丝裂原活化蛋白激酶特异性小干扰RNA表达载体对结肠癌细胞周期和DNA甲基化的影响

目的 构建丝裂原活化蛋白激酶（MEK）基因的小干扰RNA（siRNA）表达载体，观察其静默效应及对结肠癌细胞SW1116生长周期和DNA甲基化的影响。方法 选择MEK不同靶点寡核苷酸片段，克隆到pGCsilencer真核表达载体中。脂质体转染SW1116细胞，荧光显微镜评估转染效率，G418筛选稳定表达siRNA的细胞。Western印迹法检测siRNA对MEK蛋白表达的静默效果。应用四甲基偶氮唑盐微量酶反应比色法检测细胞生长活力，流式细胞术分析细胞周期，甲基化特异性PCR和DNA测序检测p16^INK4A基因启动子甲基化状态。结果 构建2个靶点的MEK重组质粒，分别转染和联合转染SW1116细胞，转染效率约为72．1％，G418筛选培养2周得到稳定表达MEK siRNA的细胞，MEK蛋白抑制率分别为74．2％和69．1％和90．2％，下游分子ERK蛋白磷酸化水平随之降低；细胞增殖活力下降2～4倍和细胞周期阻滞于G1期，细胞周期负调控冈子p16^INK4A启动子区呈低甲基化状态。结论 MEK特异性siRNA表达载体对结肠癌细胞MEK蛋白表达有一定的静默效果，多靶点联合效果更好，阻滞细胞周期于G1期，促进p16^INK4A基因去甲基化。     

重组DNA甲基化酶1表达质粒对结肠癌细胞相关基因表达的影响

目的 分析DNA甲基化酶1(DNMT1)基因的真核表达质粒对人结肠癌细胞肿瘤相关基因的表达影响。方法 分别构建并转染含有人正义和反义DNMT1的真核表达质粒入结肠癌SW1116细胞，PCR和限制性内切酶证实转染结果，以Western印迹法分析各组细胞DNMT1蛋白的表达情况。定量PCR检测hMLH1、hMSH2及c—myc、p16^INK4A基因的表达。结果 经G418筛选得到稳定转染DNMT1基因的结肠癌细胞系，且分别在该转染有正义和反义质粒的细胞系中，DNMT1蛋白表达上调和下调。同时发现转染正义DNMT1的细胞中hMLH1、hMSH2及c—myc的表达降低，而转染反义DNMT1的细胞中hMSH2的表达明显增强。各组细胞p16^INK4A基因的表达差异不明显。结论 DNMT1基因调控人结肠癌细胞中肿瘤相关基因的表达。     

甲基化修饰对人胃癌细胞系中多种基因的调控

背景：甲基化紊乱与胃癌的发生有关，近年来甲基化已成为肿瘤研究的热点。目的：探讨在DNA甲基转移酶抑制剂5-氮脱氧胞苷(5-aza-2′-deoxycytidine，5-aza-dC)的化学干预下，不同分化胃癌细胞系的抑癌基因、癌基因和与凋亡相关的基因与甲基化调控的关系，并辅以流式细胞仪检测细胞周期的变化。方法：培养高分化、中分化和未分化胃癌细胞系MKN-45、MKN-28和HGC-27，分别以不同浓度的5-aza-dC干预细胞。提取细胞的RNA，用逆转录聚合酶链反应(RT-PCR)方法检测p16^INK4A、p21%WAF1、p73、c-myc、c-Ha-ras、survivin和死亡相关蛋白激酶(DAP-kinase)等多种基因的表达情况；同时以流式细胞仪分析细胞周期的变化。结果：抑癌基因中，MKN-45和HGC-27细胞中有p16^INK4A表达，用5-aza-dC干预后其表达增强，MKN-45细胞的p16^INK4A在5-aza-dC 10μmol／L 24h、2μmol／L72h和5μmol／L 72h组表达增强，HGC-27细胞的p16^INK4A在5μmol／L24h和10μmol／L 24h组表达也有明显增强；p21^WAP1、p73无明显变化。癌基因中c-myc、c-Ha-ras变化不明显。与凋亡相关的基因中，MKN-45细胞的survivin在5-aza-dC处理后表达增强，但HGC-27细胞的DAP-kinase无明显变化。结论：在不同分化的人胃癌细胞系中，甲基化修饰对抑癌基因、癌基因以及与凋亡相关基因的调控有明显差异。p16^INK4A基因在MKN-45和HGC-27细胞中、survivin基因在MKN-45细胞中的表达受DNA甲基化调控，在MKN-28细胞中则无表达。     

p21活化激酶1基因在大肠癌细胞中的表达及意义

目的 探讨p21活化激酶l（PAK1）基因在大肠癌细胞中的表达及意义。方法 运用免疫印迹技术检测PAK1基因在8株不同转移和恶性潜能大肠癌细胞（LoVo、SW480、SW620、SW1116、HT29 HCT116和CO-LO320细胞）中的表达。结果 与HCT116、HT29、SW480、SW1116和LST细胞相比,PAK1在LoVo、COLO320和SW620大肠癌细胞中蛋白表达明显增加,而HT29和SW480细胞中的PAK1蛋白表达亦强于SW1116和LST细胞,但PAK1在SW1116和LST细胞几乎无表达。结论 PAK1蛋白过度表达可促进大肠癌的发生、发展,且可能与大肠癌的恶性生物学表型密切相关。     

HIV-1感染对T淋巴细胞p16INK4A基因甲基化及其表达的影响

目的；p16^INK4A基因在与AIDS相关的疾病中的表达缺陷，DNA甲基化可使基因转录下调。本研究观察人类免疫缺陷病毒I型（HIV－1）感染对T淋巴细胞的p16^INK4A基因的表达影响及其途径。方法：建立感染有野生型和突变体HIV－1病毒的T淋巴细胞Hut78细胞系，以RT－PCR、定量PCR和Western blotting检测细胞感染后不同时间的DNA甲基化酶（DNMT）1、3a和3b的mRNA（提高40％以上）和蛋白质水平；并由甲基化特异PCR（MSP）了解p16^INK4A基因甲基化改变，及通过RT－PCR研究该基因的mRNA表达情况。结果：无论野生型抑或突变体HIV－1感染，都能使Hut78细胞中DNMT1表达增强，DNMT3a和DNMT3b无明显变化。HIV－1感染可引起p16^INK4A基因启动子区甲基化水平提高和基因转录水平下调。结论；HIV－1感染可使p16^INK4A甲基化水平升高和表达降低，且与该病毒有无复制无关。     

DAC及TSA对结肠癌细胞系中TIP30基因表达的影响及伊立替康敏感性探讨

目的 探讨DAC及TSA对结肠癌细胞系中抑癌基因TIP30表达的影响,以及与伊立替康敏感性的关系.方法 DAC及TSA处理体外培养的结肠癌细胞系HCT116及HT29,RT-PCR法检测结肠癌细胞系HCT116及HT29药物干预前后抑癌基因TIP30表达情况的变化.MTT法检测结肠癌细胞株HCT116和HT29在不同浓度CPT-11下的凋亡情况,绘制生长抑制曲线并计算半数抑制浓度.结果 HCT116及HT29细胞系经DAC及DAC和TSA联合作用后使原来不表达或低表达的抑癌基因TIP30重新表达或表达增强;结肠癌细胞系HT29与HCT116相比伊立替康敏感性较强,DAC处理后2个细胞系伊立替康敏感性均增强.结论 TIP30基因的异常甲基化是结肠癌发生发展中的常见现象,结肠癌细胞系中TIP30启动子甲基化可能是基因失活的主要调控机制,DAC单独干预和DAC及TSA联合干预效果相似,均能显著增加高甲基化抑癌基因的重新表达.基因甲基化水平可能与化疗敏感性相关.     

5-Aza-dC和TSA对胃癌细胞系p16和hMLH-1基因甲基化水平及表达的影响

目的:探讨5-Aza-dC及TSA对胃癌细胞系中抑癌基因p16和hMLH-1基因甲基化水平和基因表达的影响.方法:5-Aza-dC及TSA处理体外培养的MKN-45细胞和MGC-803细胞,应用逆转录PCR(RT-PCR)法及甲基化特异性PCR(MSP)法分别检测两株细胞药物干预前后抑癌基因p16和hMLH-1的表达及甲基化情况.结果:MKN-45和MGC-803细胞系经TSA,5-Aza-dC及联合作用后使原来不表达或有弱表达的抑癌基因p16和hMLH-1重新表达或表达增强.胃癌细胞系MKN-45和MGC-803均显示p16、hMLH-1基因启动子区存在高甲基化,其中p16基因在两种胃癌细胞系中均表现为甲基化,hMLH-1基因在胃癌细胞系MGC-803中表现为甲基化而在胃癌细胞系MKN-45中表现为半甲基化.在5-Aza-dC及TSA的作用下,MKN-45和MGC-803细胞系中p16及hMLH-1基因的甲基化状态得到逆转.结论:胃癌细胞系中抑癌基因p16和hMLH-1基因启动子甲基化可能是导致其基因失活的主要原因,5-Aza-dC单独作用和5-Aza-dC及TSA联合应用效果相似,均能显著增强甲基化的肿瘤抑制基因的重新表达.     

氧化苦参碱对人结肠癌细胞株SW1116细胞周期通路相关调控因子的影响

背景：氧化苦参碱为中药苦参的主要有效成分，研究显示其对结肠癌细胞具有杀伤作用。目的：观察氧化苦参碱对人结肠癌细胞株SW1116细胞周期通路相关调控因子的影响，阐明其抗结肠癌作用的分子机制。方法：分别以2、3、4mg／m1氧化苦参碱干预SW1116细胞24h或48h，以流式细胞仪检测细胞周期，以逆转录聚合酶链反应（RTPCR）和蛋白质印迹法检测细胞周期蛋白（cyclin）D1、细胞周期蛋白依赖性激酶4（CDK4）、CDK抑制剂p53、核转录岗子E2F1和S期激酶相关蛋白2（Skp2）mRNA和蛋白水平的表达。结果：氧化苦参碱干预可使SW1116细胞周期阻滞于G0／G1期，cyc1inD1、CDK4、E2F1和Skp2mRNA和蛋白表达显著下降，p53mRNA和蛋白表达显著上升，作用呈剂量和时间依赖性（P〈0．05）。结论：氧化苦参碱可通过影响细胞周期相关通路以抑制人结肠癌细胞增殖。     

体外试验诱导白血病细胞p15INK4B基因重新表达

目的：探讨DNA甲基转移酶抑制剂5-氮杂-2ˊ-脱氧胞嘧啶（CdR）与组蛋白去乙酰化酶(HDAC)抑制剂丁酸钠（SB）联合诱导白血病细胞p15^INK4B基因重新表达的可能性。方法：采用急性髓系白血病细胞系KG1a和2例原代培养白血病细胞为研究对象;限制性内切酶联合PCR技术检测p15^INK4B基因启动子区甲基化状态;逆转录-聚合酶链反应（RT-PCR）检测p15^INK4BmRNA的表达;Western免疫印迹法检测p15^INK4B蛋白的表达。结果：受检细胞p15^INK4B基因启动子区呈高甲基化状态,mRNA及蛋白表达完全或部分缺失;CdR和SB可单独诱导p15^INK4BmRNA及蛋白表达,且有剂量依赖性;低浓度CdR(0.5μmol/L)联合SB(0.5mmol/L)显著诱导p15^INK4B表达,其作用高于单用高浓度CdR（1μmol/L）或高浓度SB(1mmol/L)。结论：CdR和SB可诱导甲基化失活的白血病细胞p15^INK4B基因重新表达,二者有明显的协同作用。     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

124例耐多药结核分枝杆菌基因突变特征分析

目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

Assessment of quality of life of parents of children with juvenile chronic arthritis

The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low. Received: 26 September 2001 / Accepted: 8 February 2002     

Numerical Simulation of the Effect of Rate of Change of Glucose on Measurement Error of Continuous Glucose Monitors

Background

A 5-day in-patient study designed to assess the accuracy of the FreeStyle Navigator® Continuous Glucose Monitoring System revealed that the level of accuracy of the continuous sensor measurements was dependent on the rate of glucose change. When the absolute rate of change was less than 1 mg•dl⁻¹•min⁻¹ (75% of the time), the median absolute relative difference (ARD) was 8.5%, with 85% of all points falling within the A zone of the Clarke error grid. When the absolute rate of change was greater than 2 mg•dl⁻¹•min⁻¹ (8% of the time), the median ARD was 17.5%, with 59% of all points falling within the Clarke A zone.

Method

Numerical simulations were performed to investigate effects of the rate of change of glucose on sensor measurement error. This approach enabled physiologically relevant distributions of glucose values to be reordered to explore the effect of different glucose rate-of-change distributions on apparent sensor accuracy.

Results

The physiological lag between blood and interstitial fluid glucose levels is sufficient to account for the observed difference in sensor accuracy between periods of stable glucose and periods of rapidly changing glucose.

Conclusions

The role of physiological lag on the apparent decrease in sensor accuracy at high glucose rates of change has implications for clinical study design, regulatory review of continuous glucose sensors, and development of performance standards for this new technology. This work demonstrates the difficulty in comparing accuracy measures between different clinical studies and highlights the need for studies to include both relevant glucose distributions and relevant glucose rate-of-change distributions.     

治疗高血压药物的经济学评价

重视高血压治疗中的经济学评价,对利用我国有限的卫生资源来遏制高血压对人民群众的危害有着重要的现实意义。药物经济学对于药物治疗的成本和治疗的结果给予同样的关注。因为治疗高血压的费用,不仅涉及药物价格,还包括患者的危险水平,降压疗效和对临床终点事件的影响,以及治疗的依从性和安全性。因此药物经济学更强调整体成本和价-效比。低危病人,若非药价低廉,治疗的价-效比不够理想。而在高危的患者,价-效比越小越经济而不是药费越便宜越好。