GRIM-19及其靶基因产物STAT3与肺癌相关性的研究

目的观察干扰素/维甲酸联合应用诱导细胞凋亡相关的基因(GRIM-19)蛋白及其靶基因产物转录信号转导子与激活子3(STAT3)蛋白在肺癌组织和癌旁组织中的表达,探讨GRIM-19及其靶基因产物STAT3在肺癌发生、发展中的作用。方法用Western blot方法检测37例人肺癌及其癌旁组织中GRIM-19蛋白、STAT3蛋白水平的表达,对两组蛋白的表达与相关临床病理特征进行统计学分析。结果①在肺癌组织中GRIM-19蛋白表达明显低于癌旁组织(P<0.01),而STAT3蛋白表达则高于癌旁组织(P<0.01),且GRIM-19与STAT3在肺癌组织中的表达呈负相关(r=-0.327;P<0.05)。②GRIM-19蛋白表达水平与肺癌临床分期相关(P<0.05),而STAT3蛋白表达水平则与肺癌临床分期(P<0.05)及是否有淋巴结转移相关(P<0.05),两者均与患者性别、年龄、组织分型、吸烟指数之间无关联(P>0.05)。结论GRIM-19和STAT3蛋白在肺癌组织中有表达,并与临床分期相关,提示GRIM-19作为一个新的细胞凋亡促进基因,在肺癌的发生发展过程中可能发挥着重要的作用。     

同源异盒基因BP1在肺癌组织中的表达及临床意义

目的 本研究通过对BP1mRNA在肺癌组织中的表达状况的研究,探讨BP1mRNA在肺癌中的表达水平以及和肺癌的临床关系。方法 采用逆转录聚合酶链反应（RT—PCR）技术,检测46例肺癌病人的癌组织,相应的癌旁组织和正常组织标本中BP1mRNA的表达程度及意义。结果 在46组标本中,肺癌组织中有36例BP1mRNA呈阳性表达（78．26％）,癌旁组织6例呈阳性表达（13．04％）,正常组织中未检出阳性表达。癌组织,癌旁组织和正常组织中BP1mRNA的表达率之间存在显著性差异（P〈0．01）。癌旁组织和正常组织中BP1基因的表达率之间无显著性差异（P〉0、05）。在21例高分化标本中13例呈中高表达．25例低分化标本中22例呈中高表达,两者之间存在显著性差异（P〈0．01）;在20例Ⅰ-Ⅱ期肺癌标本中12例BP1基因呈中高表达,26例Ⅲ-Ⅳ期标本中15例呈中高表达,两者之间无显著性差异（P〉0．05）。BP1基因的表达程度在24例鳞癌中21例呈高表达,在22例腺癌中19例呈高表达,两者之间无显著性差异（P〉0．05）。结论 BP1mRNA在肺癌组织中的表达显著上调;BP1基因的表达可能与肺癌分化程度有关,与病理类型和TNM分期无关。     

Mus81和GEN1基因在肺癌组织中的表达及其临床意义

目的研究肺癌组织中Mus81及GEN1的表达及其临床意义。方法采用反转录-聚合酶链反应（RT—PCR）和Westernblot检测30例肺癌组织及其相应癌旁组织中Mus81及GEN1 mRNA和蛋白的表达情况,分析其临床意义。结果30例肺癌组织中Mus81mRNA和蛋白表达水平低于相应癌旁组织,差异具有统计学意义（t=-3．529,P〈0．05;t=-4．273,P〈0．05）;30例肺癌组织中GEN1 mRNA和蛋白表达水平同癌旁相比无统计学差异（t=-2．006,P〉0．05;t=0．957,P〉0．05）。30例肺癌组织中Mus81表达水平和GEN1表达水平无明显相关性（P〉0．05）。结论肺癌组织中Mus81表达低于癌旁组织,提示Mus81表达下调可能和肺癌的发生相关;GEN1在肺癌组织中的表达水平同癌旁相比无统计学差异,提示GEN1在肿瘤的发生、发展过程中可能不起主要作用;肺癌组织中Mus81的表达水平和GEN1的表达水平无明显相关性。     

非小细胞肺癌Bcl-2及Bax蛋白的表达及其与细胞凋亡和增殖的关系

①目的探讨非小细胞肺癌Bcl-2、Bax蛋白的表达及其与细胞凋亡和增殖的关系。②方法采用SABC免疫组化法检测43例非小细胞肺癌及20例癌旁正常肺组织Bcl-2、Bax蛋白及增殖细胞核抗原（PCNA）表达水平；用TUNEL法检测细胞凋亡情况。③结果肺癌组织Bcl-2蛋白的表达显著高于癌旁肺组织（x^2=4．74，P〈0．05）；肺癌组织Bax蛋白的表达显著低于癌旁肺组织（x^2=5．65，P〈0．05）；肺癌组织中细胞凋亡指数（AI）和增殖指数（MI）均明显高于癌旁正常肺组织（t=8．28、9．62，P〈0．01）；Bcl-2蛋白表达阳性的肺癌组织AI明显低于表达阴性组（t=2．41，P〈0．05）；Bax蛋白表达阳性的肺癌组织AI明显高于表达阴性组（t=2．62，P〈0．05）；Bcl-2、Bax蛋白的表达均与MI无关（t=0．70、0．22，P〉0．05）。④结论Bcl-2蛋白具有抑制肺癌细胞凋亡作用，而Bax蛋白具有促进肺癌细胞凋亡作用，因肺癌组织存在Bcl-2蛋白表达上调，Bax蛋白表达下调，导致细胞增殖和凋亡失衡，在肺癌发生、发展过程中可能具有重要作用。     

胃癌及癌旁组织中细胞周期素D1的表达

目的探讨胃癌及癌旁组织中细胞周期素D1（CyclinDl）的表达水平及其与临床病理分期的关系。方法取术后新鲜的胃癌组织及对应的癌旁组织各37份,采用实时荧光定量RT-PCR及免疫组化方法检测Cyc—linD1的表达,分析其表达差异,并结合其临床病理资料进行综合分析。结果与癌旁组织相比,CyclinDlmRNA在胃癌组织中均呈高表达（P〈0．05）,CyclinDl蛋白在癌组织也呈高表达（P〈0．05）。CyclinDlmRNA与肿瘤的分化及大小有关护〈0．05）。CyclinD1蛋白仅与肿瘤分化程度有关（P〈0．05）。结论CyclinD1可能在肿瘤的发生发展中起重要作用。     

nm23-H1蛋白在食管癌组织中的表达及意义

目的：探讨肿瘤转移抑制基因（nm-23H1）蛋白在不同食管癌组织中表达及与临床的意义。方法：选取收治的60例食管癌患者,取患者手术标本包括食管癌组织、食管癌旁1cm粘膜（癌旁）、食管正常粘膜（切缘）及食管癌区域淋巴结,采用流式细胞仪检测不同组织标本中nm23-H1蛋白表达水平。结果：癌组织与癌旁组织、组织切缘之间nm23-H1蛋白表达比较,差异具有统计学意义（P〈0．05）;nm23-H1蛋白在癌组织与淋巴结表达比较,差异无统计学意义（P〉0．05）;在有、无淋巴结转移两组对应组织间,癌与癌、癌旁与癌旁、淋巴结与淋巴结比较,差异具有统计学意义（P〈0．05）;nm23-H1蛋白在切缘与切缘间表达比较,差异无统计学意义（P〉0．05）。nm23-H1蛋白表达与食管癌组织病理分期有关,呈逐级降低趋势（P〈0．05）。结论：nm23-H1蛋白检测可作为食管癌判断肿瘤淋巴结转移的重要指标,有助于对食管癌患者术后转移的判断。     

GRIM-1蛋白在肺癌组织中的表达及其临床意义

目的 研究干扰素/维甲酸联合应用诱导细胞凋亡相关的基因(GRIM-1)蛋白在肺癌和癌旁组织中的表达和定位,探讨其临床意义.方法 应用免疫组化法和Western印迹法检测33例肺癌组织及相应癌旁组织中GRIM-1蛋白的表达情况,并分析其表达水平与临床病例参数的联系.结果 GRIM-1蛋白在肺癌组织和癌旁组织中均有不同程度的表达,表达主要定位于细胞浆中.GRIM-1蛋白在癌旁组织中阳性率为84.85%(28/33),而在肺癌组织中阳性率为63.64%(21/33),两者之间的差异有显著性(P＜0.01).GRIM-1在肺癌组织中阳性表达与临床病理分期之间有关(P<0.01),Ⅰ～Ⅱ期GRIM-1阳性表达率显著高于Ⅲ～Ⅳ期中的表达,而与患者性别、年龄、吸烟指数、组织分型均无关(P>0.05).GRIM-1蛋白在肺癌组织中的表达量(0.89±0.09)低于癌旁组织(1.58±0.18),两组间差异有显著性(P<0.01).结论 肺癌组织中GRIM-1蛋白表达随肿瘤临床分期升高而下降,提示GRIM-1作为凋亡促进基因,在肺癌的发生发展过程中可能起着较为重要的作用.     

核基质结合区结合蛋白质1在乳腺癌中的表达及其临床意义

目的探讨核基质结合区结合蛋白质1（SATB1）在乳腺癌中的表达及其与临床病理特征的关系。方法用免疫组织化学sP法和qRT—PCR技术检测39例乳腺癌组织、19例对应癌旁组织、13例乳腺良性病变组织中SATB1蛋白及其mRNA的表达情况,分析SATB1及其mRNA表达与临床病理特征的关系。结果乳腺癌组织中SATB1阳性表达率为71．8％,明显高于乳腺良性病变的38．5％和癌旁组织的15．8％（P〈0．01）;SATB1mRNA在乳腺癌组织中的表达量分别为乳腺良性病变组织和癌旁乳腺组织的4．5倍;SATB1及mRNA在乳腺良性病变组织和癌旁乳腺组织之间的差异均无统计学意义（P〉0．05）。SATB1及其mRNA在肿瘤体积大、腋窝淋巴结转移数多、分期晚的乳腺癌组织中表达水平显著增高（P〈0．05）;而在不同年龄,不同组织学分级,不同人表皮生长因子受体-2（Herb-2）、雌激素受体（ER）、孕激素受体（PR）表达的乳腺癌组织中,SATB1及其mRNA表达的差异无统计学意义（P〉0．05）。SATB1与SATB1mRNA表达呈正相关（P〈0．01）。结论SATB1及SATB1mRNA表达水平增高与乳腺癌的发生、侵袭和转移密切相关,有望成为判断乳腺癌预后的一个重要指标。     

食管鳞癌组织中NDRGl mRNA和蛋白的表达

目的：探讨食管鳞癌组织中NDRGlmRNA和蛋白的表达情况及其与临床病理因素的关系。方法：分别采用RT-PCR和免疫组织化学SP法检测49例食管鳞癌组织（分化程度Ⅰ级14例，Ⅱ级23例，Ⅲ级12例；有淋巴结转移2l例，无淋巴结转移28例）、23例癌旁不典型增生黏膜组织及49例正常食管黏膜组织中NDRG1 mRNA和蛋白的表达。结果：食管鳞癌组织中NDRG1 mRNA相对含量低于癌旁不典型增生黏膜组织及正常食管黏膜组织（P〈0．05或0．01）；不同分化程度的食管鳞癌组织之间NDRG1 mRNA相对含量差异无统计学意义（P〉0．05）；伴淋巴结转移的食管鳞癌组织与无淋巴结转移的食管鳞癌组织NDRG1 mRNA相对含量差异无统计学意义（P〉0．05）。癌旁不典型增生组织及食管鳞癌组织中NDRG1蛋白（＋＋）阳性率（3／23和4／49）均低于正常黏膜组织的43／49（P〈0．01）；食管鳞癌组织中NDRG1蛋白表达与癌组织的分级及有、无淋巴结转移无关（P均〉0．05）。结论：食管鳞癌组织中NDRG1 mRNA和蛋白表达降低，其低表达可能与食管鳞癌发生有关。     

趋化因子受体CCR7在胃癌组织中的表达及意义

目的探讨趋化因子受体CCR7在胃癌组织中的表达及其临床意义。方法采用RT—PCR及Western blot法检测32例胃癌及其癌旁对照组织中CCR7的表达。结果CCR7mRNA在胃癌组织中的表达水平为癌旁对照组的1．66倍（P〈0．01），且其表达水平与肿瘤TNM分期（P〈0．05）、浸润深度（P〈0．05）及淋巴结转移有关（P〈0．05）；Western blot结果显示CCR7蛋自在胃癌组织中的表达水平为癌旁对照组的2．3倍（P〈0．01），且高表达于肿瘤分期较晚（P〈0．05）、分化较差（P〈0．05）、浸润较深（P〈0．05）、有淋巴结转移（P〈0．05）和远处转移（P〈0．05）的组织。结论趋化因子受体CCR7可能与胃癌的发生、发展、侵袭、转移有关。     

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.