p53基因治疗恶性肿瘤的现状与趋势

恶性肿瘤的治疗包括手术、放疗、化疗和生物治疗 ,基因治疗是生物治疗的主要内容 ,该领域的研究正方兴未艾 ,p53基因治疗恶性肿瘤越来越受到人们的重视。本文对p53基因的结构和功能以及该基因治疗恶性肿瘤的现状和趋势作一综述。1　p53基因治疗恶性肿瘤的理论依据　　p53基因是     

p53基因在肝细胞癌治疗中的现状与展望

p53基因突变可以引起细胞转化,导致癌变。通过特异性途径及载体人工导入野生型p53基因可以使肿瘤局部高表达野生型p53基因,野生型p53基因具有抑制肿瘤细胞增殖、诱导肿瘤细胞凋亡的功能,从而达到治疗恶性肿瘤的目的。目前,p53基因治疗肝细胞癌的实验及临床应用也取得了一定的成绩。就p53基因治疗肝细胞癌的现状及进展情况予以综述。     

p53基因在肝细胞癌治疗中的现状与展望

p53基因突变可以引起细胞转化,导致癌变.通过特异性途径及载体人工导入野生型P53基因可以使肿瘤局部高表达野生型p53基因.野生型p53基因具有抑制肿瘤细胞增殖、诱导肿瘤细胞凋亡的功能,从而达到治疗恶性肿瘤的目的 .目前,p53基因治疗肝细胞癌的实验及临床应用也取得了一定的成绩.就p53基因治疗肝细胞癌的现状及进展情况予以综述.     

p53基因与肝癌

p53肿瘤抑制基因突变与多数恶性肿瘤的发生发展有关,包括肝细胞癌(hepatocelluar carcinoma,HCC)在内的人类恶性肿瘤中至少有50%发生了p53基因改变。因此,以正常p53基因治疗肿瘤就成了研究热点,随着介入放射学(inter-ventional radiology)向纵深发展,经介入放射方法进行肝癌的基因治疗令人关注。本文介绍了p53基因的结构与功能,其与肝癌的病理联系以及在肝癌治疗中的应用。     

经导管动脉注入脂质体介导的p53基因治疗肝癌的实验研究

目的 以兔VX2肝癌模型为对象,探讨经导管动脉注入脂质体介导的p53基因治疗肝癌的可行性及转染和表达情况.方法 将pCMV-myc-p53质粒、阳离子脂质体LipofectAMINE以及pCMV-myc-p53和LipofectAMINE的复合体分别注入兔VX2肝癌模型的肿瘤供血动脉,并提取肿瘤组织蛋白,采用蛋白印迹法及免疫组化检测基因转染及其表达.以不同量的pCMV-myc-p53与LipofectAMINE形成的复合体分别注入兔VX2肝癌模型的肿瘤供血动脉内,同法检测基因的转染及其表达.结果 脂质体介导的p53基因经动脉途径成功转染了兔VX2肝癌模型的肿瘤组织并进行表达,其转染效率明显高于单纯基因导入,基因的量与转染效率之间存在量效关系.结论 经动脉途径导入脂质体介导的p53基因治疗肝癌是可行、有效的,具有广阔的应用前景.     

腺病毒介导的p16和p53的联合应用对胆管癌细胞QBC939的生长抑制作用

为研究p16和p53基因的联合应用对胆管癌细胞的作用,将重组体腺病毒p16、p53、p16联合p53转移到人胆管癌细胞QBC939,对p16、p53基因的表达,细胞的生长抑制及机制进行了分析。RT－PCR显示在胆管癌QBC939细胞系中p16呈低表达,p53不表达,重组体腺病毒能介导p16和p53等外源基因在胆管癌QBC939细胞系中高效表达,两者联合应用能明显抑制QBC939细胞的生长和集落形成。流式细胞计数证实其能诱导,QBC939细胞发生明显半调并导致其发生G1期阻滞,本研究显示p16及p53基因通过诱导肿瘤细胞凋亡及G1期阻滞在肿瘤的基因治疗方面发挥作用,两者联合应用具有协同作用。     

重组人p53腺病毒制品治疗原发性肝癌的进展

近几年来,利用抑癌基因治疗原发性肝癌逐渐成为研究的热点之一,重组人p53腺病毒(rAd-p53)制品治疗原发性肝癌也越来越受到高度关注。本文通过总结近几年这方面的研究进展,以评价其临床应用价值与发展前景。     

动脉灌注p53基因治疗晚期肝癌的初步临床应用

目的 初步观察动脉灌注p53基因治疗晚期肝癌的疗效.方法 晚期肝癌30例,治疗组14例,对照组16例.根据造影表现决定灌注药物的靶动脉,治疗组在靶动脉注入p53基因,每次用1012VP,加羟基喜树碱20 mg,每周1次,连用3周为1疗程,14例患者分别接受1～4疗程的治疗.对照组给予羟基喜树碱20 mg肝动脉灌注.结果 治疗组生存期最小14 d,最长405 d,平均238.1 d.对照组生存期最小18 d,最长167 d,平均80.7 d.两者相比较,P＜0.05,有显著差异.结论 p53基因治疗晚期肝癌有效.     

辐射联合外源性野生型p53基因对不同p53状态的黑色素瘤细胞系的生物学效应

目的研究辐射结合腺病毒（Ad CMV）载体介导的p53基因转导对不同p53状态的人黑色素瘤细胞系基因转移效率、凋亡和辐射敏感性的影响。方法用复制缺陷的重组腺病毒载体（AdCMV-p53）介导入p53基因转导1Gy X射线预照射的黑色素瘤细胞系A375（wt p53）和WM983a（mu p53），RT-PCR检测mRNA水平，流式细胞仪测定细胞周期阻滞及外源性P53蛋白表达情况，Tunel法检测细胞凋亡，克隆形成率测定辐射后细胞存活率。用携带报道基因的复制缺陷重组腺病毒载体AdCMV-GFP作为对照。结果1Gy X射线照射可较高地增加AdCMV-p53对A375和WM983a细胞系的基因转导效率，转导的外源性野生型p53可在两种细胞中高效表达，并诱导细胞周期G1期阻滞；单纯转导p53对A375（wt p53）细胞无明显诱导凋亡和生长抑制效应，但可部分诱导WM983a（mu p53）细胞凋亡；而转导p53基因48h后给予X射线辐射，两种细胞的克隆存活率较其对照组均明显减低，外源性p53基因对WM983a（mu p53）细胞的辐射增敏作用较A375（wt p53）细胞明显。结论外源性野生型p53基因过表达可增加黑色素瘤细胞系A375和WM983a的辐射敏感性，但对WM983a细胞系的辐射增敏作用高于A375细胞系。表明p53是基因治疗黑色素瘤较好的候选基因。     

肝癌介入治疗中应用p53的几个要点

重组人p53腺病毒注射液(recombinant human adenovirus p53,Ad-p53)已被用于与多种局部治疗方法联合治疗肿瘤.本文介绍在肝癌介入治疗过程中联合应用Ad-p53,应该重点研究两者的机制,最大限度地发挥它们抗肿瘤的协同作用.提出瘤内注射是首选的基因给药途径,建议单个肿瘤注射Ad-p53的最低用量,以及注射Ad-p53后进行肝癌介入治疗的最佳时机.介绍以p53为靶点的治疗方法有好几种理论基础,有些方法甚至相互对立,因此在治疗前须先明确要对p53进行激活还是抑制.最后提出应用Ad-p53治疗晚期恶性肿瘤应慎莺选择病例.     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.