贲门腺癌组织肿瘤抑制基因P53突变分析

采用ＰＣＲ－ＤＮＡ序列分析方法，对来自河南林州市３６例贲门癌组织进行肿瘤抑制基因Ｐ５３第４到９外显子突变分析。结果：３６例贲门癌组织中３例发生Ｐ５３基因突变（８％，３／３６）；突变分别发生在第５，６和８外显子上。对３例已知有Ｐ５３基因突变的癌组织大体标本，分别在４个不同部位（１２点、６点和９点和３点钟处）进行取材，进一步进行Ｐ５３突变结构分析，发现３例中第１例４个位点均发生Ｐ５３基因突一突变部位相     

肺癌患者P53基因突变的检测

应用多聚酶链反应单链构象多态性（ＰＣＲＳＳＣＰ）研究技术，从分子生物学角度探讨Ｐ５３肿瘤抑制基因在肺癌中的突变情况。结果：①３６例肺癌中有１７例出现Ｐ５３基因突变，占４７％；其中鳞癌突变发生率为２９％（４／１４），腺癌为５０％（５／１０），小细胞肺癌为７３％（８／１１）；１例肺泡癌未发现突变。②突变集中在Ｐ５３基因的第５、６和７个外显子，分别有６、３和３例肺癌在相应的外显子部位发生突变。③突变类型均为插入型突变，分别插入３～６个碱基对。结论：细胞分化程度低的肺癌Ｐ５３基因突变发生率高，预后差     

食管癌前病变P53肿瘤抑制基因突变分析

利用聚合酶链反应－单链构型－ＤＮＡ序列测定技术对食管癌高发区河南辉县和林县居民食管癌前病变和癌组织进行Ｐ５３肿瘤抑制基因第５，６，７和８外显子突变分析。在３７例非癌患者活检组织中共发现８例突变。其中１例发生在正常上皮，３例发生在基底细胞增生，４例发生在间变。突变均发生在第５外显子。３例在１７５密码子，２例在１７６密码子，其余３例分别在１５９，１３２和１３５密码子，２９例鳞癌组织检查发现１６例Ｐ５３基因突变（５５％）。突变多分布在第５和７外显子。点突变中，７５％为碱基转换，２５％为碱基颠换。结果提示Ｐ５３基因突变在食管癌的早期阶段已发生。     

肺癌患者P53基因突变的检测

应用多聚酶链反应单链构象多态性（ＰＣＲ－ＳＳＣＰ）研究技术，从分子生物学角度探讨Ｐ５３肿瘤抑制基因在肺癌中的突变情况。结果：①３６例肺癌中有１７例出现Ｐ５３基因突变，占４７％；其中鳞癌突变发生率为２９％（４／１４），腺癌为５０％（５／１０），小细胞肺癌为７３％（８／１１）；１例肺泡癌未发现突变。②突变集中在Ｐ５３基因的５第５、６和７个外显子，分别有６、３和３例肺癌在相应的外显子部位发生突变。③突变     

应用改进的PCR—SSCP银染色法检测卵巢上皮肿瘤p53基因突变？…

目的：探讨ＰＣＲ－ＳＳＣＰ银染法检测基因点突变的准确性和检测卵巢上皮肿瘤ｐ５３基因的点突变率。方法：建立ａＰＣＲ－ＳＳＣＰ银染技术检测了３６例卵巢上皮癌，１２例卵巢上皮交界瘤和１５例良性卵巢上皮肿瘤ｐ５３基因第５￣９外显子的点突变。结果：ａＰＣＲ－ＳＳＣＰ银染正常时出现２条带，突变时出现３条带，卵巢上皮癌ｐ５３基因突变率为３０．６％；第５、６、７、８、９外显子分别为１、１、６、３、０例，突变率在临     

应用改进的PCR-SSCP银染色法检测卵巢上皮肿瘤p53基因突变的研究

目的：探讨ＰＣＲ－ＳＳＣＰ银染法检测基因点突变的准确性和检测卵巢上皮肿瘤ｐ５３基因的点突变率。方法：建立ａＰＣＲ－ＳＳＣＰ银染技术检测了３６例卵巢上皮癌，１２例卵巢上皮交界瘤和１５例良性卵巢上皮肿瘤ｐ５３基因第５～９外显子的点突变。结果：ａＰＣＲ－ＳＳＣＰ银染正常时出现２条带，突变时出现３条带；卵巢上皮癌ｐ５３基因突变率为３０．６％；第５、６、７、８、９外显子分别为１、１、６、３、０例；突变率在临床各期、组织学分级和组织学类型之间无明显差异；卵巢上皮交界瘤仅１例ｐ５３基因第７外显子发生突变，良性卵巢瘤无１例发生突变。结论：ａＰＣＲ－ＳＳＣＰ银染法检测卵巢上皮肿瘤ｐ５３基因点突变准确率高，有助于区分卵巢上皮肿瘤的良恶性     

食管癌多中心起源理论的分子学基础研究

采用免疫组化选择性ＤＮＡ序列分析方法，对来自河南省林州市２１例原发性食管鳞癌患者食管癌组织和癌旁基底细胞增生、间变和原位癌病灶的肿瘤抑制基因Ｐ５３进行比较研究。结果：２１例原发食管癌病灶中发现１４例Ｐ５３基因突变（６７％）。突变部位分别为第５外显子（４例，占２９％）、第６外显子（１例，占７％）、第７外显子（２例，占１４％）和第８外显子（６例，占４２％）。１例突变发生在第４内显子（７％）。对１４例癌旁上皮基底细胞增生、间变和原位癌病灶的Ｐ５３基因分析发现均有不同数量的基因突变。间变及原位癌组织的Ｐ５３基因突变与癌组织极为相似，但是基底细胞增生病变的Ｐ５３基因突变与癌组织不同，其突变部位均发生在第５外显子。提示：食管上皮不同部位的孤立病灶出现相似的分子学改变，支持食管癌多中心起源的理论，随着病变从基底细胞增生到间变到原位癌和早期浸润癌的发展，这些分子学变化可能在癌变的不同阶段起重要作用。     

前列腺癌p53基因的点突变

目的 检测前列腺癌组织中Ｐ５３基因突变的发生率,探讨共与前列腺癌发生的。方法 多聚酶链反应－限制性片段长度多态性方法,检测前列腺癌组织中Ｐ５３基因第４号外显子７２位密码子的点突变。结果 前列腺癌ＤＮＡ样本中检出４号外显子Ｐ５３基因点突变４％,其中杂合性估变３６％,纯合性突变８％,对照组前列腺良笥增生未见Ｐ５３基因变化。结论 前列腺癌发生与５３基因突变有一定关系,应用Ｐ矣Ｂｓｔｕ１酶切多态性分析,对     

食管癌多中心起源理论的分子学基础研究

采用免疫组化选择性ＤＮＡ序列分析方法，对来自河南省林州市２１例原发性食管鳞癌患者食管癌组织和癌旁基底细胞增生、间变和原位癌病灶的肿瘤抑制基因Ｐ５３进行比较研究。结果：２１例原发食管癌病灶中发现１４例Ｐ５３基因突变（６７％）。突变部位分别为第５外显子（４例，占２９％）、第６外显子（１例，占７％）、第７外显子（２例，占１４％）和第８外显子（６例，占４２％）。１例突变发生在第４内显子（７％）。对１４例显     

PCR－SSCP法检测胃癌P53基因突变

应用多聚酶链反应和单链构象多态性分析法（ＰＣＲ－ＳＳＣＰ）检测１９例冰冻胃癌组织Ｐ５３基因第７外显子ＤＮＡ片段扩增及突变情况，同时应用免疫组化法（ＩＨＣ）检测相应胃癌石蜡包埋组织中Ｐ５３蛋白的表达。结果发现４例（２１．１％）胃癌组织Ｐ５３基因第７外显子发生突变。而Ｐ５３蛋白表达率达４７．４％（９／１９）。Ｐ５３基因突变及Ｐ５３蛋白表达与肿瘤发生部位、组织学类型、淋巴结转移及肿瘤分期无关（Ｐ＞０．０５）。提示在胃癌发生和演变过程中，Ｐ５３基因突变是重要事件，其中第７外显子是突变热区之一。     

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.