食管鳞状细胞癌组织中核干细胞因子蛋白的表达

目的:检测食管鳞状细胞癌组织中核干细胞因子(NS)蛋白的表达.方法:应用免疫组化SABC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NS蛋白的表达,并分析其与食管鳞状细胞癌患者病理分级、淋巴结转移等临床指标的关系.结果:食管鳞状细胞癌组织、癌旁不典型增生组织和正常食管黏膜组织中NS蛋白的阳性表达率分别为69.4%,41.9%和17.7%,3组间比较差异有统计学意义(x2=33.676,P＜0.01).NS蛋白阳性表达率与食管鳞状细胞癌的组织学分级、浸润深度及淋巴结转移有关(P均＜0.05),与年龄、性别无关(P＞0.05).结论:NS在食管癌的发生发展和增殖过程中起重要作用,NS蛋白检测可望成为食管鳞状细胞癌早期诊断的重要指标之一.     

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.     

食管鳞状细胞癌组织中EGF蛋白和mRNA的表达

目的:观察食管鳞状细胞癌组织中EGF的表达情况及其与食管鳞状细胞癌浸润、转移及发生发展的关系.方法:采用免疫组化SP法和原位杂交法分别检测62例正常食管黏膜组织、31例癌旁不典型增生组织及62例食管鳞状细胞癌组织中EGF蛋白和mRNA的表达.结果:正常食管黏膜组织、癌旁不典型增生组织及癌组织中EGF蛋白的阳性表达率依次增高,分别为27.4%、45.2%、69.4%,3组间比较差异有统计学意义(x2=21.954,P＜0.01);正常食管黏膜组织、癌旁不典型增生组织及癌组织中EGF mRNA的阳性表达率依次升高,分别为40.3%,48.3%,77.4%,3组间比较差异有统计学意义(x2=18.494,P＜0.05);食管鳞状细胞癌组织中EGF蛋白和mRNA的表达与癌组织的分化程度、浸润深度及有无淋巴结转移有关(P均＜0.05).结论:EGF过表达与食管鳞状细胞癌的浸润、转移及发生发展有关.EGF有望成为食管鳞状细胞癌早期诊断和判断预后的辅助指标.     

良恶性病变食管组织及其邻近组织中HOXA5 蛋白 和mRNA的表达

 【目的】 探讨食管鳞癌组织中同源异型盒基因(HOX)HOXA5蛋白和mRNA的表达情况,分析HOXA5表达与食管癌患者年龄?性别及其他临床病理学特征的关系。【方法】 选择31例择期手术的食管癌患者,手术切除的标本均在离体30 min内分别于癌灶、癌旁3 cm以内及手术残端食管黏膜组织3处取材;对各部分标本作HE染色进行病理学诊断及分型,用免疫组织化学染色方法检测HOXA5蛋白的表达,用荧光定量PCR法检测HOXA5 mRNA的表达。 【结果】 ①HE病理组织学检测证实31例癌组织标本均为鳞癌,癌旁3 cm以内的标本呈中-重度不典型增生,手术残端食管黏膜组织均为正常鳞状上皮。②在正常食管黏膜组织、癌旁不典型增生组织及食管鳞癌组织中HOXA5蛋白阳性表达率分别为32.3%、58.1%和64.5%(P < 0.05);HOXA5 mRNA的含量分别为0.97 ± 0.46?1.76 ± 1.03和2.37 ± 2.11(P < 0.05);HOXA5蛋白和mRNA均表现为癌组织及癌旁不典型增生组织的表达率/表达量明显高于正常食管黏膜组织。③HOXA5蛋白阳性表达率(P < 0.05)、HOXA5 mRNA的含量(P < 0.05)均与食管鳞癌组织的病理学分级有关,其在病理学Ⅲ级中的表达率明显高于病理学Ⅰ+Ⅱ级的;不支持HOXA5蛋白和mRNA的表达与患者的年龄、性别、浸润深度及有无淋巴结转移有关(均P > 0.05)。④HOXA5 蛋白表达与其mRNA的表达一致性程度良好(Kappa = 0.718, P < 0.05)。【结论】 HOXA5 蛋白和mRNA的表达在癌旁不典型增生组织、食管鳞癌组织中明显升高,它可能是食管鳞癌发生过程中的早期事件。     

食管鳞状细胞癌组织中MUC4和CerbB-2蛋白的表达

目的:探讨MUC4及CerbB-2的表达与食管鳞状细胞癌发生、发展及浸润转移的关系.方法:应用免疫组织化学SP法检测60例食管鳞状细胞癌组织、30例癌旁不典型增生组织和60例正常食管黏膜组织中MUC4及CerbB-2蛋白的表达.结果:食管鳞状细胞癌组织、癌旁不典型增生组织和正常食管黏膜组织中MUC4的阳性表达率分别为81.7%、56.7%和5.0%,CerbB-2的阳性表达率分别为73.3%、80.0%、36.7%,3组间MUC4与CerbB-2阳性表达率相比,差异均有统计学意义(P＜0.05).MUC4及CerbB-2的蛋白表达均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).结论:MUC4及CerbB-2在食管癌的浸润、转移及黏膜上皮癌变过程中起重要作用,2者联合检测可望成为食管鳞状细胞癌早期诊断和判断预后的分子指标之一.     

食管鳞状细胞癌组织中上皮型和神经型钙黏附蛋白的表达

目的:检测食管鳞状细胞癌组织中上皮型钙黏附蛋白(E-cadherin)和神经型钙黏附蛋白(N-cadherin)的表达.方法:采用免疫组织化学PV法检测62例食管鳞状细胞癌组织(男36例,女26例;≥60岁33例,<60岁29例;组织学分级:Ⅰ级15例,Ⅱ级25例,Ⅲ级22例;浸润深度:浅层7例,深层55例;有淋巴结转移20例,无淋巴结转移42例)、31例癌旁不典型增生组织及62例正常食管黏膜组织中E-cadherin、N-cadherin蛋白的表达情况.结果:正常食管黏膜、癌旁不典型增生及食管鳞状细胞癌组织中E-cadhefin的阳性表达率依次降低,分别为95.2%(59/62)、71.0%(22/31)、40.3%(25/62);N-cadherin的阳性表达率依次升高,分别为29.0%(18/62)、61.3%(19/31)、75.8%(47/62),差异均有统计学意义(P均<0.05);食管鳞状细胞癌组织中E-cadhefin和N-cadherin的表达与组织学分级、浸润深度、淋巴结转移有关(P均<0.05).且2者的表达成负相关(r=-0.534,P<0.05).结论:E-cadherin的低表达和N-cadhefin的高表达与食管鳞状细胞癌的浸润及转移密切相关.     

食管鳞状细胞癌组织中Ca125、Ca15-3、Ca19-9和Ca72-4的表达

目的:检测食管鳞状细胞癌组织中Ca125、Ca15-3、Ca19-9和Ca72-4蛋白的表达.方法:采用组织芯片技术及免疫组织化学方法检测59例食管鳞状细胞癌及相应癌旁黏膜组织中Ca125、Ca15-3、Ca19-9和Ca72-4蛋白的表达情况.结果:食管鳞状细胞癌组织中Ca125、Ca15-3的阳性表达率分别为20.7%和44.8%,高于癌旁黏膜组织(2.2%和12.8%.P均<0.05);食管鳞状细胞癌组织中Ca72-4的阳性表达率为22.0%,低于癌旁黏膜组织(61.4%.P<0.05).不同性别的食管癌患者癌组织中Ca15-3和Ca72-4的阳性表达率差异均有统计学意义(P<0.05).结论:食管鳞状细胞癌的发生可能与Ca125、Ca15-3表达上调及Ca72-4表达下调有关;Ca15-3蛋白和Ca724蛋白的表达与性别有关.     

食管鳞状细胞癌组织中CXCR4蛋白及mRNA的表达

目的:探讨CXCR4蛋白与mRNA在食管鳞状细胞癌组织中的表达及意义.方法:采用原位杂交技术及免疫组织化学方法检测62例食管鳞癌、31例癌旁不典型增生及62例正常食管黏膜组织中蛋白及mRNA的表达,并分析其与临床病理学参数的关系.结果:正常黏膜、癌旁不典型增生及食管鳞癌组织中CXCR4蛋白的阳性表达率依次增高,分别为0(0/31)、29.0%(9/31)、69.4%(43/62),组间两两比较差异有统计学意义(P<0.05);CXCR4蛋白表达与癌的组织学分级、浸润深度、淋巴结转移及TNM分期有关(P<0.05).正常黏膜、癌旁不典型增生及食管鳞癌组织中CXCR4mRNA的阳性表达率依次增高,分别为0(0/31)、12.9%(4/31)、62.9%(39/62),组间两两比较差异有统计学意义(P<0.05);CXCR4 mRNA表达与癌的组织学分级、浸润深度及TNM分期有关(P<0.05).结论:CXCR4蛋白及mRNA阳性表达率升高可能与食管鳞癌的发生、发展及浸润、转移有关.     

食管鳞状细胞癌组织中Pin1和mTOR蛋白的表达

目的:了解食管鳞状细胞癌组织中肽基脯氨酰顺反异构酶(Pin1)与哺乳动物雷帕霉素靶蛋白(mTOR)的表达情况。方法:采用免疫组化SP法检测食管鳞状细胞癌组织和癌旁正常食管黏膜组织中Pin1和mTOR的表达,分析食管鳞状细胞癌组织中二者的表达与临床病理特征的关系以及二者的关联性。结果:食管鳞状细胞癌组织中Pin1蛋白、mTOR蛋白的阳性表达率(60.0%、62.5%)均高于癌旁正常食管黏膜组织(32.5%、27.5%),差异有统计学意义(χ2Pin1=4.762,P=0.027;χ2mTOR=6.036,P=0.014)。Pin1蛋白阳性表达与淋巴结转移有关(P<0.05),与分化程度、年龄、性别及TNM分期等病理学参数无关;mTOR与其他病理参数无关。食管鳞状细胞癌组织中Pin1与mTOR的蛋白表达呈正关联(rP=0.389,P=0.008)。结论:Pin1和mTOR在食管鳞状细胞癌中的表达明显增高,Pin1可能与mTOR相互作用调节细胞周期,从而在食管鳞状细胞癌的发生过程中起着重要作用。     

食管鳞状细胞癌组织中MTA1和E-cadherin蛋白的表达

目的:探讨MTA1和E-cadherin蛋白的表达与食管鳞状细胞癌浸润转移关系.方法:采用免疫组织化学SP法分别检测49例食管鳞状细胞癌组织及49例正常食管黏膜组织中MTA1和E-cadherin蛋白的表达.结果:食管鳞状细胞癌组织中MTA1蛋白阳性表达率(71.4%)高于正常食管黏膜组织(22.4%,P＜0.05),而E-cadherin蛋白阳性表达率(34.7%)低于正常黏膜组织(65.3%,P＜0.05).MTA1和E-cadherin蛋白的表达均与食管鳞状细胞癌的浸润、转移密切相关(P＜0.05).结论:MTA1和E-cadherin蛋白表达与食管鳞状细胞癌的发展密切相关,2者联合检测可望成为判断食管鳞状细胞癌患者预后的重要指标.     

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.