雌激素受体诱导乳腺癌细胞辐射抗性的机制研究

目的 探讨雌激素受体(ESR1)对乳腺癌细胞辐射抗性的影响及分子机制。方法 在雌激素受体阴性乳腺癌细胞中转染ESR1过表达质粒(过表达对照vector组、过表达ESR1 OE组),在雌激素受体阳性乳腺癌细胞中通过慢病毒转染方法构建稳定敲低ESR1(敲低对照shNC组、敲低shESR1组)的细胞模型,采用实时荧光定量聚合酶链式反应(qPCR)和免疫印迹方法检测自噬相关基因mRNA(ATG5)和蛋白表达水平(LC3B-I、LC3B-II、P62、FIP200、ATG5、ATG7、ATG12、Beclin1、ULK1);在8 Gy X射线的电离辐射处理下,免疫印迹法检测自噬通量;采用流式细胞术检测细胞死亡;采用集落形成实验检测乳腺癌细胞辐射敏感性(未照射sham组、照射IR组、电离辐射联合铁死亡抑制剂处理Fer-1+IR组、电离辐射联合凋亡抑制剂处理Z-VAD+IR组、电离辐射联合自噬抑制剂处理CQ+IR组);用台盼蓝染色检测自噬基因敲低和过表达细胞模型以及雌激素受体抑制剂他莫昔芬(TAM)与电离辐射联合治疗下乳腺癌细胞的死亡率(他莫昔芬未处理TAM-组、他莫昔芬处理TAM+组)。结果 在8 Gy X射线照射后24 h处理条件下,雌激素受体阳性乳腺癌ZR75细胞ESR1的敲低促进细胞死亡(t=3.49、3.13, P < 0.05),而雌激素受体阴性乳腺癌MDA-MB-231细胞ESR1的过表达抑制细胞死亡(t=4.16、7.48, P < 0.05);与单纯照射相比,自噬抑制剂氯喹的处理后增加了敲低ESR1的ZR75细胞集落形成数量(t=8.49, P < 0.05), 抑制自噬可以减少沉默ESR1所致的ZR75细胞死亡。在电离辐射处理下,MDA-MB-231细胞过表达ESR1促进了细胞保护性自噬;ZR75细胞敲低ESR1后细胞保护性自噬降低。在ZR75细胞中敲低ATG5发现自噬降低,细胞死亡增加(t=4.19、6.39, P < 0.05),而在ZR75中过表达ATG5可以逆转因敲低ESR1导致的细胞死亡增加(t=1.70、4.65, P < 0.05)。化疗药物他莫昔芬处理雌激素受体阳性乳腺癌细胞ZR75后发现自噬基因ATG5、ATG12的表达下降,自噬抑制,细胞死亡增加(t=18.70, P < 0.05),电离辐射处理促进了这一进程(t=16.82, P < 0.05)。结论 雌激素受体ESR1通过增加ATG5自噬相关蛋白,促进雌激素受体阳性乳腺癌细胞的保护性自噬,从而导致雌激素受体阳性乳腺癌细胞的辐射抵抗,化疗药物他莫昔芬联合电离辐射治疗增加了雌激素受体阳性乳腺癌细胞的辐射敏感性。     

miR-27b-3p通过靶向PLK2促进乳腺癌细胞的辐射抵抗

目的 研究miR-27b-3p对乳腺癌细胞辐射抵抗的影响。方法 通过检索基因表达（GEO）数据库，筛选分析miR-27b-3p在正常乳腺组织和乳腺癌组织中的表达水平。利用实时荧光定量PCR技术分析其在不同乳腺癌细胞系中的表达水平。通过细胞克隆形成、免疫荧光和5-乙炔基-2''-脱氧尿苷（EDU）检测技术评价miR-27b-3p对乳腺癌细胞辐射抵抗作用。采用荧光素酶报告基因技术确定miR-27b-3p的靶基因PLK2，并在乳腺癌细胞中进一步验证miR-27b-3p的辐射抵抗作用。结果 与正常乳腺组织和细胞相比，miR-27b-3p在乳腺癌组织（t=2.99，P<0.01）和乳腺癌细胞中表达水平显著上调（t=21.21、32.88，P<0.05）。尤其在抗辐射细胞MCF-7R中升高更加明显（t=25.63，P<0.05）。过表达miR-27b-3p增强了MCF-7细胞的克隆形成能力（t=10.32，P<0.05），且随着辐照剂量的增加，miR-27b-3p对MCF-7增殖能力的保护效应逐渐凸显（t=8.77、8.26、8.03，P<0.05）；干扰miR-27b-3p则抑制MCF-7R细胞克隆形成数（t=40.00，P<0.05），且随着辐照剂量的增加，进一步削弱了MCF-7R细胞的增殖能力（t=8.54、8.32、8.23，P<0.05）。报告基因实验结果表明，PLK2是miR-27b-3p的直接靶标。过表达PLK2抑制了miR-27b-3p介导的乳腺癌细胞辐射抵抗（MCF-7：t=9.66，P<0.05；MCF-7R：t=6.42，P<0.05）。结论 miR-27b-3p可通过靶向PLK2提高乳腺癌细胞的辐射抗性。     

塞来昔布对正常脑胶质细胞和脑胶质瘤细胞放射增敏效应的比较及其机制

目的 探讨塞来昔布对正常少突胶质细胞（oln93）及脑胶质瘤细胞（u373）的放射增敏作用及其作用机制。方法 将两种细胞按空白处理、单独接受塞来昔布或X射线、塞来昔布联合X射线4种不同处理方式分为对照组、给药组、照射组和联合组,MTT法、克隆形成法对比两种细胞的增殖和放射敏感性,流式法测细胞的周期分布,Western blot法分析相关蛋白表达。结果 与未加药物相比,塞来昔布能抑制oln93细胞和u373细胞生长（t=2.215~30.996,P<0.05;t=0.383~11.732,P<0.05）,但相同药物浓度下抑制两种细胞差异无统计学意义。放射增敏比SER分别为1.13和1.21,并诱导G₀/G₁期阻滞（t=-6.1~5.141,P<0.05）。联合组与照射组比较,oln93细胞发生S期阻滞（t=-18.174,P<0.05）,CyclinA蛋白表达增加（t=-8.087,P<0.05）;u373细胞发生G₂/M期阻滞,Cyclin B1、DNA-PKcs、MRE11蛋白表达下降（t=-8.838~10.45,P<0.05）。结论 塞来昔布对u373的放射增敏作用比oln93细胞明显,其机制与调节细胞周期分布及DNA损伤修复有关。     

二甲双胍对不同雌激素受体状态乳腺癌细胞的放射增敏作用及其机制研究

目的 探讨二甲双胍对不同雌激素受体（ER）状态乳腺癌细胞MCF-7和MDA-MB-231是否具有放射增敏作用,并对其机制进行初步探索。方法 取指数生长期的人乳腺癌细胞MCF-7和MDA-MB-231,分为对照组、二甲双胍组、单纯照射组和二甲双胍联合照射组。采用MTT法测定二甲双胍对细胞的增殖抑制作用;克隆形成实验评估二甲双胍对乳腺癌细胞的放射增敏作用;碘化丙啶（PI）染色法检测细胞周期;Hoechst 33342染色法检测细胞凋亡率;Western blot法检测各组p-AMPK、p-mTOR蛋白的表达情况。结果 不同浓度二甲双胍对这两种细胞均具有明显的增殖抑制作用,且呈剂量依赖性。在乳腺癌细胞MCF-7和MDA-MB-231中,二甲双胍联合照射组的D_q、D₀和SF₂值均较单纯照射组明显降低（MCF-7：t=9.305、14.528、13.708,P<0.05;MDA-MB-231：t=19.560、16.893、36.048,P<0.05）,放射增敏比（SER_D0）分别为1.29和1.21。二甲双胍联合照射组与单纯照射组相比,G₂/M期阻滞更明显（t=6.103、38.431,P<0.05）,增加了放射诱导的细胞凋亡（t=9.143、14.561,P<0.05）。在MCF-7细胞中,二甲双胍联合照射组p-AMPK的表达明显高于其他处理组（t=35.194、8.647、10.316,P<0.05）,但在MDA-MB-231细胞中,p-AMPK的表达未见明显变化（P>0.05）;而对p-mTOR蛋白的抑制作用在这两种细胞中均可见到,差异有统计学意义（MCF-7：t=80.133、31.820、11.308,P<0.05;MDA-MB-231：t=12.436、15.757、8.402,P<0.05）。结论 二甲双胍对不同ER状态乳腺癌细胞（MCF-7和MDA-MB-231）均有放射增敏作用,其作用机制可能是通过激活AMPK或非AMPK依赖的途径,抑制mTOR信号级联通路,以及增加细胞G₂/M期阻滞,诱导细胞凋亡等途径实现的。     

FOXO4-DRI多肽增加非小细胞肺癌细胞放射敏感性研究

目的 探讨FOXO4-DRI多肽对非小细胞肺癌（NSCLC）细胞放射敏感性的影响。方法 为检测FOXO4-DRI对NSCLC细胞的影响,将H460和A549细胞按照射与给药方式分为对照组、FOXO4-DRI组、单纯照射组、照射+FOXO4-DRI组。采用剂量率为0.99 Gy/min γ射线单次照射,在照射前10 min对H460细胞给予FOXO4-DRI 6 μmol/L,A549细胞给予FOXO4-DRI 30 μmol/L。采用CCK-8法检测照射后24、48和72 h细胞存活率;用结晶紫染色法检测细胞克隆形成数目;用伤口愈合实验检测细胞迁移程度;用流式细胞术检测细胞凋亡和细胞周期的改变。结果 与对照组相比,FOXO4-DRI组H460细胞和A549细胞存活率降低（t=1.06~50.75,P<0.05）、迁移率降低（t=33.37~139.10,P<0.05）,克隆形成数目减少（t=5.20~93.48,P<0.05）。FOXO4-DRI诱导了细胞凋亡（t=2.95~42.00,P<0.05）,导致G₀/G₁细胞周期阻滞以及G₂/M期细胞比例下降（t=3.50~31.59,P<0.05）。与照射组相比,FOXO4-DRI可进一步降低辐照后的细胞存活率（t=2.94~23.40,P<0.05）,减少辐照后克隆形成数目（t=8.43~34.00,P<0.05）和细胞迁移率（t=5.25、7.56,P<0.05）,增加细胞凋亡（t=9.20~11.52,P<0.05）。照射+FOXO4-DRI组细胞,G₂/M期细胞比例进一步下降,S期细胞增加（t=3.85~17.62,P<0.05）。结论 FOXO4-DRI多肽通过促进细胞凋亡,降低细胞增殖能力和迁移率,可以提高NSCLC细胞放射敏感性。     

沉默EZH2诱导舌癌Tca-8113细胞凋亡及其对放射敏感性的影响

目的 探讨zeste基因增强子同源物2（enhancer of zeste homolog 2,EZH2）对舌鳞癌细胞凋亡及放射敏感性的影响。方法 以舌鳞癌Tca-8113细胞为研究对象,细胞转染EZH2小干扰RNA（EZH2 siRNA1、EZH2 siRNA2）及小干扰RNA阴性对照（siRNA-NC）,RT-PCR和Western blot检测EZH2表达水平,筛选干扰效果较好的EZH2 siRNA2继续研究。将转染EZH2 siRNA2后的Tca-8113记为EZH2 siRNA2组,同时以不做处理的细胞为对照组,用8 Gy剂量照射转染siRNA对照组和EZH2 siRNA2细胞,并依次命名为照射组和联合组,四甲基偶氮唑盐（MTT）检测细胞增殖,流式细胞术检测细胞凋亡,Western blot检测信号转导与转录因子3（STAT3）、磷酸化的STAT3（p-STAT3）、活性Caspase-3（Cleaved Caspase-3）表达。siRNA-NC组和EZH2 siRNA2组细胞用0、2、4、6、8 Gy剂量照射处理后,细胞克隆实验检测放射敏感性。结果 EZH2 siRNA1、EZH2 siRNA2均能够干扰舌鳞癌细胞中EZH2的表达,且EZH2 siRNA2干扰效果最好（t_mRNA=8.660,P_mRNA<0.01;t_蛋白=2.883,P_蛋白<0.05）。下调EZH2 siRNA2组细胞凋亡率为（29.90±1.64）%,联合组凋亡率为（38.17±1.59）%,二者比较,差异有统计学意义（t=4.742,P<0.05）,同时下调EZH2还可以降低p-STAT3水平,促进Cleaved Caspase-3蛋白表达。干扰EZH2表达后Tca-8113细胞辐射增敏比为1.668。结论 干扰EZH2表达能够协同放疗促进舌鳞癌细胞凋亡,抑制舌鳞癌细胞增殖,增加舌鳞癌细胞放射敏感性。     

Ta4C3-PVP纳米片对4T1三阴性乳腺癌小鼠移植瘤的放射增敏作用

目的 研究Ta₄C₃-PVP纳米片对三阴性乳腺癌4T1细胞小鼠移植瘤的放射增敏作用。方法 于雌性BALB/c小鼠右侧腹皮下注射4T1细胞建立4T1荷瘤小鼠模型,按肿瘤体积大小均匀分为空白对照组、单纯Ta₄C₃-PVP组、单纯照射组、Ta₄C₃-PVP联合照射组。尾静脉注射20 mg/kg Ta₄C₃-PVP预处理24 h后给予8 Gy单次肿瘤局部X射线照射,测量移植瘤体积、瘤重,检测肿瘤细胞增殖标志物Ki-67蛋白表达、DNA双链断裂（DSBs）分子标志物γ-H2AX焦点形成,绘制肿瘤生长曲线并计算放射增敏系数（EF）及抑瘤率。结果 与空白对照组相比,单纯照射组、Ta₄C₃-PVP联合照射组于照射后16 d均能明显抑制肿瘤生长（t=5.41、9.59,P<0.05）、降低瘤重（t=2.67、4.40,P<0.05）,其中Ta₄C₃-PVP联合照射组的EF达1.57,抑瘤率约为64%,明显优于单纯照射组（42%）。免疫组织化学结果显示,与空白对照组相比,单纯照射组和Ta₄C₃-PVP联合照射组肿瘤细胞Ki-67蛋白表达受到明显抑制（t=5.73、8.02,P<0.05）、γ-H2AX焦点产额明显增加（t=2.97、9.86,P<0.05）,且Ta₄C₃-PVP联合照射组较单纯照射组Ki-67表达抑制更显著（t=4.75,P<0.05）、γ-H2AX焦点产额更多（t=4.42,P<0.05）。结论 Ta₄C₃-PVP纳米片可通过增加射线诱导的DNA DSBs,增强4T1荷瘤小鼠移植瘤的放射敏感性。     

3-甲基腺嘌呤增强食管鳞癌Eca-109细胞放射敏感性的研究

目的 研究自噬在照射致人食管鳞癌Eca-109细胞死亡过程中的作用。方法 选用食管鳞癌Eca-109细胞,分为对照组、5 mmol/L给药组、10 mmol/L给药组、单纯照射组、照射+5 mmol/L组、照射+10 mmol/L组,共6组。采用Western blot检测不同处理组自噬标志物LC3B表达水平;GFP-LC3转染食管鳞癌Eca-109细胞后监测自噬体数量变化;MTT法检测不同处理组细胞活力;荧光染料Hoechst 33342观察不同处理组细胞凋亡的形态学变化;流式细胞术检测不同处理组细胞周期和细胞凋亡;克隆形成实验检测食管鳞癌Eca-109细胞不同处理组放射敏感性。结果 Western blot显示,照射后自噬水平升高,自噬抑制后LC3BⅡ和LC3BⅡ/LC3BⅠ比值明显下降(F=25.64,P<0.05);GFP-LC3转染食管鳞癌Eca-109细胞后,可见照射后自噬体荧光斑点明显增多,自噬抑制后自噬体明显减少(F=127.36,P<0.05);抑制自噬协同照射后细胞活力明显低于单纯照射组(F=129.54,P<0.05);抑制自噬后也增加了照射诱导的凋亡率和G₂/M期阻滞细胞比;线性二次模型拟合剂量存活曲线显示,抑制自噬能增加食管鳞癌Eca-109细胞的放射敏感性。结论 抑制自噬能提高食管鳞癌Eca-109细胞的放射敏感性,协同杀伤肿瘤细胞,提示抑制自噬或可用于辅助食管鳞癌的放射治疗。     

过表达miR-29c靶向抑制AKT2增强肝癌HepG2细胞放射敏感性的实验研究

目的 探讨miR-29c靶向AKT2对肝癌细胞HepG2放射敏感性的影响。方法 RT-PCR检测人正常肝THLE-3细胞和肝癌HepG2细胞中miR-29c表达。给予不同剂量（0、2、4、6和8 Gy）的X射线照射后,RT-PCR检测HepG2细胞中miR-29c表达变化。经生物信息学预测并采用双荧光素酶报告基因实验和Western blot检测miR-29c与AKT2的靶向关系。采用脂质体2000将miR-29c mimic/AKT2基因重组质粒和miR-29c inhibitor/慢病毒载体AKT2 shRNA转染至HepG2细胞中,并给予不同剂量X射线照射后,克隆形成实验和MTT实验检测miR-29/AKT2对HepG2细胞存活率和细胞活力的影响。结果 与THLE-3细胞相比,HepG2细胞中miR-29c明显降低,差异有统计学意义（t=17.816,P<0.05）;HepG2经2、4、6和8 Gy X射线照射后,细胞存活率较THLE-3细胞显著降低（t=4.541、6.823、7.218、9.363,P<0.05）,HepG2细胞中miR-29c表达显著下降（t=5.599、9.262、10.470、10.873,P<0.05）。miR-29c过表达可降低HepG2细胞存活率和细胞活力（t_存活率=4.307、7.668、7.668、6.894,P<0.05;t_细胞活力=3.443、8.116、13.434,P<0.05）;反之,抑制miR-29c表达则升高HepG2细胞存活率和细胞活力（t=4.003、6.713、7.141,P<0.05;t_细胞活力=4.282、5.113,P<0.05）。双荧光素酶报告基因实验表明,AKT2是miR-29c的靶基因,Western blot检测结果显示,miR-29c可负向调控AKT2蛋白表达。沉默AKT2后,HepG2细胞的存活分数及细胞存活率趋势与miR-29c过表达相一致;反之,AKT2过表达则与抑制miR-29c表达相一致。结论 miR-29c可通过靶向AKT2增加肝癌细胞HepG2放射敏感性。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.