检测活检胃粘膜AgNORs的临床意义

采用ｐｌｏｔｏｎ银染方法检测１５９例活检胃粘膜的ＡｇＮｏＲｓ，其中胃癌５４例，不典型增生１５例，肠化生１６例，胃溃疡１０例，慢性浅表性胃炎３４例，慢性萎缩性胃炎３０例。结果，各组病变的ＡｇＮｏＲｓ计数为：胃癌１０．９８±１．６９，不典型憎生５．１０±１．５１，肠化生４．４３±１．７６，胃溃疡３．６４±０．８５慢性浅表性胃炎１．６３±０．４６，慢性萎缩性胃炎１．６８±０．５２。经ｔ检验，胃癌组的ＡｇＮｏＲｓ计数显著高于各非癌组，不典型增生和肠化生组的ＡｇＮｏＲｓ计数与其余非癌组间也有显著性差异。认为检测ＡｇＮＯＲｓ方法简单、快速、结果稳定。可作为胃癌和癌前病变诊断的一项辅助指标。     

胃癌及其癌前病变核仁组成区相关蛋白的定量研究（Ⅱ）

应用核仁组成区相关蛋白（ＡｇＮｏＲｓ）染色观察５２例不同类型肠上皮化生（简称肠化生），１１例中重度异型增生、３０例胃窦癌及４例正常胎儿胃粘膜和２０例正常胃粘膜ＡｇＮＯＲ量的变化，发现Ⅲ型肠化生ＡｇＮＯＲ计数显著高于Ⅰ、Ⅱ型肠化生（Ｐ＜０．０５）。从正常胃粘膜上皮，经肠上皮化生到中重度异型增生到胃癌，ＡｇＮＯＲ计数随细胞异型程度的加重而递增，各组间均见显著性差异（Ｐ＜０．０５）。结果表明，Ⅲ型肠化生与胃癌的发生有密切关系，具有较高ＡｇＮＯＲ计数的中重度异型增生是重要的癌前病变。     

幽门螺杆菌感染者胃粘膜癌前病变与cmet 原癌基因蛋白表达的关系

目的研究幽门螺杆菌（Ｈｐ）感染后胃粘膜癌前病变中ｃ－ｍｅｔ原癌基因蛋白表达的情况,了解Ｈｐ在胃癌发生过程中的作用。方法１１０例经病理证实为慢性胃炎的病人用免疫组织化学方法检测胃粘膜细胞中ｃ－ｍｅｔ原癌基因蛋白表达。结果在浅表性胃炎、萎缩性胃炎、肠化生及异型增生中,ｃ－ｍｅｔ原癌基因蛋白的表达率分别为２２．２％、４４．１％、６７．５％、６１．９％。过量表达率分别为５．５％、２６．４％、３７．８％、３８．１％。Ｈｐ感染者ｃ－ｍｅｔ原癌基因蛋白表达率明显较未感染者高,分别为６３％及３２％。在萎缩、肠化生及异型增生等癌前病变中,Ｈｐ感染者与未感染者表达率分别为６８．９％及３０．５％（Ｐ＜０．０５）。结论随着病变的进展,ｃ－ｍｅｔ原癌基因的表达随之增加,Ｈｐ感染对ｃ－ｍｅｔ原癌基因蛋白表达有一定的影响。     

胃癌癌旁肠上皮化生的病理组织学研究

为了探讨肠上皮化生在胃癌发生方面的意义，作者采用粘液组织化学染色、核仁组成体区相关嗜银蛋白（ＡｇＮＯＲ）染色等方法研究了９３例胃癌癌旁肠上皮化生的特点。结果显示癌旁肠上皮化生的检出率为８０．６４％，大肠型肠上皮化生检出率５８．０６％，不完全性大肠型肠上皮化生检出率１７．２０％；７例早期胃癌中５例伴有肠上皮化生；肠上皮化生及其各种亚型在肠型胃癌和弥漫型胃癌之间的差别无显著意义（Ｐ＞０．０５）；肠上皮化生ＡｇＮＯＲ数目（２．１５±０．４９）明显多于正常幽门腺（Ｐ＜０．０１），ＡｇＮＯＲ直径（１．５８±０．４８μｍ）明显小于正常幽门腺（Ｐ＜０．０５），与胃癌细胞的差别均无显著意义。讨论认为伴有明显异型增生的肠上皮化生属于胃癌的癌前病变。     

甲型肝炎患者外周血T淋巴细胞亚群变化的检测

作应用ＣＤ系列单克隆抗体、碱性磷酸酶抗碱性磷酸酶双桥酶法（ＡＰＡＡＰ技术）对甲型肝炎患５２例外周血Ｔ淋巴细胞亚群的变化进行了检测及分析。发现患急性期ＣＤ４＾＋细胞百分率（３０．７±３．４％）较正常对照（３７．７±２．５％）明显降低（Ｐ〈０．０１），ＣＤ８＾＋率则显增高（３５．８±３．９％对２７．７±２．４％，Ｐ〈０．０１），导致ＣＤ４＾＋／ＣＤ８＾＋比值（０．８７±０．２对１．３±０．１）     

幽门螺杆菌培养滤液诱癌和促癌作用的实验研究

目的观察大鼠胃粘膜在幽门螺杆菌（Ｈｐ）培养滤液长期作用下的组织学变化及其对大鼠实验性胃癌的促癌作用。方法分别以０．２５％和０．５％的Ｈｐ培养滤液让大鼠自由饮用,观察不同时间大鼠胃粘膜厚度、表面粘液含量、ＤＮＡ合成速率及组织学变化;并观察不同时相应用Ｈｐ培养滤液对甲基硝基亚硝基胍（ＭＮＮＧ）诱癌的促癌作用。结果实验第５周时,实验组大鼠胃粘膜厚度明显变薄,表面粘液含量减少和ＤＮＡ合成速率加快,随实验时间的延长,上述改变进一步加重。至５２周实验结束时,０．５％Ｈｐ培养滤液组大鼠腺胃粘膜肠化生、硫酸粘液阳性肠化生和异型增生的发生率（５７％、３９％、１８％）明显高于０．２５％Ｈｐ培养滤液组（２８％、１０％、３％）和正常对照组（７％、０％、０％）。无论在给予ＭＮＮＧ以前、同时或以后饮用Ｈｐ培养滤液,大鼠胃癌和癌前病变的发生率均明显增加。结论Ｈｐ的毒性产物可能具有直接的诱癌和促癌作用     

胃癌高发区肠上皮化生与异型增生的关系

目的：研究两型肠上皮化生中异型增生的发生率并探讨其在胃癌发生中的作用。方法：对我国胃癌高发区山东省临朐县３５～６４岁的居民３４０１人进行了胃内７个标准部位的胃镜活检，对所有的活检材料均进行了病理检查，并研究肠化生类型及其与异型增生的关系。结果：这一人群的肠化生检出率为５２．８％，异型增生检出率为２０．１％，小肠型肠化生中异型增生的发生率为３３．６％，大肠型肠化生中的发生率为５１％（Ｐ＜０．０１）。结论：研究表明，与小肠型化生相比较，大肠型化生更易于发生异型增生，因此，最终发生癌变的危险性可能高于小肠型化生     

早孕蜕膜中淋巴细胞抗原的表达及IFN－γ测定

本文以几种抗淋巴细胞表面标志的单克隆抗体，采用花环标记、碱－磷酶抗碱－磷酶（ＡＰＡＡＰ）法、酶联免疫吸附（ＥＬＩＳＡ）法，对２３例早孕蜕膜组织中的淋巴细胞及γ－干扰素（ＩＦＮ－γ）进行了测定。结果发现，早孕蜕膜淋巴细胞中ＣＤ３＋、ＣＤ４＋、ＣＤ８＋、ＣＤ１６＋及Ｂ细胞百分率（ｘ±ｓ）分别为２９．５２±６．８０％、２３．６０±４．８６％、２０．９１±４．０６％、１．０７±１．００％、７．８１±２．５６％，ＣＤ４／ＣＤ８为１．２０±０．２０。ＣＤ３－淋巴细胞呈大颗粒淋巴细胞（ＬＧＬ）形态，蜕膜组织浸液中ＩＦＮ－γ含量＜０．６μｇ／Ｌ。提示，早孕蜕膜中存在较多ＣＤ３－、ＣＤ１６－的形态呈ＬＧＬ的ＮＫ细胞，ＣＤ４＋细胞与ＣＤ８＋细胞的比值较正常外周血明显降低     

大鼠实验性腺胃粘膜癌变过程的组化观察

对甲基硝基亚硝基胍和雷尼替丁联合诱发的大鼠腺胃粘膜癌变过程作动态组织学及粘液组化观察，发现：（１）肠上皮化生首先出现于腺颈部，之后向粘膜表面或底部延伸，支持肠化起始于腺腺颈部多潜能干细胞的观点；（２）异型增生有向粘膜表面和底部增殖两种不同的发生方式；（３）腺体囊状扩张及异型囊可能是一种胃癌前期变化；（４）实验性胃癌的组织发生至少有两种方式；异型增生→胃癌和肠上皮化生→异型增生→胃癌；（５）粘液分泌     

慢性胃炎病理组织学表现与幽门螺杆菌的关系

目的：以大样本方式进一步了解幽门螺杆菌（Ｈｅｌｉｃｏｂａｃｔｅｒｐｙｌｏｒｉ,Ｈｐ）与慢性胃炎的关系。方法：回顾性分析连续１２个月内在我院被胃镜诊断为慢性胃炎的胃窦粘膜病理组织学检查结果。结果：共１６５８例,其中Ｈｐ阴性８８９例,Ｈｐ阳性７６９例。在Ｈｐ阴性病人中轻度慢性炎症（４２．７％）比重度（２２．１％）多见;在Ｈｐ阳性病人中轻度慢性炎症（７．５％）比重度（７３．２％）少见;随Ｈｐ菌量的增加,重度炎症明显增加,轻度炎症明显减少;肠化生和粘膜萎缩在Ｈｐ阳性病人中多见,分别为２０．２％和１０．３％（其在Ｈｐ阴性病例分别为１４．５％和７．５％）。结论：Ｈｐ是慢性胃炎的重要致病因素,它与胃窦粘膜慢性炎症程度及肠化生和粘膜萎缩有密切的关系     

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.