人类错配修复基因hMSH2及p27在结直肠癌及癌旁组织中的表达及意义

目的探讨人类错配修复基因hMSH2和p27在结直肠癌及癌旁组织中的表达及其意义。方法以免疫组化方法检测54例结直肠癌组织中hMSH2和p27蛋白的表达。结果结直肠癌组织中hMSH2蛋白的阳性表达率为70．4％,显著高于癌旁组织的38．9％（P〈0．05）;p27蛋白的阳性表达率为40．7％,显著低于癌旁组织的75．9％（P〈0．01）。结直肠癌癌组织中hMSH2蛋白的表达与肿瘤临床病理特征无相关性;p27蛋白的表达与肿瘤分化程度、淋巴结转移和TNM分期相关。hMSH2和p27蛋白在结直肠癌组织申的表达呈负相关。结论hMSH2表达异常和抑癌基因p27表达下调可能与结直肠癌的发生有关。     

原发性胃癌张力蛋白同源丢失性基因蛋白的检测及临床意义

目的 研究抑癌基因PTEN在原发性胃癌不同部位的表达及意义。方法 收集55例原发性胃癌及相应癌周、远癌组织，制备冷冻切片，免疫组化sp法检测PTEN蛋白的表达。结果 胃癌组织中PTEN蛋白的表达显著低于癌周、远癌组织，与患者性别、年龄、肿瘤大小、Correa及Borrmann分型无关，与淋巴结转移有关，和胃癌组织分化程度呈正相关（rs=0．362），和浸润深度（rs=-0．343）、临床TNM分期（rs=-0．375）呈负相关。结论 PTEN蛋白的表达下调与胃癌的发生、发展有关。     

PTEN 和hMSH2蛋白的表达在胃癌发生中的作用

[目的]通过探讨胃癌组织PTEN 和hMSH2蛋白的表达的相互关系,分析二者表达在胃癌发生中的意义.[方法]用链霉素-生物素蛋白-过氧化酶法（SP法）检测63例胃癌组织及32例非癌胃黏膜组织中PTEN 和hMSH2蛋白的表达情况.[结果]PTEN蛋白在胃癌组织中的阳性表达率（61.9%）（39/63）显著低于非癌胃黏膜组织（90.6%）（29/32）（P＜0.05）,在高中分化腺癌中的阳性表达率（57.9%）（11/19）低于低分化腺癌（72.4%）（21/29）和黏液癌（60%）（9/15）,但无显著性差异（P＞0.05）;hMSH2蛋白在胃癌组织中的阳性表达率（79.4%）（50/63）显著高于非癌胃黏膜组织（53.1%）（17/32）（P＜0.05）,但在高中分化腺癌（73.7%）（14/19）、低分化腺癌（82.8%）（24/29）和黏液癌（80%）（12/15）中的阳性表达率无显著性差异（P＞0.05）.PTEN和hMSH2蛋白在胃癌组织中的表达无明显相关关系（r＝-0.158,P＞0.05）.[结论]胃癌发生时可出现PTEN蛋白表达下调,伴hMSH2蛋白的表达上调.     

DNA错配修复基因hMSH2蛋白表达与胃癌发生关系的探讨

[目的]探讨DNA错配修复基因hMSH2蛋白表达与胃癌发生以及不同病理类型之间的关系.[方法]应用免疫组化技术检测hMSH2基因在38例胃癌患者的癌组织及其癌旁组织的蛋白表达.[结果]癌细胞阳性表达率(52.63%)明显高于癌旁上皮细胞(23.68%)(P＜0.05);同例中癌细胞和癌旁上皮细胞均表达的为15.79%,同例癌细胞表达而癌旁上皮细胞不表达的例数(14/38)明显多于癌旁上皮细胞表达而癌细胞不表达的例数(3/38)(P＜0.05);高中分化腺癌、低分化腺癌和粘液癌表达阳性率分别为33.33%、52.63%、和70%.[结论]DNA错配修复基因hMSH2蛋白表达与胃癌发生密切相关.     

散发性大肠癌中hMLH_1、hMSH_2和Rb的表达及意义

目的:探讨人类mut-s同系物1(hMLH1)、人类mut-s同系物2(hMSH2)和视网膜母细胞瘤基因蛋白(Rb)在散发性大肠癌中的表达及其与大肠癌临床病理特征的关系。方法:采用免疫组化Max-Vision二步法对63例大肠癌标本中癌组织、距癌灶3cm以外的癌旁组织、距癌灶10cm以外的正常组织中hMLH1、hMSH2和Rb进行检测。结果:HMLH1在癌组织中表达的阳性率明显低于正常组织,在不同年龄组和有无淋巴结转移大肠癌中的表达有显著性差异;hMSH2在癌组织中表达的阳性率明显低于正常组织,并在不同年龄组和不同浸润范围大肠癌中表达有显著性差异;Rb在癌组织中表达的阳性率明显高于癌旁和正常组织,在不同分化程度大肠癌中的表达有显著性差异。结论:HMLH1、hMSH2和Rb可以作为临床判断大肠癌生物学行为有用的指标。     

hMSH2蛋白和P53蛋白表达在胃癌发病中的意义

[目的]探讨DNA错配修复基因hMSH2蛋白、抑癌基因P53蛋白表达在胃癌发病中的意义。[方法]采用免疫组织化学技术（S—P法）检测63例胃癌组织及32例胃炎组织hMSH2、P53的表达。[结果]胃癌组hMSH2蛋白阳性表达率（79．37％）明显高于胃炎组（53．13％）（P〈0．05）；胃癌组P53蛋白阳性表达率（88．89％）明显高于胃炎组（21．88％）（P〈0．05）。hMSH2蛋白在高中分化腺癌、低分化腺癌及黏液癌的阳性表达率分别为73．68％、82．76％和80．00％，P53蛋白阳性表达率分别为100．00％、89．66％和73．33％，两者阳性表达率与胃癌分化程度均无显著性差异（P〉0．05）。hMSH2蛋白和P53蛋白表达呈正相关。[结论]DNA错配修复基因hMSH2蛋白及抑癌基因P53蛋白的异常表达可能参与胃癌发生机制。     

PTEN与P-AKT在胃癌中的表达及意义

目的：检测人第10号染色体缺失的磷酸酶及张力蛋白同源基因（PTEN）与磷酸化丝氨酸／苏氨酸蛋白激酶B（P．AKT）在胃癌和癌旁组织中的表达,探讨它们在胃癌发生、发展中的作用。方法：应用免疫组织化学EliVision法,检测68例胃癌及其癌旁组织中PTEN和P—AKT蛋白表达水平,同时对68例胃癌和癌旁组织采用反转录一聚合酶链反应检测其中PTENmRNA的表达。结果：PTEN蛋白在胃癌组织中表达低于癌旁组织（P〈0．01）,P—AKT蛋白在胃癌组织中表达高于癌旁组织（P〈0．01）,两者呈负相关关系（P〈0．05）。胃癌组织中PTEN蛋白的表达在性别和年龄间差异均无统计学意义（P〉0．05）,但在分化程度、肿瘤大小、临床分期和淋巴结转移表达差异均有统计意义（P〈0．01）。胃癌组织中P—AKT蛋白表达在性别、年龄和肿瘤大小间差异均无统计学意义（P〉0．05）,但在分化程度、临床分期和淋巴结转移间表达差异均有统计学意义（P〈0．05）。胃癌组织PTENmRNA的半定量表达明显低于癌旁组织PTENmRNA的半定量表达（P〈0．01）。结论：PTEN基因在胃癌组织中低表达,癌旁组织蛋白表达也明显高于胃癌组织,P—AKT蛋白在胃癌组织中的表达高于癌旁组织,两者在胃癌中的表达呈负相关。     

HSP27和P53蛋白在胃癌组织中的表达及临床意义

目的：分析热休克蛋白27（ HSP27）及P53蛋白在胃癌组织及癌旁组织中的表达及其与临床病理参数之间的关系,探讨其作为预后指标的意义。方法建立组织芯片,通过免疫组化SP法检测75例无术前放化疗史的胃癌手术标本和52例癌旁组织中HSP27及P53蛋白的表达情况,并对随访患者进行生存分析。结果 HSP27阳性表达率在胃癌组织中为64．0％,在癌旁组织中为30．8％,2组差异有统计学意义（ P＜0．01）;HSP27表达与肿瘤TNM分期、分化程度、肿瘤大小和淋巴结转移有关（ P＜0．05）。 P53蛋白阳性表达率在胃癌组织中为68．0％,在癌旁组织中为7．7％,2组差异有统计学意义（P＜0．01）;P53蛋白表达与肿瘤TNM分期和分化程度有关（P＜0．05）。 Pearson相关分析显示,在胃癌中,HSP27与P53表达呈正相关（r＝0．319,P＜0．01）。 Kaplan -Meier生存分析结果显示,HSP27高表达与胃癌预后不良有关（χ2＝13．109,P＝0．000）。经Cox比例风险回归模型分析显示,肿瘤的分期、大小、有无淋巴结转移以及HSP27的表达与患者预后有关（ P＜0．05）。结论 HSP27高表达与胃癌有关,提示HSP27可能在胃癌的发生、发展中起重要作用。 HSP27与P53表达呈正相关,提示两者在肿瘤的发生、发展中可能具有协同作用。     

CD147和PTEN在非小细胞肺癌中的表达及与临床病理因素的相关性分析

目的：分析细胞外基质金属蛋白酶诱导因子（CD147）和第10号染色体同源缺失性磷酸酶‐张力蛋白（PTEN）在非小细胞肺癌（NSCLC ）中的表达,并探讨两者的相关性及其蛋白表达水平与多个临床病理因素的关系。方法采用免疫组织化学链霉素标记生物素过氧化物酶法（SP法）检测64例NSCLC患者组织中CD147和PTEN的表达情况,另选取10例患者的癌旁正常肺组织作为对照,并分析CD147和PT EN表达与临床病理参数的关系。结果 CD147在NSCLC组织中的表达率（75．00％）明显高于癌旁正常肺组织（0．00％）,差异有统计学意义（ P＜0．05）。CD147蛋白表达与肺癌组织分化程度、有无淋巴结转移及TNM分期相关（P＜0．05）。PTEN在肺癌组织中的表达率（32．81％）明显低于癌旁正常肺组织（80．00％）,差异有统计学意义（P＜0．05）。PTEN表达与TNM分期相关（P＜0．05）。Spearman相关分析结果显示NSCLC组织中CD147和 PTEN表达呈明显负相关（r＝－0．442,P＜0．05）。结论 CD147和PTEN异常表达在NSCLC的发生、发展过程中起着重要作用。     

肝细胞癌及癌旁肝组织中PTEN表达与MAPK磷酸化的相关性

目的：研究肝细胞癌（HCC）及癌旁肝组织中PTEN表达与丝裂素激活的蛋白激酶（mitogen-activated protein kinase,MAPK)磷酸化的相关性。方法：利用SP免疫组织化学检测75例HCC及其癌旁肝组织中PTEN蛋白和p42/44^MAPK的表达。结果：①HCC中PTEN蛋白的阳性率（62．7％）和阳性强度明显低于癌旁肝组织（89．3％）（P＜0．01），且阳性信号强度与HCC分化程度相关（P＜0．01），即HCC分化愈差，PTEN蛋白表达愈弱。②HCC中p42/44^MAPK的阳性率（85．3％）和表达强度明显高于癌旁肝组织（34．7％）（P＜0．01），但阳性信号强度与癌细胞分化程度无关（P＞0．05）。③相关性分析表明，HCC及癌旁肝组织中PTEN蛋白表达强度和MAPK磷酸化程度呈明显负相关（P＜0．01）。结论：提示在HCC发生中，可能是由于PTEN蛋白表达降低或缺失，不能有效抑制由致癌因子异常激活的Ras/Raf/MAPK信号转导通路，从而使肝细胞异常增殖和发生恶性转化。     

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.     

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.     

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.