CIP2A在子宫内膜样腺癌中的表达及临床意义

目的:探究蛋白磷酸酶2A(CIP2A)在子宫内膜样腺癌中的表达情况及临床意义。方法:选取2011年1月至2014年3月行手术切除并经病理证实的50例子宫内膜样腺癌(EAC)及同期行门诊刮宫术获取的40例正常增生期子宫内膜(NE)组织标本。应用RT-PCR、Western blot法检测EAC和NE组织中CIP2A mRNA及蛋白水平,免疫组化法检测CIP2A阳性表达情况。分析CIP2A在EAC和NE组织中的表达差异及与子宫内膜样腺癌临床病理特征的关系。采用Kaplan-Meier法分析CIP2A不同表达水平对患者预后生存的影响,通过COX分析预后独立危险因素。结果:免疫组化染色显示:CIP2A在子宫内膜样腺癌中呈高表达,阳性着色定位于细胞浆和细胞核中,EAC组织中CIP2A阳性表达率显著高于NE组织(P＜0.01)。RT-PCR和Western blot检测显示EAC组织中CIP2A mRNA及蛋白表达水平高于NE组织(P＜0.01)。CIP2A表达与EAC的组织学分级、FIGO分期、宫颈管受累情况、p53表达及Ki-67增殖指数有关（P＜0.05）。Kaplan-Meier法生存分析显示EAC患者5年无病生存率为92.0%、总生存率为88.0%;CIP2A表达、组织学分级、FIGO分期、肌层浸润深度、附件转移、脉管内癌栓及Ki-67增殖指数与患者预后不良相关（P＜0.05）。多因素分析显示,组织学分级、FIGO分期及脉管内癌栓是影响子宫内膜样腺癌患者预后生存的独立危险因素（P＜0.05）。结论:CIP2A在子宫内膜样腺癌中呈高表达,与患者总生存率下降相关,并非影响患者预后的独立危险因素。     

极年轻乳腺癌患者生育问题关注度的影响因素及其预后分析

目的研究极年轻乳腺癌患者生育相关问题关注度的影响因素,并分析其预后。 方法收集2009年12月至2019年1月经河北医科大学第四医院乳腺中心诊治、年龄≤25岁且有完整临床病理资料的50例极年轻乳腺癌女性患者进行回顾性研究。所有患者均完成了生育问题和结果量表(FIS)。采用单因素和多因素Logistic回归模型评估社会人口统计学因素、肿瘤因素与生育相关问题关注度之间的关系;采用Kaplan-Meier方法进行患者生存分析,用log-rank检验进行组间比较,采用Cox比例风险回归模型探讨影响极年轻乳腺癌患者预后的因素。 结果50例极年轻乳腺癌患者中,36例患者与其主管医师在确诊后/治疗前未沟通生育相关问题,仅有14例患者在确诊后/治疗前沟通过;28例患者表示乳腺癌治疗后仍有生育愿望;11例患者在治疗结束后妊娠,占全部患者的22%(11/50),其中,有6例患者在未咨询医师的情况下,自行选择人工流产,其余5例患者均足月妊娠,新生儿健康。单因素和多因素Logistic回归分析显示确诊前生育状态是极年轻乳腺癌患者生育相关问题关注度的独立影响因素(单因素分析：OR＝0.250, 95%CI: 0.070～0.897, P＝0.033;多因素分析：OR＝0.270,95%CI：0.048～0.901,P＝0.035)。50例患者中共有9例(18%)患者复发或转移,其中,7例(14%)患者死亡,原因与乳腺癌直接相关。单因素分析显示：诊断延迟时间是极年轻乳腺癌患者DFS和OS的影响因素(χ²＝8.857、6.928,P＝0.003、0.008),病理类型是患者DFS的影响因素(χ²＝4.824,P＝0.028),但不是OS的影响因素(χ²＝3.339,P＝0.069)。多因素分析结果显示：诊断延迟时间是患者DFS的独立预后因素(HR＝13.121,95%CI：1.385～124.348,P＝0.025)。生存分析结果显示：诊断延迟时间>3个月组与诊断延迟时间≤3个月组比较,患者的DFS差异有统计学意义(χ²＝4.834,P＝0.025),而OS差异无统计学意义(χ²＝1.035,P＝0.311)。 结论治疗前未生育的患者对生育相关问题关注度高。诊断延迟可能导致极年轻乳腺癌患者的预后变差,值得临床医师关注。     

消化道恶性肿瘤住院患者的能量消耗研究

目的评估消化道恶性肿瘤患者的能量消耗,探讨最佳计算公式及能量消耗的影响因素。方法采用连续入组法,纳入2016年3月至2016年12月在陆军军医大学第一附属医院肿瘤科住院治疗患者,运用代谢车测定其静息代谢能量（REE）,使用Harris-Benedict公式和30kcal/（kg·d） 公式预测患者的一日总能量消耗（TEE）。收集研究对象的相关指标如年龄、身高、体重、病程、原位癌部位、是否荷瘤等。结果共纳入26例患者,其中包括食管癌11例,胃癌8例,结直肠癌7例,73%的患者处于高代谢状态,约69%的患者处于肿瘤Ⅳ期;其中不同病程和原位癌位置与静息能量消耗有差异,差异具有统计学意义;用30kcal/（kg·d）×体重估算TEE可能并不适用于消瘦的消化道肿瘤患者。结论消化道恶性肿瘤患者大多存在营养不良且处于高代谢状态,在给消化道恶性肿瘤患者提供能量时应适当考虑病程长短、肿瘤分期以及肿瘤部位等因素。尽量使用代谢车估算恶性肿瘤患者的TEE,若没有代谢车条件时,对于能下床活动的消化道恶性肿瘤患者,体质指数（BMI）≥18.5kg/m2者推荐使用30kcal/（kg·d）×实际体重的方法估算TEE,BMI<18.5kg/m2者推荐使用30kcal/（kg·d）×标准体重的方法估算TEE。     

平板运动试验中室性早搏ST段下移诊断冠状动脉病变的价值

探讨平板运动试验中室性早搏(VPCs)ST段下移程度对反映冠状动脉(简称冠脉)病变的价值。将休息和平板运动试验中均发生VPCs并且在3个月内进行冠脉造影的92例患者按冠脉造影结果分成冠心病组和非冠心病组,比较两组VPCsST段下移程度,下移程度与冠脉狭窄程度的关系以及VPCsST段下移诊断冠心病的价值。结果:冠心病组运动中VPCsST段下移及ST/R均大于非冠心病组。其中ST/R>10%对冠心病诊断灵敏度为91%,特异度为75%;对单支、2支、3支血管病变诊断灵敏度分别为84%、91%、100%。冠脉狭窄≥90%组运动中VPCsST段下移和ST/R大于狭窄为50%~69%组。结论:运动试验中VPCsST段下移可作为诊断冠心病的有效参考指标,其下移程度可能与冠脉狭窄程度有关。     

Cross-host evolution of severe acute respiratory syndrome coronavirus in palm civet and human

The genomic sequences of severe acute respiratory syndrome coronaviruses from human and palm civet of the 2003/2004 outbreak in the city of Guangzhou, China, were nearly identical. Phylogenetic analysis suggested an independent viral invasion from animal to human in this new episode. Combining all existing data but excluding singletons, we identified 202 single-nucleotide variations. Among them, 17 are polymorphic in palm civets only. The ratio of nonsynonymous/synonymous nucleotide substitution in palm civets collected 1 yr apart from different geographic locations is very high, suggesting a rapid evolving process of viral proteins in civet as well, much like their adaptation in the human host in the early 2002–2003 epidemic. Major genetic variations in some critical genes, particularly the Spike gene, seemed essential for the transition from animal-to-human transmission to human-to-human transmission, which eventually caused the first severe acute respiratory syndrome outbreak of 2002/2003.     

The bone marrow--cardiac axis of myocardial regeneration

Congestive heart failure remains the leading cause of morbidity and mortality in the developed world. Current therapies do not address the underlying pathophysiology of this disease, namely, the progressive loss of functional cardiomyocytes. The notion of repairing or regenerating lost myocardium via cell-based therapies remains highly appealing. The recent identification of adult stem cells, including both cardiac stem/progenitor cells and bone marrow stem cells, has triggered an explosive interest in using these cells for physiologically relevant cardiomyogenesis. Enthusiasm for cardiac regeneration via cell therapy has further been fueled by the many encouraging reports in both animals and human studies. Further intensive research in basic science and clinical arenas are needed to make this next great frontier in cardiovascular regenerative medicine a reality. In this review, we focus on the role of bone marrow-derived stem cells and cardiac stem/progenitor cells in cardiomyocyte homeostasis and myocardial repair and regeneration, as well as provide a brief overview of current clinical trials using cell-based therapeutic approaches in patients with heart disease.     

野生型p53对肝癌细胞POLD1基因表达及细胞恶性表型的影响

目的:探讨野生型p53对人肝癌细胞SMMC-7721细胞增殖和细胞恶性表型影响的一种可能机制,方法:设计并构建p53特异性小干扰shRNA绿色荧光真核表达质粒(p53-siRNA)和表达EGFP-p53融合蛋白的p53绿色荧光真核增强表达质粒(pEGFP-p53),通过脂质体Lipofection-2000介导转染,将...     

A genomewide study identifies the Wnt signaling pathway as a major target of p53 in murine embryonic stem cells

Both p53 and the Wnt signaling pathway play important roles in regulating the differentiation of mouse embryonic stem cells (mESCs). However, it is not known whether they directly and/or functionally crosstalk in mESCs. Here we report a surprising antidifferentiation function of p53 in mESCs through directly regulating the Wnt signaling pathway. A chromatin-immunoprecipitation-based microarray (ChIP-chip) and gene expression microarray assays reveal that the Wnt signaling pathway is significantly (P value, 0.000048) overrepresented in p53-regulated genes in mESCs. The expression of five Wnt ligand genes is robustly induced by various genotoxic and nongenotoxic insults in a p53-dependent manner. Moreover, the induction of these Wnt genes is greatly attenuated in mouse embryonic fibroblast (MEF) cells and ESC-derived neural stem/progenitor cells, suggesting that the induction is mESC specific. It is established that the activation of the Wnt signaling pathway inhibits the differentiation of mESCs. Consistent with this notion, we detected an antidifferentiation activity from the conditioned medium (CM) collected from UV (UV)-treated mESCs. This antidifferentiation activity can be lowered by either the addition of Wnt antagonists into the CM or the reduction of p53 levels in UV-treated mESCs. Therefore, reminiscent of its dual functions on death and survival in somatic cells, p53 appears to regulate both prodifferentiation and antidifferentiation programs in mESCs. Our findings uncover a direct and functional connection between p53 and the Wnt signaling pathway, and expand the catalog of p53 regulated genes in mESCs.