大肠癌细胞DNA含量与形态学定量分析

目的探讨大肠癌的生物学行为及其临床诊治价值.方法应用流式细胞仪(flow cytometry,FCM)和扫描显微分光光度计(microspectrophotometry,MSP)对88例大肠癌和腺瘤以及83例正常结肠粘膜的细胞核进行DNA含量测定、倍体分析和细胞周期研究,所获数据与临床病理指标和血清癌胚抗原(carcinoembryonic antigen,CEA)作比较.结果正常结肠粘膜的细胞核DNA含量均为二倍体,DNA指数(DI)为1.00±0.10,MSP直方图为I型.大肠腺瘤的细胞核DNA含量明显低于大肠癌组(P＜0.01),而与正常结肠粘膜相比无显著差异(P＞0.05),其细胞核面积与大肠癌组无显著差异(P＞0.05).83例大肠癌细胞中异倍体检出率为68.68%,DI＞1.10或＜0.90,癌细胞核DNA含量与细胞核面积显著相关(r＝0.71,P＜0.01).随着Dukes分期的升高,异倍体检出率上升,二者呈正相关.细胞周期分析表明二倍体癌DNA合成期分数(SPF)介于正常结肠粘膜和异倍体癌之间.异倍体癌病人的术前CEA水平显著高于二倍体癌(P＜0.05).FCM的DI值与MSP的模态均值(MV)有很好的相关性(r＝0.73,P＜0.01),异倍体癌符合率达95%,然而二倍体癌符合率仅50%.结论DNA含量的检测有利于大肠癌的早期发现;倍体分析与CEA在评估大肠癌预后是一致的;FCM与MSP的联合应用为大肠癌的早期诊断、预后评估及制定正确的治疗方案提供了一条新的途径.     

大肠腺瘤—癌序列细胞凋亡及其调控基因p53的研究

目的研究细胞凋亡及其调控基因p53在大肠腺瘤—癌序列中的变化,以探讨其在大肠癌发生中的作用。方法利用DNA断裂原位标记法(缺口末端标记技术,TUNEL法)和免疫组织化学方法(SP法),对60例大肠腺瘤(腺瘤组)和60例大肠腺癌(腺癌组)的活检组织分别进行细胞凋亡和p53蛋白表达的检测,并采用30例正常大肠粘膜作对照组。结果对照组细胞凋亡指数(AI)显著高于腺瘤各组和腺癌组(P<0.01);腺瘤各组均高于腺癌组(P<0.01)。p53在三组中的表达差异有高度显著性(P<0.01)。在腺瘤和腺癌组中,p53阴性者的AI均高于其阳性者(P<0.05或0.01)。结论从正常大肠粘膜到腺瘤、腺癌的过程中细胞凋亡逐渐减少,表明细胞凋亡受抑制可能在大肠癌的发生发展过程中起着重要的作用。p53蛋白的表达在从正常大肠粘膜到腺瘤、腺癌的过程中逐渐增多,提示p53基因突变可能在大肠腺瘤转化为腺癌的过程中起促进作用。     

大肠癌细胞DNA含量与形态学定量分析

目的探讨大肠癌的生物学行为及其临床诊治价值.方法应用流式细胞仪(flow cytometry,FCM)和扫描显微分光光度计(microspectrophotometry,MSP)对88例大肠癌和腺瘤以及83例正常结肠粘膜的细胞核进行DNA含量测定、倍体分析和细胞周期研究,所获数据与临床病理指标和血清癌胚抗原(carcinoembryonic antigen,CEA)作比较.结果正常结肠粘膜的细胞核DNA含量均为二倍体,DNA指数(DI)为1.00±0.10,MSP直方图为I型.大肠腺瘤的细胞核DNA含量明显低于大肠癌组(P＜0.01),而与正常结肠粘膜相比无显著差异(P＞0.05),其细胞核面积与大肠癌组无显著差异(P＞0.05).83例大肠癌细胞中异倍体检出率为68.68%,DI＞1.10或＜0.90,癌细胞核DNA含量与细胞核面积显著相关(r＝0.71,P＜0.01).随着Dukes分期的升高,异倍体检出率上升,二者呈正相关.细胞周期分析表明二倍体癌DNA合成期分数(SPF)介于正常结肠粘膜和异倍体癌之间.异倍体癌病人的术前CEA水平显著高于二倍体癌(P＜0.05).FCM的DI值与MSP的模态均值(MV)有很好的相关性(r＝0.73,P＜0.01),异倍体癌符合率达95%,然而二倍体癌符合率仅50%.结论DNA含量的检测有利于大肠癌的早期发现;倍体分析与CEA在评估大肠癌预后是一致的;FCM与MSP的联合应用为大肠癌的早期诊断、预后评估及制定正确的治疗方案提供了一条新的途径.     

大肠癌组织中HPV16、18E6,ras癌基因蛋白表达的研究

为探讨人乳头瘤病毒 16、18型感染与 p2 1ras癌基因协同在大肠癌发生机理中的作用 ,采用SP免疫组化技术 ,检测30例大肠腺瘤、10例腺瘤恶变、5 3例大肠腺癌和 30例正常大肠粘膜组织中HPV16、18E6 ,p2 1ras蛋白并分析其相互关系。结果显示 :腺瘤、腺瘤恶变和腺癌组中E6 ,p2 1ras的阳性表达分别为 36 .7% (11/ 30 )、40 .0 % (12 / 30 ) ,6 0 .0 % (6 / 10 )、70 .0 % (7/ 10 )和 5 4.7% (2 9/ 5 3)、71.7% (38/ 5 3) ,而正常组均呈阴性表达。在腺瘤组中 ,随着上皮不典型性增生程度的加重 ,E6、p2 1ras的阳性表达呈逐渐上升的趋势。腺瘤伴不典型性增生Ⅱ～Ⅲ级组中E6、p2 1ras阳性表达显著高于腺瘤伴不典型性增生Ⅰ级 (P <0 .0 5 )。此外 ,腺瘤、腺瘤恶变及腺癌组中E6与 p2 1ras的双阳性表达差异均有显著性 (P <0 .0 5 )。在有淋巴结转移组中 ,E6的阳性表达和E6与p2 1ras的双阳性表达均显著高于无淋巴结转移组 (P <0 .0 5 )。提示高危HPV16、18感染并在活化的ras癌基因的协同参与下 ,与本地区大肠癌的发生、发展过程密切相关 ,在腺瘤中同时检测E6、p2 1ras蛋白有可能成为大肠癌早期诊断的免疫学指标之一。     

大肠癌及其癌前病变DNA含量及CEA原位表达的意义

应用显微分光光度计法测定了大肠癌及其癌前病变DNA含量,同时用PAP免疫组化法检测了组织CEA原位表达情况。结果显示,大肠腺瘤及腺癌DNA含量明显高于正常肠粘膜及非肿瘤性息肉,分别有33.33％(10/30)和69.70％(23/33)的异倍体发现率,正常肠粘膜CEA多为弱阳性或阴性,均为AB型(Apical bordcr),而腺癌CEA多表达为阳性或强阳性,阳性率为85.11％(40/47),除AB型外,40％(16/40)为CM型(Cytoplasm and membrane)。DNA含量、CEA表达还与癌的大体生长类型,Dukes分期、分化程度等临床病理因素有关。     

子宫内膜癌瘤组织DNA定量检测的临床意义

目的:探讨流式细胞术(FCM)定量检测肿瘤组织DNA含量对子宫内膜癌的临床价值。方法:采用FCM技术对30例子宫内膜癌(FC)患者术中肿瘤组织中DNA含量进行检测,Mcycle分析软件进行DNA倍体分析,计算DNA相对含量(DI值)、S期细胞比率(SPF)及增殖指数(PI),并与正常组织相比。结果:17例EC患者发现存在DNA异倍体,异倍体率56.7%;22例SPF异常增高,异常率73.3%;50岁以上者异倍体率、SPF及PI指数均明显增高(P<0.05);肿瘤组织中DNA异倍体检出率与SPF明显升高,显著高于对照组(P<0.05),PI指数略有上升,但差异无显著性(P>0.05);随病理分级级数与临床期别的增高,异倍体率、SPF及PI指数呈增高的趋势;复发者异倍体率、SPF及PI明显高于未复发者(P<0.05)。结论:FCM技术定量检测肿瘤组织DNA含量的变化,并与临床病理诊断有机结合,将为子宫内膜腺癌的诊断、治疗和预后提供全面客观的指标。     

Survivin基因和增殖细胞核抗原在大肠癌组织中表达及其意义

目的:探讨Survivin和增殖细胞核抗原PCNA在大肠癌组织中的表达和意义。方法:采用免疫组织化学方法检测正常大肠粘膜、腺瘤和腺癌组织中Survivin和PCNA表达。结果;Survivin在正常大肠粘膜无表达,在大肠腺癌和腺瘤组织中表达的阳性率分别为70.9%和62.5%;大肠癌组和大肠腺瘤组OD值显著高于正常大肠粘膜组;大肠癌组中PCNA-LI为(50.2±13.2)%,显著高于正常大肠粘膜组(12.6±3.1)%和大肠腺瘤组(33.2±7.9)%;大肠癌组中Survivin阳性的PCNA-LI为(61.3±9.3)%,显著高于Survivin阴性的PCNA-LI(36.4±6.6)%。结论:Survivin和PCNA的高表达在大肠癌的发生、发展中起重要作用,PCNA可反映大肠癌的增殖状况,两者可作为判断其预后的参考指标。     

大肠肿瘤中p53、bcl-2及PCNA表达的关系

目的　研究 p5 3、bcl 2及PCNA在大肠肿瘤发生发展中的作用及相互关系。方法　应用免疫组化S P法分别检测大肠正常粘膜、增生性息肉、腺瘤及腺癌中p5 3、bcl 2及PCNA蛋白表达。结果　正常粘膜及增生性息肉中 p5 3表达阴性 ,腺瘤癌变及腺癌组 p5 3蛋白表达率明显高于腺瘤组(P <0 0 5 )。腺瘤和腺癌中bcl 2表达差异显著 (P <0 0 5 )。高分化腺癌bcl 2表达率高于差分化腺癌 (P <0 0 1)。bcl 2与p5 3表达在腺瘤和腺癌中呈负相关。PCNA强阳性表达在大肠腺瘤 -癌序列中逐渐增高 ,它与腺瘤 p5 3表达、不典型增生程度及腺癌组织分化有关 (P <0 0 5 )。结论　p5 3基因突变主要涉及到腺瘤向腺癌的转变过程 ,大肠癌的发生与腺瘤中凋亡相对抑制和增殖活性增高有关。综合分析 p5 3、bcl 2和PCNA表达有助于大肠癌的早期诊断和预后判断     

大肠腺癌组织中细胞核因子κB的表达及意义

目的：探讨细胞核因子κB（NF－κB）表达与大肠腺癌生物学行为的关系。方法：应用免疫组织化学方法检测NF－κB p65在52例大肠腺癌、21例大肠腺瘤及10例正常大肠粘膜中的表达情况。结果：52例大肠癌中34例NF－κB p65阳性，阳性产物主要定位于肿瘤细胞胞浆。21例大肠腺瘤中10例NF－κB p65阳性，10例正常大肠组织中NF－κB p65无1例阳性表达。NF－κB p65的表达与患的性别、大肠癌组织学分型、淋巴结转移、Dukes'分期无关。结论：NF－κB p65是大肠癌相关的一种癌蛋白；NF－κB p65蛋白表达可能是大肠癌形成的一个早期事件，它可做为大肠癌的一个新的潜在的诊断标志物。     

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.