微量元素对控制糖尿病大鼠动脉Ⅳ型胶原沉积的实验研究

探讨了微量元素对糖尿病（DM）大鼠动脉Ⅳ型胶原沉积的影响。链脲佐菌素（STZ）诱导动物模型，经胃灌注微量元素后检测大鼠血糖及用免疫组化方法检测动脉Ⅳ型胶原水平。结果表明，微量元素钒，铬，硒能显著降低糖尿病大鼠血糖水平，减少Ⅳ型胶原沉积。抽示微量元素对糖尿病血管病变的发生有预防作用。     

B超在肝脏血管瘤的诊断应用效果观察

目的研究在肝脏血管瘤患者中使用B超进行诊断的价值和效果。方法选择湖北省咸宁市结核病防治院在2014年12月—2015年12月间收治的肝脏血管瘤200例患者进行随机抽取,对上述患者的疾病均使用B超以及CT进行诊断,将两种检查结果进行比较。结果对于已经确诊的200例肝脏血管瘤患者,B超检查显示有187例为定性诊断结果,有13例为物理诊断结果,而使用CT进行诊断只有173例患者疾病被检出,将两种检查方法的定性诊断以及检出率相对比,B超均优于CT,差异有统计学意义(P0.05)。结论对于肝脏血管瘤患者来说,进行B超诊断更加快捷简便并且检出率更高。     

CT灌注成像对肝癌TACE术后早期反应预测价值的Meta分析

系统评价术前计算机体层灌注成像(CTPI)参数对肝癌经肝动脉化疗栓塞(TACE)术后早期反应的预测价值。通过计算机检索中国知网、万方、维普、PubMed、Medline、Web of Science、Embase数据库中有关CT灌注成像和TACE预后关系的研究,使用RevMan 5.4软件进行Meta分析,效应量为均数差(MD),各效应量以95%置信区间(CI)表示。共纳入7篇文献,包括433名患者,共475个肿瘤病灶。Meta分析结果显示,肝癌TACE术后有反应组和无反应组肝动脉灌注量(ALP)差异有统计学意义(MD=16.84,95%CI 2.06～31.62,P<0.05),有反应组ALP明显高于无反应组,最佳截断值范围为9.885～22.175 mL/(100 mL·min);肝癌TACE术后早期有反应组和无反应组门静脉灌注量(PVP)、肝动脉灌注指数(HPI)、血流量(BF)、血容量(BV)、平均通过时间(MTT)、达峰时间(TTP)差异无统计学意义(P>0.05)。术前高ALP可以预测肝癌TACE术后早期有效,但是ALP更确切的截断值需要进一步研究。     

交联型"纳米花"酶用于拟除虫菊酯农药的高效水解研究

该文制备了交联型猪肝酯酶杂化“纳米花”酶（CL－PLE－NFs）,并对其制备条件进行了优化。在最佳条件下,CL－PLE－NFs的酶活为游离酶的231%,最大反应速率（Vmax）是游离酶的134%。同时,将交联型纳米花酶在4 ℃下贮藏320 d后,仍能保留70.85%的活力,表现出良好的贮藏稳定性。此外,将CL－PLE－NFs应用于拟除虫菊酯类农药的水解实验,发现其对Ⅰ型和Ⅱ型的拟除虫菊酯类农药均有较优的水解能力,在5 min内对11种拟除虫菊酯农药的水解率均在55%以上。同时,循环使用12次后,CL－PLE－NFs对溴氰菊酯农药的水解效率仍然可达65.37%。     

数字减影血管造影引导下双侧子宫动脉栓塞术在穿透性凶险性前置胎盘中的应用

本文分析了数字减影血管造影（DSA）引导下双侧子宫动脉栓塞术在穿透性凶险性前置胎盘患者中的应用效果及对母婴结局的影响。选择2017年12月～2019年7月我院收治的穿透性凶险性前置胎盘患者45例,依据是否行子宫动脉栓塞术,将患者分为观察组（n=25例）和对照组（n=20例）。观察组行DSA引导下双侧子宫动脉栓塞术治疗,对照组行常规剖宫产手术治疗。术后7天对患者效果进行评估,比较两组手术指标、母婴结局及并发症发生率。结果显示：观察组失血量、红细胞输血量、冷沉淀输血量、住院时间,少（短）于对照组,新生儿1 min Agpar评分高于对照组,差异有统计学意义（P<0.05）。观察组新生儿肺炎、新生儿呼吸窘迫综合征、新生儿窒息及新生儿高胆红素血症发生率均低于对照组,差异有统计学意义（P<0.05）。观察组子宫切除、产后出血、失血性休克和DIC发生率均低于对照组,差异有统计学意义（P<0.05）。表明DSA引导下双侧子宫动脉栓塞术治疗穿透性凶险性前置胎盘的效果确切,可明显减少患者术中出血量及术后并发症,降低手术风险,改善临床结局,且微创、安全,值得临床推广应用。     

低剂量长期补充微量元素治疗“多发性纤维脂肪血管瘤病”一例

阐述了一例“多发性纤维脂肪血管瘤病”患者,经十四个月以上的低剂量多种微量元素制剂治疗,达到良好的治疗效果。     

肝硬化合并低氧血症31例临床研究

为探讨肝硬化患者的血氧变化与临床关系，以肝炎后肝硬化患者31例为观察组（A组），采用血气分析仪测定其动脉血氧分压（PaO2)及动脉血氧饱和度（SaO2)，并以正常人15例作对照组（B组）进行比较结果表明，A组的低氧血症发生率为41％，B组为0。肝硬化患者低氧血症的发生率高，其严重程度与Child-Pugh分级有关。早期发现低氧血症并予以治疗有助于改善肝硬化患者的预后。     

乳粉中六六六、滴滴滴质控样品的研制

建立乳粉中六六六（HCH）、滴滴滴（DDD）质控样品的制备方法。以乳粉为基质,添加六六六、滴滴滴标准溶液,采用喷雾干燥法制备乳粉中六六六、滴滴滴质控样品。选择气相色谱法对所制备的样品进行定值。经均匀性和稳定性检验,质控样品的均匀性良好、稳定性达到24个月。研制的乳粉中六六六、滴滴滴质控样品的定值结果：α-六六六的质量分数为（0.812 4±0.040 0） mg/kg,γ-六六六的质量分数为（2.604±0.160） mg/kg,p,p’-DDD的质量分数为（0.847 5±0.060 0） mg/kg,k=2。     

连续CO2激光引发的1,1-二氟乙烷与氯的反应

本文报道了CW-CO2激光引发的CF2HCH3与Cl2的反应.除主要产物CF2=CH2外,还有CF2ClCH3. CF2ClCH2Cl. CF2=CHCl. CF2=CCl2和CF2Cl2.为了探索应用激光方法合成CF2=CH2的可能性,研究了激光输出功率. 照射时间. 反应体系中CF2HCH3与Cl2的比例及样品压力对CF2=CH2得率的影响.同时为了探讨反应机理,还进行了TEA-CO2激光引发CF2HCH3加Cl2实验和CW-CO2激光作用下CF2=CH2. CF2=CH2加Cl2的反应研究,令人感兴趣的是在激光照射CF2=CH2时,发现了双键的断裂.     

酸浸蚀Al-Si合金制备锂离子电池高性能多孔硅负极材料

本文首次提出利用酸浸蚀Si-Al（含Al 80%）合金粉末的方法制备多孔硅材料. 分析表明制得的多孔硅材料为晶体,并具有由纳米颗粒结集成的海绵状多孔结构,其粒径约20 μm,比表面102.7 m²·g^-1. 多孔硅电极按多孔硅:导电碳:粘结剂 = 1:1:1（by mass）涂成. 在添加15%氟化碳酸乙烯酯（FEC）的1 mol·L^-1 LiPF₆/EC + DMC（1:1,by volume）电解液,在100 mA·g^-1电流密度充放电,多孔硅电极的首次放电比容量2072 mAh·g^-1 Si. 经237次充放电循环后,其放电容量仍可保持在1431 mAh·g^-1 Si,显示了相当高的充放电稳定性. 这归因于其海绵状多孔结构有足够的微空间以承受充电过程中硅的急剧膨胀. 硅微粒的纳米尺寸有利于锂在Li-Si合金中的扩散. 纳米硅微粒可牢固地联成一整体,不易因膨胀、收缩而粉化断裂. 这种构筑多孔硅负极材料的新方法操作简便、成本低廉,有着很好的应用前景.     

超声联合计算机在晚期恶性梗阻性黄疸治疗中的应用

本文探讨了常规超声、超声造影联合计算机辅助在内镜下逆行胰胆管造影术(ERCP)、经皮经肝穿刺胆道引流术(PTCD)与超声内镜引导下胆道引流术(EUS-BD)治疗晚期恶性梗阻性黄疸中的应用。选取54例晚期恶性梗阻性黄疸患者为研究对象,将其分为ERCP组、PTCD组、EUS-BD组,分析三组患者住院天数、近期并发症和肝脏功能指标等。结果显示:(1)三组患者手术后在治疗晚期恶性梗阻性黄疸效果显著(P<0.01);(2)与其他两组相比,EUS-BD组并发症和住院天数最少(P<0.05);(3)病理分析结果显示,ERCP组和EUS-BD组对导管伤害较少。总之,EUS-BD组患者采用常规超声联合计算机辅助技术,与ERCP组超声造影及PTCD组常规超声相比,更具备优势。     

Long-term effects of photodynamic therapy on fluorescence spectroscopy in the human esophagus.

Clinical interest in laser-induced fluorescence (LIF) spectroscopy and photodynamic therapy (PDT) is growing rapidly and may ultimately lead to close parallel use of these techniques. However, variations in LIF due to photosensitizer retention as well as tissue damage and healing processes may interfere with autofluorescence-based diagnostic methods. We have investigated the compatibility of these two techniques by quantifying PDT-induced changes in LIF in the human esophagus. Fluorescence spectra were collected endoscopically at excitation wavelengths (lambda ex) of 337, 400 and 410 nm in 32 patients. Measurements were performed immediately before and after PDT treatment with porfimer sodium and during follow-up procedures. In the months following PDT regions of reepithelialized squamous showed reduced autofluorescence in comparison with untreated squamous regions (P = 0.0007). Photosensitizer fluorescence was undetectable with lambda ex = 337 nm during follow-up procedures, whereas for lambda ex = 400 and 410 nm porfimer sodium fluorescence was noted for nearly a year after treatment. Therefore, residual photosensitizer fluorescence is likely to affect certain LIF-based diagnostic techniques during a period when patients are at high risk for tumor recurrence. Modification of LIF systems and/or the use of alternative photosensitizers may be required to optimize the detection of lesions in the post-PDT patient. Given the potential of LIF as a method for surveillance following cancer therapy, further investigation of the compatibility of specific LIF approaches with cancer pharmaceuticals may be warranted.     

多层螺旋CT灌注成像评价介入性热化疗治疗中晚期肝癌的价值

为探讨多层螺旋CT灌注成像(CT perfusion imaging,CTPI)在评价介入性热化疗对中晚期肝癌疗效方面的应用价值,本文分析了72例采用介入性热化疗的中晚期肝癌患者在治疗前后的CTPI灌注参数和血清肿瘤学标志物水平。通过与治疗前数据比较,发现治疗后癌灶区CTPI灌注参数明显改善,血清肿瘤标志物明显降低。CTPI灌注参数、血清肿瘤学标志物在碘油完全沉积和部分沉积组、客观缓解和未缓解组均表现出显著的统计学差异。Pearson相关分析结果显示CTPI灌注参数与肝癌血清肿瘤标志物之间存在显著相关性。由此可见,CTPI灌注参数可有效反映介入性热化疗前后晚期肝癌患者的动脉血供变化,为临床疗效评估提供有价值的参考。     

叶酸高分子纳米胶束在小鼠体内的靶向分布

合成了带有叶酸靶向和荧光染料的聚合物FA-PEG-PLA和mPEG-b-P（LA-co-MHC／NIR）,通过混合胶束的方法制备近红外染料胶束P（NIR）（含染料NIR6％）,叶酸胶束FA-P（NIR）1（含染料NIR5．4％,叶酸LFA0．5％）和叶酸胶束FA-P（NIR）2（含染料NIR4．8％,叶酸FA0．9％）;建立了H22肝癌小鼠模型,考察了高分子纳米胶束及叶酸靶向纳米胶束在H22肝癌小鼠体内分布．结果表明,高分子纳米胶束及叶酸靶向纳米胶束在小鼠体内分布都具有时间相关性,无叶酸配体的高分子纳米胶束在尾静脉注射24h后在肿瘤部位有少量聚集,大部分胶束在肝部聚集,30h内大部分已被排泄系统排出体外;含有叶酸配体的纳米胶束在尾静脉注射后6-30h内在肿瘤部位有明显的聚集,其中,FA-P（NIR）1胶束在肿瘤和肝部位的聚集相当,FA-P（NIR）2胶束在静脉注射24h后在肿瘤聚集明显高于肝部．带有叶酸配体的高分子纳米胶束相对于不带叶酸配体的纳米胶束在小鼠肿瘤部位具有明显的聚集,并且随着叶酸含量的增大,聚集效果更明显．     

超声弹性成像联合超声造影在鉴别原发性及转移性肝癌中的应用

为探讨超声弹性成像联合超声造影在鉴别原发性及转移性肝癌中的应用价值，选择2016年12月至2018年12月期间本院消化外科住院部收治的肝癌患者160例作为研究对象，根据病理组织学检查结果将患者分为原发组和转移组，各80例，两组进行超声弹性成像和超声造影检查，分析单项和两者联合检查对原发性及转移性肝癌的鉴别诊断效能。结果显示，原发组超声弹性成像评分（3.41±0.85）分，明显高于转移组的（1.52±0.62）分，两组比较差异具有统计学意义，P<0.05。与转移组相比较，原发组造影峰值时间明显延长，造影始增时间明显缩短，造影峰值增强速率明显降低，两组比较差异具有统计学意义（P<0.05）。两者联合检查对原发性及转移性肝癌的鉴别诊断灵敏度、特异度、阳性预测值、阴性预测值、准确度高于超声弹性成像或超声造影单项检查，漏诊率和误诊率低于超声弹性成像或超声造影单项检查，两者联合检查对原发性及转移性肝癌的鉴别诊断准确度明显高于超声造影单项检查，P<0.05。说明超声弹性成像联合超声造影有利于明显提高原发性及转移性肝癌的鉴别诊断准确度，值得临床推广应用。     

Detection of circulating tumor cells in patients with gastrointestinal tract cancer using RT-PCR and its clinical implications

To investigate the relationship between the presence of circulating tumor cells in different stages of gastrointestinal tract cancer and the subsequent relapse or distant metastasis, circulating levels of CEA mRNA was serially examined at an interval of 10.6+/-4.5 or 13.7+/-3.0 months in gastric or colorectal cancer patients, respectively. CEA mRNA was measured by means of RT-PCR amplification as an indicator for micrometastatic malignant cells. Seven of twenty-nine respectable gastric cancer patients (24.1%) [EGC: 2/9 (22.2%), AGC IIIa: 1/5 (20.0%), AGC IIIb: 4/15 (26.6%)] were positive for CEA mRNA on the initial test and 10 of 29 patients (34.4%) [EGC: 2/ 9 (22.2%), AGC IIIa: 1/5 (20.0%), AGC IIIb: 7/15 (46.7%)] were positive on a follow-up test. Only in AGC IIIb, the positive rate for CEA mRNA increased about twice and 6 of 7 positive cases (85.7%) relapsed within 2.6+/-2.4 months after the follow-up test. In colorectal cancer, 4 of 19 patients (21.1%) [B2: 1/6 (16.7%), C2: 3/13 (23.0%)] were positive on the initial test and 10 of 19 patients (52.6%) [B2: 4/6 (66.7%), C2: 6/13 (46.2%)] were positive on a follow-up test showing an increase in positive rates during a follow-up, however, no significant correlation between CEA mRNA positivity and subsequent relapse was demonstrated. These results suggest that an early tumor cell dissemination may occur in gastrointestinal tract cancer without subsequent relapse, however, the serial regular examination of CEA mRNA level may contribute to predicting a subsequent relapse in AGC IIIb in gastric cancer.     

Photochemical Internalization of Bleomycin is Superior to Photodynamic Therapy Due to the Therapeutic Effect in the Tumor Periphery

Photochemical internalization (PCI) is under development for clinical use in treatment of soft tissue sarcomas and other solid tumors. PCI may release endocytosed bleomycin (BLM) into the cytosol by photochemical rupture of the endocytic vesicles. In this study, the human fibrosarcoma xenograft HT1080 was transplanted into the leg muscle of athymic mice. The photosensitizer disulfonated aluminum phthalocyanine (AlPcS_2a) and BLM were systemically administrated 48 h and 30 min, respectively, prior to light exposure at 670 nm (30 J cm⁻²). The purposes of this study were to evaluate the treatment response to AlPcS_2a-photodynamic therapy (PDT) and AlPcS_2a-PDT in combination with BLM ( i.e. PCI of BLM) in an orthotopic, invasive and clinically relevant tumor model and to explore the underlying response mechanisms caused by PDT and PCI of BLM. The treatment response was evaluated by measuring tumor growth, contrast-enhanced magnetic resonance imaging (CE-MRI), histology and fluorescence microscopy. The results show that PCI of BLM is superior to PDT in inducing tumor growth retardation and acts synergistically as compared to the individual treatment modalities. The CE-MRI analyses 2 h after AlPcS_2a-PDT and PCI of BLM identified a treatment-induced nonperfused central zone of the tumor and a well-perfused peripheral zone. While there were no differences in the vascular response between PDT and PCI, the histological analyses showed that PDT caused necrosis in the tumor center and viable tumor cells were found in the tumor periphery. PCI caused larger necrotic areas and the regrowth in the peripheral zone was almost completely inhibited after PCI. The results indicate that PDT is less efficient in the tumor periphery than in the tumor center and that the treatment effect of PCI is superior to PDT in the tumor periphery.     

PHOTODYNAMIC THERAPY OF MALIGNANT BRAIN TUMORS: CLINICAL and NEUROPATHOLOGICAL RESULTS

Abstract Fourteen patients with malignant brain tumors were treated 17 times with photodynamic treatment following either intravenous, selective intraarterial or direct intratumoral injection of Photofrin II. In eight patients the photodynamic treatment was followed immediately by single dose radiation of 4 Gy of ionizing radiation. The three injection modalities resulted in 2.5 μ.g. 3.2 μ.g and 9.8 μ,g g⁻¹ tumor tissue respectively after 3 days. The histological examination immediately after light irradiation after intravenous and intra-arterial injection demonstrated a predominantly vascular and cellular effect whereas the direct injection resulted in a direct cellular effect with little effect on vascular structures.
The median survival time for the three patients with multiple recurrences of the glioblastoma was 5 months, five patients with the first recurrence have a survival time of 2 to 7 months following PDT and six patients with the primary manifestation are surviving now up to 12 months. The intraarterial and direct intratumoral injection was tolerated well by the patients without increased skin phototoxicity.
These results indicate that the direct intratumoral and selective intraarterial injection of HPD are a feasible route for PDT however they are too preliminary to allow a final conclusion of the value of this modified PDT in the treatment of malignant brain tumors.     

Antivascular treatment of solid melanoma tumors with bacteriochlorophyll-serine-based photodynamic therapy

We describe here a strategy for photodynamic eradication of solid melanoma tumors that is based on photo-induced vascular destruction. The suggested protocol relies on synchronizing illumination with maximal circulating drug concentration in the tumor vasculature attained within the first minute after administrating the sensitizer. This differs from conventional photodynamic therapy (PDT) of tumors where illumination coincides with a maximal concentration differential of sensitizer in favor of the tumor, relative to the normal surrounding tissue. This time window is often achieved after a delay (3-48 h) following sensitizer administration. We used a novel photosensitizer, bacteriochlorophyll-serine (Bchl-Ser), which is water soluble, highly toxic upon illumination in the near-infrared (lambda max 765-780 nm) and clears from the circulation in less than 24 h. Nude CD1 mice bearing malignant M2R melanotic melanoma xenografts (76-212 mm3) received a single complete treatment session. Massive vascular damage was already apparent 1 h after treatment. Changes in vascular permeability were observed in vivo using contrast-enhanced magnetic resonance imaging (MRI), with the contrast reagent Gd-DTPA, by shortening spin-spin relaxation time because of hemorrhage formation and by determination of vascular macromolecular leakage. Twenty-four hours after treatment a complete arrest of vascular perfusion was observed by Gd-DTPA-enhanced MRI. Histopathology performed at the same time confirmed primary vascular damage with occlusive thrombi, hemorrhage and tumor necrosis. The success rate of cure of over 80% with Bchl-Ser indicates the benefits of the short and effective treatment protocol. Combining the sensitizer administration and illumination steps into one treatment session (30 min) suggests a clear advantage for future PDT of solid tumors.     

Histamine and spontaneously released mast cell granules affect the cell growth of human hepatocellular carcinoma cells

The role of mast cells in tumor growth is still controversial. In this study we analyzed the effects of both histamine and pre-formed mediators spontaneously released by mast cells on the growth of two human hepatocellular carcinoma cell lines, HA22T/VGH and HuH-6, with different characteristics of differentiation, biological behavior and genetic defects. We showed that total mast cell releasate, exocytosed granules (granule remnants) and histamine reduced cell viability and proliferation in HuH-6 cells. In contrast, in HA22T/VGH cells granule remnants and histamine induced a weak but significant increase in cell growth. We showed that both cell lines expressed histamine receptors H(1) and H(2) and that the selective H(1) antagonist terfenadine reverted the histamine-induced inhibition of HuH-6 cell growth, whereas the selective H(2) antagonist ranitidine inhibited the histamine-induced cell growth of HA22T/VGH cells. We demonstrated that histamine down-regulated the expression of beta-catenin, COX-2 and survivin in HuH-6 cells and that this was associated with caspase-3 activation and PARP cleavage. On the contrary, in HA22T/VGH cells expression of survivin and beta-catenin increased after treatment with granule remnants and histamine. Overall, our results suggest that mediators stored in mast cell granules and histamine may affect the growth of liver cancer cells. However, mast cells and histamine may play different roles depending on the tumor cell features. Finally, these data suggest that histamine and histamine receptor agonists/antagonists might be considered as "new therapeutic" drugs to inhibit liver tumor growth.