心肌细胞共培养诱导骨髓间充质干细胞向心肌样细胞分化

目的在体外以新生大鼠心肌细胞（CM）与骨髓间充质干细胞（MSCs）共同培养的方式模拟心肌微环境,研究MSCs分化为心肌细胞的机制。方法分离大鼠MSCs在体外培养纯化后进行细胞标记,将已标记的MSCs分别与搏动的CM、停止搏动的CM以及心肌细胞条件培养液混合培养。分别在共培养后第4、5天用免疫荧光染色检测MSCs细胞中的心肌特异性肌钙蛋白T（Troponin T）。结果与搏动的CM共培养后第4天MSCs出现自发收缩,与CM同步搏动并表达Troponin T,而在抑制心肌细胞搏动或缺乏与心肌直接接触的情况下MSCs未出现上述变化。结论说明在与CM直接接触的前提下,CM对MSCs的机械牵拉刺激为诱导MSCs分化为心肌细胞的必须条件。单纯的心肌细胞条件培养液则非关键因素。了解MSCs分化为心肌细胞的机制对于寻找适宜的细胞移植条件有重要指导意义。     

天名精萜类化学成分及其细胞毒活性研究

目的研究天名精Carpesium abrotanoides的萜类化学成分及其细胞毒活性。方法运用正相硅胶柱色谱、制备薄层色谱及制备型HPLC等方法进行分离纯化,并经NMR等现代波谱技术进行化合物的结构鉴定。采用MTT法研究化合物的肿瘤细胞增殖抑制活性。结果从天名精中分离鉴定了11个萜类化合物,包括6个桉烷型倍半萜:大叶土木香内酯(1)、特勒内酯(2)、异土木香内酯(3)、3α,5α-二羟基异土木香内酯(4)、异特勒内酯(5)、糙叶依瓦菊内酯(6);1个吉玛烷型倍半萜:11(13)-去氢腋生依瓦菊素(7);1个卡拉布烷型倍半萜:天名精内酯酮(8);1个少见的开环倍半萜:泊氏孔菌裂环愈创木内酯(9)和2个单萜:7,8-环氧-9-(异丁酰氧基)麝香草酚异丁酸酯(10)、10-羟基-8,9-二氧异亚丙基麝香草酚(11)。结论化合物9和11为首次从天名精属植物中分离得到,化合物3、4、6、10为首次从天名精中分离得到,首次报道了化合物4和6的13C-NMR数据。细胞毒活性研究显示,化合物1、2对人胃癌细胞HGC-27和人乳腺癌细胞MDA-MB-231的增殖有较强抑制活性,其IC50值分别为18.18、16.17μmol/L和20.65、17.62μmol/L。化合物8对人胃癌细胞HGC-27的增殖有较强抑制活性,其IC50值为24.96μmol/L。     

盐酸帕洛司琼联合GDP方案治疗老年复发性非霍奇金淋巴瘤的临床研究

目的评价盐酸帕洛司琼联合GDP (Palonosetron-GDP) 方案治疗老年复发性非霍奇金淋巴瘤的临床疗效和不良反应。方法采用Palonosetron-GDP方案治疗28例老年复发性非霍奇金淋巴瘤患者,对接受3个疗程以上患者进行临床疗效评估和不良反应分析,同时随访患者疾病进展情况。结果26例患者接受3个疗程以上Palonosetron-GDP方案化疗,其中6例完全缓解 (完全缓解率23.1%),10例部分缓解(部分缓解率38.5%),总有效率61.5%。26例患者中位肿瘤进展时间为5.3月(95%CI: 4.7~7.0)。主要不良反应为骨髓抑制,而非血液学毒性尤其是消化道不良反应轻微,其中化疗诱导恶心和呕吐不良反应Ⅰ级2例,Ⅱ级1例,没有Ⅲ~Ⅳ级呕吐反应。结论Palonosetron-GDP方案是老年复发性非霍奇金淋巴瘤的有效挽救治疗方案,其中盐酸帕洛司琼能有效预防化疗诱导的消化道不良反应而不影响其疗效。     

原代胃癌干细胞CD44表达意义探讨

目的 肿瘤干细胞(cancer stem cells,CSCs)在恶性肿瘤的发生发展中起着重要作用,且是肿瘤耐药及复发的根源.本研究探讨CSCs表面标记蛋白CD44在分离及鉴定胃癌干细胞中的重要作用.方法 收集2015-11-06-2015-12 01华中科技大学同济医学院附属同济医院3例胃癌患者手术标本.首先采用胶原酶消化法获取胃癌细胞,部分细胞分别贴壁及悬浮培养,并采用免疫荧光及流式分析的方法检测胃癌球形体中CD44的表达情况.部分细胞采用流式细胞仪分选得到CD44+及CD44胃癌细胞,并通过无血清悬浮培养法比较两群细胞的球形体形成能力.结果 免疫荧光显示,CD44蛋白在球形体中高表达;流式分析发现,贴壁的原代胃癌细胞中CD44+细胞的比例为(30.73±7.6)％,而球形体中CD44+细胞的比例高达(56.4±5.58)％,差异有统计学意义,P=0.009.球形体形成实验结果表明,与CD44-细胞相比,CD44+胃癌细胞具有更强的球形体形成能力,1 000个CD44+及CD44-胃癌细胞分别形成(14.33±2.52)和(1.67±0.58)个球形体,差异有统计学意义,P=0.001.通过比较发现,球形体培养对胃癌干细胞的富集效率为0.3％,而CD44对胃癌干细胞的富集效率为1.4％.结论 CD44是胃癌干细胞的表面标记蛋白,其可能成为胃癌靶向治疗的可靠靶标.     

中医辨证施治联合玻璃酸钠综合治疗膝关节骨性关节炎疗效观察

膝关节骨性关节炎是关节软骨的退行性变和骨质增生，关节边缘形成骨赘所致的疾病，多见于中老年人，常因疼痛、肿胀、功能障碍而致残，至今尚无特效治疗方法。我们对膝关节骨性关节炎采用中医辨证用药与关节腔内注射玻璃酸钠、紫外线局部照射等综合治疗，结果满意。介绍如下：     

太汲神系列综合治疗膝关节骨性关节炎疗效观察

膝关节骨性关节炎是关节软骨的退行性变和骨质增生为主，并在关节边缘形成骨赘所致的疾病，多见于中老年人，常因疼痛、肿胀功能障碍而致残，至今尚无特效治疗方法，我们采用紫外线照射综合药物治疗，结果满意，介绍如后。     

EPOCH方案治疗老年人外周T细胞淋巴瘤的临床研究

Objective To evaluate the clinical efficacy and toxicity of EPOCH regimen in the treatment of elderly patients with peripheral T-cell lymphoma. Methods Twenty-eight elderly patients with pathologically diagnosed peripheral T-cell lymphoma were treated with EPOCH regimen, including 96-hour continuous infusion of etoposide 50 mg/m2, epirubincin 12 mg/m2 and vincristin 0.4 mg/m2 on daysl through 4,cyclophosphamide 750 mg/m2 given as intravenous bolus on day 5 and prednisone 60 mg/m2 administered orally on daysl through 5. The EPOCH regimen was repeated very 21 days. Clinical efficacy and safety profiles of EPOCH regimen was systemically reviewed and analysed. Results All the 28 patients received a total of 85 cycles of EPOCH regimen. The median cycles was two courses. Fifteen patients achieved complete response, while five cases obtaining partial response. The overall response rate was 71.4 %. The median survival time was 20 months. In newly diagnosed patients, complete response rate (CR) as well as partial response (PR) and overall response rate (OR) reached 64.7 %, 23.5 % and 88.2 %, respectively, which was significantly higher than that in refractory cases, whose CR, PR and OR were 36.4 %, 9.1% and 45.5 %(λ 2 = 5.99, P ＜0.05). In addition, the median survivalduration of newly diagnosed patients was longer than that of refractory cases, whose median survival time was 24 and 13 months, respectively. The major adverse events was myelosuppression with grade 3-4 neutropenia and thrombocytopenia in 53.6 % and 50.0 % cases.Non-hematologic toxicities were moderate and uncommon. The frequency of adverse effects in de novo patients showed little difference in comparison with that in refractory ones (P＞0.05). Conclusion EPOCH regimen was an effective and well tolerated therapeutic schedule for elderly patients with peripheral T-cell lymphoma.     

EPOCH方案治疗老年人外周T细胞淋巴瘤的临床研究

Objective To evaluate the clinical efficacy and toxicity of EPOCH regimen in the treatment of elderly patients with peripheral T-cell lymphoma. Methods Twenty-eight elderly patients with pathologically diagnosed peripheral T-cell lymphoma were treated with EPOCH regimen, including 96-hour continuous infusion of etoposide 50 mg/m2, epirubincin 12 mg/m2 and vincristin 0.4 mg/m2 on daysl through 4,cyclophosphamide 750 mg/m2 given as intravenous bolus on day 5 and prednisone 60 mg/m2 administered orally on daysl through 5. The EPOCH regimen was repeated very 21 days. Clinical efficacy and safety profiles of EPOCH regimen was systemically reviewed and analysed. Results All the 28 patients received a total of 85 cycles of EPOCH regimen. The median cycles was two courses. Fifteen patients achieved complete response, while five cases obtaining partial response. The overall response rate was 71.4 %. The median survival time was 20 months. In newly diagnosed patients, complete response rate (CR) as well as partial response (PR) and overall response rate (OR) reached 64.7 %, 23.5 % and 88.2 %, respectively, which was significantly higher than that in refractory cases, whose CR, PR and OR were 36.4 %, 9.1% and 45.5 %(λ 2 = 5.99, P ＜0.05). In addition, the median survivalduration of newly diagnosed patients was longer than that of refractory cases, whose median survival time was 24 and 13 months, respectively. The major adverse events was myelosuppression with grade 3-4 neutropenia and thrombocytopenia in 53.6 % and 50.0 % cases.Non-hematologic toxicities were moderate and uncommon. The frequency of adverse effects in de novo patients showed little difference in comparison with that in refractory ones (P＞0.05). Conclusion EPOCH regimen was an effective and well tolerated therapeutic schedule for elderly patients with peripheral T-cell lymphoma.     

第二届“中国中医科学院唐氏中药发展奖”候选人推荐工作的通知

膝关节骨性关节炎是以关节软骨的退行性病变和骨质增生为主，并在关节边缘形成骨赘所致的疾病，多见于中老年人，常因疼痛、肿胀、功能障碍而致残，目前尚无特效治疗方法，我们采用太汲神系列综合治疗，结果满意，介绍如后。     

重症脑卒中并发急性肾功能不全相关因素分析

急性肾功能不全是重症脑卒中较常见的并发症之一，且对预后影响较大。有统计表明，急性脑卒中时肾功能不全发生率占各脏器功能损害的第3位。现将浙江省江山市人民医院近3a收治的36例重症脑卒中并发急性肾功能不全的相关因素作一分析。