miR-130a-3p通过HGF/MET信号通路抑制乳腺癌细胞MCF-7 侵袭

目的：探究miR-130a-3p 通过HGF/MET信号通路调控上皮间质转化（epithelial-mesenchymal transition,EMT）影响乳腺癌细胞侵袭转移的分子机制。方法：收集承德医学院附属医院2018 年1 月至10 月收治的22 例乳腺癌患者癌组织和配对癌旁组织标本,乳腺癌细胞系（MCF-7、MDA-MB-231 和MDA-MB-453）和正常乳腺上皮细胞MCF10A来自承德医学院基础研究所,然后采用qPCR检测组织和细胞系中miR-130a-3p 的表达情况;将实验分为对照组、miR-130a-3p mimics 组、miR-130a-3p inhibitor组、PHA665752（MET小分子抑制剂）转染组及共转PHA665752+miR-130a-3p inhibitor 组,然后采用CCK-8 法和Transwell 实验分别检测MCF-7 细胞增殖活力、侵袭和迁移能力;WB实验检测MCF-7 细胞EMT和HGF/MET信号通路相关蛋白的表达情况;此外,采用双荧光素酶报告基因检测miR-130a-3p 与MET之间的靶向关系。结果：miR-130a-3p 在乳腺癌组织和细胞系中呈低表达;过表达miR-130a-3p 可抑制MCF-7 细胞增殖、侵袭、迁移和EMT;而抑制miR-130a-3p 出现相反的结果。双荧光素酶报告基因结果证实miR-130a-3p 靶向下调MET的表达水平,且miR-130a-3p 负调控HGF/MET信号通路的表达;进一步实验证明,miR-130a-3p 通过阻断HGF/MET信号通路抑制MCF-7 细胞增殖、侵袭、迁移和EMT。结论：miR-130a-3p 通过阻断HGF/MET信号通路抑制MCF-7 细胞EMT过程,进而抑制MCF-7 细胞侵袭转移。     

过表达miR-145-5p 通过下调IGF1R抑制食管鳞状细胞TE-10 细胞的恶性生物学行为

目的：探究miR-145-5p 对食管鳞状细胞癌TE-10 细胞增殖、侵袭、迁移和上皮间质转化（epithelial-mesenchymal transition，EMT）等恶性生物学行为的分子机制。方法：qPCR法检测miR-145-5p 在食管鳞状细胞癌细胞和正常食管上皮细胞中的表达水平。采用双荧光素酶报告基因实验检测miR-145-5p 与胰岛素样生长因子1 受体（insulin-like growth factor 1 receptor，IGF1R）的靶向调控关系，Western blotting 检测IGF1R蛋白和EMT相关蛋白的表达，CCK-8 法和Transwell 检测miR-145-5p/IGF1R分子轴对TE-10 细胞增殖、侵袭、迁移的影响。结果：miR-145-5p 在3 株食管鳞状细胞癌细胞中低表达且在TE-10 细胞中表达最低（P<0.01 或P<0.05）。过表达miR-145-5p 可显著抑制TE-10 细胞的增殖、侵袭、迁移和EMT进程（P<0.01 或P<0.05）。双荧光素酶报告基因证实miR-145-5p 靶向下调IGF1R表达（P<0.01）。回复实验进一步证实，与单独过表达IGF1R相比，同时过表达miR-145-5p 和IGF1R能显著缓解IGF1R 对TE-10 细胞的增殖、侵袭、迁移和EMT 进程的促进作用（P<0.01 或P<0.05）。结论：过表达miR-145-5p 通过靶向下调IGF1R进而抑制了食管鳞状细胞癌TE-10 细胞的增殖、侵袭、迁移和EMT进程。     

miR-31-5p 通过调控TNS1 抑制乳腺癌细胞生物学行为及放疗抵抗的分子机制

目的：探讨miR-31-5p/张力蛋白1 基因（tension protein 1,TNS1）分子轴对乳腺癌细胞生物学行为的影响及其放疗抵抗的分子机制。方法：收集2017 年7 月至2017 年12 月南阳市中心医院肿瘤放疗科收治的、经手术切除的21 例乳腺癌患者癌及癌旁组织标本,以及乳腺癌细胞系MCF-7、MDA-MB-231 和SKBR-3,采用qPCR法检测癌组织和癌细胞系中miR-31-5p 的表达水平。通过6 MV-X射线照射MCF-7 细胞,构建放疗抵抗细胞株MCF-7R。随后,采用克隆形成实验、Transwell 小室法和AnnexinV/PI 染色流式细胞术检测过表达/敲降miR-31-5p 对MCF-7 和MCF-7R细胞放疗敏感性的影响;用双荧光素酶报告基因验证miR-31-5p 与TNS1 的靶向关系。结果：乳腺癌组织、细胞系和MCF-7R细胞中miR-31-5p 表达水平显著低于癌旁组织、人正常乳腺上皮细胞MCF-10A和MCF-7 细胞（均P<0.01）。过表达miR-31-5p 显著抑制MCF-7R细胞的侵袭并促进细胞凋亡（均P<0.01）,沉默miR-31-5p 在MCF-7 细胞中结果相反。双荧光素酶报告基因法证实TNS1 是miR-31-5p 靶基因。过表达miR-31-5p 通过靶向下调TNS1 显著抑制MCF-7R细胞侵袭能力并促进细胞凋亡（均P<0.01）,沉默miR-31-5p 通过上调TNS1 显著促进MCF-7 细胞侵袭和抑制细胞凋亡（均P<0.01）,从而上调MCF-7R对放射治疗的敏感性。结论：miR-31-5p/TNS1 分子轴与乳腺癌放疗抵抗存在调控关系,且过表达miR-31-5p 可逆转MCF-7R细胞对放疗抵抗作用。     

miR-103 靶向PTEN并激活PI3K/AKT通路促进肺癌细胞A549 对达沙替尼耐药

[摘要] 目的：探讨miR-103 靶向PTEN并激活PI3K/AKT信号通路促进肺癌细胞对达沙替尼（dasatinib,DASA）耐药的机制。方法：收集2014 年4 月至2018 年1 月昆明医科大学第一附属医院胸外科收治的资料完整的肺癌DASA耐药组织和不耐药组织各35 例。采用qPCR实验检测miR-103 在肺癌DASA耐药组织和细胞中的表达水平,同时,采用CCK-8、Transwell 和Wb实验检测敲降miR-103 对A549/DASA细胞增殖、迁移和上皮间质转化（EMT）的影响,双荧光素酶报告基因验证miR-103 与PTEN的靶向关系。进一步采用CCK-8、Transwell 和Wb实验检测miR-103 通过PTEN-PI3K/AKT信号通路对A549/DASA细胞恶性生物学行为的影响。结果：miR-103 在肺癌DASA 耐药组织和A549/DASA 细胞中均高表达（均P<0.01）。敲降miR-103 可显著抑制A549/DASA细胞的增殖、迁移和EMT（P<0.05 或P<0.01）。此外,双荧光素酶报告基因证实miR-103 靶向作用PTEN并下调其表达水平（P<0.01）。进一步实验显示,过表达miR-103 通过靶向下调PTEN并激活PI3K/AKT信号通路进而显著促进A549/DASA细胞增殖、迁移和EMT（P<0.05 或P<0.01）,从而上调A549/DASA细胞对DASA的耐药性。结论：miR-103/PTEN/PI3K/AKT信号通路与肺癌DASA耐药性存在调控关系,敲降miR-103 可逆转A549/DASA对DASA耐药。     

circRNA_001569通过miR-145/HBXIP轴影响乳腺癌细胞的恶性生物学行为

目的：探讨 circRNA_001569 通过 miR-145/HBXIP 轴在乳腺癌细胞增殖、侵袭、迁移中发挥的作用。方法:收集2016年1月至2019年1月期间衡水市人民医院收治的30例乳腺癌患者的癌组织和癌旁组织。qPCR检测circRNA_001569在乳腺癌组织、癌旁组织以及细胞系中的表达。生物信息学工具预测miR-145的靶基因，RNA免疫沉淀（RNA immunoprecipitation，RIP）和双荧光素酶报告基因实验检测 miR-145 或靶基因之间的相互作用 ；向乳 腺 癌 MDA-MB-231 和 MCF-7细胞中转染si-circRNA_001569、miR-145 mimics或miR-145 inhibitor，建立基因过表达或沉默的细胞模型，qPCR和Western blotting分别检测转染对相关基因和蛋白表达的影响，CCK-8法、Transwell实验检测转染对细胞增殖、侵袭和迁移的影响。结果:在乳腺癌组织和乳腺癌细胞中，circRNA_001569 和 HBXIP 均呈高表达、miR-145 呈低表达。RIP 分析和双荧光素酶实验证实了 miR-145 与circRNA_001569和HBXIP之间的靶向关系；circRNA_001569或HBXIP过表达促进MDA-MB-231和MCF-7细胞的增殖、侵袭和迁移（均 P<0.01），而 miR-145 过表达起相反的作用（均 P<0.01）。结论:circRNA_001569 可能通过下调 miR-145 的表达、上调HBXIP的表达从而促进乳腺癌细胞的增殖、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。     

纤维连接蛋白FNDC10通过增强STAT3活化促进乳腺癌细胞的恶性生物学行为

目的： 研究纤维连接蛋白Ⅲ型域包含蛋白10 （FNDC10）对乳腺癌细胞增殖、迁移和侵袭等能力的影响，并初步探讨其作用机制。 方法： 采用TCGA数据库分析FNDC10在乳腺癌组织中表达情况。通过qPCR检测FNDC10在正常永生化乳腺细胞（MCF-10A）和乳腺癌细胞（MCF-7、MDA-MB-231、BT549、MDA-MB-468、HCC1806和HCC1937）中的表达水平。选取MCF-7和MDA-MB-231细胞转染FNDC10 siRNA或对照siRNA后进行功能实验：CCK-8实验检测FNDC10对乳腺癌细胞增殖的影响，集落形成实验检测对乳腺癌细胞集落形成能力的影响，Transwell实验检测其对乳腺癌细胞迁移和侵袭能力的影响，WB法检测转移相关分子和细胞信号通路在蛋白水平的变化。 结果： FNDC10在乳腺癌组织中的表达水平明显高于正常组织（P<0.01），FNDC10在乳腺癌细胞MCF-7和MDA-MB-231内表达水平高于正常乳腺细胞（P<0.01或P<0.05）。敲低FNDC10表达抑制了乳腺癌细胞的增殖、迁移和侵袭（P<0.01或P<0.05）。机制研究表明，干扰FNDC10表达抑制了乳腺癌细胞中STAT3的活化（P<0.01或P<0.05），促进了细胞EMT标志物E-cadherin的表达（P<0.05），抑制了EMT进程。 结论： FNDC10通过增强STAT3信号通路活化促进乳腺癌细胞增殖和EMT进程，从而促进乳腺癌恶性进展。     

lncRNA HOTAIR通过miR-519d-3p/CCND1 分子轴促进乳腺癌SKBR3细胞的恶性生物学行为

目的：探究lncRNA HOTAIR/miR-519d-3p/CCND1 分子轴对乳腺癌细胞增殖和转移的影响及其可能机制。方法：收集2017 年3 月至2019 年2 月南昌市第三医院乳腺外科手术切除的乳腺癌患者的乳腺癌组织及配对癌旁组织各50 例，qPCR检测癌及癌旁组织中HOTAIR 的表达水平，乳腺正常上皮细胞及乳腺癌细胞系中HOTAIR 和miR-519d-3p 的表达水平。将乳腺癌SKBR3 细胞分为NC 组、si-HOTAIR 组、miR-519d-3p mimics 组，miR-519d-3p mimics+pcHOTAIR 组、miR-519d-3p mimics+pcCCND1 组和si-HOTAIR+pcCCND1 组，CCK-8 法检测各组SKBR3 细胞增殖能力、Transwell 检测细胞侵袭和迁移能力、Western blotting 检测SKBR3 细胞中E-cadherin、N-cadherin、Vimentin 以及CCND1 表达水平。双荧光素酶报告基因检测HOTAIR 和miR-519d-3p 以及miR-519d-3p 和CCND1 的靶向关系。结果：HOTAIR在癌组织以及乳腺癌细胞系中呈高表达，且在SKBR3 细胞系中表达最高。敲降HOTAIR可显著抑制SKBR3 细胞增殖、侵袭和迁移，并显著增加E-cadherin 的表达水平、降低N-cadherin 和Vimentin的表达水平（均P<0.05）。双荧光素酶报告基因检测显示，HOTAIR 靶向下调miR-519d-3p 的表达，miR-519d-3p 靶向下调CCND1 的表达。敲降HOTAIR可增强miR-519d-3p 对CCND1 的下调作用，抑制SKBR3 细胞EMT、增殖、侵袭和迁移能力（均P<0.05）。结论：敲降HOTAIR可抑制SKBR3 细胞增殖和转移，其机制是通过调控miR-519d-3p/CCND1 分子轴实现的。     

miR-26b-3p对乳腺癌细胞生物学行为的影响及作用机制研究

背景与目的：miRNA是一类长度为21~23个核苷酸的单链非编码RNA分子，其作用机制主要为靶向于mRNA的3’非翻译区（3’ untranslated region，3’UTR）从而抑制其靶基因的表达。miRNA在肿瘤的发生、发展过程中发挥着关键作用，探讨miR-26b-3p对乳腺癌生物学行为的影响及作用机制。方法：通过实时荧光定量聚合酶链反应（real-time fluorescence quantitative polymerase chain reaction，RTFQ-PCR）检测miR-26b-3p在三种乳腺癌细胞系MCF-7、MDA-MB-231和MDA-MB-453中的表达，选取miR-26b-3p表达水平最低的乳腺癌细胞转染miR-26b-3p mimics后，采用细胞计数试剂盒（cell counting kit-8，CCK-8）法检测细胞的增殖，采用transwell迁移和侵袭实验检测细胞迁移和侵袭能力，通过小动物活体成像及裸鼠移植瘤模型检测miR-26b-3p对乳腺癌细胞裸鼠移植瘤生长和转移的影响，采用双荧光素酶报告基因分析检测miR-26b-3p与锌指E盒结合同源盒基因1（zinc finger E-box binding homeobox 1，ZEB1）的相互作用，采用RTFQ-PCR和蛋白质印迹法（Western blot）检测ZEB1的表达。结果：乳腺癌细胞系MDA-MB-453中miR-26b-3p表达最低，在MDA-MB-453细胞中转染miR-26b-3p mimics后，miR-26b-3p的表达水平显著升高（P<0.05），细胞的增殖能力显著降低（P<0.05），细胞的迁移（P<0.001）和侵袭能力（P<0.01）显著降低。过表达miR-26b-3p可抑制裸鼠体内乳腺癌移植瘤的生长和转移。miR-26b-3p可与ZEB1的3’UTR结合，抑制ZEB1的表达。结论：miR-26b-3p可靶向于ZEB1，抑制乳腺癌细胞的增殖、迁移和侵袭，抑制乳腺癌的生长和转移。     

miR-4465 通过靶向下调HMGA1的表达抑制肝细胞癌Hep3B细胞的恶性生物学行为

目的：探讨miR-4465 靶向高迁移率族蛋白A1（HMGA1）对肝细胞癌 Hep3B 细胞增殖、迁移和侵袭能力的影响。方法：收集2020 年5 月至2021 年9 月在皖南医学院第一附属医院确诊为肝细胞癌患者的16 对癌组织和癌旁组织样本，采用qPCR 分析miR-4465 在肝细胞癌组织和Hep3B、Huh7细胞中的表达情况，双荧光素酶报告基因实验验证miR-4465 与HMGA1的调控关系。按转染物的不同将 Hep3B 细胞分为 mimics-NC 组 、miR-4465-mimics 组、inhibitor-NC 组、miR-4465 inhibitor组、si-NC 组、si-HMGA1 组；另外分组转染mimics-NC+pcDNA-NC、miR-4465 mimics+pcDNA-NC 和miR-4465 mimics+pcDNA-HMGA1进行回复实验。采用qPCR和WB法检测各组细胞中HMGA1 mRNA和蛋白水平的变化，CCK-8法检测各组细胞增殖能力的变化，划痕实验检测各组细胞迁移能力的变化，Transwell 实验检测各组细胞侵袭能力的变化。结果：miR-4465 在肝细胞癌组织和细胞中的表达水平显著低于癌旁组织和正常肝细胞（P<0.05或P<0.001）。转染48 h后，过表达miR-4465 的Hep3B细胞增殖、迁移和侵袭能力均显著下降（P<0.05、P<0.01或P<0.001）；敲低miR-4465 后细胞的增殖、迁移和侵袭能力均明显升高（P<0.05、 P<0.01或P<0.001）。双荧光素酶报告实验验证了HMGA1-3''UTR 与miR-4465 的靶向结合关系，miR-4465 可以靶向下调HMGA1 mRNA 和蛋白质的表达（均P<0.01）。过表达HMGA1 能部分逆转过表达 miR-4465 对细胞增殖、迁移、侵袭的抑制作用及HMGA1 表达的抑制作用（均P<0.05）。结论：miR-4465 通过靶向下调HMGA1 在肝细胞癌Hep3B 细胞中的表达，从而抑制Hep3B细胞的恶性生物学行为。     

The medically important dematiaceous fungi and their identification

Dematiaceous fungi include a large group of organisms that are darkly pigmented (dark brown, olivaceous, or black). In most cases the pigment is melanin, and specifically, dihydroxynaphthalene melanin. The diseases produced include chromoblastomycosis, eumycotic mycetoma, and phaeohyphomycosis. Phaeohyphomycosis is a new classification for a diverse group of previously known entities grouped together on the basis of finding dematiaceous hyphal and/or yeast-like forms in tissue; tissue involvement may be superficial, cutaneous and corneal, subcutaneous, or systemic. Identification of these fungi is based mostly upon morphology. Important structures include annellides (Phaeoannellomyces, Exophiala), phialides (Phialophora, Wangiella), adelophialides (Phialemonium without collarettes, Lecythophora with collarettes), differentiation of conidiophores (Xylohypha versus Cladosporium) and conidial hilum, septation and germination (Bipolaris, Drechslera, Exserohilum). Useful laboratory tests include the 12% gelatin test (controversial), nitrate assimilation (W. dermatitidis is negative, most other species are positive), and determination of temperature maxima (especially 37 degrees C for E. jeanselmei, 40 degrees C for W. dermatitidis and B. spicifera, 42 degrees C for X. bantiana, and 45 degrees C for Dactylaria constricta var. gallopava and Scedosporium inflatum).     

Laboratory Techniques Alternative to In Vivo Experiments for Studying the Liberation, Penetration and Fungicidal Action of Topical Antimycotic Agents in the Skin, Including Ciclopiroxolamine

Summary: Short-term experiments on excised skin (human, pig) gave the following results: 1. In the tissue activity test with direct inoculation (D-TAT) commercial preparations of the non-azole antimycotics ciclopiroxolamine, tolnaftate and naftifine, produced higher inhibitory activity against Trichophyton mentagrophytes (standard strain) in various levels of the horny layer than were produced by the azole antimycotics econazole, miconazole, clotrimazole, oxiconazole and bifonazole. Fast drying solutions of antimycotics invariably gave higher inhibitory activities than creams. In the ultrafiltration tissue activity test (UFT- TAT) against Candida albicans (2 strains), antimycotic agents ranked in order of effectiveness as follows: ciclopiroxolamine – most of the azole antimycotics – bifonazole and naftifine. 2. In tests of fungicidal activity against T. mentagrophytes (2 strains) and Microsporum gypseum (1 strain) the first step was to inoculate the skin surface. After the horny layer had been penetrated by fungal mycelia, antimycotic agents of documented fungicidal potency, chiefly in the form of creams, were applied to the skin surface and left to act for up to 18 hours. The horny layer and epidermis were then scraped off and the concentration of viable fungi was determined. Ciclopiroxolamine cream and lotion produced by far the greatest diminution in viable fungi; creams containing oxiconazole and naftifine were moderately effective and those containing tioconazole and bifonazole produced a relatively small decrease in viable fungi. To avoid erroneous results it is important to homogenize and dilute the skin scrapings; if this is not done certain antimycotics will give misleadingly high fungal killing rates. At this early stage the scatter of results is still wide and minor differences in efficacy cannot as yet be detected with certainty. 3. From the results of various comparative tests it is evident that pig skin can be used as a substitute for human skin in the tests listed under 1. and 2. above. This discovery may make a valuable contribution towards limiting the need for experiments on living animals and trials on human beings. Zusammenfassung: In Kurzzeitversuchen an exzidierter Haut (Mensch, Schwein) wurde gefunden: 1. Im Gewebeaktivitätstest mit direkter Inokulation (D-GAT) wurde mit Handelspräparaten der Nichtazol-Antimykotika Ciclopiroxolamin, Tolnaftat und Naftifin in verschiedenen Hornschichtniveaus eine höhere Hemmaktivität gegenüber Trichophyton mentagrophytes (Standard-Stamm) erzielt als mit solchen der Azol-Antimykotika Econazol, Miconazol, Clotrimazol, Oxiconazol und Bifonazol. Rasch trocknende Lösungen von Antimykotika ergaben durchweg höhere Hemmaktivitäten als Cremes. Im Ultrafiltrations-Gewebeaktivitätstest (UFT-GAT) gegenüber Candida albicans (2 Stämme) ergab sich nach erzielter Wirksamkeit die Rangfolge Ciclopiroxolamine – Mehrzahl der Azolantimykotika – Bifonazol und Naftifin. 2. In Fungizidie-Testen gegenüber T. mentagrophytes (2 Stämme) und Microsporum gypseum (1 Stamm) wurde zunächst die Hautoberfläche inokuliert. Nach Durchdringung der Hornschicht mit Pilzmyzelien wirkten auf die Hautoberfläche bis zu 18 Stunden lang überwiegend Cremes von als fungizid publizierten Antimykotika ein. Während sich in abgeschabter Hornschicht und Epidermis der so bearbeiteten Hautoberflächen mit Ciclopiroxolamin-Creme und -Lotion die weitaus höchste Verminderung lebensfähiger Keime ergab, bewirkten Cremes mit Oxiconazol und Naftifin eine mittlere und solche mit Tioconazol und Bifonazol eine relativ niedrige Keimeliminierung. Zur Vermeidung von fehlerhaften Ergebuissen mußten Homogenisierung und Verdünnung der Hautschabsel erfolgen, anderenfalls bei mehreren Antimykotika eine zu hohe Keimabtötung vorgetäuscht worden wäre. Wegen der vorerst noch hohen Streuung der Ergebnisse können kleinere Wirksamkeitsunterschiede noch nicht sicher erfaßt werden. 3. Nach dem Ergebnis verschiedener Vergleichstests kann in den Testen zu 1. und 2. Schweinehaut als Ersatz für Haut vom Menschen dienen und dürfte damit wesentlich zur Einschränkung von Versuchen am lebenden Tier und von Prüfungen am Menschen beitragen.     

Efficiency of crude and purified fungal antigens in serodiagnosis to discriminate mycotic from other respiratory diseases

Mycotic immunodiagnosis was performed in 186 hospitalized patients with different respiratory diseases, mostly considered as tuberculosis and others with a doubtful diagnosis. Crude histoplasmin, coccidioidin, paracoccidioidin, blastomycin, candidin, aspergillin, and sporotrichin, as well as purified polysaccharide-protein complexes (PPC) of Histoplasma capsulatum, Coccidioides immitis, and Paracoccidioides brasiliensis were used as antigens. Immune tests used included skin test (ST), gel immunodiffusion (ID), counterimmunoelectrophoresis (CIE), complement fixation (CF), and ELISA. A possible association with candidosis was observed in 17% of patients with tuberculosis and diabetes; one presumptive paracoccidioidomycosis, one confirmed aspergillosis, and six cases of active histoplasmosis were determined. Candidin ST showed 29% of positive reactions with an increased frequency in patients between 31 and 55 years of age. CF test showed the highest positivity percentages with crude antigens, specially for Candida antigen (26.3%) and histoplasmin (18.2%). Cross reactions were evident with crude antigens but decreased when PPC's were used in ELISA.     

Isoconazole nitrate in the treatment of tropical dermatomycoses

Summary. A total of 54 patients with culturally proven tropical dermatomycoses, comprising 23 with various types of dermatophytoses, one with foot infection due to Trichosporon beigelii and one with foot infection due to Geotrichum candidum , two with candidoses of the groin and 27 with pityriasis versicolor, were included in a clinical trial of efficacy of 1% isoconazole cream (Travogen^R, Schering, Berlin, Germany). Five patients were not evaluable. A clinical and mycological cure was achieved in 29 cases in 3–4 weeks. In 15 (31%) of the remaining patients treatment was required for 5–6 weeks, while another three patients required treatment for 8 weeks. In two patients the disease proved to be resistant to treatment with the drug.
Zusammenfassung. Insgesamt 54 Patienten mit kulturell gesicherter Dermatomykose, (23 unterschiedliche Dermatophytosen, eine Trichosporon beigelii - und eine Geotrichum candidum -Fußinfektion, 2 Candidosen der Leistengegend und 27 Pityriasis versicolor) wurden in einer klinischen Wirksamkeits-studie mit 1% iger Isoconazol-Creme (Travogen^R, Schering, Berlin, Deutschland) behandelt. Fünf Patienten waren nicht auswertbar. Eine klinische und mykologische Heilung wurde bei 47 von 49 Patienten (96%) erreicht. Bei 29 patienten (59%) wurde die Heilung bereits nach 3–4 Wochen Behandlung erreicht. Weitere 15 Patienten (31%) benötigten 5–6 Wochen und drei Patienten 8 Wochen Behandlungsdauer. Zwei Mykosesituationen erwiesen sich als therapieresistent.     

Orale Langzeitbehandlung von Onychomykosen mit Ketoconazol

Zusammenfassung: An der Studie zur Wirksamkeit und Anwendungssicherheit von Ketoconazol nahmen 27 Männer im Alter von 20 bis 80 (Median: 57) Jahre, davon 18 mit Onychomykosen und 9 als KontroUen bei den Laborwertbestimmungen, teil. Während des ersten Behandlungsmonats erhielten je 9 Patienten 200 mg und 400 mg Ketoconazol täglich. Danach wurden beide Gruppen 6 Monate mit 200 mg/d weiterbehandelt. Die klinische Beurteilung sowie hämatologische, biochemische und Plasmaspiegeluntersu-chungen erfolgten mindestens monafich, mykologische Untersuchungen wurden vor Aufnahme und bei Beendigung der Therapie vorgenommen. Erne letzte klinische Unter-suchung erfolgte 1 Jahr nach Beginn der Studie. Nach 7 Monaten Behandlung wurden 23 von 30 Nägeln mit “gebessert” bis “stark gebessert” beurteilt, nach dem behandlungsfreien Intervall galt dies für 28 von 30 Nägeln. Die Plasmaspiegel waren mit 200 mg/d ausreichend und uber den Behandlungszeit-raum konstant. Dies spricht für gute orale Resorption und Abwesenheit von Enzyminduktion. Die Laborwerte zeigten im Vergleich zu den Kontrollen und den Werten vor Behandlung keine signifikanten Abweichungen, so daß myelo-, nephro- und hepatotoxische Wirkungen von 400 bzw. 200 mg/d ausgeschlossen werden können. Der Lipidhaushalt wurde nicht beeinfluat und es trat unter Therapie als Folge der Ketoconazolwirkung lediglich Lanosterin im Serum auf. Nach Beendigung der Therapie ging der Lanosteringehalt schnell zurück. Damit erweist sich Ketoconazol in den angewandten Dosen als ein gut verträgliches und zur Langzeitbehandlung von Onychomykosen geeignetes Antimykotikum. Summary: Twenty-seven males with a median age of 57 (range: 20 to 80) years took part in this study on the efficacy and safety of ketoconazole. Eighteen men suffered from onychomycosis; nine served as controls in the safety evaluation. During the first month of treatment, nine patients received 200 mg and the nine other 400 mg ketoconazole daily. Then the treatment was uniformly continued with 200 mg/d for 6 months. Clinical evaluation and haematological, biochemical and plasma level investigations were carried out at least at monthly intervals; mycological controls were performed at the start and end of therapy. A final clinical evaluation was carried out one year after the start of the study. After 7 months of treatment, moderate or definite clinical improvement was obtained in 23 out of 30 nails. After 5 more months without antimycotic treatment this was the case in 28 of 30 nails. Plasma levels obtained with 200 mg ketoconazole daily were adequate and constant during the entire treatment period. This indicates a good oral resorption as well as the absence of induction of hepatic enzymes. The laboratory values did not show significant deviations as compared with the controls or with the pretreatment values. This excludes myelo-, nephro- and hepatotoxic effects of 400 and 200 mg ketoconazole daily. The lipid metabolism was not influenced, the only difference was the occurrence of lanosterol in the serum, which is a result of the mechanism of action of ketoconazole. After the medication period the lanosterol levels subsided rapidly. In the applied doses ketoconazole is a well-tolerated and effective drug for the systemic long-term treatment of onychomycosis.     

Large-scale molecular characterization and analysis of gastric cancer

The recent effort by The Cancer Genome Atlas （TCGA） Network has revealed that gastric cancer, which is a leading cause of cancerrelated deaths worldwide with a 5-year survival rate less than 25%, is a much more heterogeneous disease than previously thought. And yet, conventional treatment approaches and clinical trials have assumed it is a single disease. Although it is well known that under the microscope, gastric cancer cells appear quite different, the current classification scheme recognizes two main categories of gastric cancer： diffuse and intestinal.     

A conceptually new treatment approach for relapsed glioblastoma: Coordinated undermining of survival paths with nine repurposed drugs (CUSP9) by the International Initiative for Accelerated Improvement of Glioblastoma Care

To improve prognosis in recurrent glioblastoma we developed a treatment protocol based on a combination of drugs not traditionally thought of as cytotoxic chemotherapy agents but that have a robust history of being well-tolerated and are already marketed and used for other non-cancer indications. Focus was on adding drugs which met these criteria: a) were pharmacologically well characterized, b) had low likelihood of adding to patient side effect burden, c) had evidence for interfering with a recognized, well-characterized growth promoting element of glioblastoma, and d) were coordinated, as an ensemble had reasonable likelihood of concerted activity against key biological features of glioblastoma growth. We found nine drugs meeting these criteria and propose adding them to continuous low dose temozolomide, a currently accepted treatment for relapsed glioblastoma, in patients with recurrent disease after primary treatment with the Stupp Protocol. The nine adjuvant drug regimen, Coordinated Undermining of Survival Paths, CUSP9, then are aprepitant, artesunate, auranofin, captopril, copper gluconate, disulfiram, ketoconazole, nelfinavir, sertraline, to be added to continuous low dose temozolomide. We discuss each drug in turn and the specific rationale for use- how each drug is expected to retard glioblastoma growth and undermine glioblastoma''s compensatory mechanisms engaged during temozolomide treatment. The risks of pharmacological interactions and why we believe this drug mix will increase both quality of life and overall survival are reviewed.     

Endometrial cancers and predisposition

As nearly 5% of all endometrial cancers occur because of a predisposition, this possibility has systematically to be explored. The hallmarks of predisposition, a young age at diagnosis, a personal or a familial history of cancer, have to be searched systematically. The identification of a predisposition in a family has a major impact on the management of the proband or his relatives. The endometrial cancer main predisposition is Lynch's syndrome. In this review, we will focus on this condition and describe its clinical manifestations, the underlying molecular mechanisms, the cancer risks and the management guidelines. We will also get onto some far less frequent other predispositions.