P16蛋白在鼻咽癌及癌前病变组织中的表达

目的探讨P16蛋白与鼻咽癌发生发展中的关系.方法采用S-P放射免疫法检测36例鼻咽癌组织,17例鼻咽黏膜中、重度异型增生组织,15例鼻咽黏膜慢性炎症组织中P16蛋白的表达.结果鼻咽癌组织的阳性率为30.55%,鼻咽黏膜慢性炎症组织及鼻咽黏膜中、重度异型增生组织中P16蛋白的阳性率为100%,前者显著低于后者(P<0.01);在无颈部淋巴结转移组的阳性率为46.66%,伴有颈部淋巴结转移组的阳性率为19.04%,前者显著高于后者(P<0.05).结论 P16蛋白的缺失可能与鼻咽癌的发生、发展和转移有关.     

鼻咽癌组织p16蛋白、p27kip1表达与CT表现的关系

目的研究p16蛋白、p27kip1(kinase inhibition protein 1,kip1)表达与鼻咽癌(Nasopharyngeal carcinoma,NPC)CT表现的关系.方法回顾性分析确诊的47例鼻咽癌患者CT表现,应用免疫组化法检测其与18例相应癌旁组织p16蛋白、p27kip1表达状况.结果 NPC中p16蛋白、p27kip1表达阳性率分别为40.43%、34.04%,癌旁组织中表达阳性率分别为88.89%、83.33%,两组差异有显著性(P＜0.01).p16蛋白、p27kip1表达缺失均与颅内转移、骨远处转移密切相关(均P＜0.05),均与咽旁间隙浸润无明显关系(P＞0.05).结论 p16蛋白与p27kip1表达缺失与NPC发生及颅内转移、骨远处转移有密切关系.     

P16蛋白、nm23蛋白和PCNA在人鼻咽癌组织中的表达及其临床意义

目的 研究P16蛋白、nm23蛋白和PCNA在鼻咽癌(NPC)患者组织中的表达,探讨它们之间的关系,并探讨其表达结果与鼻咽癌淋巴结转移及预后的关系.方法 应用免疫组织化学SP法检测100例鼻咽癌患者和20例慢性鼻咽炎患者的病变组织中P16蛋白、nm23蛋白和PCNA的表达水平.结果 鼻咽癌组织中P16蛋白阳性表达率为31.0%(31/100),伴颈淋巴结转移者的P16蛋白阳性表达率低于无颈淋巴结转移者;生存期＜5年者的P16蛋白阳性表达率低于生存期≥5年者.鼻咽癌组织中nm23蛋白阳性表达率为77.0%(77/100),伴颈淋巴结转移者的nm23蛋白阳性表达率低于无颈淋巴结转移者;生存期＜5年者的nm23蛋白阳性表达率低于生存期≥5年者.鼻咽癌组织中PCNA的标记指数为(71.6±10.4)%,伴颈淋巴结转移者的PCNA标记指数高于无颈淋巴结转移者;生存期＜5年者的PCNA标记指数高于生存期≥5年者.鼻咽癌组织中的PCNA标记指数越高,癌细胞越容易转移,患者预后越差.结论 鼻咽癌组织中P16蛋白、nm23蛋白的低表达与鼻咽癌颈淋巴结转移和预后差有关,PCNA的高表达与鼻咽癌颈淋巴结转移和预后差有关.     

鼻咽癌组织中环氧化酶-2和CD44v6的表达及其相互关系

目的 研究环氧化酶-2(COX-2)和CD44v6在鼻咽癌的表达及它们在鼻咽癌淋巴道转移中的作用及相互关系.方法 应用免疫组化S-P法检测26例鼻咽黏膜慢性炎、65例鼻咽癌组织和30例鼻咽癌颈部淋巴结转移灶中COX-2和CD44v6的表达.结果 COX-2在鼻咽癌、淋巴结转移灶中的阳性表达率分别是61.5%和83.3%,明显高于鼻咽慢性炎组(P＜0.01);CD44v6在鼻咽慢性炎组的阳性率为15.4%,而在鼻咽癌及淋巴结转移灶中的表达率分别为50.8%和86.7%,两两比较差异有显著性(P＜0.01);在鼻咽癌和淋巴结转移灶中,COX-2阳性表达组CD44v6的表达要高于COX-2阴性组,两者的表达呈正相关(分别P＜0.05,P＜0.01).结论 COX-2在鼻咽癌组织和淋巴结转移灶中异常高表达.COX-2可能通过上调CD44v6的表达来促进鼻咽癌细胞的浸润和转移.     

cyclin D1和p16蛋白在鼻咽低分化鳞癌表达与预后的关系

目的探讨中细胞周期素D1(cyclin D1)和p16蛋白的表达与鼻咽低分化鳞癌预后的关系.方法应用免疫组化SP法检测cyclin D1和p16在66例鼻咽低分化鳞癌和20例鼻咽部炎症黏膜组织中的表达.分析这两种蛋白与鼻咽癌颈淋巴结转移、临床分期、复发和预后的关系.结果 p16的缺失表达在有淋巴结转移组高于无转移组(P＜0.0 5),而cyclin D1的过表达与淋巴结转移无关(P＞0.05).cyclin D1的过表达在有复发组高于无复发组(P＜0.05),而p16的缺失表达与复发无关(P＞0.05) .p16的缺失表达和cyclin D1的过表达均与临床分期无关(P＞0.05).p16的缺失表达和c yclin D1的过表达小于5年生存组均明显高于大于5年生存组(P＜0.05).结论 p16的缺失表达可能与淋巴结的转移和预后有关;cyclin D1的过表达可能与复发和预后有关.p16和cyclin D1均有可能独立作为鼻咽低分化鳞癌的预后评估指标.     

鼻咽癌组织中HGF、MMP-7和VEGF的表达及意义

[摘要] 目的 探讨肝细胞生长因子（HGF）、基质金属蛋白酶(MMP)-7和血管内皮 生长因子（VEGF）在鼻咽癌及其淋巴结转移中的表达及意义。方法 采用免疫组化SABC法检测23例鼻咽黏膜慢性炎、32例鼻咽癌和16例鼻咽癌颈部淋巴结转移中HGF、MMP-7和VEGF的表达。结果 HGF、MMP-7和VEGF在鼻咽黏膜慢性炎组中的阳性表达率分别为30.4%、30.4%和56.5%；鼻咽癌组则分别为50.0%、65.6%和90.6%；淋巴结转移组则分别为75.0%、18.8%和81.3%。MMP-7和VEGF在黏膜慢性炎和鼻咽癌组中的表达差异均有显著性（P＜0.05或P＜0.01）；MMP-7在鼻咽癌和淋巴结转移组中的表达差异有显著性（P＜0.01）。HGF在黏膜慢性炎和淋巴结转移组中的表达差异有显著性（P＜0.01）；鼻咽癌组中HGF与VEGF呈显著正相关性（P＜0.01）；淋巴结转移组中HGF与VEGF、MMP-7均呈显著正相关性（P＜0.05或P＜0.01）。结论 MMP-7和VEGF过表达与鼻咽良、恶性病变有关；HGF可能通过诱导VEGF表达，有利于鼻咽癌的肿瘤血管生成和转移。 ［关键词］ 鼻咽肿瘤 HGF MMP-7 VEGF 免疫组织化学     

鼻咽癌中E-cadherin、TGF-β1和Vimentin蛋白的表达及其与颈部淋巴结转移的关系

目的：探讨E-钙黏附蛋白（E-cadherin）、转化生长因子（TGF-β1）、Vi mentin在鼻咽癌的表达及其与颈部淋巴结转移的关系。方法：采用免疫组织化学S-P染色法检测36例鼻咽原发癌和30例鼻咽颈部淋巴结转移癌和20例鼻咽黏膜慢性炎症组织中E-cadherin、TGF-β1、Vi mentin蛋白的表达水平。结果：E-cadherin在鼻咽颈部淋巴结转移癌中的阳性表达率为46.7%,显著低于鼻咽原发癌80.6%（P〈0.05）和鼻咽黏膜慢性炎症90%（P〈0.05）,TGF-β1、Vi mentin在鼻咽颈部淋巴结转移癌中阳性表达率均高于鼻咽黏膜慢性炎症（P〈0.05）,但与鼻咽原发癌无明显差异;在鼻咽原发癌、鼻咽颈部淋巴结转移癌中E-cadherin与TGF-β1、Vi mentin的表达呈负相关（P〈0.05）。结论：E-cadherin表达下调在鼻咽癌侵袭转移中起重要作用,鼻咽癌中E-cadherin表达下调及转化生长因子TGF-β1表达增多可引发上皮—间叶细胞转化（EMT）,EMT可能与鼻咽癌侵袭转移相关。     

鼻咽癌患者的CT显像与PCNA和P53蛋白表达的相关性研究

目的探讨鼻咽癌患者的CT显像与增殖细胞核抗原(PCNA)和P53蛋白表达的关系,并推测CT显像反映生物学特性的可能性。方法鼻咽癌患者32例均行CT扫描,总结临床CT显像情况,然后采用免疫组织化学方法检测鼻咽部肿瘤细胞PCNA和P53蛋白的表达。结果鼻咽腔单侧壁肿块患者肿瘤细胞PCNA蛋白表达明显低于多侧壁肿块患者(P<0.05)。茎突内软组织肿块患者肿瘤细胞PCNA和P53蛋白表达明显高于无茎突内软组织肿块患者(P<0.05)。颈部淋巴结转移组中肿瘤细胞PCNA蛋白表达明显高于无颈部淋巴结转移组(P<0.05)。结论鼻咽癌患者的CT显像与PCNA蛋白表达密切相关,茎突内软组织肿块与P53蛋白表达增高相关。     

P16蛋白和P73蛋白在鼻咽癌中的表达及临床意义

目的　探讨鼻咽癌组织中P16 蛋白和P73蛋白的表达及其临床意义。方法　采用免疫组化S -P法 ,检测P16 蛋白和P73蛋白在 4 0例鼻咽癌组织和 2 0例鼻咽癌黏膜慢性炎症组织中的表达情况。结果　 4 0例鼻咽癌组织中P16 蛋白阳性表达率明显低于鼻咽黏膜慢性炎症组织 (P <0 0 5 ) ,而P73蛋白在 4 0例鼻咽癌组织中的表达较鼻咽黏膜慢性炎症组织相比明显增高 (P <0 0 5 )。P16 蛋白和P73蛋白的表达与颈部淋巴结转移、局部区域复发以及远处转移无明显相关 (P >0 0 5 ) ,且P16 蛋白与P73蛋白的表达亦无明显相关。结论　P16 蛋白的低水平表达和P73蛋白的高水平表达可能与鼻咽癌的发生发展有关。     

P16和Bcl-2蛋白在鼻咽部鳞状细胞癌的表达及相互关系

目的探讨多发性肿瘤拟制基因（P16）和B细胞淋巴瘤/白血病基因2（Bcl-2）在不同分期鼻咽部鳞状细胞癌组织及鼻咽部炎症组织中的表达情况。方法应用免疫组化SP二步法检测40例不同分期鼻咽部鳞状细胞癌组织和16例鼻咽部慢性炎症组织中P16及Bcl-2蛋白的表达。结果 P16蛋白在鼻咽部炎症组织中高表达,癌组织中低表达,P16的表达与鼻咽癌的临床分期无明显关系,有颈部淋巴结转移的鼻咽癌患者P16基因表达较无颈部淋巴结转移者低,但差异无统计学意义（P〉0.05）。Bcl-2蛋白在癌组织中高表达,炎症组织中低表达。结论 Bcl-2是在鼻咽部鳞状细胞癌组织中高表达的凋亡抑制基因,P16是鼻咽鳞状细胞癌中低表达的抑癌基因。     

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.