恶性淋巴瘤的细胞遗传学研究

采用改良法制备了４０例活检淋巴结染色体标本，有３５例获得满意分裂相。分析结果表明：淋巴结良性疾患的染色体以正常二倍体为主；恶性淋巴瘤（ＭＬ）实体瘤染色体均失去正常核型，其数目及结构畸变明显，可涉及至６，１４，８，３，１１，１８，１，１３号等染色体。在反复出现的８个标记染色体中，如１４ｑ＋，ｔ（１１；１４），ｔ（８；１４），ｔ（１４；１８），ｄｅｌ（１）（ｐ１３—ｔｅｒ），１３ｑ＋等，有４个组成与１４号染色体有关，提示１４ｑ３２的断裂重排与ＭＬ的发生可能有关；在何杰金病（ＨＤ）中ｄｅｌ（１）（ｐ１３－ｔｅｒ），１３ｑ＋出现较多，提示１ｐ１３，１３ｑ３３的断裂重排可能与ＨＤ的发生存在一定关系。     

用微卫星寻找和定位血液系统肿瘤患者丢失的基因

目的：许多血液系统肿瘤的发生与患者染色体易位和基因丢失有关，基因丢失的部位往往存在抑癌基因。用微卫星确定是否发生基因丢失及基因丢失的位置。方法：用ＰＣＲ扩增不同染色体上常见白血病易位断裂点区域附近的１９个微卫星，变性胶凝胶电泳，以及用１１号染色体上的白血病相关ＭＬＬ基因探针做Ｓｏｕｔｈｅｒｎｂｌｏｔ杂交等方法，检测４９例血液系统肿瘤患者基因的杂合性丢失（ｌｏｓｏｆｈｅｔｅｒｏｚｙｇｏｓｉｔｙ，ＬＯＨ）及丢失部位。结果：发现１８例（１８／４９）血液系统肿瘤患者１～７个微卫星位点上存在ＬＯＨ；以１１号染色体微卫星Ｄ１１Ｓ１３０１的丢失最常见；３例（３／１０）急性髓细胞白血病（ＡＭＬ）患者在Ｄ１１Ｓ１３０１位点有ＬＯＨ，其附近有抑癌基因ＷＴ１和ＲＢＴＮ２。３（３／１３）例ＡＭＬ在Ｄ１１Ｓ１３１４有ＬＯＨ，附近有ＢＣＬ１基因。ＤＮＡ杂交检测发现仅３例ＡＭＬ有ＭＬＬ基因重排，其附近ＬＯＨ不多见。结论：急性白血病患者ＬＯＨ发生率较高，白血病患者染色体１１短臂ｐ１３区是抑癌基因丢失较常见的部位。     

食管癌不同染色体位点上等位基因杂合缺失的研究

应用聚合酶链反应（ＰＣＲ）技术，配合限制片段长短多态现象（ＲＦＬＰ）分析，对２２例食管癌病人３号染色体短臂３ｐ１４～２４，１７号染色体短臂１７ｐ１３．１杂合缺失（ＬＯＨ）进行了测定。结果显示：３ｐ２４、３ｐ２１、３ｐ１４和１７ｐ１３．１位点ＬＯＨ检出情况分别为８／１１、２／４、１／９和６／６，其中３ｐ２４和１７ｐ１３．１位点的ＬＯＨ较高，提示这一位点ＬＯＨ的测定有可能成为食管癌早期诊断的分子标志。实验发现，在３ｐ２４ＥＡｐＭＤ位点的ＬＯＨ检测中，哈萨克族杂合缺失为５／５，汉族为２／４，维吾尔族为１／２，这是否与种族遗传有关，有必要扩大病例进一步研究。     

世界首报6例人类染色体异常核型

目的：本文报道６例世界首报人类染色体异常核型：①４６，ＸＹ，ｔ（１；３）（１ｐ３６；３ｐ２１）；②４６，Ｘ，ｔ（Ｘ；６）（Ｘｐ２２；６ｑ１３）；③４６，ＸＸ，ｔ（５；１２）（５ｑ３１；１２ｑ１３）；④４６，ＸＸ，ｔ（６；１０）（６ｐ１０ｐ；６ｑ１０ｑ）；⑤４５，ｉ（Ｘｑ）／４６，Ｘ，ｉ（Ｘｑ）／４７，ＸＸ，ｉ（Ｘｑ）；⑥４６，ＸＹ，ｄｅｌ（３），ｔ（３；７）（３ｑ２１；７ｑ３３）。就染色体平衡易位患者的表型效应及平衡易位染色体对染色体复合畸变的影响做了初步探讨。方法：细胞遗传学检查由静脉采取外周血，用１６４０培养液，培养淋巴细胞，常规收获细胞、制片，ＧＴＧ显带。镜下计数分析３０个～５０个分裂像，显微摄影分析５个～１０个分裂像，必要时做高分辨及其它带型。结果：６例患者中染色体平衡易位５例、嵌合型Ｘ等臂染色体１例；多次流产２例、连续２次生育巨大畸形儿１例、原发闭经２例、发育过速１例。结论：染色体平衡易位等畸变是造成临床流产、闭经、发育异常、生产畸形儿等疾患的主要原因之一。     

巨大心脏瓣膜换术围手术期处理

为提高巨大心脏（ＣＴＲ〉０．７０）瓣膜替换术的手术疗效，作者回顾性分析了３３例病人的围手术期治疗经验及随访结果，３３例病人中，心功能Ⅲ级２２例，Ⅳ级１１例，其中属心源性恶液质７例，巨大左室（ＥＤＤ〉７０ｍｍ）１１例，手术方式：二尖瓣替换术（ＭＶＲ）１７例，主动脉瓣替换术（ＡＶＲ）３例，ＡＶＲ＋ＭＶＲ１３例，并行三尖瓣成形术１１例，术后早期死亡２例，（６．１％），长期生存的３１例中，心功能Ｉ级１３例     

先天性智能发育不全患儿的细胞遗传学研究

用低叶酸培养基（ＴＣ１９９）对９０例先天性智能发育不全（ＭＲ）患儿的外周血淋巴细胞进行了Ｇ显带分析及脆性Ｘ染色体研究。发现１９例染色体异常患者，占２１．１１％。其中先天愚型１４例，占１５．５６％；其它常染色体结构异常２例；性染色体异常１例；脆性Ｘ染色体２例，占２．２２％。结果表明对ＭＲ进行细胞遗传学研究时，不仅要注意染色体数目及结构的异常，尤应进行脆性Ｘ染色体的检测。本文首次证明脆性Ｘ综合征在本地区的存在，在ＭＲ中所占的比例与国外报道大致相同。脆性Ｘ染色体的诱导方法进行了讨论。还发现１例ＭＲ患儿，核型为４６，ＸＹ，ｔ（５；１５）（ｐ１５；ｑ１３），经鉴定为世界首报核型。     

从APACHE预测评分系统观察ICU多发伤病人的临床特点

利用ＡＰＡＣＨＥⅡ预测评分系统并联合ＳＩＲＳ及ＭＯＤＳ记分对７６例ＩＣＵ多发伤患者进行临床分析。结果显示：７６例患者ＡＰＡＣＨＥⅡ平均分为１８４分;平均ＩＣＵ停留时间为９１５ｈ;死亡６例（７９％）;并发ＭＯＤＳ１３例（１７１％）,ＡＲＤＳ１０例（１３２％）,严重感染２０例（２６３％）。ＡＰＡＣＨＥⅡ评分越高,患者ＩＣＵ停留时间越长,ＭＯＤＳ发生率及死亡率越高。     

从APACHE预测评分系统观察ICU多发伤病人的临床特点

利用ＡＰＡＣＨＥⅡ预测评分系统并联合ＳＩＲＳ及ＭＯＤＳ记分对７６例ＩＣＵ多发伤患者进行临床分析。结果显示：７６例患者ＡＰＡＣＨＥⅡ平均分为１８．４分;平均ＩＣＵ停留时间为９１．５ｈ;死亡６例（７．９％）;并发ＭＯＤＳ１３例（１７．１％）,ＡＲＤＳ１０例（１３．２％）,严重感染２０例（２６．３％）。ＡＰＡＣＨＥⅡ评分越高,患者 长,ＭＯＤＳ发生率及死亡率越高。     

严重多发伤患者血清肿瘤坏死因子—α,可溶性白介素—2受体 …

为观察血清肿瘤坏死因子（ＴＮＦ－α）、可溶性白介素－２受体（ＳＩＬ－２Ｒ）在严重氏发伤患者中的变化和临床意义,随机选择５７例严重多发伤（ＩＳＳ≥２５）患者,采用酶标法于伤后２４小时内、３天、７天和１３～１５天检测血清ＴＭＦ－α、ＳＩＬ－２Ｒ水平。发现５７例例患者治疗期间有１３例发生多器官功能失常综合征（ＭＯＤＳ（,ＴＮＦ－α和ＳＩＬ－２Ｒ在创伤组明显升高（Ｐ〈０．０５）,ＭＯＤＳ组更明显（Ｐ〈０．     

家族性t（5；11）细胞遗传学分析

目的染色体平衡易位是导致妊娠妇女习惯性流产、早产、新生儿早天的重要原因之一。通过对一连续３代出现ｔ（５；１１）家系的分析，为习惯性流产病因病理学提供新的资料。方法全血微量培养法培养外周血淋巴细胞，染色体行Ｇ、Ｃ式显带分析，调查研究先证者家系系谱。结果先证者２次培养、制作，全部核型均为４６，ｘｘ，ｔ（５；１１）（ｑ１３；ｑ２３）（５ｑｔｅｒ→５ｑ１３∷１１ｑ２３→１１ｐｔｅｒ；５ｐｔｅｒ→５ｑ１３∷１１ｑ２３→１１ｑｔｅｒ），先证者父亲、祖父的全部核型均携带有与先证者相同之衍生染色体。结论先证者及其父亲、祖父均为ｔ（５；１１）（ｑ１３；ｑ２３），十分罕见。由于携带者遗传物质丢失较少，故其表型及智力不受影响，但其生育方面的影响是明显的。先证者的表型与染色体无直接关系，唯一可疑的致畸因素是其母孕早期成病性地连续服用果导片。     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.