82例喉癌放疗远期效果分析

对８２例喉癌患者治疗进行分析。５，１０年生存率为４１．５％及２５．０％，生存率与病变部位，期别，颈淋巴结转移等有关。早期声门区癌单纯放疗的疗铲不亚于手术，Ⅰ期喉癌单纯放疗与手术加放疗的疗效相近，应以放疗为主；Ⅱ期喉癌单纯放疗及手术加和疗５年生存率为６９．２％及１００％〈应选手术加放疗；Ⅲ，Ⅳ期喉癌单纯放疗及手术加放疗５年生存率为２５％及２２．７％，主张放疗。     

单纯放疗治疗早期喉鳞癌的疗效及预后因素分析

目的 研究单纯放疗治疗早期喉癌的疗效及预后因素.方法 回顾性分析2003年1月-2008年12月在山西省肿瘤医院接受单纯放射治疗的早期喉癌患者85例.用K-M法进行生存率的计算,Log-rank进行单因素分析,用COX回归行多因素分析.结果 单纯放疗组的3、5年总生存率(OS)为92.5%、82%.单纯放疗组首程治疗后的3、5年局部控制率(LC)为82.5%、70%.Cox多因素回归分析显示分期(P=0.032)、鳞癌类型(P=0.025)、年龄(P=0.02)是影响喉癌5年生存率的独立因素.年龄>60岁、治疗前KPS评分<80、T2NoMo喉癌、低分化鳞癌及声门下型喉癌是影响OS的不良预后因素.结论 单纯放疗可以作为治疗早期喉癌的首选方法.影响生存率的主要因素为:年龄、治疗前KPS评分、喉癌分期、鳞癌类型及喉癌的分型.     

局部晚期鼻咽癌放疗结束后影像学残留患者的预后分析

目的寻找调强适形放射治疗(IMRT)结束3～24个月影像学证实有肿瘤残留的局部晚期鼻咽癌患者的预后因素,为局部残留鼻咽癌患者选择优化的综合治疗方案提供依据。方法通过使用SPSS 23.0软件,寿命表法计算生存率,通过Kaplan-Meier法绘制生存曲线图。通过单、多因素分析年龄、性别、放疗剂量、化疗方案、分子靶向治疗、局部残留情况等因素对患者预后的影响。结果 (1)局部晚期鼻咽癌患者5年总生存率(OS)、局部无复发生存率(LRFS)、无远处转移生存率(DMFS)分别为70.8%、78.5%、77.5%;(2)单因素分析发现原发鼻咽肿瘤(GTVnx)残留体积、原发鼻咽肿瘤及颈部转移淋巴结(GTVnx+nd)残留体积、美国癌症联合会(AJCC)分期(第7版)及放疗剂量是影响OS的重要因素,GTVnx残留体积、GTVnx+nd残留体积还是影响LRFS的重要因素。多因素Cox回归分析结果发现:AJCC分期(H^R=3.81, 95%CI:0.58～11.76)、放疗剂量(H^R=4.05, 95%CI:1.22～12.25)为影响OS的独立预后因素(P0.05);GTVnx残留体积(H^R=4.90, 95%CI:1.33～18.13)为影响LRFS的独立预后因素(P0.05)。结论肿瘤分期、原发病灶的总处方剂量可以给临床判断有肿瘤残留的局部晚期鼻咽癌患者预后提供一定的参考价值,但也应考虑鼻咽癌放疗后局部残留体积及残留时间等因素,从而更加全面地评估该类患者的预后,并为其个体化治疗提供依据。     

下颌牙龈鳞癌个体化治疗的研究及临床疗效评价

目的 探讨下颌牙龈鳞癌的个体化治疗方案,评价预后效果.方法 以28例下颌牙龈鳞癌为研究对象,根据临床分期及术后淋巴结的转移情况分为三组,分别采取单纯手术、手术加放疗、手术加放疗加辅助化疗,随访3年,观察临床效果并评价预后.结果 Ⅰ～Ⅱ期患者采用单纯手术,复发率20％,3年生存率80％;Ⅲ～Ⅳ期淋巴结阴性患者组采用手术加放疗,复发率37.5％,3年生存率75％;Ⅲ～Ⅳ期淋巴结阳性患者,采用手术加放疗加辅助化疗,复发率42.86％,3年生存率71.42％.三组复发率和生存率比较,差异无统计学意义(P＞0.05).结论 牙龈鳞癌手术结合放疗完全可以在保存患者功能、外观及生存质量的基础上,取得较为理想的治疗效果,术后化疗的临床疗效尚需进一步研究.     

LOP方案联合放疗治疗早期鼻型结外NK/T细胞淋巴瘤疗效及安全性研究

目的 探讨LOP(门冬酰胺酶,长春新碱,地塞米松)方案化疗联合放疗治疗初治早期彝型结外NK/T细胞淋巴瘤(ENKTL)的疗效及安全性.方法 回顾性分析该院86例分期为Ⅰ/Ⅱ期的早期ENKTL患者的临床资料,患者均接受LOP方案联合放疗,至少化疗4个疗程,并接受受累野放疗,根据放疗剂量分为两组,分别为DT 49～54 Gy组及DT 55～59 Gy组,放疗27～32次,中位随访39个月,评估疗效、3年总生存率(OS).结果 (1)86例患者59例(68.60％)完全缓解(CR);18例(20.93％)部分缓解(PR);2例(2.33％)病情稳定(SD);7例(8.14％)疾病进展(PD);总反应率(ORR) 89.53％;3年OS为90.70％;(2)放疗剂量49～54 Gy组和55～59 Gy组比较,ORR、3年OS差异无统计学意义;(3)放化疗常见不良反应为骨髓抑制、消化道症状、周围神经炎、肝功能损害、黏膜炎、皮炎及凝血功能异常,经积极对症处理后多数可恢复.结论 LOP方案联合放疗对早期ENKTL有效,放疗剂量49～54 Gy组和55～59 Gy组疗效无差异;放化疗不良反应多为轻至中度,该方案对早期ENKTL安全性较高.     

乳腺浸润性微乳头状癌(IMPC) 29例临床分析

 目的  研究乳腺浸润性微乳头状癌(invasive micropapillary carcinoma of the breast,IMPC)的临床病理特征以及生存预后分析。方法  选择2006年6月至2013年6月在本院收治的IMPC 29例,中位随访42个月,分析其临床病理特点、局部复发率、远处转移率及总生存率(overall survival,OS)等生存预后指标;与320例浸润性导管癌(invasive ductal carcinoma,IDC)病例进行对照,分析比较两组间的临床病理特点及生存预后指标。为进一步探讨IMPC病理类型对于生存预后的影响,将58例IDC与29例IMPC进行2∶1配对对照研究,分析比较两组间的生存预后指标。结果   29例IMPC中23例(79.3%)发生淋巴结转移,其中4枚及以上淋巴结转移的有15例(51.7%),18例(62.1%)伴有脉管侵犯。分子分型以Luminal B型为主(21例)。3年无局部复发生存率(local recurrence free survival,LRFS)、无转移生存率(metastasis free survival,MFS)、OS分别为:74%、86%、90%。Cox回归分析得出淋巴结转移个数是IMPC局部复发的影响因素(P=0.048)。与IDC组比较,IMPC组肿瘤体积大(3.70 cm vs.2.81 cm,P=0.007),淋巴结转移率高(79.3% vs.45.0%,P<0.001),淋巴结转移个数多(5.90 vs.2.16,P=0.003),淋巴结分级高分级比例较高(N2:24.1% vs.7.5%,N3:27.6% vs.6.9%,P<0.001),脉管侵犯率高(62.1% vs.20.0%,P<0.001),手术方式中标准根治术比例高(24.2% vs.3.1%,P<0.001),化疗方式中新辅助化疗比例高(31.0% vs.9.1%,P<0.001),其余方面差异无统计学意义。Log Rank检验生存分析得出IMPC组的LRFS显著低于IDC组(P=0.001),但两组间的MFS及OS差异无统计学意义(P=0.074及0.106)。将58例IDC与29例IMPC进行配对对照研究,Log Rank检验生存分析得出两组间的LFRS、MFS与OS差异均无统计学意义(P=0.586、0.965、0.920)。 结论   乳腺IMPC是一类预后较差的特殊类型乳腺癌,其较高的淋巴脉管侵犯性而非这一病理类型,与肿瘤的生存预后相关。     

T2期腋窝淋巴结1～3个转移乳腺癌改良根治术后放疗对局部区域控制的影响及生存预后因素分析

目的探讨T2期腋窝淋巴结1~3个转移乳腺癌改良根治术后的放疗,对该类患者根治术后的局部区域控制的影响及生存预后危险因素分析。方法回顾性分析2006年6月—2011年12月期间126例在该院行改良根治术并经术后病理确诊的T2期腋窝淋巴结1~3个转移乳腺癌病例的资料,所有患者均接受术后放疗。随访满5年以上,分析患者的无局部/区域复发生存（loco-regional recurrence-free survival,LRFS）无瘤生存（disease-free survival,DFS）和总生存（overall survival,OS）及相关因素对生存预后的影响。结果共计72个月中位随访时间,全组的5年OS为95.2%、DFS为89.7%、LRFS为96.0%。采用单因素分析显示,其中年龄、ER状态、腋窝淋巴结阳性个数及百分比差异有统计学意义（P〈0.05）,考虑为其预后危险因素。结论对于T2期腋窝淋巴结1~3个转移乳腺癌改良根治术后患者,包含年龄≤35岁、ER阴性者、3个腋窝淋巴结阳性及百分比〉20%危险因素者建议放疗。     

喉癌术前放疗加手术与单纯手术疗效比较(140例前瞻性研究)

对140例首次治疗的喉癌患者做治疗前随机分组,行术前放疗加手术（41例）与单纯手术（99例）临床疗效前瞻性研究,采用生存率曲线分析和时序检验,对两组疗效从总体生存率、临床分型、T分类、分期、病理分级、术式及感染率等7个方面分层比较,两组生存率曲线差异均无显著性。140例喉癌患者3、5年生存率分别为75．4％和67．5％,声门型3、5年生存率好于声门上型,部分喉切除3、5年生存率不亚于全喉切除。     

子宫内膜癌术后放疗效果的评价

目的 探讨子宫内膜癌术后放疗的两年总生存率和无病生存率,及影响治疗效果的因素.方法 回顾性分析术后放疗的74例子宫内膜癌患者的生存情况,随机分为观察组43例,使用6MV-X线进行三维适形放疗;对照组31例,采取普通体外放疗,观察对比两组放疗效果.结果 对于两年OS来说,病理分期、淋巴结转移情况均有显著差异;多因素分析中淋巴结转移因素影响显著.对两年DFS来说,除绝经情况外,其他因素均显著差异;多因素分析显示病理类型、淋巴结转移等因素差异显著.结论 两年OS主要受单因素分析淋巴结转移及病理分期的影响,子宫内膜癌两年DFS主要受年龄、病理类型、病理分期、淋巴结转移的影响.     

单纯放疗治疗早期喉鳞癌的疗效及预后因素分析

目的研究单纯放疗治疗早期喉癌的疗效及预后因素。方法回顾性分析2003年1月-2008年12月在山西省肿瘤医院接受单纯放射治疗的早期喉癌患者85例。用K-M法进行生存率的计算,Log-rank进行单因素分析,用COX回归行多因素分析。结果单纯放疗组的3、5年总生存率（OS）为92.5%、82%。单纯放疗组首程治疗后的3、5年局部控制率（LC）为82.5%、70%。Cox多因素回归分析显示分期（P=0.032）、鳞癌类型（P=0.025）、年龄（P=0.02）是影响喉癌5年生存率的独立因素。年龄〉60岁、治疗前KPS评分〈80、T2N0M0喉癌、低分化鳞癌及声门下型喉癌是影响OS的不良预后因素。结论单纯放疗可以作为治疗早期喉癌的首选方法。影响生存率的主要因素为：年龄、治疗前KPS评分、喉癌分期、鳞癌类型及喉癌的分型。     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

A preliminary screening study on the associated proteins in human psoriasis vulgaris by serum proteomics technologies

Objective：To investigate the optimum screening conditions of associated proteins in human psoriasis vulgaris by serum proteomics technique, and to screen the different expression proteins related with psoriasis vulgaris. Methods：Serum samples of peripheral blood were collected from newly diagnosed psoriasis vulgaris patients in the clinic, and 20 matched healthy persons. Serum albumin IgG was removed by filtering with ProteoExtract Albumin/IgG. After comparative proteomics analysis the different protein spots were identified using 2-DE and MS. Results ：Electrophoresis figures with high resolution and reproducibility were obtained. Three different expression proteins were found only in the serum from psoriasis vulgaris patients, while nine other different proteins expressing from healthy volunteers. Conclusion：The protein expression was different in the serum between the psoriasis vulgaris patients and healthy volunteers. It was hoped that we could find the biomarkers related to psoriasis vulgaris by using proteomics.     

A CASE OF HUGE GASTRIC DISOPYROBEZOAR

PYTOBEZOARS are common bezoars in gastrontestinal tract, commonly seen in stomach and mall intestine,1but huge disopyrobezoars are     

Acupuncture Treatment of Chest Bi Syndrome

CASE HISTORY A male,a retired officer of 61 years old,paid his first visit on May 12,2006.The patient stated that 2 weeks before he suddenly got paroxysmal precordial choking pain,with irregular attacks.Each attack would last several seconds to several minutes.The attack was accompanied with heavy oppressed sensation in the precordial region,palpitation,lassitude,and in severe cases,sweating,which was once diagnosed by a hospital as'coronary heart disease'.Recalling the case history,the patient said that several days before he got angry with others because of some affairs in work,and he was not so used to the life pattern since he had just retired from his busy working post.At usual times,he was quick tempered and peevish.In recent days,he had poor appetite,and loose stool.     

Instructions to Contributors

The English edition of Chinese Journal of Integrative Medicine is edited and published by the Chinese Journal of Integrated Traditional and Western Medicine Press.Original scientific papers of advanced clinical and experimental medicine in the field of complementary/alternative medicine or integrative medicine are expected.