紫花牡荆素抑制小细胞肺癌NCI-H446细胞系肺癌干细胞样细胞侵袭和转移的研究

目的探讨紫花牡荆素(CAS)抑制人小细胞肺癌NCI-H446细胞系肺癌干细胞样细胞(LCSLCs)侵袭和转移作用。方法体外培养人小细胞肺癌NCI-H446细胞系细胞和LCSLCs。流式细胞术(FCM)检测CD133+表达。Trawell法检测LCSLCs侵袭和转移能力。Trawell法测定CAS对LCSLCs侵袭、转移能力的抑制作用。结果 LCSLCs呈现典型非黏附三维球状,并高表达CD133+。Trawell法结果显示LCSLCs具有很强的体外侵袭和转移能力,而CAS能显著抑制LCSLCs的体外侵袭和转移能力。结论 CAS能显著抑制LCSLCs的体外侵袭和转移能力。     

A combination of Sinomenine and Methotrexate reduces joint damage of collagen induced arthritis in rats by modulating osteoclast-related cytokines

ObjectiveTo analyze the combination therapy of Sinomenine (SIN) and Methotrexate (MTX) in rheumatoid arthritis (RA), we herein demonstrated the combination effect of SIN and MTX on collagen-induced arthritis (CIA) in rats through their modulation on osteoclast-related cytokines.MethodsCIA was induced by the immunization of type II collagen (CII) in SD rats. SIN and MTX were administrated alone or in combination after the onset of arthritis. Arthritis index and histological analysis were used to evaluate the effect of treatments. Effects of SIN and MTX on expression of receptor activator of NF-κB ligand (RANKL) and osteopontin (OPN) in synovial tissues were assayed by immunohistochemistry. RANKL, osteoprotegerin (OPG), IL-6, IL-17 and matrix metalloproteinases (MMPs) in rat serum were measured by ELISA. The expression of osteoclast-related cytokines in fibroblast-like synoviocytes (FLS) from RA patients was assayed by RT-PCR.ResultsSIN and MTX combination additively reduced the inflammatory symptoms and joint damage in CIA. Combination of SIN and MTX significantly repressed synovial RANKL and OPN production. SIN and MTX exhibited complementary and synergistic effect upon down-regulating RANKL, IL-6, IL-17 and MMPs in rat serum. SIN and MTX also modulated the expression of RANKL and OPG in RA-FLS.ConclusionSIN and MTX have additive effects, decreasing inflammation and joint damage in CIA rats by modulating osteoclast-related cytokines. These results are indicative of the combined effect of SIN and MTX for anti-arthritic treatment in RA.     

Cerebral arteriostenosis associated with elevated serum-immunoglobulin E level in young adults without risk factors for ischemic stroke: A possible manifestation of cerebral vasculitis?

We report a series of young adults with symptomatic cerebral arteriostenosis characterized by elevated serum immunoglobulin (Ig) E levels. All patients had no definite risk factors for cerebral vascular diseases. The clinical data of 26 young adults (age 18–50 years) with ischemic stroke, characterized only by increased serum IgE levels and without risk factors for cerebral vascular disease, were retrospectively reviewed. Arteriostenosis was surveyed and followed-up by digital subtraction angiography (DSA), and the stenosis rate was estimated using the warfarin–aspirin symptomatic intracranial disease technique. All patients were treated with corticosteroids according to the common strategy for vasculitis. There was no recurrent stroke during follow-up. The mean degree of stenosis before and after treatment was 69.3 ± 29.8% and 47.9 ± 45.1%, respectively. The difference of stenosis rates between initial and follow-up DSA evaluation was significant using a paired samples test (21.31 ± 26.88, 95% confidence interval [CI] 13.58–29.03, t = 5.55, p < 0.001). Kaplan–Meier survival analysis revealed that the 13-month cumulative improved lesion rate was 40.3 ± 8.7%. This remained the same at 18 months. The mean time to lesion improvement was 12.58 ± 0.96 months (95% CI 10.70–14.46) and median time was 13 ± 3.88 months (95% CI 5.39–20.61). To our knowledge, cerebral arteriostenosis with only elevated IgE serum levels has not been reported. Our data showed that corticosteroid treatment can achieve clinical and artery improvement. This suggests that the cerebral arteriostenosis seen in our study might be caused by some specific type of vessel inflammation.     

智慧医疗在居家安宁疗护中的研究现状

居家安宁疗护(HBPC)是安宁疗护的服务模式之一,智慧医疗作为一种新兴的信息技术,为HBPC高质量发展提供了新的契机。目前国内外已有研究报道将智慧医疗应用至HBPC中能够取得较好的效果,本文围绕智慧医疗的概念,对HBPC的应用形式、应用效果、应用困境及对策进行综述,旨在为我国医务人员在HBPC中深入开展智慧医疗照护模式提供参考依据。     

晚期癌症患者痛苦体验：一项丧失与疏离死亡相关的质性研究

目的 深入了解晚期癌症患者痛苦体验,为制定个体化的干预措施提供依据。方法 采用描述性现象学的方法,进行目的性抽样,于2022年4月至6月对湖南省某三级肿瘤专科医院的安宁疗护病房的15例晚期癌症患者进行半结构式深度访谈。采用Colaizzi 7步分析法对资料的分析、归纳与主题提炼。结果 晚期癌症患者痛苦体验可分为3个主题、9个亚主题:丧失相关痛苦(自我完整性丧失、自我尊严感丧失、自我价值感丧失、生命意义丧失);疏离相关痛苦(社会关系疏离、情感联结疏离);死亡相关痛苦(想到死亡充满恐惧、面对死亡不安焦虑、期待死亡结束痛苦)。结论 晚期癌症患者的痛苦体验涵盖丧失、疏离、死亡多个维度,具有多样性和个体性,应提供有针对性的干预措施,从而提高其生活质量。     

肺癌干细胞标志物的研究现状

肺癌具有高度异质性,能够抵抗化疗药物治疗,5年生存率小于15%。尽管我们关于肺癌的知识在不断增多,但仍很难确定肺癌的异质性和耐药性的发病基础。肿瘤干细胞模型近年来吸引了很多注意力,通过这种模型可以解释各种肿瘤的异质性、耐药性、休眠、复发和转移。肿瘤干细胞理论较少涉及肺癌研究。本文综述了肺癌干细胞的鉴定方法,包括其细胞表面标志物和生物学特征,还讨论了肺癌干细胞与肺癌预后的关系,从而为消灭肺癌干细胞、攻克肺癌提供理论依据。     

37例口颊癌术后腮腺瘘的放疗效果评估

目的 评估放射治疗应用于口颊癌术后腮腺瘘的疗效以及不良反应。方法 回顾性分析2010年1月-2020年1月湖南省肿瘤医院头颈外科收治的因口颊癌术后出现腮腺瘘且接受放射治疗的患者37例,所有患者均采用6-MeV电子线照射,每次2 Gy,每天1次,每周5次,照射总剂量为8~18 Gy（平均剂量9.7 Gy）,照射野包括整个腮腺区域。结果 37例接受放射治疗的腮腺瘘患者均治愈,治愈率达100%。后期随访3个月,无1例再次出现腮腺瘘。仅有1例患者出现轻微口干以及味觉改变,未观察到其他相关不良反应。结论 放疗用于口颊癌术后腮腺瘘的治疗,其起效快、效果显著、无明显的并发症,值得在临床推广应用。     

Risk-based,response-adapted therapy for early-stage extranodal nasal-type NK/T-cell lymphoma in the modern chemotherapy era: A China Lymphoma Collaborative Group study

We aimed to determine the survival benefits of chemotherapy (CT) added to radiotherapy (RT) in different risk groups of patients with early-stage extranodal nasal-type NK/T-cell lymphoma (ENKTCL), and to investigate the risk of postponing RT based on induction CT responses. A total of 1360 patients who received RT with or without new-regimen CT from 20 institutions were retrospectively reviewed. The patients had received RT alone, RT followed by CT (RT + CT), or CT followed by RT (CT + RT). The patients were stratified into different risk groups using the nomogram-revised risk index (NRI). A comparative study was performed using propensity score-matched (PSM) analysis. Adding new-regimen CT to RT (vs RT alone) significantly improved overall survival (OS, 73.2% vs 60.9%, P < .001) and progression-free survival (PFS, 63.5% vs 54.2%, P < .001) for intermediate-risk/high-risk patients, but not for low-risk patients. For intermediate-risk/high-risk patients, RT + CT and CT + RT resulted in non-significantly different OS (77.7% vs 72.4%; P = .290) and PFS (67.1% vs 63.1%; P = .592). For patients with complete response (CR) after induction CT, initiation of RT within or beyond three cycles of CT resulted in similar OS (78.2% vs 81.7%, P = .915) and PFS (68.2% vs 69.9%, P = .519). For patients without CR, early RT resulted in better PFS (63.4% vs 47.6%, P = .019) than late RT. Risk-based, response-adapted therapy involving early RT combined with CT is a viable, effective strategy for intermediate-risk/high-risk early-stage patients with ENKTCL in the modern treatment era.     

腹腔镜辅助和开腹胃癌根治术临床疗效的比较

目的：分析比较腹腔镜下全胃切除术和开腹全胃切除术治疗胃上部癌的近远期疗效。方法回顾性分析164例胃上部癌患者,分别行腹腔镜下全胃切除术或开腹全胃切除术,比较两组患者的术后并发症、总生存期（OS）和无病生存期（DFS）以了解两组患者的远期疗效。结果两组患者一般资料的差异无统计学意义。与开腹组相比,腹腔镜组患者的术中失血少,麻醉次数少,排气时间早且住院时间短。两组的术后并发症发生率、OS和DFS无显著组间差异。多变量Cox回归分析发现,病理T、N分期是OS和DFS的独立预后影响因子。结论与开腹全胃切除术相比,腹腔镜下全胃切除术治疗胃上部癌的远期临床疗效相当。