COX-2、p53与乳腺癌微血管密度和淋巴结转移的相关性

目的: 探讨COX-2、p53在乳腺癌组织中的表达及其与微血管密度和淋巴结转移的关系。方法: 应用原位杂交方法检测60例乳腺癌和20例癌旁正常乳腺组织COX-2mRNA的表达,应用免疫组织化学S-P法检测两组织中的COX-2、p53的表达,并用第FⅧ因子相关抗原抗体标记血管内皮细胞,计算肿瘤内微血管密度(MVD)。结果: COX-2(+)或p53(+)组MVD均显著高于COX-2(-)或p53(-)组(P<0.01),COX-2和p53均阳性时MVD最大(P<0.01)。淋巴结转移组COX-2、p53阳性率均高于无淋巴结转移组(P<0.005和P<0.05)。结论: COX-2、p53在乳腺癌组织中的表达与乳腺癌血管生成和淋巴结转移有关,二者在乳腺癌血管生成中可能具有协同作用。     

局部及已转移骨肉瘤中VEGF、p53表达及微血管生成的对照研究

目的探讨血管内皮生长因子(VEGF)和p53在骨肉瘤微血管新生中的作用及对原发骨肉瘤侵袭性转移性的影响.方法采用免疫组织化学方法,检测57例局部原发性骨肉瘤和27例伴发转移的骨肉瘤原发灶标本中VEGF、p53的表达,计算MVD值.比照两骨肉瘤组中VEGF、p53表达,MVD以及其它临床病理因子的差别.结果伴发转移骨肉瘤组VEGF阳性表达率高于局部骨肉瘤组(P=0.0494);p53蛋白表达在两组肿瘤中无显著差别(P＜0.05);伴发转移骨肉瘤组的微血管密度高于局部骨肉瘤组的微血管密度(P=0.0302);件发转移骨肉瘤组中肿瘤平均直径大于局部骨肉瘤组的平均直径(P=0.0350);VEGF和P53表达阳性组与阴性组相比,MVD值高(P=0.0125,P=0.0036);VEGF与P53表达阴阳性一致率为51.2%.VEGF和P53共同阳性表达组MVD值最高(42.7±22.4),而VEGF和P53共同阴性表达组MVD值为最低(23.3±20.1),差别显著(P=0.0077).结论p53和VEGF共同参与骨肉瘤血管生成并有协同作用.VEGF和MVD检测对骨肉瘤早期转移的临床预测有实际意义.     

MMP-9和p53蛋白的表达及微血管密度对乳腺癌远处转移的影响

目的观察乳腺癌组织中MMP-9,p53蛋白的表达及微血管密度与患者腋淋巴结及远处肿瘤转移之间的关系,以探讨它们与乳腺癌生物学行为的关系及机制。方法通过组织化学方法检测MMP-9,p53在肿瘤细胞中的表达,在显微镜下计算肿瘤组织中微血管密度值,观察其与患者腋淋巴结及远处肿瘤转移之间的关系。结果MMP-9主要分布在胞浆,20例乳腺纤维腺瘤细胞均未表达MMP-9,乳腺癌细胞内随同侧腋淋巴结转移量的增多,MMP-9阳性级别增加,两者呈正相关;p53主要表现为核阳性,20例乳腺纤维腺瘤细胞中18例未表达p53,随同侧腋淋巴结转移量的增多,p53表达级别增加,两者呈正相关;随同侧腋淋巴结转移量的增多,微血管密度明显增加,与对照组相比差异有显著性(P<0.05)。结论肿瘤细胞中MMP-9,p53蛋白的高表达及MVD值可以作为评估患者腋淋巴结转移及其他部位远处转移的重要指标。     

P53蛋白表达和肿瘤微血管生成与肝癌的发展及预后的关系

目的探讨p53蛋白表达和肿瘤微血管生成与肝细胞癌(HCC)发展及预后的关系.方法采用免疫组化方法检测50例肝细胞癌组织中p53蛋白的表达,并用抗CD34抗标记癌组织血管内皮细胞,计算肿瘤微血管密度(microvessl density,MVD).分析p53蛋白和MVD与HCC临床病理学特征之间的关系.结果p53阳性表达为癌细胞核棕黄色着色,CD34染色定位在血管内皮细胞上,HCC的p53表达及MVD与肿瘤大小、病灶数目、病理分级、门静脉癌栓形成、包膜是否完整有显著相关(P＜0.05).p53蛋白表达阳性者MVD值显著高于阴性者(P＜0.05);p53蛋白表达阳性或MVD≥148的肝癌病人术后生存时间比p53蛋白表达阴性或MVD＜148者低(P＜0.05).结论p53与肿瘤血管生成密切相关,而p53蛋白及MVD可作为肝癌的预后判断的一个重要指标.     

血小板反应蛋白-1在非小细胞肺癌中表达的研究

目的 观察血小板反应蛋白-1(TSP-1)在非小细胞肺癌(NSCLC)中的表达及其与肿瘤血管新生、淋巴结转移的关系,初步探讨其表达调控的基因机制.方法 选择我院收治的首次住院行完全切除术并通过病理学确诊的NSCLC患者40例,以免疫组化方法研究其肿瘤组织TSP-1及p53、 nm23-1基因的表达.结果 40例NSCLC患者肿瘤组织TSP-1表达缺失率为22.5%.淋巴结转移者和无淋巴结转移者的癌组织TSP-1表达强度间差异有统计学意义(P＜0.01);不同组织类型、临床分期、分化程度NSCLS组织TSP-1表达强度间差异均无统计学意义(P＞0.05).TSP-1高表达者与低表达者微血管密度(MVD)间差异有统计学意义(P=0.009),且MVD与TSP-1表达水平呈负相关(P＜0.05).nm23-1表达阳性者与阴性者癌组织TSP-1表达强度间差异有统计学意义(P＜0.05);p53表达阳性者与阴性者癌组织TSP-1表达强度间差异无统计学意义(P＞0.05).结论 TSP-1表达降低与NSCLC的血管新生及淋巴结转移密切相关,提示TSP-1是NSCLC血管新生的重要调控因子之一.NSCLC癌组织TSP-1表达的降低与nm23-1基因表达的缺失有关,而与p53基因无关,提示NSCLC的TSP-1表达可能主要由nm23-1基因调控.     

MMP-9的表达及微血管密度对乳腺癌远处转移的影响研究

目的 观察乳腺癌组织中MMP-9、p53的表达及微血管密度与患者腋淋巴结及远处肿瘤转移之间的关系，以探讨它们与乳腺癌生物学行为的关系及机制。方法 通过组织化学方法检测MMP-9、p53在肿瘤细胞中的表达，在显微镜下计算肿瘤组织中微血管密度值，观察其与患者腋淋巴结及远处肿瘤转移之间的关系。结果 MMP-9主要分布在胞浆，20例乳腺纤维腺瘤细胞均未表达MMP-9，乳腺癌细胞内随同侧腋淋巴结转移量的增多，MMP-9阳性级别增加，两者成正相关；p53主要表现为核阳性，20例乳腺纤维腺瘤细胞中18例未表达p53，随同侧腋淋巴结转移量的增多，p53表达级别增加，两者成正相关；随同侧腋淋巴结转移量的增多, 微血管密度明显增加，与对照组相比差异有显著性（P﹤0.05）。结论 肿瘤细胞中MMP-9、p53蛋白的高表达及MVD值可以作为评估患者腋淋巴结转移及其它部位远处转移的重要指标。 【关键词】p53蛋白； MMP-9；微血管密度；乳腺癌；肿瘤转移 【中图分类号】R737.9 【文献标识码】A     

粘着斑激酶在乳腺癌的表达及其与血管生成的关系

目的 研究乳腺癌组织中粘着斑激酶(FAK)的表达及其与微血管密度(MVD)的关系,探讨FAK介导的细胞信号转导系统对乳腺癌血管生成的作用和意义.方法 应用SP法对88例乳腺癌组织和30例乳腺良性病变组织进行FAK和CD34免疫组化染色,分析FAK蛋白表达和CD34标记的MVD值之间,及其与乳腺癌临床病理参数之间的关系.结果 在88例乳腺癌中FAK的阳性表达率为68.2%(60/88),MVD为(34.52±13.11)/HPE,与良性对照组比较均有显著差异(P＜01);FAK表达和MVD与乳腺癌肿瘤大小、腋窝淋巴结转移、临床分期呈正相关(P＜0.05),与患者年龄、组织病理学分级未见显著相关(P＞0.05);乳腺癌FAK表达与MVD呈正相关(P＜0.01).结论 FAK蛋白表达和微血管形成与乳腺癌的侵袭转移密切相关,FAK表达对乳腺癌血管生成具有促进作用.     

基质溶解素与微血管密度在乳腺癌发生中的作用及其关系

目的 研究基质溶解素(MMP-7)和微血管密度MVD与乳腺癌临床病理表现特征的关系及MMP-7对乳腺癌MVD的影响.方法 选取乳腺癌患者组织标本60例,应用免疫组织化学方法检测MMP-7和血管内皮细胞CD34的表达,分析MMP-7、MVD与患者年龄、肿瘤大小、组织学类型、淋巴结转移的关系.结果 MMP-7在直径＞2 cm、有淋巴结转移的乳腺癌组织中的阳性表达率与直径≤2 cm、无淋巴结转移的乳腺癌组织中的阳性表达率比较差异有统计学意义(P＜0.05).MVD在直径＞2 cm、有淋巴结转移的乳腺癌组织中与直径≤2 cm、无淋巴结转移的乳腺癌组织中的表达比较差异有统计学意义(P＜0.05).MMP-7阳性的乳腺癌组织MVD水平与MMP-7阴性的乳腺癌组织比较差异有统计学意义(P＜0.05).结论 MMP-7表达上调和 MVD增加与乳腺癌的演进和迁移有关,MMP-7具有促进乳腺癌微血管生成的作用.     

鼻咽癌血管生成及nm23基因表达与复发转移关系初探

目的：探讨微血管密度（Microvessel density,MVD)及nm23基因蛋白表达与鼻咽癌复发转移关系。方法：采用免疫组织化学S－P法检测了73例鼻咽癌(Nasopharyngeal Carcinoma,NPC)组织中的微血管密度、血管内皮生长因子（Vascular endothelial growth factor,VEGF）及nm23基因蛋白表达。结果：NPC中复发转移者或伴有颈部淋巴结转移者的MVD及VEGF表达显著升高,而nm23基因蛋白表达则较无复发转移者或不伴有颈部淋巴结转移者的低。结论：NPC的MVD及nm23、VEGF与其浸润和转移密切相关,有可能作为判断肿瘤生物学行为、转移潜能及预后指标。     

胰腺癌p16、Bcl-2、Bax和VEGF基因表达及新生血管密度计数的意义

目的：研究胰腺癌组织中p16、Bcl-2、Bax和VEGF基因的表达及新生血管计数的意义。 方法：采用免疫组织化学法及形态半定量方法对33例胰腺癌和6例正常胰腺组织进行新生血管密度记数和p16、Bcl-2、Bax和VEGF基因表达检测。 结果：P16蛋白表达：高、中分化胰腺癌高于低分化(P<0.05),生存期长者表达高于生存期短者(P<0.05);Bcl-2表达：高、中分化者高于低分化者;Bax表达：正常胰腺组织高于胰腺瘤组织,高、中分化者高于低分化者,生存期≥12个月者高于＜12个月者;VEGF表达：有淋巴结转移者高于无淋巴结转移者;MVD记数：正常胰腺组织低于胰腺瘤组织,有淋巴转移者高于无淋巴结转移者;MVD与VEGF表达呈正相关（r=0.79,P<0.05）;p16基因表达与VEGF表达和MVD呈负相关（r=-0.69,P<0.05;r=-0.87,P<0.05）,Bcl-2表达与其他基因表达结果无相关关系。Bax表达与p16表达呈正相关（r=0.54,P<0.05）,与VEGF表达和MVD呈负相关（r=-0.66,P<0.05）。 结论：综合检测胰腺癌组织中p16、Bcl-2、Bax和VEGF基因的表达及微血管密度对判断胰腺癌恶性程度及估计肿瘤的预后有较大帮助。     

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.