瘦素和VEGF的阳性细胞在卵巢子宫内膜异位症中的病理学研究

 【目的】探讨瘦素和血管内皮生长因子（VEGF）在子宫内膜异位症（EMs）发病机制中的作用。【方法】应用免疫组织化学法检测瘦素和血管内皮生长因子在28例卵巢子宫内膜异位囊肿患者的异位内膜、在位子宫内膜及20例正常子宫内膜中的表达特点。【结果】①腺上皮细胞中：瘦素和VEGF在异位内膜和在位内膜中的表达均高于正常子宫内膜（P〈0．05），并且异位内膜中的表达高于在位内膜（P〈0．01）；②间质细胞中：瘦素在异位内膜中的表达高于在位内膜、正常子宫内膜（P〈0．01），VEGF在异位内膜、在位内膜及正常子宫内膜中的表达差异无统计学意义（P〉0．05）；异位内膜、在位内膜中的瘦素与VEGF均呈正相关表达（P〈0．01）。【结论】瘦素和血管内皮生长因子在卵巢子宫内膜异位症的发病机制中发挥作用，两者在异位内膜和在位内膜中的血管生成过程中密切相关。     

血管内皮生长因子在子宫内膜异位症中的作用

目的：探讨血管内皮生长因子（VEGF）在子宫内膜异位症（EM）中的作用。方法：应用RT—PCR方法检测33例子宫内膜异位症患者的33份卵巢子宫内膜异位囊肿及32份在位子宫内膜组织中VEGFmRNA的表达情况，并进行阳性率及半定量的比较。以26例非子宫内膜异位症患者的26份子宫内膜组织作为对照。结果：EM组卵巢子宫内膜异位囊肿VEGFmRNA表达与在位子宫内膜比较，水平较低（P〈0．05），但高于对照组（P〈0．05）；在位子宫内膜与对照组比较VEGFmRNA表达水平较高（P〈0．01）；在不同月经周期中，在位内膜组和对照组分泌期VEGFmRNA表达水平均高于增生期（P〈0．01），在位内膜组分泌期和增生期的VEGFmRNA表达水平均分别高于对照组（P〈0．01）。结论：EM患者的异位子宫内膜中VEGFmRNA的表达，可能与其血管化程度有关；VEGF对EM的发生发展具有重要意义。     

VEGF在子宫内膜异位症中的表达

目的 通过检测子宫内膜异位症（EM）患者体内血管内皮生长因子（VEGF）的表达，探讨它在子宫内膜异位症发生发展中的作用。方法 应用ELISA测定血清和腹腔液中VEGF的含量；免疫组织化学测定正常子宫内膜与患者在位、异位子宫内膜组织中VEGF的表达。结果 ①血清、腹腔液VEGF的水平，EM各组高于正常对照组（P〈0．01）；EM早期组高于晚期组（P〈0．05）；各组腹腔液VEGF水平均高于血清水平（P〈0．05）。异位内膜组、在位内膜组VEGF的表达分别与对照组比较显著增高（P〈0．05），在异位内膜组中Ⅲ、Ⅳ期组与Ⅰ、Ⅱ期组相比明显降低（P〈0．01）。②患者的异位内膜组VEGF的表达和腹腔液组VEGF的含量呈正相关（P〈0．05；rs=0．404）。结论 患者体内VEGF的异常表达在子宫内膜异位症的发生发展中起重要的作用。     

VEGF在子宫内膜异位症中的表达及其意义

目的观察血管内皮生长因子（VEGF）在子宫内膜异位症（EMS）中的表达并探讨其在EMS发病机制中的作用。方法利用免疫组化法检测VEGF在30例EMS的异位内膜及在位内膜组织、30例正常子宫内膜组织中的表达。结果VEGF在异位内膜的表达显著高于在位内膜和正常子宫内膜（P〈0.05）。VEGF在EMS在位内膜的表达显著高于正常子宫内膜（P〈0.05）。结论VEGF在EMS的发生、发展中起重要作用。     

VEGF、MMP-7在子宫内膜异位症中的表达及意义

目的探讨血管内皮生长因子（vascular endothelial growth factor,VEGF）、基质金属蛋白酶-7（mauixmet-alloproteinases-7,MMP-7）在在正常人及子宫内膜异位症（endometriosis,EMT）患者内膜组织中的表达,探讨VEGF、MMP-7在EMT发生发展中的作用。方法通过免疫组化S-P法分别检测MMP-7及VEGF在EMT患者在位子宫内膜及异位内膜和正常子宫内膜中的表达。结果异位内膜MMP-7表达与在位内膜无差异,但高于正常内膜（P〈0.05）,在位内膜与正常子宫内膜相比,差异有显著性（P〈0.05）;卵巢异位内膜VEGF表达与同期在位内膜相比,表达增高,差异有显著性（P〈0.05）,且明显高于正常内膜（P〈0.005）;在位内膜与正常子宫内膜相比,VEGF表达差异无显著性（P〉0.05）。结论 EMT在位内膜、异位内膜中VEGF及MMP-7与异位内膜的高侵袭性和高血管新生能力有关,在EMs的发生发展中起重要作用。     

垂体肿瘤转化基因和血管内皮细胞因子在子宫内膜异位症中的表达及意义

目的：检测PTTG及VEGF在子宫内膜异位症中异位内膜、在位内膜及对照组正常内膜的表达,并探讨其相关性。方法：选取52例子宫内膜异位症患者的异位内膜、44例在位内膜,27例正常子宫内膜组织为对照组。用逆转录聚合酶链式反应（ RT－PCR）及免疫组化（ SP ）方法测 PTTG、VEGF在三组中的表达情况。结果：P TTG mRNA在子宫内膜异位症中异位内膜组表达高于在位内膜组,在位内膜组表达高于正常子宫内膜组织（ P＜0．01,P＜0．01）。 PTTG蛋白表达在异位内膜组、在位内膜组、正常内膜组的阳性率分别为：90％、79％、22％,异位内膜组和在位内膜组表达均高于正常子宫内膜组织（ P＜0．01,P＜0．01）。 VEGF蛋白表达在异位内膜组、在位内膜组、正常内膜组的阳性率分别为：90％、84％、59％,异位内膜组和在位内膜组表达高于正常子宫内膜组织（ P＜0．01, P＜0．01）。等级相关分析PTTG表达与VEGF表达呈正相关关系。结论：子宫内膜异位症中异位内膜组、在位内膜组均有PTTG mRNA及PTTG蛋白表达;且异位内膜组表达均显著高于在位内膜组及正常组;异位内膜组和在位内膜组中VEGF表达高于正常子宫内膜组织;PTTG高度表达可上调VEGF高表达,PTTG与VEGF呈正相关表达,提示子宫内膜活性增强、侵袭力增高,可促进血管形成。     

新疆汉族和维吾尔族妇女子宫内膜异位症中 VEGF和TGF-β1的表达

目的:检测血管因子 VEGF和 TGF-β1 在汉族和维吾尔族妇女子宫内膜异位症中的表达 ,以探讨血管因子在子宫内膜异位症发病中的作用。 方法:应用免疫组化法检测血管内皮生长因子 (VEGF)和转化生长因子(TGF-β1 )在无异位症妇女的正常子宫内膜与卵巢子宫内膜异位症患者的在位内膜、异位内膜中的表达。 结果 :VEGF和 TGF-β1 在异位症患者异位、在位内膜中的表达较无异位者增强 ,差异有统计学意义 (P <0 .0 1) ;维汉族妇女内异症患者的异位内膜中 VEGF与 TGF-β1 的表达差异无统计学意义 (P >0 .0 5 ) :VEGF的表达与 TGF-β1的表达呈正相关 (P <0 .0 1)。结论:VEGF与 TGF- β1 在子宫内膜异位症中的表达明显高于无异位症者 ,可能在子宫内膜异位症的发生发展中起重要作用     

组织因子和血管内皮生长因子在子宫内膜异位症组织中的表达及意义

目的：探讨组织因子（ TF）和血管内皮生长因子（ VEGF）在子宫内膜异位症（ EMs）组织中的表达及意义。方法通过腹腔镜活检或开腹手术,取得60例卵巢子宫内膜异位病灶组织及在位内膜40例,另取同期子宫肌瘤手术患者的正常子宫内膜组织25例作为对照,应用免疫组织化学技术对组织中的TF和VEGF蛋白的表达情况进行检测。结果 TF在EMs中异位内膜的表达与在位内膜中的表达差异无统计学意义（P＞0.05）,异位内膜及在位内膜中的表达明显高于正常子宫内膜（P＜0.05）;VEGF在EMs中异位内膜的表达与在位内膜中的表达差异无统计学意义（P＞0.05）,异位内膜及在位内膜中的表达明显高于正常子宫内膜（P＜0.05）。结论 TF和VEGF在EMs中诱导血管生成,促进EMs的发生发展。     

IGF—I及IGFBP-3与卵巢子宫内膜异位症相关关系的研究

目的：观察胰岛素样生长因子-I（IGF—I）及胰岛素样生长因子结合蛋白-3（IGFBP-3）在卵巢子宫内膜异位症患者原位及异位内膜的表达,探讨卵巢子宫内膜异位症的发生及侵袭机制。方法：取40例卵巢子宫内膜异位症患者异位内膜和25例异位症患者在位内膜标本作为病例组,另取20例正常妇女子宫内膜作为对照组．采用免疫组织化学方法检测IGF—I、IGFBP-3的分布及表达。结果：正常内膜及卵巢子宫内膜异位症的在位和异位内膜组织中均有IGF—I、IGFBP-3的表达,IGF—I在异位组和在位组子宫内膜腺上皮的表达显著高于正常组（P〈0．05）;IGFBP-3在正常组子宫内膜腺上皮的表达强于异位组和在位组（P〈0．05）。结论：IGF—I、IGFBP-3对卵巢子宫内膜异位症的异位内膜生长与维持起着一定作用。     

血管内皮生长因子在异位和在位子宫内膜中的表达

目的研究血管内皮生长因子（vascular endothelial growth factor,VEGF）在子宫内膜异位症（endometrio-sis,EM）患者的异位和在位内膜中的表达及其在EM发病机制中的作用。方法应用ELISA法检测有或无EM的妇女的血管内皮生长因子（VEGF）水平、采用免疫组织化学S-P法测定VEGF在EM患者异位与在位内膜及对照组增殖期和分泌期子宫内膜组织中的表达,并以抗第八因子相关抗原（F8-RA）抗体标记间质微血管并进行微血管计数（MVD）。结果在整个月经周期中,研究组异位和在位内膜中VEGF表达均持续高于对照组（P〈0.01）。EMs患者异位内膜和在位内膜的微血管密度（MVD）明显高于对照组内膜（P〈0.05）。结论VEGF在EMs患者的高表达,说明其通过促血管生成在该病发生发展中起着重要作用。     

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.