胃癌患者血浆24种氨基酸代谢物水平变化

目的 研究胃癌患者血浆氨基酸代谢物中是否有可作为胃癌诊断的生物标志物。方法 采用超高液相色谱串联质谱（UHPLC-MS/MS）法检测血浆24种氨基酸水平,比较胃癌患者与正常人群、胃癌患者不同分期、胃癌患者术前与术后的变化。结果 胃癌患者血浆中丙氨酸（Ala）、甘氨酸（Gly）、谷氨酸（Glu）等18种氨基酸水平均较正常对照组下降,缬氨酸（Val）、精氨酸（Arg）、丝氨酸（Ser）水平较正常对照组升高,差异均有统计学意义（P均<0.05）,对称性二甲基精氨酸（SDMA）、犬尿氨酸（Kyn）、马尿酸（HA）水平与正常对照组比较差异均无统计学意义（P均>0.05）。Ⅲ~Ⅳ期胃癌患者血浆中的Arg水平高于Ⅰ~Ⅱ期胃癌患者,谷氨酰胺（Gln）、Glu、甲硫氨酸（Met）、苯丙氨酸（Phe）水平低于Ⅰ~Ⅱ期胃癌患者,差异有统计学意义（P均<0.05）。18例胃癌患者术后血浆中亮氨酸（Leu）、Arg、瓜氨酸（Cit）水平分别较术前下降,Gln、赖氨酸（Lys）、Glu、Phe水平较术前升高,差异有统计学意义（P均<0.05）。结论 胃癌患者血浆氨基酸代谢物如Gln、Arg在胃癌早期预测中有重要意义。     

首诊尿毒症患者用串联质谱法分析血氨基酸和酰基肉碱

［摘要］目的　用串联质谱分析方法检测首次诊断尿毒症未行替代治疗患者的血氨基酸和酰基肉碱值，为临床诊疗提供依据．方法　选取30例首次诊断尿毒症患者为研究对象，即尿毒症组（研究组），健康体检者15例为对照组．利用串联质谱技术分析2组血中11种氨基酸及2种酰基肉碱数值，并分析统计数据．结果　研究组与对照组血丙氨酸（Ala）及酪氨酸（Tyr）在2组间的差异有统计学意义（P＜0.05），其中研究组显著低于正常组．血瓜氨酸（Cit）、甘氨酸（Gly）、脯氨酸（Pro）在2组间的差异有统计学意义（P＜0.05），其中研究组显著高于正常对照组．2组间有统计学差异的氨基酸以非必需氨基酸为主．血游离肉碱和总肉碱在2组间的差异有统计学意义（P＜0.05），2个指标在尿毒症患者组均显著高于正常对照组．结论　对于首次诊断尿毒症未行替代治疗患者，其血部分氨基酸代谢紊乱，并且以非必需氨基酸为主．其肉碱水平均高于正常高线，其分析结果可以为临床营养治疗提供依据．     

结直肠癌患者血清IL-37水平及与临床病理特征的关系*

目的?观察结直肠癌患者血浆白细胞介素-37（IL-37）水平及与临床病理特点及预后的关系,探讨血清IL-37在结直肠癌诊疗中的临床价值。方法?选取2017年1月—2019年1月在丽水市中心医院胃肠外科就诊的结直肠癌患者200例作为结直肠癌组,另取该院同期健康体检者200例作为对照组。采用酶联免疫吸附试验测定血清IL-37水平。结果?结直肠癌组血清IL-37水平低于对照组（P?<0.05）。结直肠癌不同临床分期患者血清IL-37水平比较,差异有统计学意义（P?<0.05）,随着临床分期升高血清IL-37水平降低。临床分期高、有淋巴结转移、有远处转移、生存时间短的患者血清IL-37水平低于临床分期低、无淋巴结转移、无远处转移、生存时间长的患者（P?<0.05）。不同年龄、性别、肿瘤位置、肿瘤类型、浸润深度及分化程度患者血清IL-37水平比较,差异无统计学意义（P?>0.05）。Cox回归单因素分析显示,不同临床分期、淋巴结转移、远处转移及IL-37水平结直肠癌患者生存期比较,差异有统计学意义（P?<0.05）。多因素分析显示,临床分期[RlR=0.043（95% CI：0.014,0.102）]、淋巴结转移[RlR=0.038（95% CI：0.016,0.097）]、远处转移[RlR=0.049（95% CI：0.013,0.120）]和IL-37水平[RlR=0.067（95% CI：0.028,0.168）]是结直肠癌患者生存的影响因素。结论?结直肠癌患者血清IL-37水平降低,血清IL-37水平与结直肠癌患者的临床分期、淋巴结转移、远处转移和预后关系密切。     

郑州市新生儿非衍生化法氨基酸和酰基肉碱参考区间的制定

目的制定符合郑州市出生新生儿的氨基酸和酰基肉碱参考区间,为诊断氨基酸代谢病、脂肪酸β氧化障碍、有机酸代谢病提供依据,为评价氨基酸和肉碱营养状态提供基础数据。方法利用非衍生化串联质谱法对2016年8月至2019年9月在郑州市出生的足月新生儿61 199例足跟血样本中氨基酸和酰基肉碱进行检测,通过SPSS 19.0软件,单样本Kolmogorov-Smirnov检验判断数据是否符合正态分布,根据是否符合正态分布来确定参考范围区间。结果郑州市新生儿遗传代谢病筛查11种氨基酸和31种肉碱为非正态分布,95%参考区间分别为(μmol·L~(-1)):丙氨酸(Ala)(191.973～525.634),精氨酸(Arg)(1.091～31.615),瓜氨酸(Cit)(8.509～26.006),甘氨酸(Gly)(292.654～936.183),亮氨酸(Leu+Ile)(112.876～292.379),蛋氨酸(Met)(11.488～36.253),鸟氨酸(Orn)(53.421～213.755),苯丙氨酸(Phe)(40.067～92.042),脯氨酸(Pro)(126.468～329.280),酪氨酸(Tyr)(55.688～244.478),缬氨酸(Val)(95.491～244.857),游离肉碱(C0)(10.218～38.323),乙酰基肉碱(C2)(8.594～38.262),丙酰基肉碱(C3)(0.703～3.918),丙二酰基肉碱(C3DC/C4OH)(0.036～0.248),丁酰基肉碱(C4)(0.092～0.332),甲基丙二酰基肉碱(C4DC/C5OH)(0.159～0.472),异戊酰基肉碱(C5)(0.057～0.257),甲基巴豆酰基肉碱(C5∶1)(0.002～0.049),戊二酰基肉碱(C5DC/C6OH)(0.054～0.227),己酰基肉碱(C6)(0.018～0.077),己二酰基肉碱(C6DC)(0.016～0.043),辛酰基肉碱(C8)(0.036～0.157),辛烯酰基肉碱(C8∶1)(0.049～0.241),癸酰基肉碱(C10)(0.034～0.182),癸烯酰基肉碱(C10∶1)(0.028～0.149),癸二烯酰基肉碱(C10∶2)(0.005～0.095),十二烷酰基肉碱(C12)(0.026～0.207),十二烯酰基肉碱C12∶1(0.013～0.150),十四烷酰基肉碱(C14)(0.070～0.316),十四烯酰基肉碱(C14∶1)(0.032～0.249),十四二烯酰基肉碱(C14∶2)(0.006～0.058),3-羟基十四烷酰基肉碱(C14OH)(0.004～0.030),十六烷酰基肉碱(C16)(0.802～5.460),十六烯酰基肉碱(C16∶1)(0.037～0.334),3-羟基十六烷酰基肉碱(C16OH)(0.007～0.053),3-羟基十六烯酰基肉碱(C16∶1OH)(0.014～0.061),十八烷酰基肉碱(C18)(0.301～1.290),十八烯酰基肉碱(C18∶1)(0.575～2.071),十八二烯酰基肉碱(C18∶2)(0.077～0.481),3-羟基十八烷酰基肉碱(C18OH)(0.003～0.024),3-羟基十八烯酰基肉碱(C18∶1OH)(0.007～0.032)。结论非衍生化法测定干血斑中氨基酸和酰基肉碱浓度,建立合理参考区间,可为郑州市新生儿群体筛查提供参考依据,更好地促进郑州市群体筛查的管理。     

早产儿游离肉碱和酰基肉碱代谢变化特点

目的 讨论早产儿肉碱代谢的特点。方法 选取2015 年4 月-2016 年12 月出生的1 992 例早产儿和 4 035 例正常足月儿血滤纸片,采用串联质谱技术检测样本中31 种肉碱含量。结果 除癸酰肉碱（C10）与癸二烯 酰肉碱（C10 ∶ 2）外,其余肉碱在早产组与正常对照组比较有差异（P <0.05）;与正常对照组比较,早产儿组 的大部分短链酰基肉碱和中链酰基肉碱血浆含量较高,大部分长链酰基肉碱含量较低。结论 早产儿肉碱代谢 水平与正常足月儿存在差异,临床医生应根据早产儿特殊的肉碱代谢水平提供住院期间的合理营养。     

PI3K/Akt/mTOR信号通路相关蛋白在结直肠癌中的表达及与临床病理特征和预后的关系*

目的?探究PI3K/Akt/mTOR信号通路中PTEN、p-Akt和p-mTOR在结直肠癌中的表达及与临床病理特征和预后的关系。方法?选取2016年1月—2017年12月中国人民武装警察部队海警总队医院52例结直肠癌活检标本。采用免疫组织化学SP法检测PI3K-Akt-mTOR信号通路相关蛋白在结肠癌标本及癌旁正常组织标本中的表达;Logistic回归模型分析PI3K-Akt-mTOR信号通路相关蛋白表达与临床病理特征的关系;Kaplan-Meier生存曲线分析PI3K-Akt-mTOR信号通路相关蛋白表达与预后的关系。结果?结肠癌组织中PTEN阳性率低于癌旁正常组织（P?<0.05）,而p-Akt、p-mTOR阳性率均高于癌旁正常组织（P?<0.05）;淋巴结转移患者的p-Akt和p-mTOR阳性率均高于无淋巴结转移患者（P?<0.05）;肿瘤浸润达到浆膜层患者的p-Akt阳性率高于未达浆膜层患者（P?<0.05）;肿瘤低分化患者的p-Akt阳性率高于高、中分化患者（P?<0.05）。临床分期Ⅲ、Ⅳ期患者的p-Akt和p-mTOR阳性率均高于Ⅰ、Ⅱ期患者（P?<0.05）。结直肠癌患者临床分期Ⅲ、Ⅳ期[OlR=4.098（95% CI：2.337,7.134）]是p-Akt阳性表达的影响因素（P?<0.05）。PTEN阳性患者的4年生存率为59.62%,高于阴性患者的21.15%（P?<0.05）;p-Akt阴性患者4年生存率为65.38%,高于阳性患者的19.23%（P?<0.05）;p-mTOR阴性患者4年生存率为61.54%,高于阳性患者的21.15%（P?<0.05）。结论?PI3K/Akt/mTOR信号通路相关蛋白的表达与结直肠癌的发展、预后密切相关,p-Akt、p-mTOR有望成为新的结直肠癌治疗靶点和临床指标。     

凝血酶激活的纤溶抑制物编码区基因位点C1040T和G505A单核苷酸多态性与脑梗死的相关性研究

目的：研究凝血酶激活的纤溶抑制物（TAFI）编码区CPB2基因位点C1040T和G505A的单核苷酸多态性与脑梗死之间的联系。方法：应用聚合酶链反应和限制性内切酶片段长度多态性分析技术（PCR-RFLP）检测98例脑梗死患者和100名正常对照者的TAFI基因编码区C1040T（Thr325Ile）、G505A（Thr147Ala）多态性分布特点。结果：CPB2基因C1040T（Thr325Ile）及G505A（Thr147Ala）2个位点的3种基因型在脑梗死组和对照组的频率分布分别为C1040C（Thr325Thr）33（33.7%）、29（29.0%）;C1040T（Thr325Ile）47（48.0%）、51（51.0%）;T1040T（Ile325Ile）18（18.3%）、20（20.0%）;A505A（Thr147Thr）15（15.3%）、43（43.0%）;G505A（Thr147Ala）44（45.0%）、19（19.0%）;G505G（Ala147 Ala）39（39.7%）、38（38.0%）。经χ2检验,基因型分布符合Hardy-Weinberg平衡,并且脑梗死组与对照组之间各种基因型频率分布差异无统计学意义（P〉0.05）。结论：TAFI编码区CPB2基因（Thr325Ile、Thr147Ala）的多态性与脑梗死的发生无明显相关性。     

结直肠癌组织中Thr187磷酸化p27kip1的表达及临床意义

目的 探讨第187位苏氨酸（Thr187）磷酸化的细胞周期素依赖性激酶抑制蛋白（p27kip1,简称p27）（P-p27Thr187）在结直肠癌发生、发展中的作用及其与结直肠癌临床病理特征的关系。方法 收集行手术切除的80例结直肠癌组织标本,以及6对新鲜结直肠癌和相应癌旁正常组织标本;采用免疫组织化学EnVision二步法和蛋白质印迹法检测结直肠癌组织及相应癌旁正常组织中P-p27Thr187和p27的表达;并分析其与结直肠癌临床病理特征的关系。结果免疫组织化学和蛋白质印迹结果均显示,P-p27Thr187在结直肠癌组织中的阳性表达率明显高于癌旁正常组织;结直肠癌组织中P-p27Thr187阳性表达率为100.0%（80/80）,高表达者52例（65.0%,52/80）,低表达者28例（35.0%,28/80）;而癌旁正常组织中P-p27Thr187阳性表达率为13.8%（11/80）,与结直肠癌组织比较差异有统计学意义（P＜0.05）;p27在结直肠癌组织中的阳性表达率为48.8%（39/80）,癌旁正常组织中为90.0%（72/80）,两组比较差异有统计学意义（P＜0.05）;P-p27Thr187阳性表达与肿瘤细胞分化程度和TNM分期有关（均P＜0.05）;P-p27Thr187表达强度与细胞增殖指标Ki-67表达强度呈正相关（r=0.487,P＜0.05）,与p27表达强度呈负相关（r=-0.394,P＜0.05）。结论结直肠癌组织中P-p27Thr187的异常表达可能参与了结直肠癌的发生、发展过程,其有助于综合评估结直肠癌的生物学行为,对结直肠癌的预后判断及诊治具有一定的参考价值。     

长链非编码RNA HSALNT0000015对结直肠癌细胞生物学行为的影响

目的 探讨长链非编码RNA（lncRNA）HSALNT0000015对结直肠癌细胞生物学行为的影响及其作用机制。方法 采用实时荧光定量聚合酶链反应（qRT-PCR）检测80例结直肠癌组织及配对的15例癌旁组织,同时检测人结直肠癌细胞（Lovo、SW480、HT-29、HCT116）和正常人肠黏膜上皮细胞HIEC中lncRNA HSALNT0000015的表达水平;将HCT116细胞分为空白组、对照组及实验组,分别不感染慢病毒、只感染空载质粒及感染sh-HSALNT0000015-慢病毒,采用MTT法检测细胞增殖能力,Transwell实验检测细胞迁移和侵袭能力,免疫印迹法检测转录因子Slug、上皮钙黏素（E-Cadherin）及波形蛋白（Vimentin）的表达。结果 结直肠癌组织lncRNA HSALNT0000015表达水平高于癌旁组织（P?<0.05）。结直肠癌细胞中lncRNA HSALNT0000015的表达水平均高于正常人肠黏膜上皮细胞（P?<0.05）。细胞培养12、24、48及72 h后,实验组光密度值（490 nm）低于空白组和对照组（均P?<0.05）。敲减lncRNA HSALNT0000015后,HCT116迁移及侵袭能力下降（均P?<0.05）,E-cadherin表达水平上升（P?<0.05）,转录因子Slug和Vimentin表达水平下降（均P?< 0.05）。结论 lncRNA HSALNT0000015可能通过上皮间质转化过程促进结直肠癌细胞迁移及侵袭。     

一个遗传性蛋白C缺陷症家系表型与基因突变分析

目的：对一个遗传性蛋白C（PC）缺陷症家系进行实验室表型检测和基因突变分析,探讨其分子发病机制。方法：对先证者及其家系成员（共3代6人）进行血浆蛋白C活性（PC:A）、蛋白C抗原（PC:Ag）含量及其他相关凝血指标检测。采用DNA直接测序法分析先证者蛋白C基因（PROC）9个外显子及侧翼序列,发现突变位点,再对其家系成员进行该位点的突变检测。用ClustalX-2.1-win软件分析氨基酸突变位点的保守性;用PolyPhen-2在线生物信息学软件分析突变对蛋白质功能的危害程度;用Swiss-PdbViewer软件和PIC程序进行蛋白模型分析。结果：先证者、其儿子和二姐的血浆PC:A与PC:Ag均平行下降,介于39%～58%。这3人的PROC基因第9外显子携带c.997G＞A杂合错义突变（p.Ala291Thr）。生物信息学软件分析提示：p.Ala291Thr为有害突变;Ala291在同源物种间不高度保守;蛋白模型分析显示：p.Ala291Thr突变导致Thr291与Pro327之间新增一氢键,改变了氨基酸的空间构型,使PC的稳定性下降。结论：该先证者PROC基因第9外显子存在c.997G＞A杂合错义突变,导致p.Ala291Thr;p.Ala291Thr为未报道过的新突变,是该家系遗传性PC缺陷症的主要原因。     

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.     

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.     

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.