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Improvement of lenvatinib-induced nephrotic syndrome after adaptation to sorafenib in thyroid cancer:A case report
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作者 Che Hseuh Yang Kuo Tung Chen +3 位作者 Yi Sheng Lin Chao Yu Hsu Yen Chuan Ou Min Che Tung 《World Journal of Clinical Cases》 SCIE 2020年第20期4883-4894,共12页
BACKGROUND Target therapy is licensed by United States Food and Drug Administration on certain cancers.Both sorafenib and lenvatinib are tyrosine kinase inhibitor and indicated on radioactive iodine(RAI)-refractory di... BACKGROUND Target therapy is licensed by United States Food and Drug Administration on certain cancers.Both sorafenib and lenvatinib are tyrosine kinase inhibitor and indicated on radioactive iodine(RAI)-refractory differentiated thyroid cancer(DTC).Lenvatinib is more effective in cancers'control than sorafenib,but causes more nephrotoxicity than sorafenib does.This case is the second published case about the serial adaptions from lenvatinib to sorafenib for improving the proteinuria and,meanwhile,achieving the therapeutic goal.CASE SUMMARY A 56-year-old man suffered from bilateral edematous lower extremities after 1-mo prescription of lenvatinib of 20 mg/d for RAI-refractory DTC.Aside from this symptom,he also developed hypertension.His laboratory showed grade-3 proteinuria(estimated 24-h urine protein:9993 mg),hypoalbuminemia and hypercholesterolemia.Anti-vascular endothelial growth factor(VEGF)therapyinduced nephrotic syndrome was impressed.After reduced dosage of lenvatinib of 10 mg/d and related symptomatic drugs,limited improvement was observed in both adverse effects and caner control.Under this condition,we substituted sorafenib of 400 mg/d for lenvatinib of 10 mg/d.After a 5-mo prescription,not only hypertension and peripheral edema were greatly improved,but also proteinuria was improved from grade three to grade one(estimated 24-h urine protein:962 mg).At the same time the cancer control was achieved,judged from computed tomography and laboratory evidence[thyroglobulin(Tg)before prescription of sorafenib:354.7 ng/m L;Tg after prescription of sorafenib:108.9 ng/m L].CONCLUSION Adaption from lenvatinib to sorafenib is a feasible method to improve the antiVEGF therapy-induced nephrotic syndrome and achieve the therapeutic goal at the same time. 展开更多
关键词 Molecular targeted therapy/methods receptors Vascular endothelial growth factor/drug effects Vascular endothelial growth factor/therapeutic use Vascular endothelial growth factor A/drug effects Nephrotic syndrome/drug therapy Case report
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糖皮质激素受体信号通路在膀胱癌治疗中的作用研究进展
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作者 封盛 陈继军 郑一春 《浙江大学学报(医学版)》 CAS CSCD 北大核心 2016年第6期655-660,共6页
糖皮质激素受体(GR)是核受体家族中的一员,结合配体后的受体会从细胞质中转位进入细胞核,通过对相关基因转录信号的调控发挥生物学作用。临床上,使用糖皮质激素产生的治疗效果和不良反应几乎都是通过GR信号通路实现的。越来越多的... 糖皮质激素受体(GR)是核受体家族中的一员,结合配体后的受体会从细胞质中转位进入细胞核,通过对相关基因转录信号的调控发挥生物学作用。临床上,使用糖皮质激素产生的治疗效果和不良反应几乎都是通过GR信号通路实现的。越来越多的研究表明,GR信号通路与膀胱癌的增殖、侵袭性和预后密切相关,而新一代GR选择性激动剂在提升糖皮质激素抗肿瘤作用的基础上,大大减少了不良反应,有望成为膀胱癌治疗的新方法。 展开更多
关键词 膀胱肿瘤/药物疗法 受体 糖皮质激素/治疗应用 信号传导 转录 遗传 综述
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Efficacy of Sishen Wan(四神丸) on dinitrobenzene sulfonic acid-induced ulcerative colitis and its effect on toll-like receptor 2/interleukin-1 receptor-associated kinase-4/nuclear factor-κB signal pathway 被引量:7
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作者 ZHANG Zhaohua LIU Rong +1 位作者 DU Nana ZHU Xiangdong 《Journal of Traditional Chinese Medicine》 SCIE CSCD 2022年第4期565-575,共11页
OBJECTIVE:To investigate the therapeutic effect of Sishen Wan(四神丸,SSW)on ulcerative colitis(UC)induced by dinitrobenzene sulfonic acid and its effect on toll-like receptor 2/interleukin-1 receptor-associated kinase... OBJECTIVE:To investigate the therapeutic effect of Sishen Wan(四神丸,SSW)on ulcerative colitis(UC)induced by dinitrobenzene sulfonic acid and its effect on toll-like receptor 2/interleukin-1 receptor-associated kinase-4/nuclear factor-κB(TLR2/IRAK4/NF-κB)signaling pathway in colonic tissue.METHODS:In this study,120 Sprague–Dawley rats were randomly divided into blank and model groups.The experimental UC model in rats was established by subcutaneous injection of hydrocortisone+senna gavage for 21 d+dinitrobenzene sulfonic acid(DNBS)/ethanol solution enema.The successful model rats were randomly divided into the model group;mesalazine(0.36 g/kg)group;and high-,medium-,and low-dose SSW(24,12,and 6 g/kg)groups.The model and blank groups were gavaged with equal volumes of distilled water once a day for 21 d.The general condition of the rats was observed,and the body mass,fecal properties,and occult blood were recorded for calculating the disease activity index(DAI)score.The colonic tissue of the rats was collected,and its general morphology and pathological form were noted for obtaining the colonic mucosal injury index(CMDI)score.Hematoxylin-eosin staining was used to view the pathological changes of the colon tissue in each group,apoptosis of the cells was detected using terminal deoxynucleotidyl transferase-mediated d UTP nick-end labeling staining,and quantitative real-time polymerase chain reaction was used to measure the expressions of TLR2,myeloid differentiation primary response gene 88(My D88),IRAK4,and NF-κB p65 mRNA in the colon tissue.The expressions of TLR2,My D88,IRAK4,and NF-κB p65 protein were detected using western blotting and immunohistochemistry assay,and the levels of interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α)in the colon tissue were determined using enzyme linked immunosorbent assay.RESULTS:Compared with the blank group,the general condition of the model group was relatively poor.The DAI and CMDI scores of the model group increased significantly(P<0.01),the glands and intestinal mucosa disappeared partially,and several inflammatory cells infiltrated and gathered in the mucosal layer and base layer of the rats in the model group.Furthermore,the cell apoptosis and expression levels of TLR2,My D88,IRAK4,and NF-κB p65 mRNA and protein in the colon tissue of rats in the model group increased significantly(P<0.01).The levels of IL-1βand TNF-αincreased significantly in the colon tissue of rats in the model group(P<0.01).After treatment with SSW,compared with the model group,the general condition of the UC rats improved.Moreover,the DAI and CMDI scores of the UC rats decreased significantly(P<0.05),and the pathological changes in the colon tissue of the UC rats tended to be normal.The cell apoptosis and expression levels of TLR2,My D88,IRAK4,and NF-κB p65 mRNA and protein in the colon tissue of the UC rats decreased gradually(P<0.01),and the levels of IL-1βand TNF-αdecreased significantly(P<0.01).CONCLUSION:SSW can improve the general condition and alleviate the intestinal mucosal injury of UC model rats.Additionally,SSW can inhibit the TLR2/IRAK4/NF-κB signaling pathway,but further studies are required to confirm it. 展开更多
关键词 colitis ulcerative toll-like receptor 2 interleukin-1 receptor-associated kinases NF-kappa B signal transduction therapeutic uses Sishen Wan
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补益肺肾加减方联合β_(2)受体激动剂对支气管哮喘的治疗效果及肺功能影响
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作者 王清江 王利江 李振云 《慢性病学杂志》 2021年第12期1799-1803,共5页
目的探讨补益肺肾加减方联合β_(2)受体激动剂对支气管哮喘(以下简称哮喘)的治疗效果及肺功能影响。方法选取新乡医学院第一附属医院2019年12月至2020年12月收治的78例哮喘患者作为研究对象,根据随机数字表法分为两组,每组39例。给予对... 目的探讨补益肺肾加减方联合β_(2)受体激动剂对支气管哮喘(以下简称哮喘)的治疗效果及肺功能影响。方法选取新乡医学院第一附属医院2019年12月至2020年12月收治的78例哮喘患者作为研究对象,根据随机数字表法分为两组,每组39例。给予对照组常规糖皮质激素治疗,观察组在对照组治疗基础上应用补益肺肾加减方联合β_(2)受体激动剂治疗。对两组治疗前和治疗4周后的血氧分压(oxygen partial pressure,PaO_(2))、血二氧化碳分压(carbon dioxide partial pressure,PaCO_(2))、氧饱和度(oxygen saturation,SaO_(2))水平和肺功能水平进行比较。结果观察组的治疗总有效率为94.87%,显著高于对照组的79.49%,差异有统计学的意义(P<0.05)。两组患者治疗前PaO_(2)、PaCO_(2)、SaO_(2)指标比较,差异无统计学意义(P>0.05);治疗后观察组PaO_(2)、SaO_(2)水平高于对照组,PaCO_(2)水平低于对照组,差异有统计学的意义(P<0.05)。治疗前两组肺一氧化碳弥散量(carbon monoxide diffusing capacity,DLCO)、残气容积与总肺容积比(residual volume/total lung capacity,RV/TLV)以及第1秒用力呼气容积与用力肺活量比(forced expiratory volume in one second/forced vital capacity,FEV1/FVC)指标比较,差异无统计学意义(P>0.05);治疗后观察组DL-CO、FEV1/FVC显著高于对照组,RV/TLV显著低于对照组,差异有统计学意义(P<0.05)。治疗前两组精神健康、情感职能、社会功能、活力、躯体疼痛、生理职能、生理功能、总体健康相关生活质量评分比较,差异无统计学意义(P>0.05);治疗后观察组生活质量评分明显高于对照组,差异有统计学的意义(P<0.05)。治疗期间,观察组的不良反应发生率为17.95%,与对照组的25.64%比较,差异无统计学意义(P>0.05)。结论对哮喘患者在常规止咳平喘、抗感染、糖皮质激素等常规治疗基础上,应用补益肺肾加减方联合β_(2)受体激动剂中西医结合方式进行治疗,能够减轻患者的临床症状,减少发作频率,提升治疗效果,而且能够有效改善患者肺功能,提升患者生活质量,且不会增加不良反应,安全性较好。 展开更多
关键词 支气管哮喘 补益肺肾加减方 β_(2)受体激动剂 糖皮质激素 治疗效果 肺功能
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