结直肠癌患者血清淋巴管内皮生长因子检测及其临床意义

目的 检测结直肠癌患者血清淋巴管内皮生长因子(VEGF-C)和血管内皮生长因子(VEGF)的水平,评估它们作为诊断和监测结直肠癌患者淋巴结转移指标的临床意义.方法 应用酶联免疫吸附试验(ELISA)检测66例结直肠癌患者、22例健康对照者血清中VEGF-C和VEGF的水平.结果 结直肠癌患者血清VEGF-C的浓度为(1 688.02±325.02) pg/ml,明显高于健康对照组[(948.68±250.52)pg/ml](P<0.01).结直肠癌淋巴结转移组血清VEGF-C的浓度高于无淋巴结转移组;按照有无淋巴管浸润和血管浸润分组,VEGF-C水平在浸润组中高于无浸润组.血清VEGF-C水平>1 439.7 pg/ml预测淋巴结转移的灵敏度和特异性分别达80.0%和77.8%;而血清VEGF水平>287.2pg/ml预测淋巴结转移的灵敏度和特异性分别达73.3%和72.2%;VEGF-C和VEGF水平联合检测,淋巴结转移阳性率的预测价值达84.6%,而阴性率的预测价值达94.7%.结论 血清VEGF-C水平可为结直肠癌患者淋巴结是否转移提供新的诊断依据.血清VEGF-C和VEGF水平的联合检测可作为结直肠癌患者术前临床分期的重要指标.     

非小细胞肺癌患者血清血管内皮生长因子C的水平及临床意义

目的:探讨非小细胞肺癌患者(NSCLC)血清血管内皮生长因子C(VEGF-C)表达水平及其与临床病理特征之间的关系。方法:采集20例健康体检者、30例肺炎患者及60例NSCLC患者血清,用ELISA方法检测VEGF-C表达水平。结果:NSCLC患者血清VEGF-C水平远高于正常健康人群组(P<0.01)和肺炎患者(P<0.05);有淋巴结转移的NSCLC患者血清VEGF-C水平明显高于无淋巴结转移者(P<0.05);Ⅲ、Ⅳ期NSCLC患者血清VEGF-C水平明显远高于Ⅰ、Ⅱ期患者(P<0.01);NSCLC患者血清VEGF-C水平与患者生存时间呈负相关(P<0.05)。结论:NSCLC患者血清VEGF-C的表达与病情进展密切相关,并可作为一种有用的预后指标。     

VEGF-C在乳腺癌中的表达及临床意义

目的 分析研究血管内皮生长因子(vascular endothelial growth factor-C, VEGF-C)在乳腺癌中的表达与淋巴结转移的关系.方法 RT-PCR法检测乳腺癌中VEGF-C的表达情况.结果 乳腺癌中VEGF-C的表达水平升高,90例乳腺癌中62例可检测到VEGF-CmRNA,阳性率为68.9%;乳腺癌组织中VEGF-C的阳性表达率淋巴结转移组高于无淋巴结转移组,两者差异具有显著性(P<0.05);临床分期Ⅲ、Ⅳ期的乳腺癌组织中VEGF-C阳性表达率明显高于Ⅰ、Ⅱ期,差异有显著性(P<0.01),在不同年龄、肿瘤直径、病理分型中,VEGF-C的阳性表达率相比较,差异无显著性(P>0.05).结论 VEGF-C在转录和翻译水平的过度表达是乳腺癌的普遍现象.VEGF-C在乳腺癌中表达增高,与乳腺癌的淋巴结转移密切相关,对乳腺癌的淋巴结转移起重要作用,对VEGF-C/VEGFR-3信号调控通道干预有望成为治疗乳腺癌淋巴道转移的新靶点,对临床治疗有重要的指导意义.     

P-钙粘蛋白在乳腺癌患者血清中的表达及其临床意义

目的检测P-钙粘蛋白在乳腺癌患者血清中的表达及其临床意义。方法收集乳腺癌患者60例、乳腺良性肿瘤患者46例及健康对照组30名,采用酶联免疫吸附试验(ELISA)法检测各组研究对象血清中P-钙粘蛋白的表达水平,并分析血清中P-钙粘蛋白水平与乳腺癌病理指征的关系。结果乳腺癌组血清P-钙粘蛋白水平为(36.98±4.53)ng/ml,明显高于乳腺良性肿瘤组(20.24±6.32)ng/ml和对照组(10.31±1.85)ng/ml,差异有统计学意义(P0.05)。乳腺癌临床分期Ⅲ期患者血清P-钙粘蛋白水平为(48.49±3.87)ng/ml,明显高于临床Ⅰ~Ⅱ期患者(26.35±2.04)ng/ml,差异有统计学意义(P0.05)。分化程度Ⅲ级患者血清P-钙粘蛋白水平为(41.13±2.35)ng/ml,明显高于分化程度Ⅰ~Ⅱ级患者(26.35±2.04)ng/ml,差异有统计学意义(P0.05),淋巴结转移患者血清P-钙粘蛋白水平为(42.26±3.32)ng/ml,明显高于无淋巴结转移组(28.73±1.48)ng/ml,差异有统计学意义(P0.05)。结论检测血清P-钙粘蛋白水平对乳腺癌的诊断、病情监测等具有一定的参考作用。     

细胞外信号调节激酶在乳腺癌中的表达及意义

目的:研究细胞外信号调节激酶(ERK)在乳腺癌中的表达及在乳腺癌发生发展中的作用。方法:采用Westernblot技术和免疫组化方法,研究ERK1和ERK2蛋白在60例乳腺癌,10例乳腺良性肿瘤,10例正常乳腺组织中的表达。结果:ERK1和ERK2在乳腺癌中有过度表达,与正常乳腺及乳腺良性肿瘤相比,其差异有显著性(P<0.01),乳腺癌Ⅲ～Ⅳ期表达高于Ⅱ期和Ⅰ期,差异有显著性(P<0.05);有腋窝淋巴结转移者表达高于无腋窝淋巴结转移者,差异有显著性(P<0.05)。ERK1和ERK2在高、中、低分化乳腺癌中无显著差异,与乳腺癌病理类型无关。结论:ERK的过度表达在乳腺癌的发生发展及淋巴结转移中起重要作用。     

白细胞介素-33和血管内皮生长因子C在胃癌中的表达及临床意义

目的 探讨白细胞介素-33(IL-33)和血管内皮生长因子C(VEGF-C)在胃癌患者组织标本及血清中表达,以及二者与胃癌淋巴结转移的关系.方法 分别应用免疫组织化学SP法和酶联免疫双抗夹心法(ELISA)检测98例胃癌患者和36名健康体检者胃黏膜组织标本及血清中IL-33和VEGF-C水平.结果 胃癌组织中IL-33和VEGF-C的阳性表达率分别为67.35％和74.49％,显著高于正常胃组织(47.22％和61.11％),比较差异有统计学意义(P<0.01).IL-33和VEGF-C表达在不同的肿瘤分化程度、组织浸润、淋巴结转移、远处转移及临床分期间比较差异有统计学意义(P<0.05).胃癌淋巴结转移患者的IL-33和VEGF-C的表达阳性率高于未发生淋巴结转移患者(P<0.05).胃癌患者血清IL-33和VEGF-C水平为(50.24±13.08)pg/mL和(210.73±58.35)pg/mL,高于健康体检者(P<0.05);淋巴结转移患者血清IL-33和VEGF-C水平高于未发生淋巴结转移患者,比较差异有统计学意义(P<0.05).结论 胃癌患者血清中高水平IL-33可能诱导VEGF-C分泌,促进胃癌淋巴结转移,可作为评估胃癌预后的重要指标.     

血清血管内皮生长因子C水平及癌组织中环氧化酶2的表达与乳腺癌淋巴道转移的关系

目的 探讨乳腺癌患者术前血清血管内皮生长因子C(sVEGF-C)水平、组织中环氧化酶2(COX-2)表达与乳腺癌淋巴道转移的关系.方法 采用ELISA法检测68例乳腺癌患者、35例乳腺良性病术前以及12名健康女性sVEGF-C水平.免疫组化SP法检测相应乳腺癌患者组织标本中COX-2表达及淋巴管密度(LMVD);分析sVEGF-C、COX-2及LMVD表达之间的关系.结果 (1)乳腺癌患者术前sVEGF-C水平(49±8)pg/ml显著高于健康女性志愿者(5±3)pg/ml和乳腺良性疾病者(8±4)pg/ml;(2)乳腺癌组织COX-2阳性表达率(44.1%)显著高于乳腺良性疾病(11.4%)(P=0.002);LMVD主要位于癌旁组织,癌巢中少有表达;癌旁组织中LMVD(8.7±4.7)较乳腺良性疾病组织中表达(1.8±1.7)显著增多(P=0.002);(3)在乳腺癌患者sVEGF-C水平增高者中,不但COX-2的表达显著高于sVEGF-C水平正常者COX-2的表达(P=0.024),而且LMVD(8.7±3.9)也显著高于sVEGF-C正常者的LMVD(5.6±3.3)(P=0.039);(4)乳腺癌患者COX-2表达阳性组LMVD(9.5±3.7)明显高于COX-2表达阴性组LMVD(6.0±3.8)(P=0.012);(5)在腋淋巴结转移阳性患者中,sVEGF-C水平、COX-2及LMVD表达均高于腋淋巴结转移阴性组(P值分别为0.025,0.022和0.002).结论 sVEGF-C、COX-2及LMVD在乳腺癌的淋巴道转移中有重要作用,可作为估计乳腺癌有无淋巴结转移的参考指标.     

胃癌患者血清VEGF-C和VEGF-A的水平变化及VEGF-C在胃癌组织中的表达

目的：探讨胃癌患者血清VEGF-C和VEGF-A水平与临床病理特征的相关性及血清VEGF-C水平与组织VEGF-C蛋白表达的关系。方法：采用酶联免疫吸附技术（ELISA）对28例胃癌患者及21例正常健康人血清VEGF-C和VEGF-A水平进行检测,同时应用免疫组化技术对28例胃癌组织标本进行VEGF-C蛋白表达进行 检测。结果：胃癌患者血清VEGF-C和VEGF-A水平明显高于健康对照组(均P<0.01)。胃癌组织标本VEGF-C表达阴性和阳性两组间血清VEGF-C水平比较,差异无显著性（P>0.05）。胃癌患者血清VEGF-A水平与淋巴结转移、远处转移、浸润程度及TNM分期有关(P<0.01) ;血清VEGF-C水平与淋巴结转移、浸润程度及TNM分期有关(P<0.05)。结论：血清VEGF-A和VEGF-C均可作为胃癌的标记物,对术前判定淋巴结转移具有一定的临床价值;血清VEGF-C水平与组织标本中VEGF-C表达无明显关联。     

乳腺癌和良性乳腺疾病患者血清中VEGF的变化

目的：探讨乳腺癌患者血清血管内皮生长因子（VEGF）的变化及其临床意义。方法：用ELISA法检测36例乳腺癌患者、22例乳腺纤维腺瘤及乳腺囊性增生患者和35例正常健康女性血清VEGF含量,分析VEGF与临床指标的关系。 结果：VEGF水平乳腺癌组［（145.8±13.6）ng•L^-1］与良性病变组［（80.47±3.58）ng•L^-1］和正常对照组［（58.38±7.04）ng•L^-1］比较差异有显著性（P<0.05）,VEGF水平有淋巴结转移者［（188.40±19.80）ng•L^-1］明显高于无淋巴结转移者［（94.02±12.04）ng•L^-1］（P<0.01）。 结论：乳腺癌患者血清中VEGF含量可能成为鉴别乳腺良恶性病变的辅助指标之一,有助于判断有无淋巴结转移及预后。     

VEGF-C、p53和C-erbB-2在乳腺癌中的表达及意义

目的 分析研究VEGF-C、p53和C-erbB-2在乳腺癌中的表达与转移及预后的关系.方法 用免疫组化法测定90例原发性乳腺癌中VEGF-C、p53和C-erbB-2的表达情况.结果 VEGF-C、p53和C-erbB-2在乳腺癌中的阳性表达率分别为57.8%、53.3%、43.3%,与乳腺良性病变相比较,两者差异具有显著性(P＜0.05);乳腺癌组织中VEGF-C、p53和C-erbB-2的阳性表达率淋巴结转移组高于无淋巴结转移组,两者差异具有显著性(P＜0.01);Ⅲ、Ⅳ期的乳腺癌组织中VEGF-C、p53和C-erbB-2蛋白阳性表达率明显高于Ⅰ、Ⅱ期,差异有显著性(P＜0.01);同时有2个或3个指标表达异常者淋巴结转移率为58.8%,只有一个指标表达异常或3个指标均不表达异常者的淋巴结转移率30.8%,两者比较差异具有显著性(P＜0.01).结论 VEGF-C、p53和C-erbB-2在乳腺癌中的高表达与乳腺癌淋巴结转移密切相关.VEGF-C、p53和CerbB-2在促进乳腺癌淋巴结转移中可能起协同作用,联合检测乳腺癌中VEGF-C、p53和C-erbB-2三种蛋白的表达,有利于更好地评估乳腺癌的生物学行为,提高对患者预后判断的准确性,并对临床治疗有重要的指导意义.     

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.