VEGF-C、VEGF-D及其受体FLt-4与大肠癌淋巴转移及预后的相关性研究

目的:研究VEGF-C、VEGF-D及其受体Flt-4在大肠癌组织中的表达规律,探讨其与大肠癌浸润特点、淋巴转移等生物学特性及预后的关系。方法:采用免疫组织化学染色法检测45例大肠癌组织中VEGF-C、VEGF-D及Flt-4表达情况,评估VEGF-C、VEGF-D及Flt-4的表达与大肠癌生物学特性及预后的关系。结果:研究发现大肠癌组织VEGF-C和VEGF-D及其受体Flt-4阳性表达率显著高于正常组织(P<0.05)。并且VEGF-C/VEGF-D表达与Flt-4蛋白表达呈显著正相关(P<0.01)。VEGF-C、VEGF-D及Flt-4的表达在有无淋巴管浸润组、有无淋巴结转移组及不同Dukes分期中亦有显著性差异(P<0.05),45例大肠癌患者术后5年生存率为53.3%。其中VEGF-C、VEGF-D和Flt-4阳性患者5年生存率均分别低于阴性患者组(P<0.05)。结论:在大肠癌组织中VEGF-C和VEGF-D与其受体Flt-4的表达与大肠癌淋巴管的发生及促进肿瘤细胞经淋巴管转移可能起一定作用,VEGF-C和VEGF-D表达的检测可作为预测大肠癌淋巴结转移的辅助指标;VEGF-C和VEGF-D蛋白高表达与大肠癌患者预后相关,可能成为今后大肠癌预后评估的分子指标之一。     

VEGF-C及其受体Flt-4与乳腺癌淋巴途径转移的相关性

[目的]探讨VEGF-C/Flt-4系统在乳腺癌淋巴途径转移中的作用和意义,[方法]采用免疫组织化学方法检测61例乳腺癌癌细胞的VEGF-C和Flt-4的表达,在乳腺癌期间质淋巴管上皮及Flt-4的表达情况。[结果]乳腺癌61例,VEGF-C表达阳性率为80.32%(49/61),Flt-4表达阳性率为73.77%(45/61),并且Flt-4阳性指数随VEGF-C表达的增强而增强,r=0.531,P<0.01。VEGF-C阳性指数在转移组(74.04±12.11)明显高于未转移组(55.88±13.56),P<0.01;随着癌细胞VEGF-C表达强度的增强,Flt-4阳性脉管数也随之增多,各组间均有显著差异,P<0.01。乳腺癌中Flt-4阳性脉管数在淋巴结转移(11.37±3.80)明显高于未转移组(4.64±3.84),P<0.01。VEGF-C/Flt-4的表达与肿瘤的大小、病人的年龄以及肿瘤的雌孕激素受体的表达无关;与肿瘤细胞C-erbB-2的表达及P53蛋白的表达有关。[结论]人乳腺癌细胞VEGF-C及其受体Flt-4的表达与淋巴结转移呈正相关。Flt-4阳性淋巴管数可指示乳腺癌淋巴转移。     

VEGF-C、Flt-4蛋白和LVD、Flt-4阳性脉管数在乳腺癌组织中的表达及临床意义

目的 探讨乳腺癌组织中血管内皮生长因子-C（vascular endothelial growth factor-C，VEGF-C）、fms-样酪氨酸激酶-4（fms-like tyrosine kinase-4，Flt-4）、淋巴管密度（1ymphatic-vessel density，LVD）及Flt-4阳性脉管数（Flt-4 positive number）4指标之间的相互关系及其临床意义。方法 采用链霉卵白素过氧化物酶（streptavidin-horseradish peroxidase，SP）免疫组织化学法，检测105例乳腺癌石蜡标本中VEGF-C、Flt-4、LVD及Flt-4阳性脉管数的表达水平。结果 VEGF-C与Flt-4有密切关系（P〈0.01），且二者均与Flt-4阳性脉管数及LVD有密切关系（P＜0.01）；在淋巴结转移组中，VEGF-C和Flt-4表达水平及LVD均显著高于无淋巴结转移组（P＜0.05）；VEGF-C的阳性表达与乳腺癌血行转移危险密切相关（P＜0.01）。结论 VEGF-C、Flt-4促进淋巴管生成，且二者有显著相关性；VEGF-C、Flt-4及LVD与淋巴结转移状况密切相关，VEGF-C可能是乳腺癌患者发生血行转移的危险因素。     

血管内皮生长因子C及其受体3在胃癌组织中的表达及意义

目的探讨血管内皮生长因子C(VEGF-C)和受体(VEGFR)-3在人胃癌组织中的表达及其与微血管、微淋巴管形成、淋巴转移、预后之间的关系。方法对56例人胃癌及相应癌旁组织行VEGF-C,VEGFR-3及CD34免疫组织化学染色链霉素抗生物素蛋白-过氧化物酶(SP)法检测,进行淋巴管密度计数、微血管密度(MVD)计数。结果①VEGF-C在胃癌细胞中的表达:VEGF-C阳性表达主要位于胃癌细胞胞浆和胞膜,胃癌组织中VEGF-C的阳性表达率明显高于对照组(P<0.01)。②VEGFR-3表达:VEG-FR-3表达定位于胃癌细胞和脉管内皮细胞的胞膜或胞浆。③VEGF-C与VEGFR-3间相关性:VEGF-C阳性表达的胃癌细胞VEGFR-3也多呈阳性表达,二者有相关性(r=0.439,P<0.05)。④胃癌中VEGF-C的表达与胃癌分化程度呈负相关(P<0.05);VEGF-C表达与胃癌浸润深度和局部淋巴结转移相关。侵及肌层和肌层以上胃癌组织VEGF-C表达阳性率明显高于未侵及肌层者(P<0.05);有淋巴结转移的26例患者中VEGF-C表达阳性率高于无淋巴结转移组(P<0.05);胃癌细胞中VEGFR-3的表达与肿瘤大小、浸润深度和局部淋巴结转移相关;淋巴管数与肿瘤大小、浸润深度和局部淋巴结转移相关。⑤经Kaplan-Meier生存分析,VEGF-C是影响患者术后生存的独立性指标。结论胃癌中,VEGF-C通过自分泌方式作用于受体VEGFR-3,促进胃癌组织生长,抑制分化。VEGF-C促使胃癌内淋巴管形成,促进胃癌淋巴结转移。VEGF-C和VEGFR-3表达增高、淋巴管密度增加是促使胃癌发生淋巴结转移的重要原因。VEGF-C促进微血管的形成。VEGF-C表达有推测预后的意义。     

VEGF-C、Flt-4蛋白和LVD、Flt-4阳性脉管数在乳腺癌组织中的表达及临床意义

目的探讨乳腺癌组织中血管内皮生长因子-C (vascular endothelial growth factor -C,VEGF-C)、 fms-样酪氨酸激酶-4(fms-like tyrosine kinase-4, Flt-4)、淋巴管密度(lymphatic-vessel density,LVD)及Flt-4阳性脉管数(Flt-4 positive number) 4指标之间的相互关系及其临床意义.方法采用链霉卵白素-过氧化物酶(streptavidin-horseradish peroxidase,SP)免疫组织化学法,检测105例乳腺癌石蜡标本中VEGF-C、Flt-4、LVD 及Flt-4阳性脉管数的表达水平.结果 VEGF-C与Flt-4有密切关系(P<0.01),且二者均与Flt-4阳性脉管数及LVD有密切关系(P<0.01);在淋巴结转移组中,VEGF-C和Flt-4表达水平及LVD均显著高于无淋巴结转移组(P<0.05);VEGF-C的阳性表达与乳腺癌血行转移危险密切相关(P<0.01).结论 VEGF-C、Flt-4促进淋巴管生成,且二者有显著相关性;VEGF-C、Flt-4及LVD与淋巴结转移状况密切相关,VEGF-C可能是乳腺癌患者发生血行转移的危险因素.     

大肠癌血管内皮生长因子-C及酪氨酸激酶受体-4的表达与淋巴管生成及其转移的关系

①目的探讨血管内皮生长因子-C(VEGF-C)及酪氨酸激酶受体-4(Flt-4)在大肠癌中的表达及其对大肠癌淋巴管生成及淋巴结转移中的作用。②方法以80例大肠癌标本作为研究对象,另15例大肠黏膜作为对照,采用流式细胞术分析,分别检测VEGF-C和Flt-4的表达在不同指标及临床病理特征之间的关系。③结果大肠癌组织中VEGF-C及Flt-4的表达量高于正常黏膜,VEGF-C及Flt-4在大肠癌中的表达都与分化程度、Dukes分期及淋巴结转移有关,且二者呈正相关。④结论VEGF-C可能在大肠癌癌变过程中起一定的促进作用,VEGF-C/Flt-4调控系统与大肠癌组织的淋巴管生成及肿瘤细胞的淋巴结转移密切相关。     

胰腺癌中VEGF-D及其受体Flt-4的表达与淋巴结转移的关系

目的:探讨VEGF-D及Flt-4蛋白在胰腺癌组织中的表达与胰腺癌淋巴结转移之间的关系。方法:选用63例根治性手术切除的胰腺癌组织分为有淋巴结转移组与无淋巴结转移组,另选取13例正常胰腺组织做对照。采用免疫组织化学方法(Envision法)检测VEGF-D及Flt-4蛋白在胰腺癌的表达,并进行统计学分析。结果:VEGF-D阳性表达产物主要见于癌细胞胞浆,而Flt-4阳性表达产物主要位于癌周组织的微血管和淋巴管内皮细胞胞浆。有淋巴结转移组癌组织中VEGF-D的表达率92%(23/25)高于无淋巴结转移组44.7%(17/38)(P<0.05);有淋巴结转移组中Flt-4蛋白阳性表达率92%(23/25)显著高于无淋巴结转移组中的47.4%(18/38)(P<0.05);VEGF-D、Flt-4的表达均与淋巴结转移呈明显正相关(P<0.05)。结论:胰腺癌中VEGF-D与Flt-4表达增高,具有促进胰腺癌的淋巴管增生,促进胰腺癌淋巴道转移的作用,可作为检测胰腺癌有无淋巴结转移的重要指标,选择性阻断VEGF-C或Flt-4的作用,对控制胰腺癌的淋巴道转移可能是一个有效的方法。     

VEGF-C表达和淋巴管生成与胰腺癌淋巴道转移的关系

目的:探讨人胰腺癌组织中血管内皮生长因子C(VEGF-C)及其受体VEGFR-3的表达与淋巴管生成及淋巴道转移之间的关系.方法:用免疫组织化学技术检测了VEGF-C及VEGFR-3在胰腺癌的表达,免疫组织化学双染技术显示并计数了毛细淋巴管密度(LVD),分析比较了胰腺癌有淋巴结转移组和无淋巴结转移组VEGF-C、VEGFR-3表达和LVD.结果:VEGF-C阳性表达产物主要见于癌细胞胞浆,而VEGFR-3阳性表达产物主要位于癌周组织的淋巴管和微血管内皮细胞胞浆.有淋巴结转移组癌组织VEGF-C、癌周组织VEGFR-3的表达率和LVD高于无淋巴结转移组,VEGF-C、VEGFR-3的表达与LVD相关.结论:胰腺癌VEGF-C与VEGFR-3表达增高,具有促进胰腺癌的淋巴管增生的作用.VEGF-C、VEGFR-3和LVD都与胰腺癌淋巴道转移有关,都可以作为检测胰腺癌有无淋巴结转移的重要指标,选择性阻断VEGF-C或VEGFR-3的作用,对控制胰腺癌的淋巴道转移可能是一个有效的选择.     

人直肠癌血管内皮生长因子-C的表达及其意义

目的检测血管内皮生长因子-C(VEGF-C)在人直肠癌组织和淋巴结中的表达,探讨VEGF-C在人直肠癌发生、发展和淋巴结转移中的作用。方法选择31例手术切除并经病理切片检查确诊为直肠癌患者的癌组织及其中14例淋巴结石蜡标本,采用免疫组织化学方法检测VEGF-C在癌组织和淋巴结内的表达。结果在31例直肠癌组织的癌细胞质中,VEGF-C显色阳性17例,占54.8%;在14例淋巴结中,VEGF-C显色阳性10例,占71.4%。结论 VEGF-C在直肠癌组织和淋巴结中均有较高表达,可能在促使淋巴管内皮细胞增殖、迁移并形成新的淋巴管,导致癌细胞转移过程中起重要作用。     

VEGF-C表达与微血管和淋巴管的关系及其在胃癌转移中的作用

目的:探讨胃癌旁组织中VEGF-C的mRNA表达与血管、淋巴管密度的关系以及在胃癌转移中的作用.方法:取62例胃癌标本的癌旁组织,用RT-PCR法检测VEGF-C的mRNA表达;用免疫组织化学SP法检测CD105和VEGFR-3,计算新生微血管和淋巴管的密度.结果:淋巴结转移阳性组中VEGF-C mRNA阳性表达88%,高于阴性组的21%(P<0.05);阳性组淋巴管密度6.15±1.61也高于阴性组的3.93±1.76(P<0.05);新生微血管密度在两组间差异无显著性.VEGF-C mRNA表达阳性组淋巴管密度6.03±1.73高于阴性组的4.05±1.71(P<0.05);而新生微血管密度在两组间差异无显著性.结论:VEGF-C能提高胃癌侵袭力、促进癌旁淋巴管增生,并介导癌细胞主动进入淋巴管,向全身转移.是影响胃癌预后、危害患者生命的重要因素.     

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.     

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.     

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.