Risk of second primary malignancies in a population-based study of adult patients with essential thrombocythemia

AIM: To determine the risk of second primary malignancy (SPM) and survival of patients with essential thrombocythemia (ET). METHODS: We identified all patients with ET diagnosed during 2001 to 2011 from the Surveillance, Epidemiology and End Results (SEER) 18 database. Actuarial and relative survival methods were used to calculate the survival statistics. We utilized the SEER 13 database to calculate SPM. We used multiple primary standardized incidence ratio (SIR) session of the SEER*Stat software (version 8.1.5) to calculate SIR and excess risk of SPM for ET patients. RESULTS: Age standardized five-year cause-specific survival was greater for patients < 50 years vs those ≥ 50 years (99.4% vs 93.5%, P < 0.01). Five-year cause-specific survival was lower for men vs women (70.2% vs 79.7%). A total of 201 patients (2.46%) developed SPM at a median age of 75 years. SPMs occurred at an observed/expected (O/E) ratio of 1.26 (95%CI: 1.09-1.45, P = 0.002) with an absolute excess risk (AER) of 37.44 per 10000 population. A significantly higher risk was noted for leukemia (O/E 3.78; 95%CI: 2.20-6.05, P < 0.001; AER 11.28/10000). CONCLUSION: ET patients have an excellent cause-specific five-year survival but are at an increased risk of SPM, particularly leukemia, which may contribute to excess deaths.     

Utility of different serum fibrosis markers in diagnosing patients with chronic pancreatitis and pancreatic adenocarcinoma

AIM: To estimate the levels of serum cytokines in chronic pancreatitis (CP) and pancreatic ductal adenocarcinoma (PDAC) patients in order to evaluate their usefulness as possible biomarkers. METHODS: The study included 167 Caucasian patients: 74 with PDAC (28 men and 42 women, aged 30-88 years), 78 with CP (50 men and 21 women, aged 20-79 years) and 15 age-matched healthy controls hospitalized in the Department of Digestive Tract Diseases, Medical University of Lodz, Poland between 2006 and 2013. Serum MCP-1, transforming growth factor (TGF)-β1, HA and s-Fr were measured in patients with CP (n = 78), PDAC (n = 74) and healthy controls (n = 15) using ELISA (Corgenix United Kingdom Ltd R and D Systems). The severity of CP was assessed according to the Cambridge classification. RESULTS: Both patients with CP and PDAC had a significantly higher mean TGF-β1 serum level (1066 ± 582 and 888 ± 356 vs 264 ± 93, P < 0.0001), mean s-Fr (2.42 ± 1.385 and 2.41 ± 1.275 vs 0.6 ± 0.370, P < 0.0001) and mean HA (199 ± 254 and 270 ± 358 vs 40 ± 26, P < 0.0001) compared to controls. There was no difference in mean MCP-1 between all the groups. There were no significant differences in any cytokine levels between the PC and PDAC groups. No significant differences between serum cytokines depending on age, gender or smoking status were found in CP patients. Mean s-Fr concentration was significantly higher in CP, lasting longer than 5 years compared to those with a shorter disease clinical course (2.639 ± 1.125 vs 1.870 ± 0.970, P < 0.03). There was no correlation between tumor size, localization or TNM classification and serum TGF-β1, MCP-1, s-Fr and HA levels in patients with PDAC. No significant differences between cytokines depending on diabetes presence in CP were found. Nevertheless, mean serum TGF-β1 concentration in PDAC patients was higher in those with diabetes compared to the remaining group (986 vs 839, P = 0.043). CONCLUSION: Serum TGF-β1, s-Fr and HA may be considered additional diagnostic markers of CP and PDAC. TGF-β1 may be useful to predict endocrine insufficiency in PDAC.     

Opioid-sparing effect of selective cyclooxygenase-2 inhibitors on surgical outcomes after open colorectal surgery within an enhanced recovery after surgery protocol

AIM: To evaluate the opioid-sparing effect of selective cyclooxygenase-2 (COX-2) inhibitors on short-term surgical outcomes after open colorectal surgery. METHODS: Patients undergoing open colorectal resection within an enhanced recovery after surgery protocol from 2011 to 2015 were reviewed. Patients with combined general anesthesia and epidural anesthesia, and those with acute colonic obstruction or perforation were excluded. Patients receiving selective COX-2 inhibitor were compared with well-matched individuals without such a drug. Outcome measures included numeric pain score and morphine milligram equivalent (MME) consumption on postoperative day (POD) 1-3, gastrointestinal recovery (time to tolerate solid diet and time to defecate), complications and length of postoperative stay. RESULTS: There were 75 patients in each group. Pain score on POD 1-3 was not significantly different between two groups. However, MME consumption and MME consumption per kilogram body weight on POD 1-3 was significantly less in patients receiving a selective COX-2 inhibitor (P < 0.001). Median MME consumption per kilogram body weight on POD 1-3 was 0.09, 0.06 and nil, respectively in patients receiving a selective COX-2 inhibitor and 0.22, 0.25 and 0.07, respectively in the comparative group (P < 0.001), representing at least 59% opioid reduction. Patients prescribing a selective COX-2 inhibitor had a shorter median time to resumption of solid diet [1 (IQR 1-2) d vs 2 (IQR 2-3) d; P < 0.001] and time to first defecation [2 (IQR 2-3) d vs 3 (IQR 3-4) d; P < 0.001]. There was no significant difference in overall postoperative complications between two groups. However, median postoperative stay was significantly 1-d shorter in patients prescribing a selective COX-2 inhibitor [4 (IQR 3-5) d vs 5 (IQR 4-6) d; P < 0.001]. CONCLUSION: Perioperative administration of oral selective COX-2 inhibitors significantly decreased intravenous opioid consumption, shortened time to gastrointestinal recovery and reduced hospital stay after open colorectal surgery.     

Academic hospital staff compliance with a fecal immunochemical test-based colorectal cancer screening program

AIM: To measure the compliance of an Academic Hospital staff with a colorectal cancer (CRC) screening program using fecal immunochemical test (FIT). METHODS: All employees of “Attikon” University General Hospital aged over 50 years were thoroughly informed by a team of physicians and medical students about the study aims and they were invited to undergo CRC screening using two rounds of FIT (DyoniFOB^® Combo H, DyonMed SA, Athens, Greece). The tests were provided for free and subjects tested positive were subsequently referred for colonoscopy. One year after completing the two rounds, participants were asked to be re-screened by means of the same test. RESULTS: Among our target population consisted of 211 employees, 59 (27.9%) consented to participate, but only 41 (19.4%) and 24 (11.4%) completed the first and the second FIT round, respectively. Female gender was significantly associated with higher initial participation (P = 0.005) and test completion - first and second round - (P = 0.004 and P = 0.05) rates, respectively. Phy sician’s (13.5% vs 70.2%, P < 0.0001) participation and test completion rates (7.5% vs 57.6%, P < 0.0001 for the first and 2.3% vs 34%, P < 0.0001 for the second round) were significantly lower compared to those of the administrative/technical staff. Similarly, nurses participated (25.8% vs 70.2%, P = 0.0002) and completed the first test round (19.3% vs 57.6%, P = 0.004) in a significant lower rate than the administrative/technical staff. One test proved false positive. No participant repeated the test one year later. CONCLUSION: Despite the well-organized, guided and supervised provision of the service, the compliance of the Academic Hospital personnel with a FIT-based CRC screening program was suboptimal, especially among physicians.     

硒对邻苯二甲酸酯亚慢性暴露雄性大鼠肝脏的保护作用

目的：研究邻苯二甲酸酯（DEHP）亚慢性暴露对雄性大鼠肝脏的影响及硒对大鼠肝脏的保护作用。方法：将77只雄性大鼠随机分为7组,分别设置为对照组（饲喂基础饲料）、3个DEHP染毒组（染毒剂量分别为300、600和900 mg/kg）、3个硒干预组（在相应剂量的染毒组中加入1 mg/kg酵母硒）。染毒8周,染毒期末,大鼠空腹16 h后称量大鼠体质量、采血进行生化检测以及称量肝脏质量。结果：与对照组相比,600和900 mg/kg DEHP染毒组大鼠的平均体质量明显降低（P < 0.05）;900 mg/kg DEHP染毒组大鼠的体质量增量、总摄食量、总食物利用率、明显降低（P < 0.01或P < 0.05）;各DEHP染毒组、硒干预组的肝脏平均质量、肝脏系数均明显降低（P < 0.01）。600 mg/kg DEHP染毒后的硒干预组大鼠体质量增量较相应的染毒组增加（P < 0.05）。生化指标检测结果显示,与对照组相比,600、900 mg/kg DEHP染毒组,300、600 mg/kg DEHP染毒后的硒干预组大鼠ALT浓度明显升高（P < 0.05）;900 mg/kg DEHP染毒组,300、600和900 mg/kg DEHP染毒后的硒干预组大鼠AST浓度明显升高（P < 0.01）;600、900 mg/kg DEHP染毒组大鼠TP浓度明显升高（P < 0.01）;900 mg/kg DEHP染毒组,300 mg/kg DEHP染毒后的硒干预组大鼠ALB浓度明显升高（P < 0.01）;900 mg/kg DEHP染毒组大鼠GLB浓度明显升高（P < 0.01）。900 mg/kg DEHP染毒后的硒干预组大鼠ALT、AST、TP、GLB均明显低于相应的染毒组（P < 0.01或P < 0.05）。结论：DEHP的亚慢性暴露对雄性大鼠的体质量与生长产生一定的影响,可能造成肝脏肿胀,对肝脏功能产生影响;而硒的干预可能在一定程度上缓解DEHP对肝脏的毒性作用。     

抗肿瘤新药乙烷硒啉对人舌鳞状细胞癌细胞增殖和迁移的影响

目的：探讨新型有机硒化合物乙烷硒啉（BBSKE）对人舌癌CAL27细胞株生长和增殖的影响。方法：分别采用体外细胞实验MTT、Hoechst 33258免疫荧光染色、Annexin V-FITC/PI染色流式细胞术、Transwell小室实验检测2、5、10、20 μmol/L（含1‰ DMSO）的BBSKE对CAL27细胞增殖、细胞周期及迁移的影响,并设置溶剂对照组和正常对照组。结果：5、10、20 μmol/L的BBSKE作用CAL27细胞后,其增殖抑制率较对照组明显增加（P < 0.01）,且随作用时间的延长而增加。Hoechst 33258免疫荧光染色结果显示5、10 μmol/L BBSKE组相比对照组细胞出现凋亡形态改变。Annexin V-FITC/PI染色流式细胞术分析结果显示与对照组相比,2、5、10、20 μmol/L BBSKE组CAL27细胞G2/M期比率呈梯度增加（P < 0.01）,细胞周期被阻滞于G2/M期（P < 0.01）。Transwell小室实验结果显示,CAL27细胞的迁移数量在2、5、10、20 μmol/L BBSKE组相比对照组明显减少（P < 0.01）,且迁移细胞数与药物浓度呈反比。结论：BBSKE对CAL27细胞具有增殖抑制作用,其机制可能是通过引起细胞周期阻滞于G2/M期而诱导细胞凋亡,并且抑制细胞迁移,提示BBSKE可作为舌鳞状细胞癌患者化疗治疗的备选药物。     

端端分层吻合加胃底套入包埋在微创食管癌切除术中的应用

背景与目的：食管癌术中胃与食管吻合的方式有多种,每种吻合方式各有优缺点。探讨端端分层吻合加胃底套入包埋在微创食管癌切除术中的安全性和实用性。方法：回顾并分析2019年4月—2021年4月在自贡市第四人民医院接受微创食管癌切除术的129例患者的临床病理学资料。全部患者采用胸腹腔镜联合下颈胸腹三切口（McKeown术式）的食管癌切除方法,胸部操作在胸腔镜下完成,腹部操作在腹腔镜下完成。根据吻合方式分为端端分层吻合组（87例）和端侧器械吻合组（42例）。术后随访比较两组的并发症,其中吻合口瘘、吻合口狭窄、胃食管反流是本研究的主要观察目标。结果：129例患者均顺利完成微创食管癌切除手术。端端分层吻合组术前接受新辅助治疗的患者较端侧器械吻合组多（12.0%vs2.3%,P=0.037）,两组患者的其余基本临床资料差异无统计学意义（P>0.05）。两组的平均手术时间无显著差异。端侧器械吻合组的吻合时间少于端端分层吻合组[（32.0±6.8）min vs (15.0±5.4)min,P=0.021]。两组术后并发症中吻合口瘘（1.1%vs 11.9%,P=0.023）、胃食管反流（9.1%vs...     

毛蕊花糖苷对血小板衍生生长因子BB处理后大鼠肝星状细胞的影响

目的：探讨毛蕊花糖苷对血小板衍生生长因子BB（PDGF-BB）诱导的大鼠肝星状细胞（HSC）活化、迁移、胶原沉积、纤维化作用的影响,并进一步探讨其对ERK1/2、Akt信号通路表达的影响。方法：HSC细胞分为毛蕊花糖苷（1.5、3.0、6.0 mg/L）组[重组大鼠PDGF-BB（rrPDGF-BB）预处理24 h后,不同浓度的毛蕊花糖苷干预],PDGF-BB组（rrPDGF-BB预处理24 h,无毛蕊花糖苷干预）,对照组（无rrPDGF-BB预处理,无毛蕊花糖苷干预）;分别采用划痕实验检测细胞迁移能力,ELISA法检测Ⅰ型胶原（Col-I）含量,Western blot检测纤维化HSC活化标志物α-SMA蛋白、凋亡效应分子caspase-3,及ERK1/2、Akt信号通路相关蛋白的表达水平。结果：与对照组比较,PDGF-BB组能促进HSC的迁移（P < 0.01）,毛蕊花糖苷（1.5、3.0、6.0 mg/L）组能明显抑制HSC的迁移（P < 0.01）,且毛蕊花糖苷抑制HSC的迁移有明显的剂量依赖性（r=0.894,P=0.038）;随着受试物浓度的增加,Col-I分泌呈现降低趋势,其中毛蕊花糖苷6 mg/L组抑制胶原产生的作用效果最明显（P < 0.01）;毛蕊花糖苷（1.5,3.0,6.0 mg/L）组能够抑制α-SMA蛋白的表达、激活caspase-3的活性,使ERK1/2、P-ERK1/2、Akt、P-Akt蛋白表达明显降低,且测定蛋白的表达在毛蕊花糖苷各剂量组间也呈现一定的剂量-效应关系（0.826 < r < 0.997,P < 0.01）。结论：毛蕊花糖苷可抑制rrPDGF-BB诱导的HSC的活化、迁移和纤维化作用,其机制可能与毛蕊花糖苷激活caspase-3,阻断ERK1/2、Akt信号通路,抑制HSC中细胞外基质过度沉积及胶原形成有关。     

线粒体靶向抗氧化剂Mito-TEMPO对氮芥诱导BEAS-2B细胞损伤的影响

目的: 探讨线粒体靶向抗氧化剂Mito-TEMPO对氮芥(HN2)诱导人支气管上皮细胞系BEAS-2B的影响。方法: BEAS-2B细胞分为正常对照组、Mito-TEMPO对照组、HN2染毒组和Mito-TEMPO干预组,其中正常对照组和Mito-TEMPO对照组分别给予含DMSO(体积分数为0.1%)和Mito-TEMPO(100μmol/L)的无血清培养基处理26 h,HN2染毒组给予含DMSO的无血清培养基预处理2 h,然后给予HN2(8μmol/L)染毒24 h,Mito-TEMPO干预组给予Mito-TEMPO(100μmol/L)预处理2 h,然后HN2(8μmol/L)和Mito-TEMPO(100μmol/L)共处理24 h。分别采用CCK-8法检测细胞活性,速率法检测细胞培养基上清乳酸脱氢酶(LDH)活性,倒置显微镜观察细胞形态,Annexin V/PI探针法流式细胞术检测细胞凋亡,JC-1探针法检测线粒体膜电位,紫外分光光度法检测细胞匀浆ATP含量,MitoSOX、DCFH-DA、DHE探针法分别检测细胞内线粒体ROS、H2O2及总ROS水平,实时荧光定量PCR检测炎症因子TNF-α、IL-6的mRNA表达水平。结果: 与HN2染毒组相比,Mito-TEMPO干预组细胞活性降低了约42.6%(P<0.05),细胞上清LDH水平显著增加(P<0.05),同时伴有异常形态细胞增多,Mito-TEMPO干预组细胞线粒体ROS水平降低了53.6%(P<0.05),细胞内H2O2水平及总ROS水平分别升高了171%和43.4%(均为P<0.05)。Mito-TEMPO干预对HN2染毒导致的细胞凋亡比例、线粒体膜电位、ATP含量、TNF-α、IL-6的mRNA表达水平等指标改变均无显著影响(P>0.05)。结论: 100μmol/L的Mito-TEMPO干预在HN2染毒BEAS-2B细胞模型中促进了细胞损伤,其机制可能与提高细胞内H₂O₂水平及总ROS水平有关。     

Activated systemic inflammatory response at diagnosis reduces lymph node count in colonic carcinoma

AIM: To investigate a link between lymph node yield and systemic inflammatory response in colon cancer. METHODS: A prospectively maintained database was interrogated. All patients undergoing curative colonic resection were included. Neutrophil lymphocyte ratio (NLR) and albumin were used as markers of SIR. In keeping with previously studies, NLR ≥ 4, albumin < 35 was used as cut off points for SIR. Statistical analysis was performed using 2 sample t-test and χ² tests where appropriate. RESULTS: Three hundred and two patients were included for analysis. One hundred and ninety-five patients had NLR < 4 and 107 had NLR ≥ 4. There was no difference in age or sex between groups. Patients with NLR of ≥ 4 had lower mean lymph node yields than patients with NLR < 4 [17.6 ± 7.1 vs 19.2 ± 7.9 (P = 0.036)]. More patients with an elevated NLR had node positive disease and an increased lymph node ratio (≥ 0.25, P = 0.044). CONCLUSION: Prognosis in colon cancer is intimately linked to the patient’s immune response. Assuming standardised surgical technique and sub specialty pathology, lymph node count is reduced when systemic inflammatory response is activated.     

齐墩果酸对酒精诱导的大鼠胃壁氧化损伤的保护作用

目的：研究化学单体齐墩果酸（OA）对酒精诱导的大鼠胃壁损伤的保护作用。方法：采用随机数表法将24只SD大鼠随机分为对照组（等热量葡萄糖溶液）、酒精暴露组（灌胃给予4 g/kg酒精构建酒精性胃壁损伤模型）、OA干预组（灌胃给予溶解了10 mg/kgOA的酒精溶液进行干预），共3组，每组8只，持续30 d。观察OA对酒精诱导的大鼠胃壁损伤是否具有保护作用。检测胃壁大体改变和HE病理变化；胃壁组织丙二醛（MDA）和氧化型谷胱甘肽（GSSG）含量；还原型谷胱甘肽（GSH）含量及GSH/GSSG比值，抗氧化酶转录因子Nrf-2的mRNA和蛋白表达；TNF-α、IL-6的mRNA和蛋白表达水平。结果：与对照组相比，4 g/kg的酒精暴露30 d可以成功诱导大鼠胃壁氧化损伤和炎症反应。与酒精暴露组大鼠相比，OA干预组的胃壁病理损伤程度减轻，胃壁组织MDA、GSSG含量减少（P < 0.05），GSH含量和GSH/GSSG比值增加（P < 0.05），Nrf-2的mRNA和蛋白表达水平显著升高（P < 0.05），同时TNF-α、IL-6的mRNA和蛋白表达降低（P < 0.05）。结论：OA可以通过抗氧化和抗炎作用发挥对酒精诱导大鼠胃壁损伤的保护作用。     

黑种草子总皂苷对人宫颈癌SiHa细胞生物学行为的影响

目的：研究黑种草子总皂苷提取物（TSNG）对人宫颈癌SiHa细胞的增殖、迁移、凋亡和自噬等生物学行为的影响。方法：将SiHa细胞分为空白对照组和不同浓度（0.8、0.9、1.0、1.1、1.2、1.4、1.6、1.8 mg/mL）的TSNG作用组,以及10 μmol/L羟氯喹（HCQ）干预组;四甲基噻唑蓝（MTT）法检测各组细胞的生长抑制率;划痕实验检测细胞的相对迁移率;流式细胞术Annexin V-FITC/PI染色法检测细胞凋亡率;Hoechst染色观察细胞核凋亡现象;单丹磺酰戊二胺（MDC）染色观察细胞内自噬体数量;Western blot实验检测LC3-Ⅱ和p62蛋白表达。结果：与空白对照组相比,TSNG对细胞的生长有抑制作用且呈剂量效应关系（P<0.05或0.01）;0.9、1.0、1.1 mg/mL TSNG处理组细胞相对迁移率分别为（20.40±2.49）%、（15.14±0.39）%、（5.05±1.04）%,均低于空白对照组的（36.63±2.52）%（P<0.01）;1.0、1.2、1.4 mg/mL TSNG处理组细胞的凋亡率分别为（39.10±0.22）%,（68.37±0.58）%和（80.93±0.12）%,均高于空白对照组的（10.73±0.82）%（P<0.05或0.01）;与空白对照组比较,TSNG处理组细胞核表现出凋亡现象细胞数量增多,且细胞内自噬体数量增加,LC3-Ⅱ和p62蛋白表达上升（P<0.05或0.01）;相较于TSNG作用组,HCQ预处理组LC3-Ⅱ蛋白表达无显著变化（P>0.05）。结论：TSNG对SiHa细胞体外增殖、迁移表现出明显的抑制作用,并在诱导细胞凋亡的同时阻断细胞自噬流。     

放疗延迟对乳腺癌不同分子亚型患者预后的影响

目的 探讨放疗延迟对乳腺癌不同分子亚型患者预后的影响。方法 收集2007年1月—2012年12月在我院行乳腺癌根治术患者341例,其中Luminal A型149例(对照组83例,放疗延迟组66例),Luminal B型105例(对照组63例,放疗延迟组42例),HER2+型43例(对照组28例,放疗延迟组15例),三阴型患者44例(对照组27例,放疗延迟组17例)分析放疗延迟组与对照组预后是否存在差异。结果 Luminal A型、Luminal B型、HER2+型、三阴性型在对照组和放疗延迟组的局部复发率分别为(4.8% vs. 9.1%,P=0.301),(4.7% vs. 19.0%,P=0.019),(7.1% vs. 33.3%,P=0.027),(11.1% vs. 35.3%,P=0.053);远处转移率分别为(9.6% vs. 10.6%,P=0.845),(11.1% vs. 14.2%.P=0.234),(32.1% vs. 40.0%,P=0.937),(37.0% vs. 41.2%,P=0.784);无瘤生存率分别为(85.5% vs. 80.3%,P=0.395),(84.1% vs. 66.7%,P=0.037),(60.7% vs. 33.3%,P=0.087),(55.5% vs. 23.5%,P=0.037);总生存率分别为(94.0% vs. 90.9%,P=0.539),(84.1% vs. 80.9%,P=0.672),(67.9% vs. 60.0%,P=0.606),(59.2% vs. 41.2%,P=0.242)。Cox回归分析结果显示肿瘤大小(HR=3.156,P=0.043)、淋巴结转移(HR=1.074,P=0.001)、TNM(HR=8.591,P=0.009)和分子亚型(HR=2.092,P＜0.001)为乳腺癌患者预后的独立影响因素。结论 Luminal B型及HER2+型患者的局部复发率均因放疗延迟而明显增高,Luminal B型及三阴型的无瘤生存率因放疗延迟而明显降低。肿瘤大小、淋巴结转移、TNM分期和分子亚型是影响患者总生存期的独立危险因素。     

基于TCGA数据分析CX43表达在胶质瘤中的临床意义及其与免疫细胞浸润的关系

目的：探讨连接蛋白43（CX43）基因表达在胶质瘤中的临床意义、预后价值及其在肿瘤免疫微环境中的作用。方法：基于癌症基因组图谱（TCGA）数据库胶质瘤病人的mRNA数据及相关临床信息,利用R语言统计分析CX43基因在592例具有不同病理特征的胶质瘤患者间的表达差异。采用Kaplan-Meier生存分析法评价其预后价值,基因集富集分析（GSEA）探究CX43在胶质瘤中的潜在作用机制,用CIBERSORTx分析CX43 mRNA与胶质瘤免疫细胞浸润的关系。最后利用34例术后石蜡标本进行免疫组化验证分析。结果：与对照组比较,CX43 mRNA在异柠檬酸脱氢酶野生型、染色体1p/19q无共缺失的样本中表达水平显著升高（P<0.01）。CX43高表达的胶质瘤患者预后较差（P<0.01）。GSEA结果提示CX43 mRNA高表达组在9个特征基因集中富集。CIBERSORTx免疫浸润分析提示CX43 mRNA高表达组中单核细胞、巨噬细胞M2表型、活化树突状细胞显著升高（P<0.05）。免疫组化结果提示CX43蛋白高表达与1p/19q无共缺失相关,并伴CD163阳性的M2样巨噬细胞增多。结论：CX43高表达与胶质瘤1p/19q无共缺失病理分型相关,为胶质瘤不良预后因子,且可能具有诱导巨噬细胞向M2表型极化的作用。     

老年局部晚期食管癌同步放化疗与单纯放疗的疗效比较

目的：比较老年局部晚期食管癌患者采用同步放化疗（CRT）和单纯放疗（RT）的疗效和急性不良反应。方法：回顾性分析2010年1月—2016年1月于河北医科大学第四医院就诊,年龄>70岁的82例老年局部晚期食管癌患者。比较CRT和RT两个治疗组间的完全缓解率（CRR）、部分缓解率（PRR）、疾病缓解率（DCR）、无进展生存期（PFS）、总生存期（OS）和急性不良反应,并分析食管癌预后的影响因素。结果：CRT组患者的CRR （33.3%）明显高于RT组（14.5%,P=0.049）,两组之间PRR和DCR的差异无统计学意义（P=0.058,0.064）。CRT组患者的中位PFS及PFS≥1、2、3年的患者比例均显著高于RT组（P=0.007）。CRT组患者的中位OS及OS≥1、2、3年的患者比例亦显著高于RT组（P=0.012）。单因素分析显示不同治疗方案、CRR是PFS和OS的影响因素。多因素分析显示CRR为PFS的独立预后影响因素,不同治疗方案、CRR是OS的独立预后影响因素（均为P <0.05）。CRT组患者的部分急性不良反应有恶心、呕吐、白细胞减少症、血小板减少症,发生率均高于RT组（均为P <0.05）。结论：同步放化疗可作为老年局部晚期食管鳞癌患者的治疗方案,且疗效优于单纯放疗,但仍需密切关注患者的不良反应。     

晚期非小细胞肺癌病理特征及放化疗联合治疗疗效与患者血清超氧化物歧化酶的关系

目的：探讨晚期非小细胞肺癌（NSCLC）病理特征、放化疗联合治疗疗效、总生存期与患者血清超氧化物歧化酶（SOD）活力的关系。方法：采用基因表达谱数据动态分析数据库（GEPIA）分析不同肿瘤组织SOD的表达情况。收集2018年1—12月河北工程大学附属医院肿瘤科初次确诊的174例晚期NSCLC患者作为研究对象，80例健康者作为对照，放化疗联合治疗前采集患者外周血，分离血清，WST-1法检测血清中SOD活性，根据实体瘤疗效评价标准（RECIST 1.1）评估疗效，追踪随访，分析晚期NSCLC临床病理特征、放化疗联合治疗疗效、总生存期与SOD活力的关系。结果：GEPIA分析显示33类肿瘤中，19类肿瘤组织SOD表达异常，其中肺鳞状细胞癌和肺腺癌组织SOD表达较对照组显著降低（P < 0.05）；WST-1检测结果显示晚期NSCLC患者血清SOD活力显著低于对照组（P < 0.05），不同年龄、性别、病理类型患者血清SOD活力无显著性差异（P > 0.05）；不同吸烟史及病理分级患者血清SOD有显著性差异（P < 0.05），吸烟者血清SOD活力显著低于无吸烟者（P < 0.05），低分化患者血清SOD活力显著低于中、高分化者（P < 0.05）；患者血清SOD活力与放化疗联合治疗疗效呈正相关（r=0.554，P < 0.05），治疗有效患者血清SOD活力显著高于无效患者（P < 0.05），且SOD高活力组患者总生存期显著高于低活力组（P < 0.05）。结论：NSCLC患者血清SOD活性显著降低，且受患者吸烟史、病理分级的影响，可能与放化疗联合治疗疗效和总生存期有关。血清SOD或可作为评估NSCLC临床疗效和判断预后的潜在指标，辅助NSCLC放化疗的疗效判定及预后评估。     

晚期非小细胞肺癌病理特征及放化疗联合治疗疗效与患者血清超氧化物歧化酶的关系

目的：探讨晚期非小细胞肺癌（NSCLC）病理特征、放化疗联合治疗疗效、总生存期与患者血清超氧化物歧化酶（SOD）活力的关系。方法：采用基因表达谱数据动态分析数据库（GEPIA）分析不同肿瘤组织SOD的表达情况。收集2018年1—12月河北工程大学附属医院肿瘤科初次确诊的174例晚期NSCLC患者作为研究对象，80例健康者作为对照，放化疗联合治疗前采集患者外周血，分离血清，WST-1法检测血清中SOD活性，根据实体瘤疗效评价标准（RECIST 1.1）评估疗效，追踪随访，分析晚期NSCLC临床病理特征、放化疗联合治疗疗效、总生存期与SOD活力的关系。结果：GEPIA分析显示33类肿瘤中，19类肿瘤组织SOD表达异常，其中肺鳞状细胞癌和肺腺癌组织SOD表达较对照组显著降低（P < 0.05）；WST-1检测结果显示晚期NSCLC患者血清SOD活力显著低于对照组（P < 0.05），不同年龄、性别、病理类型患者血清SOD活力无显著性差异（P > 0.05）；不同吸烟史及病理分级患者血清SOD有显著性差异（P < 0.05），吸烟者血清SOD活力显著低于无吸烟者（P < 0.05），低分化患者血清SOD活力显著低于中、高分化者（P < 0.05）；患者血清SOD活力与放化疗联合治疗疗效呈正相关（r=0.554，P < 0.05），治疗有效患者血清SOD活力显著高于无效患者（P < 0.05），且SOD高活力组患者总生存期显著高于低活力组（P < 0.05）。结论：NSCLC患者血清SOD活性显著降低，且受患者吸烟史、病理分级的影响，可能与放化疗联合治疗疗效和总生存期有关。血清SOD或可作为评估NSCLC临床疗效和判断预后的潜在指标，辅助NSCLC放化疗的疗效判定及预后评估。     

汞、砷、甲醛单一及复合污染对蚕豆根尖细胞微核的影响及污染评价

目的：探讨水环境中汞、砷、甲醛及其复合污染对蚕豆根尖细胞微核的影响及污染评价。方法：以蒸馏水作为阴性对照组,50 mg/L重铬酸钾作为阳性对照组,使用不同浓度的汞（0.001~0.03 mg/L）、砷（0.01~0.3 mg/L）、甲醛（0.9~7.2 mg/L）及其组合对蚕豆进行染毒（设MIX I、MIX Ⅱ、MIX Ⅲ3组,各含4种组合）,测定蚕豆根尖细胞的微核千分率并计算污染指数。结果：单一染毒时,当水溶液中汞浓度≥0.009 mg/L、砷浓度≥0.3 mg/L、甲醛浓度≥3.6 mg/L时蚕豆根尖细胞微核千分率均高于阴性对照组,且差异均具有统计学意义（P<0.05）。复合污染中,MIX I组砷-汞、砷-甲醛组合蚕豆根尖细胞微核千分率与阴性对照组相比显著升高,而且较砷、汞、甲醛单一染毒时明显增加,差异均具有统计学意义（P<0.05）。MIX Ⅱ组和MIX Ⅲ组中4种组合的蚕豆根尖细胞微核千分率与阴性对照组相比均显著升高,并且均明显高于单一染毒时的微核千分率,差异均具有统计学意义（P<0.05）。结论：汞（≥0.009 mg/L）、砷（≥0.3 mg/L）、甲醛（≥3.6 mg/L）可诱导蚕豆根尖细胞形成微核,复合染毒诱发的微核千分率较相同剂量单一溶液染毒呈不同程度的升高,并且存在一定的量效关系。     

TAM通过PLGF/Flt-1和TGF-β1通路促进非小细胞肺癌生长和肿瘤血管异生的研究

目的 探讨胎盘生长因子(PLGF)介导非小细胞肺癌(NSCLC)细胞和肿瘤相关巨噬细胞(TAM)之间相互作用的具体机制。方法 采用尾静脉注射法将转染腺病毒(AAV)的NSCLC A549细胞注入10周龄的雄性NOD/SCID小鼠体内,构建小鼠肺癌动物模型。流式细胞技术检测瘤体内各种巨噬细胞(MΦ)亚型,RT-qPCR检测肿瘤细胞和TAM中PLGF、血管内皮生长因子受体(Flt-1)和转化生长因子β1(TGF-β1)表达水平。根据A549细胞和MΦ细胞的培养条件不同,分为单纯A549组,单纯MΦ组,A549+MΦ组,A549+MΦ+sFlt-1组(加入10 μg/L sFlt-1),PLGF+MΦ组(加入100 ng PLGF)和PLGF+MΦ+sFlt-1组(加入100 ng PLGF和10 μg/L sFlt-1)。Transwell、MTT法分别检测不同共培养条件下A549细胞的增殖和迁移能力。根据HUVEC细胞的培养条件,分为对照组、条件培养基(CM)组、CM+SB431542组、TGF-β1组和TGF-β1+SB431542组,HUVEC细胞胶原凝胶测定法检测肿瘤血管异生情况。结果 与RFP-细胞相比,PLGF主要由肿瘤细胞表达(31.72±4.69 vs. 2.31±0.06,P＜0.001),而Flt-1主要由CD163+的巨噬细胞表达(P＜0.001)。A549+MΦ组A549细胞增殖能力显著强于单纯A549组和A549+MΦ+sFlt-1组(OD值:3.62±0.23 vs. 4.53±0.34 vs. 3.71±0.37,P＜0.05)。TAM/M2巨噬细胞中TGF-β1的表达量高于M1巨噬细胞(0.99±0.23 vs. 0.07±0.02,P＜0.05)。CM组和TGF-β1组中HUVEC细胞管状结构的形成最多(P＜0.05),TGF-β1抑制剂SB431542可抑制这一现象。结论 TAM和NSCLC细胞间通过PLGF/Flt-1和TGF-β1信号通路间的交互作用,促进NSCLC的生长和血管异生。     

活性氧在异烟肼诱导L-02细胞DNA损伤中的作用及槲皮素的保护效应

目的：探讨活性氧（ROS）在异烟肼（INH）诱导的L-02细胞DNA损伤中的作用及槲皮素的保护效应。方法：将L-02细胞分为空白对照组、INH组（10 mmol/L INH）;槲皮素低剂量组（10 mmol/L INH+25 μmol/L槲皮素）;槲皮素高剂量组（10 mmol/L INH+50 μmol/L槲皮素）。细胞处理24 h后,采用彗星试验检测细胞DNA损伤情况;分别应用荧光探针DCFH-DA和Rhodamine123检测细胞ROS水平及线粒体膜电位。结果：与空白对照组比较,L-02细胞经INH和槲皮素处理后,INH组细胞尾部DNA百分含量、尾长和尾矩均显著增加（P<0.01）;与INH组相比,低和高剂量槲皮素组细胞的尾部DNA百分含量、尾长和尾矩均明显减少（P<0.05或P<0.01）。INH组细胞线粒体ROS水平比空白对照组显著升高（P<0.01）;而低和高剂量槲皮素组细胞线粒体ROS水平比INH组明显降低（P<0.05或P<0.01）。INH组细胞线粒体膜电位显著低于空白对照组（P<0.01）,而低和高剂量槲皮素组细胞线粒体膜电位明显高于INH组（P<0.05或P<0.01）。结论：INH能诱导L-02细胞DNA损伤,ROS介导的线粒体损伤在INH诱导L-02细胞DNA损伤的过程中发挥了重要作用;槲皮素对INH诱导L-02细胞DNA损伤具有保护效应,可能与其抑制ROS介导的线粒体损伤有关。