目的:研究姜黄素(curcumin)对人肾透明细胞癌(clear-cell renal cell carcinoma,ccRCC)细胞的增殖抑制和诱导凋亡作用,及叉头框蛋白O3a(Forkhead box protein O3a,FOXO3a)在姜黄素抗肿瘤效应中发挥的关键作用.方法:MTT法用于检测姜黄素对ccRCC细胞活力的抑制作用;Annexin V/PI双染实验检测姜黄素对ccRCC细胞的诱导凋亡作用;免疫印迹法(Western blot,WB)检测姜黄素对FOXO3a、p-FOXO3a及下游BIM表达的影响,和凋亡蛋白caspase 3的激活情况.实时荧光定量PCR技术(real-time quantitative PCR,RT-qPCR)检测FOXO3a转录水平.小干扰RNA(small interfering RNA,siRNA)技术用于沉默ccRCC细胞系中FOXO3a的表达.结果:通过对6种ccRCC细胞系(ACHN、786-O、769-P、A-498、Caki-1及Caki-2)FOXO3a蛋白基础表达水平进行检测,选取FOXO3a表达较高的786-O细胞系为研究对象.0～160μmol/L姜黄素处理786-O细胞24 h和48 h后,呈时间和浓度依赖性对细胞活力具有显著抑制作用;786-O细胞在0～80μmol/L姜黄素处理24 h后,明显促进细胞凋亡水平,且伴随着凋亡相关蛋白caspase 3的激活.786-O细胞中,姜黄素抑制p-FOXO3a,促进FOXO3a活化,并上调下游BCL-2家族促凋亡蛋白BIM表达水平.在siRNA沉默FOXO3a蛋白表达后,姜黄素对786-O细胞的生长抑制和诱导凋亡作用被抑制.结论:姜黄素通过诱导激活FOXO3a,在ccRCC细胞上发挥生长抑制和诱导凋亡的抗肿瘤作用.

目的 探讨膀胱癌患者应用腹腔镜下根治术与传统开放性手术治疗膀胱癌的对比研究.方法 以南阳市中心医院收治的62例膀胱癌患者为研究对象,入选病例均来自2018年3月至2020年12月,根据治疗方式不同分组,采取传统开放性手术治疗的31例患者作为对照组,采取腹腔镜下膀胱癌根治术治疗的31例患者作为研究组,对比两种术式的应用效果及患者并发症和生存质量,并观察对白介素-6(IL-6)、P-substance(P物质)、PGE2(前列腺素E2)的影响.结果 研究组患者淋巴结清扫期间出血量、术中总出血量少于对照组,切口长度小于对照组,淋巴结清扫时间、住院时间、肠道功能恢复时间和手术时间均短于对照组,P均<0.05;淋巴清扫数量两组差异不明显,组间对比无统计学意义(P>0.05);两组患者治疗前各项细胞因子及应激反应指标无明显差异,组间比较无统计学意义(P>0.05);治疗后研究组患者IL-6、P-substance、PGE2显著低于对照组,IFN-γ显著高于对照组,组间比较有统计学意义(P<0.05);术后并发症发生率(9.68％)与对照组(35.48％)比较差异有统计学意义(P<0.05);术后各项生活质量评分高于对照组(P<0.05).结论 对膀胱癌患者应用腹腔镜下膀胱癌根治术进行治疗可取得很好的疗效,其手术操作简单、创伤性小、并发症少、术后恢复快,还能显著提升患者生活质量,此术式值得借鉴推广.

Objective:To investigate the effect and molecular mechanism of circ_0001955 on the radiosensitivity of prostate cancer DU145 cells.Methods:The si-con, si-circ_0001955, miR-con and miR-149 were transfected into DU145 cells and recorded as the si-con group, si-circ_0001955 group, miR-con group, miR-149 group. The miR-149 and pc-circ_0001955 were co-transfected into DU145 cells and recorded as the miR-149+ pc-circ_0001955 group. Untreated cells were used as the blank control (NC) group. Real-time quantitative PCR was employed to detect the expression levels of circ_0001955 and miR-149. MTT assay was performed to detect cell viability. Flow cytometry was carried out to detect cell apoptosis. Transwell chamber assay was conducted to observe cell migration and invasion. Western blot was performed to detect the expression levels of MMP-2, MMP-9, Cleaved caspase-3, Cleaved caspase-9 and γ-H 2AX proteins. Colony formation assay was employed to determine the cell radiosensitivity. Dual-luciferase reporter assay was conducted to verify the targeting relationship between circ_0001955 and miR-149. Results:The circ_0001955 was highly expressed, whereas the miR-149 was lowly expressed in prostate cancer DU145 cells. Silencing circ_0001955 or over-expressing miR-149 could decrease the cell viability, migration and invasion, down-regulate the expression levels of MMP-2 and MMP-9, up-regulate the expression levels of Cleaved caspase-3 and Cleaved caspase-9, and increase the apoptosis rate (all P<0.05). After 4 Gy dose irradiation, the expression level of γ-H 2AX was up-regulated, the cell survival fraction was decreased, and the sensitivity ratio was 1.38. circ_0001955 could targetedly regulate the expression level of miR-149. After simultaneous overexpression of circ_0001955 and miR-149, cell proliferation activity and the number of migrating and invading cells were increased, cell apoptosis rate was decreased, and cell survival fraction was increased, and the sensitivity ratio was calculated as 0.72. Conclusion:Silencing circ_0001955 can targetedly up-regulate the expression level of miR-149, which inhibits the proliferation, migration, and invasion, induces cell cycle arrest, induces cell apoptosis and increases the radiosensitivity of prostate cancer DU145 cells.

目的 探究根治性膀胱癌切除术后感染切口愈合的危险因素及与单核淋巴细胞因子的关系.方法 回顾性选取2015年1月-2018年12月于南阳市中心医院泌尿外科接受根治性膀胱癌切除术治疗的患者作为研究对象,共200例,根据术后切口是否发生感染分为感染组(n=100)和未感染组(n=100),其中感染组根据切口愈合时间分为早期愈合组(n=65)和延迟愈合组(n=35).对影响根治性膀胱癌切除术后感染切口愈合的因素进行单因素和多因素Logistic回归分析;比较感染组和未感染组血清单核淋巴细胞水平.结果 延迟愈合组患者术中出血量高于早期愈合组,白蛋白含量低于早期愈合组,手术时间长于早期愈合组,尿瘘、肠瘘次数均高于早期愈合组(均P＜0.05).经Logistic回归分析,白蛋白、术中出血量、手术时间、尿瘘、肠瘘是影响患者感染切口愈合的独立危险因素(P＜0.05).切口感染组血清肿瘤坏死因子-α(TNF-α)、粒细胞集落刺激因子(G-CSF)、白细胞介素-8(IL-8)、IL-4、IL-6水平高于未感染组(均P＜0.05),而IL-2水平低于未感染组(P＜0.05).结论 白蛋白、术中出血量、手术时间、尿瘘、肠瘘是影响患者感染切口愈合的独立危险因素,在临床上应采取有针对性的预防控制措施,避免影响术后切口的愈合.同时,对单核淋巴细胞因子的检测有助于防治术后切口感染的发生.

Objective:To observe the effect of prostate cancer gene expression marker 1 (PCGEM1) on the proliferation and apoptosis of bladder cancer cells and its molecular mechanism.Methods:159 cases of bladder cancer tissues and adjacent tissues were selected as research objects from June 2016 to June 2019. The expression level of PCGEM1 was analyzed by fluorescence quantitative polymerase chain reaction (PCR). PCGEM1 knockdown and control cell lines were established in bladder cancer cell lines T24 and BIU-87 by RNA interference technology, which were divided into PCGEM1 KD/T24 group, T24 control group, PCGEM1 KD/BIU-87 group and BIU-87 control group, respectively. The cell proliferation of each group was analyzed by cell counting kit-8 (CCK-8). The apoptosis level of each group was analyzed by flow cytometry. The expression levels of RhoA and B cell lymphoma/leukemia (bcl)-xL in each group was analyzed by Western blotting.Results:As compared with the adjacent tissues (1.34±0.21), the expression level of PCGEM1 mRNA in the bladder cancer tissues (3.91±0.29) significantly increased ( t=3.109, P<0.05). As compared with T24 group and BIU-87 group (1.80±0.17 and 1.97±0.21), PCGEM1 KD/T24 and PCGEM1 KD/BIU-87 (1.06±0.14 and 0.96±0.11) significantly decreased ( t=2.701 and 2.481, P<0.05). As compared with T24 control group and BIU-87 control group [(5.39±1.14)% and (4.90±±1.22)%], the apoptosis rate of cells in PCGEM1 KD/T24 group and PCGEM1 KD/BIU-87 group [(31.49±6.12)% and (35.92±5.09)%] significantly increased ( t=3.081, 3.815, P<0.05). As compared with the expression levels of RhoA (1.14±0.15, 1.21±0.21) and bcl-xL (0.98±0.11, 0.93±0.18) in T24 control group and BIU-87 control group, the expression levels of RhoA (0.31±0.10, 0.29±0.09) and bcl-xL (0.38±0.13, 0.41±0.11) in PCGEM1 KD/T24 group and PCGEM1 KD/BIU-87 group significantly decreased. Conclusion:PCGEM1 is highly expressed in bladder cancer. PCGEM1 can affect the expression of RhoA and bcl-xL protein and regulate the proliferation and apoptosis of bladder cancer cells.

目的 探讨3D腹腔镜在膀胱切除及标准盆腔淋巴结清扫术中的应用效果及安全性.方法 回顾性分析2015年1月至2017年1月72例于郑州大学附属南阳中心医院进行治疗的膀胱癌患者的临床资料,所有患者均行腹腔镜下根治性膀胱切除+标准盆腔淋巴结清扫术治疗.72例患者均由同一组医师进行手术,根据手术方法不同分为3D腹腔镜治疗组(31例)、2D腹腔镜治疗组(41例).比较两组患者手术时间、术中出血量、淋巴结清扫数目,术后进食时间、下地时间、住院天数、并发症、术后病理结果及随访情况.结果 3D腹腔镜治疗组手术时间、术中出血量少于2D腹腔镜治疗组,淋巴结清扫数目多于2D腹腔镜治疗组,差异有统计学意义(P<0.05);两组患者术后进食时间、下地时间、住院天数差异无统计学意义(P>0.05).3D腹腔镜治疗组术中输血、淋巴漏发生率低于2D腹腔镜治疗组(P<0.05).术后病理结果提示,两组患者病理分期差异无统计学意义(P>0.05).术后随访,3D腹腔镜治疗组总复发率低于2D腹腔镜治疗组(P<0.05).结论 3D腹腔镜在膀胱切除及标准盆腔淋巴结清扫术中应用,可提高手术操作的精确性及淋巴结清扫效果,减少并发症的发生,值得推广.

目的 探讨血清骨桥蛋白(OPN)和尿渗透压对儿童肾结石形成的预测价值.方法 选取2016年1月至2019年1月郑州大学附属南阳市中心医院收治的84例肾结石患儿为结石组,并选择同期116例健康儿童为非结石组,比较两组儿童血清O PN及尿液渗透压水平,应用ROC曲线预测血清OPN、尿渗透压及联合检测对肾结石发生的预测价值.结果 结石组患儿尿渗透压及血清OPN显著高于非结石组(P<0.05);ROC曲线显示,尿渗透压和血清OPN对肾结石的预测效能低于两者联合检测(P<0.05),其AUC分别为0.799、0.765和0.872;Youden指数提示尿渗透压、血清OPN和联合检测预测肾结石发生的最佳截点分别为≥668.553 mOsm/(kg·H2O),≥9.997 ng/mL和≥0.348,尿渗透压和血清OPN预测肾结石的准确率、灵敏度和阴性预测值显著低于两者联合检测(P<0.05).结论 血清OPN水平及尿渗透压升高可导致儿童肾结石的发生,两者联合检测对儿童肾结石发生有较高的预测效能.

目的:通过构建头孢曲松钠结石大鼠模型,探讨TRPV5(辣椒素受体-5)在结石模型组大鼠肾脏中和正常对照组大鼠肾脏中的表达差异,分析其表达量与头孢由松钠应用时间的关系,为研究头孢曲松钠相关肾结石的发生机制提供新的理论依据.方法:30只雄性SD大鼠随机分为3组,A组给予120 mg·kg-1·d-1纯化水灌胃4周,B组、C组分别以120 mg·kg-1 ·d-1头孢曲松钠灌胃2周和4周;试剂盒检测各组血、尿生化指标;用相差显微镜观察各组结石结晶形成情况;采用免疫组化、双抗体夹心法分别定性、定量大鼠肾组织TRPV5的表达.结果:3组血钙浓度无统计学差异(P＞0.05),C组与A组、B组比较血肌酐明显升高[(96.29±21.81)μmol·L-1 vs(34.72±10.49) μmol·L-1、(59.98±20.45) μmol· L-1,P＜0.05],C组尿钙浓度相比较A组明显升高[(0.72±0.25)mmol· L-1 vs (0.46±0.23) mmol·L-1,P＜0.01],C组与A组、B组比较尿肌酐降低[(2 488.28±435.75) μ-mol·L-1 vs(3 463.57±221.76)μmol·L-1、(2 971.37±319.27)μmol·L-1,P＜0.01].光镜下C组可见有大量结石结晶形成.TRPV5在3组血液中表达无明显差异(P＞0.05),C组中TRPV5在肾脏中表达明显低于A组、B组[(217.79±48.31)ng·L-1 vs(395.66±74.69)ng·L-1、(343.08±74.08)ng·L-1,P＜0.01].结论:TRPV5在头孢曲松钠干预4周组大鼠肾组织中的表达降低,表达量且与头孢曲松钠干预时间呈负相关,可能由于头孢曲松钠抑制了钙离子通道蛋白TRPV5在肾脏的表达,增加肾小管尿钙排泄从而参与了头孢曲松结石的形成.

前列腺癌是老年男性常见的疾病之一,发现时多为晚期.对于晚期前列腺癌而言,其首选的治疗手段为内分泌治疗,其中以最大雄激素阻断疗法即去势+抗雄激素治疗最为常用,有关去势方式又可分为手术去势和药物去势.目前临床上对于手术或药物去势的选择虽有大量文献进行比较分析,但尚无统一的选择标准.本文就晚期前列腺癌内分泌治疗中不同去势方式的选择做一综述.

Purpose. To use in vitro and in vivo models to evaluate Glechoma longituba extract to provide scientific evidence for this extract's antiurolithic activity. Materials and Methods. Potassium citrate was used as a positive control group. Oxidative stress (OS) markers and the expression of osteopontin (OPN) and kidney injury molecule-1 (KIM-1) were measured to assess the protective effects of Glechoma longituba. Multiple urolithiasis-related biochemical parameters were evaluated in urine and serum. Kidneys were harvested for histological examination and the assessment of crystal deposits. Results. In vitro and in vivo experiments demonstrated that treatment with Glechoma longituba extract significantly decreased calcium oxalate- (CaOx-) induced OPN expression, KIM-1 expression, and OS compared with the positive control group (P < 0.05). Additionally, in vivo rats that received Glechoma longituba extract exhibited significantly decreased CaOx deposits and pathological alterations (P < 0.05) compared with urolithic rats. Significantly lower levels of oxalate, creatinine, and urea and increased citrate levels were observed among rats that received Glechoma longituba (P < 0.05) compared with urolithic rats. Conclusion. Glechoma longituba has antiurolithic effects due to its possible combined effects of increasing antioxidant levels, decreasing urinary stone-forming constituents and urolithiasis-related protein expression, and elevating urinary citrate levels.