Fas在胆脂瘤型中耳乳突炎中的表达及意义

目的 :探讨Fas在中耳继发胆脂瘤上皮中的表达及其在胆脂瘤型中耳乳突炎发病中的作用。方法 :利用免疫组化的方法 ,检查 32例胆脂瘤上皮和 1 1例正常外耳道皮肤中的Fas蛋白的表达情况。结果 :Fas阳性细胞主要在 2 9例胆脂瘤上皮的颗粒层和角质层中 ,阳性细胞率为 (2 1 0± 1 3 8) % ,在 3例胆脂瘤上皮和 1 1例外耳道皮肤中为阴性 ,差异具有显著性 (P <0 0 5 )。结论 :Fas在胆脂瘤上皮表达增高 ,与胆脂瘤中角化物的堆积有关。     

中耳胆脂瘤组织中碳酸酐酶的免疫组化研究

目的:探讨碳酸酐酶(carbonic anhydrase,CA)在中耳胆脂瘤组织中的表达及其在中耳胆脂瘤骨质破坏机制中的作用.方法:采用免疫组化SABC染色法检测54例(57耳)中耳胆脂瘤和22例正常外耳道皮肤中CA的表达.结果:CA在中耳胆脂瘤上皮和正常外耳道皮肤的阳性表达率分别为98.25%和63.64%,中耳胆脂瘤组织CA的表达较正常外耳道皮肤高(P＜0.05).CA在胆脂瘤上皮各层细胞均有阳性表达,角化物为阴性表达.正常外耳道皮肤CA主要分布在棘细胞层和颗粒层,基底细胞层和角质层表达较弱.广泛性胆脂瘤和局限性胆脂瘤CA表达差异无统计学意义(P＞0.05).结论:CA在中耳胆脂瘤组织中的表达增强,可能与胆脂瘤破坏骨质的脱矿物质阶段有关.     

白细胞介素1β在中耳胆脂瘤上皮的表达

目的 探讨IL-1β在中耳胆脂瘤上皮组织中的表达.方法 采用酶联免疫法测定胆脂瘤上皮组织匀浆液及正常外耳道皮肤组织匀浆液中IL-1β水平.结果 在12例中耳胆脂瘤上皮及10例正常外耳道皮肤组织中,IL-1β的表达分别为(313.562±52.924)及(141.414±31.335)pg/mL(P<0.01).结论 IL-1β在中耳胆脂瘤上皮组织中存在高表达;IL-1β可能参与促进胆脂瘤上皮增生.     

中耳胆脂瘤中肿瘤抑制基因PTEN表达及其临床意义

目的 探讨中耳胆脂瘤上皮中肿瘤抑制基因PTEN表达及其在中耳胆脂瘤上皮细胞存活机制中的作用.方法 采用免疫组织化学法(SP法)检测中耳胆脂瘤组织和正常外耳道皮肤中PTEN表达.结果 PTEN主要表达于胆脂瘤和外耳道皮肤组织的上皮细胞核中,且中耳胆脂瘤上皮组织中PTEN阳性表达率明显低于正常外耳道皮肤中的表达(P＜0.01).结论 PTEN异常表达可能参与了胆脂瘤的发生过程.胆脂瘤上皮中PTEN低表达可能参与了胆脂瘤上皮细胞过度增殖机制.     

肿瘤坏死因子-α和基质金属蛋白酶-9在中耳胆脂瘤中的表达及意义

目的：探讨肿瘤坏死因子-α（TNF-α）和基质金属蛋白酶-9（MMP-9）在中耳胆脂瘤中的表达及意义。方法：用免疫组织化学技术和计算机图像定量分析法,检测TNF-α、MMP-9在23例胆脂瘤上皮及10例正常人外耳道皮肤中的表达.观察二者的表达与听小骨骨质破坏程度的相互关系。结果：胆脂瘤上皮中TNF-α、MMP-9蛋白量明显高于外耳道皮肤（P〈0.05）;TNF-α和MMP-9在胆脂瘤上皮对骨质破坏分级中的阳性表达平均值与外耳道皮肤比较差异有统计学意义（P〈0.05）;TNF-α与MMP-9之间在胆脂瘤上皮的表达具有相关性。结论：MMP-9和TNF-α在胆脂瘤组织中呈高表达,且与骨质破坏程度呈正相关,表明其与胆脂瘤的骨质破坏密切相关。并且MMP-9和TNF-α的表达有相关性,提示二者之间相互作用共同加重骨质的破坏。     

破骨细胞在中耳胆脂瘤骨质破坏中的作用

目的 探讨破骨细胞(OC)在胆脂瘤骨质破坏中所起的作用.方法通过免疫组织化学技术和计算机图像定量分析法,检测破骨细胞分化因子(RANKL)和骨保护素(OPG)在27例胆脂瘤和11例外耳道皮肤中的表达.光镜观察8例胆脂瘤周围破坏听小骨和2例正常听小骨的形态学;透射电镜观察5例胆脂瘤周围破坏听小骨和2例正常听小骨的超微结构.结果RANKL的阳性表达量在胆脂瘤中为(0.247 0±0.210 1),在外耳道皮肤为(0.045 2±0.078 9)(P<0.05);RANKL/OPG比值在胆脂瘤中为(1.379 0±1.138 0),在外耳道皮肤为(0.358 1±0.376 8)(P<0.05);OPG在胆脂瘤中的阳性表达量为(0.202 6±0.094 9), 在外耳道皮肤中的阳性表达量为(0.262 7±0.172 4)(P>0.05).胆脂瘤周围破坏听小骨中有活性OC存在以及其参与骨破坏作用的证据.结论OC在胆脂瘤的骨质破坏中发挥一定的作用.     

基质金属蛋白酶-2,9在中耳胆脂瘤中的表达及意义

目的探讨基质金属蛋白酶(Matrixmetalloproteinases,MMP)-2,9在中耳继发性胆脂瘤中的表达及其临床意义。方法应用免疫组织化学技术(SP法),检测MMP-2和MMP-9在中耳胆脂瘤和外耳道皮肤中的表达。结果34例中耳胆脂瘤MMP-2和MMP-9的阳性表达率分别为85.3%和91.2%,明显高于外耳道正常皮肤的50.0%和40.0%(P<0.05和P<0.01)。胆脂瘤上皮染色最强,多为中等至强阳性表达,胆脂瘤上皮组织各层细胞均有表达,基底膜染色强。结论MMP-2及MMP-9与胆脂瘤骨质破坏特性有关。     

TGF-β1和p21WAF1在中耳胆脂瘤中的表达及其意义

［收稿日期］ ［基金项目］ ［作者简介］ 刘继丽（1980-）,女，吉林省龙井市人，医学硕士，主要从事中耳胆脂瘤的研究。 目的： 探讨TGF-β1和p21WAF1在中耳胆脂瘤中的表达，了解两者在胆脂瘤发病中的作用。方法： 应用免疫组化技术检测20例中耳胆脂瘤组和10例正常对照组中TGF-β1和p21WAF1的表达。结果： ①p21WAF1定位于细胞核，呈棕黄色颗粒状；TGF-β1主要胞浆着色，呈棕黄色颗粒状。②中耳胆脂瘤组p21WAF1阳性表达率65％，分布于上皮的全层，以靠近基底层的棘细胞层和颗粒层显著，阳性指数（LI）均值为28.9%±6.7%；而正常对照组未见p21WAF1阳性表达。p21WAF1在中耳胆脂瘤上皮中的表达高于对照组（P<0.05）。③中耳胆脂瘤组TGF-β1阳性表达率90％， 位于上皮全层， LI为 32.3%±5.7%；在正常外耳道皮肤中阳性表达率为50％，LI 为13.3%±4.9%，两组比较差异有显著性（P<0.05）。④在中 耳胆脂瘤组p21WAF1与TGF-β1表达LI均值比较差异无显著性（P>0.05），p21WAF1表达LI均值与TGF-β1表达LI均值呈正相关关系（r＝0.913，P<0.01）。结论：TGF-β1和p21WAF1蛋白促进胆脂瘤发生发展，并具有相关性。 ［关键词］ 转化生长因子β;p21WAF1;中耳胆脂瘤;细胞凋亡 ［中图分类号］ ［文献标识码］ A  （）     

核因子-κB在中耳胆脂瘤中的表达

目的 观察核因子-κB(NF-κB)在中耳胆脂瘤中的表达,探讨其在胆脂瘤上皮细胞高度增殖过程中的作用.方法 应用免疫组化法检测26例胆脂瘤上皮、20例正常外耳道皮肤中NF-κB及增殖细胞核抗原(PCNA)的表达情况.结果 胆脂瘤上皮细胞均出现明显的NF-κB核转位,NF-κB及PCNA的表达显著高于正常外耳道皮肤组织,差异有统计学意义(P＜0.01).结论 中耳胆脂瘤上皮具有高度增殖能力,NF-κB在胆脂瘤组织中的激活可能是中耳胆脂瘤上皮细胞过度增殖的一个原因.     

The expression of matrix metalloproteinase-9 and its relationship with bone destruction in cholesteatoma

目的:探讨基质金属蛋白酶9(MMP-9)在胆脂瘤上皮中的表达及其与胆脂瘤骨质破坏之间的关系.方法:取我院住院手术患者22例的胆脂瘤上皮,外耳道正常皮肤组织作对照,分别用免疫组化的方法测定MMP-9的表达,并利用计算机图像分析系统进行分析.结果:MMP-9在中耳胆脂瘤上皮组织及外耳道深部正常皮肤均有表达,平均光密度值分别为:0.263±0.013和0.221±0.006,经统计学分析显示中耳胆脂瘤上皮组织中的含量显著高于外耳道深部正常皮肤(P＜0.05),且与骨质破坏的程度相关(r=0.9626).结论:MMP-9与中耳胆脂瘤的骨质破坏密切相关,是中耳胆脂瘤骨质破坏中的很重要的物质.     

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.