结肠癌VEGF的表达与其侵袭转移的相关性研究

目的 :探讨血管内皮生长因子在结肠癌中的表达及其与血管生成、侵袭转移之间的关系。方法 :应用免疫组化SP法 ,血管内皮生长因子单克隆抗体标记结肠癌组织 ,第Ⅷ因子单克隆抗体标记组织内的血管。结果 :血管内皮生长因子的表达与性别、分化、肿瘤发生位置无关 ,与淋巴结转移、组织学分型、Dukes分期明显相关 (P <0 .0 5 ) ,血管内皮生长因子表达阳性癌组织内微血管密度明显高于表达阴性者 (P <0 .0 1)。结论 :血管内皮生长因子的表达和微血管密度与结肠癌侵袭转移密切相关 ,血管内皮生长因子与结肠癌血管生成密切相关 ,联合检测血管内皮生长因子表达和微血管密度值对结肠癌的治疗、预后判定有一定的价值     

血管内皮生长因子和基质金属蛋白酶-9在宫颈癌演进中与微血管密度的关系及其意义

目的探讨VEGF和MMP-9在宫颈癌的演进过程中其表达与局部微血管生成间及临床病理参数间的关系。方法采用免疫组化SP法检测40例宫颈浸润癌（ICC）、52例宫颈上皮内瘤样病变（CINⅠ、Ⅱ、Ⅲ）和15例正常宫颈上皮（NCE）组织中VEGF和MMP-9的表达并检测其中微血管密度（MVD），分析VEGF和MMP-9在宫颈癌的演进过程中与MVD的关系。结果NCE、CIN及ICC组中MVD值分别为（12．31&#177;3．82）、（35．66&#177;6．35）和（48．19&#177;10．82），逐渐升高，各组比较差异有显著性（P〈0．01）。VEGF、MMP-9在NCE、CIN、ICC中的阳性表达率分别为0％、19．23％；67．50％、13、33％；42．31％、77．50％，逐渐升高，各组比较差异有显著性（P〈O．05）；在CIN和Icc中，当VEGF、MMP-9均呈阳性表达时，MVD值（50．33&#177;11．22），显著较VEGF、MMP-9均呈阴性表达时的MVD值（25．06&#177;7．63）高（P〈0．01）。VEGF和MMP-9的表达有正相关性（rs=0．284，P〈0．05）。结论微血管生成及VEGF、MMP-9参与宫颈癌发生、发展的全过程；VEGF及MMP-9在宫颈癌微血管生成中起正性调节及协同作用；MVD值升高提示宫颈癌侵袭转移潜能增加，VEGF、MMP-9可作为预测宫颈癌转移的生物学指标。     

结肠癌患者 HIF-1αVEGF 和 MMP-9表达及临床意义

目的：探讨缺氧诱导因子-1α（ HIF-1α）、血管内皮生长因子（ VEGF ）及基质蛋白酶-9（ MMP-9）在结肠癌患者的表达及临床意义。方法：采用免疫组织化学方法检测56例结肠癌组织及40例癌旁组织HIF-1α、VEGF和MMP-9,比较两组阳性率的差别及HIF-1α、VEGF和MMP-9与结肠癌临床病理特征之间有关系。结果：结肠癌组织HIF-1α、VEGF和MMP-9表达阳性率显著高于癌旁组织（P＜0．05）;HIF-1α和MMP-9与淋巴转移、组织学分化及Duke分期显著相关（P＜0．05）;VEGF与淋巴转移、Duke分期相关（P＜0．05）;HIF-1α、VEGF和MMP-9与年龄、性别及肿瘤大小无关（P＞0．05）。结论：HIF-1α、VEGF和MMP-9与结肠癌的发生、发展关系密切,三者参与了结肠癌的淋巴道转移。     

色素上皮源性因子与胃癌组织血管生成和临床病理因素的关系

【目的】研究色素上皮源性因子（PEDF）和血管内皮生长因子（VEGF）在胃癌组织中的表达及与癌组织中微血管密度（MVD）的关系。探讨PEDF在胃癌组织血管生成中的作用及PEDF与胃癌临床病理因素的关系。【方法】用S—P免疫组织化学法检测82例人体胃癌组织标本中胃癌细胞内PEDF和VEGF的表达；标记CD34分子显示血管内皮细胞，并计数上述胃癌组织内的微血管密度；统计学分析上述分子标记物间的关系以及各分子标记物与胃癌临床病理因素间的关系。【结果】所有的正常胃黏膜均有PEDF表达，胃癌组织PEDF表达率约43％，VEGF表达率约54％；与高分化胃癌相比，低分化胃癌组织PEDF表达率低（P〈0．05），MVD高（P〈0．05）；PEDF低表达的胃癌细胞易侵犯浆膜（P〈0．05），易淋巴结转移（P〈0．01）和远处转移（P〈0．01）；胃癌组织PEDF表达与MVD（P〈0．01）和VEGF（P〈0．01）表达呈负相关关系，VEGF表达与MVD呈正相关关系（P〈0．01）。【结论】PEDF低表达和VEGF高表达可能是胃癌组织内微血管生成的分子基础。是促进胃癌细胞发生淋巴及血道转移的重要因素。     

色素上皮源性因子与胃癌组织血管生成和临床病理因素的关系

 【目的】研究色素上皮源性因子（PEDF）和血管内皮生长因子（VEGF）在胃癌组织中的表达及与癌组织中微血管密度（MVD）的关系。探讨PEDF在胃癌组织血管生成中的作用及PEDF与胃癌临床病理因素的关系。【方法】用S—P免疫组织化学法检测82例人体胃癌组织标本中胃癌细胞内PEDF和VEGF的表达；标记CD34分子显示血管内皮细胞，并计数上述胃癌组织内的微血管密度；统计学分析上述分子标记物间的关系以及各分子标记物与胃癌临床病理因素间的关系。【结果】所有的正常胃黏膜均有PEDF表达，胃癌组织PEDF表达率约43％，VEGF表达率约54％；与高分化胃癌相比，低分化胃癌组织PEDF表达率低（P〈0．05），MVD高（P〈0．05）；PEDF低表达的胃癌细胞易侵犯浆膜（P〈0．05），易淋巴结转移（P〈0．01）和远处转移（P〈0．01）；胃癌组织PEDF表达与MVD（P〈0．01）和VEGF（P〈0．01）表达呈负相关关系，VEGF表达与MVD呈正相关关系（P〈0．01）。【结论】PEDF低表达和VEGF高表达可能是胃癌组织内微血管生成的分子基础。是促进胃癌细胞发生淋巴及血道转移的重要因素。     

尖锐湿疣组织中MMP-9的表达及意义

目的：研究尖锐湿疣组织中MMP-9的表达及与CD105标染的疣体内微血管密度（MVD）和瘤体生物学行为的相关性。方法：运用免疫组化SP法检测MMP-9在35例尖锐湿疣组织、15例正常包皮组织中的表达及CD105标染的新生血管的密度,分析MMP-9在尖锐湿疣组织中的表达情况,进一步分析其表达与MVD值、临床病理特征及复发的关系。结果：MMP-9在尖锐湿疣组的表达水平明显高于正常包皮组（P〈0．01）,尖锐湿疣组的MVD值高于正常包皮组（P〈0．01）。Spearman相关分析提示MMP-9表达水平与MVD值呈正相关。结论：MMP-9过表达可能与尖锐湿疣疣体的形成和频繁复发有关,MMP-9蛋白过度表达在尖锐湿疣疣体的血管形成中具有重要的临床意义。     

血管内皮细胞生长因子在乳腺癌中的表达研究

目的 探讨血管内皮细胞生长因子(Vascular endothelial growth factor，VEGF)与乳腺癌血管生成及临床病理参数的关系。方法 采用链霉菌抗生物素—过氧化物酶复合物(S—P)法，检测46例乳腺癌石蜡标本中VEGF的表达及平均微血管密度(Miscrovessel density,MVD)。结果 VEGF表达定位于肿瘤细胞浆内，CD34表达定位于血管内皮细胞浆内。癌组织中VEGF表达阳性率为76、09％。VEGF表达及MVD值与组织学分级(P＜0．05)和淋巴结转移密度相关(P＜0．01)，与组织学分型无关(P＞0、05)；VEGF阳性组MVD值明显高于VEGF阴性组(t＝2．220，P＜0．05)。结论：VEGF与乳腺癌血管生成密切相关，并能促进其生长、浸润及转移。检测VEGF和MVD可作为乳腺癌生物学行为的指标之一。     

胰腺癌微血管密度和p14蛋白表达及其发生、发展的相关实验研究

目的：探讨胰腺癌组织微血管密度、p14^ARF表达对胰腺癌发生、发展的影响。方法：用免疫组织化学Envision改良法检测10例正常胰腺组织、42例胰腺癌组织中p14^ARF蛋白的表达；以Ⅶ因子相关抗原(FVⅢ—RAg)标记血管内皮细胞，采用ABC免疫组化法检测10例正常胰腺组织、42例胰腺癌组织中微血管密度。结果：正常胰腺组织中p14^ARF的表达率为90％，胰腺癌组织中为35．7％(P＜0．01)；胰腺癌组织的平均微血管密度与正常对照组之间差异有显著性(P＜0．01)；胰腺癌临床Ⅲ、Ⅳ期的平均微血管密度明显高于Ⅰ、Ⅱ期(P＜0．05)：淋巴结有转移的胰腺癌平均测血管密度明显高于淋巴结无转移组(P＜0．05)；胰腺癌组织中p14^ARF蛋白阳性表达的平均微血管密度低于p14^ARF蛋白阴性表达的胰腺癌组织，差异有显著性(P＜0．05)，胰腺癌组织的平均微血管密度与组织学分级、癌的浸润范围及肿块大小无关(P＞0．05)。结论：微血管密度、p14^ARF与胰腺癌的发生、发展存在着密切关系。     

前列腺癌细胞中血管形成的研究

目的 探讨前列腺癌（PC）组织中微血管与其浸润，转移及预后的关系。方法 应用免疫组化SP法对30例PC和30例前列腺增生症（BPH）组织进行CD34表达并计数微血管（MV）。结论 PC组微血管密度（MVD）显著高于BPH组（P＜0．01），不同分级PC中也有显著性差异（P＜0．01）；浸润，转移性PC的MVD明显高于局限性PC组（P＜0．01），2年内死亡者其MVD均高于存活2年以上者（P＜0．05）。结论 肿瘤血管形成与PC分期，分级密切相关，癌细胞的浸润，转移有赖于肿瘤血管形成，MVD是反映前列腺癌生物学行为的重要指标。     

卵巢交界性肿瘤血管内皮生长因子的表达及临床意义

目的：检测卵巢交界性肿瘤组织中血管内皮生长因子（VEGF）的表达，研究它与VEF、微血管密度的关系，方法：应用免疫组化SP法，检测53例卵巢交界性肿瘤，18例良性卵巢肿瘤，27例卵巢癌组织中VEGF的表达，用FⅧ因子单克隆抗体标记新生血管内皮、计数微血管密度（MVD）。结果：VEGF在卵巢交界性肿瘤组织中的表达介于卵巢良性肿瘤与卵巢恶性肿瘤之间，其结果均有显著差异（P＜0．05），且其与卵巢交界性肿瘤的临床分期，MVD值密切相关（P＜0．05），其与卵巢交界性肿瘤的组织分型，有无腹腔种植无关（P＜0．05），结论：VEGF是卵巢肿瘤重要的血管生成因子，它与卵巢肿瘤的生长，侵袭与转移密切相关，检测VEGF有助于判断肿瘤的恶性程度，为交界性肿瘤的判断预后提供依据。     

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.