MACC1基因在肝细胞癌中的表达及临床意义

目的 探讨MACC1基因在肝细胞癌(hepatocellular carcinoma,HCC)中的表达及其临床意义.方法 应用逆转录聚合酶链反应(RT-PCR)方法 检测42例肝癌组织、对应癌旁肝组织以及17例正常肝组织中MACC1 mRNA的表达情况,并分析MACC1基因的表达与相关临床参数的关系.结果 MACC1基因在肝癌组织的表达水平显著高于癌旁肝组织(P＜0.01),在癌旁肝组织的表达水平显著高于正常肝组织(P＜0.05),且MACC1基因的表达水平与肝癌的TNM分期、肝内或淋巴结转移、门静脉癌栓等均明显相关(均P＜0.05),而与肿瘤个数、血清甲胎蛋白(AFP)水平、有无肝硬化等无明显关系(均P＞0.05).结论 MACC1基因可能在肝细胞癌的侵袭转移中发挥着重要作用,有可能成为肝癌治疗的新靶点之一.     

肝细胞癌组织中ZEB-1的表达及意义

目的 探讨ZEB-1在肝细胞癌(HCC)组织中的表达及意义.方法 采用免疫组织化学SP法和蛋白质印迹分析法检测ZEB-1在62例HCC组织、48例相应癌旁肝硬化组织和10例正常肝组织中的表达,并分析其与HCC临床病理特征的关系.结果 免疫组化结果显示ZEB-1在HCC组织及癌旁肝硬化组织中呈阳性表达,阳性率分别为93.5％(58/62)和83.3(40/48).蛋白质印迹分析显示ZEB-1蛋白在HCC组织中的表达高于相应癌旁肝硬化组织和正常肝组织(P＜0.05).ZEB-1在HCC组织中的表达与临床分期、肿瘤分化程度、有无发生转移、有无门脉癌栓及有无术后复发等因素相关(P＜0.05),与肿瘤直径、肿瘤数目、血清AFP水平等因素无关(P＞0.05).结论 ZEB-1的高表达与肝癌的发生、发展密切相关,并且有可能参与HCC细胞的上皮间质转化而促进肝癌的侵袭和转移.     

MACC1在肝细胞癌中的表达与临床意义

目的 探讨肝细胞癌组织结肠癌转移相关基因1 (metastasis-associated in colon cancer 1,MACC1)的表达及其临床意义.方法 采用免疫组化测定108例病理确诊肝细胞癌患者的肝癌组织和癌旁无瘤肝组织中的MACC1蛋白表达情况,实时荧光定量PCR检测30例肝癌组织、癌旁组织以及20例正常肝组织中MACC1 mRNA的表达,分析肝癌组织中MACC1的表达水平与临床病理因素及预后的关系.结果 免疫组化结果显示,肝癌组织中MACC1蛋白表达的阳性率为49.1％(53/108),高于癌旁肝组织34.2％(37/108,P=0.011);实时荧光定量PCR结果显示,MACC1 mRNA在肝癌组织中的表达高于癌旁肝组织及正常肝组织(P＜0.001).单因素方差分析表明肝癌组织中MACC1的表达与肿瘤大小、有无包膜及病理分型密切相关(P＜0.05).生存分析表明MACC1阳性患者的1年、3年和5年总体生存率分别为0.650、0.492和0.280,而MACC1阴性患者1年、3年和5年总体生存率分别0.799、0.684和0.566,差异有统计学意义(P=0.006).结论 肝癌组织中MACC1的表达与肝癌的恶性演变及患者的临床预后密切相关,MACC1有望成为判断肝癌患者临床预后的重要分子,且有可能成为肝癌分子靶向治疗的新靶点.     

Cripto-1在肝癌中的表达及与侵袭转移的关系

目的：检测 Cripto-1蛋白在不同转移潜能的人肝癌细胞株、肝癌及相应癌旁组织中的表达水平,探讨 Cripto-1蛋白的表达与肝癌侵袭转移能力之间的关系。方法采用Western blot 方法检测不同转移潜能的人肝癌细胞株、肝癌及相应癌旁组织中 Cripto-1的蛋白表达水平;采用免疫组织化学染色方法检测肝癌组织中 Cripto-1蛋白的表达并探讨与临床病理参数之间的关系。结果与癌旁肝组织相比,肝癌组织中 Cripto-1的蛋白表达水平明显升高。Cripto-1蛋白在肝癌细胞株中的表达水平与细胞株的侵袭潜能呈正比。与正常肝组织（0％）比较,Cripto-1在肝癌组织（64．6％）中高表达,且与肿瘤分化程度、血管侵犯和转移状态有相关性（P ＜0．05）。结论 Cripto-1蛋白在肝癌中高表达,并且其表达量与肝癌的侵袭转移能力密切相关。     

趋化因子受体CCR7在人胃癌组织中的表达及其与胃癌转移的关系

目的 观察趋化因子受体CCR7在胃癌中的表达情况,探讨CCR7表达水平与临床病理特征的关系.方法 采用Real-time PCR、Western blot及免疫组化技术检测CCR7在60例胃癌组织及相应的癌旁组织中的表达分布情况,并分析其表达差异与胃癌临床病理特征的相关性.结果 在60例胃癌组织中,CCR7在胃癌组织中mRNA表达水平均显著高于癌旁组织(P＜0.05).免疫组化检测结果显示CCR7在胃癌组织中的蛋白表达定位于细胞质,且CCR7蛋白在癌旁组织与胃癌组织中的阳性表达率分别为25％(15/60)和73％(44/60).经x2检验,两者差异有统计学意义(x2=24.000,P＜0.001).Western blot结果显示CCR7蛋白在胃癌组织中的表达水平显著高于癌旁组织.胃癌组织中CCR7表达水平在胃癌浸润深度、淋巴结转移、远处转移及TNM分期差异有统计学意义(P＜0.05),在患者性别、年龄及肿瘤大小差异无统计学意义.结论 CCR7在胃癌组织中高表达,其表达水平与胃癌侵袭转移密切相关,有望成为胃癌治疗新靶点.     

uPAR在肝癌中的表达及其与肝癌临床病理因素的关系

目的 探讨尿激酶型纤溶酶原激活受体(uPAR)在肝癌中的表达意义,与肝癌临床病理因素及预后的关系.方法 通过免疫组化检测uAPR在肝细胞肝癌及癌旁组织和正常肝组织中的表达,并对uPAR在肝癌中的表达水平和肝癌的诸多临床病理因素进行相关性分析.结果 肝癌中的uPAR表达显著高于相应的癌旁组织及正常肝组织(P＜0.05),uPAR的表达随肝癌分化程度的降低有上升趋势,并且和肿瘤包膜侵犯及门脉癌栓密切相关(P＜0.05);与瘤体大小、年龄大小、性别差异、有无肝硬变、AFP高低及HBsAg状况无明显关系(P＞0.05).结论 uPAR可能在肝癌的侵袭、转移过程中起重要作用,并与肝癌的恶性生物学行为及预后密切相关.     

骨桥蛋白在肝癌中表达的临床意义

目的:探讨骨桥蛋白(OPN)在肝细胞癌中的表达的临床意义.方法:应用Western blotting法检测21例肝癌及癌旁组织、12例正常肝组织中OPN的表达以及应用免疫组化法对85例肝癌组织、10例肝硬化组织和10例正常肝组织进行OPN、血管内皮生长因子(VEGF)、CD34的检测,用Weidner法计算微血管密度(MVD).并分析OPN的表达与临床病理特征之间的关系.结果:Western blotting检测结果表明OPN在肝癌组织中的表达显著增高(P＜0.01),且OPN高表达和肝癌早期复发转移显著相关(P=0.003).免疫组化法检测结果表明OPN在肝癌组织中的表达显著高于肝硬化组织和正常组织(P＜0.05):且OPN在肝癌组织中的高表达和肿瘤包膜不完整(P=0.03)、感染HBV(P=0.03)和发生早期转移、复发(P=0.018)显著相关;OPN和VEGF在肝癌中的表达呈正相关(r=0.71,P＜0.01);OPN在肝癌组织的表达与MVD呈正相关(r=0.44,P＜0.01).结论:OPN在肝癌组织中显著高表达,且OPN与包膜是否完整、感染HBV和早期复发转移相关.OPN和VEGF、MVD的表达显著相关,OPN可能参与了肿瘤血管生成的过程.     

Expression of Tumor Suppressor Gene Maspin in Hepatocellular Carcinoma and Its Clinical Significance

目的 探讨抑癌基因maspin在肝癌组织中的表达及其临床意义.方法 选取肝癌组织及其癌旁肝组织各32例,另选择正常肝脏组织30例作为对照,采用免疫组化法检测3种组织中maspin基因的表达情况,并分析maspin基因表达与肝癌临床参数的关系.结果 肝癌组织maspin基因阳性率(28.1%)显著低于癌旁组织(62.5%)和正常肝组织(86.7%);肝癌组织中maspin基因表达阳性率与肿瘤分化程度、有无肝内外转移有关(P＜0.05),与年龄、性别、肿瘤直径、TMN分期和有无门静脉侵犯无关(P＞0.05).结论 maspin基因在肝癌组织中呈低表达,其表达情况可作为判断肝癌进展情况和恶性程度的指标之一.     

LETM1在肝癌中的表达及其对SMMC-7721细胞增殖和凋亡的影响

目的 探讨亮氨酸拉链EF-hand结构域跨膜蛋白1(leucine bnzipper/EF-hand-containing transmembrane proteinl,LETMl)在肝癌组织中的表达水平及通过RNAi技术靶向LETM1基因对肝癌细胞株SMMC-7721的增殖及凋亡的影响.方法 采用免疫组织化学方法、Western blot检测重庆医科大学附属第一医院肝胆外科2012年9月至2013年4月共60例肝癌组织及其癌旁肝组织中LETM1蛋白表达情况.Western blot检测人肝癌细胞株SMMC-7721和HepG2及人正常肝细胞株LO2中的LETM1蛋白表达情况.将LETM1 siRNA经Lipofectamine 2000TM脂质体转染SMMC-7721(实验组为si-LETM1、对照组为si-NC),实时荧光定量PCR及Western blot分别检测LETM1转染后肝癌SMMC-7721细胞株中LETM1 mRNA及蛋白的表达.CKK-8及流式细胞术检测LETM1低表达对肝癌细胞增殖及细胞凋亡的影响.结果 ①免疫组织化学结果显示,LETM1蛋白在肝癌组织中的阳性表达率为73.33％(44/60),明显高于癌旁组织中的表达率28.33％(17/60,P＜0.01);Western blot检测结果显示,LETM1蛋白在肝癌组织中的表达相对量(2.335±0.221)较癌旁组织(1.386±0.081)明显增高(P＜0.01).②LETM1蛋白表达与肝癌肿瘤直径及门静脉侵犯有关(P＜0.05),而与肝癌患者性别、年龄、甲胎蛋白、HBsAg、Edmondson分级及TNM分期无关(P＞0.05).③LETM1蛋白在SMMC-7721及HepG2中的表达相对量[(分别为(1.447±0.149)、(1.190 ±0.113)]均明显高于LO2[(0.918 ±0.027),P＜0.05].④si-LETM1组与si-NC组和空白组比较,si-LETM1组细胞的增殖受到抑制(P＜0.01),尤以72 h及96 h最为显著;si-LETM1早期细胞凋亡数(14.6±2.3)％与si-NC早期细胞的凋亡数(6.3±0.7)％比较,差异有统计学意义(P=0.04).结论 LETM1蛋白在肝癌组织的表达显著高于癌旁组织;基因沉默LETM1后的肝癌细胞其增殖能力明显减弱,凋亡能力明显增强.     

Significance of TRAF3 protein expression in hepatocellular carcinoma

目的 探讨肿瘤坏死因子受体相关因子3(TRAF3)在肝细胞癌(简称肝癌)发生、发展中的意义.方法 采用免疫组化方法检测50例原发性肝癌组织、12例癌旁肝组织及10例正常肝组织中TRAF3蛋白的表达,分析其与肝癌的临床病理参数的关系.Western blot法检测TRAF3在肝癌高分化细胞系HepG2、低分化细胞系SMMC7721和人正常肝细胞系L-02中的表达差异.结果 TRAF3主要定位于细胞质,其阳性率在正常肝组织(100%)及癌旁组织(91%)明显高于肝细胞癌组织(52%).TRAF3在肝癌的表达与临床分期相关,与患者性别、年龄、癌灶数目、肿瘤大小、瘤栓有无、乙肝表面抗原(HBsAg)阴阳性、甲胎蛋白(AFP)、肿瘤包膜是否完整均无关.TRAF3总蛋白在正常肝细胞系中的表达量明显高于肝癌细胞系,且在肝癌高分化的细胞系中表达量高于低分化细胞系.结论 TRAF3在肝癌中的表达明显下调,且在肝癌中的表达水平与肝癌的侵袭程度相关,提示TRAF3可能抑制肝癌的浸润和转移.     

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.