目的 探讨倍他乐克联合胺碘酮治疗对更年期心律失常患者左心室射血分数水平的影响.方法 选取2018年7月-2019年6月该院收治的更年期心律失常患者108例.依据药物治疗方案的不同分为对照组和研究组,给予对照组患者倍他乐克治疗,给予研究组患者联合胺碘酮治疗.临床治疗效果、心功能指标水平、两组患者血清中去甲肾上腺素(NE)、肾上腺素(E)浓度、血浆肾素(PRA)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)水平以及对比两组患者用药后的药物不良反应状况.结果 研究组患者的临床治疗总有效率为83.6％,对照组治疗总有效率为63.2％,研究组疗效好于对照组(P＜0.05);经治疗干预,研究组患者心功能指标水平均有所好转,研究组左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)水平比对照组更低,左室射血分数(LVEF)、左室收缩压(LVPS)水平均比对照组更高(P＜0.05);研究组患者恶心、心动过缓及静脉炎的总发生率为16.7％;治疗前两组患者血清中NE、E、PRA、AngⅡ及ALD水平比较,差异均无统计学意义(P＞0.05),治疗3个月后研究组患者血清中上述指标水平均优于对照组(P＜0.05);对照组不良反应的总发生率为18.5％,两组差异无统计学意义(P＞0.05).结论 在更年期心律失常患者的临床治疗中应用倍他乐克联合胺碘酮方案治疗效果显著,可显著提升患者左心室射血分数水平,减少左室收缩末期与舒张末期内径,提升左室收缩压,改善心肌血管内皮功能,应用效果满意,可考虑普及应用.

Objective:To investigate the expression levels of hepatoma-derived growth factor(HDGF) and vascular endothelial growth factor(VEGF) in hepatoma tissue,and its correlations with microvessel density(MVD) and prognosis of patients.Methods:The expression levels of HDGF,VEGF and MVD in 94 liver pathology specimens and para-carcinoma tissue of more than 2 cm distance from tumor lesions were investigated using immunohistochemstry.Results:The positive expression rates of HDGF protein and VEGF protein (62.77％,65.96％) in hepatocellular carcinoma tissue were higher than those in para-carcinoma tissue (15.96％,19.15％) (P ＜0.01),and the MVD in hepatocellular carcinoma tissue was higher than that in para-carcinoma tissue (P ＜ 0.01).The expression levels of HDGF and VEGF in hepatocellular carcinoma tissue were positively correlated with the MVD count(P ＜0.01).The 3-year survival rate in patients with positive HDGF expression (19.61％) was lower than that in patients with negative HDGF expression (47.06％)(P ＜ 0.01).The 3-year survival rate in patients with positive VEGF expression(14.81％) was lower than that in patients with negative VEGF expression (56.25％) (P ＜ 0.01).Conclusions:The expression levels of HDGF and HDGF in hepatocellular carcinoma tissue increase,and which is positively correlated with MVD.The positive expressions of HDGF and HDGF are harmful to the long-term prognosis of patients.

Objective To investigate the correlation between serum tumor abnormal protein (TAP) a nd chemotherapeutic effect in patients with lung adenocarcinoma. Methods A prospective study was conducted on 90 patients with lung adenocarcinoma Liyuan Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from May 2012 to April 2016. The patients were divided into adjuvant chemotherapy group (30 cases) and palliative chemotherapy group (60 cases) according to the different treatment regimen. The adjuvant chemotherapy group was treated with FOLFOX regimen for postoperative adjuvant chemotherapy. The palliative chemotherapy group was treated with pemetrexed. The t test was used to compare the expression levels of TAP in both groups. The χ2 test was used to compare the relationship among expression of TAP, the positive results of tumor markers and the efficacy of chemotherapy. Pearson correlation analysis was used to analyze the expression level of TAP and changes of tumor markers. Results There was no statistically significant difference in serum TAP between the two groups before palliative chemotherapy [area of TAP condensed matter were (230±80)μm2 and (206±50) μm2, t=1.487, P<0.05]. The serum TAP expression in both groups was 100％. There was no statistically significant difference in serum TAP area between adjuvant chemotherapy group and palliative chemotherapy group (46.7 ％ vs. 48.3％, χ2= 0.022, P> 0.05). There was no statistically significant difference between the two groups in positive expression of tumor markers CA125, CEA, CA19-9 and ALP (χ2 values were 4.02, 3.81, 4.01, 5.01, all P>0.05). In the two groups, the changes of serum TAP before and after chemotherapy had no relationship with age, gender, pathological differentiation degree and the number of transfer viscera (all P>0.05). The expression of serum TAP, CEA and CA19-9 after chemotherapy in palliative chemotherapy group were related to the efficacy of chemotherapy (χ2=6.62, 7.78, 8.62, all P<0.01). Pearson correlation analysis showed that the changes of serum TAP in palliative chemotherapy group had no relationship with tumor markers CA125, CEA, CA19-9 and ALP (r values were 0.42, 0.19, 0.09, 0.28, all P> 0.05). The serum TAP level of the adjuvant chemotherapy group was positively correlated with the level of tumor marker CA125 (r=0.51, P=0.02), with no correlation with the changes of CEA, CA19-9 and ALP levels (r values were 0.20, 0.24, 0.19, all P>0.05). Conclusion The detection of serum TAP level in patients with lung adenocarcinoma has good accuracy and high sensitivity, which indicates that the serum level of TAP in patients with lung adenocarcinoma before and after chemotherapy can be used as an index to evaluate the efficacy of chemotherapy and an independent detection of lung adenocarcinoma.

目的 探讨溶瘤性单纯疱疹病毒G47△调节HER2促进人乳腺癌MCF-7细胞凋亡的机制研究.方法 用不同滴度G47(MOI=0.00,MOI=0.01,MOI=0.1)处理乳腺癌MCF-7/HER2过表达组(ER+,HER2-high)、MCF-7/HER2低表达组(ER+,HER2-low)和MCF-7对照组(ER+)细胞,CCK-8法检测检测细胞成活率;流式细胞术检测细胞凋亡率;Hoechst33258染色法检测乳腺癌细胞凋亡形态;Western blot检测溶瘤性单纯疱疹病毒G47△作用后乳腺癌细胞中HER2和Cleaved-caspase-3凋亡蛋白表达.结果 随着溶瘤性单纯疱疹病毒G47△给药剂量的增大,MCF-7/HER2过表达组、MCF-7/HER2低表达组和MCF-7对照组细胞存活率明显降低,细胞凋亡率显著上升,HER2和Cleaved-caspase-3凋亡蛋白表达明显上升,差异有统计学意义(P＜0.05).与病毒G47△MOI=0.01处理MCF-7对照组相比,MCF-7/HER2低表达组细胞存活率显著升高,细胞凋亡率显著下降,HER2和Cleaved-caspase-3凋亡蛋白表达明显下降;MCF-7/HER2过表达组存活率显著降低,细胞凋亡率显著上升,HER2和Cleaved-caspase-3凋亡蛋白表达明显上升;与病毒G47△MOI=0.1处理MCF-7对照组相比,MCF-7/HER2低表达组细胞存活率显著升高,细胞凋亡率显著下降,HER2和Cleaved-caspase-3凋亡蛋白表达明显下降;MCF-7/HER2过表达组存活率显著降低,细胞凋亡率显著上升,HER2和Cleaved-caspase-3凋亡蛋白表达明显上升,差异有统计学意义(P＜0.05).结论 溶瘤性单纯疱疹病毒G47△有效诱导HER2过表达乳腺癌MCF-7细胞发生细胞凋亡作用;溶瘤性单纯疱疹病毒G47△可以呈浓度依赖性地促进HER2蛋白降解,诱导乳腺癌MCF-7细胞发生凋亡.

本研究探讨叉状头/翅膀状螺旋转录因子(forkhead/winged helix transcription factor,Foxp3)过表达对人乳头状瘤病毒(human papilloma virus,HPV)感染阳性宫颈癌细胞增殖、凋亡及细胞免疫的影响,为阐明宫颈癌肿瘤免疫逃逸机制、肿瘤治疗及药物开发提供一定理论基础.利用脂质体介导转染方法,研究者建立Foxp3过表达HPV感染阳性SiHa细胞株,作为Foxp3过表达阳性细胞,同时利用pcDNA3.1空载体转染SiHa细胞株,作为本研究阴性对照,同时设置空白对照组,采用qRT-PCR方法及Western blotting法检测3组Foxp3 mRNA及蛋白表达水平.采用ELISA法检测SiHa细胞中IL-2、IL-10水平,采用MTT实验检测SiHa细胞增殖能力,流式细胞术检测SiHa细胞周期及凋亡情况.结果显示过表达组Foxp3 mRNA及蛋白表达水平明显高于阴性对照组及空白对照组,差异有统计学意义(P＜0.05),阴性对照组及空白对照组Foxp3 mRNA及蛋白表达水平相比较,差异无统计学意义(P＞0.05);与阴性对照组及空白对照组比较,过表达组IL-2水平明显降低,IL-10水平明显升高;MTT结果显示:Foxp3过表达可促进SiHa细胞增殖;FCM检测显示,Foxp3过表达可明显抑制SiHa细胞凋亡,抑制G0/G1期阻滞.由此,Foxp3过表达可促进HPV感染阳性宫颈癌细胞增殖,抑制细胞凋亡.

目的 探讨缺氧条件下骨肉瘤MG-63细胞凋亡与Ⅱ型谷氨酰胺转氨酶(TG2)表达的关系,以及TG2抗凋亡机制与细胞色素C和Caspase-3表达的关系.方法 建立骨肉瘤细胞体外缺氧培养模型,设立单纯缺氧组和TG2 siRNA缺氧组,缺氧培养时间为12 h,观察TG2活性、蛋白及mRNA水平,胞核、胞浆中细胞色素C和Caspase-3蛋白水平及细胞凋亡率.结果 单纯缺氧组胞核中TG2活性、蛋白及mRNA水平均显著高于TG2 siRNA缺氧组(P<0.05),而胞浆中比较,无显著差异(P>0.05);单纯缺氧组胞核中细胞色素C和Caspase-3蛋白水平显著高于TG2 siRNA缺氧组,胞浆中含量显著低于TG2 siRNA缺氧组(P<0.05);单纯缺氧组的细胞凋亡率显著低于TG2 siRNA缺氧组(P<0.05).结论 缺氧条件下TG2高表达有抑制MG-63骨肉瘤细胞凋亡作用,其机制可能与抑制胞核中细胞色素C和Caspase-3向胞浆中转移有关.

Objective To explore the expressions and significance of Smad4,transforming growth factor-β1 (TGF-β1),and transforming growth factor-β receptor 1 (TGF-βR1) in breast cancer cells.Methods A total of 60 patients diagnosed as breast invasive ductal carcinoma definitely in the hospital from January 2014 to January 2016 were selected as observation group.A total of 20 cases with normal breast tissue were selected as control group.The expressions of Smad4,TGF-β1,and TGF-βR1 were tested through immunohistochemical technique,the expression differences and influencing factors of their expressions were compared between the two groups.Results The positive expression rates of TGF-β1 and TGF-βR1 in observation group were higher than those in control group,and the positive expression rate of Smad4 in observation group was lower than that in control group,there were statistically significant differences (P＜0.05).The expressions of Smad4,TGF-β1,and TGF-βR1 in breast cancer had no relation with age,while they had relations with degrees of differentiation and TNM staging.The positive expression rates of TGF-β1 and TGF-βR1 in patients with low degrees of differentiation and high TNM staging were higher than those with high degrees of differentiation and low TNM staging,while the positive expression rate of Smad4 in patients with low degrees of differentiation and high TNM staging was lower than that with high degrees of differentiation and low TNM staging,there were statistically significant differences (P＜0.05).The expression of TGF-β1 in breast cancer was positively correlated with the expression of TGF-βR1 (r =0.647,P＜0.05).The expression of Smad4 in breast cancer was negatively correlated with the expressions of TGF-β1 and TGF-βR1 (r=-0.329,-0.426,P＜0.05).Conclusion The expressions of TGF-β1 and TGF-βR1 significantly increase in the tissue of breast invasive ductal carcinoma,while the expression of Smad4 decreases,which are related to the degree of differentiation and TNM staging.

Objective To observe the effects of different doses of prednisone on cancer fatigue, anorexia and nutritional status in patients with advanced gastrointestinal cancer. Methods A total of 96 patients with advanced can-cer were selected and divided into the low-dose group (20 mg/d), the high-dose group (40 mg/d) and the control group (best palliative support) according to the random number table, with 32 cases in each group. The indexes of cancer fatigue and anorexia, serum hemoglobin, albumin, total protein, prealbumin, globulin were measured before and after 2 weeks of treatment by ESAS symptom scoring system, and the adverse reactions were recorded. Results The ESAS fatigue scores and anorexia scores of the three groups were decreased after the treatment (P<0.05). The ESAS fatigue scores and anorexia scores of the low-dose group and the high-dose group were (3.34 ± 0.55) points and (3.47 ± 0.60) points, (3.51 ± 0.61) points and (3.52 ± 0.73) points, respectively, which were significantly lower than (4.61 ± 0.70) points and(4.53 ± 0.65) points in the control group (P<0.05). The levels of serum hemoglobin, albumin, total protein, prealbumin, globulin in the low-dose group and the high-dose group after the treatment were significantly higher than those before the treatment and in the control group (P<0.05). The total incidence of adverse reactions was 18.75％ in the low-dose group, significantly lower than 46.88％ in the high-dose group (P<0.05), which showed no significant difference com-pared with 9.38％in the control group (P>0.05). Conclusion Low-dose prednisone in the treatment of advanced cancer can effectively relieve cancer patients fatigue and anorexia symptoms, improve nutritional status under the premise to re-duce adverse reactions with higher safety.

Objective:To investigate the expression of Livin protein in osteosarcoma and the relationship between the microvessel density (MVD) and clinicopathological features of osteosarcoma.Methods:Selected 71 patients with osteosarcoma were collected from January 2013 to December 2015.The expression of Livin protein and MVD was observed by immunohistochemical staining.The relationship between Livin protein and MVD level in tumor tissue and clinicopathological features was also discussed.Results:In 71 cases of osteosarcoma,the expression rate of Livin was 57.75％,the positive rate of MVD was 60.56％,the difference was not statistically significant (P ＞ 0.05);there was a significant positive correlation between the expression of Livin protein in tumor tissue and the positive rate of MVD (Spearman,r =0.953,P ＜ 0.001);positive expression of Livin protein was correlated with the degree of differentiation and lung metastasis (P ＜ 0.05),Livin protein expression was not correlated with patients' age,gender,tumor size,Enneking stage,pathological type is not significant (P ＞ 0.05).Conclusion:The expression of Livin protein was significantly correlated with the degree of MVD,tumor differentiation and pulmonary metastasis in osteosarcoma.

Objective To observe the clinical efficacy of Compound Biejiaruangan Tablets combined with entecavir for treating HBeAg negative hepatitis B complicated with hepatic fibrosis and its effect on serum IFN-γ and IL-6. Methods Totally 102 patients with HBeAg negative hepatitis B complicated with hepatic fibrosis were randomly divided into the observation group and the control group, 51 cases in each group. The control group was treated with entecavir,while the observation group was treated with Compound Biejiaru-angan Tablets combined with entecavir. The levels of total bilirubin(TBIL),alanine aminotransferase(ALT),albumin (ALB),aspartate aminotransferase(AST),procollagen Ⅲ(PC Ⅲ),hyaluronic acid(HA),laminin(LN),Ⅳ collagen(Ⅳ -C),IFN-γ and IL-6 were observed. Results After treatment,the levels of TBIL,ALT,AST,PCⅢ,HA,LN,Ⅳ -C,IFN-γ and IL-6 in the two groups were significantly lower than before treatment,and the observation group was significantly lower than the control group(P < 0. 05). The levels of ALB in the two groups were significantly higher than before treatment,and the observation group was significantly higher than the control group(P < 0. 05). Conclusion Compound Biejiaruangan Tablets combined with entecavir for treating HBeAg negative hepatitis B complicated with hepatic fibrosis can effectively improve the liver function,the levels of IFN-γ and IL-6 of the patients,and reduce the degree of hepatic fibrosis,which is worthy of clinical promotion.

Objective To investigate expressions of leucine-rich repeat-containing G-protein coupled receptor 5 (Lgr5) and macrophage migration-inhibitory factor (MIF) in colorectal cancer tissues and the relationship between their expressions and clinicopathological factors.Methods The paraffin-embedded tissue specimens from 64 patients with colorectal cancer,40 patients with intestinal intraepithelial neoplasia and 34 patients with normal intestinal tissues removed by gastrointestinal surgery between May 2014 and May 2016 were collected.Envision two step immunohistochemical staining method was used to detect the expressions of Lgr5 and MIF proteins in three kinds of tissues,and the relationship between their expressions in colorectal cancer tissues and clinicopathological factors was analyzed.Results The positive expression rates of Lgr5 protein in normal intestinal tissues,intestinal intraepithelial neoplasia tissues and colorectal cancer tissues presented a gradually increasing trend:6.88％,47.50％ and 84.38％,respectively,and there were significant differences in them for pairwise comparisons (all P ＜ 0.01).The positive expression rates of MIF protein in normal intestinal tissues,intestinal intraepithelial neoplasia tissues and colorectal cancer tissues presented a gradually increasing trend also:17.65％,40.00％ and 81.25％,respectively,and there were significant differences in them for pairwise comparisons (all P ＜ 0.01).High-expressions of Lgr5 and MIF in colorectal cancer tissues were associated with pathological grading,Dukes staging and lymph node metastasis (P ＜ 0.05,P ＜ 0.01) while not with gender and age (all P ＞ 0.05).Conclusions Lgr5 and MIF present high-expressions in patients with colorectal cancer,and their expressions are closely associated with occurrence,development,invasion and metastasis of the tumor.Regulation and control of Lgr5 and MIF may be the new targets for the treatment of colorectal cancer.

患者女,78岁.因“贫血、淋巴细胞增高2年,乏力、气促1月”于2012年10月11日入住我院血液科.患者2010年2月发现右足近2～4趾骨处皮肤包块伴疼痛,无发热、皮疹等.切除肿块,病理组织学报告“右足滑膜肉瘤”,后行包括截趾在内的手术治疗共3次,均未行放疗及化疗.2010年10月行第3次手术后发现贫血,无其它不适,全身检查未发现滑膜肉瘤转移.此后,多次查Hb 70～90 g/L.淋巴细胞计数(5 ～ 7)×109/L,未诊治.既往体健无特殊病史.入院查体:神志清楚,消瘦,重度贫血貌,浅表淋巴结未触及明显肿大,皮肤黏膜无出血.

OBJECTIVE To analyze usage amount of injectable antibiotics for inpatients in our hospital and analyze the correlation of the amount and the drug susceptibility results of bacteria isolated in the bacteriology room . METHODS The medication amount of injectable antibiotics for inpatients in Jan .2010-Dec .2012 was statistically calculated as well as the susceptibility test results for major pathogens ,data were summarized with Excellsoft-ware .RESULTS Except macrolides of which usage amount (DDDs :20487) was declined slightly in 2011 ,the usage amount of other injectable antibiotics showed an increasing trend ,including cephalosporins with the largest amount (DDDs :207419) ,followed by quinolones (DDDs :93284) and penicillins (DDDs :88270) .Clinical usage amount of the downward trend was seen for ceftriaxone ,cefotaxime and their resistance rates were decreased accordingly . Resistant strains to imipenem did not appear in the recent three years as the usage amount of imipenem was flat . Resistance to other drugs was increased with the increased usage .CONCLUSION Usage amount of injectable anti-biotics for inpatients was positively correlated with bacterial drug resistance ,and to take effective measures to strengthen the control of antimicrobial drugs for injection is an effective way to reduce drug-resistant strains .

目的了解老年消化道恶性肿瘤患者心理状况,并分析其相关因素。方法应用抑郁自评量表(SDS),焦虑自评量表(SAS)调查及自制量表对32例老年消化道恶性肿瘤患者进行心理状况调查及其相关因素分析。结果老年消化道恶性肿瘤患者SDS和SAS标准分为41.58±12.78;44.39±10.67,显著高于一般老年患者。多因素Logistic回归分析提示睡眠差、疼痛感、疲乏感、对自身疾病缺乏认识、对治疗的悲观态度、严重的治疗副作用、经历手术和放化疗是心理障碍的影响因素。结论老年消化道肿瘤患者具有更多的情绪障碍,应给予心理干预,以提高患者治疗效果及生存质量。

Objective To investigate the expression of NOD2 and TLR9 in gastric epithelial cells and its effect on production of IL-8 in SGC-7901.Methods In this study SGC-7901 was cultured in vitro and stimulated with NOD2 agonist Muramyl dipeptide (MDP) and TLR9 agonist unmethylated CpG ODN alone or combined.The mRNA and protein expression of NOD2 and TLR9 were examined in gastric epithelial cells with or without treatment of MDP and unmethylated CpG ODN using RT-PCR and Western Blot.Additionally the concentration in the culture supernatants of IL-8 was measured by ELISA.Results MDP and unmethylated CpG ODN up-regulate the expression NOD2 and TLR9 mRNA and protein level in SGC-7901.They induce the production of interleukin-8(IL-8) increasing in a time(P<0.05) and concentration (P<0.05) dependent manner.Additionally the results demonstrated that TLR9 and NOD2 had synergistic effect on increasing the production of IL-8 (P<0.05).Conclusion The NOD2 agonist MDP and TLR9 agonist unmethylated CpG ODN have effect on the expression of NOD2 and TLR9 in SGC-7901 and increasing the production of IL-8.NOD2 and TLR9 synergistically enhanced these effects.

Objective:To observe the anti-tumor effects of extracts from the Semen Euphorbiae Lathyris in vitro.Method:In vitro experiments were adopted with MTT method.The tumor cell lines were Hela and K_(562).The growth condition,density and apperaence of tumor cell were observed with microscope.The absorbance were detected and the rates of inhibition tumor were calculated.Result:Experiment in vitro demonstrated that numbers of tumor cells of extracts from the Semen Euphorbiae Lathyris groups were lower obviously than ones of solvent group,especially in high dose group.The border of cells had crystalline body and a number of residual patch of cells.Compared with solvent group,the groups of Semen Euphorbiae Lathyris were higher(P<0.05).There was significant correlation of rate of inhibition tumor of extracts from the Semen Euphorbiae Lathyris with drug dose.Conclusion:Extracts from the Semen Euphorbiae Lathyris have obvious anti-tumor effect on Hela,K_(562) in vitro.

目的 探讨TLR9和NOD2在胃癌细胞SGC-7901中表达及诱导IL-8合成过程中的相互作用及意义.方法用不同浓度的NOD2激动剂(MDP)和TLR9激动剂(未甲基化的CpG ODN)以不同时间间隔单独或联合作用于体外培养的胃癌细胞SGC-7901,用ELISA法测定上清中的IL-8,用RT-PCR和Western Blot测定TLR9和NOD2的表达.数据采用SPSS13.0进行统计分析.结果 相对于未刺激组,MDP和未甲基化CpG ODN能使SGC-7901 NOD2和TLR9 mRNA和蛋白的表达增强;细胞培养上清中IL-8的分泌增强,并呈现时间依赖性和浓度依赖性,差异具有统计学意义(P＜0.05),8h浓度差异无统计学意义;二者共同作用还能协同诱导SGC-7901合成IL-8,也呈现时间和浓度依赖性,差异具有统计学意义(P＜0.05).结论 NOD2和TLR9在胃癌细胞SGC-7901中有所表达,二者在诱导SGC-7901分泌炎性因子的过程中有协同作用.

Objective To observe the antitumor effects of Valeriana Iridoids. Methods MTT method was adopted.The tumor cell lines were HL-60and K562.The growth condition,density and apperaence of tumor cell were observed under microscope.The A titres were detected and the rates of tumor inhibition were calculated. Results Experiment in vitro demonstrated that numbers of tumor cells in Valeriana Iridoids groups were significantly lower than those in 0.9%NaCl group,especially prominent in high dose group.The border of cells had crystalline body and a number of residual patch of cells.As compared with solvent group,there was significant or very significant difference(P0.05 or P0.01) between them.There was a positive correlation between the rate of tumor inhibition and the drug dose. Conclusion Valerinana Iridiods was shown to have a prominent antineoplastic effect in vitro.