压片组织及细胞印片在快速病理诊断中的应用

目的探讨压片组织及细胞印片的快速病理诊断。方法对不同部位120例病变组织进行组织压片、细胞印片，HE染色光镜观察，并与石蜡切片进行对照。结果良性38例恶性82例，压片、切片、印片一致的有114例，正确率95％；不一致6例，误诊率0．5％。结论压片组织细胞学结合印片细胞学在片中即能看到肿瘤细胞的形态特点，有能看到某些组织学结构，再对照常规石蜡切片达到相互配合的观察效果，而且操作简单，不需特殊设备。     

细胞学诊断在消化道组织活体病检中的应用

目的用印片细胞学作为初步诊断与石蜡切片诊断相结合，提高消化道组织活检的病理诊断的准确率和阳性率，减少漏诊。方法用印片法进行细胞学检查，对活检组织进行初步诊断，结合一次石蜡诊断结果，对细胞学检查阳性而石蜡切片阴性结果的组织进行反复切片诊断。结果在用细胞学作初步诊断的病例，病理诊断阳性率提高7．2％。结论将细胞学诊断作为初步诊断应用于消化道组织活检的病理诊断具有较强的应用价值。     

157例印片在术中快速病理诊断应用

目的探讨印片在术中快速病理诊断应用。方法对送检不同部位病变组织进行印片。快速HE染色，光镜下观察，并与石蜡切片诊断进行对照。结果157例中印片恶性肿瘤52例，诊断率33．12％，良性病变96例，诊断率61．14％，印片诊断准确率94．26％。石蜡切片诊断恶性59例(37．58％)，良性病变98例(62．42％)，准确率100％。8例误诊，误诊率5．1％。结论印片诊断不同于一般涂片单纯细胞学诊断，有时能看到某些组织学结构，是细胞学与组织学相互结合观察的结果。印片诊断在某些方面，优于冷冻切片诊断。     

冰冻切片的实用性和准确性的探讨

对我室１９９２年１１月～１９９４年１０月间冰冻切片诊断工作进行回顾性分析。２年间，冰冻切片共３６８例，占此期住院手术送检病例的８．７％。其中，３５４例用于确定病变性质，占９６．２％，１２例用于确定组织中是否存在转移，占３．３％；２例用于鉴别组织类别，占０．５％。乳腺和卵巢是冰冻切片最常见的组织。冰冻切片与石蜡切片诊断一致者３５８例，总符合率为９７．３％。诊断不一致的１０例中，过度诊断３例，诊断不确定２例，诊断不足５例。结果表明，冰冻切片不失为术中快速诊断的一种较为可靠、准确的方法。此外，对冰冻切片的应用和准确性的有关问题进行了讨论。作者赞同冰冻切片宜用于对病理过程作出一个笼统的而不是一个精确诊断的观点。     

冰冻切片的实用性和准确性的探讨

对我室１９９２年１１月～１９９４年１０月间冰冻切片诊断工作进行回顾性分析，２年间，冰冻切片共３６８例，占此期住院手术送检病例的８．７％，其中，３５４例用于确定病变性质，占９６．２％，１２例用于确定组织中是否存在转移，占３．３％，２例用于鉴别组织类别，占０．５％，乳腺和卵巢是冰冻切片最常见的组织，冰冻切片与石蜡切片诊断一致者３５８例，总符合率为９７．３％，诊断不一致的１０例中，过度诊断３例，诊断不确     

VCE取材Bethesda 2001报告在宫颈癌筛查中的意义

目的：探讨VCE取材Bethesda 2001报告系统在宫颈癌筛查中的意义。方法：采用VCE取材Bethesda2001报告系统对3 056例健康体检女性进行阴道细胞学检查,并对不明确意义的不典型鳞状上皮细胞（ASC-US）以上病变者经阴道镜取材进行宫颈组织病理学诊断。结果：阴道细胞学检查(VCE取材Bethesda 2001报告系统)检出宫颈异常鳞状上皮细胞66例,阳性率2.15%。其中不明确意义的不典型鳞状上皮细胞（ASC-US）17例（25.76％）,不除外高度病变的不典型鳞状上皮细胞（ASC-H）4例,（6.06％）,低度鳞状上皮内病变（LSIL）28例（42.42％）,高度鳞状上皮内病变(HSIL)14例（21.21％）,宫颈鳞癌（SCC）3例（4.55％）。66例细胞学阳性诊断病例经宫颈活检组织病理学诊断CIN I级以上病变60例（90.91％）,其中CIN Ⅰ级35例（53.03％）,CIN Ⅱ级12例（18.18％）,CIN Ⅲ级7例（10.61％）,宫颈鳞癌6例（9.09％）。结论：VCE取材Bethesda2001报告系统取材方便、报告准确,阴道细胞学检查阳性诊断与病理诊断符合率高达90.91％,VCE取材Bethesda2001报告系统在宫颈癌筛查中具有重要意义。     

阴道镜检查241例分析

目的 评价阴道镜检查在诊断宫颈上皮内瘤样病变中的价值。方法 对1999年9月—2001年12月在我院妇科就诊，因临床可疑或宫颈细胞学巴氏Ⅱ级以上而行阴道镜及病理检查的241例患者进行临床分析。结果 CIN病变的发生率在各年龄段之间无显著差异，241例阴道镜检查的患者175例做细胞学涂片，宫颈细胞学涂片为巴氏Ⅱ、Ⅱa级的患者85例，阴道镜检查定点活检病理结果为CIN病变者22例，阳性率为25．9％；宫颈细胞学涂片为巴氏Ⅱb级及以上的患者110例，阴道镜检查定点活检病理结果为CIN病变者37例，阳性率为33．6％，假阳性率为66．4％；临床可疑未涂片行阴道镜检查者66例，活检病理结果为CIN病变者21例，阳性率为31．8％。阴道镜图像为Ⅰ级者139例，病理诊断为CIN病变者7例，检出率为(5％)，均为CINⅠ；阴道镜图像为Ⅱ级者78例，病理诊断为CAN病变者51例，检出率为65．4％，其中CINⅠ为36例，CINⅡ14例，CINⅢ1例；阴道镜图像为Ⅲ级者24例，病理诊断为CIN病变者22例，检出率为91．7％，其中CINⅠ为4例，CINⅡ9例，CINⅢ9例。结论 防癌检查应从年轻患者开始，宫颈细胞涂片、阴道镜、病理活检三者有机地结合起来，以提高CIN的早期诊断率，对防止和减少子宫颈癌的发生具有重要意义。     

纤维胃镜活检涂片细胞学检查诊断价值

目的：探讨纤维胃镜活检涂片细胞学检查的诊断价值。方法：对我院1999年1月－2000年12月纤维胃镜活检涂片1370例细胞学检查总结。结果：诊断恶性病变332例（24．23％），良性病变573例（41．82％），细胞学阴性453例（33．06％），标本不良12例（0．87％）。有细胞学、病理活检、胃镜初次诊断对照共723例，其中细胞诊断恶性病变214例（29．5％），良性病变267例（36．92％），病理活检诊断恶性病变243例（33．6％），良性病变466例（64．45％），胃镜诊断恶性303例（41％），良性415例（57．39％）。细胞学初次诊断恶性病变214例，其中6例初次病理检查为阴性，最终诊断为腺癌。细胞学与病理初次诊断比较，病理初次诊断恶性243例中细胞学阳性208例，符合率85．6％，假阴性14．4％，无假阳性，特异性98．75％。结论：胃镜＋病理活检＋细胞学检查三结合才能达到更高诊断率。     

液基薄层细胞学配合阴道镜检查对宫颈病变的诊断价值

目的探讨液基薄层细胞学（TCT）配合阴道镜检查对子宫颈病变的诊断价值。方法TCT配合阴道镜检查对子宫颈病变进行筛查,以组织学诊断与TCT结果进行对比分析。结果TCT检查2202例,采用TBS分类,共检出细胞学阳性215例,占9．77％。其中不典型鳞状上皮细胞（ASC）98例（4．45％）;不典型腺细胞（AGC）2例（0．09％）;低度鳞状．卜皮内病变（LSIL）33例（1．50％）;高度鳞状上皮内病变（HSIL）36例（1．54％）;鳞状细胞癌（SCC）13例（0．59％）。对细胞学阳性（包括ASC及以上病变）或细胞学虽阴性但临床高度可疑者共236例行阴道镜榆查,其中215例行镜下活组织病理检查。细胞学与阴道镜下活组织病理诊断符合率分别为LSIL71．74％（33／46）,HSIL93．55％（CIN2为9／11,CIN3为20／20）,SCC100％（13／13）。结论采用TCT筛查,可提高宫颈病变的阳性诊断率;细胞学阳性或临床可疑患者应配合阴道镜检查及镜下活检病理诊断,以便进一步提高诊断率,为早期诊断和治疗方法选择提供可靠的依据。     

阴道镜及液基细胞筛查宫颈病变临床分析

目的探讨液基细胞学检测和阴道镜检查对宫颈病变的诊断价值。方法2005年3月-2006年12月我院门诊共有470例患者接受液基细胞学检查（TCT），并同时采用阴道镜检查及活组织病理检查，以宫颈活组织病理诊断为金标准，对结果进行分析。结果TCT检查阳性病例161例（34．3％），与组织学诊断的符合率为61．5％；TCT诊断HPV感染与组织学诊断HPV感染有相关性（P〈0．05）；阴道镜检查阳性病例289例（615％），与组织学诊断符合率为89．6％。结论TCT检查与阴道镜检查是宫颈癌筛查方便、安全、准确、可靠的方法。     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.