p16基因蛋白在大肠癌中表达的改变及其意义

目的探讨大肠癌中p16蛋白失表达及其意义,以及p16蛋白与细胞增殖活性的关系.方法应用免疫组化EnVision法检测60例大肠癌和47例大肠腺瘤中p16蛋白及Ki-67抗原的表达.结果 1.大肠癌、大肠腺瘤中p16失表达率分别为26.7%、25.5%,二者无显著性差异(P＞0.05).2.随肿瘤分化程度的下降,p16蛋白的失表达率增高,p16表达程度明显下降(P＜0.05),但p16表达的改变与Dukes'分期、淋巴结转移等无关(P＞0.05).3.大肠癌Ki-67阳性表达率为38.1%±10 1%,较腺瘤24.3%±8.3%显著增高(P＜0.01).大肠癌低分化组Ki-67阳性表达率较高、中分化组增高(P＜0.01).4.大肠癌p16阴性组Ki-67阳性表达率37.6%±11.47%与p16阳性组38.18%±9.68%相比,无显著差异(P＞0.05).结论 p16蛋白失表达与大肠癌分化呈负相关.大肠癌Ki-67阳性表达率高于腺瘤,而且分化越差,Ki-67表达越高.p16表达的改变与Ki-67阳性表达率无显著相关性.     

核因子-κB P65蛋白在大肠癌组织中的表达及意义

目的 探讨核因子-κBI(NF-κB)P65蛋白在大肠癌组织中的表达及意义.方法 采用免疫组织化学方法.检测64例大肠癌组织和11例大肠腺瘤组织、16例癌旁组织中NF-κB P65单克隆抗体的表达,分析其与NF-κB P65蛋白之间的关系.结果 NF-κB P65蛋白在大肠癌和大肠腺瘤组织中的阳性表达率分别为54.7%、18.2%,16例癌旁组织中无1例阳性表达.大肠癌组与大肠腺瘤组阳性表达率比较有显著性差异(P＜0.05).NF-κB P65蛋白在高、中、低分化大肠癌组织中的阳性表达率分别为33.3%、54.2%、613%,各组同比较无显著性差异(P＞0.05).大肠癌有淋巴结转移组中NF-κb P65蛋白阳性表达率(73.1%)高于无淋巴结转移组(42.1%),二者比较有显著性差异(P＜0.05).结论 NF-κB P65蛋白在大肠癌组中的阳性表达显著高于大肠腺瘤组,有淋巴结转移组中阳性表达显著高于无淋巴结转移组,提示NF-κB P65蛋白在大肠癌的发生、发展及淋巴结转移中起重要作用.     

p16、Ki-67蛋白在大肠腺瘤、腺癌组织中的表达及意义

目的探讨肠道肿瘤中p16和Ki-67的表达及其与预后的关系。方法收集大肠腺瘤16例、腺癌32例（高分化10例,中分化8例,低分化14例）,运用免疫组化SP法检测p16和Ki-67的表达情况,实验结果用SPSS11.5进行卡方检验。结果p16在大肠腺癌和腺瘤中的阳性率分别为46.9%和81.3%,两者相比差异有显著性（P〈0.05）,p16蛋白随着大肠癌恶性程度的增加,表达强度逐渐降低,高分化腺癌与中、低分化组相比差异有显著性（P〈0.05）,而与淋巴结转移无关（P〉0.05）;Ki-67增殖指数在腺癌中明显高于腺瘤（P〈0.05）,且与大肠癌的分化程度及淋巴结转移有关（P〈0.05）。结论p16蛋白表达在大肠腺瘤、腺癌的发生、发展过程中可能起了一定的作用,对大肠癌的诊断及评估预后有一定意义;Ki-67增殖指数与肿瘤的恶性度和淋巴结转移有关,可能是判断大肠癌预后的指标之一。     

大肠腺瘤及其癌变错配修复基因hMLH1和hMSH2表达与细胞增殖的关系

目的探讨错配修复基因hMLH1和hMSH2表达在大肠癌发生中的作用及其与细胞增殖间的关系.方法采用免疫组织化学染色法对63例大肠腺瘤、20例腺瘤癌变和20例大肠癌的hMLH1和hMSH2、PCNA和Ki-67表达进行检测.结果大肠腺瘤、癌变和大肠癌中hMLH1、hMSH2阳性表达率逐渐降低,与正常大肠粘膜相比相差显著(P＜0.01),腺瘤不典型增生分级增加其阳性率亦逐渐降低.腺瘤不典型增生Ⅱ、Ⅲ级、腺瘤癌变和大肠癌中hMSH2-者,其PCNA LI显著低于hMSH2 者(P＜0.05);hMSH2表达缺失的大肠癌,其Ki-67 LI较阳性者显著降低(P＜0.05).3组大肠病变hMLH1阳性与阴性表达组间,其PCNA LI和Ki-67 LI无差异显著性.结论提示错配修复基因突变或功能缺失与大肠癌的发生有关,可能系大肠癌发生过程中的早期事件,并对大肠肿瘤细胞增殖活性有所影响.     

p27Kip1,Skp2蛋白在大肠癌表达的临床研究

目的 检测p27Kip1及Skp2在正常大肠黏膜、大肠腺瘤、大肠癌组织中的表达,探讨p27Kip1,Skp2在正常大肠黏膜、大肠腺瘤、大肠癌之间的表达差异及其表达与大肠癌临床病理特征的关系.方法 用免疫组化S-P法检测15例正常大肠黏膜、15例大肠腺瘤、50例结直肠癌组织中p27Kip1,Skp2的表达情况.结果 ①p27Kip1在大肠癌组织中的表达明显低于大肠黏膜、大肠腺瘤组(P＜0.05),在各病理分化程度的大肠癌组织中表达差异无显著性(P＞0.05),在有淋巴结转移的大肠癌组织中p27Kip1表达明显低于无淋巴结转移组(P＜0.05),DukesC,D期大肠癌组织中p27Kip1表达明显低于DukesA,B期大肠癌组织(P＜0.05).②Skp2在大肠癌组织中的表达明显高于正常大肠黏膜、大肠腺瘤组(P＜0.05),在低分化大肠癌组织中的表达明显高于高分化大肠癌组织(P＜0.05),在有无淋巴结转移大肠癌组织中表达差异无显著性(P＞0.05),在DukesA,B期及DukesC,D期大肠癌组织表达差异无显著性(P＞0.05).③在大肠癌中p27Kip1与Skp2表达呈显著负相关(r=-0.470,P＜0.01).结论 ①p27Kip1表达的降低及Skp2表达的升高与大肠癌的发生有一定关系.②p27Kip1的低表达与大肠癌淋巴结转移、Dukes分期存在相关性,p27Kip1低表达可能合并淋巴结转移或高Dukes分期.③Skp2在低分化大肠癌组织中高表达,Skp2可作为大肠癌分化程度的辅助判断指标.④在大肠癌组织中Skp2与p27Kip1的表达呈负相关.     

APC和β-catenin在大肠癌中的表达及其意义

目的 探讨APC和β-catenin在大肠癌发生、发展中的作用.方法 应用免疫组织化学方法检测30例正常大肠黏膜、30例大肠腺瘤、10例大肠腺瘤恶变及50例大肠癌组织中APC和β-catenin蛋白的表达情况.结果 大肠癌和大肠腺瘤恶变APC阳性率分别为44.0%、40.0%,显著低于大肠腺瘤的86.7%和正常大肠黏膜的100%,差异有统计学意义(P＜0.01).大肠癌、大肠腺瘤恶变和大肠腺瘤β-catenin胞浆/胞核异位表达率分别为62.0%、50.0%、30.0%,显著高于正常大肠黏膜的0%,差异有统计学意义(P＜0.01),大肠癌β-catenin异位表达率显著高于大肠腺瘤,差异有统计学意义(P＜0.01).大肠癌中β-catenin膜表达缺失率为46.0%,显著高于大肠腺瘤(10.0%)和正常大肠黏膜的0%,差异有统计学意义(P＜0.01),且与大肠癌组织分化程度、浸润深度、淋巴结转移、Dukes分期有关.APC蛋白表达与大肠癌组织分化程度有关.大肠癌中β-catenin异位表达与APC阳性表达呈负相关关系(r=-0.39,P＜0.05).结论 APC失表达和/或β-catenin异位表达与大肠癌的发生密切相关,可能是大肠癌发生的早期事件;β-catenin膜表达缺失与大肠癌的侵袭、转移有关.     

P21在大肠癌、大肠腺瘤及正常大肠粘膜中的表达及临床意义

目的 探讨P21在正常大肠粘膜、大肠腺瘤和大肠癌中的表达变化及与大肠癌发生、发展和转移的关系.方法 采用免疫组化方法,分别检测20例正常大肠粘膜、22例大肠腺瘤和69例大肠癌中P21蛋白表达情况.结果 P21蛋白在正常大肠粘膜、大肠腺瘤和大肠癌中阳性表达率分别为15.00%、18.00%、44.93%.大肠癌中P21蛋白表达阳性率均显著高于大肠腺瘤和正常大肠粘膜(P<0.05).在发生淋巴结转移的大肠癌组织中P21阳性表达率为70.83%,高于无转移的大肠癌组织中P21(31.11%)的阳性表达率,差异具有显著性(P<0.05);P21阳性表达与临床其他病理因素均无相关性(P>0.05).结论 P21的表达与大肠癌侵袭转移的发生密切关系,阳性表达时对预测大肠癌已发生淋巴结转移具有指导意义.     

Twist和E-cadherin蛋白在大肠癌中的表达和临床意义

目的 探讨Twist和E-cadherin蛋白在大肠癌发生发展中的临床意义.方法 采用免疫组化PV9000法检测78例大肠癌和42例大肠腺瘤组织中Twist和E-cadherin蛋白的表达.采用Western blot法检测Twist蛋白在30例新鲜大肠腺癌组织和30例新鲜大肠腺瘤组织中的表达.结果 Twist蛋白在大肠癌组织中的阳性率(56.4％)明显高于腺瘤组织(26.2％)和癌旁正常黏膜组织(10％);E-cadhefin在大肠癌组织中的阳性率(48.7％)明显低于腺瘤组织(76.2％)和癌旁正常黏膜组织(100％).Twist和E-cadherin在大肠癌中的异常表达均与肿瘤分化程度和淋巴结转移有关(P均＜0.05),而与肿瘤大小无关(P＞0.05).E-cadherin的阳性表达与肿瘤的TNM分期有关(P＜0.05),但Twist的阳性表达与TNM分期无关(P＞0.05).结论 Twist和E-cadherin蛋白在大肠癌的发生及癌组织的侵袭和转移过程中可能起重要作用.     

PTEN和Caspase-3在大肠癌中的表达及临床意义

目的 检测大肠癌组织中PTEN和Caspase-3的蛋白表达,了解与大肠癌临床病理的相关因素.方法 采用S-P免疫组化法,检测PTEN和Caspase-3在各组织中的表达及意义.结果 PTEN在正常大肠组织、大肠腺瘤、大肠癌组织中的表达率分别为100%、70%和51.61%;而癌旁组织的阳性表达率60.87%,与癌组织相似,两者有明显的同步表达性(P<0.01).大肠癌中PTEN蛋白的阳性表达率明显低于非癌组(P<0.05). Caspase-3在正常黏膜、大肠腺瘤及大肠癌中的阳性表达率分别为93.33%、60%、45.16%.在癌旁组织的表达率为52.17%.正常黏膜组织Caspase-3的表达高于大肠腺瘤和大肠癌(P<0.05).PTEN表达随肿瘤分化程度的降低、临床分期提高而降低(P<0.05).Caspase-3阳性表达随肿瘤分化程度的降低而降低(P<0.05).大肠癌组织中PTEN与Caspase-3的表达呈正相关(r=0.675,P<0.01).结论 PTEN、Caspase-3的表达下调与大肠癌的发生、发展有关,二者可作为判定大肠癌生物学行为和预后的临床参考指标.     

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.