γ干扰素和内皮抑素双基因-放射治疗的体内抑瘤效应及其机制

目的探讨γ干扰素和内皮抑素双基因-放射治疗在荷Lewis肺癌小鼠的体内抑瘤效应及其机制。方法小鼠肿瘤局部注射脂质体包裹的质粒后36h，接受5Gy X射线照射，观察各组小鼠照射后不同时间肿瘤生长速率和平均存活时间；照射后第15天检测各组小鼠脾脏CTL、NK细胞毒活性和腹腔巨噬细胞TNFα分泌活性，照射后第10天用免疫组化法检测肿瘤组织微血管密度。结果基因-放射治疗后第6～18天，双基因-放射治疗组小鼠肿瘤生长速率明显低于对照组、单纯放疗组及单基因-放射治疗组，且平均生存时间明显延长。治疗后第12～18天，4次（双基因质粒＋2．5Gy）组肿瘤生长速率明显低于双基因质粒＋10Gy组，且平均生存时间明显延长。照射后第15天双基因-放射治疗组小鼠脾脏CTL、NK细胞毒活性和腹腔巨噬细胞TNFα分泌活性均明显高于对照组、单纯放疗组及内皮抑素单基因-放射治疗组，肿瘤组织微血管密度明显低于对照组、单纯放疗组及γ干扰素单基因-放射治疗组。结论双基因-放射治疗抑瘤效应明显优于单基因-放射治疗，其机理可能与辐射诱导γ干扰素和内皮抑素表达，提高机体抗肿瘤免疫功能和抗肿瘤血管生成作用有关。多次小剂量双基因-放射治疗的抑瘤效应优于单次大剂量双基因-放射治疗。     

pcEgr-IFNγ基因治疗联合放射治疗抗肿瘤作用的实验研究

目的：探讨pcEgr-IFNγ基因－放射联合治疗对修黑色素瘤B16小鼠的抗肿瘤作用及其免疫学机理。方法：肿瘤局部注射脂质体包裹的pcEgr-IFNγ重组质粒后36h,接受20GyX射线照射,观察放疗后不同时间肿瘤大小,放疗后3d瘤内IFNγ转录水平和15d部分免疫学指标。结果pcEgr-IFNγ基因－放射联合治疗后第3－15天,肿瘤生长速率明显低于单纯照射组,照第第9－15天明显低于单纯基因治疗组和空质料对照组;治疗后第3天,pcEgr-IFNγ基因－放射联合治疗组瘤内IFNγ表达水平明显高于单纯基因治疗组;脾脏NK毒胞毒活性、IL－2和IFNγ分泌活性均明显高于单纯放疗组和单纯基因治疗组。结论：pcEgr-IFNγ基因－放射联合治疗抗肿瘤作用明显优于单纯放疗和单纯基因治疗组,其机理可能与放疗诱导瘤内IFNγ基因表达增强,激活荷瘤机体抗肿瘤免疫功能有关。     

pEgr-ssEndostatin重组质粒瘤内辐射诱导表达及其抗肿瘤作用

目的 观察pEgr-ssEndostatin基因-放射治疗对移植黑色素瘤B16小鼠的抗肿瘤作用及其在瘤内辐射诱导表达。方法 肿瘤局部注射脂质体包裹的pEgr-ssEndostatin重组质粒后42h，接受20Gyx射线照射，观察放疗后不同时间肿瘤大小，检测放疗后第2天瘤内Endostatin转录水平。结果 pEgr-ssEndostatin基因-放射治疗荷瘤小鼠能够增强放疗疗效；单纯接种pEgr-ssEndostatin质粒组和接种pEgr-ssEndostatin质粒 20Gy照射组小鼠的肿瘤组织内有Endostatin mRNA表达，且pEgr-ssEndostatin质粒照射组的EndostatinmRNA水平高于单纯pEgr-ssEndostatin质粒组。结论 pEgr-Endostatin基因-放射治疗抗肿瘤作用明显优于单纯放疗和单纯基因治疗，肿瘤局部转染重组质粒后照射瘤内Endostatin表达增强。     

CpG ODN联合光动力疗法对肝癌移植瘤生长及局部CD8+细胞毒性T细胞的影响

目的 探讨以CpG寡脱氧核苷酸(ODN)为免疫佐剂联合光动力疗法(PDT)的光免疫疗法(PIT)对小鼠Heps肝癌移植瘤的抗肿瘤及免疫效应.方法 92只ICR小鼠皮下接种肝癌Heps细胞建立荷瘤鼠模型,随机分为对照组、PDT组、CpG ODN组和PIT组,治疗后定期测量各组肿瘤体积,计算抑瘤率.免疫组化法计数肿瘤局部CD8+细胞毒性T细胞(CD8+CTLs).结果 (1)与埘照组相比,PDT组、CpG ODN组和PlT组治疗后16d肿瘤体积均明显缩小(P<0.01),抑瘤率分别为73.88%、20.09%、84.47%.PIT组肿痛体积较单纯PDT组明显缩小(P<0.05).(2)免疫组化染色结果显示,PDT组、CpG ODN组和PIT组治疗后2、24h肿瘤局部CD8+CTLs数量较对照组无明显变化(P>0.05),治疗后72h肿瘤局部CD8+CTLs数量,均明显高于对照组(P<0.05);PIT组肿瘤局部CD8+CTLs数量明显高于单纯PDT组(P<0.01).结论 CpG ODN能激活宿主免疫应答而有效增强PDT对小鼠Heps肝癌移植瘤的抗肿瘤及免疫效应.     

光动力疗法及其联合注射卡介苗对小鼠肝癌移植瘤的抑瘤作用与免疫反应

目的探讨光动力疗法(PDT)联合肿瘤局部注射卡介苗(BCG)的局部免疫反应及抑瘤效应。方法建立小鼠Heps肝癌移植瘤模型96只,随机分为对照组、PDT组、BCG组和PDT+BCG联合组。观测各组移植瘤体积的变化。以F4/80抗体为标记,采用免疫组化法计数肿瘤局部巨噬细胞(MΦ)数量。结果 1.各治疗组治疗后7 d的移植瘤体积较对照组均明显缩小(P<0.01)。联合组治疗后7 d的肿瘤体积较单纯PDT组明显缩小(P<0.05)。2.免疫组化染色结果显示,PDT组和联合组治疗后2、24 h和7 d肿瘤局部MΦ数量均明显高于对照组和BCG组(P<0.01)。上述时间点联合组肿瘤局部MΦ数量明显高于PDT组(P<0.05)。结论 PDT使小鼠肝癌移植瘤体积缩小,增强荷瘤宿主治疗局部的免疫力。PDT联合局部注射BCG的治疗方法的疗效优于单纯PDT和单纯BCG。     

低剂量辐射增强小鼠肿瘤基因-放射治疗效应的免疫学机制研究

目的 探讨低剂量辐射全身照射对小鼠Lewis肺癌移植肿瘤基因-放疗方案中的免疫增强作用机制。方法 小鼠右后肢皮下接种Lewis肺癌细胞建立荷瘤模型,基因-放疗组中小鼠肿瘤局部注射由多聚乙烯亚胺包裹的pEgr-IL18-B7.1重组质粒,分别接受由2 Gy 局部照射和0.075 Gy 全身照射组合的不同治疗方案,通过³H-TdR标记方法检测小鼠CTL和NK细胞毒活性,ELISA方法检测TNF-α和IFN-γ分泌活性,观察各治疗组对荷瘤小鼠抗肿瘤免疫的作用。结果 在pEgr-IL18-B7.1基因治疗方案中,单次大剂量辐射局部照射后加多次低剂量全身照射与常规多次大剂量辐射局部照射相比,小鼠CTL和NK细胞毒活性显著增强,TNF-α和IFN-γ分泌活性有不同程度的增高。 结论 低剂量辐射可以通过促进CTL和NK细胞毒效应,上调TNF-α和IFN-γ细胞因子表达,从而增强机体抗肿瘤免疫功能,提高肿瘤基因-放疗的抑瘤效果。     

Egr-IFNγ基因治疗联合125I-脱氧尿嘧啶核苷治疗抑瘤效应的实验研究

目的 探讨Egr-IFNγ基因治疗联合放射性核素 ¹²⁵I -脱氧尿嘧啶核苷治疗方案在荷H22肝癌细胞小鼠体内抑瘤效应及机制。方法 小鼠肿瘤局部注射脂质体包裹的质粒,注射后48 h,肿瘤局部注射370kBq ¹²⁵I -UdR。观察各组小鼠治疗后不同时间肿瘤生长率;治疗后第3 天,检测肿瘤胞浆蛋白中IFNγ的表达和脾脏CTL细胞毒活性。结果 基因-放射核素治疗后第6～15天,pcDNAEgr-IFNγ+ ¹²⁵I -UdR组肿瘤生长率明显低于对照组、 ¹²⁵I -UdR组及pcDNAEgr-1+ ¹²⁵I -UdR 组;基因-放射性核素治疗后第3天,pcDNAEgr-IFNγ+ ¹²⁵I -UdR组肿瘤胞浆蛋白中可检测到IFNγ的表达,其余组肿瘤胞浆蛋白中未检测到IFNγ的表达;pcDNAEgr-IFNγ+ ¹²⁵I -UdR组小鼠脾脏CTL细胞毒活性明显高于其余组 (P<0.01)。结论 pcDNAEgr-IFNγ基因治疗联合放射性核素 ¹²⁵I -UdR治疗抑瘤效应明显优于单纯 ¹²⁵I -UdR放射性核素治疗。     

pEgr-IFNγ重组质粒辐射诱导表达及其抑瘤作用的实验研究

目的 探讨pEgr-IFNγ重组质粒在接种B16黑色素瘤小鼠体内的辐射诱导表达及其抑瘤效应。方法 小鼠肿瘤局部注射脂质体包裹的重组质粒pEgr-IFNγ后36h，接受不同剂量X射线照射，观察各组小鼠照射后不同时间肿瘤生长速率和平均存活时间，照射后第3天用RT-PCR法检测瘤内IFNγ转录水平，照射后第l，3和5天用ELISA法检测小鼠血清中IFNγ含量。结果 照射后第3天重组质粒 20Gy组瘤内IFNγ转录水平明显高于重组质粒组；照射后第l，3天血清中IFNγ含量明显高于重组质粒组和对照组；照射后第9-15天，4次(质粒 5Gy)组小鼠肿瘤生长速率明显低于重组质粒 20Gy组，且平均生存时间明显延长。结论 多次基因-较小剂量放射治疗的抑瘤效应优于单次基因．较大剂量放射治疗；基因-放射治疗组可能通过诱导瘤内IFNγ表达增强，使血液中IFNγ浓度升高，从而提高荷瘤机体免疫功能和抗肿瘤能力。     

重组腺病毒mIκBα基因联合γ射线治疗肝细胞癌的实验观察

目的 探讨重组腺病毒mIkBα基因（AdmIkBα）联合γ射线对人高转移性肝细胞癌HCC9204细胞和裸鼠HCC9204移植瘤生长的影响。方法利用有限稀释法测定病毒滴度，以不同感染复数（MOI）的AdIxBαm（10、20、30、50）转染HCC9204细胞，Westemblotting法检测转染前后细胞1：）65表达和mIxBa表达。采用4Gyγ射线对各组细胞进行治疗。MTT法检测转染组、转染组＋放射组、对照组细胞生长抑制率。建立裸鼠HCC9204肝癌动物模型，肿瘤局部注射AdmIkBα30MOI并联合6Gyy射线治疗，在不同时间测量肿瘤体积。结果病毒滴度1．252×10^9pfu／ml。mIkBa蛋白随AdmlteBa剂量增加而进行性增加，P65蛋白随AdmIkBα剂量的增加呈进行性递减。转染组体外细胞生长随AdmIkBα剂量的增加逐渐受抑制，经7射线照射后生长抑制更加明显。AdmIkBα转染和放射联合治疗后7～28d，裸鼠肿瘤生长速率明显低于单纯照射组、单纯转染治疗组。结论AdmIkBα转染联合Y射线治疗可增强对肝痛细胞杀灭作用．联合治疗明品优于单纯放疗组和单纯基因治疗组。     

肿瘤相关抗原肽与低剂量全身照射的协同抑瘤作用

目的观察低剂量X射线照射对小鼠肝癌H-22细胞膜相关抗原肽(TAP)提取物的抑瘤作用及免疫学功能的影响,为低剂量辐射(LDR)与肿瘤疫苗联合治疗肿瘤提供实验依据。方法采用微酸洗脱法制备相对分子质量≤3×106的细胞膜TAP提取物,先给予小鼠75mGyX射线全身照射,12h后以TAP提取物皮下免疫小鼠,检测脾细胞CD3、CD69和TCRαβ表面标记、脾T细胞亚组百分数的变化、脾细胞ConA反应性、IL-2和IFN-γ活性、CTL杀伤活性的变化及抑瘤效应。结果小鼠经TAP提取物免疫后,移植肿瘤的发生率降低,肿瘤平均出现时间延迟,生长速度减慢;脾细胞CD3分子和CD69分子的表达显著升高,脾细胞ConA反应性、IFNγ分泌活性和CTL杀伤活性显著增强,IL-2分泌增多。而同时给予LDR的小鼠不仅上述功能不同程度增强,脾CD8+细胞百分数显著增高。结论LDR与细胞膜TAP具有协同抑瘤作用,细胞免疫力的明显增强可能为其机制之一。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.