喉鳞癌中CD44的表达及临床意义

目的:探讨CD44在喉鳞癌(laryngealsquamouscellcarcinoma,LSCC)组织中的表达及其临床意义。方法:采用免疫组化S-P法检测10例正常喉组织,20例癌旁组织和60例喉癌组织中CD44的表达。结果:喉癌组织中CD44表达率为68.3%,明显高于癌旁组织(15.0%)及正常喉组织(0%),其差异有统计学意义(P<0.01);喉癌组织中高分化鳞癌CD44表达明显低于低分化鳞癌(P<0.01);Ⅲ～Ⅳ期喉癌组织CD44表达明显高于Ⅰ～Ⅱ期(P<0.01);有颈淋巴结转移的喉癌组织CD44表达明显高于无颈淋巴结转移的喉癌组织(P<0.01);CD44高表达病例3年生存率明显低于CD44低表达病例(P<0.05)。结论:CD44表达与喉癌的发生、发展及患者预后密切相关。     

Ki67、P53蛋白在人喉组织中的表达及临床意义

目的 探讨Ki67和P53蛋白表达在人喉癌发生、发展及预后中的作用.方法 采用免疫组织化学Envision法检测182例喉不同病变组织标本(喉癌141例,喉癌前病变18例,声带息肉15例和癌周正常喉组织8例)中Ki67和P53蛋白的表达.结果 Ki67、P53在人喉癌组织中表达阳性率均显著高于喉癌前病变、声带息肉组织及癌周正常喉组织(P＜0.01);中晚期(Ⅲ～Ⅳ期)、伴颈淋巴结转移及术后3年或5年死亡的喉癌组织中PD4、Ki67阳性表达率均显著高于早期(Ⅰ～Ⅱ期)、无颈淋巴结转移及3年或5年存活病例(P＜0.01或0.05);Ki67和P53蛋白在人喉癌组织中联合表达阳性率显著高于喉其他不同病变组织中联合表达阳性率(P＜0.01).结论 Ki67和P53联合表达与人喉癌的发生、发展及预后有一定的相关性.     

Survivin蛋白在喉鳞癌组织中的表达及其与bcl-2表达的关系

目的 探讨凋亡抑制基因survivin蛋白在喉鳞癌中的表达,及其与Bcl-2表达的相关性.方法 对47例喉鳞癌组织和癌旁组织及正常喉组织的石蜡切片,采用免疫组织化学技术SP法检测survivin蛋白及Bcl-2蛋白的表达.结果 survivin在正常喉组织中不表达,survivin在喉鳞癌、癌旁组织中的阳性表达率分别为59.6%（28/47）和25.5%（12/47）.高分化喉鳞癌中survivin的阳性表达率为33.3%,中、低分化为68.6%,两者比较差异有显著性;临床分期Ⅲ、Ⅳ期喉癌中survivin阳性率明显高于临床分期Ⅰ、Ⅱ期;有颈淋巴结转移病例的survivin阳性表达率（61.9%）明显高于无颈淋巴结转移病例（30.0%,P＜0.05）;survivin与临床分期、病理分级、淋巴结转移呈正相关.Bcl-2表达阳性、阴性者中,survivin蛋白表达阳性率分别为78.3%（18/23）、41.7%（10/24）,两者比较,差异有显著性.结论 Bcl-2可能参与了调控喉鳞状细胞癌的发生、发展过程,survivin的高表达可能提示喉癌患者预后不良.survivin蛋白表达与喉鳞癌组织中Bcl-2蛋白的异常表达密切相关.     

喉鳞状细胞癌中PUMA、P53基因的表达及其临床意义

目的:研究PUMA、P53在喉鳞状细胞癌组织中表达,探讨PUMA在喉鳞癌发生发展中作用及与P53的关系。方法:采用免疫组织化学SP法检测40例喉癌组织以及16例癌旁组织中的PUMA和P53的表达情况。结果:PUMA在喉癌中的表达阳性率(62.5%)低于癌旁组织(87.5%),P<0.05,PUMA的表达与喉鳞癌患者的颈淋巴结转移及预后有关。P53在喉癌中的表达阳性率(65.0%)高于癌旁组织(0%),P<0.01,P53的表达与喉鳞癌患者的肿瘤分化程度、颈淋巴结转移及预后有关。PUMA与P53在喉鳞癌中的表达呈负相关关系。结论:PUMA可能是喉鳞癌的一个重要的预后标记物。P53的表达与肿瘤分化、淋巴结转移有关,可作为判断预后的一个有意义的指标。     

p63及p53基因在喉鳞癌中的表达及意义

目的 探讨p63及p53基因在喉鳞癌组织中表达的临床意义及其相关性.方法 用免疫组化法检测63例喉鳞癌及其45例癌旁组织和25例喉非癌组织,检测24枚见癌转移的颈淋巴结和40枚未见转移的颈淋巴结中p63及p53的表达.结果 p63及p53蛋白在喉鳞癌组织及颈部淋巴结中的阳性表达呈细胞核阳性,p53及p63蛋白在喉鳞癌、癌旁及非癌组中的表达差异有显著性(P＜0.01);p53及p63蛋白在喉鳞癌患者颈部见转移和未见转移淋巴结组中的表达差异有显著性(P＜0.01);p63在喉鳞癌中的中、强阳性率( ～ )的表达(95.24%)明显高于p53(47.62%);p53与p63在喉鳞癌中的表达存在正相关(r=0.678,P＜0.01).结论 在喉鳞癌组织及喉癌患者颈部见转移淋巴结中的表达p63比p53更具特异性.p53与p63在喉鳞癌的发生发展过程烫中可能存在协同相关性,是喉癌的发生发展及淋巴结转移过程中的重要因素之一.     

乙酰肝素酶表达及其与喉鳞状细胞癌生物学行为关系

目的 探讨乙酰肝素酶(HPA)在喉鳞状细胞癌(喉癌)组织表达及其与喉癌临床分期、淋巴结转移和预后的关系.方法 采用免疫组化技术检测45例喉癌和癌旁组织组织中HPA的表达.结果 HPA在喉癌组织中表达阳性率为53.3%,癌旁组织为13.3%,二者比较差异有显著性(χ2=16.2,P<0.05);HPA表达阳性率与喉癌的临床分期、淋巴结转移及5年生存率明显相关(χ2=4.86～5.18,P<0.05),与喉癌的组织分化程度无关(χ2=2.13,P>0.05).结论 HPA在喉癌的侵袭和转移中可能起到重要作用,可作为判断喉癌生物学行为和预后的有用指标.     

人喉癌组织中增殖细胞核抗原、CD44蛋白的表达及其临床意义

目的：探讨增殖细胞核抗原（PCNA），CD44在人喉癌组织中的表达及其临床意义。方法：采用免疫组织化学Envision法对96例喉癌，28例非喉癌病变，51例癌旁或癌周对侧喉组织标本进行PCNA，CD44表达情况检测。结果：（1）PCNA，CD44在喉癌组织中的表达阳性率分别为87．5％（84／96）和70．8％（68／96），均显著高于非喉癌病变喉组织，癌旁及癌周喉组织（P＜0．01）。（2）晚期（Ⅲ-Ⅳ期），组织学分级2－3级（低分化）伴颈淋巴结转移喉癌组织中PCNA，CD44阳性表达率均显著高于早期（Ⅰ-Ⅱ期），组织学分级1级（高分化），无颈淋巴结转移的喉癌组织（P＜0．01）。（3）喉癌术后3年或5年存活病例CD44表达阳性率明显低于未存活病例，而PCNA的表达阳性率在术后3，5年存活或未存活病例间无统计学差异（4）PCNA与CD44表达存在正相关（P＜0．01）。结论：喉癌的发生，发展及预后与PCNA，CD44表达密切相关。     

Mdm2及ToPoⅡ在喉癌中的表达及临床意义

目的:探讨喉癌中Mdm2、ToPoⅡ蛋白和ToPoⅡmRNA的表达及与临床病理特征的关系。方法:采用免疫组化S-P法检测Mdm2、ToPoⅡ蛋白在50例喉鳞状细胞癌和10例喉正常黏膜中的表达,采用原位杂交方法检测相应标本中ToPoⅡmRNA的表达。结果:(1)Mdm2在喉癌和喉正常组织中表达的阳性率分别是86%(43/50)和20%(2/10),Mdm2与临床分期和淋巴结转移有关,与性别、分化程度、临床分型无关。(2)ToPoⅡ蛋白和ToPoⅡmRNA在喉癌表达的阳性率分别是70%(35/50)和64%(32/50),在正常组织中表达的阳性率分别是10%(1/10)和20%(2/10),ToPoⅡ与淋巴结转移、临床分期和分化程有关,ToPoⅡ与临床化疗关系密切,与性别、临床分型无关。ToPoⅡ蛋白和ToPoⅡmRNA在喉癌组织的阳性表达呈正相关(P<0.05)。(3)二者相关性:本研究得出Mdm2与ToPoⅡ呈负相关(r=-0.946)。结论:Mdm2、ToPoⅡ的异常表达可能对喉癌的发生发展起着不同作用,通过对它们的检测可以对喉癌的预后及化疗提供理论依据。     

SDF-1／CXCR4与VEGF-C在喉癌中的表达及与淋巴结转移的关系

目的:探讨趋化因子受体(CXC chemokine receptor4,CXCR4)、血管内皮生长因子-C(Vascular endothelial growth factor C,VEGF-C)、基质细胞衍生因子-1(Stromalcell derived factor-1,SDF-1)在喉鳞状细胞癌及颈淋巴结组织中的表达及其在淋巴结转移过程中的作用和可能机制.方法:应用RT-PCR技术及免疫组织化学SP法检测10例癌旁正常组织、45例喉癌原发灶中CXCR4、VEGF-C和45例颈淋巴结组织中SDF-1表达的情况.结果:不论在mRNA还是蛋白水平,喉癌原发灶均表达较高水平的CXCR4与VEGF-C(78%、67%与78%、71%),与癌旁正常组织相比,差异有统计学意义;SDF-1在颈部淋巴结组织中呈高表达,在有癌细胞浸润组的表达率(100%)显著高于无癌细胞浸润组(30%).喉癌原发灶中CXCR4和VEGF-C表达呈正相关(P＜0.05);CXCR4和VEGF-C的表达与喉癌患者的TNM分期,分化高低及有无淋巴结转移有显著相关性(P＜0.05);SDF-1的表达则仅与患者有无淋巴结转移显著相关(P＜0.05);喉癌原发灶中CXCR4与淋巴结组织中SDF-1的表达经pearson相关分析结果显示,两者的表达水平呈显著负相关(r=-0.3309,P=0.0167).结论:SDF-1/CXCR4/VEGF-C在喉癌组织及转移淋巴结中高表达,并与喉癌淋巴转移显著相关,三者在喉癌的器官特异性转移中可能起协同作用,共同促进喉癌的淋巴转移.     

增殖细胞核抗原、Ki67在人喉癌发生中的作用

目的 :检测喉不同病变组织中核增殖抗原 (PCNA)Ki6 7表达情况 ,探讨Ki6 7、PCNA联合表达在人喉癌发生中的作用 .方法 :采用免疫组织化学EnVision法对 196例喉不同病变组织标本 (喉癌 12 1例 ,喉癌前病变 2 3例 ,声带息肉 37例和癌周正常喉组织 15例 )进行Ki6 7、PCNA蛋白联合表达情况检测 .结果 :Ki6 7、PCNA在人喉癌组织中表达阳性率分别为 75 .2 % (91/ 12 1)和 80 .2 % (97/ 12 1) ,喉癌前病变组织中为 4 7.8% (11/ 2 3)和 6 0 .9% (14 / 2 3) ,声带息肉中为 2 4 .3%(9/ 37)和 2 7.0 % (10 / 37) ,癌周正常喉组织中为 13.3% (2 /15 )和 6 .7% (1/ 15 ) .喉癌临床不同分期之间、组织病理学分级之间以及有无颈淋巴结转移之间Ki6 7、PCNA表达阳性率均有显著差异 (P <0 .0 1,P <0 .0 5 ) ,喉癌不同肿瘤部位之间Ki6 7、PCNA表达阳性率无显著差异 (P >0 .0 5 ) .结论 :Ki6 7、PCNA联合表达与人喉癌的发生、发展及预后有一定的相关性     

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.