核糖体S6蛋白激酶4和热休克蛋白90在乳腺癌中的表达情况及其与患者临床病理特征及预后的关系

目的 探讨核糖体S6蛋白激酶4(RSK4)和热休克蛋白90(HSP90)在乳腺癌中的表达情况及其与患者临床病理及预后的关系.方法 采用免疫组织化学法检测72例手术切除的乳腺癌组织和72例癌旁组织的RSK4和HSP90蛋白的表达情况,分析不同临床病理特征患者RSK4和HSP90蛋白的表达情况,比较不同RSK4和HSP90表达水平患者的生存期.结果 RSK4蛋白在乳腺癌癌旁组织中的阳性表达率高于癌组织(P<0.05),HSP90蛋白在乳腺癌癌组织中的阳性表达率高于癌旁组织(P<0.05),在乳腺癌组织中RSK4与HSP90蛋白的表达呈负相关(P<0.05).不同分化程度、TNM分期患者的乳腺癌组织RSK4蛋白阳性表达率比较,差异均有统计学意义(P<0.05),不同肿瘤大小、有无淋巴结转移、不同组织学分化、不同TNM分期患者乳腺癌组织的HSP90蛋白阳性表达率比较,差异均有统计学意义(P<0.05).RSK4蛋白阳性表达患者的中位生存期为71个月,多于RSK4蛋白阴性表达患者的54个月(P<0.05),HSP90蛋白阳性表达患者的中位生存期为41个月,少于HSP90蛋白阴性表达患者的82个月(P<0.05).结论 乳腺癌组织中RSK4的表达降低,HSP90的表达升高,RSK4和HSP90在乳腺癌中可能通过某些通道存在相互影响的关系.     

胰腺癌组织FOXC2的表达及其与预后的关系

目的: 探讨叉头框C2(forkhead box C2,FOXC2)在胰腺癌中的表达及其与胰腺癌患者预后的相关性。方法: 利用Oncomine数据库分析FOXC2 mRNA在胰腺癌及癌旁组织中的表达;收集112例胰腺患者癌组织及相应癌旁组织,采用qRT-PCR和免疫组织化学染色检测FOXC2的表达,并分析其与临床病理参数的关系。应用Kaplan-meier法分析FOXC2表达对患者生存时间的影响。结果： Oncomine数据库中FOXC2 mRNA在胰腺癌癌组织中表达明显高于癌旁组织(t_Badea=4.074,t_Pei= 3.741,P均<0.05);FOXC2蛋白主要表达于胰腺癌细胞胞核,且癌组织免疫组化评分明显高于癌旁组织( t=7.571,P<0.05);FOXC2 mRNA在胰腺癌组织中表达明显高于癌旁组织( t=13.79,P<0.05);有淋巴结转移的癌组织中FOXC2阳性表达率高于无淋巴结转移的癌组织(χ ² =16.998,P<0.01),胰腺癌Ⅲ期FOXC2阳性表达率高于Ⅰ期( χ 2=15.688,P<0.001)和Ⅱ期( χ ²=10.678,P=0.001)。FOXC2阳性组胰腺癌患者的中位生存时间显著短于阴性组( χ ²=10.32,P=0.001 3),FOXC2阳性表达(HR=2.569,P=0.003)可作为预测胰腺癌预后的独立因素。 结论： FOXC2在胰腺癌组织中呈高表达,且与胰腺癌患者的预后高度相关。     

组织芯片技术检测SFRP4在人胰腺癌组织中的表达

目的 胰腺癌组织芯片检测SFRP4的表达情况。方法经手术切除及病理确诊的90例胰腺癌组织和对应癌旁组织标本,制成组织芯片,免疫组织化学技术检测SFRP4在胰腺癌及对应癌旁组织中的表达,分析其与肿瘤病理特征、预后关系。结果 SFRP4蛋白主要在细胞胞质中表达;90例样本实验结果显示,胰腺癌组织中SFRP4阳性表达率(31.1%)高于癌旁组织(14.4%),差异有统计学意义(P<0.05);本组SFRP4表达与胰腺癌患者年龄、性别、肿瘤大小、肿瘤TNM分期及预后无关(P>0.05)。结论 SFRP4在胰腺癌组织的阳性表达率高于癌旁组织,提示SFRP4参与胰腺癌的发生过程。     

S100A4蛋白在结直肠癌中的表达

目的研究S100A4蛋白在结直肠癌组织中的表达及其临床意义。方法应用免疫组织化学S-P法检测87例结直肠癌组织及癌旁结直肠组织中S100A4蛋白,并分析S100A4表达与结直肠癌临床病理因素及术后5年生存率的关系。结果在癌旁结直肠组织腺上皮中S100A4蛋白不表达;在结直肠癌组织中S100A4蛋白的表达率为64.4%(56/87);与癌旁结直肠组织比较,差异有显著性(P<0.01);S100A4蛋白在结直肠癌中的表达与临床分期、淋巴结转移及5年生存率有关(P<0.05),与其它临床病理因素无关(P>0.05)。结论S100A4蛋白和结直肠癌的侵袭和转移及预后密切相关;S100A4蛋白可作为判定结直肠癌临床病理特征及判断预后的重要指标。     

钙离子结合蛋白S100A4在胰腺癌组织中的表达及其意义

目的探讨胰腺癌组织中钙离子结合蛋白S100A4的表达及其临床意义。方法应用免疫组化EliVisionTMPlus法检测70例手术切除的原发洼胰腺癌组织及15例癌旁非肿瘤胰腺组织中S100A4蛋白的表达情况,比较S100A4表达与临床病理指标的关系。结果70例标本中S100A4阳性率为74．3％（52／70）,而癌旁非肿瘤胰腺组织中未见表达,差异有统计学意义（χ2=28．70,P〈0．05）;S100A4表达与性别、年龄及肿瘤部位无关（P〉0.05）,与肿瘤大小、分化程度、TNM分期、淋巴结转移、生存期显著相关（P〈0.05）。S100A4表达阳性组与阴性组之间无瘤生存率（χ2=13．12,P〈0．05）及总体生存率（χ2=20.64,P〈0.05）差异均有统计学意义。结论S100A4蛋白的高表达与胰腺癌的临床病理指标密切相关,其高表达提示患者预后不良。     

G蛋白信号调节蛋白2在胰腺癌组织中的表达及临床意义

目的: 探讨G蛋白信号调节蛋白2（G-protein signaling modulator 2,GPSM2）基因在胰腺癌组织中的表达及其临床意义。方法: 选取54例胰腺癌患者临床石蜡样本制作组织芯片,利用免疫组化检测GPSM2在胰腺癌组织中的表达并分析GPSM2的表达与患者临床病理参数及预后的关系;另选取同期10例新鲜胰腺癌标本及配对的癌旁组织,采用实时RT-PCR法和蛋白质印迹法检测GPSM2 mRNA和蛋白的表达水平。结果： 胰腺癌组织GPSM2 mRNA 及蛋白的表达均明显高于配对的癌旁组织（P均<0.05）。组织芯片检测结果显示,与配对的癌旁组织比较,胰腺癌组织中GPSM2表达明显上调（P<0.05）,其高表达（40例）比例达74.1%。GPSM2的表达与患者的肿瘤T分期、TNM分期、分化程度相关：T分期越差(χ2=12.654,P＜0.01),TNM分期越高(χ2=16.610,P＜0.01),肿瘤分化程度越差(χ2=10.355,P＜0.01),其GPSM2表达水平越高。生存分析表明,GPSM2高表达患者的中位生存期明显低于低表达患者（P＜0.05）。结论： 胰腺癌组织GPSM2过表达,其表达与患者的肿瘤T分期、TNM分期、肿瘤分化程度相关,且与胰腺癌的预后有一定相关性。     

Fascin-1在胰腺癌中的表达及意义

目的探讨Fascin-1蛋白在胰腺癌组织中的表达及其与临床病理参数的关系。方法采用免疫印迹法检测Fascin-1蛋白在5株胰腺癌细胞株(AsPC-1、HPAC、PANC-1、Capan-2、BxPC-3)中的表达。采用免疫组织化学染色SP法测定62例人胰腺癌中和53例癌旁正常组织中Fascin-1蛋白的表达情况,统计分析其与胰腺癌临床病理参数(TNM分期、淋巴结转移、组织分化等)的关系。结果胰腺癌细胞株AsPC-1、HPAC、PANC-1及Capan-2中Fascin-1蛋白呈阳性表达,BxPC-3中Fascin-1蛋白无表达。胰腺癌组织中Fascin-1蛋白的表达率为61.3%,癌旁正常组织中Fascin-1蛋白不表达,差异有统计学意义(P<0.05)。Fascin-1蛋白的表达与胰腺癌的TNM分期、组织分化程度、门脉是否受侵及有无淋巴结转移有关(均P<0.05),与患者的性别、年龄及肿瘤大小无关(均P>0.05)。结论 Fascin-1蛋白在胰腺癌细胞株及癌组织中高表达,在癌旁正常组织中不表达,提示其可能参与胰腺癌的发生、侵袭及转移过程。     

宫颈鳞癌组织中Snail mRNA和蛋白的表达

目的:检测宫颈鳞癌组织中Snail mRNA和蛋白的表达.方法:采用免疫组织化学及RT-PCR法,检测宫颈鳞癌组织(n=141、48)、癌旁组织(n=48、48)及正常宫颈组织(n=48、48)中Snail蛋白及mRNA的表达,并分析其与临床病理参数之间的关系.结果:宫颈鳞癌、癌旁组织中Snail mRNA的阳性表达率高于正常组织(P均<0.05),且癌组织中Snail mRNA阳性表达率与淋巴结转移情况有关(P<0.05),但与肿瘤的分化程度、FIGO分期无关(P均>0.05).3组组织中Snail mRNA相对表达量比较,差异无统计学意义(P>0.05).宫颈鳞癌及癌旁组织中Snail蛋白的阳性表达率高于正常宫颈组织(P<0.05),且癌组织中Snail蛋白阳性表达率与分化程度、FIGO分期、淋巴结转移情况有关(P均<0.05).结论:宫颈鳞癌的癌变、侵袭、转移可能与Snail蛋白及mRNA的高表达有关,Snail可作为预测宫颈鳞癌预后的指标之一.     

热休克蛋白90β在胰腺癌组织中的表达及其对预后的影响

目的研究胰腺癌组织中热休克蛋白90β(HSP90β)的表达及其对预后的影响。方法收集2015年1月至2018年1月郑州大学附属洛阳市中心医院病理科提供的51例胰腺癌标本和43例癌旁正常组织标本。采用免疫组织化学染色的方法测定HSP90β在胰腺癌组织及癌旁组织中的表达水平,分析其与胰腺癌临床病理特征和预后的关系,采用Kaplan-Meier法进行生存分析。结果 HSP90β在癌旁正常组织中的阳性表达率(18.6%)低于胰腺癌组织(56.9%),差异有统计学意义(P<0.001)。HSP90β与胰腺癌分期、分化、有无淋巴结转移有关(P<0.05),与患者年龄、性别、肿瘤大小无关(P>0.05)。Kaplan-Meier生存分析结果显示:HSP90β阴性表达患者生存时间长于阳性患者(P<0.05)。结论 HSP90β在胰腺癌组织中表达上调,可能参与胰腺癌的发生、发展、侵袭及转移过程,HSP90β高表达提示预后不良。     

Skp2和P27kip1蛋白在胰腺癌中的表达及与临床病理特征的关系

目的:探讨S期激酶相关蛋白2(S-phase kinase-associated protein 2,Skp2)与P27kip1在胰腺癌中的表达及与临床病理特征的关系。方法:采用免疫组化方法(SP法)检测31例胰腺癌组织和14例癌旁组织中Skp2和P27kip1的表达。结果:31例胰腺癌组织中Skp2阳性表达率为32.26%(10/31),显著高于癌旁组织0%(0/14)(P<0.05);P27kip1的阳性表达率为45.16%(14/31),明显低于癌旁组织78.57%(11/14)(P<0.05)。统计分析还显示:随着癌组织分化程度降低、TNM分期升高、淋巴结的转移Skp2阳性表达率相应升高(P<0.05),而P27kip1的阳性表达率降低(P<0.05)。两者的表达与性别、年龄及肿瘤大小均无关(P>0.05),且Skp2和P27kip1在胰腺癌的表达存在明显的负相关(rs=-0.59,P<0.01)。结论:Skp2和P27kip1在胰腺癌发生、发展中有重要作用。     

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.