Mel-18 mRNA在食管鳞癌中的表达及其临床意义

目的检测食管鳞癌组织中Mel-18 mRNA的表达,探讨其在食管鳞癌发生发展中的作用及其临床意义。方法 53例食管鳞癌手术标本及配对癌旁正常食管组织标本(距肿瘤5 cm以上)选自山东大学附属千佛山医院胸外科的手术患者,采用逆转录多聚酶链反应(RT-PCR)方法检测两组标本中Mel-18的表达,并分析其在肿瘤中的表达情况与各临床病理因素(性别,肿瘤部位、大小、分化程度、浸润深度、临床分期、淋巴结转移)的关系。结果食管鳞癌组织中的Mel-18 mRNA表达水平显著低于癌旁正常食管组织(P<0.01)。Mel-18 mRNA在不同性别及肿瘤部位、大小、分化程度和浸润深度间的表达均无明显差异(P>0.05)。Mel-18基因在临床分期Ⅰ、Ⅱ、Ⅲ、Ⅳ期患者中的表达依次降低(P<0.05),在淋巴结转移组和无淋巴结转移组的表达差异有统计学意义(P<0.05)。结论 Mel-18基因在食管鳞癌的发生发展中可能起抑制作用,可望成为食管鳞癌明确诊断及判断预后的新指标之一。     

PDCD5和Livin在食管鳞癌组织中的表达及其临床意义

目的探讨PDCD5和Livin在人食管鳞癌组织中的表达,并分析其与食管鳞癌的发生、癌细胞增殖和侵袭转移的关系及其临床意义。方法采用免疫组织化学S-P法检测78例食管鳞癌组织中PDCD5和Livin蛋白的表达,部分相应的癌旁组织43例作为对照。结果食管鳞癌组织中PDCD5的表达率低于癌旁组织,Livin的表达率显著高于癌旁组织,差异均有统计学意义(P<0.05);PDCD5的阳性表达率与食管鳞癌的淋巴结转移、TNM分期呈密切相关(P<0.05),而与患者的性别、年龄、及分化程度无关(P>0.05)。Livin的阳性表达率与食管鳞癌的TNM期、分化程度、淋巴结转移密切相关(P<0.05),而与患者的性别、年龄无关(P>0.05)。PDCD5与Livin食管鳞癌中的表达呈负相关(r=-0.334,P<0.01)。结论 PDCD5和Livin在食管鳞癌中异常表达,提示PDCD5与Livin的表达可能与食管癌的发生、发展相关。     

miR-106a在食管鳞癌中的表达及对耐药基因的调控作用

目的:探讨MicroRNA-106a(miR-106a)在食管鳞状细胞癌(ESCC)中的表达情况及对耐药相关基因三磷酸腺苷结合蛋白G亚族成员2 (ABCG2)、信号转导与转录激活因子3(STA T3)的调控作用.方法:收集本院胸外科行手术切除的ESCC组织及对应癌旁组织共60例,运用qRT-PCR检测miR-106a在ESCC组织及癌旁组织中的表达水平,统计分析miR-106a表达水平与患者临床病理资料间的相关性;免疫组化检测不同miR 106a含量的食管鳞癌组织中miR-106下游潜在靶点ABCG2及STAT3蛋白的表达水平,统计分析ABCG2及STAT3蛋白与miR-106a表达间的相关性;采用人工合成的miR-106a模拟物(miR-106a mimics)转染人食管鳞癌TE-1细胞,分别采用qRT-PCR及Western-Blot检测转染后ABCG2及STAT3 mRNA及蛋白的表达变化.结果:miR-106a在ESCC组织中表达水平明显低于对应癌旁组织,差异具有统计学意义(P＜0.05);miR-106a低表达与肿瘤体积增大(＞5 cm)、淋巴结转移及高TNM分期(Ⅲ+Ⅳ期)明显相关(P＜0.05);在食管鳞癌组织中miR-106a与ABCG2及STAT3的表达呈负相关关系(P＜0.05),miR-106a转染人食管鳞癌TE-1细胞可明显降低细胞内ABCG2及STAT3 mRNA及蛋白的表达水平(P＜0.05).结论:miR-106a在食管鳞癌组织中表达下调并与肿瘤恶性临床病理特征有关,miR-106a可能通过下调ABCG2及STAT3的表达来调控食管鳞癌的耐药表型.     

缺氧诱导因子-1α在食管鳞癌组织中的表达及其临床病理学意义

[目的]探讨缺氧诱导因子-1α(HIF1α)在食管鳞癌组织中的表达及其临床病理学意义.[方法]采用免疫组织化学方法检测HIF1α在128例食管鳞癌组织中的表达,分析其与患者年龄、性别、肿瘤大小、分化程度、T分期、淋巴结转移、远处转移、TNM分期、CD68表达、化学治疗、放射线治疗情况及生存率的关系.[结果]HIF1α在食管鳞癌的癌细胞及间质中均高表达.HIF1α在进展期(T分期和临床分期)食管鳞癌的癌细胞及间质组织中的表达率均明显高于早期癌组织(P<0.05);有淋巴结转移的食管鳞癌组织中HIF1α阳性表达率明显高于无淋巴结转移者(P<0.05);CD68表达呈阳性的组织中HIF1α表达率明显高于阴性组织(P<0.05).在食管鳞癌癌细胞中HIF1α呈阳性表达时患者的总生存率(OS)及无病生存率均明显低于阴性者(P<0.01,P<0.05).在食管鳞癌间质细胞中HIF1α呈阳性表达时患者的OS明显低于阴性者(P<0.01).HIF1α在食管鳞癌组织中的表达与患者年龄、性别、肿瘤大小、分化程度、远处转移、化学治疗及放射线治疗情况均无明显相关性.[结论]HIF1α在食管鳞癌中的表达对评价肿瘤进展情况及判定预后具有一定的参考价值.     

Ezrin蛋白在食管鳞癌中的表达及其临床意义

目的:探讨食管鳞癌组织中ezrin蛋白的表达及其与肿瘤侵袭和转移的关系。方法:应用免疫组织化学S-P法,检测76例食管鳞状细胞癌组织标本中ezrin蛋白的表达,以30例食管癌旁正常黏膜组织作对照,并结合食管癌的临床病理特征进行分析。结果:ezrin蛋白在76例食管鳞癌中异常表达60例,在30例癌旁正常黏膜中异常表达8例,两者差异有统计学意义(P<0.01)。同时ezrin蛋白的异常表达率与食管鳞癌的分化程度和区域淋巴结转移均有一定关系(P<0.05和P<0.01)。结论:ezrin蛋白在食管鳞癌中异常高表达,其强阳性表达预示着肿瘤细胞分化程度较差,有淋巴结转移。     

NRP1和miR-9在人NSCLC组织和癌旁组织中的表达及其临床意义

目的: 检测人非小细胞肺癌(NSCLC)组织标本中神经纤毛蛋白1(NRP1)mRNA和miR-9的表达水平,并探讨二者表达与NSCLC患者临床特征之间的关系。方法: 在患者知情同意下,收集2010-2011年吉林大学中日联谊医院匹配的NSCLC患者组织标本,包括45例正常组织、45例癌旁组织及45例肿瘤组织。采用qRT-PCR法检测不同组织中NRP1 mRNA和miR-9表达水平,分析二者表达水平与不同临床病理特征的相关性。结果: 与正常组织比较,癌旁组织中NRP1 mRNA表达水平无明显变化(P>0.05),而肿瘤组织中NRP1 mRNA表达水平明显降低(P<0.05);与正常组织比较,癌旁组织miR-9表达水平无明显变化(P>0.05),而肿瘤组织中miR-9表达水平明显升高(P<0.05)。男性癌旁组织中miR-9表达水平低于女性(P<0.05)。NSCLC患者肿瘤组织中NRP1 mRNA表达水平与性别、年龄、分化程度、TNM分期及临床分期无关联(P>0.05),但与病理分型及淋巴结转移有关联(P<0.05);NSCLC患者肿瘤组织中miR-9表达水平与年龄、肿瘤病理类型、淋巴转移、分化程度、TNM分期及临床分期无关联(P>0.05),而与性别因素有关联(P<0.05)。结论: NSCLC患者肿瘤组织中miR-9表达水平显著升高,而NRP1 mRNA表达水平明显下降,NRP1 mRNA检测有助于判断NSCLC的分型及转移。     

E-钙黏蛋白在食管鳞癌中的表达及其临床意义

目的:探讨食管鳞癌组织中E-钙黏蛋白(E-cadherin,E-cad)的表达及其与肿瘤侵袭和转移的关系。方法:应用免疫组织化学S-P法检测76例食管鳞状细胞癌组织标本中E-cad的表达,以30例食管癌旁正常黏膜组织作对照,并结合食管癌的临床病理特征进行分析。结果:E-cad在76例食管鳞癌中异常表达率59.21%;而在30例癌旁正常黏膜中异常表达率为6.67%,两者差异有统计学意义(P<0.01),同时E-cad的异常表达率与食管鳞癌的浸润深度、细胞分化程度及淋巴结转移均有一定关系(P<0.05~P<0.01)。结论:E-cad在食管鳞癌中呈异常表达,其异常表达率与肿瘤的浸润深度、分化程度、淋巴结转移密切相关。     

甲状腺乳头状癌组织中miR-129表达情况及其与临床病理特征的相关性分析

目的 分析甲状腺乳头状癌(Papillary thyroid carcinoma,PTC)组织中微小RNA-129(miR-129)的表达情况,并探讨miR-129与PTC患者临床病理特征的相关性。方法 选取本院2010年11月至2014年2月收治的125例PTC患者作为研究对象,采用回顾性分析法分析所有患者的临床资料,收集125例PTC患者其125份癌组织(研究者)及125份癌旁正常甲状腺组织标本(对照组)作为研究对象,所有组织标本均行miR-129 mRNA检测,分析PTC组织中miR-129的表达与患者临床病理特征的关系。结果 ①PTC患者PTC癌变组织中miR-129 mRNA表达水平低于癌旁正常组织(P<0.05);②miR-129的表达与PTC患者其年龄、性别、肿瘤大小情况均无明显关系(P>0.05),miR-129的表达与PTC患者临床分期、淋巴结转移及病理分级的表达有显著关系(P<0.05);③经单因素分析得出：临床分期Ⅲ~Ⅳ期、有淋巴结转移及病理分级2级及miR-129水平低表达时患者生存时间均显著缩短(P<0.05);④经多因素Cox分析得出：临床分期Ⅲ~Ⅳ期、有淋巴结转移及病理分级2级及miR-129水平低表达均为影响PTC患者预后的独立危险因素(HR=2.219,3.511,2.323,2.102)(P<0.05)。结论 miR-129在PTC患者组织中以低水平表达,临床分期Ⅲ~Ⅳ期、有淋巴结转移及病理分级2级时miR-129低表达率均上升,miR-129低表达PTC患者预后较差。     

膜联蛋白A10在人食管鳞癌及其癌旁组织中的表达及临床意义

目的:探讨膜联蛋白A10(annexin A10)在人食管鳞癌和癌旁组织中的表达以及临床意义.方法:应用半定量RT-PCR、定量PCR、Western blot法,检测 40 对配对人食管鳞癌和癌旁组织中 annexin A10表达差异;并分析该表达差异与临床病理特征如性别、年龄、肿瘤大小、浸润深度、临床分期、淋巴结转移和细胞分化的关系.结果:40 对配对人食管鳞癌组织中,armexinA10 mRNA表达水平癌组织77.06±37.11,癌旁组织66.99±17.62;蛋白表达水平癌组织为1.73±1.30,癌旁组织1.26±1.18,癌组织和配对癌旁组织表达差异有统计学意义(P<0.05).annexin A10在癌组织和癌旁组织的表达差异在淋巴结转移组和未转移组,在高中低分化组均有显著性差异,而与性别、年龄、肿瘤大小、浸润深度、临床分期关系无统计学意义.结论:annexin A10在人食管鳞癌中表达上调.并随肿瘤分化程度降低、淋巴结转移而表达增高.annexin A10可能成为食管鳞癌诊断和预后的一个新的指示靶点.     

食管鳞癌RhoC和OPN蛋白的表达及其对患者预后的影响

目的研究食管鳞癌组织中RhoC和OPN蛋白的表达及其与食管鳞癌生物学行为之间的关系。方法采用免疫组织化学方法(二步法)检测80例食管鳞癌组织中RhoC和OPN蛋白的表达情况,探讨它们与食管鳞癌肿瘤大小、组织分化程度、TNM分期、淋巴结转移和预后的关系。结果(1)RhoC蛋白在食管鳞癌组织中的阳性表达率为66.25%,其表达与淋巴结转移有关(rs=-2.115,P<0.05),而与肿瘤大小、组织分化程度和TNM分期无关(P>0.05);RhoC蛋白阳性表达组患者的术后生存时间较阴性表达组短,(P<0.001);(2)OPN蛋白在食管鳞癌组织中的阳性表达率为100%,OPN蛋白的表达水平与组织分化程度(χ2=10.766,P<0.05)及淋巴结转移有关(rs=-2.289,P<0.05),而与肿瘤大小和TNM分期无关(P>0.05);OPN蛋白的表达水平越高,患者术后生存时间越短(P<0.05);(3)RhoC蛋白和OPN蛋白在食管鳞癌组织中的表达之间存在正相关性(rs=0.408,P<0.001)。结论食管鳞癌组织RhoC和OPN蛋白的表达与淋巴结转移情况及患者的预后有密切关系,RhoC蛋白和OPN蛋白可作为食管鳞癌预后评价的参考指标。     

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…     

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.     

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.     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.