米非司酮调控卵巢癌细胞表达葡萄糖神经酰氨合成酶并逆转其多药耐药性

目的 观察米非司酮体外逆转COC1/DDP细胞对顺铂的多药耐药性(MDR)以及对细胞葡萄糖神经酰氨合成酶(GCS)表达的影响,初步探讨其增敏机制.方法 以米非司酮为MDR修饰剂,MTT法检测米非司酮对COC1/DDP的增敏效应.RT-PCR技术分析耐药株COC1/DDP的MDR逆转前后以及亲本株COC1细胞的GCS在mRNA水平的表达.结果 米非司酮增强COC1/DDP细胞对DDP敏感性;与COC1相比,COC1/DDP细胞的GCS在mRNA水平的表达增强;米非司酮使GCS表达降低,效应呈剂量依赖关系.结论 无毒性剂量米非司酮可以在体外增加卵巢癌COC1/DDP细胞对DDP的敏感性.作用机制与抑制GCSmRNA表达有关.     

Mifepristone对卵巢癌细胞的单己糖神经酰胺表达及耐药性的影响

目的研究单己糖神经酰胺在卵巢癌耐药细胞株COC1/DDP对顺铂耐药性中的作用,探索mifepristone对COC1/DDP细胞耐药性逆转的机制.方法将耐药细胞分为顺铂组、顺铂+mifepristone组,MTT方法检测各组细胞抑制率;采用改良的Hahomori方法分别提取、纯化耐药细胞COC1/DDP(用mifepristone处理前后)和敏感细胞COC1的中性鞘糖脂,高效薄层层析、凝胶光密度成像系统分析各组CMH的差异将耐药细胞分为三组顺铂组、mifepristone组、顺铂+mifepristone组,用透射电镜观察各组细胞的超微形态结构变化.结果mifepristone可以逆转COC1/DDP细胞对顺铂的耐药性,1.25μmol/L的mifepristone与浓度为(0.1～1.25)μg/ml的顺铂联合应用,使细胞的抑制率从单用上述浓度顺铂时的(8.84±6.29)%～(17..71±8.00)%上升为(15.26±6.75)%～(27.15±7.69)%(P＜0.001),且有剂量依赖性.耐药细胞的CMH表达率为(37.14±3.34)%,明显高于敏感细胞的(14.05±1.44)%(P＜0.001),耐药细胞经1.25μmol/L、5μmol/L mifepristone处理后,CMH分别下降到(26.62±2.63)%(P＜0.05)和(17.50±0.67)%(P＜0.001).顺铂和mifepristone联合作用,透射电镜观察到耐药细胞出现异染色质浓缩、边聚,产生了凋亡小体.结论mifepristone在较低浓度即可逆转卵巢癌细胞COC1/DDP对顺铂的耐药性,其增敏机制可能与抑制单己糖神经酰胺的表达、促进细胞凋亡相关.     

姜黄素对卵巢癌耐药细胞株COC1/DDP的增敏作用及其机制的研究

目的:探讨姜黄素对卵巢癌耐药细胞系COC1/DDP的增敏作用并探讨其机制.方法:采用MTT法检测姜黄素对COC1/DDP细胞的增敏作用;用流式细胞仪检测单用顺铂、单用姜黄素、顺铂与姜黄素合用作用于COC1/DDP细胞48 h后的细胞凋亡率;Western blot法检测单用顺铂及顺铂与姜黄素合用后各组细胞凋亡相关蛋白Bcl-2、Caspase-3、Survivin的表达.结果:姜黄素浓度在15～35 μmol/L以内时以一定的剂量-效应关系对COC1/DDP有明显的增殖抑制作用.顺铂的浓度在1.25～5 mg/L时加入20 μmol/L姜黄素后耐药细胞生存率下降明显(P＜0.05),尤以2.5 mg/L顺铂和20 μmol/L姜黄素联合作用时,耐药细胞生存率下降最明显;COC1/DDP中顺铂与姜黄素联合用药与单独用顺铂及单用姜黄素相比,凋亡率明显增加(P＜0.05);顺铂与姜黄素联合用药与单独用顺铂相比Bcl-2、Survivin蛋白的表达明显降低(P＜0.05),Caspase-3蛋白的表达明显增高(P＜0.05).结论:姜黄素能够显著抑制COC1/DDP增殖,并能增强该细胞系对顺铂的敏感性,其机制可能与降低Bcl-2、Survivin蛋白的表达,增加Caspase-3蛋白的表达有关.     

卵巢癌细胞系Smac基因的表达及意义

目的 探讨Smac基因在卵巢癌细胞系A2780、COC1及其顺铂(DDP)耐药株A2780/DDP、COC1/DDP中的表达及其意义.方法 半定量逆转录-聚合酶链反应和免疫印迹法检测卵巢癌细胞A2780、COC1及其顺铂耐药株A2780/DDP、COC1/DDP中Smac mRNA和蛋白的表达.结果 卵巢癌细胞A2780、COC1及其顺铂耐药株A2780/DDP、COC1/DDP四种细胞系中均有Smac mRNA和蛋白的表达;Smac在A2780、COC1中的表达高于其顺铂耐药株.结论 低表达Smac抑制凋亡,低表达Smac可能与耐药有关.     

顺铂诱导的人卵巢癌多药耐药细胞系基因表达谱分析

目的卵巢癌多药耐药性的产生是导致其化疗失败的主要原因,为研究卵巢癌耐药机制,本研究建立了人卵巢癌细胞多药耐药模型COC1/DDP,并进行了基因表达谱分析。方法以顺铂为诱导剂,采用中等剂量、间歇作用法建立多药耐药细胞系COC1/DDP,然后以其亲本细胞COC1为对照,应用cDNA微阵列检测COC1/DDP细胞的基因表达。结果与COC1细胞相比,COC1/DDP细胞对顺铂有6.2倍耐药性,细胞倍增时间延长了8.9h,S期细胞减少了(27.4±2.13)%,而G1和G2期细胞则分别增加了(19.6±3.71)%和(8.3±1.95)%,对阿霉素、5-氟脲嘧啶和长春新碱也有明显的交叉耐药性。较之COC1亲本细胞,COC1/DDP细胞有143个基因的表达水平发生改变,表达上调的有71个基因,表达下调的有72个基因,包括大量的凋亡和抗凋亡基因、信号转导和细胞周期调节基因、DNA转录与修复基因以及蛋白激酶和磷酸酶基因。结论COC1/DDP细胞具有多药耐药的特性,耐药性的产生与其特异的基因表达谱有关。     

切除修复交叉互补基因表达与卵巢癌细胞顺铂耐药的关系

目的:探讨卵巢癌细胞系COC1、COC1/DDP、A2780、A2780/DDP中切除修复交叉互补基因(ERCC1)表达与顺铂耐药的关系.方法:采用RT-PCR方法检测4种卵巢癌细胞系中ERCC1基因的表达,MTT检测各细胞系对顺铂的敏感性.结果:4种细胞系中均有ERCC1基因表达,耐药细胞中的表达量明显高于敏感细胞(P＜0.05).DDP作用于COC1、COC1/DDP细胞72小时后,随着ERCC1基因表达的升高,细胞对顺铂的耐药性增加.结论:卵巢上皮性癌细胞系中ERCC1基因表达的升高与卵巢癌顺铂耐药相关.     

川芎嗪对人卵巢癌顺铂耐药细胞株COC1/DDP的逆转作用研究

目的建立人卵巢癌顺铂耐药细胞株COC1/DDP,探讨川芎嗪对COC1/DDP顺铂耐药性的逆转作用及其机制。方法采用逐步递增DDP浓度、体外间歇诱导法诱导建立人卵巢癌顺铂耐药细胞株COC1/DDP;CCK-8(cell counting kit-8)检测川芎嗪对COC1/DDP细胞顺铂耐药性的逆转作用;GSH和GSSG试剂盒检测细胞内GSH的水平,高效液相色谱测定细胞内顺铂的含量。结果历时5个月建立了在1.0μg/mL DDP作用下生长良好的耐药细胞株COC1/DDP,耐药指数为9.44,对卡铂、长春新碱和阿霉素有不同程度的交叉耐药性;川芎嗪0.25 mg/mL对COC1/DDP的顺铂耐药性有逆转作用,逆转倍数达到3.76倍;与COC1比较,COC1/DDP细胞内GSH水平增高,顺铂含量下降,但经川芎嗪0.25 mg/mL干预后,COC1/DDP胞内的GSH水平降低,顺铂的含量增加(P<0.01)。结论川芎嗪对COC1/DDP的顺铂耐药性有逆转作用,其机制可能与干预COC1/DDP细胞内GSH/GST-π解毒系统,增加细胞内顺铂的含量有关。     

米非司酮对卵巢癌耐药细胞株COC1/DDP增敏作用研究

目的探讨米非司酮对卵巢癌耐药细胞株COC1/DDP的增敏作用。方法采用RPMI1640培养液对COC1/DDP细胞株进行培养,实验分2批进行,第一批将COC1/DDP细胞株分5组:对照组(不加任何药物)、顺铂组(2μg/ml)、高剂量米非司酮组(15μg/ml)、中剂量米非司酮组(10μg/ml)、低剂量米非司酮组(5μg/ml);第二批将COC1/DDP细胞株分5组:对照组(不加任何药物)、顺铂组(2μg/ml)、高剂量米非司酮加顺铂组(15μg/ml米非司酮和2μg/ml顺铂)、中剂量米非司酮加顺铂组(10μg/ml米非司酮和2μg/ml顺铂)、低剂量米非司酮加顺铂组(5μg/ml米非司酮和2μg/ml顺铂)。培养结束后采用MTT法观察各组COC1/DDP细胞株增殖活力和生存率的变化。结果与对照组比较,顺铂组和低剂量米非司酮组对细胞增殖活力的影响,差异均无统计学意义(P>0.05);随着米非司酮浓度的升高,对COC1/DDP细胞抑制作用逐渐增强,中、低剂量米非司酮组与顺铂组比较细胞增殖活力和生存率差异均有统计学意义(P<0.05或P<0.01),高剂量组与低剂量组比较有统计学意义(P<0.01);各剂量米非司酮加顺铂组与顺铂组比较对细胞增殖活力和生存率的影响,差异有统计学意义,且随着米非司酮浓度的升高,对COC1/DDP细胞抑制作用逐渐增强(P<0.05或P<0.01)。结论单药米非司酮和联合顺铂对COC1/DDP细胞增殖活力均具有显著抑制作用,米非司酮可提高顺铂化疗的敏感性,且与米非司酮的浓度呈剂量依赖关系。     

不同存在形式人卵巢癌细胞株的细胞内顺铂浓度测定

目的　了解人卵巢癌细胞株COC1及其耐药亚株COC1/DDP以多细胞团簇形式和单细胞形式存在的细胞内顺铂浓度的差异 ,探讨细胞存在形式在COC1/DDP耐药中的作用。方法　选用半贴壁生长的人卵巢癌细胞株COC1及其耐药亚株COC1/DDP ,应用常规继代培养法获取多细胞团簇 ,对照组用相应的单细胞悬液 ,高效液相色谱测定细胞内顺铂浓度。结果　顺铂作用 2h后COC1单细胞悬液和多细胞簇的胞内浓度分别是 (11.2 0 6 2 7± 1.340 6 )ng/10 6细胞和 (11.14 78± 1.176 2 )ng/10 6细胞 ,无统计学差异 (P >0 .0 5 ) ,COC1/DDP分别为 (5 .2 835± 0 .772 8)ng/10 6和 (4 .86 83± 1.0 380 )ng/10 6细胞 ,无统计学差异 (P >0 .0 5 ) ,同种存在形式的两种细胞间比较有统计学差异 (P <0 .0 1) ,前者分别为后者的 2 .1倍和 2 .3倍 ,而两种存在形式的细胞COC1与COC1/DDP细胞内顺铂浓度的差值经比较亦未发现统计学差异 (P >0 .0 5 )。结论　相同浓度药物作用下COC1细胞内顺铂浓度高于COC1/DDP细胞 ,细胞存在形式不是影响细胞内顺铂浓度的主要因素     

雌激素影响卵巢癌细胞系COC1顺铂耐药的相关机制

目的研究雌激素对顺铂诱导卵巢癌细胞系COC1和COC1／DDP凋亡的影响。方法运用细胞培养、MTT、原位标记法、流式细胞术和免疫组化等方法，采取雌激素预先作用卵巢癌COC1和COC1／DDP细胞16h，随后与顺铂共同培养诱导凋亡方式，动态地观察雌激素对顺铂诱导这两个细胞系凋亡影响和此过程中细胞周期分布和p53蛋白表达的改变。结果雌激素促进顺铂诱导的COC1和COC1／DDP细胞凋亡．引起细胞周期由G2到S期的转变，p53蛋白对雌激素作用无明显影响。结论处于细胞周期顺铂不敏感期的卵巢癌细胞可能与其耐药有关，雌激素可增加耐药的COC1／DDP细胞顺铂敏感性。     

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…     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…