RT—PCR分析nm23基因在乳腺肿瘤中的转录表达

目的：探讨nm23基因mRNA在乳腺癌组织、乳腺良性肿瘤组织、癌旁组织中的表达及其与临床的关系。方法：采用半定量RT-PCR方法，检测30例乳腺癌组织、8配对癌旁组织、9例慢性纤维囊性乳腺病和6例乳腺纤维腺瘤组织nm23H1和nm23H2mRNA的表达。结果：①淋巴结阳性的原发灶组织nm23H1mRNA表达明显低于淋巴结阴性的原发灶组织，Ⅲ期乳腺癌组织nm23H1mRNA水平较Ⅰ、Ⅱ期明显低。②多因素分析发现淋巴结转移与nm23H1mRNA表达有显性相关。③nm23H2mRNA与乳腺癌患肿瘤大小、淋巴结状况、绝经状况、激素受体状况、TNM分期之间无显性相关。④nm23基因的两个亚型H1和H2的mRNA在4种不同乳腺组织中均有表达。结论：nm23H1基因mRNA表达强度与淋巴结转移呈负相关。在乳腺癌转移过程中，nm23H1mRNA较nm23H2mRNA起更重要的作用。nm23H1和nm23H2基因mRNA在乳腺纤维腺瘤、慢性纤维囊性乳腺病和癌旁组织均有表达。     

乳腺浸润性导管癌中 SATB1和 BRMS1的表达及与淋巴转移的相关性

目的：探讨核基质结合区结合蛋白－1（SATB1）及乳腺癌转移抑制基因1（BRMS1）在乳腺浸润性导管癌（ IDC）原发灶、腋窝淋巴结转移灶中的表达,分析SATB1与临床病理参数的关系及两者表达的相关性。方法采用免疫组化SP法及qRT－PCR检测51例乳腺IDC组织、17例对应腋窝淋巴结转移灶组织、32例配对癌旁乳腺组织中SATB1、BRMS1蛋白及mRNA的表达情况。结果在原发灶组织、腋窝淋巴结转移灶组织SATB1阳性表达率分别是76.47％、82.35％,均高于癌旁组织的28.12％（ P ＜0.05）;BRMS1蛋白的表达率分别是25.49％、23.53％,均低于于癌旁组织的87.50％（ P＜0.05）;在原发灶组织、腋窝淋巴结转移灶组织SATB1 mRNA表达量分别是癌旁组织的3.88、6.06倍;BRMS1 mRNA表达量分别是癌旁组织的0.36、0.35倍,差异均有统计学意义（ P＜0.05）;SATB1蛋白及mRNA、BRMS1 mRNA在腋窝淋巴结有转移的乳癌原发灶中的表达与腋窝淋巴结无转移乳癌原发灶间存在明显差异（P＜0.05）;在原发灶和淋巴结转移灶中的表达差异无统计学意义（P＞0.05）。 SATB1蛋白和mRNA表达与腋窝淋巴结转移数目、临床分期有关（P＜0.05）,与患者的年龄、肿瘤大小、肿瘤病理学分级、雌激素受体、孕激素受体、人表皮生长因子受体2、增殖细胞核抗原（ Ki－67）及绝经状态无关（ P＞0.05）。相关分析结果显示在原发灶组织、腋窝淋巴结转移组织中SATB1、BRMS1蛋白及mRNA表达均无相关性（P＞0.05）。结论 SATB1、BRMS1异常表达与IDC发生、发展、淋巴转移有密切关系,SATB1有望成为评估乳腺IDC淋巴结转移潜能的分子标记物。     

MMP-9在恶性乳腺肿瘤中的表达及其对浸润转移的作用

【目的】探讨MMP-9在乳腺良、恶性肿瘤的不同表达,以及乳腺恶性肿瘤MMP-9表达与淋巴结状况之间的关系。【方法】采用免疫组织化学方法,分别对35例乳腺癌改良根治术后新鲜完整切除的乳腺癌病理标本和30例局部切除术后乳腺纤维腺瘤的石蜡组织进行MMP-9表达的测定。【结果】乳腺癌的MMP-9阳性表达率高于乳腺纤维腺瘤(P<0.001);有淋巴结转移的乳腺癌MMP-9表达阳性率高于无淋巴结转移者(P<0.05)。【结论】MMP-9可作为说明恶性乳腺肿瘤且具有浸润转移生物学特性的分子标志物。     

IGF-1在乳腺癌中的表达与临床意义

目的:探讨胰岛素样生长因子-1(IGF-1)在乳腺癌中的表达及临床意义.方法:采用免疫组织化学MaxVision法和逆转录聚合酶链式反应(RT-PCR)法检测80例乳腺癌组织、60例乳腺纤维腺瘤、50例癌旁正常乳腺组织中IGF-1蛋白和基因的表达情况,并分析IGF-1表达与乳腺癌临床病理特征的关系.结果:乳腺癌组织IGF-1蛋白和mRNA的表达均明显高于乳腺纤维腺瘤和癌旁正常乳腺组织(P<0.05).乳腺癌组织中IGF-1的表达与年龄无关(P>0.05),与肿瘤大小、淋巴结转移及组织学分级有关(P<0.05).结论:IGF-1高表达在乳腺癌的发生发展过程中可能具有重要作用.     

HMGA1在乳腺癌中的表达及临床意义

目的 探讨高迁移率族蛋白A1(HMGA1)在乳腺癌组织中的表达及临床意义.方法 应用实时定量荧光聚合酶链反应检测65例乳腺癌组织及配对的癌旁正常乳腺组织和40例乳腺纤维腺瘤组织中HMGA1 mRNA的表达情况;应用免疫组织化学法检测石蜡包埋的120例乳腺癌组织、46例乳腺纤维腺瘤组织和43例乳腺腺病组织中HMGA1的蛋白表达水平.结果 乳腺癌组织中HMGA1 mRNA的表达显著高于癌旁正常乳腺组织及乳腺纤维腺瘤组织(P＜0.01);乳腺癌组织中HMGA1蛋白的阳性表达率显著高于乳腺纤维腺瘤组织(P＜0.01)和乳腺腺病组织(P＜0.05),乳腺癌组织中HMGA1蛋白的表达与患者的年龄、淋巴结是否转移及TNM分期有关(P＜0.01,P＜0.05),三阴性乳腺癌HMGA1蛋白的阳性表达率明显更高(P＜0.05).结论 HMGA1在乳腺癌组织中表达较癌旁正常组织和良性疾病组织明显升高,并与临床分期有关,有望成为乳腺癌诊治中的一个新的靶点.     

乳腺癌中RIZ1的表达及其临床意义初探

目的研究RIZ1基因mRNA表达的改变与乳腺癌发生及与患者相关临床和病理特征之间的关系。方法采用半定量RT-PCR方法检测34例乳腺癌标本及相应癌旁组织、15例乳腺良性肿瘤RIZ1基因mRNA的表达状况，并结合相关指标进行分析。结果RIZ1基因mRNA在乳腺癌中的表达明显低于癌旁乳腺组织与乳腺良性肿瘤组织，差异均有显著性（均P〈0．05）。RIZ1基因mRNA在乳腺癌中的表达与年龄、肿瘤TNM分期、淋巴结转移、激素受体（ER）状况无相关关系（均P〉0．05）。结论：RIZ1基因mRNA表达降低可能与乳腺癌的发生相关。     

环氧化酶-2mRNA在乳腺癌组织中的表达及临床意义

目的探讨乳腺癌组织中COX-2mRNA的表达与乳腺癌发生、发展及预后的关系.方法以β-action基因为内参照,应用逆转录聚合酶链反应(RT-PCR)技术,检测35例乳腺癌组织、相应癌旁组织、正常乳腺组织中COX-2mRNA的表达,应用Gene Tools from SynGene软件,对RT-PCR产物电泳带进行半定量分析.结果35例癌组织中,29例COX-2表达明显增高(0.83),相应6例癌旁组织COX-2有不同程度的表达(0.17),正常乳腺组织表达很弱或无表达,后二者与癌组织中COX-2表达差异均有显著意义(P<0.05).COX-2表达同年龄、原发肿瘤大小、TNM分期及术前化疗与否无关(P>0.05),而与淋巴结转移状况有关(P<0.05).结论乳腺癌组织中COX-2的表达明显高于相应癌旁组织、正常乳腺组织,且其表达与淋巴结转移状况有关.     

乳腺癌组织中平滑肌22α的表达与淋巴结转移的关系

目的 分析平滑肌(SM)22α在乳腺癌组织中的表达与淋巴结转移的关系,探讨SM22α参与乳腺癌淋巴结转移的分子机制.方法 应用逆转录-聚合酶链反应(RT-PCR)检测了27例乳腺癌组织及癌旁正常乳腺组织中SM22α表达水平;同时用Western印迹分析检测了12例乳腺纤维腺瘤组织、15例乳腺癌未转移组织、12例乳腺癌淋巴结转移组织中SM22α mRNA和蛋白表达水平;利用RT-PCR和明胶酶图检测乳腺纤维腺瘤、乳腺癌未转移、乳腺癌淋巴结转移组织中基质金属蛋白酶(MMP)2、MMP9表达和活性及组织金属蛋白酶抑制剂(TIMP)1表达水平.结果 RT-PCR检测结果显示,乳腺癌组织中SM22α mRNA表达水平(5.1%±2.4%)显著低于癌旁正常乳腺组织(30.1%±5.1%)(P＜0.01),淋巴结转移组乳腺癌组织中SM22α表达水平(6.2%±3.1%)显著低于无淋巴结转移组(10.1%±4.1%)及乳腺纤维腺瘤组织(15.1%±5.3%)(均P＜0.01).Western印迹分析结果表明,SM22α蛋白在无淋巴结转移组(14.5%±2.1%)及伴淋巴结转移组乳腺癌组织中(6.2%±3.1%)表达水平均显著低于乳腺纤维腺瘤组(26.8%±5.5%)(均P＜0.01).MMP2、MMP9表达水平及活性均显著高于未转移组(P＜0.01),乳腺癌组织中SM22α表达水平与MMP2(r=-0.848;n=27;P＜0.01)、MMP9(r=-0.916;n=27;P＜0.01)活性呈负相关.结论 SM22α在乳腺癌组织中表达下调与淋巴结转移有关,SM22α可能通过负性调节MMP2、MMP9表达抑制乳腺癌淋巴结转移.     

CD15mRNA、CD44v6mRNA及nm23H1mRNA在乳腺癌组织中的表达及其临床意义

目的　探讨CD15mRNA及其蛋白、CD44v6mRNA和nm2 3H1mRNA在乳腺癌组织中的表达及与乳腺癌患者预后的关系。方法　应用催化信号放大 (CSA)原位杂交和免疫组织化学方法 ,对94例乳腺癌患者的癌组织进行了CD15mRNA及其蛋白、CD44v6mRNA和nm2 3H1mRNA表达的检测。结果　CD15mRNA及其蛋白、CD44v6mRNA高表达及nm2 3H1mRNA低表达均与乳腺癌患者的组织学分级、临床分期、淋巴结转移、复发和预后密切相关。CD15mRNA和CD44v6mRNA高表达及nm2 3H1mRNA低表达患者淋巴结转移率高、生存率低。结论　CD15mRNA表达与CD44v6mRNA和nm2 3H1mRNA表达具有正、负调节的协同作用。联合检测 3个基因 ,能更准确地判断乳腺癌的转移和预后状态。     

Ezrin在乳腺癌中的表达及其临床意义

目的 探讨膜细胞骨架连接蛋白Ezrin在乳腺癌中的表达及其与临床病理参数之间的关系.方法 采用免疫组化方法检测54例乳腺浸润性导管癌组织中Ezrin蛋白的表达,选择非典型增生5例,纤维囊性乳腺病9例和男性乳腺发育症2例作为对照.结果 在乳腺浸润性导管癌中,有淋巴结转移组Ezrin的表达高于无淋巴结转移组.结论 Ezrin与乳腺浸润性导管癌的浸润和转移密切相关,可以作为预测乳腺浸润性导管癌淋巴结转移的重要肿瘤标志物.     

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.