VEGF与Ki-67在NSCLC中的表达及其临床意义

目的:探讨血管内皮生长因子(VEGF)与核增殖抗原(Ki-67)在非小细胞肺癌(NSCLC)中的表达及临床意义.方法:选取150例NSCLC患者为研究对象,分为死亡组(n=38)和存活组(n=112).分别取每例患者的癌组织及癌旁组织各1份,采用SP法检测VEGF及Ki-67水平.比较死亡组与存活组、癌组织与癌旁组织VEGF及Ki-67阳性表达水平;分析VEGF和Ki-67阳性表达与NSCLC临床病理特征的关系及癌组织VEGF与Ki-67阳性表达的相关性.结果:死亡组患者癌组织VEGF和Ki-67阳性表达率高于存活组(P＜0.05);癌组织VEGF和Ki-67阳性表达率高于癌旁组织(P＜0.05);相关性分析显示,VEGF阳性表达与肿瘤直径、淋巴结转移、远处转移及临床分期相关(P＜0.05),Ki-67阳性表达与淋巴结转移相关(P＜0.05);回归分析显示,癌组织VEGF与Ki-67阳性表达呈正相关(P＜0.05).结论:NSCLC患者中,癌组织中VEGF与Ki-67表达水平较高,且与患者临床病理学特征相关,可作为早期诊断及判断预后的重要依据.     

C-Jun结合蛋白在肝癌细胞组织中的高表达及其意义

目的 探讨C-Jun结合蛋白(JAB1)在肝癌细胞(HCC)组织中的表达及临床病理意义.方法 收集76例HCC及癌旁组织,10例肝血管瘤旁肝组织的临床病理档案资料,采用免疫组织化学方法检测JAB1蛋白质在这些组织中的表达,并与增殖细胞核抗原(Ki67)的表达相比较.应用统计学方法对结果进行分析.结果 HCC组织中JAB1蛋白质表达的阳性率(68.85%)显著高于癌旁组织(38.72%)(P＜0.001)和血管瘤旁肝组织(34.36%)(P＜0.001).JAB1的表达与肝癌组织分化程度,血清AFP值及转移有关(P=0.000,P=0.015及P=0.000),但与患者的年龄、性别、肿瘤组织学类型、肿瘤大小等无关.HCC组织中Ki67表达的阳性率为41.45%,明显高于癌旁组织2.11%(P＜0.1301)和血管瘤旁肝组织2.01%(P＜0.001).相关性分析表明HCC组织中JAB1蛋白质表达与Ki67表达呈正相关(r=0.6192,P＜0.001).结论 JAB1在HCC组织中呈高表达,且显著高于非癌肝组织,与HCC的发生发展有关;JAB1可作为HCC细胞增生程度的潜在临床病理标记.     

乳腺浸润性导管癌组织Ki-67表达及其临床病理学意义

目的 探讨Ki-67增殖抗原在乳腺浸润性导管癌组织中的表达情况及其与临床病理学特征之间的关系.方法 选取76例行乳腺癌根治术患者的临床资料及其组织标本,采用免疫组织化学SP法检测乳腺浸润性导管癌组织中Ki-67的表达,并分析其与乳腺浸润性导管癌结合病理特点及分子分型的相关性.结果 乳腺浸润性导管癌组织Ki-67的阳性表达率为81.58％ (62/76),不同分子分型中,IuminalA型Ki-67阳性表达率最低,为7.69％(1/13),三阴性阳性表达率最高,为100.00％(15/15).Ki-67蛋白阳性表达与肿瘤直径(x2=10.081,P=0.006)、淋巴结转移情况(x2=11.878,P=0.001)、TNM分期(x2=19.465,P＜0.001)和组织学分级(x2=9.268,P=0.010)明显相关.Ki-67表达与雌激素受体(ER)(r=-0.245,P=0.033)、孕激素受体(PR)(r=-0.395,P=0.001)表达水平呈负相关,与p53(r=0.613,P＜0.001)、CerbB-2(r=0.270,P=0.018)呈正相关.结论 Ki-67在乳腺浸润性导管癌中高表达,与患者临床病理参数相关,Ki-67在乳腺浸润性导管癌患者的诊断和预后评估中具有较高的参考价值.     

p27Kip1和Ki-67在人肾透明细胞癌中的表达及意义

目的 通过检测细胞周期素依赖激酶抑制蛋白p27Kipl(p27)和增殖细胞核抗原Ki—67在肾透明细胞癌中的表达情况，探讨其与临床病理指标及预后的关系。方法 采用免疫组化SP法测定42例肾透明细胞癌及20例癌旁正常肾组织中p27蛋白和Ki—67抗原的表达。结果 在肾透明细胞癌与癌旁正常肾组织中p27或Ki—67的表达均有显著性差异(P＜0．畅)。肾透明细胞癌的病理分级与p27的表达呈负相关，而与Ki—67抗原的表达呈正相关(P＜0．01)。肾透明细胞癌中p27表达与Ki—67抗原表达、肿瘤有无转移呈负相关(P＜0．01)；Ki—67抗原表达与肿瘤有无转移呈正相关(P＜0．01)。结论 在人肾透明细胞癌的发生、发展及转移过程中，由于缺乏p27基因持续激活的后继支撑，p27蛋白被逐渐消耗，Ki—67抗原表达上调；p27表达与Ki-67表达对评估肾透明细胞癌患者预后定价值。     

颤抖蛋白异构体7在乳腺癌中的表达及其与患者预后的关系

目的: 探讨乳腺癌组织中颤抖蛋白异构体7(Quaking isoform 7,QKI-7)表达及临床意义。方法: 采用免疫组织化学方法检测QKI-7、P53和Ki-67在乳腺癌组织及癌旁组织中的表达和胞内定位;对肿瘤组织中QKI-7表达与患者临床病理参数、随访资料、P53及Ki-67的表达进行相关性分析。结果： 肿瘤组织中QKI-7阳性表达率明显低于癌旁组织(χ2=73.378,P<0.05)。乳腺癌组织中QKI-7表达与肿瘤直径、淋巴结转移、TNM分期及孕激素受体相关(P均<0.05)。QKI-7阴性表达患者的累计生存率明显低于QKI-7阳性患者;乳腺癌组织中QKI-7表达与P53表达呈正相关,而与Ki-67表达呈负相关(P均＜0.05)。结论： 乳腺癌组织中QKI-7呈低表达,是患者预后不良的标志。     

结直肠癌细胞增殖核抗原及生长抑制因子4表达的关系及预后因素

目的 探讨细胞增殖核抗原(Ki-67)和生长抑制因子 4(ING4)在结直肠癌发病机制中的作用及其对患者预后的影响.方法 应用免疫组织化学法检测71例结直肠癌组织和30例癌旁正常组织中Ki-67、ING4的表达情况,分析其表达与临床病理特征及预后的关系.结果 Ki-67在癌组织中阳性表达率(85. 9％)高于癌旁组织(6.7％)(P＜0.05), ING4在癌组织中阳性表达率(56. 3％)低于癌旁组织(90％)(P＜0.05). Ki-67表达与肿瘤浸润深度、有无淋巴结转移、淋巴结转移数目、TNM分期有关(P＜0.05), ING4表达与分化程度、有无淋巴结转移、淋巴结转移数目、TNM有关(P＜ 0.05).Ki-67、ING4在结直肠癌组织中表达呈负相关性(r=-0.428,P＜0.05).Ki-67高表达组和低表达组术后5年生存率分别为63. 9％,85. 5％,差异有统计学意义(P＜0.05);ING4阳性组和阴性组术后5年生存率分别为 97. 4％ 、45. 2％,差异有统计学意义(P＜0.05).Cox多因素分析结果显示,TNM分期、ING4表达情况均为影响患者预后的独立因素.结论 Ki-67、ING4可能参与直肠癌的发生和发展,ING4是影响结直肠癌患者预后的独立危险因素.     

结肠癌组织DPD和Ki-67蛋白的表达和临床意义

目的:探讨结肠癌组织二氢嘧啶脱氢酶(DPD)、细胞增殖核抗原Ki-67的表达及临床意义.方法:采用免疫组织化学法检测70例结肠癌组织和30例癌旁正常组织DPD、Ki-67蛋白的表达情况,并分析二者与结肠癌临床病理特征的关系.结果:结肠癌组织DPD、Ki-67的阳性表达率均明显高于癌旁正常组织(P＜0.05).结肠癌组织DPD、Ki-67表达与性别、年龄、肿瘤大小、分化程度无关(P＞0.05),与pTNM分期和浸润深度有关(P＜0.05).结肠癌组织DPD、Ki-67的表达呈正相关关系(r=0.283,P＜0.05).结论:DPD、Ki-67可能共同参与了结肠癌的发生发展过程,二者表达升高可能与结肠癌的不良预后有关.     

肝癌组织中TRAIL表达及其与癌细胞增殖、凋亡、耐药的相关性分析

目的：研究肿瘤坏死因子相关凋亡诱导配体(tumor-necrosis-factor-related apoptosis-inducing ligand, TRAIL蛋白在肝细胞癌(hepatocellular carcinoma, HCC)组织中的表达水平,分析其与临床病理特征及预后的相关性,并探讨TRAIL对HCC细胞凋亡、增殖及耐药的影响。方法 ：利用免疫组织化学法检测186例HCC患者中HCC组织及癌旁肝组织TRAIL、Caspase-3、NF-κB、P-糖蛋白(P-glycoprotein, P-gP)及Ki-67的表达,分析TRAIL与临床病理特征及预后的关系,并探讨TRAIL与HCC生物学行为(增殖、凋亡、耐药)的相关性。结果：HCC组织中TRAIL表达明显低于癌旁肝组织(P<0.01)。HCC中Caspase-3、NF-κB、P-gP的阳性表达率分别为38.2%、84.4%、66.1%,Ki-67在HCC中的高表达率为75.8%,低表达率为24.2%。Spearman相关性分析显示TRAIL与Caspase-3的表达呈正相关(P<0.01),与NF-κB、P-...     

细胞周期蛋白 D1和 Ki-67在喉癌组织中表达的相关性研究

目的：初步探讨细胞周期蛋白D1和Ki-67在喉鳞状细胞癌组织中表达的相关性。方法应用免疫组化链霉菌抗生物素蛋白-过氧化物酶连接法（ SP）检测Cyclin D1和Ki-67在喉鳞状细胞癌组织中的蛋白表达情况,分析两者在喉鳞状细胞癌组织中表达的相关性。结果在Ki-67阳性高表达的56例喉癌组织中,有41例出现Cyclin D1阳性高表达;在Cyclin D1阳性低度表达的51例患者中,有36例出现Ki-67阳性低度表达,经Spearman等级相关性检验：两者在喉鳞状细胞癌组织中的表达呈正相关（ rs ＝0.620, P ＜0.01）。结论 Cyclin D1和Ki-67高表达与喉鳞状细胞癌发生密切相关。     

乳腺癌中抑癌基因EHD2表达的临床意义与预后关系

目的：检测乳腺癌组织中抑癌基因EHD2的表达,探讨其与乳腺癌临床参数的相关性及其对预后的意义。方法：对乳腺癌及癌旁组织标本91例采用免疫组织化学法检测EHD2和增殖细胞核抗原Ki-67的表达。结合临床病理参数分析EHD2在乳腺癌中的临床意义。结果：EHD2在乳腺癌组织中表达显著低于癌旁组织（P＜0.01）,EHD2的表达与Ki-67的表达呈明显负相关（r2=0.309,P=0.009）。且EHD2的表达水平在乳腺癌的组织分化程度（P=0.001）,淋巴结转移（P=0.024）及ER的表达（P=0.029）中差异显著,但与患者的年龄、肿瘤大小、组织学类型、PR、HER2、P53等其他临床病理参数无关。Kaplan-Meier生存分析显示,EHD2高表达的乳腺癌患者总生存时间（overall survival,OS）高于EHD2低表达患者（P＜0.01）。Cox回归分析表明,EHD2、Ki-67及淋巴结转移程度是影响乳腺癌术后生存时间的独立危险因素,危险系数分别达到0.281、2.510、2.254（P＜0.05）。结论：乳腺癌的增殖与EHD2表达降低有关,低表达EHD2的乳腺癌患者预后不良,提示EHD2对判断乳腺癌预后有一定的价值。     

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.