[摘 要] 目的：研究芳香烃受体（AHR）在乳腺癌中的表达及其对乳腺癌细胞增殖、凋亡和药物敏感性的调控机制。方法：通过GEPIA数据库数据分析乳腺癌组织及癌旁组织中AHR的表达水平，探讨其与患者生存期的关联。利用基因敲低和过表达技术构建AHR表达变化的乳腺癌细胞，采用CCK-8实验、细胞计数和流式细胞分析等方法评估AHR对细胞增殖、凋亡和药物敏感性的影响，通过免疫印迹法验证相关分子机制。此外，利用AHR激动剂6-甲酰基吲哚并[3,2-B]咔唑（FICZ）研究外源性激活AHR对乳腺癌细胞多柔比星（DOX）敏感性的影响。结果：GEPIA数据库数据分析结果显示，乳腺癌组织中AHR呈明显低表达（P < 0.05）；对155例乳腺癌患者的生存期进行统计分析也显示AHR低表达与不良预后呈正相关（P < 0.05）。敲低AHR促进细胞增殖（P < 0.05），过表达则能抑制其增殖（P < 0.05）并促进其凋亡（P < 0.05）。外源激活AHR能增强乳腺癌细胞对DOX的敏感性（P < 0.05）。AHR可与MYC基因启动子结合，抑制MYC表达（P < 0.05），从而影响乳腺癌的进展。结论：AHR在乳腺癌中通过调控MYC表达影响细胞增殖和凋亡，外源激活AHR可能成为提高乳腺癌细胞对DOX敏感性的治疗策略。

【Objective】 To investigate whether 17β-estradiol (βE2) can activate the NF-E2-related factor 2(Nrf2) pathway to resist the downregulation of retinal function induced by light damage. 【Methods】 Two weeks after female SD rats were castrated, they were divided into the following six groups: control group (control), light-damage group (LD), saline group, saline light-damage group (saline-LD), βE2 group, and βE2 light-damage group (βE2-LD). Rats in the light-damage were exposed to 8000-lux fluorescence for 12 h after 18 h of dark adaptation. Then electroretinogram (ERG), immunofluorescence, Real-time PCR and immunohistochemical detection were performed after one day of dark recovery. 【Results】 The results of ERG showed that ERG was lower in LD group than in control group (P<0.05). After light damage, ROS was increased and the mRNA expressions of antioxidant genes, such as Sod1, Sod2, Cat, Glrx1, Glrx2, Txn1, and Txn2 were decreased (all P<0.05). After βE2 administration, compared with those in saline-LD, ROS level was decreased, the levels of Nrf2 protein and antioxidant genes were increased, and ERG was recovered to a certain extent in βE2-LD (P<0.05). 【Conclusion】 βE2 can restore the function of rat retina, and its mechanism might be related to the upregulation of Nrf2 and antioxidant genes.

Objective To investigate the effect of flipped classroom model in the theory teaching of urology,and to provide a reference for promoting teaching methods.Methods The clinical medicine classes 1 and 2 of 2014 in the five-year undergraduate program,with 120 students in each class,were enrolled,with class 1 as teaching reform class and class 2 as traditional teaching class.The flipped classroom model was applied in class 1,and the traditional teaching method was applied in class 2.Tests and questionnaires were used at the end of the class to evaluate teaching effect.All the data were analyzed by Graphpad Prism 6.1,t test and Chi-square test were used for stabistical analysis.Results There were significant differences between the teaching reform class and the traditional teaching class in the mean score of chapter test [(80.78± 9.02) vs.(75.03 ± 7.98),P ＜0.05] and the mean score of comprehensive quality [(82.09 ± 8.89) vs.(76.34 ± 6.45),P＜0.05].The questionnaire survey showed an overall degree of satisfaction of 98.5％ among students;81.67％ of all students actively participated in learning,91.67％ were willing to participate in the teaching with flipped classroom model,75.84％ thought this model improved learning enthusiasm,65％ thought it improved the ability of self-study,73.33％ thought it improved their understanding of the learning content,and 84.17％ thought it strengthened the communication between teachers and students.Conclusion The flipped classroom model has a better effect than the traditional teaching model in the theory teaching of urology and is easily accepted by students.Therefore,it holds promise for clinical application.

Objective To study the correlation between serum lipids and thyroid function after withdrawn of thyroid hormone in the patients with differentiated thyroid cancer .Methods One hundred and thirty cases of differentiated thyroid carcinoma treated by operative therapy in our hospital form August 2014 to August 2015 were selected .Serum FT4 ,TSH ,FT3 ,triglyceride ,total cho-lesterol ,LDL-C ,HDL-C indexes were detected before discontinuation of levothyroxine sodium (L-T4) ,before operation and 3 weeks after drug withdrawn .Thus the correlation between blood lipid levels and thyroid function was analyzed .Results The HDL-C and the TSH level was positively related before operation (P<0 .05) ,other indexes had no obvious correlation with thyroid function (P>0 .05);the blood lipid levels after medication withdrawn had no obvious correlation with thyroid function (P>0 .05);the total cholesterol levels after medication discontinuation had negative correlation with FT 3 and FT4 levels(P<0 .05);HDL-C was nega-tively correlated with FT3 and FT4 levels(P<0 .05) ,and positively correlated with TSH level (P<0 .05);LDL-C was negatively correlated with FT4 (P<0 .05) .Conclusion When the application treatment of thyroid hormone is suspended ,with the TSH level increase ,the HDL-C level has somewhat elevation ;total cholesterol ,HDL-C and LDL-C levels are negatively correlated with FT 3 and FT4 ,after discontinuation of medication withdrawn ,the blood lipids metabolism abnormality is closely related with thyroid function decline .

Objective:To investigate the relationship between VitD 3 concentration and glucose and insulin levels of OGTT in patients with CKD 3-5 stages.Methods: We included the patients with CKD 3 and 4 and 5 stages who fulfill the including standard.All patients were recorded the concentrations of [1,25 (OH):D3]concentration of glucose and insulin at fasting ,postprandial 1 h,2 h during OGTT and concentration of glycosylated hemoglobin level ,C peptide concentration.We performed the correlation analysis about [1,25 (OH):D3],glucose and insulin.Results: We totally included 91 patients with 3-5 stages CKD into our study.The D3 concentration of stage 3 were 160.9-261.3 mmol/L[(218.38±8.67)mmol/L] of stage 3,75.2-166.3 mmol/L[(117.01±4.72) mmol/L] of stage 4 and 11.8-96.5 mmol/L[(41.91±12.83)mmol/L] of stage 5 (P<0.05).The average concentrations of serum glucose at fasting,1 h after the meal and 2 h after the meal was(4.74±0.21)mmol/L,(8.31±0.43)mmol/L and(7.36±0.32)mmol/L in 3 stage and (4.92±0.25) mmol/L,(9.14±0.15) mmol/L and (9.14±0.39)mmol/L at 4 stage and (4.81±0.13)mmol/L, (10.72±0.41)mmol/L and (10.72±0.49)mmol/L at 5 stage (P<0.05).The average concentrations of insulin during OGTT at fasting,1 h after the meal and 2 h after the meal was (6.58±0.32) μU/L,(57.78±5.63)U/L and (42.77±8.45)U/L in 3 stage (6.03±0.53)U/L,(55.69±7.35)U/L and (62.52±5.39)U/L in 4 stage and (6.12±0.65)U/L,(62.82±9.73)U/L and (77.34± 8.62)U/L in 5 stage (P<0.05).Correlation analysis shows that the concentration of 1,25 (OH):D3 of different stages of patients with CKD and vitamin D 3 concentration and glucose tolerance test was found to be inversely associated with the insulin levels ( P<0.05 ) . Conclusion:There are obvious differences of concentration of vitamin D 3 between patients with 3-5 stages of chronic kidney disease (CKD).There also showed a negative correlation relationships between glucose and insulin levels ,and vitamin D3 concentration and glucose and insulin levels at OGTT of patients with 3-5 stages CKD.

ObjectiveTo analyze the characteristics of left ventricular (LV) twist and discuss the relationship between LV ejection fraction (LVEF) and LV twist in patients with chronic kidney disease (CKD) by two-dimensional speckle tracking imaging (2D-STI).MethodsForty-six patients with CKD and 30 healthy controls were enrolled in this study. After conventional echocardiography, LV end-diastolic volume (LVEDV) and LV end-systolic volume (LVESV) were measured by Biplane Simpson method and the LVEF was calculated. And relevant parameters of LV rotation and twist were measured by speckle tracking imaging. Correlation analysis of LVEDV, LVESV and LV peak rotation and twist were analyzed respectively. ResultsCompared with the control group, LV peak twist and the apical rotation were decreased in CKD patients, which was statistically significant (t=0.002 and 0.020, bothP<0.05). The inferior wall and posterior intermediate septum of basal segment were significantly decreased (t=0.044 and 0.041, both P<0.05). Pearson correlation analysis revealed LV apical peak rotation had a relationship with LVEDV and LVESV (r= 0.355 and 0.409, bothP<0.01).Conclusion2D-STI is an practical noninvasive method which can analyze LV twist accurately and recognize LV systolic dysfunction of CKD patients sensitively.

Objective To evaluate global left ventricular(LV) strain of patients with chronic renal failure(CRF) by three-dimensional speckle tracking imaging(3D-STI) and discuss the possible association between global peak strain and ejection fraction of LV.Methods The study includes 22 patients in the renal failure period,25 patients with uremia (pre-dialysis),and 20 healthy controls.Global peak longitudinal strain (GPSL),global peak area strain(GPSA) and global peak radial strain(GPSR) were measured by 3D-STI.Then possible association between GPSL,GPSA,GPSR and LVEF were discussed by the Pearson correlation analysis.Results The GPSL,GPSA,GPSR were statistically different in the control group,patients in the renal failure period and patients with uremia.There were significant differences between groups(F =13.28,4.65,4.68,P ＜ 0.01) as following,all of GPSL,GPSA,GPSR were lower in uremia group compared with control group [q =7.48(GPSL),4.19(GPSA),4.72(GPSR),P ＜0.01],GPSL was lower in renal failure group compared with control group [q =4.9 (GPSL),P ＜0.01].The Pearson correlation analysis revealed GPSL,GPSA,GPSR were strongly associated with LVEF(r =-0.679,-0.781,0.719,P ＜0.01).Conclusions In patients with CRF,the global peak strain can reveal the systolic function of left ventricle and the global peak longitudinal strain can recognize systolic dysfunction more sensitively.

Objective To assess the value of left ventricular (LV) twist and rotation in left-to-right shunt congenital heart diseases(CHD) by two-dimensional speckle tracking imaging(2D-STI).Methods 16 patent ductus arteriosus(PDA),20 ventricular septal defect(VSD) and 36 age,sex matched normal subjects were included.LV end-diastolic volume (LVEDV) and LV end-systolic volume (LVESV) were measured by Biplane Simpson method,then LV ejection fraction (LVEF) was calculated.Two-dimensional images in LV basal and apical short-axis views in three complete cardiac cycles were required.Using speckle tracking imaging,the rotation of 6 segments in basal and apical short-axis levels were measured in CHD patients and control subjects,respectively.Basal and apical rotation versus time profiles and LV twist versus time profiles were drawn.Correlation analysis of LVEDV,LVESV and LV peak twist and rotation were made respectively.Results Compared to the control group,LV peak twist and the apical rotation were increased in CDH patients,which was statistically significant (P ＜0.05).LV peak twist had significant correlation with LVEDV and LVESV.Conclusions LV volume overload which was caused by left-to-right shunt CHD significantly impacted LV twist and apical rotation,but has no significant effect in basal rotation.LV peak twist correlated with LVEDV and LVESV.

Objective To assess the left ventricular longitudinal shrinkage function in liver cirrhosis patients with two-dimensional speckle tracking imaging (2D-STI). Methods Echocardiography and Doppler echocardiography were performed in 34 patients with liver cirrhosis and 35 healthy subjects of corresponding ages. High frame rate two-dimensional images were recorded from apical long-axis view, four-chamber view and two-chamber view of left ventricle; then the left ventricular diameter, left atrium diameter, the peak filling velocity of E wave and A wave, E/A ratio, EF and FS were measured. The peak systolic strain of left ventricular segment was measured with two-dimensional strain software. Results Compared with healthy subjects, left ventricular diameter, left atrium diameter, EF and FS of liver cirrhosis patients were not statistically different (P>0.05), but the E/A ratio was lower (P<0.05). The peak systolic strain of most left ventricular segment in liver cirrhosis reduced significantly (P<0.05), except that of base segment of posterior wall, anterior wall, inferior wall, anterior and posterior interventricular septum, as well as middle segment of posterior interventricular septum. Conclusion The heart shape, systolic and diastole function of liver cirrhosis are abnormal. 2D-STI can early and accurately evaluate the systolic function of liver cirrhosis.