表达阳性率（４６．９％ ）低于高分化者（７６．５％ ,Ｐ＜ ０．０５）。Ⅲ期食管癌ｐ１６ 蛋白表达阳性率（４４．４％ ）亦低于Ⅱ期者（７２．７％ ,Ｐ＜ ０．０５）。ｐ１６ 蛋白表达与肿瘤的大体病理类型无关。ｐ１６ 蛋白在食管癌中呈低表达,其表达阳性率随病期进展、淋巴结转移、细胞分化程度降低而明显降低,因此,可作为判断食管肿瘤恶性度和预后的指标     

p53、nm23和c-erbB-2蛋白在子宫内膜癌中的表达及其临床意义

目的：研究ｐ５３、ｎｍ２３和ｃ－ｅｒｂＢ－２蛋白在子宫内膜癌中的表达及其临床意义。方法：用ＬＳＡＢ免疫组化法检测４２例子宫内膜癌中ｐ５３、ｎｍ２３和ｃ－ｅｒｂＢ－２蛋白的表达。结果：ｐ５３,ｎｍ２３,ｃ－ｅｒｂＢ－２在子宫内膜部中的阳性率分别为３１．０％、６０．０％、４７．６％,其阳性表达与年龄、不同组织学类型差异无显著性（Ｐ〉０．０５）;ｐ５３与病理分级有关,随着细胞分级的增高,其阳性率逐步升高,差异有极显著性（χ＝１６．３,Ｐ〈０．００５）;ｎｍ２３与病理分级呈负相关（Ｐ〈０．０１）,无淋巴结转移者阳性表达率明显高于有淋巴结转移者（７１．９％和２０．０％,Ｐ〈０．０５）;ｃ－ｅｒｂＢ－２的表达与癌细胞的分化程度、临床分期有关,分化程度高及早期癌中ｃ－ｅｒｂＢ－２表达强。结论：对子宫内膜癌进行ｐ５３、ｎｍ２３     

胃癌组织中p16基因mRNA和蛋白的表达及其与p53、Cyclin D1蛋白表达的相关性和临床意义

目的排除正常组织细胞的影响，探讨ｐ１６基因在胃癌发生发展及预后判断上的作用和可能的基因调节机制。方法采用ＣＤＮＡ－ｍＲＮＡ原位核酸杂交和免疫组化技术观察６１例胃癌组织和４９例癌旁非癌组织中ｐ１６基因ｍＲＮＡ和蛋白的表达，并与ｐ５３、ＣｙｃｌｉｎＤ１蛋白表达情况及肿瘤的生物学行为进行相关性分析（Ｘ２检验，Ｗｉｌｃｏｘｏｎ等级秩和检验，配对资料Ｙａｔｅｓ校正Ｘ２检验）。以ＰＣＲ随机引物法制备生物素标记的ｐ１６ＣＤＮＡ探针。结果（１）胃癌组织ｐ１６ｍＲＮＡ的阳性率为５０．８％，ｐ１６蛋白的阳性率为７０．５％，与癌旁正常胃粘膜１００％的阳性率相比，差异具有显著性意义（Ｐ＜０．００１）。１０例早期胃癌ｐ１６ｍＲＮＡ和蛋白均阳性，而５１例进展期胃癌的阳性率分别为４１．２％（２１／５１），６４．７％（３３／５１）。早期与进展期胃癌相比，ｐ１６ｍＲＮＡ和ｐ１６蛋白的阳性率均有显著性差异（Ｐ＜０．００１，Ｐ＜０．０１）。而且在同一切片中也可以观察到分化较好或浸润浅层的癌细胞表达ｐ１６ｍＲＮＡ和蛋白，而分化较差、浸润深层的癌细胞则没有表达。（２）ｐ１６ｍＲＮＡ和ｐ１６蛋白的表达强度与胃癌的分化程度、浸润深度，有无淋巴结转移及病     

p16 、p53蛋白在大肠癌中的表达及其临床意义

目的：探讨抑癌基因p16,p5３蛋白的表达与大肠癌临床病理指标间的关系,为大肠癌预后判断提供依据。方法：运用免疫组织化学技术（ＡＢＣ法）检测５５例大肠癌手术切除标本中p16,p53蛋白。结果：５５例大肠癌中,p16蛋白表达阳性率为７０．９１％,与癌组织分化程度呈正相关（Ｐ＜０．０５）,与癌组织浸润肠壁深度和Ｄukes分期呈负相关（Ｐ＜０．０５）,无淋巴结转移者p16 蛋白表达阳性率显高于有转移者,两者差异有显著性（Ｐ＜０．０１）。p53的表达阳性率为５６．４％,与癌组织浸润肠壁深度和Ｄukes分期呈正相关。结论：p16和 p５３蛋白两者联合检测可为大肠癌患者提供更多的预后信息。     

皮肤恶性黑色素瘤nm23/NDPK的表达及临床意义

①目的探讨恶性黑色素瘤ｎｍ２３／ＮＤＰＫ的表达及意义。②方法采用免疫组织化学技术检测３２例恶性黑色素瘤组织中ｎｍ２３／ＮＤＰＫ的表达。③结果３２例恶性黑色素瘤组织ｎｍ２３／ＮＤＰＫ表达阳性率为６５．６％（２１／３２）；无淋巴结转移者阳性率高于伴淋巴结转移者，其差异有显著性（χ２＝５．０６，Ｐ＜０．０５）；生存时间＞２年者ｎｍ２３／ＮＤＰＫ表达阳性率显著高于生存时间≤２年者，其差异有显著性（χ２＝５．０９，Ｐ＜０．０５），而病变浸润深度及病理分型间其ｎｍ２３／ＮＤＰＫ表达阳性率无显著性差异。④结论ｎｍ２３基因在恶性黑色素瘤的转移过程中发挥负性调控作用。检测恶性黑色素瘤组织中ｎｍ２３／ＮＤＰＫ的表达，对了解其生物学行为及判断病人预后有重要意义。     

大肠癌中p16蛋白的表达

研究大肠癌中ｐ１６蛋白的表达与肿瘤分化程度及浸转移等生物学行为的关系。方法 应用免疫组织化学ＬＳＡＢ法检测了１０５例大肠癌组织中ｐ１６蛋白的表达。结果 大肠癌ｐ１６蛋白表达的阳性率为６０．０％，随大肠癌分化程度降低，浸润肠壁深度和Ｄｕｋｅｓ分期的进展，原发灶中ｐ１６蛋白表达阳性率降低，差异具有显著性。     

nm23基因在直肠癌中的表达及其临床意义

目的研究ｎｍ２３基因表达与直肠癌生物学行为和预后的关系。方法应用免疫组织化学ＳＰ方法检测７６例直肠癌手术标本中ｎｍ２３基因的表达。结果直肠癌原发灶ｎｍ２３表达阳性率为７５．０％；其中，无伴区域淋巴结转移者阳性率为９６．２％，伴有淋巴结转移者阳性率６４％（Ｐ＜０．０１）；ｎｍ２３表达水平与直肠癌浸润深度和Ｄｕｋｅｓ＇分期呈负相关（Ｐ＜０．０５，Ｐ＜０．０１）。ｎｍ２３阳性者术后３年、５年生存率分别达６４．９％和５９．４％，而阴性者为３１．６％和２１．１％，二组患者术后３年或５年生存率差异均具有显著性意义（Ｐ＜０．０５，Ｐ＜０．０１）。结论ｎｍ２３基因在直肠癌浸润和淋巴结转移过程中发挥负性调控作用；检测直肠癌组织中ｎｍ２３基因表达，有助于对直肠癌生物学行为的进一步了解和对患者预后的判断。     

P16蛋白表达与胃癌浸润转移关系的研究

采用链霉素抗生素蛋白—过氧化物酶连接法（Ｓ—Ｐ法）,研究不同浸润深度胃癌及淋巴结转移性胃癌组织中Ｐ１６蛋白的表达。结果显示,Ｐ１６蛋白阳性表达率,浸润浅肌层胃癌为４８．００％,浸润深肌层及全层胃癌为４７．２２％,差异无显著性意义（Ｐ＞０．０５）;３０例原发及淋巴结转移性胃癌的配对标本中,原发癌Ｐ１６蛋白表达阳性率为４６．６７％,转移癌为１６．６７％,差异有显著性意义（Ｐ＜０．０５）。结果提示：Ｐ１６蛋白表达缺失可能与胃癌转移有关。     

p53蛋白在子宫内膜癌中的表达

目的探讨ｐ５３蛋白在子宫内膜癌发生、发展过程中的意义。方法应用免疫组化方法检测５０例子宫内膜癌，１２例子宫内膜腺瘤样增生，１０例单纯性增生，２０例正常子宫内膜的ｐ５３蛋白表达。结果子宫内膜癌ｐ５３蛋白阳性率为５２．０％，腺瘤样增生阳性率为１６．７％（Ｐ＜０．０５），单纯性子宫内膜增生、正常子宫内膜均为阴性。显示ｐ５３蛋白与子宫内膜癌肌层浸润深度有关（Ｐ＜０．０５）。未发现ｐ５３蛋白过度表达与子宫内膜癌分化程度、淋巴结转移之间的关系。结论子宫内膜癌ｐ５３蛋白过度表达，可作为诊断子宫内膜癌的一项参考指标。     

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…