MMP-2,TIMP-2在胰腺癌组织的表达及临床意义

目的: 研究MMP-2, TIMP-2在胰腺癌组织中的表达,探讨其与胰腺癌的侵袭转移及预后的关系. 方法: 应用S-P免疫组化法,检测32例胰腺癌,10例正常胰腺组织中MMP-2, TIMP-2的表达,及其与肿瘤临床病理参数和预后的关系.采用相关统计学方法进行分析,生存分析采用Kaplan-meier方法. 结果: 32例胰腺癌组织中MMP-2, TIMP-2的表达率分别为56.3%, 75.0%;10例正常胰腺组织中MMP-2, TIMP-2的表达率分别为20.0%, 10.0%,MMP-2, TIMP-2在两种组织间的表达有显著性差异(P<0.05); MMP-2, TIMP-2的表达与患者年龄、性别、肿瘤组织学分级和组织学类型均无显著性差异. MMP-2和TIMP-2在胰腺癌患者TNM分期中Ⅰ期、Ⅱ期、Ⅲ期的表达分别为20.0%, 35.7%, 92.3%和40.0%, 64.3%, 100%,Ⅰ期与Ⅲ期、Ⅱ期与Ⅲ期之间有显著性差异,并与淋巴结转移与否之间有显著性差异(P<0.05); MMP-2, TIMP-2的表达与否的生存时间有显著性差异(P<0.01); 胰腺癌组织中MMP-2, TIMP-2的表达无相关性. 结论: 胰腺癌中MMP-2, TIMP-2的表达与肿瘤进展有关,可被视为一种反映胰腺癌生物侵袭性的标志物;并可用于患者预后的评估.     

乙酰肝素酶、MMP-9在胰腺癌侵袭转移中的表达相关性及临床意义

目的：检测乙酰肝素酶（heparanase,HPA）和基质金属蛋白酶-9（matrix metalloproteinase-9,MMP-9）在胰腺癌、慢性胰腺炎、正常胰腺组织中的表达及相互关系,分析其与临床预后及浸润转移的关系。方法：应用免疫组化SP法检测92例胰腺癌、24例慢性胰腺炎和10例正常胰腺组织中HPA、MMP-9的表达水平,分析两者的表达与临床病理指标的关系,建立Pearson等级相关分析。结果：HPA在胰腺癌中的表达明显高于慢性胰腺炎和正常胰腺组织（77.2%、25.0%、0,P〈0.05）,HPA阳性表达与周围组织浸润、淋巴结转移呈正相关（P〈0.05）,与性别、年龄、组织学分级及1年生存率呈负相关（P〈0.05）;胰腺癌组织中MMP-9表达明显高于慢性胰腺炎和正常胰腺组织（70.7%、20.8%、20.0%,P〈0.05）,且MMP-9阳性表达与周围组织浸润、远处转移呈正相关（P〈0.05）,与性别、年龄、组织学分级及1年生存率呈负相关（P〈0.05）。HPA与MMP-9有较高的共同阳性表达率（P=0.018）。HPA和MMP-9表达呈正相关（r=0.729,P〈0.05）,其共同表达率与肿瘤对周围脏器浸润和淋巴结转移有相关性（P〈0.05）。多因素分析显示,HPA和MMP-9均非影响预后的独立因素。结论：HPA、MMP-9在胰腺癌组织中的表达可能与胰腺癌浸润、转移相关,可作为新的胰腺癌标志物用于联合检测,具有重要的临床意义,且MMP-9可能上调HPA表达水平,促进HPA介导的肿瘤浸润和转移。     

基质金属蛋白酶7 mRNA在胰腺癌组织中表达的临床意义

目的探讨胰腺癌基质金属蛋白酶-7（（matrix metalloproteinase-7,MMP-7）在胰腺癌组织中表达及临床病理意义。方法提取35例人胰腺癌及癌旁正常组织中总mRNA,采用实时荧光定量PCR法检测其中MMP-7mRNA表达情况;并分析其表达与患者年龄、肿瘤大小、淋巴结转移、肿瘤分化程度和TNM分期相关性。结果以2^-ΔΔCt≥2为阳性标准,MMP-7在胰腺癌组织中阳性表达率为82.9%（29/35）,而癌旁组织未见MMP-7mRNA表达,统计学差异显著（P〈0.001）。MMP-7mRNA过表达与肿瘤大小、淋巴结转移、TNM分期密切相关（P〈0.01）,而与患者年龄和肿瘤分化程度无关（P〉0.05）。结论MMP-7基因表达与胰腺癌进展密切相关,可能是反映胰腺侵袭转移的重要指标之一。     

OPN、MMP-9在胰腺癌发展及侵袭转移中的意义

目的探索OPN、MMP-9在胰腺癌组织中的表达情况。方法采用免疫组织化学方法检测46例胰腺癌患者手术切除的正常胰腺组织和胰腺癌组织中的OPN、MMP-9的表达情况,并对不同肿瘤分化程度、临床分期及淋巴结转移的标本作对比分析。结果胰腺癌与正常组织之间OPN、MMP-9阳性表达率均有显著性差异（P〈0.05）,正常组织显著高于胰腺癌组织;胰腺癌与正常组织之间,两种大分子蛋白的表达与胰腺癌的组织分化程度、临床分期密切相关（P〈0.05）。有淋巴结转移的OPN的表达与无淋巴结转移的有显著性差异（P〈0.05）。结论 OPN、MMP-9两种大分子蛋白与胰腺癌的发生、发展密切相关。     

EMT标记蛋白在胰腺癌组织中的表达和意义

目的探索EMT相关蛋白E-cadherin,Vimentin,α-SMA在胰腺癌组织中的表达情况。方法采用免疫组织化学方法检测46例胰腺癌患者手术切除的正常胰腺组织和胰腺癌组织中的E-cadherin,Vimen-tin,α-SMA的表达情况,并对不同病理分级和临床分期的标本作对比分析。结果胰腺癌与正常组织之间E-cadherin阳性表达率有显著性差异（P〈0.05）,正常组织显著高于胰腺癌组织;胰腺癌与正常组织之间Vim-entin,a-SMA阳性表达率有显著性差异（P〈0.05）,胰腺癌组织显著高于正常组织。三种蛋白的表达与胰腺癌的组织分化程度、临床分期密切相关（P〈0.05）。结论 EMT现象是人体内胰腺腺癌恶性进展的重要原因。这种细胞属性的变化现象与肿瘤的侵袭和预后密切相关。     

胰腺癌微血管密度和p14蛋白表达及其发生、发展的相关实验研究

目的：探讨胰腺癌组织微血管密度、p14^ARF表达对胰腺癌发生、发展的影响。方法：用免疫组织化学Envision改良法检测10例正常胰腺组织、42例胰腺癌组织中p14^ARF蛋白的表达；以Ⅶ因子相关抗原(FVⅢ—RAg)标记血管内皮细胞，采用ABC免疫组化法检测10例正常胰腺组织、42例胰腺癌组织中微血管密度。结果：正常胰腺组织中p14^ARF的表达率为90％，胰腺癌组织中为35．7％(P＜0．01)；胰腺癌组织的平均微血管密度与正常对照组之间差异有显著性(P＜0．01)；胰腺癌临床Ⅲ、Ⅳ期的平均微血管密度明显高于Ⅰ、Ⅱ期(P＜0．05)：淋巴结有转移的胰腺癌平均测血管密度明显高于淋巴结无转移组(P＜0．05)；胰腺癌组织中p14^ARF蛋白阳性表达的平均微血管密度低于p14^ARF蛋白阴性表达的胰腺癌组织，差异有显著性(P＜0．05)，胰腺癌组织的平均微血管密度与组织学分级、癌的浸润范围及肿块大小无关(P＞0．05)。结论：微血管密度、p14^ARF与胰腺癌的发生、发展存在着密切关系。     

细胞间隙连接蛋白43在胰腺癌组织表达及其意义

①目的探讨细胞间隙连接蛋白43（Cx43）在胰腺癌及正常胰腺组织中的表达、定位及其在胰腺癌发生和发展中的意义。②方法应用免疫组织化学方法检测47例胰腺癌、25例淋巴结转移灶和10例正常胰腺组织中Cx43蛋白的表达和定位。③结果Cx43蛋白在10例正常成人胰腺导管及腺泡细胞均呈阳性表达,47例胰腺癌组织Cx43表达阳性率为44．7％,而25例淋巴结转移灶中Cx43表达阳性率为20．0％。Cx43蛋白在正常胰腺、胰腺癌和淋巴结转移灶中的阳性表达率差异具有显著性（x^2=18．59,P〈0．01）。Cx43蛋白阳性表达率在组织学Ⅰ级的胰腺癌明显高于组织学Ⅲ级（P=0．047）;无周围脏器浸润的胰腺癌组织中Cx43蛋白阳性表达率为70．6％,有浸润者为30．0％,二者间差异有显著性（x^2=7．23,P〈0．01）;无淋巴结转移的胰腺癌组织Cx43阳性表达率（63．6％）高于有转移者（28．0％）,差异有显著性（x^2=6．01,P〈0．01）。Cx43蛋白阳性表达率与胰腺癌的大小和1年生存率无关（x^2=2．21、2．07,P〉0．05）。④结论Cx43蛋自在胰腺癌中的表达下调和定位异常可能是胰腺癌发生的重要环节。Cx43蛋白表达水平可以作为判断胰腺癌分化程度、浸润转移能力的重要指标。     

MMP-9在胰腺癌组织中的表达及意义

目的探讨MMP-9在胰腺癌组织中的表达及其与临床病理因素的关系。方法采用免疫组织化学技术检测73例胰腺癌、37例胰腺正常组织中MMP-9蛋白的表达,并对其与临床病理因素的关系进行相关性分析。结果胰腺癌与正常胰腺组织MMP-9蛋白表达阳性率差异有统计学意义,分别为65．75％和10．81％（P〈0．05）。胰腺癌组中,中高分化病例MMP-9蛋白表达阳性率为45．45％,低分化病例为74．51％,二者比较,差异有统计学意义（P〈0．05）;A＋B期病例MMP-9蛋白表达阳性率为43．59％,明显低于C＋D期（91．18％）（P〈0．05）;≤60岁病例MMP-9蛋白表达阳性率为59．52％,〉60岁病例阳性率为74．19％,二者比较差异无统计学意义（P〉0．05）。结论MMP-9蛋白的表达在胰腺癌组织中明显增高,且与其组织分化、临床分期有关,与患者年龄大小无关。MMP-9蛋白表达与胰腺癌的发生发展密切相关,在胰腺癌的诊断方面可能是比较好的协助诊断分型、判断预后因子。     

食管鳞状细胞癌组织MMP-2、9与TIMP-1表达及意义

目的 探讨食管鳞状细胞癌组织中基质金属蛋白酶2、9（MMP-2、MMP-9）及其组织抑制因子（TIMP-1）的表达,并分析其与临床病理因素的关系。方法 应用免疫组织化学方法,检测55例食管鳞状细胞癌组织中MMP-2、MMP-9、TIMP-1的表达。同时,取10例癌周正常食管黏膜作为对照。结果 MMP-2、MMP-9、TIMP-1在正常黏膜上皮不表达;在食管鳞状细胞癌中阳性表达率分别为21．8％、81.8％和78．2％;不同组织学分级的食管癌组织中MMP-2、MMP-9及TIMP-1蛋白阳性表达率无显著性差异（Х^2=0.68～2．76,P〉0．05）;随着肿瘤浸润程度的加深,MMP-9阳性表达率明显升高,差异有显著性（Х^2=16．55,P〈0．05）;有淋巴结转移者MMP-9阳性表达率明显高于无淋巴结转移者,差异有显著性（Х^2=10．96,P〈0．05）,且临床病理分期为Ⅲ期者明显高于0～Ⅰ及Ⅱ期（Х^2=4．89、9．46,P〈0．05）。结论 MMP-2、MMP-9、TIMP-1的表达与肿瘤分化程度无关．MMP-9表达与肿瘤浸润深度、淋巴结转移及临床分期有关。     

OPN、MMP-9在胰腺癌及其侵袭转移中的表达

目的探讨骨桥蛋白（osteopontin,OPN）和基质金属蛋白酶-9（Matrix Metalloproteinase-9,MMP-9）在人胰腺癌组织中的表达情况,分析其与临床病理特征的关系。方法应用免疫组织化学SP方法检测OPN和MMP-9在50例胰腺癌、30例癌旁组织中的表达。结果50例胰腺癌标本中OPN和MMP-9的阳性表达率分别为64.0%（32/50）、62.0%（31/50）,30例胰腺癌癌旁组织中OPN和MMP-9的阳性表达率分别为20.0%（6/30）、26.6%（8/30）,胰腺癌组织中OPN和MMP-9表达明显高于胰腺癌癌旁组织（P〈0.01）。OPN和MMP-9的表达均与肿瘤的分化程度,TNM分期及淋巴结转移有关（P〈0.05）,与肿瘤直径、性别和年龄无明显关系。OPN和MMP-9的表达有显著相关性（r=0.53,P〈0.01）。结论OPN和MMP-9在胰腺癌组织中均呈高表达且二者表达有协同作用,与胰腺癌侵袭转移密切相关,能够作为判断肿瘤的恶性程度及预后的重要参考指标。     

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.