结肠癌PTEN基因点突变的PCR-SSCP检测

①目的：探讨PTEN基因突变在结肠癌发病机制中的作用。②方法：采用聚合酶链反应(PCR)、结合单链构象多态性分析(PCR—SSCP)，对34例散发性结肠癌病人的癌组织及其癌旁组织的PTEN基因第5、7、8外显子进行点突变检测。③结果：34例结肠癌组织中有2例检测到PTEN基因突变，突变率为5．88％，其中exon7突变1例，exon8A突变1例，34例癌旁组织未检测到突变，二者差别无显著性(P=0.130)；低分化腺癌及黏液癌组织中PTEN基因突变的发生率为12．5％．中、高分化腺癌中PTEN基因突变的发生率为0，二者比较差异无显著性(P=0.214)。④PTEN基因的突变与结肠癌的发病、发展和恶化无关。     

喉鳞癌蛋白酪氨酸磷酸酶基因突变及甲基化研究

目的研究喉鳞状细胞癌(简称鳞癌)蛋白酪氨酸磷酸酶(PTEN)基因突变和启动子甲基化状况。方法应用聚合酶链反应-单链构像多态性方法(PCR-SSCP)分析银染系统,检测喉鳞状细胞癌新鲜或冰冻组织中PTEN基因第5、第8外显子的突变,采用甲基化敏感聚合酶链反应方法(MSP)分析喉癌及正常喉组织PTEN基因启动子过甲基化。结果PTEN基因突变均发生在喉鳞癌中,占17.5%(7/40),其中第5外显子有6例发生突变,突变率15.0%(6/40),这6例中有低分化3例,中分化3例,无高分化;淋巴结转移占83.3%(5/6)。第8外显子仅有1例发生突变,突变率为2.5%(1/40),该病例虽无淋巴结转移,但病理为低分化。40例喉鳞癌组织中,有40.0%(16/40)例PTEN基因启动子区甲基化,9例喉正常组织中未发现甲基化,喉癌中有2例既有第5外显子突变发生,又有启动子甲基化,占5.0%;有1例既有第8外显子突变,又有启动子甲基化,占2.5%。结论PTEN基因启动子甲基化及基因突变是其在喉鳞癌中失活的原因,并且该基因失活可能与喉鳞癌演进有关。     

p21 WAF_1基因第2外显子突变与食管癌病理特征相关性研究

目的:探讨p21WAF1基因多态性及其在食管癌发生中的意义。方法:采用聚合酶链反应-限制性片断长度多态性(PCR-RFLP)法检测53例食管癌患者p21WAF1第2外显子突变,并调查其中35例临床病理特征。结果:PCR-RFLP发现,食管癌组织和癌旁组织中p21WAF1基因突变分别为28.3%(15/53)和18.9%(10/53),两组无显著性差异,但女性食管癌患者癌组织突变率高于男性患者。p21基因多态性与食管癌的病变部位、肿瘤大小、临床分期、组织学类型和有无转移无关。结论:p21WAF1基因在人食管癌及其癌旁组织中突变几率无显著性差异。病变部位、肿瘤大小、临床分期、组织学类型和有无转移等与癌组织p21WAF1突变率无明显相关。但女性食管癌患者癌组织突变率高于男性。     

膀胱移行细胞癌的E-cadherin基因突变

目的为了探讨膀胱移行细胞癌中E cadherin基因突变情况及其与膀胱移行细胞癌的生物学行为关系。方法采用逆转录聚合酶链反应单链构象多态性 (RT PCR SSCP)检测 2 6例膀胱移行细胞癌组织和 9例正常膀胱粘膜的E -cadherin基因突变。结果在 2 6例膀胱移行细胞癌组织中检测到 3例E cadherin基因突变 ,突变率 11.5 % ,病理分级G1 G2 者突变率 7.1% ,G36 .7% ,TNM分期T1 T2 突变率 10 .5 % ,T3 T414 .3% ,随着病理分级和临床分期的增高 ,E cadherin基因突变率有上升趋势 ,但其差异无显著性。 9例正常膀胱粘膜中未检测到E cadherin基因突变。结论本实验结果显示在膀胱移行细胞癌中存在E cad herin基因突变 ,突变与病理分级和临床分期不相关。     

新疆原发性肺腺癌表皮生长因子受体基因突变与临床病理特征分析

目的：探讨新疆原发性肺腺癌中表皮生长因子受体（epidermal growth factor receptor, EGFR）基因突变情况及与临床病理特征的关系。方法：采用扩增阻滞突变系统(amplification refractory mutation system,ARMS)荧光PCR法对59 例（维吾尔族15例,汉族44例）新疆维吾尔族及汉族原发性肺腺癌手术切除标本进行EGFR基因第18-21号外显子的突变检测,同时分析其与患者临床病理特征的关系。结果：在新疆地区原发性肺腺癌手术切除标本患者中,EGFR基因突变率维吾尔族低于汉族,分别为20%（3/15）和54.5%（24/44）,差异具有统计意义（P<0.05）;其中EGFR外显子19缺失突变维吾尔族2例,汉族9例,外显子21L858R突变维吾尔族1例,汉族12例,外显子18G719X突变汉族2例,外显子21L861Q突变汉族1例。在病理组织学类型上,腺泡状为主型腺癌EGFR突变率为71%（22/31）,高于实性为主型EGFR突变率6.7%（1/15）和黏液腺癌EGFR突变率20%（1/5）。EGFR基因突变与维吾尔族或汉族肺腺癌患者的性别、年龄、部位、大体类型、淋巴结转移情况、吸烟指数及临床分期等差异无统计学意义（P>0.05）。结论：新疆原发性肺腺癌EGFR基因突变率在维吾尔族与汉族有不同,可能反映民族遗传差异性,值得进一步研究。EGFR基因突变常见于高 中分化腺癌,或以腺泡状为主型多见。     

PTEN基因在膀胱癌组织中的表达和突变

目的 检测抑癌基因PTEN在膀胱癌组织中的表达和突变情况。方法 分别应用免疫组化和聚合酶链反应单链构象多态性分析（PCR-SSCP）技术对62例膀胱癌及18例膀胱良性病变组织（对照组）中PTEN的表达及其第1和第7个外显子的突变情况进行检测。结果 在62例膀胱癌组织中．PTEN表达的阳性率为53．2%．而对照组全部为阳性表达；62例膀胱癌组织中．第7外显子突变率为25．8％．第1外显子未发现突变．在对照组织中．末发现有指示突变的异常带型；膀胱癌PTEN的突变率可能与肿瘤的病理学分级有关。结论 PTEN基因突变所致表达障碍可能在膀胱癌的发生、发展中有着重要的作用。     

胃癌患者p53基因突变的检测及其临床意义

目的:探讨胃癌患者癌组织及外周血p53基因突变表达情况,评价p53基因作为胃癌患者术后预后判定、转移监测及指导临床治疗的应用价值。方法:利用聚合酶链反应单链构像多态性分析法(PCRSSCP)和银染技术检测32例胃癌患者外周血、癌旁正常组织、癌组织中p53基因外显子5、6、7、8位点及20例健康人外周血p53基因的突变情况,并比较不同组织类型、不同分期、有无淋巴结转移胃癌患者p53基因的突变率。结果:32例胃癌患者癌旁正常组织和20例正常人外周血中未检出p53基因突变;胃癌患者癌组织中的p53基因突变率为37.5%(12/32),与癌旁正常组织无相比差异有统计学意义(P<0.05);有淋巴结转移患者的胃癌组织p53基因突变高于无淋巴结转移患者(P<0.05);胃癌患者外周血p53基因突变率为15.6%(5/32),外周血中p53基因突变阳性者其相应癌组织p53基因突变均为阳性,经过3个月随访,其中有1例确诊为肝转移。不同组织类型不同分期胃癌患者p53基因突变率差异均无统计学意义(P>0.05)。结论:p53基因突变对胃癌患者术后预后判定、转移监测及指导临床治疗有一定的意义。     

非遗传性肾透明细胞癌中VHL抑癌基因的突变及其意义

目的:探讨国人非遗传性肾透明细胞癌中VHL抑癌基因的突变及其意义.分析希佩尔林道(von HippelLindau,VHL)抑癌基因突变与肾癌分期分级的关系.方法:采用聚合酶链反应(PCR)、变性高效液相色谱(DHPLC)以及DHPLC阳性者进行直接测序的方法,分析了57例非遗传性肾透明细胞癌中VHL抑癌基因突变的情况.结果:发现30例VHL基因突变,突变率为53%.这些突变主要发生在第1,2,3号外显子的后1/3区,其中13例缺失,2例插入,15例误义突变.结论:国人非遗传性肾透明细胞癌中存在VHL基因的突变,且与患者年龄,肿瘤分期、分级无相关性.     

应用SSCP-PCR技术研究非小细胞肺癌p53基因突变

目的 :探讨非小细胞肺癌 (NSCLC) p5 3基因突变与临床病理及预后的关系 ,评价检测 p5 3基因点突变作为基因标记物在判断患者预后中的意义 .方法 :应用聚合酶链反应 单链构象多态性 (PCR SSCP)分析技术 ,检测 31例NSCLC及5例肺良性病变石蜡包埋标本 p5 3基因的点突变 .结果 :肺癌组织 p5 3基因点突变率为 4 8% (15 / 31) ,肺良性病变未检出该基因突变 ,两组相比有显著性差异 .各组织学类型肺癌p5 3基因 5～ 8外显子点突变检出频率为 :鳞状细胞癌 9例(9/ 16 ) ,腺癌 3例 (3/ 10 ) ,肺泡细胞癌 1例 (1/ 3) ,大细胞癌 2例 (2 / 2 ) .肺腺癌组织 p5 3基因点突变率比鳞状细胞癌低 .Ⅲ Ⅳ期肺癌点突变率明显高于Ⅰ期肺癌 (P <0 .0 5 ) ,p5 3基因点突变与临床分期有关 ,在低分化肺癌其突变频率明显高于分化好的肺癌 (高分化和中分化肺癌 ) ,p5 3基因突变率与年龄、性别、肿瘤大小和组织学类型无相关性 .结论 :应用PCR SSCP技术检测 p5 3基因突变能够反映肺癌的进展情况、临床分期及肿瘤分化程度 ,是判断肺癌预后的重要生物学指标 .     

肺腺癌表皮生长因子受体基因突变与组织病理学的相关性研究

目的研究肺腺癌（LAC）表皮生长因子受体（EGFR）基因突变与组织病理学的相关性。方法选取179例行LAC根治手术病人的癌组织石蜡标本,采用扩增阻滞突变系统检测LAC组织中EGFR基因突变及突变丰度情况,分析EGFR基因突变及突变丰度与临床病理特征的相关性。结果179例LAC病人中,EGFR基因突变者共108例（60.34%）,其中以19号外显子和21号外显子突变为主。不同年龄、淋巴结转移情况、胸膜浸润程度的LAC病人癌组织中EGFR基因突变差异无统计学意义（P>0.05）,不同性别、吸烟情况、肿瘤直径、临床分期、组织学亚型的LAC病人癌组织中EGFR基因突变和突变丰度差异均有统计学意义（P < 0.05~P < 0.01）。结论LAC病人EGFR基因突变与性别、吸烟情况、肿瘤直径、临床分期、组织学亚型相关,女性、肿瘤直径较小、不吸烟者、临床分期较早、腺泡状肺腺癌有较高的EGFR基因突变率。     

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.