34βE12、P63、CK5/6、α-SMA在前列腺基底细胞中的表达及意义

目的探讨高分子量细胞角蛋白34βE12、肌上皮标记物p63、细胞角蛋白CK5/6、平滑肌肌动蛋白α-SMA在前列腺基底细胞中的表达及意义。方法采用免疫组织化学SP法检测,观察34βE12、p63、CK5/6、α-SMA在前列腺增生（PH）、低级别上皮内瘤变（LGPIN）、高级别上皮内瘤变（HGPIN）、前列腺癌（Pca）中的表达。结果 30例PH组标本34βE12、p63、CK5/6大多阳性表达,10例LGPIN组多（＋＋）表达,15例HGPIN组多（＋）表达,Pca组大多阴性表达。Pca组与PH组、LGPIN组、HGPIN组比较差异有统计学意义（P〈0.05）。α-SMA基底细胞少量表达,Pca组与PH组、LGPIN组、HGPIN组比较差异均无统计学意义（P〉0.05）。结论前列腺基底细胞表达34βE12、p65、CK5/6,p65优于34βE12,α-SMA多阴性表达。在前列腺标本中联合检测34βE12、p65、CK5/6有助于对前列腺癌及其他不同病变的鉴别诊断。     

P504S、34βE12、P63、PSA四种抗原检测在前列腺穿刺活检标本中的联合应用及意义

目的探讨在前列腺穿刺活检标本组织中联合应用а-甲酰基辅酶A消旋酶（P504S）、高分子量角蛋白（34βE/12）、P63和前列腺特异抗原（prostate specific antigen,PSA）对前列腺良恶性病变的鉴别诊断意义。方法收集前列腺穿刺活检标本58例,其中前列腺癌21例、前列腺上皮内瘤变9例（高级别3例,低级别6例）,前列腺不典型性腺瘤性增生3例,前列腺基底细胞增生3例,结节性增生22例,对以上58例标本进行P504S、PSA、34βE/12、P63的免疫组化染色（S-P法）。结果P504S在前列腺癌及前列腺高级别上皮内瘤变的腺上皮中阳性表达,在低级别上皮内瘤变和前列腺不典型性腺瘤性增生中弱阳性或阴性表达,在前列腺基底细胞增生及结节性增生中阴性表达;34βE/12、P63都标记前列腺基底细胞,34βE/12表达在基底细胞质中,P63表达在基底细胞的核上。染色显示前列腺癌中基底细胞缺如,上皮内瘤变、前列腺不典型性腺瘤性增生、前列腺基底细胞增生及结节性增生均有连续或间断的基底细胞存在。PSA表达于所有前列腺病变的腺上皮中。结论在前列腺穿刺活检标本组织中联合应用P504S、34βE12、P63、PSA等4种抗体对前列腺的良恶性病变的诊断和鉴别诊断具有重要作用。     

P504s、P63和Ck34βE12联合检测在前列腺腺癌鉴别诊断中的应用价值

目的探讨P504s、P63和Ck34βE12联合免疫组化染色在前列腺良、恶性病变鉴别诊断中的价值。方法采用免疫组织化学方法观察P504s、P63、Ck34βE12和PSA在82例不同前列腺疾病中的表达情况。结果在18例前列腺腺癌中P63、Ck34βE12染色均(-),17例P504s呈( );良性前列腺增生及低度前列腺上皮内瘤(PIN)的腺泡和导管周围可见连续的P63和Ck34βE12( ),少数呈间断表达,但P504s染色皆呈(-);PIN,P63和Ck34βE12染色基底细胞呈不连续表达或(-);而增生的腺上皮,部分细胞P504s呈弱( );非典型腺瘤性增生P63和Ck34βE12呈( ),P504s呈(-)。PSA在所有病例中均强阳性表达。结论P504s对判断前列腺腺癌具有重要参考价值;P504s、P63和Ck34βE12联合检测可提高前列腺癌诊断的正确率;PSA对前列腺组织有极高的敏感性,但在良、恶性病变鉴别诊断中意义不大。     

P504s/P63/34βE12联合双染标记早期诊断前列腺癌的应用研究

目的探讨联合使用P504s、P63、34βE12双染标记前列腺组织标本早期诊断及鉴别诊断前列腺癌的可行性、特异性、敏感性以及临床应用价值。方法使用P504s单抗、P63单抗、34βE12单抗先后在同一前列腺穿刺活检组织标本上行前列腺腺泡细胞和基底细胞免疫组化双重标记染色。P504s表达于癌变的前列腺细胞浆;P63表达于前列腺基底细胞核,34βE12表达于前列腺基底细胞浆。结果 P504s表达阳性而34βE12和P63表达阴性或不连续表达提示为前列腺癌,并可行Gleason评分;P504s表达阳性、34βE12和P63完整阳性表达提示前列腺上皮内瘤;504s表达阴性、34βE12和P63连续阳性表达提示良性前列腺病变。结论通过联合使用P504s、P63和34βE12在同一前列腺标本上进行双重染色标记前列腺癌变细胞、前列腺基底细胞,通过观察前列腺基底细胞的完整性、前列腺癌细胞的形态学表现等可以有效诊断和鉴别前列腺癌、前列腺上皮内肿瘤(PIN)、良性前列腺增生等,增加对前列腺癌的早期诊断率和诊断的准确性,促进临床前列腺癌的早期治疗。     

基底细胞鸡尾酒标记法在前列腺穿刺组织中的应用价值

目的:评价基底细胞鸡尾酒抗体P63/34βE12在前列腺穿刺组织中的应用及价值。方法:应用免疫组化Envision二步法,检测70例良性前列腺增生及28例前列腺腺癌中P63/34βE12的表达情况,并同时用P63、34βE12单标记法作为对照。结果:P63/34βE12鸡尾酒及P63、34βE12标记前列腺基底细胞的强阳性率分别为87.1%、60%和41.4%,鸡尾酒法与单标记法相比具差异有显著性,(P<0.01),且P63与34βE12的强阳性率二者差异具有显著性意义(P<0.05)。结论:鸡尾酒标记法能明显提高对基底细胞免疫反应的强度和敏感性,且特异性强,可作为前列腺疾病诊断及鉴别诊断的一种有效辅助手段,具有重要的临床应用价值。     

34βE12、P63在乳腺肿瘤中的表达及意义

目的研究高分子细胞角蛋白(34βE12)及肌上皮标记物(P63)在乳腺良恶性组织中的诊断意义。方法用免疫组织化学方法 (Envision)检测34βE12及P63在46例乳腺增生症组织和86例乳腺癌组织中的表达水平。结果 34βE12在乳腺良性增生症组织中阳性表达率100%,在乳腺癌组织中阳性表达率38.4%,34βE12的表达率及其强度在良性增生症与癌组间比较差异有统计学意义(P<0.05)。46例乳腺增生症组织P63表达均为阳性,86例浸润性癌,P63均为阴性。结论通过对乳腺病变的观察,腺体周围基底细胞是否存在是乳腺良恶性的重要鉴别点,34βE12和P63是基底细胞特异性标记物,而P63更敏感,是诊断乳腺癌的首选抗体,而两者同时选用则更为理想。     

Expression and significance of 34βE12 and P63 in breast cancer

目的 研究高分子细胞角蛋白(34βE12)及肌上皮标记物(P63)在乳腺良恶性组织中的诊断意义.方法 用免疫组织化学方法(Envision)检测34βE12及P63在46例乳腺增生症组织和86例乳腺癌组织中的表达水平.结果 34βE12在乳腺良性增生症组织中阳性表达率100％,在乳腺癌组织中阳性表达率38.4％,34βE12的表达率及其强度在良性增生症与癌组间比较差异有统计学意义(P＜0.05).46例乳腺增生症组织P63表达均为阳性,86例浸润性癌,P63均为阴性.结论 通过对乳腺病变的观察,腺体周围基底细胞是否存在是乳腺良恶性的重要鉴别点,34βE12和P63是基底细胞特异性标记物,而P63更敏感,是诊断乳腺癌的首选抗体,而两者同时选用则更为理想.     

P504S、P63、CK5/6、34βE12联合应用在前列腺疾病诊断中的价值

目的 研究α甲酰基辅酶A消旋酶（P504S）、P63基因、高分子量角蛋白（CK5/6、34βE12）联合标记在不同性质的前列腺穿刺活检标本中的表达特点,探讨它们在前列腺良、恶性疾病诊断及鉴别诊断中的意义.方法 收集芜湖市第一人民医院病理科2008年1月-2012年12月前列腺穿刺活检标本50例,其中前列腺癌30例,前列腺增生性病变20例,采用免疫组织化学染色（S-P法）检测标本的P504S、P63、CK5/6、34βE12表达.结果 P504S在前列腺癌中呈阳性,前列腺增生性病变中呈阴性,差异有统计学意义（P＜0.05）;而P63、CK5/6、34βE12在前列腺癌中基底细胞表达缺失,在前列腺增生性病变中基底细胞阳性表达,差异有统计学意义（P＜0.05）.结论 P504S、P63、CK5/6、34βE12的联合应用对前列腺穿刺标本的诊断和鉴别诊断有良好的应用价值.     

高分子量细胞角蛋白及前列腺特异性抗原在前列腺腺癌中的表达和意义

目的：提高对各种前列腺良恶性病变的认识和鉴别诊断水平。方法：采用免疫组织化学染色对213例前列腺良恶性病变组织分别作高分子量细胞角蛋白34BE12和前列腺特异性抗原（PSA）标,废物地异地显示前列腺基底细胞并间接了解基细胞层的完整性。结果：前列腺腺癌基底细胞均丢失，而前列腺增生性病变基底细胞绝大多数保存完好，只有少数3级前列腺上皮内肿瘤和非典型性增生基底细胞不完整。对PSA染色，大多数前列腺腺癌表达低，少数分化好的癌组织呈阳性，而良性前列腺增生组织标本中PSA表达高。结论：研究表明，联合应用高分子量细胞有蛋白34BE12及PSA标记物，在前列腺良恶性病变的鉴别诊断及肿瘤恶性程度的判断中均有很好的应用价值。     

免疫组化联合检测诊断前列腺良恶性疾病的研究(附36例报告)

目的探讨CK34βE12、P63、P504s联合免疫组化染色在前列腺良、恶性病变鉴别诊断中的意义。方法采用免疫组化方法,观察CK34βE12、P63、P504s在不同前列腺疾病中的表达情况。结果36例前列腺病变中,28例良性前列腺增生及低度的不典型增生(PIN)的腺泡及导管周围可见连续的CK34βE12和P63呈阳性,少数呈间断表达。特别以P63染色明显,但P504s染色皆呈阴性。高度不典型增生(PIN)CK34βE12、P63染色呈不连续表达或阴性,而增生的腺上皮,部分细胞P504s呈弱(+)或(+);非典型腺瘤性增生,CK34βE12、P63呈(+)、P504s(-);前列腺癌8例中7例CK34βE12、P63染色呈(-),1例显色局灶性(+),但P504s均呈(+)。结论P63、CK34βE12、P504s联合检测可明显提高前列腺癌诊断的正确性。     

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.