Study on the dualistic mechanisms for dysregulated expression of interleukin 6 in multiple myeloma

AlthoughitiswellknownthatIL-6isakeygrowthfactorofmyelomacells[1J,itremainscon-troversialthatIL-6comesfrommyelomacellsthemselvesorbonemarrowstromalcells(BMSCs)Lz,sJ.Toinvestigatetheaccuratemecha-nismofdysregulatedsecretionofIL-6inMM,weuseddoublelabeledimmunofluorometrytechniquestodetecttheIL-6expressioninBMMNCs-TheIL-6activitiesinco-culturalsupernatantsofmyelomacellsandBMSCswerealsomeasured.MATERIALSANDMETHoDSPatientsTwentyeightMMpatients:Therewere16malesand12femalesagedfrom…     

硬皮病皮损成纤维细胞整合素表达的免疫电镜观察*

目的：研究硬皮病皮损成纤维细胞整合素表达及细胞超微结构特征。方法：将培养的硬皮病皮损成纤维细胞置包被纤维粘连蛋白的培养瓶中作粘附培养,运用间接免疫胶体金技术在电镜下观察成纤维细胞表面整合素α5,β1亚基表达、分布特征及细胞超微结构变化。结果：硬皮病皮损成纤维细胞整合素α5,β1亚基表达均较正常成纤维细胞显著增加（P<0.01）,并呈簇集分布的特征;细胞内骨架成分微丝密集成束。结论：整合素α5,β1介导的纤维粘连蛋白与成纤维细胞相互作用在硬皮病时增强。     

老年中晚期原发性肝癌患者生活质量及其对生存期的影响

目的:观察老年中晚期原发性肝癌患者的生活质量状况及其对生存期的影响。方法:回顾性分析2014年01月至2016年12月我院收治的115例老年原发性肝癌患者,调查他们的生活质量指数（LQI）,比较不同LQI水平原发性肝癌患者的生存情况,并分析影响预后的危险因素。结果:本组患者生活质量的总分是（118.72±34.26）分,LQI是0.59±0.13。参照患者1年生存状态,LQI的最佳临界值为0.63,曲线下面积为0.696。高LQI组的中位生存时间为16.5个月,显著高于低LQI组的12.4个月(P=0.037）。与低水平LQI组比较,高水平LQI组的年龄、谷丙转氨酶（ALT）、谷草转氨酶（AST）、凝血酶原时间（PT）、总胆红素（TBIL）和甲胎蛋白（AFP）水平以及门静脉癌栓发生率、保守治疗率更小或更低,白蛋白（ALB）水平和BCLC分期更高,差异均有统计学意义（P<0.05）。单因素分析结果显示,老年中晚期原发性肝癌的预后与ALB、AFP、Child-Pugh分级、门静脉癌栓、肝外转移、BCLC分期、药物保守治疗和LQI相关（P<0.05）。多因素分析结果显示,AFP≥400 ng/ml、BCLC C期和药物保守治疗是预后的独立危险因素（P<0.05）,而非门静脉癌栓、非肝外转移、LQI≥0.63是其独立保护因素（P<0.05）。结论:老年中晚期原发性肝癌患者生活质量较低,生活质量越低,预后越差。     

A formation model of superoxide radicals photogenerated in nano-TiO2 suspensions

A formation model of O₂˙⁻ produced in TiO₂ photocatalysis was established, and then a custom built continuous flow chemiluminescence (CFCL) system was used to confirm the model''s reliability by monitoring the O₂˙⁻ formation process. This model may give deeper insights into O₂˙⁻ formation for TiO₂ and other photocatalysts.

A formation model of superoxide produced in TiO₂ photocatalysis was constructed for the first time and verified.

In photocatalytic reactions, such as TiO₂, it is generally accepted that O₂˙⁻ is produced from the reduction of adsorbed oxygen by photogenerated electrons on the TiO₂ surface.^1–5 O₂˙⁻ formation is a rate-limiting process in TiO₂ photocatalytic reactions,⁶ and thus determines the efficiency of TiO₂ photocatalytic reactions by promoting the separation of photogenerated electrons and holes. Moreover, O₂˙⁻ is an intriguing active species, attracting a great deal of attention in recent years due to its unique role. Previous studies have confirmed that O₂˙⁻ plays an essential role in the photodegradation of pollutants.^7,8 Therefore, probing the dynamic formation of O₂˙⁻ over the course of time under UV irradiation is conducive to better understanding TiO₂ photocatalytic reactions. We have successfully identified surface long-lived O₂˙⁻ photogenerated on TiO₂ surface,⁹ however, the dynamic details of O₂˙⁻ formation in TiO₂ photocatalytic reactions still remain to be solved.In photocatalytic reactions, O₂˙⁻ is continuously undergoing the processes of formation and deactivation simultaneously. Many methods have been developed to determine the O₂˙⁻, including electron spin resonance (ESR),¹⁰ spectrophotometric assays,^11–13 and fluorescence assays,^14,15 but the O₂˙⁻ could only be detected at discrete times, and thus the total quantity could only be given within the irradiation duration. Given these limitations, O₂˙⁻ dynamic monitoring is a great challenge. Chemiluminescence (CL) is inherently sensitive and rapid due to the relative ease with which light emission is instantly generated through a chemical reaction when two or more reactants are mixed. These qualities of CL make it suitable for the dynamic study of O₂˙⁻, despite its characteristic instability. In a previous study, we were able to successfully develop a continuous flow chemiluminescence (CFCL) method for dynamic monitoring of the formation process of O₂˙⁻ in TiO₂ photocatalytic reactions.¹⁶For the formation mechanism of O₂˙⁻ in TiO₂ photocatalytic reactions, it is generally accepted that O₂˙⁻ formation occurs on TiO₂ surfaces by the following scheme:where O₂ denotes the dissolved oxygen (DO) in solution, S denotes the oxygen adsorption site on TiO₂ surface, k₁ and k₋₁ denote the adsorption/desorption rate constant of O₂ respectively, O₂,_s denotes the adsorbed oxygen on TiO₂ surface, k_f denotes the formation rate constant of O₂˙⁻, O_2,s˙⁻ denotes the O₂˙⁻ formed on TiO₂ surface, and k_d denotes the rate constant of O₂˙⁻ decomposition. It was reported that DO was first adsorbed on the site of TiO₂ surface following the Langmuir isotherm,⁶ and then the adsorbed O₂ was reduced to O₂˙⁻ by photogenerated electrons under UV irradiation. Meanwhile, the formed O₂˙⁻ was transformed into other species by side reactions, such as H₂O₂ or ¹O₂ which deactivated to O₂ quickly. Specifically, it is suggested by some research that O₂˙⁻ could be produced from the oxidation of H₂O₂ by valence-band hole (h⁺) or hydroxyl radical (·OH) in solution, where H₂O₂ is produced by the two-step oxidation of water or the two-electron reduction of O₂.¹⁷ It is insignificant in this study because the O₂˙⁻ detected by CFCL method is the long-lived superoxide adsorbed on TiO₂ surface which is produced from the reduction of O₂ by photogenerated electrons, not in solution according to our previous study.⁹ The process of O₂˙⁻ formation was illustrated concretely as follows: when TiO₂ semiconductor is irradiated, the photogenerated electrons transferring to the TiO₂ surface are captured by five-coordinated surface Ti⁴⁺ to form the Ti³⁺ (eqn (1)). Then the O₂ adsorbed on TiO₂ surface react with Ti³⁺ to form O₂˙⁻ (eqn (2)).^1,2,18–Ti⁴⁺–OH + e → –Ti³⁺ + OH⁻1–Ti³⁺ + O_2,s → –Ti⁴⁺⋯OO˙⁻2O₂˙⁻ + h⁺/·OH → ¹O₂3O₂˙⁻ + e + H⁺ → H₂O₂4O₂˙⁻ + O₂˙⁻ + H⁺ → H₂O₂ + O₂5Meanwhile, O₂˙⁻ formed also undergoes a decaying process possibly via the following three pathways (eqn (3)–(5)): (1) oxidation by h⁺ or ·OH, (2) further reduction by e, or (3) self-disproportionation in solution. Therefore, the number of O₂˙⁻ determined in photocatalytic reactions at any irradiation time (t) is what the total quantity of formed O₂˙⁻ subtract those decomposed via the aforementioned side reactions from t₀ s to t s upon irradiation. The formula can be expressed as follows:6In this equation, the t₀ and t of the lower and upper limit of the definite integral represent the starting and ending time of UV irradiation respectively. Based on the formation process of O₂˙⁻ mentioned above, the net rate of O₂˙⁻ formation at any time in photocatalytic reactions can be obtained as shown in eqn (7.1). The first term of the right side of the eqn (7.1) represents the formation rate of O₂˙⁻, and it is a second-order reaction with respect to the concentration of –Ti³⁺([Ti³⁺]) and adsorbed oxygen (O_2,s). k_f is a second-order formation rate constant. The second term (eqn (7.1)) represents the decay rate of O₂˙⁻, among which k_d is a second-order decay rate constant, [X] represents the concentration of e, h⁺, ·OH or O₂˙⁻ in terms of eqn (3)–(5). It is generally believed to contain the aforementioned three pathways. We have previously confirmed that the O₂˙⁻ adsorbed on TiO₂ surface is thermodynamically favored.⁹ Therefore, the two former pathways (eqn (3) and (4)) dominated the decay process under UV irradiation. These processes were considered to be pseudo-first-order due to the constant of h⁺, ·OH and e under steady-state irradiation. So is the pseudo-first-order apparent rate constant (eqn (7.2)). [O₂]_s is equal to oxygen coverage on TiO₂ surface (θ) by the number of adsorption sites ([S]) according to Langmuir isotherm (eqn (7.2)), in which θ is related to the DO concentration in solution ([O₂]), adsorption constant (k₁), desorption constant (k₋₁), and formation rate constant of O₂˙⁻ (k_f) (eqn (7.3)).7.17.27.3It has been reported that the electron transfer from TiO₂ to O₂ is the rate-limiting step in TiO₂ photocatalytic reaction.^6,19–21 Upon this, k_f is far less than k₁[O₂] and k₋₁. Furthermore, the [O₂] in solution is low, and thus k₁[O₂] is far less than k₋₁. If such speculation is true, the eqn (7.3) can be eventually transformed into the following:8where K₁ (K₁ = k₁/k₋₁) is the adsorption equilibrium constant of [O₂]. Assuming that [O₂˙⁻] = mCL + n, which is a linear relationship between O₂˙⁻ concentration and CL intensity, the eqn (8) can then be converted into the following:9Finally, the eqn (10) representing the formation model of O₂˙⁻, with respect to time as the independent variable and CL intensity as the dependent variable, would be obtained by integrating these variables with the eqn (9) from t₀ to t:10In eqn (10), k_f, K₁, [S], [O₂], m, and n are constants under certain conditions. The coefficient represents the theoretical maximum CL intensity (CL₀) corresponding to the steady-state concentration of O₂˙⁻ when t is infinite in irradiated TiO₂ suspensions. Herein t₀ is the time when irradiation starts for 50 s, due to the disturbance of background signal within the first 50 s of irradiation. According to eqn (10), given that k_f, K₁, and k_d are determined by the intrinsic property of TiO₂ photocatalyst regardless of experimental conditions, CL₀ is dependent on [Ti³⁺], [S], [O₂] and [X], which are closely related to experimental conditions. In photocatalytic reactions, [Ti³⁺] relies on the number of photogenerated electrons highly dependent on I; [S] is the total surface area of TiO₂ in suspension, closely related to [TiO₂]; [O₂] is dependent on [DO] in TiO₂ suspensions; [X], the aforementioned concentration of h⁺, ·OH and e, is also dependent on I.In order to verify the formation model of O₂˙⁻, we fit the different CL curves with eqn (10) by changing [TiO₂], I, and [DO]. As shown in Fig. 1(a–i), the CL curves from different [TiO₂], I and [DO] were well-fit by eqn (10) with high correlation coefficients (R² > 0.99), indicating that the model could simulate dynamic process of O₂˙⁻ formation. Furthermore, according to the O₂˙⁻ formation model (eqn (10)), CL intensity is linearly correlated to [S], [Ti³⁺], and [O₂], indicating that CL intensity could increase linearly with the increase of [TiO₂], I and [DO] within set limits. In order to verify this assumption, CL intensity at 300 s, 600 s, 900 s, 1200 s and +∞ under different [TiO₂], I and [DO] conditions in TiO₂ suspensions was calculated by eqn (10) (Table S1^†). Then the CL intensity from different [TiO₂], I and [DO] at different time points were linearly fit (Fig. S1–3^†), and the R square values were calculated and summarized in eqn (10). There was also a good linear relationship between CL intensity and I with high correlation coefficients (R² > 0.9), except at +∞ (R² = 0.821), indicating that CL intensity increased linearly with the increase of [Ti³⁺]. At different [DO], the corresponding R² values were also high (R² > 0.95), indicating that CL intensity was also linearly dependent on [O₂]. Overall, the formation model of O₂˙⁻ could adequately describe the dynamic process of O₂˙⁻ formation in photo-irradiated TiO₂ suspensions.Open in a separate windowFig. 1CL curves of luminol (50 μM) with photo-irradiated TiO₂ suspensions (pH = 11) under different experimental conditions: TiO₂ concentration (a–c), irradiation intensity (d–f), DO concentration (g–i). The black lines represent experimentally measured values and the red lines are the fitted values.The calculated value of R square upon different experimental conditions at different irradiation time

电化学治疗肿瘤研究进展

利用细胞电穿孔结合抗肿瘤药物治疗肿瘤 ,称为肿瘤的电化疗 (Electrochemotherapy ,ECT)。离体肿瘤细胞和活体肿瘤组织电穿孔的最低电场强度分别为 4 5 0～ 6 5 0V/cm和 4 0 0～ 6 0 0V/cm。治疗肿瘤时常用脉冲个数 8个 ,脉冲宽度 10 0 μs,场强 6 0 0～130 0V/cm .,频率 1Hz的电场。已经有 10余种抗肿瘤药物用于电化学治疗肿瘤的研究 ,其中博莱霉素的效果最好 ,其次为顺式铂氨等。电化学治疗肿瘤 ,从体外培养细胞株到体内实体瘤 ,从实验室到临床 ,都已经取得了一些成果。电场参数、电极针的直径、电场磁力线的几何分布、肿瘤的大小、给药方式和药物种类等影响电化学治疗的效果。电化学治疗肿瘤运用于临床治疗还面临着一些问题 ,比如临床药物的选择和剂量、给药方式、对正常组织的影响、治疗机理等。     

The timing of surgical treatment of knee dislocations: a systematic review

Purpose

Traumatic knee dislocations (KDs) are unusual yet limb-threatening injuries; the timing of surgical intervention is still debated. A systematic review was performed to determine the optimal timing of surgery with respect to injury pattern.

Methods

A comprehensive search of Medline, EMBASE, and Cochrane Central Register of Controlled Trials was performed for studies published between 1 January 1974 and 20 April 2014 on the surgical management of “knee dislocation” and “multiligament knee injuries”. Surgical timing was classified as acute, chronic, or staged. A systematic review was performed for patients with KD-III according to Schenck’s classification using individual patient data.

Results

Twelve studies including 150 patients (153 knees) with KDs fulfilled the study requirements. Sixty-nine cases with KD-IIIM and 84 cases with KD-IIIL were identified. Excellent or good results were demonstrated in 79.1 % (34 cases) of cases managed with staged treatment versus 58.4 % (45 cases) of cases undergoing acute surgery (p = 0.02), and versus 45.5 % (15 cases) of cases undergoing chronic surgery (p = 0.002). No statistically significant difference was found in the percentage of excellent or good results between the acute and chronic surgery groups (n.s.), or between the KD-IIIM and KD-IIIL groups (n.s.).

Conclusion

Staged treatment yields the best clinical results for patients with KD-III. No statistically significant difference was shown in the clinical results between acute surgery and chronic surgery groups.

Level of evidence

IV.

     

早期胃癌的常规钡餐检查方法及征象分析

目的：通过各种常规钡餐方法的比较及早期胃癌（ＥＧＣ）的征象分析,提高常规钡餐造影对早期胃癌的检出率,方法：对４４例手术及病理证实的早期胃癌进行回顾性研究,重点对溃疡进行研究,并与３２例胃镜或手术病例证实的良性溃疡对照,结果：ＥＣＧ病例中Ｘ线发现异常的总阳性率９５．５％,采用双对比像,粘膜像,充盈像,压迫像的阳性率分别为９０．９％,８１．８％,５４．５％,５６．８％,对病变及周围粘膜均能清晰显示并能     

恶性滋养细胞肿瘤的彩色多普勒能量图及其定量分析

目的：探讨彩色多普勒能量图（ＣＤＥ）及其定量分析技术在诊断恶性滋养细胞肿瘤中的应用价值。方法：检测１９例恶生滋养细胞肿瘤患者、２５例早孕妇女和２５例正常人子宫血流的彩色多普勒血流显像（ＣＤＩ）和ＣＤＥ表现，进而采用子宫肌层显示的血流面积百分比方法对ＣＤＥ作定量分析。结果：病例组和早孕组子宫动脉血流搏动指数（ＰＩ）较正常组显著降低（Ｐ＜０．００１和Ｐ＜０．０１），但两组间无显著差异。病例组ＣＤＩ显示子宫肌层血流呈灶状分布，早孕组呈散在小灶状分布，正常组无明显血流显示：ＣＤＥ则显示出比ＣＤＩ更为丰富的血流图像，其定量分析揭示子宫平均血流面积百分比在病例组、早孕组和正常组分别为３９．９％、２６．４％和１４．８％，三组间差异显著。结论：子宫动脉血流ＰＩ值诊断与鉴别恶生滋养细胞肿瘤价值有限；ＣＤＥ对子宫血流显示明显比ＣＤＩ丰富，用定量分析方法可以建立一个客观的诊断指标，而且有助于判断疗效     

术后心理干预对卵巢癌患者负面情绪及生活质量的影响

目的 分析术后心理干预对卵巢癌患者负面情绪及生活质量的影响.方法 选择在本院接受手术治疗的卵巢癌患者作为研究对象,随机分为接受常规术后护理的对照组和接受针对性术后心理干预的观察组,比较两组患者的负面情绪、应激水平及生活质量评分差异.结果 (1)观察组患者接受针对性术后心理干预后的焦虑及抑郁评分均明显低于对照组患者(P＜0.05);(2)观察组患者接受术后心理干预后的GIU、E、NE、COI水平均明显低于对照组患者(P＜0.05);(3)观察组患者接受针对性术后心理干预后的各项生活质量评分值均明显低于对照组患者(P＜0.05).结论 卵巢癌患者术后进行针对性心理干预可以有效缓解患者不良情绪状态,缓解全身应激水平,最终提升术后生活质量,具有积极的临床意义.     

流式细胞术在血液肿瘤诊断、研究中的应用

流式细胞术(FCM)是近代细胞生物学、分子生物学、分子免疫学和单克隆抗体技术、激光技术、电子计算机技术等学科高度发展、综合的结晶,FCM的应用标志着细胞学、肿瘤学、免疫学等进入了细胞和分子水平的研究。FCM利用多种荧光素与细胞染色,定量分析细胞表面和细胞内抗原,这些参数的定量变化已被用于确定正常和异常细胞的分化和生长,在血液肿瘤的诊断、预后检测和临床研究中发挥了非常重要的作用。FCM利用多种单克隆抗体可将血液肿瘤分为急性淋巴细胞白血病(ALL)和急性髓细胞白血病(AML)等,ALL又可分为T系和B系多个亚型,T系分为幼稚…