错配修复基因hMLH1在胃癌中表达特点的研究

[目的]了解胃癌组织错配修复基因hMLH1蛋白的表达特点.[方法]采用免疫组织化学SP法检测579例胃癌组织、333例癌旁组织和341例非癌患者胃黏膜的hMLH1蛋白表达情况.组间率的差异采用卡方检验法进行比较.[结果]胃癌组、癌旁组与非癌患者胃黏膜组的hMLH1蛋白阳性表达率分别为71.68%(415/579)、84.38%(281/333)与85.92%(293/341),前者显著低于后两者(P＜0.05),而后两者间差异无显著性意义(P＞0.05).胃癌组织中hMLH1蛋白的阳性表达率在高中分化组显著高于低分化组(P＜0.05),在无淋巴结转移组显著高于淋巴结转移组(P＜0.05),hMLH1蛋白的阳性表达率与患者性别、年龄无关(P＞0.05).[结论]我国部分胃癌发生可能与错配修复基因hMLH1的表达下调有关.     

食管鳞癌组织中c-fos和PCNA的表达及临床病理意义

目的 探讨食管鳞癌组织中c-fos和PCNA的表达及其临床意义.方法 采用免疫组化染色SP法,检测60例食管鳞癌、20例高级别食管上皮内瘤变和10例正常食管牯膜组织标本中c-fos和PCNA的表达.结果 (1)60例食管鳞癌组织、20例高级别上皮内瘤变和10例正常食管粘膜组织标本中c-fos的阳性表达率分别为55%、75%和0,差异有统计学意义(P<0.05),而PCNA的阳性表达率分别为70%、50%和10%,差异有统计学意义(P<0.05).(2)c-fos在高分化和中分化食管癌中的表达率显著高于低分化癌,差异有统计学意义(P<0.05),PCNA在高分化和中分化食管癌中的表达率显著低于低分化癌,差异有统计学意义(P<0.05);PCNA在无淋巴结转移者中的表达率高于有淋巴结转移者,差异有统计学意义(P<0.05).结论 c-fos和PCNA可能均参与了食管鳞癌的发生、发展过程,并可能作为监测肿瘤恶性程度和判断预后的指标.     

抑癌基因PTEN蛋白在肺癌组织表达的临床病理学意义

目的　研究抑癌基因PTEN蛋白在肺癌组织中的表达情况及其临床病理学意义。方法　应用免疫组织化学S -P法检测 66例肺癌组织中PTEN蛋白的表达 ,另有 1 0例癌旁肺组织作为对照组。结果　肺癌组织中PTEN蛋白的阳性表达率 2 7.3 % (1 8 66) ,显著低于癌旁肺组织 (90 .0 % ,9 1 0 ) ;PTEN在高中分化鳞癌组及低分化鳞癌组的阳性表达率分别为 55 .6 %和 0 ,具有显著性差异 (P <0 .0 1 ) ;PTEN蛋白阳性表达率与肺癌患者的年龄、性别、肿瘤体积、组织学类型、TNM分期及淋巴结转移均无明显关系 (P >0 .0 5)。结论　PTEN基因在肺癌的发生发展过程中起一定作用 ;PTEN蛋白的表达可能与肺鳞癌的分化程度有关     

肺鳞癌组织中hMLH1、PCNA、P53及P21的表达及其与微卫星不稳定性的相关性

目的:探讨肺鳞癌组织中hMLH1、PCNA、P53及P21的表达及其与癌组织微卫星不稳定性(MSI)之间的关系。方法:采用免疫组化SP法检测上述各指标在18例MSI阳性和12例MSI阴性的肺鳞癌组织中的表达。结果:在肺鳞癌组织中MSI阳性组的hMLH1的阳性表达率明显低于MSI阴性组(P<0.05);MSI阳性组PCNA指数明显低于MSI阴性组(P<0.05);MSI阳性组P53及P21蛋白的阳性表达率明显高于MSI阴性组。结论:肺鳞癌hMLH1表达、PCNA标记指数与癌组织的MSI呈负相关,而P53、P21表达则与MSI呈正相关。     

食管鳞癌及癌前病变组织中c-fos、c-jun和PCNA的表达及临床病理意义

目的探讨食管上皮内瘤变及鳞癌组织中c-fos、c-jun和PCNA的表达,及其在食管癌发生、发展过程中的意义。方法用免疫组织化学SP法检测60例食管鳞状细胞癌、20例重度上皮内瘤变和10例正常食管粘膜组织标本中c-fosc、-jun和PCNA的表达,并分析其表达与食管鳞状细胞癌临床病理特征的关系。结果 (1)60例食管癌组织、20例重度上皮内瘤变和10例正常食管粘膜组织标本中c-fos的阳性表达率分别为56%(51/60)、75%(15/20)和0%,差异有统计学意义(P<0.05);c-jun的阳性表达率分别为38%(23/60)、55%(11/20)和10%(1/10),差异有统计学意义(P<0.05);PCNA的阳性表达率分别为70%(42/60)、50%(10/20)和10%(1/10),差异有统计学意义(P<0.05)。(2)c-fos和c-jun在高分化食管癌中的表达率显著高于中、低分化癌(P<0.01);无淋巴结转移者阳性表达率高于有淋巴结转移者,临床分期Ⅰ~Ⅱ期表达率高于Ⅲ~Ⅳ期(P<0.05)。PCNA在高分化和中分化食管癌中的阳性表达率显著低于低分化癌,差异有统计学意义(P<0.05);无淋巴结转移者阳性表达率高于有淋巴结转移者,差异有统计学意义(P<0.05)。结论 c-fos、c-jun和PCNA在食管癌发生、发展中起着重要作用,可为临床早期诊断和判断预后提供客观依据。     

食管鳞癌组织中核转录因子κBP65蛋白及IκBα的表达

目的 :探讨食管鳞癌组织中核转录因子κB(NF -κB)P6 5蛋白及其抑制物IκBα蛋白的表达。方法 :用免疫组化SP法检测了 4 9例食管鳞癌及癌旁黏膜组织 (正常食管上皮 32例 ,单纯增生上皮 33例 ,轻度不典型增生 19例 ,重度不典型增生 14例 ,原位癌 12例 )中NF -κBP6 5、IκBα蛋白的表达。结果 :在癌旁正常上皮、单纯增生上皮、轻度不典型增生上皮、重度不典型增生上皮、原位癌和浸润癌中NF -κBP6 5蛋白阳性表达率分别为 6 .2 5 % (2 /32 )、18.18% (6 /33)、36 .84 % (7/19)、4 2 .86 % (6 /14 )、5 8.33% (7/12 )和 5 7.14 % (2 8/49) ,正常上皮阳性表达率低于其他各类组织 (P均 <0 .0 1)。IκBα蛋白在上述组织中的阳性表达率分别为 15 .6 3% (5 /32 )、5 7.5 8% (19/33)、6 3.16 % (12 /19)、71.4 3% (10 /14 )、6 6 .6 7% (8/12 )和 93.88% (4 6 /49) ,正常上皮阳性表达率低于其他各类组织 (P均 <0 .0 1) ,浸润癌组织中阳性率高于其他各类组织 (P均 <0 .0 5 )。 2者的表达与食管鳞癌的组织学分级、浸润深度和淋巴结转移无关。 2者表达无相关关系 ,IκBα在食管鳞癌组织中表达率高于NF -κBP6 5。结论 :NF -κBP6 5、IκBα蛋白表达均与食管鳞癌的发生发展有关 ,2者相互独立 ,IκBα可能成为食管鳞癌     

P~(16)蛋白和PCNA在肝细胞性肝癌中的表达及意义

目的 :探讨肝细胞性肝癌 (HCC)中抑癌基因P16 蛋白及增殖细胞核抗原 (PCNA)的表达、相关性及其与肿瘤临床病理的关系。方法 :采用免疫组化SP法检测 4 5例HCC及癌旁肝组织中P16 蛋白及PCNA。结果 :①P16 蛋白及PCNA在HCC中的阳性表达率分别明显低于、高于癌旁肝组织 (P <0 .0 5)。②高分化、中分化HCC中P16 蛋白的阳性表达率明显高于低分化HCC(P <0 .0 5) ;高分化HCC中PCNA的阳性表达率明显低于中分化及低分化HCC(P <0 .0 5)。③P16 蛋白与PCNA在未转移组HCC中的阳性表达率分别明显高于、低于转移组HCC(P <0 .0 5)。④临床Ⅰ期与Ⅲ期HCC比较 ,P16 蛋白的阳性表达率及PCNA的阳性表达率均有显著性差异 (P <0 .0 1 )。⑤P16 蛋白及PCNA在HCC中的表达与肿瘤直径无关。⑥HCC中P16 蛋白与PCNA的表达间存在明显负相关关系 (r =-0 .57,P <0 .0 5)。结论 :P16 基因及PCNA的表达与HCC的增殖、分化、转移状态及临床分期有关 ,且存在明显负相关关系 ,其表达状况可以作为判断HCC恶性程度及预后的有用指标。     

基质金属蛋白酶及其抑制物在口腔鳞状细胞癌中的表达和意义

目的　探讨口腔鳞状细胞癌 (oralsquamouscellcarcinoma ,OSCC)组织中基质金属蛋白酶 9(matrixmetallo proteinase 9,MMP 9) ,基质金属蛋白酶组织抑制因子 1(tissueinhibitorofmetalloproteinase 1,TIMP 1)的表达及其与肿瘤分化、转移的关系。方法　采用免疫组织化学SP法检测 4 5例口腔鳞癌标本 ,9例正常口腔粘膜标本中MMP 9TIMP 1的表达情况。结果　①口腔鳞癌中MMP 9、TIMP 1的阳性表达率分别为 6 4 .4 %和 4 2 .2 % ,与对照组比较有显著性差异。②口腔鳞癌低分化组中MMP 9、TIMP 1的阳性表达率高于高分化组 (P <0 .0 5 )。③颈淋巴结转移组中MMP 9、TIMP 1的阳性表达率高于无淋巴结转移组 (P <0 .0 5 )。结论　口腔鳞癌组织中MMP 9、TIMP 1的表达与肿瘤分化程度及颈淋巴结转移有关 ,与肿瘤发生部位无关。     

食管鳞状细胞癌组织中hMLH1、hMSH2及P53蛋白的表达

目的:检测食管鳞状细胞癌(ESCC)组织中错配修复基因hMLH1、hMSH2及P53的表达.方法:采用免疫组织化学SP法检测62例ESCC组织、31例癌旁不典型增生组织及62例正常食管黏膜组织中hMLH1、hMSH2及P53蛋白的表达.结果:ESCC组织、癌旁不典型增生组织与正常食管黏膜组织中hMLH1的阳性表达率分别为27.4%,58.1%及88.7%,hMSH2的阳性表达率分别为32.3%,51.6%及91.9%, P53的阳性表达率分别为79.0%,54.8%及35.5%,3种组织中hMLH1、hMSH2及P53的阳性表达率差异均有统计学意义(P<0.05).ESCC组织中hMLH1、hMSH2及P53的表达与分化程度、浸润深度及有无淋巴结转移有关(P均＜0.05);hMLH1、hMSH2阳性表达者P53的阳性率均低于hMLH1、hMSH2阴性表达者.结论:ESCC组织中存在hMLH1与hMSH2的低表达及P53的高表达,3者可能在食管癌的浸润、转移及黏膜上皮癌变过程中起重要作用.     

相近分化的肺鳞癌和腺癌中PCNA及EGFR表达的研究

目的 :探讨 PCNA和 EGFR在肺鳞癌、腺癌中的表达及与癌组织分型、淋巴结转移等方面的关系。方法 :用免疫组化 S- P法分别对 44例分化相近肺癌组织、1 6例正常肺组织 PCNA和EGFR的表达进行检测。结果 :肺癌组织 PCNA和 EGFR的表达明显高于正常肺组织。鳞癌与腺癌比较 ,PCNA和 EGFR表达无统计学差别 ( P>0 .0 5)。淋巴结转移阳性癌组织 PCNA和 EGFR表达与淋巴结转移阴性癌组织比较 ,无统计学差别 ( P>0 .0 5)。结论 :PCNA和 EGFR参与了肺癌的发生发展 ,在肺癌中表达有一定相关性。二者与鳞癌、腺癌分型无关 ,与淋巴结转移与否无关。     

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.