三氧化二砷对肝癌细胞顺铂化疗敏感性的调节作用

目的 探讨三氧化二砷(ATO)对肝癌(HCC)细胞对顺铂(CDDP)化疗敏感性的调节作用。方法 采用HCC细胞(HepG2细胞),根据处理方法,将细胞分为3组:采用5μM的ATO联合20μM的CDDP联合(联合组)或单独采用20μM的CDDP处理(CDDP组)HCC细胞(HepG2细胞)48 h,对照组采用生理盐水处理细胞。采用MTT法检测各组HepG2细胞的增殖率。采用流式细胞仪检测各组HepG2细胞凋亡情况。比较ATO对CDDP处理后肝癌细胞增殖率及凋亡率的影响。结果 经过48 h处理,联合组细胞增殖率明显低于CDDP组[(0.48±0.05)vs.(0.62±0.06)](P=0.0002)。经过48 h处理,联合组细胞凋亡率明显高于CDDP组[(44.32±3.59) vs.(34.63±3.25)](P=0.0001)。结论 ATO联合CDDP处理可以通过降低HCC细胞增殖率并促进细胞凋亡增加HCC细胞对CDDP化疗的敏感性,增强CDDP对肝癌细胞的杀伤力。     

ACNU联合CDDP治疗胶质瘤的实验研究

目的:观察尼莫司汀(ACNU)和顺铂(CDDP)联合应用治疗脑胶质瘤的增效作用.方法:(1)体外培养C6胶质瘤细胞,将细胞随机分为4组:A1:对照组;B1:CDDP组;C1:ACNU组;D1:联合给药组.镜下观察给药后细胞形态,流式细胞术检测细胞周期及凋亡.(2)建立大鼠颅内胶质瘤模型,随机分为4组给药:A2:对照组;B2:CDDP组;C2:ACNU组;D2:联合给药组,观察动物生存期、肿瘤病理形态及免疫组化检测PCNA、Bcl-2的表达.结果:细胞周期结果显示,D1组细胞多分布在G0/G1期及S期,G2期较少,较A1组有差异(P＜0.05).凋亡结果示D1组与A1、B1、C13组凋亡率差异明显(P＜0.01).动物生存期观察显示D2组与A2、B2、C23组生存期差异具有统计学意义(P＜0.05).免疫组化结果显示联合治疗组PCNA、Bcl-2表达均较单用药组下降,差异明显(P＜0.05).结论:ACNU与CDDP联合应用治疗恶性胶质瘤比单独用药具有明显的增效作用,手术前可先使用ACNU、CDDP联合辅助化疗,降低术后肿瘤的复发率,延长生存期;还可使肿瘤位于重要功能区的患者获得手术的机会.     

LRIG1过表达对顺铂诱导的胶质瘤细胞凋亡的影响及其机制

目的 研究过表达富含亮氨酸重复序列免疫球蛋白样蛋白1(leucine-rich repeats and immunoglobulin-like domains-1,LRIG1)对顺铂(cisplatin,CDDP)诱导的胶质瘤细胞U251凋亡的影响及其机制.方法 应用脂质体介导的基因转染技术将对照质粒(EGFP-N1)及LRIG1质粒(EGFP-N1-LRIG1)分别转染胶质瘤细胞系U251,设为对照组和LRIG1过表达组,用Real-time PCR检测转染后LRIG1表达水平;用Annexin Ⅴ/7AAD双标流式细胞术检测细胞凋亡;用Western blot检测各目的 蛋白表达水平.结果 LRIG1过表达组LRIG1 mRNA及蛋白均较对照组明显增高;0、10、20 μg/mL CDDP作用下,LRIG1过表达组细胞凋亡率均明显高于对照组(P<0.01);随着CDDP浓度增加,胶质瘤细胞U251磷酸化表皮生长因子受体(P-EGFR)表达增加;不同浓度CDDP作用下,LRIG1过表达组P-EGFR水平均较对照组明显降低,促凋亡蛋白Bax,Caspase-3表达增加,抗凋亡蛋白Bcl-2表达降低.结论 LRIG1通过下调P-EGFR水平而促进顺铂诱导的胶质瘤细胞凋亡,增强胶质瘤细胞对顺铂的敏感性.     

微小RNA-132转染对体内外肝癌生长和凋亡的作用

目的观察转染微小RNA-132(miR-132)对体内外人肝癌细胞株MHCC97H生长和凋亡的影响,初步探讨其作用机制。方法采用实时荧光定量逆转录-聚合酶链反应(RT-q PCR)检测45例肝癌组织及癌旁正常组织中miR-132的表达,CCK-8法、流式细胞术、裸鼠体内成瘤实验和TUNEL实验检验转染miR-132后对体内外MHCC97H细胞生长和凋亡的作用,Western blot法检测体外MHCC97H细胞中p-AKT、Survivin和Caspase 3蛋白的表达,免疫组织化学法检测体内肿瘤组织中Ki-67、Survivin和Caspase 3的表达。结果 miR-132在肝癌组织中的表达明显低于癌旁正常组织(P<0.05)。在体外实验中,与空白对照组和阴性对照组相比,转染组细胞中miR-132的表达明显升高,细胞増殖明显被抑制,G0/G1期细胞比例明显上升,S期细胞比例明显下降,凋亡细胞显著增加(P均<0.05)。转染组细胞中Survivin和p-AKT的表达下调,Caspase 3的表达上调,与空白对照组和阴性对照组相比,差异均有统计学意义(P均<0.05)。在体内实验中,转染组裸鼠皮下移植瘤生长明显被抑制,凋亡肿瘤细胞明显增加,Survivin和Ki-67蛋白表达下调,而Caspase 3表达增加(P均<0.05)。结论转染miR-132对体内外肝癌细胞有增殖抑制和凋亡诱导作用,miR-132有望成为肝癌治疗的新靶点。     

微小RNA-132转染对体内外肝癌生长和凋亡的作用

目的 观察转染微小RNA-132(miR-132)对体内外人肝癌细胞株MHCC97H生长和凋亡的影响,初步探讨其作用机制。方法 采用实时荧光定量逆转录-聚合酶链反应(RT-qPCR)检测45例肝癌组织及癌旁正常组织中miR-132的表达,CCK-8法、流式细胞术、裸鼠体内成瘤实验和TUNEL实验检验转染miR-132后对体内外MHCC97H细胞生长和凋亡的作用,Western blot法检测体外MHCC97H细胞中p-AKT、Survivin和Caspase 3蛋白的表达,免疫组织化学法检测体内肿瘤组织中Ki-67、Survivin和Caspase 3的表达。结果 miR-132在肝癌组织中的表达明显低于癌旁正常组织(P＜0.05)。在体外实验中,与空白对照组和阴性对照组相比,转染组细胞中miR-132的表达明显升高,细胞増殖明显被抑制,G₀/G₁期细胞比例明显上升,S期细胞比例明显下降,凋亡细胞显著增加(P均＜0.05)。转染组细胞中Survivin和p-AKT的表达下调,Caspase 3的表达上调,与空白对照组和阴性对照组相比,差异均有统计学意义(P均＜0.05)。在体内实验中,转染组裸鼠皮下移植瘤生长明显被抑制,凋亡肿瘤细胞明显增加,Survivin和Ki-67蛋白表达下调,而Caspase 3表达增加(P均＜0.05)。结论 转染miR-132对体内外肝癌细胞有增殖抑制和凋亡诱导作用,miR-132有望成为肝癌治疗的新靶点。     

二氢青蒿素联合顺铂对胃癌细胞生长的影响

目的 探讨二氢青蒿素(DHA)联合顺铂(CDDP)对人胃癌SGC7901细胞生长的影响及作用机制.方法 体外培养人胃癌SGC7901细胞,分为对照组、DHA组、CDDP组和DHA+DDP联用组,MTT比色法检测细胞增殖情况;流式细胞仪检测细胞周期分布情况及凋亡的百分比;RT-PCR和Western blotting分别测定Cyclin D1、P21、Caspase-3的mRNA和蛋白的表达水平.结果 DHA和CDDP都能明显抑制SGC7901细胞增殖,DHA+CDDP组抑制强度明显高于单一药物处理组,二者具有协同抑制作用;与对照组相比,DHA和CDDP均能使细胞周期阻滞于G1期,细胞凋亡率明显增加(P＜0.05),DHA+CDDP作用组停滞在G1期细胞比例及细胞凋亡率均显著高于单独DHA或CDDP处理组(P＜0.05);与对照组相比,DHA或CDDP处理组Cyclin D1 mRNA和蛋白表达下降、P21和Caspase-3 mRNA和蛋白表达上升(P＜0.05),DHA+CDDP组细胞Cyclin D1 mRNA和蛋白水平显著低于单用组(P ＜0.05);P21和Caspase-3 mRNA和蛋白水平显著高于单用组(P＜0.01).结论 DHA与CDDP联用对胃癌细胞的抑制具有协同作用,其作用机制可能与下调Cyclin D1和上调P21、Caspase-3基因表达,阻滞细胞周期进程和促进细胞凋亡有关.     

L-精氨酸在人肝癌细胞生长增殖中的作用

目的 :探讨L 精氨酸在人肝癌细胞生长增殖中的作用。方法 :采用噻唑蓝 (MTT)比色法和流式细胞仪 ,检测和分析不同浓度L 精氨酸作用下体外培养人肝癌细胞株QGY 770 3的生长、增殖和凋亡情况。结果 :(1)浓度在4mmol/L以下的L 精氨酸 ,轻度促进肝癌细胞的生长 ;4mmol/L以上浓度的L 精氨酸 ,则抑制肝癌细胞的生长增殖 ,且具有浓度和时间依赖性。 (2 )高浓度L 精氨酸 (16mmol/L和 6 4mmol/L)可诱导肝癌细胞凋亡 ,凋亡率较对照组显著升高 (P <0 .0 5 ) ,并且使肝癌细胞增殖指数较对照组显著降低 (P <0 .0 5 )。结论 :低浓度L 精氨酸促进肝癌细胞的生长 ;高浓度抑制肝癌细胞的生长增殖 ,并可诱导肝癌细胞凋亡。     

顺铂诱导肝细胞性肝癌细胞凋亡及其临床意义

目的：探讨顺铂（ＣＤＤＰ）体内诱导肝细胞性肝癌（ＨＣＣ）细胞凋亡的发生情况及其临床意义。方法：１８例ＨＣＣ患者随机分成２组,１０例行ＣＤＤＰ诱导治疗,另８例作对照。用流式细胞仪（ＦＣＭ）检测２且患者患者手术切除之肿瘤组织,作凋亡及细胞周期分析。结果：ＣＤＤＰ治疗组肝癌细胞凋亡率较对照组显著增高。ＣＤＤＰ治疗组肿瘤细胞Ｇ０－Ｇ１期对照组明显增加;而Ｓ期细胞有显著减少。细胞增殖指数（ＰＩ）在ＣＤＤＰ治     

人重组p53腺病毒感染p53突变mBGC-823细胞对顺铂敏感性的影响

目的:观察人重组p53腺病毒(rAd-p53)感染含突变型p53基因胃癌BGC-823细胞(mBGC-823)对顺铂(CDDP)敏感性的影响.方法:采用免疫细胞化学和Western Blot法检测rAd-p53(5×1010vp/L)感染mBGC-823细胞48 h后P53蛋白的表达;MTT法测定rAd-p53单药组(5×109、5×1010、5×1011vp/L)、CDDP单药组(3.125、6.25、12.50 mg/L)及联合用药组(5×109/3.125、5×1010/6.25、5×1011/12.5vp,mg/L)作用后mBGC-823细胞的生长抑制率;流式细胞仪检测其细胞周期与凋亡率.结果:rAd-p53感染mBGC-823细胞48 h,P53蛋白的阳性表达率为(63.74±4.21)%,显著高于对照组的(30.80±5.32)%(t=-13.039,P＜0.001);rAd-p53、CDDP单药及联合用药均可抑制细胞生长,其作用呈剂量依赖性(P均＜0.001).rAd-p53单药产生以G2/M期为主的阻滞,凋亡率为(11.76±2.33)%;CDDP单药产生以G1期为主的阻滞,凋亡率为(24.70±2.42)%;联合用药组产生G2/M期为主阻滞,凋亡率为(51.88±2.03)%;各组凋亡率比较差异有统计学意义(F=1 620.595,P均＜0.001).结论:腺病毒介导p53基因感染mBGC-823细胞改变了细胞内在突变的p53状态,诱导凋亡并增加对CDDP的敏感性.     

慢性肝病颗粒酶-B及凋亡相关蛋白表达的研究

目的 :探讨主要起坏死作用的颗粒酶 B(GrB)与凋亡蛋白在慢性肝病肝细胞的表达及与乙型肝炎病毒抗原表达的关系。方法 :77例慢性肝病患者中 ,慢性肝炎 (CH) 32例 ,肝炎后肝硬化 (LC) 14例 ,原发性肝癌 (HCC)31例 ,采用原位杂交法检测TNF α、TNFR ,用免疫组化SP法检测GrB、Fas、FasL、Bax、Bcl 2、Bcl XL、Bcl 2α及HBsAg、HBcAg在其肝组织中的表达。结果 :GrB在三种慢性肝病肝细胞中表达未见显著性差异 ;促凋亡蛋白Fas、Fasl表达在LC组高于HCC组 (P <0 .0 5、0 .0 1) ,抑凋亡蛋白Bcl 2在LC及HCC组表达明显高于CH组 (P <0 .0 0 1、0 .0 1) ;HBcAg表达在HCC组较LC组显著增多 ,前者 6 1.2 9% ( 19/ 31)、后者 2 8.5 7% ( 4 / 14 ) ,P <0 .0 5。CH组GrB随着表达程度的增强 :( + ) 8例、( ) 3例、( ) 5例炎症组织学活动指数 (HAI)均值逐渐升高 :为 4 .88、5 .34、8.4 0。结论 :促坏死的GrB对慢性肝炎肝脏炎症活动有较明显相关关系。抑凋亡蛋白Bcl 2在肝硬化及肝癌表达较明显 ,在慢性肝病时坏死、凋亡及乙型肝炎病毒抗原三者关系尚需进一步研究     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.