雷帕霉素对人肝癌裸鼠原位移植瘤生长的抑制作用

目的探讨雷帕霉素对人肝癌裸鼠原位移植瘤生长的影响及其机制。方法建立人肝癌棵鼠肝原位移植瘤模型32只,随机分为空白对照组、FK506组、雷帕霉素常规剂量组和高剂量组。用药两周后观察肿瘤体积的变化,免疫组织化学法检测肝癌组织中增殖细胞核抗原(PCNA)、血管内皮细胞生长因子(VEGF)的表达。结果对照组、FK506组、雷帕霉素常规剂量组、高剂量组平均肿瘤体积分别为:(310．15±40．16)、(605．59±116．23)、(99．19±15．27)、(151．61±27．81) mm3。与对照组相比,雷帕常规剂量组及高剂量组肿瘤体积明显缩小,PCNA、VEGF的表达均显著下调(P<0．01);FKS06组肿瘤体积与对照组相比明显增大,差异有统计学意义(P<0．01),PC- NA、VEGF的表达与对照组相比差异无统计学意义(P>0．01)。结论雷帕霉素具有显著抑制肝癌生长的作用,其机制可能是抑制了肝癌细胞的恶性增殖及VEGF的产生。     

超声及临床特征对附睾局灶性病变的鉴别价值

目的:评价超声及临床特征在附睾局灶性病变鉴别诊断中的应用价值。方法:回顾性分析附睾局灶性病变48例,包括非特异性附睾炎、附睾结核和附睾精液囊肿。分析附睾局灶性病变大小、形态、位置、回声强度及均一性,鞘膜腔是否有积液;病灶血流的程度以及患者年龄、病程和阴囊压痛程度。结果:附睾结核病灶平均面积比非特异性附睾炎病灶大(P<0.05),并多可见钙化斑。非特异性附睾炎病灶的血流信号比附睾结核(P<0.05)及附睾精液囊肿(P<0.01)丰富;非特异性附睾炎病程比附睾结核(P<0.01)和附睾精液囊肿(P<0.01)短;非特异性附睾炎病灶的压痛比附睾结核(P<0.01)和附睾精液囊肿(P<0.01)明显。附睾局灶性病变发生位置及有无鞘膜积液无明显区别(P>0.05)。结论:超声和临床特征对附睾局灶性病变鉴别诊断具有重要的价值,为临床诊断、治疗附睾疾病及评价疗效提供客观依据。     

MDR1特异性核酶逆转肝癌多药耐药的实验研究

目的探讨MDR1核酶（N2A＋tRNAi^met-iMDRl-sRz，sRz）在裸鼠体内逆转人肝癌组织多药耐药（MDR）的可行性。方法将原发性MDR人肝癌组织裸鼠原位移植模型第2代随机分为A组（空白对照组：生理盐水40μl＋Lipofect AMINE^TM2000 10μ1）、B组（阴性对照组：N2A＋tRNAi^met 10μg／40μl＋Lipofect AMINE^TM2000 10μl）和C组（核酶组：sRz 10μg／40μl＋LipofectAMINE^TM2000 10μl），均开腹瘤内注射。瘤内注药1周后用表阿霉素15mg／kg腹腔注射，每周1次，连续4周。彩色B超测量肿瘤体积。化疗结束后1周处死裸鼠，RT-PCR、Western blot法检测肿瘤中MDR1 mRNA及其蛋白P-gp的表达。结果C组每次化疗后肿瘤体积均较前缩小（F=659．99，P〈0．05）。除第1次化疗外，其余各次化疗后C组的抑制率均高于A、B组（F=35．36，12．77，97．60，P〈0．05）。化疗结束后，C组与瘤源以及A、B组相比，肿瘤组织中MDR1 mRNA和P-gp的表达明显降低（F=45．36，3590．40，P〈0．05）。结论sRz可有效降低肝癌细胞表达MDR1 mRNA和P-gp，一定程度上逆转MDR，提高E-ADM的化疗效果。单纯E-ADM化疗可使肝癌组织MDR1 mRNA和P-gp表达升高，诱导MDR的产生。     

超声在肝脏微小占位病变诊断和治疗中的应用及评价

随着高品质超声仪的普及，尤其是近几年超声造影技术的临床应用，大大提高了肝内微小占位病变（直径≤2cm）的检出率及病变性质诊断的敏感性和特异性。同时，超声技术在微小肝癌的诊断及局部微创治疗和手术中具有重要的作用。本文对此作一介绍。     

右美托咪定在无痛膀胱镜检查术中的应用

目的：探讨右美托咪定在膀胱镜检查术中应用的安全性与有效性。方法100例膀胱镜检查患者,分为观察组(右美托咪定组)和对照组(2%的利多卡因组),各50例。观察两组患者的血压、心率、血氧饱和度,咨询患者的满意度,评价镇痛效果,并进行各项指标的比较。结果对照组患者均处于清醒状态,注药后各时段血压、心率较观察组波动较大,差异有统计学意义(P<0.05);观察组镇痛效果优于对照组(P<0.05)。结论采用合适剂量的右美托咪定应用于无痛膀胱镜检查术中,能够维持血流动力学稳定,无呼吸抑制作用,患者舒适,无不良反应发生,是一种安全有效的麻醉方法。     

腹腔镜超声引导下微波消融治疗肝细胞性肝癌合并肝硬化的价值

目的评价肝硬化背景下经腹腔镜超声引导微波消融治疗肝细胞性肝癌的安全性和有效性。方法选取经腹腔镜超声引导下微波消融治疗伴有肝硬化的肝细胞性肝癌患者71例,定期对患者行血清甲胎蛋白(AFP)及影像学检查以评估治疗效果。结果术中腹腔镜超声检查,发现7个术前影像学未检出的肝内病灶(6.9%)。共计101个肝肿瘤病灶,均在腹腔镜超声引导下成功完成肿瘤微波消融治疗,患者血清AFP水平明显降低,与术前比较差异有统计学意义(P0.01)。术后仅1例患者出现术后严重并发症(1.4%),无死亡情况。术后1个月后复查,超声造影及增强CT均显示肝病灶完全消融,未见残留。术后随访(11.5±10.1)个月,4个病灶发现局部复发,6个病灶出现远处转移,3个病灶同时发生局部复发和远处转移。结论腹腔镜超声引导下的肝癌微波消融治疗具有安全、有效、恢复期短及并发症发生率低等优点。     

人肝癌组织裸鼠原位种植模型体内筛选化疗药物可行性研究

目的利用人肝癌组织裸鼠原位种植模型筛选针对供瘤患者敏感的化疗药物。方法荷瘤鼠随机分为对照组和表阿霉素(E-ADM)、5氟脲嘧啶(5-Fu)、丝裂霉素(MMC)3个治疗组,每周腹腔化疗1次,共4周次。化疗期间B超观测其移植瘤大小,选择敏感的化疗药物试用于供瘤患者。结果对照组移植瘤随时间的推移,肿瘤体积逐渐变大,而3个化疗组肿瘤体积均在化疗过程中逐渐减小,与对照组相比差异均有统计学意义(P<0·05)。应用MMC和5-Fu对供瘤患者化疗1个疗程,患者疼痛缓解,SPECT示个别转移灶消失,多个转移灶缩小。结论荷瘤鼠敏感的化疗药物同样也对供瘤患者敏感,提示该模型能较好筛选具有针对性的化疗敏感药物。     

骨骼肌消耗对小儿恶性肿瘤化疗前后营养状态的评价

为了探讨一种更好地反映恶性肿瘤患儿蛋白质一热能营养不良的判断指标,作者用B型超声波对骨骼肌的厚度进行检测,以此表明骨骼肌消耗情况,并同时观察了所得指标在化疗不同时期的变化,结果如下.1 材料和方法1.1 病儿组 新诊断恶性肿瘤病儿21例(急性淋巴细胞白血病10例,急性非淋巴细胞白血病5例,非何杰金氏淋巴瘤3例,何杰金氏病1例,恶性组织细胞病1例,骨髓增生异常综合征1例).男13例、女8例,年龄1～12岁、平均7岁.其中13例患儿接受了化疗方案包括肾上腺皮质激素的治疗,其强的松用量为2mg/kg.d,连用4～6周于化疗前及化疗后4、8、12、24周分别测量患儿身长、体重、左大腿腿围.同时行B型超声测量股四头肌的厚度及该处皮下脂肪的厚     

Gene Transfection Mediated by Ultrasound and Pluronic P85 in HepG2 Cells

In order to assess whether gene transfection could be mediated by ultrasound in associa- tion with P85 and find the appropriate parameters of ultrasound irradiation, the effects of ultrasound with or without P85 on gene transfection of HepG2 cells were examined. The HepG2 cells were irra- diated by ultrasound at 1 MHz, 0.4-2.0 W/cm2 and 50% duty cycle with plasmid encoding enhanced green fluorescent protein (EGFP) as a report gene. Forty-eight h later, the expression of EGFP was detected under the fluorescence microscopy. Transfection efficacy was quantitatively assessed by flow cytometry, and cell viability was evaluated by trypan blue exclusion. The results showed that the transfection efficacy was increased with the increases in ultrasound output power and the ideal trans- fection efficacy was achieved in HepG2 cells irradiated by ultrasound at 0.8 W/cm2 for 30 s. The transfection efficacy in ulstrasound P85 group was three times higher than in single ultrasound group [(17.63±1.07)% vs (5.57±0.56)%, P<0.05]. The cell viability was about 81% and 62% in ultrasound group and ultrasound P85 group respectively. It was concluded that ultrasound in combination with P85 could mediate the gene transfection of HepG2 cells, ideal transfection efficacy was achieved by ultrasound irradiation at 0.8 W/cm2 for 30 s, and P85 could somewhat increase the damage to cells caused by ultrasound.     

Ultrasound and Microbubbles： Their Functions in Gene Transfer In Vitro

To examine the role of ultrasound in gene delivery in vitro, three cells lines were exposed to the low-frequency ultrasound of varying intensities and for different durations to evaluate their effect on gene transfection and cell viability of the cells. Microbubble （MB）, Optison （10%）, was also used to observe the role of the microbubbles in gene transfection. The results demonstrated that as the ultrasound intensity and the exposure time increased, the gene transfer rate increased and the cell viability decreased, but at high energy intensities, the cell viability decreased dramatically, which caused the transfer rate to decrease. The most efficient ultrasound intensity for inducing gene transfer was 1 W/cm^2 with duration being 20 s. At the same energy intensity, higher ultrasound intensity could achieve maximal gene transfer rate earlier. Microbubbles could increase ultrasound-induced cell gene transfer rate by about 2 to 3 times mainly at lower energy intensities. Moreover, microbubbles could raise the maximum gene transfer rate mediated by ultrasound. It is concluded that the low-frequency ultrasound can induce cell gene transfer and the cell gene transfer rate and viability are correlated with not only the ultrasound energy intensity but also the ultrasound intensity, the higher ultrasound intensity achieves its maximal transfer rate more quickly and the ultrasound intensity that can induce optimal gene transfer is 1 W/cm^2 with duration being 20 s, and microbubbles can significantly increase the maximal gene transfer rate in vitro.