金雀异黄素对人结肠癌细胞株增殖的影响

目的 研究金雀异黄素（GEN）对人结癌细胞系（SW480）细胞的作用并探讨其作用机理。方法 采用细胞计数法MTT法、免疫组化等方法，观察GEN对体外培养的SW480细胞的生长抑制以覆COX2表达的影响。结果 GEN对体外培养SW480细胞具有明显的生长抑制效应且呈剂量-效应的依赖关系，当50μmol／LGEN作用SW480细胞24h，抑制率达28％。免疫组化的结果显示：GEN处理后的SW480细胞COX2表达下降。结论 CEN对体外培养SW480细胞具有增殖抑制作用，CEN通过下调SW480细胞COX2蛋白的表达，促进细胞凋亡。     

辣椒素对人结肠癌SW-480生长及Bcl-2/Bax表达的影响

目的 探讨辣椒素对人结肠癌SW-480细胞的作用及机制。方法 用四甲基偶氮唑蓝（MTT）方法检测SW-480细胞生长情况;透射电镜、琼脂糖凝胶电泳和流式细胞仪分析细胞凋亡;蛋白印迹法（Western blot）检测细胞内Bcl-2、Bax蛋白表达。结果辣椒素对SW-480细胞有明显生长抑制及诱导凋亡作用,并呈剂量、时间依赖性;光镜与电镜下可见到明显的凋亡细胞;琼脂糖凝胶电泳显示出特征性凋亡梯状带,随着作用时间延长,细胞内Bax蛋白表达逐渐增高、Bcl-2蛋白表达逐渐降低。结论辣椒素能明显抑制人结肠癌SW-480细胞生长,诱导细胞凋亡可能是其主要作用机制,调节Bcl-2、Bax蛋白表达是其诱导细胞凋亡的作用机制之一。     

二烯丙基二硫对人结肠癌SW480细胞增殖抑制的作用

目的探讨二烯丙基二硫(diallyl disulfide，DADS)对人结肠癌细胞系SW480增殖抑制作用及机制。方法以人结肠癌SW480细胞为实验研究对象，通过MTT法测定DADS对SW480细胞的增殖抑制效应，采用HE染色及流式细胞仪检测药物作用前后细胞形态学及细胞周期分布等方面的变化。结果MTT法测定结果显示DADS可抑制SW480细胞增殖。呈浓度依赖性；形态学观察发现DADS诱导SW480细胞呈现出成熟分化的特征；随着DADS浓度加大，阻滞在G2／M期的细胞数目增多，亚二倍体峰逐渐增高。结论DADS可抑制人结肠癌SW480细胞增殖，使癌细胞阻滞于G2/M期。     

酒石酸锑钾对结肠癌的抑制作用

【目的】观察酒石酸锑钾(PAT)对人结肠癌细胞、结肠癌裸鼠移植模型抑瘤及凋亡诱导作用。【方法】将不同浓度PAT作用于体外培养人结肠癌SW480细胞。采用MTT法检测PAT对结肠癌SW480细胞的生长抑制作用,并计算生长抑制率;60只裸鼠皮下注射结肠癌细胞株SW480建立移植瘤模型,随机分为4组,每组15只。分别在荷瘤鼠腹腔内注射氟尿嘧啶、生理盐水及不同剂量的PAT,给药15d,末次给药24h后计算抑瘤率并观察肿瘤细胞的凋亡。利用TUNEL法进行凋亡检测。免疫组化分析凋亡调控基因Bcl-2的表达。【结果】PAT对结肠癌移植瘤生长有显著性抑制作用,肿瘤细胞凋亡增加;TUNEL法观察到棕褐色着染的凋亡阳性细胞;免疫组化显示PAT作用下Bcl-2基因阳性细胞数降低。【结论】PAT可通过诱导结肠癌SW480细胞的凋亡抑制结肠癌裸鼠皮下移植瘤。     

熊果酸诱导结肠癌HT-29细胞凋亡与凋亡相关基因的关系

目的：体外实验探讨熊果酸诱导结肠癌HT-29细胞凋亡的可能性，揭示该凋亡发生与其相关基因之间的关系。方法：采用四甲基偶氮唑蓝比色、TUNEL法、流式细胞术检测熊果酸对结肠癌HT-29细胞的增殖抑制与杀伤作用；应用免疫组织化学SP法检测凋亡相关基因caspase-9、bcl-2、bax的表达。结果：熊果酸在体外对HT-29细胞有中度增殖抑制效应，在熊果酸作用下，HT-29细胞出现显著的细胞凋亡征象，TUNEL法显示细胞固缩，核染色质聚集或断裂，形成凋亡小体。流式细胞术检测在G1期之前出现sub-G1峰，凋亡率最高为11．63％，熊果酸的作用具有浓度和时间依赖性。在HT-29细胞凋亡过程中，凋亡相关基因caspase-9、bax的表达增强，bcl-2的表达减弱。结论：熊果酸在体外对结肠癌HT-29细胞有诱导凋亡作用，而caspase-9和bax的表达增强，bcl-2的表达减弱可能是其作用机制之一。     

尼莫地平对阿糖胞苷诱导HL-60细胞凋亡机制影响的研究

为了研究尼莫地平对阿糖胞苷诱导HL-60细胞凋亡机制的影响，采用琼脂糖凝胶电泳检测其DNA凋亡带，用细胞免疫组织化学方法检测细胞凋亡相关基因bcl-2、bax的蛋白表达。结果表明，实验组自培养8小时起琼脂糖凝胶电泳显示典型的DNA梯形凋亡带。Bcl-2蛋白表达在各实验组随培养时间延长逐渐下降，而Bax蛋白的表达则逐渐增加，Bcl-2／Bax比值逐渐下降，8小时就与对照组出现差异（P〈0.05）。结论：尼莫地平及阿糖胞苷均能促进HL-60细胞凋亡，诱导其凋亡的机制与下调bcl-2及上调bax基因的蛋白表达有关。尼莫地平能加强阿糖胞苷促进HL-60细胞凋亡，其机制与协同下调bcl-2的表达有关。     

circPRMT5在结肠癌患者中的表达及其对结肠癌细胞生物学性质的影响

目的探讨环状蛋白精氨酸甲基转移酶5(circPRMT5)在结肠癌患者中的表达及其对结肠癌细胞生物学性质的影响。方法选择2018年10月至2019年10月该院收治的93例结肠癌患者为研究对象,收集手术切除的结肠癌组织及癌旁正常组织,采用免疫印迹法(Western blot)检测结肠癌组织及癌旁正常组织中circPRMT5蛋白表达量。将人结肠癌SW480细胞分为空白对照组、阴性对照组、试验组,空白对照组不作任何处理,阴性对照组转染10μg pEGFP-N1质粒,试验组转染10μg pEGFP-N1-circPRMT5质粒,采用CCK-8法检测各组SW480细胞增殖率,采用Transwell小室侵袭试验检测各组SW480细胞侵袭能力,采用流式细胞术检测各组SW480细胞凋亡率,采用Western blot检测各组SW480细胞中circPRMT5蛋白表达量。结果结肠癌组织中circPRMT5蛋白表达量显著高于癌旁正常组织(P<0.05);试验组SW480细胞增殖率、侵袭能力、circPRMT5蛋白表达量显著高于空白对照组、阴性对照组(P<0.05);试验组SW480细胞凋亡率显著低于空白对照组、阴性对照组(P<0.05);阴性对照组SW480细胞增殖率、凋亡率、侵袭能力、circPRMT5蛋白表达量与空白对照组比较,差异无统计学意义(P>0.05)。结论circPRMT5在结肠癌患者中呈高表达,circPRMT5高表达能够促进结肠癌细胞增殖、侵袭,抑制结肠癌细胞凋亡。     

阿糖胞苷诱导HL-60细胞凋亡及其机制研究

为了研究阿糖胞苷诱导HL-60细胞凋亡及其机制，采用Giemsa染色、光学显微镜下观察HL60细胞的形态学变化，琼脂糖凝胶电泳检测DNA凋亡带，细胞免疫组织化学方法检测细胞凋亡相关基因Bcl-2、Bax的蛋白表达。结果显示：实验组自培养8小时起，细胞开始变形，Giemsa染色可见核膜裂解，染色质呈紫红色或蓝紫色，出现典型的凋亡小体；DNA凝胶电泳见典型的梯形条带；在细胞凋亡的同时伴有Bcl-2蛋白表达明显下降，而Bax蛋白表达明显升高，Bcl-2／Bax比值下降。结论：阿糖胞苷可明显地诱导HL60细胞凋亡，同时伴有Bcl乏蛋白表达降低、Bax蛋白升高。Bcl-2／Bax比值下降可能是阿糖胞苷诱导HL-60细胞凋亡的主要机制之一。     

白藜芦醇诱导食管癌细胞凋亡及其相关基因表达的研究

目的研究白藜芦醇诱导人食管癌Eca109细胞凋亡的作用并探讨其对凋亡相关基因survivin、bax和bcl-2表达的影响。方法不同浓度白藜芦醇作用于Eca109细胞后,采用流式细胞仪检测细胞凋亡、细胞周期分布及survivin、bax和bcl-2蛋白的表达。结果白藜芦醇能诱导食管癌Eca109细胞凋亡,使其细胞周期阻滞在GO／G1期;白藜芦醇可以上调bax蛋白的表达,下调survivin蛋白并协同抑制bcl-2蛋白的表达。结论白藜芦醇能明显诱导Eca109细胞凋亡,其机制可能与促进bax表达、抑制survivin和bcl-2表达有关。     

双糖链蛋白聚糖对大肠癌细胞生长作用研究

目的研究Biglycan对大肠癌细胞HT-29和SW480侵袭、凋亡等生长作用影响。方法采用Transwell方法检测Biglycan对大肠癌细胞HT-29和SW480的侵袭能力影响;AV／PI染色检测细胞凋亡情况;Westernblot法检测加药处理前后细胞内Rb、pRb和Ras表达变化。结果100nmol／LBiglycan和50nmol／I。Biglycan可抑制大肠癌细胞HT-29和SW480侵袭转移,同时可诱导HT-29、SW480细胞发生凋亡;经Biglycan处理后,细胞内Rb总蛋白无显著性变化,pRb和Ras出现下调趋势。结论Biglycan可抑制大肠癌细胞HT-29和SW480侵袭转移、诱导细胞凋亡,下调pRb和Ras的表达、调控细胞周期从而抑制细胞生长为其可能的作用机制。     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

Clinical Pharmacokinetics of Morphine

Morphine, the most widely used mu-opioid analgesic for acute and chronic pain, is the standard against which new analgesics are measured. A thorough understanding of the pharmacokinetics of morphine is required in order to safely and effectively use this analgesic in a wide variety of patients with different levels of organ function. A MEDLINE search was conducted to identify literature published between 1966 and January 2002 relevant to the pharmacokinetics of morphine. These publications were reviewed and the literature summarized regarding unique and clinically important elements of morphine disposition relative to its parenteral administration (including intravenous, intramuscular, subcutaneous, epidural and intrathecal administration), absorption profile (immediate release, controlled release, and sublingual/buccal, and rectal administration), distribution, and its metabolism/ excretion. Special populations, including infants, elderly, and those with renal/liver failure, have a unique morphine pharmacokinetic profile that must be taken into account in order to maximize analgesic efficacy and reduce the risk of adverse events.     

手转胎头术失败的原因与分娩结局临床分析

目的 探讨手转胎头术失败的原因与分娩结局.方法 选择2008年1月至2010年12月于我院住院分娩的持续性枕横位、枕后位产妇198例,根据行手转胎头术后结果分为成功组126例、失败组72例.比较两组分娩结局,对比分析失败原因.结果 失败组胎儿体质量≥3500 g的发生率[76.4％(55/72)]明显高于成功组[31.7％(40/126)],差异有统计学意义(x2=30.177,P=0.001)、失败组宫缩乏力发生率[58.3％(42/72)]高于成功组[38.1％ (48/126)],差异有统计学意义(x2=7.569,P=0.006)、失败组骨盆临界或轻度狭窄发生率[38.9％ (28/72)]高于成功组[23.8％(30/126)],差异有统计学意义(x2 =5.030,P=0.002)、失败组手转胎头时机不当(宫口开大＜6 cm、胎头位于坐骨棘上及宫口开大8～10 cm、胎头位于坐骨棘下≥2 cm)发生率[61.1％(44/72)]高于成功组[38.9％(49/126)],差异有统计学意义(x2=9.084,P=0.003).失败组母儿并发症(产后出血、产褥病率、胎儿窘迫、新生儿窒息)发生率高于成功组(x2 =9.586,P=0.002、x2=9.334,P=0.002、x2=5.910,P=0.015、x2=5.240,P=0.022)、失败组剖宫产发生率[72.2％(52/72)]明显高于成功组[34.1 ％(43/126),x2=26.641,P=0.001)].结论 手转胎头术能使难产变顺产,降低剖宫产率,减少母儿并发症,但须积极预防、处理导致手转胎头术失败的原因,对矫正失败后继续矫正及试产应慎重.     

Evidence-Based Pain Management and Palliative Care in Issue Four for 2009 of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly. Issue 4 for 2009 contains 4027 complete reviews, 1906 protocols for reviews in production, and 11447 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 600,000 randomized controlled trials, and 12,200 cited papers in the Cochrane methodology register. The health technology assessment database contains over 7500 citations. This edition of the Library contains 90 new reviews, of which 19 have potential relevance for practitioners in pain and palliative medicine.     

Wie zuverlässig sind Angaben zu nichtentzündlichen ausgedehnten Schmerzen?

ZusammenfassungFragestellung Es wurde geprüft, wie sich der Differenziertheitsgrad zweier Schmerzmessmethoden auf Angaben zur Ausgedehntheit klinischer Schmerzen auswirkt. Zugleich wurde der Referenzzeitraum variiert, über den die Patienten berichten sollten.Methode Erfasst wurde der Einfluss zu Lasten der Befragungsdifferenziertheit durch den Vergleich zweier Körperschema-Bildvorlagen. Drei Referenzzeiträume (Schmerz aktuell, letzte Woche, letztes halbes Jahr) wurden vorgegeben.Ergebnisse Patienten mit ausgedehnten Schmerzen gaben bei differenzierter Befragung um so mehr Schmerzen an, je weiter die Schmerzen zurück lagen und je größer der Berichtszeitraum war. Patienten mit gelenknahen Schmerzen gaben bei hoch differenzierter Befragung weniger ausgedehnte Schmerzen in der Vergangenheit an als bei globaler Einschätzung. Patienten mit Rückenschmerzen berichteten bei differenzierter Befragung zum aktuellen Schmerz über weniger ausgedehnte Schmerzen als bei globaler Befragung.Schlussfolgerung Die Angaben zur Schmerzausdehnung variieren vor allem bei Patienten mit ausgedehnten Schmerzen in Abhängigkeit von der Differenziertheit der Befragung. In diesen Fällen ist die Wahrscheinlichkeit erhöht, dass sich die Beschwerdesymptomatik zumindest teilweise erst in der Reaktion auf die situativen Befragungsbedingungen konstituiert und daher nicht auf andere Befragungsbedingungen generalisiert werden kann.