食管癌组织中p16蛋白表达及其临床意义

应用免疫组化ＳＡＢＣ法检测４９例食管鳞癌、１２例食管腺癌和２０例食管正常组织。结果显示,２８例食管鳞癌（５７．１％,２８／４９）４例食管腺癌（３３．３％,４／１２）和１８例食管正常组织（９０％,１８／２０）ｐ１６蛋白表达阳性（Ｐ〈０．０１）,伴有淋巴结转移的食管鳞癌Ｐ１６蛋白表达阳性率（３９．３％）显著低于无淋巴结转移者（８１．０％,Ｐ〈０．０１）,中低分化食管癌Ｐ１６蛋白表达阳性率（４４．４％）     

p16、p53和nm23在喉癌组织中的表达研究

目的 研究ｐ１６、ｐ５３及ｎｍ２３在喉癌中的表达及其与临床的相关性。方法 应用免疫组化的方法对４２例喉鳞癌样本进行检测。结果 在喉鳞癌中ｐ１６蛋白表达的阳性率为４７．６２％，ｐ５３的阳性率为５４．７６％，ｎｍ２３的阳性率为５２．３８％；中、低分化的鳞癌（Ⅱ～Ⅲ级）组ｐ１６阳性率低于高分化的鳞癌（Ⅰ）组（Ｐ〈０．０５），有淋巴结转移组ｐ１６的表达阳性率低于无淋巴结转移组（Ｐ〈０．０５）；ｐ５３在临床     

大肠癌中p16蛋白的表达

①目的研究大肠癌中ｐ１６蛋白的表达与肿瘤分化程度及浸润转移等生物学行为的关系。②方法应用免疫组织化学ＬＳＡＢ法检测１０５例大肠癌组织中ｐ１６蛋白的表达。③结果大肠癌ｐ１６蛋白表达的阳性率为６０．０％，随大肠癌分化程度降低、浸润肠壁深度和Ｄｕｋｅｓ分期的进展，原发灶中ｐ１６蛋白表达阳性率降低，差异具有显著性（χ２＝６．４８～１２．８０，Ｐ＜０．０１，０．０５）。无区域淋巴结转移者ｐ１６蛋白阳性率为７６．９％，伴区域淋巴结或远处器官转移者ｐ１６蛋白阳性率为５０．０％，二者差异有显著性（χ２＝７．４０，Ｐ＜０．０５）。④结论ｐ１６蛋白能抑制大肠癌的浸润与转移，ｐ１６蛋白的表达水平可作为判断大肠癌病人预后的生物学指标。     

P16蛋白在肺癌中的表达及其临床意义

目的探讨抑癌基因ｐ１６与肺癌预后的关系。方法应用ＳＰ免疫组织化学方法对７６例肺癌标本中ＣＤＫＮ２抑癌基因Ｐ１６蛋白表达进行了研究。结果７６例肺癌标本中Ｐ１６蛋白表达阳性率为４５％（３４／７６）。其中鳞癌的阳性率为５２％（２３／４４）,腺癌为２９％（７／２４）,二者比较差异有显著意义（Ｐ＜０．０５）。Ｐ１６蛋白表达与肺癌的病理分级及预后呈显著相关性（Ｐ＜０．０５）。结论ｐ１６基因对肺癌的发生发展有着重要意义。     

非小细胞肺癌中CDK4Ⅰ/P16的表达及与淋巴转移关系的研究

为研究ＣＤＫ４Ⅰ／Ｐ１６与非小细胞肺癌的发生及发展的关系，应用免疫组化ＬＳＡＢ法研究了８３例肺癌手术标本中ＣＤＫ４Ⅰ蛋白的表达。结果显示，ＣＤＫ４Ⅰ蛋白表达总的平均阳性率为６５．９３％。Ｐ１６蛋白表达与肺癌的临床分期，组织学分类、肺癌原发部位、患者的年龄及有淋巴结转移的原发灶与无淋巴结转移的原发灶之间比较无显著差异（Ｐ＞０．０５），中一高分化的肺癌（７７．９５％）与低分化的肺癌（５３．０５％）之间有显著差异（Ｐ＜０．０１）；肺癌的原发灶（６４．１６％）与相应转移灶（淋巴灶）（５３．６６％）之间有显著差异（Ｐ＜０．０１）。肿瘤大小Ｔ１＋Ｔ２（６８．９０％）与Ｔ３＋Ｔ４（６０．８３％）之间差异显著（Ｐ＜０．０５）。本研究结果表明ＣＤＫ４Ⅰ蛋白检测可以作为人非小细胞肺癌的抑制基因，并可能是肺癌术后预后的重要指标之一。     

食管鳞癌组织中CD44v4/5的表达及其与浸润转移的关系

用免疫组化ＬＳＡＢ法检测了４２例食管鳞癌中ＣＤ４４ｖ４／５的表达，结果发现：淋巴结转移组的阳性表达率为７６．１９％（１６／２１），而非转移组的阳性表达率为４２．８６（９／２１），两组间差异显著（Ｐ＜０．０５）。从Ⅰ级鳞癌到Ⅲ级鳞癌，其阳性率依次为６９．２３％（９／１３）、６４．７１％（１１／１７）和４１．６７％（５／１２），彼此间差异无显著性（Ｐ＞０．０５）。癌巢周边的癌细胞，肌间浸润的癌细胞，有核分裂的癌细胞和癌栓中的癌细胞及浸润脉管壁的癌细胞均呈强阳性表达。提示：ＣＤ４４ｖ４／５表达与食管鳞癌的浸润和淋巴道、血道转移有关。     

胃癌组织中p16基因mRNA和蛋白的表达及其与p53、Cyclin D1蛋白表达的相关性和临床意义

目的排除正常组织细胞的影响，探讨ｐ１６基因在胃癌发生发展及预后判断上的作用和可能的基因调节机制。方法采用ＣＤＮＡ－ｍＲＮＡ原位核酸杂交和免疫组化技术观察６１例胃癌组织和４９例癌旁非癌组织中ｐ１６基因ｍＲＮＡ和蛋白的表达，并与ｐ５３、ＣｙｃｌｉｎＤ１蛋白表达情况及肿瘤的生物学行为进行相关性分析（Ｘ２检验，Ｗｉｌｃｏｘｏｎ等级秩和检验，配对资料Ｙａｔｅｓ校正Ｘ２检验）。以ＰＣＲ随机引物法制备生物素标记的ｐ１６ＣＤＮＡ探针。结果（１）胃癌组织ｐ１６ｍＲＮＡ的阳性率为５０．８％，ｐ１６蛋白的阳性率为７０．５％，与癌旁正常胃粘膜１００％的阳性率相比，差异具有显著性意义（Ｐ＜０．００１）。１０例早期胃癌ｐ１６ｍＲＮＡ和蛋白均阳性，而５１例进展期胃癌的阳性率分别为４１．２％（２１／５１），６４．７％（３３／５１）。早期与进展期胃癌相比，ｐ１６ｍＲＮＡ和ｐ１６蛋白的阳性率均有显著性差异（Ｐ＜０．００１，Ｐ＜０．０１）。而且在同一切片中也可以观察到分化较好或浸润浅层的癌细胞表达ｐ１６ｍＲＮＡ和蛋白，而分化较差、浸润深层的癌细胞则没有表达。（２）ｐ１６ｍＲＮＡ和ｐ１６蛋白的表达强度与胃癌的分化程度、浸润深度，有无淋巴结转移及病     

食管鳞癌发生过程中p16蛋白表达的变化

为探讨ｐ１６基因在食管癌发生中的意义，用免疫组织化学方法检测了７０例鳞状细胞癌患者的癌旁正常粘膜上皮、不典型增生和癌组织中的ｐ１６蛋白。结果发现：不典型增生组织中的ｐ１６蛋白表达较正常上皮明显下降（Ｐ＜０．０５），而癌组织中的ｐ１６蛋白表达又较不典型增生显著减低（Ｐ＜０．０５）。并且，随着癌分化程度的下降，ｐ１６蛋白阳性率呈下降趋势。低分化者阳性率显著低于高分化者（Ｐ＜０．０５）。结果表明：ｐ１６蛋白表达的变化是食管癌发生中的早期事件，并可能与癌的进展密切相关。     

p53基因突变与人食管癌转移的关系研究

目的：探讨ｐ５３基因突变与人食管癌淋巴结转移的关系。方法：采用聚合酶链反应－单链构象多态性（ＰＣＲ－ＳＳＣＰ）结合银染技术,对４７例食管瘤组织中ｐ５３ 基因第５～８外显子进行了突变分析。结果：４７例食管癌标本中,ｐ５３基因第５～８外显子出现突变者２０例,其突变率为４２．６％;其中２２例伴有淋巴结转移的原发癌中１３例出现了突变（５９．１％）,其与无淋巴结转移组（２８．０％,７／２５）相比有显著性差异（Ｐ＜０．０５）。结论：ｐ５３基因突变与人食管癌的转移可能关系密切。     

p53与p16蛋白在乳腺癌中的表达及其预后意义

目的：探讨ｐ５３、ｐ１６两种抑癌基因蛋白表达在乳腺癌预后及转移中的价值。方法：应用免疫组化对７６例人乳腺癌石蜡包埋组织进行ｐ５３及ｐ１６蛋白表达研究。结果：ｐ５３蛋白表达阳性组肿瘤的组织学分级、腋窝淋巴结转移率高于ｐ５３蛋白表达阴性组，两组相差显著（Ｐ〈０．０５）和非常显著（Ｐ〈０．０１），而ｐ５３蛋白表达阳性组术后生存期则低于阴性组（Ｐ〈０．０１）；ｐ１６蛋白表达阳性组的腋窝淋巴结转移率、术后生     

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.