Aurora—A在喉鳞癌中表达的临床意义

【目的】了解基因Aurora—A在喉癌中的表达情况及了解其作为预测喉癌预后的新指标的可能性。【方法】用免疫组化的方法检测我科1995—1999年77例喉癌标本中Aurora—A的表达，随访3-136月，中位随访时间为71．93月．用统计软件SPSS11．0分析Aurora—A的表达与喉癌患者年龄、性别、临床分期、临床分型、肿瘤分化程度等的关系及其与预后的关系。【结果】Aurora—A在喉癌标本中的表达率为71．4％（55／77）；在晚期的喉癌中表达率为87．9％（29／33），高于早期喉癌中表达率（59．1％，26／44），P=0．006。K—M法计算分析，Aurora—A表达阳性者生存时间（中位生存时间46月）与Aurora—A表达阴性者生存时间（中位生存时间85月）有明显差异，P〈0．05。Cox多因素回归分析显示切缘情况、肿瘤分化程度、临床分期及Aurora—A表达与喉鳞癌的预后有关，P值均小于0．05。【结论】Aurora—A在喉癌组织中有一定程度表达，其表达与喉癌临床分期及预后相关。     

Aurora A激酶在软骨肉瘤中的表达及意义

目的 检测Aurora A激酶在软骨肉瘤组织中的表达情况,并进一步探讨其与软骨肉瘤各临床病理特征的关系及将其作为软骨肉瘤新的分子治疗靶点的可能性.方法 采用免疫组化SP法,检测软骨肉瘤（70例）和软骨瘤（40例）组织中Aurora A激酶的表达,评价Aurora A激酶的表达与软骨肉瘤临床病理参数的关系.结果 Aurora A激酶在软骨肉瘤中的阳性表达率明显高于软骨瘤,差异有统计学意义（P＜0.01）;Aurora A激酶在普通型软骨肉瘤低级别组的表达低于中高级别组的表达,差异有统计学意义（P＜0.01）;Aurora A激酶软骨肉瘤复发组和非复发组以及转移组和非转移组中的表达差异有统计相关性（P＜0.05）,与年龄、性别等临床参数无统计相关性（P〉0.05）.结论 Aurora A激酶在软骨肉瘤组织中的表达明显高于在软骨瘤中的表达,可能通过某种机制参与了软骨肉瘤的发生及侵袭和转移的过程,且与临床病理特征有相关性;检测Aurora A激酶的阳性表达有助于判断软骨肉瘤的恶性程度及有可能将其作为软骨肉瘤的分子治疗靶点.     

CIP2A在甲状腺乳头状癌组织中的表达及临床意义

目的探讨CIP2A在甲状腺乳头状癌、甲状腺腺瘤、结节性甲状腺肿及甲状腺正常组织中的表达及临床意义。方法应用免疫组化法检测67例甲状腺乳头状癌、26例甲状腺腺瘤、23例结节性甲状腺肿、22例甲状腺正常组织中CIP2A蛋白的表达情况。结果 CIP2A在甲状腺乳头状癌组织中的表达明显高于甲状腺腺瘤、结节性甲状腺肿及正常组织,差异有统计学意义(P0.05);CIP2A在甲状腺乳头状癌中的表达水平与淋巴结转移相关(P0.05),与甲状腺乳头状癌患者的性别、年龄、肿瘤大小及p TNM分期等无关(P0.05)。结论 CIP2A在甲状腺乳头状癌组织中过表达,且与其恶性临床病理特征紧密相关,提示CIP2A作为一个新的靶点可能为甲状腺乳头状癌的临床诊断与治疗策略提供新的方向。     

HIF-1α、VEGF在甲状腺肿瘤中的表达及其与肿瘤血管生成的关系

目的 探讨HIF-1α和VEGF蛋白在甲状腺肿瘤组织中的表达及其与肿瘤血管生成的关系.方法 应用免疫组织化学Envision法检测140例甲状腺癌组织、50例甲状腺腺瘤及30例正常甲状腺组织中HIF-1α和VEGF的表达,并检测肿瘤微血管密度(MVD),分析HIF-1α和VEGF蛋白的表达与肿瘤血管生成的关系.结果 甲状腺癌组织中HIF-1α、VEGF阳性表达和MVD计数均明显高于正常甲状腺和甲状腺腺瘤组织(P＜0.05).在140例甲状腺癌组织中,有颈部淋巴结转移、浸润达包膜或包膜外、分化程度高以及AJCC分期高者HIF-1α的表达明显高于无颈部淋巴结转移、未突破包膜、分化程度低以及AJCC分期低者(P＜0.05).有颈部淋巴结转移、浸润达包膜或包膜外以及AJCC分期高者VEGF及MVD计数明显高于无颈部淋巴结转移、未突破包膜以及AJCC分期低者(P＜0.05).甲状腺癌组织中HIF-1α、VEGF表达及MVD值之间相互两两呈显著正相关(r=0.605、0.564、0.513,P＜ 0.05).结论 HIF-1α、VEGF和MVD计数可作为辅助甲状腺肿瘤早期鉴别诊断和预测其甲状腺癌生物学行为的参考指标.     

ROCK2在前列腺癌中的表达及意义

目的 探究ROCK2蛋白在临床局限性前列腺癌患者肿瘤组织内部不同区域的表达水平及其意义。方法选取2005年1月至2010年12月行前列腺癌根治术的32例临床局限性前列腺癌患者,其中17例生化复发,15例至末次随访无生化复发。收集记录患者的前列腺特异抗原(prostate specific antigen, PSA)水平、Gleason评分、肿瘤分期及是否复发等资料。对这些前列腺根治标本进行免疫组化检测,评估肿瘤中心区、肿瘤前缘区及癌旁前列腺组织中ROCK2的表达水平,分析其与患者血PSA、肿瘤分期、分级及复发的关系。结果 ROCK2在前列腺癌组织肿瘤前缘区表达显著高于肿瘤中心区,且肿瘤前缘区ROCK2高表达与前列腺癌病理分级及生化复发相关,而肿瘤中心区ROCK2表达与前列腺癌病理分级及生化复发无相关。ROCK2表达与患者PSA水平及病理分期均无相关。结论ROCK2在前列腺癌前缘组织中高表达与肿瘤恶性程度及复发相关,该蛋白可能是前列腺癌的预后因子。     

Mta-1在甲状腺肿瘤中的表达及其临床意义

目的 探讨Mta-1蛋白在甲状腺肿瘤组织中的表达及其临床意义.方法 应用免疫组织化学Envision法检测140例甲状腺癌组织、50例甲状腺腺瘤及30例正常甲状腺组织中Mta-1蛋白的表达,分析Mta-1蛋白的表达与甲状腺癌临床病理特征之间的关系.结果 甲状腺癌中Mta-1阳性表达明显高于正常甲状腺组织和甲状腺腺瘤(P<0.05).甲状腺癌组织中,Mta-1的表达与肿瘤大小、AJCC分期、分化程度、是否有颈部淋巴结转移以及浸润深度密切相关(P<0.01),而与年龄及性别无关(P>0.05).结论 Mta-1参与了甲状腺癌的形成过程,并与甲状腺癌的浸润、转移和预后密切相关,为甲状腺癌的分子靶向治疗提供了新的靶点.     

结肠癌组织中CUL4A的表达及临床病理学意义

目的 探讨CUL4A在结肠癌进展中的作用.方法采用免疫组织化学（IHC）方法检测80例结肠癌组织及癌旁正常粘膜（距肿瘤〉5 cm）CUL4A蛋白表达情况,并分析其与结肠癌临床病理参数的相关性.结果 结肠癌组织CUL4A阳性率显著高于癌旁正常粘膜组织（P〈0.01）;结肠癌组织中CUL4A的表达与AJCC分期、肿瘤浸润深度、血管侵袭、淋巴结转移及远处转移相关,而与性别、年龄、分化程度无关.结论 CUL4A蛋自在结肠癌组织中异常表达,癌组织中的表达明显高于正常组织,并与结肠癌的进展和转移密切相关;该基因可能在结肠癌的发生发展中起重要作用.     

手术切除甲状腺肿瘤60例临床分析

目的:探讨手术切除甲状腺肿瘤的临床效果。方法:选择60例甲状腺肿瘤患者为研究对象,根据肿瘤临床分期选择个性化手术治疗。观察手术治疗效果及术后复发情况。结果:所有患者经手术治疗成功切除甲状腺肿瘤,均全部治愈。良性甲状腺肿瘤出现暂时性喉返神经损伤1例,术后恢复1~3个月后,发音正常,喉镜检查声带活动良好,未见伤口出血感染、呼吸困难及甲状腺低下等情况发生。良性甲状腺肿瘤随访9例肿瘤复发,复发率为21.4%,恶性甲状腺肿瘤随访复发率为27.7%。结论:根据甲状腺肿瘤临床分期分别给予个性化手术治疗,疗效确切,复发率低,值得临床推广应用。     

BRAF V600E和TERT启动子突变与甲状腺乳头状癌临床病理特征的关系

  目的  探讨鼠类肉瘤滤过性毒菌致癌同源体B1(BRAF)V600E和端粒酶逆转录酶(TERT)启动子突变与甲状腺乳头状癌(PTC)临床病理特征之间的关系。  方法  采用聚合酶链式反应(PCR)直接测序检测326例PTC患者肿瘤组织的BRAF V600E和TERT启动子的突变情况,并分析其与临床病理特征之间的关系。  结果  BRAFV600E突变率为82.52% (269/326),TERT启动子突变率为3.37%(11/326),其中C228T位点突变9例,C250T位点突变2例,BRAF V600E和TERT启动子同时突变者10例(3.07%)。单因素分析结果显示BRAF V600E基因突变与PTC患者年龄及是否肿瘤复发/远处转移有关(P＜0.05),TERT启动子突变与患者年龄、肿瘤最大径、是否甲状腺腺外侵犯、T分期、AJCC分期及是否肿瘤复发/远处转移有关(P < 0.05)。BRAF V600E和TERT启动子同时突变与患者年龄、肿瘤最大径、是否甲状腺腺外侵犯、T分期及AJCC分期有关(P＜0.05)。  结论  PTC患者肿瘤组织BRAF V600E和TERT启动子同时突变时提示肿瘤侵袭性高。     

胃癌组织GLDC蛋白表达及其与根治术后复发的关系探讨

目的:探讨胃癌组织中甘氨酸脱羧酶(GLDC)蛋白的表达及其与根治术后复发的关系。方法:选取在本院行根治术治疗的胃癌患者106例,检测并比较胃癌组织与切缘正常组织中GLDC蛋白的表达水平,分析GLDC蛋白表达与临床病理特征的关系。患者行根治术后随访3年,根据随访期内是否复发分复发组与未复发组,比较2组胃癌组织GLDC蛋白表达情况,采用Cox回归分析根治术后复发的影响因素,并采用Kaplan-Meier生存曲线分析胃癌组织GLDC蛋白不同表达水平患者的复发率。结果:胃癌组织GLDC蛋白低表达率高于切缘正常组织(P<0.05),肿瘤直径≥5 cm、lauren分型为弥漫型、T3～T4分期、N1～N3分期患者中癌组织GLDC蛋白表达水平更低(P<0.05)。胃癌根治术后3年复发率为65.05%,复发组肿瘤直径≥5 cm、T3～T4分期、N1～N3分期、胃癌组织GLDC蛋白低表达占比均高于未复发组(P<0.05),行术后辅助化疗占比低于未复发组(P<0.05),均为胃癌患者根治术后复发的影响因素(P<0.05)。Kaplan-Meier生存曲线分析显示,GLDC蛋白...     

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.