Survivin反义核酸诱导乳腺癌细胞凋亡的实验研究

目的探讨Survivin反义核酸技术诱导乳腺癌细胞凋亡的作用及效果。方法本实验共分6组，分为以脂质体介导反义寡核苷酸组（ASODN／Lip）、无义寡核苷酸组（NODN／Lip）及RPMI 1640培养液的空白对照组（Lip），转染人乳腺癌MCF-7细胞系，应用Hoechst 33258／PI双重染色观察MCF-7细胞的形态学改变，透射电镜观察细胞超微结构，流式细胞仪检测细胞周期和细胞凋亡的变化，DNA凝胶电泳观察凋亡情况，研究Survivin反义寡核苷酸对MCF-7乳腺癌细胞的生长抑制作用。结果Hoechst 33258／PI染色及透射电镜观察可见转染后的细胞结构呈凋亡样改变；流式细胞仪检测见转染后细胞凋亡显著增加，并出现G2／M期阻滞现象；DNA凝胶电泳在600ng／ml，800ng／ml ASODN／Lip组的电泳图谱上呈现出明显的“梯状”现象。结论凋亡抑制基因Survivin表达下涧对乳腺癌细胞的生长抑制作用主要是通过诱导细胞发生凋亡以及阻止有丝分裂发生在G2／M阻滞期来实现，Survivin靶向反义核酸技术可能成为乳腺癌基因治疗的一种有效方法。     

Optimising Hormone Therapy in Advanced Disease

Although most prostate cancer (PCa) patients nowadays are diagnosed at an early stage of disease, unfortunately still a significant number of patients will develop advanced PCa or will be diagnosed at an advanced (or metastatic) stage of disease. The group of patients showing the highest increase in incidence are those with rising prostate specific antigen (PSA) after radical therapy.In the last quarter of 2004, a Medline search has been performed targeting publications on patients diagnosed with advanced PCa, as well as with PSA relapse after previous radical therapy. This review aims at providing guidance to optimise hormone therapy in those selected groups of patients by addressing three pivotal questions; (i) who should receive hormonal treatment, (ii) what type of hormonal therapy should the patient be offered and (iii) what is the best timing of starting hormonal treatment.In patients relapsing after radical therapy, the PSA doubling time (PSA DT) has become a critical instrument to distinguish patients to have innocuous PSA evolution from patients at high risk for disease progression. A PSA DT of 3 months seems to be the cut-off point for identifying patients at risk. Therefore patients with a PSA DT of less than 3 months should be advised to initiate hormonal therapy. Antiandrogen monotherapy may be considered in this setting as it has been shown to delay progression; however, significant survival data are not yet available. Whether luteinising hormone releasing hormone (LHRH) agonists should be given continuously or intermittently (IHT) remains subject of debate.Surgical castration has been the standard of care in patients diagnosed with advanced PCa. Currently, LHRH agonists have become the preferred way of suppressing testosterone.Combination of an antiandrogen and a LHRH agonist (CAB) shows a modest benefit over LHRH agonist monotherapy. As CAB leads to increased side effects and costs, LHRH agonist monotherapy is preferred in the majority of patients.Conflicting data have been published concerning the optimal timing of LHRH agonist therapy. So it is not clear whether LHRH agonist therapy should be started immediately or deferred until appearance of symptoms. When initiating continuous hormone therapy, patients should be carefully monitored for the risk of long term androgen deprivation (anaemia, osteopenia and osteoporosis).     

减瘤手术在晚期肺癌治疗中的应用研究

目的初步探讨减瘤手术在晚期肺癌治疗方面的实用价值。方法选择2006年1月至2008年1月笔者所在医院收治的的中晚期肺癌患者20例，采用减瘤手术治疗。选择同时期15例剖胸探查肺肿物活检患者作为对照组。研究分析两组患者术后生存质量及生存时间的差异。结果减瘤组患者生存质量较好率为40．0％，对照组为20．0％，两组间比较差异有统计学意义（χ^2=7．21，P〈0．05）。生存质量评分减瘤组为（35．3±8．2）分，对照组为（27．9±7．1）分，两组间比较差异有统计学意义（t=6．59，P〈0．05）。平均生存时间减瘤组患者为11．6个月，对照组为10．3个月，两组间比较，差异无统计学意义（t=2．41，P〉0．05）。结论减瘤手术可改善中晚期或已有远处转移的肺癌患者的生存质量。     

Protein kinase C�� expression in breast cancer as measured by real-time PCR, western blotting and ELISA

The protein kinase C (PKC) family of genes encode serine/threonine kinases that regulate proliferation, apoptosis, cell survival and migration. Multiple isoforms of PKC have been described, one of which is PKCδ. Currently, it is unclear whether PKCδ is involved in promoting or inhibiting cancer formation/progression. The aim of this study was therefore to investigate the expression of PKCδ in human breast cancer and relate its levels to multiple parameters of tumour progression. Protein kinase Cδ expression at the mRNA level was measured using real-time PCR (n=208) and at protein level by both immunoblotting (n=94) and ELISA (n=98). Following immunoblotting, two proteins were identified, migrating with molecular masses of 78 and 160 kDa. The 78 kDa protein is likely to be the mature form of PKCδ but the identity of the 160 kDa form is unknown. Levels of both these proteins correlated weakly but significantly with PKCδ concentrations determined by ELISA (for the 78 kDa form, r=0.444, P<0.005, n=91 and for the 160 kDa form, r=0.237, P=0.023, n=91) and with PKCδ mRNA levels (for the 78 kDa form, r=0.351, P=0.001, n=94 and for the 160 kDa form, r=0.216, P=0.037, n=94). Protein kinase Cδ mRNA expression was significantly higher in oestrogen receptor (ER)-positive compared with ER-negative tumours (P=0.007, Mann–Whitney U-test). Increasing concentrations of PKCδ mRNA were associated with reduced overall patient survival (P=0.004). Our results are consistent with a role for PKCδ in breast cancer progression.     

Do patient characteristics,disease, or treatment explain social inequality in survival from colorectal cancer?

This paper investigates the association between individually measured socioeconomic status (SES) and all-cause survival in colorectal cancer patients, and explores whether factors related to the patient, the disease, or the surgical treatment mediate the observed social gradient.     

T淋巴瘤侵袭转移诱导因子1与胃癌细胞侵袭移行能力的相关性研究

目的：检测T淋巴瘤侵袭转移诱导因子1（Tiam1）在胃癌细胞株中的表达并分析其与胃癌细胞侵袭、移行能力的关系。方法：采用层黏连蛋白黏附法，从胃癌MKN-45细胞株（Mo）中筛选获得高黏附亚株（Mh）和低黏附亚株（ML）。应用RT-PCR和SABC免疫组化技术分别检测Tiam 1mRNA与蛋白在Mo、ML、Mh细胞中的表达。应用Boyden小室测定Mo、ML、Mh细胞的体外侵袭、移行能力并分析其与Tiam1表达间的关系。结果：胃癌MKN-45细胞高黏附亚株（MH）的体外侵袭、移行能力均较MKN-45细胞（Mo）及其低黏附亚株（Mo为强（P〈0.05），但Mo与ML细胞间无差异（P〉0.05）。Tiam 1mRNA和蛋白在MH细胞中的表达均较其在Mo和ML细胞中的表达为强（P〈0.05），但在Mo与ML细胞中的表达无差异（P〉0.05）。Tiam1蛋白和mRNA表达水平与胃癌细胞体外侵袭、移行能力呈正相关（P〈0.05或P〈0.01）。结论：Tiam1基因表达水平升高有可能促进胃癌细胞侵袭、移行能力的增强。     

刺五加注射液及抗凝剂对糖尿病足的早期干预治疗

目的观察刺五加注射液及抗凝剂(潘生丁、肠溶阿斯匹林)对糖尿病足早期干预治疗的影响。方法将符合1999年WHO诊断标准的100例糖尿病合并早期足病变的患者分为两组:干预治疗组50例,对照组50例。在控制血糖、血压、糖尿病教育的基础上,干预组予以静滴刺五加注射液及口服抗凝剂(潘生丁、肠溶阿斯匹林)治疗,对照组为口服VitB1、VitB6、复方丹参片治疗。观察治疗前后两组患者足背动脉搏动、皮肤颜色、温度,痛、温、触觉等相关指征,血糖、HbA1c、血TG、TC、HDL-C,及血流变学、眼底病变、心脑血管事件发生率等。结果干预组糖尿病足病变治疗好转率高,恶化发展率低,心脑血管事件发生率少。血脂、血流变学、下肢血管多普勒彩超及眼底病变等好转改善明显,与对照组比较差异有统计学意义(P<0.05或P<0.01)。结论刺五加注射液及抗凝剂(潘生丁、肠溶阿斯匹林)对糖尿病足病变的早期干预治疗疗效显著,有重要的临床意义。     

Is pre‐operative radiotherapy necessary in T1‐T3 rectal cancer with TME?

OBJECTIVE: The indications for pre-operative radiotherapy in rectal cancer are still unclear with the exception of T4 tumours. The aim of this study was to assess local and overall recurrence in patients with T1-T3 rectal cancers undergoing total mesorectal excision (TME). METHODS: Prospective data was collected from 150 patients with rectal cancer treated in one surgical centre between July 1997 and July 2002. One hundred and twenty-nine primary resections were carried of which 102 were with curative intent. Seventy-nine patients with T1-T3 tumours were included in the analysis. Nine had local resections and 70 underwent TME; 19 of the 70 patients were node positive and 51 were node negative. RESULTS: At a median follow-up of 37 months (range 19-79 months) there were 3 (4.3%) isolated local recurrences. One node positive patient developed isolated local recurrence compared with 2 node negative patients. The node positive patient died from a myocardial infarction while the two node negative patients died as a consequence of local recurrence. Three (4.3%) of 70 patients developed systemic relapse all of whom were node positive. The cancer specific mortality rate over the same follow-up period was 3/19 for node positive patients and 2/51 for node negative patients. Of 9 patients who had local resections, none developed local recurrence or systemic relapse. CONCLUSIONS: With TME the rate of local recurrence in T1-T3 tumours is low. Our results do not support the use of pre-operative radiotherapy for these patients.