CDH1基因甲基化水平与肺癌的相关性研究

目的探讨CDH1（cadherin 1）基因甲基化水平与肺癌及其病理类型之间的相关性．方法应用半定量荧光MSP检测50例肺癌患者的癌、癌旁和远癌肺组织及5例非肺癌对照肺组织标本中的CDH1甲基化的相对比值，并用免疫组化方法对部分结果进行验证．结果肺癌组织、癌旁组织、远癌组织以及非肺癌对照肺组织CDH1甲基化相对比值的中位数分别为0．272、0．227、0．119和0．000．癌组织和癌旁组织（P〈0．05）、癌组织和远癌组织（P〈0．05）、远癌组织和非肺癌对照肺组织（P〈0．05）的CDH1启动子甲基化水平的差异均有统计学意义（P〈0．05）；癌组织、癌旁组织和远癌组织中的鳞癌、腺癌及腺鳞癌CDH1基因甲基化相对比值之间的差异均无统计学意义（P〉0．05）．免疫组化结果与半定量荧光MSP检测结果符合．结论CDH1基因甲基化水平与肺癌具有相关性，与肺癌的组织类型无相关性．CDH1异常甲基化和E—cad表达的减弱和缺失可能是肺癌发生和发展过程中的重要因素．     

SOCS-3基因在结肠癌中的表达及甲基化测定

目的通过对细胞因子信号转导抑制因子-3（suppressor of cytokine siganaling-3,SOCS-3）基因在结肠癌和癌旁组织中的表达及其启动子甲基化状态的测定,探讨其与结肠癌发生、发展和转移等的关系。方法收集40例结肠癌患者的肿瘤标本,20例癌旁组织以及10例正常结肠组织．运用甲基化特异性PCR测定SOCS-3基因CpG岛甲基化状态,同时运用实时定量PCR分析SOCS-3基因在结肠癌组织中的表达水平。结果40例结肠癌组织中有34例（85％）存在SOCS-3基因CpG岛的异常甲基化,癌旁组织中为2例（10％）,而正常结肠组织中没有检测到SOCS-3基因呈CpG岛甲基化;结肠癌组织中SOCS-3基因CpG岛甲基化组与无甲基化组相比．其SOCS-3基因的相对表达量明显减少（P〈0．05）,表明SOCS-3基因CpG岛甲基化可导致SOCS-3基因表达降低。与患者临床资料结合分析,发现SOCS-3基因CpG岛甲基化与性别、年龄无关（P〉0．05）,而与肿瘤病理分级和TNM分期有关（P〈0．05）。结论结肠癌中存在SOCS-3基因CpG岛异常甲基化,且因CpG岛的甲基化导致其基因表达降低。SOCS-3基因CpG岛甲基化可能参与了结肠癌的发生、发展和转移。     

非小细胞肺癌相关抑癌基因甲基化谱的研究

目的抑癌基因5′-CpG岛甲基化是非小细胞肺癌（non-smallcelllungcancer,NSCLC）中常见的表观遗传学改变,相关研究报道多为单基因位点且结果不一致。为了解我国NSCLC患者相关抑癌基因的甲基化状况,本文中筛选一组NSCLC候选甲基化谱,探讨其在NSCLC发生发展中的意义及用于早期诊断的价值。方法留取78例NSCLC患者术中癌组织,相应正常肺组织及110例I/II期NSCLC、50例肺部良性病变或健康志愿者血浆标本,用甲基化特异性聚合酶链反应（methylation-specificPCR,MSP）检测20个肺癌相关抑癌基因甲基化状况。结果 12个基因（APC、CDH13、KLK10、DLEC1、RASSF1A、EFEMP1、SFRP1、RARβ、p16INK4A、RUNX3、hMLH1和DAPK）在肿瘤组织中的甲基化高于相应正常组织,尤其是前9个基因（P≤0.001）,8个基因（BRCA1、p14ARF、MGMT、NORE1A、FHIT、CMTM3、LSAMP和OPCML）甲基化程度较低或肿瘤特异性较低。多基因甲基化常见于肿瘤组织,CpG岛甲基子表型（CpGislandmethylatorphenotype,CIMP）阳性见于65.38%（51/78）的NSCLC癌组织而仅见于1.28%（1/78）的正常组织（P〈0.001）。CIMP阳性与临床分期和淋巴结转移（P分别为0.007和0.031）相关。在早期NSCLC患者血浆样本中也检测出癌组织中初步筛选的9个抑癌基因的高甲基化。将APC、RASSF1A、CDH13、KLK10和DLEC15个基因联合检测,对肿瘤诊断的敏感性为83.64%,特异性为74.0%。结论 CIMP阳性是NSCLC肿瘤组织区别于正常组织的重要特征,且与临床分期和淋巴结转移相关。APC、RASSF1A、CDH13、KLK10和DLEC15个抑癌基因甲基化的联合检测可用于NSCLC的辅助诊断。     

T-钙黏蛋白高甲基化与肺癌发生、发展关系探讨

目的：通过检测肺癌组织、良性病变组织和对照组织中CDH13基因及其甲基化水平,结合临床病理资料,找出其与肺癌发生、发展的关系.方法：采用逆转录聚合酶链反应（RT-PCR）法和特异性甲基化PCR （MSP）法.结果：肺癌组CDH13基因甲基化阳性率为46.67％（21/45）,对照组为2.22％（1/45）,良性病变组为6.67％（3/45）,前组与后两组之间的差异均有统计学意义（P＜0.05）.CDH13基因在肺癌中为0.5273±0.0687,在对照组中为0.8345±0.0385、在良性病变组织为0.8632±0.0465,前组与后两组之间的差异均有统计学意义（P＜0.05）.Ⅲ期肺癌组织的CDH13基因甲基化阳性率61.90％（13/21）明显高于Ⅰ＋Ⅱ期33.33％（8/24） （P＜0.05）.有淋巴结转移的肺癌组织中CDH13基因甲基化阳性率70.59％（12/17）与无转移组的32.14％（9/28）差异有统计学意义（P＜0.05）.肺癌组织中CDH13基因甲基化阳性组的T-钙黏蛋白阳性率23.81％（5/21）显著低于甲基化阴性组54.17％（13/24） （P＜0.05）.结论：肺癌组织中T-钙黏蛋白基因含量明显降低,存在着CDH13基因启动子5＇CpG岛高甲基化,且CDH13基因的高甲基化水平随着肺癌临床分期和淋巴结转移而增高.     

Survivin和PTEN在非小细胞肺癌中的表达及相关性研究

目的：探讨survivin和PTEN在非小细胞肺癌（NSCLC）中的表达情况及其与NSCLC临床生物学行为的关系。方法：应用免疫组织化学方法检测survivin和PTEN在78例NSCLC组织、46例癌旁组织和12例非癌肺良性病变组织中的表达情况,并将结果进行相关性分析。结果：Survivin在非癌良性病变组织、癌旁组织、非小细胞肺癌中的阳性表达率分别是0、10．9％、67．9％．其蛋白表达逐渐增强（P〈0．05）;非小细胞肺癌中的survivin表达显著高于癌旁肺组织及非癌良性病变组织中的表达（P〈0．05）。PTEN在非癌良性病变组织、癌旁组织、非小细胞肺癌中的阳性表达率分别是100％、91．3％、47．4％,其表达逐渐减弱（P〈0．05）：非小细胞肺癌中的PTEN表达低于癌旁肺组织及非癌良性病变组织中的表达（P〈0．05）。survivin蛋白的表达与NSCLC的病理学分级、淋巴结转移、TNM分期有关（P〈0．05）。PTEN蛋白的表达与NSCLC的病理学分级、淋巴结转移、TNM分期有关（P〈0．05）。Survivin与PTEN表达呈负相关（P〈0．05）。结论：Survivin和PTEN在NSCLC中的异常表达与其生物学行为密切相关,survivin在非小细胞肺癌中过度表达,PTEN在非小细胞肺癌中表达降低,并且二者的表达呈负相关,二者可作为NSCLC判断病情和评价预后的参考指标。     

BRCA1基因在散发性乳腺癌中的表达及异常甲基化

目的：通过检测乳腺癌易感基因1（BRCA1）基因在散发性乳腺癌中的表达情况及其启动子甲基化状态,探讨BRCA1基因与散发性乳腺癌的关系。方法应用实时荧光定量PCR的方法和免疫组织化学方法分别检测BRCA1 mRNA和蛋白在60例散发性乳腺癌组织、癌旁正常乳腺组织及30例乳腺良性病变组织中的表达情况;应用重亚硫酸盐测序PCR（BPS）联合TA克隆测序方法检测上述组织中BRCA1启动子CpG岛的甲基化状态,分析BRCA1基因表达和启动子甲基化相关性。结果BRCA1 mRNA和蛋白在散发性乳腺癌组织中的相对表达水平分别低于癌旁正常组织及乳腺良性病变组织,差异有统计学意义（P＜0．001）。乳腺癌组织中BRCA1蛋白的表达率为51．7％（31／60）,明显低于癌旁正常乳腺组织的71．7％（43／60）及乳腺良性病变组织的66．7％（20／30）,差异有统计学意义（P＜0．001）;散发性乳腺癌组织中BRCA1启动子甲基化率为31．7％（19／60）,癌旁正常乳腺组织及乳腺良性病变组织均未检测出甲基化,差异有统计学意义（P＝0．000）;BRCA1蛋白表达与其启动子甲基化呈负相关（r＝－0．345,P＝0．007）。结论乳腺癌易感基因BRCA1启动子区CpG岛甲基化导致BRCA1基因表达显著下调,可能参与散发性乳腺癌的发生、发展。     

膀胱移行细胞癌P16、P15、P14基因5＇CpG岛甲基化检测

目的 探讨P16、P15、P14基因5＇CpG岛在膀胱移行细胞癌中甲基化状态及其临床意义。方法 应用甲基化特异性PCR（methylation—specific PCR，MSP）方法检测40例膀胱移行细胞癌P16、P15、P14基因甲基化程度，χ^2检验分析其甲基化程度与膀胱癌病理分级分期间关系。结果 膀胱移行细胞癌P16、P15、P14 5＇CpG岛甲基化扩增阳性化率分别为27．5％、17．5％、35％，而正常膀胱组织中均未检测到三种基因5＇CpG岛甲基化。P16、P14基因甲基化与膀胱癌病理分级分期有显著性差异（P〈0．05），P15基因则没有显著性差异（P〉0．05）。结论 P16、P15、P14基因在膀胱癌组织中的甲基化率较高，三种抑癌基因5＇CpG岛异常高甲基化，在膀胱癌的发生、发展中具有重要作用。     

胃癌p16基因启动子CpG岛甲基化研究

目的：探讨p16基因启动子CpG岛甲基化在胃癌中的表达及意义．方法：采用特异性甲基化PCR（MSP）法检测p16基因启动子CpG岛甲基化水平．结果：对照组未检测到CpG岛甲基化,胃癌细胞株均检测到CpG岛甲基化,23例（74％）胃癌组织检测到CpG岛甲基化．此外,17例（74％）癌旁组织检测到CpG岛甲基化．胃癌组织p16基因CpG岛甲基化与分化程度及淋巴结转移之间无相关关系（P〉0．05）．结论：胃癌广泛存在p16基因启动子CpG岛甲基化,并且可能是胃癌发生的早期分子事件．     

p16基因甲基化在非小细胞肺癌的表达研究

目的：探讨p16基因甲基化在人非小细胞肺癌组织中的表达情况。方法：应用甲基化特异性PCR法（MS-PCR）检测45例非小细胞肺癌组织,21例肺良性疾病组织中p16基因甲基化的表达情况。结果：肺良性疾病中p16基因甲基化阳性率为14．3％,低于癌组织中的57．8％,差异有统计学意义（P=0．001）;p16基因甲基化与非小细胞肺癌细胞分化程度及淋巴结转移情况有明显的相关性（P〈0．05）。结论：p16基因甲基化的表达情况与非小细胞肺癌的发生、发展有关。     

凋亡相关基因PDCD5启动子区甲基化在新疆汉族和维吾尔族食管鳞癌中的作用研究

目的：探讨凋亡相关基因程序化细胞死亡分子5（PDCD5）启动子区 CpG岛在新疆维吾尔族和汉族食管鳞状细胞癌（鳞癌）中的甲基化情况及其与临床病理特征的相关性。方法采用甲基特异性PCR（MSP）法检测40例食管鳞癌患者（维吾尔族20例,汉族20例）癌组织、癌旁组织中 PDCD5基因甲基化情况。结果癌组织中PDCD5甲基化阳性率为80．0％（32/40）,癌旁组织中甲基化阳性率为35．0％（14/40）,差异有统计学意义（P ＜0．05）;PDCD5甲基化阳性率与食管鳞癌临床分期相关（P ＜0．05）;不同民族、性别、年龄食管鳞癌中 PDCD5甲基化阳性率差异无统计学意义（P ＞0．05）。结论在食管鳞癌癌组织中甲基化水平高于癌旁组织;PDCD5甲基化率与食管癌的临床分期有相关性,PDCD5在食管鳞癌中的甲基化率与民族、性别、年龄无相关性。     

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.