复方氨基酸注射液临床应用专家共识

复方氨基酸注射液是肠外营养中氮的来源,广泛应用于不能经胃肠道给予或经胃肠道给予不能满足其营养需求的患者,在营养治疗中起重要作用。但目前对于复方氨基酸注射液临床应用的指征、剂型、剂量、时机,国内并无系统的指南或共识。为了进一步规范复方氨基酸注射液的临床应用,中华医学会肠外肠内营养学分会（Chinese Society for Parenteral and Enteral Nutrition,CSPEN）及中国抗癌协会肿瘤营养专业委员会（Chinese Society of Nutritional Oncology,CSNO）组织全国专家,在系统性文献检索的基础上,参考美国肠外肠内营养学会（American Society for Parenteral and Enteral Nutrition,ASPEN）、欧洲临床营养和代谢学会（European Society for Clinical Nutrition and Metabolism,ESPEN）、CSPEN及CSNO指南,结合我国临床实践,经多次交流讨论,达成此共识。包括10条推荐意见,涉及不同患者的蛋白质需要量及氨基酸剂型选择。     

细胞凋亡与细胞增殖协同作用的研究

在S期,砷剂在G1/S期,TNF-α或抗Fas抗体在G1/S期), PBLs不存在这种打击依赖性的差异.未经PHA刺激的PBLs对凋亡打击无应答,PBLs经PHA刺激后进入凋亡, 在外界打击作用下凋亡明显增加,在用咖啡因废除细胞周期检测点后对打击敏感性降低.拥挤或饥饿的PBLs同样对凋亡诱导无应答.结论:大多数细胞凋亡具有周期特异性,细胞周期改变可导致凋亡模式和时相的改变.细胞凋亡与增殖的协同作用是细胞周期和凋亡信号整合的重要机制.     

miR-124 modulates gefitinib resistance through SNAI2 and STAT3 in non-small cell lung cancer

Gefitinib is used as a first-line treatment for advanced non-small cell lung cancer (NSCLC). Unfortunately, most NSCLC patients inevitably develop gefitinib resistance during treatment. In addition to EGFR mutation status, the mechanisms involved are largely unknown. In this study, we showed that miR-124, a tumor suppressor, was significantly down-regulated in gefitinib-resistant NSCLC patients and cell lines compared with gefitinib-sensitive patients and cell lines. In addition, the miR-124 depletion induced gefitinib resistance, and miR-124 overexpression sensitized gefitinib-resistant cells to gefitinib. Mechanistic analysis revealed that miR-124 decreased SNAI2 and STAT3 expression by directly targeting their 3'UTRs and that knocking down SNAI2 or STAT3 partly reversed the gefitinib resistance induced by miR-124 depletion. Our data demonstrate that the miR-124 plays a new critical role in acquired resistance to gefitinib and that the manipulation of miR-124 might provide a therapeutic strategy for reversing acquired gefitinib resistance.     

隔离区域灌注技术在外科中的应用

目前,化疗仍被公认为是恶性肿瘤的一种重要的治疗手段。通过静脉途经给药,如一次给药量太小,则达不到化疗的有效浓度;而一次给药量太大,又易造成明显的毒性反应,如骨髓抑制、肝和肾功能损害等。近年来应用较多的是隔离区域灌注(Isolated Regional     

hSav1蛋白高表达对Mst1介导的细胞凋亡的影响

Objective To elucidate the effect of hSavl expression on Mstl-mediated apoptosis in HeLa cells. Methods Plasmids pCMV-HA-hSav1 and pcDNA/4TO-Flag-Mst1 were constructed and cotransfected into HeLa cells. Triple immunofluorescent labeling of hSav1, Mst1 and nucleus was performed to determine their subcellular localization. Plasmids pCMV-HA-hSav1 and/or pcDNA/4TO-Flag-Mst1 were transfected into HeLa cells, and 36 hours later cisplatin (50 μmol/L) as a pro-apoptotic agent was added for 14 hours. Cell apoptosis was analyzed by annexin V/PI assay. Results Plasmids pCMV-HA-hSav1 and pcDNA/4TO-Flag-Mst1 were constructed and the authenticity of constructs was verified by sequencing. The binding in vitro showed that hSavl could be detect from the anti-Mstl immunoprecipitation complex. The immunofluorescent labeling showed that hSavl and Mstl had the same localization in cells. Overexpressed protein hSavl did not induce a significant cell apoptosis. However, co-expression of hSavl with Mstl resulted in a significant increase of apoptosis above the level seen with Mstl alone (24. 5% ± 2.4% vs. 39.3% ± 4.0%, P < 0. 05). Conclusion Our findings indicate that hSavl is a newly identified protein that interacts with Mst1 and a, augments Mst1-mediated apoptosis.     

介绍几种胃肠外科新器械新技术

外科手术离不开各种器械和材料,随着科技的发展和技术的进步,这些重要的＂工具＂正逐渐体现其无法比拟的价值.今昔非比,如今的手术器械再也不是仅有手术刀、血管钳、手术剪、纱布、丝线等传统经典器材,更多、更加先进的设备、材料、技术等正逐渐渗透至外科手术的每一个角落,并发挥无可替代的作用,深得专科医生的青睐和好评.胃肠外科始终承担着大部分腹部外科疾病诊断和治疗的任务,而各种新器械、新设备的应用,均在疾病诊疗过程中发挥举足轻重的作用,甚至在某些场合成为不可或缺的一员.它们有助于拓展手术范围,简化手术步骤,降低手术难度,保障围手术期患者安全,从而极大地提高业务水平,造福于患者.为了进一步增进各医院胃肠外科等专科交流,加强对胃肠外科新器械的普及应用,本文拟简明扼要地对近期胃肠外科新器械、新技术加以介绍.     

槐耳颗粒在体外对结肠癌SW480细胞侵袭转移的影响*

目的观察槐耳颗粒在体外对结肠癌SW480细胞侵袭转移的影响,并初步探讨其机制。方法SubG1法确定槐耳颗粒促进结肠癌SW480细胞凋亡的最佳作用浓度和时间,通过划痕愈合实验和Transwell侵袭实验观察槐耳颗粒对结肠癌SW480细胞侵袭转移的影响。Western blot法和Real-Time PCR(荧光定量PCR)法检测E-cadherin、twist、snail、vimentin在蛋白和mRNA水平的变化。结果槐耳颗粒3.0 g·L-1处理SW480细胞36 h后凋亡最明显。槐耳颗粒3.0 g·L-1处理SW480细胞36 h后,划痕愈合实验相对迁移率为(31.36±2.39)%,而对照组36 h后相对迁移率则为(61.11±1.09)%(P＜0.01)。Transwell侵袭实验证实槐耳颗粒3.0 g·L-1处理SW480细胞36 h后每个视野穿透细胞数为(129±12)个,而对照组为(354±20)个(P＜0.01)。槐耳颗粒3.0 g·L-1处理SW480细胞36 h后E-cadherin 在蛋白和mRNA水平表达均升高,而twist、snail和vimentin表达均降低。结论槐耳颗粒在体外能够通过抑制上皮-间质转化有效抑制结肠癌SW480细胞的侵袭转移。     

慢性顽固性便秘30例手术治疗分析

目的 研究手术治疗慢性便秘的临床价值、手术适应证及其对肠道功能的影响.方法 结肠慢传输型便秘患者25例,结肠慢传输型便秘合并出口梗阻型便秘患者1例,成人巨结肠致便秘患者4例,均行手术治疗.术后随访记录患者排便情况、并发症、生活质量.结果 所有患者术后无严重并发症及死亡.30例患者术后生活质量均得到明显改善,随访6～36个月,术后3个月内大便次数均增多,平均每日4.5次(3～6次),软便;以后大便次数逐渐减少,1年后每日1～3次成形大便,无一例需服止泻剂.术后2例患者出现粘连性肠梗阻,1例术后出现吻合口漏,其他患者均未出现肠梗阻、腹泻、腹痛、排便失禁等并发症.结论 对排便功能障碍患者,有选择性的行结肠次全切除并盲直肠吻合术,近期疗效理想,特别对于慢传输型便秘疗效较好,但长期疗效尚需进一步研究.     

5-氟尿嘧啶联合奥沙利铂对SW480细胞成瘤性及其Galectin-3表达的影响

目的探讨5-氟尿嘧啶(5-Fu)联合奥沙利铂对SW480细胞成瘤性及其对肿瘤中Galectin-3(半乳糖凝集素-3)表达的影响。方法以人结肠癌SW480细胞建立裸鼠移植瘤模型,实验分5-Fu组,奥沙利铂组,5-Fu+奥沙利铂组和注射等体积生理盐水的对照组。采用免疫组织化学方法检测移植瘤中Galectin-3的表达,以图像信号采集与分析系统进行图像扫描分析。结果 5-Fu组、奥沙利铂组和5-Fu+奥沙利铂组抑瘤率分别为30.53%、34.15%和67.22%;免疫组化显示给药组肿瘤组织中Galectin-3表达明显减弱,Galectin-3在联合用药组肿瘤组织中表达(28.875±7.491)较对照组(281.438±45.639)和单独用药组(157.644±33.721,150.682±25.539)明显减弱,图像灰度值统计分析显示差异均具有统计学意义(P<0.05或P<0.01)。结论 5-Fu和奥沙利铂可抑制肿瘤细胞生长,二者联用抑瘤作用增强。肿瘤的生长体积与Galectin-3的表达具有同向性,提示两者之间可能存在直接或间接的联系。