Hp相关胃炎患者血清表皮生长因子(EGF)和β2-微球蛋白(β2- MG)水平研究

目的探索 EGF和β2- MG在 CSG- CAG- GC演变模式中的变化规律,探讨 Hp对 EGF和- MG有无影响.方法应用尿素酶试验法、血清学试验法和组织学诊断法,进行 Hp检查,应用放射免疫法检测血清 EGF及β2- MG水平. 结果 (一 )EGF水平 (μ g/L): (1)按 CSG- CAG- GC逐渐升高,依次为 0.3229± 0.225, 0.8823± 0.2549,1.3999± 0.8935,GC组高于 CSG组( P<0.01),也高于 CAG组( P<0.05), CAG组高于 CSG组( P<0.01).( 2) CSG患者 Hp(+)组( 0.2404± 0.1103)低于 Hp(- )组( 0. 4492± 0.2931)( P<0.01); CAG患者 Hp(+)组( 0. 8119± 0.279)低于 Hp(-)组( 1.0056± 0. 1704), GC患者 Hp(+)组( 1.159± 0. 9229)低于 Hp(-)组 (1. 4963± 0. 9127),均无统计学差异( P>0.05).(二)β2- MG水平( mg/l): (1)按 CSG- CAG- GC顺序增高,依次为: 1. 659± 0. 4321, 1. 9661± 1. 0802,2.3431± 0. 5951, GC组高于 CSG组( P<0.01) ,CAG组高于 CSG组, GC组高于 CAG组,均无统计学意义( P>0.05). (2)同一胃病 Hp(+ )组与 Hp(- )组比较血清β2- MG水平均无明显差异( P>0.05).结论按 CSG- CAG- GC, EGF水平逐渐升高,β2- MG有此种趋势. Hp有降低 EGF的作用, Hp对-β2 MG水平无明显影响.     

胃癌变过程中Hp感染与凋亡基因Bcl-2表达相关性研究

目的 研究胃癌变过程中幽门螺杆菌(Hp)感染与凋亡基因Bcl-2表达、细胞凋亡和临床意义.方法 用快速尿素酶法、W-S银染法和美蓝法联合检测62例慢性浅表性胃炎(CSG)、55例慢性萎缩性胃炎(CAG)、52例肠化生(IM)、46例不典型增生(AH)、65例胃癌(GC)组织中Hp的感染,并采用免疫组化及TUNEL法分别检测Bcl-2蛋白的表达及细胞凋亡水平.结果 Hp感染率、Bcl-2蛋白阳性表达率均随着胃癌形成中病变恶性程度的加重而明显上升.Hp感染率CAG、IM、AH和AC组较CSG,GC组较CAG组均明显升高 (P＜0.05);IM、AH、GC组阳性表达率明显高于CSG组(P＜0.01,P＜0.05);GC组的阳性表达率明显高于IM组(P＜0.01);AH、GC组Hp阳性患者Bcl-2蛋白表达率均高于Hp阴性患者(P＜0.05);IM、AH、GC组中Bcl-2阳性者凋亡指数均低于Bcl-2阴性者;Hp感染阳性胃癌患者组织中Bcl-2蛋白表达与组织分化程度有明显关系,低未分化胃癌Bcl-2蛋白表达明显高于高中分化胃癌(P＜0.01).结论 在胃黏膜癌变过程中,Hp感染可能通过逐渐上调Bcl-2基因的表达,抑制细胞凋亡和分化发挥致癌作用.     

胃癌及癌前病变中COX-2和NF-κBp65蛋白表达及其相关性研究

目的观察幽门螺杆菌(Hp)、NF-κBp65、COX-2在胃黏膜癌变过程中的表达,探讨其表达与胃癌发生、发展的关系。方法用免疫组化方法测定病例中COX-2、NF-κBp65蛋白的表达,用亚甲兰染色检测Hp。结果①慢性萎缩性胃炎(CAG)、肠上皮化生(IM)、不典型增生(DYS)的Hp感染率与慢性浅表性胃炎(CSG)相比差异有显著性(χ2=6.94,χ2=6.71,χ2=10.60,P<0.01)。胃癌(GC)的Hp感染率与CSG相比差异无显著性(χ2=1.37,P>0.05)。②CAG、IM、DYS的COX-2表达率与CSG相比差异有显著性(χ2=4.81,χ2=5.96,χ2=16.57,P<0.05)。GC的COX-2表达率与CSG相比差异亦有显著性(χ2=34.50,P<0.01)。③CAG、IM、DYS的NF-kBp65表达率与CSG相比差异有显著性(χ2=4.71,χ2=9.02,χ2=20.74,P<0.05)。GC的NF-kBp65表达率与CSG相比差异亦有显著性(χ2=30.71,P<0.01)。结论 Hp感染诱导COX-2和NF-kB表达发生在胃癌形成的早期阶段。COX-2和NF-kBp65参与了胃癌的发生发展过程,这些可能为胃癌的早期诊断及临床判断预后提供理论依据。     

血清Cys C尿mAlb和尿β2-MG联合检测在肝硬化及原发性肝癌早期肾功能损伤中的应用价值

目的测定慢性肝病、肝硬化和原发性肝癌(PLC)患者血清半胱氨酸蛋白酶抑制剂C(Cys C)、尿微量白蛋白(mAlb)及尿β2微球蛋白(尿β2-MG)含量,探讨三项联合检测的临床应用价值。方法分别检测67例慢性肝病、63例肝硬化、33例PLC患者和78例正常对照者血清Cys C、肌酐(SCr)、尿素(Urea)、尿mAlb及尿β2-MG含量,并分析差异。比较肝硬化、PLC患者Child-Pugh不同等级间血清Cys C、SCr、Urea、尿mAlb、尿β2-MG水平。同时比较血清Cys C、尿mAlb、尿β2-MG单独及联合检测在慢性肝病、肝硬化、PLC患者的检出率。结果肝硬化、PLC组患者血清Cys C、尿mAlb及β2-MG水平分别为(1.40±0.47,27.57±21.45,0.29±0.09)mg/L和(1.21±0.21,19.60±7.28,0.22±0.09)mg/L,均高于慢性肝病组(1.01±0.13,11.30±3.46,0.14±0.05)mg/L(P<0.05)和正常对照(0.81±0.11,11.21±2.47,0.14±0.03)mg/L(P<0.05),肝硬化组血清Cys C、尿mAlb水平明显高于PLC组(P<0.05)。肝硬化和PLC组Child-Pugh B级、C级患者血清Cys C、尿mAlb水平均明显高于Child-Pugh A级(P<0.05)。肝硬化、PLC组患者血清Cys C、尿mAlb、尿β2-MG单独及联合检测的异常检出率分别为57.1%、38.1%、31.7%、68.3%和51.5%、33.3%、30.3%、78.8%,均高于慢性肝病组(11.9%、3.0%、3.0%、16.4%)(P<0.05),且联合检测的异常检出率明显高于同组患者单独检测异常检出率(P<0.05)。结论血清Cys C、尿mAlb及尿β2-MG水平随着慢性肝病的进展和肝功能的下降而升高,且比SCr、Urea更能灵敏的反映肝硬化、PLC患者继发早期肾功能损伤。同时三项目联合检测对肝硬化、PLC患者早期肾损伤的诊断价值优于单独检测。     

β_2-微球蛋白与糖尿病性视网膜病变的关系

通过β-微球蛋白(β_2-MG)测定,对糖尿病(DM)无合并症组(1组);DM并有视网膜病变组(2组);DM并有蛋白尿组(3组),DM并有视网膜病变及尿蛋白组(4组),进行对比研究。结果1组β_2-MG均值为25.2±9.2μg/L,2组为37.5±16.5μg/L,3组为43.2±19.41μg/L,4组为59.6±2.96μg/L。经统计学处理1、2组P<0.05,2、3组P>0.05,1、3组及1、4组P<0.05。由于β_2-MG含量可反映     

Hp、p53在胃癌和癌前病变中的表达及相关性研究

目的:探讨Hp、p53在胃癌及癌前病变中的表达及相互关系.方法:采用特殊染色方法和免疫组化方法,检测130例不同胃粘膜病变石蜡包埋标本.结果:1.慢性浅表性胃炎(CSG)、慢性萎缩性胃炎(CAG)、非典型增生(DYS)和胃癌(GC)Hp阳性率分别为40%、60%、70%和72.5%,GC与CSG比较有显著差异(P<0.05).2.p53基因蛋白在CSG、 CAG、 DYS、 GC中的表达率分别为5%、 25%、 50%、 62.5%,其中GC与CAG、CSG 相比有明显差异(P<0.01).3.在80例胃癌标本中,Hp阳性组p53阳性表达率明显高于Hp阴性组(P<0.05). 结论: 1. Hp感染在胃粘膜病变的演变过程中起着重要作用. 2.突变型p53与胃癌的发生有关.3.p53的突变与Hp感染有密切关系.     

中药消萎灵对大鼠慢性萎缩性胃炎胃粘膜血流量和血浆胃动素的影响

目的　观察中药复方消萎灵对大鼠慢性萎缩性胃炎(CAG )及胃癌前病变 (PL GC)动物模型胃粘膜血流量(GMBF)和血浆胃动素 (MTL)的影响及其病理逆转治疗作用 .方法　在成功制作大鼠 CAG及 PL GC动物模型后 ,用激光多普勒血流计测定大鼠 CAG及 PL GC的 GMBF,用放射免疫法测定血浆 MTL含量 ,并在不同组间进行比较 ,同时对各组 CAG及 PL GC的病理镜检结果进行比较 .结果　模型组较正常组胃粘膜血流量明显降低 (6 .91± 0 .72→ 4 .4 6±0 .71,P<0 .0 5 ) ,消萎灵高、低剂量组和维酶素组可明显提高GMBF(0 .34± 0 .31,6 .5 5± 0 .89,5 .5 8± 0 .6 8,P<0 .0 5 ) ,消萎灵高、低剂量组均优于维酶素组 (P<0 .0 5 ) ,消萎灵高剂量组接近正常组水平 (P>0 .0 5 ) ;模型组 MTL较正常组显著减少 (84 .3± 4 .2 ,86 .9± 4 .3,94 .7± 7.1,P<0 .0 5 ) ,消萎灵高、低剂量之间无显著差异 ,而且均优于维酶素组 (P<0 .0 5 ) ,消萎灵高剂量组、低剂量组病理镜检结果明显优于维酶素组(P<0 .0 5 ) .结论　中药消萎灵可提高 CAG及 PL GC大鼠GMBF和降低其异常增高的血浆 MTL 水平 ,改善组织病理 ,为消萎灵治疗 CAG及 PL GC提供了实验依据 .     

青海地区汉族胃癌患者血清P53、sFas蛋白表达

目的测定青海地区汉族胃癌(GC)、慢性萎缩性胃炎(CAG)、慢性浅表性胃炎(CSG)患者血清中P53蛋白、可溶性Fas蛋白(sFas)水平,明晰青海地区汉族胃癌患者血清P53、sFas蛋白表达特点。方法收集世居青海地区因消化道症状前来青海大学附属医院诊治的汉族GC、CAG、CSG患者,采用酶联免疫吸附法(ELISA)检测血清P53蛋白、sFas水平,并进行相关分析。结果 1.血清P53蛋白水平在GC组、CAG组、CSG组依次降低,差异具有统计学意义(P<0.05);2.血清sFas水平GC组较CAG组、CSG组明显降低(P<0.05);3.GC组血清P53蛋白与sFas间呈负相关,r=-0.543,P<0.05。结论青海地区汉族GC患者血清中P53蛋白显著升高、sFas显著性降低,二者联合检测有望作为胃癌诊断的一种新型的简单易行的检测指标。     

幽门螺旋杆菌感染患者胃黏膜TGFβ1表达与细胞增殖活性的研究

目的 研究幽门螺旋杆菌(Hp)感染患者不同胃黏膜病变组织中TGFβ1和Ki-67的表达,探讨Hp感染、TGFβ1及Ki-67在胃黏膜癌变过程中的作用及其相互关系.方法 选取72例不同胃黏膜病变组织的胃镜活检标本,采用快速尿素酶试验(RUT)结合Giemsa染色判断有无Hp感染,并且用免疫组织化学染色技术检测胃黏膜组织中TGFβ1及Ki-67的表达.结果 TGFβ1在CSG、CAG、IM/Dy和GC中表达的阳性率分别为39.1%、52.6%、62.3%和87.5%,CSG组与IM/Dy、GC组相比较,差异有显著性(P<0.05);IM/Dy中Hp阳性者TGFβ1表达(87.5%)显著高于Hp阴性者(33.3%)(P<0.05).从CSG到GC,Ki-67LI呈逐渐递增趋势,且TGFβ1的表达与Ki-67LI呈正相关(P<0.01).结论 TGFβ1和Ki-67在胃癌中的表达均明显增高,TGFβ1在胃癌的发生发展中起着重要作用,并且TGFβ1和Ki-67之间存在相关关系,TGFβ1可增强肿瘤细胞的增殖活性;在胃癌前病变中,Hp感染则TGFβ1表达增强,推测Hp感染是致胃癌机制中的重要环节之一.     

CagA阳性幽门螺杆菌感染与上胃肠道疾病关系的研究

目的探讨CagA阳性幽门螺杆菌(Hp)感染与上胃肠道病变的关系;并观察Hp根除治疗后血清中抗CagAIgG抗体水平的变化.方法808例因上胃肠道症状而接受胃镜检查的病人,同时作Hp检查.对Hp感染者用ELISA方法检测血清中抗CagAIgG抗体;阳性者予含质子泵抑制剂(PPI)三联疗法根除治疗.其中60例根除治疗失败病人和120例根除成功病人在Hp根除治疗结束3个月和6个月时复查血清中抗CagAIgG抗体水平.结果在不同临床疾病中,慢性浅表性胃炎(CSG)、慢性萎缩性胃炎(CAG)、胃溃疡(GU)、十二指肠溃疡(DU)和胃癌(GC)感染Hp的病人中抗CagAIgG抗体阳性率分别为55.4%、70.5%、83.2%、90.8%、89.7%.后4组阳性率明显高于CSG组,后3组均明显高于CAG组;在不同程度的胃粘膜病变中,CSG、CAG、肠上皮化生(IM)、非典型增生(Dys)和GC感染Hp的病人中抗CagAIgG抗体的阳性率分别为43.0%、53.8%、77.6%、88.6%、89.7%.IM、Dys和GC组均明显高于CSG和CAG组;60例根除失败者在治疗前及治疗后3个月和6个月时血清中抗CagAIgG水平分别为(72±41)U/ml,(67±36)U/ml和(69±40)U/ml,治疗前后差异无显著意义,无一例转为阴性;120例根除治疗成功者治疗后3个月和6个月血清中抗CagAIgG水平平均由(69±38)U/ml分别下降至(47±30)U/ml和(32±15)U/ml,治疗后与治疗前比较差异均有显著意义,在治疗后3个月和6个月时分别有7.5%(9/120)和19.2%(23/120)的病人抗体转为阴性.结论CagA阳性的Hp可能导致更严重的上胃肠道疾病和更严重的胃粘膜病变;Hp根除治疗后血清中抗CagAIgG抗体水平明显下降,但下降较慢,不宜作为个体监测疗效的指标.     

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.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.