环氧合酶-2(COX-2)在食管鳞癌组织中的表达及意义

目的探讨COX-2在食管鳞癌发生、转移中的作用及其意义。方法采用免疫组化方法检测19例食管正常黏膜、轻中度(8例)、重度(7例)不典型增生食管组织及45例食管鳞癌组织中COX-2的表达。结果正常食管黏膜组织中COX-2不表达,轻中度、重度不典型增生组织及食管鳞癌组织中COX-2的阳性表达率,分别为1/8、3/7、28/45,依次增加(P<0.05)。不同分化程度和浸润深度的食管鳞癌组织中,COX-2阳性表达率差异无统计学意义(P>0.05),但有淋巴结转移组COX-2的阳性表达率(80.95%)高于无淋巴结转移组的阳性表达率(45.83%)(P<0.05)。结论COX-2表达可能是食管癌发生过程中的早期事件,与淋巴结转移密切相关,与肿瘤分化程度及浸润深度无关,COX-2可以作为判断病情和评价预后的指标。     

环氧合酶-2在食管鳞癌组织中的表达及意义

目的探讨环氧合酶-2（COX-2）在食管鳞癌发生及其转移中的作用、意义。方法采用免疫组化方法检测19例食管正常黏膜、15例不典型增生食管组织及45例食管鳞癌组织中COX-2的表达。结果正常食管黏膜组织中COX-2不表达,轻中度、重度不典型增生组织及食管鳞癌组织中COX-2的阳性表达率分别为1／8、3／7和28／45,依次增加（P〈0．05）。不同分化程度和浸润深度的食管鳞癌组织中,COX-2阳性表达率差异无统计学意义（P〉0．05）,但有淋巴结转组织COX-2的阳性表达率（80．95％）高于无淋巴结转移组的阳性表达率（45．83％）（P〈0．05）。结论COX-2表达可能是食管癌发生过程中的早期事件,与淋巴结转移密切相关,与肿瘤分化程度及浸润深度无关．COX-2可以作为判断病情和评价预后的指标。     

食管鳞癌中Ets-1 mRNA和蛋白的表达

目的检测转录因子Ets-1 mRNA和蛋白在食管不同病变组织中的表达。方法采用原位杂交和免疫组织化学SP法检测62例食管鳞癌、31例癌旁不典型增生组织及62例食管正常黏膜组织中Ets-1 mRNA和蛋白的表达情况。结果 Ets-1 mRNA和蛋白表达阳性率在正常食管黏膜、癌旁不典型增生及食管鳞癌组织中均依次升高,组间比较差别均具有统计学意义(P<0.01)。Ets-1 mRNA的阳性表达率随着食管鳞癌分级的增高而增高,但差别无统计学意义(P>0.05),而与浸润深度及淋巴结转移密切相关(P<0.05);Ets-1蛋白的表达与食管鳞癌的分级、浸润深度及淋巴结转移均密切相关(P<0.05);二者的表达与患者的性别、年龄无关(P>0.05)。Ets-1 mRNA和蛋白在食管鳞癌组织中的表达呈正相关关系(r=0.343,P<0.05)。结论 Ets-1基因表达增强可能是食管鳞癌发生的早期事件,可作为判定食管鳞癌侵袭和转移能力的一项指标。     

Netrin-1及VEGF在食管鳞癌组织中的表达水平及其相关性研究

目的检测食管鳞癌组织中神经轴突导向因子-1(Netrin-1)及血管内皮细胞生长因子(VEGF)的表达水平,探讨Ne-trin-1和VEGF的相关性。方法应用免疫组织化学SP法和原位杂交方法检测50例食管鳞癌组织及其相应的19例癌旁不典型增生组织和20例正常食管黏膜组织中VEGF、Netrin-1蛋白及mRNA的表达水平。结果 (1)食管鳞癌组织中Netrin-1、VEGF蛋白及mRNA阳性表达率均高于癌旁不典型增生组织和正常食管黏膜组织(P<0.05);(2)有淋巴结转移组食管鳞癌组织中Netrin-1、VEGF蛋白及mRNA阳性表达率均高于无淋巴结转移者(P<0.05);(3)食管鳞癌组织中VEGF和Netrin-1阳性表达率间呈正相关(r=0.941 3,P<0.01),VEGF mRNA和Netrin-1mRNA阳性表达率间呈正相关(r=0.584 7,P<0.01)。结论人食管鳞癌组织中VEGF、Netrin-1蛋白及mRNA均呈高表达;Netrin-1、VEGF的表达在食管癌的淋巴结转移过程中起一定的作用;且二者存在正相关,可能共同参与食管癌的发生、发展。     

食管鳞癌组织中Syndecan-1蛋白及mRNA表达

目的:检测食管鳞癌组织中Syndecan-1蛋白及mRNA的表达.方法:应用免疫组化SP法和原位杂交方法检测49例食管鳞癌组织及其相应的30例癌旁不典型增生组织和49例正常食管黏膜组织中Syndecan-1蛋白及其mRNA的表达.结果:①正常食管黏膜组织中Syndecan-1蛋白和mRNA均为阳性表达.食管鳞癌组织中Syndecan-1蛋白及mRNA阳性表达率均低于癌旁不典型增生组织和正常食管黏膜组织(P均＜0.05).②淋巴结转移者食管鳞癌组织与不典型增生组织中Syndecan-1蛋白和mRNA阳性表达率均低于无淋巴结转移组(P均＜0.05).③浸润至外膜的食管鳞癌组织及不典型增生组织中Syndecan-1蛋白和mRNA的阳性表达率分别低于深肌层及浅肌层(P均＜0.05).结论:人食管鳞癌组织中Syndecan-1蛋白及mRNA均呈低表达,Syndecan-1与食管鳞癌的发生发展及浸润转移有关.     

HPA蛋白的表达与食管鳞癌血管生成、浸润、转移的关系

目的 探讨HPA蛋白在食管鳞癌中的表达及其与食管鳞癌血管生成、浸润、转移的关系.方法 应用免疫组化法(Immunohistochmeistry,IHC)检测70例食管鳞癌组织和23例切缘正常组织中HPA、CD34蛋白的表达.结果 癌组织中HPA蛋白的表达(65.7%)显著高于切缘正常组织(0.0%)(P＜0.05).有淋巴结转移的食管鳞癌组织中HPA蛋白的阳性表达率90.9%(30/33)高于无淋巴结转移组43.2%(16/37)(P＜0.05);有纤维膜浸润的食管鳞癌组织中HPA蛋白的阳性表达率92.9%(39/42)高于无纤维膜浸润组25.0%(7/28)(P＜0.05).HPA蛋白阳性表达的食管鳞癌组织中的微血管密度(Mean Miciovessel Density,MVD)值(44.85±12.74)显著高于HPA蛋白阴性者的MVD值(33.05±7.32)(P＜0.05).结论 HPA蛋白阳性表达与食管鳞癌的发生、血管生成、浸润深度、淋巴结转移有关.     

食管鳞癌组织中胰岛素样生长因子-Ⅱ蛋白的表达

目的:检测食管鳞癌组织中胰岛素样生长因子Ⅱ(IGF-Ⅱ)蛋白的表达.方法:应用免疫组织化学S-P法,检测54例食管鳞癌组织,22例癌旁不典型增生组织及54例正常食管黏膜组织中IGF-Ⅱ蛋白的表达,并分析IGF-Ⅱ表达与食管鳞癌浸润、转移的关系.结果:食管鳞癌组织、癌旁不典型增生组织及正常食管黏膜组织中IGF-Ⅱ蛋白的阳性表达率分别为85.19%、63.64%和22.22%,任意2者间差异有统计学意义(P＜0.01).IGF-Ⅱ蛋白的阳性表达与食管鳞癌的浸润深度和淋巴结转移有关(P＜0.05).结论:IGF-Ⅱ蛋白在食管鳞癌组织中高表达与食管鳞癌的发生发展、浸润转移有关.     

食管鳞癌中MTA1、MMP-9和MVD的表达及其临床病理意义

目的:探讨转移相关蛋白1(metastasis-associated protein1,MTA1),基质金属蛋白酶-9(matrix metallopro-teinases-9,MMP-9)和微血管密度(microvessel density,MVD)在人食管鳞癌中的表达及其临床病理意义。方法:采用免疫组织化学SP法分别对38例食管正常组织,45例食管癌旁不典型增生组织及64例食管鳞癌组织中MTA1、MMP-9及MVD的表达进行检测。结果:MTA1、MMP-9及MVD在正常组织、不典型增生组织及癌组织之间的表达均呈现逐渐增高趋势,组间比较差异有显著性意义(P<0.01);MTA1和MMP-9与肿瘤患者的性别、年龄及肿瘤的分化程度无关(P>0.05),与肿瘤的浸润深度及淋巴结转移有关(P<0.05);MVD的表达与肿瘤患者的性别、年龄无关(P>0.05),与肿瘤的分化程度、浸润深度及淋巴结转移有关(P<0.05)。结论:MTA1、MMP-9及MVD的高表达与食管鳞癌的浸润及转移有关,联合检测3项指标对判断食管鳞癌的侵袭转移及预后有重要意义。     

食管鳞状细胞癌组织中RECK蛋白的表达与微血管密度检测

目的:检测食管鳞状细胞癌组织中RECK蛋白的表达及微血管密度(MVD).方法:应用免疫组织化学SP法检测62例食管鳞状细胞癌组织、31例癌旁不典型增生组织及62例正常食管黏膜组织中RECK蛋白的表达与MVD.结果:食管鳞状细胞癌组织、癌旁不典型增生组织及正常黏膜组织中RECK蛋白的阳性表达率依次增高,分别为59.7%(37/62)、71.0%(22/31)、85.5%(53/62),3组间比较差异有统计学意义(P＜0.05);RECK蛋白的表达与食管鳞状细胞癌的组织学分级、浸润深度及淋巴结转移密切相关(P＜0.05).MVD与食管鳞状细胞癌的浸润深度及淋巴结转移密切相关(P＜0.05).结论:RECK和MVD在食管鳞状细胞癌的黏膜上皮癌变及浸润、转移中起重要作用,2者联合检测可望成为食管鳞状细胞癌早期诊断和预后判断的分子指标之一.     

食管鳞癌组织中细胞周期素B1和D1表达的意义

目的:探讨食管鳞癌组织中细胞周期素B1和D1(Cyclin B1, Cyclin D1) mRNA和蛋白的表达及其与食管鳞癌床生物学指标的关系. 方法:应用原位杂交法、免疫组化SP法对62例食管鳞癌组织(组织学Ⅰ级15例,Ⅱ级25例,Ⅲ级22例;有淋巴结转移20例,无淋巴结转移42例;肿瘤浸润深度:浸润至黏膜层、黏膜下层或浅肌层7例,深肌层14例,纤维膜41例)、31例癌旁不典型增生组织及62例正常食管黏膜组织进行Cyclin B1,D1 mRNA和蛋白的检测,分析其阳性表达与食管鳞癌患者临床病理因素的关系. 结果:Cyclin B1,D1的mRNA和蛋白在正常食管黏膜组织中不表达或低表达,在癌旁不典型增生组织及食管鳞癌组织中高表达,三者阳性表达率比较差异有统计学意义(P<0.05);食管鳞癌患者癌组织中CyclinB1,D1的mRNA和蛋白的表达与性别、年龄无关;与组织学分级、浸润深度及有无淋巴结转移有关(P<0.05). Cyclin B1,D1 mRNA与蛋白正常食管黏膜组织、癌旁不典型增生组织及食管鳞癌组织中的表达有高度的一致性. 结论:Cyclin B1,D1 mRNA和蛋白的高表达可促进食管鳞癌的发生与发展,在癌前病变期的鳞状上皮不典型增生组织中即出现高表达,是食管鳞癌发生过程中的早期事件.     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.