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关键词： Cell membrane vesicles   Dental pulp stem cells   Small interfering RNA   Tumor necrosis factor  

摘要： Objective;To evaluate the feasibility of using cell membrane vesicles (CMVs) as a delivery system for small interfering RNA (siRNA) and to assess their performance in a lipopolysaccha-ride (LPS)-induced inflammatory model of human dental pulp stem cells (DPSCs). Methods;CMVs were generated from cytochalasin B-treated 3T3 cells and characterized for their physicochemical properties, including morphology, size distribution, and zeta potential, using confocal microscopy and dynamic light scattering. To construct CMVs@ siTNF-ct, saponin-mediated transient permeabilization was used to facilitate siRNA loading, after which encapsulation efficiency was evaluated by flow cytometry and confocal imaging. Intracellular uptake behaviors were examined using flow cytometry in DPSCs. LPS (1 mg/L) was employed to establish a robust in vitro inflammatory microenvironment. DPSCs were subsequently treated with CMVs or CMVs@ siTNF-ct, and cell viability was assessed via CCK-8 (cell counting kit-8). The expression and secretion of tumor necrosis factor-a (TNF-a), interleukin-1 p (1L-1(3), and inter-leukin-6 (IL-6) were analyzed using quantitative real-time polymerase chain reaction (qRT-PCR) and enzyme linked immunosorbent assay (EL1SA) to evaluate both gene-silencing efficiency and downstream anti-inflammatory effects. Results;CMVs exhibited uniform spherical morphology with an average diame- ter of approximately 903 nm and a zeta potential of -9. 39 mV, confirming successful vesicle formation. CMVs efficiently encapsulated FAM-labeled siRNA, as indicated by a pronounced fluorescence shift in flow cytometry and clear colocalization signals in confocal imaging. DPSCs cultured with CMVs@ FAM-siTNF-a demonstrated increased intracellular fluorescence, reflecting efficient vesicle uptake and cytoplasmic siRNA release. Importantly, both CMVs and CMVs@ siTNF-a displayed negligible cytotoxicity. LPS stimulation significantly elevated TNF-a, 1L.-1 (3, and 1L-6 expression, validating the inflamm

关键词： Benign ovarian neoplasm   Body mass index   Fat-to-muscle mass ratio  

摘要： Objective: To investigate the association between fat-to-muscle mass ratio (FMR) of whole body, arm, leg and trunk and the risk of benign ovarian neoplasm. Methods;A total of 255 412 participants from the prospective cohort study United Kingdom biobank (UKB) were enrolled in the risk-related study of benign ovarian neoplasm. Cox proportional hazard model was used to evaluate the correlation between total and regional FMR and the risk of benign ovarian neoplasm. A priori stratified analysis was performed according to the body mass index (BMI) category to evaluate the correlation between FMR of whole body, arm, leg and trunk and the risk of benign ovarian neoplasm in people with BMI <25 kg/ m2and I!VII 3=25 kg/m2, respectively. The restricted cubic plot was used to further explore the curve of FMR associated with the risk of benign ovarian neoplasm. Finally, subgroup analysis was performed on the age of the subjects (<50 years, 50 -59 years, 3=60 years) to explore the association between FMR and the risk of benign ovarian neoplasm at different ages. Results;During a median 8. 77 years of follow-up, we recruited 1 643 cases of benign ovarian neoplasms. After adjusting for demographic, reproductive, genetic, lifestyle, and hormone-related factors, total, arm, leg and trunk FMR were significantly positively correlated with the risk of benign ovarian neoplasm and higher than BMI with the risk of benign ovarian neoplasm, among which the whole body FMR had the strongest correlation with the risk of benign ovarian neoplasm (Illy;2. 16;95% CI;1. 67 - 2. 79). Stratified analysis of FMR and the risk of benign ovarian neoplasm based on BMI showed that compared with people with ISVII 3=25 kg/m", people with BM1 < 25 kg/m" had a stronger association between whole body, arm, leg and trunk FMR and the risk of benign ovarian neoplasm (-Pilltf,*** < 0. 05). The restricted cubic plot showed that the association between FMR of the whole body, arm and trunk and the risk of benign o

摘要： 骨髓增生异常肿瘤(MDS)是一组起源于造血干细胞的高度异质性髓系肿瘤,临床表现为一系或多系血细胞减少,有向急性髓系白血病转化的风险。近年来,MDS在基础研究和新型靶向药物治疗方面取得了较大进展,第五版WHO分类对MDS的分型进行了更新。因此,中华医学会血液学分会对《骨髓增生异常综合征中国诊断与治疗指南(2019年版)》进行了修订,以规范MDS的诊断、鉴别诊断、预后评估及治疗选择,从而更好地指导临床实践。.;Myelodysplastic neoplasms (MDS) are a group of highly heterogeneous myeloid tumors originating from hematopoietic stem cells, clinically characterized by single or multiple lineage cytopenia with a risk of acute myeloid leukemia transformation. In recent years, significant progress has been made in basic research and the development of novel targeted therapy for MDS, and the 5th edition of the WHO classification has updated the subtypes of MDS. Therefore, the Chinese Society of Hematology, Chinese Medical Association has revised the "Chinese Guidelines for Diagnosis and Treatment of Myelodysplastic Syndromes (2019) " to standardize the diagnosis, differential diagnosis, prognostic assessment, and treatment selection for MDS, thereby better guiding clinical practice.

关键词： 乳腺良性肿瘤   热消融治疗   中西医结合   诊疗指南   中医五位一体  

摘要： 热消融术是一种针对乳腺良性病变的新型微创治疗方法,已证实其在乳腺良性肿瘤中的疗效。本指南综合分析高质量临床证据,结合国内著名专家的临床经验与意见,经多次专家研讨达成共识。主要阐述乳腺良性肿瘤的热消融治疗准则与操作规范,包括适应证、禁忌证、术前评估、麻醉方式、治疗类型及并发症处理等。同时,指南还强调了中医中药在热消融诊治过程中的重要作用,提出了“中医五位一体”的综合治疗方案。本指南可为从事乳腺良性肿瘤治疗的医师提供了重要的参考依据。

关键词： 肾肿瘤   肾部分切除术   微创手术   机器人辅助手术   血流控制   术中导航   手术策略  

摘要： 随着影像学进步和保肾理念深化,肾部分切除术在T1期肾肿瘤中的角色不断强化,并逐步扩展至复杂性肾肿瘤,相关手术挑战显著增加。本文阐述复杂性肾肿瘤微创肾部分切除术的发展现状、关键技术及临床应用策略,比较腹腔镜与机器人辅助手术在不同复杂度病例中的适应性与优势,概括三维重建、精准血流管理和术中导航等技术对提高手术安全性与可控性的价值。同时,总结肾门部、完全内生性、囊性及多发肾肿瘤等典型复杂情形的处理路径,并结合实践经验,阐述孤立肾、T2期及以上肾肿瘤、局部侵犯肾盂以及合并脉管瘤栓等高风险病例中实施肾部分切除术的技术策略与风险控制要点。最后,简要讨论术式选择边界及功能保护与肿瘤学安全的平衡,并展望在智能规划和质量控制支持下,该领域向标准化、可复制的精准外科模式发展的趋势。

关键词： 唾液腺肿瘤   黏液   诊断   黏液腺癌   黏液性囊腺瘤   多形性腺瘤   黏液表皮样癌   肌上皮瘤   免疫组织化学   病理学  

摘要： 本文系统阐述了以大量细胞外黏液为主要或显著特征的唾液腺肿瘤诊断及鉴别诊断要点,明确了核心鉴别特征。“富含细胞外黏液”在此特指黏液成为肿瘤的主要构成成分,而非局灶性或少量存在,这种现象与独特的组织发生学机制相关:一方面源于特定基因突变(如黏液腺癌中的AKT1 E17K)促使导管上皮分化为黏液细胞并大量分泌黏液;另一方面则源于肌上皮细胞分泌糖胺聚糖形成黏液样间质。基于2022年第5版世界卫生组织(World Health Organization,WHO)《头颈部肿瘤病理学和遗传学分类》及最新文献,本文综述相关肿瘤的组织病理学、免疫组织化学及分子病理学特征。含大量细胞外黏液的唾液腺肿瘤包括黏液性囊腺瘤、乳头状涎腺瘤样导管内乳头状瘤、黏液性肌上皮瘤、间质富含黏液的多形性腺瘤、黏液腺癌、低级别黏液表皮样癌、富黏液型唾液腺导管癌及肠型腺癌。此类肿瘤在诊断上面临双重挑战:大量黏液既可作为某些肿瘤的典型特征,也可能在其他肿瘤中掩盖其诊断性结构,导致组织学形态重叠与特征区域隐匿。核心鉴别要点包括:组织学上需仔细辨识被黏液掩盖的典型结构(如黏液表皮样癌中的表皮样细胞、唾液腺导管癌的大汗腺特征);在免疫组化方面,应用CK20可鉴别肠型腺癌(阳性)与黏液腺癌(阴性),而应用雄激素受体(androgen receptor,AR)可以鉴别唾液腺导管癌(阳性)与黏液表皮样癌(阴性);分子检测对确诊具有关键作用(如AKT1 E17K突变见于黏液腺癌,MAML2重排见于黏液表皮样癌,MEF2C: : SS18融合见于微分泌性腺癌)。本文系统梳理了富含细胞外黏液唾液腺肿瘤的核心病理特征与鉴别要点,以期为临床病理诊断提供实用参考。

关键词： 胃癌   CD8   T细胞   CD103   CD39   免疫逃逸  

摘要： 目的 检测CD103+CD39+CD8+ T细胞亚群在胃癌组织中的浸润水平并分析其应答特征,明确胃癌组织中的CD103+CD39+CD8+ T细胞亚群的临床关联性。方法 收集2023年1月至2024年5月陆军军医大学第二附属医院普外科胃癌患者的手术切除癌组织、癌旁组织以及外周血标本,采用流式细胞术结合免疫荧光染色检测CD103+CD39+CD8+ T细胞亚群在胃癌组织及癌旁组织中的应答比例与数目,并通过流式细胞术分析胃癌组织中CD103+CD39+CD8+ T细胞亚群表达的CD69、PD-1与IFN-γ水平;体外分离培养外周血来源的单个核细胞,探讨TGF-β1对CD103+CD39+CD8+ T细胞亚群的分化效果;临床关联性分析CD103+CD39+CD8+ T细胞亚群在胃癌组织中的比例与疾病进展的相关性。结果 与癌旁组织相比,CD103+CD39+CD8+ T细胞亚群在胃癌组织中的比例明显增加(P<0.05);免疫荧光染色进一步证实,胃癌组织中CD103+CD39+CD8+ T 细胞亚群的数目亦明显多于癌旁组织;与CD103+CD39-和CD103-CD39-CD8+ T细胞亚群相比,CD103+CD39+CD8+ T细胞亚群表达的活化分子CD69和免疫检查点分子PD-1均增加(P<0.05),但功能相关因子IFN-γ的表达则显著下降(P<0.05);体外TGF-β1刺激可诱导CD8+ T细胞中CD103与CD39的共表达上调(P<0.05);此外,CD103+CD39+CD8+ T细胞亚群在晚期胃癌患者癌组织中的浸润比例显著高于早期胃癌患者(P<0.05)。结论 CD103+CD39+CD8+ T细胞亚群在胃癌组织中的浸润增加,并展示出功能受抑的应答特征,从而有助于胃癌的免疫逃逸。

关键词： 霍乱毒素   肿瘤   佐剂,免疫   疫苗   细胞增殖   免疫调节  

摘要： 霍乱毒素是霍乱弧菌分泌的一种AB5型毒素,具有免疫调节能力。霍乱毒素在抗肿瘤方面具有潜在作用,其不但可通过抑制生长因子信号或触发细胞凋亡来抑制细胞增殖,还可作为一种免疫调节剂,通过介导炎症反应、调节免疫系统来抑制肿瘤的发生发展。此外,霍乱毒素还可以通过辅助靶向药物运输和作为疫苗佐剂发挥间接抗肿瘤作用。该文就霍乱毒素在肿瘤中的作用予以综述,为肿瘤的预防及治疗提供新思路。

关键词： 爪哇木棉   化学成分   细胞毒活性   杜松烷型倍半萜  

摘要： 为阐明爪哇木棉的化学成分和抗肿瘤活性,本研究采用硅胶柱色谱、半制备高效液相色谱技术等对爪哇木棉茎杆乙酸乙酯提取物进行分离纯化,结合NMR、MS等现代波谱学方法鉴定所得化合物的结构,从中共分离鉴定了19个化合物,并采用CCK-8法,评估了各化合物对BT549和4T1肿瘤细胞的体外细胞毒性。鉴定的19个成分分别为:hibiscusterpene II(1)、hibiscone C(2)、7-hydroxycadalene(3)、7-hydroxycalamenene(4)、(1S)-1-methoxylacinilene C(5)、lacinilene C(6)、(7R,9R,10R)-3,9-di-hidroxicalameneno(7)、mansonone(8)、3ξ-(1ξ-羟基)-7-羟基-1-苯并呋喃酮(9)、vavain(10)、cleomiscosin B(11)、(+)-medioresinol(12)、邻甲基苯甲醚(13)、对甲酚(14)、丁香醛(15)、(R)-(-)-mellein methyl ether(16)、丹蒽醌(17)、丁香酸乙酯(18)、β-谷甾醇(19)。其中,化合物1、2、4~9、11~18为首次从该属中分离得到。化合物1、2、3、4、6、8、10对BT549、4T1细胞增殖有一定的抑制活性,且化合物4和8细胞毒活性显著。本研究首次系统阐明了爪哇木棉中的杜松烷型倍半萜类成分为关键的其抗肿瘤活性成分,为该植物在抗肿瘤药物开发中的进一步应用提供了科学依据。