p27kip1蛋白在结肠癌组织中的表达及意义

目的：探讨p27kip1蛋白在结肠癌组织中的表达及意义。方法应用免疫组化方法检测结肠癌组织（观察组40例）及癌旁正常组织（对照组20例）中p27kip1蛋白的表达,比较其阳性表达率,并比较分析观察组不同分化程度及有无淋巴结转移患者p27kip1蛋白的阳性表达程度。结果观察组中p27kip1蛋白阳性表达16例（40.00%）,对照组中p27kip1蛋白阳性表达15例（75.00%）,差异有统计学意义（P＜0.05）。高、中分化患者p27kip1蛋白的阳性表达程度明显高于低分化患者,差异有统计学意义（P＜0.05）。有淋巴结转移患者p27kip1蛋白的阳性表达程度明显低于无淋巴结转移患者,差异有统计学意义（P＜0.05）。TNM分期Ⅰ～Ⅱ期患者p27kip1蛋白阳性表达12例（63.16%）,Ⅲ～Ⅳ期患者p27kip1蛋白阳性表达4例（19.05%）,差异有统计学意义（P＜0.05）。结论 p27kip1蛋白作为抑癌因子具有调控细胞增殖、分化及凋亡的能力,而组织中p27kip1蛋白的低表达可能导致了肿瘤的发生、发展。p27kip1蛋白可能作为临床上检测结肠癌的新指标,有助于结肠癌的肿瘤分化、肿瘤转移及肿瘤TNM分期的诊断。     

Cdk2及其抑制因子p27Kip1在胃癌中的表达和意义

目的：探讨细胞周期素依赖性激酶2（Cdk2)及其抑制因子p27^Kipl与胃癌生物学行为的关系。方法：采用免疫组织化学S－P法对60例胃癌组织原发灶和淋巴结转移灶进行Cdk2，p27^Kipl免疫组化染色，腹水或腹腔冲洗液先脱落细胞学检查。结果：Cdk2阳性表达率56．67％（34／60），阳性细胞定位于细胞核和细胞浆，以Ⅲ，Ⅳ期表达率较高（P＜0．01），与胃癌大体类型及浆膜分型关系密切（P＜0．01）；p27^Kipl阳性表达率为43．33％（26／60），阳性细胞定位于细胞浆，在高分化及Ⅰ、Ⅱ期胃癌高表达（P＜0．05），且与淋巴细胞转移密切相关（P＜0．01），Cdk2，p27^Kipl同时阳性表达19例，占31．67％（19／600。结论：Cdk2与胃癌浸润深度，淋巴结转移呈正相关，p27^Kipl表达与胃癌浸润深度，淋巴结转移呈负相关。     

PTEN和p27在胃癌组织中的表达及意义

目的探讨PTEN、p27在胃癌中的表达及两者的相互关系。方法应用免疫组化SP法检测56例胃癌组织中PTEN、p27的表达．资料统计应用卡方检验、确切概率法检验。结果胃癌组织中PTEN和p27的阳性表达均较正常胃组织降低（P〈0．05）;PTEN的表达与胃癌的淋巴结转移、临床分期、分化程度密切相关（P〈0．05）,与性别、年龄无关;p27表达与胃癌的淋巴结转移、临床分期、分化程度密切相关（P〈0．05）,与性别、年龄无关;胃癌组织中PTEN和p27的表达呈正相关。结论PTEN、p27的表达与胃癌的生物学行为有一定的相关性;PTEN、p27与胃癌发生发展、浸润转移及预后有一定的关系。     

胃癌组织中MMP9和p27的表达及其意义

①目的探讨p27和基质金属蛋白酶-9（MMP-9）在胃癌组织中的表达及其与胃癌临床病理特征的关系。②方法应用免疫组织化学（SP方法）检测p27和MMP-9在54例胃癌组织与20例正常胃组织中的表达。③结果胃癌组织中p27和MMP-9基因的阳性表达与其在正常胃组织中的表达差异具有显著性意义（P〈0．05）；胃癌组织中p27基因的阳性表达较正常胃组织显著性降低，而MMP-9阳性表达较正常胃组织显著性升高；p27和MMP-9表迭与胃癌的淋巴结转移、临床分期密切相关（P〈0．05），但与分化程度、性别、年龄无关（P〉0．05）；胃癌组织中p27和MMP-9基因之间表达的吻合度也无显著性差异（P〉0．05）。④结论p27和MMP-9基因的表达可能与胃癌的发生、转移有一定的关系．     

细胞 S 期激酶相关蛋白2和 p27 kip1在胆囊癌中的表达及与临床病理的关系

目的：研究细胞S期的激酶相关蛋白2（Skp2）以及p27kip1在胆囊癌中的表达情况,并探讨它们的相互关系及与临床病理的关系。方法收集已经病理确认的胆囊癌标本17例及慢性胆囊炎标本10例,应用免疫组织化学S－P法检测17例胆囊癌及10例慢性胆囊炎标本Skp2及p27kip1的表达状况。结果在17例胆囊癌切片标本中出现Skp2高表达15例,低表达2例;在10例慢性胆囊炎切片标本中出现Skp2高表达3例,低表达7例;Skp2在胆囊癌和慢性胆囊炎中的表达差异有统计学意义（P＜0．05）。而p27kip1在10例慢性胆囊炎标本中高表达8例,低表达2例;而在17例胆囊癌中低表达14例,高表达3例;p27kip1在胆囊癌和慢性胆囊炎中的表达差异有统计学意义（P＜0．05）。在17例胆囊癌组织中,Skp2蛋白高表达的15例中,p27kip1蛋白表现为低表达13例;在Skp2蛋白低表达的2例中,所有患者的p27kip1蛋白都表现为高表达。两者之间差异有统计学意义,并且呈现负相关（r＝－0．658,P＜0．05）。 Skp2和p27kip1在胆囊癌中的表达与患者的年龄、性别、肿瘤分化程度、肿瘤T分期、临床分期无关（P＞0．05）。结论 Skp2、p27kip1在胆囊癌的发生、发展中有重要作用,Skp2促进了胆囊癌的发生,而p27 kip1在胆囊癌的发生和发展的过程中起抑制作用,两者在胆囊癌的发生和发展中相互作用。     

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。     

p27蛋白在乳腺癌中的表达及其临床意义

目的：探讨p27蛋白在乳腺癌组织中的表达及其与临床病理意义。方法：应用免疫组化SP法检测118例乳腺癌及27例良性乳腺病变组织p27蛋白表达水平,采用x^2检验其与临床病理学持征的关系。结果：良性乳腺p27蛋白的高阳性表达率为96．30％（26／27）,癌组织为60．17％（71／118）,p27基因蛋白表达水平与乳腺肿瘤的良恶性有差异性（P＜0．05）;p27蛋白表达水平与乳腺癌病理组织学分级,淋巴结转移呈显著负相关（P＜0．05）,组织分化差,有腋淋巴结转移其p27蛋白阳性表达明显降低。结论：p27蛋白表达的下降可能与乳腺癌的发生发展有关,并可作为估价乳腺癌预后的重要指标。     

p27KIP1和CyclinE表达与喉鳞状细胞癌生物学行为的关系

目的:探讨p27^KIP1和CyclinE基因蛋白与喉鳞状细胞癌（LSCC）生物学行为的关系。方法：采用免疫组化法检测60例LSCC、40例喉不典型增生病变和20例喉正常粘膜中p27^KIP1和CyclinE基因蛋白的表达。结果：p27^KIP1和CyclinE阳性表达主要定位于细胞核；在LSCC、喉不典型增生病变和喉正常粘膜中p27^KIP1阳性表达率分别为：58．3％（35／60）、67．5％（27／40）和90．0％（18／20）（P＜0．05）；CyclinE阳性表达率分别为：45．0％（27／60），20．0％（8／40），5．0％（1／20）（P＜0．001）。LSCC中颈淋巴结转移组和非淋巴结转移组，淋巴结转移阳性组p27^KIP1阳性表达率明显低于阴性组（P＜0．01）；淋马结转移组CyclinE阳性表达率明显高于非淋巴结转移组（P＜0．01）。p27^KIP1和CyclinE表达显著相关性（P＜0．01）。结论：p27^KIP1和CyclinE异常表达可能是喉癌发生中早期分子事件，对喉癌发生发展起重要作用。     

胃癌组织及邻癌黏膜组织p27kip1表达水平及意义

目的:探讨胃癌及邻癌黏膜组织p27kip1的表达水平及其与临床病理因素的关系.方法:用免疫组织化学EnVision二步法分别检测胃癌组织、邻癌黏膜组织及胃切端黏膜组织p27kip1的表达水平;图像分析仪测定各组织实质细胞数密度、阳性细胞数密度等形态指标并计算阳性细胞比率.结果:胃癌组织及邻癌黏膜组织p27kip1的阳性率、阳性细胞数密度及阳性细胞比率均显著低于切端胃黏膜,而癌组织与邻癌黏膜组织比较各指标差异均无显著性.癌组织p27kip1表达水平与肿瘤的分化程度、浸润深度及淋巴结转移相关,而与胃癌患者的性别、年龄及肿瘤大小无关.结论:胃癌组织p27Kip1水平降低并与癌分化程度、浸润深度及淋巴结转移有关,可作为胃癌预后判断的指标.同时邻癌胃黏膜p27Kip1水平也降低,这种异常可能对癌扩散和转移也起到一定的作用.     

p1 6和p27在乳腺癌中的表达及其预后意义

目的：研究p16和p27在乳腺癌中的表达并探讨其对预后的意义。方法：对84例乳腺癌,20例乳腺不典型增生以及20例正常乳腺组织进行p16和p27表达的检测并分析其结果。结果：乳腺癌组p16阳性率和p27高表达率均明显高于对照组（P＜0．05）。p16表达与淋巴结转移,临床分期相关（P＜0．05）,p27表达与淋巴结转移,临床分期,局部复发和远处转移相关（P＜0．05）,p16阳性患者术后生存率明显高于p16阴性者（P＜0．05）,p27高表达的乳腺癌术后生存率明显高于p27低表达者（P＜0．05）,p16在乳腺癌中的表达与p27的表达相关（P＜0．01）,p16阳性并且同时有p27高表达的乳腺癌术后生存率明显高于p16阴性并且同时p27低表达者（P＜0．05）,但与单独p16阳性或单独p27高表达者相比无显著差异（P＜0．05）,结论：乳腺癌组的p16的阳性率和p27高表达率明显高于对照组,p16阳性,p27高表达的乳腺癌患者预后好;p16,p27都是乳腺癌独立的预后因子。     

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.