Ⅳ型胶原、Ⅳ型胶原酶及TIMP-1在喉癌组织中的表达

目的：探讨Ⅳ型胶原、Ⅳ型胶原酶及组织基质金属蛋白酶抑制剂－1（TIMP－1）在喉癌组织中的表达及意义。方法：应用免疫组化方法对44例喉癌组织及22例喉癌旁正常组织中Ⅳ型胶原、Ⅳ型胶原酶（包括MMP－2和MMP－2）及TIMP－1的表达进行了检测。结果：与正常组织相比，喉癌组织中Ⅳ型胶原的表达明显降低，MMP－2、MMP－9及TIMP－1的表达明显增高，差别均有显著性意义（P＜0．01）；喉癌组织中Ⅳ型胶原表达的阳性率，有颈淋巴结转移者低于无颈淋巴结转移者（P＜0．05），Ⅲ－Ⅳ期低于Ⅰ-Ⅱ期（P＜0．05），G2－3低于G1（P＜0．01）； MMP－2表达水平，Ⅲ-Ⅳ期高于Ⅰ-Ⅱ期（P＜0．05），G2－3，高于G1（P＜0．01），N0与N1－3间无显著差别（P＞0．05）；MMP－9的表达水平，N1－3高于NP（P＜0．05），在Ⅲ-Ⅳ期与Ⅰ-Ⅱ期、G2－3与G1间无显著差别（均P＞0．05）。结论：Ⅳ型胶原、Ⅳ型胶原酶及TIMP－1的表达与喉癌进展及其肿瘤生物学行为相关。     

P16抑癌基因在鼻咽癌组织中的表达

目的：为探讨P16抑癌基因与鼻咽癌（NPC)发生发展的关系。方法：采用免疫组化法检测了74例鼻咽癌组织和20例炎性鼻咽癌组织中P16基因的表达,结果：炎性鼻咽癌组织P16阳性率（100％）显著高于鼻咽癌组织（56．76％）（P＜0．01）在Ⅰ-Ⅱ和Ⅲ-Ⅳ期中鼻咽癌P16阳性率分别为66．67％和51．06％（P＞0．05）,在无颈淋巴结转移组（73．33％）显著高于伴有颈淋巴结转移组P16阳性率（45．45％）（P＜0．05）。结论：抑癌基因P16表达可能与鼻癌的发生发展呈负相关。     

鼻咽癌中VEGF的表达及意义

目的：探讨血管内皮生长因子（Vasceelar endothelial grouth factor,VEGF)与鼻咽癌生长、发展及颈淋巴结转移的关系。方法：采用免疫组化S－P清对60例鼻咽鳞状上皮癌组织 的表达进行了检测。结果：1）鼻咽癌组织中VEGF表达与患者性别、年龄以及肿瘤的大小无关；2）VEGF表达与肿瘤临床分期有关，晚期（Ⅲ、Ⅳ期）VEGF表达（83．9％）明显高于早期（Ⅰ、Ⅱ期）VEGF表达（20．7％），P＜0．005；有颈淋巴结转移鼻咽癌中VEGF的表达（73．0％）明显高于无颈淋巴结转移者（21．7％），P＜0．005。结论：VEGF表达与鼻咽癌的发生发展及颈淋巴结转移有关，它可能是评价鼻咽癌患者预后的一项重要参考指标。     

Survivin蛋白在喉癌中的表达及临床意义

目的 探讨Survivin蛋白表达与喉癌临床病理因素的相关性。方法 采用免疫组织化学技术（SP法）对45例喉癌组织和7例正常喉黏膜组织标本进行Survivin蛋白表达情况检测。结果 喉癌组织中Survivin蛋白阳性表达率为62．2％（28／45），7例正常喉黏膜组织无Survivin蛋白表达。临床分期Ⅲ-Ⅳ期喉癌组织的Survivin蛋白阳性表达率高于Ⅰ-Ⅱ期喉癌组织（P〈0．01）；中、低分化喉癌组织的Survivin蛋白阳性表达率高于高分化喉癌组织（P〈0．01）；发生颈淋巴结转移的喉癌组织的Survivin蛋白阳性表达率高于无颈淋巴结转移的喉癌组织（P〈0．01）。结论 Survivin蛋白的表达与喉癌临床分期、病理分级和颈淋巴结转移有密切关系，它的高表达可能在喉癌的发生、发展和转移中起重要作用。     

PTEN 与 p53在鼻咽癌中的表达及意义

目的：探讨PTEN基因缺失和p53基因突变在鼻咽癌中的表达及临床意义。方法：本实验以50例鼻咽癌标本作为病例组,以50例正常子鼻咽部组织作为对照组,应用免疫组织化学技术检测二组中PTEN和p53的表达,分析其不同临床病理特征中的意义及对预后的判断价值。结果：病例组PTEN阴性24例,对照组阴性0例,两组比较差异有显著的统计学意义（P＜0．01）,Ⅲ期和Ⅳ期以及有淋巴结转移的患者PTEN 阴性比例明显高于PTEN 阳性患者,差异有有显著的统计学意义（ P＜0．01）,病例组PTEN阳性38例,对照组阳性22例,两组比较差异有显著的统计学意义（P＜0．01）,有淋巴结转移的患者p53阳性比例明显高于p53阴性患者,差异有有显著的统计学意义（ P＜0．01）。结论：PTEN基因缺失和p53基因突变与鼻咽癌发生和发展密切相关。     

非小细胞肺癌中CD44变异体表达及临床意义

目的：探讨CD44V4、V5、V6与非小细胞肺癌（Non-small cell lung cancer,NSCLC)患者的淋巴结转移及预后的关系。方法：采用免疫组化方法观察CD44V4、V5、V6在76例原发性非小细胞肺癌组织及转移淋巴结中的表达。结果：在肺癌中CD44V4、V5、V6表达鳞癌多于腺癌（P＜0．01）;在正常肺组织中无表达。淋巴结转移病例中CDV633／36（91％）表达阳性,在25例转移淋巴结中24例表达阳性（96％）。CD44V6在Ⅲ-Ⅳ期患者表达高于I－Ⅱ期患者（P＜0．01）。结论：肺癌组织CD44V6阳性表达对肿瘤的组织病理分型、淋巴结转移及临床分期方面有一定的指导意义。     

蛋白水解酶在鼻咽癌组织中的表达及意义的研究

目的 观察四种蛋白水解酶－鼻咽癌灵激酶型纤溶酶原激活物（u-PA)、基质金属蛋白酶－9（MMP－9）、组织蛋白酶D（CD）、组织蛋白酶B（CB）在鼻咽癌组织中的表达、分布情况及Ⅳ型胶原（Col Ⅳ）的分布形式,探讨鼻咽癌的浸润、转移机制,为判断鼻咽癌恶性程度和估计患者的预后提供可行性指标,也为鼻咽癌患者应用蛋白酶抑制剂进行新型辅助治疗方法提供理论基础和客观依据。方法 以单因素设计从疗前鼻咽癌104例中随机化抽取病例作为实验组,随机抽取慢性鼻咽炎30例作为对照组,以免疫组织化学的方法检测鼻咽癌组织中u-PA、MMP－9、CD、CB及ColⅣ表达及分布情况。结果 （1）u-PA、MMP－9、CD、CB阳性表达率在鼻咽癌组织（分别为80．0％,90．2％,89．1％,100％）均高于对照组（分别为16．7％,30．0％,40．0％,86．7％）,差别有显著的统计学意义。u－PA、MMP－9阳性表达主要在癌细胞中CD、CB阳性表达主要见于间质细胞中。（2）鼻咽癌组织中u-PA阳性表达率以及u-PA、MMP－9表达级别在Ⅲ-Ⅳ期较I－Ⅱ期高,有颈部淋巴结转移较无转移高,差别均具有统计学意义。（3）MMP－9阳性表达率、CD、CB表达与TNM分期和颈淋巴结转移无显著关系,u-PA、MMP－9、CD、CB表达与患者的性别、年龄、肿瘤生长方式无关。（4）u-PA、MMP－9、CD、CB实质和间质的表达无明显相关性。（5）鼻咽癌组织癌巢周围未ColⅣ包绕,癌间质中ColⅣ均呈崩解缺失型。结论 鼻咽癌组织中u-PA、MMP－3、CD、CB呈高水平表达,它们在鼻咽癌扩散中可能起重要作用,其中鼻咽癌细胞的u-PA、MMP-9表达与病期进展和颈部淋巴结转移关系密切,这二者均可作为判断鼻咽癌的恶性程度和估计患者预后的可行指标。     

753基因在鼻咽癌组织中的表达

目的观察鼻咽癌组织中P53基因表达情况及其与主要临床指标间的关系。方法免疫组化检测54例鼻咽癌组织,13例鼻咽部慢性炎性组织中P53蛋白的表达情况。结果鼻咽癌组织中P53蛋白的阳性表达率为75．9％,明显高于慢性鼻咽炎组织的7．7％。不同性别P53表达无显著差别。但鼻咽癌伴颈部淋巴结转移组P53表达阳性率（90．0％）明显高于无颈部淋巴结转移组（58．3％）。结论鼻咽癌组织中存在P53蛋白异常表达,P53阳性的鼻咽癌患者较易发生颈部淋巴结转移。     

上皮型钙粘蛋白在宫颈癌中的表达及其临床意义

目的：探讨在宫颈癌发生，发展及转移过程中E-cd的表达及其临床意义。方法：选取我院1995年2月－1999年4月从未接受过放射治疗，化学治疗及其他特殊治疗的宫颈癌患者标本60例，其中经手术切除的I－II期宫颈癌标本37例，Ⅲ-Ⅳ期宫颈癌活检标本23例，同期选取正常宫颈上皮组织标本10例，宫颈上皮内瘤样病变（CIN）标本14例，要用免疫组织化学SP法观察各组织标本E－cd的表达，结果随着由正常宫颈组织向宫颈上皮内瘤样病变乃至宫颈癌的逐步发展，E－cd的阳性表达逐渐减弱，各组间存在显著性差异（P＜0．05），其在宫颈癌病理学分级中的阳性表达率亦有显著差异（P＜0．05），癌细胞分化越差，E－cd的阳性表达率越低，E－cd在有淋巴结转移中的阳性表达率无淋巴结转移者明显降低（P＜0．05），此外E－cd的阳性表达率与宫颈癌的临床分期 有关，I－II期宫颈癌中E－cd的阳性表达率显著高于Ⅲ-Ⅳ期者（P＜0．05），结论：E－cd在宫颈癌的发生，发展及转移过程中发挥着重要作用。     

MMP-2、MMP-9在鼻咽癌组织中表达的免疫组化研究

目的探讨基质金属蛋白酶2、9（MMP-2、MMP-9）在鼻咽癌组织中的表达及其意义。方法应用免疫组化S-P法检测MMP-2、MMP-9在正常对照组（7例）和鼻咽癌（45例）组织中的表达，45例鼻咽癌患者中发生颈部淋巴结转移有24例，其中I～Ⅱ期21例，Ⅲ～Ⅳ期24例。结果鼻咽癌组织中MMP-2和MMP-9的阳性率明显高于正常对照组（P〈0．05），其中淋巴结转移组阳性率比无淋巴结转移组表达明显增高（P〈0．05）。在鼻咽癌标本中还发现癌巢周边的成纤维细胞、癌周浸润的单核细胞、淋巴细胞以及血管内皮细胞中也有MMP-2和MMP-9的表达。结论MMP-2、MMP-9可能在鼻咽癌发生发展和突破基底膜向外扩散及淋巴结转移中起到重要作用。     

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.