大肠癌的病理与预后关系的分析

153例手术切除大肠癌标本的病理因素与临床预后的分析结果表明:瘤肿的组织学类型、浸润深度、生长方式及淋巴结有无癌转移与预后关系密切,癌周淋巴细胞反应及局部淋巴结的生发中心增生(GH)对判断患者预后有一定意义,而皮质旁区增生(PH)及窦组织细胞增生(SH)对判断患者预后无明显意义。     

癌周淋巴细胞及引流淋巴结反应对判断大肠癌预后的评价

随着免疫病理学的发展,癌周淋巴细胞反应及局部淋巴结形态变化的临床意义日益受到重视。关于大肠癌时淋巴细胞反应与预后的关系,国内外文献均有报道,但意见不甚一致。本文除分析与预后有关的一般病理因素外,重点探讨淋巴细胞反应对判断大肠癌预后的价值。材料及方法本文材料取自本校附属第一医院外科1960年至1974年间手术切除的大肠癌标本。其中病理资料完整并随访5年以上的病例共     

血管内皮生长因子在大肠癌组织中的表达及其临床意义

目的探讨血管内皮生长因子(vascular endothelial growth factor,VEGF)在大肠癌组织中的表达及其临床意义。方法应用免疫组织化学SP法检测80例大肠癌组织及12例癌旁正常组织中VFGF-D的表达,并分析其与大肠癌临床病理和预后的关系。结果80例大肠癌组织VFGF-D阳性表达率为45.4%明显高于癌旁正常组织中的表达(P<0.05)。大肠癌VFGF表达与大肠癌分化程度、淋巴结转移、Duke's分期及患者预后密切相关,差异均有显著性意义(P<0.05)。Duke's分期的C期和D期和有淋巴结转移的大肠癌组织VEGF阳性率明显高于Duke's分期A期和B期和无淋巴结转移的大肠癌组织。结论VEGF的高表达和大肠癌的Dukes分期、癌组织浸润、淋巴结转移和预后密切相关,并且可以作为指导大肠癌治疗方案以及判断预后的一个重要指标。     

血管内皮生长因子C在大肠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）在大肠癌中的表达及其与大肠癌临床病理学特征的关系。方法运用免疫组织化学（SP法）检测52例大肠癌和18例正常肠黏膜组织中VEGF-C的表达,并比较大肠癌组织VEGF-C的表达与临床病理学特征的关系。结果大肠癌VEGF-C表达率为48%,显著高于正常肠黏膜的表达率11%;癌组织VEGF-C表达率在Duke′s分期A＋B期、C＋D期分别为26%、66%,在有、无淋巴结转移分别为67%、22%,差异均具有统计学意义（P〈0.05）。结论 VEGF-C在大肠癌中的表达与肿瘤临床分期及淋巴结转移密切相关,可能是大肠癌恶性程度评价及判断预后的重要指标。     

大肠癌淋巴结转移对预后的影响

目的通过分析大肠癌淋巴结转移的规律,探讨它对预后的影响。方法对有完整病理学检查和随访资料的1051例根治性切除的大肠癌病例进行回顾性分析淋巴结活检数目、淋巴结转移度、转移范围和跳跃式转移等淋巴结转移相关指标对预后的影响。结果转移达肠旁组,中间组,中央组的5年生存率分别为67．2％,65．2％,50．1％,差异有显著性（P〈0．01）。无淋巴结转移病例中,取检淋巴结数〉5枚者和≤5枚者5年生存率分别为96．5％和84．4％,差异有显著性（P〈0．01）。有淋巴结转移病例中,取检淋巴结数〉7枚者和≤7枚者5年生存率分别为79．6％和57．5％,差异有显著性（P〈0．01）。淋巴结转移度和跳跃式转移不影响预后。结论淋巴结活检数目和转移范围是影响预后的潜在因素。     

探讨大肠癌淋巴结转移度与预后的关系

目的：研究分析淋巴结转移度（LNR）与大肠癌预后的关系。方法选取该院120例行根治性切除大肠癌病例,所有患者均有完整病理学检查以及随访资料,对资料进行回顾性分析。结果 LNR和淋巴结转移数目均与大肠癌术后5年无病存活率和总存活率比较,差异有统计学意义（P〈0.05）,而LNR是总存活率的独立相关因素;对淋巴结病理检查数目未超过12枚的病例,LNR与5年无病存活率比较,差异有统计学意义（P〈0.05）。结论 LNR与大肠癌术后的预后密切相关,可以作为判断预后的指标之一。     

眼科鳞状细胞癌的临床研究与预后

目的讨论眼科鳞状细胞癌的临床研究与预后.方法根据患者临床表现结合检查结果与病理学进行临床研究.结论眼睑鳞癌在病程早期可侵犯眼轮匝肌,其后可侵犯眼眶内组织或转移至颌下淋巴结或腮腺淋巴结.但是,眼睑鳞癌出现转移的时间比其他部位鳞癌晚些,预后相对较好.早期眼睑鳞状细胞癌罕有转移,有较好的预后.如侵犯眶内组织,并有耳前或颌下淋巴结转移,预后差.     

乳腺癌浸润性微乳头状癌临床病理学特征及预后分析

目的分析乳腺癌浸润性微乳头状癌临床病理学特征及预后情况。方法收集我院病理科2015年3月至2018年3月收治的23例乳腺癌浸润性微乳头状癌患者临床资料,分析其临床病理学特征和预后情况。结果本研究中的23例患者未出现叫特殊的症状和体征,肿瘤细胞呈现微乳头状或桑葚状,呈现出中空簇状特点,缺乏显微血管轴心。对患者实施1年的随访后显示,出现了淋巴结转移、中晚期以及ER阴性患者的预后相对较差(P0.05)。结论乳腺癌浸润性微乳头状癌患者没有特殊症状和体征,在诊治过程中需对其病理学特征进行观察,并注意到对预后因素进行处理。     

Hpa和VEGF-C在大肠癌中的表达及意义

目的探讨大肠癌组织中乙酰肝素酶(Hpa)和血管内皮生长因子-C(VEGF-C)的表达与大肠癌发生、浸润转移及预后的关系。方法采用免疫组织化学Envison法,对大肠癌的癌组织与正常组织中Hpa和VEGF-C表达水平进行测定,结合大肠癌的临床病理学特征及预后进行分析。结果 Hpa和VEGF-C在大肠癌组织、正常组织中表达水平比较,差异有统计学意义(P<0.01)。Hpa和VEGF-C在大肠癌无淋巴结转移与淋巴结转移组,在大肠癌Ⅰ、Ⅱ和Ⅲ、Ⅳ期组织中及生存5年以下组和生存5年和(或)5年以上组表达率比较,差异有统计学意义(P<0.01)。结论 Hpa和VEGF-C在大肠癌组织中的高表达,在有转移(淋巴转移及远处转移)组高表达,说明Hpa和VEGF-C可能在大肠癌的发生、侵袭和转移中起作用。     

HDAC1和SIRT1在喉鳞癌中的表达及意义

目的:分析组蛋白去乙酰化酶(1HDAC1)及沉默信息调节因子1(SIRT1)在喉鳞癌中的表达及意义.方法:采用免疫组化SP法检测46例喉鳞癌组织及其癌旁正常的喉黏膜组织中的HDAC1、SIRT1表达水平,并分析HDAC1、SIRT1的表达与患者性别、年龄、病理学分级、临床分期、临床分型、有无淋巴结转移、预后的关系.结果:癌组织中的HDAC1主要表达于胞核、SIRT1主要表达于胞浆;HDAC1、SIRT1在喉鳞癌中的表达率分别为79.09％及82.61％,在癌旁正常喉黏膜组织中的表达率分别为8.69％及8.69％;HDAC1、SIRT1的表达与患者性别、年龄、病理学分级、临床分期及临床分型无关,HDAC1与淋巴结的转移和预后有关(P＜0.05),SIRT1与预后有关(P＜0.05),与淋巴结转移相关性不明显.结论:HDAC1、SIRT1在喉鳞癌组织中高表达,HDAC1与淋巴结的转移和预后有关,SIRT1与预后有关.     

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.