载氟尿嘧啶聚乳酸碳纳米管复合材料对胃癌细胞株的体外杀伤效应

目的制备荷载氟尿嘧啶（5-Fu）的聚乳酸（PLLA）碳纳米管（CNT）复合材料（5-FU-PLLA-CNTs）,并探讨其对人胃癌细胞株（MGC803和MNK45）的体外杀伤效应。方法以PLLA—CNTs为原料,采用超声乳化法荷载5．FU;通过扫描电子显微镜观察5-FU—PLLA—CNTs形态和结构;用紫外可见光光度仪测定不同时间5-FU．PLLA．CNTs的5-FU释放量及累计释放量,并绘制体外释放曲线;设计实验组（不同浓度的5-Fu—PuA—CNTs）及阳性（相应浓度的5-FU）和阴性对照组（不加任何药物）,用CCK8法检测不同浓度的5-Fu．PLLA-CNTs对MGC803和MNK45的增殖抑制作用;流式细胞术检测5-FU—PuIA—CNTs作用前后细胞凋亡的变化。结果成功制备5-FU．PLLA．CNTs药物深层薄膜,薄膜载药率为（4．54±0．43）％,包封率（21．56±2．36）％。体外释放实验显示,5-FU-PLLA-CNTs在24h内释放率为23．9％,呈缓慢上升趋势,至31d体外累计释放率达85．3％。CCK8实验显示,与对照组比较,5．Fu—PLLA．CNTs对两株胃癌细胞具有明显抑制作用（P〈0．01）,随着药物浓度的增加,抑制作用增强;随着作用时间的延长,呈持续抑制状态。流式细胞仪显示,经1mg／孔5-Fu-PuJA。CNTs处理的实验组MGC803和MNK45细胞凋亡率与阴性对照组比较,差异具有统计学意义（均P〈0．05）;与阳性对照组比较,差异无统计学意义（均P〉0．05）。结论5-FU-PLLA-CNTs具有良好的药物缓释性能,对胃癌细胞株具有明显的杀伤和抑制增殖作用,其最佳浓度为1mg／孔。     

丹参酮ⅡA抑制人胆管癌细胞的生长及诱导其凋亡的实验研究

目的体外实验研究丹参酮ⅡA对人肝内胆管癌细胞株HCCC-9810的生长抑制及诱导凋亡作用。方法分别采用（0～10μg／ml）的丹参酮ⅡA作用人肝内胆管癌细胞72h后，通过MTT比色法观察其细胞毒性，荧光显微镜、投射电镜检测细胞凋亡；流式细胞术（FCM）定量检测5μg／ml丹参酮ⅡA作用不同时间后的细胞凋亡率。结果丹参酮ⅡA以剂量依赖的方式抑制胆管癌细胞的生长。1～10μg／ml丹参酮ⅡA作用72h后，胆管癌细胞出现细胞皱缩、核染色质浓缩、核碎裂以及凋亡小体出现等特征性的形态学改变。5μg／ml浓度作用12、24、36、48、72h后的细胞凋亡率分别为（2．31±0．15）％、（3．02±0．36）％、（3．86±0．44）％，（6．75±0．60）％和（20．62±1．76）％与对照组（1．08±0．14）％比较均具有显著差异。结论在体外丹参酮ⅡA能够诱导人肝内胆管癌细胞株HCCC-9810凋亡，这可能是丹参酮ⅡA抑制其生长的机制。     

七叶皂苷钠对胆管癌细胞株Hccc9810增殖和凋亡的影响

目的 观察七叶皂苷钠对人胆管癌细胞株Hccc9810增殖和凋亡的影响.方法 运用细胞染色、噻唑蓝(MTT)比色法、流式细胞术和实时荧光定量聚合酶链反应(PCR)等技术观察不同浓度(0、10、20、40 μmol/L)七叶皂苷钠对胆管癌细胞增殖、细胞周期和凋亡的影响.结果 七叶皂苷钠呈时间剂量依赖性抑制胆管癌细胞Hccc9810的增殖,其24、48、72 h的50％抑制浓度(IC50)分别为:(45.34±2.12)、(33.00±1.92)、(25.00±1.65) μmol/L;G1期比例从(49.49±1.22)％上升到(70.20±1.52)％;胆管癌细胞形态发生典型凋亡特征性改变,凋亡率随浓度的升高从20.54％上升到62.56％,差异均有统计学意义(P＜0.05).结论 七叶皂苷钠通过阻滞细胞周期和诱导细胞凋亡而抑制胆管癌细胞Hccc9810增殖.     

PTTG对胆管癌细胞生长和5-FU敏感性影响的研究

目的探讨抑制垂体瘤转化基因(PTTG)表达后胆管癌细胞体外生长的变化及其对5-FU化疗敏感性的影响。方法将反义PTTG真核表达载体pcDNA3.1-PTTGas和空白载体pcDNA3.1(+)转染入胆管癌细胞株QBC939中,筛选获得稳定表达株tQBC939(PTTG-)和tQBC939(pcDNA3.1),并设立未转染的QBC939细胞对照组,绘制细胞生长曲线,以MTT法检测细胞增殖力的变化,流式细胞仪检测细胞周期的比例变化,并采用5-FU处理细胞后,以MTT检测3组细胞的生长抑制率,计算IC50值,流式细胞仪和Hoechst染色法检测各组细胞凋亡情况。结果 tQBC939(PTTG-)组与tQBC939(pcD-NA3.1)组和QBC939组比较,前者生长较为迅速,S期细胞比例增多,G2/M期细胞比例减少(P0.05),增殖指数较高(P0.05);经5-FU处理后,tQBC939(PTTG-)的IC50值明显低于tQBC939(pcD-NA3.1)和QBC939细胞(P0.05),细胞凋亡增多。结论转染PTTG反义DNA可增强胆管癌细胞的增殖力和对5-FU化疗的敏感性。     

表皮生长因子受体抑制剂联合5-氟尿嘧啶对胆管癌细胞增殖与迁移、侵袭能力的影响

目的:探讨表皮生长因子受体(EGFR)抑制剂AG1478联合5-氟尿嘧啶(5-FU)对胆管癌细胞体外增殖、迁移和侵袭的影响。方法:体外培养人胆管癌QBC939细胞,分别用AG1478(10μmol/L)、5-FU(100 mg/L)以及联合两药处理24 h后,分别采用CCK-8法、划痕试验、Matrigel侵袭小室法检测细胞增殖、迁移及侵袭情况。结果:AG1478与5-FU单独作用后,QBC939细胞增殖、迁移和侵袭能力均明显降低(均P0.05),而与任一单独用药比较,联合用药对细胞增殖、迁移和侵袭能力的抑制作用均明显增强(均P0.05)。结论:EGFR抑制剂与5-FU联合应用可能是抑制胆管癌细胞生长、迁移和侵袭有效方法。     

载顺铂的纳米羟基磷灰石对A549肺腺癌细胞体外胀亡的影响

目的探讨载顺铂的纳米羟基磷灰石对体外培养的人肺腺癌细胞A549增殖及胀亡的影响。方法用机械融合法制备载顺铂的纳米羟基磷灰石粒子,将肺腺癌A549细胞暴露于该粒子中培养。进行形态学观察,MTT法检测载顺铂的纳米羟基磷灰石粒子体外作用于人肺癌A549细胞的量效和时效关系,流式细胞仪分析细胞周期的时相变化。结果载顺铂的纳米羟基磷灰石粒子在体外对人肺癌A549细胞系具有明显的抑制作用,并呈现良好的量效和时效关系。肺癌细胞的生长阻滞于G2/M期,细胞体积增大,胞质空泡化,染色质凝集,胞浆溶解。结论载顺铂的纳米羟基磷灰石粒子具有体外抗肺腺癌系A549的作用,细胞增殖阻滞于G2/M期,阻断细胞周期的进展,导致癌细胞溶解坏死,诱导细胞凋亡是其可能的机制之一。     

5-氟尿嘧啶纳米药膜的体外缓释及其对结肠癌细胞抑制作用研究

目的研究担载抗肿瘤药物5-氟尿嘧啶(5-FU)的左旋聚乳酸(PLLA)共混羊毛蛋白纳米纤维药膜的缓释功能及其对结肠癌细胞的体外抑制效果。方法将PLLA与羊毛蛋白共混交联,并加入抗肿瘤药物5-FU,利用高压静电纺丝技术将共混溶液制作成具有缓释效果的纳米纤维薄膜。通过扫描电镜(SEM)观察其形貌。以高效液相色谱法(HPLC)测定5-FU/PLLA羊毛蛋白药膜中5-FU的缓释效果。采用噻唑蓝(MTT)比色法,检测药膜对结肠癌细胞HCT116的体外杀伤效果。同时采用倒置相差显微镜、透射电子显微镜(TEM)观测实验组细胞的生长情况。结果由SEM可以看出5-FU能够均匀分布在纳米纤维药膜中,HPLC显示5-FU能够缓慢释放并基本符合零级动力学规律。采用不同处理因素后,通过显微镜观察,药膜浸泡时间越长的实验组细胞出现肿胀、凋亡、坏死的情况越明显。MTT检测纳米药膜实验组的细胞存活率为(47.5±2.8)%,而不含药物的纯膜组对细胞基本无影响,其存活率为(93.9±2.8)%,差异具有统计学意义(P<0.01)。结论 5-FU/PLLA羊毛蛋白纳米药膜有明显缓释效果,具有较好的肿瘤细胞抑制作用和潜在的医疗应用价值。     

5-氮-2-脱氧胞苷体内外抑制胆管癌细胞生长的研究

目的研究甲基化抑制剂 5 氮 2 脱氧胞苷在体内、体外对胆管癌细胞株生长的抑制作用。方法应用MTT法检测 5 氮 2 脱氧胞苷及其他抗肿瘤药物对胆管癌细胞株QBC939存活率的影响 ,应用流式细胞术观察细胞生长周期及凋亡率的变化。观察 5 氮 2 脱氧胞苷对裸鼠皮下移植肿瘤生长的影响。结果 5 氮 2 脱氧胞苷抑制胆管癌细胞QBC939的增殖 ,细胞周期阻滞于G1期 ,凋亡增加。以上作用与药物浓度及所用时间在一定范围内呈正相关。 5 氮 2 脱氧胞苷与其他肿瘤化疗药物协同可增强对胆管癌细胞的杀伤作用。经 5 氮 2 脱氧胞苷处理后 ,QBC939在裸鼠体内成瘤率下降 ,肿瘤体积缩小。结论 5 氮 2 脱氧胞苷诱导胆管癌细胞凋亡 ,抑制肿瘤生长 ,与其他肿瘤化疗药物有协同作用。     

脂质体华卟啉钠的制备及其对胆管癌细胞的体外光动力杀伤效应研究

目的:探讨脂质体华卟啉钠(DVDMS-L)的制备及其对胆管癌细胞的光动力杀伤效应。方法:采用薄膜-水化法制备DVDMS-L,并检测其粒径、电位及包封率。分别用相同浓度梯度(0、0.06、0.12、0.25、0.5、1μmol/L)的DVDMS-L与游离华卟啉钠(DVDMS),光照强度10J/cm~2条件下,作用于胆管癌HICC-9810细胞4h后,用CCK8法检测两者对人胆管癌HICC-9810细胞的光动力杀伤效果。结果:所制得的DVDMS-L平均粒径为(113.7±14.2)nm,Zeta电位为-(24.5±3.2)mV,包封率为(61.74±1.49)%;在光照条件下,HICC-9810细胞在DVDMS-L与DVDMS处理后存活率均明显降低,并浓度依赖性,但相同浓度(0.12～1μmol/L)下的DVDMS-L的作用明显强于DVDMS,两者的IC_50分别为0.11、0.29μmol/L(均P0.05)。结论:成功制备DVDMS-L,其对人胆管癌细胞的体外光动力杀伤效应优于游离DVDMS。     

联合应用华蟾素与氟尿嘧啶对胃癌细胞增殖抑制及诱导凋亡的作用

目的 探讨单一华蟾素体外对人胃癌细胞的增殖抑制和诱导凋亡作用以及与5-氟尿嘧啶（5-FU）联合应用对胃癌细胞的影响.方法 实验分为对照组;华蟾素（cino）组;5-FU组和cino＋5-FU组.利用体外细胞培养、倒置显微镜和荧光显微镜、MTT比色技术及流式细胞仪等方法,观察细胞形态,检测cino和5-FU对人胃癌细胞株BGC823细胞抑制率、细胞凋亡和细胞周期.结果 cino对人胃癌细胞有显著的增殖抑制作用,呈时间剂量依赖性.cino＋5-FU对BGC-823细胞的增殖抑制率显著高于单独使用组（P＜0.05）.定量分析显示cino＋5-FU组的凋亡细胞发生率显著高于cino组和5-FU组（P＜0.05）.cino＋5-FU可使G0/G1期细胞比例降低,S期细胞比例升高,且大多数被阻滞于S期.结论 cino对胃癌BGC-823细胞具有增殖抑制和诱导凋亡作用,与5-FU联用可显著提高后者的化疗效果,且呈时间剂量依赖关系.     

Reduction of Plasma Fibrinogen, Immunoglobulin G, and Immunoglobulin M Concentrations by Immunoadsorption Therapy with Tryptophan and Phenylalanine Adsorbents

Abstract Immunoadsorption (1A) therapy with tryptophan (TR-350) or phenylalanine (PH-350) adsorbents has been used to reduce the concentration of serum antibodies in human lymphocyte antigen (HLA)-immunized patients. Other forms of plasma purification have been reported to reduce the level of fibrinogen, which affects the blood properties. In this study we investigated the effects of IA therapy using both adsorbents on plasma fibrinogen and immunoglobulins G and M in 13 patients (8 patients were treated with TR-350, and 5 patients were treated with PH-350). During each session 1 plasma volume (2.8 ± 0.4 L of plasma) was processed through the immunocolumn and then returned to the patient together with the blood cells. Compared with the pretreatment values, the plasma fibrinogen, IgG, and IgM concentrations were significantly reduced after IA therapy (p < 0.01 for TR-350; p < 0.04 for PH-350). There was a positive correlation between the degree of reduction of plasma proteins and the number of IA treatments given. A nonpara-metric test (Wilcoxon's signed-rank test or the Mann-Whitney test) was used for statistical analysis. We conclude from our study that IA therapy effectively lowers the plasma levels of fibrinogen, IgG, and IgM and thus can be considered a valuable alternative to other blood purification methods.     

The multiply injured child

Blunt trauma is the principal cause of childhood death in many developed countries. This review outlines the differences between adults and children with respect to resuscitation and treatment of orthopaedic injuries in a child with polytrauma. Recent advances in techniques of fracture stabilization are reported.     

Development of Selective Low-Density Lipoprotein (LDL) Apheresis System: Immobilized Polyanion as LDL-Specific Adsorption for LDL Apheresis System

Abstract: Low-density lipoprotein (LDL) is widely recognized as one of the major risk factors for developing coronary heart diseases. Despite intensive development of LDL-lowering drugs, there still exist those patients with refractory hyperlipidemia whose plasma LDL levels are not sufficiently lowered by drugs. LDL apheresis, direct removal of plasma LDL from circulating blood, is thought to be the most promising treatment for such refractory patients. Various techniques, such as the use of an im-munoadsorbent utilizing an anti-LDL antibody, have been used in an attempt to achieve the selective removal of LDL. However, none were widely used because of complications, poor selectivity, and so forth. To establish a safe and effective LDL apheresis system, we chose a synthetic affinity adsorbent as the LDL-removing device. Synthetic polyanion compounds were used as the affinity ligands for LDL adsorbent to simulate the anion-rich sequence of LDL binding sites in the human LDL receptor. Among various polyanion compounds, those polyanions with sulfate or sulfonate groups and hydrophilic backbone were found to have strong affinity for LDL. In contrast, polyanions with carboxyl groups showed poor affinity. Dextran sulfate (DS) was selected as the affinity ligand of LDL adsorbent for its high affinity and low toxicity. The influence of its charge density and molecular weight on its affinity for LDL was suitable. The affinity rapidly increased as the charge density increased, then, reached a constant value. Little affinity was found for either the DS monomer (glucose sulfate) or DS with a molecular weight higher than 10⁴ daltons whereas DS with molecular weights in the midrange showed strong affinity. DS with a midrange molecular weight was immobilized on cellulose hard gel to give LDL adsorbent clinical application. The adsorbent demonstrated an excellent selectivity for LDL and very low density lipoprotein (VLDL) in vitro. Adsorption of high-density lipoprotein and major plasma proteins was almost negligible. Additional study of the LDL-binding mechanism revealed that DS directly interacts with positively charged sites on LDL, which demonstrates that the nature of the interaction is the same as that of LDL receptor. An LDL adsorption column (Liposorber) packed with an LDL adsorbent and polysulfone hollow-fiber plasma separator (Sulflux) was developed as an efficient LDL apheresis system. Clinical investigation proved that this system is capable of intensively lowering the plasma LDL level without affecting major plasma components.     

Artificial organs 2010: a year in review

In this Editor's Review, articles published in 2010 are organized by category and briefly summarized. As the official journal of The International Federation for Artificial Organs, The International Faculty for Artificial Organs, and the International Society for Rotary Blood Pumps, Artificial Organs continues in the original mission of its founders "to foster communications in the field of artificial organs on an international level."Artificial Organs continues to publish developments and clinical applications of artificial organ technologies in this broad and expanding field of organ Replacement, Recovery, and Regeneration from all over the world. We take this time also to express our gratitude to our authors for offering their work to this journal. We offer our very special thanks to our reviewers who give so generously of time and expertise to review, critique, and especially provide such meaningful suggestions to the author's work whether eventually accepted or rejected and especially to those whose native tongue is not English. Without these excellent and dedicated reviewers the quality expected from such a journal could not be possible. We also express our special thanks to our Publisher, Wiley-Blackwell, for their expert attention and support in the production and marketing of Artificial Organs. In this Editor's Review, that historically has been widely received by our readership, we aim to provide a brief reflection of the currently available worldwide knowledge that is intended to advance and better human life while providing insight for continued application of technologies and methods of organ Replacement, Recovery, and Regeneration. We look forward to recording further advances in the coming years.     

Avaliação do clube de revista de anestesiologia por meio de mudanças semânticas

Background and objectives

The interactive approach of a journal club has been described in the medical education literature. The aim of this investigation is to present an assessment of journal club as a tool to address the question whether residents read more and critically.

Methods

This study reports the performance of medical residents in anesthesiology from the Clinics Hospital – University of São Paulo Medical School. All medical residents were invited to answer five questions derived from discussed papers. The answer sheet consisted of an affirmative statement with a Likert type scale (totally disagree–disagree–not sure–agree–totally agree), each related to one of the chosen articles. The results were evaluated by means of item analysis – difficulty index and discrimination power.

Results

Residents filled one hundred and seventy three evaluations in the months of December 2011 (n = 51), July 2012 (n = 66) and December 2012 (n = 56). The first exam presented all items with straight statement, second and third exams presented mixed items. Separating “totally agree” from “agree” increased the difficulty indices, but did not improve the discrimination power.

Conclusions

The use of a journal club assessment with straight and inverted statements and by means of five points scale for agreement has been shown to increase its item difficulty and discrimination power. This may reflect involvement either with the reading or the discussion during the journal meeting.     

Soluble TNFα Receptors Are Increased in Chronic Renal Insufficiency and Hemodialysis and Inhibit Neutrophil Priming by TNFα

Abstract: The oxidative burst of neutrophils from azotemic patients is refractory to priming by tumor necrosis factor-α (TNFα). Soluble TNFα binding proteins (TNFR) accumulate in the plasma of azotemic patients. To test the hypothesis that these increased sTNFR concentrations inhibit TNFa priming of oxidative burst activity, we measured plasma sTNFR concentrations in nondialyzed azotemic patients, hemodialysis patients, and normal subjects, and determined TNFa priming of fMet-Leu-Phe-stimulated superoxide production in neutrophils incubated in plasma with differing levels of sTNFR. These sTNFR concentrations increased significantly as creatinine clearance decreased and were significantly greater in hemodialysis patients than could be accounted for by loss of renal function alone. TNFα primed superoxide production by normal neutrophils in normal plasma, but this effect was significantly reduced in plasma with increased concentrations of sTNFR. Neutrophils from azotemic and hemodialysis patients were refractory to priming by TNFα in autologous plasma, and incubation in normal plasma only partially corrected this defect. We conclude that sTNFR accumulate as a result of the loss of renal function and hemodialysis and inhibit TNFα priming of neutrophils in azotemic and hemodialysis patients, but that these cells also have an intrinsic functional defect.     

Lymphocytapheresis

Abstract: Leukocytapheresis has long been performed with the centrifugal method. But in 1989 in Japan, the Asahi Medical Co. developed the extracorporeal leukocyte-removal filter, Cellsorba. This filter consists of non-woven fabric, which can remove leukocytes from whole blood during extracorporeal circulation. In the incipient stage, this filter was applied to collagen diseases, rheumatoid arthritis, and systemic lupus erythematosus. During the following studies, this filter has been found to have an immunosuppressive effect. Now, it is beginning to be applied to various kinds of autoimmune diseases. Moreover, this filter has recently been recognized to be effective in inflammatory bowel diseases, ulcerative colitis, and Crohn's disease. The outline of Cellsorba and the application of this filter is described here.