目的 为初步评估在无创辅助通气基础上进行雾化肺表面活性物质(AS)治疗呼吸窘迫综合征(RDS)早产儿的安全性及效果,开展了此项临床研究。方法 2019年7月—2020年6月,经监护人知情同意,符合入选标准的RDS早产儿,入院后在经鼻间歇正压通气(NIPPV)基础上,通过振动筛网雾化器系统给予100 mg/kg注射用牛肺表面活性剂,雾化完毕继续无创辅助通气。详细观察及记录患儿在雾化初期的生命体征及血气分析结果,记录在雾化治疗期间不良反应发生情况以及患儿病情转归情况。结果 20例患儿参与研究,1例出生后26天死亡,其余均存活出院。5例在AS治疗后3天内无创辅助通气失败。和雾化前比较,AS治疗后1小时患儿血气分析主要指标均改善,血氧饱和度上升,心率下降(P＜0.05),但血压及呼吸机参数无明显变化(P＞0.05)。在雾化过程中,所有患儿无明显不良反应发生。结论 此项临床研究初步显示AS联合无创辅助通气治疗早产儿RDS是安全可行的,但尚需进一步临床研究评估其效果。

Objective To evaluate the safety and efficacy of non-invasive ventilation with aerosolized surfactant (AS) in the treatment of premature infants with respiratory distress syndrome (RDS). Methods From July 2019 to June 2020, in this unblinded Phase I study, the premature infants with RDS who met the criteria with the informed consent of their guardians were enrolled. They were treated with nasal intermittent positive pressure ventilation (NIPPV) and received one dose (100 mg/kg) of aerosolized surfactant by vibrating mesh system (Aeroneb Solo) after hospitalization. The vital signs, adverse reactions and blood gas during areosolizing were recorded and prognosis of them also recorded in detail. Results Twenty infants were enrolled, nineteen completed the study, one died in 26 days. Five infants still required endotracheal intubation and mechanical ventilation after AS treatment. One hour after AS treatment, infants' oxygen saturation and indicators of pulse oximetry improved (P＜0.05), and heart rate decreased (P＜0.05) , but blood pressure and parameters of ventilator had no change (P＞0.05). Infants all tolerated the aerosol treatment well. No other significant adverse events were identified. Conclusion We have demonstrated the feasibility and safety of AS treatment in preterm infants with RDS receiving non-invasive respiratory support. The treatment was well tolerated by infants and clinical caregivers , but still need further study.

目的 回顾性分析CT血管成像(CTA)在急诊出血性脑卒中患者中,在病因诊断、病程进展评估中的应用。方法 89例头颅平扫初诊急性出血性脑卒中病人,行CTA检查,通过后处理技术,对各种出血原因进行影像学特征分析,并根据图像特征评估血肿的稳定性,在24小时内复查CT平扫了解出血的发展。结果 89例急诊脑出血患者,CTA检查中83例病因明确,并采取相应的临床处理。5例(5.6%)病因不明确,以蛛网膜下腔出血患者为主,需临床进一步全面检查。1例患者不配合造影检查失败。CT平扫发现不稳定血肿22例,复查血肿增大16例,准确率72.2%。CTA判断血肿内持续出血患者14例,复查13例患者有血肿增大,准确率为92.8%。结论 CT平扫只能评估血肿的稳定性,而CTA出现血肿内高密度影时,高度提示血肿内出血仍在持续。急诊医生可通过CTA对脑出血患者进行病因的分析、病程的预估、及时诊断、定位,对指导治疗及手术方式有重要作用。

Objective To retrospectively analyze the value of computed tomographic angiography (CTA) on etiological diagnosis and progression evaluation in patients with emergent hemorrhagic stroke. Methods Eighty-nine patients with preliminary diagnosis of acute hemorrhagic stroke underwent CTA, then various bleeding causes were analyzed by post-processing.The stability of hematoma was evaluated according to the image features.Follow-up CT in 24 h were performed to show the development of hemorrhage. Results In 89 cases of patients with emergent cerebral hemorrhage, 83 cases had made clear diagnosis according to CTA, then the patients received specialized clinical management.The causes of hemorrhage were not clear in 5 cases (5.6%), and subarachnoid hemorrhage was found in the most of these patients, requiring further examination.Twenty-two cases of unstable hematoma were found by CT scan, and hematoma enlarged in 16 cases in follow-up scan, with an accuracy of 72.2%.Fourteen patients were diagnosed as persistent bleeding hematoma by CTA, among them 13 patients showed hematoma enlargement, with an accuracy of 92.8%. Conclusions CT scan can only evaluate the stability of the hematoma, but the CTA high density in the hematoma strongly suggests persistent bleeding in the hematoma.Emergency doctors can analyze the cause of cerebral hemorrhage, assess the progression of disease, timely diagnose, locate the bleeding point by CTA, and there is important value in guidance of treatment and surgical methods.

目的 本项目主要探究关于妊娠期妇女肛肠疾病的患病现状和危险因素分析,为减少妇女在妊娠阶段肛肠疾病的发病几率,有效预防疾病发生提供参考建议。方法 本研究主要采用现况研究,以2020年5月1日—2021年5月在本院就诊的妊娠妇女患者633例作为研究对象。采用现况调查,对研究对象进行临床检查和问卷调查。临床检查为肛肠科检查,包括肛门视诊、肛门直肠指诊检查、肛门镜检查等。问卷调查主要包括五个部分,第一部分为基础资料,包括年龄,居住地(农村/城市),学历、怀孕次数,怀孕时间,流产次数;第二部分为饮食习惯;第三部分为生活习惯和方式;第四部分为肛肠疾病患病信息;第五部分为孕产妇心理焦虑调查量表。使用SPSS、SAS统计学软件对患者数据进行分析,使用t检验和单因素方差分析检测数据之间的差异性,使用多元Logistic回归对危险因素进行分析。结果 通过对妊娠妇女进行肛肠检查,根据临床肛肠疾病诊断标准得知,633名妊娠妇女中,共有437名,患病率为69.03%;根据疾病种类进行分类得知,单纯性疾病:便秘患者156例、痔疮患者105例、肛裂患者35例、肛周脓肿患者29例、直肠脱垂24例、直肠息肉15例、直肠阴道瘘10例;合并疾病:肛裂合并痔疮43例;肛肠类癌症疾病:无;根据数据分析结果得知:633名妊娠妇女中,共有437名,患病率为69.03%;根据差异性分析,肛肠疾病患病率在不同年龄、居住地、生产次数、流产次数、饮食习惯、运动量、饮酒史、焦虑状况等因素之间有统计学差异(P<0.05),在不同学历、吸烟史、睡眠时间之间无统计学差异(P>0.05);经过采用多元Logistic回归分析,结果显示,年龄、生产次数、流产次数、食物喜好、使用水果蔬菜的频率、每日运动量、饮酒史、焦虑状况等是造成妊娠期妇女肛肠疾病发病的独立危险因素。结论 造成妊娠期妇女肛肠疾病的发病的主要影响因素为年龄、居住地、怀孕次数、孕期、流产次数、饮食习惯、运动量、焦虑状况,应该针对以上因素进行防范,有效减少发病率。

目的 探究支气管镜下肺泡灌洗并局部使用阿米卡星治疗老年支气管扩张合并感染患者的疗效及对血清炎性因子水平的影响。方法 选取我院2018年3月—2019年5月确诊支气管扩张症、合并感染的符合纳入标准的患者共64例,按照1:1比例抽签分为2组,32例纳入观察组,应用支气管镜下肺泡灌洗阿米卡星治疗;32例纳入对照组,以单纯的支气管镜下肺泡灌洗治疗。观察并比较2组患者的治疗效果、血清炎性因子水平、肺功能情况等。结果 疗效比较显示观察组的96.9%总有效率高于对照组的75.0%(P＜0.05);血清炎性因子水平在患者用药前检测无差异(P＞0.05),经过治疗后,观察组水平均优于对照组P＜0.05;经治疗后,观察组静态肺活量、补呼气量、补吸气量、用力肺活量均优于对照组,差异具有统计学意义(P＜0.05)。结论 对老年支气管扩张合并感染患者应用支气管镜下肺泡灌洗阿米卡星治疗,促进临床效果改善,患者的症状、炎症及肺功能等指标均得到明显改善,值得推广。

Objective To investigate the efficacy of bronchoscopic alveolar lavage and local application of amikacin in the treatment of elderly patients with bronchiectasis complicated with infection and its effect on the level of serum inflammatory factors.Methods A total of 64 patients with bronchiectasis complicated with infection diagnosed in our hospital from March 2018 to May 2019 were selected.They were divided into two groups evenly by proportional drawing. Thirty-two cases were included in the observation group that were treated with bronchoscopic alveolar lavage with amikacin.The other 32 cases were included in the control group that were treated with the bronchoscopic alveolar lavage only.The therapeutic effect,serum inflammatory factor level and pulmonary function of the two groups were observed and compared.Results The total effective rate of 96.9% in observation group was higher than 75.0% in control group (P<0.05).There was no difference in the levels of serum inflammatory factors before treatment (P>0.05).After treatment,the levels of the observation group were better than those of the control group (P<0.05).After treatment,the slow vital capacity,expiratory reserve volume,inspiratory reserve volume and forced vital capacity of the patients in the observation group were better than those in the control group (P<0.05).Conclusions Bronchoscopic alveolar lavage of amikacin in elderly patients with bronchiectasis complicated with infection could improve the clinical effect.The symptoms of the patients,the serum inflammatory factors and lung function of the patients were significantly improved.The treatment is worthy of promotion.

目的 探讨应用三管引流法在防治直肠癌前切除术后吻合口漏中的疗效。方法 选取在我科2018年4月—2020年3月接受腹腔镜或者开腹直肠癌前切除术患者186例,将患者随机分为两组,研究组(三管引流法)96例,对照组(常规引流法)90例,进行对比研究。比较两组患者术后吻合口漏及恢复情况。结果 研究组患者吻合口漏发生率、非计划手术率、回肠造口率低于对照组(P＜0.05),吻合口漏患者中,研究组体温恢复正常时间、C反应蛋白(CRP)恢复正常时间及住院时间均少于对照组,差异均有统计学意义(P＜0.05)。结论 应用三管引流法,可预防直肠癌前切除术后吻合口漏,通过非手术治疗避免非计划二次手术,缩短吻合口漏患者恢复时间,显示更好的临床疗效。

Objective To explore and evaluate the clinical application value of three-tube drainage for the treatment of anastomotic leakage after low anterior resection for rectal cancer. Methods We retrospectively analyzed a total of 186 rectal cancer patients after low anterior resection for rectal cancer in our hospital from April 2018 to March 2020. According to the difference of prevention to anastomotic leakage, these patients were divided into two groups randomly that 90 cases used conventional drainage as control group, and 96 cases used three-tube drainage as study group. Postoperative recovery and anastomotic leakage were compared between these two groups. Results The rate of anastomotic leakage, ileostomy and unplanned reoperation of study group were lower than those of control group (P＜0.05).The times returned to normal of body temperature and C-reactive protein (CRP), the average length of stay in hospital of study group were shorter than those of control group respectively (P＜0.05). Conclusion The application of three-tube drainage may prevent anastomotic leakage and unplanned reoperation after low anterior resection for rectal cancer and shorten postoperative recovery time, to reveal better clinical effects.

目的 观察结直肠癌患者使用联合药物FOLFOX化疗前后左心室应变参数的变化。方法 选取健康人30例作为正常组,收集病理确诊为结直肠癌并采用FOLFOX(5-氟尿嘧啶+奥沙利铂+亚叶酸钙)化疗的患者30例,以自身对照做研究,分别在化疗前、化疗1个周期后、化疗6个周期后、化疗12个周期后48 h内完成心脏超声检查,采集左心室的动态图像,获取常规参数:LVEDd、LVEDs、IVSd、LVPWd、LVEDV、LVESV、LVEF、LVFS;三维参数:SPI、SV、CO、LVEDMass、LVESMass、GAS、GRS、GLS、GCS,并比较化疗前后这些数值的变化。结果 正常组与各化疗组相比对,LVEDd、LVEDs、IVSd、LVPWd、LVPW、LVESV、SPI的变化均无统计学意义(P>0.05);LVEF、LVFS、SV、CO在化疗中、后期出现了降低,差异有统计学意义(P<0.05),HR、LVEDMass、LVESMass略升高,差异有统计学意义(P<0.05);化疗后GLS及GAS较化疗前明显减低(P<0.05),其中GAS的ROC曲线下面积为0.883,P<0.001,选30%为诊断界点,灵敏度为86.7%,特异度为80%;GLS的ROC曲线下面积为0.888,P<0.001,选19%为诊断界点,灵敏度为73.3%,特异度为90.0%。结论 三维斑点追踪技术能够早期发现FOLFOX致结直肠癌患者左心室功能的变化,其中LVGLS、LVGAS是有力的观测指标。

Objective To observe the changes of left ventricular strain parameters in patients with colorectal cancer before and after combined chemotherapy with FOLFOX. Methods 30 healthy people were selected as normal group, and 30 patients with pathologically diagnosed colorectal cancer and FOLFOX (5-fluorouracil +oxaliplatin+calcium leucovorin) chemotherapy were collected. Before, after 1 cycle of chemotherapy, after 6 cycles of chemotherapy, and within 48 hours after 12 cycles of chemotherapy, cardiac ultrasound examination was performed, and dynamic images of the left ventricle were collected to obtain conventional parameters: LVEDd, LVEDs, IVSd, LVPWd, LVEDV, LVESV, LVEF, LVFS; three-dimensional parameters: SPI, SV, CO, LVEDMass, LVESMass, GAS, GRS, GLS, GCS, and the changes of these values before and after chemotherapy were compared. Results Compared with the chemotherapy group, the normal group had no statistically significant changes in LVEDd, LVEDs, IVSd, LVPWd, LVPW, LVESV, and SPI (P>0.05); LVEF, LVFS, SV, CO were in the middle and late stages of chemotherapy. There was a decrease, the difference was statistically significant (P<0.05), HR, LVEDMass, LVEESMass were slightly increased, the difference was statistically significant (P<0.05); LGS and GAS after chemotherapy were significantly lower than before chemotherapy (P<0.05), the area under the ROC curve of GAS is 0.883, P=0.000, 30% is selected as the diagnostic boundary, the sensitivity is 86.7%, and the specificity is 80%; the area under the ROC curve of GLS is 0.888, P=0.000, 19% as a diagnostic boundary, the sensitivity is 73.3% and the specificity is 90.0%. Conclusion Three-dimensional speckle tracking technology can detect the changes of left ventricular function in patients with colorectal cancer caused by FOLFOX in early stage, of which LVLGS and LVGAS are powerful observation indicators.

目的 探讨内镜黏膜下剥离术(ESD)治疗结直肠高级别上皮内瘤变(HGIN)的安全性及临床疗效。方法 回顾性分析2016年1月—2019年6月在南方医科大学附属小榄医院经肠镜活检诊断为结直肠HGIN并接受ESD治疗的56例患者的临床资料,记录每例病变的术后病理、整块切除率、治愈性切除率、手术并发症和随诊结果。结果 病灶平均直径为(2.28±0.76) cm。53例经ESD术完整切除,3例术中改用内镜下黏膜分片切除术切除,整块切除率为94.64％ (53/56)。术后病理51例HGIN,2例HGIN伴黏膜内癌,2例浸润性癌,术前活检与术后病理总符合率为92.86%(52/56),治愈性切除率为96.43%(54/56)。术中出血发生率为89.29%(50/56),术后迟发性出血发生率为3.57%(2/56)。术中穿孔发生率为5.36%(3/56),无术后迟发性穿孔病例。中位随访期为17个月,期间共1例患者复发。结论 ESD术治疗结直肠HGIN安全有效,但需警惕浸润性癌的可能。ESD术具有较高的术中出血和穿孔的风险,术者需具备熟练的操作技术及处理手术并发症的经验。

Objective To investigate the clinical efficacy and safety of endoscopic submucosal dissection (ESD) for colorectal high-grade intraepithelial neoplasia (HGIN). Methods Data of 29 patients diagnosed as colorectal HGIN and underwent endoscopic submucosal dissection (ESD) from January 2016 to June 2019 were retrospectively analyzed. Postoperative pathology, total en bloc resection rate, curative resection rate, complication and follow-up results were recorded. Results The mean diameter of the lesions was (2.28±0.76) cm. A total of 53 cases were successfully treated by ESD, 3 cases were changed using endoscopy piecemeal mucosal resection, the en bloc resection rate was 94.64% (53/56). Postoperative diagnosis confirmed 52 cases of HGIN, 2 cases of HGIN with intra-mucosal cancers and 2 case of invasive cancer,the overall consistency rate between preoperative biopsies and postoperative pathological diagnosis was 92.86% (52/56), the curative resection rate was 96.43% (54/56). The incidence of intro-operative bleeding and postoperative delayed bleeding was 89.29% (50/56) and 3.57% (2/56) respectively. The incidence of intro-operative perforation was 5.36% (3/56) and no delayed perforation occurred. The median follow-up period was 17 months and one case recurred. Conclusion ESD is a safe and effective treatment for colorectal HGIN, but invasive cancer must be cautioned. ESD has high risk of intro-operative bleeding and perforation, therefore, the surgeon must have skilled operation and treatment experience for complications.

目的 探讨个体化低速率对比剂注射方案联合低管电压扫描在低体质量指数(body mass index,BMI)受检者头颈部CT血管成像的可行性。方法 选取我科2020年1月—2020年11月低BMI受检者头颈部CTA检查90例进行研究,随机分成三组,每组30例。A组80 kV扫描,低流速、低总量注射方案; B组120 kV扫描,高流速、低总量注射方案;C组为120kV扫描条件,高流速、高总量注射方案。对比各组注射流速、注射总量、辐射剂量长度乘积(dose legth product,DLP),评价各组图像的主动脉弓、颈总动脉、基底动脉、胸锁乳突肌中段的CT值、信噪比及对比信噪比,由两名有经验的放射科医生对各组图像质量进行主观评价。结果 图像质量主观评价A、B两组图像评分集中在4分段,C组图像评分集中在3分段,A、B组与C组主观评分比较差异有统计学意义(P<0.05)。A组对比剂注射流速和DLP比B、C组分别下降27.75%、47.10%;A、B组对比剂注射总量较C组下降39.87%,差异有统计学意义(P<0.05)。A组各血管CT值对应比B、C组数值稍高,除主动脉弓CT值外其余血管客观参数对比均有差异(P<0.05)。结论 低BMI受检者头颈部CT血管个体化低流速精准对比剂注射方案联合低管电压扫描技术在获得满足诊断要求图像质量的前提下,既能降低受检者对比剂注射速率和注射风险,又能降低辐射剂量,值得推广应用。

Objective To explore the feasibility of individualized low rate contrast agent injection scheme combined with low tube voltage scanning in CTA imaging of low body mass index(BMI) subjects' head and neck. Methods Ninety cases of head and neck CTA examination of low BMI subjects in our department from January 2020 to November 2020 were selected for the study, and randomly divided into three groups with 30 cases in each group. Group A applied 80 kV scanning, low flow rate and low total volume injection scheme. Group B applied 120 kV scanning, high flow rate, low total volume injection scheme. Group C applied 120 kV scanning, high flow rate and high total volume injection scheme. The injection velocity, injection volume, radiation dose length product (DLP) among three groups were compared. In each image of the aortic arch, common carotid artery, basilar artery and the central part of sternocleidomastoid, the CT value, the signal-to-noise ratio and contrast-to-noise ratio were evaluated. Two experienced radiologists performed image quality evaluation. Results Image quality in group A and B by subjective evaluation got 4 points out of 4, and group C got 3 points out of 4, and there was statistical difference between group A, B and C in subjective evaluation of image quality (P<0.05). The injection velocity and DLP of contrast agent in group A were 27.75% and 47.10% lower than those in group B and C, respectively. The total amount of contrast agent injection in groups A and B was decreased by 39.87% compared with group C, with statistical difference (P<0.05). The corresponding CT values of each vessel in group A were slightly higher than those in group B and C, and there were statistically significant differences in the Objective parameters of other vessels except for aortic arch (P<0.05). Conclusion The combination of individualized low flow rate and precise contrast agent injection scheme with low tube voltage scanning technology for low BMI subject could not only reduce the injection rate and risk of contrast agent, but also reduce radiation dose, on the premise of meeting the diagnostic requirements of image quality. It is worthy of popularization and application.

目的 了解石岐区户籍居民2019年死因分布和主要死因对预期寿命的影响,为调整疾病控制战略方向提供支撑。方法 对2019年石岐区户籍居民死因数据进行基于国际通用编码ICD-10的分类,通过计算预期寿命、死亡率、去死因预期寿命变化、标准化死亡率、寿命损失率和潜在寿命损失年数对死因数据进行研究与分析。结果 石岐区户籍居民2019年粗死亡率为636.88/10万,每10万男性和女性分别平均死亡706.39人和569.86人,恶性肿瘤、心脏病、脑血管病、呼吸系统疾病和内分泌营养代谢疾病为前五位死亡原因。恶性肿瘤中肺癌、肝癌和结肠直肠肛门癌的死亡率位列前三,心脏病中缺血性心脏病死亡率最高。撇除死因的影响后,增加预期寿命的前三名分别是恶性肿瘤(4.40岁)、心脏病(2.76岁)和脑血管病(1.79岁)。2019年石岐区潜在寿命损失年数为10 001.32人年,减寿率为58.64‰,恶性肿瘤、损伤和脑血管病是潜在寿命损失年数前三位死因,减寿率分别为27.80‰、7.72‰和5.18‰。结论 恶性肿瘤、心脏病和脑血管病是石岐区户籍居民的主要死因,也是造成2019年石岐区户籍居民寿命损失的最主要疾病,并造成沉重的疾病负担,应作为今后的防控重点,政府需采用综合性的防控措施,降低慢性病的危害,保护居民健康。

Objective To analyze the distribution characteristics of death causes and influence of major death causes on life expectancy of Shiqi district in 2019, and provide support to develop strategies for disease prevention and control. Methods The 2019 death causes of residents in Shiqi district were classified by International Classification of Diseases-10 (ICD-10). The life expectancy, mortality rate, cause eliminated life expectancy, standardized mortality rate, potential years of life lost rate (PYLLR), and potential years of life lost (PYLL) were calculated. Results The mortality of residents of Shiqi district in 2019 was 636.88/10⁵. The male mortality and female mortality were 706.39/10⁵and 569.86/10⁵, respectively. The top five causes of death in Shiqi district were malignant tumors, heart diseases, cerebrovascular diseases, respiratory diseases, and endocrine nutrition and metabolic diseases. The malignant tumors with top three death rates were lung cancer, liver cancer, and colorectal and anal cancer. The highest death rate of heart disease was ischemic heart disease. The top three causes shortening life expectancy were malignant tumors(4.40 years), heart diseases(2.76 years), and cerebrovascular diseases (1.79 years). The PYLL was 10 001.32 person-year, the PYLLR was 58.64‰ in Shiqi distric,2019. The top three causes of life loss were malignant tumors, injury and cerebrovascular diseases. The PYLLR of those three death causes were 27.80‰, 7.72‰, and 5.18‰, respectively. Conclusion Malignant tumors, heart disease and cerebrovascular diseases were the main death causes and the major diseases for life lost of residents in Shiqi district, which caused heavy disease burden and should be focused in the future. For protecting the residents from the harm due to chronic non-communicable diseases, comprehensive preventive and controling measures should be taken by government.

目的 通过生物信息学方法,分析阿司匹林抗结直肠癌的作用机制。方法 在DrugBank 5.1.5中查找阿司匹林的直接作用蛋白靶点(direct protein targets,DPTs);构建阿司匹林DPTs的蛋白质-蛋白质相互作用(protein-protein interaction,PPI)网络并分析相关信号通路;从GEO数据库中获取结直肠癌表达谱芯片数据,筛选中心度最高的20个结直肠癌差异表达基因作为Hub基因;将DPTs相互关联基因与结直肠癌Hub基因求交集,确认阿司匹林抗结直肠癌的潜在作用靶点,分析其在TCGA数据库结肠腺癌样本中的表达情况,并进行GO功能富集分析和KEGG信号通路分析。最终通过RT-PCR和WB实验验证阿司匹林抗结直肠癌的潜在靶点。结果 在DrugBank 5.1.5中确定了11个阿司匹林DPTs,KEGG信号通路分析发现其中6个DPTs(EDNRA,IKBKB,NFKB2,NFKBIA,PTGS2,TP53)与癌症的发生发展有关。将DPTs相关联基因与筛选的20个结直肠癌Hub基因求交集,发现5个基因(CDK1,AURKA,CCNB1,MAD2L1,TPX2)可能是阿司匹林抗结直肠癌的潜在作用靶点,其在TCGA数据库结肠腺癌样本中均表达上调,基因功能主要富集于细胞周期调控。RT-PCR和WB实验结果显示阿司匹林可以降低人结肠癌细胞中CDK1,AURKA,CCNB1,MAD2L1,TPX2的mRNA水平和蛋白表达。结论 CDK1,AURKA,CCNB1,MAD2L1,TPX2可能是阿司匹林抗结直肠癌的潜在靶点,其可能通过影响细胞周期调控发挥抗肿瘤作用。

Objective To analyze the mechanism of aspirin against colorectal cancer(CRC)by bioinformatic analysis. Methods DrugBank 5.1.5 was used to identify direct protein targets (DPTs) of aspirin. The protein-protein interaction (PPI) network of DPTs was constructed and involved signaling pathways were analyzed. CRC-associated gene expression datasets were downloaded from GEO database, and the top twenty differentially expressed genes with the highest degree were screened out as Hub genes. Common genes between the genes associated with the DPTs and the Hub genes of CRC were the potential targets of aspirin against CRC. The potential targets in TCGA database colon adenocarcinoma (COAD) samples were examined. GO functional enrichment analysis and KEGG signaling pathway analysis of the potential targets were performed. The potential targets of aspirin against CRC cells were verified by reverse transcription-polymerase chain reaction (RT-PCR) and western blot (WB). Results Eleven DPTs of aspirin were identified in DrugBank 5.1.5. KEGG signaling pathway showed that 6 genes (EDNRA, IKBKB, NFKB2, NFKBIA, PTGS2, TP53) were associated with the occurrence and development of CRC. By intersecting 20 Hub genes of CRC with genes associated with the DPTs of aspirin, it was found that 5 genes (CDK1, AURKA, CCNB1, MAD2L1, TPX2) might be the potential targets of aspirin against CRC. They were all up-regulated in TCGA-COAD samples, and the gene functions were mainly enriched in cell cycle regulation. The results of RT-PCR and WB showed that aspirin could down-regulate the mRNA and protein expression levels of CDK1, AURKA, CCNB1, MAD2L1 and TPX2 in human colon cancer cells respectively. Conclusion CDK1, AURKA, CCNB1, MAD2L1 and TPX2 could be potential targets of aspirin against CRC by affecting the progress of cell cycle regulation.