COX-2、VEGF-C、Ki67及高危型HPV在宫颈病变中的表达

目的探讨COX-2、VEGF-C、Ki67在宫颈癌(CC)及癌前病变(CIN)组织中的表达及其与高危型HPV感染的相关性,进一步探讨其在宫颈癌发生发展中的意义。方法采用免疫组织化学SABC法检测100例宫颈石蜡切片中COX-2、VEGF-C、Ki67的表达,并于术前采用HC-Ⅱ法检测患者高危型HPV感染情况。结果 (1)COX-2、VEGF-C、Ki67在CC及CIN中的表达水平均高于慢性宫颈炎组织,差异有统计学意义(P0.05);三者在宫颈癌组织中的表达水平与高危型HPV正相关(P0.05);(2)COX-2、VEGF-C分别在CIN1和CC中表达率最高,与其他组差异有统计学意义(P0.05);(3)高危型HPV在CC及CIN中的阳性率均高于慢性宫颈炎组织,差异有统计学意义(P0.05)。结论高危型HPV可能通过诱导宫颈上皮高表达COX-2、VEGF-C而促使宫颈癌发生发展。     

cFLIP在不同宫颈病变组织中的表达及临床意义

目的:研究cFLIP在宫颈癌、宫颈上皮内瘤变(CIN)、慢性宫颈炎组织中的表达及临床意义.方法:应用免疫组化染色(SP)法检测40例宫颈癌、45例CIN、15例慢性宫颈炎和10例正常宫颈组织中eFLIP的表达情况,并对宫颈癌的病理类型、分化程度、临床分期和是否有淋巴结转移等生物学行为进行相关性分析.结果:①宫颈癌组、CIN组、慢性寓颈炎组及正常宫颈组织中cFLIP的阳性表达率分别为95.00%、68.88%、20.00%、10.00%.宫颈癌组、CIN组与正常宫颈组三组间两两相比,均具有显著性差异(均P<0.05).慢性宫颈炎组与正常宫颈组相比,无显著性差异(P>0.05).②CIN Ⅰ组、CINⅡ组与宫颈癌组相比,具有显著性差异(P<0.05).CINⅢ组与宫颈癌组相比,无显著性差异(P>0.05).③cFLIP的阳性表达率与宫颈癌的病理类型、分化程度、淋巴结转移及临床分期无关(P>0.05).结论:cFLIP与宫颈癌的发生、发展密切相关,可能成为治疗宫颈癌的潜在靶点.     

COX-2在宫颈病变中的表达及其与高危型HPV感染的相关性

目的研究COX-2在宫颈癌及癌前病变（CIN）组织中的表达及其与高危型HPV感染的相关性,探讨其在宫颈癌发生发展中的意义。方法采用免疫组织化学SABC法检测100例宫颈石蜡标本中COX-2的表达,并于术前采用HC-Ⅱ法检测患者高危型HPV感染情况。结果 （1）COX-2和高危型HPV在宫颈癌及CIN中的表达水平均高于慢性宫颈炎组织,差异有统计学意义（P〈0.05）;（2）在宫颈癌及CIN中COX-2表达水平和高危型HPV感染率呈正相关（P〈0.05）。结论高危型HPV可能通过诱导宫颈上皮高表达COX-2而促使宫颈癌发生发展。     

宫颈癌及癌前病变组织中COX-2mRNA的表达及临床意义

目的为寻找宫颈癌早期的基因诊断指标及基因治疗方法提供依据。方法应用半定量RT—PCR方法检测宫颈癌及宫颈癌前病变组织中的COX-2mRNA的表达水平。结果COX-2mRNA在宫颈癌中的表达率和相对含量高于宫颈CINⅢ及原位癌和慢性宫颈炎组织。其在宫颈CINⅢ及原位癌和慢性宫颈炎组织中的表达率及相对含量比较均无明显差异（P〉0．05）。结论宫颈癌组织、宫颈CINⅢ及原位癌组织中存在COX-2的表达,COX-2mRNA的表达与癌早期的形成、分期、分化无明显关系（P〉0．05）,与淋巴结转移有显著性差异（P〈0．05）。     

P16、△NP63在宫颈上皮内瘤变及宫颈癌组织中的表达及相关性研究

目的 探讨P16、△NP63蛋白在宫颈上皮内瘤变及宫颈癌组织中的表达、意义及其相关性.方法 采用免疫组化SP法检测42例宫颈鳞癌,90例宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN),25例慢性宫颈炎组织石蜡切片中P16、△NP63蛋白的表达.结果 (1)从慢性宫颈炎组织、CIN到宫颈鳞癌,P16、△NP63的表达均递增,差异有统计学意义(P＜0.01).(2) P16蛋白表达与宫颈癌患者的年龄、临床分期及癌细胞分化程度无关,△NP63蛋白表达与宫颈癌患者年龄、临床分期无关,与癌细胞分化程度呈负相关,在分化程度差的肿瘤组织中表达增高(P＜0.05).(3)在CIN和宫颈鳞癌中,P16与△NP63蛋白表达呈正相关(rs=0.6226,P＜0.01).结论 P16、△NP63参与了CIN、宫颈鳞癌的发生、发展,其免疫组化检测对宫颈癌的早期诊断有参考价值.     

HPV16E7基因和P16~(INK4A)蛋白在宫颈病变中的表达及其临床意义

目的:检测宫颈病变组织中HPV16E7基因和P16INK4A蛋白的表达,分析基因表达变化的临床意义。方法:入选慢性宫颈炎和CINⅠ^Ⅱ患者81例、CINⅢ、宫颈浸润性鳞癌患者57例,采用PCR扩增技术检测宫颈病变组织HPV16E7基因表达,采用免疫组化方法检测宫颈病变组织P16INK4A蛋白表达,用SPSS软件行等级相关分析和χ2检验。结果:⑴HPV16E7特异性片段阳性率在慢性宫颈炎、CINⅠⅡ患者81例、CINⅢ、宫颈浸润性鳞癌患者57例,采用PCR扩增技术检测宫颈病变组织HPV16E7基因表达,采用免疫组化方法检测宫颈病变组织P16INK4A蛋白表达,用SPSS软件行等级相关分析和χ2检验。结果:⑴HPV16E7特异性片段阳性率在慢性宫颈炎、CINⅠ^Ⅱ中分别为17.0%、26.5%,在CINⅢ及宫颈浸润性鳞癌中分别为61.5%和74.2%;HPV16E7分布在慢性宫颈炎、CINⅠⅡ中分别为17.0%、26.5%,在CINⅢ及宫颈浸润性鳞癌中分别为61.5%和74.2%;HPV16E7分布在慢性宫颈炎、CINⅠ^Ⅱ和CINⅢ、宫颈浸润性鳞癌间差异具有统计学意义(P<0.001);⑵P16INK4A蛋白的表达在慢性宫颈炎、CINⅠⅡ和CINⅢ、宫颈浸润性鳞癌间差异具有统计学意义(P<0.001);⑵P16INK4A蛋白的表达在慢性宫颈炎、CINⅠ^Ⅱ分别为10.6%和30.0%,在CINⅢ和宫颈浸润性鳞癌中分别为96.0%和100%;P16INK4A蛋白的表达在慢性宫颈炎、CINⅠⅡ分别为10.6%和30.0%,在CINⅢ和宫颈浸润性鳞癌中分别为96.0%和100%;P16INK4A蛋白的表达在慢性宫颈炎、CINⅠ^Ⅱ和CINⅢ、宫颈浸润性鳞癌间差异具有统计学意义(P<0.001);⑶在HPV16E7特异性片段表达阳性的宫颈病变组织中,P16INK4A蛋白的表达均是阳性。宫颈病变组织中P16INK4A蛋白与HPV16E7的表达有相关性(r=0.482,P<0.001)。结论:HPV16E7和P16INK4A蛋白与宫颈上皮内瘤变和宫颈癌的发生具有相关性,HPV16E7和P16INK4A蛋白可能是宫颈上皮内瘤变和宫颈癌的早期预测指标。     

宫颈病变进程中的SPARC蛋白表达及其临床意义

目的 探讨富含半胱氨酸的酸性分泌蛋白 (secreted protein acidic and rich in cysteine,SPARC)表达水平与宫颈病变进程的关系及其临床意义.方法 收集宫颈炎、宫颈内上皮瘤样病变(CIN)及宫颈鳞癌患者的石蜡包埋组织标本107例,采用免疫组织化学SP法检测SPARC蛋白表达水平.结果 SPARC蛋白在宫颈间质细胞内表达,在宫颈炎的表达水平很低(23%),随着CINⅠ～Ⅱ和CINⅢ病理进程呈梯度性增高(35%和61%),在所有的宫颈癌标本中可以检出SPARC蛋白(100%),宫颈炎组和CINⅠ～Ⅱ组之间的表达差异无统计学意义,其他各组之间的表达差异均有统计学意义(P＜0.05).宫颈鳞癌中SPARC蛋白的表达差异与宫颈鳞癌的病理分化程度之间无统计学意义(P＞0.05).结论 SPARC蛋白表达水平的上调可能是宫颈病变进程的分子标志,这为揭示宫颈癌发病机制及建立临床评估体系提供了重要依据.     

HPV16-E6、P53、BTG1在子宫颈疾病中的表达及意义

目的：探讨HPV16-E6、P53、BTG1在宫颈鳞癌、高度鳞状上皮内病变（HSIL）、慢性宫颈炎等子宫颈疾病中的表达及其临床意义。方法：收集宫颈鳞癌35例、HSIL 53例、慢性宫颈炎44例的病理组织,采用RQ-PCR检测HPV16-E6、P53、BTG1转录水平的表达,Western Blot检测HPV16-E6、P53、BTG1蛋白水平的表达,分析其表达与子宫颈病变的关系。结果：在宫颈鳞癌、HSIL、慢性宫颈炎组织中,BTG1、P53两者mRNA及蛋白的表达均随病理级别的降低而逐渐升高,差异有统计学意义（P<0.05）;宫颈鳞癌、HSIL组织中HPV16-E6 mRNA及蛋白的表达均明显高于慢性宫颈炎,差异有统计学意义（P<0.01）,而宫颈鳞癌与HSIL组织中HPV16-E6 mRNA及蛋白的表达差异无统计学意义（P>0.05）。结论：HPV16-E6、P53、BTG1的表达可能与宫颈癌的发生、发展相关,并在宫颈癌发生的早期已经发生了变化,可能是宫颈癌诊断和治疗的新靶点。     

COX-2在宫颈癌变中的表达及其意义

目的 研究环氧合酶-2(cyclooxygenase-2,COX-2)在宫颈癌及癌前病变中的表达情况,探讨COX-2在宫颈上皮癌变发生发展及侵袭转移中的作用.方法 采用免疫组织化学S-P法检测COX-2蛋白在宫颈正常组织、慢性炎症、宫颈上皮内瘤变(cervical intraepithelial nioplasia,CIN)、宫颈浸润癌(invasive cervical cancer,ICC)中的表达情况.结果 COX-2在正常宫颈、宫颈炎、CIN、ICC各组中阳性表达率分别为0%、36.99%、38.46%、64.44%,4组比较差异有统计学意义(P<0.01).经χ2分割后比较(α′=0.007 143),ICC组、CIN组、宫颈炎组的阳性率显著高于正常宫颈组.ICC组阳性率显著高于宫颈炎组.COX-2与淋巴结转移、宫旁或脉管浸润及肌层浸润深度呈显著性相关(P<0.05).结论 COX-2在正常宫颈向宫颈癌变过程中阳性率逐渐增高,COX-2蛋白对宫颈癌的早期诊断有一定价值,选择性COX-2抑制剂对于宫颈癌及其癌前病变的防治有一定的应用前景.     

过氧化物酶体增殖物激活受体γ(PPAR-γ)在宫颈癌中的表达及意义

目的观察过氧化物酶体增殖物激活受体γ(PPAR-γ)在宫颈癌中的表达状况,探讨其临床意义。方法利用组织芯片技术和免疫组织化学技术检测70例宫颈癌标本、26例宫颈上皮内瘤变标本和同期26例慢性宫颈炎标本中PPAR-γ表达状况并分析其与分化程度等临床病理指标关系。结果70例宫颈癌标本中PPAR-γ表达阳性38例(54.29%),26例宫颈上皮内瘤变表达阳性7例(26.92%)、26例慢性宫颈炎标本中表达阳性1例(3.85%)。三者比较具有极显著的统计学差异(P<0.01)。PPAR-γ高表达与宫颈癌患者的年龄、临床分期和组织学类型均无相关性(P>0.05);与分化程度、淋巴转移均有差异(P<0.05)。结论PPAR-γ在宫颈癌中的表达高于宫颈上皮内瘤变和慢性宫颈炎,在宫颈癌的发病机制中可能具有重要的作用,PPAR-γ基因的激活有望成为宫颈癌治疗的一个新途径。     

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.