p16与c-myc基因表达产物在肝细胞癌及癌旁组织中的表达及临床意义

目的：探讨ｐ１６、ｃ－ｍｙｃ蛋白与肝细胞癌（ＨＣＣ）的发生、发展及恶性程度的关系。方法：应用免疫组织化学法检测了６９例ＨＣＣ和６３例癌旁组织ｐ１６及ｃ－ｍｙｃ蛋白的表达,并结合临床资料进行分析。结果：ｐ１６蛋白主要分布在胞浆,少数细胞核内也可见阳性显色。ｃ－ｍｙｃ蛋白主要分布在胞核。ｐ１６蛋白在肝癌组织及癌旁组织中的阳性率分别为２６．５％（１８／６９）和９２％（５８／６３）,两者比较差异显著（Ｐ〉     

丙型肝炎病毒C33c抗原、核心抗原和HBxAg在人原发性肝内胆管细胞癌中的分布及意义

目的：研究丙型肝炎病毒Ｃ３３ｃ抗原及核心抗原在人肝内胆管细胞癌中的分布及意义。方法：以免疫组织化学方法检测ＨＣＶ两种抗原及ＨＢｘＡｇ在肝内胆管细胞癌及癌旁肝组织中定位及分布。结果：ＨＣＶＣ３３ｃ抗原位于癌细胞或肝细胞的胞浆内；ＨＣＶ核心抗原在癌组织主要呈核阳性，在癌旁肝以胞浆阳性为主。ＨＣＶＣ３３ｃ抗原在癌组织及癌旁肝的阳性率分别为６０％（２１／３５）及１００％（２１／２１），ＨＣＶ核心抗原在上述两种组织的阳性率分别为８７．８％（２９／３３）及６１．９％（１３／２１）；ＨＢｘＡｇ在两种组织中检出率分别为７４．３％（２６／３５）及７６．２％（１６／２１）．Ｃ３３ｃ及ＨＢｘＡｇ双阳性分别为４８．６％（１７／３５）及７６．２％（１６／２１）．结论：除ＨＢＶ感染外，ＨＣＶ感染在人肝内胆管细胞癌的发生中可能起重要作用     

重庆地区HBV、HCV感染的肝癌组织中癌基因与抑癌基因的表达

提示重庆地区肝癌患者ＨＢＶ和／或ＨＣＶ的感染与癌组织中癌基因和抑癌基因表达之间的联系。方法：应用免疫组织化学方法检测ＨＢＶ和ＨＣＶ抗原以诊断ＨＢＶ和ＨＣＶ感染,癌基因ｒａｓ、ｃ－ｍｙｃ、ｃ－ｅｒｂＢ－２和抑癌基因Ｐ５３蛋白的表达也用免疫 经方法检测。结果４６例肝癌患者中,ＨＢＶ感染３４例,ＨＣＶ感染２０例;其癌组织中ｒａｓ ｐ２１、ｃ－ｍｙｃ、ｃ－ｅｒｂＢ－２和Ｐ５３蛋白表达阳性率分别为５８．７％     

肝细胞癌c-fos的表达及其与乙型肝炎病毒的关系

目的 研究肝癌组织中ｃ－ｆｏｓ和ｃ－ｃｏｆ ｍＲＮＡ的表达及其与乙型肝炎病毒（ＨＢＶ）的关系。方法 采用免疫组化及原位杂交技术检测５９例肝细胞癌组织及５６例癌旁组织中ＨＢｓＡｇ、ＨＢＶ ＤＮＡ、ｃ－ｆｏｓ蛋白及ｃ－ｆｏｓ ｍＲＡＮ的表达。结果 癌旁肝组织ＨＢｓＡｇ阳性率为８７．５％（４９／５６）。肝癌组织ＨＢＶ ＤＮＡ阳性率为５９．３％（３５／５９）。肝细胞癌组织、癌旁肝组织ｃ－ｆｏｓ蛋白 阳性率     

肝细胞癌组织中丙型肝炎NS3蛋白对P53蛋白表达的影响

目的探讨肝细胞癌（ＨＣＣ）及其癌旁肝组织中丙型肝炎病毒（ＨＣＶ）ＮＳ３蛋白对Ｐ５３蛋白表达的影响及其在肝癌发生中的作用。方法用免疫组织化学技术检测４７例乙型肝炎病毒阴性的ＨＣＣ及其癌旁肝组织中ＨＣＶＮＳ３蛋白和Ｐ５３蛋白的表达。结果ＨＣＶＮＳ３蛋白在ＨＣＣ中的阳性率（６２％）明显低于癌旁肝组织（８３％）,Ｐ＜００２５。癌组织中其表达强度与癌细胞分化程度呈相关性（Ｐ＜００２５）。Ｐ５３蛋白在癌组织中的阳性率（８１％）明显高于癌旁组织（４７％）,Ｐ＜００２５;癌细胞分化愈差,表达愈强（Ｐ＜００５）;癌组织中Ｐ５３蛋白表达与ＨＣＶＮＳ３蛋白的表达无相关性（Ｐ＞０５）,而癌旁肝组织中两者表达呈显著相关性（Ｐ＜００１）,ＨＣＶＮＳ３蛋白阳性患者中Ｐ５３蛋白表达明显高于ＨＣＶＮＳ３阴性病例,Ｐ＜００５。结论ＨＣＶＮＳ３蛋白可能是在肝细胞转化早期通过内源性机制间接作用于Ｐ５３基因使其突变导致肝细胞癌变。     

间隙连接蛋白Cx32在肝细胞癌组织中的表达

目的：探讨间隙连接蛋白Ｃｘ３２在肝细胞癌（ｈｅｐａｔｏ－ｃｅｌｌｕｌａｒｃａｒｃｉｎｏｍａ,ＨＣＣ）、癌旁肝及正常肝组织中的表达和意义．方法：应用ＳＰ免疫组织化学法检测Ｃｘ３２在４７例ＨＣＣ,１５例癌旁肝及９例正常肝组织中的表达．结果：Ｃｘ３２蛋白表达既定位于肝细胞胞质中,又定位于胞膜上．Ｃｘ３２在ＨＣＣ、癌旁肝及正常肝组织中的阳性率分别为４１．７％,７３．３％及８８．９％．经ｘ２检验,Ｃｘ３２在ＨＣＣ中的表达明显低于在癌旁肝及正常肝组织的水平（Ｐ＜０．０１）．随着ＨＣＣ分化程度的降低,其阳性率有所下降（Ｐ＜０．０５）．结论：间隙连接蛋白Ｃｘ３２表达减弱可能与ＨＣＣ的发生密切相关．     

人肝细胞癌及癌旁肝组织HBV-DNA的原位杂交检测

①目的探讨乙型肝炎病毒（ＨＢＶ）ＤＮＡ与增生结节和肝癌的关系。②方法应用原位杂交技术检测５８例肝细胞癌（ＨＣＣ）及癌旁组织中ＨＢＶ－ＤＮＡ的表达。③结果肝细胞癌及癌旁组织中ＨＢＶ－ＤＮＡ阳性率分别为３７．９％（２２／５８）和４４．８％（２６／５８），差异无显著性（χ２＝０．５６，Ｐ＞０．０５）。ＨＢＶ－ＤＮＡ在癌旁组织中主要位于胞浆内，而肝癌组织中以胞核定位为主。２２例ＨＢＶ－ＤＮＡ阳性的ＨＣＣ中，１６例ＨＣＣ及癌旁组织均阳性，６例ＨＣＣ单独阳性，两者差异有显著性（χ２＝９．０９，Ｐ＜０．０１）。６例癌旁增生结节中ＨＢＶ－ＤＮＡ阳性（６／２７），以胞核定位为主。④结论ＨＢＶ感染与ＨＣＣ存在密切关系。癌周组织ＨＢＶ－ＤＮＡ以复制型为主，癌组织内ＨＢＶ－ＤＮＡ以整合型为主；癌旁增生结节为ＨＣＣ的癌前病变。     

肝癌患者HCV感染与癌基因c—erbB—2表达的关系

探讨ＨＣＶ感染与肝癌组织中癌基因ｃ－ｅｒｂＢ－２表达的关系。方法；采用免疫组化ＳＰ法。４６例ＨＣＣ及其３８例癌旁组织中，ＨＣＶＮＳ３抗原的检出率为２１．７％和３４．２％，两者间无显著性差异。癌ｃ－ｅｒｂＢ－２蛋白的检出率分别为４７．８％和４４．７，两者间无显著性差异；肝癌组织中癌基因ｃ－ｅｒｂＢ－２蛋白表达的阳性率与该患者的ＨＣＶ感染无关。     

肝细胞癌和癌旁肝组织中血管内皮生长因子表达与微血管密 …

用免疫组织化学法研究肝细胞癌（ＨＣＣ）及癌旁肝组织血管内皮生长因子（ＶＥＧＦ）的表达与微血管（ＭＶ）密度的关系。ＶＥＧＦ在癌旁肝组织中的阳性率较ＨＣＣ中者为高（８５．４％ｖｓ６６．７％,Ｐ〈０．０５）;其表达强度在两者中差异无显著性（Ｐ〉０．０５）,其阳性信号主要位于癌细胞、癌旁肝细胞和血管内皮细胞胞浆。ＨＣＣ中ＭＶ密度明显高于癌肝组织（Ｐ〈０．０１）,并随癌细胞分化程度的降低而升高。结果提示,在     

肝细胞癌HBVDNA和癌基因表达的分子病理研究

目的：从分子水平观察肝细胞癌组织ＨＢＶＤＮＡ和癌基因的表达情况及与发病的关系。方法：应用原位核酸分子杂交技术研究４５例原发性肝细胞癌和２５例肝硬化的石蜡切片组织中ＨＢＶＤＮＡ和ｎ－ｒａｓ、ｃ－ｍｙｃ癌基因表达情况。结果：在肝细胞癌中见有ｎ－ｒａｓ和ｃ－ｍｙｃ表达增强，其检出率分别为６８．９％（３１／４５）和４０．０％（１８／４５），高于肝硬化组（２８．０％，８．０％）（Ｐ＜０．０５）。４０％肝细胞癌病例（１８／４５）两种癌基因同时过量表达，４５例肝细胞癌组织中有１９例存在有ＨＢＶＤＮＡ序列（４２．２％）并均具有ｎ－ｒａｓ或ｃ－ｍｙｃ过度表达。结论：两种癌基因ＨＢＶＤＮＡ可能有激活癌基因作用，肝细胞癌发生中可能起着重要的协同作用。ＨＢＶ感染与肝细胞癌发生有密切关系。     

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.