肺癌组织中血管内皮生长因子受体Flt1及KDR的表达及其与肿瘤转移和预后的关系

①目的　探讨肺癌中血管内皮生长因子受体Flt1、KDR的表达与其转移及预后的关系。②方法　应用免疫组织化学PowerVisionTM PV90 0 0法 ,测定 75例肺癌标本中Flt1、KDR的表达。③结果　肺癌组织中Flt1、KDR的表达较为广泛 ,主要位于肿瘤细胞胞浆及胞膜上 ,纤维母细胞和血管内皮细胞胞浆中亦有表达。Flt1、KDR在肿瘤细胞中的阳性率均显著高于在间质纤维母细胞中的表达 (χ2 =6 .0 7、5 .88,P <0 .0 5 )。肿瘤细胞及纤维母细胞中该两种受体的阳性率在不同年龄、不同性别及不同病理类型、不同病理分级之间差异均无显著性 (χ2 =0 .0 1～4 .84 ,P >0 .0 5 ;P =0 .2 9～ 0 .79)。肿瘤细胞中Flt1、KDR的阳性表达率在 3组不同大小的肿瘤间差异均有显著性(χ2 =1 0 .35、7.2 9,P <0 .0 5 ) ,而纤维母细胞中差异均无显著性 (χ2 =2 .86、2 .5 6 ,P >0 .0 5 ) ;肿瘤细胞及纤维母细胞中Flt1、KDR的阳性率在淋巴结有、无转移两组间的差异均有显著性 (χ2 =4 .72～ 9.32 ,P <0 .0 5 ) ,在 3组不同术后生存时间病人间亦均有显著性差异 (χ2 =8.81～ 1 9.1 9,P <0 .0 5 )。肿瘤细胞中Flt1、KDR的表达呈极显著性正相关 (r =0 .4 4 ,P <0 .0 1 )。④结论　肺癌的生长主要依赖自分泌机制 ,联合检测Flt1、KDR可能对肺癌转移     

VEGF mRNA、KDR mRNA及蛋白在非小细胞肺癌中表达的意义探讨

目的探讨非小细胞肺癌中血管内皮生长因子(VEGF)、受体KDRmRNA和蛋白表达的意义。方法应用原位杂交技术及免疫组织化学PV-9000法分别检测30例新鲜非小细胞肺癌标本中VEGFmRNA、KDRmRNA及蛋白的表达。结果VEGF、KDRmRNA和蛋白均主要分布在肺癌细胞、血管内皮细胞及纤维母细胞,肺癌细胞VEGFmRNA和蛋白的阳性率分别为66.67%(20/30)和60.00%(18/30),两者的表达有极显著正相关性(r=0.86,P<0.01);KDRmRNA和蛋白的阳性率分别为73.33%(22/30)和76.67%(23/30),两者的表达亦有极显著正相关性(r=0.7366,P<0.01);VEGFmRNA、KDRmRNA及相应蛋白在肺癌细胞中的表达均呈极显著性正相关(原位杂交r=0.853,免疫组化r=0.5148,均P<0.01);肺癌细胞VEGFmRNA、KDRmRNA及相应蛋白的阳性表达率在不同大小的3组肺癌标本间,差异均具有显著性(确切P=0.014,P=0.002;P=0.0087,P=0.0016);淋巴结有转移组的VEGFmRNA、KDRmRNA及相应蛋白在肿瘤细胞中的阳性表达率显著高于淋巴结无转移组者(确切P=0.007,P=0.003;P=0.0008,P=0.0073)。结论肺癌细胞产生的VEGF通过自分泌环作用于癌细胞上的KDR受体促进癌细胞生长;VEGF及KDR的检测可作为肺癌淋巴结转移的有效评估指标;VEGF及KDR有望成为肺癌治疗的新靶点。     

P16蛋白在胆囊癌组织中的表达

目的　探讨P16基因在胆囊癌的表达。方法　采用免疫组织化学方法对 2 7例胆囊癌标本P16基因表达进行检测。结果　胆囊癌P16蛋白阳性表达明显低于胆囊良性病变 (χ2 =15 . 372 5 ,P <0 . 0 1;χ2 =6 .. 0 6 6 7,P<0 . 0 5 ) ;P16蛋白阳性表达与病理类型差异无显著性意义 (χ2 =0 0 189,P >0. 0 5 ) ;P16蛋白阳性表达与Nevin临床分期差异有显著性意义 (χ2 =9 1881,P <0 . 0 5 ) ,S1-2 P16蛋白阳性表达明显高于S3 、S4-5。结论　P16基因的突变与缺失在胆囊癌有重要意义。     

52例非小细胞肺癌增殖活性及P53基因变化的实验研究

目的 :研究非小细胞肺癌的增殖活性及 P5 3的改变。方法 :应用免疫组化技术检测 5 2例肺癌的P5 3基因表达情况及其 PCNA阳性情况。免疫组化染色采用 S- P法。结果 :P5 3总阳性率为 5 1 .9% ,不同类型肺癌之间差异没有显著性 (χ2 =4 .4 87,P=0 .1 0 6 ) ;P5 3阳性组的增殖活性较 P5 3阴性组为高 ,差异有显著性 (Fisher's exact test,P=0 .0 0 2 <0 .0 5 )。结论 :P5 3基因的变化与肺癌的增殖活性有关 ,其在肺癌的发生发展中具有重要作用     

肺癌病人血管内皮生长因子表达与临床预后的关系

①目的　探讨肺癌病人血管内皮生长因子 (VEGF)表达与预后的关系。②方法　应用SABC免疫组织化学方法检测VEGF在 71例肺癌组织标本中的表达情况。③结果　肺癌组织VEGF表达阳性率为 76 .0 6 % ,明显高于肺良性病变的 2 0 .0 0 % (χ2 =2 1.2 1,P <0 .0 1) ;低分化癌VEGF阳性表达率显著高于高分化癌 (χ2 =4.146 ,P <0 .0 5 ) ,有淋巴结转移者显著高于无淋巴结转移者 (χ2 =5 .2 2 6 ,P <0 .0 5 ) ,Ⅲ～Ⅳ期癌显著高于Ⅰ～Ⅱ期癌 (χ2=5 .42 0 ,P <0 .0 5 )。④结论　VEGF是判断肺癌病人预后的重要指标之一。     

骨肉瘤中血管内皮生长因子受体KDR的表达及其分析

目的 :研究骨肉瘤中血管内皮生长因子受体 (VEG FR 2 )KDR的表达情况 ,及其与微血管密度 (MVD)关系 .方法 :对 1 0 2例骨肉瘤患者的病理标本应用CD34,KDR对其组织切片分别进行免疫组化染色 ,双盲计数法进行热点内血管测定MVD .结果 :骨肉瘤KDR在血管周围的肿瘤细胞质呈较强阳性表达 ,在部分血管内皮细胞质内表达呈弱阳性 ,MVD在KDR表达阳性与阴性组中的计数经检验有显著性差异 (P <0 .0 5 ) .结论 :KDR在骨肉瘤细胞的高度表达可能参与骨肉瘤的发病机制 .     

PTEN、bcl-2及bax基因在非小细胞肺癌中的表达及意义

①目的　探讨非小细胞肺癌PTEN、Bcl 2及Bax蛋白表达与临床病理特征的关系。②方法　采用SABC免疫组化法检测 4 3例非小细胞肺癌及 2 0例癌旁肺组织石蜡包埋标本PTEN、Bcl 2及Bax蛋白表达。③结果　肺癌PTEN、Bax表达阳性率显著低于癌旁肺组织 ,而Bcl 2蛋白表达显著高于癌旁肺组织 (χ2 =4 .74～ 1 3.6 1 ,P <0 .0 5、0 .0 1 )。PTEN蛋白表达与分化程度、有无淋巴结转移和预后有关 (χ2 =5 .31～ 8.5 0 ,P <0 .0 5、0 .0 1 ) ;Bcl 2蛋白表达与分期有关 (χ2 =5 .31 ,P <0 .0 5 ) ;Bax蛋白表达与分化程度和预后有关 (χ2 =5 .32、4 .86 ,P <0 .0 5 )。肺癌Bcl 2与Bax蛋白表达呈负相关 (χ2 =7.2 0 ,P <0 .0 1 ) ,PTEN与Bax、Bcl 2之间未见明显相关性 (χ2 =1 .1 7、1 .4 2 ,P >0 .0 5 )。④结论　肺癌组织中PTEN、Bax蛋白的低表达和Bcl 2蛋白的高表达在肺癌发生中可能起重要作用。对 3种蛋白进行联合检测 ,更有利于肺癌的早期诊断和判断肺癌的分化程度、临床分期、淋巴结是否转移及病人的预后。     

P53和LRP蛋白在非小细胞肺癌中的表达及意义

①目的　探讨P5 3蛋白和LRP蛋白在非小细胞肺癌中的表达及其意义。②方法　用免疫组化ELISA法检测 80例非小细胞肺癌组织中P5 3蛋白和LRP蛋白的表达。③结果　在 80例非小细胞肺癌组织中 ,P5 3蛋白表达阳性 12例 ,LRP蛋白表达阳性 4 0例 ;P5 3蛋白及LRP蛋白的阳性表达与非小细胞肺癌的组织学分级及淋巴结转移有关 (χ2 =4 .70 3～ 5 .4 95 ,P <0 .0 5 )。P5 3蛋白与LRP蛋白之间的阳性表达无相关性 (χ2 =2 .86 6 ,P >0 .0 5 )。④结论　P5 3蛋白及LRP蛋白表达阳性的非小细胞肺癌更易发生淋巴结转移。     

p21ras和Cyclin D1在肺癌组织中的表达及相互关系

目的　研究p2 1ras、CyclinD1在肺癌组织中的表达及其相互关系。方法　运用免疫组化S -P法检测p2 1ras、CyclinD1蛋白在 6 8例肺癌组织中表达情况。结果　p2 1ras在肺腺癌、肺鳞癌及小细胞肺癌中阳性表达率分别为 96 .6 7%、80 .6 5 %及 4 2 .86 % ,三者之间差异具有显著性 (P <0 .0 5 ) ;直径≤ 3cm的肿瘤p2 1ras全部为阳性表达 ,而直径 >3cm的肿瘤p2 1ras的阳性表达率为 83.82 % ,二者之间的差异具有显著性 (P =0 .0 5 ) ;p2 1ras在分化较好的肿瘤 (Ⅰ +Ⅱ级 )和分化较差的肿瘤 (Ⅲ级 )的阳性表达率分别为 89.80 %、6 8.4 2 % ,二者之间差异有显著性 (P <0 .0 5 )。CyclinD1在肺腺癌、肺鳞癌及小细胞肺癌中阳性表达率分别为 5 0 .0 0 %、4 1.94 %及 2 8.5 7% ,三者之间阳性表达率无显著性差异 (P >0 .0 5 ) ;CyclinD1表达水平与临床病理分期、淋巴结转移相关 (P <0 .0 5 ) ,而与其他临床病理因素无关。p2 1ras和CyclinD1表达无明显相关性 (P >0 .0 5 )。结论　p2 1ras表达可能与肺癌的组织学类型、分化程度有关 ;肺癌组织中CyclinD1表达可能与肿瘤淋巴结转移有关。     

Survivin和NF-κB在肝细胞癌中的表达

①目的　探讨凋亡抑制因子Survivin和核因子NF κB在肝细胞癌 (HCC)组织的表达情况及与临床病理特征的关系。②方法　采用免疫组化方法检测 4 1例HCC中Survivin和NF κB蛋白的表达情况 ,以相应癌旁肝组织、肝硬化组织 (10例 )、肝血管瘤旁正常肝组织 (11例 )作对照 ,并分析其与病理特征的关系。③结果　Survivin蛋白在HCC组织阳性表达率为 4 8.8% ,在对照组中不表达 ,二者比较差异有显著性 (χ2 =37.5 3,P <0 .0 1) ;门静脉浸润者的阳性表达率显著高于无门静脉浸润者 (χ2 =5 .5 1,P <0 .0 5 ) ;肿瘤呈多发者的阳性表达率显著高于单发者(χ2 =3.98,P <0 .0 5 )。NF κB蛋白在HCC组织的阳性表达率为 6 8.3% ,显著高于对照肝组织 (χ2 =4 1.12 ,P <0 .0 1)。NF κB的表达与Suvivin的表达呈正相关 (r=0 .0 6 5 6 ,P <0 .0 5 )。④结论　Survivin、NF κB在HCC组织中的高表达参与了肝癌的发生、发展 ,可能的机制是抑制了肝细胞的凋亡。     

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.