抗血管形成靶向药物的研究进展

肿瘤的生长和转移离不开肿瘤新生血管,这使得抗血管形成治疗成为肿瘤治疗的重要途径之一。血管内皮生长因子及其受体是抗肿瘤治疗的重要靶点之一。本文主要介绍了近年来抗血管形成治疗的一些最新药物研究成果——包括针对血管内皮生长因子的单克隆抗体——贝伐;针对血管内皮生长因子受体的酪氨酸激酶抑制剂——舒尼替尼、索拉非尼等;以及血管内皮生长因子受体的单克隆抗体IMC-1C11等。     

以血管内皮生长因子受体KDR为靶的肿瘤治疗的研究进展

血管内皮生长因子受体Ⅱ（激酶功能区受体，KDR）是介导血管内皮生长因子（VEGF）在肿瘤新生血管形成中发挥功能的主要受体，以KDR为靶，通过抑制VEGF与KDR的相互作用来抑制血管生长从而达到治疗肿瘤目的已经成为肿瘤治疗的新途径。本文从抗KDR的单克隆抗体、酪氨酸激酶小分子抑制剂、KDR的小肽抑制剂、核酸抑制物和导向制剂等几个方面综述了以KDR为靶治疗肿瘤的基础和临床现状及研究进展，探讨不同各种方法的优势与不足，以期在临床实施中选择合适的方法进行KDR靶向的肿瘤治疗。     

血管内皮生长因子及其受体系统与肿瘤生长相关性的研究进展

摘 要：血管内皮生长因子（VEGF）属于血小板源生长因子超基因家族成员,其在调节血管和淋巴管的生成中起重要角色。由于肿瘤的生长极度依赖血管供氧,因此血管内皮生长因子在其中的作用就显得尤其重要,而通过抑制肿瘤生长中的血管内皮生长因子—血管内皮生长因子受体（VEGF-VEGFR）系统无疑是治疗肿瘤性疾病的一个重要突破口。文章就VEGF-VEGFR系统的结构和功能及其在治疗肿瘤中作用的进展作一综述。     

血管内皮生长因子及其受体在肿瘤治疗中的应用

通过血管内皮生长因子(VEGF)和血管内皮生长因子受体(VEGFR)来治疗肿瘤,可以由基因和细胞分子水平等多种途径获得,例如,可用单克隆抗体中和靶目标、或用小分子抑制剂抑制靶目标信号传导、或通过改变靶目标基因表达等.抗VEGF及其VEGFR可以单独应用,也可与抗其他生长因子、放疗等其他方法相结合,来增加抑制肿瘤生长的效果.     

血管内皮生长因子C及其受体在血液肿瘤中的研究进展

血管/淋巴管新生是生物体重要的生理过程,在恶性肿瘤进展和浸润转移过程中也发挥着重要作用。血管内皮生长因子C（VEGF-C）可通过与其受体VEGFR-2,3信号途径诱导血管/淋巴管新生。许多血液肿瘤中均有VEGF-C及受体表达,它与临床分期、耐药、疗效和预后等有一定关系。随着对其研究的深入,针对VEGF-C及其受体靶点的治疗可能成为血液肿瘤治疗的新手段。     

淋巴管生成与肿瘤转移研究进展

血管内皮生长因子-C(VEGF-C)和血管内皮生长因子-D(VEGF-D)是血管内皮生长因子受体-3(VEGFR-3)的特异性配体,也是新近鉴定出的与淋巴管生长有关的因子,二者通过与VEGFR-3结合而介导淋巴管生成.越来越多的研究显示,人类肿瘤表达的VEGF-C和VEGF-D与肿瘤的转移播散有直接的相关性,且肿瘤进展过程与淋巴管生成有关.现综述淋巴管生成与肿瘤转移的研究进展.     

淋巴管生成因子在头颈肿瘤淋巴结转移中的作用

头颈肿瘤早期出现淋巴结转移是常见的临床现象,寻找和发现阻断肿瘤淋巴结转移的方法和途径对恶性肿瘤的治疗起到至关重要的作用.现在淋巴管生成过程中得以证实的信号传导分子机制是血管内皮生长因子(VEGF)-C和VEGF-D,这两种分子蛋白通过结合激活淋巴管内皮细胞表面的血管内皮生长因子受体-3(VEGFR-3)发挥作用,但确切...     

VEGF-C/D及其受体与胃癌淋巴转移关系的研究进展

淋巴管是肿瘤转移的一个重要途径,随着越来越多淋巴管生长因子和淋巴管标志物的发现,如血管内皮生长因子-C/ D（VEGF-C/D）及受体血管内皮生长因子受体（VEGFR）3在肿瘤淋巴管生成、肿瘤经淋巴结转移过程中的作用机制取得了较大进展。VEGF-C/D的表达与胃癌淋巴道转移、癌周淋巴管密度、生存率、预后等临床病理特征密切相关。此外,实验动物模型与体外实验研究显示,抑制VEGF-C/D表达在胃癌治疗上具有一定的应用前景。现就VEGF-C/D及其受体与胃癌淋巴转移的相关性予以综述。      

淋巴管生成与肿瘤转移研究进展

血管内皮生长因子-C(VEGF-C)和血管内皮生长因子-D(VEGF-D)是血管内皮生长因子受体-3(VEGFR一3)的特异性配体，也是新近鉴定出的与淋巴管生长有关的因子，二者通过与VEGFR-3结合而介导淋巴管生成。越来越多的研究显示，人类肿瘤表达的VEGF-C和VEGF-D与肿瘤的转移播散有直接的相关性，且肿瘤进展过程与淋巴管生成有关。现综述淋巴管生成与肿瘤转移的研究进展。     

血管内皮生长因子-C与肿瘤转移的研究进展

血管内皮生长因子-C(VEGF-C)是特异性淋巴内皮细胞刺激因子,通过与血管内皮生长因子受体-3(VEGFR-3)结合诱导淋巴管形成.临床及基础研究表明VEGF-C能促进多种恶性肿瘤细胞的侵袭和转移,是影响肿瘤预后的重要因素.检测肿瘤细胞中有无VEGF-C表达有助于判断肿瘤的进展程度,为临床手术方式的选择及术后治疗提供参考.阻断VEGF-C与VEGFR-3之间的信号传导可能成为肿瘤治疗的新途径.     

The medically important dematiaceous fungi and their identification

Dematiaceous fungi include a large group of organisms that are darkly pigmented (dark brown, olivaceous, or black). In most cases the pigment is melanin, and specifically, dihydroxynaphthalene melanin. The diseases produced include chromoblastomycosis, eumycotic mycetoma, and phaeohyphomycosis. Phaeohyphomycosis is a new classification for a diverse group of previously known entities grouped together on the basis of finding dematiaceous hyphal and/or yeast-like forms in tissue; tissue involvement may be superficial, cutaneous and corneal, subcutaneous, or systemic. Identification of these fungi is based mostly upon morphology. Important structures include annellides (Phaeoannellomyces, Exophiala), phialides (Phialophora, Wangiella), adelophialides (Phialemonium without collarettes, Lecythophora with collarettes), differentiation of conidiophores (Xylohypha versus Cladosporium) and conidial hilum, septation and germination (Bipolaris, Drechslera, Exserohilum). Useful laboratory tests include the 12% gelatin test (controversial), nitrate assimilation (W. dermatitidis is negative, most other species are positive), and determination of temperature maxima (especially 37 degrees C for E. jeanselmei, 40 degrees C for W. dermatitidis and B. spicifera, 42 degrees C for X. bantiana, and 45 degrees C for Dactylaria constricta var. gallopava and Scedosporium inflatum).     

Orale Langzeitbehandlung von Onychomykosen mit Ketoconazol

Zusammenfassung: An der Studie zur Wirksamkeit und Anwendungssicherheit von Ketoconazol nahmen 27 Männer im Alter von 20 bis 80 (Median: 57) Jahre, davon 18 mit Onychomykosen und 9 als KontroUen bei den Laborwertbestimmungen, teil. Während des ersten Behandlungsmonats erhielten je 9 Patienten 200 mg und 400 mg Ketoconazol täglich. Danach wurden beide Gruppen 6 Monate mit 200 mg/d weiterbehandelt. Die klinische Beurteilung sowie hämatologische, biochemische und Plasmaspiegeluntersu-chungen erfolgten mindestens monafich, mykologische Untersuchungen wurden vor Aufnahme und bei Beendigung der Therapie vorgenommen. Erne letzte klinische Unter-suchung erfolgte 1 Jahr nach Beginn der Studie. Nach 7 Monaten Behandlung wurden 23 von 30 Nägeln mit “gebessert” bis “stark gebessert” beurteilt, nach dem behandlungsfreien Intervall galt dies für 28 von 30 Nägeln. Die Plasmaspiegel waren mit 200 mg/d ausreichend und uber den Behandlungszeit-raum konstant. Dies spricht für gute orale Resorption und Abwesenheit von Enzyminduktion. Die Laborwerte zeigten im Vergleich zu den Kontrollen und den Werten vor Behandlung keine signifikanten Abweichungen, so daß myelo-, nephro- und hepatotoxische Wirkungen von 400 bzw. 200 mg/d ausgeschlossen werden können. Der Lipidhaushalt wurde nicht beeinfluat und es trat unter Therapie als Folge der Ketoconazolwirkung lediglich Lanosterin im Serum auf. Nach Beendigung der Therapie ging der Lanosteringehalt schnell zurück. Damit erweist sich Ketoconazol in den angewandten Dosen als ein gut verträgliches und zur Langzeitbehandlung von Onychomykosen geeignetes Antimykotikum. Summary: Twenty-seven males with a median age of 57 (range: 20 to 80) years took part in this study on the efficacy and safety of ketoconazole. Eighteen men suffered from onychomycosis; nine served as controls in the safety evaluation. During the first month of treatment, nine patients received 200 mg and the nine other 400 mg ketoconazole daily. Then the treatment was uniformly continued with 200 mg/d for 6 months. Clinical evaluation and haematological, biochemical and plasma level investigations were carried out at least at monthly intervals; mycological controls were performed at the start and end of therapy. A final clinical evaluation was carried out one year after the start of the study. After 7 months of treatment, moderate or definite clinical improvement was obtained in 23 out of 30 nails. After 5 more months without antimycotic treatment this was the case in 28 of 30 nails. Plasma levels obtained with 200 mg ketoconazole daily were adequate and constant during the entire treatment period. This indicates a good oral resorption as well as the absence of induction of hepatic enzymes. The laboratory values did not show significant deviations as compared with the controls or with the pretreatment values. This excludes myelo-, nephro- and hepatotoxic effects of 400 and 200 mg ketoconazole daily. The lipid metabolism was not influenced, the only difference was the occurrence of lanosterol in the serum, which is a result of the mechanism of action of ketoconazole. After the medication period the lanosterol levels subsided rapidly. In the applied doses ketoconazole is a well-tolerated and effective drug for the systemic long-term treatment of onychomycosis.     

裘法祖教授生平

Prof.Fazu Qiu,member of the Chinese Communist Party,surgery professor of Tongji Hospital,departed in Tongji Hospital,Wuhan,China,at fourteen to nine a.m,June 14,2008,after a disease.He turns 94 this year.He was the senior academician of the Academia Sinica,the illustrious medical scientist of China,and the Honorary Director of Tongji Medical College,as well as Huazhong University of Science & Technology.     

Laboratory Techniques Alternative to In Vivo Experiments for Studying the Liberation, Penetration and Fungicidal Action of Topical Antimycotic Agents in the Skin, Including Ciclopiroxolamine

Summary: Short-term experiments on excised skin (human, pig) gave the following results: 1. In the tissue activity test with direct inoculation (D-TAT) commercial preparations of the non-azole antimycotics ciclopiroxolamine, tolnaftate and naftifine, produced higher inhibitory activity against Trichophyton mentagrophytes (standard strain) in various levels of the horny layer than were produced by the azole antimycotics econazole, miconazole, clotrimazole, oxiconazole and bifonazole. Fast drying solutions of antimycotics invariably gave higher inhibitory activities than creams. In the ultrafiltration tissue activity test (UFT- TAT) against Candida albicans (2 strains), antimycotic agents ranked in order of effectiveness as follows: ciclopiroxolamine – most of the azole antimycotics – bifonazole and naftifine. 2. In tests of fungicidal activity against T. mentagrophytes (2 strains) and Microsporum gypseum (1 strain) the first step was to inoculate the skin surface. After the horny layer had been penetrated by fungal mycelia, antimycotic agents of documented fungicidal potency, chiefly in the form of creams, were applied to the skin surface and left to act for up to 18 hours. The horny layer and epidermis were then scraped off and the concentration of viable fungi was determined. Ciclopiroxolamine cream and lotion produced by far the greatest diminution in viable fungi; creams containing oxiconazole and naftifine were moderately effective and those containing tioconazole and bifonazole produced a relatively small decrease in viable fungi. To avoid erroneous results it is important to homogenize and dilute the skin scrapings; if this is not done certain antimycotics will give misleadingly high fungal killing rates. At this early stage the scatter of results is still wide and minor differences in efficacy cannot as yet be detected with certainty. 3. From the results of various comparative tests it is evident that pig skin can be used as a substitute for human skin in the tests listed under 1. and 2. above. This discovery may make a valuable contribution towards limiting the need for experiments on living animals and trials on human beings. Zusammenfassung: In Kurzzeitversuchen an exzidierter Haut (Mensch, Schwein) wurde gefunden: 1. Im Gewebeaktivitätstest mit direkter Inokulation (D-GAT) wurde mit Handelspräparaten der Nichtazol-Antimykotika Ciclopiroxolamin, Tolnaftat und Naftifin in verschiedenen Hornschichtniveaus eine höhere Hemmaktivität gegenüber Trichophyton mentagrophytes (Standard-Stamm) erzielt als mit solchen der Azol-Antimykotika Econazol, Miconazol, Clotrimazol, Oxiconazol und Bifonazol. Rasch trocknende Lösungen von Antimykotika ergaben durchweg höhere Hemmaktivitäten als Cremes. Im Ultrafiltrations-Gewebeaktivitätstest (UFT-GAT) gegenüber Candida albicans (2 Stämme) ergab sich nach erzielter Wirksamkeit die Rangfolge Ciclopiroxolamine – Mehrzahl der Azolantimykotika – Bifonazol und Naftifin. 2. In Fungizidie-Testen gegenüber T. mentagrophytes (2 Stämme) und Microsporum gypseum (1 Stamm) wurde zunächst die Hautoberfläche inokuliert. Nach Durchdringung der Hornschicht mit Pilzmyzelien wirkten auf die Hautoberfläche bis zu 18 Stunden lang überwiegend Cremes von als fungizid publizierten Antimykotika ein. Während sich in abgeschabter Hornschicht und Epidermis der so bearbeiteten Hautoberflächen mit Ciclopiroxolamin-Creme und -Lotion die weitaus höchste Verminderung lebensfähiger Keime ergab, bewirkten Cremes mit Oxiconazol und Naftifin eine mittlere und solche mit Tioconazol und Bifonazol eine relativ niedrige Keimeliminierung. Zur Vermeidung von fehlerhaften Ergebuissen mußten Homogenisierung und Verdünnung der Hautschabsel erfolgen, anderenfalls bei mehreren Antimykotika eine zu hohe Keimabtötung vorgetäuscht worden wäre. Wegen der vorerst noch hohen Streuung der Ergebnisse können kleinere Wirksamkeitsunterschiede noch nicht sicher erfaßt werden. 3. Nach dem Ergebnis verschiedener Vergleichstests kann in den Testen zu 1. und 2. Schweinehaut als Ersatz für Haut vom Menschen dienen und dürfte damit wesentlich zur Einschränkung von Versuchen am lebenden Tier und von Prüfungen am Menschen beitragen.     

Dermatomycosis in Dogs

During the routine examination of dogs for cutaneous lesions, 205 dogs were screened for fungi other than dermatophytes. Twenty-two dogs (10.8%) revealed the presence of non-dermatophytic fungi suspicious for representing the etiologic agents of the skin lesions. The fungi isolated were Alternaria sp. (2.9%), Penicillium sp. (2.4%), Aspergillus fumigatus (2.0%), Mucor sp. (1.5%), Cladosporium sp. (1.5%) and Fusarium sp. (0.5%). No dermatophyte was isolated in association with these fungi. The incidence of these infections was found to be greater in warm and humid climate.     

Efficiency of crude and purified fungal antigens in serodiagnosis to discriminate mycotic from other respiratory diseases

Mycotic immunodiagnosis was performed in 186 hospitalized patients with different respiratory diseases, mostly considered as tuberculosis and others with a doubtful diagnosis. Crude histoplasmin, coccidioidin, paracoccidioidin, blastomycin, candidin, aspergillin, and sporotrichin, as well as purified polysaccharide-protein complexes (PPC) of Histoplasma capsulatum, Coccidioides immitis, and Paracoccidioides brasiliensis were used as antigens. Immune tests used included skin test (ST), gel immunodiffusion (ID), counterimmunoelectrophoresis (CIE), complement fixation (CF), and ELISA. A possible association with candidosis was observed in 17% of patients with tuberculosis and diabetes; one presumptive paracoccidioidomycosis, one confirmed aspergillosis, and six cases of active histoplasmosis were determined. Candidin ST showed 29% of positive reactions with an increased frequency in patients between 31 and 55 years of age. CF test showed the highest positivity percentages with crude antigens, specially for Candida antigen (26.3%) and histoplasmin (18.2%). Cross reactions were evident with crude antigens but decreased when PPC's were used in ELISA.     

Isoconazole nitrate in the treatment of tropical dermatomycoses

Summary. A total of 54 patients with culturally proven tropical dermatomycoses, comprising 23 with various types of dermatophytoses, one with foot infection due to Trichosporon beigelii and one with foot infection due to Geotrichum candidum , two with candidoses of the groin and 27 with pityriasis versicolor, were included in a clinical trial of efficacy of 1% isoconazole cream (Travogen^R, Schering, Berlin, Germany). Five patients were not evaluable. A clinical and mycological cure was achieved in 29 cases in 3–4 weeks. In 15 (31%) of the remaining patients treatment was required for 5–6 weeks, while another three patients required treatment for 8 weeks. In two patients the disease proved to be resistant to treatment with the drug.
Zusammenfassung. Insgesamt 54 Patienten mit kulturell gesicherter Dermatomykose, (23 unterschiedliche Dermatophytosen, eine Trichosporon beigelii - und eine Geotrichum candidum -Fußinfektion, 2 Candidosen der Leistengegend und 27 Pityriasis versicolor) wurden in einer klinischen Wirksamkeits-studie mit 1% iger Isoconazol-Creme (Travogen^R, Schering, Berlin, Deutschland) behandelt. Fünf Patienten waren nicht auswertbar. Eine klinische und mykologische Heilung wurde bei 47 von 49 Patienten (96%) erreicht. Bei 29 patienten (59%) wurde die Heilung bereits nach 3–4 Wochen Behandlung erreicht. Weitere 15 Patienten (31%) benötigten 5–6 Wochen und drei Patienten 8 Wochen Behandlungsdauer. Zwei Mykosesituationen erwiesen sich als therapieresistent.     

Oncogénétique et psycho-oncologie, une collaboration recommandée...

Résumé: La possibilité depuis 1994, de connaître la probabilité individuelle de développer certains cancers a permis de proposer de nouvelles modalités de prévention, de traitements et contribué au développement actuel de loncogénétique. Une meilleure connaissance des répercussions psychologiques tant pour les patients que pour les apparentés est désormais possible et limplication des psycho-oncologues dans ce cadre de la réalisation des tests prédictifs, recommandée. La mission de «messager» qui incombe au «cas-index» doit faire lobjet dune attention particulière. La complexité de linformation et la dimension paradoxale que peut avoir parfois la communication à propos des choix, rend difficile lévaluation de la qualité du consentement. La situation particulièrement délicate dune aide à la décision à légard de la chirurgie prophylactique, exige une collaboration étroite des généticiens et des psycho-oncologues.Les soins de support en oncologie     

The role of papillomaviruses in human cancers

This review comprehensively evaluates the influence of gene-gene, gene-environment and multiple interactions on the risk of colorectal cancer (CRC). Methods of studying these interactions and their limitations have been discussed herein. There is a need to develop biomarkers of exposure and of risk that are sensitive, specific, present in the pathway of the disease, and that have been clinically tested for routine use. The influence of inherited variation (polymorphism) in several genes has been discussed in this review; however, due to study limitations and confounders, it is difficult to conclude which ones are associated with the highest risk (either individually or in combination with environmental factors) to CRC. The majority of the sporadic cancer is believed to be due to modification of mutation risk by other genetic and/or environmental factors. Micronutrient deficiency may explain the association between low consumption of fruit/vegetables and CRC in human studies. Mitochondrial modulation by dietary factors influences the balance between cell renewal and death critical in colon mucosal homeostasis. Both genetic and epigenetic interactions are intricately dependent on each other, and collectively influence the process of colorectal tumorigenesis. The genetic and environmental interactions present a good prospect and a challenge for prevention strategies for CRC because they support the view that this highly prevalent cancer is preventable.