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.     

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同源异型盒基因A5蛋白的表达

目的:测食管鳞状细胞癌组织中同源异型盒A5(HOXA5)蛋白的表达.法:用免疫组织化学SP法检测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HOXA5蛋白的表达,并分析其与食管鳞状细胞癌患者年龄、性别及其他临床指标的关系.结果:正常食管黏膜上皮组织、癌旁不典型增生组织和癌组织中HOXA5蛋白的阳性表达率分别为32.3%、41.9%和64.5%,3者相比,差异有统计学意义(χ2=13.361,P《0.05).随着肿瘤组织学分级的升高,HOXA5蛋白阳性表达率逐渐升高(χ2=10.493,P《0.05).HOXA5蛋白的阳性表达与食管鳞状细胞癌患者的性别、年龄、浸润深度、淋巴结转移无关(P均》0.05).结论:HOXA5的高表达可促进食管鳞状细胞癌的发生与发展,可能是食管鳞状细胞癌发生过程中的早期事件.     

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.     

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.     

食管鳞状细胞癌组织中B7-H1蛋白和mRNA的表达

目的:探讨食管鳞状细胞癌组织中B7-H1蛋白和mRNA的表达及其与肿瘤转移的关系.方法:应用免疫组织化学技术和RT-PCR技术检测54例食管鳞状细胞癌组织以及8例癌旁正常食管黏膜组织中B7-H1蛋白和mRNA的表达,分析B7-H1的表达与食管鳞状细胞癌患者临床病理特征的关系.结果:食管鳞状细胞癌组织中B7-H1蛋白和mRNA的阳性表达率分别为48.2%和31.5%,而癌旁正常食管黏膜组织中无B7-H1蛋白和mRNA的表达.B7-H1蛋白和mRNA的阳性表达率与食管鳞状细胞癌的浸润深度、淋巴结转移、远处转移及pTNM分期有关(P<0.05).结论:检测食管鳞状细胞癌组织中B7-H1的表达对判断其浸润、转移及病情进展有一定的价值.     

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.     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.