PTEN、P53、ER、PR与子宫内膜癌的关系

目的 探讨PTEN、p53、ER、PR与子宫内膜癌的关系.方法 采用免疫组化SP法,检测20例正常子宫内膜、20例子宫内膜增生过长、20例子宫内膜不典型增生、50例子宫内膜癌及50例子宫内膜癌旁组织中PTEN及p53的表达水平.结果 PTEN在子宫内膜增生过长组、子宫内膜不典型增生组、子宫内膜癌旁组及子宫内膜癌组中表达缺失率分别为5.0%、35.0%、34.0%、58.0%,均显著高于正常子宫内膜组的0.0%(P＜0.05,P＜0.01),且子宫内膜癌组表达缺失率明显高于子宫内膜癌旁组(P＜0.05);子宫内膜增生过长组、子宫内膜不典型增生组、子宫内膜癌旁组及子宫内膜癌组的p53的阳性表达率分别为5.0%、1O.0%、16.0%、40.0%,均明显高于正常子宫内膜组的0.0%(P均＜0.01);G1和G2、G3的PTEN表达缺失率分别为36.8%和66.7%、85.7%,三者之间差异均有统计学意义(P＜0.05,P＜0.01);ER/PR阴性组、ER/PR阳性组的PTEN表达缺失率分别为25.0%、68.4%,两组比较,差异有统计学意义(P＜0.01);G1和G2、G3的p53阳性表达率分别为31.6%和45.8%、71.4%,三者之间差异均有统计学意义(P均＜0.01);Ⅰ期和Ⅱ、Ⅲ期的p53阳性表达率分别为27.6%和66.7%、85.7%,三者之间差异均有统计学意义(P＜0.01,P＜0.05);PTEN在子宫内膜癌组织中的表达与病理分级、激素受体状态均呈正相关(r分别为0.593、0.327,P均＜0.05);p53在子宫内膜癌组织中的表达与病理分级、临床分期均呈正相关(r分别为0.361、0.602,P均＜0.05).结论 PTEN、p53二者同为抑癌基因,皆参与子宫内膜癌的发生、发展,雌孕激素可能调控PTEN的表达.     

PTEN蛋白及P53蛋白在子宫内膜癌中的异常表达

目的 探讨子宫内膜癌组织中抑癌基因PTEN、P53的异常表达及其临床意义.方法 采用免疫组织化学SP法检测子宫内膜单纯性增生20例、子宫内膜复杂性非典型增生20例、子宫内膜癌35例中PTEN及P53的表达,表达率的差异采用卡方检验.结果 PTEN在子宫内膜单纯性增生、子宫内膜复杂性非典型增生、子宫内膜癌中的表达缺失率逐渐上升,表达缺失率与组织学分级有关,差异有统计学意义(0.05).P53在子宫内膜单纯性增生、子宫内膜复杂性非典型增生、子宫内膜癌中的阳性表达率逐渐上升,阳性率与组织学分级有关,差异有统计学意义(0.05).结论 PTEN、P53均与子宫内膜癌的发生、发展有关.     

P53在子宫内膜样腺癌中的表达及其临床意义

目的研究p5 3基因在子宫内膜样腺癌中的表达 ,探讨其与子宫内膜样腺癌发生、发展的关系。方法采用免疫组化S -P法检测 3 8例子宫内膜样腺癌和 2 3例子宫内膜增生过长 (单纯型增生 5例 ,复杂型增生 8例 ,不典型增生 1 0例 )及正常增生期子宫内膜 1 0例中p5 3蛋白的表达。结果p5 3在子宫内膜样腺癌、子宫内膜增生过长及正常增生期子宫内膜组织中的表达率分别为 3 1 .6% (1 2 / 3 8)、4.3 % (1 / 2 3 )和 0 ,其中在不典型增生组织中的表达率为 1 0 % ,子宫内膜样腺癌组与子宫内膜增生过长组和正常增生期子宫内膜组比较 ,差异均有显著性 (P <0 .0 5 ) ;与不典型增生组比较差异无显著性 (P >0 .0 5 )。p5 3在子宫内膜样腺癌高分化组阳性表达率为 1 9.0 % ,低、中分化组中阳性表达率 47.1 % ,两者比较差异无显著性 (P >0 .0 5 )。p5 3在子宫内膜样腺癌手术病理分期Ⅰ期组阳性表达率为 1 1 .5 % ,Ⅱ期 +Ⅲ期 +Ⅳ期组中阳性表达率 75 % ;两者比较差异有显著性 (P <0 .0 1 )。在子宫肌层浸润深度 >1 / 2组中阳性表达率为 90 .9% ,≤ 1 / 2组中阳性表达率 7.4% ,两者比较差异有显著性 (P <0 .0 1 )。结论 p5 3参与了子宫内膜样腺癌的发生 ,并与子宫内膜样腺癌的浸润性发展有关。     

抑癌基因p27kipl蛋白在子宫内膜癌中的表达及临床意义

目的 :探讨p2 7kipl蛋白在子宫内膜癌中的表达及临床意义。方法 :采用S P免疫组化方法对 66例子宫内膜癌、2 9例子宫非典型增生病变、31例正常子宫内膜对照组进行检测。结果 :在 66例子宫内膜癌中 ,p2 7kipl表达 35例呈阳性反应 (53 % ) ,其中强阳性 9例 (1 3 .6 % )。 2 9例子宫内膜非典型增生病变中 ,p2 7kipl表达 2 2例呈阳性 (75 .8% ) ,其中 8例呈强阳性 (2 7.6 % )。 31例子宫内膜对照组中 ,p2 7kipl表达 2 7例呈阳性 (87.1 % ) ,其中 1 6例强阳性 (51 .6 % )。p2 7kipl表达在子宫内膜癌与正常子宫内膜对照组比较 ,两者差异有非常显著性 (P <0 .0 1 ) ;在子宫内膜癌组与子宫内膜非典型增生病变组比较 ,两者差异有显著性 (P <0 .0 5) ;正常子宫内膜组与子宫内膜非典型增生病变组比较差异无显著 (P >0 .0 5)。结论 :临床应用p2 7kipl蛋白的检测 ,对肿瘤的早期发现、早期诊断及预后的判断有一定参考价值。     

MDM2、GADD、p53在子宫内膜增生过长及宫内膜癌中的表达

目的:探讨癌基因 MDM2和抑癌基因 GADD、p5 3与子宫内膜增生过长、子宫内膜癌的关系。方法:应用 MDM2、GADD、p5 3单克隆抗体对 10 0例子宫内膜增生过长、宫内膜癌进行免疫组织化学染色。结果 :MDM2、p5 3在良恶性组间差异有统计学意义 (P <0 .0 5 ) ,而 GADD各组间无差异。 3种基因表达存在相关性 ,MDM2与p5 3呈正相关 ,GADD与 p5 3呈负相关。MDM2与 GADD表达与宫内膜癌的组织分型、分级无关。 结论:MDM2、p5 3参与了子宫内膜癌的发生、发展 ,GADD则间接通过 p5 3而发挥其抑癌功能。     

增殖细胞核抗原和P_(16)基因在子宫内膜不典型增生的表达及意义

目的　通过原位观察增殖细胞核抗原 (PCNA)和P16基因蛋白的表达 ,探讨其在子宫内膜不典型增生及早期癌变中的意义。方法　应用免疫组织化学SP法分别对 33例子宫内膜癌、4 1例子宫内膜重度不典型增生和 2 0例轻度不典型增生进行PCNA和P16基因的原位标记。结果　PCNA阳性表达强度随子宫内膜病变的病理分级而增强 ,其强阳性表达率在子宫内膜不典型增生和子宫内膜癌差异无显著性 (P >0 .0 5 ) ,但两者与轻度不典型增生比较差异均非常显著 (P <0 .0 1) ,P16基因蛋白阳性表达率以子宫内膜轻度不典型增生为最高 ,两组不典型增生间差异无显著性 (P >0 .0 5 ) ,而分别与内膜癌比较差异均显著 (P <0 .0 1,P <0 .0 5 )。阳性表达部位子宫内膜轻度不典型增生均为胞浆 ,部分子宫内膜重度不典型增生和子宫内膜癌为胞核或核浆。结论　细胞的过度增殖和P16基因的表达异常 ,可作为子宫内膜不典型增生早期癌变的诊断及预后的重要参考指标     

p16、bcl-2在子宫内膜良、恶性病变中的表达及其意义

目的:探讨抑癌基因p16和凋亡抑制基因bcl-2在子宫内膜增生过长、子宫内膜癌中的表达及其意义。方法:采用免疫组织化学方法检测并比较66例子宫内膜增生过长、子宫内膜癌组织中p16、bcl-2的表达。结果:从简单型、复杂型、复杂型伴非典型增生过长到子宫内膜癌p16表达率依次下降,分别为78.6%、57.1%、66.6%和40.5%,子宫内膜癌p16阳性表达率明显低于子宫内膜增生过长(P<0.05),子宫内膜癌中不同组织学分型及分级p16阳性表达差异无统计学意义(P>0.05)。bcl-2在子宫内膜癌与复杂型、非典型增生过长中的表达差异无统计学意义(P>0.05),但简单型增生过长与复杂型、非典型增生过长和子宫内膜癌中的表达差异有统计学意义(P<0.05)。bcl-2表达随着分化程度降低而降低(P<0.05)。结论:p16、bcl-2在子宫内膜癌的发生中起着一定的作用,尤其是bcl-2在复杂型、非典型增生过长中高表达,可作为临床诊断的辅助指标。     

p73在子宫内膜癌中的表达

目的　研究p73在子宫内膜癌中的蛋白表达情况 ,以探讨其在子宫内膜癌发生发展中的可能作用。方法　采用免疫组化SP法测定 5 8例子宫内膜癌标本 ,2 0例子宫内膜中、重度不典型增生标本和 2 4例正常子宫内膜标本中p73的蛋白表达情况。结果　①p73在子宫内膜癌中表达阳性率为 5 3.4 5 % ,在子宫内膜中、重度不典型增生中阳性率为 2 5 .0 0 % ,在正常子宫内膜中阳性率为 4 .17% ,各组相比 ,差异有显著意义 (P <0 .0 5 )。②p73在子宫内膜癌各期的阳性率分别为 :Ⅰ期 31.82 % ,Ⅱ期 5 6 .2 5 % ,Ⅲ～Ⅳ期 75 .0 0 % ,Ⅲ～Ⅳ期与Ⅰ～Ⅱ期相比 ,差异有显著意义 (P <0 .0 5 ) ;且p73的阳性率随组织学分级、肌层浸润深度、淋巴转移而升高 (P <0 .0 5 )。③p73“ +”的患者比p73“ -”的患者预后差 (P <0 .0 5 )。结论　p73蛋白表达异常在子宫内膜癌的发生发展中可能发挥重要作用 ;p73蛋白过表达与子宫内膜癌患者的预后有关 ,可能作为子宫内膜癌患者判断预后的指标之一。     

肝细胞生长因子及其受体c-Met在子宫内膜癌中的表达

目的　探讨肝细胞生长因子 (HGF)及其受体c Met蛋白表达与子宫内膜癌临床病理特征的关系。方法　应用免疫组化法检测 2 0例正常子宫内膜 ,4 6例子宫内膜癌组织中HGF及c Met蛋白的表达。结果　①正常子宫内膜HGF及c Met在增生期内膜的表达明显高于分泌期子宫内膜的表达。②子宫内膜癌c Met表达与临床分期、病理分级明显相关 (P <0 .0 5 ) ,Ⅰ、Ⅱ期低于Ⅲ、Ⅳ期 ,G1、G2 级低于G3 级。与年龄、肌层浸润、淋巴结转移无关 (P>0 .0 5 )。半定量分析 :HGF表达与子宫内膜癌Ⅲ +Ⅳ期有关 (P <0 .0 5 )。结论　HGF/c Met系统在子宫内膜癌的侵袭进展中起重要作用 ,c Met可能成为判断子宫内膜癌预后的良好参考指标。HGF及c Met联合检测对于判断子宫内膜癌预后有重要意义     

子宫内膜癌中PTEN蛋白和雌激素受体ER的检测及临床意义

目的探讨子宫内膜癌组织中抑癌基因PTEN和雌激素受体（ER）的异常表达及其临床意义。方法采用免疫组织化学SP法检测子宫内膜单纯性增生20例、子宫内膜复杂性非典型增生20例、子宫内膜癌35例中PTEN及ER的表达,表达率的差异采用卡方检验。结果PTEN在子宫内膜单纯性增生、子宫内膜复杂性非典型增生、子宫内膜癌中的表达缺失率逐渐上升,表达缺失率与组织学分级有关,差异有统计学意义（P〈0.05）。ER在子宫内膜单纯性增生、子宫内膜复杂性非典型增生、子宫内膜癌中的阳性表达率逐渐下降,差异有统计学意义（P〈0.05）,但阳性率与组织学分级无关,差异无统计学意义（P〉0.05）。结论PTEN、ER均与子宫内膜癌的发生、发展有关。     

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.