上皮钙黏蛋白、P53和Bcl-2在涎腺腺样囊性癌组织中的表达及与肺转移、神经浸润的相关性

目的探讨上皮钙黏蛋白（E-cad）、P53和Bcl-2在涎腺腺样囊性癌组织中的表达及与肿瘤浸润、转移和预后的关系。方法39例确诊的涎腺腺佯囊性癌患者病理标本,按有无神经侵犯分为神经侵犯组（16例）与无神经侵犯组（23例）,按有无肺转移分为有肺转移组（11例）与无肺转移组（28例）,用SP免疫组织化学法检测E-cad、P53和Bcl-2的表达并进行比较。结果涎腺腺样囊性癌神经侵犯组E-cad阳性表达率低于无神经侵犯组（P〈0．05）;神经侵犯组P53阳性表达率高于无神经侵犯组（P〈0,05）;神经侵犯组Bcl-2阳性表达率高于无神经侵犯组（P〈0．05）;肺转移组E-cad阳性表达率低于无肺转移组（P〈0,05）;肺转移组P53阳性表达率高于无肺转移组（P〈0．05）;肺转移组Bcl-2阳性表达率高于无肺转移组（P〈0．05）。结论E-cad、P53和Bcl-2表达与涎腺腺样囊性癌局部侵润、远隔脏器（肺）转移相关,可作为判断预后、指导临床综合治疗的指标。     

涎腺腺样囊性癌中Id-1表达的实验研究

目的检测涎腺腺样囊性癌、多形性腺瘤和正常涎腺组织中Id-1的表达,分析Id-1的表达与涎腺腺样囊性癌临床病理之间的关系。方法免疫组化Envison两步法检测54例涎腺腺样囊性癌、12例多形性腺瘤和10例正常涎腺组织Id-1表达。结果Id-1在涎腺腺样囊性癌、多形性腺瘤和正常涎腺组织阳性率分别为72．2％、33．3％、10．00％,涎腺腺样囊性癌与多形性腺瘤以及涎腺腺样囊性癌与正常涎腺比较差异均具有统计学意义（P‘0．05）：转移组和无转移组阳性率分别为81．6％和50．0％,差异具有统计学意义（P〈0．05）;Ⅰ-Ⅱ和Ⅲ-Ⅳ阳性率分别为46．2％和80．5％,差异具有统计学意义（P〈0．05）。结论涎腺腺样囊性癌中Id-1过表达;Id-1与涎腺腺样囊性癌发生和转移有一定关系;Id-1可能作为有效靶点对涎腺腺样囊性癌的治疗提供帮助。     

CXCR7在涎腺腺样囊性癌中的实验研究

目的研究趋化因子受体7（Chemokine receptor7,CXCR7）在涎腺腺样囊性癌（ACC）中的表达,探讨其与侵袭、转移和预后的关系。方法采用免疫组化方法检测17例正常涎腺组织、47例涎腺多形性腺瘤、41例涎腺腺样囊性癌及其切缘组织切片中CXCR7表达情况,结合临床病例资料,分析CXCR7对ACC侵袭、转移和预后的影响。结果涎腺腺样囊性癌中CXCR7表达率显著高于其他各组,差异具有统计学意义（P〈0.05）,与神经侵袭、淋巴结转移、远处转移密切相关;Kaplan-Merier曲线显示,CXCR7阳性表达组患者与CXCR7阴性表达组患者术后生存率比较,差异具有统计学意义（P〈0.05）。结论 CXCR7表达与ACC的神经侵袭、淋巴结转移、远处转移有关,有助于预后判断。     

神经生长因子受体在涎腺腺样囊性癌中的表达及临床意义

目的探讨神经生长因子受体p75NRT（NGFR／p75NRTJ在涎腺腺样囊性癌中的表达及临床意义。方法应用免疫组织化学方法检测49例涎腺腺样囊性癌中NGFR／p75NRT的表达情况。结果49例涎腺腺样囊性癌中,NGFR／p75NRT阳性表达率为653％（32／49oNGFR／p75NRT在涎腺腺样囊性癌的表达与患者性别、肿瘤部位、原发灶分期及病理分型无相关性。未见神经侵犯现象16例,有神经侵犯现象33例,两者间NGFR／p75NRT阳性表达率的差异存在统计学意义（P〈0．05）。结论神经生长因子受体与涎腺腺样囊性癌的神经侵袭性显著相关,而与肿瘤原发灶分期、病理类型无关。     

涎腺腺样囊性癌p16蛋白和增殖细胞核抗原的表达

目的 探讨涎腺腺样囊性癌中p16蛋白和增殖细胞核抗原（PCNA）表达与病理分型及淋巴转移关系,为临床治疗及判断预后提供资料。方法 利用免疫组化检测36例涎腺腺样囊性癌组织中p16蛋白阳性表达及PCNA表达。结果 p16蛋白在腺样囊性癌组织中阳性率为33．33％,PCNA阳性率为72．22％;癌组织中p16蛋白阳性表达随着病理分级增高而降低（P〈0．05）;不同病理类型癌组织中PCNA阳性表达差异无统计学意义（P〉0．05）;有淋巴转移癌组织中p16蛋白的阳性表达低于无淋巴转移癌组织（P〈0．05）,而PCNA阳性表达则高于无淋巴转移癌组织（P〈0．05）。结论 p16和增殖细胞核抗原表达水平反映该肿瘤浸润性和恶性度,可作为预测淋巴结转移和判断预后的参考指标。     

E-cadherin与Snail在涎腺腺样囊性癌中的表达及意义

目的研究E—cadherin与Snail在人腺样囊性癌（SACC）中的表达及临床意义。方法用免疫组化的方法检测E—cadherin与Snail在SACC及正常涎腺组织中的表达。结果（1）与正常涎腺组织相比,E-cadherin在SACC中表达下降,差异有统计学意义（P〈0．05）,E—cadherin表达与不同组织病理学类型有关,且在发生神经侵犯及远处转移的病例中,E—cadherin表达下降更明显（P〈0．05,P〈0．01）。（2）Snail在SACC中表达,且Snail表达与组织病理学类型及生物学行为有关,在实体型及发生神经侵犯及远处转移的病例中,Snail表达明显增加（P〈0．001,P〈0．05,P〈0．05）。（3）在SACC,E—cadherin与Snail的表达呈负相关（r=-0．496,P〈0．001）。结论snail与E—cadherin的联合检测可作为SACC恶性程度及预后的参考指标。     

CA242在人涎腺腺样囊性癌中的表达及意义

目的：研究涎腺腺样囊性癌（adenoid cystic carcinoma,SACC）中CA242的表达及其意义。方法：采用免疫组化S-P法检测36例涎腺腺样囊性癌及10例正常涎腺组织中CA242的表达情况。结果：涎腺腺样囊性癌中CA242的阳性表达率为80.5%（29/36）,显著高于其在正常涎腺组织中的表达（P〈0.05）。CA242在涎腺腺样囊性癌中的阳性表达率随SACC临床分期的增高而增加。结论：CA242在腺样囊性癌中的表达与其发生和发展关系密切,CA242的表达与涎腺腺样囊性癌的组织分级有显著相关性。     

Notch信号通路相关基因的表达与涎腺腺样囊性癌转移的关系

目的筛选与涎腺腺样囊性癌转移相关的Notch信号通路基因。方法对已构建的涎腺腺样囊性癌高低转移细胞株ACC-M、ACC-2基因表达谱进行生物信息学分析,在与Notch信号通路基因进行比对后,筛选出差异基因,通过荧光实时定量PCR技术对相关基因的表达差异进行初步验证。结果涎腺腺样囊性癌的表达谱中有46个基因与Notch信号通路有关。验证发现,Notch-1,Notch-2,Notch-4,CHUK,FOXC1,FZD2,FZD3,GBP2和RUNX1在2个细胞株中的表达差别有统计学意义（P〈0．05）,同时Notch-1在发生转移的涎腺腺样囊性癌中的表达明显高于未发生转移的涎腺腺样囊性癌（P〈0．05）。结论Notch信号通路中的多个基因可能参与了涎腺腺样囊性癌的发生和发展;Notch-1的表达与涎腺腺样囊性癌的发生、转移密切相关。     

53例涎腺腺样囊性癌MMP—2和MMP—9表达与神经浸润和淋巴结转移的关系

目的研究涎腺腺样囊性癌MMP-2和MMP-9表达情况,评估其与涎腺腺样囊性癌神经浸润和淋巴 结转移的关系。方法选取53例涎腺腺样囊性癌,以抗MMP-2和MMP-9单克隆抗体用Envision法进行免疫 组织化学染色和半定量分析。结果MMP-2和MMP-9在涎腺腺样囊性癌中的表达率分别为67.92％和 79.25％;有神经浸润的腺样囊性癌其MMP-2和MMP-9的表达水平远高于无浸润者(P＜0.05,P＜0.05);随 着MMP-2和MMP-9的表达水平增高,淋巴结转移率也增高(P＜0.05,P＜0.05)。结论提示MMP-2和 MMP-9的高表达与涎腺腺样囊性癌易侵犯神经的特性及发生淋巴结转移密切相关。     

C- MYC在涎腺腺样囊性癌中的表达及意义

目的：研究原癌基因C- MYC在涎腺腺样囊性癌（SACC）中的表达及意义。方法应用免疫组化法对54例SACC和20例正常涎腺组织石蜡标本中C- MYC表达水平进行检测并比较。结果20例正常涎腺组织中C- MYC均呈阴性表达,54例SACC标本中C- MYC阳性表达43例,阳性率为79.6%,差异有统计学意义（P＜0.05）。有神经浸润、T4期C- MYC阳性率较无神经浸润、T1-3期高（P＜0.05）,C- MYC的表达与年龄、性别、肿瘤部位、组织学类型、远处转移及淋巴结转移等生物学特性的差异均无统计学意义（均P＞0.05）。结论原癌基因C- MYC在SACC中高表达,与T分期及神经侵犯有关,有望成为SACC进展及预后的生物学标志之一。     

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.