Twist在子宫内膜腺癌的表达及其与临床生物学行为的关系

目的研究Twist蛋白在非典型增生子宫内膜和子宫内膜腺癌中的表达及其意义。方法选取13例正常内膜组织、25例非典型增生内膜、54例子宫内膜腺癌,运用免疫组织化学方法检测Twist蛋白在各组织中表达情况,并分析其与子宫内膜腺癌的临床生物学行为的相关性。结果正常子宫内膜、非典型增生内膜和子宫内膜腺癌中Twist蛋白阳性表达率分别为15.4%(2/13)、48.0%(12/25)、和74.1%(40/54),三组之间的阳性率差异均有显著统计学意义(P<0.01);在子宫内膜腺癌组中,Twist蛋白在Ⅲ级肿瘤中的阳性率明显高于Ⅰ、Ⅱ级肿瘤,肌层浸润深者阳性率高于肌层浸润浅者,ⅢA期阳性率高于Ⅰ～Ⅱ期,其差异均有统计学意义(P<0.05);而不同年龄的患者间比较,Twist蛋白阳性率差异无统计学意义(P>0.05)。结论 Twist蛋白的过表达与子宫内膜非典型增生和腺癌的发生发展有关,可作为子宫内膜腺癌诊断、鉴别诊断及预后的参考指标之一。     

雌激素受体、孕激素受体、p53及Ki-67在子宫内膜癌组织中的表达及其与临床病理特征的关系

目的：观察雌激素受体(ER)、孕激素受体(PR)、p53及Ki-67在子宫内膜癌组织中的表达,并探讨其与临床病理特征的关系。方法选取2015年2月至2016年2月我院妇科收治的子宫内膜癌患者156例为观察组,选取同期正常子宫内膜组织70例为对照组,应用免疫组化分析法检测两组患者组织中ER、PR、p53及Ki-67的表达情况,并分析ER、PR、p53及Ki-67的表达与临床病理的关系。结果观察组患者的ER和PR表达阳性率分别为44.9%和41.0%,明显低于对照组的91.4%和94.3%,p53和Ki-67表达阳性率分别为86.5%和68.6%,明显高于对照组的0和0,差异均具有统计学意义(P<0.05);Ⅲ~Ⅳ期患者的ER和PR表达阳性率分别为11.1%和18.5%,明显低于Ⅰ期和Ⅱ期患者,p53和Ki-67表达阳性率分别为100.0%和98.1%,明显高于I期和II期患者,差异均具有统计学意义(P<0.05);组织分级G3级患者的ER和PR表达阳性率分别为17.6%和17.6%,明显低于G1级和G2级,p53和Ki-67表达阳性率分别为100.0%和82.4%,明显高于G1级和G2级,差异均具有统计学意义(P<0.05);腺癌和非腺癌患者的ER、PR和p53表达阳性率比较差异均无统计学意义(P>0.05),腺癌Ki-67表达阳性率为84.5%,明显高于非腺癌的42.4%,差异有统计学意义(P<0.05)。结论 ER、PR表达缺失和p53、Ki-67表达增高与子宫内膜癌有关,且与临床病理存在较大关系。     

年轻妇女宫颈癌临床病理因素与预后的关系

目的 探讨年轻妇女宫颈癌的临床病理因素与预后的关系.方法 回顾分析2000年2月-2005年4月收治的≤35岁的118例宫颈癌患者的临床病理资料,随机选择同期收治的＞35岁的200例宫颈癌患者作为对照,并采用免疫组化SP法检测两组Survivin、P27蛋白表达的差异,分析比较两组的临床病理因素与预后的关系.结果 青年组早期宫颈癌(Ⅰa～Ⅱa)的比例明显高于对照组;青年组瘤体≥4 cm者所占比例明显低于对照组;青年组腺癌比例明显高于对照组;青年组的淋巴结转移率、深间质浸润和人乳头瘤病毒感染阳性率均明显高于对照组;Survivin的表达量青年组较对照组明显升高,两组以上指标间差异均有统计学意义(P＜0.05).青年组病理分级和脉管累及率与对照组比较,差异无统计学意义(P＞0.05);两组P27表达量间差异无统计学意义(P＞0.05).早期病例和中晚期病例中,青年组的5年生存率和2年复发率与对照组比较,差异均有统计学意义(P＜0.05).COX回归分析显示临床分期、宫颈间质浸润深度、组织学类型、淋巴结转移、累及脉管、Survivin表达为独立预后因素(P＜0.05).结论 35岁以下宫颈癌患者具有临床期别早、病理恶性程度低、瘤体大、腺癌比例高及易转移浸润的相对高危临床病理因素.临床分期、宫颈间质浸润深度、组织学类型、淋巴结转移、脉管累及和Survivin免疫表达是影响其预后的独立因素.     

Survivin，VEGF及β-catenin在子宫内膜癌中的表达及意义

目的 探讨凋亡抑制蛋白(Survivin)、血管内皮生长因子(vascular endothelial growthfactor,VEGF)及β-连环素(β-catenin)在子宫内膜癌组织中的表达和临床意义.方法 用免疫组织化学SP法检测Survivin,VEGF和β-catenin在49例子宫内膜癌和13例正常子宫内膜组织中的表达情况.结果 Survivin、VEGF和β-catenin在子宫内膜癌中的阳性率分别为69.4%、69.4%和61.2%,与对照组比较差异有统计学意义(P均<0.05).Survivin蛋白的表达在组织分化和子宫肌层浸润深度之间差异有统计学意义(P<0.05),VEGF的表达在不同的子宫肌层的浸润深度之间差异有统计学意义(P<0.01);β-catenin的表达在不同的组织分化及子宫肌层浸润深度之间的差异有统计学意义(P<0.05).三者在子宫内膜癌中的表达具有相关性.结论 Survivin、VEGF和β-catenin与子宫内膜癌的发展侵袭相关;三者共同作用促进子宫内膜癌的发展和侵袭.     

HDGF、Matriptase和β-catenin蛋白在子宫内膜样腺癌中的表达

目的 研究肝癌衍生生长因子(HDGF)、跨膜丝氨酸蛋白酶(Matriptase)和β-连环蛋白(β-catenin)蛋白在子宫内膜样腺癌中的表达，探讨三者在子宫内膜样腺癌发生、发展中的作用、可能机制及其相关性，并分析三种蛋白与患者临床病理资料之间的关系。方法 利用免疫组织化学方法检测HDGF、Matriptase和β-catenin蛋白在116例子宫内膜样腺癌组织及102例增殖期子宫内膜组织中的表达，并运用SPSS19.0版软件处理数据，分析其是否有统计学意义及三者的相关性。结果 HDGF、Matriptase和β-catenin蛋白在子宫内膜样腺癌中的表达率分别为92.2%(107/116)、84.5%(98/116)、87.9%(102/116),而在增殖期子宫内膜组织中的表达率分别为24.5%(25/102)、31.4%(32/102)、10.8%(10/102),差异有统计学意义(P<0.05);其中HDGF、Matriptase的表达与子宫内膜样腺癌患者的脉管侵犯、淋巴结转移相关(P<0.05),而与年龄、组织学分级、浸润深度、临床分期无关(P>0.05);...     

C-erbB-2和Ki-67在子宫内膜癌组织中的表达及意义

目的：研究子宫内膜癌(endometrial carcinoma,EC)组织中癌基因C-erbB-2、Ki-67的表达,探讨两者与临床病理特征之间的关系。方法用免疫组化法分别检测C-erbB-2、Ki-67在63例子宫内膜癌组织和20例子宫内膜不典型增生组中的表达。结果C-erbB-2、Ki-67在子宫内膜癌组织中的阳性率分别为82.5%、76.2%,明显高于子宫内膜不典型增生组的20.0%、15.0%(P<0.05)。 C-erbB-2、Ki-67的表达和手术病理分期、组织学分级及浸润肌层深度有关差异有统计学意义(P<0.05)。Ki-67的阳性表达与淋巴结转移有关差异有统计学意义(P<0.05),C-erbB-2的阳性表达与淋巴结转移无关差异无统计学意义(P>0.05)。结论在子宫内膜癌中C-erbB-2、Ki-67过度表达,与子宫内膜癌的侵袭性有关,可作为临床医师评估子宫内膜癌预后的重要指标。     

三阴性乳腺癌临床病理特征及多种相关蛋白表达的意义

目的研究三阴性乳腺癌(triple-negative breast cancer,TNBC)的临床病理特征及多种相关蛋白的表达意义。方法收集52例TNBC和109例非三阴性乳腺癌(non-TNBC)患者术后癌组织石蜡病理标本及其临床病理资料,分析两组患者发病年龄、肿瘤大小、淋巴结转移、病理类型、脉管转移之间的特征;应用免疫组化方法,检测癌组织中相关蛋白的表达状态,比较蛋白表达在二组之间的差异性。结果 (1)TNBC患者≤35岁、浸润癌、肿瘤直径≥5cm及脉管癌栓均高于non-TNBC患者(P均<0.05),TNBC与non-TNBC淋巴结转移数目之间差异无统计学意义(P>0.05);(2)TNBC患者组织中P53、GST-π阳性表达率分别为53.8%、63.5%明显高于non-TNBC组中36.7%、28.4%(P均<0.05);TNBC与non-TNBC患者To PoⅡ、P170、Ki-67阳性表达率比较差异无统计学意义(P>0.05)。结论 TNBC患者具有发病年轻化、侵袭性强,易发生脉管转移等特征。     

子宫内膜腺癌组织中RUNX3蛋白的表达及其对预后判定的意义

目的探讨子宫内膜腺癌组织中RUNX3蛋白的表达及其对预后判定的意义。方法本文病理标本来自本院2012年1~12月收治的经病理确诊的子宫内膜腺癌患者40例,非典型增生症40例,及同期体检健康者40例,采用免疫组化方法测定子宫内膜腺癌组织、非典型增生组织及正常子宫组织中RUNX3蛋白表达情况,并进一步分析子宫内膜腺癌肿瘤分期、病理分级、浸润程度及淋巴结转移与RUNX3蛋白表达的关系。结果子宫内膜腺癌组RUNX3蛋白阳性率低于非典型增生组及正常组(χ2=4.308、7.935,P<0.05);不同临床分期、分化程度、浸润深度子宫内膜腺癌组织RUNX3蛋白阳性率差异显著(χ2=5.479、4.916、3.852,P<0.05),淋巴结转移与子宫内膜腺癌组织RUNX3蛋白表达无关(χ2=1.073,P>0.05)。结论 RUNX3蛋白有明显抑癌作用,其表达与子宫内膜腺癌恶性程度、病理分期以及浸润深度有密切关系,可作为判断病情、治疗效果及预后的重要指标。     

Bub1和Mad2蛋白在子宫内膜癌中的表达及意义

目的探讨苯并咪唑出芽抑制解除同源物蛋白-1(Bub1)和有丝分裂阻滞缺陷蛋白-2(Mad2)在人子宫内膜癌中的表达情况。方法采用免疫组织化学SP法分别检测72例子宫内膜癌组织(A组)、40例子宫内膜不典型增生组织(B组)和40例人正常子宫内膜组织(C组)中Bub1和Mad2蛋白的表达情况,并分析其与子宫内膜癌患者的临床分期、病理分级和淋巴结转移的关系。结果 (1)Bub1蛋白在A,B,C组的阳性表达率分别为27.78%,57.50%,85.00%,3组间比较差别有统计学意义(P<0.05);A组中,不同临床分期或病理分级患者的Bub1蛋白阳性表达率差别有统计学意义(P<0.05),有、无淋巴结转移患者的阳性表达率差别无统计学意义(P>0.05)。(2)Mad2蛋白在A,B,C组的阳性表达率分别为86.11%,57.50%,22.50%,3组间比较差别有统计学意义(P<0.05);A组中,不同病理分级患者的Mad2蛋白阳性表达率差别有统计学意义(P<0.05),不同临床分期及有、无淋巴结转移患者的Mad2蛋白阳性表达率差别无统计学意义(P>0.05)。(3)Bub1和Mad2蛋白在子宫内膜癌组织中的表达呈负相关(r=-0.448,P<0.01)。结论 Bub1和Mad2蛋白相互作用,在子宫内膜癌的发生、发展过程中可能起重要作用。     

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.