人参皂甙Rg3对耐顺铂人肺腺癌细胞系A549DDP逆转作用及其机理的研究

目的探讨人参皂甙Rg3对耐顺铂(CDDP)人肺腺癌细胞系A549DDP的逆转作用及其机理.方法以A549DDP及其亲本细胞A549为研究对象,MTT法观察Rg3对A549DDP耐药的逆转作用,采用免疫组化及RT-PCR方法分别在蛋白质和mRNA水平检测耐药相关蛋白MDR1、MRP、LRP表达.结果 MTT法显示低细胞毒浓度Rg3(10 μmol)有效逆转A549DDP细胞耐药7.3倍,而20、30 μmol Rg3分别逆转耐药1.3、1.2倍;10 μmol Rg3预处理A549DDP细胞12、24、36及48 h后分别逆转耐药1.0、1.6、7.6及10.4倍,表明Rg3逆转耐药呈时间依赖性.免疫组化和RT-PCR显示:A549DDP细胞MDR1、MRP、LRP呈过量表达,以Rg3(10 μmol)预处理A549DDP 12、24、36及48 h后,MDR1、MRP表达减弱,呈时间依赖性,而LRP表达无明显时间依赖性.结论 Rg3具有中度逆转肿瘤耐药作用,并呈时间依赖性.     

染料木素对非小细胞肺癌A549/DDP细胞的耐药逆转及其机制

目的:探讨染料木素(genistein)对非小细胞肺癌A549/DDP细胞的耐药逆转及对肺耐药相关蛋白(LRP)和多药耐药相关蛋白(MRP)表达的影响。方法:采用细胞计数法绘制A549/DDP及A549细胞生长曲线;MTT法测定12.5μg/ml染料木素预处理对A549/DDP细胞耐药的逆转作用,并在荧光显微镜下观察细胞形态变化;用RT-PCR和Western blotting分别检测染料木素对肿瘤细胞LRP和MRP的mRNA及蛋白表达的影响。结果:A549/DDP和A549细胞生长曲线相似,倍增时间分别为(27.38±0.25)h和(18.15±0.36)h;染料木素预处理后耐药倍数从2.28倍下降至1.57倍;镜下观察细胞形态出现体积过大、伪足过度伸展、细胞边缘模糊等变化;LRP及MRP mRNA表达均出现明显下调(P<0.05),但二者蛋白表达无明显改变。结论:A549/DDP细胞基本保留了亲代细胞的生长特性;染料木素可以逆转A549/DDP细胞的耐药性,作用机制可能与下调LRP及MRP mRNA表达有关。     

BSO逆转人肺腺癌细胞株多药耐药性的实验研究

目的研究谷胱甘肽(GSH)合成酶抑制剂——BSO对人肺腺癌多药耐药细胞株A549DDP细胞内GSH含量影响;探讨BSO逆转多药耐药(MDR)作用机制及逆转效果。方法GSH还原酶循环法测定BSO对细胞内GSH含量的影响。MTT比色法测定经BSO预处理后顺氯氨铂(DDP)、阿霉素(ADM)对细胞50%抑制浓度(IC50)的影响。流式细胞仪检测BSO对MDR细胞内柔红霉素(DNR)荧光强度的影响。结果耐药细胞A549DDP细胞内GSH含量较人肺腺癌A549细胞内GSH含量明显增高。BSO在一定浓度范围内(50～200μmol·L-1)对A549细胞和耐药细胞A549DDP无明显细胞毒性作用(抑制率均小于10%)。BSO呈剂量依赖性非线性抑制细胞内GSH的合成,其对MDR细胞内GSH合成影响较为显著,而对A549细胞内GSH合成影响较小。BSO在一定浓度范围内能降低DDP、ADM对A549DDP细胞的IC50,而对A549细胞的IC50无明显影响。A549DDP细胞内DNR荧光强度较A549细胞显著降低,能不同程度提高A549DDP细胞内柔红霉素荧光强度,均较未处理组显著提高;与未经BSO处理的A549细胞比较,细胞内荧光强度轻度增高,但统计学上无显著性差异。结论BSO能有效逆转A549DDP细胞的MDR,其机制与降低MDR细胞内GSH含量有关。     

金复康口服液对耐药人肺腺癌A549/DDP膜转运蛋白LRP MRPmRNA表达的影响

目的:从逆转多药耐药的角度,研究金复康口服液对耐药人肺腺癌细胞A549/DDP的化疗增效的作用和分子机制。方法:应用血清药理学方法,选择A549、A549/DDP细胞,实验分为实验组和空白对照组,从细胞水平、分子水平进行研究。结果:金复康口服液低剂量能够逆转A549/DDP对DDP的耐药,逆转耐药倍数为3.45倍,与DDP(320μmol/L)合用,使DDP(320μmol/L)对A549/DDP细胞的抑制率由47.55%升高为73.32%,且q>1.15,表明金复康口服液与DDP合用有明显的协同增效作用,增加了DDP对A549/DDP细胞的敏感度;金复康口服液低剂量能够降低A549/DDP膜转运蛋白LRP、MRP的mRNA表达。结论:(1)低剂量金复康口服液与DDP合用能够增加DDP对A549/DDP的增殖抑制作用,二者具有显著的协同增效作用。(2)金复康口服液能够降低A549/DDP膜转运蛋白LRP、MRP的mRNA表达。金复康口服液可能通过降低耐药肿瘤细胞膜转运蛋白的表达而逆转肿瘤多药耐药,为扶正方药对化疗增效机理提供了新的实验依据。     

和厚朴酚对U937/ADR细胞系耐药逆转作用及其机制研究

目的 探讨和厚朴酚(HNK)对白血病细胞U937阿霉素(ADR)耐药细胞系U937/ADR多药耐药逆转作用及其机制.方法 以大剂量(IC50)ADR短时间诱导方法 ,构建U937/ADR细胞系.以低浓度HNK(IC20)与不同化疗药物联合作用于U937/ADR细胞系,检测其对不同化疗药物耐药逆转倍数.罗丹明123检测药物外排功能;荧光定量PCR(FQ-PCR)和Western blotting检测不同浓度HNK对U937/ADR细胞系核转录因子-κB(NF-κB)和耐药相关基因MDR1及其蛋白P-糖蛋白(P-gp)表达的影响;ELISA法检测NF-κB亚单位p65(NF-κB p65)的DNA结合活性.结果 成功构建了白血病多药耐药细胞系U937/ADR,对ADR耐药指数为亲代U937细胞的11倍.6.5 μg/mL HNK可以逆转U937/ADR对ADR的耐药,逆转倍数为2.20倍.HNK能够浓度依赖性地下调U937/ADR细胞NF-κB、MDR1 mRNA和P-gp表达,抑制NF-κB p65的活性.结论 HNK能有效逆转U937/ADR多药耐药,其机制可能与抑制NF-κB p65活性、下调MDR1和P-gp表达有关.     

CIK逆转耐顺铂人肺腺癌细胞对顺铂耐药与ERCC1的相关性

目的观察脐血来源的CIK细胞对A549/DDP细胞的耐药逆转作用。并探讨CIK逆转耐药机制是否与核苷酸切除修复交叉互补基因1（excision repair cross complementation group 1,ERCC1）的表达存在相关性。方法采集脐血单个核细胞经细胞因子体外诱导获得CIK细胞（cytokine induced killer cells,CIK）,MTT法检测顺铂（cisplatin,DDP）对A549细胞和A549/DDP细胞的体外杀伤作用,以及CIK细胞与A549/DDP细胞共培养前后对DDP敏感性的变化。Real-time RT-PCR法检测A549细胞、A549/DDP细胞以及CIK干预后的A549/DDP细胞中ERCC1 mRNA的表达情况。Western blot法检测A549细胞、A549/DDP细胞以及CIK干预后的A549/DDP细胞中ERCC1蛋白的表达情况。结果 A549/DDP细胞对DDP耐药,耐药指数为2.391。CIK细胞能逆转A549/DDP细胞对DDP的耐药性,逆转倍数为3.967。Real-time RT-PCR、Western blot测得A549/DDP细胞中ERCC1 mRNA和蛋白表达量比A549细胞高（P〈0.05）,CIK细胞共培养前后A549/DDP细胞中ERCC1 mRNA和蛋白表达量无明显变化。结论 CIK细胞能逆转A549/DDP细胞对DDP的耐药性,其逆转耐药的机制与ERCC1的表达无明显相关性。     

三氧化二砷对人肺腺癌细胞A549/DDP裸鼠体内的多药耐药逆转作用

目的研究三氧化二砷（As_2O_3）对人肺腺癌耐顺铂细胞A549/顺铂（DDP）裸鼠移植瘤的耐药逆转作用。方法建立人肺腺癌裸鼠移植瘤模型,观察As_2O_3、DDP及联合用药对体内移植瘤生长状况的影响;采用流式细胞术（FCM）测定不同用药对肿瘤细胞凋亡率变化和耐药细胞A549/DDP P-糖蛋白（P-gp）表达;采用RT-PCR检测不同用药对A549/DDP移植瘤组织MRP1-mRNA和LRP-mRNA表达的变化。结果体内裸鼠抑瘤实验显示As_2O_3有一定抑瘤作用,联合应用DDP可显著抑制肿瘤生长。FCM结果显示应用As_2O_3后肿瘤细胞平均凋亡率,明显高于对照组（P〈0.05）[（17.204±3.091）%vs（3.436±0.537）%],低浓度As_2O_3联合DDP后肿瘤细胞的凋亡率,明显高于DDP组（P〈0.05）[（14.472±3.891）%vs（5.612±1.167）%]。FCM对P-gp表达检测提示As_2O_3对移植瘤Pgp水平无影响。RT-PCR检测结果示含As_2O_3组MRP1表达明显低于不含As_2O_3组（P〈0.05）,肺癌耐药相关蛋白（LRP）在转录水平呈现相对低表达,含As_2O_3组同不含As_2O_3组间比较差异无统计学意义（P〉0.05）。结论 As_2O_3能在体内逆转A549/DDP细胞的耐药性,其机制可能是As_2O_3可通过下调MRP1基因表达,提高A549/DDP细胞对DDP敏感性逆转其耐药,并可能通过诱导肿瘤细胞凋亡来起作用。     

功劳木组分F_6逆转白血病MDR的作用和机制

目的:背景与目的从中药功劳木中提取、分离出来的异喹啉类生物碱组分(Fraction 6,F6),具有抗病毒、抗炎、降血压等生理活性。近年有文献报道异喹啉类生物碱具有一定的逆转肿瘤细胞耐药的作用。本文以白血病多药耐药细胞(K562/ADM)为对象来研究F6逆转肿瘤多药耐药性(Mu ltidrug resistance,MDR)的效果及作用机制,以寻找具有多药耐药逆转活性的新型中药。方法:采用MTT法检测F6及阿霉素(Adriamyc in,ADM)对K562/S和K562/ADM细胞增殖的抑制作用;RT-PCR法检测F6对耐药肿瘤细胞MDR1基因mRNA表达的影响;流式细胞仪分析细胞内罗丹明123(Rhodam ine123,Rh123)浓度,以检测F6对肿瘤细胞膜P糖蛋白(P-glycoprote in,P-gp)泵功能的影响;免疫组化方法检测F6对肿瘤细胞膜P-gp表达水平的影响;流式细胞仪检测F6对肿瘤细胞凋亡的作用。结果:10 mg/L为F6的无毒剂量;ADM对K562/S和K562/ADM细胞的IC50分别为(1.68±0.08)mg/L和(80.25±1.06)mg/L;无毒剂量F6与ADM联合应用后对K562/S和K562/ADM细胞的IC50分别为(1.09±0.07)mg/L和(16.68±0.72)mg/L,此剂量F6使K562/ADM细胞的IC50下降4.81倍;无毒剂量的F6应用前后,K562/ADM细胞MDR1基因表达水平和细胞膜P-gp表达水平无明显差异;Rh123蓄积试验中无毒剂量的F6应用后使K562/ADM细胞内Rh123浓度由F6应用前的29.21%升高到85.35%,Rh123外排试验中无毒剂量的F6应用后使K562/ADM细胞内Rh123浓度由F6应用前的27.19%升高到59.22%;凋亡检测结果显示无毒剂量的F6使K562/ADM细胞凋亡率升高3.82倍。结论:F6能有效逆转白血病细胞的MDR;F6逆转白血病MDR的机制为通过抑制肿瘤细胞膜上P-gp的药泵功能,增加耐药细胞内化疗药物浓度逆转耐药性,而不是抑制MDR1基因和P-gp表达。     

MDR1/MRP反义寡核苷酸逆转胃癌细胞耐药的研究

目的:探讨MDR1/MRP反义寡脱氧核苷酸(Antisense oligodooxynucleotide,ASODN)片段逆转人胃腺癌耐药细胞SGC7901/ADM多药耐药(Multidrugresistance,MDR)的作用.方法:经MDR1或多药耐药相关蛋白(Multidrugresistance-asscociated protein,MRP)ASODN分别或联合转染SGC7901/ADM细胞后,采用RT-PCR法检测MDR1mRNA和MRPmRNA的表达.免疫细胞化学检测SGC7901/ADM细胞内p-糖蛋白(P-glycoprotein,P-gp)、MRP的表达,流式细胞术检测瘤细胞内Rh123的潴留状况,MTT法检测瘤细胞对阿霉素、卡铂等抗癌药的敏感性.结果:SGC7901/ADM细胞经ASODN转染12h后,MDR1和MRP mRNA的表达均降低,转染24h后下降最明显,48h后恢复至转染前水平.经转染ASODN48h后,SGC7901/ADM细胞P-gp、MRP的表达显著下降,瘤细胞内Rh123的潴留量显著高于转染前,且联合转染MDR1和MRP ASODN后瘤细胞内Rh123的潴留量显著高于单纯转染组.SGC7901/ADM细胞在联合转染MDR1和MRP ASODN后对阿霉素、卡铂等化疗药物的敏感性明显高于单纯转染ASODN.结论:分别转染MDR1或MRP ASODN可部分逆转人胃腺癌耐药细胞SGC7901/ADM多药耐药,而联合转染2种ASODN则可显著提高瘤细胞耐药逆转效率.     

氯喹逆转人鼻咽癌细胞HNE1/DDP的耐药作用

目的探究氯喹对人鼻咽耐药细胞的逆转耐药作用及其机制。方法MTT检测不同浓度的顺铂（2, 4, 8, 16, 32 μmol·L-1）
以及不同浓度的氯喹（5, 10, 20, 40, 80 μmol·L-1）处理HNE1细胞,HNE1/DDP细胞48 h 对细胞增殖的影响;q-PCR方法检测5,
10 μmol·L-1 氯喹处理HNE1/DDP后的多药耐药基因MDR1 mRNA的表达;PI单染方法检测氯喹（10, 20 μmol·L-1）处理HNE1/
DDP后细胞凋亡率;采用Western blot 方法检测氯喹处理HNE1/DDP后的P-糖蛋白（P-glycoprotein, P-gp）的表达。结果MTT
结果显示,不同浓度的氯喹（5, 10, 20, 40, 80 μmol·L-1）对细胞具有明显的抑制作用,并且呈浓度依赖性;q-PCR结果表明,氯喹
作用细胞后能明显降低MDR1 mRNA水平;PI 结果显示,氯喹作用细胞后,细胞的凋亡率明显增加;通过western blot 实验表
明,氯喹能明显降低MDR1和P-gp 蛋白水平。结论氯喹能逆转人鼻咽癌细胞HNE1/DDP的耐药,其机制可能与下调MDR1
mRNA表达及抑制P-gp的功能与表达有关。
     

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.     

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…     

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.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

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.