冠心病患者血浆BNP、HCY、CRP水平变化分析

目的 :检测冠心病患者血浆中BNP、HCY、CRP水平变化 ,探讨冠心病发病机制及不稳定性心绞痛治疗前后对其影响。方法 :用化学发光和酶联免疫分析 ,对 14 6例冠心病患者和 30例正常对照者血浆BNP、HCY、高敏 -CRP水平变化及相关性进行研究 ,同时对 5 2例UAP经皮冠状动脉成形术 (PTCA)治疗前后对上述三项指标的变化进行分析。结果 :冠心病患者与正常对照组比较BNP水平有显著性差异 (p <0 0 1) ,尤其是AMI和UAP组比SAP组升高更明显 ;CRP水平比正常对照组明显增高 (p <0 0 5 ) ,特别是不稳定心绞痛和急性心肌梗塞组升高明显 (p <0 0 0 1) ;AMI组血浆中HCY水平明显高于正常和其它两组 ,HCY、CRP、BNP三项在UAP组中治疗前后比较差异显著 (p <0 0 5 )。 结论 :BNP、CRP、HCY参与了冠心病的发病过程 ,并可预测心肌梗塞病人远期心功能恢复的情况 ,UAP组经PTCA支架术后三项指标均明显降低 ,可作为疗效观察的一个重要参数 ,HCY参与了冠状动脉粥样硬化的全过程及急性心肌梗塞的发病始末。但其参与的机制有待进一步探讨。     

Prognostic factors of primary pulmonary mucoepidermoid carcinoma: a clinical and pathological analysis of 34 cases

Pulmonary mucoepidermoid carcinoma (PMEC) is a rare malignant neoplasm, and little is known about the prognostic factors. The aim of the present study was to identify the relationship between tumor’s histological features and clinical behaviors and to analyze the survival of patients with PMEC. A total of 34 patients with PMEC from May 2001 to April 2013 were included in the investigation. The clinical data, radiological manifestation, pathological findings, treatment strategy, and prognoses of all patients were analyzed retrospectively. The patients were classified into low-grade group (n = 25) and high-grade group (n = 9), based on histological grades. High-grade PMEC was more common in patient with elevated serum carcinoembryonic antigen (CEA) (P = 0.033), advanced tumor-node-metastasis (TNM) stage (P = 0.004) and lymph node metastasis (P < 0.001). The 5-year PFS and OS of all patients were 75.7% and 83.6%, respectively. Age, pathological grade, lymph node metastasis and TNM stage were correlated with the survival of PMEC patients. Lymph node metastasis was an independent predictor of OS (HR, 0.080; P = 0.029) and PFS (HR, 0.090; P = 0. 004). A higher tumor histological grade indicated a more aggressive behavior. Patients who had undergone complete resection for PMEC without any lymph node metastasis were expected to be cured.     

Clinical experiences with 20 cases of single-direction thoracoscopic lobectomy and systematic lymph node dissection for peripheral NSCLC

ObjectiveTo evaluate the safety, efficacy, feasibility of single-direction thoracoscopic lobectomy for peripheral lung cancer.MethodsFrom December 2009 to March 2011, 20 patients with peripheral lung cancer were treated with single-direction thoracoscopic lobectomy and systemic lymph nodes dissection.ResultsSurgeries were successfully performed. No significant complications occurred perioperatively. The average operation time was 193 min, the average blood loss was 234 ml, the average duration of drainage was 6 d, the postoperative hospital stay was 12 d, and the average number of lymph nodes dissected was 16.ConclusionSingle-direction thoracoscopic lobectomy is feasible and safe in the treatment of peripheral lung cancer and can simplify the surgical procedures.     

长期吸烟者血浆皮质醇及β-内啡肽的变化

目的·· :探讨长期吸烟者在戒烟前后血浆皮质醇和 β-内啡肽水平的变化及形成机制。方法·· :于戒烟前后采集长期吸烟者静脉血 ,用放射免疫方法检测血浆皮质醇及血浆 β-内啡肽的含量。结果·· :长期吸烟者的血浆皮质醇(227.82ng·ml-1±s40.03ng·ml-1)及血浆 β-内啡肽(14.68ng·ml-1±s4.48ng·ml-1)明显高于正常组 ;戒断后长期吸烟组的血浆皮质醇(271.92ng·ml-1±s32.19ng·ml-1)明显升高 ,而血浆 β-内啡肽(8.16ng·ml-1±s4.97ng·ml-1)明显降低。结论·· :血浆皮质醇及 β-内啡肽可作为判断戒烟治疗效果的指标之一 ,而改善内源性阿片肽系统及下丘脑 -垂体 -肾上腺轴的功能可能对戒烟有助。     

毒素源性大肠杆菌CFA/Ⅰ、CS3重组菌株粘附力、免疫原性和保护性研究

采用可逆性肠结扎成兔腹泻(RITARD)动物模型检测了毒素源性大肠杆菌(ETEC)定居因子抗原Ⅰ(CFA/I)和表面抗原3(CS3)重组菌各1株的肠道粘附力,免疫原性和保护性。经肠道及口服接种重组菌株对肠道均有较强的粘附力,与CFAs阴性宿主菌相比P<0.0025。口服免疫家兔时,第4周血清抗体滴度达到高峰,滴度分别为1:9000和1:80000;肠道免疫家兔后血清效价在第2周达到高峰,滴度分别为1:8000和1:60000。在抗体滴度高峰时进行ETEC野生株攻毒,结果显示口服组抗腹泻保护率为66.7％～75％,肠道组为50.1％～71.4％。攻毒后免疫家兔的排菌天数较对照组明显减少。     

2型糖尿病思看血清脂联素、胰岛素、G-反应蛋白、瘦素水平变化分析

目的:通过对2型糖尿病患者血清中脂联素(APN)、胰岛素、C-反应蛋白、瘦素(Leptin)、胰岛素抗体及谷氨酸脱羧酶抗体(GAD-Ab)检测分析,探讨胰岛β细胞功能和胰岛素抵抗的机理,为其早期诊断治疗提供依据。方法:用化学发光、酶联免疫分析、放射免疫分析对184例2型糖尿病患者和30例正常对照者及75例DM2治疗观察组经一年治疗前后水平检测比较分析。结果:正常对照组与DM2比较胰岛素、瘦素、C-反应蛋白、胰岛素抗体有显著性差异(P<0 01),且呈正相关,与脂联素比较有显著性差异(P<0 001)但呈负相关;75例治疗后除脂联素、胰岛素抗体外其它几项指标较治疗前明显下降,有统计学意义,而脂联素较治疗前明显升高(P<0 001)有显著性差异。结论: 2型糖尿病标志物的检测,对其早期诊断、治疗预后及生理机制的研究具有重要意义。     

糖皮质激素冲击和口服疗法对Graves眼病疗效比较

目的比较糖皮质激素冲击和口服疗法对Graves眼病的疗效。方法初诊的Graves眼病28例，随机分为甲基强的松龙冲击治疗组和口服强的松组。治疗前，治疗10天和3个月后评价眼部体征及临床性活动评价（CAS），并对影响治疗效果的因素进行相关分析。结果甲基强的松龙治疗10天后CAS评分，软组织炎症评分明显下降，而强的松口服治疗无明显变化，但3个月疗程结束后两者CAS评分、软组织炎症、突眼度、眼裂宽度均有明显疗效，且无显著的统计学差异，CAS下降的程度与眼病病程明显负相关（r=0．317，P〈0．05）。结论糖皮质激素冲击和口服疗法均对Grave眼病有明显效果，但前者起效较快。     

Methylation of multiple genes as diagnostic and therapeutic markers in primary head and neck squamous cell carcinoma

OBJECTIVE: To examine epigenetic events of aberrant promoter methylation as diagnostic markers in primary head and neck squamous cell carcinoma using a novel multigene approach. Promoter methylation-mediated silencing is a hallmark of several established tumor suppressor genes. Changes in DNA methylation have been reported to occur early in carcinogenesis and therefore are potentially important early indicators of existing disease. DESIGN: A multicandidate gene probe panel interrogated DNA for aberrant methylation status in 22 cancer genes using the methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) assay. Aberrant promoter hypermethylation was confirmed using methylation-specific polymerase chain reaction after bisulfite treatment. SETTING: Primary care medical center. SUBJECTS: We examined fresh-frozen primary head and neck tumor specimens from 28 patients, including 21 late-stage (19 stage IV and 2 stage III) and 7 early-stage (6 stage II and 1 stage I) tumors. RESULTS: Promoter hypermethylation was observed in 14 of the 28 patients (50%). Genes for RARB, APC, and CHFR were most frequently hypermethylated, occurring in 11 (39%) for RARB, 7 (25%) for CHFR, and 6 (21%) for APC. Aberrant methylation of CHFR was solely a stage IV event. Methylation-specific polymerase chain reaction after bisulfite treatment with conventional and real-time polymerase chain reaction confirmed aberrant methylation for RARB and CHFR. CONCLUSIONS: Promoter methylation profiling of primary head and neck squamous cell carcinoma using multiple target genes identified RARB, APC, and CHFR as frequent epigenetic events. The clinical implications of these genes as diagnostic and treatment biomarkers are highly relevant as attractive targets for cancer therapy, given the reversible nature of epigenetic gene silencing.     

ASON对急性早幼粒白血病细胞株HL60/VCR多药耐药的逆转作用

目的:探讨反义寡核苷酸(ASON)对耐长春新碱的急性早幼粒白血病细胞(HL60/VCR)多药耐药(mdr1)的逆转效果。方法:以HL60/VCR细胞为模型,合成正、反义寡核苷酸作用于HL60/VCR细胞,采用RT-PCR方法、流式细胞术及药敏试验等观察细胞mdr-1mRNA表达、mdr-1基因产物P-糖蛋白(P-gp)的表达和对药物长春新碱(VCR)的敏感性。结果:反义寡核苷酸处理的细胞mdr-1mRNA表达、P-gp表达较正义组及HL60/VCR细胞显著降低,且可明显提高HL60/VCR细胞株对长春新碱的敏感性。结论:反义寡核苷酸具有逆转HL60/VCR细胞多药耐药的作用。其作用机制可能是抑制mdr1mRNA的转录,使P-gp的表达受到明显抑制,提高对长春新碱的敏感性。     

人参皂甙Rb1对耐长春新碱的急性早幼粒白血病(HL60/VCR)细胞多药耐药逆转的实验研究

目的:研究中药人参皂甙Rb1在多药耐药(MDR)逆转中的作用。方法:培养细胞,将细胞分为对照组和实验组,阳性对照组给异搏定,阴性对照组不给药,实验组给人参皂甙Rb1。通过细胞毒试验、药敏试验、RT-PCR方法和流式细胞术了解中药人参皂甙Rb1的毒性、细胞对药物的敏感性及在细胞水平和分子水平对多药耐药的逆转作用。结果:Rb180μM时,细胞存活95.47%,100μM时存活81.43%,对照组96.9%,因此选择80μM为实验剂量。在药敏实验中,80μM人参皂甙Rb1组IC50约在0.49μg/ml,不加药组IC50约在1.3μg/ml,用药前细胞耐药倍数为335.8倍,用药后耐药倍数为126倍,人参皂甙Rb1的逆转倍数为2.65倍,小于其耐药倍数,为部分逆转。RT-PCR结果显示,对照组和给药组均有明显的扩增片段区带,流式结果显示,破膜前给药组细胞膜表面的Pgp含量明显低于对照组,而破膜后由于细胞内的Pgp释放出来,则二组的表达差异不大。结论:总之本文通过一定的检测技术,主要说明可以通过人参皂甙Rb1抑制Pgp的功能,从而提高肿瘤细胞对化疗药物的敏感性,这对于今后研究和发展肿瘤治疗来说都有着十分重要的意义。