T3期胃癌CD34与新生血管形成及淋巴结转移的关系

目的研究T3期胃癌CD34与胃癌新生血管形成及淋巴结转移的关系.方法随机选取胃癌手术标本41例,其中T3N0M020例,T3N1M021例,分别进行特异性抗体免疫组化染色,并采用Image Pro Plus 5.0图像软件分析数据,计算胃癌组织CD34微血管密度(MVD)和其他相关抗体(CD44、Ⅳ型胶原、层黏蛋白)的表达,并进行统计学分析.结果CD34 MVD计数(CD34表达强度),在T3N0M0和T3N1 M0肿瘤组分别为43.10±18.22和56.24±28.36,两组比较有显著差异(P＜0.05);CD44、Ⅳ型胶原、层黏连蛋白的表达强度,T3N0M0和T3N1M0肿瘤组比较无显著差异(P＞0.05).结论CD34与T3期胃癌组织新生血管形成及淋巴结转移的关系密切,可作为诊断T3期胃癌淋巴结转移的参考指标.     

CD105标记的微血管密度及血管内皮生长因子在胃癌中的表达

目的 :对照研究CD34和CD1 0 5在胃癌微血管中的表达并探讨胃癌间质抗CD1 0 5抗体标记的微血管密度 (MVD)和血管内皮生长因子 (VEGF)表达与肿瘤浸润和转移的关系。方法 :应用CD34抗体、CD1 0 5抗体和VEGF抗体 ,采用免疫组化S -P法对我院 2 0 0 3年 3月至 6月 4 0例手术切除的胃癌患者进行血管标记和染色 ,并取 1 0例正常组织对照。结果 :应用CD34抗体、CD1 0 5抗体测得的微血管密度在癌组织内分别为 4 7.1 8± 1 7.93、2 0 .38± 8.31 ,正常组织分别为 9.30± 3.34、阴性表达 (P<0 .0 1 )。CD1 0 5标记的MVD在高中分化及低分化胃癌中比较有显著性差异 (P <0 .0 5 ) ,并且在淋巴结转移组与无淋巴结转移组胃癌中比较 ,差异显著性高于CD34标记的MVD(P <0 .0 1、P <0 .0 5 )。而两者标记的MVD与VEGF表达均呈显著正相关 (r=0 .4 70、r =0 .4 2 6)。结论 :胃癌间质内CD1 0 5标记的微血管密度特异性高于CD34标记的MVD ,两者都和VEGF表达强度与淋巴结转移密切相关 ,血管生成可能促进胃癌的发展并影响其预后 ,在胃癌进展过程中用CD1 0 5评估新血管生成可能对预测胃癌进展危险度是一个有价值的指标。可以作为一种新的肿瘤血管生成标记物用于胃癌MVD计数 ,并与VEGF均可作为预测胃癌发生转移的指标。     

CD34与CD44s在非小细胞肺癌中的表达研究及其意义

目的探讨非小细胞肺癌(NSCLC))微血管密度(MVD)和CD44s表达与肿瘤浸润和淋巴结转移的关系.方法应用CD34和CD44s抗体,采用微波-LSAB免疫组化染色方法对78例手术切除的非小细胞肺癌进行血管标记免疫组化染色,并与10例正常组织对照.结果78例NSCLC标本平均微血管计数为65.8±14.3条,实际范围18～112条,有淋巴结转移的MVD(69.5±15.7)、CD44s(109.8±13.2)表达与无淋巴结转移的MVD(44.3±14.3)、CD44s(136.5±14.8)、正常对照的MVD(25.7±13.6)、CD44s(91.3±11.5)比较,均有非常显著的差异性(p＜0.01).MVD、CD44 s与年龄、性别、吸烟史、肿瘤大小以及病理学分级等临床病理学均无明显关系(P＞0.05).结论非小细胞肺癌间质内MVD和CD44s表达强度与淋巴结转移密切相关,二者均可作为预测非小细胞肺癌病人发生转移的指标.     

CD44v6、MMP-9、CD34表达与胃癌生物学行为的关系

目的探讨黏附分子CD44拼接变异体v6(CD44 splice variant v6,CD44v6)、基质金属蛋白酶9(matrix metallopro-teinase-9,MMP-9)表达和癌间质微血管密度(MVD)与胃癌临床病理生物学行为的关系以及它们之间的相关性。方法采用免疫组化S-P法,检测128例胃癌手术标本中CD44v6,MMP-9,CD34表达,用CD34标记血管内皮细胞并计算微血管密度MVD值。结果128例胃癌组织中CD44v6,MMP-9阳性表达率和MVD分别为58.6%,64.1%,28.68±10.25,三者均与胃癌生长方式、浸润深度、淋巴结转移、TNM分期密切相关(P<0.05);CD44v6和MVD与肿瘤远处转移有关(P<0.05);MVD与肿瘤大小和低分化成正相关(P<0.05)。三者在胃癌中表达呈正相关(P<0.05),CD44v6,MMP-9共同表达组发生深度浸润(T3-4)与淋巴结转移的概率和MVD明显高于其中之一或二者皆阴性表达者(P<0.05)。结论CD44v6,MMP-9,CD34过表达促进胃癌的浸润转移,三者具有正协同作用。联合检测CD44v6,MMP-9,CD34表达可作为判断胃癌生物学行为和预后的重要指标。     

胃癌中微血管密度及VEGF、NOS表达与肿瘤浸润、转移的相关性

目的:研究胃癌组织中微血管密度(MVD)的分布,血管内皮生长因子(VEGF),一氧化氮合酶(NOS)的表达及与肿瘤病理特征间的关系,探讨MVD、VEGF、NOS在胃癌浸润、转移中的意义及其间的相关性。方法:应用免疫组化SP法检测56例手术切除人胃癌组织石蜡包埋标本的VEGFi、NOS、eNOS、nNOS的蛋白表达,对肿瘤微血管以CD34抗体染色并检测MVD。结果:56例胃癌组织MVD值平均为36.25±6.32;VEGFi、NOS、eNOS、nNOS的阳性表达率分别为69.6%、75.0%、80.4%、83.9%;不同浸润深度、淋巴结转移程度及TNM分期的胃癌中MVD值的差异分别有统计学意义(P<0.01);VEGFi、NOS、eNOS、nNOS的表达随胃癌浸润深度的加深,淋巴结转移程度的提高而上调(分别为P<0.05,P<0.01,P<0.01,P<0.01);VEGFi、NOS阳性表达胃癌组织中的MVD值高于阴性表达者(分别为P<0.05,P<0.01);VEGF及iNOS表达均阳性者34例,VEGF表达阳性,iNOS表达阴性者5例,两者表达均阴性8例,iNOS的表达与VEGF表达有关(P<0.01)。结论:随着胃癌浸润,转移程度进展,肿瘤MVD值增高,VEGF、NOS的表达上调;胃癌中VEGF及iNOS的表达与肿瘤MVD有关,提示VEGF及iNOS在胃癌生长,浸润及转移中促进肿瘤新生血管形成;iNOS表达与VEGF表达有关,VEGF可能通过增加iNOS的表达促进肿瘤微血管形成。     

胆囊癌组织中iNOS的表达与肿瘤血管生成的关系

目的 :探讨肿瘤血管生成与胆囊癌生物学行为的关系 ,探讨诱导性一氧化氮合成酶 (induciblenitricoxidesyn thase,iNOS)在胆囊癌组织中的表达及与胆囊癌生物学行为的关系 ,探讨iNOS的表达与胆囊癌血管生成的关系 .方法 :选取手术切除的胆囊癌标本 4 0例及正常胆囊标本 8例 ,采用免疫组织化学的方法检测iNOS蛋白的表达 ,并用F Ⅷ相关抗原抗体标记血管内皮细胞 ,测定胆囊癌组织中的MVD微血管密度 (microvesseldensity ,MVD) .结合临床病理学指标进行统计学处理分析 .结果 :胆囊癌组织中MVD显著高于正常组织 (46± 14vs 14± 6 ,P <0 .0 5 ) .MVD与年龄、性别、肿瘤大小及组织学类型无关 .低分化及未分化组MVD >中分化组 >高分化组 (5 2± 9vs 4 3± 9vs 33± 6 ,P <0 .0 1) .Nevin分期Ⅳ ,Ⅴ期组的MVD显著高于Ⅰ ,Ⅱ期组及Ⅲ期组(5 2± 8vs 37± 13,P <0 .0 1) .淋巴结转移组MVD显著高于淋巴结未转移组 (5 3± 8vs 38± 8,P <0 .0 1) .肝脏转移组MVD显著高于肝脏未转移组 (5 5± 6vs 4 2± 10 ,P <0 .0 5 ) .iNOS在胆囊癌组织中阳性表达率为 5 2 .5 % ,iNOS的表达与年龄、性别、肿瘤大小、组织学类型、分化程度及临床分期无关 .淋巴结转移组iNOS的阳性表达率为 70 .0 % ,显著高于淋巴结未转移组 35 .0 % (P     

胃癌组织中血管内皮抑素及微血管密度测定

中图分类号R735.2摘要目的:探讨胃癌组织中血管内皮抑素(Endostatin)的表达及其与肿瘤血管生成的关系。方法:采用免疫组化法检测65例胃癌、20例癌旁正常组织Endostatin蛋白的表达,应用抗CD34单抗标记血管内皮细胞,测定肿瘤间质微血管密度(MVD)。结果:胃癌组织Endostatin阳性表达率(61.54%,40/65)高于癌旁正常组织的20.00%(4/20)(P<0.01);Endostatin阳性表达组的MVD值(22.80±10.82)低于Endostatin阴性表达组(29.84±9.28,P<0.01);随着Endostatin表达程度加强,MVD值减少。Endostatin表达与胃癌浸润深度、TNM分期及淋巴结有无转移有关。结论:Endostatin在抑制胃癌血管生成中可能起一定作用。     

瘤内微血管密度与胃癌临床病理特征相关性研究

目的　探讨肿瘤内血管生成在胃癌生长、侵袭、转移中的作用。方法　采用免疫组织化学SP法 ,用抗血管内皮CD34单克隆抗体对 40例胃癌及 10份正常胃组织标本进行标记分析。结果　肿瘤微血管密度 (MVD)较正常胃组织显著增高 (P <0 .0 1) ;淋巴结转移组MVD显著高于无淋巴结转移组 (P <0 .0 1) ;肿瘤肝脏转移组MVD较无肝转移组增高 (P <0 .0 5 )。结论　瘤内血管密度与胃癌的侵袭、转移密切相关 ,血管生成可能促进胃癌的发展并影响其预后。     

整合素β3mRNA和VEGF表达与胃癌临床病理及预后的相关性

目的探讨整合素β3mRNA、血管内皮生长因子（VEGF）在胃癌中的表达及其与胃癌临床、病理和预后的关系。方法采用原位杂交和免疫组织化学技术,检测118例胃癌组织中整合素β3mRNA、VEGF和CD34的表达。结果非肿瘤胃黏膜中整合素β3mRNA的阳性表达率显著低于胃癌组（P〈0．01）;具有浸润性生长、脉管侵犯和淋巴结、肝脏、腹膜转移的T3～T4期胃癌组织中整合素β3mRNA、VEGF阳性表达例数和微血管密度值（MVD）值均显著高于膨胀性生长和无脉管侵犯、淋巴结转移、肝脏及腹膜转移的T1～T1期胃癌组织（均P〈0．01）：整合素β3mRNA、VEGF表达和MVD值之间均呈正相关性（均P〈0．01）;整合素β3mRNA、VEGF呈阳性表达和MVD值≥54.9个／mm^2患者平均生存时间和5年生存率均低于整合素β3mRNA、VEGF呈阴性表达和MVD值〈54.9个／mm^2者（均P〈0．05或0.01）。结论整合素β3和VEGF可促进胃癌血管生成,并参与肿瘤侵袭转移过程,检测整合素β3和VEGF的表达可作为评价胃癌患者临床、病理和预后的重要参考指标。     

基质金属蛋白酶-9及其mRNA在胃癌中的表达与血管新生的关系

目的　观察基质金属蛋白酶 9(MMP 9)与MMP 9mRNA在胃癌组织及细胞中的表达与作用特点 ,及其与肿瘤浸润、转移及血管新生之间的关系。方法　利用 74例胃癌标本及体外培养人胃低分化腺癌细胞BGC82 3,经连续切片免疫组织化学染色、原位杂交、侵袭实验、酶谱分析及形态定量分析方法 ,进行金属蛋白酶 (MMP) 9、MMP 9mRNA、CD34、α SMA、VEGFR 1、VEGFR 2的检测 ,并结合临床病理参数进行综合分析。结果　MMP 9及其mRNA的表达均与癌组织的浸润深度、分化程度、淋巴结转移密切相关 ;MVD与癌组织的浸润深度、淋巴结转移关系密切 ;BGC82 3细胞MMP 9,MMP 9mRNA ,VEGFR 2染色均为阳性 ,VEGFR 1染色阴性 ;MMP 9抗体可使BGC82 3细胞侵袭细胞数由 6 9± 5个 /40 0倍下降为 (18± 4 )个 /40 0倍 ;直接培养于培养皿表面的BGC82 3细胞有稳定的MMP 9,MMP 2酶原表达 ,但培养于I型胶原包被培养皿表面的BGC82 3细胞MMP 2表达明显增强并出现活化形式 ;BGC82 3细胞与VEGF共孵育 ,条件培养基中MMP 9酶原含量以VEGF剂量依赖的方式增加。结论　胃癌细胞自身具有产生与分泌MMP 9的能力 ,MMP 9对肿瘤的浸润、转移及间质血管新生具有促进作用。     

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.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

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…     

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.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.