胆囊癌组织中iNOS的表达与肿瘤血管生成的关系

目的 :探讨肿瘤血管生成与胆囊癌生物学行为的关系 ,探讨诱导性一氧化氮合成酶 (induciblenitricoxidesyn thase,iNOS)在胆囊癌组织中的表达及与胆囊癌生物学行为的关系 ,探讨iNOS的表达与胆囊癌血管生成的关系 .方法 :选取手术切除的胆囊癌标本 4 0例及正常胆囊标本 8例 ,采用免疫组织化学的方法检测iNOS蛋白的表达 ,并用F Ⅷ相关抗原抗体标记血管内皮细胞 ,测定胆囊癌组织中的MVD微血管密度 (microvesseldensity ,MVD) .结合临床病理学指标进行统计学处理分析 .结果 :胆囊癌组织中MVD显著高于正常组织 (46± 14vs 14± 6 ,P <0 .0 5 ) .MVD与年龄、性别、肿瘤大小及组织学类型无关 .低分化及未分化组MVD >中分化组 >高分化组 (5 2± 9vs 4 3± 9vs 33± 6 ,P <0 .0 1) .Nevin分期Ⅳ ,Ⅴ期组的MVD显著高于Ⅰ ,Ⅱ期组及Ⅲ期组(5 2± 8vs 37± 13,P <0 .0 1) .淋巴结转移组MVD显著高于淋巴结未转移组 (5 3± 8vs 38± 8,P <0 .0 1) .肝脏转移组MVD显著高于肝脏未转移组 (5 5± 6vs 4 2± 10 ,P <0 .0 5 ) .iNOS在胆囊癌组织中阳性表达率为 5 2 .5 % ,iNOS的表达与年龄、性别、肿瘤大小、组织学类型、分化程度及临床分期无关 .淋巴结转移组iNOS的阳性表达率为 70 .0 % ,显著高于淋巴结未转移组 35 .0 % (P     

彩色多普勒超声检测宫颈癌血管生成活性对盆腔淋巴结转移的预测价值

目的　探讨宫颈癌血管生成活性与盆腔淋巴结转移的关系。方法　采用彩色多普勒血流显像(CDFI)技术检测 2 2例宫颈癌组织血流信号定量测定阻力指数 (RI) ,同时采用免疫组化技术的FⅧ RA检测肿瘤内微血管密度 (MVD) ,分析两者与盆腔淋巴结转移的关系。结果　①盆腔淋巴结转移组即LN(+ )组CDFI检测RI值 (0 .34± 0 .0 9)明显低于无盆腔淋巴结转移组LN(- )组 (0 .4 6± 0 .12 ) ,差异有显著性 (P <0 .0 5 )。②LN(+ )组MVD(6 7.4 2± 13.72 )较LN(- )组 (5 1.71± 11.4 9)显著增高 (P <0 .0 1)。③反映血管生成活性的RI值与MVD两者具有良好的相关性 (负相关 ) (r =- 0 .78,P <0 .0 1)。结论　宫颈癌血管生成活跃者淋巴转移可能性大 ,CD FI对宫颈癌肿瘤内血流检测可能为临床判断盆腔淋巴转移和手术彻底清扫淋巴结提供一较为简便的指标。     

非小细胞肺癌中血管内皮生长因子表达及与预后的关系

目的　探讨非小细胞肺癌 (NSCLC)中血管内皮生长因子 (VEGF)的表达和微血管密度 (MVD)的关系及与预后的相关性。方法　采用免疫组化方法 ,检测 6 0例NSCLC中VEGF的表达及MVD ,并以Log rank曲线检测其生存率。结果　 6 0例NSCLC中 ,VEGF表达的阳性率为 78.33% ,明显高于正常的肺组织 (4 0 % )。VEGF的表达与性别、年龄、肿物大小、病理类型等无关 (P >0 .0 5 ) ,而与MVD、淋巴结转移有关 (P <0 .0 5 )。在NSCLC中 ,VEGF阳性组的MVD〔(4 9.77± 11.9)条〕明显高于阴性组〔(31.6 7± 8.88)条〕。有淋巴结转移组的VEGF阳性率 (90 % )明显高于无淋巴结转移组 (6 6 .6 7% )。经生存曲线Log rank检测分析表明 ,VEGF表达与NSCLC的预后呈负相关。结论　VEGF的表达对肿瘤血管生成、转移起重要作用 ,与NSCLC预后密切相关 ,可以作为估计生存率的参考指标。     

微血管密度、微血管面积及nm23表达在大肠癌淋巴结转移中的作用及意义

应用免疫组化S -P法 ,检测nm2 3在伴淋巴结转移大肠癌组 (89例 )和不伴淋巴结转移大肠癌组 (12 7例 )肿瘤组织中的表达 ,并同时测定各组肿瘤的微血管密度及微血管面积。结果 ,伴淋巴结转移大肠癌组中nm2 3高表达数量 (4 3/ 89)比不伴淋巴结转移大肠癌组 (118/ 12 7)明显减低 (P <0 .0 1) ;伴淋巴结转移大肠癌组微血管密度为 5 0 .8± 2 1.8、微血管面积为 2 382 8.0± 9817.3;不伴淋巴结转移大肠癌组微血管密度为 34 .1± 19.3,微血管面积为 10 0 5 2 .9± 6 0 38.7,二组有显著性差别 (P <0 .0 1)。     

非小细胞肺癌P53、VEGF表达及其与肿瘤血管形成的关系

目的 :探讨P5 3和血管内皮生长因子 (VEGF)在非小细胞肺癌 (NSCLC)中的表达及其与肿瘤血管形成的关系。方法 :用免疫组织化学方法 (S -P法 ) ,检测 76例非小细胞肺癌患者手术切除标本P5 3、VEGF蛋白表达 ,并用Ⅷ因子抗体标记瘤组织中血管内皮细胞 ,计数MVD。结果 :非小细胞肺癌区P5 3、VEGF的阳性表达率及MVD值分别为 :5 5 .2 6 % ,36 .84 % ,32 .6 1± 8.14。非小细胞肺癌组织P5 3和VEGF的阳性表达率与淋巴结转移及临床分期密切相关。P5 3(+)或VEGF(+)组MVD (37.5 6± 6 .2 8,37.37± 7.98)均显著高于P5 3(- )或VEGF(- )组 (2 7.0 0± 5 .13,2 9.5 3± 5 .83;P <0 .0 1) ;VEGF和P5 3均为阳性时 ,MVD值最大 (4 3.5 3± 5 .0 1,P <0 .0 1)。MVD与P5 3蛋白及VEGF阳性表达、VEGF阳性表达与P5 3蛋白阳性表达均呈正相关。结论 :在非小细胞肺癌血管生成过程中 ,P5 3基因、VEGF在调控肿瘤血管形成方面起重要作用。     

微血管在非小细胞肺癌中的表达及临床意义

目的　探讨微血管形成在非小细胞肺癌中的表达及其临床意义。方法　采用免疫组织化学的方法 ,对33例病人非小细胞肺癌进行分析。结果　全部 33例非小细胞肺癌中 ,淋巴结转移组 :微血管密度 (MVD)为 43 6± 2 2 3,非淋巴结转移组 :为 2 4 6± 17 3(P <0 .0 1)。生存期 >5年 ,MVD为 2 2 4± 16 8,生存期 <半年者为 5 8 6± 2 3 4,P <0 0 1。结论MVD对非小细胞肺癌的转移及预后有预测作用 ,它的检测可为临床诊治提供更多依据。     

CD44v6、E-Cadherin表达与CNE-2Z-F1裸鼠移植瘤转移的关系

目的　探讨CD44v6、E -Cadherin表达与人鼻咽癌裸鼠移植瘤转移的关系。方法　分别将人鼻咽癌细胞克隆株F1在体外与鼠肺块共同孵育及胸内移植 ,然后将带瘤细胞肺块 (Ⅰ组 )和胸内瘤组织块 (Ⅱ组 )各行裸鼠皮下移植 ,并与瘤细胞悬液皮下移植瘤 (Ⅲ组 )比较 ,观察各组移植瘤转移特点。采用免疫组织化学技术检测各组移植瘤回复培养细胞CD44v6和E -Cadherin表达。结果　Ⅰ组和Ⅱ组皮下移植瘤的总转移率和淋巴结转移率均高于Ⅲ组 (其中ⅠvsⅢ ,P <0 .0 5) ;肺转移仅发生在Ⅰ组。这两组移植瘤细胞CD44v6表达水平明显增高 ,其阳性细胞数分别为 (79.7± 5.7) %、(74.1± 3.1 ) % ,第 3组为 (65.6± 4.31 ) %移植瘤转移率与CD44v6高表达密切相关 ;E -Cadherin阳性细胞分别为 (41 .7± 4.9) %、(43.8± 6.4) %和 (2 7.4± 4.9) % ,Ⅰ组、Ⅱ组与Ⅲ组之间比较 ,有显著差异 (P <0 .0 5)。结论　CD44v6的过表达和E -Cadherin功能障碍 ,可能在鼻咽癌侵袭转移中起一定作用。     

舌癌术前化疗PCNA、bcl-2、Bax基因表达及临床意义

目的 :通过舌癌术前化疗增殖细胞核抗原 (PCNA )和细胞凋亡相关基因 bcl- 2、Bax表达的研究 ,探讨舌癌的化疗作用机制。 方法 :对舌乳头状瘤、舌癌和舌癌术前化疗标本共 34例 ,采用免疫组织化学染色技术——酶标链亲和素生物素法 (L SAB)染色并进行光镜下观察。结果:PCNA在舌癌中的表达最强 ,在舌癌术前化疗中的表达明显减弱 (P <0 .0 5 ) ,其与舌乳头状瘤表达相似 (P >0 .0 5 )。 bcl- 2在舌癌术前化疗及舌乳头状瘤中低表达(P >0 .0 5 ) ,舌癌中表达明显增强 (P <0 .0 5 )。Bax在舌癌组和乳头状瘤组中表达有明显差异 (P <0 .0 5 )。结论 :化疗药物抑制肿瘤生长的机制可能与抑制肿瘤细胞增殖和诱导肿瘤细胞程序性死亡有关 ,提示舌癌术前化疗对肿瘤的预后有重要意义。     

微血管密度和血管内皮生长因子、P53表达与鼻咽癌预后的关系

目的 :研究鼻咽癌组织微血管密度、血管内皮生长因子和P5 3表达特征 ,探讨其作为预测鼻咽癌预后的应用价值。方法 :应用免疫组化S P法 ,计算机彩色图文分析系统 ,检测、计数分析了 10 5例鼻咽癌组织的血管内皮生长因子、P5 3表达和微血管密度 ,其中治疗后生存时间大于 5年的 5 2例 ,小于 5年的 5 3例。结果 :在附有完整临床随访资料和病理资料的 10 5例鼻咽癌病例中 ,微血管密度均值 (x±s)为 46 .5 6± 16 .34。其中生存时间小于 5年 ,发生转移的病例微血管密度均值为 5 3.5 8± 19.5 9(P <0 .0 5 ) ,5 9.80± 13.38(P <0 .0 0 1)。血管内皮生长因子 ,P5 3阳性表达病例微血管密度均值为 6 4.43± 19.14,6 0 .6 9± 18.2 5 (P均 <0 .0 1) 。结论 :提示微血管密度越大 ,鼻咽癌患者 5年生存率越低 ,越易转移。血管内皮生长因子、P5 3阳性表达 ,则微血管生成越多 ,预后亦越差。     

鼻咽癌内微血管密度与颈部淋巴结转移的关系

目的 :探讨鼻咽癌组织内微血管密度与颈部淋巴结转移的关系。方法 :应用免疫组织化学Envison法 ,对 80例鼻咽癌 (nasopharyngealcarcinoma ,NPC)的非角化性癌 (non keratinxingcarcinoma ,NKC)和 30例同时期鼻咽黏膜慢性炎症 (non tumornasopharyngeal,NP)进行血管内皮细胞CD34标记 ,并计数微血管密度 (microvasculardensity ,MVD)。结果 :80例NKC中MVD为 18 84± 5 4 6 ,30例NP的MVD为 13 4± 4 5 4 ,两组差异有显著性 (P <0 0 0 1) ;80例NKC中有颈部淋巴结转移 5 0例 ,MVD为 19 80± 5 6 7;无淋巴结转移 30例 ,MVD为 17 2 3± 4 76 ,两组间的差异有显著性 (P <0 0 5 )。结论 :鼻咽癌组织中的MVD与颈部淋巴结转移发生密切相关 ,提示它可以作为预测鼻咽癌颈部淋巴结转移的一个有用指标。     

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.