RNA干扰IGF-1受体和EGF受体表达对鼻咽癌裸鼠移植瘤细胞周期的影响

目的探讨RNA干扰IGF-1受体和EGF受体表达对鼻咽癌裸鼠移植瘤的增殖状态和鼻咽癌CNE2细胞的细胞周期趋势的影响及其作用机制。方法应用免疫组织化学S-P方法和形态计量技术对鼻咽癌裸鼠移植瘤（实验组和对照组）组织切片进行PCNA染色、HE染色以及流式细胞仪检测鼻咽癌CNE2细胞（实验组和对照组）在细胞各期的细胞比例和增殖指数。结果实验组鼻咽癌皮下移植瘤PCNA标记指数为27．19±10．20,核分裂像计数为18．80±7．47;质粒对照组和正常对照组鼻咽癌皮下移植瘤PCNA标记指数别为36．47±9．03和37．07±8．63,核分裂像计数分别为37．53±5．25和38．03±6．15,同一组的两指标显著正相关（P〈0．01）。实验组鼻咽癌CNE2细胞处于G0／G1期、S期和G2／M期的细胞比例分别为63．80±0．64、33．29±0．21和2．91±0．04,而两对照组鼻咽癌CNE2细胞处于G0／G1期、S期和G2／M期的细胞比例分别为47．91±0．65（44．64±0．28）、42．71±0．11（45．70±0．15）和9．38±0．14（9．65±0．01）。实验组鼻咽癌CNE2细胞的增殖指数为36．2±0．65,而两对照组鼻咽癌CNE2细胞分别为52．09±0．08和55．35±0．08。结论EGFR和IGF-1R基因治疗鼻咽癌机理之一可能是通过改变鼻咽癌CNE2细胞周期趋势和降低移植瘤的增殖水平达到的;PCNA标记指数、核分裂像计数和G2／M期的鼻咽癌细胞比例在一定程度上均可反应鼻咽癌细胞的增殖水平,三者可作为评估鼻咽癌增殖活性的有用指标。     

p27蛋白和增殖细胞核抗原在上颌窦鳞癌中的表达

目的:探讨p2 7蛋白和增殖细胞核抗原(proliferatingcellnuclearantigen ,PCNA)在上颌窦鳞癌中的表达及其与上颌窦鳞癌发生发展的关系。方法:应用免疫组化SABC法检测35例上颌窦鳞癌和15例鼻腔鼻窦内翻性乳头状瘤的p2 7蛋白和PCNA表达。结果:p2 7蛋白及PCNA染色阳性细胞均为细胞核着色。其中上颌窦鳞癌的p2 7蛋白阳性率为2 5 .71% ,鼻腔鼻窦内翻性乳头状瘤的阳性率为73.3%。二者差异有高度显著性(P <0 .0 1)。但鳞癌各组间经统计学检验差异无显著性。上颌窦鳞癌PCNA指数为86 .94±9.83,鼻腔鼻窦内翻性乳头状瘤的PCNA指数为4 6 .14±2 .6 6 ,二者差异有高度显著性(P<0 .0 0 1)。随上颌窦鳞癌分化程度的降低,PCNA指数增加,不同分化间PCNA指数差异有显著性(P <0 .0 5 )。结论:检测上颌窦鳞癌组织中p2 7蛋白和PCNA的表达能够快速、准确地反映肿瘤细胞的增殖状态和评价预后,对判定上颌窦鳞癌的恶性程度及指导治疗有一定的意义。     

增殖细胞核抗原在脑膜瘤中的表达及其临床意义

目的　探讨增殖细胞核抗原 (PCNA)在脑膜瘤中的表达及临床意义。方法　随机选取 43例脑膜瘤标本 ,常规固定 ,石蜡包埋切片。采用LSAB法进行免疫组化染色 ,比较恶性组与良性组及非典型增生组之间同病理级别组之间、初发组与复发组之间PCNA标记指数的差异。结果　 43例脑膜瘤均有不同程度的PCNA阳性细胞表达。良性组、非典型组和恶性组的标记指数分别为 (8.2± 5 .4) %、(15 .6± 9.8) %和 (2 7.6± 10 .6 ) % ,3组间有显著性差异(P <0 .0 5 )。初发组与复发组的标记指数分别为 (15 .2± 5 .8) %和 (2 1.4± 7.6 ) % ,有显著性差异 (P <0 .0 5 )。结论　PCNA在脑膜瘤中的表达与肿瘤的恶性程度有关 ,其高表达提示复发的可能性大 ,预后不良。     

桥本病伴结节样变的PCNA表达

目的 :探讨桥本病 (HD)结节样变的PCNA表达和临床意义。方法 :对 1999年 1月～ 2 0 0 2年 3月本院手术治疗的 2 6例桥本病进行回顾性分析 ,并取正常甲状腺组织 10例作对照组 ,应用SP免疫组化法测定标本的PCNA标记指数 ,分析PCNA表达与临床治疗的关系。结果 :桥本病结节样变标本PCNA标记指数 (PI)为 (5 3.6±12 .5 ) %,与结节样变旁组织 (13.5 0± 5 .48) %和正常对照 (7.2 0± 2 .6 1) %比较P均 <0 .0 1,差异有统计学意义。结论 :桥本病伴结节样变者局部细胞增殖加速 ,有一定癌变倾向 ,应行手术切除治疗为妥。     

鼻内翻性乳头状瘤增殖活性及基底膜抗原的表达及意义

目的　检测鼻内翻性乳头状瘤组织中增殖活性指标Ki 6 7抗原、基底膜层粘连蛋白 (Laminin ,LN)的表达 ;寻找能较好表达鼻内翻性乳头状瘤增殖活性及浸润性生长、癌变的生物学指标。方法　应用免疫组织化学SP方法检测 2 6例鼻内翻性乳头状瘤、14例鼻息肉及 11例鼻腔鳞状细胞癌组织中Ki 6 7抗原、层粘连蛋白的表达 ,并分别计数Ki 6 7阳性细胞数占细胞总数的百分比作为Ki 6 7标记指数 (Ki 6 7labelingindex ,Ki 6 7 LI)。层粘连蛋白的免疫组织化学染色以基底膜线性染色完整性分为 3级 ,分别进行观察。所有数据进行统计学处理 ,以P <0 .0 5作为有统计学意义。结果　鼻息肉、鼻内翻性乳头状瘤及鼻腔鳞癌组织中Ki 6 7标记指数分别为 :2 .2 1± 1.96 ;6 .71± 5 .39;和 11.12± 2 .6 3。统计分析表明差异有显著性意义 (P <0 .0 0 1)。基底膜层粘连蛋白的表达在三者之间差异也有显著性意义 (P <0 .0 1)。结论　Ki 6 7标记指数与细胞分化程度有很好的一致性 ,可作为独立指标反映鼻内翻性乳头状瘤的增殖活性 ,基底膜层粘连蛋白的表达可作为鼻内翻性乳头状瘤浸润性生长、癌变的生物学标志。     

P57Kip2和PCNA在乳癌中的表达及其与预后关系

①目的　探讨有丝分裂抑制因子 (P5 7Kip2 )、增殖细胞核抗原 (PCNA)蛋白表达与乳癌预后的关系。②方法　以免疫组化S P法检测 138例乳癌组织P5 7Kip2 和PCNA蛋白的表达水平。③结果　在 138例乳癌组织中P5 7Kip2 蛋白阳性 5 5例 (39.86 % ) ,其中低表达 39例 (70 .91% ) ,高表达 16例 (2 9.0 9% )。PCNA低指数表达 6 3例 (45 .6 5 % ) ,PCNA高指数表达 75例 (5 4 .35 % )。P5 7Kip2 蛋白的表达与乳癌组织腺管形成、细胞核多形性、核分裂象计数和组织学分级呈负相关 (χ2 =5 .11～ 11.0 1,P <0 .0 1) ;单因素预后分析显示P5 7Kip2 蛋白高表达组生存期长于低表达组 (χ2 =6 .93,P <0 .0 1) ,PCNA高指数表达组生存期短于低指数表达组 (χ2 =5 .13,P <0 .0 5 ) ;P5 7Kip2 阳性并PCNA低指数表达组、P5 7Kip2 阳性并PCNA高指数表达组、P5 7Kip2 阴性并PCNA低指数表达组和P5 7Kip2 阴性并PCNA高指数表达组生存期依次缩短 (χ2 =7.32 ,P <0 .0 1)。④结论　P5 7Kip2 和PCNA的联合检测有利于更准确地判断细胞增殖活性和预后 ;P5 7Kip2 在乳癌中的不同表达水平可能与不同的调控方向有关。     

舌乳头状瘤及鳞状细胞癌组织的PCNA及AgNOR表达

目的：观察增殖细胞核抗原（PCNA）及核仁组成区嗜银蛋白（AgNOR）在舌良恶性肿瘤中的表达及数量变化。方法；运用免疫组化ABC法及核仁组成区银染色技术检测36例人舌鳞状细胞癌、14例舌乳头状瘤中PCNA阳性指数和AgNOR值的变化。结果：PCNA阳性指数分别为乳头状瘤7．15±1．32，舌鳞癌24．28±2．47，鳞癌Ⅰ级19．45±15．88，鳞癌Ⅱ级22．5±18．79，鳞癌Ⅲ级65．3±17．39，舌鳞癌组与舌乳头状瘤组间有非常显著差异（P＜0．01）、鳞癌Ⅲ级与鳞癌Ⅰ级、鳞癌Ⅱ级间有显著差异（P＜0．05）及非常显著差异（P＜0．01）。AgNOR值分别为舌乳头状瘤2．16±0．33，舌鳞癌4．76±1．59，两者有非常显著差异（P＜0．01）。鳞癌Ⅰ级、Ⅱ级、Ⅲ级AgNOR值分别为4．61±1．76，4．75±0．94，4．93±1．70，3组间无显著差异。结论：PCNA及AgNOR阳性表达与肿瘤细胞的增殖活性有关，可用以辅助鉴别诊断良恶性病变。前者还可作为评估肿瘤恶性程度的一项参考指标。     

肥大细胞与皮肤基底细胞癌PCNA表达的研究

目的 :探讨肥大细胞在人皮肤基底细胞癌中的意义及对PCNA表达的影响 .方法 :分别采用免疫组化及改良甲苯胺蓝染色观察 2 4例皮肤基底细胞癌PCNA表达 ,瘤巢间质肥大细胞数及两者相关性 .结果 :发现本组病例皮肤基底细胞癌PCNA增殖指数增高 ,瘤巢间质内肥大细胞均呈脱颗粒状态 ,其密度占 15 80±7 2 3,与正常对照组相比差异有显著性意义 (P <0 0 1) .相关分析表明瘤巢间质内肥大细胞数与肿瘤PCNA表达无相关性 (P >0 0 5 ) .结论 :皮肤基底细胞癌组织内肥大细胞增多可以是机体局部抗肿瘤反应形式 ,但其确切机制不清楚 ,且与瘤细胞PCNA表达高低无关     

胃黏膜良恶性病变中增殖和凋亡的关系研究

目的 :探讨细胞凋亡和增殖在胃癌发生发展过程中的作用。方法 :对 115例胃癌及癌前病变患者和正常人采用原位末端标记法 (TUNEL)及免疫组化技术检测胃黏膜上皮细胞凋亡和增殖。结果 :正常人、浅表性胃炎、萎缩性胃炎伴肠上皮化生、不典型增生、胃癌患者的细胞凋亡指数分别为 (4 .6 2± 1.87) %、(10 .2 1± 2 .4 9) %、(2 4 .6 3± 35 .19) %、(19.32± 4 .0 7) %、(19.86± 4 .6 1) %。PCNA指数分别为 (3.9l± 1.0 4 ) %、(13.5 2± 4 .71) %、(2 0 ,2 2±4 .83) %、(39.81± 6 .35 ) %、(5 4 .77± 10 .8) %。胃黏膜癌变过程中 ,起初三个阶段细胞凋亡和PCNA同时增加 ,而至萎缩性胃炎伴肠化生 ,细胞凋亡指数显著减少 ,PCNA指数显著增加。结论 :在胃癌演变过程中细胞凋亡起重要作用 ,PCNA是反映胃癌细胞增殖活性的一项重要指标     

沙利度胺对小鼠肝癌血管形成的影响

目的 :研究沙利度胺对小鼠肝癌血管形成的影响 ,并初步探讨其抑瘤机制。方法 :小鼠肝癌 HAC细胞接种于昆明种小鼠前肢腋下皮下 ,建立小鼠肝癌皮下移植瘤模型 ,随机分为阴性对照组 (蒸馏水灌胃 )、阳性对照组 (接种后第 1、3、5天 ip环磷酰胺 10 0 m g/ kg)、沙利度胺 A组和沙利度胺 B组 (分别于接种后第 1、5天灌胃 5 0 m g· kg- 1 · d- 1 沙利度胺 0 .5 m l)。采用Envision System免疫组织化学方法 ,检测肿瘤组织微血管密度 (MVD)、增殖细胞核抗原 (PCNA)和血管内皮细胞生长因子(VEGF)。 结果 :阴性对照组、阳性对照组 MVD分别为 (16 .8± 5 .2 )、(11.5± 2 .8) ,PCNA指数分别为 (5 7.1± 6 .3) %、(6 8.2± 4.1) % ,VEGF阳性率分别为 (11.5± 4.3) %、(5 .4± 3.9) %。沙利度胺 A组、B组 MVD分别为 (2 .9± 1.3)、(10 .5±2 .7) ,PCNA指数分别为 (5 1.6± 3.3) %、(5 5 .7± 18.1) % ,VEGF阳性率分别为 (0 .8± 0 .2 ) %、(2 .2± 1.1) %。沙利度胺组MVD、VEGF阳性率均低于阴性对照组 ,差异显著 (P<0 .0 5 )。阳性对照组、沙利度胺 A组、B组抑瘤率分别为 83.8%、5 0 .1%、41.5 %。结论 :沙利度胺通过抑制小鼠肝癌的血管生成 ,抑制肿瘤生长 ,联合使用其他药物 ,可能在实体瘤的治疗中具有良好的应用     

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.     

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.