食管癌变过程中PLCE1蛋白的表达

目的探讨PLCE1蛋白的表达变化与食管鳞状细胞癌(esophageal squamous cell carcinoma,ESCC)发生的关系。方法选择138例ESCC患者手术切除标本的正常、癌旁及癌组织,采用免疫组织化学ABC法检测PLCE1蛋白的表达。结果 PLCE1蛋白在正常食管鳞状上皮、癌前病变和癌组织中的阳性表达率分别为41%、82%和83%(P<0.05);高发区/低发区及家族史阳性/家族史阴性亚组分析PLCE1蛋白阳性表达率无差异(P>0.05)。结论 PLCE1蛋白和ESCC癌变有关,PLCE1可能作为致病基因促进ESCC的发生发展。     

葡萄糖调节蛋白78和基质金属蛋白酶在口腔鳞状细胞癌中的表达

目的 探讨葡萄糖调节蛋白78 (GRP78)和基质金属蛋白酶(MMPs)在口腔鳞状细胞癌组织中的表达及意义,阐明GRP78在口腔鳞状细胞癌发生、发展中的作用.方法 采用免疫组织化学方法检测26例口腔鳞状细胞癌组织和10例正常口腔组织中GRP78蛋白的表达;采用逆转录PCR检测正常口腔组织和口腔鳞状细胞癌组织中GRP78 mRNA的表达;采用免疫组织化学方法检测26例口腔鳞状细胞癌组织中MMP-2和MMP-9蛋白的表达.结果 GRP78蛋白在口腔鳞状细胞癌组织中的阳性表达率为100％(26/26),在正常口腔组织中的阳性表达率为20％(2/10),两者比较差异有统计学意义(P＜0.01);与高分化和中分化口腔鳞状细胞癌组织比较,低分化口腔鳞状细胞癌组织中的GRP78蛋白阳性表达强度明显增高(P＜0.05).与正常口腔组织比较,GRP78 mRNA表达水平在口腔鳞状细胞癌组织中的表达增高(P＜0.05).MMP-2和MMP-9蛋白在口腔鳞状细胞癌组织中的阳性表达率均为100％(26/26).结论 GRP78和MMPs在口腔鳞状细胞癌组织中表达明显升高,提示口腔鳞状细胞癌中GRP78蛋白的表达可能与肿瘤的侵袭和转移相关.     

ZEB1的表达与肺鳞状细胞癌侵袭及转移的关系

目的：探讨锌指E-盒结合同源异形盒-1 (ZEB1)在肺鳞状细胞癌组织中的表达,分析ZEB1 mRNA和蛋白的表达水平与肺鳞状细胞癌侵袭及转移的关系。方法：选择45例肺鳞状细胞癌行外科手术切除的患者,根据所取组织与肿瘤的距离不同分为肺鳞状细胞癌组织和癌旁正常肺组织,采用RT-PCR和Western blotting方法检测肺鳞状细胞癌组织和癌旁正常肺组织中ZEB1 mRNA和蛋白的表达情况,并分析肺鳞状细胞癌不同临床病理特征ZEB1 mRNA和蛋白的表达差异;构建ZEB1特异性siRNA载体,感染肺癌NCI-H2170细胞,设未转染对照组、转染照组和ZEB1 siRNA转染组,应用Western blotting方法从蛋白质水平检测各组干扰质粒对ZEB1基因的干扰效果,通过Transwell侵袭小室观察各组NCI-H2170细胞侵袭能力的变化。结果： ZEB1 mRNA在肺鳞状细胞癌组织中的阳性表达率显著高于癌旁正常肺组织（P＜0.05）;在淋巴结转移、远处转移阳性者肺癌组织中的阳性表达率显著高于其在淋巴结转移、远处转
移阴性者肺癌组织中的表达（P<0.05）;但ZEB1 mRNA的表达与肺鳞状细胞癌患者的性别、年龄及肿瘤大小及分化程度无关(P>0.05)。肺鳞状细胞癌组织中ZEB1蛋白的表达与ZEB1 mRNA的表达结果类似,ZEB1蛋白在肺鳞状细胞癌组织中的表达量显著高于癌旁正常肺组织（P<0.05）;在淋巴结转移和远处转移阳性者癌组织中的表达显著高于其在淋巴结转移和远处转移阴性者癌组织中的表达（P<0.05）。下调NCI-H2170细胞中ZEB1蛋白的表达后,NCI-H2
170细胞的侵袭及转移能力明显降低（P<0.05）。结论：ZEB1在肺鳞状细胞癌组织中高表达,表达变化与肺鳞状细胞癌的病理特征密切相关;运用RNA干扰技术有效沉默NCI-H2170细胞的ZEB1基因后,可显著降低NCI-H2170细胞的侵袭及转移能力,提示ZEB1在肺癌的发生发展中起重要作用,抑制ZEB1的表达可能成为一种治疗肺癌的方法。
     

食管鳞状细胞癌组织中自噬基因Beclin 1蛋白的表达

目的:探讨食管鳞状细胞癌组织中Beclin 1蛋白的表达与临床病理因素之间的关系.方法:应用免疫组织化学SP法检测50例食管鳞状细胞癌和其中30例相应的癌旁正常食管上皮组织中Beclin 1蛋白的表达.结果:30例正常食管上皮组织中Beclin 1阳性表达率为100%,高于食管鳞状细胞癌组织的30%(9/30)(χ2=19.050,P<0.001).50例食管鳞状细胞癌组织中Beclin 1蛋白的表达与淋巴结转移和病理分期有关(χ2分别为13.286,4.836,P均<0.05).结论:Beclin 1与食管鳞状细胞癌的发生发展有关.     

磷脂酶Cε1蛋白在不同部位胃癌细胞中的表达

目的:观察磷脂酶Cε1(PLCE1)在不同部位胃癌组织中的表达,探讨PLCE1在不同部位胃癌组织中的表达情况及PLCE1与胃癌生物学特征的关系。方法:采用免疫组化sp法测定60例贲门部胃癌组织(贲门癌)、60例胃窦部胃癌(胃窦癌)组织和30例正常胃粘膜组织中PLCE1的表达情况。结果:PLCE1在贲门癌组织中阳性表达率为73.3%,高于在胃窦癌组织中的表达率51.7%,高于在正常胃粘膜组织的表达率16.7%;PLCE1在胃窦癌组织中的表达率高于正常胃粘膜组织中的表达率。贲门癌与胃窦癌组织PLCE1的表达与淋巴结转移、原发肿瘤侵润深度及分化程度均有关(P<0.05),与性别、年龄均无关(P>0.05)。结论:PLCE1在贲门癌与胃窦癌的表达率不同,其表达率在不同病理分期中存在差异。     

端粒酶活性与口腔鳞状细胞癌的相关性

目的 :探讨端粒酶在口腔鳞状细胞癌中的表达及其与口腔鳞状细胞癌发生发展的关系。方法 :采用端粒重复序列扩增 (telomericrepeatamplificationprotocol,TRAP)方法检测 30例口腔鳞状细胞癌患者术后标本中的病变组织及其癌旁正常组织 ,并分析其与临床病理的相关性。结果 :30例口腔鳞状细胞癌组织中端粒酶阳性表达率为 73.3% (2 2 / 30 ) ,而 30例癌旁正常组织中无 1例表现出端粒酶阳性。T1～T2 期 2 1例中端粒酶阳性表达率为 6 1.9% (13/ 2 1) ;T3 ～T4期 9例均为端粒酶阳性表达 (10 0 % )。 30例口腔鳞状细胞癌样本中Ⅰ级17例 ,端粒酶阳性表达率为 5 8.8% (10 / 17) ;Ⅱ级 8例 ,端粒酶阳性表达率为 87.5 % (7/ 8) ;Ⅲ级 5例 ,均表达出端粒酶阳性 (10 0 % )。口腔鳞状细胞癌组织端粒酶活性的阳性率明显高于癌旁正常组织 (P <0 .0 5 ) ,且端粒酶活性与口腔鳞状细胞癌的临床分期及病理分级呈正相关 (P <0 .0 5 )。结论 :端粒酶活性表达在口腔鳞状细胞癌发病机制中具有重要作用 ,同恶性肿瘤的整个病程有关 ,与其恶性程度、浸润能力有相关性 ,可作为判断预后有价值的指标之一。     

食管鳞状细胞癌组织中MTA1和E-cadherin蛋白的表达

目的:探讨MTA1和E-cadherin蛋白的表达与食管鳞状细胞癌浸润转移关系.方法:采用免疫组织化学SP法分别检测49例食管鳞状细胞癌组织及49例正常食管黏膜组织中MTA1和E-cadherin蛋白的表达.结果:食管鳞状细胞癌组织中MTA1蛋白阳性表达率(71.4%)高于正常食管黏膜组织(22.4%,P＜0.05),而E-cadherin蛋白阳性表达率(34.7%)低于正常黏膜组织(65.3%,P＜0.05).MTA1和E-cadherin蛋白的表达均与食管鳞状细胞癌的浸润、转移密切相关(P＜0.05).结论:MTA1和E-cadherin蛋白表达与食管鳞状细胞癌的发展密切相关,2者联合检测可望成为判断食管鳞状细胞癌患者预后的重要指标.     

抑癌因子PTEN在喉鳞癌组织中的表达

目的: 观察喉鳞状细胞癌组织中与张力蛋白同源第10q23.3染色体丢失的磷酸酶基因(PTEN)的表达,探讨PTEN在喉鳞状细胞癌中的作用. 方法: 收集喉鳞状细胞癌标本41例(其中有淋巴结转移者11例)和20例正常软腭黏膜组织,用免疫组织化学染色法探测PTEN的表达情况. 结果: 喉鳞状细胞癌中PTEN表达阳性率为58.54%(24/41),显著低于正常软腭黏膜组织阳性率90%(18/20),PTEN在喉鳞状细胞癌中阳性率与淋巴结转移有关(P<0.05),未见与组织分化、临床分期和年龄相关(P>0.05).结论: PTEN在喉鳞状细胞癌组织中的低度表达在喉鳞状细胞癌发展中可能起重要作用.     

PLCE1蛋白在新疆哈萨克族食管鳞癌中的表达及意义

目的:探讨PLCE1蛋白在新疆哈萨克族食管鳞癌中的表达及意义.方法:选取50例未经放化疗的诊断明确的哈萨克族食管鳞癌患者手术切除的癌组织及50例癌旁相对正常食管组织为研究对象,通过组织芯片技术及免疫组织化学技术,检测PLCE1蛋白在上述组织中的表达情况,并对数据行统计学分析.结果:(1) PLCE1蛋白的表达在食管鳞癌组织和癌旁相对正常食管组织存在差异(x2=12.981,P=0.001);(2) PLCE1蛋白的表达在食管鳞癌Ⅱ期和Ⅲ期间的差异具有统计学意义(x2=5.640,P=0.018);(3) PLCE1蛋白的表达在不同性别、年龄、分化程度及淋巴结转移组间无差异.结论:PLCE1蛋白的表达可能是哈萨克族食管鳞癌发生中重要的分子事件,与哈萨克族食管鳞癌的进展和预后可能相关.     

Erbin在肺鳞状细胞癌组织中的表达及其与患者预后的关系

目的探讨Erbin在肺鳞状细胞癌中的表达及其与患者预后的关系。方法对手术切除的80例肺鳞状细胞癌组织、80例癌旁正常肺组织的临床特征及生存资料进行回顾性分析。采用免疫组织化学法检测Erbin在肺鳞状细胞癌组织、癌旁正常肺组织中的表达情况,分析其与肺鳞状细胞癌的相关性,并采用Cox回归模型探讨影响患者预后的相关因素。结果肺鳞状细胞癌组织Erbin阳性率明显高于癌旁正常肺组织(P＜0.05)。肺鳞状细胞癌组织Erbin的阳性表达与肿瘤分化类型、肿瘤浸润深度、临床TNM分期、淋巴结转移相关(P＜0.05)。Erbin表达阴性患者术后1、3、5年生存率均明显高于Erbin表达阳性患者(P＜0.001)。不同分化类型、临床肿瘤TNM分期、是否伴有淋巴结转移、肿瘤浸润深度、是否Erbin阳性表达的肺鳞状细胞癌患者生存率比较差异有显著性(P＜0.05)。临床分期高(Ⅲ期)、伴有淋巴结转移、浸润深度＞深层肌肉层、分化类型(高分化)、Erbin表达(阳性)等因素为肺鳞状细胞癌患者预后的独立危险因素(P＜0.05)。结论Erbin阳性表达肺鳞状细胞癌恶性程度高、肿瘤浸润深、多为高分化类型,Erbin阳性表达肺鳞状细胞癌患者易发生淋巴结转移,临床分期高,生存率低,预后较差。     

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.