人宫颈癌多基因致癌机理的研究

应用核酸分子杂交、ＰＣＲ、ＰＣＲ－ＡＳＯ杂交等技术，对人宫颈癌中Ｈａ－ｒａｓ等三种癌基因、ＨＰＶ１６病毒基因及Ｐ５３、Ｒｂ抑癌基因等多基因变化及其致癌机理进行了研究。结果表明：①宫颈癌中存在Ｈａ－ｒａｓ第１２位密码子Ｇ→Ｔ点突变，突变率为１８．２％（８／４４），并有Ｈａ－ｒａｓ基因扩增，扩增率为４５％（９／２０）；②ｃ－ｅｒｂＢ２基因在宫颈癌中的扩增率为７３．３％（１１／１５），５例伴有重排；③ｃ－ｍｙｃ基因在宫颈癌中的扩增率为９１．７％（１１／１２）；④ＨＰＶ１６Ｅ６／Ｅ７为引物的ＰＣＲ检测结果，宫颈癌中的阳性率为８０．５％（３３／４１）；⑤１２例宫颈癌中未发现Ｐ５８、Ｒｂ基因缺失。上述多基因致癌机理的研究表明，人宫颈癌中Ｈａ－ｒａｓ、ｃ－ｍｙｃ、ｃ－ｅｒｂＢ２经点突变、扩增、重排而被激活，在癌变中起着协同致癌作用。ＨＰＶ１６基因的整合可能启动ｃ－ｍｙｃ，为癌变的起始因素，而Ｈａ－ｒａｓ、ｃ－ｅｒｂＢ２的基因改变可能为中、晚期事件，抑癌基因Ｐ５３、Ｒｂ的作用尚需进一步研究。     

人宫颈癌多基因致癌机理的研究

应用核酸分子杂交、ＰＣＲ、ＰＣＲ－ＡＳＯ杂交等技术，对人宫颈癌上Ｈａ－ｒａｓ等三种癌基因、ＨＰＶ１６病毒基因及Ｐ５３、Ｒｂ抑癌基因等多基因变化及其致癌机理进行了研究。结果表明：①宫颈癌中存在Ｈａ－ｒａｓ等１２位密码子Ｇ→Ｔ点突变，突变率为１８．２％（８／４４），并有Ｈａ－ｒａｓ基因扩增，扩增率为４５％（９／２０）；②ｃ－ｅｒｂ Ｂ２基因在宫颈癌中的扩增率为７３．３％（１１／１５），５例伴有重排；③     

人原发性食管癌组织中多种抑癌基因的研究

应用ＰＣＲ扩增与直接测序技术，分析１０例食管癌和癌旁组织标本中多个抑癌基因ｐ５３、Ｒｂ、ＡＰＣ和ＭＣＣ的突变与丢失。结果：１０例中６例有ｐ５３基因突变；５例有Ｒｂ基因改变；３例有ＡＰＣ改变；３例有ＭＣＣ基因改变；８例食管癌标本中至少有一种抑癌基因有改变；６例至少有两种或多种抑癌基因改变，１例癌旁组织中也有两个抑癌基因改变。结果表明，食管癌癌变与多个抑癌基因变化的累积有关。     

膀胱移行细胞癌ras,p53基因点突变检测及其临床病理学意义

为探讨基因的改变在膀胱移行细胞癌发生过程中的意义，应用聚合酶链反应——限制性片段长度多肽性（ＰＣＲ－ＲＦＬＰ）法，检测５０例膀胱移行细胞癌ｒａｓ、ｐ５３基因突变。结果显示：正常膀胱粘膜未检测到基因突变，膀胱移行细胞癌Ｈａ－ｒａｓ基因第１２位密码子突变为１６例（３２％），ｐ５３基因突变为９例（１８％），均系２４８位点突变。Ｈａ－ｒａｓ－１２位点突变率随病理分级增高而增高，与膀胱移行细胞癌分级显著相关（Ｐ＜０．０５）。ｒａｓ基因、ｐ５３基因突变患者死亡率高于无突变患者。４例膀胱移行细胞癌存在ｒａｓ基因及ｐ５３基因共同突变。     

c-erbB-2、p21、p53和PCNA在正常子宫内膜、内膜增生过长和宫内膜癌的表达及其意义

本文应用免疫组化ＳＰ法检测１１１例宫内膜组织癌基因ｃ－ｅｒｂＢ－２、ｐ２１，抑癌基因ｐ５３和增殖细胞核抗原ＰＣＮＡ的表达，探讨与宫内膜良恶性病变及宫内膜癌分级、分型及预后的关系。结果显示：ｃ－ｅｒｂＢ－２与ＰＣＮＡ的表达从正常、良性到恶性病变呈递增趋势，差异有统计学意义（Ｐ＜０．０５）。ｐ２１在宫内膜不典型增生表达最强；ｐ５３仅在宫内膜癌中表达。ｃ－ｅｒｂＢ－２、ｐ５３、ＰＣＮＡ表达与组织学分级有关，ｐ２１、ｐ５３与组织学分型有关。ｐ５３和ｃ－ｅｒｂＢ－２与ＰＣＮＡ之间存在着正相关性；ｐ５３与ｃ－ｅｒｂＢ－２、ＰＣＮＡ有共同表达，并常提示临床预后差，生存期短，死亡率高     

N—ras和C—myc反义寡核苷酸与p53和p16基因联合抑制人肝 …

目的：研究反义癌基因与抑癌基因联合抑制肝癌细胞生长的效果。方法：利用基因重组方法构建携带ｐ１６基因、ｐ５３基因的融合表达载体（ｐｃＤＮＡ１６￣５３）,利用基因合成仪体外合成Ｎ－ｒａｓ、Ｃ－ｍｙｃ反义寡核苷酸、并将Ｎ－ｒａｓ,Ｃ－ｍｙｃ反义寡核苷酸与ｐｃＤＮＡ１６￣５３融合表达载体转染到人肝癌细胞系ＳＭＭＣ７７２１细胞中,观察肝癌细胞生长情况及软琼脂集落形成能力。结果：联合治疗组肝癌细胞增殖速度最慢     

子宫肌瘤中抑癌基因p53和Rb的表达

探讨抑癌基因ｐ５３和Ｒｂ在子宫肌瘤发生发展中的作用。用Ｎｏｒｔｈｅｒｎ Ｂｌｏｔ方法检测１４例子宫肌瘤和３例子宫平滑肌肉瘤中ｐ５３和Ｒｂ基因的ｍＲＮＡ表达。结果：Ｐ５３和Ｒｂ基因在分泌期子宫肌肉中的表达水平明显高于增殖期，在子宫肌瘤中的表达水平明显低于分泌期子宫肌肉组织，在子宫肉瘤中的表达水平低于子宫肌瘤。     

人红白血病细胞株c-myc/N-ras/P_(53)mRNA的表达及其与细胞生物学特性的关系

本实验用一定浓度的苦参碱作用Ｋ５６２细胞１６ｈ, ２４ｈ,４８ｈ,采用分子生物学Ｎｏｒｔｈｅｒｎ Ｂｌｏｔ和Ｄｏｔ Ｂｌｏｔ杂交技术分析ｃ－ｍｙｃ,Ｎ－ｒａｓ及Ｐ５３ ｍＲＮＡ在Ｋ５６２细胞诱导分化过程中表达水平改变,以探讨其表达水平与细胞生物学特性的关系。结果显示苦参碱作用Ｋ５６２细胞２４ｈ时,Ｎ－ｒａｓ基因ｍＲＮＡ表达活化;Ｐ５３－基因表达增强：作用４８ｈ时,ｃ－ｍｙｃ　ｍＲＮＡ水平表达明显受抑。说明苦参碱在诱导Ｋ５６２细胞分化启动时,能明显改变早期相关癌基因的表达。提示ｃ－ｍｙｃ,Ｎ－ｒａｓ和Ｐ５３等癌基因是一类重要的细胞增殖、分化调控因素。     

肝细胞癌多种抑癌基因失活机理的研究

目的；分析肝细胞癌多种抑癌基因失活的机理。方法：应用ＰＣＲ、Ｓｏｕｔｈｅｒｎ 技术对ＰＹＮＺ２２、Ｐ５３和Ｒｂ抑癌基因失活及其机理进行了研究。结果：４１．７％的肝癌存在ＰＹＮＺ２２．１位点基因的高甲基化，３５％存在杂合缺失，过度高甲基化病例都伴有杂合失，５０％的肝癌存在Ｐ５３基因突变，突变病例多伴另一等位基因缺失；约２５％的肝癌存在Ｒｂ基因缺失，一例肝透明细胞癌存在Ｒｂ基因ＣｐＧ岛的高甲基化，未发     

p53,p21及—c—erbB—2蛋白在大肠粘膜和肿瘤中的表达

目的探讨ｐ５３、ｐ２１、及ｃ－ｅｒｂＢ－２蛋白与大肠癌发生和发展的关系。方法运用免疫组化方法检测ｐ５３、ｐ２１、及ｃ－ｅｒｂＢ－２蛋白在６８例大肠癌、１１例大肠腺瘤、２６例癌旁粘膜及１５例正常大肠粘膜中的表达情况。结果①正常粘膜及癌旁粘膜中无ｐ５３蛋白过度表达。大肠癌ｐ５３蛋白表达率比腺瘤高（Ｐ＜０．０５）。正常粘膜ｐ２１及ｃ－ｅｒｂＢ－２蛋白的阳性表达率比癌、腺瘤及癌旁粘膜低（Ｐ＜０．０１或Ｐ＜０．０５）。②正常粘膜以３种蛋白全部阴性者为多，癌旁粘膜以１种蛋白阳性或全阴者为多。③ｐ５３及ｃ－ｅｒｂＢ－２蛋白阳性的大肠癌和腺瘤的ＰＣＮＡ（ｐｒｏｌｉｆｅｒａｔｉｎｇｃｅｌｎｕｃｌｅａｒａｎｔｉｇｅｎ，ＰＣＮＡ）增殖指数高（Ｐ＜０．０１或Ｐ＜０．０５），而ｐ２１蛋白阳性及阴性的大肠癌和腺瘤的ＰＣＮＡ指数无明显差别（Ｐ＞０．０５）。ｐ２１及ｃ－ｅｒｂＢ－２蛋白阳性对癌旁粘膜及正常粘膜的ＰＣＮＡ增殖指数无明显影响。结论癌基因和抑癌基因蛋白协同表达可能与大肠腺瘤和癌的发生有关，尤其与ｐ５３蛋白的关系较为密切，似通过导致细胞过度增殖而使肿瘤发生和恶性转化。     

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.