培美曲塞、顺铂联合125I粒子植入治疗晚期非小细胞肺癌患者临床效果观察

目的 探讨培美曲塞、顺铂联合125I粒子植入治疗晚期非小细胞肺癌(NSCLC)患者的临床效果.方法 将2018年7月至2019年7月在我院接受治疗的68例晚期NSCLC患者采用随机数字法分为观察组与对照组,每组34例.对照组患者接受培美曲塞、顺铂方案化疗,观察组患者接受培美曲塞、顺铂方案化疗联合125I粒子植入放疗.治...     

培美曲塞在老年晚期非小细胞肺癌姑息性化疗中的作用

目的观察培美曲塞在老年晚期非小细胞肺癌(NSCLC)姑息性化疗中的作用。方法接受化疗的老年晚期NSCLC患者86例依据化疗方案的不同分为观察组(培美曲塞+顺铂)及对照组(吉西他滨+顺铂)各43例,对比两组短期疗效及不良反应、肿瘤标态物水平和1年累积生存率。结果两组短期治疗有效率无显著差异(χ~2=0.186,P=0.666)。观察组治疗期间不良反应发生率显著低于对照组(χ~2=4.497,P=0.034);治疗后,两组外周血癌胚抗原(CEA)、糖类抗原(CA)19-9及细胞角蛋白19血清片段(CYFRA)21-1水平均显著降低(P<0.05),观察组显著低于对照组(P<0.05)。观察组化疗后1年累积生存率显著高于对照组(χ~2=4.178,P=0.041)。结论培美曲塞联合顺铂化疗可显著提高老年晚期NSCLC的远期疗效,并降低化疗不良反应发生率。     

培美曲塞联合卡铂治疗老年晚期非鳞非小细胞肺癌临床疗效分析

目的评价培美曲塞联合卡铂治疗老年晚期非鳞非小细胞肺癌的临床疗效及毒副作用。方法92例晚期非鳞非小细胞肺癌老年患者,其中培美曲塞联合卡铂（Pc组）治疗42例,吉西他滨联合卡铂（GC组）治疗50例。结果Pc组和GC组疾病控制率（DCR）为73．8％及70．2％（P〉0．05）。PC组毒副反应发生率小于GC组。结论培美曲塞联合卡铂治疗老年晚期非鳞非小细胞肺癌的疗效与吉西他滨联合卡铂的疗效相当,但副作用明显减少,患者耐受性更好。     

吉西他滨与顺铂化疗对非小细胞肺癌行全胸腔镜肺癌根治术后生存质量的影响

目的探讨吉西他滨与顺铂化疗对非小细胞肺癌(NSCLC)患者行全胸腔镜肺癌根治术后生存质量的影响。方法行全胸腔镜肺癌根治术NSCLC患者74例,随机分组,各37例。对照组用培美曲塞+顺铂治疗,观察组采取吉西他滨+顺铂治疗,均治疗2个周期(每个周期21 d)。对比两组临床疗效、不良反应发生情况,治疗前后患者生存质量量表(QLQC30)评分变化。结果观察组有效率为54.05%,对照组为40.54%,无差异(P>0.05);治疗后观察组QLQC30量表评分高于对照组(P<0.05);两组不良反应发生率无差异(P>0.05)。结论联合吉西他滨与顺铂化疗应用于非小细胞肺癌行全胸腔镜肺癌根治术患者疗效肯定,可提高患者生存质量,且不增加不良反应发生率,安全性较高。     

参附注射液配合培美曲塞联合草酸铂二线治疗晚期非小细胞肺癌的临床观察

目的评价参附注射液配合培美曲塞联合草酸铂二线治疗晚期非小细胞肺癌的近期疗效、副反应及化疗完成情况。方法将30例晚期非小细胞肺癌患者随机分成两组,所有患者均采用培美曲塞联合草酸铂化疗,培美曲塞500mg／m2。静脉滴入,第1天给药,草酸铂100mg／m2。静脉滴入,第1天给药,3—4周为1个周期,共2～4个周期。研究组在化疗同时配合参附注射液250ml静脉滴注,每天1次,使用7～10天。结果（1）近期疗效：研究组有效率为26．6％（4／15）;对照组有效率为20％（3／15）,两组比较差异无统计学意义（P〉0．05）。（2）生活质量评价（KPS）：研究组有效率为73．3％（11／15）,对照组为46．6％（7／15）,两组比较差异有统计学意义（P〈0．05）。（3）毒副反应：研究组血液系统毒副反应发生情况低于对照组,差异有统计学意义（P〈0．05）。两组非血液系统毒副反应发生情况比较差异无统计学意义（P〉0．05）。（4）化疗完成情况：研究组化疗完成情况高于对照组,两组比较差异有统计学意义（P〈0．05）。结论参附注射液配合培美曲塞联合草酸铂二线治疗晚期非小细胞肺癌可有效降低化疗毒副反应,改善生活质量,提高患者对化疗的耐受力。     

培美曲塞或多西他赛治疗晚期非小细胞肺癌的临床观察

目的观察培美曲塞或多西他赛联合顺铂二线治疗老年晚期非小细胞肺癌的疗效及不良反应。方法分析52例晚期非小细胞肺癌患者,应用培美曲塞联合顺铂治疗25例,多西他赛联合顺铂治疗27例,评价疗效及不良反应。结果 52例中无CR病例。培美曲塞组PR 3例,SD 11例,PD 11例,中位生存期为8.7个月;多西他赛组PR 3例,SD 12例,PD 12例,中位生存期为8.5个月。两组比较,DCR和中位生存期差异均无统计学意义（P〉0.05）。培美曲塞组中性粒细胞减少的发生率低于多西他赛组。结论培美曲塞或多西他赛联合顺铂治疗晚期非小细胞肺癌疗效相当,但培美曲塞不良反应的发生率较低。     

培美曲塞联合顺铂化疗对晚期非小细胞肺癌患者血清肿瘤标志物的影响

目的探讨培美曲塞联合顺铂化疗对晚期非小细胞肺癌(NSCLC)患者血清肿瘤标志物影响。方法选择97例NSCLC患者为研究对象,均给予培美曲塞联合顺铂化疗,采用电化学发光法检测血清癌胚抗原(CEA),糖类抗原125(CA-125)、细胞角质素片段抗原21-1(CYFRA21-1)、神经元特异性烯醇化酶(NSE)表达水平。结果 97例患者中,完全缓解(CR)3例,部分缓解(PR)48例,无变化(SD)24例,进展(PD)22例。疾病控制率77.32%(75/97),进展率22.68%(22/97);化疗后,鳞癌组、腺癌组、腺磷癌组血清肿瘤标志物CEA、CA125、CYFRA21-1、NSE表达水平均明显下降(t=2.490~12.368,P0.05),化疗前后,鳞癌组血清肿瘤标志物CEA、CA125、CYFRA21-1、NSE表达水平均明显高于腺癌组与腺磷癌组(t=2.260~13.731,P0.05);化疗后,不同分期患者血清肿瘤标志物CEA、CA125、CYFRA21-1、NSE表达水平均明显下降(t=3.226~21.331,P0.05),化疗前后,Ⅳ期患者血清CEA、CA125、CYERA21-1、NSE明显高于Ⅲ期(t=7.286~10.675,P0.05);化疗前,控制组CEA、CA125、CYERA21-1表达水平明显低于进展组(P0.05);化疗后,控制组CEA、CA125、CYERA21-1表达水平明显降低(t=2.406~5.809,P0.05),化疗前后,进展组CEA、CA125、CYERA21-1表达水平明显升高,且控制组CEA、CA125、CYERA21-1表达水平明显低于进展组(t=23.976~54.697,P0.05)。结论 NSCLC患者血清CEA、CA125、CYERA21-1表达水平异常升高,培美曲塞联合顺铂化疗有助于降低患者血清CEA、CA125、CYERA21-1表达水平;血清CEA、CA125、CYERA21-1表达水平可作为病理分型、临床分期、疾病预后的重要指标。     

培美曲塞联合顺铂治疗中晚期非小细胞肺癌的有效性及安全性

目的分析培美曲塞联合顺铂治疗中晚期非小细胞肺癌的有效性及安全性。方法选取2012年1月—2014年1月江苏大学附属武进人民医院肿瘤科收治的非小细胞肺癌患者90例,根据治疗方法分为对照组47例和观察组43例。对照组患者采用吉西他滨联合顺铂化疗方案,观察组患者采用培美曲塞联合顺铂化疗方案;两组患者均至少治疗2个化疗周期。比较两组患者近期疗效、生存率及毒副作用发生情况。结果两组患者总缓解率、总控制率比较,差异无统计学意义(P0.05)。随访1、2、3年两组患者生存率比较,差异无统计学意义(P0.05)。两组患者Ⅰ~Ⅱ级、Ⅲ~Ⅳ级消化道反应及肝功能损伤发生率比较,差异无统计学意义(P0.05),而观察组患者Ⅰ~Ⅱ级、Ⅲ~Ⅳ级骨髓抑制发生率低于对照组(P0.05)。结论培美曲塞联合顺铂与吉西他滨联合顺铂治疗中晚期非小细胞肺癌的近期疗效相当,生存率相似,但培美曲塞联合顺铂化疗方案毒副作用较轻,有利于减少骨髓抑制的发生。     

顺铂培美曲塞对老年晚期非鳞状非小细胞肺癌的疗效评价

目的探讨顺铂一线联合培美曲塞对老年晚期非鳞状非小细胞肺癌临床疗效。方法对我院收治的122例患者随机分为实验组以及对照组,对照组采用顺铂一线进行治疗,实验组采用顺铂一线联合培美曲塞进行治疗,对两组患者治疗疗效以及毒副反应进行比较。结果实验组治疗有效率为27.87%,控制率为78.69%,而对照组分别为8.20%以及39.34%。实验组患者TTP为166±13 d,中位生存时间为287 d。对照组TTP为104±12 d,中位生存时间为174 d,两组患者在中位生存时间以及TTP比较中有明显的差异性;实验组患者发生不良反应率明显低于对照组。结论对老年晚期非鳞状非小细胞肺癌采用顺铂一线联合培美曲塞进行治疗,可有效改善预后,提高患者生存质量。     

贝伐单抗与培美曲塞联合治疗中晚期非小细胞肺癌的临床疗效及不良反应

目的探讨贝伐单抗与培美曲塞联合治疗中晚期非小细胞肺癌的临床疗效及不良反应。方法我院收治的非小细胞肺癌140例,经一线DP方案(多烯紫杉醇+顺铂)化疗4个周期病情得到有效控制后,随机选取70例进入贝伐单抗与培美曲塞联合治疗为实验组,另70例进入单用培美曲塞治疗为对照组。观察和比较两组化疗后的近期疗效及不良反应的发生情况。结果两组患者均没有CR,实验组PR、SD、RR及1年生存率优于对照组,但无统计学意义(P0.05),实验组的DCR明显优于对照组,具有显著性差异(P0.05)。两组患者在不良反应上的差异无统计学意义(P0.05)。结论贝伐单抗联合培美曲塞在中晚期非小细胞肺癌的临床治疗上安全、有效,值得推广应用。     

Misdiagnosis of clear cell renal cell carcinoma

Clear cell renal cell carcinoma (RCC) represents the most common histological subtype of malignant kidney tumors. Based on symptoms alone, clear cell RCC is indistinguishable from other histological classes of RCC unless the tumor is present in the context of an RCC syndrome. Histopathological examination is, therefore, important to accurately identify clear cell RCC. Clear cell RCCs have characteristic morphological criteria; these tumors can be easily identified upon typical presentation, but diagnosis can be challenging when tumor cell pattern is unusual or when availability of tissue samples is limited. In this Review, the clinical, radiological and pathological characteristics of clear cell RCCs are described, as well as the potential tumors that can be confused with clear cell RCC and need to be considered in the differential diagnoses. Finally, the importance of an accurate diagnosis is highlighted in the context of the increasing use of preoperative tissue sampling and the prevalence of clear cell tumors associated with hereditary syndromes, which could have different therapeutic and prognostic implications for patients and their families.     

Mechanism of red blood cell aging: Relationship of cell density and cell age

The human red cell has a life span of 120 days. The mechanism that determines cell removal from the circulation with such precision remains unknown. Most studies of red cell aging have been based on analysis of cells of progressively increasing age separated by density. The relationship between red cell age and density has been recently challenged, and the hypothesis has been put forward that cell death is not the result of a progressive deterioration of essential cell constituents. This theory was based on preliminary observations in transient erythroblastopenia of childhood, which could not later be confirmed. When the relationship between cell aging and increasing density is critically reviewed, it appears to be based on firm experimental evidence, confirmed by in vivo demonstration of decreasing survival of cells of increasing age. Analysis of studies using buoyant density gradients reveals that this technique can easily distinguish the single exponential slope of decline for those cell components that change progressively throughout the red cell life span from the biphasic decline of those that decrease drastically at the reticulocyte-mature red cell transition. The view that the aging of the red cell and its removal from the circulation result from a progressive series of events during the 120 days of its life span appears to be the most consistent with the available data. Density separation, validated by much experimental evidence, remains a most useful technique for the study of the mechanism of aging of the red cell. © 1993 Wiley-Liss, Inc.     

Germ cell stimulation of Sertoli cell protein phosphorylation

Cultures of Sertoli cells were treated with freshly isolated, intact germ cells to determine if germ cells were capable of influencing Sertoli cell function. By using two-dimensional polyacrylamide gel electrophoresis and autoradiography, germ cells were found to increase several-fold the incorporation of [32P]orthophosphate into two phosphoproteins (which we term germ cell-dependent phosphoproteins 1 and 2 or GC1 and GC2) of Sertoli cells. Increased phosphorylation of GC1 and GC2 was rapid, germ cell dose dependent, and calcium dependent. The increased phosphorylation of GC1 appears to involve calmodulin-dependent protein kinase, while phosphorylation of GC2 appears to involve the activation of calcium/phospholipid-dependent protein kinase (protein kinase C). Medium conditioned by germ cells was capable of eliciting the same response in Sertoli cells. Germ cells had no effect on the phosphorylation of proteins in Chinese hamster ovarian cells, but did result in increased phosphorylation of a protein in TR-ST cells, which migrated similarly to GC1 of Sertoli cells. Neither Chinese hamster ovarian nor TR-ST cells had any effect on Sertoli cell protein phosphorylation. These results indicate that germ cells may be directly involved in the local regulation of Sertoli cell function within the seminiferous epithelium. The results further suggest that the mechanism of germ cell-Sertoli cell interaction involves the mobilization of intracellular calcium, activation of Ca2+/calmodulin-dependent protein kinase, and protein kinase C. We infer from these results that germ cell-Sertoli cell interaction may operate via hydrolysis of Sertoli cell membrane phophatidylinositols.     

Red cell rheology in stomatocyte-echinocyte transformation: roles of cell geometry and cell shape

The influence of the shape of the red blood cell during stomatocyte- echinocyte transformation on its deformability was studied by microsieving through pores with diameters of 2.6, 4.5, and 6.9 micron. A stomatocytic transformation was produced by chlorpromazine (0.02, 0.1, and 0.5 mmol/L) and an echinocytic transformation by sodium salicylate (7.5, 30, and 120 mmol/L). For spherostomatocytes, an increase in filtration resistance through 2.6 and 4.5 micron pores was observed, whereas for spheroechinocytes, a decrease in filtration resistance through 2.6 micron pores was found. Larger pores (6.9 micron) were not sensitive to those shape changes. The changes in deformability can be explained by the fact that the surface area of (sphero)-stomatocytes decreased, whereas that of (sphero)-echinocytes increased; the cell volume remained essentially constant. Echinocytes produced by 24-hour adenosine triphosphate depletion differed from drug- induced echinocytes: they had an increased cell volume at constant surface area and consequently an increased filtration resistance through 2.6- and 4.5-micron filter pores. Shape changes with spicule formation are therefore not a homogeneous entity, and cell geometric factors (eg, surface area and volume) must be assessed with care. The viscosity of red cell suspensions at a hematocrit level of 45% was higher for drug-induced echinocytes than discocytes or stomatocytes at all shear rates tested. We conclude that the normal discocyte represents an optimum shape for the flow in vivo since a stomatocytic transformation could impair the passage through the microcirculation (decrease in cell filterability) and an echinocytic transformation could impair the flow in larger vessels (increase in blood viscosity).     

胆红素对肝星状细胞-T6增殖及细胞周期的影响

[目的]观察胆红素对肝星状细胞(HSC)-T6增殖及细胞周期影响.[方法]将培养细胞分成正常组和胆红素不同浓度(10 μmol/L、30 umol/L、50 /μmol/L、70 μmol/L、100 μmol/L)干预组,采用MTT法观察胆红素对HSC-T6增殖的影响,流式细胞仪观察各组细胞周期的变化.[结果]①不同浓度胆红素对HSC-T6均有促进增殖作用,且呈一定的量效关系,与正常组比较差异有统计学意义(P＜0.05);②10 μmol/L、50 μmol/L、100 μmol/L浓度胆红素作用HSC-T6后,G0/G1期减少,S期增加,G2/M期增加,与正常组比较均P＜0.05.[结论]胆红素对HSC-T6均有促进增殖作用.     

Red cell magnesium as a function of cell age

The variation in the magnesium content of human red cells as a function of cell age has been measured by atomic absorption spectrophotometry. The cell population was split into different age fractions using discontinuous density gradient centrifugation, since it is known that cell density increases with age. A mathematical model relating predicted cell age to cell density has been developed which allows the quantification of the observed fall-off in magnesium content with cell age. This model suggests that cells lose magnesium monoexponentially with age, the half-life being approximately 100 days. A previously proposed hypothesis that magnesium could enter the cells only at erythropoiesis and then decay monoexponentially predicted a half-life of 22.4 days and is therefore seen to be an oversimplification of magnesium kinetics in the red cell. The relevance of the present findings to pathologic conditions with abnormal red cell magnesium concentrations is discussed.     

Kinetics of dendritic cell chimerism and T cell chimerism in allogeneic hematopoietic stem cell recipients

Dendritic cells (DC) as potent antigen-presenting cells (APC) and T cells as effector cells play an essential role in the pathophysiology of both graft-versus-host (GvH) and graft-versus-leukemia (GvL) reactions after transplantation. Therefore, we determined the kinetics of DC and T-cell chimerism establishment after allogeneic hematopoietic cell transplantation (AHCT) in a group of 144 patients, using fluorescence-activated cell sorting (FACS) or magnetic cell sorting (MACS) followed by FISH or STR-PCR analysis for chimerism evaluation. In all, three cell lines investigated (CD3(+) T cells, CD11c(+) DC1 and CD123(+) DC2), we found a rapid and consistent establishment of complete donor chimerism (CDC) in over 70% of all patients during the first 6 weeks after AHCT. The rate of patients with CDC increased significantly over time within the first year after transplantation. A related donor (P=0.004) as well as an underlying lymphatic leukemia (P=0.03) were found to be significantly associated with development of MC in T cells. No significant correlation between DC or T cell chimerism and GvHD or relapse was detected. Our results thus demonstrate a fast and stable CDC in DC1, DC2 and T cells after AHCT that continuously increases over time in nearly all patients.     

Long-term suppression of Leydig cell steroidogenesis prevents Leydig cell aging

Male aging is accompanied by reduced testosterone production by the Leydig cells, the testosterone-producing cells of the testis. The mechanism by which this occurs is unknown. Based on the observations that reactive oxygen is capable of damaging components of the steroidogenic pathway and that reactive oxygen is produced during steroidogenesis itself, we hypothesized that long-term suppression of steroidogenesis might inhibit or prevent age-related deficits in Leydig cell testosterone production. To test this, we administered contraceptive doses of testosterone to groups of young (3 months old) and middle-aged (13 months old) Brown Norway rats via Silastic implants to suppress endogenous Leydig cell testosterone production. After 8 months, the implants were removed, which rapidly (days) restores the ability of the previously suppressed Leydig cells to produce testosterone. Two months after removing the implants, when the rats of the two groups were 13 and 23 months of age, respectively, the Leydig cells in both cases were found to produce testosterone at the high levels of young Leydig cells, whereas significantly lower levels were produced by the 23-month-old controls. Thus, by placing the Leydig cells in a state of steroidogenic "hibernation," the reductions in Leydig cell testosterone production that invariably accompany aging did not occur. If hormonal contraception in the human functions the same way, the adverse consequences of reduced testosterone in later life (osteoporosis, reduced muscle mass, reduced libido, mood swings, etc. ) might be delayed or prevented.