食管鳞癌组织中uPA、nm23的表达

目的:探讨食管鳞癌组织中uPA、nm23的表达及其与食管癌病理分级和淋巴结转移的关系。方法:应用免疫组化SP技术检测uPA及nm23在54例食管鳞癌及其癌旁和正常组织中的蛋白表达水平。结果:癌组织中uPA及nm23的阳性率分别为66.7％(36/54)和35％(19/54),uPA的表达与浸润深度和淋巴结转移呈正相关(P<0.05);nm23的表达在无淋巴结转移组明显高于有转移组(P<0.05),与浸润深度呈负相关(P<0.05)。uPA及nm23的表达呈明显负相关(x2=6.56,P<0.01)。2者均与肿瘤大小无关。结论:uPA及nm23与食管癌浸润深度和淋巴结转移关系密切。uPA与nm23联合检测以评价食管癌的转移优于单项指标。     

肝细胞肝癌组织中FN和PTEN基因表达水平及意义*

目的：研究FN和PTEN基因在肝细胞肝癌中的表达情况,探讨其在肝细胞肝癌发生发展中的作用及意义。方法：应用荧光实时定量PCR方法,检测84例肝细胞肝癌及癌旁组织中FN蛋白、PTEN蛋白、mRNA表达情况。分析FN和PTEN基因表达及肝细胞肝癌的关系。结果：FN蛋白主要定位于肝癌细胞外基质中。FN mRNA在肝细胞肝癌中的阳性率为79.76%,高于癌旁肝组织的阳性率9.52%,差异具有统计学意义（P<0.05）。PTEN蛋白明确定位于肝细胞胞质内。PTEN mRNA在肝细胞肝癌中的阳性率为38.09%,明显低于癌旁肝组织的阳性率100%,差异具有统计学意义（P<0.05）。FN在合并癌栓,淋巴结转移,AFP阳性,肿瘤数目多发的肝癌组织中的表达高,而在不同分化程度及不同肿瘤直径的肝癌组织中表达差异无统计学意义;PTEN在低分化肝癌细胞,合并癌栓,AFP阳性,淋巴结转移,肿瘤直径≥2cm的肝癌组织中表达较低,而在不同肿瘤数目的肝癌组织中表达无统计学意义,PTEN蛋白表达与HBsAg无关,与组织学分级及转移有关。结论：肝癌组织中FN mRNA的表达量高于癌旁组织,而肝癌组织中PTEN mRNA的表达量低于癌旁组织,FN和PTEN基因可能与肝细胞肝癌的发生发展有关,其可能在肝癌的发生发展、侵袭转移中起一定的促进或抑制作用。     

MTA1、nm23、c-myc在肝癌组织中的表达及其相关性

目的     检测肝癌组织及相应癌旁组织中MTA1、nm23、c-myc的表达,探讨三者之间的相关性及与肝癌侵袭、转移和肝癌生物学行为的关系。方法     采用免疫组织化学法检测60例肝癌组织及其相应癌旁组织中MTA1、nm23、c-myc蛋白的表达,并结合相关临床病理特征进行分析。结果    ① 肝癌组织中MTA1蛋白、c-myc蛋白的阳性表达率显著高于其相应癌旁组织（P<0.01）,而肝癌组织中nm23蛋白的阳性表达率显著低于其相应癌旁组织（P<0.01）。② 在肝癌组织中MTA1蛋白、c-myc蛋白的高表达及nm23蛋白的低表达,均与肿瘤分化程度, 肝内、外转移及门静脉癌栓相关（P<0.05）。此外,MTA1蛋白的高表达及nm23蛋白的低表达还与HBsAg水平有关（P<0.05）,c-myc蛋白的高表达还与有无肿瘤包膜有关（P<0.05）。③ Spearman相关分析显示,MTA1与nm23的表达呈负相关(rs =-0.625, P<0.01),MTA1与c-myc的表达呈正相关(rs =0.392, P<0.05),而nm23与c-myc之间未见明显相关性。结论    MTAl、c-myc蛋白水平的高表达和nm23蛋白水平的低表达与肝癌的侵袭、转移有关,三者的联合检测可用于判断肝癌的生物学行为,有助于肝癌的基础研究及临床治疗。      

肝细胞癌组织中血管内皮生长因子-C的表达

目的:探讨肝细胞癌组织中血管内皮生长因子(VEGF)- C的表达。方法:应用免疫组织化学方法检测 43例肝细胞癌及癌旁组织,24例正常肝组织中VEGF -C的表达。结果:肝癌、癌旁和正常肝组织中VEGF -C阳性表 达率分别为72.1%(31/43)、23.3%(10/43)和12.5%(3/24),肝癌组织与癌旁组织VEGF -C表达率差异有统计学 意义(χ2=5.82,P<0.05)。癌组织中VEGF -C的表达与门静脉癌栓、肝门淋巴结转移和复发有关(P<0.05)。结 论:VEGF -C与肝细胞癌侵袭转移相关。     

RUNX3蛋白在肝癌组织中的表达及其意义

目的探讨RUNX3蛋白在肝癌组织及其癌旁组织中的表达情况,并分析其与临床病理因素的相关性。方法采用免疫组织化学法检测RUNX3蛋白在肝癌组织及其癌旁组织中的表达水平,并分析其与临床病理因素的相关性。结果 RUNX3蛋白在肝癌组织、癌旁组织中的表达阳性率分别为49.02%(25/51)、82.35%(42/51),两者间有显著差异(χ2=12.5706,P<0.01)。RUNX3蛋白在分化程度、门静脉癌栓、肝内转移等病理因素的表达差异有统计学意义(P<0.05),而在性别、肿瘤直径、肿瘤部位、癌肿出血坏死、组织分型的表达差异无统计学意义(P>0.05)。结论 RUNX3蛋白在肝癌组织中的表达水平明显低于癌旁组织。RUNX3蛋白表达下调可能对肝癌的发生、发展具有重要作用,RUNX3基因可能是肝癌的抑癌基因。     

原发性肝癌中AnnexinA2和P19的表达及意义

目的检测AnnexinA2和P19在原发性肝癌中的表达并探讨其在肝癌发生发展及转移中的作用。方法原发性肝癌62例,分别取癌组织及癌旁肝组织,采用IHC、RT-PCR及Western blot法分别检测AnnexinA2和P19 mRNA及蛋白的表达。结果肝癌组织中AnnexinA2 mRNA及蛋白表达量均明显高于癌旁肝组织(P<0.05),肝癌组织中P19 mRNA及蛋白表达量均明显低于癌旁肝组织(P<0.05);AnnexinA2、P19阳性表达与肝癌患者的性别、年龄和肿瘤大小均无关(P>0.05),而与乙肝表面抗原、组织分级和脉管内有无癌栓均有关(P<0.05)。结论联合检测AnnexinA2、P19 mRNA及蛋白在原发性肝癌中的表达水平,对判断其发生和转移有重要价值,可为临床治疗和判断预后提供依据。     

乳腺癌PTEN蛋白表达及基质金属蛋白酶-9表达的相关性研究

目的研究乳腺癌组织中PTEN蛋白及基质金属蛋白酶-9基因的相关性及其表达的临床意义。方法选取23例乳腺癌患者(其中12例发生同侧腋窝淋巴结转移,11例未发生淋巴结转移),取肿瘤组织及癌旁组织进行免疫组织化学染色,观察乳腺癌组织及癌旁组织中PTEN蛋白及基质金属蛋白酶-9基因表达情况,同时对两种蛋白与淋巴结转移及其两者之间的关系进行分析。结果癌组织PTEN表达阳性率为43.78%,癌旁组织表达阳性率为73.91%,癌组织PTEN表达阳性率明显低于癌旁组织(P<0.05);癌组织基质金属蛋白酶-9表达阳性率为78.26%,癌旁组织表达阳性率为26.09%,癌组织基质金属蛋白酶-9表达阳性率明显高于癌旁组织,差异具有统计学意义(P<0.05)。12例淋巴结转移组PTEN表达阳性率为16.67%,基质金属蛋白酶-9表达阳性率为100.00%,非淋巴结转移组PTEN表达阳性率为72.73%,基质金属蛋白酶-9表达阳性率为54.55%,两组差异有统计学意义(P<0.05)。乳腺癌患者PTEN与基质金属蛋白酶-9表达呈负相关(r=-2.325,P<0.05)。结论乳腺癌患者乳腺肿瘤组织中PTEN蛋白呈低表达,基质金属蛋白酶-9基因呈高表达,两者呈负相关,而且与患者发生淋巴结转移密切相关,可通过测定两种蛋白水平,评估其病情及预后。     

RASAL2在乳腺癌中的表达及临床意义

应用免疫组织化学法检测60例乳腺癌组织及其癌旁组织中大鼠肉瘤蛋白活化因子2(RASAL2)的表达情况,分析RASAL2与乳腺癌临床发展及病理特征的相关性.结果显示,RASAL2在乳腺癌组织中的表达明显低于癌旁组织,差异有统计学意义(χ2=25.145,P<0.001).RASAL2在Luminal B型乳腺癌中的表达明显低于Non-Luminal B型,差异有统计学意义(χ2=4.319,P=0.038).且RASAL2的表达与雌激素受体、孕激素受体、淋巴结转移、TNM分期和有无脉管侵犯有关(P<0.05).RASAL2在乳腺癌中低表达,且与乳腺癌的发展和侵袭转移有关.     

紧密连接蛋白-1、3、4在乳腺癌患者中的表达及其临床意义

目的探讨紧密连接蛋白(claudin)-1、3、4在乳腺癌患者中的表达及其临床意义。方法收集2013年5月—2014年4月首都医科大学附属北京潞河医院病理科标本,其中乳腺癌组织和对应的癌旁正常乳腺组织均81例,分析claudin-1、3、4与乳腺癌患者年龄、部位、大小、激素受体状态、Ki67增殖活性、淋巴结转移、脉管侵犯及临床分期的关系。结果 claudin-1、3、4在癌组织中的阳性表达均低于癌旁正常组织,claudin-1在癌组织的表达(79.0%)与癌旁组织的表达(84.0%)比较差异无统计学意义(χ~2=0.655,P>0.05)。claudin-3、4在癌组织中的表达(54.3%、77.8%)与癌旁组织中的表达(85.2%、92.6%)比较差异均有统计学意义(χ~2=18.290、7.043,P<0.01);claudin-3、4在淋巴结转移组的表达(82.8%、93.1%)高于淋巴结无转移组的表达(42.3%、61.5%),二者比较差异有统计学意义(χ~2=0.365、0.322,P<0.05);claudin-3在临床分期亚组的表达(16.7%)与Ⅱ/Ⅲ亚组中的表达(44.4%)比较差异有统计学意义(χ~2=0.284,P<0.05);claudin-1的表达在不同临床病理因素间差异无统计学意义。结论 claudin-3、4蛋白在乳腺癌的发生、浸润、转移过程中发挥重要作用,可以作为癌瘤发生、发展及评估预后的生物学标记物。     

肝细胞肝癌组织中 SnailmRNA和蛋白的表达

目的  检测肝癌组织中 SnailmRNA和蛋白的表达及其与肝癌侵袭转移的关系。方法  采用免疫组织化学方法检测70例肝癌组织及其癌旁组织中Snail蛋白的表达,采用RT-PCR方法检测40例新鲜肝癌组织及其癌旁组织中SnailmRNA的表达, 并结合临床病理指标进行分析。结果  肝癌组织中Snail的阳性表达率高于癌旁组织中(P<0.05 ), 且癌组织中 Snail阳性表达率与包膜侵袭、门脉侵袭及肝内转移情况有关(P<0.05 )。肝癌组织中SnailmRNA的阳性表达率高于癌旁组织 (P<0.05 ),且癌组织中 SnailmRNA的阳性表达率与包膜侵袭、门脉侵袭情况有关(P<0.05 ),而与肝内转移情况无关(P＞0.05 )。结论  肝癌的癌变、侵袭、转移可能与Snail蛋白及 mRNA的高表达有关,抑制Snail的表达,有望成为治疗肝癌的新靶点。     

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.