Bcl-3、cyclin D1、P53、Ki-67蛋白在乳腺导管内增生性病变的表达及其意义

目的 探讨B细胞淋巴瘤因子3(Bcl-3)、细胞周期蛋白D1(cyclin D1)、P53基因编码蛋白和增殖细胞核蛋白（Ki-67）在乳腺导管内增生性病变中的表达及应用价值。方法 采用免疫组化检测乳腺普通型导管增生（UDH）、柱状上皮病变（CCL）、非典型导管增生（ADH）和导管原位癌（DCIS）组织中Bcl-3、cyclin D1、P53和Ki-67蛋白的表达。结果 Bcl-3、cyclin D1、P53、Ki-67蛋白在UDH中均少量表达;在CCL、ADH和DCIS中均明显表达,且随着病变的级别升高,阳性率逐渐增高（P<0.05）;Bcl-3、cyclin D1、P53和Ki-67蛋白在CCL、ADH和DCIS中着色强阳性（++～+++）的表达,差异有统计学意义（P<0.05）。结论 Bcl-3、cyclin D1、P53和Ki-67蛋白的表达在乳腺导管内增生性病变的病理诊断、鉴别诊断及指导临床治疗方面有较高应用价值,可显著提高乳腺导管内增生性病变的诊断准确率。     

乳腺导管内增生性病变及浸润性癌中雌激素受体亚型表达的比较性研究

目的探讨雌激素受体亚型（ERα和ERβ）在乳腺导管内增生性病变及浸润性乳腺癌中的表达及其相互关系。 方法采用免疫组织化学法检测正常乳腺组织6例，乳腺导管普通型增生(UDH) 11例, 非典型性导管增生(ADH) 7例,导管原位癌(DCIS)23例(其中Ⅰ级8例,Ⅱ级11例,Ⅲ级4例)及浸润性乳腺癌(IBC)11例中ERα和ERβ的表达。 结果ERα的表达在UDH、ADH及Ⅰ级DCIS中呈逐渐增高趋势，而在Ⅲ级DCIS及IBC中的表达降低，ERα的表达在UDH与 DCIS中差异具有统计学意义（P<0.05）；从正常乳腺组织到UDH、ADH、DCIS至IBC的发展过程中ERβ的表达逐渐降低，ERβ的表达在正常乳腺组织与ADH、DCIS和IBC中以及UDH与DCIS和IBC中的差异具有统计学意义（P<0.05）；ERα和ERβ之间表达没有相关性（P>0.05）。结论从乳腺良性增生性病变到浸润性癌的发展过程中ERα和ERβ的表达各不相同，两者可能通过不同的机制参与癌变过程。     

Claudin-1在乳腺良性上皮增生及乳腺癌组织中的表达及意义

目的探讨Claudin-1在乳腺癌发生发展中的作用及其诊断价值。方法用免疫组化sP法检测22例普通型导管增生（UDH）、19例非典型性导管增生（ADH）、15例乳腺导管原位癌（DCIS）、12例无淋巴结转移的浸润性导管癌（IDC）、16例有淋巴结转移的IDC组织中Claudin-1的表达情况。结果Claudin-1主要表达于乳腺上皮细胞,表达模式为细胞膜／浆型;与UDH组和ADH组比较,Claudin-1在DCIS和无淋巴结转移及有淋巴结转移的IDC组中的表达显著降低或消失（P〈0．01）。结论在普通型导管增生-非典型性导管增生-乳腺癌的发生发展过程中,Claudin-1的表达逐渐减弱并消失;Claudin-1可用于乳腺良性上皮增生与乳腺癌的鉴别,但不能用于区别UDH和ADH;Claudin-1可作为乳腺癌诊断的一种标记物。     

乳腺癌中膜型基质金属蛋白酶-1蛋白表达及其临床病理意义

目的探讨膜型基质金属蛋白酶-1（MT1-MMP）蛋白表达在乳腺癌发生、发展中的临床病理意义。方法收集2011年1月至2014年12月404例女性乳腺组织石蜡标本分为5组,其中浸润性乳腺癌组220例、导管原位癌（DCIS）Ⅲ组39例、DCISⅠ～Ⅱ组33例、普通型导管增生（UDH）组64例、正常乳腺组48例。采用免疫组化EnVision法检测MT1-MMP蛋白的表达。结果（1）浸润性乳腺癌、DCISⅢ、DCISⅠ耀Ⅱ、UDH、正常乳腺组中MT1-MMP蛋白阳性率分别为67.73%（149/220）、25.64%（10/39）、6.06%（2/33）、4.69%（3/64）、18.75%（9/48）;浸润性乳腺癌组阳性率显著高于DCISⅢ、DCIS玉耀域、UDH和正常乳腺组（均P＜0.01）;DCISⅢ组阳性率显著高于DCISⅠ耀Ⅱ和UDH组（均P＜0.05）。（2）MT1-MMP蛋白表达与腋窝淋巴结转移、TNM分期及孕激素受体（PR）相关（均P＜0.05）。logistic回归模型多因素分析显示浸润性乳腺癌患者MT1-MMP蛋白表达的独立相关因素包括腋窝淋巴结转移（OR=0.213,95%CI=0.084～0.544,P＜0.01）和PR表达状态（OR=1.927,95%CI=1.049～3.542,P＜0.05）。结论MT1-MMP蛋白表达自UDH和DCISⅠ～Ⅱ、DCISⅢ至浸润性乳腺癌显著升高,且其MT1-MMP蛋白表达与浸润性乳腺癌患者多项预后不良因素相关,提示其在乳腺癌进展的全过程中均发挥了重要作用,有望成为抗乳腺癌治疗的一个潜在生物学标志。     

乳腺导管内增生性病变及乳腺浸润性导管癌中TRβ1基因甲基化的研究

目的：了解乳腺浸润性导管癌及乳腺导管增生性病变组织甲状腺素受体β1（thyroid hormone receptor β1,TRβ1）基因启动子区甲基化状态,探讨其与乳腺癌发生的关系。方法：采用甲基化特异性PCR（methylation-specific polymerase chain reaction,MSP）技术,研究40例乳腺浸润性导管癌（infiltrating ductal carcinoma,IDC）、12例普通型导管增生（usual ductal hyperplasia,UDH）、8例乳腺不典型性导管增生（atpical ductal hyperplasia,ADH）,24例导管原位癌（duetal carcinoma in situ,DCIS）组织及10例健康成人女性乳腺组织中TRβ1基因启动子区甲基化状态。结果：正常乳腺组织、UDH、ADH、DCIS和IDC中,TRβ1基因甲基化率分别为0.0%（0/10）、16.7%（2/12）、37.5%（3/8）、62.5%（15/24）和80.0%（32/40）,正常组织TRβ1基因甲基化率与DCIS和IDC相比差异有统计学意义（P正常组对DCIS=0.001,P正常组对IDC=0.000）;UDH与DCIS相比,差异无统计学意义（P=0.009）;UDH与IDC相比差异有统计学意义（P=0.000）。结论：TRβ1基因启动子区CpG岛甲基化是乳腺癌发生过程中的早期事件,可能在乳腺癌发生和乳腺增生病癌变过程中起重要生物学作用。     

乳腺导管内增生性病变和乳腺癌中CCN5蛋白的表达及其意义

目的:探讨CCN5蛋白在乳腺导管内增生性病变和乳腺癌中的表达情况及其意义.方法:应用免疫组化SP法分别检测20例乳腺正常组织(NBT),110例乳腺增生性病变包括20例普通型导管增生(UDH)、30例不典型导管增生(ADH)、60例导管原位癌(DCIS),以及90例浸润性病变(IL)包括60例浸润性导管癌(IDC)、3...     

MIB-1、p63在乳腺肿瘤细胞中的表达及意义

目的探讨MIB-1、p63在不同病理类型乳腺肿瘤中的表达及其临床意义。方法根据WHO（2003）乳腺肿瘤分类标准,收集乳腺肿瘤患者手术切除标本：非典型性增生（ADH）组24例、乳腺原位癌组（DCIS）20例、浸润性癌（IDC）组45例,乳腺普通型增生（UDH）20例作为对照组。应用免疫组化进行MIB-1、p63检测,观察其在不同病理类型乳腺组织中的分布及表达水平。结果p63在UDH、ADH、DCIS组中均有不同程度的阳性表达,主要表达于导管周围的肌上皮,ADH、DCIS两组间无明显差异,但与UDH组相比,其阳性表达率明显下降,在IDC组中p63几乎不表达;MIB-1主要表达于增殖细胞中的核抗原,阳性染色定位于肿瘤细胞核,MIB-1标记的增殖指数PI在UDH、ADH、DCIS、IDC组分别为2.25±0.54、4.08±0.57、5.50±0.56、30.22±2.41,从UDH到ADH、DCIS,再到IDC,PI显著升高,p63表达呈逐渐减弱。MIB-1在IDC表达与临床病理分期、分子分型有关,而与患者年龄、肿瘤大小、组织学分级、腋窝淋巴结转移及其个数无关,临床分期越晚（Ⅲ、Ⅳ期）、分子分型为HER-2型、三阴性患者,其PI均分别高于临床分期早（Ⅰ、Ⅱ期）、分子分型为管腔型A或B患者（P＜0.05）。结论联合检测p63、MIB-1可以较好地反映乳腺增生性病变的程度,正确鉴别乳腺的良恶性病变,通过检测MIB-1的增殖表达水平可预测乳腺恶性肿瘤的浸润程度及整体预后评估。     

P63,34βE12,survivin,COX-2表达在乳腺良恶性上皮性病变鉴别诊断中的意义

目的 探讨肌上皮标记物P63、高分子细胞角蛋白34βE12、凋亡抑制蛋白survivin、环氧化酶(COX-2)在乳腺良恶性上皮性病变鉴别诊断中的意义.方法 用免疫组织化学法(S-P)检测肌上皮标记物P63、高分子细胞角蛋白34βE12、凋亡抑制蛋白survivin及环氧化酶(COX-2)在50例普通性导管增生(UDH)、53例不典型导管增生(ADH)、58例导管内癌(DCIS),63例浸润性癌(IDC)中的表达,分析其与乳腺良恶性上皮性病变的关系及意义.结果 在50例普通性导管增生(UDH),53例不典型导管增生(ADH),58例导管内癌,肌上皮表达均为阳性,63例浸润性癌,肌上皮均为阴性.34βE12的表达率及其强度在良性病变与癌组间,差异有显著性(P＜0.05).在良性病变与癌组之间,survivin,COX-2阳性表达率及表达程度差异有显著性(P＜0.05).结论 P63,34βE12可作为乳腺病变鉴别诊断中良性病变的标记物,而survivin、COX-2阳性表达,有助于良恶性病变的鉴别.     

乳腺导管内增生性病变及乳腺浸润性导管癌中TRβ1基因甲基化的研究

目的:了解乳腺浸润性导管癌及乳腺导管增生性病变组织甲状腺素受体β1(thyroid hormone receptorβ1,TRβ1)基因启动子区甲基化状态,探讨其与乳腺癌发生的关系。方法:采用甲基化特异性PCR(methylation-specific polymerase chain reaction,MSP)技术,研究40例乳腺浸润性导管癌(infiltrating ductal carcinoma,IDC)、12例普通型导管增生(usual ductal hyperplasia,UDH)、8例乳腺不典型性导管增生(atpical ductal hyperplasia,ADH),24例导管原位癌(duetal carcinoma in situ,DCIS)组织及10例健康成人女性乳腺组织中TRβ1基因启动子区甲基化状态。结果:正常乳腺组织、UDH、ADH、DCIS和IDC中,TRβ1基因甲基化率分别为0.0%(0/10)、16.7%(2/12)、37.5%(3/8)、62.5%(15/24)和80.0%(32/40),正常组织TRβ1基因甲基化率与DCIS和IDC相比差异有统计学意义(P正常组对DCIS=0.001,P正常组对IDC=0.000);UDH与DCIS相比,差异无统计学意义(P=0.009);UDH与IDC相比差异有统计学意义(P=0.000)。结论:TRβ1基因启动子区CpG岛甲基化是乳腺癌发生过程中的早期事件,可能在乳腺癌发生和乳腺增生病癌变过程中起重要生物学作用。     

乳腺导管内增生性病变p35外显子突变的研究

 目的肿瘤抑制基因突变是浸润性乳腺癌发生发展中常见事件,而其与包括普通型增生（UDH）,不典型增生（ADH）及导管内原位癌（DCIS）的乳腺导管内增生性病变关系不明。探讨在乳腺导管内增生性病变的外显子突变情况,以期了解突变在乳腺癌发生发展中的作用。方法用高分辨率熔解曲线和测序研究122 例乳腺导管内增生性病变中外显子5~8 的突变情况。结果经HRM筛选,14 例患者DNA熔解曲线与野生型标准品熔解曲线大于阈值,经测序分析,其中13例出现外显子突变。35例UDH 中均未发现突变,10.7%（6/56）ADH 和22.6%（7/31）DCIS 发现至少1 个位点的点突变,其中1 例DCIS 发现2 个位点的突变。结论突变发生于乳腺导管内增生性病变中的ADH与DCIS,其可能为乳腺癌发生发展中的早期事件。     

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.