驱动蛋白Eg5抑制剂在肿瘤研究中的进展

有丝分裂双极纺锤体是癌症化学疗法中一个已证实的药物靶点,如紫杉烷和长春碱等作用于微管抑制纺锤体形成,在临床上是一类很成功的抗肿瘤药物。但微管在细胞的高尔基体、突触小泡等细胞器的转运具有重要作用,对轴突微管也有抑制影响。因此,作用于微管的抗增殖药物具有不可逆转的神经毒性,长期使用这类药物会使肿瘤产生抗药性[1]。寻找有丝分裂纺锤体的其他靶点是目前开发新的抗肿瘤药物的重要途径。纺锤体驱动蛋白家族是纺锤体形成的重要蛋白,已成为近     

多西他赛联合顺铂治疗晚期非小细胞肺癌60例临床观察

多西他赛为紫杉醇类抗肿瘤药,一种具有抗肿瘤活性的天然产物,作用机制独特。通过干扰细胞有丝分裂和分裂间期细胞功能所必需的微管网络而起抗肿瘤作用。多西他赛可与游离的微管蛋白结合,促进微管蛋白装配成稳定的微管,同时抑制其解聚,导致丧失了正常功能的微管束的产生和微管的固定,从而抑制细胞的有丝分裂。国外有临床研究证实,多西他赛联合顺铂治疗晚期非小细胞肺癌（NSCLC）安全性高,     

多西他赛加阿霉素联合化疗治疗晚期转移性乳腺癌的护理69例

多西他赛为紫杉类抗肿瘤药物，通过干扰细胞有丝分裂和分裂期间细胞功能的必须的微管网而起抗肿瘤作用。多西他赛与游离的微管蛋白相结合，促进微管蛋白装配成稳定的微管，同时抑制其解聚，导致丧失了正常功能的微管束的产生和微管的固定，从而抑制细胞的有丝分裂。其主要不良反应为骨髓抑制、体液潴留。其他毒性有过敏反应、皮肤反应、心血管副反应等。近年来临床研究显示：     

安素泰加顺铂(或卡铂)治疗晚期恶性肿瘤20例近期疗效观察

紫彬类药物是一种作用于微管(微管蛋白)系统的药物,它促进微管蛋白形成微管并抑制微管的解聚,导致微管柬的异常排列,抑制了细胞有丝分裂时纺锤体的形成,使细胞有丝分裂停止于细胞周期的G2晚期和M期,从而抑制细胞复制,既便在缺少三磷酸鸟苷(GTP)和微管相关蛋白(MAP)的条件下也可诱导形成无功能且不能解聚的微管,从而发挥抗肿瘤作用,我们自1999-02～2000-08以澳大利亚Faulding公司生产的紫彬醇[商品名称：安素泰(Anzataz)]加顺铂(PDD)／卡铂(CBP)联合治疗晚期恶性肿瘤加例,疗效较好,报告如下。     

以和微管相互作用的药物治疗癌症

癌细胞通过有丝分裂而无限制地增殖。由微管蛋白所形成的微管在有丝分裂过程中促使姐妹染色单体分离,从而形成两个子细胞并获得质与量都相同的遗传信息。在抗癌药中,发现有一类药的作用机制是与微管蛋白相结合从而干扰了染色体的分离,导致癌细胞停滞于有丝分裂的早期或前中期而死亡。这一发现启发了能干扰微管功能的新型药物的研究与开发。目前,已有一些与微管蛋白结合机制不同的这类药物,具有明显的抗癌疗效且副作用轻微,尤其是那可丁及其衍生物。后者若与免疫疗法药物伍用则更具有良好的前景。     

紫杉醇联合吡喃阿霉索治疗晚期乳腺癌的护理

紫杉醇是一种新一代的抗微管药物。它的作用机制是在肿瘤细胞分裂时能与细胞微管蛋白结合,促使细胞中微管稳定和聚合,抑制微管解聚,使细胞有丝分裂受阻,从而抑制肿瘤生长㈣。紫杉醇是近年来在乳腺癌治疗中倍受重视的一类新型抗肿瘤药物。我科从2003年5月至2005年5月对15例复发或转移的晚期乳腺癌行以紫杉醇为主联合吡喃阿霉素的化疗,取得了较满意的效果,现将治疗方法及护理措施报道如下。     

紫杉醇联合吡喃阿霉素治疗晚期乳腺癌的护理

紫杉醇是一种新一代的抗微管药物。它的作用机制是在肿瘤细胞分裂时能与细胞微管蛋白结合，促使细胞中微管稳定和聚合，抑制微管解聚，使细胞有丝分裂受阻，从而抑制肿瘤生长㈣。紫杉醇是近年来在乳腺癌治疗中倍受重视的一类新型抗肿瘤药物。我科从2003年5月至2005年5月对15例复发或转移的晚期乳腺癌行以紫杉醇为主联合吡喃阿霉素的化疗，取得了较满意的效果，现将治疗方法及护理措施报道如下。     

天然来源的微管蛋白抑制剂

微管(microtubule)由微管蛋白和微管结合蛋白构成,是构成细胞网骨架的主要成分。微管有聚合和解聚的动力学特性,在保持细胞形态、细胞的分裂增殖、细胞器的组成与运输及信号物质的传导方面发挥重要作用。以微管为靶点的抗肿瘤药就是利用其动力学特性,或促进其解聚或抑制其聚合,从而达到直接影响细胞的有丝分裂,影响细胞的诸多正常生理功能,使细胞分裂停止于M期。本文简要综述近年来以微管为靶点的抗肿瘤药物的研究进展。1微管生物学特征1.1微管的分子结构:微管是由13条原纤维(protofilament)构成的中空管状结构,直径约为22~25 nm,壁厚约为5…     

天然抗肿瘤药物研究进展

天然药物在抗肿瘤药物的研究中占有相当大的比例。天然药物除通过抑制增殖或诱导凋亡等直接作用于肿瘤细胞外,还通过免疫调节、抑制转移等间接调节诱导肿瘤细胞死亡。对近几年来广泛研究的天然抗肿瘤药物按照作用方式进行分类,具有直接杀伤作用的天然药物主要介绍DNA拓扑异构酶抑制剂、蛋白激酶C抑制剂、细胞周期蛋白依赖激酶抑制剂、端粒酶抑制剂、微管抑制剂、DNA干扰剂等;间接调节作用的天然药物则主要对免疫调节剂、抑制转移剂进行总结。     

多西紫杉醇临床应用的研究进展

紫杉类化疗药物是一类作用于微管的抗肿瘤药物,能促使微管蛋白迅速聚集成微管,并结合到微管上抑制微管的解聚,从而使细胞有丝分裂终止,诱导肿瘤细胞凋亡。代表药物为紫杉醇和多西紫杉醇。研究证明多西紫杉醇无论单药或联合用药,在肿瘤的化疗治疗中都显示出突出疗效。     

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.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

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.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.