CAG方案治疗老年急性髓细胞白血病的临床观察

目的 探讨小剂量阿糖胞苷和阿克拉霉素联合粒细胞集落刺激因子(G-CSF)治疗急性髓细胞白血病(AML)的疗效和不良反应.方法 回顾性分析71例中位年龄65岁的AML患者,均采用CAG预激方案诱导治疗,为阿克拉霉素10 mg/d,第1-8天,阿糖胞苷10 mg/m2,12 h 1次,第l～14天,G-CSF 200μg/(m2·d),第1～14天.结果 化疗后总有效率73.2%,完全缓解(CR)57.7%.初诊患者CR率为65.3%;复发、难治患者为40.9%;≥70岁患者为40%;中等预后染色体的CR率为68.4%.10例预后不良染色体异常的患者完全缓解4例.早期死亡率2.8%,总生存期中位时间14个月.初诊时白细胞＜10×109/L的CR率61.1%,治疗前白细胞＞10×109/L的CR率52.9%.化疗的不良反应主要为骨髓抑制,未见严重的非造血系统不良反应.结论 CAG预激方案为治疗AML的较有效、安全的方案.尤其对低增生性老年AML疗效肯定.     

急性白血病合并静脉血栓栓塞症临床分析

目的分析急性白血病合并静脉血栓栓塞症的临床治疗。方法我院2008年1月-2012年1月收治确诊为急性白血病且并发静脉血栓栓塞症的患者18例,对其临床资料进行分析。结果所有患者栓塞肢体肿胀处均消失,消失时间为6-13d,患者均无出血倾向。结论治疗急性白血病患者时需预防血栓栓塞的发生,对于已发生血栓栓塞的患者,可给予肝素及抗凝剂进行治疗,效果确切安全。     

蟾毒灵对人大肠癌HCT116细胞增殖的影响

目的研究蟾毒灵对人大肠癌HCT116细胞增殖及细胞周期的影响。方法采用MTT法观察不同浓度蟾毒灵对人大肠癌HCT116细胞增殖的抑制作用;透射电镜观察细胞形态及超微结构;流式细胞术分析细胞周期分布情况。结果蟾毒灵对大肠癌细胞生长抑制作用呈浓度-时间依赖性,蟾毒灵可将细胞周期阻滞于S期,透射电镜观察到典型的细胞凋亡特征。结论诱导大肠癌细胞周期S期阻滞可能是蟾毒灵抑制大肠癌细胞增殖的机制之一。     

肿瘤相关巨噬细胞在乳腺癌中的治疗进展

摘 要：乳腺癌发育期间,肿瘤相关巨噬细胞（tumor-associated macrophages,TAMs）通过炎症、血管生成和靶向信号通路,分泌相应的细胞因子等方式对乳腺癌起作用。肿瘤相关巨噬细胞由于其可塑性和异质性,被认为是乳腺癌的潜在治疗靶点。然而,临床上TAMs针对性治疗仍见效甚低。因此,了解TAMs促进乳腺癌进展的机制将促进开发乳腺肿瘤治疗的新方法。全文综述TAMs在乳腺癌进展过程中的具体机制及靶向治疗方式,为临床乳腺癌的治疗提供了新的思路。     

自噬在急性胰腺炎中的作用及研究进展

急性胰腺炎(AP)作为临床上常见的急腹症,其具体发病机制尚未阐明,所以其治疗一直是临床上的难点。研究显示,自噬在AP的发病中起到了非常重要的作用,可以导致胰腺腺泡细胞中胰蛋白酶原的激活以及引起炎症反应的发生和进一步加剧。笔者就自噬的基本分子机制以及自噬在AP中的作用机制方面的研究进展进行综述。     

水通道蛋白1在急性坏死性胰腺炎大鼠胰腺组织的表达及其意义

Objective To study the expression of aquaporin 1 ( AQP1 ) in pancreas and its pathogenic role in rats with experimental acute necrotizing pancreatitis (ANP). Methods Forty-eight male Sprague-Dawley rats were randomly divided into two groups : control group ( n = 24 ) and ANP group ( n = 24). Six rats in each group were sacrificed at 3,6,12 and 18 h after induction of experimental models. Quantity of ascites and levels of serum amylases were measured at each time point. Serum AQPI was determined by ELISA. Pathological changes of pancreatic tissues were examined. Capillary permeability in pancreatic tissues was tested by Evans Blue (EB) extravasation method. AQPI expression in pancreatic tissues was detected by immunohistochemieal staining, Western blot and fluorescence quantitative polymerase chain reaction (FQ-PCR). Results (1) Serum amylase level at 3,6,12, and 18 h in control group was (1308±759) ,(1077±508), (1325±761),(1328±762) U/L,and that in ANP group was (9102± 2199), (8799±1634), (9398±1473), (9484±862) U/L respectively. The concentration of EB in pancreatic tissues at each time point in control group was (205.61±32.99), (141.46±27.18 ), (96.94± 26.79), (61.43±24.82) mg/L, and that in ANP group was ( 273.59±23.47 ), ( 253.51±31.68 ), (221.15±73.68 ), (185.28±42.35) ,respectively. There was significandy difference between two groups. Serum AQP1 level in control group at each point was ( 74.08±11.80), (78.49±9.06 ), (75.77± 7.37 ), ( 72.75±13.87 ) mg/L, and that in AN P group was (73.29±9.61 ), ( 62.85±7.28 ), (62.07± 4.39 ), (46.33±11.91 ) mg/L, respectively ( P < 0.01 ). ( 2 ) Protein expression of AQPI in pancreatic tissues detected by immunohistochemical staining in control group at each time point was 114.13±7.92, 122.39±7.99,145.98±6.48,113.98±6.48, and that in ANP group was 80.07±14.89,110.54± 4.45,103.77±10.48,99.18±6.95;Protein expression of AQP1 in pancreatic tissues detected by Western blot in control group at each time point was 1.19±0.33,1.02±0.25,0.90±0.33,1.06±0.20,and that in ANP group was 0.83±0.11,0.96±0.21,0. 58±0.28,0.72±0.14, respectively ( P < 0.05 ). ( 3 ) The mRNA level of AQP1 gene expressed in pancreas in control group at each time point was 0.91±0.22,1.01±0.83,0.48±0.23,0.61±0.51,and that in ANP group was 2.13±0.63,2.02±1.40, 2.07±0.86,2.49±2.47,respectively (P<0.01).Condusion The expression of AQP1 wasdown-reg-ulated in pancreas in rats with ANP,which might could play an important role in the pathogenesis of capil-lary leak syndrome.     

盐酸氟桂利嗪的临床应用进展

盐酸氟桂利嗪(Flunarizine)为非竞争性双苯哌嗪类钙通道抑制剂[1],可以抑制ca2 内流,从而使血管扩张,尤其对脑血管有选择性作用,在临床上主要用于脑血管灌注不足的疾病。随着临床应用的增加,其应用领域不断扩大。     

水通道蛋白1在急性坏死性胰腺炎大鼠胰腺组织的表达及其意义

Objective To study the expression of aquaporin 1 ( AQP1 ) in pancreas and its pathogenic role in rats with experimental acute necrotizing pancreatitis (ANP). Methods Forty-eight male Sprague-Dawley rats were randomly divided into two groups : control group ( n = 24 ) and ANP group ( n = 24). Six rats in each group were sacrificed at 3,6,12 and 18 h after induction of experimental models. Quantity of ascites and levels of serum amylases were measured at each time point. Serum AQPI was determined by ELISA. Pathological changes of pancreatic tissues were examined. Capillary permeability in pancreatic tissues was tested by Evans Blue (EB) extravasation method. AQPI expression in pancreatic tissues was detected by immunohistochemieal staining, Western blot and fluorescence quantitative polymerase chain reaction (FQ-PCR). Results (1) Serum amylase level at 3,6,12, and 18 h in control group was (1308±759) ,(1077±508), (1325±761),(1328±762) U/L,and that in ANP group was (9102± 2199), (8799±1634), (9398±1473), (9484±862) U/L respectively. The concentration of EB in pancreatic tissues at each time point in control group was (205.61±32.99), (141.46±27.18 ), (96.94± 26.79), (61.43±24.82) mg/L, and that in ANP group was ( 273.59±23.47 ), ( 253.51±31.68 ), (221.15±73.68 ), (185.28±42.35) ,respectively. There was significandy difference between two groups. Serum AQP1 level in control group at each point was ( 74.08±11.80), (78.49±9.06 ), (75.77± 7.37 ), ( 72.75±13.87 ) mg/L, and that in AN P group was (73.29±9.61 ), ( 62.85±7.28 ), (62.07± 4.39 ), (46.33±11.91 ) mg/L, respectively ( P < 0.01 ). ( 2 ) Protein expression of AQPI in pancreatic tissues detected by immunohistochemical staining in control group at each time point was 114.13±7.92, 122.39±7.99,145.98±6.48,113.98±6.48, and that in ANP group was 80.07±14.89,110.54± 4.45,103.77±10.48,99.18±6.95;Protein expression of AQP1 in pancreatic tissues detected by Western blot in control group at each time point was 1.19±0.33,1.02±0.25,0.90±0.33,1.06±0.20,and that in ANP group was 0.83±0.11,0.96±0.21,0. 58±0.28,0.72±0.14, respectively ( P < 0.05 ). ( 3 ) The mRNA level of AQP1 gene expressed in pancreas in control group at each time point was 0.91±0.22,1.01±0.83,0.48±0.23,0.61±0.51,and that in ANP group was 2.13±0.63,2.02±1.40, 2.07±0.86,2.49±2.47,respectively (P<0.01).Condusion The expression of AQP1 wasdown-reg-ulated in pancreas in rats with ANP,which might could play an important role in the pathogenesis of capil-lary leak syndrome.     

高脂血症性重症急性胰腺炎病因及发病机制研究概况

高脂血症能够诱发和加重重症急性胰腺炎的胰腺损伤,一直是临床研究的焦点,其发病机制尚未完全阐明.在众多学说中,游离脂肪酸的毒性作用、胰蛋白酶原活化加速、胰腺微循环障碍一直是占主导地位的理论.近年来,关于肠道细菌移位、胰腺腺泡内钙超载等理论也受到了关注和重视.本文将对高脂血症性重症急性胰腺炎的病因及发病机制的研究概况进行概述.     

大承气汤对急性坏死性胰腺炎大鼠胰腺水通道蛋白1的影响

目的 观察急性坏死性胰腺炎( ANP)大鼠胰腺组织水通道蛋白1(AQP1)的表达以及大承气汤对其的影响.方法 160只雄性SD大鼠按随机数字法分为对照组、ANP组、地塞米松组、乙酰唑胺组及大承气汤组,每组32只.采用胆胰管逆行注射5％牛磺胆酸钠方法制备ANP模型.地塞米松组于造模后即刻静脉给予地塞米松4 mg/kg体重;乙酰唑胺组于造模前2h用含乙酰唑胺的生理盐水1ml灌胃;大承气汤组于造模前48、24、2h分别用大承气汤2ml/次灌胃;对照组仅开腹触摸胰腺数次后关腹.制模后3、6、12、18 h分批处死8只大鼠.记录腹水量;检测血清淀粉酶;胰腺组织病理检查及电镜观察;伊文思兰(EB)血管外渗法检测毛细血管通透性;实时PCR和蛋白质印迹法检测AQP1 mRNA和蛋白表达.结果 ANP组血清淀粉酶水平显著升高,胰腺损伤明显;地塞米松组和大承气汤组淀粉酶水平较ANP组降低,胰腺损伤减轻;乙酰唑胺组淀粉酶水平高于ANP组,胰腺病理损伤较ANP组加重.造模后6h,对照组、ANP组、地塞米松组、乙酰唑胺组、大承气汤组胰腺组织EB含量分别为(13.44±2.56)、( 126.35±14.80)、(86.31±14.46)、(108.99±15.07)、(78.29±16.85) mg/L;AQP1 mRNA表达量为(170.07±22.48)％、(83.93±8.98)％、(117.09±10.70)％、(69.00±8.98)％、(112.82±11.79)％;AQP1蛋白表达量为0.23±0.06、0.10±0.02、0.32±0.03、0.13±0.02、0.45±0.04.ANP组的EB量显著高于对照组,而AQP1mRNA及蛋白的表达显著低于对照组(P值均＜0.05);地塞米松组及大承气汤组EB含量显著低于ANP组,而AQP1 mRNA及蛋白的表达显著高于ANP组(P值均＜0.05).结论 AQP1在ANP大鼠胰腺组织毛细血管渗漏的发生中起重要作用.大承气汤通过调控AQP1的表达可减轻ANP大鼠的胰腺损伤.