85例非小细胞肺癌中p53基因异常的预后价值

目的：探讨ｐ５３蛋白表达和基因突变在非小细胞肺癌（ＮＳＣＬＣ）中的预后价值。方法：利用免疫组化方法检测８５例ＮＳＣＬＣ的ｐ５３蛋白表达，聚合酶链式反应－单链构象多态性（ＰＣＲ－ＳＳＣＰ）方法检测３１例肺腺癌ｐ５３基因５、６、７、８外显子突变，研究结果进行单因素生存分析。结果：本组ＮＳＣＬＣ病人的平均年龄为５５．６±８．４岁（中位数５５岁），随访时间的中位数为４７个月，３年、５年总体生存率分别为６６％和６１％。ｐ５３蛋白表达与预后无关（χ２＝１．００，Ｐ＝０．８），而ｐ５３基因突变组病人的生存率显著低于无ｐ５３基因突变组（χ２＝４．８１，Ｐ＝０．０３）。同时，ｐ５３蛋白表达与ＰＣＲ－ＳＣＰ检测的ｐ５３基因突变的一致率仅为５２％。结论：在ＮＳＣＬＣ中ｐ５３蛋白表达和基因突变可能有不同的预后意义，ｐ５３基因突变可作为肺腺癌的辅助预后指标。     

子宫内膜良恶性病变bcl－2，p53蛋白表达的免疫组化研究

用ＡＢＣ免疫组化方法观察８５例子宫内膜良恶性病变ｂｃｌ－２和ｐ５３蛋白的表达．结果：各型子官内膜增生ｂｃ１－２高表达，ｐ５３阴性表达。子宫内膜典型腺癌Ⅰ级、Ⅱ级和Ⅲ级ｂｃ１－２阳性分别为１６／２０例，５／８例和２／７例，显示ｂｃ１－２表达随典型腺癌分化程度降低而降低（Ｐ＜０．０５），ｐ５３阳性分别为３／２０Ｒ例，３／８例和４／７例，显示ｐ５３蛋白表达随典型腺癌分化程度降低而升高（Ｐ＜０．０５）子宫内膜癌ｂｃｌ－２和ｐ５３蛋白表达呈负相关。结果还提示，ｂｃ１－２和ｐ５３可能对宫内膜癌具有重要作用。     

子宫内膜良恶性病变bcl—2,p53蛋白表达的免疫组化研究

用ＡＢＣ法免疫组化方法观察８５例子宫内膜良恶性病变ｂｃｌ－２和ｐ５３蛋白的表达，结果：各型子宫内膜增生ｂｃｌ－２高表达，ｐ５３阴性表达，子宫内膜典型腺癌Ｉ级，Ⅱ级和Ⅲ级ｂｃｌ－２阳性分别为１６／２０例，５／８例和２／７例，显示ｂｃｌ－２表达随典型腺癌分化程度降低而降低（Ｐ〈０．０５），ｐ５３阳性分别为３／２０例，３／８例和４／７例，显示ｐ５３蛋白表达随典型腺癌分化程度降低而升高（Ｐ〈０．０５），子     

p53、nm23和c-erbB-2蛋白在子宫内膜癌中的表达及其临床意义

目的：研究ｐ５３、ｎｍ２３和ｃ－ｅｒｂＢ－２蛋白在子宫内膜癌中的表达及其临床意义。方法：用ＬＳＡＢ免疫组化法检测４２例子宫内膜癌中ｐ５３、ｎｍ２３和ｃ－ｅｒｂＢ－２蛋白的表达。结果：ｐ５３,ｎｍ２３,ｃ－ｅｒｂＢ－２在子宫内膜部中的阳性率分别为３１．０％、６０．０％、４７．６％,其阳性表达与年龄、不同组织学类型差异无显著性（Ｐ〉０．０５）;ｐ５３与病理分级有关,随着细胞分级的增高,其阳性率逐步升高,差异有极显著性（χ＝１６．３,Ｐ〈０．００５）;ｎｍ２３与病理分级呈负相关（Ｐ〈０．０１）,无淋巴结转移者阳性表达率明显高于有淋巴结转移者（７１．９％和２０．０％,Ｐ〈０．０５）;ｃ－ｅｒｂＢ－２的表达与癌细胞的分化程度、临床分期有关,分化程度高及早期癌中ｃ－ｅｒｂＢ－２表达强。结论：对子宫内膜癌进行ｐ５３、ｎｍ２３     

P53基因蛋白在子宫内膜癌中的表达及其临床意义

为了研究Ｐ５３基因突变与子宫内膜癌的关系，本研究应用免疫组化Ｓ－Ｐ法检测了６４例子宫内膜癌，１６例正常子宫内膜，３２例子宫内膜增殖症及５例子宫内膜息肉组织中Ｐ５３蛋白表达情况。结果：突变型Ｐ５３蛋白在子宫内膜癌组织中的阳性率为３７．５％，而在正常子宫内膜、子宫内膜单纯性及复合性增生、内膜息肉中均阴性，不典型增生１例（１／３）阳性。突变型Ｐ５３阳性表达与临床分期、组织学级别相关，与病理类型、肌层浸润     

P53及Bcl-2蛋白在大肠腺瘤及腺癌中的表达

目的：检测大肠腺瘤及腺癌中Ｐ５３蛋白及Ｂｃｌ－２蛋白的表达，探讨ｐ５３基因、ｂｃｌ－２基因在大肠癌发生发展过程中的作用。方法：应用免疫组织化学ＡＢＣ法检测１０例正常大肠粘膜、３０例大肠腺瘤、１００例大肠腺癌及癌旁粘膜中Ｐ５３蛋白及Ｂｃｌ－２蛋白的表达。结果：大肠腺瘤Ｐ５３、Ｂｃｌ－２蛋白阳性率分别为２６．７％及７６．７％，大肠腺癌Ｐ５３、Ｂｃｌ－２蛋白阳性率分别为４３％及６７％，均显著高于正常粘膜与癌旁粘膜（Ｐ＜０．０１）；随着腺瘤不典型增生程度的加重，Ｐ５３蛋白阳性率显著增高（Ｐ＜０．０１），而Ｂｃｌ－２蛋白表达与腺瘤分级无关；大肠腺癌Ｐ５３蛋白阳性率显著高于腺瘤Ⅰ级不典型增生（Ｐ＜０．０１），与Ⅱ、Ⅲ级不典型增生间差异无统计学意义（Ｐ＞０．０５），分化差的大肠腺癌Ｐ５３蛋白阳性率显著高于分化好的大肠腺癌（Ｐ＜０．０１），而分化差的大肠腺癌Ｂｃｌ－２蛋白阳性率显著低于分化好的大肠腺癌（Ｐ＜０．０５），大肠腺癌Ｐ５３、Ｂｃｌ－２蛋白表达呈负相关（Ｐ＜０．０５）；Ｐ５３蛋白表达患者复发率高、５年生存率低（Ｐ＜０．０５），Ｂｃｌ－２蛋白过度表达的大肠癌患者复发率低、５年生存率高（Ｐ＜０．０５）。结论：ｂｃｌ－２     

胃腺癌p53基因点突变的研究

目的 探讨胃腺癌原发灶及淋巴结转移灶与ｐ５３基因突变的关系。方法 用ＰＣＲ－ＳＳＣＰ方法检测４７例胃腺癌及相关淋巴结转移灶ｐ５３基因第７外显子的突变。结果 ４７例原发灶有８例（１７％）、淋巴结转移灶有１８例（３５％）检测到ｐ５３基因突变。原发灶与转移灶同时发生鹤煌有７２例（１５％）。胃癌原发灶ｐ５３基因突变与患者年龄、性别、病灶大小、肿瘤部位、肉眼类型、浸润深度、组织学类型、临床分期无关（Ｐ〉０．     

p53蛋白在子宫内膜癌中的表达

目的探讨ｐ５３蛋白在子宫内膜癌发生、发展过程中的意义。方法应用免疫组化方法检测５０例子宫内膜癌，１２例子宫内膜腺瘤样增生，１０例单纯性增生，２０例正常子宫内膜的ｐ５３蛋白表达。结果子宫内膜癌ｐ５３蛋白阳性率为５２．０％，腺瘤样增生阳性率为１６．７％（Ｐ＜０．０５），单纯性子宫内膜增生、正常子宫内膜均为阴性。显示ｐ５３蛋白与子宫内膜癌肌层浸润深度有关（Ｐ＜０．０５）。未发现ｐ５３蛋白过度表达与子宫内膜癌分化程度、淋巴结转移之间的关系。结论子宫内膜癌ｐ５３蛋白过度表达，可作为诊断子宫内膜癌的一项参考指标。     

子宫内膜腺癌组织中P^53抑癌基因的表达

研究Ｐ＾５３抑癌基因与子宫内膜腺癌的方法。方法；用免疫组化Ｓ－Ｐ法检测了下沉子宫内膜，子宫内膜增殖沔及子宫内膜腺癌组织中抑癌基因Ｐ＾５３的表达情况。结果：突变型Ｐ＾５３蛋白在子宫内组织中的阳性率为４８．６％，而在正常子宫内膜及各种类型子宫内膜增殖症中均为阴性。     

非小细胞肺癌组织P53蛋白免疫组化研究

应用Ｓ－Ｐ免疫组化方法研究Ｐ５３表达变化与非小细胞肺癌病理类型,病理分化程度和淋巴结转移的关系,发现Ｐ５３阳性染色率为６４．１％,鳞癌的阳性率为７２．９２％,明显高于腺癌和大细胞癌（５７．１４％和３３．３３％,Ｐ〈０．０５）,有淋巴结转移组Ｐ５３蛋白染色阳性率高于无淋巴结转移组（７４．４２％和５１．４３％,Ｐ〈０．０５）,揭示Ｐ５３蛋白表达与病理类型及淋巴结转移有关。     

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…     

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.     

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.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.