喉癌前病变的DNA流式细胞术定量研究

目的 探讨喉癌前病变中的ＤＮＡ含量作为癌变早期分子标志物的临床意义。方法 应用流式细胞术对８０例喉癌前病变组织的ＤＮＡ含量进行定量检测。结果 ２９例Ⅰ级不典型增生中出现１例ＤＮＡ异倍体,３０例Ⅱ级不典型增生中出现２例ＤＮＡ异倍体,２１例Ⅲ级不典型增生中出现１１例ＤＮＡ异倍体。结论 喉癌前病变的ＤＮＡ异倍体出现率随不典型增生病变的分级增高而增加,出现ＤＮＡ异倍体的喉癌前病变的癌变率显著增高,ＤＮＡ异     

鼻咽癌癌前病变生物学特征及其检出指标

本成果采用现代医学、生物学的先进技术,对鼻咽部的癌前病变,即不典型增生的一些生物学特征进行研究。结果证明,鼻咽部不典型增生上皮细胞,特别是底层重度不典型增生细胞的DNA含量、异倍体率、核仁组织者区的数目、大小、形态和“肿瘤性血管生成”等检出数值均在正常组织与癌之间。上述方法可提示不典     

甲状腺肿瘤细胞DNA含量分析

本文应用流式细胞术对６６例甲状腺肿瘤进行了ＤＮＡ含量分析。结果表明２６例甲状腺腺癌中，１１例为ＤＮＡ异体，１２例为近二倍体；不同类型的甲状腺癌之间，ＤＮＡ含量无统计学差异，但ＤＮ含量与组织学分化程度密切相关。４０例甲状腺腺瘤中，仅２例为ＤＮＡ异倍体，与甲状腺腺癌相比，甲状腺癌的异倍体率明显升高（Ｐ〈０．０１）；且２例经重新复习切片，１例被确确诊为滤泡性癌另１例伴有不典型增生，因此，流式分析ＤＮＡ含     

肝细胞不典型增生的DNA含量与组织化学反应关系的探讨

用组织化学及免疫组织化学方法检测２２例肝细胞不典型增生（ＬＣＤ）的γ－ＧＴ酶、甲胎蛋白（ＡＦＰ）、癌胚抗原（ＣＥＡ）的表达情况。其中１７例同时应用显微分光光度计检测其ＤＮＡ含量，以探讨其与上述３种肿瘤标志表达情况的关系。结果显示：ＬＣＤ的肿瘤标志表达既不同于非不典型增生之肝细胞也不同于肝细胞癌，其ＤＮＡ含量均值及倍体分布介于癌与非不典型增生肝细胞之间（ｐ＜０．０５～０．０１）。ＤＮＡ的改变与肿瘤标志的表达存在一定的内在联系。提示ＬＣＤ是一类轻重不同的增生性病变，其中含非整倍体细胞较多的或许是肝细胞癌的癌前病变。     

人肝细胞癌及其癌前病变的DNA,AgNORs定量分析

用图象分析法对２０７例人正常肝，慢性肝炎，肝硬化、肝细胞不典型增生和肝细胞肝癌中的细胞ＤＮＡ指数、增殖指数、核面积、二倍体细胞比率和超五倍体细胞百分比等项参数进行量测定；同时进行核仁组织区计数及其与ＤＮＡ含量相关关系研究。结果显示：人肝癌的发生符合肿瘤发生多阶段理论，癌前病变ＬＣＤ其各项指标均显著增加，其中异倍体ＬＣＤ各项指标ＨＣＣ十分接近，因而提出异倍体ＬＣＤ作为病变进入演进期的标志，为肝癌发生     

405例人体肿瘤细胞DNA含量的流式细胞术检测分析

为探讨不同类型的人体肿瘤细胞周期中ＤＮＡ含量与肿瘤组织学间的关系,采用流式细胞术检测了４０５例鹇肿瘤组织中瘤细胞的ＤＮＡ含量,并用光学显微镜观察了肿瘤组织的病理改变。结果显示：２２例良性肿瘤及３８３例恶性肿瘤中异倍体出现率分别是２７％及５２％;不同组织类型的恶生肿瘤中异倍体的出现率以腺癌为最高,其中肝癌、肠癌及胃癌异倍体的出现胃癌异倍体的出现率分别为６１％、５５％及５１％,肉瘤次之,为３７％,鳞癌     

乳腺囊性增生病癌变过程中部分因素变化的意义

检测乳腺囊性增生病（ＦＣＤ）经不典型增生到癌变部分因素的变化。结果提示：从因明显ＦＣＤ症状活检至癌变为２～１０年；从Ⅱ级以上不典型增生到临床癌变需２～７年；癌变率为３．１％。ＦＣＤ患者存在性激素分泌调控失常，血浆雌激素和催乳素含量增加，导致上皮细胞增生。乳腺一般性增生细胞的ＤＮＡ含量和超微结构与正常乳腺上皮细胞相似；无肿瘤相关抗原及异常基因产物表达。而发生在一般性增生基础上的不典型增生则呈现细胞基因物质ＤＮＡ含量增加，部分为超４Ｃ的多倍体细胞；同时出现细胞膜和细胞核超微结构异常；雌激素受体含量增加，对性激素的依赖性和敏感性增强；部分不典型增生细胞出现胚胎性肿瘤相关抗原和异常基因产物表达。随不典型增生程度加重至乳腺癌，上述诸因素的变化趋势具有明显规律性。提示ＦＣＤ上皮细胞从一般性增生经不典型增生至乳腺癌为细胞生物学连续逐渐变化的过程。部分不典型增生细胞中具有癌倾向的细胞生物学行为异常和表型变化与乳腺癌发生密切相关。细胞核ＤＮＡ含量等异常变化及程度可作为乳腺癌前病变发展程度的客观标志     

膀胱移行细胞癌核DNA含量检测及其与预后关系的探讨

对膀胱粘膜良，恶性病变进行了核ＤＮＡ含量研究，其中不典型增生（Ⅱ，Ⅲ级），乳头状瘤各５例，移行细胞癌４５例（Ⅰ，Ⅱ，Ⅲ级各１５例），正常膀胱粘膜５例。结果显示：正常粘膜，不典型增生主要为２Ｃ细胞，乳头状瘤以３Ｃ为主，且部分不典型增生和乳头状瘤核ＤＮＡ含量递增，非倍体，Ｓ期细胞增多，各级间以及与不典型增生和乳头状瘤间相差非常显著（Ｐ＜０．０１）。随访结果显示随着分级升高ＤＮＡ含量增加而复发率，死亡率     

激光治疗喉癌前病变

目的 在手术治疗喉癌前病变的同时,最大限度地保留和恢复喉的正常发音功能.方法 激光外科手术治疗喉癌前病变60例,其中采用声带黏膜上皮层切除术治疗声带黏膜白斑及轻度不典型增生16例;采用声带黏膜剥脱术治疗中、重度不典型增生38例;激光切除成人型喉乳头状瘤6例.结果 16例声带黏膜白斑发轻度不典型增生者术后2个月发音恢复正常;38例中重度不典型增生者术后3～5个月发音逐渐恢复正常;6例喉乳头状瘤患者术后发音明显优于经颈路手术的发音.结论 嗓音显微外科手术既能分层切除声带病变,又能最大限度地保留和恢复喉的发声功能,是治疗喉癌前病变首选的微创手术方法.     

胆囊粘膜增生、异型增生和癌细胞核的DNA、AgNOR含量测定研究

应用全自动图像分析仪对45例胆囊切除标本的粘膜增生、不典型增生、原位癌及浸润癌各类型进行DNA含量和AgNOR计数定量分析研究。结果表明:DNA含量和AgNOR数量随增生-不典型增生-原位癌-浸润癌的程度变化而增多。二者呈明显相关,随其增生程度增加,二倍体细胞减少直至消失。非整倍体细胞增多是判断增生程度和癌前病变及癌的一种标志。腺瘤样增生与不典型增生Ⅰ级、不典型增生Ⅱ与Ⅲ级DNA含量和倍体变化以及AgNOR计数无明显差异反映了它们之间可能重叠或相近关系。     

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.