胃癌血管内皮细胞生长因子的表达及微血管密度检测

①目的 探讨胃癌组织血管内皮细胞生长因子（VEGF）的表达及微血管密度（MVD）的检测及其临床意义。②方法 应用免疫组织化学方法（SP法）对34例胃癌及正常组织进行VEGF多克隆抗体及CD34单克隆抗体染色，观察胃癌VEGF的表达与MVD之间的相关性。③结果 血管内皮细胞生长因子的表达与肿瘤组织微血管密度之间存在正相关性，二者均与大肠癌的病理分级、临床分期有显著相关性，但与性别无关。④结论 血管内皮细胞生长因子与胃癌组织微血管形成有关，VEGF和MVD均与胃癌的生长转移相关，可作为反映胃癌预后的指标。     

膀胱移行细胞癌微血管密度与其复发的关系

目的:探讨肿瘤微血管形成能力与膀胱移行细胞癌复发的关系及机制。方法:采用免疫组化的方法对42例膀胱移行细胞癌组织中的第Ⅷ因子相关抗原,碱性成纤维细胞生长因子(bFGF)及血管内皮细胞生长因子(VEGF)分别进行特异染色,记数肿瘤内微血管密度(MVD),并观察bFGF、VEGF的表达。结果:VEGF和bFGF的阳性表达率分别为:59.5%和40.5%,MVD阳性表达组显著高于阴性表达组(P<0.05),术后复发组显著高于未复发组(P<0.05),且高MVD组复发率高于低MVD组(P<0.05)。结论:MVD与膀胱移行细胞癌复发有关,而且血管形成因子的异常表达是其微血管形成能力增高的重要因素。     

VEGF及PD-ECGF在膀胱癌的表达及与肿瘤血管生成的关系

目的：研究膀胱移行细胞癌中血管内皮生长因子（VEGF），血小板源性内皮细胞生长因子（PD－ECGF）的表达及肿瘤血管形成的情况及意义。方法：采用免疫组化SP法分析68例原发性膀胱移行细胞部的VEGF，PDECGF的表达情况，检测CD34以计算微血管密度（MVD）。结果：膀胱癌中VEGF表达率为61．76％（42／68）；PDECGF表达率为54．41％（37／68）；二者共同阳性表达率为38．24％（26／68）。VEGF，PD－ECGF与膀胱癌的分级，分期和预后相关，并与MVD呈正相关（P＜0．05）。此外二者之间也有相关性（P＜0．05）。结论：VEGF，PD－ECGF能共同调节膀胱癌的血管形成，可用于判断膀胱癌的生物学行为。     

COX-2、VEGF蛋白表达及微血管密度在非小细胞肺癌中的意义

目的探讨环氧化酶2（COX-2）、血管内皮生长因子（VEGF）和微血管密度（MVD）在非小细胞肺癌（NSCLC）进展过程中的意义，分析COX-2、VEGF和MVD的相关性。方法应用免疫组化两步法检测17例正常肺组织、48例NSCLC组织中COX-2、VEGF的表达水平及其MVD。结果NSCLC中COX-2、VEGF蛋白表达及MVD高于正常肺组织，差异非常显著，并与肿瘤浸润发展有-定相关性。MVD随COX-2、VEGF表达增强而增高。结论COX-2、VEGF及MVD可以作为判断NSCLC恶性程度及预后的生物学指标；COX-2的高表达影响VEGF表达上调，促进肿瘤血管形成，增加微血管密度。     

膀胱移行细胞癌iNOS的表达及其与MVD关系的研究

目的：探讨膀胱移行细胞癌组织中诱导型一氧化氮合酶（iNOS）的表达及其与肿瘤微血管密度（MVD）的关系。方法：采用iNOS及CD34抗体对35例膀胱移行细胞癌标本，12例癌旁粘膜标本及8例正常膀胱粘膜标本进行免疫组化染色，观察标本中iNOS的表达及与MVD值之间的相关性。结果：35例肿瘤标本中iNOS阳性表达率85．7％，iNOS表达与肿瘤病理分级、分期无关。移行细胞癌MVD值较癌旁粘膜、正常粘膜高，且低分化肿瘤的MVD值较高分化者高，浸润性肿瘤的MVD值较浅表性肿瘤高；iNOS表达与MVD存在正相关性。癌旁粘膜与正常膀胱粘膜比较，iNOS表达与MVD值的差别无 显著性意义。结论：iNOS在膀胱移行细胞癌中的表达增高，可能与肿瘤血管形成有关。     

血管内皮生长因子在直肠癌中的表达和临床意义

目的：探讨血管内皮生长因子（VEGF）在直肠癌组织中的表达及其对肿瘤新生血管生成及转移的影响。方法：用免疫组化技术,检测46例患者直肠癌VEGF的表达和微血管密度（MVD）,并分析其与浸润深度、淋巴结转移的相关性。结果：VEGF表达阳性细胞和肿瘤新生血管主要位于癌浸润的边缘,VEGF表达阳性组MVD值较高,淋巴结转移组VEGF表达阳性率增高,VEGF表达与MVD值之间呈显著正相关,结论：直肠癌VEGF表达增强,在肿瘤血管生成和侵袭转移中有重要作用。     

唇鳞癌中VEGF表达和微血管密度的临床意义

目的：研究微血管密度(microvessel density,MVD)和血管内皮生长因子(vascular endothelial growth factor,VEGF)在唇鳞癌中的表达，探讨其临床意义。方法:采用SABC免疫组织化学染色方法检测37例唇鳞癌中MVD和VEGF的表达，采用SPSS软件行统计分析。结果：62．16％唇癌组织呈VEGF阳性表达。VEGF表达阳性的唇癌组织MVD显著高于VEGF表达阴性者(P＜0．05)。VEGF表达与肿瘤的分化程度、淋巴结转移及浸润深度密切相关，而与肿瘤的临床分期无关。MVD记数与肿瘤的分化程度、淋巴结转移、浸润深度及临床分期密切相关。结论：唇癌组织VEGF表达与微血管密度有明显的相关性，是唇癌主要的新生血管诱导因子之一，VEGF、MVD可做为反映唇癌生物学行为的一个有效指标。     

大肠癌组织中CD105标记微血管密度表达及其临床意义

肿瘤的生长和转移都依赖于新生血管的形成（angiogenesis）。CD105（endoglin）是主要表达于新生血管内皮细胞上的一种糖蛋白，是一种新型的血管内皮标记物。血管内皮生长因子（VEGF）对肿瘤新生血管的生成起决定性作用。本研究应用抗-CD105单克隆抗体对大肠癌新生血管的微血管密度（MVD）进行定量检测．并对大肠癌组织MVD与VEGF表达的相关性进行了分析，探讨MVD和VEGF的表达在大肠癌生长、转移及预后判断中的临床价值。     

膀胱移行细胞癌组织间质微血管密度和增殖细胞核抗原的表达及意义

目的：探讨膀胱移行细胞癌组织中增殖细胞核抗原（proliferating cell nuclear antigen,PCNA)与肿瘤间微血管密度（microvessel density,MVD)和肿瘤侵袭力，复发的关系及意义。方法：应用免疫组化LSAB法检测72例膀胱移行细胞癌PCNA，第Ⅷ因子相关抗原（VWF：Ag)的表达，并对病人进行随访分析。结果：PCNA增殖指数与肿瘤间质微血管密度之间存在正相关性，两者的表达皆与膀胱移行细胞癌的病理分级显著相关，I级与Ⅱ级，Ⅱ级与Ⅲ级之间存在显著性差异（P＜0．01），侵袭性肿瘤明显高于浅表性肿瘤（P＜0．01），手术3年后随访复发组明显高于未复发组（P＜0．01）。结论：PCNA的表达为膀胱移行细胞癌的恶性表型，且与膀胱肿瘤间质微血管形成有关，上述两项指标联合检测对评估膀胱移行细胞癌的预后有重要的意义。     

缺氧诱导因子-1α和血管内皮生长因子在膀胱癌中的表达及其与微血管密度的关系

目的 研究膀胱癌及正常膀胱组织缺氧诱导因子-1α(HIF-1α)、血管内皮生长因子(VECF)的表达及微血管密度(MVD)在膀胱移行细胞癌血管生成及生物学行为的关系.方法 采用免疫组织化学方法检测40例膀胱移行细胞癌和10例正常膀胱组织的HIF-1α、VEGF表达及MVD.结果 膀胱移行细胞癌组织中HIF-1α阳性表达率为77.5%,VEGF阳性表达率为75%,MVD平均为(37.8±8.3),正常膀胱组织中仅1例可见VEGF表达.膀胱移行细胞癌组织HIF-1α及VEGF表达较正常膀胱组织明显增高(P<0.05);膀胱移行细胞癌组织MVD值显著高于正常组织;HIF-1α阳性表达程度与VEGF阳性表达率及MVD成正相关;膀胱移行细胞癌组织中HIF-1α表达与病理分级呈正相关(P<0.05).结论 HIF-1α、VEGF在膀胱移行细胞癌组织血管生成过程中起主要作用;HIF-1α与膀胱移行细胞癌的生物学行为有关,可作为膀胱癌生物学行为的标志.     

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.