抑癌基因p53在子宫内膜癌中的表达及意义的探讨

目的　探讨抑癌基因p5 3在子宫内膜癌发生、发展过程中的作用。方法　采用免疫组化ABC法检测37例子宫内膜癌、2 0例子宫内膜腺瘤样增生、18例子宫内膜单纯性增生、2 8例正常子宫内膜标本的抑癌基因 p5 3的表达。结果　p5 3表达阳性率 :子宫内膜癌为 48.6 5 % ;子宫内膜腺瘤样增生为 10 % ,显著低于子宫内膜癌 (P <0 .0 1) ;单纯性增生子宫内膜及正常子宫内膜均为阴性。子宫内膜癌病理组织学分级G1级 p5 3阳性表达率为13.33 % ,显著低于G2级 6 6 .6 7% (P <0 .0 1) ;而G2级又低于G3级 p5 3阳性表达率 (80 % ) (P <0 .0 5 )。在子宫内膜癌的手术分期中一期p5 3阳性表达率为 32 % ,显著低于二期以上的 83 .33% (P <0 .0 1)。子宫内膜癌局限于子宫内膜组p5 3阳性表达率为 9.1% ,低于癌侵润肌层组的 5 0 % (P <0 .0 5 )。p5 3表达阳性的子宫内膜癌患者 3年、5年生存率显著低于表达阳性的患者 (P <0 .0 1)。结论　抑癌基因p5 3在子宫内膜癌发生、发展的不同阶段起作用 ,与子宫内膜癌生物学行为相关 ,对子宫内膜癌的预后判断及治疗的选择具有临床意义     

肝细胞生长因子及其受体c-Met在子宫内膜癌中的表达

目的　探讨肝细胞生长因子 (HGF)及其受体c Met蛋白表达与子宫内膜癌临床病理特征的关系。方法　应用免疫组化法检测 2 0例正常子宫内膜 ,4 6例子宫内膜癌组织中HGF及c Met蛋白的表达。结果　①正常子宫内膜HGF及c Met在增生期内膜的表达明显高于分泌期子宫内膜的表达。②子宫内膜癌c Met表达与临床分期、病理分级明显相关 (P <0 .0 5 ) ,Ⅰ、Ⅱ期低于Ⅲ、Ⅳ期 ,G1、G2 级低于G3 级。与年龄、肌层浸润、淋巴结转移无关 (P>0 .0 5 )。半定量分析 :HGF表达与子宫内膜癌Ⅲ +Ⅳ期有关 (P <0 .0 5 )。结论　HGF/c Met系统在子宫内膜癌的侵袭进展中起重要作用 ,c Met可能成为判断子宫内膜癌预后的良好参考指标。HGF及c Met联合检测对于判断子宫内膜癌预后有重要意义     

增殖细胞核抗原和P_(16)基因在子宫内膜不典型增生的表达及意义

目的　通过原位观察增殖细胞核抗原 (PCNA)和P16基因蛋白的表达 ,探讨其在子宫内膜不典型增生及早期癌变中的意义。方法　应用免疫组织化学SP法分别对 33例子宫内膜癌、4 1例子宫内膜重度不典型增生和 2 0例轻度不典型增生进行PCNA和P16基因的原位标记。结果　PCNA阳性表达强度随子宫内膜病变的病理分级而增强 ,其强阳性表达率在子宫内膜不典型增生和子宫内膜癌差异无显著性 (P >0 .0 5 ) ,但两者与轻度不典型增生比较差异均非常显著 (P <0 .0 1) ,P16基因蛋白阳性表达率以子宫内膜轻度不典型增生为最高 ,两组不典型增生间差异无显著性 (P >0 .0 5 ) ,而分别与内膜癌比较差异均显著 (P <0 .0 1,P <0 .0 5 )。阳性表达部位子宫内膜轻度不典型增生均为胞浆 ,部分子宫内膜重度不典型增生和子宫内膜癌为胞核或核浆。结论　细胞的过度增殖和P16基因的表达异常 ,可作为子宫内膜不典型增生早期癌变的诊断及预后的重要参考指标     

抑癌基因p27kipl蛋白在子宫内膜癌中的表达及临床意义

目的 :探讨p2 7kipl蛋白在子宫内膜癌中的表达及临床意义。方法 :采用S P免疫组化方法对 66例子宫内膜癌、2 9例子宫非典型增生病变、31例正常子宫内膜对照组进行检测。结果 :在 66例子宫内膜癌中 ,p2 7kipl表达 35例呈阳性反应 (53 % ) ,其中强阳性 9例 (1 3 .6 % )。 2 9例子宫内膜非典型增生病变中 ,p2 7kipl表达 2 2例呈阳性 (75 .8% ) ,其中 8例呈强阳性 (2 7.6 % )。 31例子宫内膜对照组中 ,p2 7kipl表达 2 7例呈阳性 (87.1 % ) ,其中 1 6例强阳性 (51 .6 % )。p2 7kipl表达在子宫内膜癌与正常子宫内膜对照组比较 ,两者差异有非常显著性 (P <0 .0 1 ) ;在子宫内膜癌组与子宫内膜非典型增生病变组比较 ,两者差异有显著性 (P <0 .0 5) ;正常子宫内膜组与子宫内膜非典型增生病变组比较差异无显著 (P >0 .0 5)。结论 :临床应用p2 7kipl蛋白的检测 ,对肿瘤的早期发现、早期诊断及预后的判断有一定参考价值。     

ERK2和PI3K蛋白在子宫内膜癌中的表达及意义

[目的]测定细胞外信号调节激酶2(extracellular singnal-regulated kinase,ERK2)和磷脂酰肌醇-3-激酶(phosphatidylinositol 3-kinase,PI3K)在正常子宫内膜组织、子宫内膜癌及癌前病变中的表达,探讨其在子宫内膜癌发生、发展中的作用和相互关系.[方法]良恶性子宫内膜石蜡标本共66例,其中子宫内膜腺癌43例,非典型增生子宫内膜12例,正常增生期子宫内膜11例.采用免疫组织化学方法(S-P法)检测ERK2和PI3K蛋白的表达,采用SPSS11.5软件系统进行数据分析.[结果]PI3K与ERK2蛋白在增生期子宫内膜细胞中均以阴性表达为主,PI3K蛋白在子宫内膜非典型增生、子宫内膜癌的阳性率分别为33.3％、81.4％,其中Ⅰ+Ⅱ期、Ⅲ+Ⅳ期子宫内膜癌阳性率分别为78.9％、90％;ERK2蛋白在子宫内膜非典型增生、子宫内膜癌的阳性率分别为33.3％、65.1％,其中Ⅰ+Ⅱ期、Ⅲ+Ⅳ期子宫内膜癌阳性率分别为60.6％、80％,两者在增生期子官内膜、子宫内膜非典型增生、子宫内膜癌中的表达差异显著(P＜0.05),而在子宫内膜癌不同手术病理分期间差异不显著(P＞0.05).[结论]ERK2和PI3K的表达与子宫内膜癌发生发展关系密切,且两者表达呈正相关(γ=0.3651).     

P16和细胞周期素D1在子宫内膜癌组织中的表达及临床意义

目的 :探讨P1 6基因、细胞周期素D1 (cyclinD1 )在子宫内膜癌中的表达及其与临床分期、病理分级的关系。方法 :用免疫组化法检测 41例子宫内膜癌、1 5例增生型子宫内膜、8例正常子宫内膜中P1 6蛋白、cyclinD1蛋白的表达 ,并对比观察其表达在子宫内膜癌不同的病理分级、肌层浸润、临床分期中的差异。结果 :P1 6蛋白在子宫内膜癌中阳性表达率为 5 1 .2 % ,明显低于正常及增生型子宫内膜 (P <0 .0 1 ,P <0 .0 5 )。子宫内膜癌中cyclinD1表达阳性率为 5 6.1 % ,高于正常和增生型子宫内膜 (P <0 .0 1 )。P1 6表达随着子宫内膜肿瘤病理分级、浸润深度和临床分期增高而降低 ,而cyclinD1蛋白表达阳性率却逐渐增高。两者协同表达异常则见于低分化、深肌层浸润及晚期子宫内膜癌。结论 :P1 6基因、cyclinD1的异常表达与子宫内膜癌的发生、发展密切相关 ,可作为指导临床治疗和判断预后的指标     

子宫内膜癌中细胞凋亡和p53基因的表达

目的 探讨细胞凋亡在子宫内膜癌发生发展中的作用。细胞凋亡与抑癌基因p53表达产物的关系。以及p53蛋白表达与预后相关性。方法 应用免疫组织化学方法和TUNEL技术，对子宫内膜腺癌癌变过程中各种病变组织中p53蛋白和细胞凋亡进行测定。结果 正常增生期子宫内膜有偶发凋亡，早期子宫内膜癌和晚期子宫内膜癌的细胞凋亡率分别为1.82%和3.86%，p53蛋白在正常增生期子宫内膜，早期子宫内膜癌和晚期子宫内膜癌的表达率分别为8.31%,38.9%和57.1%。p53蛋白阴性组细胞凋亡率明显高于p53蛋白阳性组。结论 细胞凋亡参与子宫内膜癌的发生发展，子宫内膜癌细胞凋亡受p53基因调控，p53蛋白可能成为评判预后的指标。     

Cyclin D_1蛋白在子宫内膜癌的表达及意义

目的 :探讨 Cyclin D1蛋白与子宫内膜癌发生、发展及预后的关系。方法 :采用免疫组化 HIGH- SABC法 ,检测子宫内膜腺癌 Cyclin D1蛋白的表达。结果 :Cyclin D1蛋白在子宫内膜癌表达率为 40 .5 %。明显高于正常子宫内膜和子宫内膜不典型增生 ( P<0 .0 5 ) ,其表达与病理分级、临床分期及转移无关 ( P>0 .0 5 )。但强阳性率 ( 1 6.7% )表达在 G1明显低于 G2 、G3( P<0 .0 5 ) , 期明显低于 期、 期 ( P<0 .0 5 ) ,并与转移有关 ( P<0 .0 5 )。强阳性表达与病理分级、临床分期及转移呈正相关。结论 :1 Cyclin D1蛋白过表达与子宫内膜癌的发生、发展、转移及预后有关。2临床上检测 Cyclin D1蛋白产物可用于判断子宫内膜癌患者的预后。     

P53在子宫内膜样腺癌中的表达及其临床意义

目的研究p5 3基因在子宫内膜样腺癌中的表达 ,探讨其与子宫内膜样腺癌发生、发展的关系。方法采用免疫组化S -P法检测 3 8例子宫内膜样腺癌和 2 3例子宫内膜增生过长 (单纯型增生 5例 ,复杂型增生 8例 ,不典型增生 1 0例 )及正常增生期子宫内膜 1 0例中p5 3蛋白的表达。结果p5 3在子宫内膜样腺癌、子宫内膜增生过长及正常增生期子宫内膜组织中的表达率分别为 3 1 .6% (1 2 / 3 8)、4.3 % (1 / 2 3 )和 0 ,其中在不典型增生组织中的表达率为 1 0 % ,子宫内膜样腺癌组与子宫内膜增生过长组和正常增生期子宫内膜组比较 ,差异均有显著性 (P <0 .0 5 ) ;与不典型增生组比较差异无显著性 (P >0 .0 5 )。p5 3在子宫内膜样腺癌高分化组阳性表达率为 1 9.0 % ,低、中分化组中阳性表达率 47.1 % ,两者比较差异无显著性 (P >0 .0 5 )。p5 3在子宫内膜样腺癌手术病理分期Ⅰ期组阳性表达率为 1 1 .5 % ,Ⅱ期 +Ⅲ期 +Ⅳ期组中阳性表达率 75 % ;两者比较差异有显著性 (P <0 .0 1 )。在子宫肌层浸润深度 >1 / 2组中阳性表达率为 90 .9% ,≤ 1 / 2组中阳性表达率 7.4% ,两者比较差异有显著性 (P <0 .0 1 )。结论 p5 3参与了子宫内膜样腺癌的发生 ,并与子宫内膜样腺癌的浸润性发展有关。     

子宫内膜癌Survivin蛋白和COX-2的表达及相关性研究

目的：探讨子宫内膜癌组织中Survivin蛋白和COX-2的表达及其在子宫内膜癌发生、浸润和转移中的作用。方法：应用免疫组织化学法检测子宫内膜癌组织、不典型增生子宫内膜和正常子宫内膜组织中Survivin蛋白和COX-2的表达。结果：Survivin蛋白在子宫内膜癌中的阳性率高于正常子宫内膜和不典型增生子宫内膜,差异有显著性（P〈0．05）;COX-2在子宫内膜癌中的阳性率高于正常子宫内膜和不典型增生子宫内膜,差异有显著性（P〈0．05）。在子宫内膜癌组织中,随组织学病理分级的增加、手术临床分期的进展、肌层浸润程度的加深,Survivin蛋白和COX-2表达阳性率逐渐上升,差异有显著性（P〈0．05）。结论：Survivin蛋白、COX-2高表达与子宫内膜癌的发生、发展过程相关,联合检测可为子宫内膜癌的早期诊治及预后判断提供可能的理论依据。     

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.