生存蛋白在胃癌中的表达及与p53、c-erbB2表达的关系

目的　研究人胃癌组织中凋亡抑制蛋白 (IAP)家族的生存蛋白 (survivin)的表达与临床病理及与 p5 3和c erbB2表达的关系。方法　采用免疫组化的方法检测 5 6例胃癌患者肿瘤组织及 2 0例慢性胃炎患者胃粘膜中survivin和 p5 3、c erbB2的表达。结果　 2 0例慢性胃炎患者胃粘膜中survivin的表达阳性 1例 ,阳性率为 5 % ;5 6例胃癌组织中survivin阳性 2 7例 ,阳性率 4 8.2 % ;5 6例胃癌患者c erbB2阳性率 35 .7% (2 0 / 5 6 ) ,p5 3阳性率39.3% (2 2 / 5 6 )。survivin表达与患者年龄、肿瘤浸润深度、淋巴结转移、临床分级等无明显相关性 ,而与肿瘤Lauren组织分型相关。survivin阳性率在肠型胃癌 (2 0 / 32 ,6 2 .5 % )中显著高于弥漫型 (7/ 2 4 ,2 9.2 % ,P <0 .0 5 )。survivin在c erbB2阳性和阴性患者中阳性率分别为 80 % (16 / 2 0 )和 30 .6 % (11/ 36 ) ,两者间有显著差异 (P <0 .0 1) ;survivin在 p5 3阳性和阴性患者中阳性率分别为 6 8.2 % (15 / 2 2 )和 35 .3% (12 / 34) ,两者比较也有显著差异 (P <0 .0 5 )。结论　胃癌患者survivin高表达导致的凋亡抑制在胃癌的发生发展中起了重要作用 ,survivin表达与胃癌中 p5 3和c erbB2异常表达相关。     

大肠癌组织中凋亡抑制蛋白survivin的表达及其与bcl-2、c-erbB2表达的关系

目的 :探讨凋亡相关基因survivin在大肠癌组织中的表达与临床病理及与bcl 2和c erbB2表达的关系。方法 :采用免疫组化的方法检测 12例大肠正常粘膜及 5 7例大肠癌患者肿瘤组织中survivin和bcl 2、c erbB2的表达。结果 :12例大肠正常粘膜中survivin呈阴性表达 ,阳性率 0 0 % ;5 7例大肠癌组织中survivin阳性表达 3 6例 ,阳性率 63 2 % ;bcl 2阳性表达 3 3例 ,阳性率 5 7 9% ;c erbB2阳性表达 3 0例 ,阳性率 5 2 6%。survivin表达与患者年龄、性别、组织分型、淋巴结转移及Dukes分期等无明显相关性。survivin在bcl 2阳性和阴性患者中阳性率分别为 72 7% ( 2 4/3 3 )和 2 9 2 % ( 7/2 4) ,两者间有显著差异 (P <0 0 1) ;survivin在c erbB2阳性和阴性患者中阳性率分别为 73 3 % ( 2 2 /3 0 )和 3 7 0 % ( 10 /2 7) ,两者间也有显著差异 (P <0 0 1)。结论 :大肠癌患者survivin高表达导致的凋亡抑制在大肠癌的发生发展中起了重要作用 ,survivin表达与大肠癌中bcl 2和c erbB2异常表达相关。     

Evi1基因在急性髓系白血病中的表达及意义

目的　探讨急性髓系白血病 (AML)中Evi1基因的表达及意义。方法　应用半定量RT -PCR方法检测了HEL白血病细胞系 (Evi1阳性细胞株 )、94例AML(初治 49例 ,复发 2 3例 ,缓解 2 2例 )患者及 10名正常对照Evi1基因的表达。结果　① 10名正常人骨髓单个核细胞中无Evi1mRNA的表达 (阴性 ) ,HEL细胞系Evi1阳性。②AML患者Evi1基因总的阳性表达率为 18.1% (17/94) ,M5型未见表达 ,M1～M4各型的阳性率无差异 (P >0 .0 5)。AML初治、复发、完全缓解的Evi1基因阳性率分别为 2 6.5%、17.4%、4.5% ,各组间无明显差异 (P >0 0 5)。③AML初治患者中Evi1阳性表达者首次完全缓解 (CR1)后缓解持续时间短于Evi1阴性表达者 (P <0 0 1) ,早期病死率 (确诊后 3个月内死亡 )明显升高 (P <0 .0 1)。结论　Evi1基因在AML的发病中可能起一定作用 ,可作为判断AML预后不良的一个指标     

急性白血病免疫表型检测及临床观察

目的:探讨急性白血病免疫表型特点及其与预后的关系。方法 :用间接免疫荧光法对 10 8例急性白血病行免疫表型检测。 结果 :1初诊按 FAB标准诊断的 M2 、M5和 L3各 1例 ,最后确诊为急性混合细胞性白血病( MAL) ;4例急性未分化型白血病 ( UAL)确诊为急性髓细胞白血病微分化型 ( M0 )。 2 AL L 中 11.5 %伴有髓系抗原表达 ;B- AL L中 CD34 +明显高于 T- AL L (分别为 5 3%和 2 8% ) ,但差异无统计学意义 ( P >0 .0 5 ) ,骨髓内原始 +幼稚细胞数 T- AL L明显低于 B- AL L ( P <0 .0 5 )。 3AML中 2 2例 ( 2 7.8% )伴有至少一个淋系抗原表达。 4CD7+- AML 中 CD34 、CD38、HL A- DR等早期干 /祖细胞抗原高表达 ,CD7在 M3中低表达而在 M0 M1 中高表达 ( P<0 .0 1)。 结论:免疫表型分析对 MAL和 M0 的诊断不可缺少 ;CD7+- AML提示预后差     

P21蛋白在浸润性乳腺癌中的表达和意义

目的 :探讨 P2 1蛋白的表达与乳腺癌临床病理特征的关系。方法 :应用免疫组化 SABC法检测 4 2例乳腺癌组织中 P2 1蛋白的表达。结果 :P2 1蛋白定位于细胞核 ,在 I/ 期和 / 期乳腺癌 P2 1蛋白阳性率分别为 90 .3%和 4 5 .5 % (P<0 .0 5 ) ,在生存期≥ 5 a组和 <5 a组 P2 1蛋白阳性率分别为 88.2 %和 37.5 % (P<0 .0 5 )。结论 :P2 1蛋白表达对判断乳腺癌预后有重要意义。     

WT1基因在白血病患者中的表达及临床意义

目的 :探讨 WT1基因在白血病患者中的表达及其临床意义。方法 :采用逆转录聚合酶链反应 (RT- PCR)方法测定 5 3例急性白血病、15例慢性粒细胞白血病、2 1名正常人的 WT1基因表达。结果 :5 3例急性白血病患者中 4 1例 WT1基因表达阳性 ,阳性率为 77.35 % ,其中急性髓系白血病 (AML )和急性淋巴细胞白血病 (AL L )阳性率分别为 80 .6 %和 72 .0 % ,两组相比差异无统计学意义 (P >0 .0 5 ) ;15例的慢性粒细胞白血病 (CML ) WT1基因表达阳性率为 4 6 .7% ,其中 7例急变期和加速期阳性率为 10 0 % ,8例慢性期阳性率为 0 %。 2 7例急性白血病完全缓解 (CR)患者中 2 2例 (81.5 % ) WT1基因表达转阴 ,4例复发患者 WT1基因表达再次升高。 2 1例正常人的 WT1基因表达阴性 ;RT- PCR检测 WT1基因灵敏度为 10 - 4水平。结论 :1WT1基因在各种类型白血病患者中均有表达 ,在正常人中不表达。 WT1的表达与白血病病程相关 ;2 WT1基因可作为检测MRD的标记性基因。 WT1基因的表达与白血病患者的化疗效果及预后密切相关。     

Survivin凋亡抑制基因在垂体腺瘤中的表达及其与bcl-2、p53相关性的研究

目的 :探讨凋亡抑制基因survivin在垂体腺瘤中的表达 ,及其与bcl 2和p5 3表达蛋白的相关性。方法 :采用免疫组织化学链霉菌抗生物素蛋白 过氧化酶连接法 (SP法 ) ,检测survivin、bcl 2、p5 3基因表达蛋白在 8例正常垂体组织及 3 8例垂体腺瘤组织中的表达。结果 :survivin基因表达蛋白在正常垂体中无表达 ,3 8例垂体腺瘤中 ,2 3例表达阳性 ,占 60 5 %病理分型中PRL型、GH型、混合型阳性表达率分别为 12 /17、7/13、4/8三者比较 ,差异无显著性 (P >0 0 5 )。垂体腺瘤bcl 2表达蛋白的阳性与阴性中 ,survivin蛋白表达阳性率分别为 15 /17、8/2 1。两者比较 ,差异有显著性 (P <0 0 5 ) :而p5 3表达蛋白的阳性和阴性中 ,survivin蛋白表达阳性率分别为 2 /6,2 2 /2 3 ,两者相比 ,差异无显著性 (P >0 0 5 ) :survivin基因蛋白的表达阳性率与垂体腺瘤组织中的bcl 2蛋白表达密切相关 ,与p5 3蛋白表达无相关性。结论 :survivin蛋白表达的异常而引起细胞凋亡抑制 ,在垂体腺瘤的发生中起一定作用 ,其过度表达提示垂体腺瘤增生极度活跃 ,survivin蛋白表达与垂体腺瘤中bcl 2蛋白的异常表达密切相关     

急性髓系白血病细胞粘附分子表达特点

目的 研究急性髓系白血病(AML)中细胞粘附分子(CAM)的表达特点.方法 应用流式细胞仪间接免疫荧光技术检测85例AML中CAM的表达情况.结果 ①CAM表达阳性率:CD54 60.0%、CD11a 52.9%、CD49e 50.6%、CD49f 49.4%、CD11b 47.1%、CD11c 29.4%和CD15 16.5%;M1、M4和M5阳性率比较高,M0、M2和M3阳性率比较低,M7不表达CAM;②CD34阳性率60.0%.结论 AML中CAM表达与CD34细胞表达相一致.     

肺耐药蛋白基因在急性白血病中的表达及意义

目的 :检测急性白血病患者肺耐药蛋白 (lung resistance protein,LRP)基因 m RNA表达 ,探讨其与多药耐药和预后的关系。方法 :采用半定量逆转录 -聚合酶链反应 (RT-PCR)技术检测 47例急性白血病患者及 7例正常对照者骨髓细胞 LRP基因的表达。结果 :正常骨髓细胞 LRP基因表达阴性 ,2 5例初治急性非淋巴细胞白血病 (ANLL)患者中 1 4例 LRP表达阳性 ,1 2例初治急性淋巴细胞白血病 (ALL)中仅 1例阳性 ,1 0例复发难治患者 8例阳性 ;初治 ANLL组及复发难治组较正常对照组相比表达率明显升高 ,差异有显著性 (P=0 .0 0 1 ,P=0 .0 2 4) ,LRP m RNA表达水平与初次化疗不敏感及预后差有关 ,LRP阳性患者的完全缓解率明显低于表达阴性者 (分别为 3 / 1 1 ,4/ 5 ,P<0 .0 5 )。结论 :LRP基因表达水平与急性非淋巴细胞白血病化疗效果及预后密切相关 ,是一项新的耐药指标。检测 LRP的表达可以指导治疗 ,估计预后     

急性非淋巴细胞白血病细胞survivin mRNA的表达

目的 :探讨急性非淋巴细胞白血病 (ANLL)细胞survivinmRNA表达及与疗效关系。方法 :应用RT -PCR方法检测 2 8例初发ANLL患者和 6例正常对照骨髓单个核细胞survivinmRNA的表达。结果 :ANLL患者survivinmRNA表达阳性率 75 .0 % (2 1/ 2 8)明显高于正常对照的 2 / 6 (χ2 =3.919,P <0 .0 5 ) ;survivinmRNA表达阴性的ANLL患者接受 1个疗程化疗后骨髓缓解 (BMR)率高于阳性者 (83.3%vs 2 5 .0 % ,P =0 .0 2 3)。结论 :survivin基因在ANLL细胞高表达 ,可能是ANLL患者对化疗药物不敏感的原因之一     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.