非放标AR基因多态性分析探讨子宫平滑肌瘤的克隆性

目的：根据女性体细胞中两条X染色体上雄激素受体（AR）基因的限制性片段长度多态性进行非放标克隆性检测，以探讨子宫平滑肌瘤的克隆组成。方法：自新鲜子宫平滑肌瘤组织中提取基因组DNA，经HhaⅠ消化后，PCR扩增，变性聚丙烯酰胺凝胶电泳后银染显示单股DNA片段长度，结果：在检测的54例子宫平滑肌瘤标本中，32例（59．3％）具有这种AR位点的多态性；其中3例标本X染色体失活发生了严重偏移，不适用于这种克隆性分析，对29例共68个平滑肌瘤结节的分析均显示AR位点长度多态性丢失，提示全部为单克隆细胞组成，其中8例结节个数≥3佣的多发性子宫平滑肌瘤中，6例标本的不同瘤结节均具有相同的X染色体灭活带型，另外，发现1例具有X染色体失偏移的标本其肿瘤组织中有额外条带出现，而且两个瘤结节具有相同改变，结论：此研究为国内开展非放标AR克隆性检测奠定了基础，同时还证实我们以前的研究结果，部分子宫平滑肌瘤不同瘤结节之间可能有共同的克隆起源。     

肺硬化性血管瘤整个病变的克隆性

目的:探讨肺硬化性血管瘤(PSH)整个病变的克隆性并阐明其本质.方法:利用激光显微切割技术获取22例女性肺PSH组织中多角形细胞和表面立方细胞构成的整个病变及病变周围正常肺组织,分别提取基因组DNA,通过基于女性体细胞构成组织内X染色体失活嵌合性和磷酸甘油酸激酶(PGK)基因位点的克隆性分析、观察PSH整个病变的克隆性.结果:22例肺PSH光镜下均表现为典型的组织病理学特征,即呈实性、乳头状、硬化性和出血性组织结构.病变主要由间质圆形或多角形细胞及被覆在乳头状结构表面的立方细胞所构成.克隆性检测结果表明有7例31.8%(7/22)显示PGK基因位点多态性.经HpaⅡ酶切后,所有具有多态性的标本2个条带中有1个条带的密度明显减弱或消失,而另1个条带保留,证明其均为肿瘤性增生.结论:PSH是一种真性肿瘤,构成PSH的2种主要细胞起源于同一类型细胞.     

平滑肌瘤女性患者中肿瘤坏死子-α-308启动子和p53密码子72基因的多态性

肿瘤坏死因子-α(TNF-α)是一种致炎细胞因子,在自身免疫性疾病中发挥重要的作用。p53与细胞生长调控和抑癌作用有关。本文旨在研究TN F-α-308启动子基因多态性及p53基因多态性能否作为平滑肌瘤的易感性指标。试验采用前瞻性基础研究。试验地点为医学中心的妇科和遗传学科。第1组:平滑肌瘤患者(n=159),第2组:非平滑肌瘤患者(n=131)。从外周血白细胞中获取基因组D N A。对TNF-α和p53的基因多态性行聚合酶链反应(PCR)扩增、限制性酶切和电泳检测。鉴定两种基因的多态性:①染色体6p21.3的TN F-α基因A(可酶切)/G(不可酶切)多态性。②…     

子宫富于细胞性平滑肌瘤雌、孕激素受体及Ki-67的表达及临床意义

目的 分析评价子宫富于细胞性平滑肌瘤中雌激素受体（ER）、孕激素受体（PR）、Ki-67的表达及临床意义.方法 收集2010～2014年湖北省妇幼保健院41例子宫富于细胞性平滑肌瘤、12例普通型子宫平滑肌瘤、5例恶性潜能未定子宫平滑肌瘤及10例子宫平滑肌肉瘤患者的子宫组织标本,采用免疫组化法检测各子宫组织中ER、PR以及Ki-67的表达水平.结果 ER在普通型子宫平滑肌瘤（83.3％）、富于细胞性平滑肌瘤（90.2％）以及恶性潜能未定型平滑肌瘤的阳性表达率（80.0％）逐渐下降,差异无统计学意义（P＞0.05）.ER在普通型子宫平滑肌瘤、富于细胞性平滑肌瘤以及恶性潜能未定型平滑肌瘤的阳性表达率均显著高于子宫平滑肌瘤肉瘤（10.0％）的表达,差异有高度统计学意义（P＜0.01）.PR在普通型子宫平滑肌瘤（100.0％）、富于细胞性平滑肌瘤（97.6％）以及恶性潜能未定型平滑肌瘤的阳性表达率（80.0％）逐渐下降,但差异无统计学意义（P＞0.05）.PR在普通型子宫平滑肌瘤、富于细胞性平滑肌瘤以及恶性潜能未定型平滑肌瘤的阳性表达率均显著高于子宫平滑肌瘤肉瘤（20.0％）,差异有高度统计学意义（P＜0.01）.Ki-67在普通型子宫平滑肌瘤[（0.020±0.009）个/10 HPF]、富于细胞性平滑肌瘤中[（0.039±0.011）个/10 HPF]的表达量比较,差异无统计学意义（P＞0.05）.Ki-67在普通型子宫平滑肌瘤、富于细胞性平滑肌瘤中的表达均显著低于恶性潜能未定型平滑肌瘤[（0.231±0.077）个/10 HPF]和子宫平滑肌肉瘤中[（0.320±0.103）个/10 HPF]的表达,差异有高度统计学意义（P＜0.01）.子宫富于细胞性平滑肌瘤组织中ER和PR表达没有明显的相关性（P＞0.05）,两者与Ki-67呈显著正相关（r=0.399、0.452,P＜0.05）.结论 子宫富于细胞性平滑肌瘤组织中ER和PR高表达,ER和PR的表达与Ki-67呈正相关.ER、PR和Ki-67的表     

不同位点显微切割对宫颈鳞癌及其上皮内瘤变克隆性分析的影响

目的探讨同一病例不同位点组织显微切割方法对宫颈鳞状细胞癌(squamous cell carcinoma,SCC)及其宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)克隆性检测结果的影响和意义。方法随机选取病理存档宫颈SCC 22例,CIN 48例,采用单位点或多位点显微切割方法,分别切取病变上皮组织及其相应的间质,抽提DNA,用限制性内切酶HpaⅡ酶切,聚合酶链反应(PCR)扩增人类X染色体上的雄激素受体基因第一外显子,比较酶切前后的结果,判断病变的克隆性特征。结果纯合子8例,杂合子62例,杂合率88.6%。CIN组单克隆性病变明显高于正常对照组,单位点显微切割病变的单克隆率为CINⅠ5/20(25%)、CINⅡ/Ⅲ16/22(72.7%)和宫颈SCC17/20(85%);多位点显微切割病变的单克隆率为CINⅠ3/20(15%)、CINⅡ/Ⅲ13/22(59%)和宫颈SCC12/20(60%),其检测结果差别有统计学意义(P<0.05)。多点微切割的病变中,10例呈现不同的X染色体失活类型。结论单位点显微切割的方法检测宫颈病变单克隆性比多位点显微切割更为准确,对判断CIN的肿瘤属性有意义。多位点显微切割对研究SCC发生的单中心或多中心起源有意义。本组结果提示大部分SCC起源于单个位点的单克隆改变,而部分病例为多位点的单克隆发生。     

X染色体失活和微卫星分析确定多发性子宫平滑肌瘤的独立克隆来源

目的:本研究分析了来自14例多发性子宫平滑肌瘤患者的43份样本的15个微卫星标志物的等位基因状态,并进行X染色体灭活分析,探讨子宫平滑肌瘤的肿瘤发生中的克隆性和遗传的关系。研究设计:本研究对定位于3q、7p、11及15q的15个微卫星多态性标志物进行自动性分析。通过X-连锁雄激素受体基因的甲基化状态来评估X染色体的失活。结果:15个微卫星标志物中至少有1个发生等位基因缺失,8例中有7例的杂合性缺失类型不同,在同一患者的3份样本同时监测到7p22-15存在杂合性缺失。X染色体失活分析显示12例患者中有9例患者的所有肿瘤样本中均出现了同样的…     

伴发乳头状肾细胞癌的家族性多发性皮肤和子宫平滑肌瘤

多发性皮肤和子宫平滑肌瘤是一种常染色体显性遗传综合征,可导致皮肤发生良性平滑肌瘤,在女性可发生子宫平滑肌瘤。该综合征可重叠遗传性平滑肌瘤病和肾细胞癌综合征,患者不仅发生皮肤平滑肌瘤,还可发生罕见的II型乳头状肾细胞癌。近来,上述两个综合征均发现编码延胡索酸水合酶基因杂合性突变。延胡索酸水合酶在Kreb循环中催化延胡索酸转变为苹果酸,并可能有肿瘤抑制功能。作者报道1个发生多发性平滑肌瘤、子宫平滑肌瘤和乳头状肾细胞癌的家系。先证者为女性,波兰人,77岁,30岁时发生右上臂多发性皮肤平滑肌瘤,40岁时因子宫平滑肌瘤行子宫…     

子宫平滑肌肿瘤临床病理分析

目的总结子宫平滑肌肿瘤临床病理组织学分型。方法回顾性分析300例子宫平滑肌肿瘤的临床病理资料。结果子宫肌壁间258例（86%）,浆膜下18例（6%）,黏膜下24例（8%）,平滑肌瘤276例（92%）,平滑肌肉瘤2例（0.67%）,交界性平滑肌瘤22例（7.33%）。结论良性平滑肌瘤最多见,恶性平滑肌瘤很少见,交界性平滑肌瘤将会随着诊断水平的不断提高越来越少。     

子宫富于细胞性平滑肌瘤雌激素受体孕激素受体Ki-67表达与临床病理特点相关性研究

本文利用免疫组织化学技术对32例子宫富于细胞性平滑肌瘤（cellular leiomyoma,CL）雌激素受体（ER）、孕激素受体（PR）和Ki-67进行检测,目的在于探讨ER、PR、Ki-67在不同临床病理特点子宫富于细胞性平滑肌瘤中的表达情况及在其发生发展中的意义。     

雷公藤多甙对子宫肌瘤患者子宫和肌瘤血供的影响

子宫肌瘤是女性生殖系统最常见的良性肿瘤 ,是起源于单个平滑肌细胞的单克隆性肿瘤 ,至少有 30 %的 30岁以上妇女患有肌瘤。虽然肌瘤相当常见 ,但其发病机制尚不清楚。目前认为肌瘤的发生与肌细胞遗传物质的改变有关 ,现已发现肌瘤细胞中存在多种类型的染色体异常 ,以7、12、14     

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.