血浆胃动素检测对胃肠癌和非癌疾病的诊断价值

采用放射免疫法对 136例已确诊的胃肠癌和非癌疾病及正常健康人的血浆胃动素 (ＭＴＬ)进行检测 ,以探讨其对胃肠疾病的诊断价值 ,报道如下。1　资料和方法1.1　检测对象　受检病人选自 1996年 4月～ 1997年 12月徐州医学院附属医院肠道门诊、肿瘤科及宿州市第一人民医院内科的病人 ,正常健康人选自健康体检者。1.2　分组　共分 3组 :癌组、非癌组、正常组。癌组(经病理确诊 ) 40例 ,其中胃癌 19例 ,肠癌 2 0例 ,贲门癌 1例 ;男 2 7例 ,女 13例 ,年龄 2 9～ 6 8岁 (平均4 2 .4岁 )。非癌组 (经钡餐透视及电子胃镜及纤维结肠镜确诊 ) 56例 ,其…     

血清CEA、CA50、CA19-9检测对胃肠肿瘤的诊断意义

采用放射免疫法检测 5 8例胃肠道恶性肿瘤和 2 0名健康人血清癌胚抗原 (CEA)及糖链抗原 (CA5 0、CA19-9)含量。结果 :胃肠肿瘤CEA、CA5 0、CA19-9检测值明显高于对照组 (P <0 .0 1)。大肠癌组CEA值较胃癌高 ,而胃癌组CA5 0值较大肠癌组高。胃癌与大肠癌组间三项指标的阳性率间无显著差异。癌胃体癌CA5 0较胃角胃窦部癌阳性率为高 ,提示CA5 0对胃癌尤其是胃体癌的诊断有较高的临床价值     

84例胃癌雌孕激素受体的研究

应用免疫组化ＳＰ法，检测了８４便胃癌组织及１４例非癌性胃组织的雌激素（ＥＲ）Ｔ 孕激素（ＰＲ）受体。结果显示，非癌胃组织不含ＥＲ和ＰＲ，胃癌的ＥＲ和ＰＲ阳怀率分别为３５．７％和３０．９％，阳性者多见于分化差者，对ＥＲ、ＰＲ阳性者可试用内分泌治疗。     

胃癌自由基代谢变化对胃区域淋巴结癌转移的影响

目的：研究胃癌胃壁组织中自由基代谢变化对胃区域淋巴结癌转移的影响。方法：52例胃癌患者新鲜离体胃标本,分别于癌中央、癌旁、癌远侧端等3处取材，检测胃壁组织中SOD活性及MDA含量，并按照胃区域淋巴结有无癌转移及胃癌病理类型而进行分组。结果：胃癌淋巴结转移组（A组）与非转移组（B组）比较，癌中央组织中两组均表现为SOD活性显著降低，MDA含量显著升高，两组比较差异无显著性；而癌旁、癌远侧端组织比较，两者差异具有极显著性。胃非黏液性癌淋巴结转移组（C组）与非转移组（D组）比较，其结果与A，B组一致。胃黏液性癌淋巴结转移组（E组）与非转移组（F组）比较，在各部位SOD及MDA差异无显著性。结论：胃非黏液性癌胃区域淋巴结癌转移与自由基代谢状况密切相关，胃壁中抗氧化能力降低，脂质过氧化反应增强将促进癌组织向胃区域淋巴结转移。而胃黏液性癌胃区域淋巴结转移与自由基代谢状况无关。     

胃液胃癌抗原检测与胃镜病理127例对比分析

本文采用胃癌单克隆抗体斑点试剂盒对１２７例住院及门诊患者进行胃癌抗原检测与胃镜胃病理做对照，真阳性９例，真阴性５６例假阳性６２例，其敏感性１００％，正确性５１．１８％，阳性预测值为１２．１％，无漏诊病人。对胃癌及非胃癌组，胃癌前病变与良性进行Ｘ＾２检验均有显著性差别，因此可用于胃癌大面积普查及门诊筛检。本组检验胃癌与癌前病变无显著性差别，这可能与癌前癌病变分泌的糖蛋白有交叉反应，本文对假阳性的原因     

Fas、Fas配体和IFN-γ在胃癌中的表达

目的：研究Fas、Fas配体(FasL)和干扰素-γ(IFN-γ)在胃癌中的表达规律及可能的意义。方法：在石蜡包埋的58例胃癌组织和其中相对应的53例癌旁正常组织中，采用免疫组化方法检测Fas、FasL蛋白的表达，采用原位杂交方法检测IFN-γ mRNA的表达。结果：胃癌组织中胃癌细胞和癌旁组织中胃上皮细胞Fas阳性率分别为19．0％和64．2％，胃癌组阳性率明显低于癌旁组(χ^2=23．46；P=0．00)。胃癌组织中胃癌细胞和癌旁组织中胃上皮细胞FasL阳性率分别为63．8％和45．3％，胃癌组阳性率明显高于癌旁组(χ^2=3．83；P=0．05)。癌旁组织中胃上皮细胞，IFN-γ阳性率为49．1％，而胃癌组织中未发现一例阳性。结论：胃癌细胞Fas—FasL系统平衡失调，本研究中胃癌细胞不表达IFN-γ，可能与胃上皮细胞癌变及免疫逃逸有关。     

在胃癌多阶段形态发生中P_53蛋白表达

应用免疫组化(SP)法探讨P_(53)蛋白在胃癌多阶段形态发生中及胃癌不同分型间表达的关系。结果显示胃癌中P_(53)蛋白表达阳性率为50％,癌旁非癌上皮为3.3％,癌中表达明显高于癌旁非癌上皮,尤其是异型增生与早期胃癌两组间P_(53)蛋白表达差异显著(P<0.01),后者显著高于前者并随癌分化降低,P_(53)表达增强,在低、未分化组中P_(53)蛋白表达明显高于高、中分化组(P<0.01);而在胃粘液癌与普通型癌间表达无显著差异。本文结果提示:虽然这P_(53)基因蛋白表达可出现于胃癌早期,但P_(53)强阳性表达主要发生于胃癌较晚期。     

胃癌组织中肝素酶mRNA的原位表达与胃癌转移的关系

目的:探讨肝素酶(HPA)mRNA表达与胃癌转移的关系。方法:采用原位杂交技术检测36例胃腺癌组 织、相应癌旁组织及111例正常胃组织HPA mRNA的表达。结果:正常胃组织、癌旁和胃癌组织HPA mRNA阳性表达率分别为9.1％、33.3％和72.2％,3者间差异均有统计学意义(P<0.05)。有淋巴结转移组的癌及癌旁组织中HPA mRNA阳性表达率分别为88.9％,40.7％。无淋巴结转移组癌及癌旁组织中阳性表达率分别为22.2％,11.1％,2组间差异均有统计学意义(P<0.05)。结论:HPA mRNA高表达可作为判断胃癌转移的有益指标。     

阿的平荧光胃脱落细胞检查对胃癌的诊断价值(附55例报告)

本文报道55例采用阿的平荧光胃脱落细胞检查结果,其中胃癌组31例,荧光阳性20例,阳性率64.6％,阿的平荧光检查与细胞学检查符合率73.7％;良性组24例,荧光阴性20例,符合率83.3％。本法操作简单,对病人无多大痛苦,镜检速度快,可用于胃癌普查的筛选。并就阿的平荧光胃脱落细胞检查对胃癌诊断的机理及影响荧光胃脱落细胞检查的可能因素进行了讨论。     

萎缩性胃炎与胃癌关系研究新进展

胃癌是我国最常见的恶性肿瘤，每年约16～20万人死于该病。目前胃癌最有效的治疗措施仍为手术治疗，早期胃癌术后五年生存率可从晚期胃癌的20～40％提高到95％以上，十年生存率约90％，而微小胃癌五年存活率几乎100％。WHO资料显示从癌前疾病和病变演变成早期胃癌需数年或十年以上时间，因而进一步明确癌前病变与胃癌的关系，确定胃癌高危人群随访范围，将是胃癌二级防冶的有效措施。以往一般认为，胃息肉、残胃、恶性贫血、萎缩性胃炎（简称“萎胃”，下同）及胃溃疡均为前状态，西南医院消化内科经近20年研究表明，萎缩性胃炎是上述癌前状态的共同基础，值得重视。     

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.