抑癌基因PTEN与FHIT在卵巢上皮癌中的表达及其相关性研究

目的通过检测PTEN与FHIT基因蛋白在卵巢上皮性癌、交界性肿瘤、良性囊肿、正常卵巢组织中的表达,探讨抑癌基因PTEN与FHIT基因蛋白在卵巢癌发生发展中的作用,分析PTEN与FHIT基因蛋白在卵巢癌中表达的相关性。方法采用免疫组织化学S-P方法检测卵巢上皮性癌45例、卵巢交界性肿瘤10例、卵巢良性囊肿10例、正常卵巢5例中PTEN、FHIT蛋白的表达。结果卵巢癌和卵巢交界性肿瘤组织中PTEN蛋白表达率(50.0%,53.3%)明显低于卵巢囊肿和正常卵巢组织(100%,100%);在卵巢上皮性癌中,PTEN蛋白表达与肿瘤的病理分级及临床分期呈负相关(P<0.05),与肿瘤的组织类型和淋巴转移无相关性(P>0.05);FHIT蛋白在卵巢上皮性癌中的表达明显低于交界性肿瘤、良性肿瘤及正常卵巢组织,差异有统计学意义(P<0.05);FHIT的阳性表达与肿瘤的组织分化正相关(P<0.005);而与临床分期、组织类型及淋巴结转移无相关性(P>0.05);PTEN和FHIT蛋白在上皮性卵巢癌中的共同联合表达有相关性(P<0.005)。结论 PTEN、FHIT基因蛋白在卵巢癌中表达显著降低,且二者表达呈正相关;患者卵巢肿瘤组织中的FHIT和PTEN基因蛋白表达显著降低,有望成为卵巢癌早期诊断的重要指标之一。     

卵巢上皮性肿瘤中Ezrin、E-cadherin及EGFR的表达及临床意义

目的探讨卵巢上皮性肿瘤中Ezrin、E-cadherin和EGFR的表达意义及其与预后的关系。方法选取有随访资料的卵巢上皮性肿瘤(包括卵巢癌77例和11例良性、9例交界性卵巢上皮性肿瘤),并随机选取正常卵巢组织7例,应用用免疫组化SP法检测Ezrin、E-cadherin和EGFR的表达。结果 Ezrin和E-cadherin在正常卵巢组织、良性、交界卵巢上皮肿瘤组织及卵巢癌组织中的表达阳性率呈递减趋势,并与卵巢癌FIGO分期、组织学分级呈负相关。而EGFR表达的呈上升趋势,其表达与卵巢癌FIGO分期及腹腔种植呈正相关。单因素分析显示Ezrin和E-cadherin阴性表达患者的累积生存率明显缩短,而EGFR阴性表达患者累积生存率高。多因素COX回归模型显示:Ezrin、E-cadherin的阴性及EGFR的阳性表达是卵巢癌患者生存独立危险因素。相关分析显示,Ezrin与E-cadherin的表达呈正相关,与EGFR呈负相关。结论 Ezrin与卵巢癌的浸润及转移密切相关,是卵巢癌不良预后因素,并协同调节E-cadherin和EGFR而影响卵巢癌细胞的粘附和转移性。     

FAS和HER-2/neu蛋白在卵巢上皮性癌组织中的表达及其相关性研究

目的 研究脂肪酸合成酶（FAS）和人表皮生长因子受体2（HER-2/neu）在卵巢肿瘤组织中的表达及其相关性.方法 应用免疫组化SP法检测52例卵巢癌、10例交界性卵巢肿瘤、10例良性上皮性卵巢肿瘤组织中FAS和HER-2蛋白的表达情况.结果 （1）卵巢癌及交界性卵巢肿瘤组织中的FAS阳性表达率明显高于良性上皮性卵巢肿瘤组织（P =0.000）;卵巢癌组织中的HER-2阳性表达率明显高于卵巢良性上皮性肿瘤及卵巢交界性肿瘤组织（P=0.045）.（2）FAS蛋白表达与组织学类型有关（P =0.009）.（3）FAS、HER-2/neu蛋白阳性者的平均生存时间短于阴性者（P=0.024、0.005）.（4）FAS与HER-2/neu在卵巢癌中的表达正相关（r= 12.46,P=0.000）.结论 FAS、HER-2/neu蛋白的过表达可能在卵巢癌的发生和发展中起一定作用,可明显缩短患者术后生存时间,是卵巢上皮性癌患者的不良预后因素,两者在卵巢癌的发生、发展中可能有某种相互促进的作用.     

MUC1在卵巢肿瘤的表达

目的 观察MUC1在不同组织分化程度卵巢上皮性肿瘸的表达，探讨卵巢恶性肿瘤的早期诊断方法．方法 采用免疫组化方法检测69例卵巢上皮性肿瘤MUC1的表达，分析其表达与卵巢上皮性肿瘤临床及病理的关系。结果 MUC1在上皮性肿瘤中有表达，其表达率随组织恶性程度的升高，在良性卵巢肿瘤、交界性卵巢肿瘤、卵巢癌中依次增高；且与卵巢肿瘤病理分型、临床分期有不同程度的相关性，但与淋巴结转移无相关。结论 MUC1与卵巢癌的发生发展密切相关，MUC1作为新型肿瘤标记物，对评价卵巢上皮交界性肿瘤癌变潜能及卵巢癌预后有重要意义．     

高尔基体蛋白73在上皮性卵巢肿瘤中的表达及意义

目的 研究正常卵巢组织及良性、交界性、恶性卵巢肿瘤组织中高尔基体蛋白73(GP73)的表达的差异,初步探讨GP73的表达与卵巢癌发病的关系及与卵巢癌预后的相关性.方法 免疫组织化学法检测卵巢癌组织68例、交界性卵巢上皮肿瘤21例、良性卵巢上皮肿瘤26例、正常卵巢组织20例中GP73的表达,结合临床病理特征分析其与卵巢癌预后的相关性.结果 GP73在正常卵巢组织及良性、交界性、恶性卵巢上皮肿瘤组织中均有表达;与正常组比较,GP73在良性、交界性组中的表达无明显差异(P＞0.05),而在恶性组中高表达(P＜0.01);在恶性组中,GP73的表达与临床分期、分级相关,而与组织类型无关;GP73的表达与术后生存时间相关,术后生存时间越短,GP73表达越高.结论 GP73在恶性卵巢上皮肿瘤组织中高表达,且随着组织分化程度越差,临床分期越晚,其表达也随之增加,恶性卵巢上皮性肿瘤患者的术后生存时间越短,GP73的表达越高.为判断肿瘤的恶性程度及预测患者术后生存时间提供理论依据.     

EZH2蛋白在卵巢上皮性肿瘤中的表达及其作用

目的观察EZH2在不同卵巢组织中的表达,探讨其在肿瘤发展中可能发挥的作用。方法采用免疫组织化学染色检测15例正常卵巢组织、32例卵巢良性肿瘤、28例卵巢交界性肿瘤及50例卵巢癌中EZH2蛋白的表达,其中15例正常卵巢组织、23例卵巢良性肿瘤、23例交界性肿瘤及25例卵巢癌行RT-PCR检测。结果 1EZH2蛋白在卵巢癌细胞核中的表达明显高于正常卵巢组织(P<0.01)、卵巢良性肿瘤(P<0.01)及交界性肿瘤(P<0.05),且与肿瘤的分级和分期具有相关性(P<0.01,P<0.05);2 EZH2蛋白在卵巢肿瘤组织的细胞质中亦有表达,且良性肿瘤和交界性肿瘤中的表达高于卵巢癌(P均<0.05);3 EZH2蛋白在卵巢癌细胞核中的表达与Ki-67呈正相关性(r=0.40,P<0.01)。结论卵巢肿瘤组织细胞核及细胞质中均有EZH2蛋白的表达,且卵巢癌细胞核中EZH2蛋白的表达与肿瘤的分期及分级具有相关性,并参与细胞增殖。     

XAF1、CHD5和Ki67在卵巢肿瘤浆液性腺癌中表达的临床意义及与预后的关系

目的探讨XAF1、CHD5和Ki67在卵巢肿瘤浆液性腺癌中表达的临床意义及与预后的关系。方法分析卵巢上皮性肿瘤切除标本63例进行观察,通过组织病理学结果证实,卵巢良性肿瘤15例,卵巢交界性肿瘤13例,卵巢浆液性腺癌35例。同时选取5例子宫肌瘤患者手术切除的部分卵巢正常组织作对照。结果 XAF1、CHD5在卵巢正常组织、良性上皮性肿瘤组织阳性率明显高于卵巢交界性上皮性肿瘤和卵巢上皮性癌组织,同时XAF1、CHD5联合Ki-67的检测,XAF1、CHD5在卵巢浆液性腺癌中的表达与临床分期、组织病理学分级、淋巴结转移存在明显的负相关性,P<0.05,差异有统计学意义。结论探讨其在卵巢上皮性肿瘤发生、发展中的作用及二者之间的相互关系,指导卵巢浆液性腺癌的临床合理治疗和准确预后判断具有重要的临床意义。     

NGF、TrkA及c-Met表达对原发性上皮性卵巢癌病情评估及预后预测的作用

目的 分析NGF、TrkA及c-Met表达对原发性上皮性卵巢癌病情评估、预后预测的作用。方法 收集岳池县人民医院2016年6月~2018年6月收治的115例原发性上皮性卵巢癌患者为研究对象，所有患者均行手术治疗，将卵巢癌患者作为癌组织组，将对侧正常卵巢组织作为正常组织组。采用免疫组化方法检测各组组织中NGF、TrkA及c-Met指标，比较各组组织中NGF、TrkA及c-Met表达情况；分析NGF、TrkA及c-Met与原发性上皮性卵巢癌患者各病理参数的相关性；统计原发性上皮性卵巢癌患者预后情况，以Kaplan-Meier生存分析NGF、TrkA及c-Met表达对原发性上皮性卵巢癌患者预后生存的影响；采用多元Logistic回归分析对原发性上皮性卵巢癌患者预后生存的危险因素进行分析；采用ROC曲线分析NGF、TrkA及c-Met表达在原发性上皮性卵巢癌患者预后生存中的预测价值。结果 癌组织组NGF、TrkA及c-Met阳性表达率显著高于正常组织组，差异具有统计学意义（P<0.05）；原发性上皮卵巢癌患者中NGF、TrkA及c-Met表达与年龄、组织分化类型、腹腔积液无明显相关性（P>0.05）；而与淋巴结转移、临床分期、分化程度有相关性（P<0.05）；115例患者经两年随访后显示，两年生存率为35.65%（41/115）。生存分析显示NGF、TrkA及c-Met表达阴性者生存期较阳性表达者长（P<0.05）。分化程度、临床分期、淋巴转移、NGF、TrkA及c-Met阳性为影响原发性上皮卵巢癌患者预后生存的独立危险因素（P<0.05）；ROC曲线显示，NGF、TrkA及c-Met及三者联合曲线下面积分别为0.780、0.851、0.808、0.946，各指标曲线下面积以联合检测最大。结论 NGF、TrkA及c-Met与原发性上皮卵巢癌患者病情评估及预后密切相关，临床监测该水平对患者病情评估及预后具有重要作用。     

SSTR_2在上皮性卵巢肿瘤中的表达及意义

目的:探讨SSTR2在卵巢浆液性肿瘤中的表达及其与生物学行为和预后的关系。方法:采用免疫组化SP法检测48例上皮性卵巢肿瘤中SSTR2蛋白的表达水平。结果:SSTR2在良性肿瘤中的阳性表达率为83.3%(10/12),交界性卵巢上皮性肿瘤中的阳性表达率为60.0%(3/5),卵巢上皮性癌中的阳性表达率为45.2%(14/31),3组间有显著性差异(P<0.05)。卵巢癌组中,TNM分期越晚、组织分化越差、体内有腹水患者的肿瘤组织中SSTR2表达却相对增高,其间有显著差异(P<0.05)。结论:SSTR2表达水平可能与卵巢癌组织分化、临床分期有关。     

AIB1蛋白在卵巢肿瘤中的表达及意义

目的:探讨AIB1蛋白在卵巢肿瘤组织中的表达及其临床意义。方法:采用免疫组化法检测44例卵巢癌组织、25例卵巢交界性肿瘤、20例卵巢良性肿瘤、20例正常卵巢组织中AIB1蛋白的表达,结合肿瘤的临床学资料及临床分期,分析其相关性。结果:卵巢癌组织中AIB1蛋白的表达显著高于卵巢交界性肿瘤、卵巢良性肿瘤和正常卵巢组织(P<0.05),在卵巢癌肿瘤组织中,AIB1蛋白的表达与肿瘤的临床分期密切相关(P<0.05),而与肿瘤的组织学类型、病理分级无显著相关性(P>0.05)。结论:AIB1蛋白的过表达可能与卵巢癌的发生发展相关。     

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.     

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.