进展期胃癌S-1与5-FU基础化疗有效性和安全性Meta分析

目的 S-1被应用于进展期胃癌一线化疗中,其疗效也备受关注.本研究评估S-1基础化疗对比5-氟尿嘧啶(5-Fluorouracil,5-FU)基础化疗方案在进展期胃癌一线化疗中的有效性和安全性.方法 用“胃癌、替吉奥或S-1、5-氟尿嘧啶和随机对照研究”等检索词,在Pubmed、Embase、Cochrane Library、ASCO会议摘要、中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)和中文科技期刊全文数据库(VIP)等检索相关的临床随机对照试验,检索时间截止至2016-10.提取总生存期、无疾病进展生存期、有效率、3～4级不良反应等数据.采用Revman 5.3和STATA 12.0进行数据分析.结果 共纳入18个随机对照研究,3 581例患者.结果显示,S-1基础化疗在总生存期(HR=0.92,95％CI为0.84～1.01,P=0.07)及无疾病进展生存期(HR=0.90,95％CI为0.76～1.07,P=0.25)方面与5-FU基础化疗方案差异无统计学意义,但有更高的有效率,RR=1.46,95％CI为1.22～1.74,P＜0.001.S-1基础化疗方案3～4级中性粒细胞减少(P＜0.001)、白细胞减少(P＜0.001)、血小板减少(P=0.01)、口腔炎(P＜0.001)和脱发(P=0.02)等不良反应较5-FU基础化疗发病率更低,差异有统计学意义.结论 相比于5-FU基础化疗,S-1基础化疗在进展期胃癌一线治疗中均是有效且更安全的化疗方案.     

红花多糖对人PBMC和CD8＋T细胞增殖作用的影响

目的探讨红花多糖（safflower polysaccharide,sPs）体外对人外周血单个核细胞（PBMC）和CD8＋T细胞增殖作用的影响。方法采用葡聚糖-泛影葡胺密度梯度离心法（ficoll-hypaque density gradient centrifugation）从健康成人外周血中分离PBMC,在体外与不同浓度的SPS共同培养,用3H-TdR法检测PBMC增殖活性;流式细胞术检测CI）8＋T细胞的增殖情况。结果SPS能够促进PBMC增殖,尤其1．25g·L-1和0．625g·L-1。两组PBMC增殖作用明显,与对照组比较差异有统计学意义（P〈0．05）;SPS对CD8＋T细胞的增殖有促进作用,与对照组比较差异有统计学意义（P〈0．05）。结论SPS可促进PBMC、CD8＋T细胞的增殖,增强机体非特异性和特异性免疫功能。     

胆道恶性肿瘤组织耐药相关蛋白P-gp和GST-π表达临床意义的探讨

目的:探讨耐药相关蛋白P-糖蛋白(P-gp)和谷胱甘肽S转移酶(GST-π)在胆道恶性肿瘤组织中的表达及其与临床病理参数的相关性.方法:采用免疫组化SP法检测60例胆道恶性肿瘤组织中P-gp和GST-π的表达.结果:60例胆道恶性肿瘤组织P-gp阳性表达率为88.3%,GST-π阳性表达率为93.3%.肿瘤高、中分化组织P-gp和GST-π阳性表达率分别为79.3%和86.2%,均低于低分化组织的96.8%和100.0%,P值均<0.05;局部浸润组织P-gp和GST-π阳性表达率分别为96.4%和100.0%,均高于无局部浸润组织的81.3%和87.5%,P值均<0.05;淋巴转移组织P-gp和GsT-π阳性表达率分别为97.0%和100.0%,均高于无淋巴转移的77.8%和85.2%,P值均<0.05.结论:P-gp和GST-π在胆道恶性肿瘤组织中呈高表达,联合检测P-gp和GST-π对指导临床化疗药物、制定合理的个体化疗方案和判断预后有着重要的意义.     

Two BRM promoter polymorphisms predict poor survival in patients with hepatocellular carcinoma

Polymorphisms in the promoter of the BRM gene, a critical subunit of the chromatin remodeling SWI/SNF complex, have previously been implicated in risk and prognosis in Caucasian‐predominant lung, head and neck, esophageal, and pancreatic cancers, and in hepatocellular cancers in Asians. We investigated the role of these polymorphisms in hepatocellular carcinoma (HCC) risk and prognosis. HCC cases were recruited in a comprehensive cancer center while the matched controls were recruited from family practice units from the same catchment area. For risk analyses, unconditional logistic regression analyses were performed in HCC patients and matched healthy controls. Overall survival analyses were performed using Cox proportional hazard models, Kaplan‐Meier curves, and log‐rank tests. In 266 HCC cases and 536 controls, no association between either BRM promoter polymorphism (BRM‐741 or BRM‐1321) and risk of HCC was identified (P > 0.10 for all comparisons). There was significant worsening of overall survival as the number of variant alleles increased: BRM‐741 per variant allele adjusted hazards ratio (aHR) 5.77, 95% confidence interval (CI) 2.89‐11.54 and BRM‐1321 per variant allele aHR 4.09, 95%CI 2.22‐7.51. The effects of these two polymorphisms were at least additive, where individuals who were double homozygotes for the variant alleles had a 45‐fold increase in risk of death when compared to those who were double wild‐type for the two polymorphisms. Two BRM promoter polymorphisms were strongly associated with HCC prognosis but were not associated with increased HCC susceptibility. The association was strongest in double homozygotes for the allele variants.     

Exposure to power frequency electric fields and the risk of childhood cancer in the UK

The United Kingdom Childhood Cancer Study, a population-based case-control study covering the whole of Great Britain, incorporated a pilot study measuring electric fields. Measurements were made in the homes of 473 children who were diagnosed with a malignant neoplasm between 1992 and 1996 and who were aged 0-14 at diagnosis, together with 453 controls matched on age, sex and geographical location. Exposure assessments comprised resultant spot measurements in the child's bedroom and the family living-room. Temporal stability of bedroom fields was investigated through continuous logging of the 48-h vertical component at the child's bedside supported by repeat spot measurements. The principal exposure metric used was the mean of the pillow and bed centre measurements. For the 273 cases and 276 controls with fully validated measures, comparing those with a measured electric field exposure >/=20 V m(-1) to those in a reference category of exposure <10 V m(-1), odds ratios of 1.31 (95% confidence interval 0.68-2.54) for acute lymphoblastic leukaemia, 1.32 (95% confidence interval 0.73-2.39) for total leukaemia, 2.12 (95% confidence interval 0.78-5.78) for central nervous system cancers and 1.26 (95% confidence interval 0.77-2.07) for all malignancies were obtained. When considering the 426 cases and 419 controls with no invalid measures, the corresponding odds ratios were 0.86 (95% confidence interval 0.49-1.51) for acute lymphoblastic leukaemia, 0.93 (95% confidence interval 0.56-1.54) for total leukaemia, 1.43 (95% confidence interval 0.68-3.02) for central nervous system cancers and 0.90 (95% confidence interval 0.59-1.35) for all malignancies. With exposure modelled as a continuous variable, odds ratios for an increase in the principal metric of 10 V m(-1) were close to unity for all disease categories, never differing significantly from one.     

双歧杆菌对实验性大肠癌化bcl-2及bax基因表达的影响

目的 通过观察大肠癌裸鼠移植瘤bcl-2及bax基因的蛋白表达水平,探讨双歧杆菌的抑瘤途径及机制.方法 采用免疫组化SP法检测了40只裸鼠大肠癌移植瘤bcl-2及bax基因的蛋白表达率及表达强度.结果 双歧杆菌注射组大肠癌移植瘤bcl-2蛋白表达率及阳性细胞密度均低于肿瘤对照组,bax基因的表达情况则相反.结论 双歧杆菌可使大肠癌裸鼠移植瘤的bcl-2基因表达下调,bax基因表达增强,最终诱导肿瘤细胞凋亡,实现其抗瘤目的.     

2例Cornelia de Lange综合征病例报告并NIPBL基因突变研究

目的：对2例生长发育迟缓伴有特殊面容及肢体发育异常的患儿进行基因检测,实现罕见病的精准诊断,为遗传咨询提供指导。方法：应用单基因检测及全外显子组高通量测序技术对临床疑似CdLS患儿进行致病基因突变筛查,并行一代测序验证以及患儿父母的验证。结果：本研究中的2例患儿均检测到国内外尚未报道的NIPBL基因突变,c.2252 dupA、p.Asn751Lysfs以及NM-015384.4：c.6179dupA,父母均无携带,为新生变异。结论：对于发育迟缓伴特殊面容及肢体异常的患儿要考虑到Cornelia de Lang综合征可能,采用基因检测手段实现精准诊断,为患者及家属遗传咨询提供依据。     

VEGF反义寡核苷酸抑制大鼠胶质瘤生长的时间与剂量的效应关系

目的在大鼠脑内原位注射反义寡核苷酸观察胶质瘤的生长抑制情况的时间与剂量的效应关系。方法所有大鼠均在立体定向导引下右尾状核区接种1×106C6胶质瘤细胞。不同时间和剂量VEGF反义寡核苷酸均在立体定向导引下原穿刺靶点注射。其中实验Ⅰ组在接种细胞的同时原位注射1000μmol/L的VEGF反义寡核苷酸,而实验Ⅱ组则同时注射2000μmol/L的VEGF反义寡核苷酸。对照Ⅰ组为对照。实验Ⅲ和Ⅳ组在细胞接种后的1和2周各原位注射1次,共2次,每次实验Ⅲ组为1000μmol/L、实验Ⅳ组为2000μmol/L的VEGF反义寡苷核酸。对照Ⅱ组为对照。实验V组仅在接种后2周注射1次2000μmol/L的VEGF反义寡核苷酸,并设对照Ⅲ组为对照。实验3周时处死所有的大鼠,解剖出全脑标本,观察肿瘤的生长情况,测量肿瘤大小。结果实验Ⅰ组的抑瘤率为94.5％,实验Ⅱ组的抑瘤率为100％。实验Ⅲ组的抑瘤率为91.5％,实验Ⅳ组为100％,实验Ⅴ组抑瘤率为87.8％。实验组和对照组的肿瘤体积比较有非常显著的差异。结论 原位应用VEGF反义寡核苷酸能取得很好的抗血管生成的治疗效果,抑瘤效果有明显的浓度依赖性。原位早期使用足量反义核酸能取得更好的效果。