大肠癌组织中凋亡抑制蛋白survivin的表达及其与bcl-2、c-erbB2表达的关系

目的 :探讨凋亡相关基因survivin在大肠癌组织中的表达与临床病理及与bcl 2和c erbB2表达的关系。方法 :采用免疫组化的方法检测 12例大肠正常粘膜及 5 7例大肠癌患者肿瘤组织中survivin和bcl 2、c erbB2的表达。结果 :12例大肠正常粘膜中survivin呈阴性表达 ,阳性率 0 0 % ;5 7例大肠癌组织中survivin阳性表达 3 6例 ,阳性率 63 2 % ;bcl 2阳性表达 3 3例 ,阳性率 5 7 9% ;c erbB2阳性表达 3 0例 ,阳性率 5 2 6%。survivin表达与患者年龄、性别、组织分型、淋巴结转移及Dukes分期等无明显相关性。survivin在bcl 2阳性和阴性患者中阳性率分别为 72 7% ( 2 4/3 3 )和 2 9 2 % ( 7/2 4) ,两者间有显著差异 (P <0 0 1) ;survivin在c erbB2阳性和阴性患者中阳性率分别为 73 3 % ( 2 2 /3 0 )和 3 7 0 % ( 10 /2 7) ,两者间也有显著差异 (P <0 0 1)。结论 :大肠癌患者survivin高表达导致的凋亡抑制在大肠癌的发生发展中起了重要作用 ,survivin表达与大肠癌中bcl 2和c erbB2异常表达相关。     

高表达Ck2β与大肠癌发生和转移的相关性研究

摘要：目的探讨ck2β蛋白在正常大肠粘膜、大肠腺瘤和大肠癌组织中的表达及其在大肠癌发生及转移中的作用。方法
采用免疫组化方法检测46例正常大肠粘膜组织、20例大肠腺瘤及66例大肠癌组织中ck2β蛋白的表达。用RNA干扰技术
沉默大肠癌细胞中ck2β蛋白表达,Western blot 实验检测干扰效果;平板克隆形成实验检测细胞增殖能力的变化;Transwell
侵袭小室实验检测细胞侵袭能力的变化。结果ck2β在正常大肠粘膜组织中不表达或弱表达,核表达阳性率为
8.7%,浆表达阳性率为13.0%;在大肠腺瘤组织中中度表达,60%呈核阳性表达,40%呈浆阳性表达;而在大肠癌组织中,
ck2β呈强阳性表达,核表达阳性率为75.8%,浆表达阳性率为62.1%,三者间差异有统计学意义(P<0.05)。ck2β蛋白表达与
大肠癌的淋巴结转移密切相关,伴发淋巴结转移的大肠癌组织ck2β阳性表达明显高于无淋巴结转移者(P<0.05)。体外实
验发现,沉默大肠癌细胞中ck2β的表达能显著抑制细胞的增殖及侵袭能力。结论ck2β蛋白的表达与大肠癌的发生和转
移密切相关。
     

凋亡相关蛋白在大肠癌中的表达及其与凋亡关系的研究

目的 探讨大肠癌中survivin和caspase-3的表达及其与细胞凋亡的关系.方法 采用免疫组织化学法测定50例正常大肠黏膜和66例大肠癌组织中survivin和caspase-3的表达.结果 survivin在大肠癌中的表达明显高于正常大肠黏膜组织(48.5%vs0,P<0.01),与淋巴结转移和分化程度有关(P<0.05).caspase-3在大肠癌中的表达明显低于正常组织(46.9%vs80.0%,P<0.05),与Dukes分期有关(P<0.05).survivin和caspase-3的表达具有相关性(P<0.05).结论 survivin、caspase-3与大肠肿瘤的细胞凋亡密切相关,参与细胞凋亡的调节机制,在大肠癌恶变的过程中发挥重要的作用.     

Survivin在大肠癌中的表达及其与cyclin D1、细胞增殖指数、微血管密度的关系

目的 :探讨survivin在大肠癌发生发展过程中的作用及其与cyclinD1、细胞增殖指数 (PI)、微血管密度 (MVD)的关系。方法 :免疫组织化学SP法检测 12例正常大肠黏膜、2 8例大肠腺瘤和 46例大肠癌组织中survivin、cyclinD1、ki -67、CD3 1的表达。以CD3 1标记微血管 ,ki -67记数作为细胞增殖指数。结果 :Survivin和cyclinD1在正常大肠黏膜组、大肠腺瘤组、大肠癌组的阳性率分别为 0 %、14 .3 %、65 .2 % ,8.3 %、2 5 %、5 8.7%。大肠癌组survivin、cyclinD1的表达显著高于正常大肠黏膜组和腺瘤组 ( P <0 .0 1)。Survivin和cyclinD1的表达与大肠癌临床病理参数无明显相关关系 ( P >0 .0 5 )。大肠癌中survivin的表达与cyclinD1、PI、MVD呈正相关 (P <0 .0 5 )。结论 :Survivin在大肠癌形成过程的早期表达上调 ,有望成为大肠癌的早期诊断标志物 ;Survivin可能通过调控细胞周期、促进肿瘤细胞增殖和微血管的形成等途径参与大肠癌的发生发展。     

抗凋亡基因survivin在60例大肠癌中的表达及意义

目的:探讨survivin在大肠癌中的表达及其与诊断、预后等方面的意义。方法:利用免疫组化技术检测60例大肠癌及相应癌旁正常黏膜组织石蜡切片中survivin蛋白的表达情况。结果:60例大肠癌组织中有39例survivim蛋白表达阳性(占65.0%),癌旁正常黏膜仅有6例阳性(占10%),其阳性率与癌组织分化程度无明显相关性(P>0.05),但与淋巴结转移和浸润深度有明显相关性(P<0.05)。结论:survivin蛋白在大肠癌组织中有较高的表达率,其表达与侵袭性和预后有关。     

APC和β-catenin在大肠癌中的表达及其意义

目的 探讨APC和β-catenin在大肠癌发生、发展中的作用.方法 应用免疫组织化学方法检测30例正常大肠黏膜、30例大肠腺瘤、10例大肠腺瘤恶变及50例大肠癌组织中APC和β-catenin蛋白的表达情况.结果 大肠癌和大肠腺瘤恶变APC阳性率分别为44.0%、40.0%,显著低于大肠腺瘤的86.7%和正常大肠黏膜的100%,差异有统计学意义(P＜0.01).大肠癌、大肠腺瘤恶变和大肠腺瘤β-catenin胞浆/胞核异位表达率分别为62.0%、50.0%、30.0%,显著高于正常大肠黏膜的0%,差异有统计学意义(P＜0.01),大肠癌β-catenin异位表达率显著高于大肠腺瘤,差异有统计学意义(P＜0.01).大肠癌中β-catenin膜表达缺失率为46.0%,显著高于大肠腺瘤(10.0%)和正常大肠黏膜的0%,差异有统计学意义(P＜0.01),且与大肠癌组织分化程度、浸润深度、淋巴结转移、Dukes分期有关.APC蛋白表达与大肠癌组织分化程度有关.大肠癌中β-catenin异位表达与APC阳性表达呈负相关关系(r=-0.39,P＜0.05).结论 APC失表达和/或β-catenin异位表达与大肠癌的发生密切相关,可能是大肠癌发生的早期事件;β-catenin膜表达缺失与大肠癌的侵袭、转移有关.     

CDK8、STAT1和TMEFF2在大肠组织中的表达及意义

目的探讨CDK8、STAT1、TMEFF2在大肠癌、大肠腺瘤及正常大肠黏膜组织中的表达情况及与临床病理特征之间的关系,探讨其在大肠癌发生、发展中的可能作用。方法组织标本均取自结肠镜活检组织标本,采用免疫组化Evision两步法,分别检测CDK8、STAT1和TMEFF2在不同大肠组织中的表达情况,并分析其与临床病理特征之间的关系。结果 CDK8表达定位于细胞核,其在100例大肠癌、15例大肠腺瘤、15例正常大肠黏膜组织中的表达率分别为37%(37/100)、0(0/15)和0(0/15),CDK8在大肠癌中的表达率明显高于大肠腺瘤和正常大肠黏膜组织(P<0.05),且其表达与患者其他各临床病理因素无明显关系(P>0.05)。STAT1表达定位于细胞浆和细胞核,其在100例大肠癌、15例大肠腺瘤、15例正常大肠黏膜组织中的表达率分别为26%(26/100)、73%(11/15)和67%(10/15),STAT1在大肠癌中的表达率较大肠腺瘤和正常大肠黏膜明显降低(P<0.05);STAT1在结肠癌中的表达率明显高于直肠癌(P<0.05),且其表达与患者其他各临床病理因素无明显关系(P>0.05)。TMEFF2在15例正常大肠黏膜、15例大肠腺瘤和15例大肠癌中均无表达。结论 CDK8在大肠癌中表达异常升高,提示CDK8在大肠癌的发生、发展中起重要作用;STAT1在大肠癌中表达下调,与大肠癌的形成及发展密切相关,STAT1的表达与肿瘤位置相关。TMEFF2在大肠癌中表达缺失,可能不参与大肠肿瘤的发生、发展过程。     

大肠癌中hTERT和bcl-2基因表达与端粒酶活性的关系

目的 :探讨端粒酶逆转录酶 (hTERT)和bcl 2基因在大肠癌发生过程中的作用及其与端粒酶活性的关系。方法 :采用原位RT PCR和免疫组化S P法分别对 4 6例大肠癌及其相应正常大肠组织中hTERTmRNA与bcl 2蛋白表达进行检测 ,并用TRAP法测定上述组织标本中端粒酶活性。结果 :大肠癌组织中hTERTmRNA与bcl 2蛋白阳性表达率分别为 87.0 %和 71.7% ,它们与正常大肠组织比较差异均有显著性 (P <0 .0 1)。大肠癌中端粒酶活性阳性率为 80 .4 % ,明显高于正常大肠组织 (P <0 .0 1)。hTERTmRNA及bcl 2蛋白阳性表达分别与端粒酶活性呈显著正相关 (r分别为 0 .70和 0 .5 7,P均 <0 .0 5 )。结论 :hTERTmRNA及bcl 2蛋白过度表达与大肠癌的发生密切相关 ,并可能参与大肠癌端粒酶活性调节     

免疫组化法检测大肠肿瘤DNA修复基因APE1表达和细胞定位

目的 探讨DNA修复基因脱嘌呤/脱嘧啶核酸内切酶(apurinic/apyrimidinic endonuclease 1,APE1)在大肠癌发生、发展中的作用.方法 应用免疫组化PowerVisionTM法检测125例大肠癌、72例大肠腺瘤、60例癌旁大肠黏膜和40例正常大肠黏膜中APE1的表达和细胞定位,并分析其与大肠癌临床病理之间的关系.结果 正常大肠黏膜APE1呈胞核表达,大肠腺瘤和大肠癌组织APE 1表达特征发生改变,呈胞核表达、单纯胞浆表达或核浆共同表达,大肠癌组织APE1胞浆异位表达率为73.6%,大肠腺瘤APE1胞浆异位表达率为83.3%,二者差异无统计学意义(P＞0.05),但均显著高于癌旁大肠黏膜(10%)和正常大肠黏膜(0) (P＜0.01).APE1胞浆异位表达与大肠癌临床分期和淋巴结转移有关(P＜0.01、P＜0.05).结论 APE1胞浆异位表达可能在大肠癌的发生、发展中起重要作用.     

结肠腺瘤性息肉蛋白、β-连接素和E-钙黏素在大肠癌中的表达

目的:探讨结肠腺瘤性息肉蛋白(APC)、β-连接素(β-catenin)和E-钙黏素(E-cadherin)在大肠癌发生、发展中的作用。方法:采用免疫组化方法检测30例正常大肠黏膜、30例大肠腺瘤、10例大肠腺瘤恶变及50例大肠癌组织中APC、β-catenin和E-cadherin蛋白的表达情况。结果:大肠癌和大肠腺瘤恶变APC阳性率分别为44.0%,40.0%,显著低于大肠腺瘤(86.7%)和正常大肠黏膜(100%)。大肠癌、大肠腺瘤恶变和大肠腺瘤β-catenin胞浆(胞核)异位表达率分别为62.0%,50.0%,30.0%,显著高于正常大肠黏膜(0%),大肠癌β-catenin异位表达率显著高于大肠腺瘤。大肠癌中β-catenin、E-cadherin膜表达缺失率为46.0%,34.0%,显著高于大肠腺瘤(10.0%,6.67%)和正常大肠黏膜(0%,0%),且与大肠癌组织分化程度、浸润深度、淋巴结转移、Dukes分期有关。APC蛋白表达与大肠癌组织分化程度有关。大肠癌中β-catenin异位表达与APC阳性表达呈负相关关系;β-catenin与E-cadherin胞膜阳性表达呈正相关关系。结论:APC失表达和(或)β-catenin异位表达与大肠癌的发生密切相关,可能是大肠癌发生的早期事件;β-catenin、E-cadherin膜表达缺失与大肠癌的侵袭、转移有关。     

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.     

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.