胃腺癌组织中细胞胀亡与血管生成素-2检测

目的 :检测胃腺癌组织中胀亡与血管生成素 - 2 (angiopotietin - 2 ,Ang - 2 )的表达。方法 :采用免疫组化SP法检测 6 1例胃腺癌组织及 30例正常胃粘膜组织中Ang - 2的表达 ,并利用透射电镜技术观察其中细胞胀亡情况。结果 :①胃腺癌组织中Ang - 2阳性表达率为 78.6 9% (4 8/ 6 1 ) ,在正常胃粘膜中未见表达 ,差异有统计学意义 ;②胃腺癌组织中发现有不同时期的胀亡细胞 ,胀亡指数 (OI)在Ang - 2阳性和阴性组中分别为 0 .73± 0 .93,2 .98±0 .5 1 ,差异有统计学意义 (P <0 .0 5 ) ;③与无淋巴结转移组比较 ,有淋巴结转移组Ang - 2阳性率较高 ,而OI较低 ,差异均有统计学意义 (P <0 .0 5 ) ;④OI、Ang- 2与胃癌的大体分型、分化程度、组织学类型、肿瘤大小、肿瘤部位及患者性别、年龄无关。结论 :胃腺癌中Ang - 2在促进肿瘤血管形成时 ,促进肿瘤的侵袭转移 ,抑制胀亡的发生     

大肠癌组织中细胞胀亡及MMP-2检测

目的 :检测大肠癌组织中胀亡细胞及MMP - 2。方法 :应用透射电镜和免疫组化方法检测 5 1例大肠癌组织中胀亡细胞和MMP - 2的表达。结果 :①大肠癌组织中可检测到不同时期的胀亡细胞。②大肠癌组织中MMP- 2表达率 5 4 .9% (2 8/ 5 1 ) ,明显高于正常大肠粘膜 (P <0 .0 5 )。③MMP - 2在淋巴结转移组的阳性表达率为 6 9.5 7% (1 6 / 2 3) ,明显高于无淋巴结转移组的 4 2 .86 % (1 2 / 2 8) ;有淋巴结转移组胀亡指数明显低于无淋巴结转移组 (P<0 .0 5 )。④MMP - 2表达阳性组OI高于MMP - 2阴性组。结论 :大肠癌组织中存在胀亡细胞和MMP - 2的表达 ,2者关系密切 ,且均与大肠癌的转移有关。     

胃腺癌组织中MVD、VEGF及细胞胀亡检测

目的 :检测胃腺癌组织中微血管密度 (MVD)、血管内皮细胞生长因子 (VEGF)与胀亡。方法 :用免疫组织化学方法检测 4 0例胃腺癌组织中MVD和VEGF的表达 ,用透射电镜检测胃癌细胞的胀亡情况。结果 :4 0例胃癌组织中 ,MVD 9～ 78,平均 (36 .5± 1 6 .5 ) ;1 6例VEGF表达阳性 ,阳性率为 4 0 %。胃癌组织中可出现不同时期的胀亡细胞 ,胀亡指数为 (2 .5 94± 0 .1 5 7)。VEGF的表达与胀亡细胞的发生呈负相关 (P <0 .0 5 )。结论 :胃癌组织中血管形成抑制了细胞胀亡的发生。     

人结直肠腺癌组织中细胞胀亡及碱性成纤维细胞生长因子测定

目的:探讨结直肠腺癌组织中细胞胀亡情况及碱性成纤维细胞生长因子(bFGF)的表达及其意义.方法:应用透射电镜观察60例结直肠腺癌组织(结肠癌29例,直肠癌31例;高分化腺癌18例,中分化腺癌28例,低分化腺癌14例;有淋巴结转移22例,无淋巴结转移38例;Dukes分期A期8例,B期30例,C期22例)及20例癌旁正常组织中的细胞胀亡情况,并应用免疫组织化学SP法检测上述组织中bFGF表达情况.结果:结直肠腺癌组织中存在细胞胀亡,正常组织中未发现;结直肠腺癌组织细胞胀亡指数(OI)与分化程度、淋巴结有无转移有关(P＜0.05或0.01),与Dukes分期无关(P＞0.05);结直肠腺癌组织中bFGF的阳性表达率为60.0%(36/60),与肿瘤的分化程度、Dukes分期、淋巴结有无转移相关(P＜0.01或0.05),而正常组织中bFGF阳性率为5.0%(1/20),2组比较差异有统计学意义(P＜0.01).OI与bFGF表达率呈负相关(r=-0.730,P＜0.01).结论:细胞胀亡与bF-GF表达和结直肠腺癌的生物学行为密切相关.     

食管鳞状细胞癌组织中细胞胀亡及微血管密度检测

目的 :检测人食管鳞状细胞癌组织中细胞胀亡及微血管密度 (MVD)。方法 :利用透射电镜和免疫组织化学技术 ,对 6 0例手术切除的食管癌组织进行细胞胀亡和MVD检测 ,分析胀亡指数 (OI)与肿瘤MVD、临床病理分期、分化的关系。结果 :食管鳞状细胞癌组织中存在胀亡细胞 ;N0 期癌组织中OI高于N1 期 (P <0 .0 5 ) ;随分化程度的升高 ,OI升高 (P <0 .0 0 5 ) ;MVD高表达组OI高于低表达组 (P <0 .0 0 1 ) ,OI与T分期无关。结论 :食管鳞状细胞癌组织中存在胀亡细胞 ,其与食管癌的生物学行为有一定相关性     

食管鳞状细胞癌组织中细胞胀亡与凋亡检测

目的 :探讨食管鳞状细胞癌组织中细胞胀亡与凋亡的存在及 2者间的关系。方法 :收集 30例食管鳞状细胞癌标本 ,利用透射电镜、TUNEL及免疫组织化学技术检测其中的胀亡、凋亡细胞及微血管密度 (MVD)。结果 :食管鳞状细胞癌组织中存在胀亡及凋亡细胞 ,凋亡指数 (AI)和胀亡指数 (OI)分别为 (1 .7± 1 .2 )和 (3.2± 1 .9)。与MVD低表达组比较 ,高表达组OI较低 ,而AI较高 ,差异有统计学意义 (P <0 .0 0 1或P <0 .0 0 5 )。结论 :食管鳞状细胞癌存在凋亡和胀亡两种细胞死亡方式 ,2者的存在及分布与MVD有关。     

胃癌组织中水通道蛋白1、微血管密度与细胞胀亡的关系及临床意义

目的：探讨胃癌组织中水通道蛋白1（AQP1）、微血管密度（MVD）与细胞胀亡的关系及临床意义。方法采用免疫组化法、蛋白印迹法检测55例胃癌、22例胃正常组织中AQP1的表达,Ⅷ因子相关抗原多克隆抗体标记血管内皮细胞法计数MVD,透射电镜观测细胞胀亡情况。随访并分析AQP1与胃癌患者预后的关系。结果胃癌组织中存在细胞胀亡;Ⅲ＋Ⅳ临床分期胃癌组织中的胀亡指数（OI）高于Ⅰ＋Ⅱ临床分期（P＜0.01）;淋巴结转移组OI明显高于无淋巴结转移组（P＜0.05）。AQP1表达强度与MVD呈显著正相关（P＜0.05）。在胃癌组织标本中,AQP1阳性表达率为58.2％,明显高于正常胃组织（P＜0.01）。胃癌伴淋巴结转移组AQP1表达水平明显高于无淋巴结转移组（P＜0.05）。多因素生存分析显示AQP1表达、有无淋巴结转移是预后的独立危险因素（P＜0.05）。结论细胞胀亡和AQP1表达与胃癌的血管生成、生物学行为密切相关;AQP1可以作为判断胃癌预后的临床指标。     

肺腺癌组织中COX-2 mRNA的表达

目的 :研究肺腺癌组织中环氧合酶 2 (COX 2 )的表达及其与转移的关系。方法 :应用逆转录 多聚酶链反应 (RT PCR) ,对 4 5例肺腺癌 (临床分期Ⅰ期 1 4例 ,Ⅱ期 2 0例 ,Ⅲa期 8例 ,Ⅲb期 3例 ,淋巴结转移者 2 0例 ,无淋巴结转移者 2 5例 )和 1 5例癌旁组织COX 2mRNA的表达进行半定量分析。结果 :COX 2mRNA在肺腺癌组织中的表达 (1 .81 3± 0 .0 6 3)高于癌旁肺组织 (0 .6 2 4± 0 .0 4 2 ) (P <0 .0 5 ) ;有淋巴结转移组肺腺癌组织COX 2mRNA的表达为 2 .98± 0 .0 1 ,高于无淋巴结转移组 1 .0 1± 0 .96 (P <0 .0 5 ) ;COX 2mRNA表达随肺腺癌的临床分期增高而增高。结论 :COX 2可作为肺腺癌的重要生物学指标 ,有助于对肺腺癌生物学行为的了解 ,从而指导临床治疗     

大肠腺癌组织中凝血酶敏感蛋白-1和微血管密度检测

目的:探讨大肠腺癌组织中凝血酶敏感蛋白 1 (thrombospondin 1, TSP- 1)的表达及其临床意义。方法:利用免疫组织化学SP法检测 45例大肠腺癌组织中TSP- 1的表达及微血管密度 (microvesseldensity, MVD),并以15例正常大肠黏膜组织为对照。结果:正常大肠黏膜组织中未见TSP- 1阳性表达;大肠腺癌组织中TSP- 1的阳性率为 42. 2% (19 /45)。TSP- 1阳性组MVD为(14. 37±4. 86 ),低于TSP- 1阴性组的 ( 29. 80±6. 35 ) (t=2. 735,P<0. 01);TSP- 1的阳性表达率随肿瘤Dukes分期的增加而降低(χ2 =4. 62,P<0. 05),与MVD呈负相关 (r=-0. 783,P<0. 01)。结论:TSP 1的阳性表达抑制了大肠癌新生血管的形成,从而阻止其发展及转移。     

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。     

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…     

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.     

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.     

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.     

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.     

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.     

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.