苯乙酸对大肠癌细胞C-myc基因表达的影响

目的观察诱导分化剂苯乙酸（Phenylacetate,PA）抑制结直肠癌细胞Hcr-8增殖过程中C-mye基因表达的变化。方法体外细胞培养,运用流式细胞技术观察苯乙酸对HCT-8细胞凋亡的影响。应用原位分子杂交方法观察应用PA后对HCT-8细胞C-mye mRNA表达的情况。结果PA组HCT-8细胞G1期比例从32．3％增加到61．0％,S期比例从59．6％下降到29．7％。PA治疗后HCT-8细胞C-mye mRNA表达阳性表达率为（12．05±7．92）％,显著低于非治疗组中的阳性率（55．15±21．64）％（P〈0．01）。通过细胞周期的检测发现,PA抑制大肠癌细胞HCT-8增殖的方式为抑制细胞周期G1期比例。结论PA通过下调结直肠癌细胞C-myc mRNA的生成以及细胞生长G1期阻滞在肿瘤诱导分化治疗方面发挥作用。     

苯乙酸对大肠癌细胞HCT-8的诱导分化作用研究

目的 探讨苯乙酸对大肠癌细胞株HCT-8的诱导分化作用。方法 应用[3H]-TdR掺入法与细胞计数法、流式细胞技术、电子显微镜检测PA对大肠癌细胞HCT-8增殖的抑制作用、细胞周期各时相及其超微结构的变化。结果 HCT-8细胞增殖抑制率与PA剂量呈显著正相关关系;应用PA后,HCT-8细胞增殖抑制于G0/G1期,大量细胞堆积于S期末期,不能完成全部DNA合成,细胞核变规整,细胞质增多。结论 PA对大肠癌HCT-8细胞存在时间和剂量依赖性增殖抑制作用,可提高大肠癌细胞HCT-8的分化程度,具有广阔的临床应用前景。     

苯乙酸对肝癌细胞抑制作用机制的研究

目的探讨苯乙酸（PA）对肝癌细胞系SSMC-7721细胞增殖的抑制作用的机制。方法应用噻唑蓝（Mrr）比色法，以0．25、0．5、1．0、2．0、4．0mmol／L的PA作用于SSMC-7721细胞，分别于24、48、72h对细胞增殖抑制率进行检测；流式细胞仪检测2．0mmol／L苯乙酸作用36小时后的SSMC-7721细胞周期各时相的变化；检测经或者不经过2．0mmol／L苯乙酸作用的SSMC-7721细胞中Caspase-3活性的差异；检测苯乙酸对SSMC-7721细胞中HOX基因活性的影响。结果随苯乙酸浓度和作用时间的增加，细胞增殖抑制率逐渐增加，抑制作用呈剂量-时间依赖性。2．0mmol／L的PA是最佳实验浓度；苯乙酸可使SSMC-7721细胞的G0／G1期和G2／M期细胞比例增加；苯乙酸可通过Caspase-3途径诱发SSMC-7721细胞凋亡；苯乙酸可下调SSMC-7721细胞中HOXP1基因的表达。结论PA可通过细胞周期阻滞、Caspase-3途径诱导的凋亡和下调HOXPI基因的表达抑制肝癌SSMC-7721细胞的增殖。     

苯乙酸对胶质瘤细胞C6中同源盒基因表达的影响

目的　观察诱导分化剂苯乙酸 (PA)抑制胶质瘤细胞C6增殖过程中 ,生物发育调节的主控基因———同源盒基因 (Hox基因 )表达的变化。方法　根据引物的不同 ,将已知的 2 2种HOX基因分为 3组 (P1,P2 ,P3)。用逆转录PCR(RT PCR)及图像分析法检测应用PA前后 ,Hox基因组在胶质瘤细胞C6中表达的变化。针对应用PA前后表达显著不同的Hox基因组 ,用组内包含的特异Hox基因的引物 ,重复上述实验 ,检测特异Hox基因的表达。Hox基因 (组 )表达水平用基因 (组 ) β 肌动蛋白 (β actin)灰度比值表示。结果　胶质瘤细胞C6中 ,P2组Hox基因表达明显弱于P1、P3组(0 6 82 5± 0 0 987<0 8817± 0 0 731,0 86 0 8± 0 0 881,P <0 0 0 1)。应用PA后 ,P2组Hox基因表达 (0 8386± 0 0 811)显著增强 ,与用药前比较 ,差异显著 (P <0 0 0 1)。P2组中 ,HoxB2基因应用PA后比未用药组表达显著增强 (0 7763± 0 12 4 1>0 4 839± 0 1343,P <0 0 0 1)。HoxB4基因在应用PA前后于胶质瘤细胞C6中均未见表达。结论　胶质瘤的发生可能与HoxB2基因表达减弱有关。PA在分化诱导胶质瘤过程中 ,对HoxB2基因mRNA水平的表达有明显的上调作用 ,PA的作用机理与调节胶质瘤细胞转录过程有关。     

苯乙酸钠调控人前列腺癌细胞凋亡的研究

目的　为了观察苯乙酸钠 (NaPA)对人前列腺癌细胞株 (PC - 3)的分化诱导作用。方法　应用流式细胞术(FCM)、台盼蓝染色计数法和3 H -TdR掺入法观察NaPA对人前列腺癌细胞株的细胞周期动力学变化的影响。结果　苯乙酸钠对人前列腺癌细胞株的细胞呈剂量依赖性抑制 ,细胞周期的G0 /G1期升高 ,S期、G2 /M期相对下降 ,表明NaPA可抑制人前列腺癌细胞株增殖 ,主要是S期合成降低。结论　提示NaPA通过诱导前列腺癌细胞凋亡治疗前列腺癌具有可期待前景。     

金丝桃素对C6胶质瘤细胞周期变化的研究

目的 探讨光活化的金丝桃素对Wistar大鼠胶质瘤株C6的分化诱导作用。方法 应用流式细胞术(FCM)、MIT法和3H—TdR掺入法观察光活化的金丝桃素对C6胶质瘤细胞株的细胞周期动力学变化的影响。结果 光活化的金丝桃素对C6胶质瘤细胞株的细胞呈剂量依赖性抑制，细胞周期的G0／G1期升高，S期、G22／M期相对下降，表明光活化的金丝桃素可抑制C6胶质瘤细胞株增殖，细胞的增殖周期阻滞在G1期。结论 提示光活化的金丝桃素通过诱导C6胶质瘤细胞凋亡而治疗脑胶质瘤具有可期待前景。     

利用稳定转染细胞模型研究RIG-G基因的生物学功能

目的 通过建立稳定表达RIG-G蛋白的细胞模型研究RIG-G基因的生物学功能.方法 利用Tet-off表达系统在U937细胞中转入外源的RIG-G基因并诱导其表达;比较RIG-G基因表达前后细胞生长、形态、细胞周期的分布和表面分化抗原以及相关细胞周期调控蛋白水平的变化.结果 RIG-G蛋白可通过上调细胞周期抑制因子P21和P27的蛋白水平,将细胞阻滞在G0/G1期.与转染空质粒对照细胞相比,G0/G1期细胞的比例由(43.9±5.6)%增加到(63.9±2.3)%(P＜0.01),细胞的生长被抑制,抑制率达到(68.7±0.2)%.此外,RIG-G蛋白还能使细胞表面分化抗原CD11C的表达升高至(61.3±1.1)%,细胞出现胞体变小、核浆比缩小、核凹陷、染色质变粗糙等部分分化的形态特征.而对照细胞的CD11C表达则为(18.0±0.4)%(P＜0.01).结论 RIG-G蛋白具有重要的抑制细胞增殖和促进细胞分化的能力.     

5-FU联合热疗诱导SW480细胞凋亡及其对细胞周期的影响

目的探讨5-Fu（5-氟尿嘧啶）联合热疗诱导SW480细胞（人结直肠癌细胞株）的增殖抑制率、细胞周期各时相的影响及亚细胞结构改变。方法应用MTT比色法检测SW480细胞的增殖抑制率,流式细胞仪检测细胞周期各时相的变化,电子显微镜观察亚细胞结构变化。结果联合热疗组与5-FU组、热疗组相比差异非常显著,P〈0．01。且SW480细胞周期进程发生明显改变,G1期细胞增多、S期细胞减少、G2／M细胞相对增多,细胞凋亡率升高。电子显微镜结果显示染色质趋边凝集、线粒体膜、溶酶体膜、内质网膜系统明显改变,可见凋亡小体。结论5-FU联合热疗可显著提高SW480细胞增殖抑制率,抑制SW480细胞G1期向S期转化进程,诱导细胞凋亡及亚细胞结构改变。     

结直肠肿瘤干细胞体外培养形态、标志物及转移动力学特征

目的：探讨结直肠肿瘤干细胞在体外分化过程中细胞形态、干细胞及转移相关标志物表达和转移侵袭能力的变化,为进一步研究结直肠肿瘤干细胞分化走向及转移侵袭能力改变提供实验依据。方法取来源于人结直肠癌的细胞系 HCT116,无血清培养分离出 CD133＋细胞,加血清诱导分化,相差显微镜下观察其形态变化;在未分化状态下无血清培养第7天和14天与血清诱导分化后收集细胞,利用流式细胞仪检测干细胞标志物 CD133＋其表达量,采用激光共聚焦、RT-PCR 和免疫荧光检测 CD133＋、N-cadherin 及 Vimentin 表面标记分子的表达,Tr-answell 小室检验 CD133＋细胞的转移侵袭能力。结果（1）细胞形态：无血清培养分离的 CD133＋细胞,在生长过程中聚集成规则的细胞球,血清诱导后即贴壁生长,贴壁形态与同来源细胞形态一致,且再次无血清悬浮培养后聚集成球稳定生长。（2）标志物变化：结直肠肿瘤干细胞未分化时 CD133＋、N-cadherin 及 Vimentin 表面标记分子均高表达,流式细胞仪检测未分化细胞 CD133第7天表达率为（20．4±0．52）％,第14天表达率为（78．5±2．80）％,分化后表达率为（0．50±0．17）％。（3）转移侵袭能力：CD133＋细胞穿过孔膜细胞数为104．67±14．64,显著高于血清诱导的分化细胞28．67±6．5（P ＜0．05）。结论细胞形态、标志物表达及转移能力的改变均表明高表达 CD133＋的 HCT116结直肠癌肿瘤干细胞可定向分化为同源的结直肠癌细胞,且 CD133＋细胞血清诱导分化后通过 MET而导致转移侵袭能力下调。     

RNA干扰沉默CXCR4基因对Jurkat细胞周期和凋亡的影响

本文研究探讨下调CXCR4的表达对人T-ALL Jurkat细胞周期和凋亡的影响。设计合成CXCR4的特异性siRNA,采用脂质体转染Jurkat细胞株。用RT—PCR检测siRNA对细胞内CXCR4基因表达的影响,用流式细胞术检测细胞周期分布和细胞的凋亡情况。结果表明：成功构建了CXCR4的特异性siRNA;与空白对照组相比,转染CXCR4siRNA的Jurkat细胞的CXCR4mRNA表达水平明显下降（56．9％±1．4％FS68．3％±2．4％）,G0／G1期细胞比例增加（35．8％±1．9％vs18．1％±1．2％）,G,／M期和S期细胞比例相应下降（19．8％±1．7％VS27．2％±1．5％;44．4％±2．1％VS54．7％±2．8％）,凋亡细胞率明显增高（20．9％±2．0％VS3．13％±0．9％）。结论：CXCR4的特异性siRNA能够有效下调CXCR4基因表达,诱导Jurkat细胞凋亡和细胞周期阻滞,从而抑制细胞的增殖。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.