血管内皮生长因子与其受体FLT-1、FLK-1/KDR在非小细胞肺癌中的表达及临床研究

目的研究血管内皮生长因子(VEGF)与其相关受体FLT1、FLK1/KDR在非小细胞肺癌(NSCLC)中的表达及其与肿瘤血管形成、临床分期、淋巴结转移的关系。方法应用免疫组织化学方法和酶联免疫吸附试验(ELISA)检测112例NSCLC患者的肺癌组织和血清中VEGF及其受体FLT1、FLK1/KDR的表达水平,并分析其临床意义。结果NSCLC组织中VEGF及其受体FLT1、FLK1/KDR的表达水平明显高于正常黏膜组织和癌旁组织(P<0.05),且随临床分期Ⅰ、Ⅱ、Ⅲ～Ⅳ期的顺序明显上升(P<0.05);同时有淋巴结转移组的VEGF及其受体FLT1、FLK1/KDR阳性率明显高于无淋巴结转移组(P<0.05)。NSCLC患者血清VEGF水平显著高于正常对照组(P<0.01),并随肺癌临床分期Ⅰ、Ⅱ、Ⅲ～Ⅳ期的顺序明显上升(P<0.05),淋巴结转移组明显高于无淋巴结转移组(P<0.05)。结论VEGF及其相关受体FLT1、FLK1/KDR在NSCLC组织中表达明显增高,并与NSCLC的发生、发展及其淋巴结转移有关,血清VEGF是NSCLC增生、转移的重要指标。     

HIF-1α和VEGF在非小细胞肺癌组织中的表达及其与肿瘤血管生成的关系

目的探讨缺氧诱导因子(HIF-1)与血管内皮生长因子(VEGF)在非小细胞肺癌(NSCLC)组织中的表达及与肿瘤血管生成的关系.方法免疫组化法检测NSCLC组织HIF-1α和VEGF的表达,并测定微血管密度(MVD).结果 NSCLC组织中HIF-1α及VEGF阳性表达率显著高于正常肺组织(P＜0.05);HIF-1α的表达与淋巴结转移及临床分期有关(P＜0.05),与肿瘤的大小和肿瘤的分化程度无明显关系(P＞0.005);VEGF在NSCLC组织中的表达与肿瘤的大小、淋巴结转移、肿瘤的分化程度及临床分期均密切相关(均P＜0.05);HIF-1α与VEGF、MVD,VEGF与MVD的表达之间均呈正相关(r分别为0.589、0.448、0.571,均P＜0.01).结论HIF-1 α及VEGF的增强表达与非小细胞肺癌的浸润性发展和肿瘤血管生成有密切关系.     

肺癌患者血清的NO水平和VEGF表达及其临床意义

目的 探讨肺癌患者血清NO水平和VEGF表达及其在临床中的诊治价值.方法 分别用化学比色法和ELISA法检测62例肺癌患者血清NO和VEGF的水平.结果 肺癌患者血清NO和VEGF的水平均高于正常对照组(P均＜0.01);肺腺癌组NO水平高于鳞癌组(P＜0.05)而与VEGF水平无相关性(P＞0.05);肺癌的临床分期与NO水平呈负相关(P＜0.05),而与VEGF水平呈正相关(P＜0.05);有淋巴结转移组NO水平低于无淋巴结转移组(P＜0.05),且VEGF水平显著高于无淋巴结转移组(P＜0.01);肺癌患者术后3d的血清NO水平与术前相比明显降低(P＜0.01),但术后7 d上升到接近术前水平(P＞0.05),而VEGF水平在手术或化疗后均明显降低(P均＜0.05).结论 检测肺癌患者血清的NO和VEGF水平有助于了解肺癌的生物学行为,为肺癌的诊断、治疗提供理论基础.     

MMP-9、VEGF在非小细胞肺癌中的表达及意义

目的 检测、评价MMP-9、VEGF在非小细胞肺癌(non-small cell lung cancer,NSCLC)中的表达及意义.方法 采用免疫组化染色技术检测46例NSCLC手术患者肿瘤组织中的基质金属蛋白酶-9(MMP-9)、血管内皮生长因子(VEGF)阳性表达率,与同一病例组来源正常肺组织中的相关因子阳性表达率进行统计学分析;采用酶联免疫吸附方法检测患者术前、术后第1、3、7、10、14天的MMP-9、VEGF血清浓度,并进行统计学分析.结果 NSCLC组织中MMP-9、VEGF的阳性表达率较正常肺组织阳性率高,差异有统计学意义(P＜0.01);NSCLC组织中MMP-9、VEGF阳性表达者年龄、性别差异无统计学意义(P＞0.05);NSCLC组织中MMP-9在腺癌的阳性表达高于鳞癌,两者差异有统计学意义(P＜0.05),VEGF在腺癌的阳性表达略高于鳞癌,但差异无统计学意义(P＞0.05);TNM分期中Ⅰ期与Ⅱ、Ⅲ期MMP-9、VEGF在肿瘤组织中阳性表达组间差异有统计学意义(P＜0.01或0.05);不同分化程度的NSCLC组织中MMP-9、VEGF的阳性表达高分化与中、低分化组间差异有统计学意义(P＜0.01);有淋巴结转移的NSCLC,其MMP-9、VEGF在肿瘤组织中阳性表达较无淋巴结转移的高,组间差异有统计学意义(P＜0.05);术前、术后1、3、7、10、14天MMP-9、VEGF血清浓度除MMP-9术后第10与14天比较(P＞0.05)以外,其他各组间比较均有统计学意义(P＜0.01).结论 NSCLC组织中MMP-9、VEGF出现较高表达,并与NSCLC组织学分型、分期、分化程度、侵袭转移情况密切相关,可作为评估NSCLC侵袭、转移和预后的参考指标.但NSCLC原发肿瘤切除术后血清VEGF、MMP-9表达水平较术前显著升高,不能直接作为NSCLC原发肿瘤切除术后的围手术期判定指标.     

血小板源性生长因子B在非小细胞肺癌中的表达及其与微血管密度的关系

目的 探讨非小细胞肺癌(NSCLC)组织中血小板源性生长因子B(PDGF-B)的表达及微血管密度(MVD)在NSCLC血管生成及生物学行为的关系.方法 用免疫组织化学方法检测65例非小细胞肺癌和18例正常肺组织中PDGF-B表达及MVD.结果 NSCLC组织中PDGF-B的阳性表达率为58.5%,MVD值为(34.66±8.91).两者均显著高于正常肺组织(P＜0.05);PDGF-B的表达与癌组织的分化程度、淋巴结转移及临床分期显著相关(P＜0.01);MVD值与癌组织的大小、分化程度、淋巴结转移及临床分期显著相关(P＜0.05或P＜0.01);NSCLC组织中,PDGF-B与MVD的表达呈正相关(R＝0.488,P＜0.05).结论 PDGF-B是NSCLC血管生成的正性调节因子,说明其可能在促进血管生成机制中起一定作用,对肺癌的生长、侵袭及转移中起重要作用.     

VEGF与Ki-67在NSCLC中的表达及其临床意义

目的:探讨血管内皮生长因子(VEGF)与核增殖抗原(Ki-67)在非小细胞肺癌(NSCLC)中的表达及临床意义.方法:选取150例NSCLC患者为研究对象,分为死亡组(n=38)和存活组(n=112).分别取每例患者的癌组织及癌旁组织各1份,采用SP法检测VEGF及Ki-67水平.比较死亡组与存活组、癌组织与癌旁组织VEGF及Ki-67阳性表达水平;分析VEGF和Ki-67阳性表达与NSCLC临床病理特征的关系及癌组织VEGF与Ki-67阳性表达的相关性.结果:死亡组患者癌组织VEGF和Ki-67阳性表达率高于存活组(P＜0.05);癌组织VEGF和Ki-67阳性表达率高于癌旁组织(P＜0.05);相关性分析显示,VEGF阳性表达与肿瘤直径、淋巴结转移、远处转移及临床分期相关(P＜0.05),Ki-67阳性表达与淋巴结转移相关(P＜0.05);回归分析显示,癌组织VEGF与Ki-67阳性表达呈正相关(P＜0.05).结论:NSCLC患者中,癌组织中VEGF与Ki-67表达水平较高,且与患者临床病理学特征相关,可作为早期诊断及判断预后的重要依据.     

VEGF-C及其受体Flt-4基因在非小细胞肺癌中的表达

目的:探讨血管内皮生长因子C(VEGF-C)及其受体Flt-4与非小细胞肺癌(NSCLC)组织的关系.方法:采用RT-PCR检测40例NSCLC、12例癌旁组织VEGF-C、Flt-4基因的转录表达,并与肺癌的临床病理特征进行分析.结果:NSCLC中VEGF-C mRNA及Flt-4 mRNA的相对含量明显高于癌旁组织(P＜0.01);与淋巴结转移正相关(P＜0.01).VEGF-C mRNA与肺癌的TNM分期正相关(P＜0.01).结论:VEGF-C与NSCLC的发生有一定关系;VEGF-C表达可做为肺癌患者判断淋巴转移的估计指标之一.     

血管内皮生长因子和基质金属蛋白酶-7在非小细胞肺癌中的表达及意义

目的 测定非小细胞肺癌（NSCLC）患者组织中血管内皮生长因子（VEGF）和基质金属蛋白酶-7（MMP-7）的表达,探讨二者在NSCLC发生、发展中的作用.方法 采用免疫组织化学SP法检测56例NSCLC患者肿瘤组织及其癌旁正常肺组织中VEGF和MMP-7的表达.结果 NSCLC组织中VEGF和MMP-7的阳性率分别为66.07％和57.14％,与癌旁组织相比,二者阳性率表达明显升高（P＜0.05）.VEGF和MMP-7在NSCLC组织中的表达呈正相关（P＜0.01）.VEGF和MMP-7表达与组织类型无关,与TNM分期、肿瘤分化程度及淋巴结转移密切相关.结论 VEGF和MMP-7在NSCLC组织中的表达与肿瘤的浸润、转移有关,有助于判断患者的预后.     

VEGF及Ki67与NSCLC生物学行为的相关性研究

目的　探讨血管内皮生长因子 (VEGF)、细胞核增殖相关抗原 (Ki67)在非小细胞肺癌 (NSCLC)的表达及与其生物学行为的关系。方法　用SP免疫组织化学方法观察VEGF、Ki67在 62例NSCLC组织的表达。结果　VEGF、Ki67在NSCLC组织中表达阳性率均明显高于癌旁正常组织 (P <0 .0 1)。它们的表达与临床分期及有无淋巴结转移有明显相关 (P <0 0 5 ) ,有淋巴结转移组VEGF、Ki67阳性率明显高于无淋巴结转移组 ,Ⅲ～Ⅳ期NSCLC组织中明显高于Ⅰ～Ⅱ期(P <0 0 5 )。VEGF、Ki67阳性的患者 3年生存率均明显低于阴性者 (P <0 0 5 )。通过Cox回归分析发现临床分期、VEGF、Ki67及淋巴结转移可以作为独立的指标影响NSCLC患者的生存时间。结论　VEGF、Ki67与NSCLC的形成、转移有重要关系 ;VEGF、Ki67阳性的患者 3年生存率明显降低 ;通过检测VEGF、Ki67可以估计NSCLC患者的预后和指导临床治疗     

NSCLC组织中VEGF和Ki67的表达及其与生存时间的相关性

目的　探讨血管内皮生长因子 (VEGF)、细胞核增殖相关抗原 (Ki6 7)在非小细胞肺癌 (NSCLC)中的表达及其与患者生存时间的相关性。方法　用SP免疫组织化学方法观察VEGF、Ki6 7在 6 2例NSCLC组织中的表达。用Kaplan Meier法计算生存率。结果　 (1 )VEGF、Ki6 7在NSCLC组织中表达阳性率均明显高于癌旁正常组织 (P <0 0 1 )。 (2 )VEGF、Ki6 7在NSCLC组织的表达与临床分期及有无淋巴结转移明显相关 (P <0 0 5 ) ,有淋巴结转移组VEGF、Ki6 7阳性率明显高于无淋巴结转移组 ,Ⅲ～Ⅳ期的阳性率明显高于Ⅰ～Ⅱ期的阳性率 (P <0 0 5 )。 (3)VEGF、Ki6 7阳性患者的 3年生存率均明显低于阴性者 (P <0 0 5 )。结论　VEGF、Ki6 7在NSCLC组织的阳性表达与NSCLC的临床分期、淋巴结转移有关。VEGF、Ki6 7阳性患者的预后差     

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.