原发性肝癌伴肝外恶性肿瘤32例临床分析

目的探讨原发性肝癌(primary liver cancer,PLC)伴肝外恶性肿瘤(extra hepatic malignant carcinoma,EHM)的临床特点。方法回顾性分析1994年1月至2003年12月江苏省高邮市人民医院及复旦大学附属中山医院经手术切除并病理证实的PLC伴EHM32例的临床资料。结果肝肿瘤直径1·5~14·5cm,≤5·0cm15例。HBsAg( )24例,抗HCV( )2例,AFP>20μg/L15例,伴明显肝硬化23例。入院前误诊11例。随访5年存活率为47·1%,以PLC为第二原发癌(异时性)20例,5年存活率为64·9%,PLC与EHM同时性发生12例,5年存活率为0。结论(1)PLC伴EHM具有PLC的基本特点。(2)异时性PLC伴EHM预后明显优于同时性。(3)PLC与EHM相伴使PLC易误诊为转移性肝癌。     

Peritoneal Carcinoembryonic Antigen Level for Predicting Locoregional and Distant Spread of Gastric Cancer

Purpose Peritoneal recurrence is not an uncommon cause of death after surgery for gastric cancer, even after surgery with curative intent. This indicates that there is undetected residual disease in the peritoneal cavity. We conducted this study to determine the value of peritoneal and serum carcinoembryonic antigen (CEA) levels and peritoneal washing cytology in predicting the locoregional and distant spread of gastric cancer. Methods We prospectively evaluated 70 consecutive patients with gastric cancer by measuring peritoneal CEA (pCEA) and serum CEA (sCEA) levels and peritoneal washing cytology results, and studying their effect on the histopathologic properties. The effect of the pCEA level on disease-free survival (DFS) and overall survival (OS) was also evaluated in patients treated with curative intent. Results Twenty-one (30%) patients had sCEA levels >10 ng/ml, whereas 25 patients (35.7%) had pCEA levels >10 ng/g protein and 26 patients (37.1%) had positive cytology. The pCEA levels were significantly higher in patients with hepatic metastases (P = 0.034), or serosal (P = 0.028), and peritoneal (P = 0.026) involvement, whereas the sCEA levels were significantly higher only in patients with hepatic metastases (P = 0.04). Similarly, positive cytology was mainly detected in patients with hepatic metastases (P = 0.004). The pCEA levels significantly affected DFS (P = 0.002) and OS (P = 0.01) in 34 patients treated with curative intent. Conclusion Since pCEA levels are more useful for predicting locoregional recurrence, their measurement during surgery may help plan the most appropriate surgical strategy and adjuvant therapy.     

The effect of interleukin-10 on acute pancreatitis induced by cerulein in a rat experimental model.

To investigate whether interleukin-10, a potent anti-inflammatory cytokine, could have a therapeutic effect on rats on that were made pancreatitis by cerulein. Thirty Wistar Albino rats were randomized into sham, pancreatitis, and therapy groups (n = 10 in each). Nothing was applied to the sham group; pancreatitis by inject-ing cerulein (50 micro/g/kg/h) was induced in the pancreatitis and therapy groups. Interleukin-10 (10.000 U) was injected at 1 and 4 h after pancreatitis inductions in the therapy group. The rats were sacrificed at postoperative hour 24. The following parameters were investigated: the leukocyte count, blood glucose, amylase, lipase and tumor necrosis factor-alpha levels in the blood samples; histopathological search, and wet/dry weight ratios of the pancreas tissues. The ratio of wet/dry pancreatic tissue weight, serum tumor necrosis factor-alpha, amylase and lipase lev-els, and histologic damage scores in the pancreatitis and therapy groups were significantly higher when they were compared with the sham group(p < .01). However, all of these values were significantly lower in the therapy groups than in the pancreatitis group (p < .01). Interleukin-10 decreases pancreatic tissue injury induced by cerulein-induced pancreatitis in rats. Nevertheless, more experimental studies are needed to compare endogenous interleukin-10 with exogenous interleukin-10 effects before clinical usage of this drug.     

左归降糖舒心方含药血浆对ox-LDL诱导小鼠巨噬细胞泡沫化和凋亡的影响

目的?探讨左归降糖舒心方含药血浆对氧化低密度脂蛋白（ox-LDL）诱导巨噬细胞泡沫化和凋亡的影响及其作用机制。方法?将巨噬细胞J774A.1随机分为正常组、模型组、牛磺熊去氧胆酸（TUDCA）组、左归降糖舒心方含药血浆组、西药联合含药血浆组,每组5个复孔。除正常组外其余各组以ox-LDL（100?mg/L）处理构建巨噬细胞泡沫化模型。正常组和模型组正常培养,其余各组分别用10%相应含药血浆培养24?h。CCK-8法比较各组J774A.1细胞增殖情况,计算细胞抑制率;油红O染色检测细胞内脂质蓄积水平;Western blot检测双链RNA样内质网激酶（PEPK）、活化转录因子4（ATF4）、真核翻译起始因子2α（eIF2α）、C/EBP环磷酸腺苷反应元件结合转录因子同源蛋白（CHOP）及半胱氨酸蛋白酶蛋白-12（Caspase-12）的表达水平。结果?与正常组比较,模型组细胞抑制率增高,在ox-LDL浓度为100?mg/L时细胞抑制率为（50.06±0.09）%,有明显的脂质颗粒蓄积（P<0.01）。与模型组比较,各药物干预组细胞抑制率降低,可有效阻断ox-LDL的摄入及脂质堆积,其中左归降糖舒心方含药血浆组优于西药联合含药血浆组,与TUDCA组作用效应相当。ox-LDL可诱导细胞内质网应激相关蛋白p-PERK、p-eIF2α、ATF4、CHOP与Caspase-12表达上调。左归降糖舒心方含药血浆可显著抑制100?mg/L ox-LDL所致的p-PERK、p-eIF2α、ATF4的上调,降低内质网相关凋亡蛋白CHOP与Caspase-12的表达（P<0.01）,和TUDCA组作用相当(P＞0.05),其效果较西药联合含药血浆组明显（P<0.01）。结论?左归降糖舒心方含药血浆能有效改善ox-LDL诱导的巨噬细胞泡沫化、细胞凋亡及内质网应激状态,其作用机制可能与调控内质网应激信号通路PERK/eIF2α/ATF4通路,降低细胞内CHOP与Caspase-12表达有关。      

NF⁃κB p65调控IRF⁃8基因启动子活性及其启动子结合元件的初步鉴定

目的：探讨大鼠核因子?κB（nuclear factor?κB,NF?κB）p65亚基在细胞内过表达和其活性变化对干扰素调节因子?8（interferon regulatory factor?8,IRF?8）基因启动的影响,并初步筛查IRF?8启动子上可能的p65结合元件。方法：采用聚合酶链式反应（polymerase chain reaction,PCR）技术扩增大鼠p65基因蛋白编码区（complete sequence coding,CDS）序列,将其插入到空载pIRES2?EGFP质粒中,构建大鼠野生型（wild type,WT）p65过表达质粒（pIRES2?p65 WT）。在此基础上,将p65第535位丝氨酸（serine,S）突变为天冬氨酸（aspartic,D）或丙氨酸（alanine,A）,分别构建p65持续活化突变型质粒（pIRES2?p65 S535D）和p65显性负性突变型质粒（pIRES2?p65 S535A）。之后应用生物信息学软件预测IRF?8基因启动子区p65的结合元件,并据此构建IRF?8启动子全长（full?length,FL）和3个截短的荧光素酶报告质粒,即pGL3?IRF?8?FL（-1 892 ~ +174 nt）、pGL3?IRF?8?1（-1 360 ~ +174 nt）、pGL3?IRF?8?2（-752 ~ +174 nt）和pGL3?IRF?8?3（-68 ~ +174 nt）。将上述质粒行不同组合共转染人胚肾293T（human embryonic kidney 293T,HEK?293T）细胞,Western blot和荧光素酶实验分别检查p65的表达和IRF?8的启动子活性,并分析IRF?8启动子区可能的p65结合元件。结果：菌液PCR及测序证实上述质粒构建成功。分别将pIRES2?p65 WT、pIRES2?p65 S535D、pIRES2?p65 S535A和pGL3?IRF?8?FL共转染HEK?293T,发现过表达pIRES2?p65 WT或pIRES2?p65 S535D均可明显增加IRF?8启动子活性,且以pIRES2?p65 S535D更为显著;而过表达pIRES2?p65 S535A后,IRF?8启动子活性无明显变化。将pGL3?IRF?8?FL、pGL3?IRF?8?1~3和pIRES2?p65 S535D共转染HEK?293T后发现,pGL3?IRF?8?3的启动子活性显著低于pGL3?IRF?8?FL、pGL3?IRF?8?1和pGL3?IRF?8?2,提示大鼠IRF?8启动子-752~68 nt区域可能存在p65结合元件。结论：在HEK?293T细胞内过表达野生型或持续活化突变型p65可显著促进IRF?8基因的启动,且p65与IRF?8启动子的结合元件可能位于-752~-68 nt部位。     

基于智能规则的医院检查预约平台应用研究

以上海市胸科医院为例,从总体架构、智能规则库、模型构建和计算等方面阐述基于智能分配规则的医院检查预约平台建设,选取对照组和观察组对平台使用前后预约情况进行对比,结果表明该平台有助于缩短检查等候时间,优化检查预约流程,提升患者满意度。     

艾灸合暖宫贴干预寒湿凝滞型痛经的临床观察

目的探讨艾灸合暖宫贴对寒湿凝滞型痛经女大学生痛经症状、疼痛程度和睡眠质量的影响。方法选择寒湿凝滞型痛经女大学生80例,随机分为西药组和艾灸合暖宫贴组,每组40例,共观察4个月经周期。采用中医痛经症状评分、疼痛视觉模拟评分(visual analogue scale,VAS)和匹兹堡睡眠质量指数评分(Pittsburgh sleep quality index,PSQI),评定患者治疗前、第3个月经周期(治疗期间)、第4个月经周期(停止治疗)的痛经症状、疼痛程度和睡眠质量的变化情况。结果治疗后的第3个月经周期,两组的中医痛经症状评分、VAS评分和PSQI评分均较前明显下降(P<0.05)。第4个月经周期,停止治疗后,西药组的中医痛经症状评分、VAS评分较第3个月经周期上升(P<0.05),但较治疗前评分降低(P<0.05);艾灸合暖宫贴组中医痛经症状评分、VAS评分和PSQI评分与西药组比较,差异有统计学意义(P<0.01)。结论艾灸合暖宫贴可以改善寒湿凝滞型痛经女大学生的痛经症状、疼痛程度和睡眠质量,疗效具有持久性,值得推广应用。     

金樱根质量控制方法提升研究及等级评价体系的建立

目的 提升金樱根药材的质量控制方法,对其进行安全性分析与等级评价.方法 对现行质量标准进行总结,改进薄层鉴别方法,建立特征图谱,并对含量测定方法进行研究;采用电感耦合等离子体质谱法测定其铅、镉、砷、汞、铜的残留量;利用SPSS统计软件对其进行聚类分析.结果 TLC鉴别方法各斑点清晰,分离度良好,可以区分真伪,建立的特征...     

不同炮制方法对黄药子抗胃癌作用及其肝毒性的影响

目的 评价不同炮制方法对黄药子抗胃癌作用及其肝毒性的影响.方法 80只小鼠随机分为空白对照(Ct)组、黄药子生品(RD)组、清炒黄药子(FD)组、酒炙黄药子(WD)组、当归煎汤炙黄药子(2:1)(ASR2:1 DB)组、黄芪煎汤炙黄药子(1:2)(AR1:2DB)组、黄芪煎汤炙黄药子(1:1)(AR1:1 DB)组、黄...