食管癌与结肠癌及其癌旁组织端粒酶活性的检测

①目的 建立测定端粒酶活性的PCR－TRAP方法，并探讨其对食管癌、结肠癌诊断的意义。②方法 应用PCR－TRAP方法，对36例食管癌、40例结肠癌及其癌旁组织进行了粒酶活性的检测。③结果 36例食管鳞状细胞癌组织端粒酶活性阳性检出率为80．50％，癌旁组织阳性检出率为6．00％，二者相比，差异有极显著意义（χ^2＝41．3，P＜0．001）。其中17例伴淋巴结转移中端粒酶活性均呈阳性，而未伴随淋巴结转移的病人中端粒酶活性阳性检出率为63．15％，二者差异有极显著性（χ^2＝7．02，P＜0．01）。40例结肠腺癌组织中端粒酶活性阳性检出率为91．75％，癌旁组织中阳性检出率为5．00％，两者相比差异有极显著性（χ62＝60．26，P＜0．001）；40例结肠癌均为腺细胞癌，其中12例伴淋巴结转移的标本中10例检测出活性，而29例未伴随淋巴结转移的病人中，有27例均为腺细胞癌，其中11例伴淋巴结转移的标本中10例检测出活性，而29例未伴随淋巴结转移的病人中，有27例检出端粒酶的活性，两者相比差异无显著性（P＞0．05）。④ 结论 端粒酶活性增高可能是致食管、结肠组织癌变的重要因素；端粒酶活性的检出可作为食管癌、结肠癌诊断的指标之一。     

食管癌及大肠癌和癌旁组织端粒酶活性的临床意义

目的：建立测定端粒酶活性的PCR－TRAP方法，并探讨其在食管癌、大肠癌诊断的意义。方法：应用端粒酶活性的PCR－TRAP方法，对36例食管癌、40例大肠癌及其癌旁组织进行了检测。结果：食管癌组织与癌旁组织端粒酶活性阳性检出率相比，差异有非常显性；伴随淋巴结转移的标本中端粒酶阳性检出率与未伴随淋巴结转移的标本比较，具有非常显性差异。40例大肠癌组织中端粒酶活性阳性检出率明显高于癌旁组织（P＜0．001）；伴随淋巴结转移的标本中端粒酶活性阳性检出率与未伴随淋巴结转移的标本相比，差异无显性。结论：端粒酶活性增高可能是致食管、大肠组织癌变的重要因素；端粒酶活性的检出可作为食管癌、大肠癌诊断的指标之一。     

食管鳞癌及癌旁组织中端粒酶活性的表达

目的:检测食管鳞癌及癌旁组织中端粒酶活性的表达。方法:采用PCR－TRAP方法检测38例食管鳞癌组织、16 例癌旁组织及12例正常食管粘膜组织的端粒酶活性,并观察食管鳞癌端粒酶活性表达与临床病理因素的关系。结果:38例食管鳞癌组织中,32例端粒酶活性呈阳性,阳性检出率为84．21%;16例癌旁组织中,5例端粒酶活性呈阳性,阳性检出率为31．25%;12例正常食管粘膜组织中,1例端粒酶活性呈阳性,阳性检出率为8．33%。食管鳞癌组织与正常食管粘膜组织或癌旁组织中端粒酶活性的差异具有显著性(P＜0．05)。端粒酶活性表达与食管鳞癌的临床分型、组织学分级、淋巴结转移、浸润程度及肿瘤大小无关。结论:端粒酶活性的检测可作为食管鳞癌诊断的指标。     

大肠癌及其转移淋巴结中端粒酶活性的研究

目的　研究大肠癌、癌旁组织及转移淋巴结中端粒酶的活性表达 ,探讨其与大肠癌的生物学特性及预后诸因素的关系。方法　采用PCR ELISA法定量检测 34例大肠癌组织、2 0例癌旁组织及 1 6例转移淋巴结中端粒酶的活性 (TA)。结果　 34例大肠癌组织中 ,端粒酶阳性表达 31例 ,阳性率 91 2 %。 2 0例癌旁正常粘膜组织中 ,仅 2例为阳性 (1 0 % )。 1 6例转移淋巴结中 ,1 3例检出端粒酶活性表达 ,阳性率为 81 3 %。淋巴结转移“ +”的大肠癌组织与淋巴结转移“ -”的大肠癌组织端粒酶活性A值相比有显著差异 (P <0 .0 5)。大肠癌组织与癌转移淋巴结中端粒酶活性水平明显高于癌旁组织 (P <0 .0 1 )。端粒酶的活性表达与大肠癌的部位、病理类型、分化程度、分期及侵袭范围等临床病理因素无明显相关性。结论　端粒酶的活性水平与大肠癌的发生、发展密切相关 ,是一种特异性很强的恶性肿瘤标志物 ,有可能成为大肠癌早期诊断的标志物和治疗的新靶点     

宫颈癌组织中端粒酶活性定量定性测定

目的 :探讨宫颈癌组织中端粒酶活性检测的意义及其与临床病理因素的关系。方法 :用TRAP ELISA定量及TRAP 银染定性方法 ,对 36例宫颈癌组织进行端粒酶活性检测 ,2 5例非癌宫颈组织作为对照。结果 :91 6 7%(33/ 36 )宫颈癌组织端粒酶活性阳性 ,而对照组 2 5例中仅 1例 (4 % )癌旁组织端粒酶活性阳性 ;宫颈癌和对照组端粒酶活性均值分别为 (1 5 80± 0 831) ,(0 0 38± 0 0 2 3) ,差异有显著性 (P <0 0 1) ;端粒酶活性高低与宫颈癌临床分期、体积大小无关 ,而与肿瘤分化程度和盆腔淋巴结转移有关 ,肿瘤分化程度越差 ,端粒酶活性越高 ,有淋巴结转移的宫颈癌组织端粒酶活性显著高于无淋巴结转移者。结论 :端粒酶活化在宫颈癌的发生过程中起重要作用 ,端粒酶活性可能与宫颈癌某些临床病理因素有关     

食管癌组织端粒酶活性检测的临床意义

目的 检测食管癌及癌旁食管粘膜组织中端粒酶活性,探索端粒酶活性与食管癌发生发展的关系。方法 采用PCR－TRAP方法检测43例食管癌和癌旁组织以及10例癌周正常食管粘膜的端粒酶活性。结果 43例食管癌组织38例（88．4％）表达阳性,癌旁组织7例（16．3％）表达阳性（P＜0．01）,10例正常食管膜表达阴性（P＜0．01）。端粒酶活性表达与病人的性别、肿瘤部位和大小、分化程度、临床分期、有无淋巴结转移无明显相关。结论 端粒酶活性与食管癌发生发展有密切关系,并有可能成为食管癌的临床肿瘤标记物,进而为食管癌早期诊断与治疗提供可靠指标。     

胆管癌组织端粒酶活性检测及意义

目的　探讨端粒酶活性与胆管癌的关系及其诊断意义。方法　采用端粒酶PCR ELISA法检测 2 3例胆管癌组织的端粒酶活性 ,同时以 5例胆管癌癌旁组织及 5例正常胆总管组织做对照。结果　 2 3例胆管癌组织中有 1 8例显示端粒酶活性(78.3% ) ,而癌旁组织、正常胆总管组织未显示活性。端粒酶阳性检出率与患者性别、肿瘤部位、分化程度、大小等因素无相关性 ,但肿瘤转移与端粒酶阳性检出率有显著差异 (P <0 .0 5 )。结论　端粒酶见于大多数胆管癌组织中 ,其活性可能在胆管癌的发生发展中起重要作用 ,有望成为恶性肿瘤诊断的标记物     

肺癌组织端粒酶活性测定

①目的　探讨端粒酶作为肺癌诊断标记物的可行性及临床意义。②方法　用TRAP法检测 2 9例肺癌组织、2 7例癌旁组织和 35例正常组织标本中端粒酶活性表达。③结果　 2 9例肺癌组织中 2 1例 (72 .4 % )端粒酶活性表达阳性 ,2 7例癌旁组织中 6例 (2 2 .2 % )端粒酶活性表达阳性 ,35例正常组织均不表达端粒酶活性。癌组织、癌旁组织与正常组织标本端粒酶活性比较有显著差异 (χ2 =34.0 13、3.937,P <0 .0 1、0 .0 5 )。④结论　端粒酶表达与肿瘤发生有关 ,其癌旁组织中端粒酶活性有可能成为判定肿瘤复发和预后的指标。     

端粒酶活性、PCNA在乳腺癌中的表达及其临床意义

目的:探讨端粒酶活性和增殖细胞核抗原在乳腺癌中的表达关系及联合检测对乳腺癌早期诊断及预后评估的临床意义.方法:采用TRAP-PCR-ELISA与S-P法检测乳腺癌组织81例,乳腺癌癌旁组织37例,乳腺良性病变组织11例的端粒酶活性和增殖细胞核抗原的表达.结果:81例乳腺癌组织、37例乳腺癌癌旁组织中端粒酶表达阳性率分别为74 1%和10 8%,P＜0 05差异有统计学意义,11例良性病变组织中未测出端粒酶活性;腋窝淋巴结转移、组织学分型与端粒酶阳性表达率,P＞0 05差异无统计学意义.81例乳腺癌组织PCNA的表达率71 6%.淋巴结转移组PCNA阳性表达率较无淋巴结转移组增高(P＜0 05),且呈正相关;端粒酶活性与PCNA表达的一致率92 24%,呈正相关.结论:端粒酶活性与PCNA联合检测,在乳腺癌早期诊断及预后评估方面有重要的临床意义.     

不同类型肺癌标本端粒酶活性检测的临床意义

目的 :探讨不同类型肺癌标本端粒酶活性检测的临床意义 ,分析端粒酶活性与肺癌分期、组织学类型和有无淋巴结转移间的关系。方法 :收集 42例新鲜手术切除肺癌组织和 35例癌旁组织 ;6 3例肺癌支气管肺泡灌洗液 ,同时行刷片和灌洗液细胞学检查 ,31例非肺癌肺疾病的灌洗液 ;34例肺癌痰液 ,31例非肺癌肺疾病的痰液。采用PCR -TRAP银染法检测端粒酶活性。结果 :①新鲜手术切除肺癌标本和癌旁组织的端粒酶活性阳性率分别为 6 4.3% ( 2 7/ 42 ) ,0 % ( 0 / 35 ) ,( χ2 =34.6 1,P <0 .0 1) ;Ⅰ～Ⅱ期肺癌和Ⅲ～Ⅳ期肺癌端粒酶活性阳性率分别为86 .7% ( 13/ 15 )和 77.8% ( 2 1/ 2 7) ( χ2 =0 .0 9,P >0 .0 5 ) ;无淋巴结转移和有淋巴结转移的端粒酶活性阳性率分别为 75 .8% ( 2 2 / 2 9)和 92 .3% ( 12 / 13) ,( χ2 =0 .6 9,P >0 .0 5 )。鳞癌、腺癌、小细胞癌端粒酶活性阳性率分别为 77.2 % ( 13/ 18)、87.5 % ( 14 / 16 )和 87.5 % ( 7/ 8) ( χ2 =0 .13,0 .0 2 ,0 .0 3,P均 >0 .0 5 )。②肺癌与非肺癌肺疾病支气管肺泡灌洗液端粒酶活性阳性率分别为 76 .2 % ( 4 8/ 6 3)和 6 .5 % ( 2 / 31) ( χ2 =40 .6 ,P <0 .0 1)。端粒酶阳性率高于刷检( χ2 =0 .3.0 1,P >0 .0 5 ) ,高于灌洗液细胞学 ( χ2 =2 4.96     

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.