内皮细胞特异性分子1在结直肠癌组织中的表达

目的探讨人内皮细胞特异性分子-1(ESM-1)在结直肠癌组织中的表达。方法原位杂交、免疫组织化学法检测ESM-1在9例正常黏膜、37例腺瘤和88例结直肠癌组织中的表达。结果原位杂交检测到ESM-1 mRNA在正常黏膜和腺瘤中的表达呈强阳性,表达率分别为67%和94%,而在结直肠癌组织中表达显著低于正常组织,为34%;免疫组化检测到正常黏膜和腺瘤中ESM-1蛋白表达率为67%和81%,而结直肠癌组织中表达率为39%。ESM-1mRNA和蛋白表达具有较好的一致性。结论ESM-1在结直肠癌组织中的表达明显降低。     

HER2在胃癌组织中的表达及其临床意义

目的探讨表皮生长因子受体2(HER2)在胃癌组织中的表达及其与临床病理特征的关系。方法应用免疫组织化学方法检测90例胃癌组织中的HER2蛋白的表达,并将检测结果与患者临床病理特征进行综合分析。结果 (1)胃腺癌组织中HER2蛋白阳性表达率为14.4%(13/90);(2)HER2蛋白表达与患者的性别、民族无相关性(P>0.05);(3)年龄≥60岁HER2蛋白阳性表达率高于年龄<60岁者(P<0.05),低分化腺癌组HER2蛋白的阳性表达率高于高、中分化腺癌(P<0.05),Ⅲ、Ⅳ期HER2蛋白阳性表达率高于Ⅰ、Ⅱ期(P<0.05),有区域淋巴结转移的HER2蛋白阳性表达率高于无区域淋巴结转移者(P<0.05),肿瘤直径≥5cm的HER2蛋白阳性表达率高于肿瘤直径<5cm者(P<0.05),说明HER2蛋白表达与年龄、分化程度、分期、肿瘤直径及区域淋巴结有相关性。(4)HER2蛋白表达与胃癌患者生存时间相关(P<0.05)。结论测定胃癌组织中HER2蛋白的表达,有助于判断患者预后,也为分子靶向治疗药物在胃癌的应用提供了理论依据。     

MTA-1和Ezrin在乳腺癌组织中的表达及其相关性探讨

目的 探讨肿瘤转移相关基因MTA-1和细胞骨架连结蛋白Ezrin在乳腺癌组织中的表达及两者之间的相关性和与乳腺癌临床病理的关系.方法 分别应用分子原位杂交及免疫组织化学sP法检测80例乳腺癌组织和15例正常乳腺组织中MTA-1 mRNA、Ezrin蛋白的表达,分析两者之间的相关性及与乳腺癌患者病理类型、年龄、临床分期、淋巴结转移等参数的关系.结果 正常乳腺组织MTA-1 mR.NA(13.3%)、Ezrin蛋白(20.0%)的表达率明显低于乳腺癌组织中MTA-1 mRNA(66.2%)和Ezrin蛋白(68.7%)的表达率,P＜0.05;MTA-1 mRNA与Ezrin蛋白的表达呈正相关(r=0.634,P=0.000);MTA-1 mRNA和Ezrin蛋白在乳腺癌中的表达与肿瘤临床分期和淋巴结转移状态相关,P值均＜0.05;与患者年龄、肿瘤大小、病理类型无相关性,P值均＞0.05.MTA-1+/Ezrin+组的无病生存率低于MTA-1-/Ezdn- 组(X2=7.610,P=0.006).结论 提示MTA-1和Ezrin在肿瘤转移中具有协同作用,高表达组患者的临床预后差与肿瘤淋巴转移有关.     

恶性淋巴瘤组织中内皮细胞特异性分子-1mRNA及其蛋白的表达

目的探讨恶性淋巴瘤组织中内皮细胞特异性分子-1(ESM-1)mRNA和蛋白的表达及其与临床病理特征的关系.方法采用免疫组化S-P法、原位杂交方法对58例淋巴瘤组织和10例正常淋巴结的ESM-1蛋白及mRNA进行检测.结果 ESM-1蛋白及 mRNA 在淋巴瘤组织中均有表达,在血管中较少表达.结论 ESM-1分子可能参与了淋巴瘤的发生发展过程.     

乳腺癌中Nupr1蛋白及mRNA表达及临床意义

目的 检测Nupr1蛋白及mRNA在乳腺癌中的表达,探讨其与乳腺癌的关系。方法 选取手术切除的228例乳腺癌组织,以60例乳腺良性病变为对照组,用免疫组化法检测癌组织Nupr1蛋白的表达情况,用实时荧光定量PCR法检测组织中Nupr1 mRNA 的表达,分析Nupr1的表达与乳腺癌临床病理特征的关系。结果 乳腺癌组织Nupr1蛋白及mRNA水平均显示高表达,二者增高趋势趋于一致,乳腺癌组织Nupr1高表达率均高于对照组;Nupr1高表达率与乳腺癌分期、分子分型相关(P<0.05),与月经状态、组织学类型、组织学分级及肿瘤大小无关(P>0.05)。结论 Nupr1 mRNA在乳腺良性病变-乳腺癌前病变-乳腺癌中表达逐渐增高,推测此基因可能在乳腺癌发生及进展过程中起了重要作用;在mRNA水平及蛋白水平表达的一致性进一步说明了此基因在乳腺癌发生发展中起了重要作用;Nupr1高表达与预后不良有关,检测Nupr1的表达情况可作为乳腺癌预后判断的有用指标,并可为肿瘤靶向治疗提供新思路。     

赖氨酰氧化酶在乳腺癌中的表达及临床意义

目的研究赖氨酰氧化酶(LOX)在乳腺癌组织、正常乳腺组织及乳腺良性病变组织中的表达,并与乳腺癌常规预后指标比较,探讨其与乳腺癌侵袭/转移的关系。方法逆转录聚合酶链式反应(RT-PCR)检测56例乳腺癌组织、56例正常乳腺组织及20例乳腺良性病变组织中LOX mRNA与低氧诱导因子1(HIF-1α)mRNA的表达;应用免疫组织化学技术检测相应组织中LOX蛋白及HIF-1α的表达,并行统计学分析。结果 LOX mRNA在乳腺癌组织、正常乳腺组织及乳腺良性病变组织中的表达率分别为57.14%、32.14%、25.00%,乳腺癌组织中LOXmRNA的表达率明显高于正常乳腺组织及乳腺良性病变组织(P<0.01);LOX蛋白在乳腺癌组织、正常乳腺组织及乳腺良性病变组织中的表达率分别为48.21%、26.78%、20.00%,乳腺癌组织中LOX蛋白的表达率明显高于正常乳腺组织及乳腺良性病变组织(P<0.05);LOX mRNA及LOX蛋白在不同临床分期及淋巴结转移中的表达率差异有统计学意义(P<0.05),其中Ⅲ、Ⅳ期乳腺癌LOX mRNA及LOX蛋白的表达率明显高于Ⅰ、Ⅱ期(P均<0.01),但在不同年龄及肿瘤大小患者的癌组织中LOX mRNA及LOX蛋白的表达率差异无统计学意义(P>0.05);LOX蛋白的表达与HIF-1α呈正相关(r=0.368)。结论 LOX蛋白及LOX mRNA在乳腺癌组织中的表达率高于正常乳腺组织及乳腺良性病变组织,LOX与乳腺癌的发生可能有关;LOX高表达的乳腺癌其恶性程度更高,更易发生远处转移;HIF-1α与LOX在乳腺癌的侵袭/转移过程中具有协同作用。     

CD15mRNA、CD44v6mRNA及nm23H1mRNA在乳腺癌组织中的表达及其临床意义

目的　探讨CD15mRNA及其蛋白、CD44v6mRNA和nm2 3H1mRNA在乳腺癌组织中的表达及与乳腺癌患者预后的关系。方法　应用催化信号放大 (CSA)原位杂交和免疫组织化学方法 ,对94例乳腺癌患者的癌组织进行了CD15mRNA及其蛋白、CD44v6mRNA和nm2 3H1mRNA表达的检测。结果　CD15mRNA及其蛋白、CD44v6mRNA高表达及nm2 3H1mRNA低表达均与乳腺癌患者的组织学分级、临床分期、淋巴结转移、复发和预后密切相关。CD15mRNA和CD44v6mRNA高表达及nm2 3H1mRNA低表达患者淋巴结转移率高、生存率低。结论　CD15mRNA表达与CD44v6mRNA和nm2 3H1mRNA表达具有正、负调节的协同作用。联合检测 3个基因 ,能更准确地判断乳腺癌的转移和预后状态。     

乳腺癌PFKFB3表达及其临床意义

目的：初步探讨PFKFB3在乳腺癌组织中的表达及其与临床预后的相关性。方法：采用免疫组织化学和qRT-PCR法检测乳腺癌组织PFKFB3蛋白及mRNA的表达情况,分析PFKFB3表达与临床病理特征及患者预后的关系。结果：乳腺癌组织PFKFB3蛋白阳性表达率为60.8%,高于癌旁组织的20.0%,差异有统计学意义（P<0.001）。乳腺癌组织PFKFB3mRNA相对表达量1.73±0.21,高于癌旁组织的0.78±0.21,差异有统计学意义（P<0.05）。PFKFB3蛋白表达与肿瘤分级、原发肿瘤大小（T）、淋巴结的转移（N）、TNM分期及分子分型正相关（P＜0.05）。Kaplan-Meier生存曲线分析显示PFKFB3阳性组术后生存时间短于阴性组,差异有统计学意义（P＜0.05）,单因素分析显示,PFKFB3蛋白表达、肿瘤分级、原发肿瘤大小（T）、淋巴结转移（N）、TNM分期及分子分型与乳腺癌患者预后相关（P<0.05）,多因素分析显示PFKFB3蛋白表达、TNM分期为乳腺癌患者预后的独立危险因素（P<0.05）。结论：PFKFB3在乳腺癌组织中高表达,且与肿瘤的侵袭和转移密切相关,其高表达提示乳腺癌患者预后不良。     

RASSF1A基因在乳腺癌组织中的表达及意义

目的 探讨RASSF1A基因mRNA在乳腺癌组织中的表达与乳腺癌临床病理特征的关系.方法 采用逆转录-聚合酶链反应(RT-PCR)方法检测40例乳腺癌组织和15例乳腺良性病变即乳腺增生病组织中RASSF1A mRNA的表达水平.结果 ①RASSF1A mRNA在乳腺增生病组织中全部表达,在40例乳腺癌组织中有21例表达缺失,缺失率为52.5%;②在乳腺癌组织中淋巴结有转移者RASSF1A mRNA的表达率明显低于淋巴结无转移者,RASSF1A mRNA的表达缺失与淋巴结转移呈负相关(P<0.05);与年龄、组织学分级及雌激素受体(ER)、孕激素受体(PR)及CerbB-2蛋白的表达没有明显的相关性(P>0.05).结论 RASSF1A基因表达缺失可能与乳腺癌的发生、发展过程及其预后存在着一定的相关性.     

女性乳腺癌组织ERα、ERβ的表达及其意义

目的: 研究雌激素受体α(ERα)与ERβ mRNA及ERα蛋白在女性乳腺癌组织中的表达,并探讨ER亚型的表达与乳腺癌临床病理特征之间的关系及其表达意义。方法: 采用R T-PCR及免疫组化S-P法,检测52例乳腺癌组织及19例乳腺纤维腺瘤组织中ERα与ERβ mRNA及ERα蛋白的表达。结果: ERβ mRNA总表达率在乳腺癌组织中为51.9%,高于其在乳腺纤维腺瘤组织中的表达率21.1%(P<0.05);ERαmRNA单独表达率在乳腺纤维腺瘤组织中为63.2%,高于其在乳腺癌组织中的表达率25.0%(P<0.05);ERα与ERβ mRNA共表达表型在乳腺癌组织中的表达率为51.9%,高于其在乳腺纤维腺瘤组织中的表达率15.8%(P<0.05);在乳腺癌组织中ERα与ERβ共表达表型与淋巴结转移有一定关系(P<0.05),并趋向于更高的肿瘤病理学分级;ERα蛋白在乳腺癌及乳腺纤维腺瘤两种组织中的表达率相似。结论: 在乳腺癌组织中ERα与ERβ共同表达可能是乳腺癌患者预后不良的指标。     

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.