肿瘤抗原冲击致敏的IL-2基因修饰的巨噬细胞治疗肾癌的实验研究

目的 :观察体外肿瘤抗原冲击致敏的白细胞介素 2 (IL 2 )基因修饰的巨噬细胞对肾癌小鼠的治疗效果并探讨其相关的免疫机理。方法 :通过重组腺病毒的介导 ,将IL 2基因转入新鲜分离的小鼠腹腔巨噬细胞 ,经肿瘤抗原冲击致敏后回输治疗原位肾癌小鼠 ,采用 4h5 1 Cr释放法检测脾脏NK和CTL活性。结果 :IL 2基因修饰的巨噬细胞经肿瘤抗原冲击后体内回输可使肾癌小鼠肺转移结节明显减少 ,存活期明显延长 ,40 %肾癌小鼠达到长期存活。治疗后荷瘤小鼠脾脏NK和CTL活性显著提高。结论 :IL 2基因修饰的巨噬细胞经肿瘤抗原冲击后自体回输是治疗肾癌的有效方法。     

Intrauterine light delivery for photodynamic therapy of the human endometrium

Photodynamic therapy is currently being evaluated as a minimallyinvasive procedure for endometrial ablation not requiring anaesthesia.Light penetration depths at 630, 660 and 690 nm and the optimalconfiguration of intrauterine light-diffusing fibres were determinedin 14 human uteri to assist in the design of a light intrauterinedevice. Post-menopausal ex-vivo uteri showed a significantlylower light penetration depth than pre-menopausal uteri. Witha single central diffusing fibre inserted, the fluence ratemeasured in the uterine wall at the most remote point of thecavity decreased to 1.1 ± 0.4% of that measured at closestproximity, whereas it decreased to only 40.0 ± 9.0% withthree fibres. Distension of the uterine cavity with 2 ml ofan optically clear fluid increased the fluence rate at the fundusbetween the fibres at a depth of 2 mm by a factor of 4. We concludethat in normal-sized pre-menopausal uterine cavities, threediffusing fibres will deliver an optical dose above the photodynamicthreshold level at a depth of 4 mm, even in the most remoteareas, in <30 min without causing thermal damage. For distortedand elongated cavities, either slight distension of the cavityor the insertion of a fourth diffusing fibre is required.     

Photodynamic action of concanavalin A-chlorin conjugate e6 on human fibroblasts

Laboratory of Biomembranes, Institute of Applied Molecular Biology, Ministry of Health of the USSR, Moscow. (Presented by Academician of the Academy of Medical Sciences of the USSR I. P. Ashmarin.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 109, No. 2, pp. 150–152, February, 1990.     

小鼠生精细胞特异表达载体AAV-Dazl-RFP-Flag的构建及表达验证

目的构建含有生精细胞特异启动子Dazl的真核报告基因表达载体AAV-Dazl-RFP-Flag,研究生精细胞特异启动子Dazl在生精细胞中的启动效果。方法通过同源重组的方法对腺相关病毒载体AAV-CMV-RFP-Flag进行改造,构建小鼠生精细胞特异表达载体AAV-Dazl-RFP-Flag。在体外,转染GC1-spg野生型细胞和HEK-293T细胞,通过免疫荧光、q-PCR、Western blot验证AAV-Dazl-RFP-Flag在体外的表达特异性。在体内,将AAV-Dazl-RFP-Flag进行腺相关病毒(AAV)包装,通过显微注射技术将AAV注射到小鼠睾丸内,通过q-PCR检测AAV-Dazl-RFP-Flag在体内的表达特异性。结果成功构建了AAV-Dazl-RFP-Flag表达载体,并在体内、外水平验证了AAV-Dazl-RFP-Flag的表达。结论小鼠生精细胞特异表达载体AAV-Dazl-RFP-Flag可以在生精细胞中特异性表达,为雄性生殖不育的基因治疗提供更高效的载体工具。     

Epstein-Barr病毒载体介导的白细胞介素12在肝癌细胞中的靶向表达

目的研究白细胞介素－１２（Ｉｎｔｅｒｌｅｕｋｉｎ－１２，ＩＬ－１２）在肝癌细胞靶向性表达，探索肝癌基因治疗新方法。方法将白介素－１２分别克隆到带有人甲胎蛋白启动子和增强子的Ｅｐｓｔｅｉｎ－Ｂａｒｒ（ＥＢ）病毒载体中，得到重组表达载体ｐＥＢＡＦ／Ｐ３５和ｐＥＢＡＦ／Ｐ４０，分别在４种细胞系中作共转染，用逆转录－聚合酶链反应（ＲＴ－ＰＣＲ）、酶联免疫吸附试验（ＥＬＩＳＡ）和Ｗｅｓｔｅｒｎｂｌｏｔ检测各细胞系中ＩＬ－１２的表达情况。结果用ｐＥＢＡＦ／Ｐ３５和ｐＥＢＡＦ／Ｐ４０共转染４种细胞后ＩＬ－１２基因只在产生甲胎蛋白的肝癌细胞（ＨｅｐＧ２）中表达，活性检测证明，表达的ＩＬ－１２有诱使ＩＦＮ－γ产生的生物学活性。结论本研究在肝癌细胞中靶向性和组织特异性的表达了有活性的ＩＬ－１２，为既能杀死肝癌细胞，又不影响正常肝细胞功能的新型基因治疗方案做了有益的探索。     

重组人内皮抑素腺病毒抗肿瘤实验研究

目的肿瘤生长具有血管依赖性。内皮抑素为胶原X羧基末端裂解片段,是重要的内源性血管抑制因子。实验中利用重组人内皮抑素腺病毒(recombinanthumanendostatinadenorirus,Ad-hEndo)在肿瘤局部给药以探索其抗血管基因治疗的可行性。方法以Ad-hEndo感染体外培养肿瘤细胞,观察重组蛋白表达及其对培养的血管内皮细胞的抑制效应;在裸鼠A549肺癌模型中瘤内注射重组病毒,观察肿瘤抑制效应、剂量依从效应和毒副反应。结果不同感染复数的Ad-hEndo感染肿瘤细胞均表达重组内皮抑素蛋白,并能抑制血管内皮细胞的生长。动物实验中Ad-hEndo治疗组肿瘤体积及肺转移结节数明显低于对照组,且转移数与治疗剂量负相关。结论以腺病毒为载体的肿瘤局部血管基因治疗能抑制肿瘤新生血管形成进而有效抑制肿瘤生长和转移,其效应具有剂量依从性。     

Die Kombinationstherapie Insulin/Sulfonylharnstoff in der Langzeittherapie des Typ-II-Diabetes nach „Sekundärversagen“

Summary In type 2 diabetes with secondary failure of sulfonylurea therapy good metabolic control can seldom be achieved by insulin therapy even with high insulin doses. Hyperinsulinemia however is a possible risk factor of cardiovascular disease in type 2 diabetes. Maintaining the effects of sulfonylurea action insulin should be added in as small amounts as possible to avoid hyperinsulinemia and to ameliorate hyperglycemia.16 type 2 diabetics with secondary failure were treated either with insulin alone (group A;n=8) or with 3.5 mg b.i.d glibenclamide plus small amounts of intermediate insulin (group B;n=8) in a randomised order. After the inpatient period outpatient control was performed monthly up to six months, later on four times a year up to two years.Both groups were comparable with regard to age, duration of diabetes, body weight and metabolic control. The daily insulin dose was 14±2 IU after one month and 19±2 IU after two years in group B. In contrast 30±3 IU and 43±5 IU respectively were needed in group A (p<0.001). All patients B were treated with one daily injection, all patients A needed two injections. Resulting in nearly identical metabolic control in group A basal insulin levels exceeded those in group B after two years significantly (28.6±3.7 vs. 18.6±1.6 mcU/ml;p<0.01). Endogenous C-peptide response was suppressed in group A compared to group B after inpatient period and after one month (0.12±0.01 vs. 0.49±0.15 and 0.09±0.04 vs. 0.13±0.08 pmol/ml;p<0.05). The combined therapy of insulin and sulfonylureas demonstrates the benefit of a prolonged sulfonylurea administration in the treatment of type 2 diabetes with secondary failure.As compared to common insulin therapy a small amount of exogenous insulin by one daily injection additionally to glibenclamide shows similar improvement in metabolic control. Hyperinsulinemia as a risk factor of macroangiopathy is markedly reduced in patients treated with combined therapy compared to those with insulin alone.

Herrn Professor Dr. N. Zöllner zum 65. Geburtstag gewidmet     

Behandlung mit Mexiletin

Summary Pharmacokinetics of the antiarrhythmic agent mexiletine were found to be highly variable. Ineffective or toxic doses can be avoided by monitoring mexiletine concentrations in patients plasma. However, the success of antiarrhythmic therapy is mainly determined by the severety of the underlying disease. Therefore, the efficacy of treatment with mexiletine should be controlled by Holter monitoring.

Herrn Prof. Dr. G. Schütterle zum 60. Geburtstag gewidmet     

特瑞普利单抗联合舒尼替尼治疗晚期肾细胞癌的初步疗效分析

目的：评估特瑞普利单抗联合舒尼替尼治疗晚期肾细胞癌的疗效与安全性。方法：回顾性分析2020年1月—2022年3月海军军医大学第二附属医院接受特瑞普利单抗联合舒尼替尼治疗的25例晚期肾癌患者临床资料,其中男21例,女4例,中位年龄为59 (33~80)岁。25例患者病理类型均为透明细胞癌,其中2例为TFE3融合基因相关肾癌,1例部分肉瘤样变,25例患者均发生局部进展或远处转移。评价其生存获益和相关不良反应发生情况。结果：中位随访时间11.0(2.5～24)个月,25例患者均可评价疗效,总体人群ORR 36.0%,DCR 84.0%,9例患者部分缓解,12例患者病情稳定,4例患者疾病进展,中位PFS 12.7个月(95%置信区间：10.7～14.7),中位OS尚未达到。治疗总体不良反应发生率为88.0%,常见不良反应包括皮疹、腹泻、手足皮肤反应、高血压等,90%的不良反应为1~2级。     

Treatment of parkinsonian tremor with clozapine

Summary After preliminary obsevations on 5 psychotic and 7 nonpsychotic parkinsonian patients had shown unexpected impressive beneficial effects of the atypical neuroleptic clozapine on tremor, an open clinical study including 12 patients was started. Under a dosage-range 25–50 mg/day significant reduction of tremor intensity and tremor related functional disability (CURS, Sweet's scale) was achieved. Akinesia was not deteriorated, initial fatigue disappeared spontaneously. Pharmacological mode of action of clozapine's antitremor effect remains unclear. Its broad receptor binding spectrum with strong antiserotonergic properties might here play a major role.