苦瓜蛋白逆转K562／AO2细胞多药耐药性的研究

目的：研究非细胞毒性质量浓度苦瓜蛋白对耐阿霉素的人红白血病细胞株K562／AO2多药耐药性的逆转作用和促凋亡作用。方法：采用CCK-8法测定苦瓜蛋白的细胞毒性及其对K562／AO2细胞敏感性的影响,用流式细胞仪检测K562／AO2细胞经不同药物处理后细胞的凋亡情况。结果：苦瓜蛋白对K562／AO2细胞有一定的细胞毒作用,其非细胞毒性质量浓度为5μg／mL,非细胞毒性质量浓度苦瓜蛋白对K562／AO2细胞对阿霉素、长春新碱（VCR）和柔红霉素的耐药性都有部分逆转作用（分别为5．4、6．5和4．0倍）;5μg／mL苦瓜蛋白联合VCR诱导K562／AO2细胞凋亡,凋亡率为（19．38±1．06）％,而对照组为（1．64±0．27）％,单一苦瓜蛋白组为（3．79±0．82）％,单一VCR组为（9．83±0．98）％。结论：苦瓜蛋白能部分逆转人红白血病K562／AO2细胞对阿霉素、VCR和柔红霉素的耐药,一定剂量的苦瓜蛋白与VCR联合应用可增加肿瘤细胞凋亡率。     

AO锁骨钩钢板治疗肩锁关节脱位疗效分析

目的 探讨AO锁骨钩钢板治疗肩锁关节脱位的临床疗效.方法 回顾性分析我院2005年1月-2007年6月采用A0锁骨钩钢板治疗18例TossyⅢ型肩锁关节脱位患者的临床资料.结果 18例患者均获7-18个月随访.术后7-18个月(平均9月)去除内固定.按KarlassonⅢ型分类进行评价:A级10例,B级8例,优良率100%.术后无切口感染、内固定失败等并发症.结论 AO锁骨钩钢板是治疗肩锁关节脱位的可靠方法,固定牢固,能早期活动,恢复快.     

A phase I trial of surgical resection with Gliadel Wafer placement followed by vaccination with dendritic cells pulsed with tumor lysate for patients with malignant glioma

High grade gliomas are associated with poor prognosis and high mortality. Conventional treatments and management of high grade gliomas have shown little improvement in 5-year overall survival. This phase I trial evaluated the safety, immunogenicity, and potential synergy of surgical resection with Gliadel Wafer implantation, followed by autologous tumor lysate-pulsed dendritic cell (DC) vaccine in patients with malignant glioma. Primary end points of this study were safety and surrogate markers of immunogenicity, overall survival, and progression free survival. Following surgical resection, Gliadel Wafers were placed along the resection cavity. Patients subsequently received intradermal injections of autologous tumor lysate-pulsed DC vaccines 3 times at 2 week intervals. Treatment response was evaluated clinically and through MRI at regular intervals. Twenty-eight patients received Gliadel Wafers and DC vaccination: 11 newly diagnosed (8 glioblastoma [GBM], 2 anaplastic astrocytoma [AA], and 1 anaplastic oligodendroglioma [AO]) and 17 recurrent (15 GBMs, 1 AA, and 1 AO) high grade gliomas. Immunogenicity data was collected for 20 of the 28 patients. Five of 20 patients showed elevated IFN-γ responses following vaccination. Median progression-free survival and overall survival for all GBM patients in the trial from the start of vaccination were 3.6 months and 16.9 months respectively. Comparisons between vaccine responders and non-vaccine responders were not statistically significant. Adjuvant autologous dendritic cells pulsed with tumor-lysate following resection and Gliadel Wafer placement is safe, elicits modest immunogenicity and shows similar clinical outcomes in patients who had DC vaccination in previous studies.     

Circulating complexes of the vitamin D binding protein with G-actin induce lung inflammation by targeting endothelial cells

This study investigated the actin scavenger function of the vitamin D binding protein (DBP) in vivo using DBP null (−/−) mice. Intravenous injection of G-actin into wild-type (DBP+/+) and DBP−/− mice showed that contrary to expectations, DBP+/+ mice developed more severe acute lung inflammation. Inflammation was restricted to the lung and pathological changes were clearly evident at 1.5 and 4 h post-injection but were largely resolved by 24 h. Histology of DBP+/+ lungs revealed noticeably more vascular leakage, hemorrhage and thickening of the alveolar wall. Flow cytometry analysis of whole lung homogenates showed significantly increased neutrophil infiltration into DBP+/+ mouse lungs at 1.5 and 4 h. Increased amounts of protein and leukocytes were also noted in bronchoalveolar lavage fluid from DBP+/+ mice 4 h after actin injection. In vitro, purified DBP-actin complexes did not activate complement or neutrophils but induced injury and death of cultured human lung microvascular endothelial cells (HLMVEC) and human umbilical vein endothelial cells (HUVEC). Cells treated with DBP-actin showed a significant reduction in viability at 4 h, this effect was reversible if cells were cultured in fresh media for another 24 h. However, a 24-h treatment with DBP-actin complexes showed a significant increase in cell death (95% for HLMVEC, 45% for HUVEC). The mechanism of endothelial cell death was via both caspase-3 dependent (HUVEC) and independent (HLMVEC) pathways. These results demonstrate that elevated levels and/or prolonged exposure to DBP-actin complexes may induce endothelial cell injury and death, particularly in the lung microvasculature.     

Plating of humeral shaft fractures--has the pendulum swung back?

We reviewed 49 patients following plate osteosynthesis of humeral shaft fractures. There were no complications as a result of surgery. Union occurred in 47 patients (96%) at a mean of 9 weeks. Two patients required secondary procedures to achieve union. All patients had full range of motion in the elbow and shoulder joints following union. In the light of the popularisation of intramedullary nailing techniques in the last decade, with recognised complications of iatrogenic radial nerve injury, inadequate rotational stabilisation, non-union and shoulder impingement, we advocate plating of humeral shaft fractures as the surgical treatment of choice.     

甘草黄酮对S180和H22荷瘤小鼠肿瘤细胞DNA和RNA的影响

目的观察甘草黄酮对S180和H22荷瘤小鼠肿瘤细胞DNA及RNA的影响.方法Si8o和H2z荷瘤小鼠随机分为甘草黄酮高、中、低剂量(25、11.25、5.58 mg/kg)组,阳性对照(环磷酰胺25 mg/kg)组和阴性对照(生理盐水)组,各组均sc给药.运用激光扫描共聚焦显微镜技术与吖啶橙(AO)荧光探针技术结合检测单一肿瘤细胞DNA和RNA的变化情况.结果不同剂量甘草黄酮组和环磷酰胺组的DNA及RNA荧光强度较生理盐水组有不同程度的减弱;甘草黄酮高、低剂量组RNA/DAN值与生理盐水组比较差异无显著性;甘草黄酮中剂量组、环磷酰胺组RNA/DNA值较生理盐水组有非常显著提高(P＜0.01).结论甘草黄酮与肿瘤细胞DNA和RNA结合后抑制其进一步复制与合成,可能是其抗肿瘤作用的途径之一.     

内固定治疗股骨远端骨折的临床分析

目的探讨股骨远端各型骨折内固定的方法。方法对76例股骨远端骨折分别选用股骨逆行交锁髓内钉治疗21例、动力髁螺钉治疗31例、AO支撑钢板治疗24例。结果随访9~24个月,全部病例均骨性愈合,其中优41例、良29例、一般5例、差1例,优良率92%。结论治疗股骨远端骨折的方法各有优缺点,治疗上互不替代,逆行交锁髓内钉适用于无明显骨缺损髁上骨折(A1、A2型);动力髁螺钉适用于髁上有碎折块的低位髁上骨折、单纯外髁及Y型髁间骨折(A3、B1、B2、C1型);AO支撑钢板适用于髁间碎裂严重的C2、C3型骨折。     

AO钛制弹性髓内钉治疗小儿胫骨干骨折

目的探讨儿童胫骨干骨折的治疗方法和疗效。方法自2005年2月至10月,对15例儿童胫骨干骨折采取闭合复位,小切口AO钛制弹性髓内钉内固定治疗。结果15例随访5～12个月,全部骨性愈合,愈合时间为2～5个月,平均3.5个月,平均5周下地完全负重,完全康复,无任何并发症发生。结论AO钛制弹性髓内钉闭合复位内固定治疗儿童胫骨干骨折,感染率低,安全、微创、固定稳固,可尽早恢复功能活动,愈合快,并发症少。     

AO微型钢板内固定治疗掌指骨骨折

目的总结分析应用AO微型钢板内固定治疗掌、指骨骨折的临床效果。方法2002年3月~2005年3月,对掌、指骨骨折40例54处行切开复位、AO微型钢板内固定治疗。结果术后39例得到4~12个月随访,骨折愈合率为100%。X线片示骨折愈合时间为2~4周,平均2.9周。重返工作岗位时间为3~12周,平均4.6周。根据TAM系统评价法评定手指功能恢复情况,36例优良,优良率为92.31%。结论AO微型钢板内固定治疗掌指骨骨折轻便又牢固,便于早期功能锻炼,能加速骨折愈合和功能恢复,效果满意。     

AO重建钢板治疗肱骨干下1/3段骨折

目的：探讨应用AO重建钢板治疗肱骨干下1/3段骨折的临床治疗效果.方法：应用AO重建钢板经后正中入路治疗不伴桡神经损伤的肱骨干下1/3段骨折35例,其中AO/ASIF A型13例、B型19例、C型3例.结果：术后随访10～24个月,平均18个月,所有患者均获骨性愈合.按Rodriguez疗效标准评价,优27例、良8例.无并发症发生.结论：AO重建钢板治疗肱骨干下1/3段骨折具有固定牢靠、愈合快、功能恢复良好等优点.