目的比较应用瑞芬太尼及氯胺酮行全身麻醉对血小板减少产妇剖宫产术效果及新生儿的影响。方法选择在全身麻醉下行剖宫产术的合并血小板减少产妇120例,随机分成氯胺酮组和瑞芬太尼组各60例。氯胺酮组产妇采用氯胺酮进行麻醉诱导,瑞芬太...目的比较应用瑞芬太尼及氯胺酮行全身麻醉对血小板减少产妇剖宫产术效果及新生儿的影响。方法选择在全身麻醉下行剖宫产术的合并血小板减少产妇120例,随机分成氯胺酮组和瑞芬太尼组各60例。氯胺酮组产妇采用氯胺酮进行麻醉诱导,瑞芬太尼组产妇采用瑞芬太尼进行麻醉诱导。比较两组产妇围术期相关指标,气管插管前(T0)、气管插管时(T1)、皮肤切开时(T2)以及拔管时(T3)的平均动脉压和心率,以及新生儿出生后1 min、5 min、10 min Apgar评分及脐动脉血气分析指标。记录产妇在麻醉过程的不良反应发生情况。结果两组产妇的手术时间、术中出血量、拔管所需时间、离室所需时间差异均无统计学意义(均P>0.05)。在T0时点,两组产妇的平均动脉压以及心率差异无统计学意义(P>0.05);在T1、T2、T3时点,瑞芬太尼组产妇的平均动脉压及心率均低于氯胺酮组(均P<0.05)。氯胺酮组产妇T1、T2、T3时点的平均动脉压、心率均高于T0时点(均P<0.05);瑞芬太尼组产妇T1、T2、T3时点的平均动脉压、心率与T 0时点比较,差异均无统计学意义(均P>0.05)。两组新生儿出生后1 min、5 min以及10 min Apgar评分及脐动脉血pH值、PaCO2、PaO2,氧饱和度差异无统计学意义(均P>0.05)。两组产妇麻醉过程均未发生不良反应。结论对于合并血小板减少的产妇,瑞芬太尼和氯胺酮均可用于全身麻醉下行剖宫产,对新生儿无不利影响;但与氯胺酮相比,瑞芬太尼更利于产妇血流动力学稳定。展开更多
2018年3月8?9日,中国临床肿瘤学会(Chinese Society of Clinical Oncology,CSCO)和中国抗癌协会肺癌专业委员会联合主办了第15届“中国肺癌高峰论坛”。本次论坛的主题为“聚焦中枢神经系统转移:精确诊断,精准治疗”。晚期肺癌患者往往...2018年3月8?9日,中国临床肿瘤学会(Chinese Society of Clinical Oncology,CSCO)和中国抗癌协会肺癌专业委员会联合主办了第15届“中国肺癌高峰论坛”。本次论坛的主题为“聚焦中枢神经系统转移:精确诊断,精准治疗”。晚期肺癌患者往往合并脑转移,在1 000多例的肺癌尸检结果中,肺癌脑转移发生率23%~36%,是脑转移性肿瘤中最常见的类型,且通常预后较差[1]。目前肺癌脑(膜)转移的综合治疗管理和治疗结果,仍不令人满意,治疗效果不佳,中位总生存时间16个月,其中脑膜转移的患者则仅为4.5个月左右[2?5]。近10年肺癌的治疗出现了革命性的改变,但肺癌脑转移的诊断和治疗成了提高肺癌长期生存率的瓶颈。临床医师及科研工作者,应如何对脑转移进行准确及时的诊断?在众多的分型分类体系中,又该如何参考应用?如何全面地对脑转移患者的颅内/颅外病灶进行合理评估?对于伴有驱动基因敏感突变的脑转移患者群体,应怎样对待酪氨酸激酶抑制剂(tyrosine kinase inhibitor,TKI)治疗的定位和应用时机?随着血管生成抑制剂和免疫检查点Checkpoint抑制剂的应用发展,新的治疗选择在肺癌脑转移治疗应用中又该如何管理?以上都是肺癌脑转移综合管理中的疑点和难点,急需解答和形成共识以指导临床实践。本次肺癌高峰论坛,综合近年来发表的前瞻性及回顾性重要研究结果、结合我国肺癌脑转移治疗管理的实际情况,与会专家们就肺癌脑转移的综合管理进行了详细的讨论和各抒己见的争辩,最后达成了以下四点共识。展开更多
2017年3月3-4日，中国临床肿瘤学会（Chinese Society of Clinical Oncology，CSCO）和中国抗癌协会肺癌专业委员会联合主办了第十四届“中国肺癌高峰论坛”。本次论坛的主题是“精准与联合：共谱免疫治疗新乐章”。检查点抑制剂（Check...2017年3月3-4日，中国临床肿瘤学会（Chinese Society of Clinical Oncology，CSCO）和中国抗癌协会肺癌专业委员会联合主办了第十四届“中国肺癌高峰论坛”。本次论坛的主题是“精准与联合：共谱免疫治疗新乐章”。检查点抑制剂（Checkpoint inhibitor）因其对多肿瘤类别广泛的适用性及能带来持久的有效缓解，短期内在全球范围掀起了免疫治疗的狂潮。而在非小细胞肺癌患者中，免疫治疗同样带来了令人欣喜的临床获益。展开更多
Background Dihydropyrimidine dehydrogenase （DPD）, a key enzyme involved in the catabolism of 5-fluorouracil （5-FU）, is the attractive candidate for pharmacogenetic research on efficacies and toxicities of 5-FU. Th...Background Dihydropyrimidine dehydrogenase （DPD）, a key enzyme involved in the catabolism of 5-fluorouracil （5-FU）, is the attractive candidate for pharmacogenetic research on efficacies and toxicities of 5-FU. The aim of this study is to explore the association between polymorphisms of dihydropyrimidine dehydrogenase gene （DPYD） and clinical outcomes of gastric cancer patients treated with fluorouracil-based adjuvant chemotherapy in the Chinese population.展开更多
Background Platinum-based chemotherapeutics are the most common regimens for advanced non-small-cell lung cancer （NSCLC） patients, and genetic factors are thought to represent important determinants of drug efficacy...Background Platinum-based chemotherapeutics are the most common regimens for advanced non-small-cell lung cancer （NSCLC） patients, and genetic factors are thought to represent important determinants of drug efficacy. We prospectively assessed the status of the XPC Ala499Val and Lys939GIn gene polymorphisms and investigated whether these SNPs can predict the response to cisplatin/carboplatin-based regimens in advanced NSCLC patients in a Chinese population.Methods The treatment outcomes of 96 advanced NSCLC patients who were treated with platinum-based chemotherapy were evaluated. The polymorphic status of xeroderma pigmentosum group C （XPC） gene was genotyped by the 3-D polyacrylamide gel-based DNA microarray method.Results The distributions of XPC Lys939GIn genotypes differed significantly between the response group （complete ＋partial responses） and the non-response group （stable ＋ progressive disease; P=0.022）. The heterozygous A/C genotype carriers had a poorer response rate than the wild A/A genotype carriers in stage Ⅲ （OR, 0.074; 95% CI,0.008-0.704; P=0.023）. The XPC Ala499Val polymorphisms were not associated with response to platinum-based chemotherapy.Conclusion Polymorphisms of the XPC gene, Lys939GIn, may be a predictive marker of treatment response for advanced NSCLC patients in stage Ⅲ.展开更多
Background The cytosine arabinoside （Ara-C）-based chemotherapy is the major remedial measure for acute myeloid leukemia （AML）. Deoxycytidine kinase （DCK） and cytidine deaminase （CDA） are the key enzymes in the...Background The cytosine arabinoside （Ara-C）-based chemotherapy is the major remedial measure for acute myeloid leukemia （AML）. Deoxycytidine kinase （DCK） and cytidine deaminase （CDA） are the key enzymes in the metabolism of Ara-C. Many single nucleotide polymorphisms （SNPs） and haplotypes of DCK and CDA, which contribute to susceptibility to Ara-C, have been identified in Africans and Europeans. However, there has been no report about the relation among three SNPs in DCK （rs115543896, rs72552079, and rs111454937） and two SNPs in CDA （rs2072671 and rs60369023）, and their clinical response to Ara-C for a Chinese population. In this study, we aimed to investigate whether these five SNPs are associated with the therapeutic outcomes of Ara-C-based chemotherapy regimens in patients with AML. Methods A total of 151 Chinese patients with AML were enrolled in our study. SNPs genotyping were performed using the MassARRAY system by means of the matrix-assisted laser desorption ionization-time of flight mass spectrometry （MALDI-TOF-MS） method. Results The results illustrated that DCKrs111454937 AA genotype was more frequent in patients with higher platelet count, and A allele frequency was significantly higher in the group 〈40 years, lower white blood cell （WBC） count patients group and the group with platelet counts 〉60xl0e/L. Meanwhile, both DCKrs72552079 TC （OR=1.225, 95% C1=1.225-9.851, P=0.0192） and CDArs60369023 GA （OR=9.851,95% C1=1.31-77.93, ,~=-0.0263） significantly improved Ara-C-based chemotherapy response. While DCKrs11554389 AA （OR=0.147, 95% CI=0.027-0.801, P=0.0267） was associated with the decrease of Ara-C-based chemotherapy response. Conclusion It is evident that the DCK and CDA polymorphisms might be the important markers for the AML patients＇ therapy outcomes in a Chinese population.展开更多
文摘目的比较应用瑞芬太尼及氯胺酮行全身麻醉对血小板减少产妇剖宫产术效果及新生儿的影响。方法选择在全身麻醉下行剖宫产术的合并血小板减少产妇120例,随机分成氯胺酮组和瑞芬太尼组各60例。氯胺酮组产妇采用氯胺酮进行麻醉诱导,瑞芬太尼组产妇采用瑞芬太尼进行麻醉诱导。比较两组产妇围术期相关指标,气管插管前(T0)、气管插管时(T1)、皮肤切开时(T2)以及拔管时(T3)的平均动脉压和心率,以及新生儿出生后1 min、5 min、10 min Apgar评分及脐动脉血气分析指标。记录产妇在麻醉过程的不良反应发生情况。结果两组产妇的手术时间、术中出血量、拔管所需时间、离室所需时间差异均无统计学意义(均P>0.05)。在T0时点,两组产妇的平均动脉压以及心率差异无统计学意义(P>0.05);在T1、T2、T3时点,瑞芬太尼组产妇的平均动脉压及心率均低于氯胺酮组(均P<0.05)。氯胺酮组产妇T1、T2、T3时点的平均动脉压、心率均高于T0时点(均P<0.05);瑞芬太尼组产妇T1、T2、T3时点的平均动脉压、心率与T 0时点比较,差异均无统计学意义(均P>0.05)。两组新生儿出生后1 min、5 min以及10 min Apgar评分及脐动脉血pH值、PaCO2、PaO2,氧饱和度差异无统计学意义(均P>0.05)。两组产妇麻醉过程均未发生不良反应。结论对于合并血小板减少的产妇,瑞芬太尼和氯胺酮均可用于全身麻醉下行剖宫产,对新生儿无不利影响;但与氯胺酮相比,瑞芬太尼更利于产妇血流动力学稳定。
文摘2018年3月8?9日,中国临床肿瘤学会(Chinese Society of Clinical Oncology,CSCO)和中国抗癌协会肺癌专业委员会联合主办了第15届“中国肺癌高峰论坛”。本次论坛的主题为“聚焦中枢神经系统转移:精确诊断,精准治疗”。晚期肺癌患者往往合并脑转移,在1 000多例的肺癌尸检结果中,肺癌脑转移发生率23%~36%,是脑转移性肿瘤中最常见的类型,且通常预后较差[1]。目前肺癌脑(膜)转移的综合治疗管理和治疗结果,仍不令人满意,治疗效果不佳,中位总生存时间16个月,其中脑膜转移的患者则仅为4.5个月左右[2?5]。近10年肺癌的治疗出现了革命性的改变,但肺癌脑转移的诊断和治疗成了提高肺癌长期生存率的瓶颈。临床医师及科研工作者,应如何对脑转移进行准确及时的诊断?在众多的分型分类体系中,又该如何参考应用?如何全面地对脑转移患者的颅内/颅外病灶进行合理评估?对于伴有驱动基因敏感突变的脑转移患者群体,应怎样对待酪氨酸激酶抑制剂(tyrosine kinase inhibitor,TKI)治疗的定位和应用时机?随着血管生成抑制剂和免疫检查点Checkpoint抑制剂的应用发展,新的治疗选择在肺癌脑转移治疗应用中又该如何管理?以上都是肺癌脑转移综合管理中的疑点和难点,急需解答和形成共识以指导临床实践。本次肺癌高峰论坛,综合近年来发表的前瞻性及回顾性重要研究结果、结合我国肺癌脑转移治疗管理的实际情况,与会专家们就肺癌脑转移的综合管理进行了详细的讨论和各抒己见的争辩,最后达成了以下四点共识。
文摘2017年3月3-4日，中国临床肿瘤学会（Chinese Society of Clinical Oncology，CSCO）和中国抗癌协会肺癌专业委员会联合主办了第十四届“中国肺癌高峰论坛”。本次论坛的主题是“精准与联合：共谱免疫治疗新乐章”。检查点抑制剂（Checkpoint inhibitor）因其对多肿瘤类别广泛的适用性及能带来持久的有效缓解，短期内在全球范围掀起了免疫治疗的狂潮。而在非小细胞肺癌患者中，免疫治疗同样带来了令人欣喜的临床获益。
文摘Background Dihydropyrimidine dehydrogenase （DPD）, a key enzyme involved in the catabolism of 5-fluorouracil （5-FU）, is the attractive candidate for pharmacogenetic research on efficacies and toxicities of 5-FU. The aim of this study is to explore the association between polymorphisms of dihydropyrimidine dehydrogenase gene （DPYD） and clinical outcomes of gastric cancer patients treated with fluorouracil-based adjuvant chemotherapy in the Chinese population.
基金This work was supported by the grants from the Prophase Force-Study Program of the Jiangsu Province Natural Science Foundation （No. BK2005203）, the Medical Science Technology Research ＂Eleventh Five-Year＂ Program of the People＇s Liberation Army （No. 06MAlll）, and the Focal Project of Nanjing Medical Technology Development （No. ZKX05030）.
文摘Background Platinum-based chemotherapeutics are the most common regimens for advanced non-small-cell lung cancer （NSCLC） patients, and genetic factors are thought to represent important determinants of drug efficacy. We prospectively assessed the status of the XPC Ala499Val and Lys939GIn gene polymorphisms and investigated whether these SNPs can predict the response to cisplatin/carboplatin-based regimens in advanced NSCLC patients in a Chinese population.Methods The treatment outcomes of 96 advanced NSCLC patients who were treated with platinum-based chemotherapy were evaluated. The polymorphic status of xeroderma pigmentosum group C （XPC） gene was genotyped by the 3-D polyacrylamide gel-based DNA microarray method.Results The distributions of XPC Lys939GIn genotypes differed significantly between the response group （complete ＋partial responses） and the non-response group （stable ＋ progressive disease; P=0.022）. The heterozygous A/C genotype carriers had a poorer response rate than the wild A/A genotype carriers in stage Ⅲ （OR, 0.074; 95% CI,0.008-0.704; P=0.023）. The XPC Ala499Val polymorphisms were not associated with response to platinum-based chemotherapy.Conclusion Polymorphisms of the XPC gene, Lys939GIn, may be a predictive marker of treatment response for advanced NSCLC patients in stage Ⅲ.
文摘Background The cytosine arabinoside （Ara-C）-based chemotherapy is the major remedial measure for acute myeloid leukemia （AML）. Deoxycytidine kinase （DCK） and cytidine deaminase （CDA） are the key enzymes in the metabolism of Ara-C. Many single nucleotide polymorphisms （SNPs） and haplotypes of DCK and CDA, which contribute to susceptibility to Ara-C, have been identified in Africans and Europeans. However, there has been no report about the relation among three SNPs in DCK （rs115543896, rs72552079, and rs111454937） and two SNPs in CDA （rs2072671 and rs60369023）, and their clinical response to Ara-C for a Chinese population. In this study, we aimed to investigate whether these five SNPs are associated with the therapeutic outcomes of Ara-C-based chemotherapy regimens in patients with AML. Methods A total of 151 Chinese patients with AML were enrolled in our study. SNPs genotyping were performed using the MassARRAY system by means of the matrix-assisted laser desorption ionization-time of flight mass spectrometry （MALDI-TOF-MS） method. Results The results illustrated that DCKrs111454937 AA genotype was more frequent in patients with higher platelet count, and A allele frequency was significantly higher in the group 〈40 years, lower white blood cell （WBC） count patients group and the group with platelet counts 〉60xl0e/L. Meanwhile, both DCKrs72552079 TC （OR=1.225, 95% C1=1.225-9.851, P=0.0192） and CDArs60369023 GA （OR=9.851,95% C1=1.31-77.93, ,~=-0.0263） significantly improved Ara-C-based chemotherapy response. While DCKrs11554389 AA （OR=0.147, 95% CI=0.027-0.801, P=0.0267） was associated with the decrease of Ara-C-based chemotherapy response. Conclusion It is evident that the DCK and CDA polymorphisms might be the important markers for the AML patients＇ therapy outcomes in a Chinese population.
