甲酰四氢叶酸联合5-FU在大肠癌化疗中的应用

本文总结近 1 0年甲酰四氢叶酸 (LV)联合 5 FU在不同剂量、投药方式和间隔时间下 ,对大肠癌化疗疗效及两者与大肠癌化疗新药依林诺特肯 (CPT 1 1 )和草酸反式环己二胺铂 (L OHP)联合应用现状 。

Clinical Observation on 930 Child Epilepsy Cases Treated with Anti-epilepsy Capsules

1090 cases of child epilepsy were divided randomly into two groups: the treatment group (930 cases treated with anti-epilepsy capsules) and the control group (160 cases treated with luminal). The results showed that in the treatment group, 534 cases were markedly effective, 241 effective, 96 improved, 46 ineffective, and 13 aggravated, with a total effective rate of 83.33%; while in the control group, 64 cases were markedly effective, 19 effective, 38 improved, 29 ineffective, and 10 aggravated, with a total effective rate of 51.88%. The treatment group showed an obviously higher total effective rate than that in the control group (P<0.01). After treatment, cases in the two groups all had lower frequency of epilepsy attacks and shorter duration of each attack as compared with that before treatment (P<0.01), but the situation was obviously better in the treatment group. The anti-epilepsy capsules had very good effect on various types of epilepsy, especially on autonomic epilepsy and on epilepsies due to wind, phlegm, or terror as differentiated in TCM. After treatment, the recovery rate shown by EEG examination was 54.3% in the treatment group, while 38.4% in the control group, the former being obviously higher than the latter (P<0.01).

OBSERVATION ON THE THERAPEUTIC EFFECT OF BIRD-PECKING MOXIBUSTION OF SPECIFIC ACUPOINTS IN THE TREATMENT OF FUNCTIONAL DYSPEPSIA

Objective: To observe the therapeutic effect of moxibustion of some specific acupoints for treatment of functional dyspepsia (FD, qi-distension type). Methods:A total of 50 cases of FD patients were randomly divided into treatment group (n=26) and medication group (n=24). In treatment group, bird-pecking moxibustion was applied to Zhongwan (CV 12), Qihai (CV 6), Neiguan (PC 6) and Gongsun (SP 4) 5～6 times in every treatment till the local skin got flush. The treatment was given once daily, continuously for 10 days. In control group, the patients were ordered to take Motilium 10 mg/time, 3 times daily. Following 10 days’ treatment the therapeutic effect was assessed.Results:After treatment, of the 26 cases in treatment group, 11 (42.3%) were cured, 7 (26.92%) had remarkable improvement in their symptoms, 6 (23.07%) had improvement and 2 (7.69%) failed, with a total effective rate of 92.31%. Of the 24 cases in medication group, 9 (37.50%) were cured, 6 (25.00%) experienced remarkable improvement in their symptoms, 6 (25.00%) were improved and 3 (12.50%) failed, with a total effective rate of 87.50%. Comparison between two groups showed that the therapeutic effect of moxibustion was significantly superior to that of medication (P<0.05). In addition, the difference value of the therapeutic effect index (TEI) between post-and pre-treatment in treatment group was also significantly higher than that of medication group (P<0.05). Conclusion: Bird-pecking moxibustion of specific acupoints can effectively improve clinical symptoms of FD patients.

Seventy-two Cases of Antidiabetic-Induced Hepatopathy Treated by Huatan Yigan Decoction

In order to observe the therapeutic effects of Huatan Yigan Decoction (化痰益肝汤 Decoction for resolving phlegm and replenishing the liver) on antidiabetic-induced hepatopathy, 129 cases were divided into two groups, 72 cases in the treatment group were administrated with Huatan Yigan Decoction and 57 cases in the control group with the liver-protecting drugs. Their liver function, plasma prothrombin time (PT), blood urea nitrogen and symptoms of the patients before and after treatment were observed during the three therapeutic courses. Results: The total effective rate and cured rate of the treatment group manifested an obvious difference in comparison with those of the control group (P＜0.05 or P＜0.01). Even though the liver function, blood urea nitrogen (BUN) and symptoms in both groups were improved markedly, these indicators in the treatment group were improved more markedly than those in control group (P＜0.01). No adverse effect was found during the treatment. Conclusion: Huatan Yigan Decoction shows a repair action on hepatic injury.

The Therapeutic Effects of the Radiotherapy Plus TCM Treatment Observed in Senile Non-Parvicellular Lung Cancer Patients at the Late Stage

47 senile non-parvicellular lung cancer patients at stage Ⅲ or Ⅳ were randomly divided into a treatment group (26 cases) treated by radiotherapy plus traditional Chinese medicine (TCM) and a control group (21 cases) treated only by radiotherapy for observation of the therapeutic effects.The patients in the treatment group orally took Chinese medicine during and after the radiotherapy.There was no obvious difference in short-term therapeutic effects between the two groups,but the long-term curative effects in the treatment group was obviously superior to that in the control group (P<0.05 or P<0.01).Conclusion:radiotherapy plus TCM can prolong the survival period for senile non-parvicellular lung cancer patients.

Clinical Observation in 46 Cases of Angina Pectoris Treated by the Catgut-embedding Therapy

With the catgut-embedding therapy, the author treated 46 cases of angina pectoris from October 1997 to February 2002, and achieved good therapeutic results. This is reported as follows.

A brief history of human constitutionology

Human constitutionology studies human itself, which was proposed by Dr. Kuang. The study on human constitution in Chinese medicine has ever increased since the late 1970s. This review on the development of human constitutionology in Chinese Traditional Medicine （TCM） and western medicine is expected to give people with a different background to understand the establishment of this new subject, and its significance in promoting modernization of TCM and multi-disciplinary collaboration in human study and as an individualized model guiding the re-orientation of modern madicine.

COMPARATIVE STUDY ON THE THERAPEUTIC EFFECT OF ACUPUNCTURE AND WESTERN MEDICINES FOR TREATMENT OF PERIPHERAL FACIAL PALSY

Subjective: To observe the therapeutic effect of acupuncture in treatment of acute peripheral facial paralysis. Methods: A total of 80 cases of facial palsy were randomly divided into acupuncture group (n=50) and Western medicine (control) group (n=30). In acupuncture group, Cuanzhu (BL 2), Sibai (ST 2), Yangbai (GB 14), etc. were punctured, combined with TDP radiation, cupping or administration of Chinese medicinal herbs according to the concrete situations. Acupuncture treatment was given once daily, with 6 days being a therapeutic course, continuously for 4 courses. In control group, patients were treated with intravenous injection of “energy mixture”, dexamethasone, compound Danshen injectio, etc.. Results: After treatment, in acupuncture group, of the 50 cases, 48 were cured and 2 had improvement, with the effective rate being 100%; among them, 12 cases were cured in 7 days, 23 cured in 8～14 days, 10 cured in 15～21 days and 3 cured in 22～28 days. In control group, of the 30 cases, 19 were cured, 8 had improvement and 3 had no apparent changes, with the effective rate being 90%. Of the 19 cured cases, 5 were cured within 8～14 days, 10 cured in 15～21 days and 4 cured in 22～28 days. Conclusion: In treatment of acute periphery facial palsy, acupuncture is obviously superior to Western medicines in the therapeutic effect and cure duration.

SUMMARY OF RESEARCHES ON THE TREATMENT OF PROTRUSION OF LUMBAR INTERVERTEBRAL DISC BY"SHE-BIE" OINTMENT-PARTITION MOXIBUSTION

In the present paper the authors sum up their research results about "She-Bie" (black-tail snake-ground beetle) Ointment-partition moxibustion for treatment of lumbar intervertebral disc protrusion (LIDP). Animal experiments showed that when used externally, "She-Bie" Ointment had striking anti-inflammation and pain-relief actions but had no irritant and no allergic effects to the skin. In the treatment of mild type of LIDP, "She-Bie" Ointment partition moxibustion could work well in improving clinical symptoms; and in the treatment of moderate type of LIDP, it could be used as a supplementary measure and raise the excellent and good rates of the therapeutic effect further. For this reason, "She-Bie" Ointment partition moxibustion deserves being popularized in clinical treatment of LIDP.

Development of Novel Antiviral Therapies for Hepatitis C Virus

Over 170 million people worldwide are infected with hepatitis C virus (HCV), a major cause of liver diseases. Current interferon-based therapy is of limited efficacy and has significant side effects and more effective and better tolerated therapies are urgently needed. HCV is a positive, single-stranded RNA virus with a 9.6 kb genome that encodes ten viral proteins. Among them, the NS3 protease and the NS5B polymerase are essential for viral replication and have been the main focus of drug discovery efforts. Aided by structure-based drug design, potent and specific inhibitors of NS3 and NS5B have been identified, some of which are in late stage clinical trials and may significantly improve current HCV treatment. Inhibitors of other viral targets such as NS5A are also being pursued. However, HCV is an RNA virus characterized by high replication and mutation rates and consequently, resistance emerges quickly in patients treated with specific antivirals as monotherapy. A complementary approach is to target host factors such as cyclophilins that are also essential for viral replication and may present a higher genetic barrier to resistance. Combinations of these inhibitors of different mechanism are likely to become the essential components of future HCV therapies in order to maximize antiviral efficacy and prevent the emergence of resistance.

Clinical Observation on Treatment of Rheumatoid Arthritis with Fengshi Xiandan in 53 Cases

We have successfully developed Fengshi Xiandan (风湿仙丹) and used it to treat 53 cases of rheumatoid arthritis (RA),with indomethacin used to treat another 53 cases of RA as the controls.The results showed that the rate of cure and obvious effect was 54.7% and the total effective rate was 92.4% in the treatment group,as compared to 26.4% and 66.0% respectively in the control group,with an obvious difference in curative effect between the two groups (P<0.01).The improvement of all the main clinical symptoms and signs except arthralgia in the treatment group was superior to that in the control group (P<0.05 or P<0.01). The improvement of erythrocyte sedimentation rate (ESR),rheumatoid factor (RF),C-reaction protein (CRP), immunoglobulin (Ig),T-lymphocyte subgroups,micro-circulation in nail fold,and red blood cell (RBC) and hemoglobin (Hb) of anemia patients in the treatment group was superior to that in the control group (P<0.05 or P<0.01).There was an obvious difference (P<0.05 or P<0.01) in superoxide dismutase (SOD) of RBC and lipid peroxide (LPO) of plasma before treatment in the two groups as compared to normal group (P<0.05 or P<0.01).The level of SOD and LPO after treatment in the treatment group obviously tended to normal as compared to that befbre treatment (P<0.05 or P<0.01).The reduction of LPO in the treatment group was obviously superior to that in the control group (P<0.01).The result shows that Fengshi Xiandan (风湿仙丹) with an obvious curative effect on RA can not only control the symptoms of RA but also improve its pathologic damage and prevent its development.

The expression and significance of multi-drug resistance genes in breast cancer stem cells

Objective: To approach the expressions of MDR1 and BCRP in breast cancer stem cells and differentiated cells. Methods: The breast cancer stem cells were separated from human breast cancer primary tissues and MCF-7 by flow cytometry. Then we measured the expressions of MDR1 and BCRP with different subset cells by Realtime-PCR. Results: Contrasted with breast cancer differentiated cells, the expressions of MDR1 and BCRP in breast cancer stem cells were higher (P < 0.01), and the proportion of stem cells rose after chemotherapy (P < 0.01). Conclusion: Contrasted with breast cancer differentiated cells, breast cancer stem cells have stronger ability of drug-resistance with higher level of multi-drug resistance genes, and it is one of key points for chemotherapy failure of breast cancer.

Inhibitory effect of toremifene monotherapy or combined with gemcitabine on A549 human lung adenocarcinoma cells

Objective： The aim of this study was to investigate the effect of toremifene on A549 human lung adenocarci- noma cells, and its sensibilization with gemcitabine, so that to provide a new clinical approach for non-small-cell lung cancer （NSCLC）. Methods： A549 cells were seeded into 96-well plates and exposed to different agents （gemcitabine or gemcitabine with toremifene）. The cytotoxicity of each agent was evaluated by MTT, cell cycle and apoptotic rate were detected by flow cytometry （FCM）. Results： 1. By using FCM, we found A549 cells in S and G2/M phases with toremifene decreased but increased in G0/G1 phase. The higher concentration of toremifene, the more decreased was when compared with the control group. 2. FCM showed toremifene＇s apoptosis effect on A549 cells increased with its increasing dose. 3. By MTT, toremifene had no cytotoxic effect on A549 cells at the concentration of 5 or 2.5 pmol/L. The IC5o of gemcitabine to A549 was 34.51 tJmol/L, and the combined group was 13.59 pmol/L. Conclusion： Toremifene could inhibit the growth of A549 human lung adenocarcinoma cells. Toremifene combined with gemcitabine showed significantly remarkable chemotherapy sensibilization on A549 human lung adenocarcinoma cells.

Safety and Efficacy of Digoxin TherapymWhere Are We Now？

The aim of our study was to determine the criteria and key factors for the effectiveness of digoxin therapy. A prospective opened-type study was carried out in conditions of everyday clinical practice. The concentrations of digoxin were quantified from blood samples taken following the achievement of drug steady-state （using AxSYM microparticle enzyme immunoassay-MEIA）. The risk/benefit ratio was evaluated based upon the correlation between measured blood concentrations of the drug and clinical response. Study results （100 decompensated patients） revealed that therapy indication field was correctly covered, showing a higher prevalence in elderly. On average, each examinee had 2 or 3 comorbidities. Applied daily dose of digoxin ranged from 0.053 mg to 0.25 mg. Renal function was assessed by creatinine clearance which is one of the key factors for the accomplishment of optimal digoxin serum concentrations （p 〈 0.05）. Co-administration of seven drugs was complicating factor for the management of rational therapy. 76/100 patients were within referent range （0.8-2.0 ng/mL）, while 13/100 were above the upper limit. Four side effects in total were recorded （nausea, vomiting, confusion）, whereas in only two patients digoxin was excluded from the therapy. Digoxin confirmed the justifiability of its use in contemporary clinical practice.

Development of a simple and rapid method to measure the free fraction of lamotrigine in plasma using HPLC:applications for therapeutic drug monitoring

Lamotrigine (LTG) is a widely used antiepileptic drug (AED) for the treatment of new-onset, as well as refractory epilepsy. Due to the narrow treatment window and large individual variability in the pharmacokinetics and pharmacodynamics of LTG, therapeutic drug monitoring (TDM) is necessary in clinical practice to guide dose adjustments. Individual differences and drug combinations can also affect protein binding rate, which further affects the unbound concentration of LTG. The unbound fraction is more closely related to adverse reactions and therapeutic efficacy than total concentration. Therefore, it may be more meaningful to determine the unbound LTG concentration in plasma than the total concentration.Unbound LTG in plasma was extracted by ultrafiltration. High-performance liquid chromatography (HPLC) was used to measure unbound LTG concentration. This method was validated by studies of its selectivity, linearity, lower limit of quantification (LLOQ), accuracy, precision, recovery, and stability.The method was validated over a linear range of 0.2 to 10.0 μg·mL–1, and its LLOQ was 0.2 μg·mL–1. The method’s relative standard deviations (RSDs) for intra-day and inter-day precision were less than 15%, and its accuracy (RE) was ±4.69%. The recoveries of unbound LTG at three different concentrations satisfied the requirements for the analysis of biological samples, and no significant degradation of LTG was observed under different storage conditions.A simple HPLC method showed good performance when used to measure unbound LTG concentration. This method might be used to study the relationship between unboundLTG concentrations and its effectiveness according to TDM.