间断低剂量二乙基亚硝胺诱导C57BL/6J小鼠肝癌模型

[目的]建立C57BL/6J小鼠诱发性肝癌模型。[方法]C57BL/6J小鼠40只,随机分为4组:对照组、DEN1组、DEN2组、DEN3组。DEN1组及DEN3组小鼠于实验第1天腹腔注射二乙基亚硝胺溶液,剂量为20 mg/kg,对照组和DEN2组小鼠腹腔注射同体积PBS溶液。实验第5周,DEN2组和DEN3组小鼠的饮水中添加浓度为10 mg/L的二乙基亚硝胺,连续饮用4周后,改为正常饮水;实验第16周,处死各组动物,计算小鼠肝脏指数,观察各组小鼠肝脏大体及镜下改变。[结果]对照组和DEN1组小鼠肝脏无肉眼可见的癌结节,肝癌发生率为0;DEN2组有2只小鼠发现肝脏有单个微小结节,肝癌发生率为20%;DEN3组小鼠肝脏均有大小不等的多个白色癌结节,肝癌发生率为100%,病理组织切片显示为肝细胞癌。[结论]间断低剂量二乙基亚硝胺能够快速诱导C57BL/6J小鼠肝细胞癌模型。     

DEN诱发大鼠肝癌模型的实验病理研究

目的：建立DEN肝癌模型并初步动态观察大鼠肝癌发生的病理形态演变过程。方法：用2‰DEN溶液灌喂诱发Wistar大鼠肝癌，病理常规HE染色动态观察。结果：病理学检查证实DEN成功诱发肝癌，诱癌率为87．17％（34／39），大鼠肝癌癌变过程大致经过肝细胞损伤期、肝细胞增生硬化期和肝细胞癌变期等三个时期，具有与人体肝癌相似的病变过程及病理学变化特征。结论：该肝癌模型可作为研究人类肝癌的一种理想的动物模型。     

b-FGF在原发性肝细胞肝癌中的表达及临床意义

目的：研究b-FGF在原发性肝细胞肝癌中的表达及临床意义。方法：采用免疫组化S-P法分析b-FGF在原发性肝细胞肝癌中的表达。结果：原发性肝癌45例中b-FGF表达阳性者31例（68．9％），显著高于癌旁组织23例中b-FGF表达阳性者8例（34．8％）及正常肝14例中b-FGF表达阳性者6例（42．3％）；在高分化（8／17）、无肝内转移（16／28）、无淋巴转移（18／31）的肝癌中b-FGF阳性表达率明显低于低分化（23／28）、有肝内转移（15／17）、有淋巴转移（13／14）的肝癌病人（P〈0．05）。结论：b-FGF可能是原发性肝细胞肝癌的生物学行为和预后的重要标记物，阳性表达者可能恶性程度高和预后不良。     

异位肝组织原发性肝细胞性肝癌的临床病理学观察

目的探讨异位肝组织原发性肝细胞性肝癌临床病理特点。方法对1例异位肝组织原发性肝细胞性肝癌进行临床病理及免疫组化观察,并复习相关文献。结果患者因血清AFP升高发现肿瘤,核磁共振检查发现肿瘤位于左肋膈角及脾脏之间,手术完整切除后AFP下降,病理诊断为异位肝组织原发性肝细胞性肝癌。结论异位肝组织非常少见,异位肝组织可发生于肝脏常见的相应病变甚至肿瘤;血清AFP升高是异位肝细胞癌的重要临床特征;异位肝细胞需要和转移肝细胞癌及肝样腺癌鉴别。     

Clinicopathological study of ectopic hepatocellular carcinoma

目的 探讨异位肝组织原发性肝细胞性肝癌临床病理特点.方法 对1例异位肝组织原发性肝细胞性肝癌进行临床病理及免疫组化观察,并复习相关文献.结果 患者因血清AFP升高发现肿瘤,核磁共振检查发现肿瘤位于左肋膈角及脾脏之间,手术完整切除后AFP下降,病理诊断为异位肝组织原发性肝细胞性肝癌.结论 异位肝组织非常少见,异位肝组织可发生于肝脏常见的相应病变甚至肿瘤;血清AFP升高是异位肝细胞癌的重要临床特征;异位肝细胞需要和转移肝细胞癌及肝样腺癌鉴别.     

兔VX2肝癌模型的建立

目的建立可供实验研究的稳定的兔VX2肝癌模型。方法新西兰大白兔59只,取瘤块（1mm^3大小）开腹包埋法接种到兔肝脏左叶,于种植后第1,1．5,2,2．5,3,3．5,4周分别行超声学检查主要观察兔肝VX2成瘤检出情况。成瘤情况均经病理学证实。结果①围手术期3只兔因麻醉死亡,1只因感染死亡,成活率为93．2％（55／59）;②兔肝原位肝实质内种植成功50个,其中伴有16只异位种植,单纯异位种植为3只,未发现病灶2只,原位成瘤率为90．9％（50／55）;③接种后1周、1．5周经超声检查22例,发现病灶者8例,检出率为36．4％（8／22）;其余肿瘤在2周及2周以后超声检查全部检出。两个时间段检出率有明显差异;④兔肝VX2肝癌的超声主要表现为略高回声、等回声、低回声,周围可见声晕。结论建立兔VX2肝癌模型成功率高、方法简单、周期短、动物死亡率低,种植2周后超声学筛选及监测本瘤有意义。     

18F-FDGPET/CT在原发性肝癌诊断中的应用研究

目的评价18F-脱氧葡萄糖（18F-FDG）PET/CT（正电子发射计算机断层扫描）诊断原发性肝癌的价值.方法分析原发性肝癌行PET/CT检查病例50例,其中病理诊断组35例,临床诊断组15例.根据18F-FDG摄取程度将病灶分为3种类型.Ⅰ型：病灶18F-FDG摄取明显高于周围正常肝组织;Ⅱ型：病灶18F-FDG摄取比周围正常肝组织稍增高;Ⅲ型：病灶18F-FDG摄取低于周围正常肝组织或无摄取.结果临床诊断中：14例为Ⅰ型,其余1例为典型Ⅱ型;病理诊断中：中分化肝细胞性肝癌（HCC）17例、低分化HCC5例和胆管细胞癌（CCC）5例为Ⅰ型,中分化肝细胞性肝癌5例及高分化肝细胞性肝癌1例为Ⅱ型,2例高分化HCC为Ⅲ型.PET/CT显像还发现了CT未发现的转移灶5个.结论18F-FDGPET/CT是诊断原发性肝癌的一种有效方法,能评价HCC的分化程度,但在Ⅲ型的诊断中,应结合11C-乙酸盐PET/CT或MRI等手段联合分析.     

肝癌的PCNA与临床预后关系的研究

对52例肝细胞癌结合临床作PCNA免疫组化研究。结果肝癌细胞PCNA阳性率为35．5％，而正常肝为阴性。肝细胞癌分化越差，其PCNA阳性率越高。并显示PCNA与肝癌分化程度、转移、浸润及预后密切有关，可作为评估肝癌患者预后的一个指标。     

二乙基亚硝胺诱发大鼠肝癌的病理形态学研究

使用DEN诱发大鼠肝癌,整个诱癌过程分为非特异性药物反应、非癌性增生性改变和肝癌发生3个阶段。非癌性增生性改变表现为由各种异常肝细胞组成的增生结节和小胆管腺瘤样增生,从实验过程和形态学看,增生性改变与癌肿发生具有密切关系。依分化程度,肝癌的超微结构呈多样性改变。在1例胆管细胞癌中发现与APUDoma所见不能区别的致密核心颗粒,推测为1种特殊类型的胆管细胞癌。作者认为,DEN诱发的肝癌具有肝细胞和胆管细胞两种组织起源。     

促凋亡基因bax在肝细胞癌的表达及其临床意义

目的：研究促凋亡基因bax在肝细胞癌（HCC）的表达及其临床意义。方法：应用免疫组化SP方法，检测44例原发性肝细胞癌（包括其中22例肝癌伴肝硬化）、肝硬变20例和正常肝组织中bax蛋白的表达。结果：bax阳性率在HCC为2．27％（1／44）、肝硬变为30％（6／20）和10例正常肝组织为50％（6／20）和10例正常肝组织为50％（5／10）。结论：肝癌与肝硬化之间以及肝癌与正常肝组织间均有显著差别P＜0．05，bax参与细胞凋亡的调节作用。     

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.