质子放疗前后恶性肿瘤患者T细胞亚群的变化

目的探讨用质子放射治疗恶性肿瘤病人的过程中,通过检测病人T细胞亚群的变化,来判断质子治疗是否对细胞免疫功能产生影响。方法将20例经病理学证实的恶性肿瘤患者采用质子束局部外照射,在治疗前后分别取病人外周血,用流式细胞仪检测放疗前后T细胞亚群水平。结果CD4+T细胞、CD8+T细胞无明显变化,CD4+T/CD8+T在治疗后比治疗前明显降低(P<0.05)。结论质子治疗时可导致T细胞亚群变化,抑制细胞免疫功能。     

Animation-assisted CPRII program as a reminder tool in achieving effective one-person-CPR performance

Objective

The objective of this study is to compare the skill retention of two groups of lay persons, six months after their last CPR training. The intervention group was provided with animation-assisted CPRII (AA-CPRII) instruction on their cellular phones, and the control group had nothing but what they learned from their previous training.

Methods

This study was a single blind randomized controlled trial. The participants’ last CPR trainings were held at least six months ago. We revised our CPR animation for on-site CPR instruction content emphasizing importance of chest compression. Participants were randomized into two groups, the AA-CPRII group (n = 42) and the control group (n = 38). Both groups performed three cycles of CPR and their performances were video recorded. These video clips were assessed by three evaluators using a checklist. The psychomotor skills were evaluated using the Resusci^®Anne SkillReporter™.

Results

Using the 30-point scoring checklist, the AA-CPRII group had a significantly better score compared to the control group (p < 0.001). Psychomotor skills evaluated with the AA-CPRII group demonstrated better performance in hand positioning (p = 0.025), compression depth (p = 0.035) and compression rate (p < 0.001) than the control group.

Conclusion

The AA-CPRII group resulted in better checklist scores, including chest compression rate, depth and hand positioning. Animation-assisted CPR could be used as a reminder tool in achieving effective one-person-CPR performance. By installing the CPR instruction on cellular phones and having taught them CPR with it during the training enabled participants to perform better CPR.     

活髓片与四物汤对再生障碍性贫血小鼠骨髓基质细胞的影响比较

目的 :比较活髓片与四物汤对免疫介导再生障碍性贫血 (再障 )模型小鼠骨髓造血微环境及表面黏附分子表达等方面的影响。方法 :采用免疫介导法制作再障小鼠模型 ,分成正常对照组、再障模型组、活髓片组和四物汤组 ,于制模后第 11～ 14日取骨髓细胞制成单细胞悬液 ,进行成纤维细胞培养 ,于培养的第 2 8日收集细胞 ,上流式细胞仪进行细胞周期、凋亡率及血管细胞黏附分子 1(VCAM 1)表达水平检测。结果 :再障模型小鼠骨髓培养基质细胞凋亡率增加、培养细胞 VCAM 1表达水平下降 ,培养基质细胞绝大部分停留在 G0 / G1期 ,S期和 G2 M期细胞显著减少 ,与正常对照组比较有极显著性差异 (P均 <0 .0 1)。四物汤和活髓片两种中药复方均能促进小鼠骨髓培养基质细胞的分化增殖 ,降低细胞的凋亡率 ,促进培养细胞 VCAM 1的表达 ,但活髓片的效果明显优于四物汤 (P<0 .0 5 )。结论 :活髓片具有改善免疫介导再障小鼠骨髓造血微环境紊乱状况 ,促进骨髓培养基质细胞表面黏附分子的表达水平 ,且整体效果优于四物汤     

LAMA3在泛癌中的表达水平及其与泛癌预后、免疫微环境的相关性分析

目的 分析层粘连蛋白3（Laminin subunit alpha 3,LAMA3）在泛癌中的表达水平及其与泛癌患者预后、免疫微环境之间的关系。方法 本研究从多个数据库中收集转录组、预后、免疫相关数据,可视化分析LAMA3在泛癌中的表达水平及其与泛癌预后、免疫微环境的相关性。结果 与正常组织相比,LAMA3在11种肿瘤中显著高表达,如结肠癌（colon adenocarcinoma,COAD）,肾透明细胞癌（kidney renal clear cell carcinoma,KIRC）,胰腺癌（pancreatic adenocarcinoma,PAAD）等;在11种肿瘤中显著低表达,如胶质母细胞瘤（glioblastoma multiforme, GBM）、脑低级别胶质瘤（brain lower grade glioma,LGG）、皮肤黑色素瘤（skin cutaneous melanoma,SKCM）等。LAMA3表达水平不仅与包括PAAD在内的多种肿瘤预后显著相关,还与SKCM等多种肿瘤的肿瘤突变负荷（tumor mutation burden,TMB）、微卫星不稳定性（microsatellite instability,MSI）和肿瘤免疫浸润显著相关。此外,基因共表达分析结果表明LAMA3与多种常见的免疫基因表达显著相关。结论 LAMA3可作为泛癌预后、免疫治疗反应评估的生物标志物。     

转移性结直肠癌抗EGFR治疗耐药机制的研究进展

表皮生长因子受体(epidermal growth factor receptor,EGFR)是转移性结直肠癌(metastatic colorectal cancer, mCRC)的主要治疗靶点之一,然而抗EGFR治疗的耐药一直是亟待解决的临床难题。肿瘤细胞本身EGFR相关信号通路异常激活,基因组不稳定性等遗传学或表观遗传学改变是引发耐药最常见的机制,近期也有研究发现肿瘤微环境中细胞丰度和细胞因子的变化等也是引发抗EGFR治疗耐药的重要机制。我们将从肿瘤细胞和肿瘤微环境两个方面,对mCRC抗EGFR治疗的耐药机制进行综述。     

红藤合剂灌肠联合输卵管通液术治疗输卵管阻塞性不孕的临床疗效及对盆腔局部微环境的影响

目的 评价红藤合剂灌肠联合输卵管通液术治疗对输卵管阻塞性不孕的临床疗效及对盆腔局部微环境的影响。方法 选取2019年5月—2020年9月海南省中医院140例输卵管阻塞性不孕患者作为研究对象,按照随机数字表法分为对照组和观察组,每组70例。对照组采用输卵管通液术治疗;观察组在对照组治疗的基础上给予红藤合剂灌肠。3个月后行子宫输卵管造影检查,比较两组输卵管再通情况;随访12个月,比较两组妊娠情况和复发情况;对所有患者进行治疗前后中医症候和局部体征评分;比较两组子宫内膜厚度和子宫内膜类型、子宫内膜动脉阻力指数（RI）、搏动指数（PI）及血管化血流指数（VFI）;检测治疗前后宫腔液白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、转化生长因子-β₁（TGF-β₁）及结缔组织生长因子（CTGF）水平;检测治疗前后月经血趋化因子1（CXCL1）、趋化因子13（CXCL13）、IL-6及TNF-α水平;对所有患者行安全性评价。结果 治疗后,观察组输卵管再通率为76.19%（48/63）,高于对照组的58.06%（36/62）（P <0.05）。12个月随访期间,观察组妊娠率为70.83%（34/48）,高于对照组的44.44%（16/36）（P <0.05）;观察组复发率为12.50%（6/48）,低于对照组的30.56%（11/36）（P <0.05）。治疗后两组患者中医症候和局部体征评分较治疗前均降低（P <0.05）,且观察组评分低于对照组（P <0.05）。治疗后两组患者子宫内膜厚度、A型子宫内膜类型比例及VFI增加（P <0.05）,RI和PI较治疗前降低（P <0.05）,且观察组VFI高于对照组,RI和PI低于对照组（P <0.05）。治疗后两组患者宫腔液IL-6、TNF-α、TGF-β₁及CTGF水平较治疗前降低（P <0.05）,且观察组低于对照组（P <0.05）。治疗后两组患者月经血CXCL1、CXCL13、IL-6及TNF-α水平较治疗前降低（P <0.05）,且观察组低于对照组（P <0.05）。研究期间未发现与使用红藤合剂灌肠相关的不良反应。结论 红藤合剂灌肠联合输卵管通液术治疗输卵管阻塞性不孕可减轻临床症状,改善局部微循环和局部微环境,提高输卵管再通率和临床妊娠率,并降低复发率,临床使用安全。     

Progress in the studies on the molecular mechanisms associated with multidrug resistance in cancers

Chemotherapy is one of the important methods to treat cancer, and the emergence of multidrug resistance (MDR) is one major cause for the failure of cancer chemotherapy. Almost all anti-tumor drugs develop drug resistance over a period of time of application in cancer patients, reducing their effects on killing cancer cells. Chemoresistance can lead to a rapid recurrence of cancers and ultimately patient death. MDR may be induced by multiple mechanisms, which are associated with a complex process of multiple genes, factors, pathways, and multiple steps, and today the MDR-associated mechanisms are largely unknown. In this paper, from the aspects of protein–protein interactions, alternative splicing (AS) in pre-mRNA, non-coding RNA (ncRNA) mediation, genome mutations, variance in cell functions, and influence from the tumor microenvironment, we summarize the molecular mechanisms associated with MDR in cancers. In the end, prospects for the exploration of antitumor drugs that can reverse MDR are briefly discussed from the angle of drug systems with improved targeting properties, biocompatibility, availability, and other advantages.     

艾愈胶囊联合阿那曲唑治疗绝经后激素受体阳性乳腺癌的临床研究

目的 探讨艾愈胶囊联合阿那曲唑治疗绝经后激素受体(HR)阳性乳腺癌的临床疗效。方法 选取2019年1月-2022年1月海南医学院第一附属医院收治的136例绝经后HR阳性乳腺癌患者,按随机数字表法分为对照组和治疗组,每组各68例。对照组口服阿那曲唑片,1片/次,1次/d。治疗组在对照组基础上口服艾愈胶囊,3粒/次,3次/d。两组均连续治疗3个月。观察两组临床疗效,比较治疗前后两组癌灶最大径、中医症状评分、癌症治疗性功能评价量表-乳腺癌(FACT-B)评分以及血清肿瘤标志物[糖类抗原15-3(CA15-3)、癌胚抗原(CEA)、组织多肽特异性抗原(TPS)]和肿瘤坏死因子(TNF)-α、白细胞介素(IL)-8、血管内皮生长因子(VEGF)、可溶性E-选择素(sE-selectin)水平。结果 治疗后,治疗组客观缓解率是38.2%,高于对照组的29.4%,两组比较差异无统计学意义;治疗组临床获益率是76.5%,显著高于对照组的60.3%(P<0.05)。治疗后,两组癌灶最大径均显著缩小,中医症状评分均显著降低,FACT-B评分则均显著增加(P<0.05);且均以治疗组改善更显著(P<0.05)。治疗后,两组血清CA15-3、CEA、TPS水平均较治疗前显著下降(P<0.05);且均以治疗组降低更显著(P<0.05)。治疗后,两组血清TNF-α、IL-8、VEGF、sE-selectin水平均较治疗前显著下降(P<0.05);且均以治疗组降低均更显著(P<0.05)。结论 艾愈胶囊联合阿那曲唑治疗绝经后HR阳性乳腺癌的抗肿瘤疗效确切,能有效降低患者肿瘤负荷,减轻症状,提高生活质量,并可进一步改善肿瘤微环境,且安全性好。