胶质母细胞瘤切除术后同步放化疗的疗效

目的探讨胶质母细胞瘤切除术后同步放化疗的疗效。方法研究对象选择我院神经外科2014年1月～2016年8月经手术切除治疗并经病理确诊的胶质母细胞瘤患者50例,根据术后是否行同步放化疗将其分为观察组与对照组,其中观察组患者术后实施同步放化疗,对照组患者术后拒绝行放化疗,比较两组患者的存活率。结果治疗后,观察组患者的术后3个月存活率及术后6个月存活率、术后9个月存活率明显高于对照组,术后1年存活率和术后2年存活率明显高于对照组,差异有统计学意义(P0.05)。结论对于胶质母细胞瘤患者给予手术切除,术后同步进行放疗和化疗,能明显提高患者的术后1年和术后2年存活率。     

肿瘤电场治疗应用胶质母细胞瘤1例

胶质母细胞瘤(GBM)是成人最常见的原发性恶性肿瘤,在星形细胞肿瘤中恶性程度最高,手术合并放化疗是GBM标准的治疗方式。由于其浸润性,肿瘤无法完全切除,胶质母细胞瘤容易复发且预后较差,因此需要寻求更有效的治疗方法,其中肿瘤电场治疗(TTFields)与放化疗联合治疗方案显著延长了胶质母细胞瘤的生存时间。本文报道1例GBM患者,手术切除肿瘤后行规律放化疗同步TTFields治疗,现患者预后良好,术后复查MRI未见肿瘤复发。     

基因芯片技术在脑胶质瘤诊疗中的研究进展

胶质母细胞瘤(GBM)是神经系统最常见的高度恶性肿瘤,手术切除加同步放化疗后的平均生存期也仅为1a余。对基因芯片在GBM中的相关信号通路的研究,分子表达特征及个体化治疗进行综述,旨在为胶质母细胞瘤诊断、治疗以及预后有关的基因通路表达的研究拓展思路。     

螺旋断层放射治疗联合替莫唑胺治疗脑胶质母细胞瘤的疗效分析

目的 对恶性脑胶质瘤术后螺旋断层放射治疗联合口服化疗药物替莫唑胺(TMZ)的疗效进行分析.方法 收集2011年10月～2012年8月就诊于沈阳军区总医院的23例脑胶质母细胞瘤术后患者的相关信息,所有患者均应用螺旋断层放射治疗技术调强放射治疗,同步给予替莫唑胺胶囊化疗,其中13例继续服用替莫唑胺胶囊辅助化疗6个周期,5例辅助化疗＞6个周期,5例仅同步放化疗未辅助化疗.23例平均随访14个月,对治疗的疗效、不同影响因素与恶性胶质瘤预后的影响和治疗的相关副反应进行分析.结果 患者中位总生存期(OS)为17.2个月,中位无疾病进展生存期(PFS)为8.6个月,其中KPS评分较高(＞80)患者的PFS明显延长;辅助化疗≥6个周期患者的PFS和OS明显延长;手术至放疗时间＜4个周期患者的OS明显延长.所有患者均未出现Ⅲ～Ⅳ级毒副反应,耐受性良好.结论 应用螺旋断层放疗技术同步放化疗治疗胶质母细胞瘤安全、有效,具有可行性,为临床治疗提供了新的方向.     

MMP-13在胶质母细胞瘤中的表达及对患者术后生存期的影响

目的 探讨基质金属蛋白酶13 (Matrix metalloproteinase 13,MMP-13)的表达对胶质母细胞瘤患者术后生存期的影响.方法 免疫组化法检测31例胶质母细胞瘤患者肿瘤组织标本中MMP-13的表达,Kaplan-Meier生存曲线和Log-rank检验比较MMP-13强表达组与弱表达组患者术后生存期之间的差异.结果 MMP-13在胶质母细胞瘤中总表达率为77.4％,强表达组术后生存期明显短于弱表达组(P＜0.0001,x2=18.275).结论 MMP-13有潜力作为胶质母细胞瘤患者预后的影响因素.     

治疗首次术后脑胶质母细胞瘤“放化疗同步”优于“单纯放疗”

首都医科大学附属北京天坛医院胶质瘤治疗中心教授江涛、放疗中心主任邱晓光最近通过对60例胶质母细胞瘤患者术后放、化疗跟踪研究发现,放疗加化疗同步治疗首次术后胶质母细胞瘤,在提高局部控制率、延缓肿瘤复发与提高患者无瘤生存期方面都明显优于传统的单纯放疗,而不良反应均较轻微,两组间没有明显差异。该研究发表在2008年7月《中华神经外科杂志》上。     

短程放疗联合替莫唑胺在老年胶质母细胞瘤患者中的生存获益分析

目的 探讨短程放疗联合替莫唑胺(TMZ)方案在术后KPS评分较差的老年胶质母细胞瘤(GBM)患者治疗中的生存获益情况.方法 回顾分析行完整切除但术后KPS评分不佳的新诊断老年GBM患者71例,对不同MGMT状态下各辅助治疗方案进行生存分析和比较.结果 71例患者年龄65~85岁,平均(71.10±5.19)岁,其中男50例,年龄(71.36±5.35)岁,女21例,年龄(70.48±4.90)岁;其中62例在随访截止日期前死亡,总体平均生存期(OS)(11.92±0.51)个月,2年生存率0;接受短程同步放化疗联合TMZ辅助治疗组平均生存期显著提高(P=0.002),与单纯短程放疗组相比差异性最大(P=0.001),而单纯短程放疗与单纯TMZ辅助治疗组之间OS差异无统计学意义(P>0.05);术后免疫组化MGMT阴性表达组患者更能从短程同步放化疗联合TMZ辅助化疗中获得生存获益(P=0.004).结论 对于≥65岁接受肿瘤切除后功能状态不佳的老年GBM患者,短程同步放化疗联合TMZ辅助治疗可能是一种能获得更多生存获益的术后辅助治疗方案,在MGMT启动子甲基化患者中,这种获益优势更加明显.     

胶质母细胞瘤术后同步放化疗临床疗效观察

目的 观察胶质母细胞瘤术后,替莫唑胺(TMZ)同步放化疗的临床疗效.方法 2006年4月～2007年4月收治55例手术后病理证实为胶质母细胞瘤的病人,随机分为2组:①辅助化疗组(30例),术后放疗后予TMZ辅助化疗,第1周期化疗[150 mg/(m2·d),d1～5,间隔28d];第2～4周期[200 mg/(m2·d),d1～5],间隔28 d);②同步放化疗组(25例),放疗开始便予TMZ第一周期化疗[(150 mg/(m2·d),d1～5)],放疗28 d时予TMZ第2周期化疗[(200 mg/(m2·d),d1～5)1,以后再予TMZ辅助化疗2周期.术后放疗剂量均为DT60Gy/30次.随访至2009年4月,观察总生存时间、无进展生存时间以及毒副反应.结果 辅助化疗组的中位生存时间为7.6月,同步放化疗组的中位生存时间为13.8月.中位无进展生存时间分别为:4.25月和6.65月.2年总生存率分别为:13.33%和24%(P=0.0420).2年无进展生存率分别为:10%和16%(P=0.0231).差别均有统计学意义.且没有发现明显毒副反应.结论 胶质母细胞瘤术后予TMZ同步放化疗疗效优于术后放疗后辅助化疗,且病人能很好的耐受.     

立体适形放疗在治疗脑胶质母细胞瘤术后患者的应用

脑胶质母细胞瘤的治疗以手术加放疗、化疗的综合治疗为主,由于脑胶质母细胞瘤的生物学特性为浸润性生长,无明确边界,手术治疗难以彻底清除病变,术后必须配合放疗。但术后放疗的剂量因受正常脑组织耐受剂量的限制,很难达到较高的剂量以控制复发。如何提高照射剂量是提高脑胶质母细胞瘤术后病例的局部控制率、延长生存期的关键所在。立体适形放射治疗为照射剂量的提高提供了有利途径。笔者对本院1999—2002年收治的12例脑胶质母细胞瘤术后进行立体适形放疗的患者资料进行回顾性分析,报告如下。1资料与方法1.1一般资料脑胶质母细胞瘤术后患者12…     

功能区低级别胶质瘤患者生存影响因素分析

目的 探讨功能区低级别胶质瘤(LGGs)患者生存影响因素.方法 回顾性分析2011年1月至2015年6月安徽医科大学第一附属医院神经外科新诊断的62例功能区LGGs患者的临床资料,统计分析患者生存影响因素.结果 单因素分析发现年龄<40岁、术前KPS≥70分、肿瘤全切、少突胶质细胞瘤、术后进行联合放化疗的功能区LGGs患者无进展生存期(PFS)和总生存期(OS)优于年龄≥40岁、术前KPS<70分、非全切、星形细胞瘤或混合性少突-星形细胞瘤、术后不放化疗或单独放疗/化疗患者,差异有统计学意义(P<0.05);多因素分析示年龄、术前KPS评分、手术切除程度、病理类型是影响生存的独立因素(P<0.05).结论 年龄较轻、术前高KPS评分及含有少突胶质细胞成分的功能区LGGs患者预后较佳,手术全切及术后放化疗能延长患者生存期.     

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…