环氧化酶在宫颈癌中的表达及其临床意义

目的：研究环氧化酶（COX）在正常宫颈上皮组织宫颈上皮内瘤变（CIN）及宫颈癌中的表达,探讨其与宫颈癌临床、痛理特征的关系。方法：采用组织芯片技术结合免疫组织化学PV法分别检测101例宫颈癌、12例宫颈上皮内瘤变和正常宫颈上皮组织中COX-1、COX-2的表达。结果：①COX—1在正常宫颈组织、CIN及宫颈癌中的表达差异无统计学意义（P〉0．05）。COX-2在正常宫颈组织中无表达,在CIN（66．7％）及宫颈癌（87．1％）中的表达率明显高于正常宫颈组织（P〈0．01）,但COX-2在CIN及宫颈浸润癌中的表达率比较,差异无统计学意义（P〉0．05）。②宫颈癌中COX-1的表达与发病年龄、临床分期、病理分级、宫颈浸润深度及淋巴结转移无关（P〉0．05）;COX-2的表达与发病年龄、临床分期、病理分级及宫颈浸润深度无关（P〉0．05）,而与淋巴结转移有关（P〈0．05）,伴淋巴结转移者COX-2的表达较高。结论：COX-1的表达可能与宫颈癌的发生、发展无直接关系;COX-2过度表达可能参与宫颈癌的发生、发展过程,故可作为反映宫颈癌生物学行为的有效指标之一。     

宫颈癌组织及细胞中环氧合酶-2的表达及其意义

目的: 研究宫颈癌组织及细胞株中环氧合酶-2(COX-2)蛋白及基因表达情况. 方法: 用免疫组化方法检测29例宫颈癌患者COX-2的表达水平,并以14例慢性宫颈炎症患者和18例正常宫颈上皮为对照组;用免疫细胞化学方法和原位分子杂交法检测宫颈癌细胞株SiHa和HeLa中COX-2蛋白及基因表达. 结果: ①宫颈癌患者COX-2表达阳性率为75.9%,高于慢性宫颈炎症患者和正常宫颈上皮组(P<0.01);②COX-2在不同宫颈癌FIGO(国际妇产科联盟)分期、病理分级中的表达水平不同,但这一差异无统计学意义(P>0.05);③COX-2在宫颈鳞癌及腺癌中均有表达,但两者相比无显著性差异(P>0.05),在腺鳞癌中未见COX-2表达;④COX-2在宫颈癌细胞株SiHa和HeLa中均有阳性表达,两者表达强度无明显差异;⑤在宫颈癌细胞株SiHa和HeLa中均可见到COX-2 mRNA呈阳性表达. 结论: 宫颈癌中COX-2的表达水平明显上调,其表达与宫颈癌的发生发展有关.     

宫颈癌组织中HPV和p53基因表达的检测

①目的 探讨人乳头瘤病毒（HPV）感染和p53基因异常在宫颈癌发生发展中的作用。②方法 用PCR技术检测12例宫颈原位癌、45例宫颈癌和20例正常宫颈组织中HPVl6／18DNA，RT-PCR检测HPV16／18阳性标本E6基因mRNA表达，聚合酶链反应-单链构象多态性（PCR-SSCP）技术检测p53基因外显子5～8的突变，同时采用免疫组化技术检测P53蛋白的表达。③结果 宫颈原位癌、宫颈癌HPV16／18阳性率均为66．67％，明显高于正常宫颈组织（20．00％），差异有显著性（χ^2=5．12、12．09，P〈0．05、0．01）。宫颈癌组织中HPV16／18 E6基因mRNA阳性表达率明显高于正常宫颈组织，差异有显著性（P=0．039）。宫颈原位癌和正常宫颈组织间、宫颈原位癌和宫颈癌间HPV16／18 E6 mRNA阳性表达率差异均无显著性（P=0．141、0．272）。45例宫颈癌标本中测得exon5和exon7突变各1例，均发生在HPV阴性宫颈癌组织，未检测到exon6和exon8的突变。宫颈原位癌和正常宫颈组织中均未检测到p53基因突变。正常宫颈组织中未检测到P53蛋白表达，宫颈原位癌和宫颈癌组织中P53蛋白阳性表达率分别为25．00％和42．22％，明显高于正常宫颈组织（χ^2=10．81，P（0．01）。P53蛋白的表达与HPV16／18感染无明显相关性（P〉O．05）。④结论 HPV感染和p53基因异常与官颈癌的发生密切相关，官颈癌组织中p53基因的突变率较低，推测P53蛋白的异常累积可能并非p53基因突变所致。     

HIF-1α和 P53蛋白在宫颈上皮内瘤样变及宫颈癌中的表达及意义

目的探讨HIF-1α和P53蛋白在宫颈癌,宫颈上皮内瘤样变及宫颈鳞状上皮组织中的表达及意义。方法采用免疫组化SP法检测了HIF-1α和P53蛋白在20例宫颈鳞状上皮组织,28例宫颈上皮内瘤样变和54例宫颈癌中的表达情况,其中宫颈鳞状上皮组织作为对照组。结果HIF-1α在宫颈鳞状上皮、宫颈上皮内瘤样变和宫颈癌中的阳性表达率分别为0.0%、35.71%、64.81%,三者阳性表达呈逐渐上升的趋势,三者之间存在显著性差异(P<0.01);HIF-1α在宫颈上皮内瘤样变中的表达与对照组间差异显著(P<0.05);HIF-1α在宫颈癌中的表达与对照组间差异显著(P<0.01);HIF-1α在宫颈上皮内瘤样变中的表达与在宫颈癌中的表达间存在显著性差异(P<0.05);HIF-1α在CINⅠ、CINⅡ、CINⅢ中表达率分别为0.0%、37.50%、63.64%,呈现逐渐上升趋势,但统计学无显著性差异(P>0.05);同时研究还表明HIF-1α在宫颈癌组织学类型上无显著性差异(P>0.05)。P53蛋白在宫颈鳞状上皮、宫颈上皮内瘤样变和宫颈癌中的阳性表达率分别为0.0%、35.71%、74.07%,三者阳性表达呈逐渐上升趋势,三者之间存在显著性差异(P<0.01);P53蛋白在宫颈上皮内瘤样变中的表达与对照组间差异显著(P<0.05);P53蛋白在宫颈癌中的表达与对照组间差异显著(P<0.01);P53蛋白在宫颈上皮内瘤样变中的表达与在宫颈癌中的表达间有显著性差异(P<0.01);P53蛋白在CINⅠ、CINⅡ、CINⅢ中表达率分别为0.0%、33.3%、54.55%,呈现逐渐上升的趋势,但统计学无显著性差异(P>0.05);同时研究还表明P53蛋白在宫颈癌组织学类型上无显著性差异(P>0.05)。HIF-1α与P53蛋白在正常宫颈组织中均无阳性表达,随着宫颈上皮内瘤样变的发展,出现逐渐上升的阳性表达趋势,直到宫颈癌组织中,HIF-1α与P53蛋白均出现强阳性表达,并且二者具有显著性差异(P<0.01),具有相关性。结论HIF-1α与P53蛋白的过度表达与宫颈癌的发生、发展有关,是宫颈癌发生的早期事件。     

COX-2和TGFβ1在宫颈癌中的表达及其意义

目的 探讨环氧合酶-2（COX-2）和转化生长因子β1（TGFβ1）的表达与宫颈癌生物学行为特征的关系。方法 采用免疫组化SP法检测郑州大学第三附属医院2002年1月～2006年3月期间70例宫颈癌和25例正常宫颈组织中COX-2、TGF-β1的表达。结果 COX-2和TGFβ1蛋白在宫颈癌和正常宫颈组织中的表达差异有显著性意义（P〈0．05）；COX-2表达与宫颈癌淋巴结转移、肿瘤大小和组织学类型显著相关，TGFβ1的表达与淋巴结转移、肿瘤大小、临床分期和组织学类型显著相关。COX-2与TGFβ1的表达之间呈正相关（r=0．553，P〈0．05）。结论 COX-2和TGFβ1蛋白表达与宫颈癌的发生发展相关，并对宫颈癌的淋巴结转移可能起重要作用。     

FHIT基因在宫颈CIN及鳞癌中的表达及其与HPV16/18感染的关系

目的研究16、18型人乳头瘤病毒（HPVl6／18）DNA与脆性组氨酸三联体（FHIT）基因在宫颈鳞癌和宫颈上皮内瘤变（CIN）中的袁达情况,探讨其在宫颈癌变中的作用和意义。方法采用原位杂交法检测HPVl6／18在50例CIN和50例宫颈鳞癌中的感染情况,同时采用免疫组化S—P法检测FHIT基因的表达情况。结果正常宫颈组织鳞状上皮、CINI、CINII、CINIII和宫颈癌组织中FHIT表达下调或缺失袁达率分别为0％（0／15）、13．33％（2／15）、33．33％（5／15）、50％（10／20）、78％（39／50）,正常宫颈组织与宫颈癌之间、CIN与宫颈癌之间、低级别CIN（CINI）与高级别C1N（CINII、CINIII）之间比较,差异均有显著性（P〈0．05）;在高、中、低分化的浸润性宫颈癌中,FHIT表达下调或缺失表达率分别为61．53％（8／13）、73．68％（14／19）、94．44％（17／18）,P〈0．05;FHIT表达与宫颈鳞癌的临床分期及有无淋巴结转移无关。HPVl6／18DNA在CIN和宫颈鳞癌中的阳性表达率分别为40％（20／50）、60％（30／50）,均明显高于正常宫颈组0％（0／15）,P〈0．05;宫颈癌中HPVl6／18感染与FHIT表达呈明显正相关,P〈0．05．结论FHIT表达缺失、HPVl6／18感染均与CIN和宫颈癌的发生密切相关,FHIT缺失可作为CIN有可能发展为浸润癌的有用指标,HPVl6／18感染可能是宫颈癌中FHIT异常的原因。     

基质金属蛋白酶-9及环氧合酶-2在宫颈癌组织中的表达及临床意义

目的 探讨基质金属蛋白酶-9(MMP-9)和环氧合酶-2(COX-2)在宫颈癌组织中的表达情况及相关性.方法 SP法检测93例宫颈癌,65例宫颈上皮内瘤变(CIN)、37例正常宫颈中MMP-9和COX-2的表达情况.结果 MMP-9和COX-2蛋白在正常宫颈中均无表达,两者在宫颈癌、CIN和正常宫颈中的表达与在宫颈癌伴有淋巴结转移与未转移的表达比较差异均有统计学意义(P<0.05),在宫颈癌中的表达呈正相关(r=0.3771,P<0.05).结论 MMP-9和COX-2在宫颈癌中高表达且可能起协同作用.     

COX-2和VEGF在宫颈癌组织中的表达及临床意义

目的 探讨血管内皮生长因子(VEGF)和环氧化酶2(COX-2)在宫颈癌中的表达及其与宫颈癌临床病理特征的关系.方法 采用免疫组化SP法检测COX-2、VEGF在56例宫颈癌、15例正常宫颈组织中的表达.结果 COX-2和VEGF蛋白在宫颈癌和正常宫颈组织中的表达有显著性差异(P<0.01).COX-2蛋白表达与宫颈癌分化程度、组织学类型、淋巴结转移等显著相关(P<0.05);VEGF蛋白表达与宫颈癌临床分期、淋巴结转移有显著相关(P<0.05).宫颈癌中VEGF与COX-2的表达密切相关(r=0.58,P<0.01).结论 COX-2和VEGF两种蛋白与宫颈癌的发生发展相关,并在宫颈癌的侵袭转移中起一定作用.     

宫颈癌组织Bcl-2基因的表达与HPV感染的关系

目的研究宫颈癌组织Bcl-2基因的表达与人乳头瘤病毒（HPV）感染的关系。方法应用免疫组化PV-9000法对正常宫颈组织38例、各级宫颈上皮内瘤样变（CIN）组织106例、宫颈癌组织66例中Bcl-2基因的表达水平进行检测。应用PCR方法对66例宫颈癌组织中HPV表达进行检测及分型。结果Bcl-2在各宫颈组织中均有表达,宫颈癌组Bcl-2阳性表达率（57．6％）,显著高于正常宫颈组（15．8％）和CINI组（19．4％）,P均〈0．01;高于CINⅡ组（28．6％）,P〈0．05;与CINlI组（60．0％）比较差异无统计学意义,P〉0．05。宫颈癌组织中Bcl-2蛋白表达与HPV感染具有相关性,P〈0．05。Bcl-2蛋白在HPVl6／18阳性宫颈癌组织和HPV其他型别阳性宫颈癌组织中表达差异无统计学意义,P〉0．05。结论Bcl-2蛋白的高表达可能在宫颈癌的发生发展中起重要作用。Bcl-2蛋白的高表达与宫颈癌HPV感染相关,但与HPV型别关系不大。Bcl-2蛋白可能成为宫颈癌诊断和治疗的指标。     

宫颈癌与CIN中端粒酶活性及增殖细胞核抗原的表达

目的 探讨宫颈癌、宫颈上皮内瘤样病变(CIN)中端粒酶及增殖细胞核抗原(PCNA)的表达.方法 采用TRAP-银染法检测宫颈癌、CIN及正常宫颈的端粒酶活性,并用S-P法测定相应标本的增殖细胞核抗原水平.结果 宫颈癌、CIN及正常宫颈中端粒酶阳性表达率分别为86.67%、35.71%和0.00%:PCNA标记指数分别为66.73±12.41、37.28±11.25和6.97±4.05,各组比较差异有显著性(P<0.01,P<0.05),并且端粒酶阳性组PCNA表达级别高于端粒酶阴性组,差异有显著性(P<0.05).结论 端粒酶阳性表达与宫颈癌的发生有关;PCNA高表达与端粒酶激活有关.     

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.