大肠癌中miRNA-20a的表达与TNM分期和淋巴结转移相关性研究

目的分析miRNA-20a在大肠癌中的表达及其与临床病理特征的关系。方法选择52例肠癌患者的手术标本(癌组织及其癌旁组织)提取总RNA,采用TaqMan探针逆转、实时定量PCR检测miRNA-20a在大肠癌及其癌旁正常组织中的表达量,并分析其与临床病理特征关系。结果肠癌组织miRNA-20a表达量为2.05(0.046～10.274),与癌旁正常组织相比显著上调(Z=-3.597,P=0.000);miRNA-20a的表达与TNM分期(T=3.223,P=0.001)相关,TNM分期越高,miRNA-20a表达越高;miRNA-20a也与淋巴结转移相关(Z=-2.141,P=0.037),淋巴结转移患者miRNA-20a表达增加。miRNA-20a表达与性别、年龄、肿瘤位置和组织分化无关。结论 miRNA-20a表达上调可能与大肠癌的发生及其转移有关。     

食管鳞状细胞癌组织中趋化因子受体-7和肾小球上皮整合膜蛋白的表达

目的:检测食管鳞状细胞癌(ESCC)组织中趋化因子受体-7(CCR7)、肾小球上皮整合膜蛋白(Podopla-nin)的表达。方法:采用免疫组化SP法检测40例ESCC组织及癌旁正常食管组织中CCR7及Podoplanin蛋白的表达,其中Podoplanin蛋白以其标记的微淋巴管密度(MLVD)值表示;分析ESCC组织中CCR7蛋白、MLVD值与临床病理特征的关系。结果:ESCC组织中CCR7蛋白阳性表达率高于癌旁正常食管组织(校正χ2=23.310,P<0.001);ESCC组织中MLVD值高于癌旁正常食管组织(Z=5.416,P<0.001);CCR7蛋白表达阳性癌组织的MLVD值高于CCR7阴性组织(t=3.478,P<0.001);CCR7蛋白、MLVD值与ESCC患者的病理分期和淋巴结转移有关(χ2=6.114,P=0.013;χ2=4.352,P=0.035;t=3.668,P<0.001;t=4.888,P<0.001)。结论:CCR7和Po-doplanin蛋白表达的上调可能促进了ESCC的侵袭与淋巴结转移。     

miR-182在三阴性乳腺癌中的表达及意义

目的探讨miR-182在三阴性乳腺癌中的表达及意义。方法 收集30例石蜡包埋的三阴性乳腺癌患者的癌组织和癌旁组织标本,并收集患者的基本资料。RT-PCR测定miR-182的相对表达,分析miR-182在TNBC中的表达与肿瘤的大小、分级、淋巴结转移、远处转移、TNM分期、无疾病生存率、总生存率等的相关性。结果RT-PCR结果提示,癌组织中miR-182表达为癌旁组织的8.6倍,差异有统计学意义(P＜0.001)。miR-182在淋巴结阳性及TNM分期Ⅲ期中表达高于淋巴结阴性(Z=-3.454,P=0.001)及TNM(Ⅰ+Ⅱ)期者(Z=-3.946,P=0.000),差异有统计学意义;COX回归多因素分析显示,miR-182高表达(HR=0.107,95％CI:0.018～0.643,P=0.015)、淋巴结阳性(HR=0.189,95％CI:0.020～1.757,P=0.016)、脉管瘤栓(HR=0.190,95％CI:0.020～1.826,P=0.008)、Ki67≥14％(HR=0.182,95％CI:0.041～0.801,P=0.024)、TNM分期(Ⅲ期)(HR=0.501,95％CI:0.044～5.741,P=0.001)是独立的预后因子。结论 miR-182在三阴性乳腺癌中表达上调,与淋巴结转移及临床分期相关,miR-182高表达是三阴性乳腺癌独立的预后因素之一,与预后差相关。     

XRCC1和ERCC1在食管鳞状细胞癌中的表达与放疗疗效及预后的相关性研究

目的 探讨X线修复交叉互补基因1(XRCC1)、切除修复交叉互补基因1(ERCC1)在食管鳞状细胞癌(ESCC)患者癌组织中的表达与放射治疗疗效及预后的相关性.方法 采用免疫组织化学SP法检测治疗前59例ESCC组织和23例癌旁组织标本中XRCC1、ERCC1蛋白的表达,结合临床病理特征和随访资料进行分析.结果 XRCC1、ERCC1主要表达于细胞核,两者表达无明显相关性.XRCC1蛋白在ESCC组织和癌旁组织中的阳性表达率分别为52.5%和13.0%(P=0.001).ERCC1蛋白在ESCC组织和癌旁组织中的阳性表达率分别为33.9%和65.2%(P=0.010).XRCC1蛋白在汉族组和少数民族组阳性表达率分别为72.2%和43.9%(P=0.045).ERCC1蛋白在无淋巴结转移组和有淋巴结转移组阳性表达率分别为48.3%和20.0%(P=0.022).XRCC1阴性表达组的近期放疗有效率为92.9%,较阳性表达组的80.6%略有升高(P=0.323).ERCC1阳性表达组和阴性表达组患者的中位生存期分别为13.2个月(95%CI:10.1～16.3)、21.4个月(95%CI:19.1～23.7)(P=0.001).多因素分析显示,ERCC1表达、病变长度与患者的生存期密切相关,是独立的预后因素(P=0.001、0.037).结论 XRCC1、ERCC1蛋白的表达情况可能在食管癌的发生中起一定作用.ERCC1表达与食管癌的淋巴结转移及放疗预后密切相关,其阳性表达是预后不良的标志.     

斑菲素蛋白2在食管鳞状细胞癌组织中的表达及临床意义

目的:观察斑菲素蛋白2(PKP2)在食管鳞状细胞癌(ESCC)组织中的表达情况,分析其临床意义。方法:选择115例ESCC组织标本、20例癌旁正常食管组织标本为研究对象。检测所有标本PKP2表达情况。比较ESCC组织标本与正常癌旁组织标本PKP2阳性表达检出率。分析PKP2表达与临床病理参数间的关系。比较不同PKP2表达患者生存情况。比较ESCC组织与正常癌旁组织PKP2 mRNA相对表达量。采用受试者工作特征(ROC)曲线分析PKP2的预测价值。结果:115例ESCC组织中,检出PKP2高表达54例,检出率为46.96%,较20例癌旁正常组织显著增高(P<0.05)。与阴性表达组比,阳性表达组患者TNM高分期占比高,淋巴结转移率高(均P<0.05)。生存分析发现,PKP2阳性表达患者生存时间较阴性表达组短(P<0.05)。ROC曲线分析发现,PKP2阳性表达用于预测淋巴结转移、TNM分期的曲线下面积(AUC)为0.785和0.763,有一定预测价值。结论:PKP2在ESCC组织中普遍呈高表达,对预测患者生存情况、TNM分期及淋巴结转移有一定应用价值。     

结直肠癌中PD-L1的表达及其与临床病理特征的关系

目的 观察结直肠癌中程序性细胞死亡配体(PD-L1)的表达并分析其与临床病理特征的关系。方法 收集潍坊市中医院2018年1月～2022年3月期间根治性手术治疗的结直肠癌患者193例,采用免疫组化方法检测PD-L1在癌组织及癌旁组织的表达。结果 结直肠癌组织中PD-L1蛋白阳性表达率为27.98%(54/193),明显高于癌旁组织3.11%(6/193);结直肠癌组织中PD-L1表达与病理分型(P=0.002)、TNM分期(P<0.001)、肿瘤大小(P=0.022)和淋巴结转移(P<0.001)具有相关性,差异具有统计学意义;与年龄(P=0.124)、性别(P=0.949)、部位(P=0.119)无关,差异无统计学意义;在淋巴结转移灶中PD-L1的表达与转移癌分化程度具有相关性(P=0.031),与转移灶的大小无关(P=0.672)。结论 PD-L1在结直肠癌中表达率较癌旁组织有所升高,但与其他肿瘤相比表达率低,其表达与患者的临床病理特征密切相关。PD-L1在淋巴结转移癌中的表达率下降。PD-L1的表达对结直肠癌诊断和治疗有重要临床价值。     

5-脂氧合酶激活蛋白在食管鳞状细胞癌组织中的表达及临床意义

目的:探讨5-脂氧合酶激活蛋白(FLAP)在食管鳞状细胞癌(ESCC)组织中的表达及临床意义。方法:收集经胃镜、手术病理结果等检查确诊为ESCC的297例患者的癌组织标本,并选取其中66例患者的癌旁相对正常的食管组织标本,使用免疫组织化学法检测FLAP表达情况。比较ESCC患者癌旁组织和癌组织FLAP阳性率,以及不同临床病理特征ESCC患者FLAP阳性率。分析FLAP阳性表达与ESCC患者不同临床病理特征的相关性。结果:ESCC组织标本FLAP阳性率高于癌旁组织标本(P<0.05)。肿瘤细胞转移扩散患者的FLAP阳性率高于肿瘤细胞未转移扩散患者,TNMⅢ期患者的FLAP阳性率高于Ⅰ-Ⅱ期患者,低分化患者的FLAP阳性率低于中、高分化患者(均P<0.05)。中、高分化患者间以及Ⅰ、Ⅱ期患者间的FLAP阳性率比较,差异无统计学意义(均P>0.05)。Kendall相关性检验结果显示,ESCC患者肿瘤细胞转移扩散、TNM分期与FLAP阳性表达呈正相关,分化程度与FLAP阳性表达呈负相关(均P<0.05)。结论:与癌旁组织相比,FLAP在ESCC组织中的表达显著增强,且...     

RhoA-Rho激酶通路在鼻咽癌细胞的表达

目的观察鼻咽癌患者癌组织中RhoA蛋白-Rho激酶蛋白表达情况。方法收集增城市人民医院2009年2月—2014年6月耳鼻喉科住院治疗,进行活检的鼻咽癌患者切除标本共62例,包括癌组织及癌旁组织。通过SABC免疫组织化学法检测患者癌组织及癌旁组织中RhoA蛋白-Rho激酶蛋白表达情况。结果鼻咽癌组织RhoA蛋白阳性表达率及Rho激酶蛋白阳性率高于癌旁组织(P=0.00);鼻咽癌癌组织RhoA及Rho激酶表达在年龄及性别分布上无差异,而TNM分期中Ⅲ期+Ⅳ期RhoA及Rho激酶表达阳性率高于Ⅰ期+Ⅱ期患者,同时存在淋巴结转移患者其RhoA及Rho激酶表达阳性率高于未转移患者。结论鼻咽癌患者癌组织中RhoA蛋白及Rho激酶表达阳性率高,TNM分期越高及存在淋巴结转移者其RhoA蛋白及Rho激酶表达阳性率越高。RhoA-Rho激酶信号通路参与了鼻咽癌发生发展的过程。     

食管鳞状细胞癌组织中Livin与半胱氨酸蛋白酶-3的表达

目的：检测食管鳞状细胞癌（ESCC）组织中Livin与半胱氨酸蛋白酶-3（Caspase-3）蛋白的表达。方法：采用免疫组化SP法检测53例ESCC及53例癌旁正常食管组织中Livin及Caspase-3蛋白的表达。结果：ESCC组织中Livin蛋白的阳性表达率（52.8%）高于癌旁正常食管组织（7.5%,χ2=20.346,P〈0.001）,其阳性表达率与ESCC浸润深度及淋巴结转移有关（P均〈0.05）。ESCC组织中Caspase-3的阳性表达率（39.6%）低于癌旁正常食管组织（83.0%,χ2=16.690,P〈0.001）,其阳性表达率与ESCC组织分化程度、浸润深度及淋巴结转移有关（P均〈0.05）。ESCC组织中Livin与Caspase-3蛋白的表达负关联（rP=-0.302,P=0.021）。结论：Livin和Caspase-3蛋白参与了ESCC的发生与发展;Livin蛋白可能通过抑制Caspase-3蛋白的活性发挥作用。     

食管癌组织MTA1蛋白表达与患者临床病理特征及3年生存率的关系

目的 探讨食管癌组织中肿瘤转移相关蛋白1(MTA1)的表达与临床病理特征、3年生存卒的关系.方法 选取2010年1月至2012年12月该院病理科收集的96例食管癌患者术后病理标本、符合纳入标准的癌旁组织标本40例采用免疫组织化学染色,分析MTA1蛋白表达与患者临床病理特征及远期生存率的关系.结果 食管癌组织中MTA1蛋白阳性表达率(73.96％)显著高于癌旁组织的2.50％(P＜0.05);食管癌组织中MTA1蛋白阳性表达主要与患者的TNM分期、淋巴结转移具有显著的相关性(P＜o.05);食管癌组织中MTA1蛋白阳性表达患者的3年生存率(33.80％)显著低于阴性患者(60.00％)(P＜0.05);食管癌患者的远期生存率与TNM分期、MTA1蛋白表达具有显著的关系(OR=1.638、1.433,P＜0.05).结论 食管癌组织中MTA1蛋白高表达,并且与患者的TNM分期、淋巴结转移有关,MTA1蛋白高表达是食管癌患者预后的独立危险因素.     

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.