超声、PET/CT及两者联合检测对恶性黑色素瘤淋巴结转移的临床价值分析

目的：探讨超声、正电子发射断层成像/计算机断层成像（positron emission tomography/computed tomography,PET/CT）及两者联合检测对恶性黑色素瘤（malignant melanoma,MM）淋巴结转移评估的准确性,指导临床MM患者淋巴结活检及清扫的术前评估。方法：收集41例MM住院患者临床资料,分析术前淋巴结相关影像资料、术后淋巴结病理结果及病理结果跟影像结果的相关性。结果：超声、PET/CT以及两者联合检测的敏感度分别是47.36%、73.68%、78.95%,特异度分别是59.09%,86.36%、50.00%,准确度分别是53.66%、80.49%、63.41%,阳性预测值分别是50.00%、82.35%、57.69%,阴性预测值分别是56.52%,79.17%、73.33%,正确指数分别是6.45%、60.04%、28.95%。结论：PET/CT在评估MM术前淋巴结是否转移方面具有重要价值,其准确度、特异度、阳性预测值、阴性预测值均高于超声及两者联合检测,当PET/CT检查淋巴结转移为阴性时,应结合超声两者联合综合判断,避免淋巴结...     

RING finger and WD repeat domain 3 regulates proliferation and metastasis through the Wnt/β-catenin signalling pathways in hepatocellular carcinoma

BACKGROUNDHepatocellular carcinoma (HCC) exhibits high invasiveness and mortality rates, and the molecular mechanisms of HCC have gained increasing research interest. The abnormal DNA damage response has long been recognized as one of the important factors for tumor occurrence and development. Recent studies have shown the potential of the protein RING finger and WD repeat domain 3 (RFWD3) that positively regulates p53 stability in response to DNA damage as a therapeutic target in cancers. AIMTo investigate the relationship between HCC and RFWD3 in vitro and in vivo and explored the underlying molecular signalling transduction pathways. METHODS RFWD3 gene expression was analyzed in HCC tissues and adjacent normal tissues. Lentivirus was used to stably knockdown RFWD3 expression in HCC cell lines. After verifying the silencing efficiency, Celigo/cell cycle/apoptosis and MTT assays were used to evaluate cell proliferation and apoptosis. Subsequently, cell migration and invasion were assessed by wound healing and transwell assays. In addition, transduced cells were implanted subcutaneously and injected into the tail vein of nude mice to observe tumor growth and metastasis. Next, we used lentiviral-mediated rescue of RFWD3 shRNA to verify the phenotype. Finally, the microarray, ingenuity pathway analysis, and western blot analysis were used to analyze the regulatory network underlying HCC. RESULTSCompared with adjacent tissues, RFWD3 expression levels were significantly higher in clinical HCC tissues and correlated with tumor size and TNM stage (P < 0.05), which indicated a poor prognosis state. RFWD3 silencing in BEL-7404 and HCC-LM3 cells increased apoptosis, decreased growth, and inhibited the migration in shRNAi cells compared with those in shCtrl cells (P < 0.05). Furthermore, the in vitro results were supported by the findings of the in vivo experiments with the reduction of tumor cell invasion and migration. Moreover, the rescue of RFWD3 shRNAi resulted in the resumption of invasion and metastasis in HCC cell lines. Finally, gene expression profiling and subsequent experimental verification revealed that RFWD3 might influence the proliferation and metastasis of HCC via the Wnt/β-catenin signalling pathway.CONCLUSIONWe provide evidence for the expression and function of RFWD3 in HCC. RFWD3 affects the prognosis, proliferation, invasion, and metastasis of HCC by regulating the Wnt/β-catenin signalling pathway.     

不同证候H22荷瘤小鼠肿瘤ABC转运蛋白家族基因转录特征

目的:观察不同证候H22荷瘤小鼠肿瘤组织ABC转运蛋白家族基因表达的特征。方法:对来源于早期邪毒壅盛和单纯气虚、中期阳气虚和中晚期气阴阳虚四种证候小鼠H22肿瘤组织4张Affymetrix GeneChip Mouse Exon 1.0 STArray数据标准化处理后,筛选其中的ABC转运蛋白基因进行差异分析。结果:从芯片中共筛选出与ABC转运蛋白有关的基因47个,以邪毒壅盛小鼠肿瘤基因转录最活跃,气虚次之,阳气虚最低;四种常见证候间共有25个基因转录具有明显差异;Abce1和Abcf1等7个基因中在四种常见证候肿瘤中转录水平最高。结论:Tap1(Abcb2)和Abcd2等6个高表达基因可能是邪毒壅盛型小鼠肿瘤增长快的重要因素;不同证候荷瘤小鼠肿瘤组织中的ABC转运蛋白基因转录既存在一定共性又存在很大差异,进一步证明了H22荷瘤小鼠证候客观存在的物质基础,为中医辨证论治提供分子依据。     

荆防散干预一氧化氮合酶-一氧化氮通路的抗炎机制实验研究

目的 观察荆防散干预炎症模型动物一氧化氮合酶-一氧化氮(NOS/NO)通路的抗炎机制,为其功效和临床应用提供药理学依据.方法 采用角叉菜胶诱导大鼠胸膜炎模型和卵白蛋白致小鼠哮喘模型,测定大鼠胸腔渗出液与小鼠肺组织匀浆中NOS,iNOS活力和NO含量的变化.结果 荆防散各剂量组能不同程度地降低小鼠肺组织匀浆与大鼠胸腔渗出液中NOS、iNOS活力,并减少NO含量,其中以5 g·kg-1剂量作用显著.结论 荆防散能通过抑制NOS活力,尤其是与炎症反应密切相关的iNOS活力,从而减少炎症介质NO的生成来发挥抗炎作用,提示干预NOS/NO通路是其抗炎作用机制之一.     

止颤汤对移植入帕金森病大鼠脑内神经干细胞增殖分化作用的研究

目的:探讨止颤汤对移植入帕金森病大鼠脑内的神经干细胞向多巴胺能神经元分化的作用.方法:实验动物分为4组,正常组及模型组用生理盐水灌胃,同时脑内移植普通培养基;对照组脑内移植神经干细胞,生理盐水灌胃;中药组脑内移植神经干细胞,用止颤汤灌胃.分别在处理后7d、14d、28d取脑做切片,免疫组化法检测TH蛋白表达,Rt-PCR法检测各组Ptx3、Nurrl、Shh等mRNA表达.结果:与对照组比较,在动物处理后7d及14d,中药组大鼠脑内TH表达和对照组差异显著,脑内Ptx3、Shh等mRNA在部分时间点表达有显著改善.结论:止颤汤对移植入帕金森病大鼠脑内神经干细胞向多巴胺能神经元分化有一定促进作用.     

关于针灸推拿专业学位研究生住院医师规范化培训的思考

中医专业学位研究生住院医师规范化培训(以下简称"规培")是对临床型研究生教育的重大改革,是提高专业学位研究生教育水平的重大举措,对提高我国临床医师的整体职业素质具有重要意义.现阶段我校专业学位研究生规培教学工作刚刚起步,在科室安排、培训考核、课程设置及导师带教等方面尚存在一些问题,需逐步探索和完善.本文以我校针灸推拿专业临床型研究生规培为例,针对培训实施过程中存在的突出问题进行分析并提出具体的有针对性的建议,以期规范研究生规培工作,提高我校研究生培训质量,培养出高素质、高层次医学专业人才.     

穴位杵针配合眼周按摩治疗18—30岁女性黑眼圈的临床疗效观察

目前治疗黑眼圈的方法很多,可以采用针灸、按摩、药膳、中药外敷、中药内服、西药内服、物力治疗、化妆品、改变生活习惯,等等。但单纯使用每种方法都其局限性,所以,仍需要去探求有效易行的方法。     

药之害在医不在药

对于近期国内外医药界把“龙胆泻肝丸事件”归结于中药中含有马兜铃酸的普遍倾向本文提出了完全不同的看法,作者认为其事实并非如此,药之害在医不在药。之所以出现“龙胆泻肝丸事件”,是因为国外不懂中医的人以及国内一些西医未遵循中医理论正确辨病,乱用中药造成的,不能归罪于中药。中西医诊疗思想有很大的不同,中药必须按中医理论辨证使用,如果不辨病使用中药,出现问题,只能怪医(本文是在第四届中医药战略地位研讨会上的演讲稿)。     

复方中药汤剂治疗轻微型肝性脑病的研究

目的观察复方中药汤剂对轻微型肝性脑病的疗效。方法对40例经数字联接试验(NCT)、数字符号测验(DST)检查异常的患者随机分配入对照组、中药汤剂组,每组20例;对照组予复合维生素B口服、中药汤剂组给予复合维生素B和中药汤剂口服,观察2组治疗前后症状积分、NCT、DST、肝功能、血氨情况。结果治疗后2组ALT、AST及记忆力减退、头晕、智力测验、血氨均有显著性差异(P均<0.05)。结论复方中药汤剂对轻微型肝性脑病有一定的治疗作用,且不良反应少。