5-氨基酮戊酸光动力疗法联合重组人干扰素α2b软膏治疗老年患者表浅基底细胞癌的临床观察

目的 探讨5-氨基酮戊酸光动力疗法(5-Aminolevulinic acid mediated photodynamic therapy,ALA-PDT)联合重组人干扰素α2b软膏治疗老年表浅基底细胞癌(Basal cell carcinoma,BCC)患者的疗效。方法 选取143例BCC老年患者,随机分为PDT组(72例)和手术组(71例),PDT组采用ALA-PDT疗法联合干扰素治疗,手术组采取常规外科手术治疗,对两组患者的疗效、手术创伤面积、病变面积、复发情况、安全性等进行随访比较。结果 PDT组治疗后完全缓解率显著高于手术组(81.94% vs.57.75%,P＜0.05),而两组总有效率比较无统计学差异(91.66% vs.81.73%,P＞0.05);随访1年后,PDT组患者复发率显著低于手术组(9.72% vs.22.54%,P＜0.05);此外,PDT组平均创伤面积、治疗后病变面积也显著小于手术组(P＜0.05)。结论 ALA-PDT联合干扰素是一种临床疗效好,复发率低,创伤性小的治疗表浅基底细胞癌的有效方法。     

二维超声及彩色多普勒能量图对库肯勃瘤的诊断价值

库肯勃瘤是一种胃、肠道及乳腺转移的恶性卵巢肿瘤,恶性度高,正确诊断及明确治疗密切关系患者的生存期及生存质量,同时为寻找原发灶提供依据,赢得治疗时机.     

血卟啉甲醚声动力疗法诱导体外C6胶质瘤细胞凋亡作用

Objective To study apoptotic effect and mechanisms of sonodynamic therapy (SDT) with hematoporphyrin monomethyl ether (HMME) on C6 glioma cells in vitro. Methods Time of ultrasound irradiation was optimized by methyl thiazol tetrazolium (MTT) . Apoptotic rate( AR) generation of reactive oxygen species (ROS) ,mitochondrial membrane potential (MMP) were detected by flow cytometry ,and expressions of apoptosis proteins were measured by Western blotting after SDT treatment. Results 60 s is the optimal time irradiation by MTT when the ultrasound frequency was maintained in 1 mHz and the average intensity was kept in 1. 0 W/cm2. To compare with the control,HMME and ultrasound group,treatment of C6 glioma cells with SDT resulted in the occurrence of apoptosis(34. 7 ±1.9)% .which was associated with the production of ROS ( 36. 4 ± 3. 1) % and loss of MMP (44. 9 ± 3. 4) %. The results showed that significantly increased expression in bax,Caspase-9 ,-3 , decreased in bcl-2 after SDT treatment. The results also showed apparent release of cytochome c in the SDT group versus to the other three groups. Conclusion Our results suggested that SDT mediated by HMME could induce apoptosis in C6 glioma cells.The mitochondrial signal pathway may play a pivotal role in the apoptosis.     

金丝桃素光动力效应对大鼠C6胶质瘤抑制作用及其对血管细胞黏附因子-1和基质金属蛋白酶-9的影响

目的探讨金丝桃素被光激活后对C6胶质瘤的抑制作用及其对血管细胞黏附因子-1(VCAM-1)和基质金属蛋白酶-9(MMP-9)的影响。方法36只C6脑内胶质瘤模型Wistar大鼠随机分为6组:对照组,单纯光照组,金丝桃素低、高剂量非光照组,金丝桃素低、高剂量光照组。实验第2周和3周MRI观察肿瘤的生长情况。第3周切取肿瘤,称重计算抑瘤率。SP法检测瘤组织中VCAM-1和MMP-9。结果(1)MRI检测显示,金丝桃素光照组肿瘤体积比对照组明显减小(P0.05)。(2)高剂量光照组抑瘤率为75.6(;低剂量光照组抑瘤率为51.4(。单纯光照组、金丝桃素非光照组对肿瘤无抑制作用。(3)金丝桃素光照组中VCAM-1和MMP-9明显低于对照组(P0.05)。VCAM-1与MMP-9呈正相关(r=0.82)。结论光激活的金丝桃素可能通过抑制VCAM-1和MMP-9,降低肿瘤突破基质屏障的能力,抑制肿瘤新生血管形成,而制约胶质瘤生长和侵袭。     

二维超声及彩色多普勒对库肯勃瘤的诊断价值

目的分析库肯勃瘤的二维及彩色多普勒超声表现,旨在探讨对其诊断价值.方法回顾分析40例经术后病理证实为库肯勃瘤的病人,观察肿瘤的形态、大小、内部回声、被膜、与周围组织的关系,有无腹水,内部及周边血流.结果库肯勃瘤具有较为特殊的声像图特点,本组40例患者中26例超声诊断为库肯勃瘤,定性诊断符合率65%.结论二维超声及彩色多普勒对诊断库肯勃瘤有重要的诊断价值.     

超声引导微创经皮肾镜钬激光治疗复杂性肾结石

目的 探讨超声引导微创经皮肾镜钬激光碎石术治疗复杂性肾结石的治疗效果.方法 使用超声引导微创经皮肾镜钬激光治疗复杂性肾结石121例,超声引导经皮肾镜气压弹道碎石术治疗复杂性肾结石82例,比较碎石率、结石取净率和术后严重并发症.结果 超声引导微创经皮肾镜钬激光纽碎石率一期为95.8%,二期为96.0%;结石取净率-期为89.6%,二期为92.0%;术后严重并发症3.3%;超声引导经皮肾镜气压弹道组碎石率-期为83.9%,二期为85.0%;结石取净率一期为74.2%,二期为80.0%;术后严重并发症3.7%.结论 超卢引导微创经皮肾镜钬激光治疗复杂性肾结石疗效明显优于气压弹道碎石,是治疗复杂肾结石的一种安全、有效的方法.     

声动力疗法促脑胶质瘤凋亡的实验研究

目的探讨声动力疗法对荷瘤鼠脑胶质瘤组织的促凋亡作用及其治疗机制。材料与方法 74只Wistar大鼠于右侧尾状核处接种C6胶质瘤细胞,制作颅内胶质瘤模型,行增强MRI筛选荷瘤鼠。依MRI结果分为对照组、血卟啉甲醚组(HMME组)、超声组和声动力组(SDT组),每组16只。声动力参数为1.0MHz、1.0W/cm2、60s超声辐照和5mg/kg血卟啉甲醚。治疗后24h行TUNEL染色检测胶质瘤细胞凋亡率,电镜检测凋亡形态学改变,免疫组化检测蛋白GFAP、S-100、Bcl-2/Bax、Caspase-3、Caspase-9、Fas/Fas-L表达和Cytc释放,并记录4组大鼠生存期。结果 74只Wistar大鼠共68只成瘤,成瘤率为91.89%。与对照组[(3.20±0.72)%]比较,SDT组[(30.60±1.60)%]及超声组([14.50±0.80)%]凋亡率显著提高(P<0.05),HMME组([3.60±0.51)%]无明显凋亡发生(P>0.05);SDT组荷瘤鼠生存期长达(46.3±3.1)d,较对照组[(31.1±2.1)d]显著延长(P<0.05),超声组[(32.4±2.3)d]、HMME组[(30.1±3.0)d]生存期较对照组无明显变化(P>0.05)。电镜检测到SDT组、超声组胶质瘤细胞核固缩,染色质边集,线粒体肿胀;免疫组化显示GFAP、S-100、Bax、Caspase-3、Caspase-9呈高表达,Bcl-2、Fas-L呈低表达和Cytc释放,Fas表达无明显变化。结论声动力疗法对荷瘤鼠胶质瘤有促凋亡治疗作用,并与线粒体内源性凋亡途径密切相关。     

血卟啉甲醚声动力疗法诱导体外C6胶质瘤细胞凋亡作用

Objective To study apoptotic effect and mechanisms of sonodynamic therapy (SDT) with hematoporphyrin monomethyl ether (HMME) on C6 glioma cells in vitro. Methods Time of ultrasound irradiation was optimized by methyl thiazol tetrazolium (MTT) . Apoptotic rate( AR) generation of reactive oxygen species (ROS) ,mitochondrial membrane potential (MMP) were detected by flow cytometry ,and expressions of apoptosis proteins were measured by Western blotting after SDT treatment. Results 60 s is the optimal time irradiation by MTT when the ultrasound frequency was maintained in 1 mHz and the average intensity was kept in 1. 0 W/cm2. To compare with the control,HMME and ultrasound group,treatment of C6 glioma cells with SDT resulted in the occurrence of apoptosis(34. 7 ±1.9)% .which was associated with the production of ROS ( 36. 4 ± 3. 1) % and loss of MMP (44. 9 ± 3. 4) %. The results showed that significantly increased expression in bax,Caspase-9 ,-3 , decreased in bcl-2 after SDT treatment. The results also showed apparent release of cytochome c in the SDT group versus to the other three groups. Conclusion Our results suggested that SDT mediated by HMME could induce apoptosis in C6 glioma cells.The mitochondrial signal pathway may play a pivotal role in the apoptosis.     

血卟啉甲醚声动力诱导体外C6胶质瘤细胞凋亡与蛋白Bcl-2/Bax表达

目的 探讨血卟啉甲醚声动力疗法(sonodynamic theraoy,SDT)对体外C6胶质瘤细胞的促凋亡作用及蛋白Bcl-2/Bax表达.方法 取处于对数生长期C6胶质瘤细胞接种于96孔6孔培养板上.采用噻唑蓝比色分析法(MTT)观察不同时间超声辐照后细胞存活率,筛选最佳照射时间;流式细胞仪检测24 h后对照组(control)、血卟啉甲醚组(hematoporphyrin monomethyl ether ,HMME)、单纯超声组(ultrasound)、超声联合HMME组(SDT)C6胶质瘤细胞凋亡率;Western blot 检测凋亡蛋白Bcl-2、Bax的表达.结果 当超声频率为1.0 MHz,声强为1.0 W/cm2 ,MTT筛选60s为最佳辐照时间.同对照组、HMME及单纯超声组比较,SDT组凋亡率明显增高(P<0. 05),同时伴有凋亡蛋白Bax,上调表达,Bcl-2下调表达.结论 血卟啉甲醚声动力诱导体外C6胶质瘤细胞凋亡,Bcl-2/Bax参与并调节凋亡过程.     

血卟啉甲醚声动力疗法诱导体外C6胶质瘤细胞凋亡作用

目的 探讨血卟啉甲醚声动力疗法(SDT)对体外C6胶质瘤细胞的促凋亡作用及机制.方法 取处于对数生长期的C6胶质瘤细胞接种于96孔、6孔培养板上.采用噻唑蓝(MTT)比色法观察在不同时间超声波辐照后细胞存活率;流式细胞仪检测24 h后对照组、血卟啉甲醚组(HMME)、单纯超声组、超声血卟啉组(SDT)C6胶质瘤细胞凋亡率、活性氧(ROS)产生、线粒体膜电位(MMP)的改变;Western blot检测凋亡蛋白bcl-2、bax、Caspase-3、-9的表达及细胞色素C(Cyt-C)的释放.结果 当超声频率为1.0 mHz,声强为1.0 W/cm2,MTT筛选60 s为最佳辐照时间.与对照组、HMME及单纯超声组比较,SDT组凋亡率(34.7±1.9)%明显增高(P＜0.05),同时伴有ROS(36.4±3.1)%的产生和MMP(44.9±3.4)%的降低.SDT组Cyt-C的释放增加;凋亡蛋白bax、Caspase-3、-9表达水平增高,凋亡蛋白bcl-2表达水平减低.结论 血卟啉甲醚声动力诱导C6胶质瘤细胞凋亡过程中伴有ROS的产生和MMP的减低,线粒体途径对C6胶质瘤细胞凋亡起着重要作用.

Abstract：

Objective To study apoptotic effect and mechanisms of sonodynamic therapy (SDT) with hematoporphyrin monomethyl ether (HMME) on C6 glioma cells in vitro. Methods Time of ultrasound irradiation was optimized by methyl thiazol tetrazolium (MTT) . Apoptotic rate( AR) generation of reactive oxygen species (ROS) ,mitochondrial membrane potential (MMP) were detected by flow cytometry ,and expressions of apoptosis proteins were measured by Western blotting after SDT treatment. Results 60 s is the optimal time irradiation by MTT when the ultrasound frequency was maintained in 1 mHz and the average intensity was kept in 1. 0 W/cm2. To compare with the control,HMME and ultrasound group,treatment of C6 glioma cells with SDT resulted in the occurrence of apoptosis(34. 7 ±1.9)% .which was associated with the production of ROS ( 36. 4 ± 3. 1) % and loss of MMP (44. 9 ± 3. 4) %. The results showed that significantly increased expression in bax,Caspase-9 ,-3 , decreased in bcl-2 after SDT treatment. The results also showed apparent release of cytochome c in the SDT group versus to the other three groups. Conclusion Our results suggested that SDT mediated by HMME could induce apoptosis in C6 glioma cells.The mitochondrial signal pathway may play a pivotal role in the apoptosis.