乳腺癌组织中耐药相关基因表达的研究

【目的】探讨乳腺癌组织中胎盘型谷胱甘肽转移酶(GST-π)、多药耐药相关蛋白(MRP)、肺耐药蛋白(LRP)及P-糖蛋白(P-gp)4种耐药相关基因的表达情况，分析它们之间及它们与雌激素(ER)、孕激素(PR)、原癌基因C-erbB2、P53蛋白、肿瘤转移之间的相关性。【方法】收集了103例临床病理确诊为乳腺癌的癌组织标本，患者术前均未经过化疗。采用免疫组织化学方法检测GST-π、MRP、LRP及P-gP的表达情况，与同时检测的ER、PR、c-erhB2、P53等与乳腺癌预后有关的因素进行相关性分析，并将病例按有无淋巴结转移分成2组，分别对2组的GST-π、MRP、LRP、P-gP的表达进行卡方检验。【结果】4种耐药相关基因在乳腺癌组织中均有表达，其阳性率分别为GST-π56．3％、MRP16．7％、LRP72．8％、P-gp57．1％，均以低量表达为主(阳性细胞数小于25％)，有、无淋巴结转移2组之间4种耐药相关基因的表达差异均无显著性。仅GST-π表达与C-erbB2、LRP之间及LRP表达与C-erbB2之间存在正相关关系，相关系数分别为r=0．323，r=0．244，r=0．231，其他指标相互间无相关性。【结论】乳腺癌组织的原发多药耐药主要与GST-π、LRP及P-gp的表达有关，化疗前这几种耐药相关基因表达的检测可为化疗药物的选择及预后判断提供参考依据。     

多药耐药基因、谷胱甘肽-S-转移酶-π、胸苷酸合成酶在胃癌中的表达及意义

目的 检测多药耐药基因（P-gp）、谷胱甘肽-s-转移酶-π（GST-π）、胸苷酸合成酶（TS）在胃癌中的表达及其临床指标和预后关系。方法采用SP免疫组化法检测P-gP、GST-π、TS在62例胃癌患者中的表达。结果62例胃癌患者中P-gP、GST-π、TS表达率分别为77．4％、67．7％、12、9％。P-gP、GST-π表达率明显高于TS。结论P-gP、GST-π在原发性胃癌中有较高的表达率，P-gp的表达与分化程度和淋巴结转移有一定关系，可作为治疗和提示预后的指标。GST-π与肿瘤分化程度有一定相关性。P-gP、GST-π过表达导致胃癌化疗失败。鸭表达率低，提示5-FU可作为治疗原发性胃癌化疗的首选药物。     

乳腺癌组织中P-gp、GST-π与TopoⅡ耐药基因的表达及临床意义

目的探讨多药耐药基因蛋白P-糖蛋白(P-gp)、谷胱甘肽-S-转移酶-π(GST-π)及DNA拓扑异构酶Ⅱ(TopoⅡ)在乳腺癌中的表达及其临床意义。方法用免疫组化法检测52例未经抗肿瘤治疗的原发乳腺癌中P-gp、GST-π及TopoⅡ的表达水平。结果52例乳腺癌组织中P-gp、GST-π和TopoⅡ表达率分别为57.7%、53.8%和76.9%,P-gp、GST-π和TopoⅡ的表达与组织学类型、年龄无关(P>0.05),与临床分期、淋巴结转移有显著性差异(P<0.05),P-gp和GST-π的表达呈显著正相关(P<0.05),P-gp和TopoⅡ的表达呈明显负相关(P<0.05),GST-π和TopoⅡ呈明显负相关(P<0.05)。结论乳腺癌化疗前检测P-gp、GST-π及TOPOⅡ耐药基因蛋白,对肿瘤的化疗药物选择及判断预后有一定的价值。     

乳腺癌组织中多药耐药相关基因产物表达的研究

目的探讨多药耐药(MDR)基因产物P-糖蛋白(P-gp)、谷胱甘肽-S-转移酶-π(GST-π)及DNA拓扑异构酶Ⅱ(TopoⅡ)在乳腺癌组织中的表达,分析其与临床病理特征及预后的关系。方法采用免疫组织化学方法,检测184例术前未经抗肿瘤治疗的原发性乳腺癌组织中P-gp、GST-π及TopoⅡ基因产物的表达。结果乳腺癌组织中P-gp、GST-π和TopoⅡ阳性表达率分别为49.5%、45.6%和73.9%;2种MDR基因产物共表达率为31.0%,3种MDR基因产物阳性表达率共为67.4%,明显高于单独阳性表达率12.4%(P<0.01)。P-gp、GST-π和TopoⅡ的阳性表达在不同年龄、组织学类型间的表达率差异无统计学意义(P>0.05);在腋淋巴结有无转移者间的表达率差异有统计学意义(P<0.05);P-gp阳性表达率在不同临床分期的差异无统计学意义(P<0.05),GST-π和TopoⅡ的阳性表达率在不同临床分期间有统计学意义(P>0.05)。但三种耐药基因产物阳性表达率在根治术后局部复发和远处转移者明显高于无复发转移者。结论乳腺癌组织中存在着P-gp、GST-π及TopoⅡ表达水平的变化;单基因和多基因协同作用,以多基因共表达为主;阳性表达者根治术后局部复发和远处转移率较高。化疗前联合检测P-gp、GST-π及TopoⅡ对乳腺癌化疗药物的选择具有指导作用,对预后的判断有参考价值。     

P-gp、GST-π、Topo Ⅱ在乳腺癌中的表达及其意义

目的探讨P-糖蛋白（P-gp）、谷胱甘肽S转移酶π（GST-π）及DNA拓扑异构酶Ⅱ（TopoⅡ）在乳腺癌组织中的表达及其意义。方法采用免疫组化SP法检测96例术前未行化疗的乳腺癌组织中P-gp、GST-π、TopoⅡ以及雌激素受体（ER）、孕激素受体（PR）和人表皮生长因子受体2（HER2）的表达。结果P-gp、GST-π、TopoⅡ的阳性表达率分别为41．7％、42．7％、69．8％。P-gp的阳性表达与肿瘤大小、分期以及腋淋巴结转移均有关（均P〈0．05）；在组织学分级Ⅱ、Ⅲ级者、ER／PR阴性者和HER2阳性者中P-gp的阳性表达率有增高趋势，但无统计学意义（均P〉0．05）。GST-π的表达在腋淋巴结阳性者和组织学分级Ⅱ、Ⅲ者中有增高趋势。TopoⅡ的阳性表达在组织学分级Ⅰ级较Ⅱ、Ⅲ级有增高趋势，但无统计学意义（P〉0．05）。P-gp、GST-π、TopoⅡ存在共表达情况。结论乳腺癌组织的原发多药耐药与P-gp、GST-π、TopoⅡ的表达有关，化疗前对它们进行检测可对化疗药物的选择及预后判断提供参考依据。     

乳腺癌P-gp、GST-π和Topo Ⅱ的表达及其意义

目的探讨P-糖蛋白(P-gp),谷胱甘肽S转移酶π(GST-π),DNA拓扑异构酶Ⅱ(TopoⅡ)在乳腺癌组织中的表达及其意义。方法采用免疫组化SP法对78例术前未行化疗患者的乳腺癌组织切片中P-gp、GST-π、TopoⅡ的表达进行分析。结果P-gp、GST-π、TopoⅡ的阳性表达率分别为38.5%、46.2%、73.1%,与年龄、肿瘤大小、ER/PR和HER2状况无关。腋淋巴结阳性组P-gp和GST-π的阳性表达率与阴性组比较,差异有统计学意义(2χ=5.175,2χ=4.614,P<0.05);肿瘤不同分期的P-gp的阳性表达率差异有统计学意义(2χ=5.848,P<0.05)而且随分期增高而增高。结论乳腺癌组织的原发多药耐药与P-gp、GST-π、TopoⅡ的表达有关,化疗前对它们进行检测可为化疗药物的选择及预后判断提供参考依据。     

GST-π、P-gp及Topo Ⅱ在大肠癌中的表达及其多药耐药的临床研究

目的探讨大肠癌组织中谷胱甘肽s转移酶（GST-π、糖蛋白（P-gp）和DNA拓扑异构酶Ⅱ（TopoⅡ）的表达与临床病理和预后及多药耐药的关系。方法采用免疫组化方法检测111例大肠癌组织中GST-π、P-gp和TopoⅡ的表达。对其组织病理改变和5年生存率进行综合分析。结果在高、中分化及低分化大肠癌组织中，GST-π阳性率分别为56．3％、66．2％和92．6％；TopoII阳性率为25．0％、32．3％和66．7％，P-gp阳性率为37．5％、50．0％和74．1%。GST-π和TopoII表达在高、低分化两组间及中、低分化两组间均有非常显著的差异（P〈0．01），P-gp表达均有显著差异（P〈0．05）。而在不同的年龄、性别、Duke’S分期及有无淋巴结和远处转移中，GST-π、P-gP、TopoII的表达均无显著差异（P〉0．05）。5年内生存者，GST-π、P-gp和TopoII表达阳性率低于5年内死亡者，GST-π和P-gp有显著差异（P〈0．05），TopoII有非常显著差异（P〈0．01）。结论耐药表型GST-π、P-gp和TopoII可作为多药耐药的标志物，其表达可能作为评估大肠癌预后的有价值的指标。     

多药耐药类蛋白对乳癌新辅助化疗疗效的影响

目的：评价乳癌组织多药耐药类蛋白P-糖蛋白（P-gP）、谷胱甘肽转移酶（GST-π）、拓扑异构酶Ⅱ（TopoⅡ）表达对新辅助化疗近期疗效的预测价值。方法：采用免疫组织化学方法检测100例乳癌患者新辅助化疗前后肿瘤组织中P-gP、GST-π及TopoⅡ的表达，并与疗效作相关性分析。结果：P-gP在化疗前后的阳性表达率分别为42％和65％，差异有统计学意义（P〈0．05）；GST-π在化疗前后阳性表达率分别为65％和70％，差异无统计学意义（P〉0．05）；TopoⅡ化疗前后阳性表达率分别为40％和35％，差异无统计学意义（P〉0．05）。P-gP与GST-π化疗前共表达率为40％，呈正相关（r=0．539，P〈0．01）。P-gP、GST-π及TopoⅡ阳性者化疗有效率分别为28．6％、46．2％、75．0％，阴性者分别为55．0％（P〈0．05）、60．0％（P〉0.05）、35．0％（P〈0．05）。P-gP与GST-π同时阳性者化疗有效率为25％。结论：P-gP和TopoⅡ对乳癌新辅助化疗疗效有一定预测价值。     

乳腺癌P-gp、LRP、GST-π、TOPO-Ⅱ的表达及其与术前化疗的关系

目的:探讨P-gp、LRP、GST-π、TOPO-Ⅱ在乳腺癌中的表达以及术前化疗对乳腺癌多药耐药的影响及其临床意义.方法:采用免疫组织化学S-P法,对18例术前曾用化疗和70例术前未用化疗的88例乳腺癌组织检测P-gp、LRP、GST-π、TOPO-Ⅱ的表达.结果:88例乳腺癌中P-gp、LRP、GST-π、TOPO-Ⅱ的阳性率分别为42.0%、53.4%、48.9%、40.9%.术前应用化疗的病人乳腺癌组织P-gp、LRP、GST-π三者阳性表达率均较未用化疗的病人高.P-gp和LRP差异有显著性(P＜0.05),而GST-π差异无显著性(P＞0.05),TOPO-Ⅱ有化疗史的病人比无化疗史的病人低,但差异无显著性(P＞0.05).结论:P-gp、LRP、GST-π、TOPO-Ⅱ的耐药机制各不相同,同时检测P-gp、LRP、GST-π、TOPO-Ⅱ等多种导致多药耐药的因素,对乳腺癌化疗有重要的指导意义.     

卵巢癌组织中MDR1(P-gp)、GST-π基因的表达与化疗耐药及预后的研究

目的探讨MDR1、GST-π的表达与化疗耐药及预后的关系。方法采用免疫组化SP法检测47例卵巢癌组织中MDR1(P-gp)、GST-π的表达情况。结果①MDR1(P-gp)、GST-π阳性表达的患者对化疗的有效率分别为34.5%和34.6%,而阴性患者对化疗的有效率则为77.8%和71.4%。两者比较差异有显著性。②复发患者的肿瘤组织中MDR1(P-gp)、GST-π阳性表达率明显高于初治组。③在预后方面,MDR1(P-gp)、GST-π表达阳性的患者比阴性的患者差。结论①MDR1(P-gp)、GST-π阳性表达的患者化疗疗效差。②复发患者的肿瘤组织中MDR1(P-gp)、GST-π表达阳性率明显高于初治组,提示卵巢癌对化疗药物特别是铂类药物可能有获得性耐药,与肿瘤组织在接受化疗后出现基因激活有关。③MDR1(P-gp)、GST-π的阳阴性表达与化疗预后相关。     

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…     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

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.     

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.     

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.