三阴乳腺癌细胞中Atg13基因的过表达与化疗耐药的研究

目的 探讨自噬相关基因13（Atg13）与三阴性乳腺癌的化疗耐药之间的关系。方法 间歇刺激法构建对阿霉素耐受的MDA-MB-231 TNBC细胞株（命名为MDA-MB-231/Dox）,并采用药物敏感实验和细胞凋亡实验（TUNEL染色）对耐药细胞株MDA-MB-231/Dox的耐药表型进行鉴定;蛋白免疫印迹实验检测敏感细胞MDA-MB-231和耐药细胞MDA-MB-231/Dox中的自噬相关蛋白LC3A、LC3B的表达情况,免疫荧光法测定细胞内的LC3B荧光斑点数;脂质体转染重组干扰质粒sh-Atg13至耐药细胞MDA-MB-231/Dox中,并经嘌呤霉素筛选得到稳转细胞（命名为MDA-MB-231/Dox + sh-Atg13）,蛋白免疫印迹实验检测稳转细胞MDA-MB-231/Dox+sh-Atg13及空载体对照细胞MDA-MB-231/Dox+control plasmid中的Atg13蛋白表达水平,同时检测细胞内的自噬水平（自噬相关蛋白LC3A、LC3B的表达量及LC3B荧光斑点数）及各组细胞对Dox的药物敏感性。结果 成功构建对Dox耐药的TNBC细胞株MDA-MB-231/Dox,并且发现耐药细胞中的基础自噬水平显著高于亲本细胞MDA-MB-231（P<0.05）。重组干扰质粒sh-Atg13抑制Atg13基因表达后,使得耐药细胞MDA-MB-231/Dox中的自噬体标志分子LC3B蛋白表达量显著降低（P<0.05）,且耐药细胞对Dox的药物敏感性增加（IC50值显著降低,P<0.05）。结论 在TNBC细胞MDA-MB-231中,Atg13参与了细胞对Dox获得性耐药的产生。     

miR-28-3p通过抑制BIN1表达促进三阴性乳腺癌MDA-MB-468细胞的恶性生物学行为

目的：探讨 miR-28-3p 在三 阴 性 乳 腺 癌（triple negative breast cancer,TNBC）组 织 和 细 胞 系 中 的 表 达 及 其 对MDA-MB-468细胞恶性生物学行为的影响。方法：收集2013年1月至2014年1月河北医科大学第四医院乳腺中心手术切除的、经病理证实的 83 例女性 TNBC 患者的癌组织和癌旁组织标本,以及 TNBC 细胞系 MDA-MB-468、HCC-1937、MDA-MB-231、MDA-MB-436、MDA-MB-453和人正常乳腺上皮细胞MCF10A,用qPCR检测组织和细胞系中miR-28-3p的表达水平并分析其表达与患者临床病理特征的相关性。用miR-28-3p抑制剂转染MDA-MB-468细胞后,用CCK-8、流式细胞术、细胞划痕和Transwell实验分别检测miR-28-3p抑制剂对MDA-MB-468细胞增殖、凋亡、侵袭和迁移能力的影响,用Western blotting检测MDA-MB-468细胞中桥接整合因子1（bridging integrator-1,BIN1）蛋白的表达水平。通过生物信息学工具预测miR-28-3p的靶基因BIN1,用双荧光素酶报告基因实验验证miR-28-3p对BIN1的调控作用。结果：TNBC组织及细胞系中miR-28-3p表达水平显著高于癌旁组织及MCF10A细胞（均P<0.01）;83例TNBC组织中共有56例（67.47%）高表达miR-28-3p,其高表达与患者的Ki-67表达水平、肿瘤大小和TNM分期密切相关（均P<0.05或P<0.01）。与miR-NC组比较,miR-28-3p抑制剂组MDA-MB-468细胞增殖、侵袭和迁移能力降低,凋亡率升高（均P<0.05或P<0.01）。双荧光素酶报告基因和实验证实BIN1是miR-28-3p的靶基因,miR-28-3p抑制剂可上调MDA-MB-468细胞中BIN1蛋白的表达（P<0.05）。结论：miR-28-3p在TNBC组织及细胞中呈高表达状态,miR-28-3p抑制剂上调BIN1表达进而抑制MDA-MB-468细胞的增殖、迁移和侵袭能力,并促进其凋亡。     

miR-216b-5p靶向ATG5介导自噬逆转食管癌Eca109细胞的顺铂耐药性

目的：探讨miR-216b-5p 对食管癌Eca109 细胞顺铂（DDP）耐药性的影响及其作用机制。方法:采用qPCR 法检测miR-216b-5p 在食管癌细胞TE-1、KYSE-150、Eca109 和耐药细胞Eca109/DDP 中的表达水平。利用脂质体转染技术分别将miR-216b-5p mimic 及mimic NC、自噬相关蛋白5（ATG5）过表达质粒转染到Eca109/DDP 细胞中,用CCK-8、EdU 法和FCM分别检测转染后细胞的增殖和凋亡;mRFP-eGFP-LC3双荧光标记实验检测mRFP-eGFP-LC3慢病毒感染后各组细胞自噬发生情况, WB法检测自噬相关蛋白LC3、Beclin 1和P62 表达。用荧光素酶报告基因实验验证miR-216b-5p与ATG5的靶向关系,WB法检测ATG5的表达。建立裸鼠Eca109/DDP细胞移植瘤模型,观察miR-216b-5p过表达对移植瘤生长的影响。结果：miR-216b-5p在TE-1、KYSE-150、Eca109 和Eca109/DDP 细胞中均呈低表达（均P<0.05）。过表达miR-216b-5p可显著抑制Eca109/DDP 细胞的增殖并诱导凋亡（均P<0.05）,减少细胞中自噬小体数量（P<0.05）,下调LC3Ⅱ/LC3Ⅰ比值和Beclin 1蛋白水平、上调P62 蛋白水平（均P<0.05）。双荧光素酶报告基因实验证实miR-216b-5p靶向并负调控ATG5的表达（P<0.05）,过表达ATG5 可使miR-216b-5p mimic 对Eca109/DDP 细胞增殖、自噬的抑制作用和凋亡的诱导作用明显减弱（均P<0.05）,自噬相关蛋白P62 表达降低、LC3Ⅱ/LC3Ⅰ比值和Beclin 1 表达升高（均P<0.05）。荷瘤实验结果表明,miR-216b-5p 过表达可显著抑制裸鼠移植瘤的生长（P<0.05）。结论：miR-216b-5p过表达可逆转食管癌Eca109/DDP细胞对DDP的耐药性,其机制可能与靶向负调控ATG5表达并影响细胞自噬有关。     

miR-520a-3p靶向ABCG2增强乳腺癌细胞对多西他赛敏感性的机制研究

目的:研究miR-520a-3p对乳腺癌细胞多西他赛敏感性的影响,并探索潜在的分子机制。方法:收集2015年4月至2017年10月在我院乳腺外科确诊的45例乳腺癌标本,实时荧光定量PCR法检测乳腺癌组织中miR-520a-3p的表达水平。分析miR-520a-3p与乳腺癌化疗耐受和肿瘤生物学特征的相关性。采用实时荧光定量PCR检测乳腺癌细胞MCF-7、MCF-7/Doc和MDA-MB-231中miR-520a-3p和三磷酸腺苷结合盒转运蛋白（ABCG2）mRNA的表达,采用蛋白质免疫印迹实验检测ABCG2的表达。转染miR-520a-3p mimic后,采用细胞毒性实验观察乳腺癌细胞对多西他赛敏感性的变化。采用实时荧光定量PCR和蛋白质免疫印迹实验观察miR-520a-3p升高后,ABCG2 mRNA和蛋白的表达变化。进一步采用双荧光素酶活性实验验证miR-520a-3p对ABCG2的靶向作用。结果:化疗耐药组新辅助化疗后肿瘤原发部位的miR-520a-3p表达水平明显降低（P＜0.05）,同时相关性分析发现,miR-520a-3p低表达与高TNM分期（III期）和淋巴结转移相关（P＜0.05）。miR-520a-3p在MCF-7/Doc和MDA-MB-231细胞中表达较在MCF-7细胞中下降（P＜0.05）,而ABCG2的表达水平则明显升高（P均<0.05）。上调miR-520a-3p后,MCF-7和MCF-7/Doc细胞对多西他赛的敏感性增强（P＜0.05）,而ABCG2在mRNA和蛋白水平的表达均下降（P＜0.05）。双荧光素酶报告基因结果则证实ABCG2是miR-520a-3p的靶基因。结论:miR-520a-3p可逆转MCF-7/Doc对多西他赛的耐药性,这一作用可能与负调控肿瘤耐药相关蛋白ABCG2的表达从而抑制药物外排有关。     

莱菔素通过阻断STAT3 信号通路杀伤三阴性乳腺癌细胞MDA-MB-468和MDA-MA-231

[摘要] 目的：探讨染色体区域维持因子1（CRM1）抑制剂莱菔素（LFS-01）通过抑制信号转导及转录激活因子3（STAT3）信号通路杀伤三阴性乳腺癌（TNBC）细胞的作用及其机制。方法：通过分子动力学模拟技术,验证LFS-01 是否可与CRM1 分子结构上的核输出信号（NES）口袋结合。通过CCK-8 法检测LFS-01 对4 种不同的乳腺癌细胞杀伤活力。用不同浓度的LFS-01 处理TNBC细胞MDA-MB-468 和MDA-MB-231,免疫荧光法检测CRM1 货物蛋白STAT3 以及带有NES序列的蛋白在细胞内定位的变化;WB检测LFS-01 对STAT-3 信号通路以及其下游蛋白表达的影响;WB、细胞免疫荧光和透射电镜法检测自噬的发生;通过流式细胞术检测药物对细胞周期和凋亡的影响。结果：分子动力学模拟结果表明,LFS-01 能够与CRM1 的NES口袋结合,显示其在结构上影响后者蛋白转运功能的可能性。LFS-01 能特异性杀伤TNBC 细胞MDA-MB-468 和MDA-MB-231。10 μmol/L LFS-01 处理后TNBC细胞中STAT3 和带有NES标签的蛋白均被阻滞于细胞核中,而在对照组中这些蛋白均匀分布在细胞质中。随着LFS-01 剂量的提高和处理时间的延长,MDA-MB-468 和MDA-MB-231 细胞中磷酸化STAT3 蛋白、Bcl-xL 和Cylin D1 表达均降低,细胞内自噬标志蛋白LC3B表达上升;同时出现高密度、多层的团状自噬小体;细胞周期阻滞于S 期,并且凋亡率显著升高（P<0.05 或P<0.01）。结论：LFS-01 可阻断CRM1 运载蛋白出核、进而抑制STAT3 信号通路的激活,从而促进TNBC 细胞MDA-MB-468 和MDA-MB-231 发生自噬、细胞周期阻滞和凋亡。     

miR-21通过靶向PDCD4调控三阴性乳腺癌细胞的迁移和侵袭

目的： 研究miR-21在三阴性乳腺癌细胞MDA-MB-231中的表达，以及其是否通过调控PDCD4影响MDA-MB-231细胞的迁移和侵袭。方法： 采用实时定量PCR（qPCR）法检测MDA-MB-231细胞和正常乳腺细胞MCF-10A中miR-21和PDCD4 mRNA的表达。将MDA-MB-231细胞随机分为5组：空白对照组，转染miR-21模拟物组，模拟物对照组，转染miR-21抑制物组和抑制物对照组。采用Western blot法检测MDA-MB-231细胞PDCD4蛋白的表达；采用荧光素酶报告基因试剂盒检测转染不同载体后荧光强度的变化来判断miR-21的靶标；采用Transwell实验检测各组细胞的迁移和侵袭数目。结果： miR-21和PDCD4 mRNA在MDAMB-231细胞中的表达水平分别明显高于和低于MCF-10A细胞（P均 < 0.01）。过表达或抑制miR-21可调节PDCD4的表达水平。荧光素酶报告基因试剂盒检测结果显示miR-21可直接靶向调控PDCD4的表达。Transwell实验结果表明过表达miR-21表达能增强MDA-MB-231细胞的迁移和侵袭能力。结论： 在MDA-MB-231细胞中，miR-21通过靶向调控PDCD4表达影响细胞的迁移和侵袭。miR-21可能成为抑制三阴性乳腺癌迁移和侵袭的靶点。     

miR-21通过靶向PDCD4调控三阴性乳腺癌细胞的迁移和侵袭

目的： 研究miR-21在三阴性乳腺癌细胞MDA-MB-231中的表达,以及其是否通过调控PDCD4影响MDA-MB-231细胞的迁移和侵袭。方法： 采用实时定量PCR（qPCR）法检测MDA-MB-231细胞和正常乳腺细胞MCF-10A中miR-21和PDCD4 mRNA的表达。将MDA-MB-231细胞随机分为5组：空白对照组,转染miR-21模拟物组,模拟物对照组,转染miR-21抑制物组和抑制物对照组。采用Western blot法检测MDA-MB-231细胞PDCD4蛋白的表达;采用荧光素酶报告基因试剂盒检测转染不同载体后荧光强度的变化来判断miR-21的靶标;采用Transwell实验检测各组细胞的迁移和侵袭数目。结果： miR-21和PDCD4 mRNA在MDAMB-231细胞中的表达水平分别明显高于和低于MCF-10A细胞（P均 < 0.01）。过表达或抑制miR-21可调节PDCD4的表达水平。荧光素酶报告基因试剂盒检测结果显示miR-21可直接靶向调控PDCD4的表达。Transwell实验结果表明过表达miR-21表达能增强MDA-MB-231细胞的迁移和侵袭能力。结论： 在MDA-MB-231细胞中,miR-21通过靶向调控PDCD4表达影响细胞的迁移和侵袭。miR-21可能成为抑制三阴性乳腺癌迁移和侵袭的靶点。     

miR-124 通过靶向BECN1 基因调控细胞自噬抑制食管癌KYSE170 细胞的侵袭和迁移

目的：探讨miR-124 通过调控细胞自噬对食管癌KYSE170 细胞侵袭和迁移能力的影响。方法：食管癌KYSE170 细胞转染miR-124 mimic,Transwell 实验检测细胞侵袭和迁移能力的变化,双荧光素酶报告基因验证miR-124 对BECN1(Beclin1)基因的靶向调控作用,Western blotting 分析对BECN1、P62 及LC3 蛋白表达水平的影响。向KYSE170 细胞中转染BECN1 siRNA沉默BECN1 的表达,Transwell 法检测细胞侵袭及迁移能力的变化,Western blotting 检测BECN1、P62 及LC3 蛋白的表达。将miR-124 mimic 与BECN1 过表达质粒共转染至KYSE170 细胞,Transwell 实验检测细胞侵袭及迁移能力的变化,Western blotting 检测自噬相关基因表达的变化。结果：转染miR-124 mimic 后,KYSE170 细胞的侵袭和迁移能力下降(P<0.05),BECN1 蛋白及荧光素酶报告基因活性均明显下调(均P<0.01),自噬相关蛋白P62 表达增高,LC3 表达水平明显降低(均P<0.01)。沉默BECN1 表达抑制食管癌细胞侵袭及迁移(P<0.01),而过表达BECN1 使miR-124 mimic 对KYSE170 细胞自噬、侵袭和迁移能力的抑制作用明显减弱(P<0.01),自噬相关蛋白P62 表达降低、LC3 蛋白表达水平明显升高(均P<0.01)。结论：miR-124 能够抑制食管癌细胞侵袭及迁移能力,其机制可能与靶向调控自噬相关基因BECN1 的表达影响细胞自噬有关。     

过表达lncRNA LINC00886靶向调控miR-451a影响乳腺癌MDA-MB-231细胞生物学行为

目的:探究过表达长链非编码RNA（lncRNA）LINC00886通过调控微小RNA-451a（miR-451a）对乳腺癌（BC）MDA-MB-231细胞生物学行为的影响。方法:荧光定量PCR（qRT-PCR）检测人乳腺上皮细胞系（MCF-12A）和4种BC细胞系（HCC1937、SUM159、SK-BR-3和MDA-MB-231）中lncRNA LINC00886、miR-451a表达。将MDA-MB-231细胞分为对照组、LINC00886-NC组、LINC00886组、LINC00886+miR-NC组、LINC00886+miR-451a组。qRT-PCR法检测MDA-MB-231细胞中lncRNA LINC00886、miR-451a表达水平;克隆形成实验和EdU染色检测MDA-MB-231细胞增殖能力;流式细胞术、Transwell小室实验、划痕愈合实验分别用来检测MDA-MB-231细胞凋亡、侵袭、迁移;蛋白印迹法检测MDA-MB-231细胞中增殖细胞核抗原（PCNA）、Bcl-2相关X蛋白（Bax）、B淋巴细胞瘤-2（Bcl-2）、活化的半胱氨酸天冬氨酸蛋白酶3（Cleaved caspase-3）、基质金属蛋白酶（MMP）-2、MMP-9蛋白表达;双荧光素酶报告基因检测lncRNA LINC00886与miR-451a的靶向关系。结果:与人乳腺上皮细胞MCF-12A相比,BC细胞系中lncRNA LINC00886表达水平降低,miR-451a表达水平升高（P＜0.05）;过表达lncRNA LINC00886可升高MDA-MB-231细胞凋亡率、Bax和Cleaved caspase-3蛋白表达,降低miR-451a表达、集落形成数、EdU阳性细胞百分比、侵袭细胞数、迁移率以及PCNA、Bcl-2、MMP-2、MMP-9蛋白表达（P＜0.05）;上调miR-451a表达可减弱lncRNA LINC00886过表达对MDA-MB-231细胞的影响（P＜0.05）;lncRNA LINC00886可靶向调控miR-451a表达。结论:过表达lncRNA LINC00886可通过靶向抑制miR-451a表达促进MDA-MB-231细胞凋亡并抑制MDA-MB-231细胞增殖、侵袭和迁移。     

circNEIL3 通过靶向miR-4784 调控乳腺癌MDA-MB-231 细胞的增殖、迁移和侵袭

目的：研究环状RNA nei 样DNA糖化酶3（circNEIL3）和微小RNA（miR）-4784 对乳腺癌细胞MDA-MB-231 的增殖、迁移和侵袭的影响。方法：收集2018 年1月至2019 年12月在济南市中西医结合医院经组织病理诊断为乳腺癌并行手术切除的45 例乳腺癌患者的癌组织和配对癌旁组织，qPCR 法检测乳腺癌组织、癌旁组织中circNEIL3 和miR-4784 的相对水平。将circNEIL3 的小干扰RNA（si-circNEIL3）、miR-4784 模拟物、si-circNEIL3+miR-4784 抑制物分别转染MDA-MB-231 细胞，采用CCK-8法、平板克隆实验、划痕愈合实验、Transwell 实验检测circNEIL3和miR-4784 表达对细胞活力、克隆形成、迁移和侵袭的影响。双荧光素酶报告基因实验、RNA免疫沉淀（RIP）和RNA pull-down 实验检测circNEIL3和miR-4784 之间相互作用。结果：乳腺癌组织中circNEIL3呈高表达（P<0.05），miR-4784 呈低表达（P<0.05）。干扰circNEIL3显著降低MDA-MB-231 细胞活力、克隆形成数、划痕愈合率以及侵袭数（均P<0.05）。过表达miR-4784 显著降低MDA-MB-231 细胞活力、克隆形成数、划痕愈合率以及侵袭数（均P<0.05）。双荧光素酶报告基因实验、RIP 和 RNA pull-down 实验均证实circNEIL3 与miR-4784 可直接结合，干扰circNEIL3 能明显上调miR-4784表达（P<0.05），过表达circNEIL3 能明显下调 miR-4784 表达（P<0.05）。抑制miR-4784 表达部分逆转干扰circNEIL3对MDA-MB-231 细胞活力、克隆形成、迁移和侵袭的抑制作用（P<0.05）。结论：干扰circNEIL3通过靶向上调miR-4784表达抑制MDA-MB-231细胞的增殖、迁移和侵袭。     

洛铂联合多西他赛行肿瘤细胞减灭术加腹腔热灌注化疗治疗腹膜癌的临床观察

目的 分析洛铂联合多西他赛行肿瘤细胞减灭术（cytoreductive surgery, CRS）加腹腔热灌注化疗（hyperthermic intraperitoneal chemotherapy, HIPEC）治疗腹膜癌（peritoneal carcinoma, PC）的围手术期安全性及疗效。 方法 PC患者行CRS+HIPEC治疗,药物为洛铂50 mg/m2、多西他赛60 mg/m²,加入12 000 ml 0.9%氯化钠溶液加热至（43±0.5）℃持续灌注60 min。记录术后6天体温和心率变化、围手术期不良事件、血常规及血生化指标、术后患者恢复情况及生存结果。结果 90例PC患者行95次CRS+HIPEC,手术时间180~450 min (中位数485 min）;术后6天最高体温、心率分别为36.4℃~38.6℃（中位数37.5℃）、76~124 bpm（中位数100 bpm）,严重不良事件16例,包括围手术期死亡2例。中位生存期20.8月（95%CI: 13.1~25.8月）,1、3、5年生存率分别为75.6%、45.6%、43.3%。 结论 洛铂联合多西他赛进行CRS+HIPEC治疗PC安全性可接受,有助于延长患者生存期。     

Endoscopic Endonasal Dacryocystorhinostomy: Best Surgical Management for DCR

EEDCR is a highly rewarding Endoscopic procedure for management of dacryocystitis when epiphora does not respond to medications or repeated syringing of nasolacrimal duct. It is a simple, less time consuming, safe but skilful, highly satisfying surgery both for the patients as well as the surgeons. There is very big advantage of EEDCR, it is close 100% successful procedure, even if there is recurrence of epiphora it is again correctable fully with no residual affects. EEDCR is far more superior to External DCR/Laser DCR and there are definite reasons for it. A total number of 578 cases have been operated by me from April 1, 2005 to March 31, 2011, only very few reoccurrences were there and they were corrected easily so much so that it can be said that it is a close 100% successful procedure and best surgical management of DACRYOCYSTITIS up to date. The successful outcome was defined as symptomatic relief from epiphora and dacryocystitis and a patent nasolacrimal duct upon syringing at the end of procedure and on follow up of patient.     

参麦注射液对阿霉素所致大鼠心肌损伤保护作用的实验研究

目的　观察参麦注射液 (SMI)对阿霉素 (ADM )诱导大鼠心肌损伤的保护作用和抗氧化作用。方法　选用ADM诱导大鼠心肌损伤模型。SD大鼠 60只 ,随机分为 3个组 ,每组 2 0只 ,分别为正常组、治疗组、对照组。正常组 :实验第 1～ 9天注射生理盐水 ,每天 3ml/kg ,1次 /天。治疗组 :实验第 1～ 9天注射参麦注射液 ,每天 3ml/kg ,1次 /天 ,第 4天注射阿霉素 ,隔天 1次 ,连用 3次 ,用生理盐水配置成 1mg/ml,每次 3mg/kg。对照组实验 1～ 9天注射生理盐水 ,每天 3ml/kg ,1次 /天。第 4天注射阿霉素 ,以后隔天 1次 ,连用 3次 ,用生理盐水配置成 1mg/ml,每次 3mg/kg。到期测定血丙二醛 (MDA )含量和超氧化物歧化酶(SOD )活性 ,并进行心肌病理检查。结果　对照组MDA水平明显高于治疗组 ,对照组SOD水平则显著低于治疗组 ,即加用SMI可提高SOD活性 ,降低MDA含量。SMI能明显减轻大鼠心肌损伤 ,对照组与治疗组比较 ,治疗组心肌损伤明显减轻 ,治疗组与正常组比较无显著性差异。参麦注射液有抗氧化作用 ,与对照组比较 ,血SOD水平升高 ,MDA水平降低 ,心肌病理计分下降。结论参麦注射液有抗氧化作用和对阿霉素所引起的心脏毒性具有保护作用 ,为临床寻找有效的阿霉素所致心肌损伤保护药物提供良好的客观依据 ,值得临床推广应用     

Denosumab in patients with cancer and skeletal metastases: A systematic review and meta-analysis

Background

We conducted a systematic review of the literature to determine the efficacy and safety of denosumab in reducing skeletal-related events (SRE) in patients with bone metastases.

Methods

A literature search using MEDLINE, EMBASE, Web of Science and The Cochrane Collaboration Library identified relevant controlled clinical trials up-to-March 14, 2012. Two independent reviewers assessed studies for inclusion, according to predetermined criteria, and extracted relevant data. The primary outcomes of interest were SRE, time to first on-study SRE, and overall survival. Secondary outcomes included pain, quality of life, bone turnover markers (BTM), and adverse events.

Results

Six controlled trials including 6142 patients were analyzed. Compared to zoledronic acid, denosumab had lower incidence of SRE with a risk ratio (RR) of 0.84 (95% confidence intervals (CI) 0.80–0.88), delayed the onset of first on-study SRE (RR 0.83; 95% CI 0.75–0.90) and time to worsening of pain (RR 0.84; 95% CI 0.77–0.91). No difference was observed in overall survival with pooled hazard ratio of 0.98 (95% CI 0.90–1.0). For total adverse events, denosumab was similar to zoledronic acid (RR 0.97; 95% CI 0.89–1.0). No significant differences were observed in the frequency of osteonecrosis of the jaw (RR 1.4; 95% CI 0.92–2.1). Patients on denosumab had a greater risk of developing hypocalcemia (RR 1.9; 95% CI 1.6–2.3).

Conclusions

Denosumab was more effective than zoledronic acid in reducing the incidence of SRE, and delayed the time to SRE. No differences were found between denosumab and zoledronic acid in reducing overall mortality, or in the frequency of overall adverse events.     

体内诱导艾氏腹水瘤细胞的耐药性研究

肿瘤细胞耐药性的存在是临床化疗失败的主要原因之一。本实验在小鼠体内用阿霉素（ADR）诱导艾氏腹水瘤细胞（EHR）的耐药性，探讨细胞产生耐药性的机理。HPLC法测定细胞内药物浓度．结果表明耐药细胞─—EHR/ADR细胞内ADR积聚低于EHR细胞，而对ADR外排快于EHR细胞；异博定（VER）增加EHR／ADR细胞对ADR的摄取并阻滞其外排．而对EHR影响不大，揭示EHR／ADR细胞具有MDR特性。     

邻近腋窝的上皮样血管内皮瘤1例报道

We described a case of a 71-year-old woman with an epithelioid hemangioendothelioma (EHE) in her left axilla,a rare location which hasn't been reported yet. The patient suffered from numbness, pain and decreased muscle strength of her left upper extremity. Sonography revealed a hypoechoic mass surrounded the axillary artery and brachial artery. No obvious capsule was demonstrated. CT showed a soft-tissue mass with some calcifications and peripheral ring-like en-hancement. The MRI indicated a mass with mainly intermediate signal intensity on Tl-weighted imagine and intermediate signal intensity on T2-weighted imagine. The diagnosis was confirmed by histopathologic examination after surgery. There are some correlations of these imaging features with its histopathologic characters.     

Oxygen for relief of dyspnoea in mildly- or non-hypoxaemic patients with cancer: a systematic review and meta-analysis

The aim of this study was to determine the efficacy of palliative oxygen for relief of dyspnoea in cancer patients. MEDLINE and EMBASE were searched for randomised controlled trials, comparing oxygen and medical air in cancer patients not qualifying for home oxygen therapy. Abstracts were reviewed and studies were selected using Cochrane methodology. The included studies provided oxygen at rest or during a 6-min walk. The primary outcome was dyspnoea. Standardised mean differences (SMDs) were used to combine scores. Five studies were identified; one was excluded from meta-analysis due to data presentation. Individual patient data were obtained from the authors of the three of the four remaining studies (one each from England, Australia, and the United States). A total of 134 patients were included in the meta-analysis. Oxygen failed to improve dyspnoea in mildly- or non-hypoxaemic cancer patients (SMD=-0.09, 95% confidence interval -0.22 to 0.04; P=0.16). Results were stable to a sensitivity analysis, excluding studies requiring the use of imputed quantities. In this small meta-analysis, oxygen did not provide symptomatic benefit for cancer patients with refractory dyspnoea, who would not normally qualify for home oxygen therapy. Further study of the use of oxygen in this population is warranted given its widespread use.     

GF方案与TP方案一线治疗晚期非小细胞肺癌的临床对照研究

Objective  

The aim of the study was to evaluate the efficacies of initial gemcitabine plus cisplatin (GP) and paclitaxel plus cisplatin (TP) 1st-line chemotherapies for advanced non-small cell lung cancer (NSCLC) and observe their side effects.     

鼻咽癌患者放射性骨坏死引起的正电子显像假阳性结果1例及文献复习

目的:探讨鼻咽癌(NPC)患者放射性骨坏死(osteoradionecrosis,ORN)引起正电子假阳性结果的原因及避免因此引发诊断错误的方法。方法:回顾性分析1例放疗后的鼻咽癌患者,行鼻咽部MRI及正电子显像后,再行组织病理学检查,对三种结果进行分析、比较。结果:MRI及正电子显像均诊断患者颅底区域肿瘤复发,组织病理学结果则显示鼻咽部病灶为放射性骨坏死。因此正电子扫描结果为假阳性结果。结论:鼻咽癌患者放疗后所致的放射性骨坏死容易引起正电子显像假阳性结果并可能引发不必要的治疗,因此NPC患者的正电子图像,对于可能的局限性肿瘤复发诊断,应该非常慎重。     

Bortezomib-related neuropathy may mask CNS relapse in multiple myeloma: A call for diligence

Background: Neuropathy is a common adverse effect of bortezomib. Isolated central nervous system (CNS) relapse in MM remains exceedingly rare and carries a dismal prognosis. We present an unusual case of bortezomib related neuropathy masking a CNS relapse of MM. Case presentation: A 57-year-old female was diagnosed with standard-risk MM with clinical and cytogenetic features not typically associated with CNS involvement. She was treated with 4 cycles of bortezomib/cyclophosphamide/dexamethasone (VCD) and achieved a VGPR, after which she underwent an autologous stem cell transplant (ASCT) followed by bortezomib maintenance. Six months after ASCT she developed symptoms suggestive of peripheral neuropathy which was attributed to bortezomib. However the symptoms persisted despite discontinuation of bortezomib. Imaging and cerebrospinal fluid analysis subsequently confirmed a CNS relapse. Discussion: CNS involvement in MM (CNS-MM) is uncommon and is considered an aggressive disease. Recently published literature has reported biomarkers with prognostic potential. However, isolated CNS relapse is even less common; an event which carries a very poor prognosis. Given the heterogeneous neurologic manifestations associated with MM, clinical suspicion may be masked by confounding factors such as bortezomib-based therapy. The disease may further remain incognito if the patient does not exhibit any of the high risk features and biomarkers associated with CNS involvement. Conclusion: In the era of proteasome inhibitor (PtdIns)/immunomodulator (IMID)-based therapy for MM which carries neurologic adverse effects, it is prudent to consider CNS relapse early. This case further highlights the need for more robust biomarkers to predict CNS relapse and use of newer novel agents which demonstrate potential for CNS penetration.