胃腺癌中IGFIR的表达及与抑癌基因PTEN相关性的研究

目的：研究胰岛素样生长因子Ⅰ受体（IGFIR）与抑癌基因PTEN在胃腺癌组织中的表达，探讨IGFIR与PTEN的相关性及其与胃癌临床病理学特征的关系。方法：采用免疫组织化学SP法检测60例胃腺癌患者肿瘤组织和60例癌旁正常组织中IGFIR和PTEN的表达水平。结果：60例胃腺癌组织中IGFIR蛋白表达阳性率为70％（42／60），癌旁正常胃组织中的阳性表达率为35%（21／60），二者比较有显著差异（P=0．000）；PTEN蛋白在胃腺癌中的阳性表达率为41．7％（25／60），在癌旁正常组织中的表达率为71．7％（43／60），两者比较有显著差异（P=0．001）；IGFIR的表达水平与病人的年龄、性别无显著相关性（P〉0．05），IGFIR在低分化腺癌表达要高于中高分化腺癌（P=0．002），有淋巴结转移者要高于无淋巴结转移者（P=0．003），并与肿瘤的临床分期（P=0．003）、浸润深度（P=0．006）有关；在胃腺癌组织中IGFIR和PTEN蛋白表达之间旱明显负相关（rs=-0．469，P〈0．001）。结论：IGFIR的表达与胃癌的生物学行为密切相关，其高表达可能有助于肿瘤的生长和转移，IGFIR有可能成为一个很好的分子治疗靶点；抑癌基因PTEN的失活与胃癌的发生发展密切相关；PTEN可能对IGFIR的表达有着调控作用。     

胃癌组织中血管生成素-2基因的表达和微血管密度研究

目的探讨血管生成素-2（Ang-2）基因在胃癌组织中的表达、微血管密度（MVD）与胃癌生物学行为之间的关系。方法采用免疫组化SP方法,检测64例胃癌组织、22例癌旁正常组织、20例胃良性疾病组织中血管生成素（Ang-2）,以CD34作为血管内皮细胞标记物,对CD34阳性血管进行MVD计数。结果 Ang-2在胃癌组织中的阳性表达率为68.75%,在癌旁正常组织和胃良性病变组织中的阳性表达率分别为22.27%、40.00%,差异有统计学意义（P〈0.01）;Ang-2表达与胃癌浸润深度、淋巴结转移、远处转移、临床分期呈正相关（P〈0.05）,Ang-2阴性表达者5年总生存期明显高于Ang-2阳性表达组（分别为50.00%及18.75%,P〈0.05）;胃癌组织、癌旁组织和胃良性病变组织中MVD分别为33.69±11.60、10.65±3.00和17.20±1.98,3者比较差异有统计学意义（P〈0.01）;MVD与浸润深度、淋巴结转移、远处转移及临床分期呈正相关（P〈0.01）,而与肿瘤大小、分化程度、有无脉管侵犯无相关（P〉0.05）;MVD≤33的胃癌患者总生存期较MVD〉33患者明显延长（分别为45.45%及16.67%）,差异有统计学意义﹙P〈0.05）。经相关分析,Ang-2阳性表达率与MVD呈正相关（r=0.618,P〈0.01）。结论 Ang-2的表达和MVD与胃癌的生长、浸润、转移及预后有一定的相关性。     

核因子-κB和环氧合酶-2在胃癌组织中的表达与肿瘤微血管形成的关系

目的研究核因子-κB（NF-κB）和环氧合酶-2（COX-2）在胃癌组织中的表达及其与肿瘤微血管密度（MVD）之间的关系。方法 采用免疫组织化学SP法检测142例胃癌中NF-κB、COX-2的表达和MVD，以相应的癌旁正常组织（30例）作对照。结果 NF-κB在胃癌组织中的阳性表达率为62．0％（88／142），显著高于对照组（2／30，P〈0．01）；NF-κB的表达与胃癌淋巴结转移、组织学类型和远处转移等临床病理指标显著相关（P〈0．05）。COX-2在胃癌组织中的阳性表达率为64．1％（91／142），在对照组无表达，二者比较差异有极显著性意义（P〈0．01），且COX-2的表达与是否有淋巴结转移显著相关（P〈0．01）。NF-κB和COX-2的表达呈正相关（r=0．380，P〈0．01）。NF-κB阳性表达组或COX-2阳性表达组胃癌MVD显著高于其阴性表达组。结论 NF-κB和COX-2在胃癌的发生发展中起着重要作用，促进了胃癌的血管生成。     

上皮性钙粘蛋白与肝细胞癌侵袭、转移的关系研究

目的探讨上皮性钙粘蛋白（E-Cadherin）在人肝细胞癌（HCC）中的表达及其与肝癌侵袭、转移性的关系。方法选择56例有完整随访资料的原发性肝细胞癌及相应癌旁组织标本、20例正常肝组织标本，用RT-PCR方法检测E-Cadherin mRNA的表达；用免疫组织化学方法检测E-Cadherin的表达。结果1．E-Cadherin在肝细胞癌组织中的表达低于癌旁组织和正常组织，差异有显著性意义（P〈0．05）；癌旁组织和正常组织中E-Cadherin的表达无显著性差异（P〉0．05）；2．E-Cadherin在肝癌组织中的表达与术后复发时间呈正相关（P〈0．05；R^2=0．786），与病理分期呈负相关（P〈0．05；R^2=0．678）；3．癌组织中E-Cadherin表达与肝外转移呈负相关（P〈0．05；R^2=0．704）；4．癌旁组织中E-Cadherin表达与术后复发时间呈正相关（P〈0．05；R^2=0．742）。结论E-Cadherin与肿瘤的分化程度，侵袭转移能力，复发倾向相关，在临床中有望作为肿瘤分化、复发、转移的评估指标之一。     

胃癌中缺氧诱导因子-1α、血管内皮细胞生长因子的表达及与微血管密度的关系

目的研究HIF-1α、VEGF在胃癌及正常胃组织中的表达及胃癌MVD特点，探讨它们在胃癌的发生、发展、浸润和转移中的作用。方法应用免疫组化sP法检测54例胃癌中HIF-1α、VEGF的表达情况并检测CD34标记的肿瘤MVD，探讨HIF-1α、VEGF在肿瘤血管生成中的作用，并分析HIF-1α、VEGF及MVD与胃癌ll告床病理因素的关系。结果HIF-1α在胃癌中的表达率（74．07％）明显高于正常胃组织（O％），P〈0．01；HIF-1α的表达与胃癌TNM分期、肿瘤浸润深度和淋巴结转移显著相关，P〈0．05。VEGF在胃癌的阳性表达率（68．5％）明显高于正常胃组织（13.3％）。P〈0．05；VEGF的表达与胃癌TNM分期、肿瘤浸润深度、淋巴结转移显著相关，P〈0．05。胃癌MVD（31．5±7．1）明显高于正常胃组织MVD（6．7±2．4），P〈0．01；胃癌MVD与胃癌TNM分期、肿瘤浸润深度和淋巴结转移显著相关，P〈0．01或P〈0．05。胃癌组织中HIF-1α与VEGF的表达呈正相关；HIF-1α与MVD的表达呈正相关；VEGF与MVD的表达呈正相关。结论HIF-1α，VEGF和MVD在胃癌的发生发展中起重要作用，联合检测可作为判断胃癌恶性程度和预后的指标。关     

趋化因子受体CCR7在胃癌组织中的表达及意义

目的探讨趋化因子受体CCR7在胃癌组织中的表达及其临床意义。方法采用RT—PCR及Western blot法检测32例胃癌及其癌旁对照组织中CCR7的表达。结果CCR7mRNA在胃癌组织中的表达水平为癌旁对照组的1．66倍（P〈0．01），且其表达水平与肿瘤TNM分期（P〈0．05）、浸润深度（P〈0．05）及淋巴结转移有关（P〈0．05）；Western blot结果显示CCR7蛋自在胃癌组织中的表达水平为癌旁对照组的2．3倍（P〈0．01），且高表达于肿瘤分期较晚（P〈0．05）、分化较差（P〈0．05）、浸润较深（P〈0．05）、有淋巴结转移（P〈0．05）和远处转移（P〈0．05）的组织。结论趋化因子受体CCR7可能与胃癌的发生、发展、侵袭、转移有关。     

组织芯片检测磷酸化AKT蛋白在不同胃组织中的表达

目的探讨磷酸化AKT蛋白在不同胃组织中的表达意义。方法采用免疫组织化学染色,检测胃组织芯片（包括对照组正常胃黏膜、癌旁、非典型增生、原发癌及淋巴结转移癌组织）中磷酸化AKT蛋白表达。结果与正常胃黏膜、癌旁和非典型增生组织相比,AKT蛋白磷酸化在原发癌、淋巴结转移癌中表达升高（P〈0．01）;与正常胃黏膜组织比较,磷酸化AKT蛋白在非典型增生组织中表达上调（P=0．26）。结论磷酸化AKT蛋白表达与胃癌的发生发展有关。     

色素上皮源性因子与胃癌组织血管生成和临床病理因素的关系

【目的】研究色素上皮源性因子（PEDF）和血管内皮生长因子（VEGF）在胃癌组织中的表达及与癌组织中微血管密度（MVD）的关系。探讨PEDF在胃癌组织血管生成中的作用及PEDF与胃癌临床病理因素的关系。【方法】用S—P免疫组织化学法检测82例人体胃癌组织标本中胃癌细胞内PEDF和VEGF的表达；标记CD34分子显示血管内皮细胞，并计数上述胃癌组织内的微血管密度；统计学分析上述分子标记物间的关系以及各分子标记物与胃癌临床病理因素间的关系。【结果】所有的正常胃黏膜均有PEDF表达，胃癌组织PEDF表达率约43％，VEGF表达率约54％；与高分化胃癌相比，低分化胃癌组织PEDF表达率低（P〈0．05），MVD高（P〈0．05）；PEDF低表达的胃癌细胞易侵犯浆膜（P〈0．05），易淋巴结转移（P〈0．01）和远处转移（P〈0．01）；胃癌组织PEDF表达与MVD（P〈0．01）和VEGF（P〈0．01）表达呈负相关关系，VEGF表达与MVD呈正相关关系（P〈0．01）。【结论】PEDF低表达和VEGF高表达可能是胃癌组织内微血管生成的分子基础。是促进胃癌细胞发生淋巴及血道转移的重要因素。     

色素上皮源性因子与胃癌组织血管生成和临床病理因素的关系

 【目的】研究色素上皮源性因子（PEDF）和血管内皮生长因子（VEGF）在胃癌组织中的表达及与癌组织中微血管密度（MVD）的关系。探讨PEDF在胃癌组织血管生成中的作用及PEDF与胃癌临床病理因素的关系。【方法】用S—P免疫组织化学法检测82例人体胃癌组织标本中胃癌细胞内PEDF和VEGF的表达；标记CD34分子显示血管内皮细胞，并计数上述胃癌组织内的微血管密度；统计学分析上述分子标记物间的关系以及各分子标记物与胃癌临床病理因素间的关系。【结果】所有的正常胃黏膜均有PEDF表达，胃癌组织PEDF表达率约43％，VEGF表达率约54％；与高分化胃癌相比，低分化胃癌组织PEDF表达率低（P〈0．05），MVD高（P〈0．05）；PEDF低表达的胃癌细胞易侵犯浆膜（P〈0．05），易淋巴结转移（P〈0．01）和远处转移（P〈0．01）；胃癌组织PEDF表达与MVD（P〈0．01）和VEGF（P〈0．01）表达呈负相关关系，VEGF表达与MVD呈正相关关系（P〈0．01）。【结论】PEDF低表达和VEGF高表达可能是胃癌组织内微血管生成的分子基础。是促进胃癌细胞发生淋巴及血道转移的重要因素。     

Dicer在胃癌组织的表达及临床意义

目的：探讨Dicer在胃癌组织中的表达及临床意义。方法：应用免疫组织化学法检测40例人胃癌组织和40例癌旁正常胃组织标本中Dicer的表达,并结合临床资料进行统计学分析。结果：Dicer在胃癌组织中阳性率为47．5％,癌旁正常胃组织为85．O％,Dicer阳性率低于癌旁正常胃组织（P〈0．01）;胃癌组织高、中度分化、有淋巴结转移、临床分期早期患者Dicer阳性率均高于低度和未分化、无淋巴结转移、临床进展期患者（P〈0．05～P〈0．01）,而在性别、年龄和癌灶原发部位间Dicer阳性率差异均无统计学意义（P〉0．05）。结论：胃癌组织中Dicer表达明显降低,并且Dicer表达与胃癌分化程度、有无淋巴结转移及临床分期有一定关系。     

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.