阻塞性睡眠呼吸暂停低通气综合征合并难治性高血压的护理体会

近年来,国内外使用鼻罩连接呼吸机进行持续正压通气(NCPAP)治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)已成为首选治疗方法,并取得了较好的效果[3]。我院2004年1月至2007年12月将96例OSAHS合并难治性高血压患者分为两个试验组,48例治疗组的患者使用NCPAP治疗并配合护理干预提高其治疗的依从性,结果显示NCPAP治疗OS-AHS并发的高血压是一种针对高血压病因的非药物治疗高血压的方法,从而可降低冠心病、脑血管病发生率,改善患者预后。现将治疗和护理体会报道如下。1资料与方法1.1一般资料本组96例为我院来自门诊及病房OSAHS合并难治性高血压患者,男78例,女18例,年龄61岁～78岁。其中4例曾行腭咽成形术,所选患者排除存在影响OSAHS和血压状况的其他疾病。OSAHS诊断标准符合中华医学会呼吸分会睡眠学组制订的标准[4],难治性高血压诊断标准符合2004年中国高血压防治指南(实用本)的标准[5]。1.2方法1.2.1监测方法患者当日禁饮酒和咖啡,停用镇静剂及抗高血压药,按测试常规监测最低氧分压(SpO2)及呼吸有关参数,经PSG诊疗系统(Alice3型及Alice4型,美国伟康公司)整夜...     

难治性高血压合并OSAHS20例临床分析

目的探讨难治性高血压合并阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的治疗方法,分析治疗后血压下降机制。方法对20例难治性高血压合并OSAHS进行血压测量、多导睡眠监测（PSG）、一般处理和手术治疗。结果血压治愈率为75％（15例）,有效率为20％（4例）,无效率为5％（1例）;OSAHS治愈率为60％（12例）,显效率为30％（6例）,有效率为10％（2例）。结论改善睡眠结构,降低呼吸暂停和低通气次数,有利于难治性高血压合并OS—AHS患者血压的控制。     

阻塞性睡眠呼吸暂停低通气综合征与高血压关系的探讨

目的:探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与高血压发生的关系以及自动调压持续气道正压通气呼吸机(Auto-CPAP)的治疗效果。方法:检测无合并高血压的单纯OSAHS患者71例及合并高血压的OSAHS患者62例的血压变化及呼吸睡眠指标,并抽取30例OSAHS合并高血压患者予Auto-CPAP治疗并监测其血压变化及呼吸睡眠指标。结果:OSAHS合并高血压患者的AHI、SaO2<90%的时间、觉醒指数、呼吸暂停最长时间均明显高于单纯OSAHS组,而最低SaO2、总睡眠时间则明显低于单纯OSAHS组。OSAHS合并高血压组的睡前血压和醒时血压均明显高于单纯OSAHS组。OSAHS合并高血压患者经Auto-CPAP治疗1个月后及3个月后其醒时血压、AHI、ESS、觉醒指数均较治疗前及治疗1周后明显下降。OSAHS患者的平均动脉压与AHI、BMI、ESS、觉醒指数呈正相关,与最低SaO2呈负相关。结论:OSAHS合并高血压患者的病情严重程度高于无合并高血压的OSAHS患者。Auto-CPAP治疗OSAHS合并高血压患者有效且依从性好。     

阻塞性睡眠呼吸暂停低通气患者高血压患病率的分析

①目的 了解阻塞性睡眠呼吸暂停低通气综合征(OSAHS)人群的高血压患病率.②方法 纳入我院门诊或住院患者共280例,其中非高血压者190例,符合OSAHS诊断标准的患者127例,无睡眠呼吸暂停者63例;原有高血压者90例,符合OSAHS诊断标准的患者58例.③结果 非高血压OSAHS组患者血压晨起较睡前血压明显升高(P<0.05);非高血压OSAHS组与高血压OSAHS组内比较晨起与睡前差异有显著性(P<0.01),晨起血压明显升高.④结论 OSAHS患者的高血压患病率明显高于一般人群,且高血压患者合并OSAHS比率较高;睡眠呼吸暂停与高血压患病率密切相关,是独立于年龄、体质量、饮食、遗传等原因的高血压发病因素之一,是高血压发生和发展的重要危险因素.     

经鼻持续气道正压通气对阻塞性睡眠呼吸暂停低通气患者血清脂联素和血压的影响

目的:探讨在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者中持续气道正压通气(NCPAP)对血清脂联素和血压的影响,以及血清脂联素水平和高血压之间可能存在的相关关系.方法:选择23例男性中、重度OSAHS患者,于NCPAP治疗前1天和NCPAP治疗中、后检测血清脂联素、平均动脉压(MAP).结果:OSAHS患者接受NCPAP治疗后,血清脂联素水平逐渐升高而MAP逐渐降低;血清脂联素水平和MAP显示与NCPAP治疗前相比,NCPAP治疗的第3天和第7天均未见统计学差异(均为P＞0.05),但在NCPAP治疗的第14天差异显著(P＜0.01).结论:OSAHS可引起低脂联素血症,后者可能参与了OSAHS并发高血压的发病,且可被NCPAP治疗所纠正.     

阻塞性睡眠呼吸暂停低通气综合征与高血压的关系探讨

目的:探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与高血压的关系.方法:随机选取150例观察对象,根据临床表现和多导睡眠呼吸监测(PSG)结果,分为正常对照组和OSAHS组.分别测量两组受试者睡前以及醒后血压、睡前血氧饱和度(SaO2)和睡眠状态时的最低SaO2值,并对两组测量结果进行比较.对31例OSAHS合并高血压患者行nCPAP/BiPAP(经鼻面罩持续正压通气/双水平持续正压通气)治疗,并观察其疗效.结果:OSAHS患者睡前、醒后收缩压和舒张压较对照组明显升高(p＜0.01), OSAHS合并高血压患者31例,经nCPAP/BiPAP治疗后21例患者血压均明显下降,其中4例患者血压恢复正常,别外10例患者考虑有其它原因合并存在,经nCPAP/BiPAP治疗1月后,仍需两种降压药物才能维持血压正常范围.结论:OSAHS与高血压密切相关,且是高血压发病的独立危险因素.     

持续气道正压通气治疗阻塞性睡眠呼吸暂停低通气综合征相关性高血压的临床研究

阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的主要特点是睡眠过程中由于上气道完全或部分阻塞导致呼吸暂停从而产生慢性间歇性低氧、二氧化碳潴留,反复胸腔内负压增大、反复微觉醒、睡眠结构异常、白天嗜睡及记忆力下降,并可引起自主神经功能紊乱等.治疗OSAHS能有效控制继发于OSAHS的高血压患者的血压.持续气道正压通气(CPAP)是目前治疗OSAHS的首选方法,也是治疗OSAHS患者高血压的有效方法[1].这种方法的应用减轻了患者的痛苦,降低了各种心脑血管的并发症,降低了病死率.2006年6月～2010年10月采用持续气道正压通气治疗阻塞性睡眠呼吸暂停低通气综合征相关性高血压的方法,对23例诊断明确的OSAHS合并高血压的患者,早期应用CPAP呼吸机进行治疗,在治疗2天后发现原来难以控制的高血压得到了有效控制,与平时使用的药物产生了协同作用,取得了理想的效果,现报告如下.     

NPPV联合降压药物对老年OSAHS合并高血压患者血清HGF水平及血压的影响

阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apneahypopnea syndrome,OSAHS)是一种全身性疾病,成人发病率为2％～4％,并与高血压密切相关[1-2].文献[3]报道血清中肝细胞生长因子水平(hepatocyte growth factor,HGF)与OSAHS、高血压严重程度相关.本研究比较老年OSAHS合并高血压患者进行常规降压药物或无创正压通气(NPPV)联合降压药物治疗效果,观察HGF水平及血压变化情况,探讨NPPV对老年OSAHS合并高血压患者疗效的影响.     

持续气道正压通气改善阻塞性睡眠呼吸暂停综合征合并高血压的研究进展

<正>阻塞性睡眠呼吸暂停综合征(OSAS)是指睡眠时上气道塌陷堵塞所致呼吸暂停和通气不足,临床症状表现为睡眠结构紊乱、打鼾、血氧饱和度下降频发以及白天嗜睡等~[1]。OSAS可引起多器官系统,尤其是心血管系统的损伤,据报道约50%～60%的OSAS患者合并高血压,同时50%左右的高血压患者患有OSAHS~[2]。2013年难治性高血压诊断治疗专家共识将OSAS列为难治性高血压的主因之一~[3]。研究证实~[4],OSAHS的严重程度与血压增高程度呈明     

妊娠合并OSAHS孕妇血清ENA-78和MIF水平分析

目的：分析妊娠合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)孕妇血清趋化因子(ENA-78)和巨噬细胞移动抑制因子(MIF)的水平。方法：82例妊娠合并OSAHS孕妇为观察组,其中50例为单纯OSAHS患者、32例为OSAHS合并高血压患者;选择同期40例正常妊娠孕妇作为对照组。采用标准的多导睡眠呼吸监测系统监测所有孕妇,根据呼吸暂停时的低通气指数(AHI)将妊娠合并OSAHS孕妇分为三组,轻度29例、中度27例、重度26例。采用ELISA法检测所有孕妇血清ENA-78和MIF的水平。结果：OSAHS合并高血压孕妇、单纯OSAHS孕妇血清MIF、ENA-78水平明显高于对照组孕妇,OSAHS合并高血压孕妇血清MIF、ENA-78水平明显高于单纯OSAHS孕妇(P＜0.01);重度OSAHS孕妇血清MIF、ENA-78水平明显高于中度和轻度OSAHS孕妇,中度OSAHS孕妇血清MIF、ENA-78水平明显高于轻度OSAHS孕妇(P＜0.01)。结论：血清ENA-78和MIF水平能反映妊娠合并OSAHS病情的严重程度。     

UniPron is A Fully Effective Non-hormonal Reversible Contraceptive in Baboon Model （Papio Anubis）

Objective To determine the safety and efficacy of UniPron as a reversible contraceptive.
Methods Vaginal swabs were obtained before and after UniPron administration, cultured onto appropriate culture media and bacteria identification was done based on type of media used, Gram stain reactions, colony morphology and biochemical tests. Vaginal biopsy tissues were processed using paraffin wax method, stained with hematoxylin and eosin and examined under light microscopy to determine the effect of the product on vaginal tissues. The effect of UniPron on sperm was examined by mixing the product with electroejaculated spermatozoa in vitro at different concentrations. For efficacy studies, male baboons of proven fertility were mated with UniPron treated or untreated females of proven fertility during the fertile stages.
Results All the five females （100%） that were treated with UniPron did not conceive and they regained total fertility when the treatment was stopped while all the controls conceived. At a concentration of 40%, UniPron completely immobilized spermatozoa in an in-vitro system. UniPron mechanism of action was by lowering the vaginal pH and on application in baboon, the pH was lowered for at least 3 h after which it went back to normal.
Conclusions As we plan for a study to test UniPron as a microbicide to prevent STIs including HIV, our current study has established that this novel product is effective in contraception and harmless to vaginal tissues and vaginal microbial flora in a baboon model （Papio anubis）.     

Evaluation of diuretic and laxative activity of hydro-alcoholic extract of Desmostachya bipinnata （L,） Stapf in rats

OBJECTIVE： In continuation to the growing evidence for therapeutical potential of Desmostachya bipinnata （Linn） Stapf, the current pharmacological study was carried out to evaluate the diuretic and laxative activity of its hydro-alcoholic extract in rats. METHODS： The hydro-alcoholic extract of D. bipinnata whole plant was prepared by using Sox- hlet extractor and subjected to analysis by standard preliminary phytochemical tests. Evaluation of both diuretic and laxative activity was carried out using standard methods as reported earlier. Frusemide （20 mg/kg） was served as positive control for diuretic activity and sennosides （10 mg/kg） served as negative control for laxative activity. RESULTS： The hydro-alcoholic extract showed significant diuretic activity and was found to be the most potent in increasing the urinary output at 500 mg/kg when the effect was compared with that of the standard frusemide （P〈0.01）. Moreover, this extract was found to be most effective in increasing urinary electrolyte concentration （Na＋, K＋, and Cl-） at both doses tested. Whereas the results for laxative activity showed minimal increase of feces output at the dose of 500 mg/kg and the increase was negligible when compared with that of the standard drug sennosides. CONCLUSION： Altogether, the above significant findings validate and support its folkloric diuretic use and lend pharmacological credence to the ethno-medical use of this plant in traditional system of medicine, which demands further studies to investigate its active constituents, as well as its use and safety.     

Effect of the disruption of three cytoskeleton components on chondrocyte metabolism in rabbit knee cartilage

Background Chondrocytes＇ phenotype and biosynthesis of matrix are dependent on having an intact cytoskeletal structure.Microfilaments,microtubules,and intermediate filaments are three important components of the cytoskeletal structure of chondrocytes.The aims of this study were to determine and compare the effects of the disruption of these three cytoskeletal elements on the apoptosis and matrix synthesis by rabbit knee chondrocytes in vitro.Methods Chondrocytes were isolated from full-thickness knee cartilage of two-month-old rabbits using enzymatic methods （n=24）.The isolated cells were stabilized for three days and then exposed to low,medium,and high doses of chemical agents that disrupt the three principal cytoskeletal elements of interest：colchicine for microtubules,acrylamide for intermediate filaments,and cytochalasin D for actin microfilaments.A group of control cells were treated with carrier.Early apoptosis was assessed using the Annexin-FITC binding assay by flow cytometry on days 1 and 2 after exposure to the disrupting chemical agents.The components and distribution of the cytoskeleton within the cells were analyzed by laser scanning confocal microscopy （LSCM） with immunofluorescence staining on day 3.The mRNA levels of aggrecan （AGG） and type Ⅱ collagen （Col-2） and their levels in culture medium were analyzed using real-time PCR and enzymelinked immunosorbent serologic assay （ELISA） on days 3,6,and 9.Results In the initial drug-dose-response study,there was no significant difference in the vitality of cells treated with 0.1 μmol/L colchicine,2.5 mmol/L acrylamide,and 10 μg/L cytochalasin D for two days when compared with the control group of cells.The concentrations of colchicine and acrylamide treatment selected above significantly decreased the number of viable cells over the nine-day culture and disrupted significantly more cell nuclei.Real-time PCR and ELISA results showed that the mRNA levels and medium concentrations of AGG and Col-2 were significantly decreased for     

Liuwei Dihuang,a traditional Chinese herbal formula,suppresses chronic inflammation and oxidative stress in obese rats

OBJECTIVE： To investigate the anti-inflammatory, anti-oxidative stress, and adipokine-ameliorating effects of Liuwei Dihuang （LWDH）, a traditional Chinese herbal formula, in obese rats. METHODS： After 2 weeks of acclimation with free access to regular rodent chow and water, obese-prone-caesarean-derived （OP-CD） rats were fed a modified AIN-93G diet containing 60% energy from fat. Treatment was performed twice daily by gavage feeding with 500, 1 500, or 3 500 mg/kg body weight LWDH suspended in water （n=12 rats per group）. Twelve obese-resistant-CD （OR-CD） rats were fed the atherogenic diet and gavaged with water, and served as the normal control. Blood biomarkers of inflammation, oxidative stress and adiponectin were measured post-sacrifice and used to determine the treatment effect of LWDH and assess the suitability of OR/OP-CD rats for studying these parameters. RESULTS： After 9 weeks of treatment, LWDH lowered serum C-reactive protein （CRP） and tumour necrosis factor-α （TNF-α） levels. Serum interleukin-6 （IL-6） levels showed a tendency towards reduction, but were not significantly different from the OP-CD control. Liver superoxide dismutase （SOD） activity was increased in response to all three doses of LWDH, while the levels of reduced （GSH） and oxidized glutathione （GSSG） and thiobarbituric acid reactive substances （TBARS） were unchanged. Serum adiponectin levels were increased in response to oral administration of LWDH at the dose of either 500 or 1 500 mg/kg body weight. In addition, comparisons between OR-CD and OP-CD rats revealed differential, and for some biomarkers, conflicting characteristics of high-fat diet-fed OP-CD rats in reference to obese human subjects in terms of inflammatory and oxidative stress biomarkers and circulating adiponectin levels. CONCLUSION： The results show, for the first time, the anti-inflammatory, anti-oxidative stress and adiponectin-ameliorating effects of LWDH in obese rats. The suitability of the OP-JOP-CD rat model as     

Iloprost inhibits fracture repair in rats

Background Previous studies have shown that prostaglandins （PGs） dramatically stimulate healing processes in bone.However,the effect of prostaglandin l2 （PGI2） on fracture healing remains unclear.To investigate the effect of PGI2,a study on fracture healing process in closed tibia fractures was designed.Methods Thirty-six Sprague-Dawley male rats were randomized into two groups.On the first day,their right tibias were fractured by three-point bending technique.The study group （n=18） received a single injection of 10 μg/kg iloprost for 5 days,while the control group （n=18） received saline solution in the same way.On the 7th,14th and 28th days following the fracture,six rats were sacrificed and their right legs were harvested in each group.The progression of fracture healing was assessed for each specimen by the scores of radiography （by Lane-Sandhu） and histology （by Huo et al）.Results On the 7th day,the radiographic and histologic scores were equal.On the 14th day radiographic total score was 6 and histologic total score was 23 in the iloprost group,whereas radiographic total score was 11 and histologic total score was 33 in the control group.On the 14th day radiographic and histologic scores were significantly decreased in the iloprost group compared to the control group （P 〈0.05）.On the 28th day radiographic total score was 12 and histologic total score was 37 in the iloprost group,whereas radiographic total score was 15 and histologic total score was 40 in the control group.On the 28th day although there was a decrease in radiographic and histologic scores of the iloprost group acording to control group,it was not statistically significant （P 〉0.05）.Conclusion Iloprost delays fracture healing in early stage in rats.     

Effect of Shenfu on the Expression of Bcl-2 and Bax of Intestinal Mucosal Epithelial Cells after Ischemic Reperfusion in Rats

Objective To study the effect of Shenfu on the expression of bax and bcl-2 in small intestinal mucosal epithelial cells after ischemic reperfusion injury and explore the effect of Shenfu on small intestinal mucosal epithelial cells apoptosis. Methods 36 SD rats were randomized into three groups, each consisting of 12 rats： Sham group （S group）, Ischemic reperfusion group （IR group）, Shenfu group （SF group）, Ischemic reperfusion models were made by ligated the superior menseneric artery for 1 hour followed by 2 hrs reperfusion. Histological mucosal damage in each group was graded according to Chiu＇s score. Immunohistochemistry detected the expression of bax and bcl-2, and obtained the optical density （OD） value using a color image pattern analysis system, and then calculated the ratio of bcl-2/bax. TUNEL method measured apoptotic intestinal mucosal epithelial cells, and calculated the apoptotic index. Results There were edema and epithelial impairment in part of villus and the integral was higher in SF group than S group （P〈0.05）, but lower than IR group （P〈0.01）. Compared IR group with S group and SF group, the average OD value of bcl-2 and bax had significant statistic difference （P〈0.01）, and the average OD value of bcl-2 in SF group was higher than in S group （P〈0.05）, meanwhile bcl-2/bax was significantly lower in IR group than in S group and SF group （P〈0.01）, but that was higher in SF group than in S group （P〈0.05）. Apoptotic index in IR group was significantly higher than that in other two groups （P〈0.01）, and that in SF group was higher than in S group （P〈0.05）. Conclusion Shenfu can enhance the expression of bcl-2, decrease the expression of bax, meanwhile increase the ratio of bcl-2/bax, inhibit small intestinal mucosal epithetlial cells apoptosis, and protect small intestine mucosal epithetlial after ischemic reperfusion.     

补肾活血方对PCOS大鼠模型卵巢中PAI-1mRNA表达的影响

目的探讨补肾活血方对大鼠PCOS模型卵巢局部纤溶酶原激活物抑制因子-1（PAI—1mRNA）表达的影响。方法选用未成年24d龄SD雌性大鼠60只,随机分为模型组、克罗米酚组、补肾活血方高剂量组、补肾活血方低剂量组、正常对照组5组。用Bogovich法建立大鼠多囊卵巢病理模型。以克罗米酚为对照。用原位杂交法观察补肾活血方对多囊卵巢大鼠局部PAI—1mRNA的影响。结果模型组卵巢局部PAI—1mRNA存在卵泡膜间质细胞显著增高,用补肾活血方高、低剂量与克罗米酚药后,卵巢局部PAI-1mRNA的表达明显降低．差异具有统计学意义（P〈0．05、P〈0．01）。补肾活血方高剂量组与克罗米酚组比较,差异具有显著统计学意义（P〈0．01）;低荆量组与克罗米酚组比较差异无统计学意义（P〉0．05）,补肾活血方高、低剂量组比较,低剂量组卵泡膜间质细胞上PAI-1的基因表达增高更明显,但二者差异无统计学意义（P〉0．05）。结论PAI-1mRNA可能与多囊卵巢综合征的发病机制有关。以补肾活血立法的补肾活血方能降低多囊卵巢大鼠局部PAI—1mRNA的显著增高表达．降低PAI—1mRNA卵巢局部的作用。提示补肾活血方可能通过PAI—1mRNA途径促进卵巢排卵的机制。     

New Mechanism of Herb-herb Interaction between Ginseng and Trogopterus Based on CYPs in Rat Livers

The study was designed to investigate the potential mechanism of herb-herb interaction between ginseng and Trogopterus （Trg） based on Cytochrome P450 isozymes （CYPs） in rat livers. We estimated the influence on CYP1A2, CYP2E1, and CYP3A1/2 activity caused by ginseng and Trg used in combination. The CYP1A2 and CYP2E1 enzyme activity were induced by ginseng and Trg used in combination. And this induction effect was caused via inducing CYP1A2 and CYP2E1 protein expression which was supposed caused by inducing the gene expression of CYP1A2 and CYP2E1.     

益智健脑颗粒联合针灸对阿尔茨海默病大鼠学习记忆的影响

目的观察益智健脑颗粒联合针灸对阿尔茨海默病（Alzheimers disease,AD）大鼠学习记忆的影响。方法将大鼠随机分为假手术组（A组）、模型组（B组）、针灸组（C组）、益智＋针灸组（D组）各10只,B、C、D 3组分别以海马CA1区注射β淀粉样蛋白25-35（Aβ25-35）造模,A组注射等量的双蒸水,各组分别治疗20 d后行Morris水迷宫试验,观察大鼠学习记忆能力变化。结果B组较A组的平均潜伏期明显延长,差异具有统计学意义（P〈0.05）;与B组比较,C组、D组的平均潜伏期明显缩短,过台次数增多,差异具有统计学意义（P〈0.05,P〈0.01）;与C组比较,D组的潜伏期缩短,过台次数增多,差异具有统计学意义（P〈0.05）。结论益智健脑颗粒联合针灸能够提高Aβ25-35介导的AD模型大鼠的学习记忆能力。     

The Targeted Pro-apoptotic Effect of scFv-mediated Delivery of Caspase-6 on HER2-positive Osteosarcoma Cells

Objective To investigate the pro-apoptotic effect of scFv-mediated delivery of caspase-6 fusion protein on osteosarcoma E 10 cells. Methods The expression of human epidermal growth factor receptor-2 （Her-2） in osteosarcoma cell line E10 was examined by flow cytometry analysis. ScFv-mediated delivery of caspase-6 was generated by sequential fusion of the genes of a signal peptide, a single-chain Her-2 antibody （e23sFv）, a PEA translocation domain （PEA aa253-264）, and an recombinant caspase-6. The pCMV-immunocaspase-6 was produced by cloning above mentioned fusion genes into pCMV plasmid, and then pCMV-immunocaspase-6 plasmid mixed cationic liposome was transfected into E10 cells. The expression of fusion gene on transfected E10 cells was detected by immunocytochemical staining, The pro-apoptotic effects of fusion gene expression on morphology and growth status of E10 cells were observed by trypan blue cell staining, electron microscopy and MTT assay. Results The fusion protein was detected in the cytoplasm of the transfected E10 cells. These cells presented typical characteristics of apoptosis as detected by electron microscopy. MTT assay revealed that the proliferation of transfected E10 cells was suppressed than that of non- or mock-transfected cells （P〈0.01）. Conclusion ScFv-mediated delivery of caspase-6 fusion protein can induce apoptosis of Her-2 positive osteosarcoma E10 cells, suggesting the potential of this strategy for the treatment of human high-grade osteosarcoma.