子宫内膜异位症异位内膜组织中内皮型一氧化氮合成酶、血管内皮生长因子和CD34的表达

目的：探讨子宫内膜异位症（EMs）异位内膜组织中内皮型一氧化氮合成酶（eNOS）、血管内皮生长因子（VEGF）和CD34的表达情况。方法：采用免疫组织化学方法分别测定38例EMs异位内膜与40例正常对照组子宫内膜组织中eNOS、VEGF和CD34的表达，分析异位内膜组织中eNOS、VEGF表达的相关性。结果：EMs异位内膜组织中eNOS、VEGF和CD34的表达较正常内膜组织的表达明显增高；在EMs异位子宫内膜组织中，eNOS和VEGF的表达成正相关（r=0．984，P〈0．05）。结论：异位内膜组织的侵袭力增强及血管生成可能与eNOS、VEGF高表达有关。     

子宫内膜异位症病人雌激素受体亚型和VEGF表达

目的 探讨雌激素受体亚型、血管内皮生长因子(VEGF)的表达与子宫内膜异位症(EMs)的相关性及其预后的关系.方法 采用免疫组化法检测79例EMs病人异位内膜组织及20例正常子宫内膜标本中的雌激素受体亚型-α(ER-α)、雌激素受体亚型-β(ER-β)及VEGF的表达情况,并分析其与EMs预后的关系.结果 异位内膜组ER-α、ER-β阳性表达率及表达强度均低于正常子宫内膜组(χ2=9.98、4.23,P<0.01、0.05),VEGF阳性表达率高于正常子宫内膜组(χ2=4.11,P<0.05).异位内膜VEGF高表达的EMs病人复发率明显高于低表达者(χ2=6.39,P<0.05); 异位内膜中ER-α高表达者VEGF表达率亦相应较高,ER-α低表达者其VEGF表达率亦相应较低(r=0.93,P<0.01).结论 ER-α、ER-β可能参与了EMs发生发展的病理过程及异位内膜血管生成的调节,检测VEGF的表达对于估计EMs的预后可能有重要临床价值.     

子宫内膜异位症患者异位内膜中COX-2、VEGF和KDR的表达及意义

目的 探讨环氧化酶-2（COX-2）、血管内皮生长因子（VEGF）和血管内皮生长因子受体（KDR）在子宫内膜异位症（EMs）患者异位内膜组织中的表达。方法 采用免疫组织化学方法测定EMs异位内膜38例（实验组）和正常子宫内膜40例（对照组）中COX-2、VEGF和KDR的表达。结果 ①EMs异位内膜组织中COX-2、VEGF和KDR的表达均较对照组正常子宫内膜的表达高，差异均有统计学意义（P〈0．05）。②在EMs异位内膜组织中，COX-2和VEGF的表达水平呈高度正相关（r=0．984，P〈0．05）。结论异位内膜组织的侵袭力增强及血管生成可能与COX-2、VEGF高表达有关，二者在EMs的发生发展中发挥作用。     

组织因子和血管内皮生长因子在子宫内膜异位症组织中的表达及意义

目的：探讨组织因子（ TF）和血管内皮生长因子（ VEGF）在子宫内膜异位症（ EMs）组织中的表达及意义。方法通过腹腔镜活检或开腹手术,取得60例卵巢子宫内膜异位病灶组织及在位内膜40例,另取同期子宫肌瘤手术患者的正常子宫内膜组织25例作为对照,应用免疫组织化学技术对组织中的TF和VEGF蛋白的表达情况进行检测。结果 TF在EMs中异位内膜的表达与在位内膜中的表达差异无统计学意义（P＞0.05）,异位内膜及在位内膜中的表达明显高于正常子宫内膜（P＜0.05）;VEGF在EMs中异位内膜的表达与在位内膜中的表达差异无统计学意义（P＞0.05）,异位内膜及在位内膜中的表达明显高于正常子宫内膜（P＜0.05）。结论 TF和VEGF在EMs中诱导血管生成,促进EMs的发生发展。     

COX-2,VEGF在子宫内膜异位症组织中的表达及相关性

目的:探讨环氧化酶-2(COX-2)和血管内皮生长因子(VEGF)在子宫内膜异位症(EMs)组织中的表达与生物学行为的相关性. 方法:采用免疫组织化学法对32例EMs患者组织中COX-2和VEGF的表达进行检测. 结果:32例EMs,患者组织中COX-2和VEGF的阳性表达率分别为84.3%和93.8%,较正常内膜的表达明显增高(P<0.001). 在位内膜、异位内膜的COX-2和VEGF在增殖期和分泌期分别为83.3%, 85.7%和94.4%, 92.9%,差异不显著(P>0.05). COX-2表达与VEGF的表达有一定相关性(r=0.747,P<0.001).结论:COX-2和VEGF在EMs的发生、发展中起着关键性作用,二者在血管生成过程中密切相关,可能为EMs的治疗提供新的靶点.     

VEGF和PTEN蛋白在子宫内膜异位症中表达及临床意义

目的 研究血管内皮生长因子（VEGF）和磷酸酶基因（PTEN）蛋白在子宫内膜异位症（EMs）中的表达及其调节,从血管形成和基因调控方面进一步探究它们在EMs发生、发展中的作用和意义.方法 取EMs异位内膜58例,EMs在位内膜25例,正常子宫内膜20例,应用免疫组化二步法对VEGF和PTEN蛋白的表达进行研究,结合病例的治疗、复发及受孕情况进行分析.结果 VEGF在EMs患者的异位内膜中表达高于在位和正常内膜中的表达率（P＜0.05）,但PTEN在EMs患者的异位、在位内膜均低于正常内膜中的表达（均P＜0.05）;VEGF在EMs在位和异位内膜中的增生期与分泌期中的表达比较差异有统计学意义（P＜0.05）,但正常内膜中差异无统计学意义（P ＞0.05）;而PTEN在EMs患者在位、异位和正常内膜中的增生期和分泌期中的表达差异无统计学意义（P ＞0.05）.在VEGF和PTEN 蛋白表达与患者的年龄、痛经情况、囊肿大小及术后受孕与否均关系不密切,但与临床分期和术后复发密切相关;VEGF和PTEN蛋白表达呈负相关（P＜0.05）.结论 VEGF直接参与EMs的血管生成,PTEN蛋白在EMs中表达存在缺失或减弱,从而上调VEGF的表达.它们可能参与EMs的血管生成,促进异位内膜细胞的种植和病情发展.     

缺氧诱导因子-1α在子宫内膜异位症中的表达与微血管密度的关系

目的 检测缺氧诱导因子-1α(HIF-1α)在子宫内膜异位症(EMs)中的表达及其与血管生成的关系,探讨其在EMs发病机制中的作用.方法 取68例EMs的异位内膜、20例在位内膜和20例正常子宫内膜标本,应用免疫组化SP法检测HIF-1α蛋白的表达情况,用CD34单克隆抗体标记血管内皮细胞,计数子宫内膜组织中的微血管密度(MVD).结果 HIF-1α在EMs组异位内膜的表达强度显著高于在位内膜组及对照组(P＜0.01),各组中分泌期与增生期表达强度比较差异无显著性(P＞0.05):EMs组异位内膜中的MVD显著高于正常对照组(P＜0.05):MVD与HIF-1α的表达水平呈正相关(r=0.718,P＜0.01).结论 HIF-1α在EMs的异位内膜过度表达,且与异位内膜的血管生成密切相关.推测HIF-1α可能在EMs的发病机制中起着重要作用.     

c-kit受体与血管内皮生长因子在子宫内膜异位症中的表达及意义

目的:探讨c-kit受体及血管内皮生长因子VEGF在子宫内膜异位症(EMs)患者的异位和在位内膜组织中的表达。方法:采用免疫组化SABC法,检测34例EMs病人异位内膜(异位内膜组)组织及在位内膜(在位内膜组)组织c-kit受体和VEGF的表达,并与30例非EMs病人在位内膜(对照组)进行比较。结果:①异位和在位内膜组中,c-kit受体阳性表达平均光密度(MOD)均高于对照组(P<0.05);②异位和在位内膜组中,VEGF阳性表达也均高于对照组(P<0.05);③c-kit受体和VEGF在在位内膜组和对照组的分泌期高于增生期(P<0.05);在在位内膜组分泌期和增殖期的表达均高于对照组同期水平(P<0.05);④异位和在位内膜组中,c-kit与VEGF的表达呈正相关(P<0.05)。结论:c-kit受体和VEGF在EMs的发生、发展中可能起着重要作用,二者在血管生成过程中密切相关,可能为EMs的治疗提供新的靶点。     

ER、PR和AR在子宫内膜异位症组织中的表达及其意义

目的:研究ER、PR及AR在内异症异位内膜、在位内膜和正常对照子宫内膜组织中的表达,阐述性激素及其受体与子宫内膜异位症发生机制的关系,探究治疗EMs的新途径。方法:利用免疫组织化学的方法检测50例EMs患者异位内膜、在位内膜及20例正常对照子宫内膜组织中ER、PR及AR的表达情况。结果:ER在EMs患者在位子宫内膜组织中的表达均明显高于异位内膜及正常对照子宫内膜,比较差异均有统计学意义(P0.05);PR在EMs患者异位内膜组织中的表达明显低于在位内膜及正常对照子宫内膜,比较差异均有统计学意义(P0.05);AR在EMs患者异位内膜组织中的表达明显低于在位内膜及正常对照子宫内膜,比较差异均有统计学意义(P0.05)。结论:EMs患者异位内膜PR及AR表达的相对增高可能在内异症的发生与发展中起着一定的作用。     

VEGF在人子宫内膜异位症裸鼠模型组织中的表达及意义

目的 建立人子宫内膜异位症(EMs)裸鼠模型,检测血管内皮生长因子(VEGF)在正常在位内膜及裸鼠异位内膜的表达,探讨其在EMs发生发展中的作用.方法 分别采用皮下种植和腹腔注射的方法,建立EMs裸鼠模型,光镜下观察异位病灶的形态学特点,并采用免疫组化法检测正常在位内膜及裸鼠异位内膜中VEGF蛋白表达水平.结果 实验裸鼠共20只,皮下种植组10只,8只成模,腹腔注射组10只,7只成模,异位病灶在光镜下呈现增生期特点;正常在位内膜10例,VEGF蛋白在异位内膜中的表达有增多趋势(t=2.632,P<0.05).结论 成功建立人EMs裸鼠皮下种植及腹腔注射模型,检测到VEGF表达较正常在位内膜增多,该模型可用于进行人EMs血管生成及抗血管生成治疗的研究模型.     

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…