血清miRNA-21-5p和miRNA-574-5p在良恶性肺结节鉴别诊断中的价值

目的 探究血清miRNA-21-5p和miRNA-574-5p在良恶性肺结节鉴别诊断中的价值。方法 本院收治肺结节患者的57例,据病理结果 分为良性结节组(n=12)和恶性结节组(n=45)。收集临床资料,RT-PCR检测血清miRNA-21-5p和miRNA-574-5p水平。结果 两组在性别、年龄、不同直径、肿瘤家族史、不同密度结节、吸烟史等方面无差异(P>0.05);两组在分布上有显著性差异(P<0.05),其中恶性结节组在右肺上叶的发生率最高(48.89%)。两组miRNA-21-5p和miRNA-574-5p水平比较,P<0.05,其中恶性结节组更高。据ROC曲线分析,miRNA-21-5p和miRNA-574-5p诊断恶性肺结节的AUC分别为0.690和0.711,联合AUC为0.819。结论 血清miRNA-21-5p和miRNA-574-5p在良恶性肺结节鉴别中诊断,具有较高的价值,有成为潜在的血清生物标志物的可能性。     

p185蛋白在宫颈鳞癌组织中的表达及其意义

目的探讨p185蛋白在宫颈鳞癌诊断及宫颈良、恶性疾病鉴别诊断中的意义。方法用免疫组化法检测宫颈癌、宫颈炎症及正常宫颈组织中p185蛋白的表达情况。结果(1)实验组25例宫颈原位癌及86例宫颈鳞癌组织中p185表达率为39.7%,而20例正常宫颈组织中无表达,18例宫颈炎症患者的宫颈组织中5例p185蛋白有微量表达,p185蛋白的表达与患者年龄无相关性(P>0.05);(2)p185蛋白在原位癌组织和浸润癌组织中的表达差异无统计学意义(P>0.05),但低分化鳞癌中p185蛋白表达与原位癌比较,差异具有统计学意义(P<0.01),II期和III期宫颈癌患者组织中的p185蛋白表达明显高于0期和I期的患者(P<0.05);(3)淋巴结转移与宫颈鳞癌组织中p185蛋白的表达具有相关性(P<0.05)。结论p185蛋白的表达是细胞恶变的标志,可以为宫颈鳞癌的临床及病理诊断提供进一步的依据。     

不同宫颈病变患者血清和宫颈病变组织中凋亡相关因子的表达及其临床意义

目的: 观察凋亡相关因子在不同宫颈病变患者血清和宫颈病变组织中的表达,探讨其与宫颈鳞状细胞癌(鳞癌)临床病理特征的关系。方法: 选取镜检确诊为不同宫颈病变的患者140例,其中子宫颈鳞癌70例、宫颈原位癌(CINⅢ)50例和宫颈炎20例,均空腹抽取静脉血同时留取镜检组织。采用酶联免疫法、实时荧光定量法和免疫组织化学法分别检测患者血清及不同宫颈病变组织中凋亡相关因子--肿瘤抑制基因(p53)、细胞凋亡信号受体(Fas)、肿瘤坏死因子α(TNF-α)和细胞周期素E (cyclin E)蛋白和mRNA表达,并分析其蛋白表达与宫颈鳞癌临床分期、病理类型和淋巴结转移的关系。结果: 与宫颈炎患者比较,宫颈鳞癌和宫颈原位癌患者血清及宫颈组织中p53、Fas、TNF-α蛋白和mRNA表达水平均明显降低(P<0.01),而cyclin E蛋白和mRNA表达水平明显升高(P<0.01),宫颈鳞癌患者与宫颈原位癌患者比较差异无统计学意义(P>0.05);p53、Fas、TNF-α和cyclin E阳性表达率与宫颈鳞癌临床分期、病理类型和淋巴结转移均有密切关联(P<0.01)。结论: 宫颈鳞癌和宫颈原位癌患者血清和宫颈病变组织中p53、Fas和TNF-α表达水平下调和cyclin E表达水平上调可能与宫颈癌的浸润和转移有关联,可作为宫颈癌早期诊断的标记物,并可为宫颈癌的术后用药和预后判断提供理论依据。     

血清CA125、miRNA-139-5p、miRNA-15a水平检测在卵巢癌患者中的临床意义

目的:探讨血清糖类抗原125(CA125)、微小RNA-139-5p(miRNA-139-5p)、微小RNA-15a(miRNA-15a)水平检测在卵巢癌患者中的临床意义。方法:选取74例卵巢癌患者作为卵巢癌组,选取同期74名该院健康体检者作为对照组,比较卵巢癌组与对照组、不同分化程度卵巢癌患者、不同病理分期卵巢癌患者血清CA125、miRNA-139-5p、miRNA-15a水平,分析血清CA125、miRNA-139-5p、miRNA-15a水平与卵巢癌分化程度和病理分期的相关性。结果:卵巢癌组CA125、miRNA-139-5p水平均高于对照组,miRNA-15a水平低于对照组,差异有统计学意义(P<0.05);卵巢癌低分化患者血清CA125、miRNA-139-5p水平均高于中分化和高分化患者,且中分化患者高于高分化患者;卵巢癌低分化患者miRNA-15a水平低于中分化和高分化患者,且中分化患者低于高分化患者,差异有统计学意义(P<0.05);卵巢癌患者血清CA125、miRNA-139-5p水平随着病理分期升高而升高,即Ⅰ期<Ⅱ期<Ⅲ期<Ⅳ期,卵巢癌患者miRNA-15a水平随着病理分期升高而降低,即Ⅰ期>Ⅱ期>Ⅲ期>Ⅳ期,差异有统计学意义(P<0.05);Pearson相关性分析结果显示,CA125、miRNA-139-5p水平与卵巢癌分化程度呈负相关,与病理分期呈正相关,miRNA-15a水平与卵巢癌分化程度呈正相关,与病理分期呈负相关(P<0.05)。结论:卵巢癌患者血清CA125、miRNA-139-5p水平升高,miRNA-15a水平降低,且与卵巢癌分化程度、病理分期存在相关性,血清CA125、miRNA-139-5p、miRNA-15a水平可为临床卵巢癌患者诊治提供参考依据。     

血清外泌体miRNA-21在肝癌诊断中的应用

目的 探究血清外泌体miRNA-21的表达水平在肝癌诊断中的应用。方法 收集2018年12月-2019年12我院收治肝癌患者30例为研究对象，另选取正常健康体检者30例做对照组，收集所有受试者外周血血清，提取血清外泌体，采用实时荧光定量PCR(RT-qPCR)法检测血清外泌体miRNA-21表达水平；分析血清外泌体miRNA-21表达水平与肝癌患者临床病理参数的关系。绘制ROC曲线分析miRNA-21检测对肝癌的诊断价值。Logistic回归分析影响肝癌患者发生的危险因素。结果 与对照组比较，肝癌患者血清外泌体miRNA-21表达水平明显升高；miRNA-21表达水平与患者年龄、性别、AFP水平无关；血清外泌体miRNA-21-5p和miRNA-21-3p表达水平诊断的肝癌患者的AUC分别为0.711、0.977，特异度分别为80%、100%，灵敏度分别为66.7%、90%,miRNA-21诊断肝癌患者的AUC为0.982，特异度为90%，灵敏度为96.7%。结论miRNA-21-5p和miRNA-21-3p在肝癌患者血清外泌体中显著高表达，两者联合检测可提高对肝癌诊断的特异度及灵敏度...     

p16、p53、Ki-67和血清SCC-Ag在宫颈鳞癌中的表达及意义

目的 探讨p16、p53、Ki-67和血清鳞状细胞癌抗原(squamous cell carcinoma antigen, SCC-Ag)在宫颈鳞癌患者中的表达及意义。方法 采用免疫组织化学法检测31例宫颈鳞癌与31例宫颈炎组织中p16、p53、Ki-67的表达,同时采用化学发光微粒子免疫法检测治疗前的血清SCC-Ag水平。结果(1) 宫颈炎和宫颈鳞癌中p16、p53、Ki-67、SCC-Ag的阳性率分别为0%、0%、12.9%、0%和96.8%、48.4%、100%、71%,两组比较有显著差异(P<0.05)。(2) p53高表达与淋巴结或脉管转移有关,Ki-67表达随组织学分级升高而升高,血清SCC-Ag水平随临床分期升高而升高(P<0.05)。(3) 经Spearman等级相关分析,p16染色强度与血清SCC-Ag水平呈正相关(r=0.467,P<0.05),在临床Ⅰ期宫颈鳞癌中,两者间正相关更显著(r=0.59,P<0.05)。结论 P53、Ki-67、血清SCC-Ag与宫颈鳞癌发展的恶性程度相关,其在表达上的差异与肿瘤生物学行为有一定关系,宫颈鳞癌在发生发展过程中,尤其是早期阶段,p16与血清SCC-Ag可能有协同作用。     

MicroRNA-574-5p对冠状动脉平滑肌细胞生长的影响及其调控机制

目的:研究miRNA-574-5p对冠状动脉平滑肌细胞(Vascular smooth muscle cells,VSMCs)增殖的影响及其调控的分子机制。方法:实时定量PCR检测冠心病(coronary artery heart disease,CAD)患者及健康体检者外周血中miRNA-574-5p的表达及正常人VSMCs细胞中miRNA-574-5p及ZDHHC14的表达。MTT法检测细胞增殖,流式细胞仪检测细胞凋亡。双荧光素酶报告分析检测miRNA-574-5p与靶基因的结合。结果:与正常体检者对比,CAD患者血清中miRNA-574-5p的表达显著增加(P<0.05)。与阴性对照组相比,miRNA-574-5p类似物显著提高VSMCs的增殖(P<0.01),降低VSMCs的凋亡(P<0.01)。经在线miRNA靶基因预测软件分析,miRNA-574-5p的一个靶基因为ZDHHC14。miRNA-574-5p降低ZDHHC14 3'UTR端的荧光素酶活性(P<0.01),且抑制其表达(P<0.01)。ZDHHC14过表达降低miRNA-574-5p诱导的VSMCs的增殖(P<0.05),提高miRNA-574-5p诱导的VSMCs的凋亡(P<0.05)。结论:miR-574-5p通过抑制ZDHHC14表达促进VSMCs增殖,并抑制其凋亡。miR-574-5p可能为CAD相关因子,并可能成为CAD治疗的潜在分子靶点。     

宫颈癌患者血清微小核糖核酸-381、微小核糖核酸-145水平变化及与临床病理参数相关性分析

目的:探讨宫颈癌(CC)患者血清微小核糖核酸-381(miRNA-381)、微小核糖核酸-145(miRNA-145)水平的变化及与临床病理参数的关系。方法:选取CC患者80例作为观察组，并于同期健康女性体检者选取68例作为对照组。采用定量聚合酶链反应法(QRT-PCR)检测两组血清miRNA-381、miRNA-145表达水平，同时收集其临床病理资料，探究血清表达水平与临床病理参数的关系。结果:观察组血清miRNA-381、miRNA-145水平低于对照组(均P<0.05);CC患者血清miRNA-381、miRNA-145表达水平与患者年龄、乳头瘤病毒感染、肿瘤直径、病理分期等因素无关(均P>0.05);与病理类型、组织分化程度、浸润深度、脉管浸润、淋巴结转移有关(均P<0.05)。结论:CC患者中血清miRNA-381、miRNA-145呈低表达，其表达水平与病理类型、组织分化程度、浸润深度、脉管浸润、淋巴结转移有关。     

血清miR-18a、miR-485-5p对HPV阳性宫颈癌的诊断价值

目的 探讨宫颈癌患者伴人乳头瘤病毒(HPV)与单纯宫颈癌患者血清微小RNA(miR)-18a, miR-485-5p表达差异,分析二指标对HPV阳性宫颈癌的诊断价值。方法 选取2020年1月—2021年1月黄河三门峡医院收治的91例HPV阳性宫颈癌患者为HPV阳性宫颈癌组,62例HPV阳性非宫颈癌妇女为HPV阳性组,57名体检健康妇女为对照组,采用qRT-PCR检测血清miR-18a、miR-485-5p的表达。采用受试者操作特征曲线(ROC)分析血清miR-18a、miR-485-5p对HPV阳性宫颈癌的诊断价值。结果 HPV阳性宫颈癌组血清miR-18a表达高于对照组和HPV阳性组,而miR-485-5p表达低于对照组和HPV阳性组(均P<0.05)。血清miR-18a、miR-485-5p表达与HPV阳性宫颈癌患者FIGO分期、间质浸润深度、是否淋巴结转移有关(均P<0.05)。ROC曲线显示,miR-18a、miR-485-5p、联合诊断HPV阳性宫颈癌的AUC分别为0.752、0.802、0.876,灵敏度分别为67.03%、75.82%、83.52%,特异度分别...     

p16INK4a、FGF-2和D2-40与宫颈癌浸润转移的关系

目的探讨肿瘤抑制基因p16INK4a、成纤维细胞生长因子-2(FGF-2)和D2-40在CIN3、微小浸润癌、宫颈浸润癌中的表达及其在宫颈癌浸润转移中的作用。方法采用免疫组化学方法,检测35例CIN3、13例微小浸润癌及62例宫颈浸润癌中p16INK4a、FGF-2和D2-40蛋白的表达情况。结果 p16INK4a在微小浸润癌中的过表达率明显高于CIN3(P<0.01);FGF-2在CIN3、微小浸润癌和宫颈浸润鳞癌中的阳性率分别为51.43%、53.85%、76.92%,差异有统计学意义(P<0.05);FGF-2的表达强度与宫颈病变的发展程度呈正相关(P<0.01)。p16INK4a和FGF-2的阳性强度与宫颈癌淋巴结转移呈正相关(P<0.01或P<0.05),FGF-2与宫颈癌浸润深度有关,二者均与宫颈癌的肿瘤大小、组织学分级、临床分期无相关性;D2-40的阳性反应与临床病理因素无相关性。p16INK4a、FGF-2的表达和D2-40阳性反应之间无相关性(P>0.05)。结论 p16INK4a异常表达可能有助于诊断微小浸润癌,其阳性强度与宫颈癌淋巴结转移正相关;检测FGF-2在宫颈活检组织中的表达,对评估宫颈病变的发展以及宫颈癌浸润和转移的情况有重要的临床参考价值。     

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.     

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.