TCMP方案治疗对常规化疗耐药的复发转移性乳腺癌

目的:为评估由三苯氧胺、环磷酰胺、氨甲喋呤和顺铂组成的TCMP方案对常规化疗耐药后复发转移性乳腺癌的疗效.方法:25例对常规化疗耐药的复发转移性乳腺癌患者接受TCMP方案化疗.给药方法是三苯氧胺,10mg,口服,每天2次;环磷酸胺,0.8～1.0,静推,第1天;氨甲喋呤,40mg,肌注,第1、8天;顺铂40mm,静滴,第1～4天.23例患者有客观评价指标,均接受TCMP方案化疗最小2周期.结果:23例可评价患者中,总客观有效率为52.17%(95%可信区间31～73%),其中2例CR,10例PR.经Ridit检验治疗效果与雌激素受体状态无关.结论:以上提示TCMP方案对常规治疗耐药后复发转移性乳腺癌有较好疗效,三苯氧胺与以顺铂为主化疗方案在乳腺癌的治疗中有协同作用.     

骨转移瘤的放射治疗

目的探讨关于骨转移瘤常规分割放疗组与低分割放疗组的止痛效果。方法４８例病人，２８例采用常规分割，ＤＴ２００ＣＧＹ／次，每周５次，ＤＴ３０００～５０００ＣＧＹ；２０例采用低分割照射，ＤＴ４００～５００ＣＧＹ／次，每周２～３次，ＤＴ２５００～３０００ＣＧＹ。结果放疗起到了明显的止痛作用，常规分割放疗组与低分割放疗组止痛效果大致相同，无统计学意义（Ｐ＞０．０５）。结论放疗原则应根据病情及预计生存期长短来决定。对一般情况好，预计生存期长的病人应采取积极的治疗，给予大剂量长疗程的常规分割，而对于那些病情相对较重，行动又不方便，无望长期生存的病人，应采取低分割照射，且见效快，同样起到止痛作用     

产时羊水粪染新生儿脐动脉乳酸水平的变化

目的 研究产时羊水粪染（meconium—staind amniotic fluid，MSAF）新生儿脐动脉血乳酸水平的变化及与血气分析新生儿结局的关系。方法 2005年2月至2006年3月245例足月妊娠、单胎、头位，无产科、内科合并症产妇，根据产时羊水有无MSAF分为两组，MSAF组（n=50），清亮组（n=195），检测脐动脉血乳酸、血气分析，以及新生儿行为神经测定（neonatal behavioral neudogioal assessment，NBNA）。结果 MSAF组与清亮组脐动脉血乳酸水平、pH值及碱剩余（BE）比较，差异无显著意义（P＞0．05）。脐血乳酸水平在MSAF程度之间，差异无显著意义（P＞0．05）。脐血乳酸与pH值、BE呈明显负相关关系（r=-0．64，r=-0．63，P＜0．01）。MSAF组合并产时异常胎心监护图形、酸中毒者，其脐动脉血乳酸水平明显升高，差异有显著意义（P＜0．05，P＜0．01）。新生儿NBNA评分，两组间相比差异无显著意义（P＞0．05）。结论 脐动脉血乳酸水平与pH值、BE有较好的相关性，产时单纯MSAF与提示急性窒息的指标乳酸无明显关系。     

肌苷对大鼠脑缺血再灌注后GAP-43 mRNA表达影响

目的探讨肌苷对脑缺血再灌注后中枢神经再生的作用。方法线栓法建立大脑中动脉缺血再灌注模型,随机分为治疗组和对照组,每组再随机分为缺血1.5 h再灌注2 h、12 h、1 d、2 d、3 d、7 d1、4 d组(n=4),另取4只作假手术组。应用BEDERSON等神经功能评分法评定神经功能,原位杂交技术检测脑缺血再灌注后各时间点脑组织生长相关蛋白基因(GAP-43 mRNA)的表达。结果对照组于再灌注2 h~7 d、治疗组于再灌注12 h~7 d,GAP-43 mRNA表达与假手术组比较明显增多(t=2.70~29.84,P<0.05),治疗组与对照组比较GAP-43mRNA表达于再灌注2 h一过性下降,12 h和7 d明显增高(t=1.97~7.41,P<0.05);治疗组与对照组比较神经功能恢复于再灌注7 d有显著性差异(t=2.31,P<0.05)。结论肌苷可促进大鼠脑缺血再灌注后神经功能恢复,其作用机制可能是通过调节与神经轴突再生有关的GAP-43 mRNA表达而实现的。     

脉冲振荡肺功能测定在学龄前期儿童哮喘治疗中价值

目的探讨脉冲振荡肺功能(IOS)测定在学龄前期儿童哮喘治疗中的应用价值。方法应用MasterScreen系列肺功能测定系统,对不能配合完成常规肺功能(PFT)测试的学龄前期不同病期哮喘病儿(发作组32例,缓解组30例)及正常对照儿童(20例)进行IOS测试。结果所有儿童全部完成测试。发作组与缓解组比较,除R20外,R5、R5-R20、X5、Fres、Zrs各指标差异皆有显著性(F=6.51~14.42,q=6.02~8.80,P<0.01)。缓解组R5-R20、Fres与对照组比较差异有显著性(q=5.98、6.04,P<0.01)。发作组除R20、R5-R20、Fres外,其余指标异常率与缓解组比较,差异均具有极显著性(2χ=14.60~28.61,P<0.01)。结论学龄前期儿童哮喘IOS测试有很好的可行性,IOS测定可作为哮喘病儿治疗评价中的很好的手段。     

眼眶炎性假瘤23例影像诊断分析

目的：比较分析影像检查方法对眼眶炎性假瘤的定位及定性诊断的价值.方法：对23例（25只眼）眼眶炎性假瘤患者的B超、CT及磁共振成像（MRI）检查结果进行观察分析.结果：B超、CT和MRI检查均可确定病变位置并提示病变的性质,但B超能较好显示病变内部结构和动态,CT发现病变及确定位置较精确,MRI可提示病变的组织结构.结论：三种影像学检查均能对眼眶炎性假瘤作出定位及定性诊断,但各有其优缺点,将三者结合可以互补不足,使诊断更确切.     

Breast cancer stem cells: Multiple capacities in tumor metastasis

Breast cancer is the leading cause of cancer death among women worldwide. Accumulating evidence indicates that the local recurrent and/or distant metastatic tumors, the major causes of lethality in the clinic, are related to the aggressive phenotype of a small fraction of cancer cells loosely termed as cancer stem cells (CSCs), tumor initiating cells (TICs), or cancer metastasis-initiating cells (CMICs). Breast cancer stem cells (BCSCs) are shown to exhibit unique growth abilities including self-renewal, differentiation potential, and resistance to most anti-cancer agents including chemo- and/or radiotherapy, all of which are believed to contribute to the development and overall aggressiveness of the recurrent or metastatic lesions. It is in the urgent need not only to further define the nature of heterogeneity in each tumor but also to characterize the precise mechanisms governing tumor–host cross-talk which is assumed to be initiated by BCSCs. In this review, we will focus on recently identified key factors, including the BCSCs among circulating tumor cells, interaction of BCSCs with the host, epithelial mesenchymal transition (EMT), tumor microenvironment, the intrinsic resistance due to HER2 expression, potential biomarkers of BCSCs and cancer cell immune signaling. We believe that new evidence coming from both bench and clinical research will help to develop more effective approaches to control or significantly reduce the aggressiveness of metastatic tumors.     

知柏地黄丸治疗糖调节受损患者的临床研究

目的观察知柏地黄丸对糖调节受损(IGR)患者的临床疗效及对胰岛素抵抗、胰岛β细胞功能的影响。方法 176例IGR患者,随机分为治疗组与对照组,观察结束共脱落及剔除病例19例,纳入统计病例157例,治疗组77例,对照组80例,两组均给予教育及生活方式干预,治疗组在其基础上给予知柏地黄丸口服,治疗12个月后,观察两组体重指数(BMI)、HOMA胰岛素分泌指数(HOMA-β)、早期胰岛素分泌指数(EISI)及HOMA胰岛素抵抗指数(HOMA-IR)的改变。结果两组患者的BMI及HOMA-IR较治疗前均有下降,HOMA-β明显升高,差异有统计学意义(P0.05,P0.01);与对照组比较,治疗组治疗后HOMA-IR下降,EISI及HOMA-β升高,差异有统计学意义(P0.05,P0.01)。结论知柏地黄丸能减轻胰岛素抵抗,改善胰岛β细胞功能,延缓或预防IGR患者向2型糖尿病(T2DM)发展。     

Epstein-Barr virus gene polymorphism in different parts of the same nasopharyngeal carcinoma patient

In most previous studies, comparisons of Epstein-Barr virus (EBV) gene polymorphisms and genotypes were made between strains from tumors and normal throat washings (TWs) from different individuals. However, it remains controversial whether different EBV subtypes are present in different parts of the same NPC patient. In order to address this question, in this study, we compared the genotypes in sets of paired throat washings (TW) and paraffin-embedded tissues of 20 patients with nasopharyngeal carcinoma (NPC), and we found the same genotype in throat washings (TWs) and tumor cells from the same individual in most cases. The subtypes of EBER and EBNA1 genes were furthermore sequenced, and identical EBV strains were identified in tumor tissues and TWs. In conclusion, different sites of the same individual are infected by the same EBV strains, except for a few differences in occasional cases, suggesting that the EBV subtype detected in throat washings is a reasonable guide to the subtype present in the carcinoma tissue.     

Preoperative neutrophil-to-lymphocyte ratio is a more valuable prognostic factor than platelet-to-lymphocyte ratio for nonmetastatic rectal cancer

Several combinations of inflammatory factors, including neutrophil-to- lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), have been reported to be prognostic factors in various malignant tumors, including colorectal cancer (CRC). The aim of this study was to evaluate the prognostic value of NLR and PLR for patients with rectal cancer (RC) who underwent curative surgery. Data from patients who underwent curative resection for RC were retrospectively reviewed. The cutoff for NLR and PLR was defined as 2.3 and 144 by receiver operating characteristic (ROC) curve. Overall survival (OS) and disease-free survival (DFS) were assessed using Kaplan-Meier method. Multivariable Cox regression model was used to evaluate the independent prognostic significance of variables. A total of 140 patients were eligible in the study. High NLR (> 2.3) and high PLR (> 144) both predicted lower OS and DFS according to Kaplan-Meier method. But in the multivariable Cox regression model, only the high NLR retained significance for reduced OS and DFS. According to Chi-square test, patients with higher NLR had larger tumor size and higher pN-stage. While PLR was only associated with the pN-stage. High preoperative NLR was shown to be a negative independent prognostic factor in patients undergoing resection for nonmetastatic RC. It may be helpful as a factor to guide the postoperative therapies.