人体胰腺癌细胞株PANC-1中四环素可诱导的周期素D1表达抑制系统的建立

[目的]在人体胰腺癌细胞株PANC-1中建立一个四环素可调控周期素D1表达系统。研究抑制周期素D1对胰腺癌细胞的影响。[方法]反义周期素D1质粒通过两次稳定转染进入胰腺癌细胞株PANC-1细胞中，其表达调控系统采用Tet-Off系统（四环素调控系统）。通过抑制周期素D1表达对PANC-1细胞生长、集落形成能力以及周期素蛋白表达的影响，评价此系统的可调控性和有效性。[结果]通过第一次转染pTet—Off质粒，选择两个最佳表达克隆行第二次转染DTRE-反义周期素D1质粒，并通过免疫印记测定挑选出能在Tet—Off系统中最有效地表达反义周期素D1的克隆。通过Tet—Off系统对反义周期素D1的调控．发现周期素D1的表达抑制可明显地抑制胰腺癌细胞生长和集落能力，并可导致胰腺癌细胞形态学改变。其抑制作用与四环素调控浓度和时间有关。[结论]此研究在PANC-1胰腺癌细胞株中建立了一个高效、可诱导的反义周期素D1的表达系统。通过这个系统的建立，可进一步在体内和体外研究周期素D1的抑制对胰腺癌细胞的影响．并可结合其它治疗手段如化疗来探讨联合治疗在临床的潜在应用价值。     

Infections of the Urinaryin Tract in Pregnancy

Asymptomatic bacteriuria is common in pregnant women and more easily detected during pregnancy. The risk of pyelonephritis is present, therefore early treatment is necessary. Routine screening of prenatal patients is advisable, since bacteriuria is quite likely to continue after pregnancy. Diagnostic procedures are described and treatment outlined.     

Evaluation of the dedicated Frontier™ coronary bifurcation stent: A matched pair analysis with drug-eluting and bare metal stents

Treatment of coronary bifurcation lesions (CBL) remains challenging. This study sought to evaluate a novel dedicated stent system (Frontier stent) by angiographic and clinical comparison with the provisional T-stenting technique using drug-eluting (DES) and bare metal stents (BMS). The study group comprised 105 CBL in 105 patients. 35 consecutive CBL were treated with the Frontier system. The control group of 70 CBL (35 DES, 35 BMS) was pair matched with the former group stratified by the type of CBL (Medina classification) and the reference diameter of the main branch (MB). Clinical, procedural, and quantitative angiographic data (QCA) were obtained in all patients. A follow-up angiography 6 +/- 2-month post-index intervention was performed in 84/105 (80%) patients, clinical 6-month follow-up was available in all patients (100%). All Frontier stent procedures were clinically and angiographically successful. Post-procedural QCA analysis of the MB and the side branches revealed comparable minimal lumen diameters (MLDs) between groups. Moreover, contrast use and radiation exposure were not different between groups. DES use, however, was associated with a significantly lower late lumen (LL) loss in the main and the side branch as compared to the Frontier stent and BMS group. Likewise, MACE rates were lowest in the DES group (6%, P < 0.05 vs. BMS) as compared to the Frontier stent (9%) and the BMS group (16%). The Frontier stent accomplishes treatment of CBL with excellent acute clinical, procedural, and angiographic results. Provisional T-stenting using DES provides superior clinical and angiographic long-term results as compared to BMS and Frontier stents. The results of next generation CBL systems combining a dedicated specific CBL design with DES surfaces are to be awaited.     

An introduction to comparative effectiveness research

Research examining the process of deciding between treatment alternatives, the applicability of the existing literature to this process, and the way that this knowledge can be applied to inform clinical decisions is termed comparative effectiveness research (CER). Despite its emerging role in both clinical medicine and public policy, many neurosurgeons are unaware of the history of CER, the principles fundamental to its implementation, and the nature and extent to which it impacts patient care. We present a review of literature that provides a brief history of the evolution of CER, an overview of its scientific, financial, and public policy implications, and a discussion of its implementation and potential significance in modern clinical practice. We discuss how CER seeks to combine treatment efficacy data with quality of life, outcomes, and other forms of effectiveness data to guide selection of optimal patient management strategies. This research paradigm strengthens the final step in clinical research that should follow the traditional demonstration of efficacy and reemphasizes the potentially important role of observational and retrospective investigations in establishing effectiveness of efficacious procedures in actual application to individual patients. It is useful for neurosurgeons to understand the CER model, because it occupies an emerging role in both clinical medicine and public policy and presents a potentially useful model for informing medical decision-making in the type of real-world situations commonly encountered by clinical neurosurgeons.     

Endovascular treatment of AVM-associated aneurysm of anterior inferior cerebellar artery through persistent primitive hypoglossal artery

We present a patient with the combination of persistent primitive hypoglossal artery and the origin of left common carotid artery from the brachiocephalic trunk, who had subarachnoid haemorrhage caused by a ruptured aneurysm. The aneurysm was on distal anterior inferior cerebellar artery which was a feeder to cerebellar arterio-venous malformation.