500 Cases of High-intensity Focused Ultrasound (HIFU) Ablated Uterine Fibroids and Adenomyosis

ObjectiveClinical outcomes of 500 high-intensity focused ultrasound (HIFU)-treated uterine fibroids and adenomyosis are analyzed and presented.Materials and methodsThis is a retrospective cross-sectional analysis from a single tertiary medical center. From April 2015 to October 2018, 546 cases were enrolled for the study. After excluding 46 patients with less than 3 months of follow-up period, there were 404 fibroids, 149 adenomyosis and 53 mixed conditions entered for analysis. The patients’ uterine fibroids and adenomyosis were treated by HIFU according to Chongqing Haifu protocol, with 12 cm diameter transducer of focal length 10–16  cm at 0.8 or 1.6 MHz T2-weight MRI imaging was rendered prior to and 3 month post treatment to assess lesion volume change using non-perfusion volume, which was the primary outcome. Secondary outcomes including quality of life, subjective satisfaction, adverse events and pregnancy rate were determined using self-reported questionnaires. The mean follow up period ranged from 3 to 38 months with an average of 21 months.ResultsThree months after HIFU-treated uterine fibroids and adenomyosis, the lesion size reduced 40.2% and 46.3%, respectively. Symptoms all improved with better quality of life for the fibroid group, while those with adenomyosis or combined diseases benefit the most from pain control. Serum CA125 decreased significantly for all studied groups, and LDH only showed improvement for fibroids group. Number of adverse events is comparable to Chongqing data (approximately 10.2%), with mostly mild and self-resolving conditions. No permanent sequelae or death was documented. Twelve pregnancies are reported in this cohort.ConclusionHIFU is safe and effective in treating uterine fibroids and adenomyosis. The results are reproducible if standardized treatment schedules are followed. It is a promising treatment alternative with the advantages of precision, non-invasiveness, rapid recovery and readiness for pregnancy.     

miR-26b通过调节Notch1信号通路参与原发性肝细胞肝癌侵袭的机制研究

目的:探讨miR-26b参与原发性肝细胞肝癌（HCC）侵袭的机制。方法:在细胞培养液中培养人肝细胞系HL-7702和HCC细胞各系Hepb-3、HuH-7、MHCC97-L、MHCC97-H。实时荧光定量PCR法（qRT-PCR）检测miR-26b的表达水平；用miR-26b mimics、miR-26b inhibitors和Notch1-siRNA分别转染HCC细胞；MTT实验检测转染后HCC细胞的活力；采用Western blot检测Notch1受体蛋白表达水平的变化；Transwell小室测定不同处理后的HCC细胞的侵袭能力。结果:人正常肝细胞系HL-7702和HCC细胞系Hepb-3、HuH-7、MHCC97-L、MHCC97-H中的miR-26b相对表达含量随其侵袭和迁移能力的升高而依次下降；抑制miR-26b的表达，Notch1受体蛋白表达明显增高，而此时HCC细胞的侵袭性显著增强；相反，上调miR-26b的表达，Notch1受体蛋白表达明显降低，而HCC细胞侵袭性显著下降；miR-26b可能通过调控Notch1信号通路调节HCC细胞侵袭性。结论:miR-26b通过负调控Notch1信号通路抑制HCC细胞侵袭能力，为HCC侵袭的机制奠定了理论基础，miR-26b可能成为HCC治疗的新靶点。     

基质金属蛋白酶组织抑制剂-2过表达对人成釉细胞瘤鸡胚尿囊膜移植瘤的抑制作用

目的探讨基质金属蛋白酶组织抑制剂-2（TIMP-2）基因过表达对人成釉细胞瘤鸡胚尿囊膜（CAM）移植瘤的抑制作用。方法建立成釉细胞瘤的鸡胚尿囊膜移植瘤模型。将实验分组：空白对照组（Empt）,脂质体转染组（Lipo）,质粒转染组（P）。TIMP－2基因转染成釉细胞CAM移植瘤细胞后,测定移植瘤体积和瘤重;将移植瘤侵袭能力分为4个级别进行移植瘤病理检查。Western blot分析移植瘤基质金属蛋白酶-2（MMP-2）及TIMP-2蛋白的表达。结果移植瘤能在鸡胚绒毛尿囊膜上生长。接种后第9天,转染质粒组的0级侵袭为7例、2级侵袭为1例、3级侵袭为0例。TIMP-2基因转染可以显著抑制成釉细胞CAM移植瘤的局部侵袭能力。质粒转染组TIMP-2表达明显高于空白组TIMP-2的表达（P＜0.05）;质粒转染组MMP-2表达明显低于空白组MMP-2的表达（P＜0.05）。结论成功建立成釉细胞瘤的CAM移植瘤模型。TIMP-2基因转染后,成釉细胞瘤CAM移植瘤的侵袭性生长被抑制。移植瘤的侵袭性生长被抑制的可能原因是由于特异性抑制MMP-2蛋白引起的。     

人乳腺癌组织活化型MMP-2的分布及意义

目的：研究人乳腺癌组织中活化型MMP-2的分布及与乳腺癌侵袭和转移的关系。方法：采用组织酶谱分析和DQ明胶原位酶谱分析方法检测乳腺癌组织中明胶酶活性。结果：组织酶谱分析显示,乳腺癌组织中存在MMP-2和MMP-9,只有MMP-2存在活化型;DQ明胶原位酶谱分析显示,活化型MMP-2主要定位于肿瘤细胞中;在癌组织中绿色荧光表达均为强阳性,而在肿瘤边缘癌组织中荧光表达强弱不同,表达强度与肿瘤的分级、淋巴结转移有关。结论：人乳腺癌组织中明胶酶活性主要由MMP-2产生,活化型MMP-2主要定位于肿瘤细胞,其表达强度与肿瘤的分级、淋巴结转移有关,并在乳腺癌的侵袭和转移中发挥重要作用。     

人参皂苷Rh2通过调控GSK-3β/Wnt双信号通路影响骨肉瘤细胞增殖和凋亡

目的：探讨人参皂苷Rh2（Rh2）对骨肉瘤细胞增殖、凋亡、迁移和侵袭的影响,并进一步研究Rh2在骨肉瘤中抗肿瘤作用的机制。方法：分别以不同浓度的Rh2 处理骨肉瘤细胞,用MTT法检测骨肉瘤细胞活性的变化;用基质凝胶（Matrigel）侵袭和孔膜法（Transwell）迁移实验检测骨肉瘤细胞的侵袭和迁移能力的变化;用Annexin V-FITC/PI调亡检测试剂盒及流式细胞仪检测骨肉瘤细胞的调亡变化;用Western blot法检测细胞侵袭、凋亡相关蛋白的表达情况。结果：骨肉瘤细胞经过不同浓度的Rh2处理后,MTT实验结果表明Rh2在一定浓度范围内可以显著抑制骨肉瘤细胞的生长（P ＜0.05）。Matrigel侵袭和Transwell迁移实验结果表明Rh2可以有效抑制骨肉瘤细胞的侵袭与迁移（P ＜0.05）。Annexinv-FITC/PI凋亡检测试剂盒及流式细胞仪检测结果表明,Rh2可以促进骨肉瘤细胞的凋亡反应（P ＜0.05）。Western blot实验结果则显示Rh2 可以上调Bax、E-cadherin蛋白的表达,并抑制Bcl-2、PARP、MMP2、MMP9 蛋白的表达。Rh2 还可以通过激活GSK-3β并抑制β-catenin、Cyclin D1和C-myc相关蛋白来达到调控骨肉瘤细胞增殖、凋亡、迁移和侵袭反应的作用。结论：Rh2可以抑制骨肉瘤细胞的增殖并诱导其凋亡,这种作用可能是通过激活GSK-3β并抑制Wnt/β-catenin信号通路来实现的。     

喉癌甲状软骨侵犯危险因素及基于双能CT碘图喉癌体积诊断甲状软骨侵犯

目的 观察喉癌甲状软骨侵犯的危险因素,分析基于双能CT碘图肿瘤体积对喉癌甲状软骨侵犯的诊断效能。方法 回顾性分析经手术病理证实的108例喉癌患者,根据病理结果分为甲状软骨受侵犯组（49例）和未受侵犯组（59例）;对比2组基本资料及基于双能CT碘图的肿瘤体积,采用二元Logistic回归方程分析喉癌甲状软骨侵犯危险因素及其诊断喉癌甲状软骨侵犯的效能。结果 甲状软骨受侵犯组与未受侵犯组患者性别、年龄、病程及肿瘤分化程度差异均无统计学意义（P均>0.05）,喉癌分型、前联合侵犯及基于双能CT碘图的肿瘤体积差异均有统计学意义（P均<0.01）。Logistic回归分析结果显示,基于碘图的肿瘤体积（P<0.01）和前联合侵犯（P=0.03）是喉癌甲状软骨侵犯的危险因素;以肿瘤体积=3.91 cm³为临界值诊断甲状软骨侵犯的敏感度及特异度分别为93.90%及89.80%,Youden指数为0.84,AUC为0.97[95% CI（0.94,0.99）,P<0.01]。结论 基于双能CT碘图的肿瘤体积和前联合侵犯是喉癌甲状软骨侵犯的危险因素;基于双能CT碘图的肿瘤体积可用于诊断甲状软骨侵犯。