34例胃肠间质瘤的临床病理分析

目的:分析探讨胃肠间质瘤(GIST)的临床病理学特征,为临床治疗提供更加可靠的参考。方法:对2013年2月至2013年12月期间在我院就诊的34例胃肠间质瘤进行常规病理及免疫组化,对CD117,CD34,SMA,S-100染色特点进行分析。结果:胃肠间质瘤主要分布在胃和小肠。34例中良性21例,低度恶性8例,恶性5例。胃肠间质瘤中有梭形细胞和上皮样细胞组成。免疫组化标记:肿瘤细胞以CD117和CD34阳性为主。结论:CD117,CD34标记阳性对胃肠间质瘤的诊断具有重要价值。     

胃肠道间质瘤21例临床病理分析

目的：探讨胃肠道间质瘤的临床病理及免疫组化特点。方法：对21例胃肠道间质瘤进行临床病理分析,并应用CD117、CD34、SMA、S-100以及V im抗体进行免疫组化染色。结果：镜下梭形细胞为主型14例（66.7%）,上皮样细胞为主型5例（23.8%）,混合细胞型2例（9.5%）。其中良性10例,潜在恶性4例,恶性7例,CD117阳性表达率85.7%（18/21）、CD34阳性率71.4%（15/21）。结论：胃肠道间质瘤是胃肠常见的间叶性肿瘤,缺乏定向分化。CD117和CD34阳性表达是诊断胃肠道间质瘤最可靠的辅助指标。     

24例胃肠道间质瘤临床病理分析

目的探讨胃肠间质瘤的病理组织学和免疫组化学特点及诊断要点。方法对24例胃肠间质瘤进行常规病理及免疫组化CD117、CD34、SMA、S-100染色特点分析。结果24例胃肠间质瘤由梭形细胞和上皮样细胞组成,其中21例CD117和18例CD34标记阳性,阳性表达率分别为87.5%和75%。结论胃肠间质瘤是胃肠常见的间叶性肿瘤,缺乏定向分化。CD117和CD34标记阳性对胃肠间质瘤的诊断具有重要价值。     

5例胃肠道间质瘤临床病理分析

目的探讨胃肠间质瘤的病理组织学和免疫组化学特点及诊断要点。方法对5例胃肠间质瘤进行常规病理及免疫组化CD117、CD34检查。结果5例胃肠间质瘤由梭形细胞和上皮样细胞组成,其中3倒CD117和2例CD34标记阳性。结论胃肪间质瘤是胃肠常见的间叶性肿瘤,缺乏定向分化。CD117和CD34标记阳性对胃肠间质瘤的诊断具有重要价值。     

胃肠间质瘤46例

目的总结胃肠间质瘤的诊断经验，以期对临床病理工作有所借鉴。方法回顾性研究一组胃肠间质瘤，HE染色，免疫组化标记Vimentin、CD117、CD34在该组肿瘤的表达情况。结果该组46例标本中Vimentin均阳性，CD117阳性45例，CD34阳性32例。结论Vimentin、CD117、CD34对胃肠间质瘤特异性表达，具有临床应用的价值。     

胃肠道间叶性肿瘤46例临床病理分析

目的:探讨胃肠道间叶性肿瘤及胃肠间质瘤的病理组织学和免疫组化学特点及诊断要点。方法:对46例胃肠间叶性瘤进行常规病理及免疫组化CD117、CD34、SMA、S-100、NSE、CD31、Desm in染色特点分析。结果:42例胃肠间质瘤由梭形细胞和上皮样细胞组成,其中36例CD117和32例CD34标记阳性,阳性表达率分别为86%和76%。结论:胃肠间质瘤是胃肠常见的间叶性肿瘤,缺乏定向分化。CD117和CD34标记阳性对胃肠间质瘤的诊断具有重要价值。     

56例胃肠间质瘤临床病理分析

目的探讨胃肠间质瘤的病理组织学和免疫组化学特点及诊断要点。方法对56例胃肠间质瘤进行常规病理及免疫组化CD117,CD34,SMA,S-100染色特点分析。结果 56例胃肠间质瘤中50例CD117和47例CD34标记阳性,阳性表达率分别为89.28%和83.93%。结论胃肠间质瘤是胃肠常见的间叶性肿瘤,缺乏定向分化。CD117和CD34标记阳性对胃肠间质瘤的诊断具有重要价值。     

18例胃肠道间质瘤临床病理研究及免疫组化分析

目的 探讨胃肠道间质瘤组织病理学形态特征和免疫组化特点。方法 对18例胃肠道间质瘤进行常规病理检查和免疫组化CD117、CD34、Vimentin、Desmin、SMA、S-100和NSE染色。结果胃肠道间质瘤由梭形细胞和上皮样细胞组成，其中良性3例，潜在恶性9例，恶性6例，绝大多数病例肿瘤细胞CD117和CD34标记阳性。结论胃肠道间质瘤是胃肠道常见的间叶源性肿瘤，缺乏定向分化。肿瘤细胞CD117和CD34标记阳性对胃肠道间质瘤的诊断具有非常重要的价值。     

胃肠道间质瘤57例临床病理及免疫组化分析

目的:探讨胃肠道间质瘤的病理和免疫组化的特点及之间的关系.方法:免疫组化标记CD117、CD34、SMA、Desmin4种抗体于胃肠道间叶源性肿瘤,确诊57例间质瘤,对其进行临床病理组织学和免疫组化分析.结果:免疫组化显示57例GIST中CD117阳性表达率为98.25%,CD34的阳性表达率为78.95%;SMA的阳性表达率为35.09%;Desmind的阳性表达率为1.75%.结论:CD117、CD34对胃肠间质瘤特异性表达,具有临床应用价值.免疫组化CD117、CD34阳性表达是确诊间质瘤最有价值的依据,但间质瘤的预后判断仍需结合肿瘤的大体、核分裂数及原发部位及生物学行为等综合考虑.     

18例胃肠道间质瘤临床病理研究及免疫组化分析

目的探讨胃肠道间质瘤组织病理学形态特征和免疫组化特点。方法对18例胃肠道间质瘤进行常规病理检查和免疫组化CD117、CD34、Vimentin、Desmin、SMA、S-100和NSE染色。结果胃肠道间质瘤由梭形细胞和上皮样细胞组成,其中良性3例,潜在恶性9例,恶性6例,绝大多数病例肿瘤细胞CD117和CD34标记阳性。结论胃肠道间质瘤是胃肠道常见的间叶源性肿瘤,缺乏定向分化。肿瘤细胞CD117和CD34标记阳性对胃肠道间质瘤的诊断具有非常重要的价值。     

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.