甲状腺乳头状癌淋巴管生成与淋巴结转移、血管内皮生长因子C表达的关系

目的探讨甲状腺乳头状癌淋巴管生成的分布特点及与血管内皮生长因子CCVEGF-C）的表达，淋巴结转移的关系。方法应用免疫组化方法检测80例甲状腺乳头状癌组织中VEGF-C的表达，并用淋巴管内皮细胞特异性抗体D2-40标记淋巴管，记数肿瘤淋巴管密度（LVD），结合临床病理资料进行分析。结果甲状腺乳头状癌组织中VEGF-C表达阳性及淋巴结有转移者LVD显著增高（均P〈0．05Io结论甲状腺乳头状癌中新生淋巴管主要分布在肿瘤间质组织中。LVD与VEGF-C蛋白表达和淋巴结转移密切相关。     

环氧化酶-2表达与甲状腺乳头状癌淋巴管生成及淋巴结转移的关系

目的探讨环氧化酶-2(COX-2)表达对甲状腺乳头状癌淋巴管生成的影响及与淋巴结转移的关系。方法运用envision免疫组化法测定60例甲状腺乳头状癌患者和15例癌旁正常甲状腺组织病理标本COX-2及血管内皮生长因子C(VEGF-C)蛋白表达,并进行评分,同时采用D2-40显色淋巴管进行淋巴管密度(LVD)计数测定。结果甲状腺乳头状癌中COX-2、VEGF-C较癌旁正常组织表达明显增高;有淋巴结转移的甲状腺乳头状癌患者中COX-2、VEGF-C的阳性率明显高于无淋巴结转移患者,LVD计数显著高于无淋巴结转移患者(P<0.01);60例癌标本中COX-2表达与LVD计数、VEGF-C表达与LVD表达、COX-2表达与VEGF-C表达均存在显著正相关(r=0.71、0.68、0.65,P<0.01)。结论COX-2对甲状腺乳头状癌患者的淋巴管形成起着重要的作用,可能通过上调VEGF-C的表达促进肿瘤淋巴管的形成,有利于甲状腺乳头状癌淋巴结的转移。     

LYVE-1在甲状腺肿瘤中的表达及意义探讨

目的:探讨淋巴管生成因子在甲状腺肿瘤中的变化规律以及与转移的相关性,为此类疾病的预防、治疗和判断预后提供理论依据.方法:选择甲状腺肿瘤病理石蜡切片135例,亚急性甲状腺炎13例,腺瘤48例,乳头状癌38例,髓样癌10例,滤泡状癌27例,未分化癌12例,其中有淋巴结转移20例.运用免疫组化检测各标本LYVE-1的表达水平,分析对不同病理类型的甲状腺癌及有无淋巴结转移肿瘤之间LYVE-1的表达水平的关系.结果:LYVE-1所标记的甲状腺恶性肿瘤中淋巴管的密度显著高于甲状腺良性肿瘤.在甲状腺癌中,有淋巴结转移者淋巴管的密度显著高于无淋巴结转移者.在各病理类型的甲状腺癌组织中,乳头状癌组织中淋巴管的密度为11.4±8.6,髓样癌组织中淋巴管的密度为4.2±2.4,未分化癌组织中淋巴管的密度为8.8±1.8,乳头状癌与髓样癌相比较t=2.6020,P=0.0124,乳头状癌与未分化癌相比较t=2.6227,P=0.0117,在统计学上均具有显著统计学差异.结论:①在甲状腺肿瘤中LYVE-1表达是恶性肿瘤较良性肿瘤高,恶性肿瘤中表达程度由高到低依次为乳头状癌、未分化癌、滤泡状癌及髓样癌,有淋巴结转移的肿瘤较无转移的肿瘤表达升高.②LYVE-1与淋巴结转移有关.     

LYVE-1在胃癌中的表达及意义

目的：通过LYVE-1在胃癌组织中的表达,探讨胃癌组织癌内、癌周淋巴管生成机制及其与淋巴结转移的关系。方法：选用泸州医学院附属医院病理科随访的53例胃癌患者的手术切除组织病理存档蜡块,利用免疫组织化学方法检测LYVE-1和nm23在53例胃癌组织及正常胃黏膜组织中的表达,并进行微淋巴管密度（lymphatic vessel density,MLD）计数;分析nm23表达与LYVE-1阳性MLD、淋巴结转移的关系。结果：在胃癌组织中,癌周LYVE-1阳性MLD在淋巴结转移阳性组明显高于淋巴结转移阴性组（P〈0.01）;并显著高于正常胃黏膜组织及癌内组织（P〈0.01）;后两者MLD无显著性差异（P〉0.05）。而癌内LYVE-1阳性MLD在各临床病理参数之间无显著差别（P〉0.05）。结论：癌周淋巴管生成可能促进了淋巴结转移的发生,癌周淋巴管对胃癌的发生、发展起重要作用。     

膀胱移行细胞癌中LYVE-1标记的淋巴管密度及其临床意义

目的 应用特异的淋巴管内皮透明质酸受体-1(LYVE-1)检测膀胱移行细胞癌(BTCC)组织中淋巴管密度（LVD）,探讨癌组织中LYVE-1标记的LVD及其临床意义。方法 收集45例BTCC组织和10例正常膀胱黏膜组织标本,应用免疫组化方法检测LYVE-1标记的淋巴管数量,计算其淋巴管密度值,分析LVD与临床病理参量之间的关系。结果 BTCC组织内LVD显著高于正常膀胱黏膜组织(4.81±0.93 vs 1.56±0.37, P < 0.0001);浸润超过肌层组的LVD显著高于浸润未超过肌层组(6.22 ±0.32 vs 4.45 ±0.64, P < 0.0001);淋巴结阳性组的LVD显著高于淋巴结阴性组(6.20 ±0.32 vs 4.46±0.66, P < 0.0001) ,三者均有统计学意义。结论 在膀胱移行细胞癌组织中,淋巴管的生成与肿瘤的发生发展和侵袭转移密切相关。随着我们深入研究膀胱移行细胞癌淋巴管生成机制及LYVE-1的功能、结构,必将进一步明确膀胱移行细胞癌的恶变转移机制。     

VEGF-C、VEGFR-3与LYVE-1在甲状腺癌中的表达及意义

目的：探讨VEGF-C、VEGFR-3和LYVE-1在甲状腺癌中的表达及意义。方法：用免疫组化S-P法检测87例甲状腺癌（其中有淋巴结转移者20例）VEGF-C、VEGFR-3和LYVE-1的表达水平，并对不同肿瘤的上述指标分别进行相关性分析。结果：在甲状腺癌中VEGF-C、VEGFR-3和LYVE-1均有不同程度的表达，其表达程度由高到低依次为乳头状癌、未分化癌、滤泡状癌及髓样癌，有淋巴结转移的肿瘤较无转移的肿瘤表达升高；VEGF-C、VEGFR-3的表达与LYVE-1的表达呈正相关。结论：VEGF-C、VEGFR-3与甲状腺癌淋巴管生成有关，从而推测甲状腺癌淋巴管生成与淋巴结转移密切相关。     

D2-40标记的甲状腺乳头状癌中微淋巴管密度与淋巴结转移之间的关系

目的：应用新型淋巴内皮标记物D2-40分析甲状腺乳头状癌及周围组织微淋巴管密度(MLVD)与淋巴结转移之间的关系。方法：应用免疫组织化学Envison法检测46例甲状腺乳头状癌和20例结节性甲状腺肿中D2-40和CD34的表达，分别计数MLVD和微血管密度(MVD)，分析其与甲状腺乳头状癌淋巴结转移之间的关系，同时与病变中MVD行对比观察。结果：91.3％甲状腺乳头状癌乳头轴心中的间质中无淋巴管。微淋巴管主要位于甲状腺乳头状癌周围结缔组织及被膜中。甲状腺乳头状癌周围结缔组织及被膜中的MLVD和MVD与淋巴结转移有密切关系，MLVD和MVD越高淋巴结转移率越高。同时甲状腺乳头淋巴管内的癌栓与淋巴结转移也显著相关（P＜0.001）。结论：甲状腺乳头状癌的转移过程与微淋巴管及微血管的形成有密切关系。干预肿瘤转移抑制血管生成的同时也需要抑制淋巴管生成。     

淋巴管内皮透明质酸受体-1在乳腺癌中的表达及意义

目的探讨淋巴管内皮透明质酸受体-1（LYVE-1）在乳腺癌组织中的表达及临床意义。方法采用免疫组化方法对70例乳腺癌组织和20例乳腺纤维腺瘤组织中的LYVE-1表达进行检测,计算淋巴管密度（LVD）,分析LYVE-1的表达水平与乳腺癌淋巴结转移及其他病理参数[年龄、肿瘤大小、病理分期、雌激素受体（ER）、孕激素受体（PR）及C-erbB2]间的关系。结果LYVE-1所标记的乳腺癌组织中LVD明显高于乳腺纤维腺瘤组织（9．35±3．37vs1．31±1．02,P〈0．01）,有淋巴结转移的乳腺癌组织LVD明显高于无淋巴结转移者（P〈0．01）。乳腺癌患者不同年龄、肿瘤大小、ER、PR及C-erbB2LVD比较差异无统计学意义（P〉0．05）,但不同病理分期患者LVD比较差异有统计学意义（P〈0．01）。结论LYVE-1的表达与乳腺癌的淋巴道转移有关,LVD可作为乳腺癌淋巴道转移的生物学指标,对乳腺癌临床预后的评估有一定的指导意义。     

人胰腺癌组织LYVE-1表达与癌组织淋巴管转移关系研究

目的观察胰腺癌组织淋巴管内皮细胞LYVE-1的表达,为研究癌淋巴管转移的分子机制提供形态学依据。方法用免疫组化的方法对人胰腺癌和正常胰腺组织中LYVE-1的表达情况进行观察,用LYVE-1来标记淋巴管,检测癌组织中微淋巴管密度（LMVD）。结果胰腺癌组织血管内皮细胞LYVE-1不染色,淋巴管内皮细胞LYVE-1阳性表达,经计数微淋巴管数量,癌组织中的LMVD明显高于癌旁正常胰腺组织（P〈0.01）,并且LMVD的表达与VEGF-C、VEGF-D的表达具有显著相关性（P〈0.01）。结论LYVE-1可选择性的表达在胰腺癌组织淋巴管内皮上,能明确的区分血管及淋巴管成分,可作为一个淋巴管内皮细胞较特异的标记物。由于LMVD在癌组织中的表达明显增高,说明淋巴管数量的增加可能与胰腺癌的淋巴转移有关。     

甲状腺乳头状癌中Prox1蛋白的表达及其临床意义

目的 探讨Prox1蛋白在甲状腺乳头状癌中的表达情况及其临床意义.方法 通过免疫组化SP法检测53例甲状腺乳头状癌组织和颈部淋巴结中Prox1蛋白表达情况.结果 甲状腺乳头状癌组织中Prox1蛋白呈高表达,与癌旁正常组织相比,差异有显著性（P＜0.05）;Prox1蛋白在颈部淋巴结中呈高表达,癌细胞转移组的表达率显著高于无癌细胞转移组,Prox1蛋白表达水平与甲状腺乳头状癌患者的临床分期及淋巴结转移有关（P＜0.05）;Prox1蛋白表达水平在甲状腺乳头状癌组织与转移淋巴结组织呈正相关（r=0.3207,P=0.0151）.结论 Prox1在甲状腺乳头状癌中呈高表达,促进了癌细胞向颈部淋巴转移.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

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.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.