凋亡相关基因Bcl-2、Bag-1在宫颈上皮病变中的表达及意义

目的：探讨Bcl-2蛋白和Bag-1蛋白在宫颈癌发生、发展中的表达变化以及两者的关系。方法：采用免疫组织化学SP法,分别对39例宫颈上皮内瘤变CINⅠ/Ⅱ、25例CINⅢ（原位癌4例）及36例浸润性宫颈鳞癌（ISCC）组织中的Bcl-2和Bag-1蛋白进行检测,并以20例子宫肌瘤经手术切除的正常宫颈鳞状上皮作对照进行分析。结果：Bcl-2蛋白在正常宫颈组织、CINⅠ/Ⅱ、CINⅢ和宫颈癌组织中表达率分别为10.00%、43.57%、76.00%、66.67%,其表达在CIN和宫颈癌组织间差异无统计学意义（P〉0.05）,在其余各组之间差异有统计学意义（P〈0.05）。Bag-1在正常宫颈组织、CINⅠ/Ⅱ、CINⅢ和宫颈癌组织中的表达率分15.00%、48.72%、72.00%、83.33%,其表达在正常组织与CIN和宫颈癌之间差异有统计学意义（P〈0.01）,在上皮内瘤变与宫颈癌中差异也具有统计学意义（P〈0.05）。宫颈癌中Bcl-2与Bag-1蛋白表达同时增加。结论：宫颈鳞状上皮不典型增生和鳞状上皮癌中均有Bcl-2、Bag-1过表达,表明它们在宫颈癌的发生、发展中均起重要作用。Bcl-2与Bag-1在肿瘤早期抗凋亡作用相互增强,呈正相关关系。     

宫颈病变中凋亡调控因子Bcl-2、Survivin及Fas的表达与意义

目的:探讨Bcl-2、Survivin、Fas在宫颈癌发生、发展中的变化。方法:应用免疫组化SP法对42例宫颈上皮内瘤变(CIN)Ⅰ、38例CINⅡ、45例CINⅢ及40例浸润性宫颈鳞癌(ISCC)和30例正常宫颈组织的石蜡标本进行Bcl-2、Survivin、Fas的检测。结果:Bcl-2、Survivin在宫颈癌组织中的阳性率与CIN、正常宫颈组织有显著性差异(P<0.05),且在宫颈上皮癌变过程中CIN各组Bcl-2、Survivin表达呈逐级升高趋势,Fas在CIN及宫颈癌组织中的表达低于在正常组织中的表达,差异有显著性(P<0.05),且Survivin与Bcl-2、Fas有相关性。结论:Bcl-2、Survivin在宫颈癌和宫颈上皮内瘤样变中的表达水平增加,而Fas表达水平降低,提示Bcl-2、Survivin、Fas通过调控细胞凋亡参与了宫颈癌的发生和发展。     

宫颈上皮内瘤样病变及宫颈鳞癌组织中细胞凋亡和P53的表达

目的探讨细胞凋亡和P53蛋白在宫颈上皮内瘤样病变(CIN)和鳞癌中的表达。方法采用DNA末端缺口标记技术和免疫组织化学技术检测15例正常宫颈组织、14例CINⅠ、10例CINⅡ、20例CINⅢ和52例浸润性宫颈鳞癌(ISCC)中细胞凋亡标记指数(A-LI)和增殖细胞核抗原标记指数(PCNA-LI)。结果在正常宫颈组织未检测到凋亡细胞,从CINⅠ→CINⅡ→CINⅢ,A-LI逐渐增加(P＜0.05),ISCC中A-LI明显低于CIN(P＜0.01),PCNA-LI随宫颈癌各级病变的进展逐渐增加(P＜0.05);在正常宫颈和CINⅠ,未检测到P53蛋白表达,在CINⅡ可检测到少量阳性细胞,P53-LI在CINⅢ明显低于ISCC(P＜0.01)。结论细胞凋亡在宫颈癌发生发展中发挥了重要作用,P53蛋白的调节可能阻断了细胞凋亡。     

水通道蛋白1和血管内皮生长因子在宫颈鳞状上皮癌组织中的表达及相关性

目的:探讨水通道蛋白1(AQP1)和血管内皮生长因子(VEGF)在宫颈鳞状上皮癌组织中的表达及相关性。方法:应用免疫组织化学法检测41例宫颈鳞状上皮癌、55例宫颈上皮内瘤变(CIN)和22例正常宫颈组织中AQP1、VEGF的表达,探讨二者在宫颈癌组织中的表达及相关性。结果:AQP1在宫颈鳞状上皮癌、CIN的阳性率分别为90.24%、81.82%,均显著高于正常宫颈组织的40.91%(P<0.01);VEGF在宫颈鳞状上皮癌、CIN的阳性率分别为100.00%、96.36%,显著高于正常宫颈组织的63.64%(P<0.01);AQP1在宫颈鳞状上皮癌和CIN组织中的表达差异无统计学意义(P>0.05),而宫颈鳞状上皮癌组织中VEGF表达均明显高于CIN组织(P<0.01);AQP1、VEGF的表达与宫颈鳞状上皮癌患者的年龄和组织学分化程度间差异均无统计学意义(P>0.05);AQP1和VEGF的表达呈明显正相关关系(P<0.01)。结论:AQP1和VEGF在宫颈鳞状上皮癌和CIN组织中表达上调,可能与宫颈鳞状上皮癌的发生、发展有一定关系。     

宫颈鳞状上皮癌中Bcl-2、P53的表达及其相关临床研究

目的 探讨宫颈鳞状上皮癌中Bcl-2、P53的表达及其相关临床研究.方法 用免疫组织化学方法检测60例宫颈鳞状上皮非典型性增生患者,50例原位癌患者和60例浸润性宫颈鳞状上皮癌患者中Bcl-2、P53表达情况.结果 Bcl-2在鳞状上皮非典型性增生、原位癌浸润、鳞状上皮癌中表达率分别为26.7%、44.0%和43.3%.表达在不典型增生与癌之间差异有统计学意义,且和组织分化程度有关.P53在三者之间表达率分别为6.7%、8.0%和26.7%,角化型和非角化型鳞状上皮癌之间表达差异有统计学意义（P＜0.05）.结论 宫颈鳞状上皮非典型性增生和鳞状上皮癌中均有Bcl-2和P53表达,表明它们在鳞状上皮癌的发生、发展中起一定作用,且P53异常表达是宫颈癌的早期事件,和宫颈癌的发生有关.     

HIF-1α和 P53蛋白在宫颈上皮内瘤样变及宫颈癌中的表达及意义

目的探讨HIF-1α和P53蛋白在宫颈癌,宫颈上皮内瘤样变及宫颈鳞状上皮组织中的表达及意义。方法采用免疫组化SP法检测了HIF-1α和P53蛋白在20例宫颈鳞状上皮组织,28例宫颈上皮内瘤样变和54例宫颈癌中的表达情况,其中宫颈鳞状上皮组织作为对照组。结果HIF-1α在宫颈鳞状上皮、宫颈上皮内瘤样变和宫颈癌中的阳性表达率分别为0.0%、35.71%、64.81%,三者阳性表达呈逐渐上升的趋势,三者之间存在显著性差异(P<0.01);HIF-1α在宫颈上皮内瘤样变中的表达与对照组间差异显著(P<0.05);HIF-1α在宫颈癌中的表达与对照组间差异显著(P<0.01);HIF-1α在宫颈上皮内瘤样变中的表达与在宫颈癌中的表达间存在显著性差异(P<0.05);HIF-1α在CINⅠ、CINⅡ、CINⅢ中表达率分别为0.0%、37.50%、63.64%,呈现逐渐上升趋势,但统计学无显著性差异(P>0.05);同时研究还表明HIF-1α在宫颈癌组织学类型上无显著性差异(P>0.05)。P53蛋白在宫颈鳞状上皮、宫颈上皮内瘤样变和宫颈癌中的阳性表达率分别为0.0%、35.71%、74.07%,三者阳性表达呈逐渐上升趋势,三者之间存在显著性差异(P<0.01);P53蛋白在宫颈上皮内瘤样变中的表达与对照组间差异显著(P<0.05);P53蛋白在宫颈癌中的表达与对照组间差异显著(P<0.01);P53蛋白在宫颈上皮内瘤样变中的表达与在宫颈癌中的表达间有显著性差异(P<0.01);P53蛋白在CINⅠ、CINⅡ、CINⅢ中表达率分别为0.0%、33.3%、54.55%,呈现逐渐上升的趋势,但统计学无显著性差异(P>0.05);同时研究还表明P53蛋白在宫颈癌组织学类型上无显著性差异(P>0.05)。HIF-1α与P53蛋白在正常宫颈组织中均无阳性表达,随着宫颈上皮内瘤样变的发展,出现逐渐上升的阳性表达趋势,直到宫颈癌组织中,HIF-1α与P53蛋白均出现强阳性表达,并且二者具有显著性差异(P<0.01),具有相关性。结论HIF-1α与P53蛋白的过度表达与宫颈癌的发生、发展有关,是宫颈癌发生的早期事件。     

S期激酶相关蛋白2在宫颈上皮内肿瘤和宫颈鳞状细胞癌中的表达及意义

目的 探讨S期激酶相关蛋白2(Skp2)在正常宫颈上皮、宫颈上皮内肿瘤(CIN)、宫颈鳞状细胞癌(SCC)中的表达及其在宫颈癌演进过程中作用和意义.方法 用鼠抗人Skp2单克隆抗体,免疫组化两步法标记12例正常宫颈组织、30例宫颈上皮内肿瘤、30例宫颈鳞状细胞癌组织.结果 正常宫颈组织、宫颈上皮内肿瘤和宫颈鳞状细胞癌Skp2表达阳性率分别为0%、76.6%、83.3%.正常宫颈组织与宫颈上皮内肿瘤、正常宫颈组织与宫颈癌Skp2的表达有显著差异(P＜0.01).而宫颈上皮内肿瘤与宫颈癌比较Skp2的表达无显著性差异(P＞0.05).结论 Skp2参与了正常宫颈组织向宫颈上皮内肿瘤的演变,可能与宫颈鳞状细胞癌的发生和发展有关.     

p63、p73蛋白在宫颈癌及癌前病变中的表达及其相关性研究

目的 研究p63、p73蛋白在宫颈癌及癌前病变中的表达及两者的相关性,初步探讨p63、p73基因在宫颈肿瘤发生、发展过程中的作用.方法 采用免疫组化方法检测12例正常宫颈组织、38例宫颈上皮内瘤变(CIN)、32例宫颈鳞癌和8例宫颈腺癌患者的病理组织切片中p63、p73蛋白的表达情况,分析两者与相关临床病理参数问的关系及两者之间的相关性.结果 p63蛋白定位于细胞核内,主要表达在正常宫颈鳞状上皮基底细胞和旁基底细胞、增生的储备细胞、不典型增生的鳞状上皮细胞和鳞癌组织中.在正常组、宫颈上皮内瘤变I级组(CIN Ⅰ)、宫颈上皮内瘤变Ⅱ级组(CIN Ⅱ)、宫颈上皮内瘤变Ⅲ级组(CIN Ⅲ)和鳞癌组中的阳性率分别为;8.3%、44.4%、40.0%、47.4%和68.8%,正常组、CIN组和鳞癌组之间差异有显著性意义.p73蛋白定位于细胞核内.主要表达在宫颈鳞状上皮的基底细胞中,在鳞癌癌巢中散在分布.在正常组、CIN Ⅰ组、CIN Ⅱ组、CINⅢ组和鳞癌组中的阳性率分别为:91.7%、88.9%,80.0%、73.3%和46.9%,正常组和CIN组与鳞癌组之间差异有显著性意义.在正常组、CIN组和鳞癌组之间p63、p73蛋白表达的阳性率呈负相关.在宫颈癌中,p63蛋白的阳性率与组织学类型,分级有关,与发病年龄、临床分期、淋巴结转移、浸润程度及肿瘤大小无关;p73蛋白的阳性率仅与组织学类型有关.结论 p63高表达于鳞状细胞中,可作为宫颈鳞癌及具有向鳞状上皮分化倾向的增生储备细胞的标志物.宫颈鳞癌组织中p63明显高于正常宫颈组织,而p73明显低于正常宫颈组织,提示在宫颈癌的发生、发展过程中,两者可能起到了相互拈抗的作用.     

p57KIP2、PCNA在宫颈癌中表达的研究

目的 探讨p57^KIP2、PCNA蛋白在宫颈癌发生、发展中作用。方法 用免疫组织化学S-P法检测100例宫颈鳞癌（squamous cell carcinoma,SCC）、60例宫颈上皮内瘤变（cervical intraepithelial neoplasia，CIN）和30例正常宫颈鳞状上皮（nonmal cervical squamous epithelium，NE）组织中p57^KIP2、PCNA蛋白的表达情况。结果 p57^KIP2蛋白在宫颈SCC、CIN及NE中的阳性表达率分别为51．00％、56．67％和63．33％；PCNA蛋白在宫颈SCC、CIN及NE中的阳性表达率分别为85．00％、60．00％、26．67％。p57^KIP2蛋白在宫颈SCC组织中阳性表达率与在CIN、NE中阳性表达率之间比较，以及在CIN、NE组织中阳性表达率之间比较，差异均无显著性（P〉0．05）；PCNA蛋白在宫颈SCC组织中阳性表达率与在CIN、NE中阳性表达率之间比较、在CIN中阳性表达率与在NE中阳性表达率之间比较，差异均有显著性（P〈0．01）。结论 p57^KIP2、PCNA蛋白对宫颈癌的发生、发展有一定的意义，PCNA蛋白的异常表达是宫颈癌发生的早期事件。     

PCNA和Bax在青年妇女宫颈鳞状上皮病变中的表达

目的探讨青年妇女子宫颈鳞状上皮病变中增殖细胞核抗原(PCNA)、Bax的表达水平,及其在子宫颈癌发病中的作用。方法用免疫组化方法(Elivision法)检测40例宫颈上皮内瘤变(CIN)Ⅰ级、40例CINⅡ~Ⅲ级及30例早期浸润癌标本的PCNA、Bax表达水平,并选择30例正常宫颈及慢性炎症宫颈鳞状上皮作为对照。结果PCNA、Bax表达率随CIN病变进展而逐渐升高。早期浸润性鳞癌的PCNA阳性表达率较其余各组高(<0.01),CINP CNA阳性表达率较正常宫颈鳞状上皮高(<0.05)。宫颈癌标本Bax的阳性表达率为53.3%,高于正常宫颈鳞状上皮及CINⅠ级(<0.01)。结论青年妇女子宫颈癌的发生发展可能与PCNA和Bax细胞异常增殖和凋亡失衡有关。     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.