MUC2在溃疡性结肠炎发病机制中的意义研究

目的探讨MUC2的表达在溃疡性结肠炎发病中的作用,为研究溃疡性结肠炎的发病机制提供实验依据。方法选择溃疡性结肠炎患者42例,应用免疫组织化学S-P二步法检测其结肠病变黏膜组织中的MUC2表达水平;并设立正常对照组30例。结果正常组织中MUC2阳性表达,溃疡性结肠炎组与正常对照组表达水平的比较（1.0±0.9vs5.2±2.7）,有显著性差异（P〈0.01）。MUC2的表达强度与病情活动性（病情轻重、内镜分级、组织学分级、病变部位）之间有一定的关系。结论在UC患者结肠黏膜组织中MUC2表达水平明显减低,提示MUC2与UC关系密切,参与了UC的发生发展过程,可能在UC的发病机制中起重要作用。MUC2表达活性与UC的病情活动性及严重性（病情轻重、内镜分级、组织学分级、病变部位）有一定关联,其表达量也可作为判断疾病程度的指标之一。MUC2的阳性染色都表现在胞质中。正常对照组的结肠黏膜中均检测到活化的MUC2,而溃疡性结肠炎组MUC2的表达明显减低,说明MUC2的表达减低与溃疡性结肠炎的发生有关。     

溃疡性结肠炎中核因子-кB和Th2细胞因子的表达及其意义

目的 探讨溃疡性结肠炎(UC)患者结肠黏膜活检组织中NF-кB的表达及其与Th2细胞因子水平的关系.方法 用免疫组织化学SP法检测60例活动期UC内镜活检标本及30例正常对照石蜡组织中NF-кB表达情况,同时用放射免疫法检测UC组和正常对照组血清中IL-4和IL-10的表达水平.结果 60例UC组中NF-кBp65均为阳性表达,主要分布在结肠黏膜上皮细胞、腺上皮细胞和巨噬细胞.对照组均为阴性和弱阳性表达,主要分布于上皮细胞.UC组的NF-кBp65表达平均灰度值与正常对照组比较差异有显著性(P＜0.05),活动期UC组血清中IL-4和IL-10表达水平与正常对照组比较差异无显著性(P＞0.05).NF-кBp65的表达与活动期UC病情活动性及内镜分级有相关性(为P＜0.05和P＜0.01).结论 NF-кB诱导、参与了UC的发生发展过程,并与UC病情活动性及内镜分级有较好的相关性,可客观反映UC的炎症活动情况;细胞因子IL-4和IL-10可作为反映UC恢复期的指标,NF-кB可能与诱导调控细胞因子有直接关系.     

溃疡性结肠炎PCNA、EGFR、MUC2表达水平及临床意义

目的 探究溃疡性结肠炎(ulcerative colitis, UC)患者结肠黏膜组织中黏液基因蛋白2(mucin2,MUC2)、表皮生长因子受体(epidermal growth factor receptor, EGFR)、增殖细胞核抗原(proliferating cell nuclear antigen, PCNA)的表达,并分析其与UC病情严重程度、内镜下病变严重程度的相关性。方法 选取2017年6月～2020年10月潍坊市人民医院收治的54例UC患者(轻度13例,中度32例,重度9例),另选取同期10例健康对照者的结肠镜活检标本,采用免疫组化法检测结肠黏膜组织中MUC2、EGFR、PCNA表达,比较两组MUC2、EGFR、PCNA表达水平之间的差异,分析黏膜组织中MUC2、EGFR、PCNA水平与UC不同病情严重程度及Mayo内镜下评分(mayo endoscopic subscore, MSE)的相关性,并分析EGFR及MUC2与PCNA之间的相关性。结果 UC组的EGFR、MUC2表达水平低于对照组(P<0.05),PCNA表达水平高于对照组(P<0.05)...     

5-LOX和NF-κB P65在溃疡性结肠炎患者黏膜组织中的表达及相互关系

目的研究5-脂氧合酶(5-LOX)和核因子κB P65(NF-κB P65)在溃疡性结肠炎(UC)患者结肠黏膜的表达,并探讨二者的关系。方法取32例UC患者结肠黏膜标本进行组织学分级,同时收集正常对照者结肠黏膜标本26例。分别采用实时荧光定量RT-PCR和免疫组织化学法检测UC患者结肠黏膜5-LOX、NF-κB P65的表达,并分析其相互关系。结果 32例UC患者组织学分级1级11例,2级17例,3级4例。UC患者结肠黏膜5-LOX、NF-κB P65表达高于正常对照组,差异有统计学意义(P<0.05),二者的阳性表达率随UC组织学分级增加而增加;5-LOX与NF-κB P65呈正相关。结论 5-LOX和NF-κB P65在UC结肠炎症发生发展中可能发挥重要作用。     

诱导型血红素氧合酶-1在溃疡性结肠炎结肠中的表达

目的研究诱导型血红素氧合酶-1(HO-1)在活动性溃疡性结肠炎(UC)患者结肠中的表达,探讨气体信使分子一氧化碳(CO)在UC发病机制中的可能作用.方法采用免疫组织化学SABC染色法,在符合临床和病理诊断标准的33例UC患者肠镜活检标本中分别检测结肠组织的HO-1的阳性细胞,并设立正常对照组.结果HO-1主要表达在结肠黏膜上皮细胞,UC患者表达明显强于对照组(P＜0.01).结论HO-1在UC患者结肠中的异常表达表明气信使分子CO在UC发病机制中可能起重要作用.     

溃疡性结肠炎患者结肠黏膜COX-2和TNF-α的表达及其意义

目的研究溃疡性结肠炎(UC)患者结肠黏膜环氧合酶-2(COX-2)和肿瘤坏死因子-α(TNF-α)的表达以及与UC严重程度的关系。方法采用免疫组织化学染色法对38例活动期UC患者和10例对照组结肠黏膜中COX-2和TNF-α的表达进行检测。结果 UC患者结肠黏膜中COX-2和TNF-α的表达较对照组显著增高(P<0.05),且COX-2和TNF-α的表达与活动期UC患者的病情严重程度及内镜分级有关(P<0.05),COX-2与TNF-α的表达呈正相关(r=0.831,P<0.05)。结论 COX-2和TNF-α参与了UC的发病过程,并且可以反映UC的炎症活动情况。     

白头翁复方灌肠对溃疡性结肠炎模型大鼠MUC2、IL-6及IL-10的影响

目的 研究白头翁复方灌肠治疗溃疡性结肠炎(UC)模型大鼠的疗效及机制.方法 采用三硝基苯磺酸(TNBS)制备 UC模型大鼠,随机分为正常对照组(CON 组)、TNBS 造模组(TNBS 组)、中药白头翁复方治疗组(ZY组)和柳氮磺砒啶肠溶片治疗组(SASP组).观察大鼠一般情况、肠黏膜大体形态学和组织学改变,酶联免疫吸附法(ELISA法)检测大鼠血清 IL-6、IL-10水平,实时荧光定量PCR法检测大鼠结肠组织 IL-6、IL-10含量,免疫组织化学法检测大鼠结肠组织 MUC2表达情况.结果 与 TNBS组相比,ZY组与 SASP 组均可减轻 UC 模型大鼠的炎症程度,DAI评分、CMDI评分和组织病理学评分明显改善,血清及组织 IL-6水平下降,IL-10水平升高,结肠黏膜 MUC2表达量明显增加,差异有统计学意义(P<0.05).结论 白头翁复方灌肠对 TNBS 复制的大鼠UC模型有治疗作用效果,可能通过降低促炎因子 IL-6的表达、升高抑炎因子 IL-10的表达和上调黏蛋白 MUC2表达量,进而增强肠道黏膜免疫屏障和抗炎能力,对 UC起到治疗作用.     

溃疡性结肠炎大鼠肠黏膜超微结构变化及肠组织中P-选择素表达的研究

目的:探讨溃疡性结肠炎(ulcerative colitis,UC)大鼠肠黏膜超微结构的变化及肠组织中P-选择素表达情况和在UC发病机制中的作用.方法:用三硝基苯磺酸(TNBS)/乙醇制作实验性溃疡性结肠炎的动物模型,电镜观察肠黏膜超微结构的变化及免疫组化法检测实验性溃疡性结肠炎肠组织中P-选择素表达.结果:UC组P-选择素的表达明显高于对照组,UC组电镜下见结肠黏膜上皮细胞微绒毛消失,内质网扩张,线粒体明显肿胀,对照组电镜下可见结肠黏膜上皮细胞有较多的粗短的微绒毛,未见扩张的内质网及肿胀的线粒体.结论:UC肠黏膜超微结构明显改变,P-选择素在UC中表达明显上调,在UC的发生和维持中发挥了重要作用.     

溃疡性结肠炎患者TLR9表达变化的研究

目的 从Toll样受体9(TLR9)的角度探讨溃疡性结肠炎(ulcerative colitis,UC)的发病机制和微生态制剂治疗UC的作用机制.方法 采用随机、对照设计,将30例轻、中度活动期的UC患者分为:美常安联合柳氮磺胺吡啶(SASP)组(A组)10例、丽珠肠乐联合SASP组(B组)10例、SASP组(C组)10例,疗程均为4周;正常对照组10例(肠镜及结肠病检均示正常).于治疗前后取病变肠组织,用免疫组化法检测TLR9的表达水平,以逆转录聚合酶链反应(RT-PCR)检测TLR9 mRNA的表达,比较UC患者与正常对照组TLR9蛋白和mRNA在结肠组织中的表达水平,及UC患者治疗前后TLR9蛋白和mRNA在结肠组织中的表达变化,并对3组UC患者治疗前后的Sutherland疾病活动性指数(DAI)、肠镜分级积分、病理组织学分级积分、大便菌群变化进行比较.结果 ①免疫组化显示TLR9在UC结肠上皮和炎症细胞中的表达均高于正常对照组(P＜0.01).RT-PCR检测UC患者结肠组织可见TLR9 mRNA表达,而正常对照组未检出TLR9 mRNA的表达.且TLR9与Sutherland DAI、肠镜分级积分、病理组织学分级积分及大便菌群积分呈正相关性.②免疫组化及RT-PCR检测显示A、B、C3组治疗前病变肠组织中TLR9及TLR9 mRNA均为阳性表达,治疗后均为弱阳性或阴性表达,各组治疗前后3组组内比较差异有统计学意义(P＜0.05);3组组间比较,A、B组间无差异,C组与A、B组比较,差异均有统计学意义(P＜0.01).③3组治疗前后Sutherland DAI、肠镜分级积分、病理组织学分级积分变化均具有统计学意义(P＜0.05或P＜0.01);3组(组间)比较:Sutherland DAI、肠镜分级积分、病理组织学分级变化差值A、B组间差异无统计学意义,与C组比较差异均有统计学意义(P＜0.01).大便菌群变化A、B组治疗前后具有统计学意义,C组治疗前后大便菌群变化无统计学意义.结论 TLR9失调可能参与溃疡性结肠炎发病机制;微生态制剂能有效降低UC患者的TLR9表达水平,TLR9下调可能是益生菌治疗UC的作用机制之一.     

核因子NF-κB与凋亡调控蛋白Bcl-2/Bax在溃疡性结肠炎表达及意义

目的：探讨NF-κB、Bcl-2/Bax介导的结肠黏膜细胞凋亡在溃疡性结肠炎（UC）发病机制中的作用。方法：用免疫组织化学S-P法检测60例活动期UC患者及30例正常对照结肠黏膜组织中NF-κB、Bcl-2、Bax表达情况,并应用图像分析处理系统定量测定。结果：UC组NF-κB、Bcl-2表达平均灰度值低于对照组（141.78±16.11 vs 168.05±19.53,152.36±19.20 vs 197.65±12.48,P〈0.01）;UC组Bax表达平均灰度值高于对照组（215.83±17.46vs191.27±18.32,P〈0.05）。NF-κB、Bcl-2、Bax的表达与活动期UC的内镜分级有相关性（P〈0.05）。UC患者结肠黏膜上皮细胞及炎性细胞Bcl-2阳性表达率高于对照组（P〈0.05）;Bax在炎性细胞阳性表达率低于对照组（P〈0.05）,而Bax在上皮细胞的表达,UC组与对照组间差别无统计学意义（P〉0.05）。UC组NF-κB与Bcl-2的表达有正相关性（r=0.755,P〈0.01）,NF-κB与Bax的表达有负相关性（r=-0.698,P〈0.01）。结论：NF-κB、Bcl-2/Bax介导的结肠黏膜细胞凋亡可能是UC上皮层破坏及溃疡形成的机制之一。     

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.