应用原位PCR检测小儿急性白血病免疫球蛋白重链重排

目的：探讨间期细胞原位PCR方法在小儿急性白血病研究中的临床应用价值。方法：采用dig-11-dUTP标记免疫球蛋白重链（IgH）第三互补决定区（CDR－Ⅲ）的引物，建立直接原位PCR方法，检测小儿急性白血病患儿间期淋巴细胞。结果：22例淋巴细胞性白血病初诊患儿中，18例外周血间期淋巴细胞可检测到IgH基因重排；3例骨髓安全缓解，外周血间林巴细胞原位PCR仍有阳性细胞，3个月复发。结论：间期细胞原位PCR技术能敏感、准确地检测小儿B细胞系急性淋巴细胞性白血病，并帮助预测复发。     

基因重排检测技术的建立及其在淋巴瘤诊断中的应用

目的:建立基于克隆性分析技术的B和T淋巴细胞产生的抗原受体分子基因重排检测技术,探讨B淋巴细胞免疫球蛋白及T淋巴细胞受体基因重排在恶性淋巴瘤临床诊断中的应用. 方法: 从组织蜡块中切取组织片5～10张,提取基因组DNA,PCR扩增,聚丙烯酰胺凝胶电泳后银染显示基因重排结果. 结果:20例良性淋巴组织反应性增生病例中, 淋巴细胞IgH及TCR基因重排均为阴性;18例T细胞非何杰金氏淋巴瘤中TCRγ基因重排12例, TCRβ基因重排3例,未见有IgH基因重排;32例B细胞性非何杰金氏淋巴瘤标本中有28例IgH基因重排阳性,有2例TCRγ和IgH基因重排均阳性;3例未确诊的疑难病例均为IgH基因重排;IgH及TCR基因重排检出率在淋巴瘤组与良性组之间,差异有显著意义(P<0.05). 结论:应用PCR法检测B淋巴细胞IgH和T淋巴细胞TCR基因重排可作为淋巴细胞来源的良、恶性病变的一种辅助诊断手段,且适用于石蜡标本以进行回顾性研究.     

外套细胞淋巴瘤bcl-1/IgH基因重排的检测与序列分析

目的：寻找一种敏感、特异而又快捷的方法检测外套细胞淋巴瘤中bcl-1/IgH基因重组，并分析bcl-1/IgH基因重排产物的序列，以了解bcl-1/IgH基因重排发生的确切机理。方法：对28例经临床确诊的外套细胞淋巴瘤的新鲜冰冻组织，通过半巢式PCR检测bcl-1/IgG基因重排，并对bcl-1/IgH基因重排产物进行克隆和序列分析。结果：通过半巢式PCR测到有bcl-1/IgH基因重排者计17／28例。而采用一步法PCR仅9例有此基因重排，两者相比，差异显著（x^2＝4．59，P＜0．05）。对bcl-1/IgH基因重排产物进行序列分析后发现，bcl-1/IgH基因重排产物为74－162bp大小，融合基因连接区为6－24bp大小。在断裂点集中的65bp范围内，找到10个不同的断裂点，其中5个未见文献报道。对JH基因序列的分析，发现bcl-1/IgH基因重排时，JH1，JH3，JH4，JH5和JH6都可能参与重排，其中，以JH4多见，而JH2则没有涉及。结论：该半巢式PCR方法是检测外套细胞淋巴瘤中bcl-1/IgH基因重排的一种敏感 而特异的方法，对外套淋巴细胞淋巴瘤的明确诊断和治疗都有一定的指导意义，而对bcl-1/IgH基因重排的序列分析，则将为外套细胞淋巴瘤的发病机理研究提供理论依据。     

PCR检测非霍奇金淋巴瘤IgH和TCRβ基因重排

目的 探讨PCR方法检测IgH和TCRβ基因重排在非霍奇金淋巴瘤(NHL)诊断中的临床意义。方法 用PCR方法检测40例非霍奇金淋巴瘤和5例慢性淋巴结炎的基因重排情况。结果 20例B细胞NHL中检测出19例IgH基因重排，20例T细胞NHL中检测出17例TCRβ基因重排。结论 PCR方法检测NHL中IgH和TCRβ基因重排具有敏感、特异的优点，在非霍奇金淋巴瘤的诊断中具有重要价值。     

B细胞淋巴瘤免疫球蛋白重链基因重排的检测

目的 探讨免疫球蛋白重链(IgH)基因重排的检测在B细胞性淋巴瘤(B-NHL)中的诊断价值。方法 用聚合酶链式反应(PCR)方法检测B细胞淋巴瘤30例．淋巴结反应性增生(RH)10例及T细胞淋巴瘤(T-NHL)2例的IgH基因重排。结果 30例B-NHL中，22例(73．3％)出现IgH基因克隆性重排，而RH及T-NHL均未出现IgH基因重排。结论 B细胞淋巴瘤中存在B细胞单克隆增生，支持肿瘤单克隆起源学说；IgH基因克隆性重排检测对鉴别B细胞淋巴瘤和反应性增生以及T细胞和B细胞淋巴瘤有重要意义。     

免疫球蛋白重链T细胞受体γ基因重排在急性淋巴细胞白血病中的表达

目的：探讨初诊急性淋巴细胞白血病（ALL）患者免疫球蛋白重链（IgH）、T细胞受体γ（TCRγ）基因重排情况。方法：应用多聚酶链反应（PCR）检测19例初发ALL患者骨髓IgH、TCRγ基因重排。结果：19例标本中10例发生单一IgH基因重排，5例发生单-TCRγ基因重排，2例同时出现IgH/TCRγ基因重排。结论：ALL患者IgH基因重排几率高于TCRγ基因重排，且存在着交叉重排现象。     

B细胞恶性肿瘤患者血浆游离DNA中IgH基因重排检测及临床意义

目的：探讨检测B细胞肿瘤患者血浆DNA 标本IgH基因重排对辅助诊断及判断预后的临床意义。方法：采集83例B细胞急性淋巴细胞白血病（B-ALL）、B细胞非霍奇金淋巴瘤(B-NHL)及多发性骨髓瘤（MM）患者共110份血浆标本，提取血浆游离DNA，PCR检测IgH基因重排。结果：63例初发B细胞肿瘤患者IgH基因重排检测阳性率为77.8％，而缓解病例的阳性率为27.6％，初发患者检测阳性率显著高于缓解病例（P < 0.01）。结缔组织病、感染性疾病及健康人均呈阴性结果。IgH基因重排检测阳性率与B-NHL和MM的分期、血清β2-微球蛋白（β2-MG）和乳酸脱氢酶（LDH）水平无关（P > 0.05）。追踪检测16例患者显示12例初发检测阳性者治疗缓解后转为阴性，其中3例缓解后6～9月检测血浆IgH基因重排再次转为阳性，随后此3例患者均出现临床复发，检测转阳较临床复发提前1～4月。1例在初诊和完全缓解期间检测均为阳性ALL患者，经异基因干细胞移植后转为阴性；3例检测始终阳性的患者疗效不佳，始终未获缓解。结论：初治B细胞肿瘤患者血浆游离DNA中检测IgH基因重排阳性率高、特异性强、取材简便，有望用于B细胞肿瘤辅助诊断，追踪检测还有助于判断预后。 【关键词】 B细胞，肿瘤； 血浆，DNA； 免疫球蛋白， 重链；基因重排； PCR     

基因重排检测技术诊断脾脏淋巴瘤

目的:利用B和T淋巴细胞产生的抗原受体分子基因重排检测技术,探讨1例原发性脾脏恶性淋巴瘤(PLS)基因重排检测结果.方法:从组织蜡块中切取组织片5～10张,提取基因组DNA,PCR扩增,聚丙烯酰胺凝胶电泳后银染显示基因重排结果.结果:脾脏淋巴瘤免疫组化证实为B细胞性滤泡性淋巴瘤.从24个不同部位取得的组织经PCR均扩增成功,所有部位组织T细胞受体基因重排阴性,22个部位组织B细胞单克隆性免疫球蛋白基因重排阳性,基因重排阳性率91.7%.结论:应用PCR法检测B淋巴细胞IgH和T淋巴细胞TCR基因重排可作为淋巴细胞来源的良、恶性病变的一种辅助诊断手段,对脾脏淋巴瘤有较高的诊断价值.     

多聚酶链反应检测淋巴细胞白血病免疫球蛋白重链基因重排及其临床意义

用多聚酶链反应技术扩增42例急、慢性白血病患骨髓白血病球蛋白重链（IgH)基因重排产生的第三互补决定区（CDR-Ⅲ）DNA序列。结果显示：35例淋巴细胞白血病中25例出现IgH基因单克隆性重排（71.4%)，其中急、慢性B淋巴细胞白血病各为80%（16/20）和87.5%(7/8)及2例T、B淋巴细胞双表型白血病，另外有1例急性未分化白敌国病也出现这种重排，而5例，急性T淋巴细胞白血病和6例急性髓细胞白血病均无重排，对3例CDR-Ⅲ阳性克隆的B-ALL病例在完全缓解期进行微小残留病变检测，其中2例PCR阳性病人先后复发，1例PCR阴性病人缓解持续时间明显长于阳性病人。     

半巢式PCR方法检测外套细胞淋巴瘤bcl—1／IgH基因重排

目的探讨敏感、特异而又快捷的bcl-1/IgH基因重排检测方法.方法对28例经临床确诊的外套细胞淋巴瘤的新鲜冰冻组织,分别采用半巢式PCR和一步法PCR检测bcl-1/IgH基因重排.结果通过半巢式PCR测得有bcl-IgH基因重排者计17/28例,而采用一步法PCR仅9例有此基因重排,两者检出率差异有显著性意义(x2=4.59,P＜0.05).结论半巢式PCR方法检测外套细胞淋巴瘤中bcl-1/IgH基因重排比一步法PCR敏感而特异.     

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.