突变型p53、VEGF在肾细胞癌中的表达及其与血管形成的关系

目的探讨p53、血管内皮生长因子(VEGF)在肾细胞癌组织中的表达及其与肿瘤血管形成的关系.方法利用免疫组织化学S-P法对30例肾细胞癌组织中的p53、血管内皮生长因子的表达及微血管密度(MVD)进行研究.结果 p53、VEGF的表达和微血管密度计数均与肾细胞癌组织学分级呈正相关(P<0.05);p53和VEGF的总阳性表达率分别为53.3%(16/30)和56.7%(17/30);p53阳性或VEGF阳性组MVD(64.0±15.9;63.4±15.2)均显著高于p53阴性或VEGF阴性组(40.6±11.9;39.6±12.5;P<0.01),p53、VEGF均为阳性时,MVD值最大(67.2±14.6,P<0.01);MVD计数与VEGF表达明显相关(P<0.01);p53表达与VEGF的表达显著相关(P<0.01).结论 p53、VEGF的表达及MVD计数可作为判定肾细胞癌恶性程度的重要生物学指标;p53、VEGF的表达对肿瘤血管形成起重要作用,p53可能通过p53-VEGF调节旁路途径促进肾细胞癌的肿瘤血管形成.     

胃癌组织中SP与p53基因的表达及形态定量分析

目的探讨胃肠激素SP和突变型p53基因在胃癌组织中表达的临床意义及其演变关系.并为胃癌预防和早期诊断及胃癌细胞是否存在内分泌功能提供形态学依据.方法采用S-P免疫组织化学方法检测了33例胃癌组织、17例癌旁病变组织和13例正常胃粘膜组织中SP、p53 基因的蛋白表达,并同时应用图像分析技术对SP、p53阳性细胞进行了形状因子、等效直径和异形指数等指标的测定.结果免疫组织化学法检测显示 胃癌组织中SP阳性表达明显高于癌旁组织和正常胃粘膜组织(P<0.001).癌旁组织较正常胃粘膜组织阳性率增加但差异无统计学意义(P>0.05).伴淋巴结转移者阳性率明显高于无淋巴结转移者(P<0.01).胃癌组织中P53基因蛋白阳性表达率和阳性细胞密度均高于癌旁组织(P<0.05).正常胃粘膜组织未见表达.胃癌组织SP、p53两基因共同表达率为36.4%(12/33).图像分析结果显示胃癌组织SP阳性细胞面积上大于正常胃粘膜组织(P<0.02),而形状因子、异型指数在各组间差异均无统计学意义(P>0.05).胃癌和癌旁组织中p53细胞核在等效直径、形状因子和异型指数各参数差异有统计学意义(P<0.01～0.001).结论SP与p53基因高表达参与了胃癌的发生和发展.SP免疫阳性细胞并非全是胃组织中残留的内分泌细胞,部分属于癌细胞.对P53蛋白进行阳性定量可作为胃癌预防和早期诊断的参考指标.     

甲状腺肿瘤ras-p21及EBV LMP-1的表达及意义

目的研究ras癌基因及EBV感染在甲状腺癌中的意义。方法应用SABC免疫组化法对88例甲状腺肿瘤(乳头状癌34例,滤泡性癌17例,髓样癌5例,未分化癌8例,腺瘤24例)进行研究,观察ras癌基因蛋白产物p21及EBvLMP-1的表达情况。结果甲状腺癌p21的表达与甲状腺肿瘤良恶性有关,甲状腺癌p21阳性率(62.5％)明显高于甲状腺腺瘤(33.3％)(P<0.05)。甲状腺癌p21与组织学分型无关。LMI-1在甲状腺癌中的表达率为15.6％,癌周组织无表达。结论ras癌基因突变为甲状腺癌发生中的早期事件,p21检测可作为甲状腺滤泡性肿瘤良恶性鉴别的辅助指标,提示EBV感染与甲状腺癌的发生有关。     

甲状腺癌ret、ras、p53基因的表达及意义

目的通过对甲状腺癌ret、ras、p53基因研究,揭示其在甲状腺癌发病中的意义,为进一步进行甲状腺癌的防治奠定基础。方法用免疫组织化学方法检测66例甲状腺癌和102例甲状腺良性病变中ret、ras、p53基因的表达并进行比较。结果ret在甲状腺乳头状癌、滤泡状癌、未分化癌、结节性甲状腺肿、桥本病及甲亢中均有表达,在髓样癌和滤泡状腺瘤中未检测到;ras在各型甲状腺病中均有表达,但在乳头状癌、滤泡状腺瘤及桥本病中的阳性率明显高于其他类型,差异有统计学意义（P〈0．05）;p53在各型甲状腺癌中的表达率为20％～50％,良性病变中仅在1例滤泡状腺瘤和3例结节性甲状腺肿中呈阳性。ret、p53在甲状腺癌中的表达显著高于甲状腺良性病变,差异有统计学意义（P=0．001）;ras在甲状腺良恶性病变中均有较高表达,差异无统计学意义（P=1．000）。结论甲状腺癌的发病与癌基因ret、ras及抑癌基因p53的突变有密切联系。ret、p53在甲状腺癌中的表达显著高于甲状腺良性病变;ras在甲状腺良恶性病变中均有较高表达,但在乳头状癌、滤泡状腺瘤及桥本病中的阳性率明显高于其他类型。因此,甲状腺癌的防治除考虑高碘因素外,也应充分注意遗传因素的影响。     

巨噬细胞移动抑制因子和p~(53)及MVD在食道鳞癌组织中的表达与意义

目的:探讨巨噬细胞移动抑制因子(MIF)、p53和CD34在食管鳞癌组织表达的相关性。方法:应用免疫组织化学技术对63例食管鳞癌(ESCC)组织中的MIF、p53的表达,新生血管热区的CD34阳性微血管密度(MVD)进行研究。结果:食道鳞癌MIF、p53总体阳性表达率及MVD分别为93.8%(60/64)、84.3%(54/64)及(31.12+12.20)/高倍视野,明显高于正常胃黏膜组(P&lt;0.05),伴有淋巴结转移的癌组织中p53及MVD水平均高于无淋巴结转移的癌组织(P&lt;0.05),MIF、p53和MVD在低分化食管鳞癌的表达率分别为:100%、95.2%和(40.13&#177;20.04)/高倍视野,与高分化食管鳞癌组织差别具有显著性(P&lt;0.05);MIF和p53及MVD表达呈正相关(P&lt;0.05)。结论:MIF、p53和MVD在低分化胃癌、淋巴结转移组织中表达明显增高,且两者的表达有呈明显的正相关。提示MIF是与食道癌密切相关的因子之一。     

细胞周期蛋白D1与p16蛋白在胃癌表达的研究

目的研究细胞周期蛋白D1(CyclinD1)和p16蛋白在胃癌发生、发展中的作用,以及与胃癌生物学行为的关系.方法应用免疫组化SP法观察CyclinD1和p16蛋白在70例胃癌组织和癌旁正常组织中的表达,用增殖细胞核抗原标记指数(PCNALI)做参数,分析CyclinD1和p16蛋白与胃癌预后的关系.结果①CyclinD1蛋白阳性率在胃癌为67.1%,在癌旁正常组织没有表达(P<0.01);在高分化癌为42.3%,低于低分化癌的80.6%(P<0.01)和未分化癌的87.5%(P<0.05);在PCNALI高组为97.1%,明显高于PCNALI低组的63.6%(P<0.01).②p16蛋白阳性率在胃癌为40.0%,低于癌旁的65.7%(P<0.01);在高分化组为69.2%,高于低分化组的27.8%(P<0.01)和未分化组的0.0%(P<0.01);在PCNALI高组为17.7%,低于PCNALI低组的61.1%(P<0.01).③胃癌中CyclinD1和p16蛋白均阳性的5例,均阴性的为0,前者阳性而后者阴性的42例,前者阴性而后者阳性的23例,二者间有非常显著的关联(P<0.01).结论①在胃癌中CyclinD1过表达而p16表达缺失,二者呈负相关.②CyclinD1过表达及p16缺失均与胃癌的发生和肿瘤分化程度有关,并且也可能与预后有关.     

甲状腺乳头状癌Survivin、p53表达与临床病理特征

目的 探讨新的凋亡抑制基因survlvin和抑癌基因p53在甲状腺乳头状癌组织中的表达与甲状腺乳头状癌发生发展、临床病理特征之间的关系.方法 应用免疫组织化学(SP法),检测survivin、p53在102例甲状腺乳头状癌组织及10例结节性甲状腺肿组织中的表达.结果 102例甲状腺乳头状癌组织中survivin、突变型p53(mt-p53)基因的阳性表达率分别为66.7%和81.4%.与良性病变组survivin、p53的阳性表达率30%、0%相比较二者差异有显著的统计学意义(P<0.05).甲状腺乳头状癌组织中突变型p53及surivivin阳性表达率在不同性别、不同年龄、肿瘤大小,WHO大体分类及组织学分级间差异无显著性(P>0.05).伴有淋巴结转移的甲状腺乳头癌组织中surivivin的阳性表达率为79.5%,不伴有淋巴结转移者,survivin的阳性率为57.1%,二者差别有显著性(P<0.05).突变型p53在甲状腺乳头状癌组织中表达的阳性率与淋巴结转移无关(P>0.05).结论 Survivin与mt-p53在甲状腺乳头状癌组织中表达上调.Survivin表达与淋巴结转移有关.突变型p53表达与淋巴结转移无关.     

原发性肝细胞癌癌组织中p33ING1b与p53基因的表达

目的研究p33ING1b与p53蛋白在原发性肝细胞癌中表达的相关性及ING1b基因在原发性肝细胞癌中的突变率.方法应用免疫组织化学SP方法检测了57例原发性肝细胞癌癌组织、51例癌旁肝组织及12例正常肝组织中p33ING1b和p53蛋白的表达,并分析了原发性肝细胞癌癌组织中乙肝病毒(HBV)的感染率;应用聚合酶链式反应(PCR)联合单链构象多态性(SSCP)方法检测了28例配对癌及癌旁肝组织中ING1b基因两个外显子的突变情况,对有异常泳动条带的DNA片段分别克隆测序.结果在57例原发性肝细胞癌癌组织中,p33ING1b、p53蛋白的阳性率分别为42.1%和57.9%,p33ING1b、p53表达均呈阳性者有19例(33.3%),且两者在癌组织中阳性分布区域相同;p33ING1b蛋白表达与p53蛋白表达在癌组织中呈显著正相关(r=0.783, P<0.01);配对癌旁肝组织及正常肝组织中p53蛋白表达均为阴性,p33ING1b蛋白在13例癌旁肝组织及2例正常肝组织中呈弱阳性表达;在57例原发性肝癌组织中有35例(61.4%)HBV X蛋白呈阳性,其病理类型均为肝细胞肝癌,在51例癌旁肝组织中检出HBV X蛋白阳性者39例(76.47%),癌组织中HBV感染与p33ING1b、p53蛋白表达均有关(P<0.01);PCR-SSCP结果表明,ING1b基因在原发性肝细胞癌中突变率较低为7.1%(2/28).结论 p33ING1b、p53蛋白在原发性肝细胞癌中的表达呈显著正相关,p33ING1b的存在可能还有其他不依赖p53蛋白的途径;HBV感染与p33ING1b、p53蛋白表达均有关;基因突变不是p33ING1b丧失抑癌功能的主要因素.     

Survivin、p53基因在甲状腺乳头状癌组织中表达的研究

目的探讨新的凋亡抑制基因survivin和抑癌基因p53在甲状腺乳头状癌组织中的表达与甲状腺乳头状癌发生发展、临床病理特征之间的关系.方法应用免疫组织化学(SP法),检测survivin、p53基因在102例甲状腺乳头状癌组织及10例结节性甲状腺肿组织中的表达.结果102例甲状腺乳头状癌组织中survivin、突变型p53基因的阳性表达率分别为66.7%和81.4%.与良性病变组织中survivin、p53的阳性表达率30%、0%相比较二者差异有显著的统计学意义(P＜0.05).甲状腺乳头状癌组织中突变型p53及survivin阳性表达率在不同性别、不同年龄、肿瘤大小,WHO大体分类、组织学分类及组织学分级间差异无显著性(P＞0.05).伴有淋巴结转移的甲状腺乳头癌组织中survivin的阳性表达率为79.5%,不伴有淋巴结转移者,survivin的阳性率为57.1%,二者差别有显著性(P＜0.05).突变型p53在甲状腺乳头状癌组织中表达的阳性率与淋巴结转移无关(P＞0.05).结论 Survivin与mtp53基因在甲状腺乳头状癌组织中表达显著正相关.     

43例乳腺浸润性导管癌GST-π和P53蛋白的检测分析

目的观察谷胱甘肽-硫-转移酶(GST-π)和肿瘤抑癌基因产物p53蛋白在乳腺浸润性导管癌组织中的表达并探讨其临床意义.方法应用免疫组织化学SABC法,对43例乳腺浸润性导管癌标本GST-π和p53蛋白表达进行检测.结果乳腺浸润性导管癌标本的GST-π的阳性表达率为72.1%;p53的阳性表达率为67.4%,与淋巴结转移的差异有显著性意义(P<0.05).结论联合检测GST-π和p53蛋白,对预测乳腺癌淋巴结转移危险性、指导临床进行针对性治疗有一定的作用.     

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.