多西他赛脂肪乳注射液在大鼠体内的药代动力学研究

制备多西他赛脂肪乳注射液,并考察大鼠尾静脉给药后体内的药代动力学行为。采用高压均质法制备多西他赛脂肪乳注射液,将12只Wistar大鼠随机分为多西他赛脂肪乳注射液组和多西他赛注射液组,尾静脉给药剂量均为6 mg/kg,采用HPLC法测定大鼠血中多西他赛的浓度,采用3P97程序计算多西他赛药代动力学参数。多西他赛脂肪乳注射液平均粒径为(221.6±13.4)nm,聚合物分散指数(PDI)为0.092±0.003,Zeta电位为-30.3 mV。多西他赛脂肪乳注射液和多西他赛注射液在大鼠体内的t_1/2(α)分别为(0.072±0.014)和(0.066±0.015)h;t_1/2(β)分别为(0.573±0.253)和(0.432±0.184)h;AUC_{0-12 h}分别为(7.98±1.25)和(6.26±1.83)μg·h/mL。多西他赛脂肪乳注射液与市售多西他赛注射液相比,在大鼠体内具有相似的药代动力学特征,药代动力学过程均符合双室模型。     

生物电阻抗分析法观察乳腺癌患者上肢淋巴水肿治疗效果

目的：研究生物电阻抗分析法观察乳腺癌患者术后上肢淋巴水肿经爱脉朗(Daflon)治疗后的效果。方法：乳腺癌患者术后发生上肢淋巴水肿19例，口服爱脉朗治疗，治疗前后采用多频生物电阻抗分析法测定人体组成成分，计算细胞外液／细胞内液(ECW/ICW)和细胞外液／全身水量(ECW/TBW)比值。结果：治疗后患侧肢体液体含量及机体ECW/ICW和ECW/TBW比值均显著低于治疗前。结论：生物电阻抗分析法能准确观察乳腺癌患者术后上肢淋巴水肿，爱脉朗能明显改善乳腺癌患者术后上肢淋巴水肿。     

唑来膦酸联合化疗治疗非小细胞肺癌骨转移48例

目的 探究为非小细胞肺癌骨转移患者行唑来磷酸联合多西他赛化疗方案予以治疗的临床效果,及对患者生活质量的影响,为该疾病的临床治疗提供参考.方法 择取47例患者参与此次研究,为本组行唑来磷酸联合多西他赛化疗按方案予以治疗.通过视觉模拟评分法(VAS)评定本组患者治疗前、后的疼痛程度,比较本组患者治疗前、后的骨病灶抑制率、肺部原发病灶抑制率、行为状态评分(KPS)、碱性磷酸酶(AKP)水平、血清钙浓度、治疗不良反应,以及通过生活质量评定量表(SF-36)评定患者治疗前后生活质量.结果 经过治疗后,本组患者的VAS评分、AKP水平以及血清钙相比治疗前有显著下降,KPS评分以及SF-36评分相比治疗前有明显上升,治疗后(5.95±1.34)分、躯体功能(1.95±0.40)分、情绪功能(1.88±0.32)分、角色功能(1.92±0.43)分以及社会功能(1.91±0.34)分,均显著优于治疗前相应指标(4.02±1.23)分、(1.61±0.31)分、(1.52±0.23)分、(1.64±0.31)分以及(1.64±0.22),数据通过统计学进行分析后差异具有统计学意义(P<0.05).治疗后骨病灶抑制率为59.57%、肺部原发病灶抑制率为44.68%.结论 唑来磷酸联合多西他赛化疗方案应用于非小细胞肺癌骨转移患者治疗中的临床效果理想,可有效抑制其骨转移及肺癌症状和进展,缓解患者因病所受的疼痛感,降低治疗不良反应发生率,并提升患者的生活治疗,因此该种治疗方案具有推广的价值.     

多西他赛联合塞替派治疗中晚期非小细胞肺癌的临床观察

目的探讨多西他赛联合塞替派治疗中晚期非小细胞肺癌的疗效及不良反应。方法中晚期非小细胞肺癌86例,随机分为两组,应用多西他赛联合塞替派方案(A组)(多西他赛35mg/m2d1,8,塞替派60mg/m2d1,21d为1疗程),多西他赛联合顺铂方案(B组)(多西他赛35mg/m2d1,8,顺铂80mg/m2d1,21d为1疗程)化疗2个疗程,评价其效果。结果 A组和B组治疗效果分别为:两组均无完全缓解(CR),部分缓解(PR)25.58%vs 20.93%,稳定(SD)53.49%vs48.83%,进展(PD)20.93%vs 39.70%。P值均>0.05,差异无统计学意义;最常见不良反应为骨髓抑制、胃肠道反应(恶心,呕吐)、肝脏损害转氨酶升高,手足综合征程度较轻。两组患者不良反应0～Ⅱ°和Ⅲ°～Ⅳ°比较,差异无统计学意义(P>0.05)。结论多西他赛联合塞替派方案治疗中晚期非小细胞肺癌有一定的近期疗效,不良反应可耐受,可以作为经济有效的化疗方案。     

多西他赛联合顺铂治疗晚期乳腺癌的临床观察

目的:观察多西他赛联合顺铂对一线治疗失败的晚期乳腺癌的疗效和不良作用.方法:经病理组织学确诊的晚期乳腺癌34例,采用多西他赛注射剂70mg/m2静滴第1天.每位患者用多西他赛前一天应用地塞米松针10mg静推,应用多西他赛前30分钟再次给予地塞米松针10mg静注和苯海拉明20mg肌注以预防过敏反应和液体潴留综合征.顺铂30mg/m2静脉点滴,第1～4天.化疗前用格拉斯琼镇吐剂.21天为1个周期,2周期评价疗效.结果:可评价疗效34例,CR 2例,PR 15例,SD 10例,PD 7例.有效率(CR PR)50.0%,临床获益率(CR PR SD)79.4%.主要毒副反应是骨髓抑制、消化道反应、脱发等.结论:多西他赛联合顺铂治疗晚期乳腺癌的近期疗效显著,是晚期乳腺癌的有效解救治疗方案.     

多西他赛与顺铂单药化疗同期放疗治疗非手术食管癌的对照研究

目的 比较多西他赛与顺铂单药化疗同期放疗治疗非手术食管癌的疗效及安全性.方法 方便收集2011年1月-2013年2月在该院住院治疗的失去手术治疗机会的原发性食管癌患者70例.根据治疗方法分为顺铂组35例和多西他赛组35例.所有患者均接受相同放疗方案,多西他赛组在放疗同期给予多西他赛治疗;顺铂组患者在放疗同期给予顺铂治疗.比较两组的生存期、 近期疗效及不良反应发生情况.结果 顺铂组生存时间、1年生存率分别为(20.2±3.2)个月、60.0%,多西他赛组分别为(21.0±4.5)个月、57.1%,两组比较差异无统计学意义(P>0.05),多西他赛组的近期有效率为100.0%,明显高于顺铂组的82.9%(P<0.05).结论 多西他赛联合同期放疗对非手术食管癌的有效率较高,毒副作用较轻,值得临床借鉴推广.     

冰帽对预防乳腺癌术后化疗患者脱发的效果分析

目的 探讨佩戴冰帽持续降温对预防乳腺癌患者术后化疗引起脱发的效果.方法 选择化疗方案含有多西他赛的乳腺癌术后化疗患者120例,随机分为A、B、C 3组,各40例.A组于多西他赛输注前30 min将电子冰帽戴在头上,佩戴至化疗药输注结束;B组于多西他赛输注时开始佩戴,至化疗药输注结束摘下;C组于多西他赛输注时开始佩戴电子冰帽,佩戴至化疗药输注结束后2 h.分析3组6个疗程结束后的脱发程度.结果 A组中发生Ⅰ度脱发19例,Ⅱ度脱发15例,Ⅲ脱发6例;B组中发生Ⅰ度脱发22例,Ⅱ度脱发12例,Ⅲ脱发5例;C组中发生Ⅰ度脱发33例,Ⅱ度脱发6例,Ⅲ脱发1例;3组发生0度脱发和Ⅳ度脱发均为0例.3组比较,差异有统计学意义(P<0.05).结论 化疗期间佩戴冰帽可以预防化疗引起脱发,佩戴时间越长,预防化疗引起脱发的效果越显著.     

白花蛇舌草乙醇提取物逆转肺癌细胞化疗耐药的作用研究

摘 要 目的 探讨白花蛇舌草乙醇提取物（EEHDW）在肺癌化疗耐药中的作用及可能的机制。方法 EEHDW作用于多西他赛耐药细胞系A549/DTX后，采用集落形成、Transwell和CCK-8检测处理前后细胞的增殖、侵袭和半数抑制量（IC50）情况，Western blot检测上皮间质转化相关蛋白E-钙黏蛋白（E-cadherin）和波形蛋白（vimentin）的表达，同时分析PI3K/Akt信号通路中磷酸化PI3K（p-PI3K）和磷酸化Akt（p-Akt）蛋白表达变化情况。结果 与亲本A549细胞相比，多西他赛耐药的A549/DTX发生了上皮间质转化（EMT）；与对照组相比，EEHDW（2、4、6mg/mL）能抑制A549/DTX细胞的集落形成[(102±9.23)、(69±4.25)、(68±3.12)比(201±8.18), P<0.05]和侵袭能力[(42±5.58)、(21±3.25)、(22±4.36)比(129±9.23), P<0.05]；Western blot结果显示EEHDW（2mg/mL）能够上调E-cadherin蛋白表达，下调vimentin蛋白表达[(31.35±5.27)比(76.05±7.81)、(82.24±6.80)比(35.04±5.32)，P<0.05]；EEHDW（2mg/mL）处理A549/DTX细胞48h后，细胞对多西他赛的半数抑制量IC50显著降低[(81.36±7.58)比(45.38±6.82) ，P<0.05]；此外，与对照组相比，EEHDW（2mg/mL）能够抑制磷酸化(p)-PI3K[(45.62±6.15)比(22.85±4.29) ，P<0.05]和p-Akt[(43.51±3.18)比(23.25±3.67) ，P<0.05]蛋白的表达水平。结论 EEHDW能够抑制A549/DTX细胞增殖、侵袭，逆转多西他赛诱导的EMT和化疗耐药，其机制可能与PI3K/Akt信号通路有关。     

介入化疗对宫颈癌DNA含量、细胞周期时相的影响

目的 :探讨介入化疗对宫颈癌DNA含量和细胞周期时相的影响。方法 :取正常宫颈组、宫颈癌组介入化疗前和介入化疗后各 2 0例的宫颈组织标本 ,用流式细胞术测定其DNA含量 (DI)和S期细胞比率 (SPF)。结果 :(1)宫颈癌组介入化疗前和介入化疗后的DI分别为 (1.31± 0 .34,1.10± 0 .15 ) ,都明显高于正常宫颈组 (1.0 1± 0 .0 6 )(P <0 .0 1,P <0 .0 5 )。宫颈癌组介入化疗后的DI显著低于介入化疗前 (P <0 .0 5 )。宫颈癌II期与III、IV期间DI无显著性差异 (P >0 .0 5 )。 (2 )宫颈癌组介入化疗前DNA异倍体为 13例 ,介入化疗后为 6例 ,两者有显著性差异 (P <0 .0 5 )。 (3)宫颈癌组介入化疗前的SPF(2 4 .93± 9.4 6 % )、介入化疗后的SPF(14 .0 3± 6 .5 9% )均较正常宫颈组的SPF高 (6 .99± 4 .0 7% ,P <0 .0 0 1)。宫颈癌组介入化疗后的SPF低于介入化疗前 (P <0 .0 0 1)。III、IV期的SPF显著高于II期的SPF(P <0 .0 5 )。结论 :介入化疗能抑制宫颈癌组织DNA的复制、降低宫颈癌组织的S期细胞比率 ,抑制肿瘤细胞的增殖     

多西他赛联合卡铂治疗晚期非小细胞肺癌的临床研究

目的 观察国产多西他赛联合卡铂治疗晚期非小细胞肺癌的临床疗效和毒副反应.方法 53例晚期非小细胞肺癌患者均经细胞学或组织学证实,所有患者均进行多西他赛联合卡铂方案化疗,其中多西他赛75 mg/m2静脉滴注,第1天;卡铂AUC=5 mg/(ml·min),静脉滴注,第1天;21天为1周期,化疗两周期评价一次疗效.每例患者至少接受二个疗程化疗.结果全组53例患者均可评价疗效,完全缓解(CR)2例,部分缓解(PR)22例,稳定(SD)20例,疾病进展(PD)9例,总有效率为45.3%.其中初治患者28例,CR+PR 16例,有效率57.1﹪;复治25例,PR 8例,有效率32.0%.毒性反应主要有骨髓抑制和胃肠道反应,疲乏,脱发,口腔粘膜炎.结论多西他赛联合卡铂方案是治疗晚期非小细胞肺癌较为理想的方案之一.     

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…