脑星形细胞瘤p16基因缺失及5'CpG岛甲基化检测

目的探讨p16基因异常与脑星形细胞瘤发生、发展的关系。方法利用PCR及PCR-based甲基化技术检测了56例不同级别的脑星形细胞瘤组织p16基因缺失及5'CpG岛甲基化状况。结果18例高病理级别的脑星形细胞瘤发生了p16基因缺失,而低病理级别的脑星形细胞瘤无一例发生缺失（P<0.05）;6例脑星形细胞瘤发生了p16基因5'CpG岛甲基化。结论p16基因失活可能参与脑星形细胞瘤的病理发生、恶性进展。p16基因纯合缺失是p16基因失活的主要机制。     

原发性膀胱移行细胞癌中p16基因状态的研究

目的：研究原发性膀胱移行细胞癌中p16基因的状态。方法：采用多重PCR分析法、SSCP分析法及以PCR为基础的甲基化分析法，分别对40例原发性膀胱移行细胞癌及其相应的癌旁组织中，p16基因的缺失、突变及甲基化情况进行了检测。结果：40例肿瘤标本中，发现7例（17．5％）p16基因缺失，3例（7．5%）发生了突变，9例（22．5％）有甲基化存在。全部相应的癌旁组织中均未发现有p16基因缺失、突变或甲基化存在。结论：p16基因的异常改变在原发性膀胱移行细胞癌的发生与发展中可能起重要作用。     

卵巢癌p16基因的纯合性缺失、突变及表达异常的研究

目的：研究p16基因的纯合性缺失，突变及表达异常与卵巢癌的发生是否存在相关关系。方法：采用PCR-SSCP检测卵巢癌p16基因的纯合性缺失和突变；采用RP-PCR定性及半定量分析p16基因；采用免疫组化技术检测p16蛋白。结果：32例卵巢癌中检测到1例外显子1突变，未检测到p16基因的纯合性缺失；RT-PCR分析卵巢癌中p16基因mRNA均有表达，半定量分析卵巢癌与正常卵巢组织中p16基因mRNA表达水平无差别；免疫组化检测9例卵巢癌中的p16蛋白为阴性（28.2%)。结论：卵巢癌的发生与p16基因的纯合性缺失和突变无相关关系，与p16基因异常表达有相关关系。     

p16蛋白在人脑星形细胞瘤中的表达及意义

目的：研究p16蛋白在人脑星形细胞瘤发病和预后的关系。方法：用SP免疫组化法观察星形细胞瘤中p16蛋白的表达情况。结果：p16在39例星形细胞瘤中表达的缺失率为71．8％，并且缺失率随星形细胞瘤恶性程度的增加而升高。术后各观察期内复发病例中p16蛋白缺失率明显高于未复发病例（P＜0．05）。结论：p16蛋白表达的缺失与星形细胞瘤的发生有较密切的关系，在一定程度上可以提示它的恶性程度及预后。     

非小细胞肺癌p16基因缺失的研究

目的：分析我国非小细胞肺癌(NSCLC)患者肿瘤组织中p16基因缺失的情况．探讨该基因在肺癌发生中的作用。方法：采用逆转录-聚合酶链反应．对31例手术切除的NSCLC标本中p16基因外显子1和外显子2的缺失进行检测。结果：31例NSCLC中．有26例发生了p16基因的缺失．缺失率达83．9%；p16基因缺失以杂合性缺失为主；p16基因缺失与NSCLC组织学类型，分化程度，有无淋巴结转移以及临床分期无关；NSCIC Ⅰ，Ⅱ期病例即有较为显著的p16基因的缺失。结论：抑癌基因p16在NSCLC发生发展中起主要作用。p16基因缺失可能是NSCLC发生的早期始动环节．检测相关标本中p16基因缺失对肺癌的早期诊断有重要意义。     

成人急性白血病患者骨髓中p16基因的表达

目的：研究成人急性白血病患者p16基因纯合缺失和甲基化变化与其表达之间的关系，探讨其成人急性白血病发生发展中的生物学意义，方法：分别用多重聚合酶联反应（PCR）技术及甲基化敏感限制性内切酶－PCR技术检测了71例成人急性白血病患者DNA中p16基因纯合缺失及甲基情况；应用原位杂交及免疫技术检测p16基因mRNA及p16基蛋白表达，结果：71例成人急性白血病患者中，2例检测出p16基因纯合缺失，在无p16基因纯合缺失的病例中，5例急性淋巴细胞白血病（5／26）和9例急性髓性白血病（9／43）患者测出p16基因甲基化，p16mRNA及p16蛋白的阳性率分别为70．4％（50／71例）、61．9％（44／71例），结论：在成人急性白血病的发生发展中，p16基因甲基化比p16基因纯合缺失更具有意义；p16基因表达异常与成人急性白血病的发生发展密切相关。     

人原发性肝癌中p16基因缺失突变研究

目的 探讨p16基因缺失和突变在人原发性肝癌分子发病机理中所起的作用。方法 采用多重PCR和PCR-SSCP对31例人原发性肝癌、31例癌旁肝硬化组织以及8例正常人白细胞中p16基因第一、二外显子和部分第一，二内含子缺失和突变进行了研究。结果 在31例人原发性肝癌中发现4例p16基因第一外显子和部分第一内含子区域缺失，缺失率为13%，第二外显子和外部分第二内含子区域未见缺失；SSCP分析发现在肝癌和癌旁肝硬化组织中p16基因第一内含子及其下游第二外显子18bp区域存在三种单链构象。结论 在人原发性肝癌中p16基因缺失频率较低，罕见突变。     

非星形细胞脑肿瘤罕见P16基因突变

在人脑星形细胞瘤中存在着很高的P16基因突变率且与其演化有关已被证实,但P16基因在非星形细胞脑肿瘤中的存在状况研究甚少.为了解P16基因及其蛋白表达在非星形细胞脑肿瘤中存在状况及在其演化上的作用.采用复合PCR-SSCP技术检测了76例非星形细胞脑肿瘤标本的P16基因第2外显子突变情况,并用SP免疫组化法俭测其蛋白表达.结果:76例标本没发现P16基因缺失和蛋白丢失,仅1例WHOⅢ级少枝胶质细胞瘤发现SSCP存在泳动变位.P16基因在非星形细胞脑肿瘤中突变罕见,在其演化上并不起主要作用.     

胰腺癌MTS1／p16基因纯合性缺失和突变的研究

目的：研究人胰腺癌组织及正常胰腺组织中p16基因第1外显子和第2外显子的纯合性缺失和突变情况。探讨p16基因异常与胰腺癌的关系。方法：应用聚合酶链式反应－单链构象多态性分析（PCR－SSCP）技术检测51例胰腺癌组织中p16基因第1外显子和第2外显子的纯合性缺失和突变频率,以正常胰腺组织15例为对照。结果：全部被检胰腺癌组织中有23例发生p16基因第2外显子缺失,缺失率45％,有1例发生第1外显子的突变,未发现第1外显子缺失和第2外显子突变。正常胰腺组织中均未发生第1外显子和第2外显子的缺失及突变。结论：p16基因缺失与胰腺癌的发生关系密切,p16基因的突变可能与胰腺癌的发生关系不大。     

人脑胶质瘤中p16基因的表达

目的 探讨胶质瘤中p16基因的缺失及免疫组化情况.方法 利用、PCR技术和免疫组化检测43例胶质瘤p16基因的缺失.结果 PCR组:12例脑星形细胞瘤p16E1和p16E2均缺失,占28名(12/43),2例仅缺失p16E1,占5%(2/43);p16E基因缺失多发生在Ⅲ-Ⅳ级脑星形细胞瘤中(Ⅲ级6/16,Ⅳ级8/14),Ⅰ、Ⅱ级与Ⅲ、Ⅳ级比较有显著性差异(P<0.05).免疫组化组:p16表达缺失率为60.5%.P16表达缺失在Ⅲ级(43.6%)、Ⅳ级(85.7%)脑胶质瘤中显著高于Ⅰ-Ⅱ级(22.2%)(P<0.05).结论 p16基因失活可能与脑星形细胞瘤的分化程度有关,p16基因缺失是p16基因失活的主要机制.     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.