Tumor-specific gene expression using the survivin promoter is further increased by hypoxia

Increasing evidence indicates that survivin, an inhibitor of apoptosis protein (IAP), is expressed in human cancer cells but is absent from most normal adult tissues. Here, we examined the feasibility of using a survivin promoter (Sur-P) to direct therapeutic expression of a proapoptotic gene specifically in human tumor cells. First, we demonstrated that this promoter was highly active in human tumor cells but not in normal cells. Second, we found that Sur-P activity was upregulated by hypoxia in tumor cells. Third, to further enhance this promoter's activity under hypoxia, we added a hypoxia-responsive element (HRE) from the vascular endothelial growth factor gene promoter in its 5' region, and showed that this combination resulted in a further increase in the level of gene expression in hypoxic tumor cells. Finally, we demonstrated that expression of an autocatalytic reverse caspase-3 gene by this promoter specifically induced apoptotic cell death in human tumor cells but not in normal cells. These findings support the use of promoters Sur-P or chimeric HRE-Sur-P for generating novel vectors for cancer gene therapy.     

Short-term Rosuvastatin Treatment for the Prevention of Contrast-induced Acute Kidney Injury in Patients Receiving Moderate or High Volumes of Contrast Media: A Sub-analysis of the TRACK-D Study

Background:

Current randomized trials have demonstrated the effects of short-term rosuvastatin therapy in preventing contrast-induced acute kidney injury (CIAKI). However, the consistency of these effects on patients administered different volumes of contrast media is unknown.

Methods:

In the TRACK-D trial, 2998 patients with type 2 diabetes and concomitant chronic kidney disease (CKD) who underwent coronary/peripheral arterial angiography with or without percutaneous intervention were randomized to short-term (2 days before and 3 days after procedure) rosuvastatin therapy or standard-of-care. This prespecified analysis compared the effects of rosuvastatin versus standard therapy in patients exposed to (moderate contrast volume [MCV], 200–300 ml, n = 712) or (high contrast volume [HCV], ≥300 ml, n = 220). The primary outcome was the incidence of CIAKI. The secondary outcome was a composite of death, dialysis/hemofiltration or worsened heart failure at 30 days.

Results:

Rosuvastatin treatment was associated with a significant reduction in CIAKI compared with the controls (2.1% vs. 4.4%, P = 0.050) in the overall cohort and in patients with MCV (1.7% vs. 4.5%, P = 0.029), whereas no benefit was observed in patients with HCV (3.4% vs. 3.9%, P = 0.834). The incidence of secondary outcomes was significantly lower in the rosuvastatin group compared with control group (2.7% vs. 5.3%, P = 0.049) in the overall cohort, but it was similar between the patients with MCV (2.0% vs. 4.2%, P = 0.081) or HCV (5.1% vs. 8.8%, P = 0.273).

Conclusions:

Periprocedural short-term rosuvastatin treatment is effective in reducing CIAKI and adverse clinical events for patients with diabetes and CKD after their exposure to a moderate volume of contrast medium.     

经后路全内镜技术治疗腰椎间盘突出症86例疗效观察

目的 探讨后路全内镜(Full Endoscopic,FE)技术取除突出髓核组织治疗腰椎间盘突出症的可行性及有效性.方法 2012年8月至2013年8月共收治经临床确诊为单节段腰椎间盘突出症患者86例,腰4/5节段35例、腰5骶1节段51例.采用后路全内镜技术取出突出髓核组织的治疗方法,根据术后腰痛及腿痛缓解情况、下床活动及住院时间评估恢复效果.手术前后采用VAS评分评价患者腰痛缓解情况,ODI评分评价患者腿痛及日常工作与生活情况.结果 84例患者顺利完成手术,术后下床时间8 ～ 12h,平均10 h;术后住院时间为2～4d,平均3d;术后2周恢复非体力劳动的工作.84例患者均无神经根、硬膜损伤及其它手术并发症发生,均获随访,随访时间6 ～12个月.与术前相比,术后VAS评分及ODI评分明显改善(P＜0.05).另2例患者改开放手术.结论 采取后路全内镜下技术取出突出髓核组织治疗腰椎间盘突出症具有创伤小、神经根减压充分、出血少,恢复快等优点,体现了外科微创手术有的放矢、立竿见影的确切效果.     

TRAF4 enhances oral squamous cell carcinoma cell growth,invasion and migration by Wnt-β-catenin signaling pathway

Oral squamous cell carcinoma (OSCC) ranks as the fifth most common cancer worldwide with poor prognosis. Recently, tumor necrosis factor receptor-associated factor 4 (TRAF4) has attracted increasing attenuation due to its overexpression in certain cancers. However, its function and underlying mechanism in OSCC remains elusive. In this study, the high expression of TRAF4 mRNA and protein levels was noted in OSCC cell lines. Its overexpression with pcDNA3.1-TRAF4 vector transfection dramatically promoted cell proliferation and inhibited cell apoptosis, indicating a pivotal role of TRAF4 in OSCC cell growth. Simultaneously, TRAF4 elevation also increased cell invasion and migration. Mechanism analysis confirmed that TRAF4 up-regulation induced the expression of β-catenin and the downstream target molecules of cyclinD1, c-myc, Bcl-2, MMP-9 and MMP-2, indicating that TRAF4 could induce the activation of Wnt/β-catenin pathway. After pretreatment with β-catenin siRNA, the pathway was remarkably silenced. Simultaneously, cell growth, invasion and migration induced by TRAF4 were strikingly abrogated, suggesting that TRAF4 may promote OSCC cell growth, invasion and migration by Wnt/β-catenin pathway. Together, this study confirmed that TRAF4 acts as an oncogene for the development and progression of OSCC. Therefore, our study may support a promising therapeutic target for the treatment of OSCC.     

不同途径胆汁再利用对恶性梗阻性黄疸患者营养状况的影响

目的探讨两种胆汁再利用方法的临床应用价值,并观察有无不良反应。方法选取恶性梗阻性黄疸行经皮肝穿刺胆道引流术(PTCD)患者,随机分为胆汁回输联合肠内营养(EN)组(A组39例)、胆汁口服联合EN组(B组36例)与对照组(C组38例),通过各项指标比较各组患者胃肠功能及营养状况。结果 A、B组患者营养状况明显高于C组,差异有统计学意义,P0.05;A、B两组患者各项指标差异无统计学意义,P0.05;三组患者胃肠功能差异均无统计学意义,P0.05。结论两种胆汁再利用联合EN均可改善患者营养状况,且作用相似。住院患者可以首选胆汁回输联合EN,而不能进行胆汁回输的患者,可以选择口服胆汁联合EN。     

加味双柏软膏的制备及质量控制

目的制备加味双柏软膏,对其质量控制方法进行研究。方法采用薄层色谱图(TLC)鉴别黄柏、侧柏叶,高效液相色谱(HPLC)法测定大黄素、大黄酚含量,并对其质量进行控制。结果黄柏、侧柏叶的薄层鉴别斑点清晰、专属性强;大黄素质量浓度在2.012~50.3μg/m L范围内与峰面积呈良好线性关系(r=0.999 9,n=6),平均回收率为98.82%,RSD为1.62%(n=9);大黄酚质量浓度在5.258~105.16μg/m L范围内与峰面积呈良好线性关系(r=0.999 9,n=6),平均回收率为98.66%,RSD为1.51%(n=9)。结论加味双柏软膏制备工艺合理可行,该法操作简单、专属性强、重复性好、结果准确可靠。     

糖尿病患者社区责任制护理的效果评价

目的 探讨社区责任制护理在管理糖尿病患者中的效果.方法 选取2011年4月至2012年4月在本院进行治疗的糖尿病患者170例,随机分成观察组和对照组,各85例,观察组患者给予社区责任制护理,对照组给予常规糖尿病护理,1年后对两组患者血糖控制率、疾病认知度、并发症的发生率进行比较.结果 实施社区责任制护理后,观察组的主要生化指标明显优于对照组;卫生知识知晓率、健康行为形成率亦优于对照组;新增并发症率及致残率明显降低(P＜0.05),两组比较差异有统计学意义.结论 对糖尿病患者实施社区责任制护理能够取得理想的效果,有助于患者改善生化指标、提高卫生知识知晓率和健康行为形成率、降低并发症率和致残率,值得社区推广.