多形性腺瘤及恶变组织中bal—2表达

采用免疫组化方法，观察ｂｃｌ－２基因产物在多形性腺瘤及其恶变组织中的表达与分布，以图像分析仪进行了计数分析。结果显示肿瘤组织中以导管样上皮细胞，粘液样细胞以及软骨样细胞的阳性表达较高，而鳞状上皮团块中，ｂｃｌ－２表达极代。各组阳性病比例：对照组５例慢性诞腺炎为８０％，１５例多形性腺瘤为８０％，７例多形性腺瘤恶性病变为８６％。     

NF-κB在涎腺多形性腺瘤中的表达及意义

目的:研究(NF-KB)在涎腺多形性腺瘤中表达及意义.方法:应用免疫组化EnVision法检测30例涎腺多形性腺瘤NF-KB的表达.结果:30例多形性腺瘤石蜡切片NF-KB免疫组化染色中,10例(33．3％)呈强阳性(+ + +);12例(40％)强表达(+ +);6例(20％)弱表达(+);2例(6．6％)无表达.NF-KB的表达主要见于浆液腺腺泡上皮和导管上皮,呈强阳性(+ + +)表达;黏液腺肌上皮样上皮呈强表达(+ +);间质成分中血管内皮呈弱阳性(+)表达、纤维结缔组织呈弱阳性(+)表达.结论:NF-KB在涎腺多形性腺瘤呈阳性表达,提示瘤细胞增殖力较强,可能是涎腺多形性腺瘤容易复发和发生恶性转化的原因.     

腮腺硬化性多囊性腺病临床病理分析

目的探讨腮腺硬化性多囊性腺病的临床病理特征和鉴别诊断。方法报道1例腮腺硬化性多囊性腺病的临床资料、HE染色和免疫组化染色结果,结合文献讨论。结果镜下见病变以大量增生胶原纤维为背景,其间分布不规则增生的导管和腺泡成分,呈模糊的小叶状结构,部分导管扩张呈囊状,结构类似乳腺纤维囊性病。部分扩张的导管上皮呈大汗腺样化生,部分上皮细胞呈合体细胞样,其胞质内含丰富、粗大的强嗜伊红颗粒,部分上皮呈泡沫细胞样,局部见平滑肌增生成结节状,间质中散在淋巴细胞浸润。结论腮腺硬化性多囊性腺病是一种罕见疾病,镜下病变复杂多样,需与慢性硬化性涎腺炎、多形性低度恶性腺癌、腺泡细胞癌、腺样囊性癌、黏液表皮样癌等鉴别。     

尺骨软骨样副脊索瘤1例及文献复习

目的：探讨尺骨软骨样副脊索瘤的临床病理特征，及其与原发或转移性肿瘤的鉴别诊断。方法：对1例原发于尺骨的软骨样副脊索瘤的标本，通过光镜，免疫组化进行病理组织学观察和会诊及病理读片会讨论等方法。结果：组织学特征为：肿瘤细胞呈大小不等的小叶状或小梁状排列，小叶边缘为软骨样小梁；小叶间血管扩张充血；小叶内瘤细胞呈片状，小梁状、岛状分布，细胞大小不一，核多靠边，浆呈大空泡状，类似脂肪样细胞，有的核居中，类似软骨样细胞，核异形性不明显，未找到核分裂，瘤细胞间为淡兰色或粉染的粘液样物质。免疫组化（ABC）：CK、EMA、S－100蛋白、NSE Vimentin染色均为阳性，Desmin、CD34均为阴性。会诊和读片会讲座均诊为软骨样副脊索瘤。结论：原发于尺骨的软骨样副脊索瘤非常罕见，组织形态学上很难确诊。免疫组化有助于明确诊断。     

涎腺含肌上皮细胞性肿瘤分化及起源之初探

目的 为了进一步探讨含肌上皮细胞性肿瘤的分化与起源,以及提高鉴别诊断水平。方法 应用免疫组织化学对涎腺肌上皮瘤和多乳形腺瘤的ＣＫ－１８,Ａｃｔｉｎ表达以及组织学特征进行研究。结果 人组织结构上看,肌上皮瘤由肿瘤性肌上皮细胞为主“主质成分”和腺管产结构为辅的“次质成分”构成;多形性腺瘤则由粘液和软骨样物质组成的“细胞疏松区”和上皮性与肌上皮性两种成分组成的“细胞密集区”构成。从免疫组织化学表达上看,     

S-100蛋白阳性树突状细胞在涎腺及涎腺良恶性肿瘤中的表达

目的　探讨S - 10 0蛋白阳性树突状细胞 (S - 10 0 +DC)在涎腺及涎腺良恶性肿瘤中的分布及意义。方法　将 2 0例正常涎腺组织、2 0例涎腺良性肿瘤、2 0例涎腺恶性肿瘤的蜡块制成 5 μm厚的连续切片 ,行HE和免疫组化染色。结果　①S - 10 0 +DC在正常涎腺及涎腺良、恶性肿瘤中 ,分布呈显著差异性 (P <0 .0 1) ;②在涎腺多形性腺瘤中黏液样及软骨样和导管样结构的外层肌上皮细胞高度表达S - 10 0蛋白 ;③腺样囊性癌癌实质内高度表达S - 10 0蛋白。结论　①DC在局部抗肿瘤免疫中发挥重要作用 ;②证实了涎腺多性肿瘤中黏液样及软骨样组织来源于肌上皮细胞 ;③通过S - 10 0蛋白在癌组织中的表达位置 ,为鉴别此实验中的 4种涎腺恶性肿瘤的组织分型提供了参考     

涎腺腺样囊性癌免疫组化表达的临床意义

目的观察涎腺腺样囊性癌的免疫组化表达特点,探讨CD117表达对腺样囊性癌预后的意义。方法采用组织芯片和免疫组化方法,观察41例涎腺腺样囊性癌、19例涎腺基底细胞腺瘤及31例涎腺多形性腺瘤平滑肌特异性肌动蛋白(SMA)、p63基因蛋白(p63)、S-100蛋白(S-100 Protein)、细胞角蛋白(CKpan)、上皮膜抗原(EMA)、Ki-67核抗原(Ki-67)及C-kit原癌基因(CD117)的表达,总结各抗体在涎腺腺样囊性癌、基底细胞腺瘤及多形性腺瘤中表达的强度和阳性分布模式,分析其诊断、鉴别诊断和预后意义。结果免疫组化标记SMA、p63、S-100蛋白、CKpan、EMA在涎腺腺样囊性癌、基底细胞腺瘤、多形性腺瘤中显示不同的分布特点。SMA、p63、S-100蛋白标记,腺样囊性癌肿瘤细胞巢周边及筛孔衬覆细胞呈阳性,腺管状结构外层细胞显示阳性;基底细胞腺瘤瘤细胞巢外围及腺管结构外层细胞呈阳性;多形性腺瘤阳性细胞弥漫分布或巣状分布。CKpan、EMA标记,腺样囊性癌肿瘤细胞胞质、胞膜强阳性;基底细胞腺瘤腺样结构内层细胞胞质阳性;多形性腺瘤上皮分化的肿瘤细胞标记阳性,肌上皮细胞分化的肿瘤细胞部分阳性。腺样囊性癌不同预后组Ki-67表达有差别,复发生存病例及死亡病例与无复发生存病例比较,差异有统计学意义(SNK-q检验q值分别为7.472 9和5.218 6,P<0.01)。死亡病例CD117强阳性表达与无复发生存病例比较,差异有统计学意义(P=0.039 4)。Ki-67指数高、CD117表达强阳性者预后较差。结论 SMA、p63、S-100蛋白、CKpan、EMA的不同表达对涎腺腺样囊性癌、基底细胞腺瘤、多形性腺瘤的诊断和鉴别诊断具有参考价值,Ki-67、CD117的表达与涎腺腺样囊性癌的预后相关。     

hMSH2h、MLH1基因与涎腺肿瘤研究进展

涎腺肿瘤多为上皮来源肿瘤,一般认为hMSH2在正常组织和肿瘤组织的细胞核内表达,亦在正常涎腺的导管上皮细胞胞浆中表达,但在导管上皮来源的多形性腺瘤、粘液表皮样癌,腺样囊性癌等良恶性肿瘤的导管上皮细胞胞浆未见表达,其意义和机理有待于我们进一步研究.     

腮腺混合瘤84例临床分析

腮腺混合瘤又称为多形性腺瘤，是腮腺肿瘤中最常见的一种。研究表明此肿瘤主要来源于腮腺润管的腺上皮细胞和肌上皮细胞，病理组织学上主要有肿瘤性上皮组织、粘液样和软骨样组织组成。本文收集我院1995年至2005年间腮腺混合瘤患者84例，全部病例均手术切除治疗，术后切除标本均经病理组织学证实。现对腮腺混合瘤的临床诊断及治疗方法作回顾性分析和进一步探讨。     

乳腺低级别腺鳞癌3例临床病理分析

目的探讨乳腺低级别腺鳞癌的临床病理学特征、诊断与鉴别诊断。方法对3例乳腺低级别腺鳞癌进行光镜形态学观察及应用免疫组化染色分析,随访并文献复习。结果3例乳腺低级别腺鳞癌位于乳腺实质部．由小腺样结构、实性上皮细胞巢和含有梭形细胞的问质构成。免疫组化染色显示癌巢组织上皮性标记物（CK、CK5／6、P63）及EGFR表达阳性,ER、PR、HER2呈阴性表达;癌巢外层细胞肌上皮标记物（Calponin、SMA）呈灶性表达。分别随访4年、3年、1年均无肿瘤复发和转移。结论乳腺低级别腺鳞癌是一种低度恶性的化生性癌,预后良好。对该肿瘤的确诊主要依赖于病理组织学形态,并结合免疫组化结果,同时需和其他肿瘤如乳头汗管瘤样腺瘤、乳腺腺病、乳腺原发性鳞癌或腺鳞癌、高分化浸润性导管癌或小管癌、乳腺髓样癌、放射状瘢痕／复杂性硬化性病变、乳腺纤维肉瘤相鉴别。     

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.