CT联合血清CA125水平评估卵巢癌行初次理想肿瘤细胞减灭术的临床价值

目的:探讨螺旋CT扫描联合血清糖类抗原125(CA125)水平对于预测晚期卵巢癌(Ⅲ期和Ⅳ期)患者行初次理想肿瘤细胞减灭术的临床价值。方法:基于Suidan等在2014年确定的3项临床标准(年龄≥60岁、CA125≥500 U/mL、ASA3-4)及6项影像学表现(肾上腺腹膜后淋巴结1 cm、小肠粘连及增厚、肠系膜病灶1 cm、肝周病变1 cm、病变侵袭肠系膜上动脉根部脉1 cm、胃网膜病变1 cm),收集我院收治的晚期卵巢癌患者98例进行回顾性分析,术前2周内行全腹及盆腔增强CT扫描并采集空腹血,对增强CT图像及血清CA125水平进行检测和分析,运用x~2检验及ROC曲线评价其用于预测晚期卵巢癌患者行理想肿瘤细胞减灭术的可能性。结果:98例晚期卵巢癌中,非理想肿瘤细胞减灭术患者51例,占52%。行初次理想肿瘤细胞减灭术和初次非理想肿瘤细胞减灭术卵巢癌患者3项临床标准和6项影像学表现的分布比较差异均具有统计学意义(P0.05)。仅通过影像学评分,预测初次理想肿瘤细胞减灭术的ROC曲线下面积为0.633,而3项临床标准联合6项影像学表现时,预测初次理想肿瘤细胞减灭术ROC曲线面积为0.702。结论:基于此评分系统的建立,预测分数越高,非理想肿瘤细胞减灭术发生率越高。CT联合血清CA125水平对于评估晚期卵巢癌患者行初次理想肿瘤细胞减灭术具有一定的临床价值。     

新辅助化疗联合肿瘤细胞减灭术对晚期卵巢癌患者的疗效及对血流动力学参数的影响

目的:探讨新辅助化疗联合肿瘤细胞减灭术对晚期卵巢癌患者的疗效及对血流参数的影响。方法:选取2015年1月-2017年6月我院诊治的158例晚期卵巢癌患者,按治疗方法分为对照组、观察组,各79例。对照组使用肿瘤细胞减灭术进行常规卵巢癌治疗,观察组在常规基础上联合新辅助化疗进行治疗。比较两组临床疗效、治疗前后血流动力学参数的变化及不良反应的发生情况。结果:治疗后,观察组化疗的表观缓解率(83.54%)显著高于对照组(62.03%)(P0.05)。两组患者治疗前各血流动力学参数比较差异无统计学意义(P0.05),观察组术后1、4、12 w颈动脉收缩期最大流速(peak systolic velocity,PSV)均显著低于对照组(P0.05),血管阻力指数(resisitance index,RI)、搏动指数(pulsatility index,PI)均显著高于对照组(P0.05)。两组患者在治疗期间出现的心脏毒性反应的发生率比较差异无统计学意义(P0.05),对照组患者治疗期间骨髓抑制、恶心呕吐、肝脏损伤、肾脏损伤的不良反应程度显著低于观察组(P0.05)。结论:新辅助化疗联合肿瘤细胞减灭术能够显著提高患者的临床疗效,改善卵巢的血流动力学参数。     

新辅助化疗联合间隔肿瘤细胞减灭术治疗晚期卵巢癌的临床观察

目的:观察新辅助化疗与间隔肿瘤细胞减灭术联合治疗晚期卵巢癌的临床疗效。方法:选取我院收治的晚期卵巢癌患者88例,采取分层随机法分成两组,对照组采取间隔肿瘤细胞减灭术治疗,将全子宫、大网膜、双附件、肿瘤转移灶、阑尾切除,根据手术中的情况,切除腹主动脉旁、盆腔淋巴结及受累的脏器,观察组在对照组基础上采取新辅助化疗,行2-3次化疗后进行手术,采取TP方案进行新辅助化疗,150 mg/m~2紫杉醇,行静脉滴注,持续滴注3小时,每天1次;0.06卡铂、200 m L 0.9%氯化钠注射液,行静脉滴注,每天1-3次;每个疗程间隔3周。比较两组的临床治疗总有效率、腹水量、术中出血量、病灶大小、手术时间、住院时间。结果:观察组的治疗总有效率(75.00%)显著高于对照组(54.55%)(P0.05),腹水量、术中出血量均明显少于对照组,病灶显著小于对照组(P0.05),手术时间、住院时间均明显短于对照组(P0.05)。结论:新辅助化疗联合间隔肿瘤细胞减灭术治疗晚期卵巢癌患者的临床效果明显优于单用间隔肿瘤细胞减灭术。     

NDRG2在上皮性卵巢癌中的表达及与预后的关系

目的:探讨NDRG2在上皮性卵巢癌中的表达及其与预后的关系。方法:收集新鲜的上皮性卵巢癌和正常卵巢组织各15例,采用real-time PCR检测和比较其NDRG2 m RNA的表达。收集上皮性卵巢癌病理切片96例进行免疫组化检测其NDRG2蛋白的表达,并收集患者的临床病理资料,随访患者的生存情况,分析NDRG2蛋白的表达与上皮性卵巢癌患者临床病理特征和预后的关系。结果:上皮性卵巢癌组织中NDRG2 mRNA和蛋白的表达均显著低于正常卵巢组织(P0.05)。NDRG2在上皮性卵巢癌组织中的表达随着上皮性卵巢癌病理分期的升高而降低,而且其表达降低和患者不良预后显著相关(P=0.002),但其表达和不同上皮性卵巢癌的病理类型、分化程度以及年龄均无明显相关性。去除手术病理分期的影响,NDRG2表达下调和肿瘤细胞减灭术的满意程度以及术后规范化疗是三个影响上皮性卵巢癌预后的重要因素。结论:NDRG2在上皮性卵巢癌中的表达下降,并与患者的不良预后呈显著正相关。     

不同给药途径的新辅助化疗在晚期上皮性卵巢癌的疗效观察

目的:探讨新辅助化疗中不同给药方式在晚期上皮性卵巢癌的临床疗效及意义。方法:选取132例初治上皮性卵巢癌患者,临床分期为Ⅲc一Ⅳ期。随机平均分为4组(A组:单纯紫杉醇静脉化疗B组:单纯卡铂腹腔灌注C组:紫杉醇静脉联合卡铂腹腔D组:直接手术)。A、B、C三组给予1个疗程新辅助化疗后评估其疗效,行卵巢癌肿瘤细胞减灭术;D组直接手术治疗,比较各组治疗情况。结果:4组的满意肿瘤减灭率分别为78.8%、75.7%、87.9%、63.6%;化疗A、B与C组间、化疗各组与D组间在减灭术成功率、手术时间、术中出血量、术后排气时间上比较均有统计学意义(P0.05);新辅助化疗各组不良反应可耐受,均顺利完成手术,其中骨髓抑制及神经毒性以C组发生率较高(P0.01)。结论:1新辅助化疗可降低手术风险,有效提高满意的减灭术的成功率,改善生存质量。2静脉联合腹腔灌注较单途径用药的临床疗效好,毒副作用略高但可耐受。     

卵巢上皮性癌中干扰素介导的跨膜蛋白1的表达意义

目的:探讨干扰素介导的跨膜蛋白1(Interferon-induced transmembrane protein 1,IFITM1)基因在卵巢上皮性癌中表达的相关性及其意义。方法:应用Western blotting检测正常卵巢、卵巢良性肿瘤、卵巢交界性肿瘤和卵巢上皮性癌组织中IFITM1蛋白表达。免疫组织化学检测12例正常卵巢、21例卵巢良性肿瘤、18例卵巢交界性肿瘤和85例卵巢上皮性癌组织中IFITM1的蛋白表达,同时分析IFITM1表达状况与临床病理因素之间的相关性。结果:Western blotting显示卵巢上皮性癌和卵巢交界性肿瘤中IFITM1表达水平明显高于正常卵巢组织和卵巢良性肿瘤。免疫组化显示在正常卵巢组织中IFITM1阳性表达率为41.7%(5/12),在卵巢良性肿瘤组织中71.4%(15/21),在卵巢交界性肿瘤组织中为72.2%(13/18),在卵巢上皮性癌中为77.6%(66/85),IFITM1蛋白表达强度在正常卵巢、良性卵巢肿瘤、交界性卵巢肿瘤、上皮性卵巢癌间的比较有统计学意义(P0.05)。IFITM1蛋白表达与病理类型、肿瘤分化程度、肿瘤FIGO分期有关(P0.05),与淋巴结转移、腹水无明显相关性。化疗敏感组和耐药组的IFITM1表达强度间差异有统计学意义(P0.05)。结论:IFITM1在正常卵巢、卵巢良性肿瘤、卵巢交界性肿瘤和卵巢上皮性癌组织中的表达依次升高,并与卵巢癌以铂类为基础的化疗耐药性产生有相关性,为进一步研究IFITM1在卵巢癌诊治及化疗中的应用前景提供依据。     

上皮性卵巢癌组织中P-AKT、P-gp的表达及其临床病理意义

目的探讨卵巢上皮癌组织中P-AKT(或称磷酸化蛋白激酶B,phosphorylated protein kinase B)和P-gp(P-glycoprotein)的表达及其与临床病理因素之间的关系。方法采用免疫组化法检测60例卵巢上皮癌组织、30例卵巢良性肿瘤组织和30例正常卵巢组织中P-AKT、P-gp的表达。结果(1)P-AKT、P-gp在上皮性卵巢癌中的阳性表达率(61.7%、50.0%)高于其在卵巢良性肿瘤组织和正常卵巢组织中的表达(13.3%、1.7%;6.7%、0),P0.05。(2)P-AKT和P-gp的异常表达均与卵巢癌的FIGO分期相关(P0.05),与组织学类型、病理分级无关。(3)P-AKT和P-gp蛋白的过表达呈显著正相关性(r=0.26,P0.05)。(4)P-AKT、P-gp阳性组的复发率(51.4%、73.3%)高于其阴性组的复发率(26.9%、30.8%),P0.05。P-AKT、P-gp阳性组的生存率(62.2%、56.7%)低于其阴性组的生存率(91.3%、90.0%)P0.05。结论:P-AKT、P-gp与上皮性卵巢癌的发展及预后有关。P-AKT可能通过作用于其下游的P-gp蛋白促进卵巢癌细胞的恶性转化及对化疗药物的耐药。     

紫杉醇加铂类和环磷酰胺加铂类方案对卵巢上皮性癌疗效

目的:探讨紫杉醇加铂类(PT组)和环磷酰胺加铂类(PC组)在卵巢上皮性癌初治患者中的疗效.方法:时1998年1月至2004年1月第四军医大学西京医院和第三军医大学大坪医院收治的78例卵巢上皮性癌术后患者进行回顾性分析,其中PT组36例.PC组42例,比较两组的近期疗效和3年存活率、无进展生存时间以及不良反应.结果:PT和PC方案的患者化疗有效率分别为77.8%和66.7%(P＜0.01),中位生存时间分别为29个月和23个月(P＜0.01),中位无进展生存时间分别为23个月和15个月(P＜0.01),3年存活率分别为41.7%和19.0%(P＜0.05).在早期(Ⅰ期+Ⅱ期)卵巢癌患者中,PT组和PC组中位生存时间和中位无进展生存时间差异无统计学意义,但中晚期(Ⅲ期+Ⅳ期)患者PT组和PC组中位生存时间和中位无进展生存时间分别为25.4月和21.0月以及16.1月和7.9月(P＜0.05),有统计学意义,表明PT方案对中晚期患者可能更具有优势.PT组脱发和血液学毒性发生率高于PC组,而消化系统毒性和肝肾功损害发生率低于PC组.结论:卵巢癌的辅助化疗中,PT方案在化疗反应率、无进展生存时间及3年存活率均优于PC方案,对中晚期患者,前者的优势更为显著.     

晚期卵巢高级别浆液性腺癌术后血CA125下降情况与残余病灶大小关系的研究

目的:探讨血清CA125测定对评估卵巢高级别浆液性腺癌术后血CA125下降情况与残余病灶大小关系的价值.方法:回顾性研究卵巢高级别浆液性腺癌Ⅱc-Ⅳ期患者62例,按照瘤体减灭术后残余病灶大小分为3组,A组为术后残余病灶＞1cm,B组为≤ 1cm者,C组为肉眼未见病灶者,查阅术前、术后第1次化疗后血CA125值.结果:C组下降百分比与B组、A组相比有统计学差异(分别为P=0.024,P=0.002).结论:术后残余病灶大小不同的患者血CA125下降情况不同,在关于肿瘤标志物的研究中将肉眼未见病灶组单独列出研究有很大的必要性.     

中国人卵巢上皮性肿瘤nm23H1基因遗传不稳定性的研究

采用石蜡包埋组织抽提DNA,PCR-单链构象多态性(PCR-SSCP),常规银染、Envision免疫组织化学染色和Leica-Qwin计算机图像分析等方法,研究人类17号染色体D17S396位点微卫星不稳定(microsatellite instablility,MSI)和杂合性缺失(loss of heterozygosity,LOH),对卵巢上皮性肿瘤nm23H1蛋白表达的影响,阐明nm23H1基因遗传不稳定性与卵巢肿瘤进展的关系,为揭示nm23H1基因作用机制和肿瘤转移机制提供实验依据。本实验中,卵巢上皮性癌D17S396位点遗传不稳定发生率为40%,明显高于交界性肿瘤的9.52%,而在良性肿瘤和正常卵巢组织中,未见该位点遗传不稳定的发生。其中,LOH的发生率,随肿瘤恶性程度的增高而增加(P<0.05)。在卵巢上皮性癌中,淋巴转移组的LOH发生率高于无淋巴转移组(P<0.01)。FIGO Ⅲ Ⅳ期的LOH发生率高于Ⅰ Ⅱ期(P<0.05)。MSI发生率与卵巢上皮癌组织类型、分化程度、淋巴转移及FIGO分期均无关。nm23H1 蛋白阳性率在卵巢上皮性癌和交界性肿瘤组织中分别为56.00%和57.14%,高于良性肿瘤的13.64%和正常卵巢组织的8.33%(P<0.01)。卵巢上皮性癌中,淋巴转移组nm23H1蛋白阳性率低于无淋巴转移组;FIGO Ⅲ Ⅳ期nm23H1蛋白阳性率低于Ⅰ Ⅱ期(P<0.05)。此外,计算机图像定量分析显示,在各临床病理参数影响下,nm23H1蛋白的表达强度没有差异。在卵巢上皮性癌中,LOH阳性组中nm23H1蛋白阳性率为0.00%,显著低于LOH阴性组的73.68%(P<0.01)。实验结果提示, nm23H1基因的遗传不稳定性可能是卵巢上皮性癌发生、发展的一个重要机制。LOH的发生可作为卵巢组织恶变的判断指标。nm23H1基因的MSI和LOH,通过相互独立的途径调控卵巢上皮癌的发生和转移,后者可抑制卵巢上皮癌局部nm23H1蛋白的表达,并赋予卵巢上皮癌高淋巴结转移、低预后的特性。提高卵巢上皮癌局部nm23H1蛋白的表达,可减缓肿瘤的淋巴转移并提高预后率。     

Recent advances in the study of Kaposi's sarcoma-associated herpesvirus replication and pathogenesis

It has now been over twenty years since a novel herpesviral genome was identified in Kaposi's sarcoma biopsies. Since then, the cumulative research effort by molecular biologists, virologists, clinicians, and epidemiologists alike has led to the extensive characterization of this tumor virus, Kaposi's sarcoma-associated herpesvirus(KSHV; also known as human herpesvirus 8(HHV-8)), and its associated diseases. Here we review the current knowledge of KSHV biology and pathogenesis, with a particular emphasis on new and exciting advances in the field of epigenetics. We also discuss the development and practicality of various cell culture and animal model systems to study KSHV replication and pathogenesis.     

A Unique Protease Cleavage Site Predicted in the Spike Protein of the Novel Pneumonia Coronavirus (2019-nCoV) Potentially Related to Viral Transmissibility

正Dear Editor,In December 2019, a novel human coronavirus caused an epidemic of severe pneumonia(Coronavirus Disease 2019,COVID-19) in Wuhan, Hubei, China(Wu et al. 2020; Zhu et al. 2020). So far, this virus has spread to all areas of China and even to other countries. The epidemic has caused 67,102 confirmed infections with 1526 fatal cases     

Curcuminoids as inhibitors of thioredoxin reductase: A receptor based pharmacophore study with distance mapping of the active site

Curcumin is the yellow pigment of turmeric that interacts irreversibly forming an adduct with thioredoxin reductase (TrxR), an enzyme responsible for redox control of cell and defence against oxidative stress. Docking at both the active sites of TrxR was performed to compare the potency of three naturally occurring curcuminoids, namely curcumin, demethoxy curcumin and bis-demethoxy curcumin. Results show that active sites of TrxR occur at the junction of E and F chains. Volume and area of both cavities is predicted. It has been concluded by distance mapping of the most active conformations that Se atom of catalytic residue SeCYS498, is at a distance of 3.56 from C13 of demethoxy curcumin at the E chain active site, whereas C13 carbon atom forms adduct with Se atom of SeCys 498. We report that at least one methoxy group in curcuminoids is necessary for interation with catalytic residues of thioredoxin. Pharmacophore of both active sites of the TrxR receptor for curcumin and demethoxy curcumin molecules has been drawn and proposed for design and synthesis of most probable potent antiproliferative synthetic drugs.     

The structure, reproduction and taxonomy of Vidalia and Osmundaria (Rhodophyta, Rhodomelaceae)

Comprises species occurring mostly in subtidal habitats in tropical, subtropical and warm-temperate areas of the world. An analysis of the type species, V. spiralis (Sonder) Lamouroux ex J. Agardh, a species from Australia, establishes basic characters for distinguishing species in the genus. These characters are (1) branching patterns of thalli, (2) flat blades that may be spiralled on their axis, (3) width of the blade, (4) primary or secondary derivation of sterile and fertile branchlets and (5) position of sterile and fertile branchlets on the thalli. Application of the latter two characters provides an important basic method for separation of species into three major groups. Osmundaria , a genus known only in southern Australia, was studied in relation to Vidalia , and its separation from the Vidalia assemblage is not accepted. Species of Vidalia therefore are transferred to the older genus name, Osmundaria. Two new species, Osmundaria papenfussii and Osmundaria oliveae are described from Natal. Confusion in the usage of the epithet, Vidalia fimbriala Brown ex Turner has been clarified, and Vidalia gregaria Falkenberg, described as an epiphyte on Osmundaria pro/ifera Lamouroux, is revealed to be young branches of the host, Osmundaria prolifera.     

New or rare chromosome counts in Artemisia L. (Asteraceae, Anthemideae) and related genera from Kazakhstan

Fifteen chromosome counts of six Artemisia taxa and one species of each of the genera Brachanthemum, Hippolytia, Kaschgaria, Lepidolopsis and Turaniphytum are reported from Kazakhstan. Three of them are new reports, two are not consistent with previous counts and the remainder are confirmations of very scarce (one to four) earlier records. All the populations studied have the same basic chromosome number, x = 9, with ploidy levels ranging from 2x to 6x. Some correlations between ploidy level, morphological characters and distribution are noted.