VEGFA、VEGFC及其受体和angiopoietin-1/angiopoietin-2及其受体在发育第3-12周人胚胎肝的表达

本研究观察VEGFA和VEGFC及其受体和angiopoietin-1／angiopoietin-2及其受体在发育第3—12周人胚胎肝的表达。在征得意外流产孕妇同意并签字后，收集其意外流产受精龄为第3—12周的人胚胎，4％多聚甲醛固定，石蜡包埋切片，HE和免疫组织化学染色，光镜观察。结果表明：在发育第4周，肝由少量肝索组成，肝内未见造血细胞和血细胞。肝内大、圆、有核的原始血细胞于发育第5周开始出现，并强表达VEGFA、flt-4和Tie-2，其数量在发育第7周达高峰。第11—12周，阳性细胞数量减少。这类细胞仅于发育第6周时短暂表达Flk-1。第7—12周，肝细胞表达VEGFC和flt-1，阳性反应产物积聚在细胞质中。发育第5周到第12周胚胎肝血管内，有angiopoie—tin-1和angiopoietin-2阳性反应的细胞存在，细胞形态同上述VEGFA、fkt-4和Tie-2阳性细胞。angiopoietin-1和angiopoietin-2阳性反应较弱，Tie-2的免疫反应强。发育各期，肝细胞也弱表达angiopoietin-1和angiopoiefin-2和Tie-2。发育各期血管内皮细胞为上述各种因子和受体阴性反应。结论：发育第7周之前和第7周之后，VEGF家族及其受体在肝内造血灶的细胞表达模式不同。胎肝造血与肝细胞的发育可能相关。     

刺槐素对小鼠Th17细胞的分化功能的影响及其机制的初步探讨

目的建立小鼠Thl7细胞的体外诱导及培养方法并探索刺槐素（Acacetin）对Th17细胞的分化、功能的影响及其机制的初步探索。方法分离、纯化BABL／c小鼠脾脏%细胞,用转化生长因子8、IL-6、IL-23等促进%细胞向Thl7细胞分化。培养的Th17细胞分为五组：正常组、模型对照组、Acacetin1μM组、Acacetin10μM组、Acacetin30pM组。流式细胞术检测Thl7细胞的比例,酶联免疫吸附试验检测IL-17A的表达,实时荧光定量聚合酶链反应检测IL-17AtuRNA及ROR-γtmRNA的表达。结果该培养方法可使Th17细胞的比例明显升高（P〈0．01）。与模型对照组相比,AcacetinlμM组、Acacetin10μM组、Acacetin30肛M组的Thl7细胞的比例呈剂量依赖性降低（P值均〈0．05）。IL-17A蛋白的表达也呈剂量依赖性降低（P值均〈0．05）,IL-17AmRNA和ROR-γtmRNA的表达与模型对照组比较明显降低（P〈0．05）,以Acacetin（30uM）组最明显（P〈0．01）。结论Acacetin在体外可以抑制小鼠脾脏%细胞向Thl7细胞的分化,并抑制IL-17AmRNA和IL-17A蛋白的表达,其机制可能与抑制细胞内孤儿受体ROR-γt的表达有关。     

Clinical and economic impact of epoetin in adjuvant-chemotherapy for breast cancer

Introduction Anaemia is a common toxicity in cancer patients and epoetins (EPOs) are now an established treatment. The economic profile of EPO treatment was assessed in patients with breast cancer treated by adjuvant-chemotherapy.Materials and methods Two strategies were compared: without treatment by EPO and with the possible use of treatment by EPO (epoetin alfa) when required. The clinical effectiveness criterion was time adjusted to quality of life and economic data included only direct medical costs.Main results One hundred ninety-two patients were included. In the group with the strategy containing the possible use of EPO, 45.5% of patients effectively received EPO. A significant difference in the haemoglobin level profile over time was observed which provided a significant overall benefit of 0.0052 (p<10⁻⁴) quality-adjusted life year (QALY) associated with an extra cost of €1,615 (p<10⁻⁴). In the base case analysis, the cost per added QALY was estimated as €310,577 with the strategy containing the possible use of EPO.Conclusion This robust result seems to be unacceptable, but the only relevant point of discussion might be the level of acceptable incremental cost-effectiveness ratio (ICER) for a patient.