保护前列腺癌患者功能状态的基因治疗

目的：综述关于基因治疗的研究进展及其在前列腺癌治疗中的应用，旨在为前列腺癌基因治疗的基础研究和临床应用提供更多理论依据。资料来源：应用计算机检索Medline 1990-01／2004-05相关前列腺癌基因治疗的章，检索词“pmstate cancer and gene therapy”，并限定章语言种类为英语。计算机检索万方数据库《中国临床康复》杂志1990-01／2004-05相关癌胚抗原的章，限定章语言种类为中，检索词“前列腺癌，基因治疗”。资料选择：选择符合关键词的献，并查看每篇献后的引。对资料进行初审。纳入标准：①基因治疗的载体。②前列腺癌的基因治疗策略。③前列腺癌基因治疗的靶向性问题。开始查找全，所查献为RCT研究类章，未排除是否盲法。资料提炼：共收集到137篇相关献。41篇献符合纳入标准。排除的96篇章中54篇内容与纳入标准无关，33篇系重复研究，9篇为Meta分析研究。资料综合：根据献按照基因治疗的载体选择、前列腺癌的基因治疗策略及治疗的靶向性问题等三个方面进行综述。其中2篇关于前列腺癌研究发展及治疗现状，8篇为关于基因治疗载体的研究，22篇为各种基因治疗策略的分析，9篇为前列腺癌靶向性基因治疗的相关问题。结论：应用传统治疗方法治疗前列腺癌，难以取得较好效果，且副作用较大，利用激活机体免疫系统对抗肿瘤进行基因治疗成为一种崭新的有效的方法．此方法可能在减少传统疗法对前列腺癌患前列腺功能的影响及改善前列腺功能障碍方面有突破性进展。     

基因治疗血管再狭窄的研究进展

冠心病是威胁人类健康的主要疾病之一,目前采取的治疗方式主要包括介入治疗、冠脉搭桥手术等.然而,血管再狭窄的发生仍是术后困扰许多医生的难题[1].近年来,相对于药物治疗,基因治疗由于影响血管再狭窄发生进程而备受关注.     

腹膜纤维化基因治疗进展

腹膜透析过程中腹膜发生了各种结构和功能的变化,使腹膜透析的效率降低,并最终导致腹膜衰竭。以基因技术为基础的治疗方法可以通过改变腹膜的基因表达来预防腹透对腹膜的各种损害,保护其作为透析膜的能力。本文就有关基因治疗在腹膜纤维化中应用的最新进展作一综述。     

骨缺损的基因治疗

目的:创伤、肿瘤及人工关节翻修手术等均可造成骨缺损。传统的治疗方法包括自体骨、异体骨和人工骨移植,但每种方法均存在一定的局限性,难以完全满足临床需要。骨缺损的基因治疗克服了传统治疗方法的局限,具有重要研究意义。资料来源:应用计算机检索Pubmed数据库1990-01/2005-04有关骨缺损的基因治疗文章,检索词“bone,gene therapy,bone morphogenetic protein”,限定文章语言种类为English。同时计算机检索中国期刊全文数据库、万方数据1994-01/2005-04期间的相关文章,检索词“骨缺损,基因治疗,骨形成蛋白,组织工程”,限定文章语言种类为中文。资料选择:对资料进行初审,选取符合研究要求的有关文章,并开始查找全文。纳入标准:①有关骨缺损的基因治疗研究。②有关骨组织工程研究。排除标准:①重复研究;②综述文章。资料提炼:共收集到168篇有关骨缺损的基因治疗及组织工程骨方面的文章,排除重复或类似的同一研究,28篇符合研究要求。资料综合:①基因治疗骨缺损的技术选择:人骨形态发生蛋白基因是目前骨缺损基因治疗中应用最多的目的基因,已在兔、鼠、羊和狗模型中证实其对骨缺损的修复作用。各种研究中,靶细胞多采用骨髓基质细胞,载体多选用腺病毒。②基因治疗骨缺损研究进展:基因治疗与组织工程相结合以及多基因联合治疗骨缺损是该领域研究的方向。③问题与展望:目前的研究大多处于实验阶段,要应用于临床还有很多工作需要改进。结论:多种细胞生长因子具有促进骨愈合的作用,通过骨缺损的基因治疗方法可保证细胞生长因子局部的靶向释放,最大限度地增加局部治疗效果,减少全身副作用,被认为是维持骨缺损局部生长因子有效治疗浓度最有希望的一种方法。     

端粒酶的结构功能与前列腺癌的相关性研究进展

目的：端粒酶是一种特殊的DNA聚合酶，它能以自身内源性RNA为模板合成端粒序列并添加到染色体末端上，稳定染色体，阻止细胞分裂衰亡。端粒酶的激活是肿瘤获得无限生长能力的关键步骤，是众多肿瘤发展所必需的：对端粒酶的结构、功能及其对前列腺癌早期诊断、预防及为保存前列腺器官功能的早期治疗中的价值进行综述。资料来源：应用计算机检索Medline数据库1990—01／2003—12相关端粒酶的文章，检索词“telomerase，prostate neoplasm”，限定文章语言种类为英文。同时计算机检索中国期刊全文数据库、万方数据库2000—01／2003—12相关端粒酶的文章，检索词“端粒酶；前列腺肿瘤”，限定文章语言种类为中文。资料选择：对资料进行初审。纳入标准：有关端粒酶的结构功能与前列腺癌相关性的文献。排除标准：文献中重复研究、综述、Meta分析类文资料提炼：共收集到13篇有关端粒酶结构功能的文献，10篇有关端粒酶与前列腺癌相关性的文献。查找全文。资料综合：将所选资料按照以下顺序归纳总结：①端粒酶的结构与功能。②端粒酶与肿瘤的关系。③端粒酶在前列腺癌诊断、治疗中的应用。结论：端粒酶的激活与细胞的永生化和恶性肿瘤的发生发展密切相关。端粒酶活性的检测和以端粒酶为靶点的基因治疗为前列腺癌预防和早期干预提供实验学价值。     

骨关节炎的基因治疗

随着人口老龄化的加快,骨关节炎的发病率逐年增加,现已成为最常见的老年性疾病之一。而在治疗上,目前仍然以药物疗法为主,传统的药物治疗不仅疗效有限,而且还会同时造成全身其他脏器的许多不良反应,难以长期坚持。应用基因疗法治疗骨关节炎就是将编码对骨关节炎有治疗作用的特殊蛋白基因通过适当的载体导入关节软骨细胞或滑膜细胞中,使其在病变关节内长期、稳定、高效地表达而治疗疾病。介绍基因治疗骨关节炎的作用机制、目的基因的构建、靶细胞的培养、靶细胞的体外转染、转染效果检测和转染后回植等程序。     

骨缺损的基因治疗

目的：创伤、肿瘤及人工关节翻修手术等均可造成骨缺损。传统的治疗方法包括自体骨、异体骨和人工骨移植，但每种方法均存在一定的局限性，难以完全满足临床需要。骨缺损的基因治疗克服了传统治疗方法的局限，具有重要研究意义。资料来源：应用计算机检索Pubmed数据库1990-01／2005-04有关骨缺损的基因治疗文章，检索词“bone，gene therapy，bone morphogenetic protein”，限定文章语言种类为English。同时计算机检索中国期刊全文数据库、万方数据1994-01／2005-04期间的相关文章，检索词“骨缺损，基因治疗，骨形成蛋白，组织工程”，限定文章语言种类为中文。资料选择：对资料进行初审，选取符合研究要求的有关文章，并开始查找全文。纳入标准：①有关骨缺损的基因治疗研究。②有关骨组织工程研究。排除标准：①重复研究：②综述文章。资料提炼：共收集到168篇有关骨缺损的基因治疗及组织工程骨方面的文章，排除重复或类似的同一研究，28篇符合研究要求。资料综合：①基因治疗骨缺损的技术选择：人骨形态发生蛋白基因是目前骨缺损基因治疗中应用最多的目的基因，已在兔、鼠、羊和狗模型中证实其对骨缺损的修复作用。各种研究中，靶细胞多采用骨髓基质细胞，载体多选用腺病毒。②基因治疗骨缺损研究进展：基因治疗与组织工程相结合以及多基因联合治疗骨缺损是该领域研究的方向。③问题与展望：目前的研究大多处于实验阶段，要应用于临床还有很多工作需要改进。结论：多种细胞生长因子具有促进骨愈合的作用，通过骨缺损的基因治疗方法可保证细胞生长因子局部的靶向释放，最大限度地增加局部治疗效果，减少全身副作用，被认为是维持骨缺损局部生长因子有效治疗浓度最有希望的一种方法。     

超声治疗提高前列腺癌患者免疫功能的研究进展

前列腺癌是男性泌尿系统最常见的肿瘤之一,多发于老年男性,在欧美发达国家中发病率位居第一,死亡率位居第二。近年来,我国前列腺癌的发病率存在上升趋势。手术切除局部病灶并辅以放疗及激素疗法是现行治疗早期前列腺癌的标准方法,但有近15%-40%患者接受根治性切除术后8年出现复发,约1/3患者会发生远处转移,平均生存期小于5年。     

间质干细胞的基因治疗

目的：总结以间质干细胞为载体细胞的基因治疗的进展，为细胞基因修饰在实验性基因治疗中的应用提供提示。 资料来源：用计算机检索Medline，Pubmed和Springer数据库1998—01／2005—12与骨髓间质干细胞基因治疗相关的文章，检索词为“mesenehymal stem cells。gene therapy”，并限定文章语言种类为English。同时计算机搜索CNKI中国全文期刊数据库1998—01／2005—12与骨髓间质干细胞基因治疗相关的文章，限定文章语言种类为中文，检索词为“间质干细胞．基因治疗”。 资料选择：对资料进行初审，纳入标准：①选择与间质干细胞，转基因，基因治疗、运输、转导有关文章。②在1998年以后发表的文章。排除标准：重复文章、综述文献、Meta分析类文章。 资料提炼：共搜集到273篇相关文章，入选11篇。对检索到的文章的相关信息综合加以概括综述，其中间质干细胞的生物学特性、自我更新和分化10篇，以间质干细胞作为靶细胞的基因治疗31篇。 资料综合：细胞介导的基因治疗，包括诱导转移性基因进入细胞的病毒和非病毒载体的设计，转移性基因的能力，引导修饰性基因或者被分泌的治疗性物质进入疾病组织的能力以及在于细胞内的治疗性物质产物的最佳化和调节等。运载缺失的基因可以促进心脏的功能性恢复，心肌的再生则可以用来修复心肌损伤。骨髓来源的间质干细胞对治疗自身免疫性疾病的免疫抑制效应非常重要。 结论：间质干细胞是具有潜在应用前景的基因治疗的载体细胞。间质干细胞来源丰富，易于在体外分离和培养，并具有自我更新和多系分化的能力，通过体内外分泌一系列的蛋白从而对遗传缺陷性疾病或获得性疾病进行治疗。     

端粒酶的结构功能与前列腺癌的相关性研究进展

目的:端粒酶是一种特殊的DNA聚合酶,它能以自身内源性RNA为模板合成端粒序列并添加到染色体末端上,稳定染色体,阻止细胞分裂衰亡。端粒酶的激活是肿瘤获得无限生长能力的关键步骤,是众多肿瘤发展所必需的。对端粒酶的结构、功能及其对前列腺癌早期诊断、预防及为保存前列腺器官功能的早期治疗中的价值进行综述。资料来源:应用计算机检索Medline数据库1990-01/2003-12相关端粒酶的文章,检索词“telomerase,prostateneoplasm,限定文章语言种类为英文。同时计算机检索中国期刊全文数据库、万方数据库2000-01/2003-12相关端粒酶的文章,检索词“端粒酶;前列腺肿瘤”,限定文章语言种类为中文。资料选择:对资料进行初审。纳入标准:有关端粒酶的结构功能与前列腺癌相关性的文献。排除标准:文献中重复研究、综述、Meta分析类文章。资料提炼:共收集到13篇有关端粒酶结构功能的文献,10篇有关端粒酶与前列腺癌相关性的文献。查找全文。资料综合:将所选资料按照以下顺序归纳总结:①端粒酶的结构与功能。②端粒酶与肿瘤的关系。③端粒酶在前列腺癌诊断、治疗中的应用。结论:端粒酶的激活与细胞的永生化和恶性肿瘤的发生发展密切相关。端粒酶活性的检测和以端粒酶为靶点的基因治疗为前列腺癌预防和早期干预提供实验学价     

腹腔镜下前列腺癌根治术结合内分泌辅助治疗高危前列腺癌的效果

目的探讨腹腔镜下前列腺癌根治术结合内分泌辅助治疗高危前列腺癌的效果。方法选取50例局部晚期高危前列腺癌患者,均行腹腔镜下前列腺癌根治术治疗,根据术后是否进行辅助内分泌治疗(AHT)将其分为观察组及对照组,比较2组手术一般情况及2年生存率。结果 50例患者均成功手术。观察组的2年总体无生化复发率为76%,对照组为52.00%,观察组中进行AHT治疗的所有患者在随访过程中均能够耐受治疗。结论腹腔镜下前列腺癌根治术结合内分泌辅助治疗高危前列腺癌,能够显著提高患者的2年无生化复发率,控制疾病进展。     

Radiation therapy for prostate cancer

The advent of image-guided or CT-based treatment planning, such as 3D-conformal or intensity modulated radiation therapy has allowed safe delivery of high- dose radiation therapy in men with prostate cancer with an acceptable rate of side effects and complications. External-beam radiation therapy designed to decrease exposure of normal tissues using methods such as 3D-conformal treatment planning is under clinical evaluation. Randomized trial shows escalation of radiation dose leads to improved biochemical disease-free survival for a select group of patients. Interstitial brachytherapy has been also employed for patients with selected for favorable characteristics, including low Gleason score, low PSA level, and stage T1 to T2 tumors. Long-term follow-up of patients is necessary to assess treatment efficacy and side effects.     

Radiation therapy for prostate cancer

OBJECTIVES: To review the advances in radiation therapy for prostate cancer and the nursing care of patients with prostate cancer. DATA SOURCES: Peer-reviewed journal articles, including research studies and review articles. CONCLUSIONS: Radiation therapy is used to cure early stage prostate cancer, control locally advanced disease, and effectively palliate symptoms of metastasis. The three forms of treatment used include external beam radiation therapy, brachytherapy; and radiopharmaceutical treatments. IMPLICATIONS FOR NURSING PRACTICE: Nursing care of patients receiving radiation therapy for prostate cancer includes managing the symptoms associated with the disease and treatment, educating patients and families about self-care measures, and providing support throughout the course of the disease.     

Platelet functional status in patients with gastric cancer at combined treatment stages

Platelets are active cells that excrete various humoral factors that contribute to thrombogenesis and inflammation. The investigation was undertaken to study induced platelet aggregation in patients with gastric cancer at combined treatment stages and to evaluate the impact of intraoperative radiotherapy (IOR). The study covered patients with gastric cancer (GC). Group 1 included Stage III GC patients who had undergone elective radical surgery; Group 2 comprised Stage III GC patients who had radical surgery with a session of IOR; Group 3 consisted of Stage IV GC patients who had undergone palliative surgery or explorative laparotomy. Induced platelet aggregation were explored from the BIOLA aggregometer (Russia) readings before, 30 minutes, 1, 3, 5, 7, and 14 days after surgery. Adenosine phosphate, adrenaline, collagen were used as inducers. It is concluded that there is a need for postoperative laboratory control and correction of platelet activity. In GC patients operated on with IOR, platelet activity should be monitored for at least 2 weeks after surgery.     

Gene therapy approaches for stem cell protection

Cytotoxic exposure of bone marrow and other non-hematopoietic organs containing self-renewing stem cell populations is associated with damage to the supportive microenvironment. Recent evidence indicates that radical oxygen species resulting from the initial oxidative stress persist for months after ionizing irradiation exposure of tissues including oral cavity, esophagus, lung and bone marrow. Antioxidant gene therapy using manganese superoxide dismutase plasmid liposomes has provided organ-specific radiation protection associated with delay or prevention of acute and late toxicity. Recent evidence has suggested that manganese superoxide dismutase transgene expression in cells of the organ microenvironment contributes significantly to the mechanism of protection. Incorporating this knowledge into designs of novel approaches for stem cell protection is addressed in the present review.     

Implications of androgen-deprivation therapy in patients with prostate cancer: A case study

S.R., a 65-year-old male with a history of prostate cancer, went to a cancer center in 2003. He had developed symptoms of bladder outlet obstruction in 1999 and was seen by a urologist. His baseline prostate-specific antigen (PSA) was 44 ng/ml. On physical examination, his prostate was enlarged, and a biopsy in January 2000 revealed adenocarcinoma with a Gleason score of 8. A metastatic workup, including a bone scan and a computed tomography scan of the abdomen and pelvis (CT A/P), was negative for evidence of metastatic disease. S.R. received conformal external beam radiation, and the luteinizing hormone-releasing hormone agonist leuprolide acetate was initiated. Following treatment, his PSA nadired to 0.2 ng/ml, and he did well until 2002, when his PSA started to rise. A reevaluation CT A/P revealed enlarged retroperitoneal and pelvic lymph nodes, and a bone scan was positive for metastatic disease. He underwent a bilateral orchiectomy in November 2002.     

Gene therapy for breast cancer

Not only the local treatments like surgery and radiation but also the systemic treatments like chemotherapy and hormone therapy are rather effective on both primary and metastatic breast cancer patients. Nevertheless, the curativity and survival of this disease have been not satisfied yet. The difficulties of the treatment seems the emergence of drug-resistant cells and the low immunity of the host. Gene therapy offers a potentially useful approach for the treatment of breast cancer. The approaches of gene therapy for breast cancer that are now undergoing as clinical protocols in USA can be divided into three strategies: (1) approaches that alter the metabolic or signaling pathways within the breast cancer cell; (2) approaches designed to enhance the immune response to the tumor cells(immuno gene therapy); and (3) approaches that use the drug-resistant gene with chemotherapy. According to the new biology of breast cancer by Fisher, the systemic treatments are more important. Immuno-therapy seems especially promising in this field. Moreover, the immuno gene therapy is hopeful that could overcome the difficulties like heterogeneity and low immunogenicity of breast cancer cell.     

Gene therapy for colorectal cancer

Colorectal cancer is an important public health problem worldwide. Gene therapy has therapeutic potential for patients with advanced or recurrent colorectal cancer, incurable by conventional treatments. To date, many strategies of gene therapy have been explored, including mutant gene correction, prodrug activation, immune stimulation and genetically-modified oncolytic viruses. Although the preclinical results of gene therapy for colorectal cancer have shown promise, gene therapy is still at an early stage of clinical development and has not yet shown a significant therapeutic benefit for patients. The main obstacles for introduction of gene therapy to patients are poor targeting selectivity of the vectors and inefficient gene transfer. As the science supporting tumour-selective vectors evolves, gene therapy may expand rapidly in the clinical practice of colorectal cancer treatment.