DcR3和Ki-67在胃癌的表达及临床意义

目的探讨诱捕受体3(DcR3)蛋白和细胞核增殖抗原(Ki-67)在胃癌组织中的表达及其与胃癌临床病理特征之间的关系.方法采用免疫组织化学SP法检测98例胃癌组织和56例癌旁正常胃组织中DcR3和Ki-67的表达,分析其与多种临床病理特征之间的关系.结果 (1)98例胃癌组织中DcR3和Ki-67阳性表达率分别为55.1%(54/98)、68.4%(67/98).56例癌旁正常胃组织未发现DcR3和Ki-67的阳性表达.(2)DcR3的表达与胃癌的分化程度、淋巴结转移及TNM分期显著正相关(P<0.01),与患者性别、年龄、肿瘤部位及浸润深度等无相关性(P>0.05).(3)Ki-67的表达与胃癌的分化程度、浸润深度(P<0.01)及TNM分期(P<0.05)显著相关,与患者性别、年龄、肿瘤部位及淋巴结转移等无相关性(P>0.05).(4)DcR3和Ki-67的表达显著正相关(P<0.01).结论 (1)DcR3在胃癌组织中具有较高的表达率.(2)DcR3和Ki-67的异常表达可促进胃癌的发生发展,其蛋白检测可作为判断胃癌分化、浸润、转移、分期的重要参考指标.     

胃癌原发灶中p~(53)和ki-67的表达及其意义

目的探讨胃癌原发病灶中p53及ki-67基因蛋白表达与胃癌的分化、浸润程度及淋巴结转移的关系。方法采用免疫组化法检测70例胃癌原发肿瘤组织中p53及ki-67基因蛋白的表达。结果胃癌原发肿瘤组织中p53、ki-67主要表达在细胞核,阳性表达率分别为72.9%(51/70)和31.4%(22/70),p53的阳性表达率显著高于ki-67的阳性表达率(P<0.01);p53基因蛋白的表达与淋巴结转移显著相关(P<0.05);而ki-67基因蛋白表达则与肿瘤的浸润深度呈显著相关(P<0.05)。结论胃癌组织中ki-67的表达与胃癌浸润有关,检测突变型p53对判断胃癌淋巴结转移具有重要的参考价值。     

胃癌P^53和Ki-67表达与淋巴结转移的相关性

目的研究P53和Ki-67抗原的表达与胃癌淋巴结转移的关系.方法45例胃癌分2组,淋巴结转移组28例,无转移组17例.以P53和Ki-67的单克隆抗体,用SP法免疫组织化学技术对淋巴结转移组和无转移组进行标记.结果淋巴结转移组与无转移组P53阳性表达分别为19例(19/28),5例(5/17),转移组的p53阳性率高于无转移组,差异有显著性(P<0.05).淋巴结转移组和无转移组的Ki-67高表达分别为21例(21/28)、7例(7/17),转移组Ki-67高表达率明显高于无转移组(P<0.05).P53阳性组的Ki-67高表达率明显高于p53阴性组(P<0.01).结论淋巴结转移组p53阳性表达和Ki-67高表达明显高于无转移组(P<0.05).p53和Ki-67表达可作为预测淋巴结转移,判断预后的指标之一.     

食管鳞癌组织中Ki-67和nm23的表达及其临床意义

目的:探讨Ki-67与nm23在食管鳞癌组织中的表达及其与癌组织分化、侵袭、转移的关系,以及Ki-67与nm23在组织中表达的相关性。方法:用免疫组化SP法对175例食管鳞癌组织中Ki-67与nm23进行检测。结果:175例食管鳞癌组织中,Ki-67阳性表达98例(56.0%),nm23阳性表达137例(78.3%)。Ki-67蛋白表达与食管癌淋巴结转移及病理分期有关(P<0.05),淋巴结转移者明显高表达(75.7%),无淋巴结转移者明显低表达(24.3%);食管癌TNM分期Ⅲ、Ⅳ期组织中,其高表达率明显高于低表达者。nm23蛋白表达与食管癌淋巴结转移有关(P<0.05),淋巴结转移者明显低表达(42.9%),无淋巴结转移者明显高表达(83.6%)。食管癌组织中Ki-67蛋白低表达与nm23高表达之间有明显相关性。结论:Ki-67蛋白高表达与nm23蛋白低表达可能与食管鳞状细胞癌浸润转移过程关系密切,Ki-67和nm23蛋白表达的检测有助于判断患者的预后。     

胃癌及癌旁组织中Bcl-2和Ki-67蛋白表达及其意义

①目的　探讨胃癌及癌旁组织中Bcl- 2和Ki- 67 蛋白表达的意义及其相关关系。②方法　采用S P免疫组织化学染色法检测58例胃癌及癌旁组织Bcl- 2和Ki- 67蛋白的表达。③结果　胃癌、伴癌前病变和不伴癌前病变癌旁黏膜组织中Bcl- 2阳性表达率分别为44.8%(26/58)、68.8%(11/16)和21.4%(9/42),胃癌及伴癌前病变癌旁黏膜组织中Bcl- 2蛋白的表达明显高于不伴癌前病变癌旁黏膜组织(χ2=12.139,P<0.05)。但其表达与胃癌的分化程度、淋巴结转移、病理学分期及浸润程度无关(χ2=0.129~3.652,P>0.05)。胃癌、伴癌前病变和不伴癌前病变癌旁黏膜组织中Ki 67平均指数分别为38.6±15.0、34.3±10.3和12.4±10.9,胃癌、伴癌前病变癌旁黏膜组织中Ki 67蛋白的表达明显高于不伴癌前病变癌旁黏膜组织(F=50.80,q=14.0、8.1,P<0.01),Ki -67 蛋白在Bcl 2阳性胃癌组织中的表达明显高于Bcl 2阴性胃癌(t=2.07,P<0.05)。④结论　Bcl 2 与癌变前期过程有关,其抑制凋亡是胃癌发生的早期事件。Ki -67表达对胃癌的进展程度评估有一定意义。     

Tip30和p53蛋白在胃癌组织中的表达及其临床意义

目的探讨Tip30和p53蛋白在胃癌中的表达及其临床意义。方法收集2013年1月—2014年12月秦皇岛市第一医院普外一科收治的60例胃癌患者为研究对象,采用免疫组化SP法检测胃癌组织及其癌旁正常组织中Tip30和p53的表达,并探讨两者的相关性及临床意义。结果 60例胃癌组织中Tip30阳性率为46.67%(28/60),显著低于癌旁正常组织中的95.00%(57/60),差异有统计学意义(P<0.05)。60例胃癌组织中p53的阳性率为48.33%(29/60),高于癌旁正常组织中的5.00%(3/60),差异有统计学意义(P<0.05)。Tip30蛋白表达相关因素包括胃癌分化程度、浸润程度、临床分期、是否发生淋巴结转移等(P<0.05)。p53蛋白表达相关因素包括胃癌浸润程度、临床分期及淋巴结转移等(P<0.05)。胃癌组织中Tip30蛋白与p53蛋白表达呈显著负相关(r=-0.637,P<0.05)。结论 Tip30低表达和p53高表达可作为预测胃癌不良预后的重要指标。     

Her-2和Ki-67在胃癌组织中的表达及其相关性研究

目的:检测胃癌组织标本中Her-2及Ki-67的表达情况并探究其相关性及两者与肿瘤临床病理参数关系.方法:收集胃腺癌组织标本213例,免疫组织化学(IHC)检测Her-2和Ki-67的表达状态;荧光原位杂交(FISH)进一步检测Her-2基因扩增情况并分析它们与临床病理参数之间关系.结果:213例胃腺癌组织中,Her-2和Ki-67阳性表达率分别为39.44%(84/213)和81.22%(173/213),Her-2基因表达与肿瘤的浸润深度、分化程度、TNM分期和淋巴结转移相关(P<0.05),而与性别、年龄和有无脉管癌栓无关(P>0.05);Ki-67表达与分化程度、TNM分期、浸润深度、淋巴结转移和有无脉管癌栓有关(P<0.05),与性别和年龄无关(P>0.05).Her-2基因扩增与Ki-67高表达呈正相关(r=0.177,P<0.05).结论:联合检测胃腺癌患者Her-2基因状态和Ki-67表达情况对病情评估以及预后判断有重要意义,给个体化分子靶向治疗提供科学依据.     

plk1、Raf-1和Ki-67在胃癌组织中的表达及其意义

目的探讨plk1、Raf-1和Ki-67在胃癌组织中的表达及其相关性,分析它们的表达与胃癌临床病理指标之间的关系。方法采用免疫组织化学SP法检测80例胃癌组织和15例癌旁正常胃组织中plk1、Raf-1和Ki-67的表达水平。结果80例胃癌组织中plk1、Raf-1和Ki-67的阳性表达率分别为82．5％（66／80）、81．3％（65／80）、80．0％（64／80）,15例癌旁正常胃组织中均未见表达。plk1和Raf-1表达与胃癌的浸润深度、TNM分期以及淋巴结转移显著相关（P〈O．05）,与患者性别、年龄、肿瘤部位、分化程度无相关性;Ki-67表达与胃癌的分化程度、浸润深度、TNM分期以及淋巴结转移显著相关（P〈0．01）,而与其它因素无关。plk1与Ki-67、Raf-1与Ki-67、plk1与Raf-1的表达显著相关（P〈0．01）。结论plk1、Raf-1和Ki-67的过表达可能与胃癌的发生发展有关,三者联合检测可为判断胃癌生物学行为乃至预后提供重要的参考指标。     

胃癌患者p53基因突变的检测及其临床意义

目的:探讨胃癌患者癌组织及外周血p53基因突变表达情况,评价p53基因作为胃癌患者术后预后判定、转移监测及指导临床治疗的应用价值。方法:利用聚合酶链反应单链构像多态性分析法(PCRSSCP)和银染技术检测32例胃癌患者外周血、癌旁正常组织、癌组织中p53基因外显子5、6、7、8位点及20例健康人外周血p53基因的突变情况,并比较不同组织类型、不同分期、有无淋巴结转移胃癌患者p53基因的突变率。结果:32例胃癌患者癌旁正常组织和20例正常人外周血中未检出p53基因突变;胃癌患者癌组织中的p53基因突变率为37.5%(12/32),与癌旁正常组织无相比差异有统计学意义(P<0.05);有淋巴结转移患者的胃癌组织p53基因突变高于无淋巴结转移患者(P<0.05);胃癌患者外周血p53基因突变率为15.6%(5/32),外周血中p53基因突变阳性者其相应癌组织p53基因突变均为阳性,经过3个月随访,其中有1例确诊为肝转移。不同组织类型不同分期胃癌患者p53基因突变率差异均无统计学意义(P>0.05)。结论:p53基因突变对胃癌患者术后预后判定、转移监测及指导临床治疗有一定的意义。     

Ki-67 p53和VEGF在三阴性乳腺癌组织中的表达及临床意义

目的观察三阴性乳腺癌(TNBC)患者癌组织中Ki-67、p53、血管内皮生长因子(VEGF)的表达变化,探讨其临床意义。方法采用免疫组化SP法检测68例TNBC患者癌组织中Ki-67、p53、VEGF的表达,分析其与TNBC临床病理特征及预后的关系,并以非三阴性乳腺癌(N-TNBC)组织68例为对照。结果 TNBC组织中Ki-67、p53、VEGF阳性表达率分别为76.47%(52/68)、70.58%(48/68)、45.8%(31/68),Ki-67、p53及VEGF的表达与年龄、肿瘤大小、TNM分期无显著相关性,与淋巴结转移状况有关(P<0.01)。结论 TNBC组织中p53、Ki-67、VEGF阳性表达率均上调,其可作为TNBC重要的预后指标。     

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.