不同灸疗模式对热敏灸小镇慢性病干预效果评价研究

目的：观察不同灸疗模式对热敏灸小镇常见慢性病的干预效果。方法：以KOA、LDH、FD为研究对象,以可以高效激发艾灸得气的灸具为施灸手段,根据施灸过程中有无基层医疗卫生机构参与分为小镇自灸组和指导艾灸组,对比两种施灸模式的干预效果。结果：两种艾灸模式对KOA、LDH、FD均有疗效,差异有统计学意义（P<0.05）,指导艾灸组干预KOA、LDH、FD疗效更为显著,差异有统计学意义（P<0.05）。结论：有基层医疗卫生机构参与的施灸模式可以提高热敏灸小镇慢性病的干预效果,值得在基层推广应用。     

Wnt2B通过NF-κB/p65调节乳腺癌细胞的凋亡

目的研究Wnt2B对乳腺癌细胞株MDA-MB-231凋亡的影响,探讨其在乳腺癌发生发展过程中的重要作用。方法应用免疫组化技术检测40例乳腺癌组织标本中Wnt2B的表达;应用Western blot检测乳腺癌配对细胞系MDA-MB-231和MCF-7中Wnt2B蛋白水平;通过瞬时转染Wnt2B特异的siRNA沉默高表达Wnt2B的MDA-MB-231细胞系后,采用流式细胞仪检测转染前后细胞的凋亡水平;应用Western blot、共聚焦显微镜和凝胶电泳迁移实验(EM-SA)检测下调Wnt2B表达后对NF-κB/p65的表达和活性的影响。结果相对于Wnt2B阴性表达的正常乳腺组织,35例乳腺癌组织的表达呈强阳性并且存在核浆转移现象;在高转移细胞系MDA-MB-231中Wnt2B表达明显高于低转移细胞系MCF-7;针对Wnt2B的siRNA沉默成功下调MDA-MB-231中Wnt2B表达后,细胞凋亡率明显增加并伴随NF-κB/p65的表达下降和活性降低;应用NF-κB/p65特异性的抑制剂PDTC阻断此通路后,Wnt2BsiRNA诱导细胞的凋亡效应被阻断。结论 Wnt2BsiRNA通过NF-κB/p65通路抑制乳腺癌细胞系MDA-MB-231的凋亡而产生抗瘤作用,Wnt2B可能成为乳腺癌有效治疗靶点之一。     

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??Coexisting nodular goiter and thyroid carcinoma: a retrospective analysis of 262 cases HE Liang, ZHANG Hao??DONG Wen-wu, et al. Department of General Surgery, the First Hospital, China Medical University, Shenyang 110001, China
Corresponding author: ZHANG Hao,E-mail: haozhang@mail.cmu.edu.cn
Abstract Objective To summarize the clinical characteristics and the highlight of diagnosis and treatment of nodular goiter in patients with coexistent thyroid carcinoma??Methods A total of 262 nodular goiter coexisting with thyroid carcinoma patients underwent operations from January 1998 to December 2007 at the First Hospital, China Medical University were retrospectively reviewed??Results Two hundreds and sixty-two patients accounted for 33.9% in thyroid carcinoma patients at the same time. The age mainly ranged from 40 to 59 years. The sex ratio was 1:5.2 (male:female). The clinical characteristics were manifested as nodular goiter. In addition to 25 patients who received secondary operation had a clear diagnosis before surgery. 70.0% of tumors were suspected as malignant lesions by preoperative ultrasound examination, in which 39.2% exhibited as microcalcification. The accuracy rate of intra-operative fast frozen section pathological examination was 93.2%. Tumor nodules less than 2.0 cm in diameter accounted for 62.9%, and microcarcinomas accounted for 40.1%. Clinical phase I cases accounted for 74%. The main pathological type was papillary carcinoma??93.1%??. The various styles of thyroidectomy were performed according to the different pathological results?? Neck dissection was performed in 122 patients, and 46 of them had cervical lymph node metastasis. Conclusion Most patients with coexisting thyroid carcinomas and nodular goiter have small tumor size and lower incidence of lymph node metastasis. The coexistent thyroid carcinoma was often well differentiated papillary cancer??The preoperative ultrasonography and the intra-operative fast frozen section examination are helpful for the diagnosis of thyroid carcinoma in nodular goiter?? Regular follow-up in patients with nodular goiter could improve the early diagnostic rate of coexisting thyroid carcinoma.     

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??Carotid body tumors and neurogenic tumors at bifurcation of carotid artery??a control study LI Guang-xin, XIN Shi-jie, ZHANG Jian, et al. Department of Vascular and Thyroid Surgery, the First Affiliated Hospital of China Medical University, Shenyang 110001, China
Corresponding author: XIN Shi-jie, E-mail: sjxin@cmu.edu.cn
Abstract Objective To explore the experiences for differential diagnosis and surgical treatment of carotid body tumors and neurogenic tumors at bifurcation of carotid artery. Methods The clinical data of 16 cases of carotid body tumors and 14 cases of neurogenic tumors at bifurcation of carotid artery performed operation between November 2004 and June 2011 in the First Affiliated Hospital of China Medical University were analyzed retrospectively. The clinical manifestations, imaging features, surgical procedures and follow up of the cases were compared. Results There is no statistical difference of age, sex, physical condition, clinical manifestation and size of tumors between two groups. The operating time ???119±46??min?? and bleeding volume ???230±127??mL?? of the former group were obviously larger than those ???65±13??min????89±38??mL??of the later group??P<0.05??. Fifteen cases of the former group had total tumor resection. Six of them had reconstruction of internal carotid artery using great saphenous vein graft. All cases of the later group had total tumor resection without occluding carotid artery. One case of the former group had minimal damage of hypoglossal nerve. One case of the former group had Horner syndrome after the operations. One case of the later group had hoarseness. Three cases of the later group had Horner syndrome after the operations. There was no difference in incidence of complication between two groups (P >0.05) . The hospital stay of the former group ???17±7??d?? was longer than that of the later group ???14±5??d?? ??P>0.05??. Conclusion The clinical manifestations of carotid body tumors and neurogenic tumors at bifurcation of carotid artery are similar. It’s difficult to diagnose exactly before operation. Surgical operation is an available treatment. A clear understanding of the disease and sufficient prepare before operation are key factors for successful treatment.     

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??Report for 25 cases of the upper arm central venous port implantation in breast cancer patients LIU Qian, ZHAO Xuan, WANG Ying-xin, et al. Breast Disease Center, Peking University First Hospital, Beijing 100034, China
Corresponding author: LIU Ying-hua,E-mail: liuyinhua7520@163.com
Abstract Objective To discuss the standard procedure and potential advantages in upper arm central venous ??CV?? port implantation. Methods Retrospectively analyze the results of upper arm CV port implantations performed in Peking University First Hospital Breast Disease Center to confirm the clinical utility and advantages of upper arm CV port implantation compared to internal vein CV port implantation. Results 97 CV port implantations were performed in Peking University First Hospital Breast Disease Center from January to October 2017. Procedural success and complication rates between internal vein ??n=72?? and upper arm ??n=25?? groups were compared. There is no significant difference in surgery time ??t=0.342??P=0.733??and short-time complication??P=1.000?? between the upper arm and internal vein groups. Conclusion Upper arm CV port implantation can provide safety and comfort benefits to clinicians and patients if performed following implantation procedures strictly.     

BTLA-HVEM通路阻断对树突状细胞功能影响的体内外研究

目的 探讨阻断BTLA-HVEM(B/T淋巴细胞弱化因子疱疹病毒进入介质)通路对树突状细胞功能的影响和相关免疫学机制.方法 构建小鼠BTLA胞外功能区的真核表达载体psBTLA,转染CHO细胞;HSP70-TC-1肿瘤抗原肽刺激小鼠骨髓来源DCs,流式细胞仪检测处理后DCs表面BTLA、HVEM的表达,同时给予转染了psBTLA质粒的CHO细胞的培养上清处理后,检测DCs表面B7-1的表达,ELISA检测上清中IL-12的分泌;处理后的DCs刺激脾细胞,检测淋巴细胞增殖和细胞因子分泌;检测psBTLA体内转染对宫颈癌细胞系TC-1成瘤小鼠DCs表达B7-1和肿瘤生长的影响.结果 成功构建小鼠BTLA胞外段的真核表达载体psBTLA,获得了稳定转染psBTLA的CHO细胞,在其培养上清检测到BTLA胞外段(sBTLA)的表达.DCs经抗原肽刺激后BTLA、HVEM表达均上调,加入含sBTLA的上清处理后上调B7-1,上清中分泌的IL-12增加,与脾细胞共培养时促进细胞增殖和IL-2、IFN-γ的分泌;体内基因转染psBTLA促进DCs表达B7-1以及抑制肿瘤生长.结论 通过sBTLA阻断BTLA-HVEM共抑制通路,可以进一步促进DCs的功能,更好地激活淋巴细胞,促进抗肿瘤免疫应答.     

枸杞多糖在小鼠脓毒症肝损伤中的保护作用及机制

目的 研究枸杞多糖对脓毒症小鼠模型致肝损伤的保护作用,并探讨枸杞多糖在脓毒症肝损伤中的相关机制。方法 将BALB/c小鼠随机分为4组,每组10只,分别为Ⅰ组假手术(sham)组,Ⅱ组脓毒症急性肝损伤(CLP)组,Ⅲ组枸杞多糖组[400 mg/(kg·d)](LBP+CLP)组,Ⅳ组枸杞多糖预处理后假手术(LBP+sham)组。干预2周后采用盲肠结扎穿孔法(CLP)建立脓毒症小鼠模型,观察24h后解剖小鼠肝脏组织及收集小鼠血液,分别检测血清中丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)活性及肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)含量变化;观察肝脏组织的病理学变化及肝组织中Cleaved caspase-3、Bcl-2、TLR-4、NF-κB的蛋白表达水平。结果 给予LBP干预2周后,Ⅲ组小鼠血清中肝酶水平及炎性因子显著上升,肝脏组织病理损伤较模型组均明显改善。另外,Ⅲ组与Ⅱ组比较肝组织中抗凋亡蛋白Bcl-2明显上调,而Cleaved caspase-3、TLR-4、NF-κB等蛋白水平显著降低。Ⅳ组与Ⅰ组比较,差异无统计学意义。结论 枸杞多糖在脓毒症小鼠中能减轻炎性反应及肝脏受损,缓解细胞凋亡,其保护作用可能与TLR-4/NF-κB炎症通路有关。     

联合用药靶向胶质母细胞瘤样干细胞的治疗进展

胶质母细胞瘤作为常见的恶性胶质瘤,其等级系数高,致死性强.随着肿瘤干细胞理论的提出,为肿瘤靶向治疗提供了新的途径.通过联合用药抑制生长机制,阻止胶质母细胞瘤样干细胞的增殖,从而为靶向治疗恶性胶质瘤提供了可能.本文就联合用药靶向胶质母细胞瘤样干细胞进行简要综述.