血管内皮生长因子在人食管癌中的表达和临床意义

目的 :研究血管内皮生长因子 (VEGF)在人食管癌中的表达及其临床意义。方法 :对 72例食管鳞癌患者手术切除标本 ,10例正常食管组织 ,应用免疫组织化学技术 ,抗VEGF单克隆抗体检测VEGF的表达 ,抗CD34单克隆抗体测定组织微血管密度 (MVD)。结果 :VEGF在 4 0例 (5 5 .6 % )食管鳞癌中阳性表达 ,而正常食管组织不表达 ;食管鳞癌组织MVD为 6 7.5± 2 7.6 ,正常食管组织MVD为 2 9.9± 9.4 ,两者之间有显著性差异 (P <0 .0 1) ;VEGF评分为高级的食管鳞癌组织MVD高于VEGF评分为阴性和低级的食管鳞癌组织(P <0 .0 1) ,MVD与VEGF的表达呈正相关 (P <0 .0 1) ;VEGF的表达和MVD值在淋巴结转移组显著高于无淋巴结转移组 (P <0 .0 1)。结论 :VEGF在食管鳞癌组织表达且与肿瘤血管形成有关 ;VEGF的表达和MVD与食管鳞癌的淋巴结转移密切相关 ,可作为术前治疗方案的选择和确定手术范围的重要指导因子     

血管内皮细胞生长因子121(VEGF121)在胃癌中的表达及其临床意义

目的　探讨VEGF12 1血管生成因子在胃癌中的表达与胃癌微血管密度及胃癌临床病理特征的关系。方法　采用免疫组织化学方法对 5 9例胃癌、2 5例胃慢性良性病变、15例癌旁正常胃黏膜组织检测VEGF12 1阳性表达及微血管密度 (CD34标记 )。结果　 (1)胃癌中VEGF12 1阳性表达率为 79 6 6 % (4 7/5 9) ,高于胃慢性良性病变和癌旁正常组织 (P <0 0 5 ) ;胃癌微血管密度 (MVD)高于胃慢性良性病变和癌旁正常组织 (P <0 0 5 )。 (2 )胃癌中VEGF12 1阳性表达率在不同浸润深度组和有无远处转移组有显著性差异 (P <0 0 5 )。胃癌中微血管数量增加 ,形态结构异常 (P <0 0 5 )。结论　VEGF12 1在胃癌中高表达 ,并与胃癌的浸润转移一致。检测VEGF12 1在胃癌中的表达对判断胃癌的恶性程度有价值。     

乳腺癌患者血清血管内皮细胞生长因子的检测及其临床意义

目的 :研究乳腺癌血清血管内皮生长因子 ( Vascular endothelial growthfactor,VEGF)的表达水平及其和微血管计数 ( MVC)、临床病理特征之间的关系。方法 :免疫组化 SP法测定微血管计数 ,酶联免疫吸附法测定血清 VEGF表达水平 ,结合临床病理特征进行分析。结果 :乳腺癌患者血清 VEGF中位数为 393.5 pg/ml,健康人 66.0 0 pg/ml。乳腺癌患者血清 VEGF高于健康人 ,差异具有显著性 ( P<0 .0 1 )。血清 VEGF临床分期 、 期高于 期 ,差异具有显著性 ( P<0 .0 1 )。 、 期之间无显著性差异 ( P>0 .0 5 )。临床分级 、 级高于 级 ,差异具有显著性 ( P<0 .0 1 ) , 、 级之间无显著性差异 ( P>0 .0 5 )。腋窝淋巴结转移者高于未转移者 ,差异具有显著性 ( P<0 .0 1 )。高 MVC组患者血清 VEGF阳性率明显高于低 MVC组 ,差异具有显著性 ( P<0 .0 5 )。结论 :血清 VEGF表达与乳腺癌的进展、恶性程度、腋窝淋巴结转移相关 ,可作为判断乳腺癌恶性程度和淋巴结转移的一个生物学指标     

乳腺肿瘤中VEGF的表达和MVD分布

目的　探讨血管内皮细胞生长因子 (VEGF)的表达和微血管密度 (MVD)的分布与乳腺癌肿瘤大小、组织学分级、雌激素受体 (ER)表达、腋淋巴转移及复发转移和生存率的关系。方法　用 因子抗体与抗 VEGF多克隆抗体分别作乳腺病灶病理切片的免疫组织化学染色 ,在显微镜下判断 VEGF染色程度和进行微血管计数。结果　乳腺癌的 VEGF阳性表达率为 5 1.35 % (38/74 ) ,MVD均值为 (30 .8± 19.4 )个 /2 0 0倍视野 ,而良性乳腺疾病的 VEGF阳性表达率 16 .13% (5 /31) (P<0 .0 0 5 ) ,MVD均值为 (16 .0 9± 7.9)个 /2 0 0倍视野 (P<0 .0 5 ) ;乳腺癌中 ,MVD与肿瘤大小、组织学分级、腋淋巴转移及复发转移有关 (P<0 .0 5 ) ,VEGF与腋淋巴转移及复发转移有关(P<0 .0 5 )。 VEGF和 MVD与患者的无瘤生存率明显相关 (P<0 .0 5 )。 VEGF和 MVD之间无明显关系。结论　乳腺癌的 VEGF和 MVD与患者的预后有关 ,均可作为判断乳癌患者预后的指标之一。 VEGF不是影响肿瘤新生血管形成的唯一因素。     

血管内皮生长因子和微血管密度在结直肠癌中的意义

目的　探讨血管内皮生长因子 (VEGF)和微血管密度 (MVD)在结直肠癌中的表达以及它们之间的关系。方法　应用免疫组织化学S P法检测 87例结直肠癌组织中血管内皮生长因子的表达以及微血管密度。结果　 87例结直肠癌组织中VEGF的表达阳性率为 6 6 .7% ,MVD为 32 .80± 12 .11。VEGF和MVD在侵及浆膜层的结直肠癌中明显高于侵及肌层者 ,在淋巴结转移阳性组高于淋巴结转移阴性组 ,在DukesC、D期明显高于A、B期 ,差异均有显著性 (P <0 .0 5 ) ,且随着肿瘤分化程度的降低而增高 (P <0 .0 5 ) ;VEGF阳性组中的MVD值显著高于VEGF阴性组 (P <0 .0 1)。结论　VEGF与结直肠癌血管生成密切相关 ,VEGF的表达和MVD可作为判断结直肠癌恶性程度的生物学指标     

乳腺癌VEFG,bFGF及其受体的表达和与微血管计数的关系

目的　探讨乳腺癌VEGF ,bFGF及其受体的表达特征和与微血管计数的关系。方法　SABC免疫组化法检测 70例乳腺癌组织中VEGF ,FLK - 1,bFGF ,FLG阳性系数值和MVC值 ,探讨其与腋窝淋巴结转移、临床病理特征之间的关系。结果　腋窝淋巴结转移组VEHF ,bFGF ,FLK - 1,和MVC值明显高于腋窝淋巴结未转移组 ,有非常显著性差异 (P <0 .0 1)。VEGF ,FLK - 1,FLG和MVC值临床分期 0～Ⅱ期和Ⅲ～Ⅳ期组间有显著性或非常显著性差异 (P <0 .0 5或P <0 .0 1)。VEGF ,bFGF表达与MVC的表达呈高度正相关 ,VEGF和bFGF ,VEGF和FLK - 1,bFGF和FLG表达呈相关。结论　乳腺癌VEGF ,bFGF及其受体与肿瘤血管生成、淋巴转移密切相关 ;VEGF ,bFGF可以促进其受体的表达 ;VEGF的表达与bFGF高表达有关。     

细胞核转录因子和血管内皮细胞生长因子在胃癌组织中的表达及其意义

目的　研究早期、中期、晚期胃癌和不典型增生及慢性胃炎中细胞核转录因子 κBp65 (NF κBp65 )、血管内皮细胞生长因子 (VEGF)的表达 ,探讨胃癌发生、浸润和转移过程中NF κBp65、VEGF的表达和微血管密度 (MVD)的关系及其临床意义。方法　收集 1997年～ 2 0 0 2年期间经术后病理证实的早期、中期和晚期胃癌患者 62例作为研究对象 ,同时将 15例不典型增生及 2 0例慢性胃炎患者作为对照 ,进行免疫组织化学染色 ,检测NF κBp65、VEGF的表达和MVD ,分析它们之间的关系及其意义。结果　胃癌组中NF κBp65、VEGF的表达阳性率分别为 62 .9%、5 1.6% ,而对照组的NF κBp65、VEGF的表达阳性率仅为 17.1%、11.4% ,胃癌组与对照组NF κBp65、VEGF的表达阳性率差异有显著性 (均为P <0 .0 1)。胃癌组中的MVD明显增高 (P <0 .0 1) ;胃癌组中 ,早期、中期和晚期胃癌之间NF κBp65、VEGF表达阳性率和MVD差异有显著性 (均为P <0 .0 5 )。NF κBp65表达与VEGF表达呈正相关 (r =0 .5 93 ,P <0 .0 0 1)。胃癌组中有淋巴结转移者VEGF的表达和MVD明显高于无淋巴结转移者 (均为P <0 .0 5 )。结论　胃癌中NF κBp65、VEGF表达阳性率和MVD均增高 ,与肿瘤的浸润程度、淋巴结转移密切相关 ,NF κB、VEGF对肿瘤血管生成有重要作用     

贲门癌组织TSP-1表达与MVD和淋巴结转移的关系

【目的】探讨贲门癌组织TSP 1表达与微血管密度 (MVD)与淋巴结转移的关系。【方法】采用免疫组化法检测 83例贲门癌患者癌组织中TSP 1的表达和MVD ,并分析TSP 1表达与MVD和淋巴结转移的关系 ,TSP 1免疫组化结果以低表达 (- / +)和高表达 (++/ +++)进行分组 ,MVD以其中位数为界分为低MVD组 (<16 / 0 739mm2 )和高MVD组 (≥ 16 / 0 739mm2 )。【结果】TSP 1阳性率为 80 72 % (6 7/ 83) ,高表达组MVD低 (P =0 0 0 1) ,淋巴结转移率为 5 2 % ,低表达组MVD高 ,淋巴结转移率为 87 9%。【结论】贲门癌组织TSP 1表达可以降低MVD和减少淋巴结转移。     

直肠癌血管生成与肿瘤细胞增殖和转移的关系

目的 :探讨血管生成在直肠癌细胞增殖、浸润和淋巴结转移中的意义。　方法 :免疫组化法检测和分析 4 6例直肠癌标本中的微血管密度 (MVD)值、血管内皮细胞生长因子 (VEGF)阳性表达率、Ki 6 7标记指数 (Ki 6 7LI)与肿瘤浸润深度和淋巴结转移的关系。　结果 :MVD值、VEGF阳性表达率和Ki 6 7LI随肿瘤浸润深度的增加而增加 (P <0 .0 1)。MVD值、VEGF阳性表达率和Ki 6 7LI在淋巴结转移阳性组显著高于阴性组 (P <0 .0 1)。MVD值、Ki 6 7LI在VEGF表达阳性组显著高于VEGF表达阴性组 (P <0 .0 1)。MVD值与Ki 6 7LI之间呈显著正相关(r =0 .36 ,P <0 .0 1)。　结论 :直肠癌血管生成可促进癌细胞增殖、浸润和淋巴结转移     

鼻咽癌内血管内皮生长因子的表达及微血管密度的病理意义

目的 :探讨鼻咽癌内血管内皮生长因子 (VEGF)的表达及微血管密度 (MVD)的病理意义。方法 :应用免疫组织化学S P法对鼻咽癌内VEGF的表达及MVD进行检测。结果 :鼻咽癌内VEGF的阳性表达率为 83%(5 3/ 6 4 ) ,VEGF的表达及MVD均与患者的 5年生存率及淋巴结转移相关 (P <0 0 5 ) ,同时VEGF的表达与MVD呈正相关关系 (P <0 0 1)。结论 :鼻咽癌内VEGF的高表达及高MVD与患者的不良预后及淋巴结转移有关     

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.     

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.