奈达铂联合吉西他滨治疗晚期非小细胞肺癌研究进展

目的观察奈达铂联合吉西他滨治疗晚期非小细胞肺癌的疗效及毒副作用.方法 对39例晚期非小细胞肺癌患者使用吉西他滨联合奈达铂方案化疗:吉他西滨l 000 mg/m2,第1、8天;奈达铂80~100 mg/m2.第1、2天,静滴,每4周为一个疗程;连续使用两个疗程后评价.结果 39例总有效率(CR+PR)为40.8%;不良反应较轻.结论 奈达铂联合吉西他滨是治疗晚期非小细胞肺癌较好的化疗方案之一.     

吉西他滨联合奈达铂治疗晚期非小细胞肺癌30例临床观察

目的观察吉西他滨联合奈达铂治疗晚期非小细胞肺癌的疗效及毒副作用。方法对30例晚期非小细胞肺癌患者使用吉西他滨联合奈达铂方案化疗：吉他西滨1 000 mg/m2,第1、8天;奈达铂80~100 mg/m2,第1~3天,静滴,每4周为一个疗程;连续使用两个疗程后评价。结果 30例总有效率（CR＋PR）为36.7%;不良反应主要为骨髓抑制（特别是血小板下降）、外周神经毒性,但恶心和呕吐较轻。结论吉西他滨联合奈达铂是治疗晚期非小细胞肺癌较好的化疗方案之一。     

TP和GP两种方案治疗晚期非小细胞肺癌近期疗效观察

目的:肺癌已成为癌症死亡的主要原因,其中非小细胞肺癌在肺癌中所占比例较大,其愈后较差,生存期短.本文观察了新药多西紫杉醇联合奈达铂及吉西他滨联合奈达铂治疗中晚期(Ⅲ、Ⅳ期)非小细胞肺癌(non-small cell hung cancer, NSCLC)的近期疗效及不良反应.方法:77例中晚期非小细胞肺癌初治的患者,其中多西紫杉醇联合奈达铂化疗方案组40例,多西紫杉醇75mg/m2,静点第1天.奈达铂80mg/m2,加入500ml的生理盐水中,静脉滴注2小时,静点第2天.吉西他滨联合奈达铂方案组37例,吉西他滨1.0g/m2,静点第1.8天.奈达铂80mg/m2,加入500ml的生理盐水中,静脉滴注2小时,静点第2天.以上方案化疗前均常规应用5-HT3受体拮抗剂止吐.两组均为21天一周期,均在用药2个周期后进行疗效评价.结果:多西紫杉醇联合奈达铂组有效率(52.50%),吉西他滨联合奈达铂组有效率(40.54%),二者差异无统计学意义(P>0.05);多西紫杉醇联合奈达铂组血小板降低发生率47.5%,发生率低于吉西他滨联合奈达铂组(83.78%),二者差异有统计学意义(P<0.01);两组白细胞下降发生率分别为87.5%和94.59%,二者差异无统计学意义(P>0.05);两组对肾脏、心脏均无明显损害.结论:多西紫杉醇联合奈达铂方案治疗中晚期(Ⅲ、Ⅳ期)非小细胞肺癌的有效率不低于吉西他滨联合奈达铂方案,不良反应主要为骨髓抑制,特别是血小板下降.在临床工作中可根据患者的不同情况选用不同的化疗方案.     

吉西他滨与紫杉醇联合奈达铂治疗晚期非小细胞肺癌的疗效及毒性反应观察

目的观察吉西他滨联合奈达铂化疗方案对照紫杉醇联合奈达铂化疗方案治疗晚期非小细胞肺癌的近期疗效及毒性反应。方法经组织病理学确诊为非小细胞肺癌,TNM分期为晚期的患者,共133例,按单纯随机法分为2组:吉西他滨组67例,采用吉西他滨(Gem)1 000 mg/m2D1、D8+奈达铂(NDP)80 mg/m2D1(或D8)方案,紫杉醇组66例,采用紫杉醇(PTX)175 mg/m2D1+奈达铂80 mg/m2D1方案,21 d为1个周期。于第2周期末评定靶病灶变化,对靶病灶无变化或增大者转2线方案化疗。对靶病灶缩小者继续原方案化疗,于第4周期末进行疗效评价,并对2种方案的毒性反应比较。结果全部完成4个周期者,吉西他滨组55例,治疗有效率54.55%,部分缓解的30例中鳞癌占27例;紫杉醇组51例,治疗有效率50.98%,部分缓解的26例中腺癌占24例。血液毒性在吉西他滨组化疗各周期均有不同程度白细胞降低,以Ⅰ、Ⅱ为主。第4周期末,发生Ⅲ、Ⅳ度骨髓抑制患者中,2组间白细胞和血小板受抑制无差异(P>0.05);而血红蛋白下降,吉西他滨组高于紫杉醇组,2组间差异有统计学意义(P<0.05);非血液毒性中便秘在吉西他滨组高于紫杉醇组(P<0.05),脱发、肌痛、周围神经损害紫杉醇组高于吉西他滨组(P<0.05),其余症状在2组间无差异(P>0.05);2组患者均无化疗相关性死亡。结论 2种化疗方案,近期疗效无差异。从组织类型亚型观察,鳞癌选择吉西他滨,非鳞癌选择紫杉醇更适合。2组患者的毒性反应均能耐受,吉西他滨组患者毒性反应的主观症状较少,因而耐受性及依从性更好。     

Efficiency and toxic reaction of nedaplatin combined with gemcitabine or paclitaxel in treatment of advanced non-small cell lung cancer: report of 133 cases

[目的]观察吉西他滨联合奈达铂化疗方案对照紫杉醇联合奈达铂化疗方案治疗晚期非小细胞肺癌的近期疗效及毒性反应.[方法]经组织病理学确诊为非小细胞肺癌,TNM分期为晚期的患者,共133例,按单纯随机法分为2组:吉西他滨组67例,采用吉西他滨(Gem)1000mg/m2D1、D8+奈达铂(NDP)80mg/m2D1(或D8)方案,紫杉醇组66例,采用紫杉醇(PTX)175mg/m2D1+奈达铂80mg/m2D1方案,21d为1个周期.于第2周期末评定靶病灶变化,对靶病灶无变化或增大者转2线方案化疗.对靶病灶缩小者继续原方案化疗,于第4周期末进行疗效评价,并对2种方案的毒性反应比较.[结果]全部完成4个周期者,吉西他滨组55例,治疗有效率54.55％,部分缓解的30例中鳞癌占27例;紫杉醇组51例,治疗有效率50.98％,部分缓解的26例中腺癌占24例.血液毒性在吉西他滨组化疗各周期均有不同程度白细胞降低,以Ⅰ、Ⅱ为主.第4周期末,发生Ⅲ、Ⅳ度骨髓抑制患者中,2组间白细胞和血小板受抑制无差异(P＞0.05);而血红蛋白下降,吉西他滨组高于紫杉醇组,2组间差异有统计学意义(P＜0.05＝;非血液毒性中便秘在吉西他滨组高于紫杉醇组(P＜0.05＝,脱发、肌痛、周围神经损害紫杉醇组高于吉西他滨组(P＜0.05＝,其余症状在2组间无差异(P＞0.05);2组患者均无化疗相关性死亡.[结论]2种化疗方案,近期疗效无差异.从组织类型亚型观察,鳞癌选择吉西他滨,非鳞癌选择紫杉醇更适合.2组患者的毒性反应均能耐受,吉西他滨组患者毒性反应的主观症状较少,因而耐受性及依从性更好.     

奈达铂联合方案治疗晚期非小细胞肺癌初步观察

目的观察奈达铂联合第三代药物吉西他滨或紫杉醇类药物两药方案治疗非小细胞肺癌的疗效和毒副反应。方法在我院住院的晚期非小细胞肺癌30例,应用奈达铂联合第三代药物吉西他滨或紫杉醇类药物两药方案治疗,奈达铂80mg/m^2,加入生理盐水（NS）500mL静滴,第1天。①联合紫杉醇组（TN组）,紫杉醇150mg/m^2,静脉滴注,第1天。②联合多烯紫杉醇组（DN组）,多烯紫杉醇60mg/m^2,静脉滴注,第1天。③联合吉西他滨组（GN组）,吉西他滨1g/m^2,加入生理盐水100mL中静滴半小时,第1、8天。三组方案均为每21天为1个周期,治疗2～4个周期。结果总体疗效（CR）0例,部分缓解（PR）11例,SD15例,进展（PD）4例,总有效率为36．7％,疾病控制率分别为86．7％。总的毒副反应以血液学毒性较多见,非血液学毒性方面,胃肠道反应较多,经处理后可恢复。结论奈达铂联合第三代药物吉西他滨或紫杉醇类药物两药方案治疗非小细胞肺癌有一定疗效,毒副反应可以耐受。     

吉西他滨联合奈达铂双周方案治疗晚期非小细胞肺癌的临床观察

目的 探讨吉西他滨联合奈达铂双周方案治疗晚期体力状态较差的非小细胞肺癌（NSCLC）的近期疗效和不良反应.方法 26例晚期NSCLC患者（ECOG PS=2或3）,采用吉西他滨1 000 mg/m2 静滴d1联合奈达铂50 mg/m2 静滴d1,每2周1次化疗,每4周为1个疗程,每2个疗程评价疗效和毒性.结果 26例患者均可评价近期疗效：初治的19例患者中,完全缓解0例,部分缓解7例,稳定8例,进展4例,有效率（CR＋PR）36.8%,疾病控制率（CR＋PR＋SD）78.9%,中位疾病进展时间为6个月.复治的7例患者中,完全缓解0例,部分缓解1例,稳定2例,进展4例,有效率14.2%,疾病控制率42.8%,中位疾病进展时间为3个月.毒副作用主要为骨髓抑制,以血小板和白细胞减少为主.结论吉西他滨联合奈达铂双周方案治疗体力状态较差的晚期非小细胞肺癌疗效较好,毒副作用可以耐受.     

培美曲塞二钠或吉西他滨联合奈达铂治疗80例晚期非小细胞肺癌的临床比较研究

目的：比较培美曲塞二钠或吉西他滨联合奈达铂治疗晚期非小细胞肺癌（NSCLC）的临床疗效及毒副作用。方法：将80例晚期NSCLC按随机数字表法分为吉西他滨加奈达铂组（GN）40例和培美曲塞二钠加奈达铂组（PN）40例。GN组给予吉西他滨1000 mg/m2,d 1,8;奈达铂80 mg/m2,d 2。PN组培美曲塞二钠500 mg/m2,d 1;奈达铂80 mg/m2,d 2,两组均为每21天为一个周期重复,完成2个周期后进行评价。结果：PN组有效率为42.5%,GN组为40.0%,差异无统计学意义（P〉0.05）;PN组骨髓抑制发生率小于GN组（P〈0.05）。结论：培美曲塞二钠联合奈达铂治疗晚期非小细胞肺癌的疗效与吉西他滨加奈达铂的疗效相当,但副作用明显减少,可以作为临床一线治疗。     

吉西他滨联合奈达铂治疗晚期非小细胞肺癌疗效观察

目的观察吉西他滨联合奈达铂治疗晚期非小细胞肺癌的疗效及毒副反应。方法23例入选病例均为Ⅲ/Ⅳ期非小细胞肺癌。给予吉西他滨1000mg/m^2,静脉滴注d1,d8; 奈达铂80mg/m^2,静脉滴注d1。28d为1周期,4个疗程后评价疗效。结果23例患者均可评价疗效及不良反应,CR2例,PR12例,总有效率为60.9%,中位生存期11.3个月,一年生存率51.7%。主要毒副反应为骨髓抑制和消化道不良反应,无化疗相关死亡。结论吉西他滨联合奈达铂治疗晚期非小细胞肺癌疗效好,不良反应可耐受,值得临床应用。     

紫杉醇联合不同铂类治疗晚期非小细胞肺癌临床研究

目的观察紫杉醇联合不同铂类治疗晚期非小细胞肺癌的疗效及不良反应。方法120例初次确诊为非小细胞肺癌患者,随机分为4组。顺铂组:给予紫杉醇175 mg/m2,顺铂80 mg/m2;卡铂组:给予紫杉醇175 mg/m2,卡铂80 mg/m2;草酸铂组:给予紫杉醇175 mg/m2,草酸铂130 mg/m2;奈达铂组:给予紫杉醇175 mg/m2,奈达铂80 mg/m2;4组均每21天重复1次,连用4周期。化疗结束2周后复查、比较4组的有效率和不良反应发生率。结果120例患者均可顺利完成4个周期化疗。顺铂组、卡铂组、草酸铂组和奈达铂组有效率分别为33.3%、30.0%、33.3%、36.7%,差异无统计学意义(P>0.05)。III-IV期不良反应对比,草酸铂组白细胞及血小板下降优于其他3组,差异有统计学意义(P<0.05),而肌肉关节疼痛、神经损害、肾功能损害及恶心呕吐差异无统计学意义(P>0.05)。结论紫杉醇联合顺铂、卡铂、草酸铂、奈达铂治疗晚期非小细胞肺癌的疗效大致相等,但草酸铂不良反应明显较少。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…