异位妊娠无创诊断的研究进展

长期以来,腹腔镜检查和清宫术后病理学诊断,被认为是异位妊娠(ectopic pregnancy,EP)诊断的"金标准",但二者均有创。相关新型血清标志物的发现、经阴道超声(transvaginal sonography,TVS)等新技术的应用及相关临床指标评分系统的建立,使异位妊娠无创诊断的准确性提高,但单独血清学或影像学检测指标在异位妊娠鉴别诊断中均存在不足,采取联合诊断已成共识。Logistic诊断模型、Bayes判别分析等诊断模型的建立,使异位妊娠的联合诊断更科学和实用,Meta分析使诊断效能评价更准确。随着各种诊断模型的优化,异位妊娠的无创诊断将广泛应用于临床。     

EP方案同步放化疗治疗非小细胞肺癌的疗效观察

目的:观察EP方案同步放化疗治疗局部晚期非小细胞肺癌的疗效及毒性反应。方法:32例Ⅱ~Ⅲb期非小细胞肺癌患者接受放化疗同步治疗,6mV加速器常规分割剂量放射治疗,2GY/(次.d),每周5d,DT:60~66GY(6~7周),治疗范围包括原发灶,同侧肺门和纵隔淋巴结,放疗开始同步使用EP方案4个周期,其中2周期是在放疗中应用,其余2周期是在放疗后接周期应用。结果:同步放化疗近期有效率84.38%,1年生存期为68.75%。主要毒副反应为骨髓抑制(71.88%)、胃肠道反应(75.0%),其次是放射性食道炎(56.25%)和放射性肺炎(21.88%)。结论:EP方案同步放化疗是目前治疗NSCLC的标准治疗方案之一,其疗效确切,局控率高,经济,毒性可以接受,值得临床推广。     

绝经期子宫内膜息肉组织中基质金属蛋白酶-9及环氧化酶-2的表达及其相关性

目的探讨绝经期子宫内膜息肉(EP)组织中基质金属蛋白酶(MMP)-9及环氧化酶(COX)-2表达及两指标的相关性。方法选取未使用任何激素类药物治疗的绝经前、后EP患者、正常子宫内膜(对照组)各30例。采用免疫组化法检测在绝经前后EP及正常子宫内膜组织中MMP-9及COX-2蛋白的表达,并分析两指标的相关性。结果 MMP-9、COX-2在绝经前EP组织中表达分别为83.33%(25/30)、57.67%(17/30),均明显高于对照组的26.67%(8/30)、20.00%(6/30)(χ2=19.461、8.531,P0.05);在绝经后EP中表达分别为73.33%(22/30)、47.67%(13/30),均明显高于对照组的30.00%(9/30)、16.67%(5/30)(χ2=11.279、5.079,P0.05);MMP-2与COX-2在绝经前后EP组织中呈正相关(r=0.383,P=0.037)。结论 MMP-9和COX-2在绝经期EP组织高表达,且呈正相关,这两种蛋白酶可能参与绝经期EP的形成。     

PGE2/EP4 antagonism enhances tumor chemosensitivity by inducing extracellular vesicle‐mediated clearance of cancer stem cells

Cells expressing mesenchymal/basal phenotypes in tumors have been associated with stem cell properties. Cancer stem cells (CSCs) are often resistant to conventional chemotherapy. We explored overcoming mesenchymal CSC resistance to chemotherapeutic agents. Our goal was to reduce CSC numbers in vivo, in conjunction with chemotherapy, to reduce tumor burden. Analysis of clinical samples demonstrated that COX‐2/PGE₂/EP₄ signaling is elevated in basal‐like and chemoresistant breast carcinoma and is correlated with survival and relapse of breast cancer. EP₄ antagonism elicts a striking shift of breast cancer cells from a mesenchymal/CSC state to a more epithelial non‐CSC state. The transition was mediated by EP₄ antagonist‐induced extracellular vesicles [(EVs)/exosomes] which removed CSC markers, mesenchymal markers, integrins, and drug efflux transporters from the CSCs. In addition, EP₄ antagonism‐induced CSC EVs/exosomes can convert tumor epithelial/non‐CSCs to mesenchymal/CSCs able to give rise to tumors and to promote tumor cell dissemination. Because of its ability to induce a CSC‐to‐non‐CSC transition, EP₄ antagonist treatment in vivo reduced the numbers of CSCs within tumors and increased tumor chemosensitivity. EP₄ antagonist treatment enhances tumor response to chemotherapy by reducing the numbers of chemotherapy‐resistant CSCs available to repopulate the tumor. EP₄ antagonism can collaborate with conventional chemotherapy to reduce tumor burden.     

Electrochemotherapy of cholangiocellular carcinoma at hepatic hilum: A feasibility study

Aim

We evaluated feasibility, safety and efficacy of Electrochemotherapy (ECT) in a prospective series of patients with unresectable Perihilar-Cholangiocarcinoma (PHCCA).

Endocardial Potential Mapping from a Noncontact Nonexpandable Catheter: A Feasibility Study

In previous studies, we established methodology for reconstructing endocardial potentials, electrograms and isochrones from a non-contact intracavitary probe during a single beat. The probe was too large to be introduced percutaneously. Here we examine the possibility of similar mapping with a small multielectrode catheter that could be introduced percutaneously and does not expand inside the cavity. Cavity geometry and endocardial potentials were recorded in an isolated canine left ventricle. Simulated catheter probes were introduced into the cavity. Probe potentials were computed from the measured endocardial potentials and perturbed to include measurement noise, geometrical errors, and limited electrode density. Endocardial potentials were then reconstructed from the perturbed probe potentials and compared to the actual measured potentials. Of all probes simulated, a 3.0 mm (9F) catheter that assumes a curved geometry (e.g., a J shape) inside the cavity performed best (better than a larger 7.6 mm cylinder simulating an inflatable probe). Without bending, a straight cylindrical probe of the same size (9F, 3.0 mm) did not perform well. Sixty probe electrodes were needed for accurate reconstruction. The J-probe reconstruction was very robust in the presence of noise (10%) and of geometry errors (3 mm shift, 10° rotation). The results demonstrate the feasibility of accurate single-beat endocardial mapping using a 9F percutaneous multielectrode catheter that assumes a J shape in the cavity without the need for expansion (e.g., into a balloon or a basket). The robustness of the procedure to noise and geometrical errors suggests its applicability in the clinical EP laboratory and the possibility of determining probe position in vivo using current imaging modalities. © 1998 Biomedical Engineering Society. PAC98: 8759Wc     

Prolonged negative surface potentials of the cat sensomotor cortex and responses of neurons and glial cells

Evoked potentials to stimulation of the ventrolateral and intralaminar thalamic nuclei, the surface of the sensomotor cortex, and the pyramidal pathways, derived from the same point, and also corresponding postsynaptic responses of pyramidal neurons were studied in acute experiments on cats anesthetized with ether or superficially with pentobarbital (25–30 mg/kg, intraperitoneally), and immobilized with muscle relaxants. Surface application of strychnine inhibits the slow negative potential arising in response to direct and primary responses, and the corresponding slow potentials of the IPSP. The action of iontophoretic application of strychnine on IPSP of pyramidal neurons and responses of cortical glial cells also were studied. Both methods of application of strychnine block mainly the early component of the IPSP, during which the input resistance is significantly lower than that during the late component, evidence of their different genesis. The results of the investigation show that slow negative potentials are a reflection of hyperpolarization of pyramidal neurons, and that the separate components of the responses have a common genesis.Translated from Fiziologicheskii Zhurnal SSSR imeni I. M. Sechenova, Vol. 70, No. 8, pp. 1132–1141, August, 1984.     

Ethyl pyruvate and ethyl lactate down-regulate the production of pro-inflammatory cytokines and modulate expression of immune receptors

Esters of alpha-oxo-carbonic acids such as ethyl pyruvate (EP) have been demonstrated to exert inhibitory effects on the production of anti-inflammatory cytokines. So far, there is no information about effects, if any, of ethyl lactate (EL), an obviously inactive analogue of EP, on inflammatory immune responses. In the present study, we provide evidence that the anti-inflammatory action of alpha-oxo-carbonic acid esters is mediated by inhibition of glyoxalases (Glo), cytosolic enzymes that catalyse the conversion of alpha-oxo-aldehydes such as methylglyoxal (MGO) into the corresponding alpha-hydroxy acids using glutathione as a cofactor. In vitro enzyme activity measurements revealed the inhibition of human Glo1 by alpha-oxo-carbonic acid esters, whilst alpha-hydroxy-carbonic acid esters such as EL were not inhibitory. In contrast, both EP and EL were shown to suppress the Lipopolysaccharide (LPS)-induced production of pro-inflammatory cytokines such as tumor necrosis factor-alpha, interleukin (IL)-1beta, IL-6 and IL-8 from human immunocompetent cells, and modulated the expression of the immune receptors HLA-DR, CD14 and CD91 on human monocytes. Here, we show a crossing link between glyoxalases and the immune system. The results described herein introduce glyoxalases as a possible target for therapeutic approaches of immune suppression.