肝癌生长、转移中的微血管生成机制

目的　研究微血管生成在肝癌、肝硬化、正常肝间的差异及其与肝癌生长、转移、病理特点的关系 .方法　用 因子抗体和 APA试剂盒对 45例肝癌、2 1例肝硬化和 8例正常肝的标本行免疫组织化学染色 ,然后在 2 0 0 (× )显微镜下计数每一视野下的微血管数目 .结果　肝癌、肝硬化、正常肝组织的微血管数目分别是 6 7.4± 2 3.8,14.4± 5 .8和 3.5±2 .0 ,经统计学分析 ,三者相差显著 (P<0 .0 1) ,微血管数与肝癌的转移、包膜形成相关 ,而与肝癌的大小、分级无关 .结论　微血管生成在肝癌的转移、包膜形成中具有重要的作用     

血管紧张素Ⅱ 1型受体和血小板源性生长因子在原发性肝细胞癌中的表达和意义

目的:探讨血管紧张素Ⅱ1型受体(AT1)和血小板源性生长因子(PDGF)在原发性肝细胞癌的表达及与临床特征之间的关系。方法:免疫组化法检测36例原发性肝细胞癌组织中AT1和PDGF表达,并以17例正常肝组织为对照。结果:肝癌组织中AT1和PDGF阳性率分别为88.9%和80.5%;2者在低分化组表达强度均高于高分化组(P<0.001);有转移者表达强度([8.17±0.75)和(6.67±0.82)]高于无转移者([4.23±2.23)和(3.80±2.44);]术前化疗组([6.86±1.35)和(6.57±0.98)]高于未化疗组([4.41±2.51)和(3.72±2.43);]AT1和PDGF二者呈正相关关系(r=0.883,P<0.001)。结论:AT1和PDGF在原发性肝细胞癌中高表达,可能在肝细胞癌的增殖、转化和转移过程中起重要作用。     

Rel mRNA和NF-κB2 mRNA在人肝细胞癌中的表达及其临床意义

【目的】探讨Rel及NF-κB2的mRNA在人肝细胞癌(hepatocellularcarcinoma,HCC)组织中的表达及其临床意义。【方法】用逆转录聚合酶链反应检测55例HCC患者癌组织及癌旁肝组织中RelmRNA和NF-κB2mRNA的表达情况。【结果】RelmRNA及NF-κB2mRNA在肝癌组织中的表达水平均明显低于其癌旁组织(分别为0.315±0.142对0.505±0.225;0.273±0.141对0.491±0.242,均P<0.05)。这两种因子在肝癌组织中的表达水平与临床分期及肝外转移明显有关,而与门静脉癌栓、术后复发、肿瘤数目、肿瘤直径及血清AFP水平等无明显关系。【结论】提示Rel、NF-κB2可能与肝癌的发生、发展有关。     

血清白介素-6在诊断肝细胞肝癌中的临床价值研究

目的:探索血清白介素-6(IL-6)在原发性肝细胞肝癌(HCC)诊断中的临床价值。方法:采用酶联免疫法(ELISA法)和电化学发光法分别测定30例原发性肝细胞肝癌患者、30例肝良性疾病患者血清白介素-6和甲胎蛋白(AFP)水平,并与30例正常对照组进行比较。结果:原发性肝细胞肝癌组患者血清IL-6水平(25.99±18.57 ng/L)及AFP水平(441.40±351.75μg/L)明显高于肝良性病组IL-6(9.09±7.44 ng/L)及AFP水平(86.86±58.64μg/L)和正常对照组IL-6(1.43±1.00 ng/L)及AFP水平(7.92±4.88μg/L),差异有统计学意义(p<0.05)。血清IL-6诊断原发性肝细胞肝癌的敏感性、特异性分别为83%、81%,而AFP的敏感性和特异性分别为63%、98%。二者联合检测时的敏感性、特异性则分别为90%,82%。结论:血清IL-6在原发性肝细胞肝癌的检测中敏感性明显高于AFP。若两项指标联合检测,可显著提高原发性肝细胞肝癌阳性检出率,有助于防止原发性肝细胞肝癌的漏诊。     

肝细胞肝癌与癌旁肝组织胰岛素受体结合特性的对比研究

目的　研究肝细胞肝癌与癌旁肝组织胰岛素受体密度与亲和力的差异。方法　采用体外受体结合实验 ,通过 Scatchard分析 ,计算两种细胞膜的最大结合容量 (Bmax)与平衡解离常数 (Kd值 )。结果　肝癌细胞膜胰岛素受体 Bmax为 1.94± 0 .6 4pm ol/ mg蛋白 ,Kd值为 2 .12± 0 .6 2 nmol/ L;癌旁肝组织细胞膜胰岛素受体 Bmax为1.42± 0 .5 7pmol/ mg蛋白 ,Kd值为 2 .2 1± 0 .78nm ol/ L。肝癌细胞膜胰岛素受体 Bmax显著高于癌旁组织细胞膜 (P<0 .0 5 ) ,而肝细胞肝癌与癌旁肝组织细胞膜的胰岛素受体亲和力无显著性差异 (P>0 .0 5 )。结论　肝细胞肝癌较癌旁肝组织表达胰岛素受体增高 ,而受体亲和力无明显差异     

51例胸腹水中细胞AgNOR定量研究

51例胸腹水中细胞AgNOR染色后显示,AgNOR颗粒均值分别为腺癌(19例)8.99±2.31;未分化癌(4例)7.24±1.40;恶性肿瘤(未分类,3例)9.16±1.10;间皮瘤(2例)12.73±1.61;白血病浸润(2例)4.21±0.64;正常淋巴细胞(51例)2.01±0.28;正常间皮细胞(51例)2.81±0.32。恶性肿瘤细胞与非肿瘤细胞AgNOR颗粒数量有显著性差异(P<0.001),而且颗粒的分布及形态亦不相同。证明AgNOR染色对鉴别良恶性胸腹水有重要价值。     

ApoM在不同肝细胞中的表达及其与临床病理因素的关系

目的:检测ApoM基因在肝硬化肝组织、正常肝组织、肝癌组织和癌旁组织中的表达并探讨其与肝癌临床病理联系。方法:采用免疫组化方法检测79例肝癌及癌旁组织、32例肝硬化及7例正常标本中ApoM的表达。结果:肝细胞癌患者组织中ApoM表达水平明显高于癌旁组织(P<0.001)。ApoM在肝细胞癌组织、癌旁组织肝硬化组织和正常肝组织中表达具有显著性差异(P<0.05)。ApoM在中、高分化肝癌组织中表达高于低分化型。结论:ApoM在正常肝细胞中呈弱表达,肝硬化组织中较高表达,但在肝癌组织中呈低表达。其表达水平与肝癌细胞分化有一定关联,这表明ApoM在肝癌细胞发生、发展中发挥着作用。     

原发性肝细胞癌细胞凋亡的研究

通过对原发性肝细胞癌细胞凋亡的研究，探讨其生物学及临床意义，采用细胞凋亡的原位末端标记技术，检测了 １７ 例正常肝组织（包括癌周边肝组织）及 １８ 例原发性肝细胞癌组织中的细胞凋亡情况。结果：正常肝组织及癌周边肝组织的细胞凋亡数平均值分别为 ２２±１３ 及 ２６±０７９，而肝细胞癌组织为 １２３±２６。本结果表明：正常肝组织及肝癌周围肝组织中有较低的细胞凋亡数，而肝癌组织中有较高的细胞凋亡数，二者相比具有显著性差异， Ｐ＜ ０００５。     

食管粘膜病变AgNOR的计量学研究

采用银染技术,对不同食管粘膜病变进行AgNOR计数和最大直径的计量学研究。结果显示:AgOR颗粒的形态、大小、多少及分布随病变的加重而有明显改变;AgNOR颗粒的平均最大直径在各组间均有非常显著性差异(P<0.001—0.05);AgNOR平均计数在轻、重度不典型增生两组间有显著性差异(P<0.05),而在其它各相邻组之间无显著性差异(P>0.05),但轻、重度不典型增生和癌细胞与正常食管粘膜组比较均有极显著性和癌细胞与正常食管粘膜组比较有极显著性意义(P均<0.001)。提示,AgNOR计数和最大直径均能反映食管粘膜各病变时上皮细胞的增生程度,但测定AgNOR颗粒的最大直径似乎比平均计数更敏感。认为,若同时进行该两项指标检测,更有利于对不同食管粘膜病变进行定性。     

原发性肝癌患者外周血甲胎蛋白mRNA表达水平与临床参数的关系

目的　了解肝细胞癌患者外周血甲胎蛋白 (AFP)mRNA的表达水平与不同临床参数的关系。方法　采用realtimeRT -PCR技术 ,定量检测 5 6例肝细胞癌、17例慢性活动性肝炎、2 1例肝硬化和 2 0名健康志愿者外周血AFPmRNA的表达水平。结果　 5 6例肝癌患者外周血AFPmRNA的平均表达水平为 34 6 44 .6± 9490 5 .4copies/μgRNA ,其中 2 9例为阳性 ;17例慢性活动性肝炎、2 1例肝硬化患者和 2 0名健康志愿者外周血均未检测到AFPmRNA的表达。结论　肝癌患者外周血AFPmRNA表达水平与肝癌分期、门静脉癌栓及肝外转移密切相关 ,与肿瘤直径、数目及血清AFP水平无明显相关 ,可作为预测肝癌发生远处转移的一个可靠指标     

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…