浅表型膀胱癌p53基因过度表达的预后价值

用抗ｐ５３单克隆抗体ＤＯ－７检测４９例浅表型膀胱癌病理蜡块，获总阳性率２８．６％（１４／４９）。其中血管浸润组阳性率６０％（６／１０），显著高于无血管浸润组的２０．３０％（８／２９，Ｐ〈０．０５）。病理分级Ｇ１阳性率１３．６％（３／２２），Ｇ２３８．９％（９／２１），Ｇ３５０％（４／６），总体构成比无统计学意义。初步随访结果表明，除病理分级外，ｐ５３阳性及血管浸润与否均与疾病进展无相关性。但ｐ５３     

TGF-β_1在肾癌中的表达及与细胞凋亡和凋亡抑制基因bcl-2的关系

目的：阐明ＴＧＦ－β１在肾癌中的作用及机理。方法：应用免疫组化结合微波抗原修复和流式细胞技术，对５２例肾癌及１４例癌旁正常组织的凋亡率及ＴＧＦ－β１（ｔｒａｎｓｆｏｒｍｉｎｇｇｒｏｗｔｈｆａｃｔｏｒ）、ｂｃｌ－２的表达进行了定性、定量的测定，并就它们的相关性进行了分析。结果：ＴＧＦ－β１在正常肾组织和肾癌组织的阳性率分别为２１．１４％，５３．８４％；阳性蛋白细胞率分别为（１８．０７±６．５２）％，（４０．８４±１８．６７）％。ＴＧＦ－β１、ｂｃｌ－２在肾癌组织的阳性率和相对蛋白含量高于正常肾组织（Ｐ＜０．０５）。ＴＧＦ－β１的表达与临床分期，病理分级无关（Ｐ＞０．０５），凋亡率随ＴＧＦ－β１的表达有增高的趋势，与ｂｃｌ－２的表达无明显相关（Ｐ＞０．０５）。结论：ＴＧＦ－β１促进肾癌细胞的凋亡，可能是肾癌发生、发展的负调因子。但其调节细胞凋亡的机理与ｂｃｌ－２的表达无关     

肝癌组织中转化生长因子β亚型的表达及与肝癌复发的关系(摘要)

探讨原发性肝癌（ＨＣＣ）组织中３种转化生长因子β（ＴＧＦβ）的表达及其与肝癌复发的关系。方法ＡＢＣ免疫组织化学方法检测５２例小肝癌患者癌组织中３种ＴＧＦβ的免疫反应性,并根据术后２年内肝癌有无复发,分析其与肝癌复发的关系。结果复发组ＴＧＦβ１表达阳性率为８５％（１７／２０）,无复发组ＴＧＦβ１表达阳性率为４７％（１５／３２）,两组比较差异有显著意义（Ｐ＜０．０５）。复发组ＴＧＦβ２阳性率５０％（１０／２０）,强阳性率４０％（８／２０）,无复发组ＴＧＦβ２阳性率６６％（２１／３２）,强阳性１３％（４／３２）,两组比较差异有显著意义（Ｐ＜０．０５）。复发组ＴＧＦβ３阳性率４５％（９／２０）,无复发组ＴＧＦβ３阳性率６３％（２０／３２）,两组比较差异无显著意义（Ｐ＞０．０５）。结论肝癌组织中ＴＧＦβ１、ＴＧＦβ２的免疫反应性与肝癌复发呈正相关。     

前列腺特异性抗原在前列腺癌筛选中的意义

目的：探讨前列腺特异性抗原在前列腺癌诊断中的敏感性和特异性，为临床前列腺癌筛选提供一定的理论基础。方法：收集血清90例，其中，正常对照组、前列腺癌组、良性组各30例，比较三组前列腺特异性抗原的含量。结果：正常对照组血清前列腺特异性抗原含量为（1．59±0．93）μg/L；前列腺癌组血清前列腺特异性抗原含量为（72．34±69．87）μg／L，阳性率93．4％，与正常对照组比较，差异有统计学意义（P〈0．01）；良性组血清前列腺特异性抗原含量为（3．47±2．37）μg／L，阳性率23．7％，与正常对照比较，轻度增高，但无统计学意义，而与前列腺癌组比较差异有统计学意义（P〈0．01）。结论：前列腺特异性抗原在前列腺癌的诊断中发挥着极其重要的作用，但其诊断的特异性还有待于进一步提高。     

肿瘤标志物联检临床应用的分析

目的探讨多项肿瘤标志物联检对恶性肿瘤诊断的价值。方法对198例恶性肿瘤患者应用化学发光和放免法进行血清相关肿瘤标志物的联合检测。结果198份肿瘤患者标本肿瘤标志物联检总阳性率75．8％,其中肝癌组阳性率最高（95．2％）,膀胱癌,肾癌组阳性率最低（50%）。结论肿瘤标志物联检可弥补单项检测的不足,提高诊断的敏感性。     

庚型肝炎病毒合并/重叠其他肝炎病毒感染状况调查

目的：了解庚型肝炎病毒（ＨＧＶ）合并／重叠其他肝炎病毒感染状况。方法：分别对４９７例不同病原的病毒性肝炎患者进行ＨＧＶＲＮＡ（ＲＴＰＣＲ）检测，对其中１８０例患者进行抗ＨＧＶ（ＥＬＩＳＡ）检测。结果：①ＨＧＶ在各型病毒性肝炎患者中总的合并／重叠感染率为７．８％（３９／４９７）。②ＨＧＶ合并／重叠感染丙型肝炎病毒感染率为１８．９％（１０／５３），高于其他肝炎病毒的合并／重叠感染率，Ｐ＜０．０１。③有输血史的病人ＨＧＶＲＮＡ阳性率（１６．０％，１２／７５）高于无输血史的患者（６．４％，２７／４２２），Ｐ＜０．０１。④合并／重叠ＨＧＶ感染组与非合并／重叠ＨＧＶ感染组比较，两组肝功能指标无统计学差异（Ｐ＞０．０５）。⑤抗ＨＧＶ的检出率为１２．８％（２３／１８０），但其中仅有２１．７％（５／２３）同时为ＨＧＶＲＮＡ阳性。结论：①输血是传播ＨＧＶ的主要途径之一，但ＨＧＶ也可经非输血途径传播。②ＨＧＶ致病性可能较弱。③抗ＨＧＶ阳性并不一定代表ＨＧＶ病毒复制。     

膀胱移行细胞癌尿脱落细胞VEGF表达的研究

目的：研究尿脱落细胞ＶＥＧＦ表达与膀胱癌的关系，探讨其作为膀胱肿瘤诊断标记物的临床意义。方法：应用免疫组化技术检测４０例膀胱癌患者和２０例非肿瘤患者尿脱落细胞ＶＥＧＦ的表达。结果：ＶＥＧＦ在非肿瘤组尿脱落细胞无表达，而在肿瘤组尿脱落细胞表达率为４０％，联合常规ＨＥ染色检测可提高肿瘤检出率达８６．２％。复发组膀胱癌尿脱落细胞ＶＥＧＦ表达率７０％，明显高于初发组的３０％（Ｐ＜０．０５）。ＶＥＧＦ在膀胱癌的表达率与肿瘤分期有相关性，而与肿瘤分级程度无相关性。结论：检测尿脱落细胞ＶＥＧＦ表达，可作为膀胱肿瘤诊断、监测复发的良好指标，可提高尿脱落细胞检测膀胱癌的阳性率。     

膀胱移行细胞癌血管内皮生长因子的表达及临床意义

目的：探讨血管内皮生长因子与膀胱癌浸润及复发的关系。方法：应用ＬＳＡＢ免疫组织化学技术检测４０例膀胱移行细胞癌血管内皮生长因子（ＶＥＧＦ）的表达。结果：膀胱癌细胞ＶＥＧＦ的表达率为５５％（２２／４０）,浸润性癌组ＶＥＧＦ的表达显著高于表浅性癌组（Ｐ＜０．０１）,有淋巴结转移癌组显著高于无转移癌组（Ｐ＜０．０５）,复发性癌组较初发性癌组差异有显著性（Ｐ＜０．０１）。结论：ＶＥＧＦ可作为判断膀胱癌生物学行为的指标之一。     

胃幽门螺杆菌感染患者血清抗体间接免疫荧光检查方法及其意义

目的：研究幽门螺杆菌（Ｈｅｌｉｃｏｂａｃｔｅｒｐｙｌｏｒｉ，Ｈｐ）感染的一种无创伤性血清免疫荧光抗体检查技术，作为消化性溃疡（ＰＵ），慢性胃炎（ＣＧ）以及非溃疡性消化不良（ＮＵＤ）患者Ｈｐ感染的快速诊断和Ｈｐ清除与否的指标，并和内镜活检尿素酶法，直接细菌染色法比较，以确定Ｈｐ血清免疫荧光抗体的诊断价值．方法：观察对象为内镜诊断的ＰＵ２８例；ＣＧ１２２例及正常人３０例，共１８０例，均经尿素酶及Ｈｐ染色两法测试．两法均阳性者１００例（ＰＵ１７，ＣＧ８３），阴性５０例，还有阴性健康者３０例．结果：免疫荧光法测试结果，在前两法阳性组的阳性率为９６％（９６／１００），阴性组的阳性率为２２％（１１／５０），阴性健康组的阳性率为３％（１／３０）．结论：Ｈｐ血清免疫荧光与非免疫荧光比较，前者对Ｈｐ诊断特异性强，敏感性高，在粘膜内Ｈｐ定位清晰．     

无水乙醇栓塞对肾癌微血管和碱性成纤维生长因子及其受 …

用免疫组织化学ＳＰ法对无水乙醇栓塞后肾癌手术标本３６例及同期单纯手术切 标本１０全名微血管数目、碱性成纤维生长因子（ｂＦＧＦ）和其受体（ＧＦＧ－Ｒ）的表达进行检测，并进行比较。结果显示术前栓塞组的微血管数目低于手术对照组，用不着工异有显著性（Ｐ〈０．００１），ｂＦＧＦ和ＦＧＦ－Ｒ的表达具有一致性，术前栓塞组ｂＦＧＦ和ＦＧＦ－Ｒ阳性率为５５．６％，手术对照组ＢＦＧＦ和ＦＧＦ－Ｒ阳性率为６０％，两组相     

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.