重叠综合征患者的护理

目的分析同时患睡眠呼吸暂停综合征与慢性阻塞性肺疾病患者疾病认知情况及行为依从程度,并进行针对性健康教育,探讨其有效护理干预措施。方法采用自制调查问卷,对50例患者入院时的疾病知识、行为依从程度和自评症状进行第一次评估,然后根据问卷中反映的问题在住院期间及回到社区后对患者采取针对性的护理指导,8周后再一次对患者进行疾病知识、行为依从程度和自评症状评估,将前后两次评估结果进行对比统计分析。结果健康教育和护理干预前后50例患者疾病相关知识对比P<0.01,行为依从程度有所提高(P<0.05),疾病症状对比部分亦有改善(P<0.05)。结论患者在住院期间,医务人员应当在实施治疗的同时,提供疾病相关知识和积极正确的疾病自我管理方式,更应重视及完善重叠综合征患者的出院指导,提供系统性、针对性、全面的家庭护理知识,提高患者的社区生活质量。     

Cystic tumors of the liver: on the problems of diagnostic criteria

We report on three cases of cystic neoplasms of the liver with mucinous epithelium. Case 1 showed a low-grade cystic neoplasm with ovarian-like stroma (OS). Case 2 showed a low-grade cystic neoplasm without OS, and case 3 showed a high-grade cystic neoplasm without OS. In all three cases, bile duct communication (BDC) was absent. Currently, pancreatic mucinous cystic neoplasm (MCN) and intraductal papillary mucinous neoplasm of the pancreas (IPMN) are clearly distinguishable. However, MCN of the liver and intraductal papillary neoplasm of the bile duct (IPN-B) are not as easily distinguished. According to the latest WHO classification (2010), these conditions are classed as typical MCN of the liver, MCNs of the liver without OS, or IPN-Bs without BDC. The clinicopathological differences between MCN without OS and IPN-B without BDC are controversial. We present three cases describing these presentations and discuss the difficulties related to the diagnostic criteria used to distinguish between MCN of the liver and IPN-B.     

Novel quinolone CHM‐1 induces apoptosis and inhibits metastasis in a human osterogenic sarcoma cell line

Novel 2‐phenyl‐4‐quinolone compounds have potent cytotoxic effects on different human cancer cell lines. In this study, we examined anticancer activity and mechanisms of 20‐fluoro‐6,7‐methylenedioxy‐2‐phenyl‐4‐quinolone (CHM‐1) in human osterogenic sarcoma U‐2 OS cells. CHM‐1‐induced apoptosis was determined by flow cytometric analysis, DAPI staining, Comet assay, and caspase inhibitors. CHM‐1‐inhibited cell migration and invasion was assessed by a wound healing assay, gelatin zymography, and a Transwell assay. The mechanisms of CHM‐1 effects on apoptosis and metastasis signaling pathways were studied using Western blotting and gene expression. CHM‐1 induced G2/M arrest and apoptosis at an IC₅₀ (3 µM) in U‐2 OS cells and caspase‐3, ‐8, and ‐9 were activated. Caspase inhibitors increased cell viability after exposure to CHM‐1. CHM‐1‐induced apoptosis was associated with enhanced ROS generation, DNA damage, decreased ΔΨ_m levels, and promotion of mitochondrial cytochrome c release. CHM‐1 stimulated mRNA expression of caspase‐3, ‐8, and ‐9, AIF, and Endo G. In addition, CHM‐1 inhibited cell metastasis at a low concentration (<3 µM). CHM‐1 inhibited the cell metastasis through the inhibition of MMP‐2, ‐7, and ‐9. CHM‐1 also decreased the levels of MAPK signaling pathways before leading to the inhibition of MMPs. In summary, CHM‐1 is a potent inducer of apoptosis, which plays a role in the anticancer activity of CHM‐1. © 2009 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 27:1637–1644, 2009     

CDA-II,a urinary preparation,induces growth arrest and apoptosis of human leukemia cells through inactivation of nuclear factor-kappaB in a caspase-dependent manner

CDA-II (cell differentiation agent II) was a urinary preparation, isolated from healthy human urine. We determined the anticancer activity of CDA-II using human acute myeloid leukemia (AML) cell lines, K562, Kasumi-1 and KG-1. An in vitro cytotoxicity assay showed that CDA-II exhibited growth arrest in leukemic cells, while it did not induce cytotoxicity in normal peripheral blood monouclear cells (PBMCs). In vivo studies using the Kasumi-1 xenografted SCID mouse model showed tumor inhibition rate were increased and the survival time were prolonged in a dose-dependent manner, without any significant toxicity on mice body. Depolarized mitochondrial membranes and the activation of caspase-3, 9 as well as PARP were found in leukemic cells treated with CDA-II for 6–24 h. We further found NF-κB nuclear translocation were prevented by CDA-II treatment, which therefore inactivated NF-κB and down-regulated its target genes expression, including Bcl-2/Bax ratio, Mcl-1 and XIAP. The caspase-3 inhibitor Z-DEVD-FMK inhibited CDA-II-induced apoptosis and CDA-II combined with NF-κB inhibitor PDTC significantly increased the apoptotic rate of leukemic cells. We concluded that CDA-II potently induced caspase-dependent leukemia-specific apoptosis in leukemic cells mediated through inactivation of NF-κB, involving in Bcl-2 family and XIAP, which has no cytotoxicity on normal cells.     

人端粒酶逆转录酶基因转染U2OS细胞对其基质金属蛋白酶2活性的影响

目的：观察人端粒酶逆转录酶(hTERT)基因转染U2OS细胞对其基质金属蛋白酶2(MMP-2)的影响,探讨hTERT基因与端粒酶的关系及端粒酶活性在肿瘤浸润和转移中的作用。方法：利用重组质粒PCI-Neo-hTERT转染人骨肉瘤细胞系U2OS,选取转染的2个阳性克隆株进行实验,同时以未转染的U2OS细胞为对照。通过RT-PCR和TRAP-ELISA法检测阳性克隆株hTERT基因的转染效果,明胶酶谱法和RT-PCR检测转染hTERT基因对细胞MMP-2的表达和活性的影响。结果：与对照组比较,2个阳性克隆株可见特异性hTERT表达,并表现出明显的端粒酶活性状态（ΔA>0.2　U）。阳性克隆株MMP-2 mRNA的表达无明显改变（P>0.05）,而酶原型MMP-2减少（P<0.01）。结论：hTERT稳定转染克隆U2OS细胞株中异位表达hTERT可以产生端粒酶活性,而且端粒酶活性的出现,可能通过调节MMP的分泌影响细胞外基质成分的降解和构建而对肿瘤的浸润和转移产生一定影响。     

活化自体淋巴细胞过继性免疫治疗在原发性肝细胞癌中的疗效观察

目的：评价活化自体淋巴细胞过继性免疫治疗（adoptive immunotherapy,AIT）是否有助于改善原发性肝细胞癌的临床疗效。方法：选取2016年8月至2018年12月在中国人民解放军总医院第五医学中心确诊的64例原发性肝细胞癌患者,通过分层随机法分为免疫治疗组（n=29）和对照组（n=35）。免疫治疗组患者取60 ml外周血分离制备单个核细胞并在含OKT-3和IL-2的培养基中活化培养,回输前进行质控检测。免疫治疗组中的Ⅰ~Ⅲ期患者（n=14）于一线治疗后接受自体淋巴细胞输注（3个月内输注6次）,Ⅳ期患者（n=15）仅接受自体淋巴细胞输注;对照组患者接受肝细胞癌相关的其他治疗。疗效评估的主要终点是2 年无复发生存（relapse-free survival,RFS）率,次要终点为无进展生存期（progression-free survival,PFS）和总生存期（overall survival,OS）。结果：入组患者中位随访时间为2.8年（0.2~4.2年）。免疫治疗组29名患者共接受了167次（计划174次,完成率96%）预定淋巴细胞输注（平均每人次回输9.30×109个细胞,其中CD3+HLA-DR细胞约占63%）,治疗期间未观察到3级或4级不良反应发生。与对照组相比,免疫治疗组患者2年RFS率显著升高（62.1% vs 22.9%,OR=0.181,95%CI：0.06~0.54,P=0.002）,中位PFS（28 vs 8个月,P=0.004）和中位OS（38 vs 34个月,P=0.915）均显著延长。在Ⅰ~Ⅲ期患者中,免疫治疗组（n=14）2年RFS率较对照组（n=18）显著升高（92.9% vs 33.3%,OR=0.38,95%CI：0.004~0.368,P=0.005）,中位PFS明显延长（38 vs 14.5个月,P=0.005）,而两组OS间无显著差异;Ⅳ期患者两组间PFS（P=0.077）及OS（P=0.994）均未见显著差异。结论：活化自体淋巴细胞AIT为安全可行的肝细胞癌辅助性治疗方法,可提高Ⅰ~Ⅲ期肝细胞癌一线治疗后RFS率、延长患者RFS时间,而对进展期肝细胞癌患者的PFS和OS无明显影响。     

lncRNA DNM3OS在喉鳞状细胞癌组织和细胞中的表达及其临床和生 物学意义

目的：检测lncRNA DNM3OS在喉鳞状细胞癌（laryngeal squamous cell carcinoma,LSCC）组织和LSCC细胞株中的表达及其临床意义,探讨其对LSCC TU177细胞体外增殖、迁移及侵袭的影响,并分析DNM3OS与EMT的关系。方法：从河北医科大学第四医院生物标本库选取2014年3月至2018年12月收治的68例LSCC患者手术切除的癌及癌旁组织标本,应用qPCR法检测DNM3OS在LSCC组织和细胞株中的表达水平。采用siRNA敲低TU177细胞中DNM3OS的表达,应用MTS、克隆形成及Transwell小室等方法分别检测敲低DNM3OS表达对TU177细胞增殖、迁移和侵袭等生物学行为的影响。应用qPCR和WB法检测转染si-DNM3OS后对EMT标志物上皮钙黏素（E-cadherin）、神经钙黏素（N-cadherin）、波形蛋白（vimentin）、扭曲蛋白（twist）、锌指转录因子2（SNAI2）mRNA和蛋白的变化。结果：LSCC组织中DNM3OS表达水平明显高于癌旁组织（P<0.01）,并与患者的TNM分期、淋巴结转移及生存期有关联（P<0.05 或 P<0.01）。DNM3OS在LSCC细胞株（Hep-2、AMC-HN-8、TU177、TU212及TU686）中均呈现不同程度的高表达（P<0.05 或 P<0.01）,转染si-DNM3OS后TU177细胞中DNM3OS的表达显著降低（P<0.01）。与对照组相比,DNM3OS表达敲低可抑制TU177细胞的体外增殖、迁移和侵袭能力（P<0.05 或 P<0.01）,可上调 TU177 细胞中E-cadherin的表达而下调 N-cadherin、vimentin、twist和SNAI2的表达（均P<0.01）。结论：DNM3OS高表达与LSCC的恶性进展有关,其可能为预测LSCC患者预后的潜在指标;DNM3OS可能通过影响EMT进程促进LSCC细胞的侵袭和转移。     

Proteins of the retinoblastoma pathway,FEN1 and MGMT are novel potential prognostic biomarkers in pancreatic adenocarcinoma

Background

We studied the expression of some major proteins involved in cell-cycle regulation and DNA repair, the roles of which are not well known in pancreatic ductal adenocarcinoma (PDAC), but which have a significant impact on carcinogenesis of many other cancers.

High PITX1 expression in lung adenocarcinoma patients is associated with DNA methylation and poor prognosis

Background

Pituitary homeobox 1 (PITX1) is a member of the PITX gene family which is vital to proper development of early embryo. However, the relationship of PITX1 expression and overall survival (OS) in non-small cell lung cancer (NSCLC) is not clear.