反义寡核苷酸阻断乳腺癌细胞中葡萄糖神经酰胺合成酶的表达和意义

目的探讨靶向葡萄糖神经酰胺合成酶（glucosylceramide synthase,GCS）的基因试剂MBO－asGCS逆转乳腺癌多药耐药的作用机制及其意义。方法MBO-asGCS处理体外培养的人乳腺癌细胞MCF-7及其耐药型MCF-7／AdrR,采用细胞毒性分析测定MBO—asGCS对MCF-7-AdrR存活率的影响,RT—PCR和Western印迹分析对耐药型细胞GCS的表达变化,检测对caspase3／7的活性影响及流式细胞仪测定MBO-asGCS对耐药型细胞的凋亡情况。结果MBO-asGCS转染人耐药型乳腺癌细胞MCF-7／AdrR后,与未转染组细胞的Ic50分别是0．18μmol／L和12．50μmol／L,药物敏感性提高了69倍;MBO—asGCS抑制GCS的mRNA表达70％,减少GCS蛋白表达39％（P〈0．01）;转染MBO．asGCS后耐药型细胞的caspase3／7活性上升53％（P〈0．05）,细胞凋亡率上升5．6倍（P〈0．01）。结论GCS过表达是耐药型乳腺癌细胞的特征,靶向人GCS的反义寡核苷酸可直接抑制GCS的过表达,诱导耐药细胞凋亡,有效逆转其耐药性,GCS可能是治疗耐药型乳腺癌的一个潜在靶点。     

miR-145对人乳腺癌MCF-7/ADR细胞耐药逆转的作用机制研究

目的:探讨miR-145对人乳腺癌阿霉素耐药细胞株MCF-7/ADR阿霉素耐药的影响及可能的作用机制。方法:采用实时定量PCR方法检测miR-145在乳腺癌细胞株MCF-7及MCF-7/ADR中的表达差异;脂质体转染法将构建好的miR-145 mimics,miR-145inhibitor成功转染进MCF-7/ADR细胞中,MTT法检测转染后MCF-7/ADR细胞对阿霉素的敏感性,流式细胞仪检测耐药细胞对阿霉素诱导凋亡的影响,Western blot检测转染前后抗凋亡蛋白Bcl-2、多药耐药基因MDR1表达蛋白P-gp的表达差异。结果:miR-145在人乳腺癌细胞株MCF-7/ADR中表达下降;上调miR-145可以增强MCF-7/ADR细胞对阿霉素的敏感性,显著抑制MCF-7/ADR细胞增殖,并促进阿霉素诱导的细胞凋亡,同时显著抑制了耐药细胞中Bcl-2和P-gp的表达。结论:miR-145通过抑制Bcl-2和P-gp蛋白的表达来增加MCF-7/ADR细胞对阿霉素的敏感性和凋亡。     

靶向MDR1基因siRNA逆转HepG2/ADM细胞耐药性的研究

目的 采用RNA干扰技术逆转人类肝癌细胞系/阿霉素(human hepatocellular liver carcinoma cell line/adriamycin,HepG2/ADM)细胞中多耐药基因,探讨该基因能否有效地抑制多耐药基因(multidrug resistance gene,MDR1)及其编码的糖蛋白(P-glycoprotein,P-gp)的表达,并检测对HepG2/ADM耐药表型的逆转效果.方法 采用药物大剂量冲击法建立HepG2/ADM耐药模型,构建靶向MDR1的小干扰RNA表达载体,并转染到HepG2/ADM细胞中,应用半定量逆转录-聚合酶链反应检测基因转染前后MDR1 mRNA表达水平的变化,Western-blot检测各组细胞P-gp蛋白表达的变化,用噻唑蓝法检测各组细胞对阿霉素、顺铂、长春新碱和氟尿嘧啶等药物的敏感性.结果 HepG2/ADM细胞系不仅对阿霉素耐药,而且对其他化疗药也有抗性,呈现多药耐药特性;重组质粒鉴定结果表明针对MDR1的小干扰RNA表达载体成功构建;与对照组比较,转入细胞后MDR1 mRNA水平明显下降,P-gp蛋白表达明显降低;转入细胞后HepG2/ADM细胞对化疗药物的敏感性明显提高,部分逆转其耐药性.结论 靶向MDR1的小干扰RNA可显著抑制HepG2/ADM细胞中MDR1基因和P-gp蛋白的表达,逆转P-gp介导的HepG2/ADM细胞的耐药性.     

小干扰RNA诱导人卵巢癌细胞MDR1基因沉默的研究

目的 采用RNA干扰技术逆转人卵巢癌OVCAR8/TR细胞中多药耐药基因,探讨该技术能否有效地抑制多药耐药基因MDR1的表达,降低该基因编码的糖蛋白P-gp的水平.方法 设计合成针对MDR1的小片段RNA(siRNA),将合成的siRNA用脂质体转染具有多药耐药基因MDR1高表达的人卵巢癌泰素耐药细胞株OVCAR8/TR,用荧光定量RT-PCR检测转染后不同时间点MDR1的mRNA的变化,流式细胞仪定量测定转染后不同时间点P-gp表达的情况.结果 MDR1的siRNA转染细胞48 h基因的抑制达最高,转染的第5 d回到正常水平.阴性对照组mRNA的量与未转染组的mRNA的量差异无统计学意义.P-gp在转染后的72 h其抑制最强,至第5 d时恢复接近正常水平,阴性对照组蛋白表达与未转染组的蛋白表达差异无统计学意义.结论 siRNA能够有效地抑制多药耐药基因MDR1的mRNA和P-gp的表达,为逆转卵巢癌的多药耐药带来了新的希望.     

Alopecurone B逆转人乳腺癌细胞MCF-7阿霉素耐药株活性研究

目的 研究黄酮化合物Alopecurone B（APB）对人乳腺癌细胞阿霉素耐药株MCF-7/ADR多药耐药的逆转活性及逆转机制。方法 人乳腺癌细胞阿霉素耐药株MCF-7/ADR维持在含有250 ng/mL阿霉素的培养基中,使用MTT法、qPCR、Western blot和流式细胞术研究APB对耐药株P-糖蛋白(P-gp)功能和表达的影响。结果 APB能逆转MCF-7/ADR细胞多药耐药,抑制P-gp的功能,下调P-gp基因和蛋白的表达。结论 APB具有强效逆转人乳腺癌细胞MCF-7/ADR多药耐药的效果,其机制涉及对P-gp的调控。      

转染肿瘤坏死因子及反向多药耐药基因对乳腺癌细胞耐药基因表达的影响

目的构建反向pEGFP-MDR1重组表达载体和pDsRed2-TNF-α重组表达载体,在乳腺癌耐药细胞株MCF-7/ADR中进行表达,并观察它们对多药耐药(MDR)基因的影响。方法应用RT-PCR和DNA重组技术构建反向绿色荧光蛋白pEGFP-MDR1融合蛋白表达载体和红色荧光蛋白pDsRed2-TNF-α融合蛋白表达载体,分别和同时导入乳腺癌耐药细胞株MCF-7/ADR中进行表达,应用荧光显微镜直接观察融合蛋白的表达情况,RT-PCR和免疫细胞化学染色法分别检测转染前后MDR1-mRNA和P糖蛋白表达情况。结果转染了反向pEGFP-MDR1载体的细胞可见到绿色荧光,转染了pDsRed2-TNF-α载体的细胞可见到红色荧光,而同时转染了反向pEGFP-MDR1载体和pDsRed2-TNF-α载体的细胞可见到红色及绿色荧光。转染后的细胞在mRNA水平及蛋白水平明显降低了耐药细胞MCF-7/ADR的MDR1基因的表达。结论反向pEGFP-MDR1融合蛋白和pDsRed2-TNF-α融合蛋白能在乳腺癌耐药细胞MCF-7/ADR中分别及同时获得表达,并能抑制MDR1基因在MCF-7/ADR细胞中的表达,为进一步研究基因治疗联同免疫治疗逆转乳腺癌耐药建立了很好的基础。     

五味子乙素对转染多药耐药1基因的MCF-7细胞的多药耐药逆转作用

目的 探讨五味子乙素(SchB)对转染多药耐药1基因(MDR1)的人乳腺癌细胞MCF-7的多药耐药逆转作用及相关机制。方法 将人MDR1基因导入MCF-7细胞,形成耐药细胞株MCF-7／MDR1;用该细胞株为模型评价SchB的体外逆转多药耐药作用,用MTT法进行化疗药物单独或与SchB联合作用时对耐药细胞的IC50比较,计算逆转倍数。结果 转染细胞MCF-7／MDR表现为P糖蛋白高表达,对阿霉素、长春新碱、紫杉醇、高三尖杉酯的抗药性均增加;SchB(25μmol／L)显著减少阿霉素、长春新碱、紫杉醇和高三尖杉酯对MCF-7／MDR细胞的IC50,逆转倍数达6．03-23．94倍;SchB(25μmol／L)使MCF-7／MDR细胞对若丹明123的胞内积聚增加约5倍。效果与维拉帕米10μmol／L浓度时相当;但SchB(25μmol／L)不影响MCF-7／MDR细胞的P-糖蛋白表达。结论 SchB能有效逆转转染MDR1的MCF-7细胞的多药耐药,其机制可能是抑制了P-糖蛋白的药物外排生物学活性。     

逆转胶囊对人乳腺癌MCF-7/ADR细胞中P-gp和MRP表达的影响

目的:检测逆转胶囊对乳腺癌耐药相关蛋白表达的影响,探讨其逆转乳腺癌多药耐药的作用机制。方法:流式细胞术、免疫印迹技术(Western-blot)检测逆转胶囊作用前后MCF-7/ADR细胞表面P-糖蛋白(P-gp)、多药耐药相关蛋白(MRP)的表达。结果:逆转胶囊能显著抑制MCF-7/ADR细胞表面P-gp的表达,并可诱导MRP表达下降,其作用随血药浓度增加和作用时间的延长而增强。结论:逆转胶囊逆转乳腺癌多药耐药的机制与下调P-gp和MRP的表达有关。     

结直肠癌中microRNA-451部分逆转MDR1/P-gp途径介导的多药耐药

目的 研究microRNA-451在结直肠癌组织与细胞中的表达及其在MDR1/P-gp途径介导的多药耐药中的作用.方法 收集68例新鲜结直肠癌及癌旁组织,RT-qPCR检测其miR-451表达情况,Western blot检测P-gp蛋白是否表达,并分析其关系;RT-qPCR检测结直肠癌耐奥沙利铂细胞HCT116/L、耐阿霉素细胞LoVo/adr及对应亲本细胞中miR-451的表达;利用脂质体将miR-451 mimics(模拟物)、NC RNAs转染2组耐药细胞,RT-qPCR和Western blot分别检测转染后其MDR1 mRNA和P-gp的表达;MTT检测转染细胞在不同浓度奥沙利铂、阿霉素下的增殖并计算其半数抑制浓度(IC50);流式细胞术进一步比较NC转染组和mimics转染组耐药细胞在同一浓度奥沙利铂、阿霉素下凋亡率.结果 相对于癌旁组织,miR-451在结直肠癌组织中低表达,其表达下调与P-gp阳性表达存在相关性(r=-0.404,P=0.002);与亲本细胞相比,miR-451在2组耐药细胞中表达明显降低(P＜0.01);mimics转染组细胞MDR1 mRNA、P-gp相对表达量明显下降,IC50及凋亡率与NC组均有显著差异(P＜0.05).结论 miR-451在结直肠癌中通过MDR1/P-gp途径参与多药耐药,耐药细胞转染miR-451mimics后,可部分逆转耐药.     

新型寡核苷酸对乳腺癌细胞葡萄糖神经酰胺合酶与P-糖蛋白表达的影响

目的: 观察新型反义寡核苷酸MBO-asGCS对乳腺癌细胞中葡萄糖神经酰胺合酶(GCS) 与 P-糖蛋白(P-gp)表达的影响.方法: 实时PCR检测MBO-asGCS处理的耐药型乳腺癌细胞MCF-7-AdrR,蛋白质印迹分析MCF-7-AdrR及其转化细胞中GCS与P-gp的蛋白表达,TUNEL法检测MBO-asGCS处理的MCF-7-AdrR中的细胞凋亡情况.结果: 在耐药株和GCS过表达的MCF-7-AdrR/GCS中GCS和P-糖蛋白表达特征性上升,而在asGCS转化细胞MCF-7-AdrR/asGCS中GCS和P-糖蛋白表达明显下降; MBO-asGCS处理的MCF-7-AdrR中GCS基因表达下调63.6%,凋亡细胞显著增加(P<0.01).结论: 乳腺癌细胞的耐药机制中可能存在GCS和P-糖蛋白的某种关联,升高的GCS可促进神经酰胺的代谢并增强P-糖蛋白的表达,产生耐药现象,反义寡核苷酸可抑制GCS表达,下调P-糖蛋白并促进凋亡.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.