胃癌及癌前病变中P21与P53蛋白表达、幽门弯曲杆菌感染的相关性研究

目的:利用胃癌及癌前病变生物学恶性信息,检测胃粘膜活检组织中幽门弯曲杆菌感染与P21、P53表达的关系。方法：收集胃粘膜活检标本,应用免疫组化技术,常规石蜡切片、HE、Giemsa染色观察。结果：幽门弯曲杆菌（HP）感染率：慢性浅表性胃炎（CSG）30．8％（8／26）,慢性萎缩性胃炎67.9％19／28）,肠上皮化生63．6％（21／23）,不典型增生（AH）73％（22／30）,胃癌（GC）64．1％（25／39）。HP感染与各型病变中P21表达阳性率（％）关系：HP阳性者为36.8～64．0,其中GC为最高,AH为次;HP阴性者为22．2～57．1,与P53表达阳性率（％）关系：HP阳性者为31.6～60．0,其中GC为最高,AH为次;HP阴性者为11．1～50．0。结论：对胃癌及癌前病变进行HP及两种蛋白检测,有助于认识HP感染是胃癌发生的高危因素及胃粘膜萎缩→肠化生→异型增生→癌变的P21、P53表达阳性率呈递增的规律。     

幽门螺杆菌感染与小儿胃炎和十二直肠溃疡的关系

目的：探讨幽门螺杆菌（Hp）感染与小儿胃炎和十二直肠溃疡的关系。方法：对186例有消化道症状的儿童进行内窥镜检查,并取胃窦部活检组织作细菌培养和组织病理学检查。结果：内镜检查有消化道疾病的患儿178例,病变检出率为95．7％（178／186）,Hp感染检出80例,阳性率为44．9％。儿童Hp感染率与年龄呈显著丑三相关（r=0．94,P=0．012）;慢性中度炎症比轻度炎症者幽门螺杆菌感染率明显增高,重度炎症比中度炎症幽门螺杆菌感染率明显增高;少数民族Hp感染率为56．3％（45／80）,汉族为35．7％（35／98）,差异有统计学意义。HP感染患儿所患上消化道疾病的发生率与年龄旱显著正相关（r=0．990,P=0．003）。结论：（1）小儿Hp感染率随年龄增长而递增;（2）胃粘膜病变越重Hp阳性率越高;（3）少数民族儿童的Hp感染率高于汉族。     

胃粘膜幽门螺杆菌检测分析

通过胃粘膜幽门螺杆菌（HP）检测分析，探讨HP感染与胃疾病的关系。方法：用MB染色检测1354例胃粘膜HP。结果：1354例胃粘膜HP检出率为51．5％。其中慢性浅表性胃炎、慢性萎缩性胃炎、胃溃疡胃息肉、腺体异型增生、胃癌活检组织中的HP检出率分别为49．5％、53．5％、60．2％、51．8％、68．3％、39．8％。胃癌的HP检出率明显低于其他病变（P＜0．01）。慢性浅表性和萎缩性胃炎中有活动性变化535例，HP感染80．2％，无活动性病变465例，HP感染只有18．9％，两者有非常显著的差异（P＜0．001）。萎缩性胃炎伴肠化292例，HP检出阳性105例（35．9％），不伴有肠化127例，HP检出阳性119例（93．7％），这二组也有非常显著性差异（P＜0．01）。结论：HP的感染与活动性胃炎、胃溃疡、胃息肉及腺体异型增生有明显的关系，本组病例胃癌的HP检出率偏低，HP感染与胃癌的关系有待进一步研究。     

幽门螺杆菌感染与胃粘膜淋巴滤泡发生的关系

目的：了解胃粘膜淋巴滤泡的发生与HP感染的关系,胃炎性质及活动程度对其发生的影响。方法：对206例慢性胃炎、消化性溃疡的患者进行胃镜检查,取粘膜组织作幽门螺杆菌（HP）检测和组织病理观察。结果：在HP感染的患者中粘膜淋巴滤泡的检出率为47．5％,而无HP感染者仅为13．1％,HP感染程度和产生的差异对淋巴滤泡的发生无显著影响;活动性胃炎中胃粘膜淋巴滤泡的发生率高于非活动性胃炎;浅表性胃炎和萎缩性胃炎的淋巴滤泡发生率无明显差异。结论：胃粘膜淋巴滤泡的发生与HP感染可能有直接的关系,可作为HP相关性胃十二指肠疾病中一个较为恒定的形态学特征和标志。     

幽门螺杆菌相关性胃炎血清胃泌素的测定比较

目的：评价幽门螺杆菌（HP）相关性胃炎血清胃泌素测定的意义。方法：对慢性胃炎的HP感染的106例不同时间空腹血清胃泌素测定分为4组进行比较。结果：当HP感染仅限于胃粘膜内的血中抗HP抗体还没产生时，胃泌素的释放轻度增加（P＜0．05），若HP感染不仅在胃粘膜中，而血中产生抗HP抗体后，胃泌素的释放明显增加（P＜0．01）。当HP在胃粘膜已清除，血中虽有抗HP抗体存在，但胃泌素释放基本不受影响（P＞0．05）。。结论：只要在胃粘膜中发现HP感染，使胃泌素释放增加，需要进行抗HP治疗，若仅血中查出抗HP抗体，而胃粘膜中未发现HP感染此时可不需治疗。     

122例消化门诊患者幽门螺杆菌感染情况及其根除疗效分析

目的：了解本地区群众幽门螺杆菌（ HP）感染率，观察HP根除治疗效果。方法：应用14 C－尿素呼气试验随机调查本院消化门诊患者HP感染情况，对HP阳性者进行胃镜和／或病理检查，对有根除治疗适应证者应用四联疗法，记录并统计HP感染、HP转阴率及试验、治疗期间不良反应情况。结果：本地区群众HP感染百分比为48．4％，农村居民HP感染百分比59．6％，明显高于城市居民的41．3％（P＜0．01），男性HP感染百分比51．6％，明显高于女性的44．8％（p＜0．05），并且HP感染百分比有随年龄增长而增高的趋势，慢性胃炎、消化性溃疡患者HP感染率明显高于其他上消化道疾病患者（ P ＜0．05）。3种治疗方案HP根除率分别达到81．5％、81．5％及81．5％。结论：本地区群众HP感染率与全国相仿，对具有消化道症状患者，建议积极接受14 C －UBT进行HP检测，并对HP阳性者进一步做胃镜检查，对有适应证者及时进行HP根除治疗。     

功能性消化不良检测和根除幽门螺杆菌的诊疗价值

目的：检测幽门螺杆菌(HP)在功能性消化不良（FD）患者中感染情况，探讨检测和根治HP对FD患者的诊疗意义。方法：采用^14C－尿素呼气试验检测572例FD患者的HP感染情况，对HP性阳患者进行三联根除治疗，并与HP阴性患者行PPI标准剂量治疗进行症状改善情况对比。结果：572FD患者中，HP阳性337例，阳性率58．92％，阴性235例；HP阳性患者中253例完成三联根除治疗且停药一个月后复本HP达阴性者214人，根除率84．58％（214／235），消化不良症状改善率26．17％，阴性患者235例中的187例症状改善率5．88％（11／187）。结论：检测和根治HP能改善部分FD患者的临床症状。     

幽门螺杆菌与舌苔,内镜象的关系

205例胃痛患者经中医舌象观察及内窥镜检查、胃粘膜HP检测发现，活动性胃炎HP检出率为94.3％，黄苔出现率78．0％．胃、十二指肠球部溃疡（77．0％伴活动性胃炎）HP检测度为86．4％．黄苔出现率为71．0％。非活动性胃炎HP检测度为34．5％，黄苔出现率为58．0％，其差别有显著性意义（P＜0．05），表明胃内炎症轻重，与HP感染率及黄苔出现率相关。     

乙型肝炎病毒及幽门螺杆菌感染对慢性乙型肝炎患者胃粘膜病变的影响

目的：探讨乙型肝炎病毒及幽门螺杆菌感染对慢性乙型肝炎患者胃粘膜病情变化的影响。方法：对60例感染慢性乙型肝炎病毒的感染者用酶联免疫吸附法（ ELISA ）检测血清中乙型肝炎病毒表面抗原和乙型肝炎病毒核心抗原及幽门螺旋杆菌抗原;免疫组织化学法（ Envision ）检测胃粘膜组织中三者抗原,同时联合快速尿素酶。分为慢性乙型肝炎组和肝硬化组两组,每组30例,肝硬化组再分为食管静脉曲张组和无食管静脉曲张组,每组15例。同时选择30例无肝病的胃炎患者为对照组。结果：29例经胃镜检测发现乙型肝炎病毒,且其中20例患者胃粘膜组织有异常病变,病变主要以中、重度为主,占患者总数的68．97％。31例患者的胃部粘膜组织中组织异常,其炎性病变以轻、中度为主,占70．97％。差别具有统计学意义（ P＜0．05）。慢性乙型肝炎病毒感染者胃粘膜组织中乙肝病毒表面抗原和乙肝病毒核心抗原均为阳性的胃粘膜病变的程度较重。胃粘膜有炎症表达的幽门螺旋杆菌的感染率在慢性乙型肝炎组和肝硬化组分别为77．78％和79．31％,无肝病的胃炎组的感染率为56．70％,各组间无显著性的差别,且差别无统计学意义（ P＞0．05）。结论：乙型肝炎病毒是感染者胃粘膜病变的主要诱因之一,且与胃粘膜病变程度有关;幽门螺旋杆菌感染和慢性乙型肝炎患者胃粘膜病变程度之间无显著关联性。     

消化道钩虫蛔虫病患者HP感染情况分析

目的通过对158例钩虫蛔虫感染患者的胃镜检查，探讨钩虫蛔虫感染患者出现上消化道症状的疾病种类及其与幽门螺杆菌（Helicobacter pylori，HP）感染的关系。方法对有上消化道症状、经胃镜确诊为钩虫蛔虫感染的158例患者，同时在胃镜下钳取胃黏膜进行快速尿素酶实验及病理检查，所得结果与同期随机选取接受同样检查的非钩蛔虫或感染者158例结果进行统计学分析。结果实验组HP阳性者94例（59．49％，94／158），对照组HP阳性者52例（32．91％，52／158）。两组结果经统计学处理，实验组HP检出率高于对照组（Х^2=22．45866，P〈0．01）；实验组内钩虫感染者HP阳性68例（64．76％，68／105），阴性37例（35．83％37／105），蛔虫感染者HP阳性26例（49．05％，26／53），阴性27例（50．94％，27／53），经统计学处理，两组HP感染无显著性差异（Х^2-3．6050，P〉0．05）。结论肠道钩虫或蛔虫感染者与HP感染存在共存关联性，其出现消化道症状和合并上消化道疾病可能与合并HP感染有关。     

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.     

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.