Interaction between cisplatin,5-fluorouracil and vincristine on human hepatoma cell line (7721)

AIM To evaluate the killing effects of CDDP, 5-Fu and VCR on human hepaoma cell line (7721).METHODS The median-effect principle was used.RESULTS Killing effects of the individual drug were enhanced as the median concentration increased. Antagonism was produced when two drugs were used at a higher concentration (CI＞1), and synergism was achiened when CI＜1. Finally, the effect was influenced by both the ratios of drug concentration and the sequence of administration.CONCLUSION The drug administration order and drug concentrations are significant factors that need to be considered in clinical practice.INTRODUCTIONThe combined chemotherapy for malignant carcinoma is desired to produce efficacious synergism between each drug, alleviate side effects of drugs and delay drug resistance. Clinically, the interaction (namely synergism, summation and antagonism) of different anticancer drugs in combination is usually evaluated by Chou-Talalay′s combination index (i.e., median-effect principle)[1-9]. In this paper the combination effect between Cisplatin (Cis), 5-Fluorouracil (5-Flu) and Vincristine (VCR) on human hepatoma cell line 7721, was analyzed in vitro.

Preparation of anti-resistant stealthy liposomes by incorporating vincristine with quinacrine and the pharmacokinetics in Sprague-Dawley rats

Aim The objectives of the present study were to prepare stealthy vincristine plus quinacrine liposomes and evaluate the pharmacokinetics in Sprague-Dawley rats. Methods Anti-resistant stealthy liposomes were prepared by incorporating vincristine with quinacrine together using the ammonium sulfate gradient loading procedure. For the pharmacokinetic study, Sprague-Dawley rats were divided into two groups： each rat in the Group Ⅰwas administered intravenously via tail vein as stealthy liposomal vincristine plus quinacrine, and the Group Ⅱ similarly given as a mixture solution of free vincristine plus free quinacrine. The concentrations of vincristine and quinacrine in plasma were measured by HPLC with diode array detection and fluorescence detection, respectively. Results The mean particle size of stealthy liposomes was 135.9 ±7.1 nm and the encapsulation efficiencies of stealthy liposomes were 〉 90% for vincristine, and 〉 85% for quinacrine, respectively. Administered as the stealthy vincristine plus quinacrine liposomes, the plasma exposures of both vincristine and quinacrine were significantly extended, and the mean concentrations of both vincristine and quinacrine were significantly higher compared to those given as the mixture solution of free vincristine plus free quinacrine. The Cmax, t1/2, AUC0-24 h values of vincristine for stealthy liposomal group were significantly increased, but the total clearance Cl values decreased, as compared to those of free drug group, respectively. Similarly, the Cmax, t1/2 and AUC0-24 h values of quinacrine for the stealthy liposomal group were significantly increased, but the total clearance C1 values decreased, as compared to those of free quinacrine. Conclusion The anti-resistant stealthy liposomes are successfully prepared by incorporating vincristine with quinacrine, and the liposomes extend significantly the duration in blood circulation and improve evidently the plasma concentrations of both vincristine and quinacrine.

Folic acid-conjugated liposomal vincristine for multidrug resistant cancer therapy

We encapsulated vincristine into folic acid-conjugated PEGylated liposomes to improve the anti-tumor efficacy on multidrug resistant cancers.It was observed that the drug delivery system we constructed exhibited maximum cytotoxicity on KBv200 cells(multidrug resistant variant)compared with any other formulations.The semi-quantitative analysis of region of interest revealed that there was a great increase in area under curve(AUC)of a near-infrared fluorescein in solid tumors due to folic acid-mediated accumulation.Folic acid-conjugated PEGylated liposomes showed a significant tumor growth inhibiting effect in vitro and in vivo.TUNEL assay revealed that folic acid-conjugated PEGylated liposomes could induce cell apoptosis much more greatly than others.This study demonstrated that it had potential application prospective for the treatment of multidrug resistant cancer.

Mechanism of all-transretinoic acid increasing retinoblastoma sensitivity to vincristine

Objective: To explore the mechanism of all-transretinoic acid (ATRA) increasing retinoblastoma (RB) sensitivity to vincristine, and the inhibiting effect of vincristine combined with ATRA treatment on the SO-RB50 cell proliferation. Methods: SO-RB50 cells were cultivated by routine culture method. Different concentrations of vincristine or ATRA were added into culture solution. After 48 h, cell counting kit-8 was used to detect the median inhibitory concentration (IC50) of vincristine combined with ATRT treatment to SO-RB50 cells. SO-RB50 cells were divided into drug combination group, vincristine group, ATRA group and control group. Different drugs were added into the culture solution respectively for cell culture based on the IC50 value. Cell counting kit-8 was used to detect the cell proliferation every 24-h cultivation. After continuous determination for 6 d, data was processed to draw the cell growth curve. After drug use for 72 h, flow cytometry was used to detect the proportion of different cell cycles of SO-RB50 cells in each group. After drug use for 48 h, annexin V/propidium iodide method was used to detect the SO-RB50 cell apoptosis in each group. Results: The IC50 value of vincristine treatment on the SO-RB50 cells was 0.11 mu mol/L, and ATRT was 12.84 mu mol/L. The cell growth curve in control group rose gradually along with the extended culture time, but after vincristine and ATRA treatment, the cell growth curve was smooth and steady. The cell increment was the least in drug combination group and its cell growth curve was the smoothest. There was significant difference in A(450) 48 h and 72 h after treatment (F-grouping=77.316, P<0.001: F-time=86.985, P<0.001). Compared with control group. A(450) value in drug combination group, vincristine group, ATRA group was significantly lower (P<0.001). Compared with control group, the G(2)/M phase cell proportion in vincristine group was significantly increased, while the G(0)/G(1) phase cell proportion was significantly decreased; the G(0)/G(1) phase cell proportion in ATRA group was significantly increased, while the S phase cell proportion was significantly decreased (F-G0/G1=85.878, F-s=56.455, F-G2/M=85.878, P<0.001). After 48 h, there was significant difference in SO-RB50 cell apoptosis rate among groups (F=11.312, P<0.05). The apoptosis rate in drug combination group was significantly higher than that of other groups (P<0.001). Conclusions: ATRA can increase the sensitivity of SO-RB50 cells to vincristine. Vincristine combined with ATRA treatment can significantly increase the inhibiting effect on SO-RB50 cells, which may be related with promoting cell apoptosis and involving in cell cycle control.

CHEMOTHERAPY FOR ADVANCED NASOPHARYNGEAL CARCINOMA WITH METHOTREXATE, VINCRISTINE, CISPLATIN AND ADRIAMYCIN

Objective: To evaluate the efficacy and toxicity of M-VCA (methortrexate 30 mg/m2, vincristine 2 mg, cisplatin 70 mg/m2, adriamycin 30 mg/m2) combination chemotherapy for advanced nasopharyngeal carcinoma. Methods: Thirty-five patients with advanced nasopharyngeal carcinoma, including 11 patients with untreated local advanced nasopharyngeal carcinoma and 24 patients with local-regional recurrent or metastatic nasopharyngeal carcinoma, received the chemotherapy of M-VCA. The cycle was repeated on day 22 for two cycles. All patients completed the chemotherapy courses. Results: The overall response rate was 75%, with untreated local advanced nasopharyngeal carcinomas 11/11(100%), local-regional recurrent nasopharyngeal carcinomas 12/18(67%), lung metastases 8/9(89%), bone metastases 5/9(56%), and liver metastases 1/2(50%). The main side effects included mild to moderate degree alopecia, nausea/vomiting, and neutropenia. Conclusion: M-VCA is well tolerated and has good efficacy for advanced nasopharyngeal carcinoma and is worth investigating further.

Preparation and quality evaluation of vincristine sulfate-loaded PEG-PLGA nanoparticles

Objective To prepare the PEG-PLGA nanoparticles loaded with vincristine sulfate(VCR-loaded PEG-PLGA-NPs) and evaluate their quality.Methods VCR-loaded PEG-PLGA-NPs were prepared by the double emulsion solvent evaporation method.The main experimental factors,which influenced the physical and chemical properties of the nanoparticles,were investigated and optimized.Results Under optimal conditions,the VCR-loaded PEG-PLGA-NPs had an average diameter of 135.9 nm with narrow size distribution.The encapsulation efficiency was 68.2%,while the drug loading capacity was 8.34%.In vitro,VCR was released from the PEG-PLGA-NPs sustainedly for more than 13 days with the total amount of 81%.Moreover,the VCR-loaded PEG-PLGA-NPs were relatively stable,which was confirmed by the stability testing.Conclusion The VCR-loaded PEG-PLGA-NPs are a promising nano drug with controlled release,which can be applied widely.

The interaction between cytarabine and vincristine on HL-60 cell line in vitro

Objective： To analyze the effect of cytarabine combined with vincristine on HL-60 cell line in vitro. Methods： The median-effect equation and MTr assay were used on HL-60. Results： The cytotoxic activity of cytarabine（Ara-C） and vincristine （VCR） used alone or in combination enhanced as drug concentration increased. The order of administration did not influence the cytotoxic activity of the combined antitumor drugs. The ratio of drug concentration was a factor to influence the killing effect. The interaction of the agents was synergistic at lower concentration, and antagonistic at higher concentration. Conclusion： The combined drugs interaction（CI 〈 1 ） was synergistic at lower concentration and antagonistic at higher concentration. The ratio of drug concentration is a significant factor that can influence the killing effect.

Randomized Trial Comparing Cyclophosphamide, Methotrexate, and 5-Fluorouracil (CMF) Regimen with Rotational CMFEV Regimen (E=Epirubicin, V=Vincristine) as Adjuvant Chemotherapy in Moderate Risk Operable Breast Carcinoma

Objectives: The CMFEV (cyclophosphamide, methotrexate, 5-fluorouracil, epirubicin, vincristine) regimen is an innovative schedule, designed by our Group, aimed at administering five partially or totally no cross-resistant cytotoxic agents in breast carcinoma. It was randomly compared to CMF (cyclophosphamide, methotrexate, 5-fluorouracil) as primary treatment in operable disease and demonstrated a short-term significant increase in clinical complete response rate and a long-term significant locoregional relapse-free survival in premenopausal patients. So, it seemed worth comparing this regimen with CMF as adjuvant chemotherapy in moderate risk operable breast carcinoma. Methods: Four hundred and eighty-nine patients with stage I or II moderate risk breast carcinoma were randomized to receive CMF or CMFEV regimen for 6 cycles after surgery. Main end points were overall survival (OS), invasive disease-free survival (IDFS) and recurrence-free interval (RFI), as estimated by Kaplan-Meier analyses and log-rank tests. Results: At a median observation time of 7.3 years (range 5.4 months-10.3 years), no significant differences in OS and IDFS were observed between the two arms. Deaths from breast carcinoma were more frequent with CMF (58.5%) than with CMFEV regimen (41.7%) as well as recurrences from breast carcinoma (58.8% with CMF and 41.2% with CMFEV). These differences were not statistically significant. Conclusion: CMFEV appears more effective than CMF in preventing recurrences from primary disease in patients with moderate risk stage I-II breast carcinoma. The lack of statistical significance of the observed differences was probably due to the limited number of patients enrolled which rendered the study underpowdered.

Unilateral Ptosis in a Child with Wilm’s Tumor Induced by Vincristine

Vincristine is a chemotherapy drug belonging to the group of Vinca alkaloids which also includes vinblastine and vindesine. It is used in hematological malignancies and solid tumors. The Vinca alkaloids are neurotoxic, usually causing peripheral neuropathy, and rarely cranial neuropathies. We report a case of a 33-month-old male child diagnosed with Wilms’ tumor, who had an isolated unilateral right ptosis following vincristine, with a good improvement after stopping it.

Side Effects of Vincristine and L-Asparaginase in Patients with Acute Lymphoblastic Leukemia in a Mexican Pediatric Hospital

Background: The treatment used to combat acute lymphoblastic leukemia (ALL) is multidrug;therefore it is important to use active pharmacovigilance to detect, assess and analyze the likely adverse reactions which may occur during the same period. Objective: To determine the frequency of adverse reactions to chemotherapeutic drugs in children with ALL. Material and Methods: Intensive pharmacovigilance was used to record the reports of adverse reactions to vincristine, L-asparaginase and the vincristine-L-asparaginase combination in children with ALL in a paediatric hospital. For each notification, the adverse reactions were analyzed in order to verify causality. Results: Forty patients were evaluated. Twenty children were female (50.0%) and 20 were male (50%). The children had a mean age, weight and height (±standard deviation: SD) of 8.1 (±3.4) years, 31.4 (±13.9) kg and 1.3 (±0.2) m, respectively. Vincristine was administered to 19 patients, vincristine plus L-asparaginase were given to 19 patients and only 2 patients used L-asparaginase. One-hundred-ninety adverse reactions were detected in the patients, with an average (±SD) of 4.8 (±2.6). Ondansetron was the drug administered for the treating of nausea and vomiting. One hundred eighty-one (95.3%) adverse reactions were identified as “definite”, 5 (2.6%) as “probable” and 4 (2.1%) as “doubtful”. Conclusions: There is a high incidence of adverse reactions by the administration of vincristine and L-asparaginase;the reactions of highest incidence were: nausea, vomiting, neutropenia, diarrhea, constipation, mucositis, headache, and abdominal pain. It is important to promote the detection, collection, reporting, assessment and treatment of ARD’s in children. It is necessary to promote the conduct further studies on pharmacovigilance with this type of treatments and to increase the duration of the studies.

ALL患儿诱导缓解期长春新碱联合应用三唑类抗真菌药物发生毒副作用单中心分析

目的研究急性淋巴细胞白血病(ALL)儿童诱导缓解期联合应用长春新碱与三唑类药物出现的毒副作用。方法回顾性分析2010年1月1日—2013年12月31日北京儿童医院诊断为ALL患儿在诱导缓解治疗过程中长春新碱和三唑类药物联合应用出现毒副作用。将患儿分为无联合用药组、长春新碱+伊曲康唑联合组,长春新碱+伏立康唑联合组,长春新碱+氟康唑联合组,分析4组患儿相关毒副作用的发生率及治疗预后。结果共纳入ALL患儿708例,发病中位年龄为8(1~16)岁。存在长春新碱与三唑类抗真菌药物联合应用组共215例,其中联合伊曲康唑组79例,联合伏立康唑组36例,联合氟康唑组100例。无联合用药组493例。联合用药组患儿相关并发症发生率:高血压37例(17.2%),趾端麻木39例(18.1%),腱反射迟钝4例(1.8%),腹痛腹胀42例(19.5%),肠梗阻5例(2.3%),低血钠43例(20%)。联合用药组相关并发症发生率均高于无联合用药物组(P<0.05)。联合用药组中,高血压发生率、腱反射迟钝发生率及低血钠发生率:伊曲康唑组与伏立康唑组无差别(P>0.05),但大于氟康唑组(P<0.05);趾端麻木、腹痛腹胀发生率:伊曲康唑组大于伏立康唑组大于氟康唑组(P<0.05);肠梗阻发生率:伏立康唑组大于伊曲康唑组大于氟康唑组(P<0.05)。对于发生的毒副作用,给予相关的对症处理及调整药物后,相关并发症均可以得到缓解及消失。结论在ALL患儿诱导缓解治疗过程中,三唑类药物联合长春新碱用药可能加重毒副作用发生,伊曲康唑和伏立康唑相比氟康唑可能更容易加重长春新碱毒性,故建议治疗过程中避免同时使用三唑类抗真菌药物及长春新碱。

碳酸锂联合长春新碱促进儿童急性T淋巴细胞白血病细胞增殖抑制和凋亡

儿童急性T淋巴细胞白血病(T-cell acute lymphoblastic leukemia,T-ALL)是T系前体细胞发生恶性转化的一种侵袭性肿瘤,化疗药物的毒副作用及耐药性问题仍然是阻碍其治疗成功的难题。长春新碱(vincristine,VCR)是治疗儿童T-ALL疗效显著的传统化疗药物,但其副作用明显。碳酸锂(Li_(2)CO_(3))可增强其它化疗药物的疗效,但其联合VCR的研究未见报道。该研究旨在探讨Li_(2)CO_(3)联合VCR对2种儿童T-ALL细胞系CCRF-CEM和Jurkat细胞增殖、凋亡及细胞周期的作用。噻唑蓝(thiazolyl blue tetrazolium bromide,MTT)比色法结果显示,与对照组比较,单用VCR或Li_(2)CO_(3),随着其浓度的增加,2种细胞存活率均逐渐降低(P<0.05)。2种细胞在相同Li_(2)CO_(3)浓度下存活率不同(P<0.01)。Li_(2)CO_(3)联合VCR处理细胞存活率与单独VCR组处理相比,2种细胞的细胞存活率和VCR的半抑制浓度(half maximal inhibitory concentration,IC_(50))值降低,Li_(2)CO_(3)与VCR的2药相互作用指数(coefficient of drug interaction,CDI)均小于1。流式细胞仪检测结果发现,对照组、Li_(2)CO_(3)组、VCR组和Li_(2)CO_(3)联合VCR组,2种细胞Li_(2)CO_(3)联合VCR组的G_(2)/M期和凋亡细胞占比最高,Li_(2)CO_(3)联合VCR组和VCR组比,均存在显著性差异(P<0.05)。总之,我们的研究结果提示,Li_(2)CO_(3)与VCR联合促进T-ALL细胞增殖抑制,使细胞周期阻滞于G_(2)/M期,且促进细胞凋亡,结果为儿童T-ALL临床治疗及减少VCR毒副作用提供了新的实验依据,也为其药物研发提供新的思路。

口服L-苏糖酸镁预防长春新碱诱导的大鼠记忆和情感障碍

目的:观察L-苏糖酸镁(magnesium-L-threonate,L-TAMS)对长春新碱(vincristine,VCR)诱导的大鼠记忆和情感障碍的影响并探讨其机制。方法:采用随机数表法将SD大鼠随机分为三组:Control组(饮用正常水并注射等量生理盐水)、VCR组(大鼠腹腔注射长春新碱并饮用正常水)、L-TAMS+VCR组(VCR注射前7天起至实验结束在饮用水中加入L-TAMS),每组5~7只。采用新颖物体识别测试(novel object recognition test,NORT)检测大鼠记忆能力;高架十字迷宫实验(elevated plus-maze test,EPMT)检测大鼠焦虑行为;强迫游泳实验(forced swimming test,FST)检测大鼠抑郁行为。使用在体电生理实验技术记录海马CA3-CA1突触后诱发场电位的幅度;Western blot检测海马内N-甲基-D-天冬氨酸受体(N-Methyl-D-Aspartate-Receptors,NMDARs)亚基NR2B表达的情况;免疫荧光检测海马CA1与前扣带回皮质(anterior cingulate cortex,ACC)内小胶质细胞的表达情况。结果:与Control组比较,VCR组认知系数降低,静止不动时间延长,进入高架十字迷宫开放臂的时间和次数减少,海马CA3-CA1突触后场电位幅度降低,海马内NR2B含量显著降低,海马CA1和ACC内小胶质细胞的表达增多,腹腔注射VCR之前,提前7天直至实验结束口服L-TAMS可预防VCR所引起的上述变化。结论:L-TAMS可通过上调海马突触后膜NMDARs亚基NR2B,逆转VCR引起的CA3-CA1突触后场电位幅度显著降低,改善海马突触传递受损,同时,降低大鼠海马CA1和前扣带回皮质的小胶质细胞表达,减轻神经炎症,进一步预防VCR诱导的记忆和情感功能障碍。

lncRNA HIF1A-AS1对长春新碱耐药视网膜母细胞瘤细胞化疗敏感性的影响

目的:探讨长链非编码RNA-HIF1A-AS1(lncRNA HIF1A-AS1)调节缺氧诱导因子-1α(HIF-1α)表达对长春新碱(VCR)耐药视网膜母细胞瘤(RB)细胞化疗敏感性的影响。方法:建立人RB VCR耐药细胞株SO-RB50/VCR,实时荧光定量PCR(RT-qPCR)检测SO-RB50与SO-RB50/VCR细胞lncRNA HIF1A-AS1表达;在SO-RB50/VCR细胞中抑制lncRNA HIF1A-AS1表达或同时过表达HIF-1α,检测SO-RB50/VCR细胞对VCR的半数抑制浓度(IC_(50))及细胞增殖、凋亡情况;Western blot检测HIF-1α、多药耐药相关蛋白(MRP)、P-糖蛋白(P-gp)蛋白表达。结果:与SO-RB50细胞相比,SO-RB50/VCR细胞中lncRNA HIF1A-AS1与HIF-1α蛋白表达水平升高(P<0.05);在SO-RB50/VCR细胞中抑制lncRNA HIF1A-AS1表达后,细胞凋亡率显著升高(P<0.05),细胞吸光度(OD_(450))值显著降低,VCR对细胞的IC_(50)值及HIF-1α、MRP、P-gp蛋白表达水平显著降低(P<0.05);过表达HIF-1α可减弱下调lncRNA HIF1A-AS1表达对SO-RB50/VCR细胞耐药性的抑制作用。结论:lncRNA HIF1A-AS1在SO-RB50/VCR细胞中高表达,抑制lncRNA HIF1A-AS1表达可通过下调HIF-1α表达,降低SO-RB50/VCR细胞对VCR的耐药性。

靶向载长春新碱超声微泡的制备及体外寻靶实验研究

目的 制备载长春新碱(VCR)且靶向结合外周神经髓鞘细胞的超声脂质微泡,观察其体外寻靶情况。方法 采用薄膜水化-机械振荡法制作载药超声微泡(VCR-MBs),生物素-亲和素桥接法制作靶向载药超声微泡(VCR-TMBs),观察VCR-TMBs形态、粒径、稳定性、体外显影、包封率及靶向性等理化性质。流式细胞仪检测VCR-TMBs对细胞的损伤及凋亡作用,体外通过VCR-TMBs联合超声(US)对大鼠肾动脉处理,HE染色观察脱髓鞘改变。结果 MBs、VCR-MBs及VCR-TMBs光镜下均成圆形,分布均匀。MBs、VCR-MBs及VCR-TMBs粒径分别为(3.22±1.07)、(3.48±1.06)及(3.22±0.79)μm,差异无统计学意义(P>0.05);与MBs、VCR-MBs相比,VCR-TMBs保存3 d时浓度明显下降(P<0.05);采用高效液相色谱法测定VCR-TMBs的包封率及载药率分别为(82.90±9.98)%、(2.07±0.25)%;免疫荧光法测定VCR-TMBs可靶向聚集在Schwann细胞膜上;流式细胞仪检测示VCR-TMBs+US促细胞凋亡作用优于单纯VCR+US及VCR-MBs+US(P<0.05);组织HE染色示VCR-TMBs联合US可有效使体外大鼠肾动脉神经脱髓鞘及变性坏死。结论 成功制备VCR-TMBs,其可靶向识别Schwann细胞,促进细胞凋亡,使大鼠肾动脉神经脱髓鞘改变,可为后期体内VCR-TMBs实现肾动脉周围神经去交感化做前期准备。

天然产物EM-E-11-4逆转人口腔上皮癌细胞KBV_(200)多药耐药作用及其机制

目的考察无毒浓度千金烷二帖化合物EM-E-11-4对P-糖蛋白(P-glycoprotein,P-gp)介导人口腔上皮癌多药耐药(multi-drug resistance,MDR)的逆转作用并检测其对P-gp功能的影响。方法MTT比色法测定EM-E-11-4对人口腔上皮癌KB及其具有多药耐药株表型的KBV_(200)细胞的细胞毒活性,采用维拉帕米为参比药,非细胞毒剂量EM-E-11-4(2.5、5、10μmol·L^(-1))与3种常用抗癌药合用考察其逆转肿瘤多药耐药的作用,并计算逆转倍数。EME-11-4对P-gp的转运功能采用阿霉素蓄积实验检测。EM-E-11-4对基础与维拉帕米诱导的P-gp ATPase活性采用P-gp-GloTM试剂盒检测。结果EM-E-11-4能够有效逆转P-gp介导的KBV_(200)的多药耐药,并具有良好的剂量依赖关系。10μmol·L^(-1)EM-E-11-4能够逆转KBV_(200)细胞对紫杉醇、长春新碱和阿霉素3种抗癌药物的耐药作用,逆转倍数分别为33.8、36.4、20.1。无细胞毒作用的EM-E-11-4对P-gp的转运功能有显著抑制作用,并且能够增加阿霉素在肿瘤细胞内的蓄积,具有良好的浓度依赖性。同时,EM-E-11-4能明显抑制维拉帕米刺激的重组P-gp的ATPase活性。结论EM-E-11-4能逆转P-gp介导的肿瘤多药耐药,其作用机制与抑制P-gp的转运功能有关,为其临床治疗口腔上皮癌肿瘤多药耐药提供了理论依据。

三唑类抗真菌药物与长春新碱联用致神经毒性3例报道并文献复习

目的探讨三唑类抗真菌药物与长春新碱联用引起血液肿瘤患儿发生神经毒性,提醒临床对三唑类抗菌药物与长春新碱的药物相互作用引起重视。方法报道3例血液肿瘤患儿,长春新碱与三唑类抗菌药物联用致严重的舌体麻木伴疼痛、肢端麻木、腹痛等神经毒性,停用三唑类抗真菌药物,并给予相应处理后毒性明显缓解。结果长春新碱的神经毒性为其常见不良反应,与三唑类抗真菌药物联用可加重其神经毒性。结论临床应加强对三唑类抗真菌药物和长春新碱的药物相互作用的认识,避免联用以保证临床用药安全。

一例犬传染性性病肿瘤的诊治

6岁雌性未绝育家养贵宾犬,发现阴道内有肿物,阴道流血就诊。采用血常规、血生化和肿物病理切片等的检查方法进行诊断。结果表明:该犬患有传染性性病肿瘤,经手术与长春新碱化疗相结合的治疗方案连续治疗4周,病症痊愈,回访未见病情复发。长春新碱对犬传染性性病肿瘤有良好的治疗效果。

Potentiation of PIEZO2 mechanically-activated currents in sensory neurons mediates vincristine-induced mechanical hypersensitivity

Vincristine,a widely used chemotherapeutic agent for treating different cancer,often induces severe peripheral neuropathic pain.A common symptom of vincristine-induced peripheral neuropathic pain is mechanical allodynia and hyperalgesia.However,mechanisms underlying vincristine-induced mechanical allodynia and hyperalgesia are not well understood.In the present study,we show with behavioral assessment in rats that vincristine induces mechanical allodynia and hyperalgesia in a PIEZO2 channel-dependent manner since gene knockdown or pharmacological inhibition of PIEZO2 channels alleviates vincristine-induced mechanical hypersensitivity.Electrophysiological results show that vincristine potentiates PIEZO2 rapidly adapting(RA)mechanically-activated(MA)currents in rat dorsal root ganglion(DRG)neurons.We have found that vincristine-induced potentiation of PIEZO2 MA currents is due to the enhancement of static plasma membrane tension(SPMT)of these cells following vincristine treatment.Reducing SPMT of DRG neurons by cytochalasin D(CD),a disruptor of the actin filament,abolishes vincristine-induced potentiation of PIEZO2 MA currents,and suppresses vincristine-induced mechanical hypersensitivity in rats.Collectively,enhancing SPMT and subsequently potentiating PIEZO2 MA currents in primary afferent neurons may be an underlying mechanism responsible for vincristineinduced mechanical allodynia and hyperalgesia in rats.Targeting to inhibit PIEZO2 channels may be an effective analgesic method to attenuate vincristine-induced mechanical hypersensitivity.

长春新碱联合顺铂对Ⅰb~Ⅱb宫颈癌术前的近期疗效

目的探讨长春新碱联合顺铂用于Ⅰb~Ⅱb期宫颈癌术前辅助化疗对血清肿瘤标志物及近期疗效的影响。方法选取56例宫颈癌病例,采用简单随机分组将宫颈癌病例均分为观察组和对照组。对照组术前采用顺铂辅助化疗,观察组术前采用长春新碱联合顺铂辅助化疗,均治疗28 d。在化疗结束14 d后,对全部患者进行宫颈癌根治手术。观察比较2组治疗疗效、治疗前后T细胞亚群和血清肿瘤标志物表达水平,以及不良反应发生率。结果观察组病例的有效率(75.00%)显著高于对照组(53.57%),P<0.05;治疗后,观察组患者体内CD3+、CD4+以及CD4+/CD8+显著高于对照组,而CD8+则低于对照组(P<0.05);观察组血清糖类抗原125(carbohydrate antigen 125,CA125)、鳞状细胞癌相关抗原(squamous cell carcinoma antigen,SCCA)和癌胚抗原(carcinoembryonic antigen,CEA)水平低于对照组(P<0.05);观察组与对照组不良反应发生率分别为14.28%和32.14%,2组比较差异无统计学意义(P>0.05)。结论在Ⅰb~Ⅱb期宫颈癌术前,采用长春新碱联合顺铂辅助化疗,可有效提高治疗效果,增强机体的免疫力,降低宫颈癌患者血清中肿瘤标志物的表达水平,且不良反应发生率较低。