不同制剂紫杉醇联合表柔比星治疗晚期乳腺癌的临床观察

目的探讨紫杉醇或白蛋白结合型紫杉醇联合表柔比星治疗晚期乳腺癌的临床疗效及不良反应。方法选取62例晚期乳腺癌患者,按照随机对照双盲的原则将其分为治疗组和对照组各31例,其中治疗组采用白蛋白结合型紫杉醇(260 mg/m^2)联合表柔比星(75 mg/m^2)治疗,对照组采用紫杉醇(175 mg/m^2)联合表柔比星(75mg/m^2)治疗。治疗2个周期后,观察比较两组患者的临床疗效及不良反应发生情况。结果治疗组的治疗总有效率93.5%(29/31)高于对照组的71.0%(22/31),差异具有统计学意义(χ~2=5.420,P=0.020)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论与紫杉醇联合多柔比星比较,白蛋白结合型紫杉醇联合表柔比星治疗晚期乳腺癌疗效好且不良反应可耐受。

米非司酮逆转人乳腺癌细胞MCF-7/ADR耐多柔比星机制的探讨

目的探讨米非司酮对乳腺癌耐药细胞株MCF-7/ADR的逆转耐药作用。方法以亲本乳腺癌细胞MCF-7和耐多柔比星(阿霉素)乳腺癌细胞MCF-7/ADR为研究对象,分别应用MIF进行干预后,流式细胞仪检测MIF作用前后瘤细胞P-gp的表达、细胞内阿霉素蓄积量的变化以及细胞周期的分布。结果 (1)10μmol/L MIF作用72小时后,MCF-7/ADR细胞P-gp表达率[(23.21±1.80)%]明显高于MCF-7细胞[(19.37±2.37)%,P<0.05]。(2)5μmol/L ADR处理后,MCF-7/ADR细胞内ADR蓄积量为(47.13±4.11)%,低于MCF-7细胞[(60.24±2.61)%,P<0.05]。(3)10μmol/L MIF联合5μmol/L ADR处理细胞,MCF-7/ADR和MCF-7细胞内ADR的蓄积量分别为(82.72±2.42)%及(88.63±2.75)%(P>0.05);但均较单用ADR时升高(均P<0.01)。(4)MIF作用前,MCF-7/ADR细胞G0/G1期比例[(77.21±3.10)%]高于MCF-7细胞G0/G1期比例[(59.05±2.16)%,P<0.05];MCF-7/ADR细胞S期比例明显低于MCF-7细胞(P<0.05)。经10μmol/L MIF作用后,MCF-7细胞G0/G1期比例(75.28±2.53)%较MIF作用前明显升高(P<0.05);S期比例则较MIF作用前显著降低(P<0.05);MCF-7/ADR细胞G0/G1期比例和S期比例分别为(80.13±2.72)%及(13.52±1.03)%,与MIF作用前比较差异均无统计学意义(均P>0.05);两种瘤细胞的G2/M期比例与MIF作用无关(P>0.05)。结论 (1)MIF可以逆转MCF-7/ADR的耐药性,其作用机制与降低细胞P-gp含量、增加细胞内ADR蓄积量有关。(2)10μmol/L浓度的MIF对MCF-7/ADR细胞周期分布影响不大。

乳腺癌新辅助化疗随机临床研究的初步结果

目的 :1)探讨NE方案作为乳腺癌新辅助化疗 (术前化疗 )的疗效及不良反应 ;2 )比较NE方案作为新辅助化疗和辅助化疗 (术后化疗 )对乳腺癌患者不良反应的差别。方法 :对原发肿块 >3cm的可手术乳腺癌患者采用单盲及随机对照的方法进行分组研究。新辅助化疗组术前予以 3个周期NE方案化疗 ,然后行改良根治术 ,术后再用NE方案化疗 3个周期。辅助化疗组先行改良根治术 ,术后用NE方案化疗 6个周期。结果 :新辅助化疗组CR 5 16例 (31 2 5 % ) ,PR 7 16例 (4 3 75 % ) ,总有效率 75 %。新辅助化疗组和辅助化疗组的主要严重不良反应分别为白细胞减少 (83 33%、88 2 4 % )、血小板减少(2 2 2 2 %、2 3 5 3% )、血红蛋白降低 (16 6 7%、17 6 5 % )、谷丙转氨酶升高和 或谷草转氨酶升高(11 11%、11 76 % )、恶心呕吐 (2 7 78%、2 3 5 3% )、腹痛和 或腹泻 (5 5 6 %、0 % )及脱发 (2 7 78%、35 2 9% ) ;两组的不良反应发生率差异无显著意义 ,P >0 0 5。结论 :NE作为乳腺癌的新辅助化疗方案具有良好疗效 ,不良反应可以耐受。

Combination of "low-dose" ribavirin and interferon alfa-2a therapy followed by interferon alfa-2a monotherapy in chronic HCV-infected nonresponders and relapsers after interferon alfa-2a monotherapy

AIM To report on the efficacy, safety and tolerability of interferon alfa-2a combined with a "low dose" of ribavirin for relapsers and non responders to alpha interferon monotherapy.METHODS Thirty-four chronic hepatitis C virus-infected non-responders to interferon alfa2a monotherapy (a course of at least 3 months treatment) and 13 relapsers to interferon alfa 2a monotherapy (a dose of 3 to 6 million units three times per week for at least 20 weeks but not more than 18 months) were treated with the same dose of interferon alfa-2a used before (3 to 6 million units three times per week) and ribavirin (10 mg/ kg daily) for 6 months. In complete responders, interferon alfa-2a was administered for further 6 months at the same dose used before as monotherapy.RESULTS Seven (20.6%) of 34 non-responders stopped the combined therapy due to adverse events, including two patients with histological and clinical Child A cirrhosis. In 17/27 (63%)non-responders, the combined therapy was stopped after three months because of non-response. Ten of the 27 non-responders completed the 1;2-month treatment course. At a mean follow up of 28 months (16- 37 months)after the treatment, 4/10 (15%) previous non-responders still remained complete responders,All 13 previous relapsers completed the 12-month treatment course. At a mean follow up of 22months (9 - 36 months) after treatment, 6/13(46%) the previous relapsers were stillsustained complete responders.CONCLUSION Our treatment schedule of the combined therapy for 6 months of interferon alfa2a with a low dose of ribavirin (10 mg/kg/day)followed by 6 months of interferon alfa-2amonotherapy is able to induce a sustainedcomplete response rate in 15% of non-responders and 46% of relapsers with chronic hepatitis C virus-related liver diseases comparable to those obtained with the standarddoses of ribavirin 1000 - 1200 mg/day.Randomized prospective controlled trials using lower total amounts of ribavirin in combination with interferon should be performed.

甲状腺原发性恶性淋巴瘤11例报告

目的:分析甲状腺原发性恶性淋巴瘤(primarythyroidlymphoma,PTL)的临床病理特点,探讨其较为合理的诊治方法。方法:对11例PTL患者的临床病理资料进行回顾性分析。所有患者都接受甲状腺腺叶切除或加颈淋巴结清除术,术后单纯化疗6例,联合放疗2例,余3例拒绝治疗。接受化疗的8例中,7例采用CEOP(环磷酰胺、表柔比星、长春新碱和泼尼松)方案,1例采用COMP(环磷酰胺、长春新碱、甲氨蝶呤和泼尼松)方案。结果:11例患者中除1例拒绝术后治疗失随外,10例随访3～92个月,平均28.5个月。术后化疗的8例均无瘤生存,其中2例已生存5年以上;拒绝治疗的另2例均于短期内复发,其中1例经化疗达完全缓解,1例因此死亡。结论:PTL似乎好发于60岁左右的女性,病理类型大多为B细胞来源的非霍奇金淋巴瘤(NHL),术后辅助化疗很重要。

TE与TC方案新辅助化疗治疗三阴乳腺癌的对比研究

目的比较TE与TC方案用于三阴乳腺癌(triple-negative breast cancer,TNBC)新辅助化疗的疗效及不良反应。方法收集术前接受新辅助化疗的三阴性乳腺癌患者82例,随机分为TE组和TC组。TE组接受紫杉醇联合表柔比星(44例),方案为:表柔比星75 mg/m2,d1;紫杉醇175 mg/m2,d2。TC组接受紫杉醇联合卡铂(38例),方案为:紫杉醇175 mg/m2,d1;卡铂AUC=5,d2。两组均21天为1周期,完成化疗2周期后疗效评定,决定是继续化疗还是手术治疗。结果除2例中途退出,所有患者均可评价疗效。TE组与TC组的有效率分别为66.7%(28/42)和65.8%(25/38)。其中常见的不良反应有骨髓抑制、恶心、呕吐、周围神经毒性,均可耐受,无化疗相关死亡。结论紫杉醇联合表柔比星与紫杉醇联合卡铂治疗三阴乳腺癌新辅助化疗的疗效相当,不良反应均可耐受。

时辰化疗治疗非小细胞肺癌的临床观察

为了对比观察CAP方案的时辰化疗与常规化疗的疗效及不良反应 ,对 72例非小细胞肺癌患者 ,用抽签法随机分为时辰化疗组与常规化疗组 ,两组患者的治疗时间不同 ,但用药剂量及化疗周期相同。结果时辰化疗组 3 8例 ,完全缓解率及总有效率分别为 18 4% ( 7/ 3 8)及 5 7 9% ( 2 2 / 3 8) ;常规化疗组 3 4例 ,分别为 2 9% ( 1/ 3 4)及 3 2 3 %( 11/ 3 4)。两组相比差异有统计学意义 ,P =0 0 0 5 6。时辰化疗组Ⅱ度以上的白细胞毒性、消化道毒性的发生率分别为 15 8% ( 6/ 3 8)、2 3 7% ( 9/ 3 8) ,而常规化疗组分别为 5 2 9% ( 18/ 3 4)、67 6% ( 2 3 / 3 4) ,两组相比差异有统计学意义 ,P<0 0 0 1。初步研究结果提示 ,用CAP方案时辰化疗治疗非小细胞肺癌疗效高、毒副反应小 ,明显优于常规化疗 ,且费用低 ,值得临床推广应用。

Effects of chitosan on dental bone repair

Objectives: Bone defects following tumor resection and osteolysis due to dental and bone lesions and periodentium tissue disorders are serious challenges. One of these materials used is chitosan, a derivative of crustaceans’ exoskeleton. The aim of this study was to assess effects of chitosan on socket repair after dental extraction. Methods: Twenty four dental sockets of 15-24 years old patients were visited by a maxillofacial surgeon for extracting premolar teeth for orthodontic purposes. The sockets in one side were filled-in by chitosan. In the other side, the sockets were left unfilled. After 10 weeks, periapical radiographs were obtained from the repair sites, were digitalized and then evaluated for densitometry using Adobe Photoshop Software. Each socket was divided into coronal, middle and apical. Dental density of each socket in case and control groups was recorded. The density of regenerated bone was compared against the maximum bone density of each individual. Wilcoxon signed range test and paired t-test were used for data analysis. Results: Bone density in middle and apical sections in case group was significantly more than control group. In apical section in case group regenerated bone reached up to 98.2% of normal bone density. In each patient, the bone density in epical and middle sections was increase 29.3% and 10.8% of normal bone density. Conclusions: Chitosan significantly increased bone density in epical and middle sections. Chitosan can be used for bone repair in cases of bone loss. Various densitometry studies for evaluating chitosan effects in different bone defects are suggested.

“No Need to Get Salty” Or Is There? Sodium Functionality as a Consideration in Nutrition Public Health Policy

Aim: Public health professionals focus on both downstream (individual) and upstream (population-level) interventions to reduce sodium consumption and prevent sodium-related chronic diseases. Effective upstream interventions specifically aimed at reducing dietary sodium intake include the implementation of comprehensive nutrition standards that restrict the amount of sodium contained in foods available for purchase. The aim of this work was to identify sought-after foods that did not meet the Philadelphia Nutrition Standards’ sodium limits and reformulate those foods to be standards-compliant and consumer-acceptable. Subject and Methods: Two foods were reformulated for compliancy with the Philadelphia Nutrition Standards’ sodium limits and consumer acceptability: the hoagie roll and soft pretzel. Reformulation included sensory testing and engaging potential manufacturing partners to investigate products’ commercial potential. Results: While hoagie roll reformulation led to a local company manufacturing and selling the reformulated product, soft pretzel reformulation stalled due to lack of consumer acceptability of the reformulated product. Salt contributes desirable characteristics in the texture, taste, and appearance of the soft pretzel, the absence of which consumers found unacceptable. Conclusion: Product reformulation holds great potential to create lower-sodium foods that otherwise have all of the characteristics of the higher-sodium “original” products but requires an understanding of the role of salt in product recipes. Reducing salt without considering its multiple functions in food may result in a product that is unacceptable or even unsafe. A simple four-step tool can help public health practitioners evaluate the extent to which products are suitable for reformulation.

不同途径给表阿霉素及联用血液灌流的临床意义

目的探讨不同途径给表阿霉素（ＥＰＩ）的优劣和血液灌流（ＤＨＰ）对ＥＰＩ的吸附能力．方法观察肝癌患者肝动脉和外周静脉持续输注ＥＰＩ后外周血浆ＥＰＩ浓度的改变，并应用ＤＡＣｒｅｓｉｎＤＨＰ吸附ＥＰＩ的临床研究．结果肝动脉给药能明显降低外周血浆ＥＰＩ浓度（１５，３５ｍｉｎＥＰＩ浓度分别为３７３μｇ／Ｌ±１１３μｇ／Ｌｖｓ７６６μｇ／Ｌ±２６４μｇ／Ｌ，Ｐ＜００１，３３９μｇ／Ｌ±９７μｇ／Ｌｖｓ５２１μｇ／Ｌ±１０６μｇ／Ｌ，Ｐ＜００５），显著降低血浆高峰浓度（μｇ／Ｌ，５１５±１６３ｖｓ９００±８４，Ｐ＜００１）；而两组浓度曲线下面积（ＡＵＣ）的差别不明显（１∶１０５）．ＤＡＣｒｅｓｉｎＤＨＰ对ＥＰＩ有明显吸附性能，吸附率达６７％．结论局部给抗癌药优于全身给药，ＤＡＣｒｅｓｉｎＤＨＰ对ＥＰＩ有明显吸附性能．