Estrogen and estrogen receptors in kidney diseases

Acute kidney injury (AKI) and chronic kidney disease (CKD) are posing great threats to global health within this century. Studies have suggested that estrogen and estrogen receptors (ERs) play important roles in many physiological processes in the kidney. For instance, they are crucial in maintaining mitochondrial homeostasis and modulating endothelin-1 (ET-1) system in the kidney. Estrogen takes part in the kidney repair and regeneration via its receptors. Estrogen also participates in the regulation of phosphorus homeostasis via its receptors in the proximal tubule. The ERα polymorphisms have been associated with the susceptibilities and outcomes of several renal diseases. As a consequence, the altered or dysregulated estrogen/ERs signaling pathways may contribute to a variety of kidney diseases, including various causes-induced AKI, diabetic kidney disease (DKD), lupus nephritis (LN), IgA nephropathy (IgAN), CKD complications, etc. Experimental and clinical studies have shown that targeting estrogen/ERs signaling pathways might have protective effects against certain renal disorders. However, many unsolved problems still exist in knowledge regarding the roles of estrogen and ERs in distinct kidney diseases. Further research is needed to shed light on this area and to enable the discovery of pathway-specific therapies for kidney diseases.     

索拉非尼联合免疫检查点抑制剂治疗TACE抵抗的中晚期肝癌的疗效及安全性

目的 探讨索拉非尼联合免疫检查点抑制剂（immune checkpoint inhibitors,ICIs）治疗经肝动脉化疗栓塞术（transcatheter arterial chemoembolization,TACE）抵抗的中晚期肝癌的疗效及安全性。方法 回顾性分析2017年1月至2021年3月期间在温州医科大学附属第五医院确诊为TACE抵抗的中晚期肝癌患者的资料,共54例,年龄28～82（56.1±11.8）岁,其中BCLC B期24例,C期30例;Child-Pugh A级34例,B级20例。根据治疗方法不同,分为对照组和联合组,对照组接受单一索拉非尼治疗（n=33）,联合组接受索拉非尼联合ICIs治疗（n=21）;比较两组患者的一般情况、肿瘤反应性、肿瘤无进展生存时间（progression-free survival,PFS）及不良反应的发生情况。结果 联合组（2例CR、11例PR、4例SD和4例PD）的肿瘤反应性明显优于对照组（2例CR、8例PR、10例SD、13例PD）（P=0.041）。联合组的中位PFS明显长于对照组（13.5个月 vs 6.8个月,P=0.010）;多因素分析显示Child-Pugh B级（HR 2.202,95%CI 1.059～4.581,P=0.035）、BCLC C期（HR 4.077,95%CI 1.902～8.742,P<0.001）、AFP≥400 ng/mL（HR 5.728,95%CI 2.227～14.729,P＜0.001）是TACE抵抗肝癌PFS的独立危险因素,索拉非尼联合ICIs（HR 0.180,95%CI 0.082～0.392,P<0.001）是肝癌患者的保护因素。联合组并发皮炎、腹泻的发生率明显多于对照组（P<0.05）。结论 索拉非尼联合ICIs治疗提高TACE抵抗中晚期肝癌的肿瘤反应性,延长患者PFS,是一种有效、安全的治疗方案。     

Cyclical use of tamoxifen and high-dose medroxyprogesterone acetate in advanced estrogen receptor positive breast cancer

Summary One-hundred and seventy patients with estrogen receptor positive (10 pmol/g protein) advanced breast cancer have been treated in a prospective randomized study either with continuous tamoxifen 30 mg × 1 daily (TAM), or with TAM 30 mg × 1 daily for 8 weeks alternating with medroxyprogesterone acetate 500 mg × 2 daily for 8 weeks (TAM/HD-MPA). The response rate was 62% in the group treated with cyclic TAM/HD-MPA versus 41% in the TAM alone group (p = 0.02). There was no significant difference in duration of remissions or survival.     

医学高职高专教育英语教学模式研究

目的 :探讨适合医学高职高专教育的英语教学模式。方法 :通过对 10个医疗单位和开封医专往届毕业生调查 ,英语在实际工作中的运用 ,并对其调查结果用卡氏检验法进行统计。结论 :现有的医学高职高专教育的英语教学模式不适合医学高职高专教育的培养目标。结果 :医学高职高专教育英语教学模式应把基础英语和专业英语放到同等重要位置 ,旨在培养学生在实际工作中运用语言的能力     

Effect of advanced glycosylation end products on activity of protein kinase C in human peripheral blood mononuclear cells

Objectives To investigate the effect of advanced glycosylation end products (AGEs) on the a ctivity of protein kinase C (PKC) in human peripheral blood mononuclear cells (P BMC) and to observe whether aminoguanidine (AG) can influence the effect of AGEs .Methods After PBMC were isolated from human peripheral blood and incubated with differen t concentrations of AGEs-BSA for various periods, total PKC activity in PBMC wa s determined by measuring the incorporation of (32)P from ［γ-(32) P］ ATP into a special substrate using Promega PKC assay kit.Results AGEs-BSA increased the total PKC activity in PBMC from 83.43±6.57 pmol/min/ mg protein to 116.8±13.82 pmol/min/mg protein with a peak at 15 min. AGEs -BSA also increased the total PKC activity in a concentration-dependent manner fro m 83.1±6.4 pmol/min/mg protein (control) to 119.1±13.3 pmol/min/mg prote in (control vs AGEs-BSA 400 mg/L, P&lt;0.01).Furthermore, AGEs-BSA induc ed an elevation of PKC activity in a glycosylating time-related manner, from 80 .9±8.2 (control) to 118.3±11.5 pmol/min/mg protein (glycosylation for 12 wk, P&lt;0.01).The total PKC activity stimulated by AGEs-BSA pretreated wi th AG (100, 200 mg/L) was markedly lower than that of AGEs-BSA group not pretr eated with AG (P&lt;0.05, P&lt;0.01).Conclusions AGEs-BSA increased the total PKC activity in PBMC in a concentration and incuba tion time dependent manner. The ability of AGEs-BSA to stimulate PKC activity was markedly decreased by pretreatment of AGEs-BSA with AG.     

高龄老年白内障透明角膜切口超声乳化术临床探讨

目的 探讨避免高龄老年白内障手术风险的办法。方法 对高龄老年白内障３６眼采用透明角膜切口和机械碎核协助进行超声乳化手术。结果 术中血压平稳,眼心反射不明显,安全手术。术后１月视力〉０．５占８６．１１％。结论采用透明角膜切口避免球后麻醉和压迫眼球并缩短术程,能减少风险;机械碎核可降低超声能量,减少角膜并发症,提高疗效。