HER-2/neu蛋白在胃癌中的表达及意义

[目的] 探讨表皮生长因子受体HER-2/neu在胃癌组织表达的临床病理学意义.[方法] 采用免疫组织化学法检测67例胃癌标本HER-2/neu蛋白的表达,并分析检测结果与患者的随访资料及临床病理学参数的关系.[结果] HER-2/neu蛋白在胃癌组织的阳性表达率为22.4%(15/67),而在癌旁正常组织无表达.HER-2/neu表达与患者的性别、年龄、分化程度均无相关关系(P>0.05),而与肿瘤的Lauren分类、临床分期及淋巴结转移相关(P<0.05).HER-2/neu蛋白表达阳性患者的中位生存期为30.0个月,表达阴性的为50.0个月,二者差异有显著性意义(P<0.05).运用COX比例风险模型分析提示HER-2/neu和临床分期为胃癌独立预后因素.[结论] 检测胃癌组织中HER-2/neu蛋白的表达,有助于判断患者预后.     

食管鳞状细胞癌组织中Galectin-9和MMP-2蛋白的表达及与预后的关系

目的:探讨食管鳞状细胞癌(简称食管鳞癌)组织中Galectin-9和MMP-2蛋白的表达及与预后的关系。方法:制备组织芯片,应用免疫组化SP法检测63例食管鳞癌及其癌旁正常食管黏膜组织中Galectin-9和MMP-2蛋白的表达,分析2种蛋白的表达与临床病理指标和预后的关系。结果:食管鳞癌组织中Galectin-9蛋白的阳性表达率为62.5%,低于癌旁正常食管黏膜组织的89.3%(χ2=11.529,P<0.001),其表达与肿瘤的分化程度有关(P=0.001),且阳性表达者生存期更长(P=0.013)。食管鳞癌组织中MMP-2蛋白的阳性表达率为67.9%,高于癌旁正常食管黏膜组织的35.7%(χ2=9.633,P=0.001),其表达与肿瘤浸润深度、TNM分期、淋巴结转移有关(P均<0.05),且阳性表达者生存期较短(P=0.036)。结论:食管鳞癌组织中Galectin-9低表达,MMP-2高表达;检测二者可用于判断食管鳞癌预后。     

食管鳞癌RhoC和OPN蛋白的表达及其对患者预后的影响

目的研究食管鳞癌组织中RhoC和OPN蛋白的表达及其与食管鳞癌生物学行为之间的关系。方法采用免疫组织化学方法(二步法)检测80例食管鳞癌组织中RhoC和OPN蛋白的表达情况,探讨它们与食管鳞癌肿瘤大小、组织分化程度、TNM分期、淋巴结转移和预后的关系。结果(1)RhoC蛋白在食管鳞癌组织中的阳性表达率为66.25%,其表达与淋巴结转移有关(rs=-2.115,P<0.05),而与肿瘤大小、组织分化程度和TNM分期无关(P>0.05);RhoC蛋白阳性表达组患者的术后生存时间较阴性表达组短,(P<0.001);(2)OPN蛋白在食管鳞癌组织中的阳性表达率为100%,OPN蛋白的表达水平与组织分化程度(χ2=10.766,P<0.05)及淋巴结转移有关(rs=-2.289,P<0.05),而与肿瘤大小和TNM分期无关(P>0.05);OPN蛋白的表达水平越高,患者术后生存时间越短(P<0.05);(3)RhoC蛋白和OPN蛋白在食管鳞癌组织中的表达之间存在正相关性(rs=0.408,P<0.001)。结论食管鳞癌组织RhoC和OPN蛋白的表达与淋巴结转移情况及患者的预后有密切关系,RhoC蛋白和OPN蛋白可作为食管鳞癌预后评价的参考指标。     

ercc1基因在食管鳞癌中的表达及其临床意义

目的 探讨切除修复交叉互补基因1(ercc1)在食管鳞癌中的表达规律及临床意义.方法 采用免疫组织化学染色法检测110例食管鳞癌组织及110例远癌组织中ercc1蛋白的表达水平,分析ercc1基因的表达水平与食管鳞癌临床病理特征的关系以及预后之间的关系.结果 ercc1基因在食管鳞癌组织中高表达的比率为63%(69/110),在远癌组织中高表达的比率为7%(8/110);ercc1基因的阳性表达与食管鳞癌患者年龄(χ2=0.006,P=0.940)、性别(χ2=0.034,P=0.854)、肿瘤大小(χ2=1.844,P=0.175)、肿瘤浸润深度(χ2=0.020,P=0.889)、淋巴结转移(χ2=0.979,P=0.323)以及长期饮酒史(χ2=3.816,P=0.051)无关,而与肿瘤分化程度(χ2=4.542,P=0.033)和临床分期(χ2=6.203,P=0.013)存在相关性;并且ercc1基因的表达水平与食管鳞癌患者预后有相关关系.结论 ercc1基因在食管癌组织中的高表达的比率远高于远癌组织,ercc1基因的表达与临床分期和分化程度存在相关关系,并且ercc1基因的高表达影响患者预后,检测食管鳞癌组织中ercc1基因的表达水平有助于判断肿瘤的恶性程度,对食管鳞癌患者的术后个体化治疗及预后分析具有一定的指导意义.     

PTK7在食管鳞状细胞癌中的表达及临床意义

目的研究酪氨酸蛋白激酶-7(PTK7)在食管鳞状细胞癌、癌旁组织中的表达及其与食管鳞状细胞癌的发展、侵袭、淋巴结转移的关系,分析其在食管鳞癌中的诊断价值及预后变化。方法收集食管鳞状细胞癌标本80例及癌旁组织63例,采用免疫组织化学链霉菌抗生物素蛋白-过氧化物酶连结(SP)法检测PTK7蛋白的表达,结合临床相关因素进行χ2检验及Kaplan-meier等统计学分析。结果 80例患者食管鳞状细胞癌组织中有45例PTK7蛋白表达阳性(χ2=50.17,P<0.01),食管癌旁非典型增生及正常鳞状上皮中PTK7蛋白表达均阴性。PTK7表达与食管鳞癌的年龄、性别、分化程度、浸润深度、淋巴结转移、浸润长度、临床分期等比较差异无统计学意义(P>0.05);与5年生存率比较差异亦无统计学意义(χ2=0.2,P>0.1);当肿瘤组织PTK7蛋白表达综合免疫组化评分≥5分时,5年生存率有下降趋势(χ2=3.35,P=0.06)。结论 PTK7表达与食管鳞癌有关,当PTK7综合免疫评分≥5分时,5年生存率有下降趋势利用检测的表达有助于综合判断食管鳞癌的相关性和临床预后     

FAS和HER-2/neu蛋白在卵巢上皮性癌组织中的表达及其相关性研究

目的 研究脂肪酸合成酶（FAS）和人表皮生长因子受体2（HER-2/neu）在卵巢肿瘤组织中的表达及其相关性.方法 应用免疫组化SP法检测52例卵巢癌、10例交界性卵巢肿瘤、10例良性上皮性卵巢肿瘤组织中FAS和HER-2蛋白的表达情况.结果 （1）卵巢癌及交界性卵巢肿瘤组织中的FAS阳性表达率明显高于良性上皮性卵巢肿瘤组织（P =0.000）;卵巢癌组织中的HER-2阳性表达率明显高于卵巢良性上皮性肿瘤及卵巢交界性肿瘤组织（P=0.045）.（2）FAS蛋白表达与组织学类型有关（P =0.009）.（3）FAS、HER-2/neu蛋白阳性者的平均生存时间短于阴性者（P=0.024、0.005）.（4）FAS与HER-2/neu在卵巢癌中的表达正相关（r= 12.46,P=0.000）.结论 FAS、HER-2/neu蛋白的过表达可能在卵巢癌的发生和发展中起一定作用,可明显缩短患者术后生存时间,是卵巢上皮性癌患者的不良预后因素,两者在卵巢癌的发生、发展中可能有某种相互促进的作用.     

卵巢癌Her-2/neu基因扩增和表达与临床病理特征的关系

目的研究卵巢癌中Her-2/neu基因扩增和表达及其与临床病理特征的关系。方法实时PCR检测69例卵巢癌组织中Her-2/neu基因的扩增状况,免疫组化检测Her-2/neu蛋白表达情况,将结果与临床病理特征相联系。结果本组卵巢癌组织中Her-2/neu基因扩增率为15.9%,蛋白过表达率约为29%;基因扩增率在黏液性囊腺癌和浆液性囊腺癌组织之间的差异具有显著性(P<0.05)。结论Her-2/neu基因扩增在卵巢黏液性囊腺癌组织中较为常见,其预后意义有待于进一步探讨。     

食管鳞状细胞癌组织中乏氧诱导因子-1α蛋白和mRNA的表达

目的:探讨食管鳞痛组织中乏氧诱导因子-1α(HIF-1α)的表达及其临床意义.方法:分别采用免疫组化及RT-PCR技术检测46例食管鳞癌组织和46例正常食管黏膜组织中HIF-1α蛋白及mRNA的表达情况,并分析2者的表达与食管鳞癌患者临床病理特征的关系.结果:食管鳞癌组织中HIF-1α蛋白阳性染色主要位于癌细胞胞质/核内,阳性率为41.3%(19/46),而正常食管黏膜组织中均呈阴性表达.食管鳞癌组织中HIF-1α mRNA的表达水平(1.17±0.25)高于正常食管黏膜组织(0.35±0.12)(t=13.942,P<0.001).46例食管鳞癌组织中HIF-1αmRNA高表达(高于癌组织中的平均水平)者为24例(52.2%).食管鳞癌组织中HIF-1α mRNA表达水平与HIF-1α蛋白表达阳性率呈正关联(rp=0.474,P<0.01).食管鳞癌组织中HIF-1α蛋白的表达与肿瘤的浸润深度(χ2=6.624,P=0.010)和淋巴结转移有关(χ2=7.404,P=0.007),HIF-1α mRNA表达水平与肿瘤的组织学分级(χ2=0.321,P=0.571)、淋巴结转移(χ2=0.708,P=0.400)、浸润深度(χ2=2.333,P=0.127)及临床分期(χ2=0.067,P=0.800)均无关.结论:食管鳞癌组织中HIF-1α在蛋白水平的表达对临床更具有指导意义.     

HER-2/neu基因在肝细胞癌中的表达及意义

目的研究HER-2/neu在肝细胞癌(HCC)患者中的表达及其临床意义。方法应用免疫组织化学SP法检测30例HCC、10例肝硬化、10例正常肝组织中HER-2蛋白的表达情况。结果HCC中HER-2阳性表达率显著高于肝硬化及正常肝组织(χ2=6.482,P=0.032);HCC中HER-2的表达与是否伴有肝硬化(P=0.041)、侵袭性(P=0.028)、Edmondson分级(P=0.012)有明显的相关性,与其他临床病理特征无明显相关性。HER-2表达阳性患者的平均生存时间明显短于阴性表达患者(P=0.036)。结论HER-2/neu基因在HCC的侵袭性生长转移和发展中可能具有一定的促进作用,在HCC组织中HER-2/neu表达阳性的患者预示较差的预后。     

NDRG1蛋白表达与食管鳞癌临床病理特征及预后的关系

目的:探讨NDRG1在食管鳞癌发生、发展过程中的表达及意义。方法:采用免疫组化SP法检测20例正常食管黏膜组织和78例食管鳞癌组织中NDRG1蛋白的表达情况。结果:在正常食管黏膜组织、食管鳞癌组织中NDRG1蛋白阳性表达率分别为100%(20/20)、55.1%(43/78),差异均具有显著统计学意义(P<0.01)。在食管鳞癌组织中NDRG1蛋白的表达与淋巴结转移情况呈负相关(R=-0.237,P=0.036)。而与食管鳞癌患者的年龄、性别、肿瘤的分化程度、TNM分期及5年生存率无相关性。结论:NDRG1在食管鳞癌组织中下调表达可能与食管鳞癌的发生、发展有关,NDRG1可能作为一个潜在的肿瘤转移抑制基因在食管鳞癌的发生、发展及转移过程中发挥着抑制作用。     

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.