VEGF、TGF-β1及DC在肾癌中的表达及其临床意义

目的:探讨血管内皮生长因子(vascular endothelial growth factor VEGF)、转化生长因子-β1(transforming growth factor-β1 TGF-β1)和树突状细胞(dendritic cell,DC)在肾透明细胞癌组织中的表达并分析其临床意义.方法:应用免疫组织化学方法,检测40例肾透明细胞癌组织中VEGF、TGF-β1及CD1a阳性树突状细胞(CD1a DC)的表达情况,结合临床资料分析VEGF、TGF-β1和CD1a在肾癌中的表达及其临床意义.结果:VEGF在肾癌组织中均有较强表达率;VEGF表达率依肾癌临床分期Ⅰ期、Ⅱ期、Ⅲ～Ⅳ期的顺序而明显上升(P＜0.05);TGF-β1在肾癌组织的表达水平较正常肾组织高,其表达率与肾癌分期有关(P＜0.05);所有病例均有CD1a DC表达,其在肾癌组织中的浸润程度明显高于正常肾组织(P＜0.001),但CD1a DC与肾癌临床分期无相关性.结论:VEGF可作为判断肾癌恶性程度的参考指标.TGF-β1对肾癌是一种重要负性调节因子,可抑制肾癌进展并可作为判断肾癌恶性程度的参考指标.非成熟状态的DC(CD1a Dc)主要表达于癌组织中.由于肾癌组织中免疫抑制因子如VEGF、TGF-β1的存在,抑制了癌组织中树突状细胞的成熟,造成癌组织中DC主要以不成熟状态的形式存在,不能有效地呈递肿瘤抗原,这可能是导致肾癌细胞逃脱机体免疫监视的机制之一.     

肝癌组织中浸润树突状细胞的数量和表面分子表达的临床意义

目的:研究人肝癌组织中浸润树突状细胞(DC)的数量和表面分子表达的临床意义.方法:原发性肝细胞癌(肝癌)术后组织标本30例,采用免疫组化方法(即用型两步法SupervisionTM)检测肝癌组织中DC标志蛋白S-100的表达;从肝癌组织中分离浸润性单个核细胞,流式细胞术检测DC的表面分子表达,并用RT-PCR技术检测肝癌组织IL-10、TGF-β1和VEGF-AmRNA.结果:肝癌组织中DC的数量少,高分化肝癌组织中DC浸润数量[(27.22±15.38)个/HPF]高于低分化肝癌[(11.92±8.56)个/HPF](P＜0.01);肝癌组织中浸润DC的表面分子如CDla、HLA-DR、CD80、CD86和CD54等MHC-Ⅰ、Ⅱ类分子,共刺激分子和黏附分子存在低表达或不表达,与肝癌的分化程度密切相关.在mRNA水平上,IL-10、TGF-β1和VEGF-A基因在肝癌组织中的表达显著高于正常肝组织(P＜0.001,P＜0.05).结论:肝癌组织中浸润DC的数量减少并存在功能缺陷,与肝癌分化程度密切相关.     

TGF-β1、VEGF和MMP-2蛋白在口腔鳞状细胞癌中的表达及其临床意义

目的:研究口腔鳞状细胞癌组织中TGF-β1、VEGF和MMP-2的表达及其临床意义。方法:用链霉素亲生物素-过氧化酶免疫组织化学(SP)法检测40例口腔鳞状细胞癌组织中TGF-β1、VEGF和MMP-2的表达,分析TGF-β1、VEGF和MMP-2的表达与临床病理参数的关系以及TGF-β1的表达与VEGF和MMP-2表达的相关性。结果:TGF-β1表达阳性率为55%(22/40),VEGF表达阳性率为60%(24/40),MMP-2表达阳性率为65%(26/40)。TGF-β1、VEGF和MMP-9的表达与口腔鳞状细胞癌患者的年龄、性别及组织分化程度无明显关系(P>0.05),与临床分期和淋巴结转移有关。Ⅲ期与Ⅰ、Ⅱ期比较,原发灶中TGF-β1、VEGF和MMP-2表达率有升高趋势(P<0.05)。有淋巴结转移者与无淋巴结转移者比较,原发灶中TGF-β1、VEGF和MMP-2表达率有升高趋势(P<0.05)。TGF-β1的表达与VEGF和MMP-2的表达呈明显的正相关性。结论:TGF-β1、VEGF和MMP-2的表达与口腔鳞状细胞癌的浸润和转移有关。     

胃癌TGF-β1蛋白表达及与细胞增殖和血管生成的关系

目的研究胃癌转化生长因子β1(TGF-β1)表达和意义.方法运用免疫组化S-P法检测50例胃癌、10例正常胃黏膜TGF-β1、Ki-67、血管内皮生长因子(VEGF)表达及微血管密度(MVD).结果胃癌TGF-β1与Ki-67表达较正常胃黏膜明显增强.TGF-β1表达与胃癌分化程度、淋巴结转移和浸润深度显著相关.胃癌TGF-β1表达与Ki-67表达、VEGF表达显著相关,与MVD无直接关系.结论 TGF-β1过表达胃癌细胞除增殖活性增强外,还可能促进胃癌的浸润和转移.     

缺氧诱导因子 1α及血管内皮生长因子的表达与胃癌生物学行为的关系

目的探讨缺氧诱导因子1α(HIF-1α)和血管内皮生长因子(VEGF)在胃癌组织中的表达及其与临床病理因素的关系. 方法对48例手术切除后的胃癌标本进行连续切片和HIF-1α、VEGF免疫组织化学检测. 结果 HIF-1α蛋白呈高表达,阳性率为66.7%,VEGF阳性表达率为60.4% .HIF-1α、VEGF与胃癌的浸润深度、淋巴结转移及TNM分期密切相关,VEGF阳性表达与HIF-1α阳性表达程度呈正相关. 结论胃癌组织中VEGF的表达依赖于HIF-1α;HIF-1α及VEGF过表达与胃癌的不良生物学行为有关,可能成为预测胃癌侵袭转移的重要指标.     

胃癌血清IL-10和IL-12与肿瘤分期及血管生成的关系研究

目的:探讨血清中IL-10、IL-12与胃癌病理分期及肿瘤血管形成的关系。方法:选取我院病理证实的36例胃癌患者做实验组,健康体检的28例做对照组,所有研究对象检测血清IL-10、IL-12含量,胃癌患者组织标本免疫组化表达血管内皮生长因子(VEGF)的含量并收集患者病理与临床指标。结果:胃癌患者血清IL-10含量比对照组血清中含量明显增加,胃癌分期较晚、有淋巴结转移、组织分化差的患者血清中IL-10含量比胃癌无淋巴结转移、分期与组织分化较好的患者含量高,而胃癌患者血清IL-12与之相反,且胃癌患者血清IL-10、IL-12的含量与胃癌组织中VEGF免疫组化表达相关。结论:胃癌患者血清IL-10、IL-12含量与胃癌淋巴转移、肿瘤分期、组织分化等病理参数相关,并与胃癌VEGF的促肿瘤血管新生有一定关系。     

胃癌组织及腹腔液中TGF-β1表达与胃癌预后的关系

目的:探讨胃癌组织及腹腔液中TGF-β1表达与胃癌预后的关系.方法:采用免疫组化技术检测80例胃癌患者原发灶中TGF-β1表达,并采用ELISA方法检测该80例胃癌患者腹腔液中TGF-β1表达.同时行腹腔液细胞学检查(PLC).结果:80例胃癌组织中TGF-β1表达阳性率为46.25%(37/80),与胃癌浸润深度(P＜0.01)、浆膜类型(P＜0.01)、腹膜转移(P＜0.05)相关;而80例胃癌腹腔液中TGF-β1均检测到TGF-β1表达,其表达水平与浆膜类型(P＜0.01)、PLC检查(P＜0.01)及TNM分期(P＜0.01)相关.结论:胃癌组织及腹腔液中TGF-β1表达水平与胃癌腹膜转移相关因素及TNM分期密切相关,检测其表达对评估胃癌患者的预后具有重要意义.     

TGF-β1在膀胱移行细胞癌中的表达及其对血管生成的调节作用

目的本论文通过研究转化生长因子β1(transforming growth factor-β1,TGF-β1),血管内皮生长因子(vascular endothelial growth factor,VEGF)在膀胱移行细胞癌组织中的表达以及平均血管密度(mean vascular density,MVD),探讨TGF-β1对膀胱肿瘤血管生成的调节作用。方法采用免疫组织化学的方法(SABC法)测定TGF-β1、FactorⅧ和VEGF在正常膀胱粘膜和移行细胞癌组织中的表达情况及相互关系。结果膀胱移行细胞癌组织中,TGF-β1的阳性率为64%。随着肿瘤分期、分级的升高,TGF-β1的染色强度有逐渐增强的趋势。VEGF的染色强度与肿瘤的分期、分级呈明显的相关性。浸润性和高分级膀胱癌的MVD明显高于浅表性和低分级膀胱癌的MVD。TGF-β1和VEGF同时表达阳性时的MVD最高。结论TGF-β1可能通过上调膀胱癌细胞VEGF的表达促进肿瘤的血管生成来参与膀胱肿瘤的浸润、转移。     

血管内皮生长因子、缺氧诱导因子-1α在胃癌中的表达及其对预后影响的研究

目的 研究血管内皮生长因子(VEGF)、缺氧诱导因子-1α(HIF-1α)在胃癌组织中的表达和临床病理特征的关系,探讨它们在胃癌增殖、浸润、转移中的作用及对胃癌患者预后的影响.方法 收集135例来自复旦大学附属中山医院1999年12月-2005年12月手术的胃癌病例,采用组织芯片和免疫组化法检测胃癌标本VEGF、HIF-1α表达情况,分析其与临床病理特征的关系及两者之间的相关性.用K-M生存分析及Cox回归单因素、多因素比较分析影响胃癌患者预后因素.结果 胃癌组织VEGF、HIF-1α阳性表达均明显高于癌旁组织,差异有显著性(P＜0.01),胃癌组织VEGF阳性表达与肿瘤直径、分化程度、浸润深度、淋巴结转移相关(P＜0.05).胃癌组织HIF-1α阳性表达与肿瘤浸润深度显著相关(P＜0.01).胃癌组织中VEGF、HIF-1α的表达呈正相关(P＜0.01),单因素分析结果显示胃癌的肿瘤部位、Borrmann分型、浸润深度、淋巴结转移、TNM分期、VEGF阳性表达、HIF-1α阳性表达等影响因素与预后相关(P＜0.05),多因素分析TNM分期、淋巴结转移、HIF-1α阳性表达为影响胃癌患者生存的独立预后因素(P＜0.05).结论 HIF-1α在胃癌中是肿瘤耐受缺氧的中心环节,VEGF和HIF-1α的阳性表达可作为判断肿瘤具有高度侵袭转移潜能和预后不良的重要指标.     

TGF-β1蛋白在大肠癌组织的表达及意义

目的:研究转化生长因子β1(TGF-β1)在大肠癌组织的表达及临床意义.方法:运用免疫组化S-P法检测70例大肠癌组织、10例正常大肠粘膜组织标本的TGF-β1表达,并分析TGF-β1表达与大肠癌临床病理因素及术后生存率的关系.结果:大肠癌组织TGF-β1表达较正常大肠粘膜明显增强;TGF-β1过度表达与大肠癌淋巴结转移、Dukes分期及预后密切相关.结论:TGF-β1促进大肠癌细胞浸润和转移并影响预后;TGF-β1表达可作为大肠癌预测复发和判断预后具有参考意义的新指标.     

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.