增殖细胞核抗原在肝癌及癌旁组织中的表达

①目的探讨增生结节、肝硬变与肝癌之间的关系。②方法应用免疫组织化学方法检测了７０例肝癌及癌旁组织中增殖细胞核抗原（ＰＣＮＡ）的表达。③结果肝癌组织中ＰＣＮＡ阳性表达明显高于癌旁组织（χ２＝６．６９，Ｐ＜０．０５）；在癌旁组织中，增生结节ＰＣＮＡ阳性表达显著高于肝硬变及正常肝组织（χ２＝８．４５，Ｐ＜０．０５），而后两者间ＰＣＮＡ表达差异无显著性（χ２＝０．００２，Ｐ＞０．０５）。④结论增生结节与肝硬变是两种不同性质的细胞群体。肝硬变仍为成熟的细胞，而增生结节可以持续增殖，甚至转变为癌。     

癌基因相关分子在胃粘膜良恶性病变中的检测

目的：探索胃粘膜癌变的病理学指标,为更有效地防治这类病变提供可靠依据。方法：对胃粘膜良恶性病变（共１２０例）,用免疫组织化学ＬＳＡＢ法检测生物素化的菜豆凝集素受体（ＰＨＡＲ）、ｐ５３ 蛋白及增殖细胞核抗原（ＰＣＮＡ）的表达。结果：（１）ＰＣＮＡ在正常胃粘膜组阳性率最低,与各组间均有差异（Ｐ＜ ０．０００５）,随病变加重而递增。同时,强阳性率在中～重度不典型增生组与腺癌组之间有差异（Ｐ＜ ０．０５）。（２） ｐ５３蛋白在正常胃粘膜、慢性浅表性胃炎活动性（ＣＳＧ）、慢性萎缩性胃炎（ＣＡＧ）、中～重度肠化及轻度不典型增生４组阴性。中～重度不典型增生组及腺癌组阳性,二者间有差异（Ｐ＜ ０．０５）。（３）ＰＨＡＲ阳性率在正常胃粘膜组阴性,随病变程度加重逐步递增,且与各组间均有差异（Ｐ＜ ０．０５）。中～重度不典型增生组与腺癌组在ＰＨＡＲ强阳性率上有差异（Ｐ＜ ０．０５）。（４）腺癌组ＰＨＡＲ、ＰＣＮＡ、ｐ５３蛋白强阳性率三项指标之间有相关性（Ｐ＜ ０．０００５）。结论：ＰＨＡＲ的强阳性表达可作为区分中～重度不典型增生与腺癌的辅助指标。ｐ５３ 蛋白阳性,若同时伴有ＰＨＡＲ强阳性表达,是胃癌的明显标志。ＣＡＧ和中～重度肠化属早期癌     

胃癌及其癌前病变核仁组成区相关蛋白的定量研究（Ⅱ）

应用核仁组成区相关蛋白（ＡｇＮｏＲｓ）染色观察５２例不同类型肠上皮化生（简称肠化生），１１例中重度异型增生、３０例胃窦癌及４例正常胎儿胃粘膜和２０例正常胃粘膜ＡｇＮＯＲ量的变化，发现Ⅲ型肠化生ＡｇＮＯＲ计数显著高于Ⅰ、Ⅱ型肠化生（Ｐ＜０．０５）。从正常胃粘膜上皮，经肠上皮化生到中重度异型增生到胃癌，ＡｇＮＯＲ计数随细胞异型程度的加重而递增，各组间均见显著性差异（Ｐ＜０．０５）。结果表明，Ⅲ型肠化生与胃癌的发生有密切关系，具有较高ＡｇＮＯＲ计数的中重度异型增生是重要的癌前病变。     

胃良恶性病变组织中P185蛋白的表达

应用抗ｃｅｒｂＢ２癌基因蛋白（Ｐ１８５）的单克隆抗体，采用免疫组化ＡＢＣ方法，对正常胃粘膜、各级胃粘膜异型增生、早期胃癌及进展期胃癌进行研究。结果：在正常胃粘膜腺体颈部偶见Ｐ１８５蛋白的弱阳性表达；在轻、中、重度异型增生病变中Ｐ１８５蛋白的表达率分别为５０％、８３．３％、８５．７％；在早期及进展期胃癌中Ｐ１８５蛋白的表达率分别为２２．２％和５６．７％。重度异型增生表达率显著高于早期胃癌（Ｐ＜０．０５），进展期胃癌表达率显著高于早期胃癌（Ｐ＜０．０５），淋巴结转移组的表达率高于淋巴结未转移组（Ｐ＜０．０５），但Ｐ１８５蛋白的表达与胃癌组织学类型及胃癌肿块大小无相关性（Ｐ＞０．０５）。提示：Ｐ１８５蛋白有可能参与正常胃粘膜的增殖、修复及癌变过程，Ｐ１８５蛋白阳性的肿瘤可能具有更强的浸润及转移能力。     

P^16蛋白,增殖细胞核抗原在肾癌的表达及与预后的关系

目的　探讨多肿瘤抑制基因Ｐ１６／ＭＴＳ１蛋白在肾细胞癌（ＲＣＣ）的表达及与临床病理指标、预后的关系。方法　采用免疫组化方法对Ｐ１６蛋白和增殖细胞核抗原（ＰＣＮＡ）在５６例ＲＣＣ的表达进行病理观察。结果　Ｐ１６蛋白在ＲＣＣ的阳性率为６０．７％（３４／５６）,各组织学分级的阳性率差异有显著性（Ｐ＜０．０１）,其阳性组和阴性组的５年生存率差异无显著性。ＰＣＮＡ标记指数（ＰＣＮＡＬＩ）在１％～８５％,平均为１９．７％,在不同组织学分级及临床分期中差异有显著性（Ｐ＜０．０１）。ＰＣＮＡ高表达组和ＰＣＮＡ低表达组的５年生存率差异有显著性（Ｐ＜０．０５）。Ｐ１６蛋白的表达与ＰＣＮＡ无一致性（Ｐ＜０．０５）。结论　ＰＣＮＡＬＩ是反映ＲＣＣ组织分化程度及预后的良好指标,Ｐ１６蛋白的胞浆型表达对肾癌临床分期及预后无明显影响。     

大肠癌上皮c-myc蛋白、表皮生长因子受体和增殖细胞核抗原的表达及其与预后意义

应用免疫组化ＬＳＡＢ法检测ｃ－ｍｙｃ、表皮生长因子受体（ＥＧＦＲ）和增殖细胞核抗原（ＰＣＮＡ）对有随访资料的大肠癌的表达。结果提示：ｃ－ｍｙｃ阳性表达中，大肠癌（７０４９％）明显高于正常粘膜（２６６％，Ｐ＜０．０５）。正常大肠粘膜未发现ＥＧＦＲ阳性表达，而大肠癌有较高表达（７７０４％）。ＰＣＮＡ阳性表达中，大肠癌（４６４０±２６．５）％明显高于正常粘膜（１５１２±５．４４）％，Ｐ＜０．０５）。ＥＧＦＲ表达与大肠癌Ｄｕｋｅｓ分期有关（Ｐ＜０．０５）。ＰＣＮＡ表达与大肠癌分化程度及Ｄｕｋｅｓ分期有关（Ｐ＜０．０５）。大肠癌４年生存率ＥＧＦＲ和ＰＣＮＡ表达＞６５％组均明显低于＜２５％组（Ｐ＜０．０５），ＥＧＦＲ－ＬＩ和ＰＣＮＡ－ＬＩ与生存期均有明显负相关。结论表明：ｃ－ｍｙｃ、ＥＧＦＲ和ＰＣＮＡ表达与大肠癌的大肠癌细胞增殖有相关性。ＥＧＦＲ和ＰＣＮＡ表达与大肠癌的生存期均有明显负相关，该两项指标对大肠癌临床诊治和预后的评估有重要价值。     

微血管密度及细胞增殖活性与乳腺癌预后相关性研究

采用ＦⅧ相关抗原及增殖细胞核抗原（ＰＣＮＡ）抗体对５０例乳腺浸润性导管癌进行免疫组化研究。结果：癌组织内微血管密度（ＭＶＣ）与肿瘤大小，组织学分级及腋窝淋巴结转移均无相关性（Ｐ＜０．０５）。ＰＣＮＡ表达水平虽与肿瘤大小无关（Ｐ＞０．０５），但乳腺癌Ⅱ、Ⅲ级者其ＰＣＮＡ表达水平明显高于Ｉ级，并有显著差异（Ｐ＜０．０５）：腋窝淋巴结转移组其ＰＣＮＡ表达水平明显高于无淋巴结转移组，且有显著差异（Ｐ＜０．０５）。结果提示乳腺癌组织内微血管密度对评估其预后实用价值不大。ＰＣＮＡ的表达水平与乳腺癌组织学分级及腋窝淋巴结转移均有密切关系，它可作为反映乳腺癌侵袭能力的一项重要指标，对评估乳腺癌的转移和预后有辅助意义。     

PCNA在乳腺癌的表达及其与组织学分级和预后的关系

为了观察研究ＰＣＮＡ在各型乳腺癌的表达及其与组织学分级和预后的关系，应用抗ＰＣＮＡ单克隆抗体ＰＣ１０，通过免疫组化方法对６３例有随访资料的乳腺癌石蜡切片进行了检测。结果ＰＣＮＡ阳性标记率为１４‰～５７８‰。平均２３７４‰；随乳腺癌组织学分级的增高，ＰＣＮＡ阳性标记率呈增高趋势，二者显著正相关（ｒ＝０９９７５，Ｐ＜００５）；ＰＣＮＡ表达与是否有腋窝淋巴结转移及复发、死亡明显相关（Ｐ＜００５；Ｐ＜００１）。说明ＰＣＮＡ在一定程度上可作为乳腺癌恶性程度的指标，并与预后相关。     

肾癌增殖细胞核抗原和p53的表达

目的 探讨增殖细胞核抗原（ＰＣＮＡ）ｐ５３与肾癌生物学行为的关系。方法 采用免疫组化Ｓ－Ｐ法检测ＰＣＮＡ和ｐ５３在肾癌不同组织学类型，病理分级和临床分期的表达情况，结果 （１）透明细胞癌与颗粒细胞癌间ＰＣＮＡ的表达差异无显著性（Ｐ〉０．０５），梭形细胞癌ＰＣＮＡ表达强阳性；（２）ＰＣＮＡ的表达与肾癌的病理分级及临床分期相关（Ｐ〈０．０５），随着肿瘤分组和分期增高ＰＣＮＡ表达呈上升趋势，高分期组（Ⅲ     

增殖细胞核抗原与乳腺癌预后的关系（附56例临床分析）

应用免疫组织化学Ｓ－Ｐ法对５６例乳腺癌作增殖细胞核抗原的临床病理研究。结果发现ＰＣＮＡ半定量分级与乳腺癌生存期呈高度显著性负相关（Ｐ〈０．０１）；与组织学分级和淋巴结转移呈显著性正相关（Ｐ〈０．０５），乳腺癌的ＰＣＮＡ阳性表达与肿瘤大小，患者年龄，大体形态，病理分型，浸润深度无相关意义（Ｐ〉０．０５），表明ＰＣＮ表达与乳腺癌组织学分级、术后生存期有密切关系。     

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.