EB病毒在鼻咽癌变过程中作用的研究

小结作者参加“EB病毒在鼻咽癌变过程中作用研究”的结果。包括：（1）EB病毒感染与鼻咽癌变的关系。（2）EB病毒血清学与鼻咽癌变的关系；（3）EB病毒在鼻咽癌以外的EB病毒相关性肿瘤中的作用；（4）EB病毒编码产物在鼻咽癌变中的作用。文章强调下列观点；（1）EB病毒开始感染异型性上皮细胞是鼻咽癌变的早期分子事件；（2）EB病毒LMP1可在上皮癌变中起关键作用；（3）检测血清中两种以上的抗EB病毒抗体可以提高鼻咽癌血清学诊断的效益。     

EB病毒相关性疾病病理学研究的进展

报告作者及其同事在鼻咽癌高发的广州地区所做EB 病毒相关性疾病病理学研究的进展。内容 包括: ①EB 病毒病理生物学; ②EB 病毒相关性疾病病理学; ③检测组织中的EB 病毒; ④EB 病毒血清学。 重点是EB 病毒相关性疾病的病理学以及评估各种检测EB 病毒相关性疾病患者组织和血清中EB 病毒的方 法。     

三种不同检测方法在鼻咽癌诊断中的价值比较

[摘要] 目的 探讨电子鼻咽镜、鼻咽CT及EB病毒血清学检查三种检测方法在鼻咽癌诊断中的价值。方法 采用电子鼻咽镜、鼻咽CT及EB病毒VCA-IgA血清学检查三种检测方法对我院就诊的45例可疑鼻咽癌患者进行检查,所有患者随访半年,比较三种方法诊断鼻咽癌的敏感性。结果 45例观察对象中38例确诊为鼻咽癌,确诊的38例鼻咽癌患者中,电子鼻咽镜检查诊断鼻咽癌36例;鼻咽CT检查诊断鼻咽癌31例;EB病毒血清学检查发现28例EB病毒VCA-IgA为阳性。经统计学分析电子鼻咽镜检查在鼻咽癌早期的诊断中具有较高的敏感性,差异有统计学意义（P<0.05）。结论 电子鼻咽镜检查可对鼻咽癌作出较准确的判断,对鼻咽癌的可疑患者及早行电子鼻咽镜检查在鼻咽癌的早期诊断中具有重要意义。     

EB病毒相关性疾病病理学研究的进展

报告作者及其同事在鼻咽癌高发的广州地区所做EB病毒相关性疾病病理学研究的进展。内容包括：①EB病毒病理生物学；②EB病毒相关性疾病病理学；③检测组织中的EB病毒；④EB病毒血清学。重点是EB病毒相关性疾病的病理学以及评估各种检测EB病毒相关性疾病患者组织和血清中EB病毒的方法。     

鼻咽结核及其合并鼻咽癌的诊治体会

目的探讨鼻咽结核合并鼻咽癌的临床特征,提高认识,减少误诊.方法对自1984年3月～2004年1月,我们诊治的6例鼻咽结核合并鼻咽癌和20例鼻咽结核患的临床资料进行分析.结果鼻咽结核组:①年轻;②颈淋巴结偏小、多个,多双侧,常融合成串,质地中,可活动;③耳、鼻症状少;④无颅神经损害;⑤EB病毒VCA-IgA抗体滴度测定阴性;⑥病变部位均在顶壁是其特点;⑦咽痛(12/20)和颈酸痛(13/20)可能又是鼻咽和颈淋巴结结核特有的临床症状.鼻咽结核合并鼻咽癌组:①中年居多;②颈淋巴结较大,质地硬,固定;③多有耳、鼻症状;④常伴颅神经损害;⑤EB病毒VCA-IgA抗体滴度测定阳性;⑥50%(3/6例)患初诊误诊为鼻咽结核.结论鼻咽结核合并鼻咽癌易误诊,临床医师应提高警觉,与鼻咽结核的鉴别诊断除临床表现外,需做活检在病理上给予确诊,EB病毒VCA-IgA抗体滴度测定有重要的鉴别诊断价值.误诊会降低存活率.     

应用抗补体免疫酶法检查鼻咽癌细胞和鼻咽部上皮细胞中的EB病毒核抗原

本文用抗补体免疫酶法检查鼻咽部脱落细胞的EBNA,结果①79例鼻咽癌病人全部阳性,其阳性检出率比细胞学(87.3％)和组织学(91.1％)方法高;②4例初次检查EBNA阳性,但细胞学和组织学阴性者,3个月内复查也找到癌细胞;③18例头颈部其他肿瘤病人和21例胎儿全部阴性,并为细胞学和组织学方法所证实。这表明抗补体免疫酶法检查EBNA是特异和敏感的,有助于鼻咽癌的早期诊断。除了在鼻咽癌细胞发现EBNA外,在鼻咽部柱状上皮细胞和增生细胞也发现EBNA,这可能与EB病毒引起的癌变过程有关。     

鼻咽癌31例EB病毒壳抗原免疫球蛋白A抗体的测定(摘要)

<正> 自发现鼻咽癌病人与EB 病毒(Epstein-BarrVirus)有血清学上关系以来,不同地区学者陆续报道鼻咽癌病人中血清EB 病毒壳抗原免疫球蛋白A(VCA-IgA)抗体阳性率很高,且呈高滴度分布。本文应用免疫荧光细胞化学方法对西安地区31例鼻咽癌患者,13例非鼻咽癌患者(包括头颈部其它恶性肿瘤6例,鼻咽粘膜慢性炎症7例)进行了VCA-IgA 抗体测定。     

45例EB病毒VCA-IgA抗体阳性者鼻咽粘膜组织学改变追踪观察

我们应用血清学普查鼻咽癌,证实免疫酶法测定血清EB病毒VCA-IgA抗体(以下简称VCA-IgA)对鼻咽癌的诊断较为特异。本组45例VCA-IgA阳性临床诊断非鼻咽癌追踪观察发现:鼻咽粘膜由单纯性增生、化生发展到异型增生、化生以至癌变,或异型增生、化生发展到癌变者,其抗体水平升高。鼻咽粘膜正常或单纯性增生、化生者,或由异型增生或化生变成正常粘膜或单纯增生化生者,则其抗体水平保持相对稳定。从动态观察中还发现,中度至重度异型     

EB病毒感染情况结合间接鼻咽镜筛查长沙市健康人群鼻咽癌

目的 检测EB病毒VCA-IgA在健康人群中的抗体水平,了解长沙市人群中的EB病毒感染情况,并结合间接鼻咽镜筛查鼻咽癌.方法 使用酶联免疫吸附法,检测EB病毒VCA-IgA水平.对于EB病毒VCA-IgA阳性个体,应用问接鼻咽镜检查鼻咽部,发现异常即取组织送病理检查.结果 长沙市1 808例健康人群EB病毒VCA-IgA检测:阳性者206例,检出阳性率为11.39%.其中男性阳性率为12.17%,女性阳性率为9.66%.男女无显著性差异(P=0.121).阳性个体EB病毒VCA-IgA抗体滴度在1:10~1:20之间.共对198例阳性个体进行间接鼻咽镜检查,最后病理学检查确诊鼻咽癌3例.结论 长沙市健康人群EB病毒感染率较高,存在相对较高的鼻咽癌患病风险;血清EB病毒VCA-IgA普查结合间接鼻咽镜是鼻咽癌人群筛查的有效手段.     

EB病毒基因检测诊断鼻咽癌的初步探讨

有关资料表明,EB病毒感染与鼻咽癌的发生有密切关系。鼻咽癌患者体内都有较高水平的抗EB病毒抗EB病毒抗体。长期以来,免疫酶法已做为鼻咽癌的重要血清学检测指标之一,但它是一种间接辅助的检测手段,有一定局限性。本实验用PCR法检测71例IgA/VCA抗体阳性患者的鼻咽部脱落细胞中的EB病毒DNA,从中了解它与免疫酶     

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.