上皮细胞黏附分子在胃癌组织中的表达及其与预后的关系

目的 探讨上皮细胞黏附分子（EPCAM）在胃癌组织中的表达及其与胃癌浸润转移及预后的关系,以及EPCAM作为胃癌早期诊断、预后判断和治疗靶点的临床价值。方法 应用免疫组织化学法检测436 例胃癌组织及92例癌旁非肿瘤胃黏膜组织中EPCAM 的表达情况,分析并探讨EPCAM 的表达与临床病理参数及预后的关系。结果 在92 例非肿瘤胃黏膜组织中,50例（54.3%）EPCAM 蛋白为阴性表达,42例（45.7%）呈弱阳性表达。在436 例胃癌组织中,EPCAM 蛋白高表达179 例（41.1%）,低表达257 例（58.9%）,主要在细胞包膜表达。EPCAM 蛋白的表达强度与肿瘤部位、肿瘤大小、Lauren 分型、浸润深度、淋巴结分期、TNM 分期、淋巴结转移和远处转移密切相关（均P＜0.01）,而与患者性别、分化程度、组织学类型无关（均P ＞0.05）。EPCAM 高表达患者的5 年生存率（57.2%）明显低于EPCAM 低表达胃癌患者的5 年生存率（17.3%,P＜0.05）。I、II 和III 期EPCAM高表达胃癌患者的5年生存率明显低于EPCAM 低表达患者的5年生存率（P＜0.05）;IV 期EPCAM 高表达和低表达胃癌患者的5年生存率无统计学差异。EPCAM 表达、远处转移和TNM 分期（均P＜0.05）是胃癌的独立预后因素。结论 EPCAM 在胃癌中高表达,且其表达与淋巴结转移、远处转移、肿瘤的TNM 分期显著相关,提示EPCAM 可以作为胃癌的早期诊断的筛查指标以及治疗的靶点之一。     

不同肿瘤分期方法对胃癌手术患者预后评估的影响

目的探讨影响胃癌手术患者预后的相关因素,并比较采取不同肿瘤分期方法对预后评估的影响。方法回顾性分析2006年1月至2009年6月有完整随访资料的170例胃癌手术患者的临床资料,比较采用3种不同的肿瘤分期方法对胃癌独立预后因素的影响。结果单因素生存分析显示术前血色素、血CEA、血CA199、手术方式、手术时间、输血、肿瘤大小、肿瘤分化程度、肿瘤浸润深度(T分期)、淋巴结转移数(N分期)、远处转移情况(M分期)、TNM分期与胃癌患者预后显著相关。多因素生存分析显示,当采用肿瘤浸润深度、淋巴结转移数、远处转移情况来表示肿瘤分期时,肿瘤浸润深度、淋巴结转移数、远处转移情况是胃癌患者的独立预后因素;当采用简单的TNM分期(Ⅰ、Ⅱ、Ⅲ、Ⅳ期)来表示肿瘤分期时,简单TNM分期、肿瘤大小、肿瘤分化程度、手术时间是胃癌患者的独立预后因素;而当采用细致的TNM分期(ⅠA、ⅠB、ⅡA、ⅡB、ⅢA、ⅢB、ⅢC、Ⅳ期)来表示肿瘤分期时,仅细致TNM分期是胃癌患者的独立预后因素。结论肿瘤分期是影响胃癌手术患者预后的最重要因素,细致的TNM分期更有助于对胃癌手术患者的预后评估。     

IGF-1R在胃癌组织中的表达及其与浸润转移和预后的关系

目的 探讨胰岛素样生长因子-1受体（IGF-1R）在胃癌组织中的表达及其与胃癌浸润、转移的关系.方法 应用免疫组化SP法检测436例胃癌组织石蜡标本及92例癌旁非肿瘤胃黏膜组织标本中IGF-1R表达.结果 IGF-1R在胃癌组织表达明显高于癌旁非肿瘤胃黏膜组织,436例胃癌组织中有385例 IGF-1R蛋白表达阳性,216例高表达,IGF-1R蛋白的阳性表达与患者的年龄、肿瘤部位、肿瘤大小、Lauren分型、浸润深度、脉管侵犯、淋巴结转移、远处转移及TNM分期有关.I、II和 III期胃癌患者中IGF-1R高表达者5年生存率明显低于IGF-1R低表达者,IV期胃癌患者的5年生存率与IGF-1R表达无关,IGF-1R表达、浸润深度、淋巴结和远处转移和TNM分期为胃癌患者独立的预后因素.结论 胃癌组织IGF-1R表达与淋巴结和远处转移及预后显著相关,IGF-1R可能成为一个预测肿瘤进展、浸润和转移的分子标记物.     

长链非编码RNA HOXC13-AS在胃癌中的表达及临床意义

目的探究长链非编码同源盒基因C13反义RNA(lnc RNA HOXC13-AS)在胃癌中的表达水平及在胃癌进展中的意义。方法选取胃癌患者112例,术中收集入组患者癌组织及癌旁组织(距病灶≥5 cm)。采用实时荧光定量(qRT-PCR)技术检测胃癌及癌旁组织中lnc RNA HOXC13-AS表达水平,分析其与患者临床病理特征及预后的关系。结果胃癌组织中lnc RNA HOXC13-AS表达水平明显高于癌旁组织(P<0.05)。T1~T2期浸润、Ⅰ~Ⅱ期TNM分期、高中分化、无脉管侵袭、无淋巴结转移、无远处转移患者胃癌组织lncRNA HOXC13-AS表达水平均低于T3~T4期浸润、Ⅲ期TNM分期、低分化、有脉管侵袭、有淋巴结转移、有远处转移患者(均P<0.05)。lnc RNA HOXC13-AS高表达组患者3年总生存明显低于lncRNA HOXC13-AS低表达组患者(P<0.05)。TNM分期Ⅲ期、淋巴结转移、远处转移及lnc RNA HOXC13-AS高表达是影响胃癌患者不良预后独立危险因素(均P<0.05)。结论与癌旁组织相比,胃癌组织中lncRNA HOXC13-AS表达水平明显升高,与T3~T4期浸润、Ⅲ期TNM分期、低分化、有脉管侵袭、有淋巴结转移及有远处转移等临床病理特征及生存率低等不良预后有关,可能作为生物标志物,为胃癌临床诊断及预后评估提供帮助。     

SOX2在食管小细胞癌中的表达及预后价值

目的 探讨食管小细胞癌(small cell esophageal carcinoma, SCEC)手术切除患者SRY相关高迁移率族盒蛋白2(SRY related high-mobility-group box protein 2,SOX2)的表达及其预后价值。方法 通过免疫组织化学方法检测SCEC患者癌组织中SOX2的表达,同时检测癌周正常食管黏膜中SOX2的表达,采用Spearman相关性分析SOX2表达水平与临床病理参数的关系,Kaplan-Meier生存分析和COX比例风险模型分析影响SCEC预后的危险因素。结果 118例SCEC患者中SOX2的阳性率为46.6%(55/118),其中高表达组27.1%(32/118),低表达组19.5%(23/118),SOX2的表达与局部浸润深度、TNM分期、淋巴结转移、远处转移相关;SOX2高表达组更多见于TNMⅢ～Ⅳ期、局部浸润纤维膜、有淋巴结转移和远处转移的患者;SOX2低表达组更多见于肿瘤直径<2 cm和2～4 cm、局部浸润黏膜下层和肌层的患者。Kaplan-Meier生存分析结果显示肿瘤直径、TNM分期、局部浸润深度、淋...     

CD83+肿瘤浸润性树突状细胞在胃癌组织的表达及临床意义

目的肿瘤组织浸润树突状细胞(tumor infiltrating dendritic cells,TIDCs)数量和功能对患者预后有显著床意义,但CD83 TIDCs在胃癌组织中的表达情况尚不清楚,需要进行研究.方法采用免疫组化、原位杂交及流式细胞术检测45例胃癌TIDCs的CD83蛋白、CD83 mRNA以及S-100表达,并分析其临床意义.结果免疫组化显示胃癌组织(42/45)中有S100 散在表达;CD83主要表达于胃癌组织癌旁及正常胃黏膜上.原位杂交显示CD83 mRNA在少数标本中(7/45)表达.流式细胞术检测到低水平CD83表达(4%,45/45).S-100和CD83 mRNA表达数量与患者年龄、性别、肿瘤部位、浸润深度、病理分期及淋巴结转移情况无显著相关性.CD83蛋白免疫组化表达与胃癌TNM分期显著负相关(r=-0.924,P＜0.01);CD83流式细胞检查的表达率与胃癌TNM分期及淋巴结转移呈显著负相关(r=-0.879,P＜0.01;r=-0.782,P＜0.05).结论胃癌TIDCs CD83表达与胃癌TNM分期及淋巴结转移有关,可作为临床研究指标使用.     

P-ERK在胃癌及癌旁组织中的表达及其意义

目的研究人胃癌组织中P-ERK蛋白的表达情况及其与胃癌临床病理特征的关系.方法应用免疫组化方法检测57例胃癌其癌旁正常组织中P-ERK蛋白的表达水平.结果胃癌中P-ERK蛋白表达阳性率84.2%(48/57)明显高于相应正常胃黏膜12.3%(7/57)(P＜0.01);P-ERK的表达水平与患者的性别、年龄及癌组织分化程度无关(P＞0.05);TNM分期Ⅲ,Ⅳ期胃癌组织P-ERK蛋白表达水平高于Ⅰ,Ⅱ期胃癌组织(P＜0.05);有淋巴结转移的胃癌组织中P-ERK蛋白表达水平高于无淋巴结转移的胃癌组织(P＜0.01):胃壁浸润程度越深P-ERK蛋白表达水平越高.结论p-ERK蛋白表达水平与胃癌TNM分期、胃壁浸润深度及转移能力有关,提示P-ERK蛋白的过表达促进了胃癌发生、发展.     

IL-38在胃癌组织中的表达及临床意义

目的:探讨IL-38蛋白在胃癌组织中的表达及其与胃癌患者各临床病理参数之间的关系,探讨其与胃癌患者预后的关系。方法:建立组织芯片,通过免疫组织化学SP法检测78例无术前放、化疗史的胃癌患者手术标本和72例癌旁组织中IL-38蛋白的表达情况,并对随访患者进行生存分析。结果:IL-38在胃癌组织中阳性表达率为84.6%,在癌旁组织表达率为45.8%,差异有统计学意义(P<0.01);IL-38阳性表达与肿瘤TNM分期和淋巴结转移有关(P<0.05)。Kaplan-Meier生存分析结果显示,IL-38的高表达与胃癌不良预后有关(P<0.01)。经Cox比例风险回归模型分析显示,IL-38、肿瘤TNM临床分期和淋巴结转移与患者预后有关,且IL-38、有无淋巴结转移可作为独立的预后因素。结论:IL-38在胃癌组织中高表达,IL-38阳性表达与肿瘤TNM分期和淋巴结转移有关。IL-38高表达与胃癌患者不良预后相关,且IL-38、有无淋巴结转移可作为独立的预后因素。本实验明确IL-38与胃癌临床病理参数及预后之间的关系,为胃癌的临床诊断及治疗提供新的靶点。     

人胃癌组织中C-Met与骨桥蛋白的表达

目的:探讨胃癌组织中C-Met与骨桥蛋白的表达情况,以及2者的表达与胃癌侵袭、转移的关系.方法:应用免疫组织化学方法检测60例(男36例,女24例;组织类型肠型35例,弥漫型25例;TNM分期Ⅰ、Ⅱ期28例,Ⅲ、Ⅳ期32例;高分化16例,中分化26例,低分化18例;无浆膜浸润24例,有浆膜浸润36例;无淋巴结转移19例,有淋巴结转移41例;无远处转移21例,有远处转移39例)胃癌组织中C-Met与骨桥蛋白的表达.结果:60例胃癌组织中C-Met与骨桥蛋白表达的阳性率分别为66.7%(40/60)、73.3%(44/60),C-Met与骨桥蛋白的表达与肿瘤组织类型、临床病理分期、浸润深度、淋巴结转移程度及有无远处转移有关(P＜0.05).胃癌组织中C-Met与骨桥蛋白的表达呈正相关(rs=0.533,P＜0.05).结论:C-Met与骨桥蛋白与胃癌侵袭转移密切相关,能够作为反映肿瘤的生物学特性评估预后.     

胃癌组织中叉头框蛋白M1的表达与临床病理特征及预后的相关性

目的 探讨胃癌组织中叉头框蛋白M1(FOXM1)的表达及其与预后的相关性。方法 采用免疫组化SP法检测并比较胃癌和癌旁组织FOXM1的表达。分析FOXM1表达与胃癌患者临床病理特征的关系;采用Cox比例风险回归模型分析胃癌患者预后的危险因素;采用Kaplan-Meier生存曲线分析FOXM1与患者预后的关系。结果 胃癌组织FOXM1蛋白高表达率高于癌旁组织,差异有统计学意义(P<0.05);胃癌组织FOXM1高表达与年龄、分化程度、TNM分期、淋巴结转移、肿瘤大小、脉管神经侵犯和浸润深度相关(P<0.05);Cox回归分析显示,TNM分期、淋巴结转移、脉管神经侵犯、浸润深度和FOXM1均是影响胃癌患者无进展生存期(PFS)和总体生存时间(OS)的独立危险因素(P<0.05);Kaplan-Meier法分析结果显示,FOXM1高表达组患者PFS和OS累积生存率低于低或无表达组(P<0.05)。结论 FOXM1可能在胃癌的发生发展过程中发挥着重要作用,且FOXM1高表达是胃癌的不良预后因素。     

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

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.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

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…     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.