Induction of apoptosis in multi-drug resistant (MDR) human glioblastoma cells by SN-38, a metabolite of the camptothecin derivative CPT-11

 The overexpression of the multidrug resistance (mdr1) gene and its product, P-glycoprotein (P-gp), is thought to limit the successful chemotherapy of human tumors. Recent studies demonstrate that SN-38, a metabolite of the camptothecin (CPT) derivative CPT-11, has antitumor effects on several tumors, but the mechanisms responsible for its cytotoxicity remain unclear. We therefore determined whether SN-38 has cytotoxic effects on MDR human glioblastoma GB-1 cells and non-MDR human glioblastoma U87-MG cells. Furthermore, we determined what role SN-38 plays in the induction of cytotoxicity in these tumor cells. In this study, we demonstrated that SN-38 had significantly stronger antitumor effects on GB-1 and U-87MG cells than did CPT (P<0.01 and P<0.05, respectively). In addition, findings obtained using a DNA fragmentation assay, Hoechst 33258 staining, in situ end-labeling and cell cycle analysis demonstrated that SN-38 induced apoptosis in these tumors. Our results suggest that SN-38 has a stronger antitumor effect on malignant glioma cells regardless of MDR expression than does CPT, and therefore can be considered a new chemotherapeutic agent potentially effective in the treatment of human primary or recurrent malignant gliomas resistant to chemotherapy. Received: 6 October 1995/Accepted 29 June 1996     

食管异物摘取术的麻醉选择

为探讨食管异物摘取术的麻醉方法，提高手术效果，对７２例食管异物患者采用强化表面麻醉法和气管内插管麻醉法进行了手术和对比观察。７２例异物均取出顺利，无严重并发症发生。资料显示：两种麻醉各具优越性，前者适用于年龄较大的儿童和成人，后者适用于食管异物并呼吸困难的小儿。     

妊高征患者合体滋养细胞质膜部分生化指标的变化

目的：研究妊高征（ＰＩＨＳ）患者胎盘合体滋养细胞质膜（ＳＴＣＰＭ）中生化指标的变化及原因。方法：ＰＩＨＳ２４例，其中轻度８例、中度７例、重度９例，以正常孕妇１８例作对照，用Ｗｈｉｔｓｅｔ等法制备ＳＴＣＰＭ，以孔雀石绿无机磷法（ＭＧＩｏＰＡ）测定ＡＴＰａｓｅ的活性，用ＤＰＨ荧光探针测定膜的微粘度来推断膜的流动性，用硫代巴比妥酸荧光微量测定法测丙二醛酸（ＭＤＡ）以代表脂质过氧化物（ＬＰＯ）。结果：ＰＩＨＳ组Ｎａ＋、Ｋ＋－ＡＴＰａｓｅ、Ｃａ２＋、Ｍｇ２＋－ＡＴＰａｓｅ活性均显著低于对照组（Ｐ＜０．０５），且随病情加重而降低，膜的流动性亦显著降低（Ｐ＜０．０５），ＭＤＡ则显著增高，且随病情加重而增高；ＭＤＡ与两种ＡＴＰ酸呈负相关关系（Ｐ＜０．０５）。结论：ＰＩＨＳ的ＳＴＣＰＭ生化指标发生变化，其变化的原因之一是脂质过氧化作用增强     

三七、茜草复方对置铜宫内节育器家兔子宫局部t-PA活性的影响

目的 探讨三七、茜草(SQ)复方治疗置铜宫内节育器(Cu-IUD)所致子宫异常出血的作用机理。方法 制 作家兔置Cu-IUD动物模型,以吲哚美辛作对照,观察SQ复方对置Cu-IUD家兔模型子宫匀浆中组织型纤溶酶原激 活物(t-PA)活性的影响。结果 置Cu-IUD家兔模型子宫匀浆中t-PA的含量增高(P<0．01),经SQ复方治疗后与模 型组比较有显著性差异(P<0．01),说明SQ复方能减少家兔子宫匀浆中t-PA的含量,降低t-PA的活性。结论 SQ 复方通过降低置Cu-IUD家兔子宫内膜局部的纤溶活性而达到止血的目的。     

The effect of nerve-root injections on the need for operative treatment of lumbar radicular pain. A prospective, randomized, controlled, double-blind study

BACKGROUND: The purpose of the present study was to determine the effectiveness of selective nerve-root injections in obviating the need for an operation in patients with lumbar radicular pain who were otherwise considered to be operative candidates. Although selective nerve-root injections are used widely, we are not aware of any prospective, randomized, controlled, double-blind studies demonstrating their efficacy. METHODS: Fifty-five patients who were referred to four spine surgeons because of lumbar radicular pain and who had radiographic confirmation of nerve-root compression were prospectively randomized into the study. All of the patients had to have requested operative intervention and had to be considered operative candidates by the treating surgeon. They then were randomized and referred to a radiologist who performed a selective nerve-root injection with either bupivacaine alone or bupivacaine with betamethasone. The treating physicians and the patients were blinded to the medication. The patients were allowed to choose to receive as many as four injections. The treatment was considered to have failed if the patient proceeded to have the operation, which he or she could opt to do at any point in the study. RESULTS: Twenty-nine of the fifty-five patients, all of whom had initially requested operative treatment, decided not to have the operation during the follow-up period (range, thirteen to twenty-eight months) after the nerve-root injections. Of the twenty-seven patients who had received bupivacaine alone, nine elected not to have the operation. Of the twenty-eight patients who had received bupivacaine and betamethasone, twenty decided not to have the operation. The difference in the operative rates between the two groups was highly significant (p < 0.004). CONCLUSIONS: Our data demonstrate that selective nerve-root injections of corticosteroids are significantly more effective than those of bupivacaine alone in obviating the need for a decompression for up to thirteen to twenty-eight months following the injections in operative candidates. This finding suggests that patients who have lumbar radicular pain at one or two levels should be considered for treatment with selective nerve-root injections of corticosteroids prior to being considered for operative intervention.     

眼视动系统检查对突发性聋预后评估的初步报告

目的探讨用眼视动系统检查的各项参数值评估突聋患者预后的科学性。方法用113例突聋患者治疗前的扫视跟踪实验(saccade test，ST)、眼跟踪试验(eye trucking test，ETT)、变温试验(caloric test，CaT)等十项前庭功能检查参数值与治疗后的听力结果建立Logistic回归模型，作Logistic回归和逐步回归分析，分析各参数间统计学的差异。结果用二种回归方法对自变量逐步剔除，最终有三项指标入选，表明与突聋的预后有关，分别为左、右扫视跟踪试验及左侧变温试验。结论用眼视动系统检查的参数值判定突聋的预后，具有一定的科学性，根据ETT及ST参数值的大小及曲线的类型可基本确定脑血管的缺血程度，CaT的参数值可判定半规管功能正常与否，半规管功能正常或亢进其预后也较好。     

全麻下改良额肌瓣悬吊术治疗儿童先天性重度上睑下垂临床观察

目的寻找一种治疗先天性重度上睑下垂的有效手术方法。方法总结94眼先天性重度上睑下垂行改良额肌瓣悬吊术。结果94眼中85眼满意(90%),94眼基本满意(100%)。结论该术式简单,效果好,是治疗先天性重度上睑下垂的首选方法。     

先天性小肠闭锁术后肠动力功能障碍的原因探讨

目的探讨小肠闭锁术后发生肠动力功能障碍的原因及手术切除病变肠管范围。方法对小肠闭锁手术切除小肠标本15例及对照组6例非肠道或神经系统疾病死亡的足月新生儿尸检小肠标本肠壁S-100蛋白、α-平滑肌肌动蛋白（α-SMA）和c-kit蛋白进行免疫组化研究。观察闭锁两端肠壁肠神经系统（ENS）、平滑肌和肠间质细胞（ICCs）病理改变及其分布范围，并行统计学处理。结果闭锁近端肠壁S-100、α-SMA和c—kit阳性表达明显低于对照组。随远离盲端，以上指标呈逐渐增加趋势。在闭锁近端16cm、远端4cm处，三者病变总体趋于正常。结论小肠闭锁两端肠壁与肠动力密切相关的ENS、平滑肌和ICCs均存在病变。是小肠闭锁术后发生肠道动力功能障碍的原因。在患儿小肠长度允许的情况下．切除闭锁近端肠管16cm以上，而远端切除4cm．可减少或避免术后肠动力功能障碍的发生。     

肝素在治疗妊娠中晚期脐动脉血流异常的临床探讨

目的探讨肝素对妊娠中晚期脐动脉血流异常的影响,以便寻找改善脐动脉血流异常的有效治疗方法。方法采用脐动脉血流收缩期最大血流速度(S)与舒张末期血流速度(D)的比值,将脐动脉血流S/D比值大于相应孕周的第95百分位以上的83例妊娠中晚期妇女共85例胎儿(2例双胎)分为研究组(41例孕妇,42例胎儿)和对照组(42例孕妇,43例胎儿)。研究组应用肝素6 250 u+5%葡萄糖500 mL;对照组应用低分子右旋糖酐500 mL,丹参30 mL+10%葡萄糖500 mL。定期复查脐动脉血流S/D比值(每天1次)。结果研究组平均每天脐动脉血流S/D比值下降0.39,对照组平均每天脐动脉血流S/D比值下降0.12,两组结果比较差异具有显著性(t=3.45,P<0.05)。研究组所需治疗时间显著短于对照组(3.5±2.7 vs 7.3±3.1d),两组比较差异具有显著性(t=5.83,P<0.01)。研究组脐动脉血流S/D比值下降率为100%,对照组为68.3%,两组比较差异有统计学意义(χ2=4.12,P<0.05)。结论肝素可显著改善妊娠中晚期脐动脉血流异常,效果显著,疗程缩短,值得推广。     

农村中医药人力资源教育意愿调查及社会伦理分析

通过研究样本地区农村中医药人力资源的现状,对中医药人力资源的培训与继续教育意愿进行分析,探讨合理配置农村中医药人力资源的政策和措施,促进农村中医事业的发展,实现卫生公平.