p53和bcl-2在胰腺癌组织中的表达及意义

目的 检测p53和bcl-2蛋白在胰腺癌及其它胰腺疾病组织中的表达,并探讨其临床意义.方法 应用链霉菌抗生物素过氧化酶免疫组化法对32例原发性胰腺导管腺癌、12例胰腺癌手术切缘经病理证实的正常胰腺组织、10例良性疾病组织进行p53和bcl-2蛋白检测.结果 p53蛋白阳性表达仅见于原发性胰腺导管腺癌,阳性率为43.8%,p53蛋白表达与原发性胰腺导管腺癌临床病理特征无关;bcl-2蛋白在原发性胰腺导管腺癌、正常胰腺组织和良性疾病组织中均表达,阳性率分别为46.9%、25.0%和20.0%,在胰腺癌中表达率较高,但无统计学意义;bcl-2蛋白表达在组织学高、中分化和临床Ⅰ～Ⅱ期显著高于组织学低分化和临床Ⅲ～Ⅳ期(P＜0.05).结论 p53和bcl-2蛋白在胰腺癌的发生中起着重要的作用;bcl-2蛋白的表达能反映胰腺癌的生物学行为.     

增殖细胞核抗原和微血管密度在胰腺癌中的表达及意义

目的 通过检测增殖细胞核抗原(proliferating cell nuclear antigen, PCNA)蛋白及微血管密度(microvessel density, MVD)在胰腺癌中的表达,探讨其临床意义.方法 应用链霉菌抗生物素过氧化酶(streptavidin-peroxidase, SP)免疫组化法对32例原发性胰腺导管腺癌、12例正常胰腺组织进行PCNA蛋白和MVD检测.结果 PCNA蛋白在原发性胰腺导管腺癌、正常胰腺组织均表达,其分化指数PI值(proliferation index)分别为30.26±14.23和21.63±6.76,两组比较差异有显著性(P＜0.05);MVD值在两组分别为32.17±3.42和15.42±3.28, 两组比较差异有显著性(P＜0.05).PCNA蛋白表达在组织学高、中分化、临床Ⅰ～Ⅱ期及无淋巴结转移组显著低于组织学低分化、临床Ⅲ～Ⅳ期及有淋巴结转移组(P＜0.05).结论 PCNA蛋白能较好地反映胰腺癌的恶性程度和增生活性,MVD与转移和预后有关.     

胰腺癌组织PCNA和c-erbB-2, nm23-H1癌基因的表达

目的　研究胰腺癌组织中 c- erb B- 2 ,nm2 3- H1及增殖细胞核抗原 (PCNA)的表达与生物学行为之间的关系 .方法　用免疫组织化学方法 (SABC)对 39例胰腺导管癌 c-erb B- 2 ,nm2 3- H1基因和 PCNA的表达进行检测 .结果　 39例胰腺导管癌中 c- erb B- 2 ,nm2 3- H1基因蛋白的表达率、PC-NA增殖指数分别为 4 6 % ,6 7% ,2 8± 16 ;c- erb B- 2 ,nm2 3-H1与组织学分级有关 (P<0 .0 5 ) ,而与临床分期关系不大 (P>0 .0 5 ) ;PCNA增殖指数与组织学分级和临床分期有关 (P<0 .0 1) ;c- erb B- 2 ,nm2 3- H1,PCNA均与淋巴结转移呈正相关 .结论　 c- erb B- 2 ,nm2 3- H1,PCNA是反映胰腺癌生物学行为的重要指标 .     

Survivin在胰腺癌组织中的表达及其与细胞增殖的关系研究

目的 :探讨凋亡抑制蛋白survivin的表达与胰腺癌细胞增殖及其生物学特性的关系。方法 :用免疫组织化学方法Envision法对 5 1例胰腺导管癌survivin蛋白和ki6 7的表达进行检测。结果 :5 1例胰腺导管癌中survivin .蛋白的表达率为 80 .4 % ,ki6 7平均标记指数为 2 6 .5 2± 12 .2 2 ;二者在 11例癌旁非肿瘤胰腺组织中均未发现阳性表达。survivin的表达与组织学分级有关 (P <0 .0 1) ,而与临床分期和淋巴结转移关系不大 (P >0 .0 5 ) ;ki6 7标记指数与组织学分级和临床分期和淋巴结转移有关 (P <0 .0 1) ;survivin的阳性表达与肿瘤细胞的增殖指数密切相关 (P <0 .0 1)。结论 :survivin基因在胰腺癌中高度表达可能与肿瘤的发生发展及细胞的增殖密切相关。     

肺腺癌组织中COX-2 mRNA的表达

目的 :研究肺腺癌组织中环氧合酶 2 (COX 2 )的表达及其与转移的关系。方法 :应用逆转录 多聚酶链反应 (RT PCR) ,对 4 5例肺腺癌 (临床分期Ⅰ期 1 4例 ,Ⅱ期 2 0例 ,Ⅲa期 8例 ,Ⅲb期 3例 ,淋巴结转移者 2 0例 ,无淋巴结转移者 2 5例 )和 1 5例癌旁组织COX 2mRNA的表达进行半定量分析。结果 :COX 2mRNA在肺腺癌组织中的表达 (1 .81 3± 0 .0 6 3)高于癌旁肺组织 (0 .6 2 4± 0 .0 4 2 ) (P <0 .0 5 ) ;有淋巴结转移组肺腺癌组织COX 2mRNA的表达为 2 .98± 0 .0 1 ,高于无淋巴结转移组 1 .0 1± 0 .96 (P <0 .0 5 ) ;COX 2mRNA表达随肺腺癌的临床分期增高而增高。结论 :COX 2可作为肺腺癌的重要生物学指标 ,有助于对肺腺癌生物学行为的了解 ,从而指导临床治疗     

抑癌基因p16在胰腺癌中的表达及其意义

目的 :研究抑癌基因 p1 6在胰腺癌中的表达及其意义。方法 :采用免疫组化 LSAB法 ,以p1 6多克隆抗体检测胰腺腺癌 2 8例 ,正常胰腺组织 6例中 P1 6蛋白的表达。结果 :1正常胰腺组织中 P1 6蛋白的表达率与胰腺腺癌中 P1 6蛋白的表达率比较差异显著 (P<0 .0 5)。 2胰腺腺癌中P1 6蛋白的表达率与病人的年龄、性别、肿瘤大小等因素无相关性 (P>0 .0 5)。 3不同分化程度的胰腺腺癌中 P1 6蛋白的表达率差异显著 (P<0 .0 5)。 4胰腺腺癌中 P1 6蛋白的表达率在是否有淋巴结转移两组间比较无统计学意义 (P>0 .0 5)。 5胰腺腺癌中 P1 6蛋白的表达率与病人术后生存期长短之间比较呈正相关 (P<0 .0 5)。结论 :抑癌基因 p1 6在胰腺癌的发生、发展过程中起一定作用 ;P1 6蛋白的表达率与胰腺癌的恶性程度呈负相关 ;P1 6蛋白的表达率与病人术后生存时间呈正相关 ;P1 6蛋白的表达率与病人的年龄、性别、肿瘤大小、是否有淋巴结转移无关     

细胞间隙连接蛋白43在胰腺癌组织表达及其意义

①目的探讨细胞间隙连接蛋白43（Cx43）在胰腺癌及正常胰腺组织中的表达、定位及其在胰腺癌发生和发展中的意义。②方法应用免疫组织化学方法检测47例胰腺癌、25例淋巴结转移灶和10例正常胰腺组织中Cx43蛋白的表达和定位。③结果Cx43蛋白在10例正常成人胰腺导管及腺泡细胞均呈阳性表达,47例胰腺癌组织Cx43表达阳性率为44．7％,而25例淋巴结转移灶中Cx43表达阳性率为20．0％。Cx43蛋白在正常胰腺、胰腺癌和淋巴结转移灶中的阳性表达率差异具有显著性（x^2=18．59,P〈0．01）。Cx43蛋白阳性表达率在组织学Ⅰ级的胰腺癌明显高于组织学Ⅲ级（P=0．047）;无周围脏器浸润的胰腺癌组织中Cx43蛋白阳性表达率为70．6％,有浸润者为30．0％,二者间差异有显著性（x^2=7．23,P〈0．01）;无淋巴结转移的胰腺癌组织Cx43阳性表达率（63．6％）高于有转移者（28．0％）,差异有显著性（x^2=6．01,P〈0．01）。Cx43蛋白阳性表达率与胰腺癌的大小和1年生存率无关（x^2=2．21、2．07,P〉0．05）。④结论Cx43蛋自在胰腺癌中的表达下调和定位异常可能是胰腺癌发生的重要环节。Cx43蛋白表达水平可以作为判断胰腺癌分化程度、浸润转移能力的重要指标。     

胰腺癌组织中a—连环素的表达

目的　探讨α 连环素 (α Cat)在胰腺癌组织中的表达及与其生物学行为的关系。②方法　应用免疫组织化学PicTureTM二步法 ,检测 47例胰腺癌组织、5例正常胰腺组织及 12例癌周正常胰腺组织中α Cat的表达 ;同时检测 47例胰腺癌组织中细胞增殖核抗原 (PCNA)的表达。③结果　α Cat蛋白主要定位于正常胰腺腺泡和导管上皮细胞间的连结处 ,正常胰腺和癌周正常胰腺组织均呈阳性表达 ,6 1.7%的胰腺癌组织表达减低 ;α Cat表达与胰腺癌的组织学分级、淋巴结和肝转移显著相关 (χ2 =4.47～ 15 .46 ,P <0 .0 5 ,0 .0 1) ,而与胰腺癌大小、增殖程度、侵袭能力及 1年生存率无关 (χ2 =0 .0 7～ 2 .77,P均 >0 .0 5 )。④结论　胰腺癌存在α Cat基因的失活及蛋白表达的下调 ,α Cat蛋白可作为评估胰腺癌分化和转移 ,尤其是肝转移的重要生物学指标。     

应用组织微阵列研究D2-40在胰腺癌中的表达及其临床病理意义

目的探讨淋巴管内皮标记物D2-40在胰腺癌组织中的表达及其临床病理意义。方法应用免疫组织化学法检测胰腺癌组织芯片中D2-40在88例胰腺导管腺癌和11例正常胰腺组织的表达水平,并计数淋巴管密度（LVD）,分析其与胰腺癌临床病理参数的关系。结果 88例胰腺导管腺癌组织LVD明显低于11例正常胰腺组织（P〈0.05）;胰腺癌临床分期和病理分级越高,LVD就越大（均P〈0.01）,有淋巴结转移的胰腺癌组织中LVD显著高于无淋巴结转移的胰腺癌组织（P〈0.01）。结论 D2-40在胰腺导管腺癌组织中的表达明显高于正常胰腺组织,并且和胰腺癌的临床分期、病理分级和淋巴结转移显著相关,两者的联合检测可能更有助于判断胰腺癌患者的预后。     

胰腺癌组织中P21ras、TGF-α及EGFR蛋白的表达

目的:检测原发性胰腺导管腺癌组织中P21ras、转化生长因子-α(TGF-α)及表皮生长因子受体(EGFR)蛋白的表达情况.方法:应用免疫组织化学SP法检测30例原发性胰腺导管腺癌和10例正常胰腺组织中P21ras、TGF-α及EGFR蛋白的表达情况.结果:原发性胰腺导管腺癌组织中P21ras、TGF-α及EGFR的阳性表达率分别为63.3%(19/30)、80.0%(24/30)和70.0%(21/30),均高于正常胰腺组织的1/10、2/10和0(P分别为0.008、0.001和<0.001);P21ras的表达与胰腺癌的病理分级(P=0.042)、临床分期(P=0.007)及淋巴结转移(P=0.023)关系密切,而TGF-α及EGFR的表达与上述指标无明显相关性(P>0.05);胰腺癌组织中TGF-α与EGFR的表达密切关联(rP=0.607.P<0.001).结论:胰腺癌组织中F21ras蛋白表达是一早期而普遍的事件,检测P21ras蛋白有助于胰腺癌的早期诊断,TGF-α与EGFR能够形成自分泌环,参与胰腺癌的发生.     

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.