灵芝多糖拮抗环孢素A,氢化可的松及抗肿瘤药的免疫抑制作用

灵芝多糖在50,100和200μg·ml~1时可完全拮抗环孢素A,丝裂霉素C,氟尿嘧啶和阿糖胞苷对小鼠混合淋巴细胞反应(MLR)的轻度抑制(抑制50％以下)作用,部分拮抗氢化考的松对MLR的严重抑制(抑制50％以上)作用。     

半乳糖酰化壳聚糖衍生物包复的5-氟尿嘧啶白蛋白微球的制备

目的:制备肝靶向的半乳糖酰化壳聚糖衍生物包复的5-氟尿嘧啶白蛋白微球.方法:采用乳化-交联固化法制备了5-氟尿嘧啶白蛋白微球,分别以均匀设计和单因素处方分析优化了该制备工艺,然后在其表面通过静电作用力包裹壳聚糖衍生物,采用正交实验设计确定最佳包裹条件,得到壳聚糖衍生物包复的5-氟尿嘧啶白蛋白微球.结果:优化后的制备条件为:5-氟尿嘧啶浓度10 μg/ml,w/o体积比1/20,戊二醛加入量1.0 ml/100 mg牛血清白蛋白,固化时间4 h,衍生物包复时包裹时间10 min,衍生物浓度2%,冰醋酸浓度2%.结论:本法简便、易操作,实验设计方案经济有效.     

Radiation recall phenomenon secondary to capecitabine: possible role of thymidine phosphorylase

Background: The first reported case of radiation (XRT) recall related to capecitabine described dermatitis in a previously radiated field in a breast cancer patient (Ortman; JCO). We previously reported the first case of recall syndrome manifesting as diffuse gastritis and duodenitis related to capecitabine with prior XRT with 5-FU in a pancreatic cancer patient (Saif; JARCET). We report here another pancreatic cancer patient with a radiation recall receiving capecitabine following capecitabine-XRT. Patients and methods: From April 2004 to June 2005, 20 patients with locally advanced pancreatic adenocarcinoma were treated with capecitabine 1,600 mg/m² daily with concomitant radiation (5040cGy) Monday–Friday (weekends off) for a total of 6 weeks, followed by capecitabine 2,000 mg/m² daily for 14 days every 3 weeks. One male patient with tumor in the neck and body of pancreas and not infiltrating the duodenum dropped hemoglobin to 7.3 g/dl at the end of the ninth week, and melena on rectal examination. Specimen of primary pancreatic ductal adenocarcinoma was obtained via EUS-guided biopsy before starting XRT on day 1 and utilized for RNA extraction. TP mRNA level was determined by real-time quantitative PCR (RT-Q-PCR). Results: Upper endoscopy revealed gastritis consistent with radiation toxicity. Colonoscopy was negative. Transfusion of three units of packed red blood cells (PRBCs) was given. The dose of capecitabine was reduced by 25%. His anemia continued to progress, a CT scan revealed 39% decrease in the tumor size (PR). Analysis of tumor specimen prior to the start of capecitabine-XRT showed TP expression of 183.16 (high). In addition to TP, DPD was 7.40, and TNF-alpha 4,114.56. Conclusion: We believe this case to be the second case of radiation recall presenting as diffuse gastritis in a patient receiving capecitabine after previous treatment with XRT. Further studies, including the role of TP are warranted into the pathogenesis of this unique phenomenon.     

氟尿嘧啶炭纳米粒新型制剂的淋巴靶向性研究

目的对氟尿嘧啶(5-FU)炭纳米粒新型制剂在大鼠体内的淋巴靶向性进行研究。方法采用反相高效液相色谱法测定大鼠经腹腔注射5-FU炭纳米粒新剂型与5-FU普通剂型(20mg/kg体重)后大鼠体内淋巴组织的药物浓度。结果腹腔注射5-FU炭纳米粒新剂型组中淋巴组织中药物浓度高于5-FU普通剂型组,炭纳米粒可以吸附5-FU并被淋巴组织吞噬,体现出一定的淋巴靶向性,5-FU炭纳米粒新剂型组中的5-FU在淋巴组织中持续时间较长。结论 5-FU炭纳米粒注射液能显著改善淋巴靶器官局部药物浓度,具有较好的淋巴靶向性。     

Successful treatment for esophageal carcinoma with lung metastasis by induction chemotherapy followed by salvage esophagectomy： Report of a case

We here report a case of a 51-year-old man with lung metastasis from esophageal carcinoma that was initially treated by combination chemotherapy consisting of fluorouracil and nedaplatin. Because metastatic disease disappeared, salvage esophagectomy was performed. Although chest wall recurrence developed at the thoracotomy wound, prolonged survival of 48 months was achieved by local tumor resection and additional chemotherapy. This combination chemotherapy is regarded as a promising and considerable treatment for metastatic esophageal carcinoma.     

Adjuvant chemotherapy with folinic acid and 5-fluorouracil in patients with locally advanced rectal cancer previously treated by preoperative radiochemotherapy and curative tumor resection

BACKGROUND AND AIMS: The role of postoperative adjuvant chemotherapy in patients with rectal cancer pretreated by preoperative radiochemotherapy (RCT) and curative surgery is still poorly investigated. PATIENTS AND METHODS: We pooled data from both arms of a phase III trial in which patients with locally advanced (T3/4) rectal cancer were randomized to preoperative RCT alone or combined with pelvic radio-frequency hyperthermia. After surgery, R0-resected patients were scheduled to adjuvant chemotherapy with four monthly courses of 50 mg folinic acid (FA) and gradually escalated 5-fluorouracil (5-FU, 350-500 mg/m2, days 1-5). Reasons preventing initiation of chemotherapy and treatment-related toxicities were evaluated. Patients' characteristics and survival parameters were compared between the treated and untreated patient groups. RESULTS: Out of 93 patients, 73 (79%) started adjuvant chemotherapy, whereas 19 (21%) did not, mostly due to perioperative complications and refusal. Chemotherapy-related toxicities were mild to moderate in most cases, but--together with protracted postoperative complications--prevented the intended dose escalation of 5-FU in 71% of patients. Distant-failure-free (p=0.03) and overall survival (p=0.03) were improved in the chemotherapy group, although there was a negative selection of patients with unfavourable characteristics into the untreated patient group. INTERPRETATION/CONCLUSION: Adjuvant chemotherapy using FA and 5-FU can be safely applied to the majority of patients with rectal cancer pretreated by RCT and surgery. Survival data are not suitable to allow far-reaching conclusions, but are in line with suggestions of a favourable effect of adjuvant chemotherapy in these patients.     

长春瑞滨加醛氢叶酸和大剂量氟尿嘧啶治疗晚期三阴性乳腺癌

目的 探讨长春瑞滨（NVB）加醛氢叶酸（CF）和大剂量氟尿嘧啶（5-FU）治疗晚期三阴性乳腺癌（TNBC）的疗效.方法 选择2010年4月～2012年4月我院收治的35例晚期TNBC患者作为观察对象,给予NVB联合CF、大剂量5-FU进行治疗,观察患者化疗后的有效率、毒副反应、疾病进展时间（TTP）、1年生存率.结果 治疗总有效率为74.29%,其中CR为5例,PR为21例,SD为5例,PD为4例,RP为26例.绝经前后有效率分别为40.00%、34.29%;浸润性导管癌和小叶癌有效率分别为42.85%、31.43%;转移灶单个和多个有效率分别为62.85%、8.57%;既往治疗包含紫杉类和不含紫杉类有效率均为37.14%.主要副作用有白细胞下降和口腔溃疡,其中白细胞下降总发生率为60.00%,口腔溃疡总发生率为74.29%,毒副反应大多为Ⅱ～Ⅲ级,在病患可承受范围内,疾病进展时间为（9.5±2.3）个月、1年生存率为（76.36±8.21）%.结论 NVB联合CF、大剂量5-FU治疗TNBC能提高有效率以及患者生存率,安全性较高,值得临床推广应用.     

奥沙利铂联合吡柔比星和氟尿嘧啶治疗晚期肝癌的临床疗效分析

目的观察联合化疗治疗晚期肝癌的临床疗效及安全性。方法选取我院自2009年1月至2012年10月收治的40例晚期原发性肝癌患者作为研究对象,给予奥沙利铂、吡柔比星及氟尿嘧啶联合化疗,观察临床治疗效果及毒副反应情况。结果 40例患者CR 2例,PR13例,SD 15例,PD 10例,临床总有效率为37.5%。初治9例和复治21例患者的总有效率比较无明显差异(χ2=1.052,P>0.05)。主要毒副反应包括白细胞下降13例(32.5%),贫血2例(5.0%),血小板减少5例(12.5%),恶心呕吐6例(15.0%)。结论应用奥沙利铂为主的联合化疗方案治疗晚期原发性肝癌疗效较好,毒副反应较少,对改善患者预后具有重要价值。     

氟尿嘧啶与氢化可的松注射液配伍稳定性考察

目的考察氟尿嘧啶注射液与氢化可的松注射液的配伍稳定性。方法观察及测定2种注射液在0.9%氯化钠注射液中配伍后于室温放置24h内的外观、pH值及不溶性微粒。结果室温24h内,氟尿嘧啶与氢化可的松混合后加入0.9%氯化钠注射液中的外观、pH值均无明显变化,微粒数目不断减少。结论氟尿嘧啶与氢化可的松注射液以0.9%氯化钠注射液作为溶媒宜配伍。