Lower Phosphorylation of p38 MAPK Blocks the Oxidative Stress-induced Senescence in Myeloid Leukemic CD34~+CD38~- Cells

Leukemia seems to depend on a small population of "leukemia stem cells (LSCs)" for its growth and metastasis. However, the precise surviving mechanisms of LSCs remain obscure. Cellular senescence is an important obstacle for production and surviving of tumor cells. In this study we investigated the activated state of a pathway, in which reactive oxygen species (ROS) induces cellular senescence through DNA damage and phophorylation of p38 MAPK (p38), in myeloid leukemic CD34+CD38- cells. Bone marrow samples were obtained from patients with acute myeloid leukemia (AML, n=11) and chronic myeloid leukemia (CML, n=9). CD34+CD38- cells were isolated from mononuclear cells from these bone marrow samples, and K562 and KG1a cells (two kinds of myeloid leukemia cell lines) by mini-magnetic activated cell sorting. Hematopoietic stem cells (HSCs) from human cord blood served as controls. Intracellular ROS level was detected by flow cytometry. DNA damage defined as the γH2AX level was measured by immunofluorescence staining. Real-time RT-PCR was used to detect the expression of p21, a senescence-associated gene. Western blotting and immunofluo-rescence staining were employed to determine the p38 expression and activation. The proliferation and apoptosis of CD34+CD38- cells were detected by MTT assay and flow cytometry. Our results showed that ROS and DNA damage were substantially accumulated and p38 was less phosphorated in myeloid leukemic CD34+CD38- cells as compared with HSCs and H2O2-induced senescent HSCs. Furthermore, over-phosphorylation of p38 by anisomycin, a selective activator of p38, induced both the senescence-like growth arrest and apoptosis of CD34+CD38- cells from K562 and KG1a cell lines. These findings suggested that, although excessive accumulation of oxidative DNA damage was present in LSCs, the relatively decreased phosphorylation of p38 might help leukemic cells escape senescence and apoptosis.     

颈前路手术治疗上颈椎骨折的围手术期护理体会

目的探讨颈椎骨折的围手术期护理措施。方法对行颈前路手术的患者,采取术前精心准备,术后仔细观察和及时预防,处理各种并发症等措施,加强围手术期的护理。结果本组患者围手术期内均无并发症发生,按期出院。结论加强围手术期护理,有利于颈前路手术患者的早日康复,预防并发症的发生。     

早期乳腺癌腋窝亚LevelⅡ淋巴结清扫的初步研究

目的:探索基层医院早期乳腺癌腋窝淋巴结外科处理的适宜方法。方法:对9例符合研究条件的病例先美兰染色(meythylene blue staining)实施前哨淋巴结活检(sentinel lymph node biopsy,SLNB),再补充实施腋窝淋巴结清扫术(axillary lymph node dissection,ALND);ALND术中显露腋静脉,以腋静脉下2cm为界缝线标记,术后将标本从缝线处分离,对淋巴结进行分组取材,将前哨淋巴结、腋静脉下2cm内淋巴结(亚levelⅡ淋巴结)、腋窝其余淋巴结(其余淋巴结)分组送病理检查,观察各组淋巴结数量及肿瘤细胞腋淋巴结转移规律。结果:找到前哨淋巴结6例;5例前哨淋巴结、亚levelⅡ淋巴结、其余淋巴结均为阴性;1例前哨淋巴结、亚levelⅡ淋巴结、其余淋巴结均为阳性;另有1例患者前哨淋巴结未找到,而亚levelⅡ淋巴结检出阳性。结论:基层医院对于早期乳腺癌腋窝淋巴结清扫,可以用美兰染色行前哨淋巴结活检,若前哨淋巴结阳性或未找到前哨淋巴结,行ALND;若前哨淋巴结阴性,行亚levelⅡ淋巴结清扫。     

乳腺癌新辅助化疗角度测量定位法肿块体表投影临床应用价值的探讨

目的:探讨应用角度测量定位法确定乳腺癌新辅助化疗后肿块体表投影的应用价值。方法:对16例新辅助化疗的乳腺癌患者,应用角度测量定位法记录肿块4个位点与穿刺点的距离和角度,标记化疗前肿块的位置。化疗后根据记录的角度和距离复原标记点的位置,比较和分析化疗前后测量点的完全符合率,确定该测量方法的可行性和实用性。结果:14例共56个测量点(87.5%),化疗前体表肿块测量点与化疗后按角度和距离复原化疗前肿块的4个位点完全符合;误差<0.1cm 1例(6.25%)。误差0.1～0.5cm 1例(6.25%)。结论:肿块角度测量定位法具有较好的可行性和准确性;对明显突出皮肤的肿块和下垂型乳房的肿块需辅助其他测量方法。     

新生儿高胰岛素血症41例临床分析

对１９９５年７月至１９９６年１２月收治的４１例新生儿高胰岛素血症进行临床分析，了解新生儿在某些病理状态，如窒息，小于胎龄儿（ＳＧＡ），感染等情况下，可使胰岛β细胞的功能受影响，而发生高胰岛素血症，其中６３．４％发生低血糖，低血糖可使神经系统受到损害，因此对此类人密切检测，及时诊治至关重要。     

对药品集中招标采购的几点看法

为了保证药品质量，确保人民用药安全、有效，减轻社会医药费用负担，规范药品购销行为，遏制药品流通领域的不正之风，国家卫生部、国家计委、国家经贸委、国家药品监督管理局、国家中医药管理局、国务院纠风办等六部委（局）早在1999年即下发了《关于进一步做好医疗机构药品集中招标采购工作的通知》。为了贯彻、落实六部委（局）通知精神，全国各省、市、县级医疗机构均参与了各种形式的药品集中招标采购活动。药品集中招标采购开展近4年来，虽然有了一定的成效，但同时存在的一些问题也不容忽视。     

特殊性自发性脑干出血的临床与MRI对照分析

作者对１２例自发性脑干出血患者的临床表现与ＭＲＩ改变进行对照分析，发现本组病例的共同特点是起病轻，进展缓慢，ＭＲＩ出血部位多位于桥脑背侧、桥延部附近，血量均在５ｍｌ以下，作者推测桥延部右背侧可能存在一定的“静区”。     

补益剂抗癌作用的实验研究

本文从实验研究方面综述了四君子汤、补中益气汤、四物汤、当归补血汤、六味地黄汤、生脉散、金匱肾气丸、人参蜂皇浆等著名补益剂的抗癌作用。指出在中西医结合治疗癌症时,须重视中医辨证,区别气、血、阴、阳之差异,配合选用上述方剂,对控制肿瘤生长转移大有裨益。     

眼球突出病变的磁共振成像

本文报告了１９例经临床治疗和／或手术病理证实的突眼疾病的ＭＲＩ表现，并与Ｂ超、ＣＴ检查进行对比分析。作者认为ＭＲＩ较ＣＴ和Ｂ超具有更高的软组织分辨力；在确定病变部位、范围和性质方面均具有优势。     

相位对比速度在三维相位对比序列中的评价

对３８例颈部磁共振血管成像（ＭＲＡ）使用三维相位对比序列（３ＤＰＣ），分别选择不同的相位对比速度参数进行血管成像质量的对比，认为各血管所需的最佳相位对比速度是：颈内、颈外动脉６０～７０ｃｍ／ｓ，椎动脉３０ｃｍ／ｓ，颈内静脉３０ｃｍ／ｓ。肯定了此参数在扫描中的作用。