伽玛刀联合立体定向手术治疗颅内囊性肿瘤

目的探讨立体定向穿刺抽吸手术与伽玛刀联合治疗颅内囊性肿瘤在立体定向放射外科治疗中的作用。方法分析颅内囊性肿瘤40例,单纯立体定向穿刺抽液19例,留置Ommaya囊抽液19例,内窥镜下手术切除肿瘤并排除囊液2例。肿瘤体积缩小后再行立体定向磁共振成像（MRI）定位、伽玛刀治疗,并计算抽液前后肿瘤体积的变化。依据Logistic综合方程计算抽液前后风险概率的变化,将抽液前后的肿瘤体积和风险概率进行配对t检验。结果抽液后瘤囊完全消失,病灶体积明显缩小。抽液前后肿瘤容积和风险概率均显著降低（容积变化：t＝8.108,P＜0．001;风险概率：t＝5．933,P＜0．001）。随访时间6个月～42个月,平均17.5个月。经伽玛刀治疗后,瘤结节消失10例,缩小12例,无变化17例,增大1例。结论颅内囊性肿瘤立体定向穿刺抽液后肿瘤体积缩小,使立体定向放射外科治疗并发症的风险概率显著降低,是联合伽玛刀治疗囊性肿瘤一种有效方法;针对肿瘤病理类型的不同采用伽玛刀放射外科联合单纯穿刺或置管抽取囊液、结合囊内治疗是囊性肿瘤治疗成功的关键。     

改良颏帽牵引矫治早期骨性反的体会

改良颏帽牵引矫治早期骨性反■的体会青岛市李沧区医院（２６６０４１）吴爱芳，康春生近年来，我们采用改良颏帽牵引的方法矫治１３例早期骨性反患者，效果较好。现报告如下。临床资料：本组年龄５～１０岁，平均７岁。其中乳牙反５例，混合牙反８例；３例有反家族史。Ｘ...     

脑胶质瘤中miR-21以及EGFR信号通路异常表达的相关性研究

目的 探讨不同病理级别国人脑胶质瘤中miR-21表达;miR-21编码基因扩增与突变;miR-21与EGFR信号通路关键成员表达关系.方法 荧光实时定量PCR法和荧光原位杂交法测定不同病理级别人脑胶质瘤标本中miR-21表达;半定量PCR法检测miR-21编码基因拷贝数并测序PCR产物;免疫组织化学染色法检测胶质瘤标本EGFR、pAKT和PTEN表达水平.结果 荧光实时定量PCR与荧光原位杂交miR-21表达随着胶质瘤病理级别的升高而增加(F=35.516;P=0.000);不同病理级别中人脑胶质瘤中miR-21编码基因拷贝数差异无统计学意义(F=1.219;P=0.305);miR-21表达与EGFR(rs=0.710,P=0.000)、pAKT(rs=0.638,P=0.000)表达呈正相关,与PTEN表达呈负相关(rs=-0.286,P=0.027).结论 miR-21在国人脑胶质瘤中过表达且与EGFR信号通路关键成员表达相关.     

靶向性蛋白激酶B1和环氧合酶-2 shRNA腺病毒载体的构建和在人胃癌细胞的表达

Objective To construct a short hairpin RNA (shRNA) adenovirus vector targeting protein kinase BI (PKB1/Akt1) and cyclooxygenase-2 (COX-2) and observe their expression in human gastric carcinoma cell line SGC-7901. Methods Akt1 and COX-2 shRNA expression frames were sub-cloned to pGSadeno adenovirus vector by homologous recombination technology to construct pGSadeno-Aktl + COX-2 ( pGSadeno-A + C) vector. Furthermore after screening and amplification,recombinant ade-novirus vector was digested with Pacl and transfected into HEK293 cells. The replication adenovirus rAd5-A + C was packed and amplified in the HEK293 cells, and its titer was detected. After human SGC-7901 cells in vitro were transfected by rAd5-A + C,Akt1 and COX-2 mRNA and protein expression levels were detected by real-time PCR and Western blot respectively. Compared with rAdS-A + C,SGC-7901 and gen-eral rAd5-HK were selected as the negative controls. Results The recombinant adenovirus rAd5-A + C was constructed successfully and its titer reached 1.0 ×1010 pfu/ml. Aktl and COX-2 mRNA expression was downregulated significantly, and their ACt values ( 12.26±0.05 and 5.41±0.09 respectively ) were higher than rAd5-HK group (10.63±0.02 and 3.75 +0.08 respectively) and control group (10.57± 0.02 and 3.73±0.08 respectively) (P <0.01 ). There was no significant difference between rAd5-HK and control groups (P >0.05). Aktl and COX-2 protein expression was downregulated by 70.5% and 63.7% respectively ( P < 0.01 ) in rAd5-HK group as compared with control group ( P > 0.05 ). Conclu-sion The shRNA aclenovirus vector targeting Akt1 and COX-2 can specifically inhibit Akt1 and COX-2 expression,and this may be a new strategy in gastric carcinoma gene therapy targeting Akt1 and COX-2.     

靶向性蛋白激酶B1和环氧合酶-2 shRNA腺病毒载体的构建和在人胃癌细胞的表达

Objective To construct a short hairpin RNA (shRNA) adenovirus vector targeting protein kinase BI (PKB1/Akt1) and cyclooxygenase-2 (COX-2) and observe their expression in human gastric carcinoma cell line SGC-7901. Methods Akt1 and COX-2 shRNA expression frames were sub-cloned to pGSadeno adenovirus vector by homologous recombination technology to construct pGSadeno-Aktl + COX-2 ( pGSadeno-A + C) vector. Furthermore after screening and amplification,recombinant ade-novirus vector was digested with Pacl and transfected into HEK293 cells. The replication adenovirus rAd5-A + C was packed and amplified in the HEK293 cells, and its titer was detected. After human SGC-7901 cells in vitro were transfected by rAd5-A + C,Akt1 and COX-2 mRNA and protein expression levels were detected by real-time PCR and Western blot respectively. Compared with rAdS-A + C,SGC-7901 and gen-eral rAd5-HK were selected as the negative controls. Results The recombinant adenovirus rAd5-A + C was constructed successfully and its titer reached 1.0 ×1010 pfu/ml. Aktl and COX-2 mRNA expression was downregulated significantly, and their ACt values ( 12.26±0.05 and 5.41±0.09 respectively ) were higher than rAd5-HK group (10.63±0.02 and 3.75 +0.08 respectively) and control group (10.57± 0.02 and 3.73±0.08 respectively) (P <0.01 ). There was no significant difference between rAd5-HK and control groups (P >0.05). Aktl and COX-2 protein expression was downregulated by 70.5% and 63.7% respectively ( P < 0.01 ) in rAd5-HK group as compared with control group ( P > 0.05 ). Conclu-sion The shRNA aclenovirus vector targeting Akt1 and COX-2 can specifically inhibit Akt1 and COX-2 expression,and this may be a new strategy in gastric carcinoma gene therapy targeting Akt1 and COX-2.     

PTEN基因治疗鼠C6胶质瘤的体内实验研究

目的 探讨PTEN基因在动物体内对脑胶质瘤的生长作用。方法 将大鼠C6胶质瘤细胞（对照组）和转染PTEN cDNA的C6细胞（转染组）种植于SD大鼠右侧尾状核。荷载C6脑胶质瘤鼠用PTEN cDNA原位治疗（治疗组）。并以空载体治疗作为对照（空载组）。每组10只。观察大鼠的一般情况、生存期、肿瘤体积变化以及肿瘤病理组织学与细胞生物学特征变化。结果 对照组和空载组大鼠均于3周内死亡。而转染组5只大鼠和治疗组6只大鼠观察60d内无自然死亡，生存期较对照组明显延长（P〈0．01）。结论 PTEN基因在动物体内可以抑制脑胶质瘤的生长。可以成为恶性胶质瘤基因治疗的优选靶之一。     

敲低IKKε抑制人胶质瘤细胞U251增殖和侵袭的体外研究

目的 探究敲低IKKε表达对人胶质瘤细胞系U251生物学特征的影响. 方法 采用脂质体介导的IKKε小干扰RNA(IKKε siRNA)转染U251细胞,同时设转染无义序列组和对照组,RT-PCR鉴定转染后IKKε mRNA的表达;MTT法检测转染后细胞的增殖能力;流式细胞术检测细胞周期分布的改变;Transwell实验检测细胞侵袭能力的变化;Western blotting法检测核增殖抗原(PCNA)、细胞周期素D1 (Cyclin D1)、基质金属蛋白酶-9(MMP9)和NF-κB P65的表达. 结果 与对照组和无义序列组比较,转染IKKε siRNA组细胞IKKε mRNA的表达和细胞增殖率降低,G0/G1期细胞比例增高,穿膜细胞数明显减少,差异均有统计学意义(P＜0.05).Western blotting检测结果显示IKKε siRNA组细胞PCNA、MMP9、Cyclin D1的表达较对照组和无义序列组明显下调,而且NF-κB组分P65从胞浆向胞核的转座减少. 结论 IKKε在胶质瘤细胞增殖和侵袭过程中发挥重要作用,有望成为人脑胶质瘤基因治疗的侯选靶点.     

脑膜瘤伽玛刀治疗的剂量—容积效应初步研究

目的 :探讨脑膜瘤伽玛刀治疗中的剂量 容积效应与并发症之间的关系。方法 :应用Logistic综合方程分析边缘剂量 15Gy的容积 风险概率关系和风险概率为 3%的剂量 容积关系 ;并应用Logistic综合方程回顾性地分析了 37例脑膜瘤伽玛刀治疗的风险概率与并发症的关系。结果 :边缘剂量为 15Gy的容积 风险概率呈直线关系 ,风险概率为 3%的剂量 容积呈反变曲线关系。37例脑膜瘤伽玛刀治疗后 ,在平均 16 4个月的随访期内 ,3%警戒线以下 18例 ,无并发症发生 ,3%警戒线以上 19例 ,有 5例 ( 5 / 19,2 6 7% )发生并发症 (P <0 0 5 )。结论 :脑膜瘤伽玛刀治疗中的剂量的选择依赖于容积 ,按照容积大小分组选择剂量可以提高治疗的安全性 ,3%等效应线可以作为脑膜瘤伽玛刀治疗的警戒线。     

46,XX男性性别逆转综合征二例报告

46,XX男性性别逆转综合征是一种少见的性别异常疾病,患者有睾丸,并表现为男性外观,而染色体核型为46,XX.2001和2003年我们分别收治2例,现报告如下.