结直肠腺癌组织 Caveolin-1表达与微淋巴管密度的关系及临床意义

目的:探索结直肠腺癌中Caveolin-1和微淋巴管密度(lymphatic microvessel density,LMVD)的关系及其与肿瘤临床病理特征和预后的关联。方法:运用免疫组织化学法测定90例结直肠腺癌和45例正常结直肠组织中Caveolin-1的表达,并以D2-40为标记物,测定结直肠腺癌组织的LMVD,分析Caveolin-1和LMVD与临床病理参数之间的关联。结果:结直肠腺癌中Caveolin-1蛋白的阳性表达率(73.33%)明显高于正常结直肠组织(11.11%,P<0.01);结直肠腺癌中的LMVD值(18.25±2.36)明显高于正常结直肠组织(3.14±1.58,P<0.01);Caveolin-1表达程度和LMVD与肝转移、肿瘤浸润深度、淋巴结转移和TNM分期具有相关性(P<0.01);Caveolin-1表达阴性组的LMVD值明显低于阳性组(P<0.01);结论:Caveolin-1在结直肠癌中的表达与微淋巴管生成密切相关,其表达和LMVD是结直肠癌患者的独立预后指标。     

RUNX3和ki-67在结直肠癌中的表达及其相关性

目的:通过对RUNX3、ki-67蛋白在结直肠腺癌中表达的研究,探索RUNX3、ki-67与结直肠腺癌发生发展的关系。方法:应用免疫组织化学法(SP方法)检测RUNX3和ki-67在30例癌旁正常组织、60例结直肠腺瘤、60例结直肠癌组织标本中的表达情况,并结合临床资料分析二者的表达与临床病理特征之间的关系。结果:RUNX3和ki-67在结直肠腺癌组织中的阳性表达率分别为38.33%和80.00%,而在癌旁正常组织(切缘距离癌组织>10 cm,且经病理证实)、结直肠腺瘤中的阳线表达率分别为86.67%、10.00%和63.33%、51.67%,差异具有统计学意义(P<0.05)。RUNX3和ki-67在癌组织中的表达呈负相关(r=-0.377,P<0.05)。RUNX3的表达与结直腺肠癌的TNM分期、肠壁浸润深度、淋巴结转移、肝转移呈负相关(P<0.05),ki-67的表达与结直腺肠癌的TNM分期、肠壁浸润深度、淋巴结转移、肝转移呈正相关(P<0.05),而二者与患者性别、年龄、肿瘤大小、部位、分化程度和组织学类型无关(P>0.05)。结论:RUNX3低表达、ki-67高表达与结直肠癌的发生、发展有密切关联,有望成为临床诊治的新靶点,并为结直肠癌的治疗起指导作用。     

结直肠腺癌中细丝蛋白A表达和微淋巴管密度的关系

目的探讨结直肠腺癌中细丝蛋白A(FLNa)和微淋巴管密度(LMVD)的临床病理意义及二者之间的关系。方法应用免疫组织化学法检测结直肠腺癌患者癌组织及正常结直肠组织中FLNa的表达水平,用D2-40作为标记计数LMVD,分析与临床病理参数的关系及FLNa与LMVD相关性。结果 FLNa在结直肠癌组织的阳性表达率低于正常结直肠组织,结直肠癌组织的LMVD值高于正常结直肠组织;FLNa表达水平和LMVD值与肿瘤的肝转移、淋巴结转移和肠壁浸润深度具有相关性;FLNa表达阳性组的LMVD值低于FLNa表达阴性组。结论 FLNa的低表达与肿瘤的微淋巴管生成可能共同参与了结直肠腺癌的发生和发展过程,FLNa的低表达促进了微淋巴管的生成。     

肝细胞生长因子及其受体c-Met在结直肠癌组织中的表达

目的 探讨肝细胞生长因子( HGF)及其受体c-Met在结直肠癌组织中的表达及其与临床病理参数之间的关系.方法 采用免疫组织化学法,检测63例结直肠癌患者及20例良性腺瘤及周围正常结肠组织中HGF、c-Met的表达;计数微淋巴管密度(LMVD),分析HGF和c-Met表达及与LMVD和临床病理参数之间的关系.结果 HGF与c-Met在结直肠癌组织中的阳性表达率显著高于结直肠良性腺瘤及周围正常组织(P＜0.01);结直肠癌组织中LMVD明显高于对照组(U=7.94,P＜0.01);HGF及c-Met阳性表达的结直肠癌组织较阴性者有更高的LMVD(P ＜0.01);HGF及c-Met在结直肠癌组织中的表达与淋巴结转移和TNM分期显著相关(P＜0.01).结论 HGF和c-Met与结直肠癌的发生发展密切相关,有可能成为结直肠癌治疗的新靶点.     

469例结直肠癌术后患者预后因素分析

目的探讨影响结直肠癌术后患者预后的因素。方法回顾性分析469例结直肠癌患者的临床病理及生存随访资料。采用Cox回归模型分析性别、年龄、肿瘤直径大小、浸润深度、分化程度、淋巴结转移情况、TNM分期、癌胚抗原(CEA)、糖类抗原(CA125、CA199)与预后的关系。结果性别、年龄、肿瘤直径大小与结直肠癌术后患者预后均无关(P0.05);分化程度、浸润深度、淋巴结转移、TNM分期、CEA、CA-125均与结直肠癌术后患者预后密切相关,且差异有统计学意义(P0.01)。结论分化程度、浸润深度、淋巴结转移、TNM分期、CEA、CA-125均可作为结直肠癌术后患者预后的主要危险因素之一。     

结直肠癌P27蛋白表达及其意义

目的 研究P27蛋白表达与结直肠癌发生、发展等关系.方法 采用免疫组化S-P法分别检测结直肠癌及正常结直肠黏膜中P27蛋白表达.结果 P27在结直肠癌中阳性表达率为31.3%(20/64),与正常结直肠黏膜组织100.0%(10/10)相比,差异有显著性(P＜0.05).P27阳性表达率下降与肿瘤的分化程度,浸润深度、TNM分期及淋巴结转移有密切相关,差异有显著性(P＜0.05).结论 P27在结直肠癌的发生发展中起重要的抑制作用.P27蛋白表达降低的结直肠癌易发生淋巴结及远处转移和肌层浸润,P27是结直肠癌预后的一个独立指标.     

eIF4E和cyclinD1在结直肠癌中的表达和临床意义

目的探讨eIF4E和cyclinD1蛋白表达在结直肠癌的发生发展中的临床意义。方法用EnVision二步法检测80例原发性结直肠癌、30例结直肠腺瘤和20例正常结直肠黏膜eIF4E和cyclinD1蛋白表达。结果①eIF4E蛋白在结直肠黏膜、腺瘤和腺癌组中的阳性率分别为10.0%,83.3%,92.5%,腺癌组和腺瘤组阳性率均高于黏膜组(P<0.01)。eIF4E蛋白在结直肠癌中的表达与肿瘤浸润深度、淋巴结转移、TNM分期和5年生存有显著相关性(P<0.05);②cyclinD1蛋白在结直肠黏膜、腺瘤和腺癌组中的阳性率分别为0、46.7%,55.0%,腺癌组和腺瘤组阳性率均高于黏膜组(P<0.01)。cyclinD1蛋白在结直肠癌中的表达与组织学分级(P<0.05)、淋巴结转移和TNM分期(P<0.01)有显著相关性;③结直肠癌组织中eIF4E与cyclinD1蛋白表达呈正相关(r=0.914,P<0.01)。结论①eIF4E蛋白表达上调可发生结直肠癌发展的全过程,提示eIF4E在结直肠癌的发生发展中起重要作用。eIF4E蛋白高表达的结直肠癌大多浸润深、淋巴结转移较多,患者预后较差,eIF4E可作为临床上结直肠癌的预后评价指标;②结直肠癌中eIF4E与cyclinD1蛋白表达呈正相关,提示两者存在协同关系。     

MMP-2及TIMP-2蛋白表达与结直肠癌病理生物学行为和预后的关系

目的探讨MMP-2,TIMP-2蛋白表达与结直肠癌浸润、转移及其预后的关系。方法检测、比较50例结直肠腺癌和18例结直肠腺瘤组织中MMP-2,TIMP-2蛋白表达。结果①MMP-2,TIMP-2蛋白在结直肠腺癌组中的表达较高(P<0.0001);②MMP-2的蛋白表达伴随癌组织浸润深度的增加、TNM分期的升高和淋巴结转移的发生而增强(P<0.05);③生存期限与MMP-2蛋白表达呈负相关(rs=-0.22437;P=0.0481),与TIMP-2无关(rs=-0.27,P=0.0587);④MMP-2与TIMP-2的蛋白表达没有相关关系(P=0.1069)。结论MMP-2,TIMP-2蛋白在结直肠癌组织中的表达较高,MMP-2蛋白的表达与结直肠癌浸润、转移和预后有关。     

结直肠腺癌KLF4和BIRC7表达及其临床病理意义

目的 研究结直肠癌、癌旁组织和腺瘤中KLF4和BIRC7表达水平及其临床病理意义.方法 结直肠癌、癌旁组织和腺瘤手术切除标本经4％甲醛固定后常规制作石蜡包埋切片,KLF4和BIRC7染色方法为EnVision免疫组化法.结果 结直肠癌KLF4表达阳性率明显低于癌旁组织和腺瘤(P＜0.05),结直肠癌BIRC7表达阳性率明显高于癌旁组织和腺瘤(P ＜0.01);高分化、无淋巴结转移、仅侵犯肌层病例及TNM临床分期Ⅰ+Ⅱ的结直肠癌病例KLF4表达阳性率明显高于低分化、淋巴结转移、侵犯浆膜层或浆膜外及TNM临床分期Ⅲ+Ⅳ的结直肠癌病例(P ＜0.05或P＜0.01);低分化、淋巴结转移、侵犯浆膜层或浆膜外及TNM临床分期Ⅲ+Ⅳ的结直肠癌病例BIRC7阳性表达率明显高于高分化、淋巴结未转移、仅侵犯肌层及TNM临床分期Ⅰ+Ⅱ的结直肠癌病例(P ＜0.05或P＜0.01);结直肠癌中KLF4与BIRC7表达水平呈负相关(P＜0.01).结论 KLF4和BIRC7表达水平反映了结直肠癌发生、进展、生物学行为和预后,两者在结直肠癌发生发展方面可能起到互相协调作用.     

结直肠癌组织中SOX9与RUNX1表达及其临床意义

目的探讨结直肠癌组织中SOX9与RUNX1表达及其临床意义。方法采用免疫组化染色法检测88例结直肠癌组织及癌旁正常组织中SOX9、RUNX1表达情况,分析与结直肠癌患者临床特征的关系,同时分析SOX9与RUNX1表达的相关性。结果SOX9在结直肠癌组织中高表达,RUNX1在癌旁正常组织中高表达。不同肿瘤分化程度、TNM分期、有无侵及浆膜、有无淋巴结转移、有无远处转移的患者直肠癌组织中SOX9高表达率比较,差异均有统计学意义（均P＜0.05）;不同TNM分期、血癌胚抗原（CEA）水平、有无侵及浆膜、有无淋巴结转移、有无远处转移的患者直肠癌组织中RUNX1高表达率比较,差异均有统计学意义（均P＜0.05）。结直肠癌组织中SOX9、RUNX1均高表达13例,均低表达4例;结直肠癌组织中SOX9与RUNX1表达呈负相关（rs=-0.54,P＜0.05）。结论SOX9、RUNX1表达与结直肠癌发生、发展关系密切;临床上联合检测有助于判断患者预后情况,为结直肠癌的基因治疗提供新思路。     

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.