Suppression of MMQ cells by fulvestrant: possible mechanism of action and potential application for bromocriptine-resistant prolactinomas

Bromocriptine is an effective treatment for most prolactinomas. Estrogen receptor (ER) antagonists are an alternative for treating patients with bromocriptine-resistant prolactinomas (BCRP). Previously, we reported that fulvestrant, a selective ER antagonist, significantly inhibited the proliferation of, and prolactin secretion by, MMQ cells, a prolactin-secreting rat pituitary cell line, an exemplary model for prolactinoma. In this study, we used fulvestrant to block ERα expression by MMQ cells and analyzed the expression of β-catenin and Wnt inhibitory factor-1 (WIF1) to investigate the effects of fulvestrant on the Wnt signaling pathway. In addition, we examined the gene expression of ERα, β-catenin and WIF1 in clinical BCRP specimens to explore the correlation between gender and clinical features. There was no significant difference in β-catenin expression between fulvestrant-treated cells and untreated cells, whereas WIF1 expression was higher in the treated cells. In clinical BCRP specimens, ERα expression was higher (especially in male patients), whereas β-catenin expression was similar to normal pituitaries. In addition, WIF1 expression was significantly lower in BCRP specimens than in normal pituitaries. The tumor volume was larger in male patients than in female patients. Prolactin concentration was positively correlated with tumor volume, and a positive linear correlation was observed between ERα expression and tumor volume. In conclusion, the anti-tumor activity of fulvestrant on MMQ cells seems to be associated with ERα and the non-canonical Wnt pathway, and higher ERα levels in male patients with BCRP may contribute to the larger tumor volumes observed. Fulvestrant holds promise as a therapeutic agent for BCRP.     

脂蛋白（a）和胱抑素C联合检测在2型糖尿病中的临床应用效果分析

目的：对胱抑素C和脂蛋白（ a）在2型糖尿病临床诊断治疗中的价值进行分析探讨。方法：对我院收治的2型糖尿病患者和体检中心选取的正常组进行胱抑素C和脂蛋白（ a）检验，采用免疫比浊法进行检测，并将2组检验结果进行比较，分析2组检验结果之间的差异，概括两者在2型糖尿病诊断治疗中的价值。结果：观察组的胱抑素C水平和脂蛋白（ a）水平与健康组之间存在明显差异，其胱抑素C和脂蛋白（a）水平均明显高于健康组，p＜0．05，且胱抑素C与脂蛋白（a）之间呈正相关关系。结论：糖尿病患者的胱抑素C和脂蛋白（ a）水平明显高于正常健康人群，是2型糖尿病临床诊断治疗的重要指标，对其进行联合检测能够有效监测糖尿病发展，预防和控制并发症发生。     

针灸在内科急诊中应用

针灸疗法不仅对一些常见的慢性病有极佳效果,对于急性病也有很好疗效。针灸疗法在内科急诊中占据非常重大的地位,介绍针灸疗法取穴依据及痉挛性疾病、功能性疾病和头疼治疗。     

β-catenin与wisp-1在结肠癌中的表达及意义

目的：探讨β-catenin与wisp-1 在原发性结肠癌中表达及临床意义。方法：分别用免疫组化Envision法和实时荧光定量PCR法检测β-catenin、wisp-1 蛋白和基因在53例结肠癌及53例配对正常结肠中的表达。分析两因子表达与临床病理的关系。结果：β-catenin、wisp-1蛋白在结肠癌的异常表达率均高于正常结肠中异常表达率（P〈0.05）。结肠癌中β-catenin蛋白异常表达与淋巴结转移、Duke分期和部位有关（P〈0.05）。wisp-1蛋白异常表达与淋巴结转移、Duke分期有关。β-catenin基因在结肠癌中平均表达是其在正常结肠中的3.237倍（P〈0.05），其异常表达与肿瘤部位及淋巴结转移有关（P〈0.05）。wisp-1基因在结肠癌中平均表达是其在正常结肠中的2.908倍（P〈0.05），其异常表达与肿瘤类型有关（P〈0.05）。结论：β-catenin与wisp-1异常表达特点提示两者与结肠癌的发生发展有密切关系。     

ACD - A solution as anticoagulant during continuous renal replacement therapy in high risk bleeding patients

Objective To assess the efficacy and safety of ACD-A solution as anticoagulant during continuous renal replacement therapy (CRRT) in high risk of bleeding patients. MethodsForty high risk bleeding patients on continuous veno - venous hemofiltration (CVVH) were randomly divided into two groups: ACD-A group (22 patients, 61 cases) and heparin-free group (18 patients, 47 cases). Serum creatinine, function of the coagulation system, electrolyte and acid-base were monitored pre - and post - CVVH. The vital signs of the patients during treatment, dialyser clotting and the incidence of bleeding episodes were recorded. Results(1) The serum level of creatinine decreased significantly after treatment in both groups, but the rate of decrease was obviously higher in ACD-A group than that in heparin - free group[(55.4±10.2)% vs (42.0±5.2)%, P＝0.031]. (2) The average duration of CVVH treatment was (17.3±3.8) h in ACD-A group and (9.7±4.5) h in heparin-free group. There was significant difference between them (P＝0.019). The frequency of dialyzer clotting was much higher in heparin-free group than that in ACD-A group (88% vs 4.9%, P＜0.001). (3) There was no significant difference in the function of the coagulation system between pre- and post-CVVH in either group (P＞0.05). (4) Electrolyte, acid-base and glucose tended to be stable during the treatment in ACD -A group. (5) The vital signs were kept stable and no bleeding episodes were found in all patients of two groups. ConclusionsAnticoagulation with ACD-A is safe, effective and convenient for CRRT in critically ill patients at high risk of bleeding. The occurrence of complications can be reduced by configurating appropriate replacement fluid and close laboratory monitoring.     

中药药氧疗法联合黛力新治疗缺血性脑卒中后抑郁状态临床研究

目的:观察中药药氧疗法联合黛力新治疗缺血性脑卒中后抑郁状态的临床疗效。方法:将100例患者随机分为观察组和对照组,每组50例。对照组给予口服黛力新治疗,观察组在对照组基础上予以中药药氧疗法治疗。分别于治疗前、治疗6周后采用汉密尔顿抑郁量表(Hamilton depression scale for depression,HAMD)(24项)评估患者治疗后抑郁状态的严重程度,脑卒中生活质量量表(stroke-specific quality of life,SS-QOL)评价患者的生活质量;观察患者治疗过程中的各种不良反应,评价临床疗效。结果:治疗后观察组HAMD评分、SS-QOL评分均明显低于对照组,差异有统计学意义(P0.01)。观察组有效率为88.00%,对照组有效率68.00%,两组比较,差异有统计学意义(P0.01)。两组患者治疗过程中均未出现严重不良反应,两组比较,差异无统计学意义(P0.05)。结论:中药药氧疗法与黛力新联合应用可改善缺血性脑卒中患者的抑郁情绪,增强治疗效果,提高患者生活质量。     

Co-expression of guanine-nucleotide exchange factor DOCK180 and ELMO1 in ovarian cancer cells

目的 寻找卵巢癌细胞中鸟嘌呤核苷交换因子Dock 180与Elmo1呈相互协同作用的依据.方法 采用Westem blot检测人卵巢癌组织、良性肿瘤组织及正常卵巢组织中的Dock 180与Elmo1的表达水平；免疫组化检测卵巢癌组织中Dock 180与Elmol的分布；免疫荧光检测Dock180与Elmo1在卵巢癌细胞SKOV3中的定位分布；检测Dock180表达缺失的SKOV3细胞中内源性Elmo1的表达水平.结果 Dock 180与Elmo1在人卵巢癌组织中的表达水平呈明显正相关(r=0.829,P＜0.05),在卵巢癌组织中二者的表达水平显著高于卵巢良性肿瘤组织组和卵巢正常组织组(P＜0.05)[Dock180:(1.054±0.114)、(0.518 ±0.126)、(0.425±0.072); Elmo1:(0.864 ±0.114)、(0.374±0.076)、(0.300±0.105)].免疫组化及细胞化学染色均显示二者在人卵巢癌组织和细胞内的分布具有一致性.而且在Dock180表达缺失细胞中,Elmol的表达水平也同时降低.结论 Dock180与Elmo1在促进卵巢癌的癌变过程中可能具有相互协同作用.     

心脏瓣膜置换术中应用胰岛素调控血糖水平的初步研究

目的 探讨体外循环术中应用胰岛素持续输注控制血糖水平对患者术后TNF-α浓度、肝、肾功能和近期疗效的影响,为临床上更合理地控制体外循环术中血糖水平提供一定的临床依据.方法 将2010年3月至10月于宁夏医科大学总医院行体外循环下瓣膜置换术的患者(36例)随机分为胰岛素组(18例)和对照组(18例).胰岛素组从麻醉诱导后开始以微量泵持续泵注胰岛素至手术结束时,控制术中血糖水平在3.9～6.1mmol·L-1,术后未作血糖控制；对照组患者术中、术后均未控制血糖.检测患者术中、术后不同时间点血糖、血乳酸、血钾和血浆TNF-α的浓度,检查患者术后的肝肾功能,并记录患者术中体外循环时间、主动脉阻断时间、术后呼吸机辅助通气时间、ICU停留时间、住院时间、房颤发生率、感染率及死亡率.结果 胰岛素组患者体外循环术中血糖、血乳酸水平明显低于对照组,术后1h血糖水平低于对照组,血乳酸水平两组差异无统计学意义；胰岛素组患者血浆TNF-α浓度明显降低于对照组,患者术后肝、肾功能指标均优于对照组,且术后ICU停留时间与对照组相比明显缩短,但两组患者术后呼吸机辅助呼吸时间、感染率、房颤发生率和住院时间无明显差异.结论 ①应用胰岛素持续输注控制体外循环瓣膜置换术中血糖水平于3.9 ～ 6.1 mmol·L-1,有利于控制术中血乳酸和血糖水平,对术后血糖控制也有一定的作用.②应用胰岛素控制患者术中血糖水平可以降低患者血浆TNF-α浓度,减轻患者全身炎性反应,对患者的肝、肾功能有一定的保护作用,但是对患者近期疗效无明显影响.