Survivin基因在大肠癌中的表达及其临床意义

目的探讨凋亡抑制基因survivin在大肠癌的表达，及在大肠癌发展、转移等生物学特性中的作用。方法收集大肠癌组织62例和25例正常大肠组织，用免疫组织化学SP法检测survivin的表达情况。结果62例大肠癌组织，35例survivin表达阳性，大肠癌组织阳性表达率为56．4％，而在正常大肠组织中不表达。而且与肿瘤的病理分期、淋巴结转移显著相关（P〈0.05），与浸润深度没有显著性差异（P〉0．05）。结论Survivin基因在大肠癌中呈高表达，检测survivin基因的表达可以预测大肠癌的恶性程度和预后。     

COX-2 Survivin在大肠癌组织中的表达及意义

目的：研究环氧化酶-2（COX-2）和生存素（Survivin）在大肠癌组织中的表达,探讨两者间的相互关系。方法：采用SP免疫组化技术,检测92例大肠癌及30例正常大肠组织中COX-2和Survivin的表达,并对其与临床病理参数的关系进行分析。结果：30例正常大肠组织中COX-2和Survivin的表达为阴性,92例大肠癌组织中COX-2和survivin的阳性表达率分别为60．9％和71．7％,显著高于正常大肠组织（P〈0．05）,COX-2阳性表达与大肠癌淋巴结转移、临床分期相关（P〈0．05）,与大肠癌大小、浸润程度、分化程度无关（P〉0．05）。Survivin阳性表达与大肠癌淋巴结转移、临床分期、分化程度相关（P〈0．05）,与肿瘤大小及浸润程度无关（P〉0．05）,COX-2与Survivin表达密切相关（P〈0．05）。结论：COX-2和Survivin在大肠癌组织中的表达密切相关。     

Survivin和Caspase 3蛋白在大肠黏膜癌变过程中的表达及意义

目的探讨凋亡相关基因Survivin和Caspase 3在大肠粘黏膜癌变过程中的表达及其在大肠癌发生、发展中的可能作用及两者间的相互关系。方法采用免疫组织化学sP法检测67例大肠癌、45例大肠腺瘤和22例正常大肠黏膜组织中Survivin和Caspase 3的表达,分析其与大肠癌临床病理特征的关系,并探讨两者问的相互关系。结果Survivin在大肠黏膜癌变过程中的表达率逐渐升高,Survivin在大肠正常黏膜、大肠腺瘤、大肠癌中阳性表达率分别为9．1％（2／22）,51．1％（23／45）,62．7％（42／67）;Caspase 3在大肠正常黏膜、大肠腺瘤、大肠癌中的阳性表达率逐步降低,分别为86．4％（19／22）、62．2％（28／45）、34．3％（23／67）。Survivn的表达与大肠癌的侵袭深度和淋巴结转移及Dukes分期有关（P〈0．05）,而与性别、年龄、部位等因素无关（P〉0．05）;Caspase 3的表达与大肠癌的组织分化程度有关（P〈0．05）,而与其他临床病理因素无关（P〉0．05）。Survivn、Caspase 3在大肠癌中的表达具有相关性（P〈0．05）。结论Survivn可能在大肠黏膜癌变过程及大肠癌的浸润、转移中起重要作用,Survivin可能通过抑制Caspase 3的表达,促进大肠癌的发生。     

Survivin蛋白在前列腺癌中的表达及其意义

目的 研究凋亡抑制因子Survivin蛋白在前列腺癌中的表达及临床意义。方法 应用免疫组织化学方法，对Survivin蛋白在41例前列腺癌、5例正常前列腺组织和10例前列腺增生组织中表达水平进行检测。结果 Survivin在正常前列腺组织、前列腺增生组织庭前列腺癌组织表达阳性率分别为0、10，0％和68．3％。正常前列腺组织与前列腺增生组织组织表达水平差异无显著性（P〉0．05），Survivin在肿瘤组织中表达明显高于非肿瘤组织（P〈0．01）。不同的病理分级前列腺癌组织中Survivin表达差异无显著性（P〉0．05）。随临床分期的增高，survivin阳性表达例数增加，差异有显著性（P〈0．05）。结论 Survivin在前列腺癌组织中稳定的高表达。使它可能成为前列腺肿瘤治疗中潜在的药物分子靶，并能预示前列腺癌组织的侵袭能力。     

Caspase-3基因在大肠癌、大肠腺瘤中的表达及其与细胞凋亡的关系

目的探讨大肠癌、大肠腺瘤中Caspase-3基因的表达及其与细胞凋亡的关系。方法采用免疫组化S-P法和原位末端标记法分别检测28例大肠癌、10例大肠腺瘤及5例正常大肠黏膜中Caspase-3基因的表达水平及细胞凋亡。结果Caspase-3基因在大肠癌、大肠腺瘤和正常黏膜组织中表达分别为46．4％（13／28）、60．0％（6／10）、80.0％（4／5），三者之间有显著性差异（P〈0．01）。大肠癌、大肠腺瘤中细胞凋亡指数显著高于正常黏膜组织（P〈0．01），凋亡指数与肿瘤的分化程度有关（P〈0．01），与病理类型、Dukes分期无关。大肠癌、大肠腺瘤中Caspase-3基因表达与细胞凋亡指数密切相关，阳性表达的细胞平均凋亡指数明显高于阴性表达的平均凋亡指数（P〈0．01），而正常黏膜组织中二者无显著性差异（P〉0．05）。结论肿瘤早期阶段的细胞凋亡异常和过度增生，可能是大肠癌的发病原因之一，作为细胞凋亡的调控因子，Caspase-3可能在大肠癌的发生发展中起重要作用。     

Survivin、COX-2在大肠癌中的表达及意义

目的：检测大肠癌中凋亡抑制基因Survivin和环氧合酶（COX-2）的表达，探讨Survivin、COX-2在大肠癌发生、发展及转移中的作用及意义。方法：收集60例大肠癌标本及其病例资料，应用免疫组织化学方法检测Survivin、COX-2在大肠癌标本中的表述情况。结果：①大肠癌中Survivin、COX-2的阳性表达率分别为71．67％、80．00％，明显高于癌旁正常大肠组织（P〈0．01）；②Survivin、COX-2的表达与大肠癌的Dukes分期及淋巴结转移明显相关（P〈0．05）③Survivin、COX-2在大肠癌中的表达呈正相关（P〈0．01，r=0．333）。结论：Survivin、COX-2可能在大肠癌的发生发展中起关键作用，二者与大肠癌的临床病理参数密切相关，二者联合检测对大肠癌的诊断预后有-定价值。     

Survivin基因在人胃癌及癌前病变中表达的研究

目的探讨凋亡抑制基因survivin在胃癌及癌前病变组织中的表达。方法应用RT—PCR技术研究survivin mRNA在46例胃癌组织及相应正常组织中的表达，ELISA技术定量检测上述标本中survivin蛋白表达，免疫组织化学染色（IHC）Envision法定性检测46例胃癌标本、114例胃炎及癌前病变组织survivin蛋白表达。结果46例胃癌组织的survivin mRNA阳性表达率为32．6％,46例相应正常组织为10．87％。两组差异有统计学意义（P〈O．05o胃癌组的survivin蛋白表达浓度（75．27—358．44pg/ml）显著高于正常组（0—161．23pg／ml）（P〈0．05）。Survivin蛋白阳性表达率在浅表性胃炎（30％）、萎缩性胃炎（14．7％）、胃黏膜肠化组织（30％）差异均无统计学意义（均P〉0．05）。与不典型增生（60％）、胃癌组织（46．5％）差异均有统计学意义（均P〈0．05）。胃癌组织survivin mRNA、蛋白表达阳性率及浓度在不同性别、肿瘤长径、发生部位、大体类型、组织类型、分化程度、有无脉管侵犯、浸润深度、有无淋巴结转移、有无远处转移、TNM分期间差异均无统计学意义（均P〉0．05）。结论Survivin在胃癌、胃黏膜不典型增生中的表达高于正常组织。提示与胃癌发生有关；与临床病理特征无关，提示survivin可能在肿瘤的形成阶段起作用，与胃癌发展侵袭无关。     

大肠腺瘤、大肠癌序列过程中AKT2、HIF-α的表达及其临床意义

目的检测丝氨酸／苏氨酸蛋白激酶2（AKT2）、缺氧诱导因子-1α（HIF-100在正常大肠组织、癌旁大肠黏膜组织、大肠腺瘤及大肠癌中的表达，探讨2种标志物在大肠癌发生、发展中的作用及其相关性，为大肠癌临床病理诊断及预后判断提供参考指标。方法将50例大肠癌手术标本和10例相应癌旁大肠黏膜组织及14例正常大肠组织制作成组织芯片，同时将17例大肠腺瘤活检标本进行常规切片，应用免疫组化SABC法研究AKT2、HIF—1α在其中的表达。结果AKT2、HIF—1α在大肠癌中的阳性表达分别为84．0％、64．0％，二者表达呈显著正相关（r=0．285,P〈0．05）。AKT2在大肠癌中的阳性表达（84．0％）明显高于大肠腺瘤阳性表达（52．9％）和正常大肠组织的阳性表达（14．3％）（P〈O．05、P〈0．01）。HIF-1α在大肠癌中的阳性表达（64．0％）明显高于正常大肠组织（28．6％）（P〈0．05）；但在大肠腺瘤中的阳性表达为58．8％，与大肠癌的阳性表达比较，无显著性差异（P〉0．05）。AKT2、HIF—1α的表达与Dukes分期、淋巴结转移有关，而与患者性别、年龄及组织学分级无关。结论AKT2、HIF-1α在大肠癌中的阳性表达均较正常大肠组织增高，且二者呈正相关。AKT2可能通过调节HIF-1α表达来影响大肠癌的发生、发展、转移；AKT2、HIF-1α在正常大肠组织-大肠腺瘤-大肠癌发展过程中可能起重要作用，AKT2比HIF-1α能更好地作为临床监控大肠腺瘤癌变及大肠癌进展的指标。     

肝癌组织survivin的表达与凋亡,增殖和p53的关系

目的：研究肝癌survivin的表达与细胞增殖、凋亡以及053表达的关系．方法：应用免疫组化法检测原发性肝癌组织42例、癌旁肝硬化组织34例、正常肝组织10例中survivin,p53,增殖细胞核抗原（PCNA）的表达．应用TUNEL法检测细胞凋亡．结果：在42例肝癌组织中survivin阳性30例（71．4％）,显著高于癌旁肝硬化组织（11．8％）和正常肝组织（0％,P〈0．001）．肝癌中survivin蛋白的高表达与病理分级（P=0．003）,p53蛋白水平（P=0．008）、细胞增殖凋亡比（P=0．001）及患者生存时间（P=0．002）存在显著相关性,而与年龄、性别、肿瘤大小、临床分期、门脉癌栓（局部转移）无显著相关（P〉0．05）．结论：肝癌组织survivin高表达在打破肝癌细胞的增生和凋亡之间的平衡中起着重要作用．Survivin可能抑制p53阴性肝癌细胞的凋亡,在肿瘤细胞的进一步恶性转化中发挥作用．     

大肠癌COX-2、bcl-2和caspase-3基因的表达意义

目的探讨COX．2、bcl-2和caspase-3基因在大肠癌组织中的表达及其意义。方法应用免疫组化ABC法检测28例大肠癌和10例正常黏膜中COX-2、bcl-2和caspase-3表达,应用TUNEL法检测细胞凋亡。结果在大肠癌及正常粘膜中COX-2的阳性表达分别为82、1％和0．0％,bcl-2的阳性表达分别为75．0％和20．0％,两者在大肠癌组织中的表达率均显著高于正常黏膜（P〈0．01）。caspase-3的阳性表达分别为46．4％和90．0％,在大肠癌组织中的表达率显著低于正常黏膜（P〈0．01）。COX-2、bcl-2和caspase-3均与大肠癌的临床病理特征无相关性（P〉0．05）。COX-2及bcl-2表达与凋亡指数显著负相关（分别为r=-0、563,P〈0．05;r=-0．578,P〈0．01）。caspase-3与凋亡指数呈显著正相关（r=0、714,P〈0．01）。大肠癌高、中、低分化各组间及不同Dukes分期（A、B期和C、D期）各相间凋亡指数无统计学意义（P〉0．05）。结论在大肠癌中COX-2、bcl-2表达增强,细胞凋亡受抑制而caspase-3表达下降,其促凋亡作用减弱,它们参与了肿瘤发生发展的共同通道,在大肠癌的发生和发展过程中起到重要作用。     

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.