细胞间隙连接蛋白43在耐药性卵巢癌中的表达

目的探讨细胞间隙连接蛋白43(CX43)与上皮性卵巢癌化疗疗效(耐药或敏感)及临床病理的关系.方法从1999年1月至2003年6月间临床资料及随访资料完整的卵巢癌病例中,筛选出60例原发上皮性卵巢癌和6例正常卵巢作为研究对象.根据临床诊断将其分为3组:①化疗耐药组30例,②化疗敏感组30例,③正常卵巢组6例.全部病例术前均未接受过放疗,入院后均行全子宫和双附件切除 盆腔淋巴结清扫 阑尾切除 大网膜切除术,66例患者均有随访结果.用流式细胞仪定量分析66例标本组织中CX43蛋白的表达量.结果CX43蛋白的表达为化疗耐药组＜化疗敏感组＜正常卵巢组织,单向方差分析两两比较结果差异有显著意义.结论CX43蛋白表达量的下降与上皮性卵巢癌的化疗耐药显著相关.     

上皮性卵巢癌ERCC1表达与顺铂化疗耐药的关系

目的 探讨切除修复交叉互补基因(ERCC1)在原发性上皮性卵巢癌顺铂化疗耐药中的意义.方法 用组织芯片仪制备组织芯片并结合免疫组织化学技术,检测56例上皮性卵巢癌病人癌组织中ERCC1蛋白的表达情况,并以38例正常卵巢组织作为对照,分析其与顺铂化疗耐药的关系,同时分析ERCC1在原发性上皮性卵巢癌中的表达与临床手术-病理分期(FIGO,2000)、病理学类型、分化程度、发病年龄、发生部位以及疾病发生的相关性.结果 38例正常卵巢组织中ERCC1阳性表达者17例(44.74%),56例上皮性卵巢癌组织ERCC1阳性表达者31例(55.36%),二者比较差异无显著性(χ2=1.022,P＞0.05).上皮性卵巢癌中ERCC1的表达与临床手术-病理分期、病理学类型、分化程度、发病年龄、发生部位及发病率均无明显的相关性(P>0.05).上皮性卵巢癌顺铂化疗耐药组ERCC1的阳性表达率为76.67%,明显高于敏感组的30.77%,差异有显著性(χ2=11.87,P<0.05).结论 上皮性卵巢癌ERCC1表达与顺铂化疗耐药相关.     

EPS8在卵巢浆液性腺癌中的表达分析

目的检测表皮生长因子受体通路底物8（epidermal growth factor receptor pathway substrate 8, Eps8）在卵巢浆液性腺癌组织、上皮性卵巢良性肿瘤及正常卵巢组织的表达,探讨Eps8在不同卵巢组织中的表达情况及在卵巢癌化疗耐药中的作用。方法采用免疫组织化学法检测76例卵巢浆液性腺癌（其中化疗敏感型40例,化疗耐药型36例）组织、15例上皮性卵巢良性肿瘤及15例正常卵巢组织中Eps8的表达情况,并分析其与卵巢癌化疗耐药间的关系。结果Eps8在卵巢浆液性腺癌组织中高表达,在上皮性卵巢良性肿瘤及正常卵巢组织中低表达,差异有统计学意义（P〈0．05）,但在化疗耐药型及化疗敏感型中的表达差异无统计学意义（P〉0．05）。结论Eps8在卵巢浆液性腺癌中高表达,其定位主要在细胞浆中,在化疗耐药型及化疗敏感型中的表达差异无统计学意义。     

多药耐药蛋白P170在上皮性卵巢癌组织中的表达及意义

目的探讨上皮性卵巢癌组织多药耐药蛋白P170的表达及意义.方法采用流式细胞术检测42例上皮性卵巢癌组织P170的表达情况.结果上皮性卵巢癌组织P170表达率与正常卵巢组织间比较有显著性差异(P<0.01),上皮性卵巢癌组织P170表达率与患者年龄、组织学类型、病理分级和分期之间差异无统计学意义(P>0.05).结论卵巢癌细胞可以原发表达多药耐药蛋白P170,通过流式细胞术检测P170蛋白对于评价多药耐药水平,选择化疗药物和预后判断具有一定的临床指导意义.     

UTP23在上皮性卵巢癌中的表达及化疗耐药性研究

目的 探讨UTP23在上皮性卵巢癌中的表达水平及其与化疗耐药的关系。 方法 采用免疫组化方法对64例上皮性卵巢癌患者和40例卵巢组织良性增生患者组织中的UTP23蛋白表达进行测定,并分析UTP23表达水平与临床病理特征、化疗耐药及预后的关系。 结果 UTP23蛋白表达于上皮性卵巢癌细胞的胞浆中,呈棕黄色颗粒染色。上皮性卵巢癌患者UTP23低表达为46例,明显高于卵巢组织良性增生组的6例,差异有统计学意义(P<0.05)。化疗耐药组患者UTP23低表达为29例,明显高于化疗敏感组的17例,差异有统计学意义(P<0.05)。UTP23低表达与年龄、病理类型、有无腹水、残余病灶大小等无关(P>0.05),与分化程度、临床分期、有无淋巴结转移等有关(P<0.05)。UTP23低表达患者生存时间明显短于高表达组患者,差异有统计学意义(P<0.05),COX回归单因素分析显示,UTP23表达与总生存时间相关[RR=0.587,P=0.032,95%CI:0.336(0.361~0.986)]。 结论 UTP23低表达与上皮性卵巢癌患者疾病进展、化疗耐药及预后等密切相关,提示UTP23可能作为一个新的判断化疗效果和评估预后的指标。      

脱嘌呤/脱嘧啶核酸内切酶与卵巢上皮性癌耐药相关性研究

目的 探讨脱嘌呤/脱嘧啶核酸内切酶(APE1)与卵巢上皮性癌耐药性的相关性以及其在卵巢癌化疗耐药中的作用机制.方法 应用免疫组织化学法对78例原发性卵巢上皮性癌组织和卵巢癌顺铂敏感株A2780、顺铂耐药株CP70中APE1的表达进行测定.结果 APE1在卵巢上皮性癌组织中呈胞核表达、胞浆表达或核浆共同表达.化疗敏感组和耐药组的APE1表达强度间差异有统计学意义(P=0.045),核表达者化疗敏感率与浆表达、核浆表达者比较差异有统计学意义(P=0.037).在卵巢癌顺铂耐药株CP70中APE1表达水平较顺铂敏感株A2780明显增高.结论 APE1表达强度和定位与以铂类为基础化疗药物的敏感性相关,时卵巢癌的化疗疗效有提示作用,检测APE1对前瞻性预测化疗药物敏感性和判断化疗疗效具有一定的临床指导价值.     

转录激活因子2和切除修复交叉互补基因1与卵巢癌顺铂耐药的关系

目的：探讨转录激活因子-2（ATF-2）、切除修复交叉互补基因1（ERCC1）表达在卵巢上皮性癌顺铂化疗耐药中的意义。方法：应用SP法检测56例石蜡包埋卵巢癌标本及RT-PCR方法检测34例卵巢癌新鲜组织ATF-2、ERCC1蛋白及mRNA的表达,分析其与顺铂耐药的关系以及二者的相关性。结果：ATF-2表达与患者年龄、组织学类型及有无腹水无关,不同手术分期其表达差异有统计学意义（P〈0.05）。ERCC1表达与卵巢上皮性癌患者年龄、手术分期、病理组织学类型及有无腹水无关（P〉0.05）。顺铂化疗耐药组ATF-2、ERCC1蛋白的阳性表达率分别为69.23%、73.08%,高于化疗敏感组33.33%、46.67%,组间差异有统计学意义（P〈0.05）。RT-PCR结果显示34例卵巢上皮性癌新鲜组织ATF-2/β-actin mRNA、ERCC1/β-actin分别波动于0.181～2.276、0.294～3.060,化疗耐药者ATF-2 mRNA、ERCC1 mRNA相对表达量分别为1.132±0.645、1.565±0.714,亦高于敏感组0.651±0.461、0.594±0.268,差异有统计学意义（P〈0.05）。结论：ATF-2、ERCC1表达与卵巢上皮性癌顺铂耐药有关,可能成为预测卵巢癌顺铂敏感性指标。     

间隙连接蛋白Cx43在卵巢癌中的表达及意义

目的：探讨间隙连接蛋白Cx43（connexin43,Cx43）在上皮性卵巢癌中的表达及意义。方法：对10例正常卵巢上皮，38例不同分化程度的卵巢浆液性囊腺癌的石蜡包埋切片，用免疫组织化学SP法和计算机图像分析系统检测Cx43蛋白的表达，结果：正常卵巢上皮及卵巢癌组织中Cx43蛋白定位于细胞膜和细胞质中；不同分化程度卵巢癌组织中Cx43阳性表达的相对面积和平均吸光度值均显著低于正常卵巢表面上皮细胞（P＜0．01），而且随着卵巢癌细胞分化程度的下降而显著降低（P＜0．01）。结论：Cx43蛋白表达下降与上皮性卵巢癌的发生发展密切相关。     

Survivin蛋白在卵巢癌组织中的表达及临床意义

目的：运用组织芯片技术结合免疫组化的方法分析Survivin蛋白在正常卵巢、卵巢良性肿瘤、卵巢癌组织中的表达情况,探讨Survivin蛋白在卵巢癌的发生发展、浸润转移和化疗耐药中的作用,为以Survivin作为分子治疗靶点的抗肿瘤基因治疗提供理论依据。方法：运用组织芯片技术联合免疫组化法检测27例卵巢癌、20例正常卵巢组织、30例卵巢良性肿瘤中凋亡抑制基因Survivin的表达情况,分析其与卵巢癌临床病理特征的关系,并进行临床随访分析Survivin基因与卵巢癌化疗耐药的关系。结果：①Survivin蛋白在卵巢癌组织中的阳性表达显著高于卵巢良性肿瘤和正常卵巢,两两比较,Survivin在卵巢癌中的表达率与在正常卵巢组织及卵巢良性肿瘤中的表达率比较有差别,且差别有统计学意义（P〈0.05）;Survivin蛋白与卵巢癌的临床分期有显著相关性（P〈0.05）;Survivin蛋白表达与卵巢癌的组织类型、病理学分级、患者年龄、是否绝经、有无腹水形成无关（P〉0.05）。②Survivin蛋白在卵巢癌化疗耐药组中高表达。结论：Survivin蛋白高表达在卵巢癌的发生发展中起重要作用,Survivin蛋白在卵巢癌以顺铂和紫杉醇为基础的化疗耐药中起重要作用。     

白细胞介素-6在上皮性卵巢癌中的表达及其意义

目的:研究白细胞介素-6(interleukin-6,IL-6)在上皮性卵巢癌中的表达及其意义。方法:采用Western blot和RT-PCR方法检测20例上皮性卵巢癌组织和10例正常卵巢组织中IL-6蛋白及mRNA的表达。结果:上皮性卵巢癌组织中IL-6蛋白的表达较正常卵巢组织中低(P=0.000),差异有统计学意义;IL-6 mRNA在卵巢癌组织中的表达显著低于正常组(P=0.000)。结论:IL-6在上皮性卵巢癌组织呈低表达,为进一步探讨IL-6在上皮性卵巢癌发生、发展中的生物学作用提供了实验依据。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.