CD147、E-cadherin在肾细胞癌中的表达及意义

目的 检测人肾癌组织中CD147、E-cadherin的表达,探讨二者在肾癌中表达的相关性及其与预后的关系. 方法利用组织芯片技术构建82例肾癌与26例癌旁正常肾组织芯片,应用Envision免疫组织化学方法检测CD147与E-cadherin在肾癌组织和癌旁组织中的表达. 结果肾癌中CD147的表达率为70.7%（58/82）,癌旁正常肾组织26.9%（7/26）显著高于正常肾组织（P＜0.01）.肾癌中E-cadherin的表达率为37.8%（31/82）,癌旁正常肾组织的表达率69.2%（18/26）显著低于正常肾组织（P＜0.01）. 结论肾癌中CD147异常高表达,而E-cadherin表达下降,可能参与肿瘤的发生发展,检测CD147与E-cadherin可能作为评估肾癌预后的指标.     

FBP1在肾透明细胞癌组织中的表达变化及意义

目的 探讨果糖1,6二磷酸酶1(FBP1)在人肾透明细胞癌(RCCC)及其癌旁组织中的表达,以及在肾癌发生、发展及预后中的作用和临床意义.方法 选取手术切除的118例RCCC患者的石蜡切片和40例RCCC患者的新鲜标本,分别采用免疫组织化学方法、Western blot和逆转录聚合酶链反应(RT-PCR)方法检测肾癌及对应癌旁组织(阴性切缘)中FBP1蛋白及mRNA的表达,分析其与患者临床病理特征及预后的相关性.结果 免疫组织化学发现78.81％ (93/118)的癌旁组织中可见FBP1蛋白呈强阳性表达,仅39.83％(47/118)的肾癌组织中FBP1蛋白表达阳性.Western blot发现肾癌组织中FBP1的表达阳性率较其相应癌旁组织明显下降(P＜0.01).RT-PCR法发现癌旁组织FBP1 mRNA表达水平亦明显高于肾癌组织(P＜0.05).FBP1低表达与临床分期、病理分级、危险系数及是否复发明显相关(P＜0.05),与年龄、性别、症状及肿瘤大小、部位、是否有坏死、是否有血管侵犯和肾上腺是否有累及无关(P＞0.05).FBP1阳性表达的肾癌患者的5年生存率高于FBP1阴性表达者(P＜0.05).结论 FBP1及其蛋白在人肾癌组织中低表达,与肾癌的发生、发展相关,可能成为肾癌预后的侯选标志物之一.     

结直肠癌细胞增殖核抗原及生长抑制因子4表达的关系及预后因素

目的 探讨细胞增殖核抗原(Ki-67)和生长抑制因子 4(ING4)在结直肠癌发病机制中的作用及其对患者预后的影响.方法 应用免疫组织化学法检测71例结直肠癌组织和30例癌旁正常组织中Ki-67、ING4的表达情况,分析其表达与临床病理特征及预后的关系.结果 Ki-67在癌组织中阳性表达率(85. 9％)高于癌旁组织(6.7％)(P＜0.05), ING4在癌组织中阳性表达率(56. 3％)低于癌旁组织(90％)(P＜0.05). Ki-67表达与肿瘤浸润深度、有无淋巴结转移、淋巴结转移数目、TNM分期有关(P＜0.05), ING4表达与分化程度、有无淋巴结转移、淋巴结转移数目、TNM有关(P＜ 0.05).Ki-67、ING4在结直肠癌组织中表达呈负相关性(r=-0.428,P＜0.05).Ki-67高表达组和低表达组术后5年生存率分别为63. 9％,85. 5％,差异有统计学意义(P＜0.05);ING4阳性组和阴性组术后5年生存率分别为 97. 4％ 、45. 2％,差异有统计学意义(P＜0.05).Cox多因素分析结果显示,TNM分期、ING4表达情况均为影响患者预后的独立因素.结论 Ki-67、ING4可能参与直肠癌的发生和发展,ING4是影响结直肠癌患者预后的独立危险因素.     

结直肠癌HER2及Ki-67表达的关系及预后因素分析

目的 探讨人表皮生长因子受体2 (HER2)和细胞增殖核抗原(Ki-67)在结直肠癌发病机制中的作用及其对患者预后的影响.方法 应用免疫组织化学法检测71例结直肠癌组织和30例癌旁正常组织中HER2、Ki-67的表达情况,分析其表达与临床病理特征及预后的关系.结果 HER2在癌组织中阳性表达率(32.4％)高于癌旁组织(10.0％),Ki-67在癌组织中阳性表达率(85.9％)高于癌旁组织(6.7％),差异有统计学意义(P＜0.05).HER2表达与肿瘤分化程度、有无淋巴结转移、淋巴结转移数目、TNM分期有关(P＜0.05);Ki-67表达与肿瘤浸润深度、有无淋巴结转移、淋巴结转移数目、TNM分期有关(P＜0.05).HER2、Ki-67在结直肠癌组织中表达呈正相关(r=0.515,P=0.001).HER2阳性患者和阴性患者术后5年无病生存率分别为48.4％ 、80.8％,差异有统计学意义(P＜0.05);Ki-67高表达患者和低表达患者术后5年无病生存率分别为56.5％、85.5％,差异有统计学意义(P＜0.05).HER2阳性患者和阴性患者术后5年生存率分别为60.9％、80.8％,差异有统计学意义(P＜0.05);Ki-67高表达患者和低表达患者术后5年生存率分别为63.9％、85.5％,差异有统计学意义(P＜0.05).单因素分析显示,肿瘤分化程度、浸润深度、有无淋巴结转移、转移淋巴结数目、TNM分期、HER2和Ki-67表达情况与患者的预后均有关(P＜0.05).Cox多因素分析结果显示,浸润深度、TNM分期为影响患者预后的独立因素.结论 在结直肠癌发生、发展过程中伴随着HER2和Ki-67的表达,HER2和Ki-67阳性者5年无病生存率及5年生存率明显降低.     

Expression of HDAC7 in renal cell carcinoma and its clinical significance

目的 检测并分析肾癌(透明细胞癌)组织中HDAC7 mRNA和蛋白的表达差异,探讨其与肾癌的发生、发展以及患者预后之间的关系.方法 应用实时荧光定量PCR和免疫组化法对60 例肾癌组织及20例正常肾组织中HDAC7的表达情况进行检测,并通过对患者随访,探讨其蛋白表达水平与肾癌临床病理学指标及患者预后之间的关系.结果 HDAC7在肾癌组织中的表达较正常肾组织明显增高,且与肾癌的病理分级和临床分期之间均呈负相关(P＜0.05).HDAC7低表达者的生存率低于HDAC7高表达者(P＜0.05).结论 HDAC7可能与肾癌的发生、发展有关,提示HDAC7可作为评估肾癌恶性程度及预后的肿瘤标志物.     

肾癌组织中Tiam1与KISS-1蛋白的表达

目的:检测肾癌组织中Tiam1与KISS-1蛋白的表达.方法:应用免疫组织化学SP法检测50例肾癌患者癌组织、癌旁组织和16例正常肾组织中Tiam1及KISS-1蛋白的表达.结果:肾癌组织、癌旁组织和正常肾组织中Tiam1蛋白的阳性表达率分别为82%、6%和6%,3者比较,差异有统计学意义(λ2=69.094,P＜0.05),KISS-1蛋白的阳性表达率分别为30%、90%、88%,3者比较,差异有统计学意义(λ2=43.481,P＜0.05).随肾癌分化程度的升高,Tiam1蛋白的阳性表达率逐渐降低(λ2=7.804,P＜0.05),KISS-1蛋白阳性表达率逐渐升高(λ2=6.770,P＜0.05).肾癌组织、癌旁组织中2者的表达呈负相关(r分别为-0.602和-0.477,P＜0.05).结论:Tiam1蛋白在肾癌组织中高表达,KISS-1蛋白在肾癌组织中低表达,联合检测2者有助于进一步阐明肾癌发生发展的机制.     

CD147和Survivin在肾细胞癌中的表达及临床病理分析

目的： 检测CD147和Survivin在人肾细胞癌组织中的表达,以探讨二者在肾细胞癌中表达的相关性及其与预后的关系。 方法： 利用组织芯片技术构建85例肾细胞癌与35例癌旁正常肾组织芯片,应用免疫组织化学Envision法检测CD147 和Survivin在肾癌组织中的表达。 结果： 肾细胞癌组中CD147 和Survivin的表达率分别为65.7%（23/35）和71.4%（25/35）,显著高于癌旁对照组（ P ＜0.01）。CD147 在肾细胞癌中的表达随着肿瘤大小与病理分级的升高而升高（ P＜0.05）;Survivin在肾细胞癌中的表达随着病理分级与临床分期的升高而升高（ P＜0.05）。CD147和Survivin在肾细胞癌中的表达具有弱一致性（Kappa=0.388, P＜0.05）。Logistic回归分析显示Survivin的表达是肾细胞癌的独立危险因素（OR=16.256,95%CI：1.132~233.515,P＜0.05）。 结论： CD147和Survivin在肾细胞癌中均有过量表达,可能参与了肾癌的发生发展过程,两者联合检测可用于评估肾细胞癌的恶性程度和预后。     

CML66 在肾癌组织中的表达及其临床意义

目的 探究慢性粒细胞白血病肿瘤抗原 66（CML66）在肾肿瘤组织中的表达及其临床意义。 方法 采用免疫组化法 检测 155 例肾癌组织及其癌旁正常肾脏组织、36 例肾血管平滑肌脂肪瘤组织中 CML66 蛋白的表达,分别比较肾癌组织与癌旁正常肾 脏组织、肾血管平滑肌脂肪瘤组织的 CML66 阳性表达率,并分析肾癌组织 CML66 阳性表达率与临床特征的关系。 结果 肾癌组织 中 CML66 阳性表达率为 83.9%,明显高于癌旁正常肾脏组织的 35.5%（P＜0.05）;但与肾血管平滑肌脂肪瘤组织的 80.6%比较,差异 无统计学意义（P ＞0.05）。肾癌组织病理分级Ⅲ、Ⅳ级,临床分期Ⅲ、Ⅳ期的 CML66 阳性表达率均分别高于Ⅰ、Ⅱ级 / 期,差异均有统计 学意义（P＜0.05）。 结论 CML66 在肾癌组织中高表达有助于明确诊断,可作为评估肾癌病理分级、临床分期的指标,可能对肾癌术 后辅助治疗有一定的参考价值。     

UTX在肾癌中的高表达及其临床意义

目的:检测UTX(ubiquitously transcribed TPR gene on the X chromosome)在肾透明细胞癌中的表达及其临床意义.方法:收集临床诊断明确肾透明细胞癌患者组织标本45例,提取组织mRNA,制作组织切片,采用实时定量PCR和免疫组织化学分析UTX在肾癌组织和癌旁组织表达的差异,并分析其表达改变与临床病理参数之间关系.结果:实时定量PCR结果显示,UTX mRNA在肾癌组织中的表达明显高于癌旁组织[(0.883 2±0.703 8vs.0.199 7 ±0.140 0,P＜0.05],免疫组织化学结果同样表明肾癌组织UTX表达水平明显高于癌旁组织(P＜0.05),UTX在肾癌组织中的蛋白评分高出癌旁组织4倍[12±4vs.3±3,P＜0.05].UTX在肾癌组织中的表达与性别、年龄、肿瘤大小、TNM分期无明显关系,但与病理分级关系密切(P=0.004).结论:UTX在肾透明细胞癌中表达增高,并且与肾癌分级相关.     

膜细胞骨架蛋白-ezrin差异表达与肾癌转移、侵袭的关系

目的:探讨细胞骨架连接埃兹蛋白(Ezrin)在肾细胞癌中的表达及与肿瘤转移、侵袭的关系.方法:收集50例肾癌组织及40例相应癌旁正常肾组织,按肾癌组织(有无淋巴结转移,有无腔静脉瘤栓形成),癌旁正常肾组织,伴有淋巴结转移的肾癌组织,伴有腔静脉瘤栓形成的肾癌组织分组.采用RT-PCR,Western Blot,免疫组化检测ezrin的表达.结果:RT-PCR,Western Blot结果显示,在肾癌组织及癌旁正常肾组织中均可检测到ezrin mRNA及蛋白,且肾癌组织表达水平显著高于癌旁正常肾组织.免疫组化检测ezrin蛋白阳性表达率在肾癌组织中为96%(48/50),癌旁正常肾组织组为75%(30/40)(X2=10.350,P=0.002);ezrin mRNA表达阳性率肾癌组为82%(41/50),癌旁正常肾组织组为62.5%(25/40)(X2=4.321,P=0.038),肾痛组均显著高于癌旁正常肾组织组.免疫组化评分及ezrin mRNA阳性表达率,淋巴结转移组显著高于无淋巴结转移组[(9.500±2.502)vs(7.232±3.045),13/14 vs 16/36,P<0.05];腔静脉瘤栓形成组显著高于无腔静脉瘤栓形成组[(9.315±3.027)vs(7.563±2.991),14/14 vs 22/36,P<0.05].肾癌组织中ezrin蛋白,ezrin mBNA表达水平与患者的性别、年龄、肿瘤分期、分级、肿瘤大小及肿瘤病理类型无关(P>0.05).结论:ezrin在肾癌组织中表达及其强度与肾痛淋巴结转移及腔静脉瘤栓形成有关,ezrin可能参与了肾癌的发生、侵袭和转移,测定肾癌组织中ezrin mRNA及蛋白有助于进一步评估肾细胞癌的预后和制定合理的治疗方案.     

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.