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。     

PTEN、eIF4E及CyclinD1在胃癌中的联合表达及临床意义

目的探讨PTEN、eIF4E和CyclinD1在胃癌组织中的联合表达及其与肿瘤临床病理特征之间的关系。方法采用免疫组织化学方法检测56例胃癌组织和10例正常胃黏膜组织中PTEN、eIF4E和CyclinD1的表达。结果①PTEN在胃癌组织中蛋白表达阳性率为51．8％（29／56）,明显低于它在正常胃黏膜组织中的阳性表达率100．O％（10／10,P=0．012）;eIF4E和CyclinD1在胃癌组织中蛋白表达阳性率分别为76．8％（43／56）和51．8％（29／56）,明显高于它们在正常胃黏膜组织中的阳性表达率0％（0／10,P=0．000）和0％（0／10,P=0．007）;②P阳Ⅳ与胃癌组织分化程度呈正相关（P=0．029）,与胃癌浸润深度（P=0．033）、淋巴结转移呈负相关（P=0．003）;elF4E与胃癌组织分化程度呈负相关（P=0．010）,与胃癌浸润深度、淋巴结转移无相关关系;CyclinD1与胃癌的组织分化程度（P：0．004）、浸润深度（P=0．032）、淋巴结转移相关（P=0．013）;③胃癌中PTEN的阳性表达率与elF4E和CyclinD1均呈负相关（P=0．006,P=0．007）,eIF4E与CyclinD1的阳性表达率呈正相关（P=0．041）。结论PTEN、elF4E和CyclinD1在胃癌的发生、发展中起着不同的作用;联合检测PTEN、eIF4E和CyclinD1,可能有助于对胃癌恶性程度的判定及侵袭转移能力的评估,进而为胃癌的预后分析和进一步治疗提供依据。     

宫颈鳞状细胞癌原发灶及淋巴结转移灶中EGFR1、HER2及ki67的表达

目的：检测宫颈鳞状细胞癌原发灶及淋巴结转移灶中表皮生长因子受体1（EGFR1）和人表皮生长因子受体2（HER2）表达及细胞增殖标记（ki67）的表达差异。方法：60例有淋巴结转移的宫颈鳞状细胞癌原发灶及转移灶石蜡包埋组织,采用免疫组化检测EGFR1、HER2及ki67在宫颈鳞状细胞癌原发灶及相应淋巴结转移灶中的表达差异。结果：EGFR1在宫颈鳞状细胞癌原发灶中阳性表达率为66．67％（40／60）,淋巴结转移灶中的阳性表达率为70％（42／60）,两者密切相关（r=0．763,P〈0．001）;HER2在两者中阳性表达率均为25％（15／00）,两者密切相关（r=0．644,P〈0．001）;ki67在两者中阳性表达率均为85％（51／60）,两者密切相关（r=0．889,P〈0．001）。结论：宫颈鳞状细胞癌组织原发灶及淋巴结转移灶EGFR1、HER2及细胞增殖标记ki67高度一致,其细胞增殖能力没有异质性。     

胃癌PTEN与Survivin的表达及其相关性研究

目的探讨胃癌磷酸酶基因PTEN与Survivin的表达及其相关性。方法用免疫组织化学SP法检测70例胃癌、相应癌旁及正常胃黏膜组织中PTEN与Survivin的表达情况。结果PTEN蛋白表达在胃癌、相应癌旁及正常胃黏膜组织中阳性率分别为45171％、8429％及91．42％,差异有统计学意义（P〈0．01）;Survivin蛋白表达在胃癌、相应癌旁及正常胃黏膜组织中阳性率分别为5571％、1714％及8．57％,差异有统计学意义（P〈0．01）;PTEN与胃癌浸润深度、淋巴结转移、肝转移及临床分期呈负相关（均P〈0．05）;Survivin与胃癌淋巴结转移、肝转移及临床分期呈正相关（均P〈005）;胃癌PTEN阳性表达率与Survivin呈显著负相关（P〈0．05）。结论PTEN、Survivin基因在胃癌的发生、发展中起着不同程度的作用;联合检测PTEN及Survivin可能对胃癌恶性程度的判定及预后评估提供帮助。     

胃癌原发灶与癌旁正常组织及淋巴结转移灶中Her-2表达的研究

目的 探讨表皮生长因子受体2(Her-2)在胃癌原发灶、癌旁正常组织及淋巴结转移灶中的阳性表达及其与胃癌原发灶间的关系.方法 应用免疫组织化学(PV-9000)方法 检测56例胃癌患者的原发灶、淋巴结转移灶及癌旁正常组织中Her-2蛋白的表达.结果 胃癌癌旁正常组织、原发灶、淋巴结转移灶的Her-2蛋白的表达阳性率分别为3.4%、14.3%、12.5%.在56例病例中,癌旁正常组织、淋巴结转移灶的Her-2表达状态与原发灶的一致率分别为89.3%和94.6%,而在Her-2表达阳性的标本中,癌旁正常组织、淋巴结转移灶的阳性表达结果 与原发灶的一致率分别为100.0%、85.7%.胃癌不同组织中Her-2蛋白表达在不同性别、民族、年龄、分化程度的患者间差异无统计学意义(P＞0.05);结论 胃癌癌旁正常组织和淋巴结转移灶不宜作为临床检测Her-2表达的标本,但在无法获得原发灶标本时,淋巴结转移灶的检测结果 有一定的参考价值.     

β-catenin在胃癌及其淋巴结转移癌中的表达及意义

目的探讨β-连接素（β-catenin,β-cat）在胃癌原发灶及相应淋巴结转移癌中的表达及意义。方法采用免疫组织化学（S-P）法检测28例远癌正常胃组织,70例胃癌（48例有淋巴结转移）及相应淋巴结转移癌中β—cat的表达。结果70例胃癌组织中β-cat表达率为68．6％,远低于正常胃组织的阳性率（92．9％）（P〈0．05）。β-catenin在48例胃癌原发灶和淋巴结转移癌中的表达率有较高的一致性（两者均表达占41．1％,两者均不表达占25％）。β—cat的阳性表达与胃癌的分化程度、浸润深度及淋巴结转移密切相关（P〈0．05）,且在胃癌原发灶与其淋巴结转移癌中显著相关（列联系数R=0．317,P〈0．05）。结论β—cat可作为判断胃癌生物学行为的指标,为预测胃癌的转移及预后评估提供依据。     

胃癌组织中P53及P21蛋白的表达及意义

目的：探讨P53和P21蛋白异常表达在胃癌发生发展中的作用。方法：应用免疫组化技术检测38例胃癌及相应癌旁组织中P53和P21蛋白的表达。结果：胃癌组织P53蛋白表达率84．21％（32／38）,癌旁组织P53蛋白表达均为阴性。胃癌组织P53蛋白表达率明显高于癌旁组织,差别具有显著性（χ^2=55．27,P〈0．05）。胃癌组织P21蛋白阳性表达率52．63％（20／38）,癌旁组织P21蛋白阳性表达率89．73％（34／38）,胃癌组织P21蛋白阳性表达率明显低于癌旁组织,差别有显著性（χ^2=12．546,P〈0．05）。胃癌组织中P21与P53蛋白共同阳性表达率为47．36％,但两者无相关性（P〉0．05）。结论：P53和P21蛋白表达异常与胃癌发生有着密切关系。     

PTEN与P-AKT在胃癌中的表达及意义

目的：检测人第10号染色体缺失的磷酸酶及张力蛋白同源基因（PTEN）与磷酸化丝氨酸／苏氨酸蛋白激酶B（P．AKT）在胃癌和癌旁组织中的表达,探讨它们在胃癌发生、发展中的作用。方法：应用免疫组织化学EliVision法,检测68例胃癌及其癌旁组织中PTEN和P—AKT蛋白表达水平,同时对68例胃癌和癌旁组织采用反转录一聚合酶链反应检测其中PTENmRNA的表达。结果：PTEN蛋白在胃癌组织中表达低于癌旁组织（P〈0．01）,P—AKT蛋白在胃癌组织中表达高于癌旁组织（P〈0．01）,两者呈负相关关系（P〈0．05）。胃癌组织中PTEN蛋白的表达在性别和年龄间差异均无统计学意义（P〉0．05）,但在分化程度、肿瘤大小、临床分期和淋巴结转移表达差异均有统计意义（P〈0．01）。胃癌组织中P—AKT蛋白表达在性别、年龄和肿瘤大小间差异均无统计学意义（P〉0．05）,但在分化程度、临床分期和淋巴结转移间表达差异均有统计学意义（P〈0．05）。胃癌组织PTENmRNA的半定量表达明显低于癌旁组织PTENmRNA的半定量表达（P〈0．01）。结论：PTEN基因在胃癌组织中低表达,癌旁组织蛋白表达也明显高于胃癌组织,P—AKT蛋白在胃癌组织中的表达高于癌旁组织,两者在胃癌中的表达呈负相关。     

共刺激信号B7-1的缺失促进了胃癌生成及转移

目的：探索共刺激信号B7—1的表达缺失对胃癌生成及淋巴结转移的影响。方法：应用RT-PCR技术检测44例胃癌组织、癌旁组织标本中B7-1 mRNA的表达,分析其与胃癌病理学特征的关系。结果：所有癌旁胃组织都有B7—1基因的表达,而44例胃癌组织中只有8例有表达,癌旁正常胃组织与胃癌组织中B7—1基因表达率差异有显著性（X^2=9．14,P〈0．05）。有淋巴结转移的35例胃癌组织中,1例有B7—1基因表达,无淋巴结转移的9例胃癌组织中有7例检测到B7—1 mRNA的表达,有淋巴结转移的胃癌组织中B7—1 mRNA的表达率显著降低（X^2=23．66,P〈0．05）。结论：B7—1 mRNA表达缺失促进了胃癌生成及淋巴结转移。     

抑癌基因PTEN在大肠癌中的表达及临床意义

目的探讨抑癌基因PTEN在大肠癌中的表达及临床意义。方法采用免疫组化S-P法检测70例大肠癌组织中PTEN的表达,并探讨其与组织分化程度、淋巴结转移和Dukes分期等生物学行为的相关性。另选择30例癌旁正常大肠组织作对照组。结果70例大肠癌标本中PTEN阳性表达32例。30例癌旁正常组织中PTEN表达均阳性。大肠癌组织中PTEN的阳性率明显低于癌旁正常组织（X^2=26．27,P〈0．01）。大肠癌组织中PTEN表达与生物学行为的关系较密切,与组织分化程度呈正相关（r=0．30,P〈0．05）,与淋巴结转移和Dukes分期呈负相关（r=-0．27,P〈0．05;r==-0．26,P〈0．05）。结论PTEN基因异常改变参与大肠癌的发生与发展过程,其表达水平与大肠癌的生物学行为具有明显相关性,参与大肠癌恶化演变、浸润和转移过程,有望成为大肠癌基因诊断和治疗的新靶点。     

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.