Application of pegylated recombinant human granulocyte colony-stimulating factor(PEG-rhG-CSF) for the prevention of neutropenia in triple negative breast cancer patients older than 65 years during adjuvant chemotherapy

Objective The aim of this study was to compare the efficacy and safety of pegylated recombinant human granulocyte colony-stimulating factor(PEG-rhG-CSF)and recombinant human granulocyte colonystimulating factor(rhG-CSF)for the prevention of neutropenia in elderly breast cancer patients during adjuvant chemotherapy.Methods A total of 45 oncology inpatients with breast cancer,who received adjuvant chemotherapy and were older than 65 years from May 2017 to October 2018 in the General Hospital of the Northern Theater of the Chinese people’s Liberation Army,were included.Epirubivin Cyclophoshamide-Docetaxel(EC-T)sequential adjuvant chemotherapy was chosen.Forty-five patients were randomly divided into two groups;25 patients in the treatment group were treated with PEG-rhG-CSF and 20 patients in the control group were not treated with PEG-rhG-CSF,but only rhG-CSF.The experimental group was treated with the PEG-rhG-CSF at the end of chemotherapy for 24–48 h,with a 6 mg subcutaneous injection once per chemotherapy cycle.In the control group,rhG-CSF was administered after 48 h of chemotherapy,with a 100μg subcutaneous injection,1/d,d 1–7.The dosage could be increased step by step with the exacerbation of neutropenia.The primary aims of this study was to discover the incidence of leukopenia,neutropenia,neutrophilic fever,and adverse reactions in the two groups.Results The incidence of neutropenia,neutrophilic fever and adverse reactions decreased in the treatment group compared to the control group,but no significant difference existed between two groups(P>0.05).Patients in treatment group had a lower,but not statistically significant,incidence of adverse reactions(P>0.05).Conclusion Applying PEG-rhG-CSF could be effective in preventing neutropenia in elderly patients with postoperative adjuvant chemotherapy to treat breast cancer.It may effectively control the occurrence of neutropenia after chemotherapy and reduce the chance of infection.The incidence of side effects,such as fever and bone pain,was low.The adverse drug reactions were well tolerated by patients,which could ensure the smooth progress of chemotherapy.

Pharmacokinetic Study of a Novel Recombinant Human Granulocyte Colony-stimulating Factor in Rats

Objective To study the pharmacokinetics of a novel recombinant human granulocyte colonystimulating factor (rhG-CSFa) in rats and to determine the proteolytic rates of rhG-CSFa in the whole blood and serum of rats in vitro. Methods The pharmacokinetics of rhG-CSFa and conventional (wild type,WT) granulocyte colonystimulating factor (G-CSF) were investigated in Sprague-Dawley rats which received either intravenous or subcutaneous injection of rhG-CSFa or WT G-CSF at three different doses (20,50,or 100 μg/kg). The blood samples of rats were collected at multiple time points (from 0.08 to 12 h) and the concentrations of rhG-CSFa and WT G-CSF in serum were determined with a sandwich enzyme-linked immunosorbent assay (ELISA). For the study of proteolytic rates in vitro,the concentrations of rhG-CSFa or WT G-CSF were determined at 3-minute intervals after addition of the respective drug to rat’s whole blood or serum. Results Pharmacokinetic analysis of serum rhG-CSFa or WT G-CSF levels indicated that,at each dose tested,for either route of drug administration,the area under concentration-time curve values and the maximum serum concentration of rhG-CSFa were higher than those of WT G-CSF,and the serum half life of rhG-CSFa was longer than that of WT G-CSF. Subsequent in vitro whole blood and serum stability study showed that the rates of drug degradation in WT G-CSF were 1.8 folds and 1.5 folds higher than those in rhG-CSFa,respectively. Conclusion rhG-CSFa has better serum and whole blood stability in vitro and higher bioavailability in vivo as compared to WT G-CSF.

Anti-apoptotic effects of recombinant human granulocyte colony-stimulating factor in focal cerebral ischemic rats

The neuroprotective effects of granulocyte colony-stimulating factor in cerebral ischemia/reperfusion injury are currently contentious. The present study examined the effects of subcutaneous injection of recombinant human granulocyte colony-stimulating factor (50 μg/kg) over 5 days in a model of cerebral ischemia/reperfusion with intraluminal filament occlusion in rats. The results indicated that recombinant human granulocyte colony-stimulating factor reduced brain infarct volume following cerebral ischemia/reperfusion injury in rats, down-regulated the expression of caspase-3 mRNA (a key protease for apoptosis in the cerebral ischemia zone), lowered the rate of neuronal apoptosis in the cerebral ischemia zone, and notably ameliorated neurological function. These results indicate that recombinant human granulocyte colony-stimulating factor has anti-apoptotic effects on neurons following focal cerebral ischemia/reperfusion injury, and exerts neuroprotective effects.

A New Protocol for Solubilization, Refolding and Purification of Recombinant Human Granulocyte Colony-stimulating Factor in Inclusion Bodies

Recombinant human granulocyte colony-stimulating factor (rhG-CSF) in inclusion bodies was solubilized by 8 mol/L urea solution and subsequently precipitated by acetone to improve its purity. After that, the precipitates were solubilized by sodium hydroxide solution containing 2 mol/L urea. Then the solubilized rhG-CSF was passed through a size exclusion chromatography for refolding and extensive purification, and further purified by a weak anion exchange chromatography. The purity and mass recovery of refolded rhG-CSF were 96.5% and 75.6%, respectively. The bioactivity was 8.4×107 IU/mg.

Refolding with Simultaneous Purification of Recombinant Human Granulocyte Colony-stimulating Factor from Escherichia coli Using Strong Anion Exchange Chromatography

The urea denatured recombinant human granulocyte colony-stimulating factor (rhG- CSF) which was expressed in Escheriachia coli (E. coli) was refolded with simultaneous purification by strong anion exchange chromatography (SAX) in the presence of low concentration- of urea. The effect of urea concentration on this refolding process was investigated. The obtained refolded rhG-CSF has a high specific activity of 2.3×108 U/mg, demonstrating that the proteins were completely refolded during the chromatographic process. With only one step by SAX in 40 min, purity and mass recovery of the refolded and purified rhG-CSF were 97% and 43%, respectively.

A retrospective study of pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) in preventing neutropenia during definitive concurrent chemoradiotherapy in patients with esophageal squamous carcinoma

Objective:To compare the efficacy and safety of pegylated recombinant human granulocyte colony-stimulating factor(PEG-rhG-CSF)for preventive or delayed treatment in neutropenia,completion rate of concurrent chemoradiotherapy and hospitalization rate in patients with esophageal squamous carcinoma during definitive concurrent chemoradiotherapy.Methods:A total of 70 patients with esophageal squamous carcinoma in Peking University Cancer Hospital from January 2019 to December 2020,who received PEG-rhG-CSF during concurrent chemoradiotherapy,were enrolled in this retrospective analysis.There were 32 patients in the preventive group,and 38 patients in the delayed group.The incidence of neutropenia,completion rate of concurrent chemoradiotherapy and neutropeniarelated hospitalization rate were compared between PEG-rhG-CSF preventive group and delayed group.Results:The incidence of severe neutropenia(Grades 3–4)in all patients was 31.4%.Comparison between preventive group and delayed group showed that the incidence of severe neutropenia was 6.3%and 39.4%(χ^(2)=10.428,P=0.001),respectively.In preventive group,the incidence of severe neutropenia was 3.7%and 20.0%,respectively,for primary prevention and secondary prevention of PEG-rhG-CSF(χ^(2)=12.321,P=0.001).The completion rate of concurrent chemoradiotherapy was 93.8%in the preventive group and 63.2%in the delayed group(χ^(2)=9.220,P=0.002).The incidence of treatment interruption was 25.7%in the whole group,12.5%in the preventive group and 36.8%in the delayed group(χ^(2)=5.389,P=0.020).Seven patients(7/70,10.0%)were hospitalized and treated with intravenous antibiotics for neutropenia,including 1 in the preventive group and 6 in the delayed group(P=0.078).Conclusions:Prophylactic use of PEG-rhG-CSF during concurrent chemoradiotherapy for patients with esophageal squamous carcinoma can effectively reduce the incidence of neutropenia,ensure the safety of treatment,and improve the completion rate of concurrent chemoradiotherapy.

Clinical Study of Recombinant Human Granulocyte-Macrophage Colony-Stimulating Factor on Chemotherapy-Induced Leukopenia.

We have studied the efficacy and safery of recombinant human granulocyte-macrophate colony-stimulating

rhG-CSF在治疗儿童化疗性口腔黏膜炎中的应用研究

目的探究重组人粒细胞集落刺激因子(recombinant human granulocyte-colony stimulating factor,rhG-CSF)在治疗儿童化疗性口腔黏膜炎中的应用效果。方法选取2020年1月至2022年6月于笔者医院肿瘤外科化疗的60例化疗性口腔黏膜炎患儿,按随机数字表法分为两组,每组30例。对照组采取生理盐水口腔护理,实验组采取rhG-CSF口腔护理。比较两组患儿干预效果、口腔黏膜炎分度、生存质量[健康状况调查简表(36-item short—form,SF-36)]、患儿家长护理满意度。结果实验组总有效率较对照组高,差异有统计学意义(P<0.05)。干预5d,实验组患儿口腔黏膜炎分度结果优于对照组,差异有统计学意义(P<0.05)。干预5d,两组患儿SF-36评分较干预前高,实验组较对照组高,差异有统计学意义(P<0.05)。实验组患儿家长满意度较对照组高,差异有统计学意义(P<0.05)。结论rhG-CSF口腔护理可有效提高儿童化疗性口腔黏膜炎的干预效果,减轻口腔黏膜炎分度,改善患儿生存质量,提高患儿家长护理满意度。

聚乙二醇化重组人粒细胞刺激因子预防急性淋巴细胞白血病患儿化疗后中性粒细胞减少的临床疗效观察

目的探讨聚乙二醇化重组人粒细胞刺激因子(PEG-rhG-CSF)预防急性淋巴细胞白血病(ALL)患儿化疗后中性粒细胞减少的临床疗效。方法回顾性分析2020年7月至2023年7月在绵阳市中心医院就诊的60例急性ALL患儿的临床资料。根据治疗方法不同将患儿分为观察组和对照组,各30例。对照组采用重组人粒细胞刺激因子(rhG-CSF)进行干预,观察组采用PEG-rhG-CSF进行干预。比较两组患儿化疗前及化疗3周后绝对中性粒细胞计数(ANC)和白细胞计数(WBC)水平,化疗后3周的中性粒细胞减少的开始时间、持续时间和结束时间,比较两组患儿化疗3周后在白细胞降低发生率、中性粒细胞减少症(FN)发生率及不良反应发生率。结果化疗3周后,两组患者的ANC、WBC水平均较化疗前升高,且观察组患儿的ANC、WBC水平分别为(6.77±4.22)×10^(9)/L、(9.17±3.36)×10^(9)/L,均明显高于对照组[(6.34±2.34)×10^(9)/L、(8.91±3.56)×10^(9)/L],差异均有统计学意义(P<0.05)。两组患儿中性粒细胞减少的开始时间比较,差异无统计学意义(P>0.05);观察组患儿中性粒细胞减少的持续时间和结束时间分别为(8.99±3.31)、(4.79±1.18)d,均明显短于对照组[(15.56±4.91)、(6.97±3.32)d],差异均有统计学意义(P<0.05)。观察组患儿白细胞降低率、FN实际发生率、再住院率和抗生素使用率分别为30.00%、10.00%、3.33%、3.33%,均明显低于对照组(56.67%、40.00%、43.33%、36.67%),差异均有统计学意义(P<0.05)。观察组患儿的ANC减少、感染、骨骼肌肉酸痛、腹泻、恶心呕吐发生率分别为16.67%、6.67%、3.33%、6.67%、10.00%,均明显低于对照组(43.33%、30.00%、16.67%、26.67%、36.67%),差异均有统计学意义(P<0.05)。结论PEG-rhG-CSF能明显缩短急性ALL患儿化疗后中性粒细胞减少的持续时间和结束时间,且不良反应发生率低,在预防急性ALL患儿化疗后中性粒细胞减少方面疗效显著,安全性较高。

PEG-rhG-CSF在血液肿瘤自体造血干细胞动员中的临床分析

目的:探讨无外周血CD34监测下聚乙二醇重组人粒细胞集落刺激因子(PEG-rhG-CSF)在血液肿瘤自体外周血干细胞动员中的采集时机及采集效果。方法:回顾性分析2017年8月至2022年1月福建医科大学附属第一医院收治的46例行自体外周血干细胞动员的血液恶性肿瘤患者。采用大剂量化疗联合PEG-rhG-CSF或重组人粒细胞集落刺激因子(G-CSF)动员方案,其中应用PEG-rhG-CSF动员的27例(PEG-rhG-CSF组),应用G-CSF动员的19例(G-CSF组),比较两组患者动员采集效果。结果:46例患者共采集86例次,PEG-rhG-CSF组与G-CSF组获得采集物的单个核细胞中位数分别为6.54(3.85-12.61)×10^(8)/kg和6.15(1.13-11.58)×10^(8)/kg(P>0.05),采集物CD34^(+)细胞数分别为11.44(1.33-65.02)×10^(6)/kg和4.95(0.30-24.02)×10^(6)/kg(P<0.05),采集时机分别为14(10-20)和14(4-22)d(P>0.05)。PEG-rhG-CSF组在外周血白细胞(WBC)≥10×10^(9)/L时单次所采集的产物CD34^(+)细胞数明显高于外周血WBC<10×10^(9)/L时采集的数量[19.04(2.85-65.02)×10^(6)/kg vs 6.22(0.81-34.86)×10^(6)/kg,(P<0.05)]。结论:采用PEG-rhG-CSF动员外周血干细胞单次采集足量CD34^(+)细胞成功率高,中位动员时间为14 d;在无外周血CD34监测情况下,外周血WBC≥10×10^(9)/L可以考虑作为单次采集足量干细胞的采集阈值。

重组人粒细胞集落刺激因子联合阿司匹林对不明原因不孕症患者子宫内膜容受性的影响

目的探讨重组人粒细胞集落刺激因子(rhG-CSF)联合阿司匹林对不明原因不孕症患者子宫内膜容受性的影响。方法回顾性分析2020年10月至2022年10月河北燕达医院收治的97例不明原因不孕症患者的临床资料。根据治疗方式分为常规组(n=48,采用阿司匹林治疗)和联合组(n=49,采用rhG-CSF联合阿司匹林治疗)。比较两组治疗前后的子宫内膜厚度、子宫血流灌注指标[子宫动脉阻力指数(RI)、搏动指数(PI)、收缩期流速与舒张期流速比值(S/D)],比较两组的妊娠结局。结果治疗后,联合组子宫内膜厚度大于常规组,差异具有统计学意义(P<0.05)。治疗后,两组RI、PI及S/D值均降低,且联合组低于常规组,差异具有统计学意义(P<0.05)。治疗后,联合组生化妊娠率、临床妊娠率均高于常规组,差异具有统计学意义(P<0.05)。结论rhG-CSF联合阿司匹林治疗不明原因不孕症患者,可提高其的子宫内膜容受性,改善子宫血流灌注,有效提高妊娠率。

经完全性手术切除的Ⅱ~ⅢA期EGFR野生型NSCLC术后辅助化疗中预防应用PEG-rhG-CSF的临床获益分析

目的探究经完全性手术切除的Ⅱ~ⅢA期表皮生长因子受体(EGFR)野生型非小细胞肺癌(NSCLC)术后辅助化疗中预防应用聚乙二醇化重组人粒细胞集落刺激因子(PEG-rhG-CSF)的临床获益。方法前瞻性选取2019年2月至2021年2月广东医科大学附属医院经完全性手术切除的Ⅱ~ⅢA期EGFR野生型NSCLC术后辅助化疗患者90例作为研究对象,根据随机数字表法将患者分为观察组与对照组,每组各45例。对照组预防性应用重组人粒细胞(rhG-CSF),观察组预防性应用PEG-rhG-CSF。对患者随访3个月,比较两组治疗前及治疗1、3、5、10 d后的白细胞计数、中性粒细胞计数水平及白细胞减少症、中性粒细胞减少症发生情况,并记录患者随访期内化疗后的不良反应情况。结果两组患者在治疗前及治疗1、3、5 d后的白细胞计数水平比较,差异均无统计学意义(P>0.05);治疗10 d后,观察组患者的白细胞计数水平为(5.65±1.11)×10^(9)/L,高于对照组[(4.66±1.08)×10^(9)/L],差异有统计学意义(P<0.05)。两组患者在治疗前及治疗1、3、5 d后的中性粒细胞计数水平比较,差异均无统计学意义(P>0.05);治疗10 d后,观察组患者的中性粒细胞计数水平为(3.61±1.51)×10^(9)/L,高于对照组[(2.65±1.46)×10^(9)/L],差异有统计学意义(P<0.05)。观察组患者2、3级白细胞减少症和中性粒细胞减少症发生率分别为15.56%、11.11%,均低于对照组(35.56%、42.22%),差异均有统计学意义(P<0.05)。两组患者在骨骼肌疼痛、疲劳、感染、发热、胃肠反应等方面比较,差异均无统计学意义(P>0.05)。结论对经完全性手术切除后Ⅱ~ⅢA期EGFR野生型NSCLC患者,术后辅助化疗中预防应用PEG-rhG-CSF可以提高白细胞计数和中性粒细胞计数水平,并减少白细胞减少症和中性粒细胞减少症的发生,有助于改善患者的免疫功能和预后。

四君子汤联合rhG-CSF对卵巢癌患者术后化疗导致白细胞降低的临床效果

目的分析四君子汤联合重组人粒细胞刺激因子注射液(rhG-CSF)对卵巢癌患者术后化疗导致白细胞降低的临床效果。方法选取80例卵巢癌术后化疗导致白细胞降低患者,随机分为对照组(40例)和联合组(40例)。其中对照组给予rhG-CSF治疗,联合组给予四君子汤联合rhG-CSF治疗。比较2组Th1类细胞因子水平[肿瘤坏死因子α(TNF-α)、γ-干扰素(IFN-γ)、白细胞介素-2(IL-2)],Th2类细胞因子水平[白细胞介素-6(IL-6)、白细胞介素-4(IL-4)、白细胞介素-10(IL-10)],白细胞计数(WBC)、血小板计数(PLT)、中性粒细胞计数(NE),中医证候积分,临床疗效及不良反应发生情况。结果与治疗前比较,2组治疗后血清TNF-α、IL-6、IL-4、IL-10水平、神疲乏力、自汗盗汗、食少纳呆、腰膝酸软等中医证候积分均明显降低(P<0.05),且与对照组比较,观察组明显降低(P<0.05);2组血清IFN-γ、IL-2、WBC、PLT、NE水平明显升高(P<0.05),且与对照组比较,观察组明显升高(P<0.05);观察组总有效率(52.50%)明显高于对照组(30.00%)(P<0.05);观察组不良反应发生率(2.50%)明显低于对照组(20.00%)(P<0.05)。结论四君子汤联合rhG-CSF治疗卵巢癌术后化疗导致白细胞降低患者可有效改善临床症状,升高白细胞水平,提高免疫功能,安全有效。

儿童神经母细胞瘤化疗后严重感染的影响因素及重组人粒细胞刺激因子预防的应用效果

目的:分析并探究儿童神经母细胞瘤(NB)化疗后严重感染的影响因素及重组人粒细胞刺激因子(rhG-CSF)预防的应用效果,为临床提供依据。方法:回顾性分析2020年3月—2021年12月南阳市中心医院收治的100例NB患儿的一般资料,统计所有患儿在化疗治疗后严重感染的发生率,并统计临床上可能诱发感染的影响因素。将停止化疗24 h后立即接受rhG-CSF预防干预的患儿为观察组(n=57);将出现粒细胞缺乏现象后再接受rhG-CSF预防干预的患儿为对照组(n=43)。观察两组患者严重感染发生情况并分析其影响因素,比较rhG-CSF预防的应用效果。结果:100例患儿中严重感染发生率为27.00%(27/100)。NB患儿化疗后严重感染发生率单因素分析结果显示,不同患儿年龄、病情分期、远处转移、血清神经元特异性烯醇化酶(NSE)、手术切除、化疗药物、化疗持续时间等都会影响到患儿化疗后严重感染发生率,差异有统计学意义(χ2=5.372、6.222、6.322、5.983、4.785、10.079、7.193,P<0.05)。应用rhG-CSF干预治疗后,对照组严重感染发生率高于观察组,持续时间长于对照组,差异有统计学意义(χ^(2)=6.515;t=10.218,P<0.05)。结论:影响儿童NB化疗后严重感染的主要因素为患儿年龄、临床分期、血清NSE水平、选用的化疗药物、化疗的持续时间等,若能够在患儿化疗24 h后及时给予rhG-CSF干预治疗,则能显著降低患儿群体出现严重感染的概率,有利于更好地改善患儿的预后。

大补元煎加味联合聚乙二醇化重组人粒细胞集落刺激因子对含铂双药化疗后Ⅲ、Ⅳ度骨髓抑制患者的临床效果

目的探讨大补元煎加味联合聚乙二醇化重组人粒细胞集落刺激因子(PEG-rhG-CSF)对含铂双药化疗后Ⅲ、Ⅳ度骨髓抑制患者的临床效果。方法选取150例含铂双药化疗后Ⅲ、Ⅳ度骨髓抑制患者,将其随机分为对照组和研究组,每组75例。对照组行PEG-rhG-CSF治疗,研究组在对照组的基础上行大补元煎加味治疗,两组均持续用药21 d。比较两组血常规指标、T淋巴细胞亚群、生活质量和治疗期间不良反应的发生情况。结果治疗21 d后,研究组白细胞、中性粒细胞、CD3+、CD4+水平和CD4+/CD8+,以及生存质量测定量表生理领域评分、心理领域评分、社会领域评分与环境领域评分均高于对照组,CD8+水平低于对照组(均P<0.05)。两组治疗期间不良反应的发生情况差异无统计学意义(P>0.05)。结论大补元煎加味联合PEG-rhG-CSF可改善含铂双药化疗后Ⅲ、Ⅳ度骨髓抑制患者的血常规指标,纠正T淋巴细胞紊乱,改善生活质量。

rhGM⁃CSF预防非小细胞肺癌放疗所致急性放射性食管炎的效果观察

目的探讨注射用重组人粒细胞⁃巨噬细胞集落刺激因子(rhGM⁃CSF)预防非小细胞肺癌(NSCLC)放疗所致急性放射性食管炎的效果。方法选取2016年6月至2020年10月医院收治的168例拟接受放疗的NSCLC患者为研究对象,以随机数字表法分为对照组(n=84)和研究组(n=84)。对照组采用三维适形放疗联合化疗进行治疗,研究组在对照组的基础上采用rhGM⁃CSF治疗,2组均治疗2~6个周期。比较2组治疗前后免疫功能、生活质量核心问卷(QLQ⁃C30)评分,比较2组治疗后放射性食管炎发生情况以及放射性食管炎视觉模拟量表(VAS)评分。结果治疗后,2组CD4+、CD3+、CD16+CD56+水平均升高(P<0.05),研究组高于对照组(P<0.05);治疗后,2组放射性食管炎分级等级差异有统计学意义(P<0.05),且研究组3~4级放射性食管炎发生率低于对照组(P<0.05);2组放射性食管炎患者VAS评分均降低(P<0.05),研究组放射性食管炎患者VAS评分低于对照组(P<0.05);2组QLQ⁃C30评分均降低(P<0.05),研究组低于对照组(P<0.05)。结论rhGM⁃CSF联合三维适形放疗用于治疗NSCLC患者,可改善患者的免疫功能,提高患者的生活质量,减少3~4级放射性食管炎发生率,减轻NSCLC患者经三维适形放疗所致放射性食管炎患者疼痛。

PEG-rhG-CSF皮下注射与替吉奥联合调强放疗对晚期食管癌的疗效及生存质量的影响

目的探讨皮下注射聚乙二醇化重组人粒细胞集落刺激因子(PEG-rhG-CSF)联合替吉奥在晚期食管癌调强放疗治疗中的价值。方法前瞻性选取2018年1月至2019年9月淮北矿工总医院收治的60例晚期食管癌患者作为研究对象,采用随机数字表法将患者分为观察组和对照组,各30例。对照组患者采用替吉奥+调强放疗措施治疗,观察组患者在对照组基础上同时给予PEG-rhG-CSF注射治疗。比较两组患者放疗近期效果、外周血T淋巴细胞亚群及NK细胞、生存质量评分、毒副反应发生率、生存率及生存时间差异。结果两组的治疗效果分布比较,差异无统计学意义(P>0.05)。治疗后,观察组患者的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、CD16^(+)CD56^(+)NK细胞占比分别为(62.50±4.80)%、(38.51±3.00)%、1.49±0.15、(22.63±2.24)%,均高于对照组[(58.83±5.28)%、(36.67±2.89)%、1.39±0.13、(21.55±1.87)%],差异均有统计学意义(P<0.05)。治疗后,观察组患者的乏力、恶心、食欲不振、失眠评分为(36.29±4.16)、(44.10±5.06)、(33.52±4.27)、(34.20±4.86)分,均低于对照组[(38.85±3.78)、(47.03±4.81)、(37.30±4.52)、(37.56±5.20)分],差异均有统计学意义(P<0.05)。治疗过程中,观察组患者的恶心、呕吐、放射性食管炎、放射性肺炎发生程度均低于对照组,差异有统计学意义(P<0.05)。随访2年,观察组生存率43.33%,对照组生存率33.33%,观察组的中位生存时间21个月,对照组20个月,两组差异无统计学意义(P>0.05)。结论PEG-rhG-CSF联合替吉奥在晚期食管癌调强放疗治疗中应用能缓解放化疗引起的细胞免疫功能受损、改善生存质量、降低毒副反应发生率。

PRP凝胶与rhGM-CSF凝胶治疗慢性难愈性创面的效果及对创面修复因子的影响

目的比较自体富血小板血浆(PRP)凝胶与重组人粒细胞巨噬细胞集落刺激因子(rhGM-CSF)凝胶治疗慢性难愈性创面的效果及对创面修复因子的影响。方法将80例慢性难愈性创面患者分为PRP组和rhGM-CSF组,各40例。在外科常规治疗基础上,PRP组采用PRP凝胶治疗,rhGM-CSF组采用rhGM-CSF凝胶治疗。比较两组患者创面完全愈合时间,治疗2周后创面愈合率、感染控制水平,治疗前后创面修复因子[血管内皮生长因子(VEGF)、血小板衍生生长因子(PDGF)、碱性成纤维细胞生长因子(bFGF)、表皮生长因子(EGF)]表达量、疼痛视觉模拟量表(VAS)评分。记录两组患者治疗过程中不良反应的发生情况。结果PRP组创面完全愈合时间短于rhGM-CSF组(P<0.05)。治疗2周后,PRP组患者创面愈合率高于rhGM-CSF组;两组患者疼痛VAS评分、白细胞计数及血清C反应蛋白水平均低于治疗前,创面VEGF、PDGF、bFGF、EGF表达量均较治疗前升高,且PRP组患者上述指标均优于rhGM-CSF组(均P<0.05)。两组患者治疗前后的创面细菌培养阳性情况差异无统计学意义(P>0.05)。治疗过程中PRP组无不良反应发生,rhGM-CSF组共出现3例不良反应,两组不良反应总发生率差异无统计学意义(P>0.05)。结论PRP凝胶与rhGM-CSF凝胶对慢性难愈性创面患者的创面愈合情况、疼痛、感染水平等均具有改善作用,而PRP凝胶上述效果优于rhGM-CSF凝胶。

聚乙二醇化重组人粒细胞刺激因子在乳腺癌化疗中的应用效果分析

目的 分析聚乙二醇化重组人粒细胞刺激因子在乳腺癌化疗中的应用效果。方法 选取新疆医科大学第一附属医院乳腺外科2018年1月-2021年11月因乳腺癌行化学治疗的1 024例患者作为研究对象,根据化疗后是否预防性应用聚乙二醇化重组人粒细胞刺激因子(PEG-rh G-CSF)分为2组,518例不应用PEG-rh G-CSF(对照组),506例应用PEG-rh G-CSF(观察组),比较2组患者化疗后Ⅲ~Ⅳ级骨髓抑制、发热、感染发生率,静脉抗生素应用率,再住院率及化疗药物减量或延迟率。结果 观察组Ⅲ~Ⅳ级骨髓抑制、发热及感染等不良反应发生率,再住院率,静脉抗生素应用率,化疗药物减量或延迟率均较对照组明显降低,差异有统计学意义(P<0.05)。结论PEG-rh G-CSF的预防性应用能够显著降低乳腺癌化疗后Ⅲ~Ⅳ级骨髓抑制、发热、感染、再住院、静脉抗生素应用及化疗药物减量或延迟等发生率,对减轻患者化疗后身心创伤、保障化疗周期的足剂量续贯进行及优化乳腺癌管理具有重要的临床应用价值。

不同种类敷料治疗烧伤疗效的网状Meta分析

目的:目前烧伤敷料种类多样,但何种敷料效果最佳却仍缺乏相应的循证医学证据。文章采用网状Meta分析方法系统评价11种敷料治疗烧伤的疗效。方法:计算机检索中国知网、万方数据知识服务平台、维普数据库、中国生物医学文献数据库、PubMed、Embase、Web of Science及Cochrane Library数据库,检索时间为各数据库建库至2021年8月,纳入关于不同敷料治疗烧伤创面的临床随机对照试验。对文献进行筛选和资料提取,采用RevMan 5.4和Stata 14.2软件进行文献质量评价和数据分析。结果:纳入32项随机对照试验,共3795例烧伤患者,涉及11种敷料。网状Meta分析结果显示:①在缩短烧伤创面愈合时间方面,网状Meta分析排序结果从优到劣依次为:重组人粒细胞巨噬细胞集落刺激因子>富血小板血浆>芦荟敷料>成纤维细胞生长因子>银离子敷料>羊膜>重组人表皮生长因子>蜂蜜敷料>传统敷料>磺胺嘧啶银>异种猪皮敷料;②在控制烧伤创面感染率方面,网状Meta分析排序结果从优到劣依次为:蜂蜜敷料>异种猪皮敷料>银离子敷料>芦荟敷料>磺胺嘧啶银>富血小板血浆>传统敷料。结论:重组人粒细胞巨噬细胞集落刺激因子在缩短烧伤创面愈合时间方面总体效果最佳,蜂蜜敷料在控制创面感染率方面总体效果最好,但未来仍需更多高质量随机对照试验来进一步证实。