非小细胞性肺癌中P-gp表达与CD147、MMPs表达的关系

目的 研究肿瘤细胞自然状态下耐药时,肿瘤细胞多药耐药与转移的关系。方法 选取112例未经化疗的非小细胞性肺癌手术切除标本,用免疫组织化学染色观察P-gp、CD147、MMP-1、MT1-MMP的蛋白表达,分析各指标之间的关系。结果 人肺癌组织中P-gp的表达与CD147、MMP-1、MT1-MMP具有明显的一致性,CD147、MMP-1、TM1-MMP在腺癌中表达高于鳞癌,且与淋巴结转移相关。结论 非小细胞性肺癌自然状态下耐药时,P-gp与CD147、MMPs等肿瘤浸润、转移相关蛋白的表达之间可能存在着共同的调节机制。CD147对MMPs的调节,可能与多药耐药肿瘤的浸润、转移特性有关。     

CD147与肿瘤关系的研究进展

细胞外基质金属蛋白酶诱导因子,又名CD147,此因子为一类跨膜糖蛋白,在体内若干类生理与病理反应中大量表达。目前,人们正在对肿瘤侵袭和转移的发生机制进行多水平及途径的研究,国内外已有许多研究表明,CD147在多种恶性肿瘤中表达活跃。恶性肿瘤的侵袭和转移过程病理机制复杂,其中,在CD147诱导作用下,会形成MMPs,后者所导致的细胞基底膜降解,与CD147所参与的肿瘤细胞代谢以及血管重建,均同恶性肿瘤转移与侵袭呈现出密切的关系,因而CD147已成为肿瘤治疗的一个新靶点,为恶性肿瘤的早期诊断、临床治疗以及预后评估提供新的标准及理念。现就CD147在肿瘤发生发展中的作用做一综述。     

CD44与胶质瘤

恶性肿瘤具有无限制生长、浸润和转移的特性，肿瘤的浸润和转移与肿瘤细胞之间、肿瘤细胞与胞外基质的相互作用有关。近年来，关于细胞粘附分子在肿瘤的浸润和转移中的作用，以及针对细胞粘附分子的基因治疗已经取得了很大进展。CD44作为粘附分子家族中的一员，研究得最为广泛。本文就CD44最新研究进展及其与胶质瘤的关系综述如下。     

CD147与肿瘤关系研究现状

CD147是一种广泛表达于人体多种组织的跨膜糖蛋白,属于免疫球蛋白超家族,参与机体多种生理和病理过程.CD147在多种肿瘤组织中高表达,可促使肿瘤细胞侵袭、转移,诱导肿瘤血管生成,促进糖酵解,并且参与调节肿瘤细胞的自噬,已成为肿瘤治疗的一个新靶点.现就CD147在肿瘤发生发展中的作用做一综述.     

CD147在肿瘤发生及转移中的作用研究进展

CD147是一种广泛表达于人体多种组织的跨膜糖蛋白,属于免疫球蛋白超家族,参与机体多种生理和病理过程。CD147在多种肿瘤组织中高表达,可促使肿瘤细胞侵袭、转移、锚着非依赖性生长,并诱导肿瘤血管生成,已成为肿瘤治疗的一个新靶点。现就CD147在肿瘤发生发展中的作用做一综述。     

CD_(147)与甲状腺癌的研究进展

CD_(147)在恶性肿瘤的发生、发展过程中起重要作用,其不仅影响肿瘤的浸润及转移,同时对肿瘤细胞能量代谢方式亦有一定的影响。甲状腺癌作为最常见的恶性内分泌腺癌,其发病率呈逐年上升趋势。因此,迫切需要寻找一个研究甲状腺癌的新方向,为其临床诊断、治疗及预后提供新方案。而CD_(147)参与了甲状腺癌的生长、转移及预后等,所以研究其与甲状腺癌的关系,为甲状腺癌的靶向治疗方面带来了新的曙光。     

CD147和CD44v6在甲状腺乳头状癌中表达及其与侵袭转移的意义

目的探讨CD147和CD44v6在甲状腺乳头状癌(PTC)中的表达及其与肿瘤浸润转移的关系。方法采用免疫组化SP法检测CD147和CD44v6在80例甲状腺乳头状癌、30例甲状腺腺瘤和20例正常甲状腺组织中的表达。结果 PTC中CD147和CD44v6的阳性表达率为46.3%和76.3%,显著高于甲状腺腺瘤的13.3%和23.3%,正常甲状腺组织均阴性表达;腺外浸润组CD147和CD44v6的阳性表达率分别为53.3%和83.3%,显著高于无浸润组的25%和55%;淋巴结转移组CD147和CD44v6的阳性表达率分别为58.9%和83.9%,显著高于无转移组的16.7%和58.3%。CD147和CD44v6的阳性表达与PTC浸润与转移呈正相关(=0.282,<0.05)。结论 CD147和CD44v6在促进PTC的浸润与转移中呈互补作用,二者联合检测对甲状腺癌的诊断以及肿瘤浸润转移的判断和预后评估有重要的参考价值。     

肿瘤相关中性粒细胞蛋白酶在肿瘤增殖、侵袭及转移病机中的作用

炎性微环境与肿瘤发生、发展关系十分密切。近年研究发现,肿瘤微环境中存在大量中性粒细胞浸润现象,即肿瘤相关中性粒细胞(TANs),深入研究证实TANs不仅参与肿瘤炎性微环境的形成和维持,而且广泛涉及肿瘤病理过程。TANs合成分泌大量蛋白酶,与肿瘤细胞增殖、侵袭、转移和新生血管形成密切相关;其中弹性蛋白酶主要参与肿瘤的增殖过程;组织蛋白酶与肿瘤的转移、侵袭和血管组织重塑密切相关基质金属蛋白酶调控肿瘤血管生成和转移。对TANs及其蛋白酶的深入研究可为肿瘤病理机制提供新的认识,而以蛋白酶为靶点来调控、抑制肿瘤细胞生长,可能成为干预肿瘤发生、发展的重要方法。     

CD_(147)与MMP-2和MMP-9在乳腺癌中的研究进展

CD147被称为细胞外基质金属蛋白酶(MMPs)诱导因子,可诱导周围细胞表达并分泌MMPs,而MMPs可降解细胞外基质,两者共同参与肿瘤细胞之间、肿瘤细胞和基质细胞之间的相互作用,促进肿瘤的侵袭与转移。MMPs家族中又以MMP-2、MMP-9与乳腺癌关系最为密切,故该文主要针对MMP-2、MMP-9及其诱导因子CD147在乳腺癌发生、发展中的作用以及以CD147和MMPs为靶点的抗肿瘤治疗的相关研究进展予以综述。     

肿瘤微环境中间质细胞对肿瘤的作用

肿瘤微环境中存在大量的间质细胞,如炎性细胞、内皮细胞、脂肪细胞、肿瘤相关成纤维细胞等,这一系列的细胞与肿瘤细胞相互作用,分泌多种细胞因子,在促进肿瘤细胞生长、增殖的同时,也为肿瘤细胞的侵袭转移及逃避机体免疫系统的攻击提供了必要的条件。明确肿瘤与微环境尤其是间质细胞的关系,进而明确在肿瘤发生、发展、转移过程中发挥重要作用的关键分子,寻找其相对应的靶点,对于肿瘤的诊断及治疗具有重要的意义。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.