急性白血病患者骨髓单个核细胞中基质细胞衍生因子-1和血管内皮生长因子的表达

目的:探讨急性白血病(AL)患者骨髓单个核细胞中蛋白基质细胞衍生因子-1(SDF-1)及血管内皮生长因子(VEGF)的表达及其临床意义.方法:应用免疫组化SP法分别检测初治AL组(65例)、完全缓解期急性白血病(AL-CR)组(20例)、复发难治白血病(RRAL)组(24例)及正常对照组(15例)的骨髓单个核细胞中SDF-1及VEGF蛋白的表达情况,并分析SDF-1及VEGF蛋白的表达与初治AL患者临床特征的关系.结果:初治AL组骨髓单个核细胞中SDF-1及VEGF蛋白的阳性表达率分别为67.7%(44/65)和64.6%(42/65),均高于RRAL组[70.8%(17/24)和66.6%(16/24)]、AL-CR组[15.0%(3/20)和20.0%(4/20)]和正常对照组[6.6%(1/15)和13.3%(2/15)],差异有统计学意义(χ2=33.159和23.382,P＜0.001).骨髓单个核细胞中SDF-1和VEGF蛋白的表达与初治AL患者的白细胞计数(χ2=11.413和15.363.P＜0.001)及髓外浸润(χ2=10.100和13.333,P＜0.001)有关.结论:初治AL患者骨髓单个核细胞中SDF-1与VEGF蛋白的高表达参与了AL的发生、发展、浸润、复发和转移,动态检测2者的表达水平对判断AL的疗效和预后有重要意义.     

急性白血病患者血浆VEGF测定及其临床意义

目的:探讨急性白血病(AL)患者血浆血管内皮细胞生长因子(VEGF)含量变化与临床病情的关系.方法:用双抗体夹心酶联免疫吸附法(ELISA)检测54例AI患者血浆VEGF含量,同时检测骨髓涂片有核细胞中原始及幼稚白细胞数.结果:(1)AL患者血浆VEGF含量为(64.87±33.66)ng/L,明显高于对照组的(33.12±11.87)ng/L(P<0.01);(2)AL患者初始血浆VEGF含量为(64.87±33.66)ng/L,明显高于缓解组的(42.07±17.75)ng/L(P<0.01),复发、难治患者血浆VEGF含量为(78.12±30.88)ng/L,上升明显,同缓解组相比差异有统计学意义(P<0.05),同初始组相比差异无统计学意义(P>0.05).结论:AL患者血液中的VEGF含量同患者病情的临床变化有着一定联系,能够作为了解病情、疗效观察、愈后判断的重要指标.     

非霍奇金淋巴瘤患者血清VEGF及Endostatin水平检测的临床相关研究

目的探讨非霍奇金淋巴瘤(non-Hodgkin's lymphoma,NHL)患者血清VEGF及Endostatin(ES)水平变化与其临床特征、治疗、预后因素的关系.方法采用ELISA法检测162例NHL患者和50例正常健康人血清VEGF及ES水平.结果①162例NHL患者血清中VEGF、ES水平(198.97±17.92)pg/ml和(34.82±7.91)pg/ml,均分别显著高于正常健康人(31.58±6.68)pg/ml和(16.80±3.87)pg/ml(P＜0.01),V/E比值也非常显著高于正常人.②NHL患者血清中VEGF、ES水平以及V/E比值与其恶性程度、临床分期和骨髓侵犯(VEGF除外)等显著相关(P＜0.05),而与其年龄、性别、细胞类型之间无明显关系.③50例NHL完全缓解(CR)患者血清中VEGF、ES水平及V/E比值均非常显著低于122例NHL初治患者(IP)(P＜0.01);但血清中VEGF、ES水平仍非常显著高于正常健康人(P＜0.01),而两者V/E比值差异并不明显(P＞0.05).39例复发/难治NHL患者(RRP)血清中VEGF水平显著高于IP组(P＜0.05),但其ES水平差异并不明显(P＞0.05),其V/E比值非常显著高于IP组(P＜0.01).④NHL患者血清VEGF、ES水平以及V/E比值与其预后指标LDH、CRP、β2-MG均呈显著正相关;血清VEGF、ES两者之间亦呈显著正相关.结论NHL患者血清中VEGF、ES水平升高,与淋巴瘤的恶性程度及肿瘤负荷大小密切相关,其两者的比值(V/E)对NHL患者的治疗、预后判断有重要意义.     

血管内皮生长因子与小儿川崎病血管损伤的关系

目的 探讨血管内皮生长因子(VEGF)在小儿川崎病血管损伤中的作用机制.方法 应用酶联免疫吸附实验(ELISA)检测52例川崎病(KD)患儿急性期、缓解期及28例健康对照组儿童血浆VEGF含量,并将KD患儿分为有冠脉损伤(CAL)组与无冠脉损伤(NCAL)组.结果 KD患儿组急性期和缓解期的VEGF水平均显著高于健康对照组[分别为(231.26±75.31)pg/ml,(127.67±63.17)pg/ml比(43.94±19.58)pg/ml,P＜0.01];NCAL组急性期VEGF水平明显高于CAL组[(269.99±69.33)pg/ml比(184.10±52.48)pg/ml,P＜0.01],缓解期NCAL组血浆VEGF含量下降值显著大于CAL组;KD患儿组急性期血浆VEGF水平与血清白蛋白呈显著负相关(r=-0.604,P＜0.01).结论 VEGF参与了川崎病血管损伤的病理生理过程,持续不降的VEGF可能与KD发生了冠脉损伤有关.     

血管内皮生长因子与小儿川崎病血管损伤关系的研究

目的 探讨血管内皮生长因子(VEGF)在小儿川崎病血管损伤中的作用机制.方法 应用酶联免疫吸附实验(ELISA)检测52例川崎病(KD)患儿急性期、缓解期及28例健康对照组儿童血浆VEGF含量,并将KD患儿分为有冠脉损伤(CAL)组与无冠脉损伤(NCAL)组.结果 KD患儿组急性期和缓解期的VEGF水平均显著高于健康对照组[分别为(231.26±75.31)pg/ml,(127.67±63.17)pg/ml比(43.94±19.58)pg/ml,P＜0.01];NCAL组急性期VEGF水平明显高于CAL组[(269.99±69.33)pg/ml比(184.10±52.48)pg/ml,P＜0.01],缓解期NCAL组血浆VEGF含量下降值显著大于CAL组;KD患儿组急性期血浆VEGF水平与血清白蛋白呈显著负相关(r=-0.604,P＜0.01).结论 VEGF参与了川崎病血管损伤的病理生理过程,持续不降的VEGF可能与KD发生了冠脉损伤有关.     

人类白细胞抗原-G在急性白血病患者的表达及意义

目的 检测急性白血病患者膜结合型人类白细胞抗原-G(mHLA-G)和分泌型HLA-G(sHLA-G)的表达,探讨HLA-G表达水平的变化对急性白血病发生和发展的影响.方法 采用酶联免疫吸附法和流式细胞术分别检测40例初发、10例难治复发、30例化疗前后患者及10例正常人sHLA-G和mHLA-G的表达情况.结果 正常人血清中sHLA-G的平均水平为5.87±2.07 ng/ml,初发患者为10.05±6.5 ng/ml、难治复发患者为12.32±5.85 ng/ml;正常人mHLA-G的平均水平为(0.29±0.20)%,初发患者(0.60±0.44)%、难治复发患者(0.77±0.41)%.白血病初发患者sHLA-G和mHLA-G水平均显著高于正常人组(P＜0.05),初发与难治复发患者比较无统计学差异(P＜0.05).15例1疗程化疗后获得完全缓解患者sHLA-G和mHLA-G水平显著低于化疗前(P＜0.05),而15例未缓解患者其sHLA-G和mHLA-G水平较治疗前无明显差异(P＜0.05).结论 HLA-G表达水平变化可能与急性白血病的病情发展、疗效以及预后有关.     

白血病患者血清VEGF、EGF联合检测的临床意义

目的:检测白血病患者血清中血管内皮生长因子(VEGF)与表皮生长因子(EGF)的浓度,探讨VEGF和EGF在白血病患者血液中的表达及二者之间的关系和意义.方法:应用酶联免疫技术(ELISA法)检测20例白血病患者及40名健康人血清中VEGF和EGF浓度.结果:40例白血病患者血清VEGF含量为398.6±114.8pg/ml,对照组血清VEGF的含量为108.5±50.6 pg/ml,两组比较具有显著的相关性(P＜0.05);40例白血病患者血清EGF含量为1.80±0.52μg/L,40例正常对照组血清EGF含量为0.76±0.80μg/L,见表1.结论:白血病患者血清VEGF、EGF浓度显著高于健康对照组,且二者呈显著正相关.     

急性白血病多药耐药基因表达及临床意义

目的研究多药耐药基因(MDR1)在急性白血病(AL)中的表达及与预后的关系.方法采用链亲和素-胶体金原位杂交(ISH-SAG)方法对59例不同病期的AL患者进行MDR1检测.结果(1)ANLLMDR1阳性表达率(50.0%)虽高于ALL阳性表达率(37.5%),但差异无显著意义(P＞0.05).(2)MDR1在复发难治组的阳性表达率明显高于缓解组(P＜0.05).(3)MDR1阳性表达与临床缓解密切相关,MDR1阳性表达者的完全缓解(CR)率(22.2%)明显低于MDR1阴性者的CR率(80.0%)(P＜0.05).(4)MDR1阳性表达作为耐药标准的评价,其敏感率、特异率、准确率分别为77.8%、80.0%、79.0%.结论MDR1阳性表达与临床耐药相关,是影响AL患者预后的一个重要的因素.且其敏感性、特异性均较高.     

乳腺癌外周血管内皮生长因子的表达及其意义

目的研究血管内皮生长因子在乳腺癌患者外周血中的表达水平与乳腺转移复发之间的相关性。方法采用酶联免疫吸附法（ELISA法）检测38例乳腺患者,术前、后外周血中VEGF含量,分析乳腺癌外周血VEGF含量与乳腺癌转移复发的相关性。结果乳腺癌患者术后随访时新出现转移者与无复发转移者的外周血VEGF含量分别为（416.29±22.58）pg/ml,（84.54±15.84）pg/ml及两者术前外周血VEGF含量分别为（385.07±10.73）pg/ml,（209.66±59.03）pg/ml,两者间外周血VEGF含量差异均有统计学意义（P〈0.05）。结论术后定期检测外周血VEGF含量可以用来判断乳腺癌复发及治疗效果。     

急性白血病患者WIF-1基因启动子甲基化及β连环蛋白表达的研究

目的 探讨急性白血病(AL)患者Wnt抑制因子1(WIF-1)基因启动子甲基化及β连环蛋白(β-catenin)的表达在白血病中的意义.方法 采用甲基化特异性PCR检测山东大学附属千佛山医院2009年1月至2010年6月55例AL患者及对照组骨髓单个核细胞WIF-1基因启动子甲基化情况,流式细胞术检测AL患者及对照组骨髓单个核细胞β-catenin表达.结果 32.7％(18/55)的AL患者WIF-1基因启动子区域有异常甲基化,对照组末检测到WIF-1基因甲基化,两组差异有统计学意义(P＜0.05).甲基化组首次诱导治疗完全缓解率(38.9％,7/18)低于非甲基化组(81.1％,30/37),差异有统计学意义(P＜0.05).甲基化组与非甲基化组β-catenin的表达(17.5％±3.3％、15.4％±3.6％)均高于对照组(10.5％±1.5％,均P＜0.05);甲基化组β-catenin的表达高于非甲基化组(P＜0.05).结论 WIF-1基因启动子甲基化及β-catenin过表达可能参与了AL患者Wnt/β-catenin途径的异常激活.     

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.