预见性护理改善老年卵巢癌化疗患者毒、副作用指标评分观察

目的观察预见性护理改善老年卵巢癌化疗患者毒、副作用指标评分情况。方法连续选择近期在我科接受化疗的老年卵巢癌患者47例,入选对象按接受化疗时间随机分为预见性护理组(23例)和对照组(24例)。预见性护理干预内容包括:认知干预、饮食指导、心理干预、有氧运动指导、预防选用止吐药及转移注意力等。对照组仅行卵巢癌化疗常规护理。两组患者化疗结束后均接受了WHO制定的"抗癌药急性和亚急性毒副反应表现和分级标准"评分。结果化疗后预见性护理组的恶心和呕吐、腹痛、便秘、腹泻各条目评分和毒、副作用总分均明显低于对照组(P<0.01或P<0.05)。结论预见性护理可明确改善老年卵巢癌化疗患者毒、副作用指标评分。

专项护理干预对老年非小细胞肺癌患者化疗期间消化道毒副作用影响

目的观察专项护理干预对老年非小细胞肺癌(NSCLC)患者化疗期间消化道毒、副作用评分影响。方法连续选择2016年1月至2017年12月在我院呼吸内科接受GP方案联合化疗的老年NSCLC患者57例,接受治疗期间同时进行了专项护理干预(包括干预负性情绪、认知干预、干预毒和副反应、饮食干预等),化疗前后接受了WHO推出的《抗癌药急性和亚急性毒副反应评分标准》中消化道条目评估。结果 57例老年NSCLC化疗患者专项护理干预后消化道的恶心及呕吐、腹泻、便秘、食欲不振等条目分评分及消化道毒、副作用总分均明显少于专项护理干预前(P<0.05,P<0.01)。结论专项护理干预方法可显著减低老年NSCLC患者化疗期间消化道毒副作用反应。

艾迪注射液对进展期胃癌化疗患者近期疗效指标影响

目的观察艾迪注射液对进展期胃癌化疗患者近期疗效指标影响。方法连续选择近期来我院接受化疗的进展期胃癌患者77例,根据自愿原则分组,艾迪注射液治疗(治疗组)35例和未接受艾迪注射液治疗(对照组)42例,治疗后评估近期疗效指标。结果治疗组近期临床有效率51.42%,CR3例(8.57%),PR15例(42.85%),NC6例(17.14%),PD11例(31.42%),对照组分别为51.42%、7.14%、38.09%、19.04%和35.71%,2组近期疗效相差不明显(P>0.05),但治疗组各项消化道毒、副作用反应评分明显低于对照组(P<0.05～0.01)。结论艾迪注射液治疗可明显减轻进展期胃癌化疗患者毒、副作用反应,但对近期疗效影响不明显。

Clinical Benefit with Intraoperative Radiotherapy Combined with Regional Chemotherapy for Advanced Pancreatic Carcinoma

Objective: To evaluate the effectiveness of intraoperative radiotherapy (IORT) in combination with regional chemotherapy in the treatment of advanced pancreatic carcinoma.Methods: 17 patients with advanced pancreatic adenocarcinoma were treated with IORT and regional chemotherapy with 5-FU, Epirubucin and Mitomycin, and 6 cases accepted external radiotherapy postoperatively.Results: 35.29% (6/17) of the patients were clinical benefit responders and 23.53% (4/17) had a partial response. The median survival time was 11 months and the 1-year survival rate was 35.29% (6/17)Conclusion: IORT in combination with regional chemotherapy had a good impact on clinical benefit without severe side effects in locally advanced pancreatic carcinoma and led to a significant prolongation of the survival time. Key words pancreatic cancer - intraoperative radiotherapy - chemotherapy

The clinical effects of DC-CIK cells combined with chemotherapy in the treatment of advanced NSCLC

Objective: The aim of the study was to evaluate the safety and therapeutic effects of autologous dendritic cells co-cultured with cytokine-induced killer cells (DC-CIK) combined with chemotherapy in advanced non-small cell lung cancer (NSCLC) patients. Methods: Fifty patients with advanced NSCLC (stages III to IV), who had received therapies in our Center (Department of Biotherapy, Affiliated to Cancer Hospital of Shanxi Medical University, Taiyuan, China) from August 2008 to January 2010, were treated by DC-CIK + chemotherapy as the combined treatment group; fifty advanced NSCLC patients treated with chemotherapy at the same time served as controls. The immunologic function, short-term therapeutic effects, the 1-year survival rate, the life quality, the chemotherapy side effects were compared between the two groups, the safety and therapeutic effects of DC-CIK cells therapy were observed too. Results: There was no obvious change of subsets of T cells in peripheral blood before and after therapy in DC-CIK + chemotherapy group, and IFN-γ was improved after therapy in this group (P < 0.05); in chemotherapy alone group, the ratios of CD3+CD4+, CD3+CD8+, CD3-CD56+ cells and the secretion of IL-2, TNF-α decreased significantly after therapy (P < 0.05); the ratios of CD3+CD8+, CD3+CD56+ were improved after cell culture (P < 0.05). The disease control rate (DCR) of DC-CIK + chemotherapy group was higher than that in the chemotherapy alone group (78.0% vs 56.0%, P < 0.05); the 1-year survival rates of DC-CIK + chemotherapy group and chemotherapy alone group were 50% and 44% respectively, had no significant difference. Compared with chemotherapy alone group, the occurrence of chemotherapy side effects (including bone marrow suppression, nausea and vomiting, peripheral nerve toxicity) was less in the DC-CIK + chemotherapy group (P < 0.05). The physical and appetite were better in DC-CIK + chemotherapy group after therapy. Conclusion: To compare with simple chemotherapy, DC-CIK + chemotherapy for advanced NSCLC is safe and effective, and it can improve patients' life quality and remission rate, and prolong their survival time.

New approach to anal cancer:Individualized therapy based on sentinel lymph node biopsy

Oncological treatment is currently directed toward a tailored therapy concept.Squamous cell carcinoma of the anal canal could be considered a suitable platform to test new therapeutic strategies to minimize treatment morbidity.Standard of care for patients with anal canal cancer consists of a combination of radiotherapy and chemotherapy.This treatment has led to a high rate of local control and a 60% cure rate with preservation of the anal sphincter,thus replacing surgical abdominoperineal resection.Lymph node metastases represent a critical independent prognostic factor for local recurrence and survival.Mesorectal and iliac lymph nodes are usually included in the radiation field,whereas the inclusion of inguinal regions still remains controversial because of the subsequent adverse side effects.Sentinel lymph node biopsies could clearly identify inguinal node-positive patients eligible for therapeutic groin irradiation.A sentinel lymph node navigation procedure is reported here to be a feasible and effective method for establishing the true inguinal node status in patients suffering from anal canal cancer.Based on the results of sentinel node biopsies,a selective approach could be proposed where node-positive patients could be selected for inguinal node irradiation while node-negative patients could take advantage of inguinal sparing irradiation,thus avoiding toxic side effects.

The Discussion of Peritoneal Dialysis Patients Taking Proper Portion of Valacyclovir

Dialysis patients have risk in Zoster virus because of low immune. Valacyclovir, used for Zoster virus, is digested in kidney and it has side effect of nerve virus on patients with malfimction kidneys. This article reviews 8 dialysis cases and discusses the proper Valacyclovir portion for peritoneal dialysis patients.

Hepatotoxicity induced by cyproterone acetate:A report of three cases

Cyproterone acetate (CPA) is a steroidal synthetic progestagen and anti-androgenic compound widely administered in prostate cancer which has been evidentially correlated with a severe hepatotoxic potency. Three male patients aged 78-83 years are presented, in whom severe hepatotoxic reactions emerged after CPA administration. Patients were treated with CPA at the doses of 200-300 mg/d for malignant prostate disease for 3-12 mo prior to the acute manifestation of the hepatic disease. Clinical features compatible with mixed hepatocellular and cholestatic liver disease including jaundice, white stools and dark urine, manifested in all three cases whereas encephalopathy and ascites were present in two of the patients. Other primary causes of hepatotoxicity (alcohol consumption and viral hepatitis) were also verified in two cases, and in those patients biopsy findings revealed the presence of cirrhotic lesions in liver parenchyma. Discontinuation of the therapeutic agent led to the amelioration of the clinical profile in all the patients whereas a patient died 40 d after hospital admission due to sepsis, despite acute liver disease improvement. The current article highlights the hepatotoxic potency of a widely administered therapeutic agent and illustrates the importance of clinical surveillance especially in patients with previous hepatic diseases. Three relevant cases are reported and a review of the published literature is made.

Effect and mechanism of β-L-D4A on DNA polymerase α

AIM： To investigate the safety of β-L-D4A on DNA polymerase α.METHODS： Ion exchange chromatography was used to separate DNA polymerase cc from crude extract of human Hela cells. Detailed kinetic parameters were determined for β-L-D4A against DNA polymeraseα . RESULTS： DNA polymerase was purified with 4% yield and 31000 units/mg specific activity. The Michaelis constant （Km = 3.22 i^mol/L）, 50% inhibition concentration （IC50 = 178.49 μmol/L） and inhibition constant （Ki = 126 mol/L） of β-L-D4A were determined by kinetic analysis. CONCLUSION： β-L-D4A is a more safe nucleoside for hepatitis B virus （HBV） infection with a lower host toxicity.

Identification of an allosteric hotspot for additive activation of PPARγ in antidiabetic effects

Thiazolidinediones(TZDs),such as rosiglitazone(RSG),which activates peroxisome proliferator activated receptor-y(PPARy),are a potent class of oral antidiabetic agents with good durability.However,the clinical use of TZDs is challenging because of their side effects,including weight gain and hepatotoxicity.Here,we found that bavachinin(BVC),a lead natural product,additively activates PPARγ with lowdose RSG to preserve the maximum antidiabetic effects while reducing weight gain and hepatotoxicity in db/db mice caused by RSG monotherapy.Structural and biochemical assays demonstrated that an unexplored hotspot around Met329 and Ser332 in helix 5 is triggered by BVC cobinding to RSG-bound PPARy,thereby allosterically stabilizing the active state of the activation-function 2 motif responsible for additive activation with RSG.Based on this hotspot,we discovered a series of new classes of allosteric agonists inducing the activity of TZDs in the same manner as BVC.Together,our data illustrate that the hotspot of PPARγ is druggable for the discovery of new allosteric synergists,and the combination thera py of allosteric synergists and TZD drugs may provide a potential alternative approach to the treatment of type 2 diabetes mellitus.

Use of liposomal doxorubicin for adjuvant chemotherapy of breast cancer in clinical practice

Breast cancer is one of the malignant tumors with the highest morbidity and mortality. It is helpful to reduce the rate of tumor recurrence and metastasis by treating breast cancer with adjuvant chemotherapy, so as to increase the cure rate or survival of patients. In recent years, liposomes have been regarded as a kind of new carrier for targeted drugs. Being effective for enhancing drug efficacy and reducing side effects, they have been widely used for devel- oping anticancer drugs. As a kind of anthracycline with high anticancer activity, doxorubicin can treat or alleviate a variety of malignant tumors effectively when it is used on its own or in combination with other anticancer drugs~ Alt- hough liposomal doxorubicin has been extensively used in the adjuvant chemotherapy of breast cancer, its exact therapeutic efficacy and side effects have not been definitely proven. Various clinical studies have adopted different combined regimes, dosages, and staging, so their findings differ to certain extent. This paper reviews the clinical application of liposomal doxorubicin in the adjuvant chemotherapy of breast cancer and illustrates therapeutic effects and side effects of pegylated liposomal doxorubicin （PLD） and non-PLD （NPLD） in clinical research, in order to discuss the strategies for applying these drugs in such adjuvant chemotherapy, looking forward to providing references for related research and clinical treatment in terms of dosage, staging, combined regimes, and analysis methods and so on.

A novel bone marrow targeted gadofullerene agent protect against oxidative injury in chemotherapy

Chemotherapy as an effective cancer treatment technique has been widely used in tumor therapy. However, it is still a challenge to overcome the serious side effects of chemotherapy, especially for its myelotoxicity. Here we report a novel strategy using the water soluble gadofullerene nanocrystals（GFNCs） to protect against chemotherapy injury in hepatocarcinoma bearing mice, which was induced by the commonly chemotherapeutic agent cyclophosphamide（CTX）.The GFNCs were revealed to specifically accumulate in the bone marrow after intravenously injecting to mice and they exhibited excellent radical scavenging function, resulting in a prominent increase of mice blood cells and pathological improvements of the primary organs in the GFNCs（15 mg kg-（-1））treated mice after the CTX（60 mg kg-（-1）） therapy. Moreover,the GFNCs maintained and even strengthened the antineoplastic activity of the CTX agent. Therefore, the GFNCs would be the promising chemoprotective agents in chemotherapy based on their high efficiency, low toxicity and metabolizable property.

Selective inactivation of Gram-positive bacteria in vitro and in vivo through metabolic labelling

Bacterial infections are grave threats to human health,particularly those caused by the most common Grampositive bacteria.The massive administration of broad-spectrum antibiotics to treat various bacterial infections has led to the evolution and spread of drug resistance.As a universal antimicrobial technique unapt to induce drug resistance,photothermal therapy(PTT)is attracting extensive attention in recent years.However,its unspecific killing capability and side effects towards adjacent mammalian cells severely impede the practical applications.Herein,we proposed a metabolic engineering strategy to selectively inactivate Gram-positive bacteria by PTT.A bioorthogonal photothermal agent was prepared by the conjugation of IR-780 iodide and dibenzocyclooctyne(IR780-DBCO).Upon pre-metabolizing with 3-azido-D-alanine,Gram-positive bacteria rather than Gramnegative ones,such as Staphylococcus aureus and vancomycinresistant Enterococcus faecalis(VRE),could be specifically tied up by the explosive IR780-DBCO via copper-free click chemistry.Thereafter,they spontaneously detonated under 15 min near-infrared light irradiation and inactivated nearly 100% Gram-positive bacteria in vitro.Moreover,superbug VRE-induced infection was significantly inhibited by this approach in a mouse skin wound model.This metabolic labelling-based photothermal ablation strategy specific to Gram-positive microbes would stimulate the development of precise antibacterial candidates for preclinical applications.