EPOCH方案和CHOP方案一线治疗非特殊性外周T细胞淋巴瘤回顾性临床对照研究

目的：比较EPOCH方案和CHOP方案一线治疗非特殊性外周T细胞淋巴瘤（FFCL—U）的疗效及不良反应。方法：A组：2008年1月至2010年4月,24例经病理确诊的PTCLU患者,采用EPOCH方案化疗：足叶已甙50mg/（m^2·d）,长春新碱04mg/（m^2·d）,表阿霉素15mg/（m^2·d）,上述三种药物持续静脉滴注96h,环磷酰胺750mg／m^2,静脉滴注,d0;强的松60mg/（m^2·d）,口服,d1-5。每3周为1周期。B组：2005年1月至2007年4月PTCL—U患者35例,采用CHOP方案化疗：环磷酰胺750mg/m^2,静脉滴注,d1,表阿霉素75mg/m^2,静脉滴注,d1,长春新碱14mg/m^2,静脉滴注,d1,强的松60mg/（m^2·d）,口服,d1-5,每3周为1周期。对两组的近期疗效、疾病进展时间、不良反应进行分析比较。结果：A组和B组的完全缓解效率分别为66.7％（16／24）和40.0％（14／35）,有显著性差异（P=0.0441）,有效率分别为79.2％（19／24）和65.7％（23／35）,无显著差异（P=0.2624）。A组和B组的中位疾病进展时间12.0月（1—27月）、10月（1—28月）（P=0.2045）。主要不良反应白细胞减少、神经毒性、脱发、心脏毒性等指标均无显著性差异（P〉0.05）。轻度口腔炎的发生率A组高于B组：24.8％：13％（P〈0.05）。结论：一线治疗PTCL—U,EPOCH方案近期疗效较CHOP方案具有一定的优势,不良反应相近,耐受性好。     

基于形气神三位一体生命观论孙思邈养生

形气神三位一体的生命观是古人对生命现象的体察和领悟,是我国传统文化中重要的生命观。本文从形气神三位一体的生命观探讨孙思邈养生的内涵,揭示孙思邈养生的实质即为人体形气神三者的统一。     

Safety and efficacy of single-day GemOx regimen in patients with pancreatobiliary cancer: a single institution experience

Background: GemOx (gemcitabine 1000 mg/m² >?100 min on day 1 and oxaliplatin 100 mg/m² on day 2 every 2 weeks) achieved a response rate of 26.8%, improved progression-free survival (PFS) but failed to demonstrate a benefit in overall survival (OS) compared with gemcitabine in pancreatic cancer. This regimen has regained attention after recent pooled- and meta-analysis suggested a survival benefit of gemcitabine–platinum doublets over gemcitabine. However, GemOx is associated with inconvenience to patients, early cumulative dose developing neuropathy and thrombocytopenia. In addition, fixed dose rate of gemcitabine showed no benefit >?30 min infusion schedule in the ECOG6201 study. Pharmacokinetic profiles of both drugs did not show statistically significant difference regardless of the order of administration.

Patients and methods: In order to create a more convenient and equally effective regimen, we conducted a retrospective study to evaluate the efficacy and safety of single-day modified GemOx (S-GemOx, gemcitabine 1000 mg/m² >?30 min and oxaliplatin 85 mg/m² >?2 h on day 1 every 2 weeks) in patients with pancreatic and biliary cancers.

Results: In all, 34 patients (median age 60 years, male/female: 17/17) received S-GemOx including locally advanced or metastatic pancreatic cancer (26) and biliary duct carcinoma (8). Median treatment was six cycles with duration of 12 weeks (range (r): 2 – 56). Median cumulative dose of oxaliplatin was 517.5 mg/m² (r: 85 – 2380). A total of 27 of 34 patients were evaluated for efficacy after initial staging: 1 (3.7%) complete response (CR), 4 (14.8%) partial response (PR), 18 (66.7%) stable disease and 4 (14.8%) progression of disease. Overall response rate (CR + PR) was 18.5%. Median PFS and OS were 7 and 11.6 months, respectively. All patients were assessed for toxicities. Grade 3/4 hematological toxicities include anemia (8%), neutropenia (11%), thrombocytopenia (5%), nausea/vomiting (3%), diarrhea (3%), hypersensitivity reaction (14%) and neuropathy (3%). No deaths occurred due to therapy.

Conclusions: S-GemOx regimen provides convenient schedule, toxicities appear to be comparable with GemOx. The incidence of neuropathy (3 vs 19.1%) and thrombocytopenia (5 vs 14%) are substantially lower compared with GemOx. Prospective studies of S-GemOx in a large patient population are warranted.     

丹七散瘀搽剂用于预防化学治疗性静脉炎194例

目的观察丹七散瘀搽剂对化学治疗性静脉炎的预防作用。方法选择山西省肿瘤医院2007年1月至2012年2月住院化学治疗期间使用丹七散瘀搽剂的患者194例,观察其化学治疗性静脉炎的发生情况。结果化学治疗同时应用丹七散瘀搽剂溻渍治疗患者静脉炎发生率为o,且经临床观察无毒副反应。结论丹七散瘀搽剂溻渍治疗可有效预防静脉炎的发生,且安全可靠。     

标准剂量BEACOPP方案治疗晚期霍奇金淋巴瘤的疗效观察

目的观察标准剂量BEACOPP方案治疗Ⅲ-Ⅳ期霍奇金淋巴瘤（HL）的疗效和安全性。方法20例初治的晚期霍奇金淋巴瘤患者,均接受标准剂量BEACOPP方案化疗,初治肿瘤最大径≥5cm或在化疗后有肿瘤病灶残留的患者给予局部放疗。结果20例患者中14例完全缓解,4例部分缓解,总有效率为90％。主要不良反应为骨髓抑制和肝功能损害,其中2例患者出现Ⅱ度药物性肺损伤,治疗期间未发现治疗相关性死亡。结论标准剂量BEACOPP方案治疗晚期霍奇金淋巴瘤安全有效。     

卡介菌多糖核酸不同治疗方案治疗慢性荨麻疹的疗效探讨

目的 探讨卡介菌多糖核酸不同治疗方案治疗慢性荨麻疹的临床疗效.方法 将120例患者采用随机数字表法分为三组,每组40例.对照组单纯口服地氯雷他定片5 mg/次,1次/d;治疗组在对照组的基础上肌注卡介菌多糖核酸2ml/次,治疗1组隔日肌注1次,治疗2组隔2日肌注1次.均连续治疗30 d.治疗第10、20、30 d观察疗效.记录治疗费用、不良反应等.结果 治疗20、30 d后,治疗1组有效率分别为82.5％、90.0％,治疗2组有效率分别为80.0％、87.5％,对照组有效率分别为57.5％、67.5％.治疗2组平均治疗费用明显少于治疗l组（P＜0.05）.结论 卡介菌多糖核酸不同给药时间治疗慢性荨麻疹临床疗效相仿,隔2日肌注1次治疗方案最佳.     

Reversing epigenetic mechanisms of drug resistance in solid tumors using targeted microRNA delivery

ABSTRACT

Introduction: Tumor cells utilize many different mechanisms to desensitize themselves to the cytotoxic effects of drugs, but it has recently been recognized that alterations in epigenetic control of gene expression underly many of them. As master regulators of gene expression, microRNAs (miRNAs) present a promising therapeutic strategy for the reversal of epigenetic changes that lead to drug resistance phenotypes in tumor cells.

Areas covered: Effects of epigenetic changes on drug resistance in a variety of solid tumors are discussed. Specific miRNAs that are involved with the regulation of epigenetic machinery are highlighted. Further, we consider how delivery of miRNA or antagomirs may be utilized to resensitize drug-resistant tumor cells.

Expert opinion: Reversal of epigenetically controlled tumor drug resistance mechanisms via miRNA delivery presents a novel strategy for enhancing the efficacy of chemotherapeutics. Further, the ability to target delivery of miRNAs may provide the opportunity to go beyond reversal of resistance to hyper-sensitization of tumor cells to the cytotoxic effects of drugs. However, understanding of the role of miRNA in epigenetic regulation is still in its early stages and further research is critical for potential utility in improving therapeutic efficacy in cancer patients.     

Long-term delivery of protein and peptide therapeutics for cancer therapies

ABSTRACT

Introduction: Proteins and peptides are prominent therapeutic agents, which are effective in number of ailments. Long-term delivery of protein and peptide therapeutics requires polymeric encapsulation to protect from degradation and for its sustained release. However, results from encapsulation of protein macromolecules in dynamic delivery systems report unreliable clinical outcome, indicating ease of degradation, low permeability, and serious immune responses. A specifically targeted delivery system as tumor or cancer theranostics may surpass these limitations.

Areas covered: This review covers recent advancements in approaches involving conjugated protein nano-formulations as targeting delivery technology for various ailments encompassing mostly cancer treatment options. Progressions in targeted chemotherapeutics, protein nanoparticles, peptide nanoparticles, lipidation, and antibody drug-conjugates are discussed.

Expert opinion: Significant expansions have been made in forming new generation of antitumor-recombinant proteins, which proves a milestone of advancements for more potent and explicit cancer therapies. However, transformation of biologics from laboratory to clinical trials is an immense challenge, because of drop in efficiency of drug-loading, poor reproducibility of nanoparticles, inadequate information regarding long-term toxicity and insufficient pharmacokinetics data. Hence, early stage tumor diagnosis with précised drug delivery to tumor site is crucial for protein- and peptide- based therapeutics for cancer.     

化毒祛邪汤辅助CHOP化疗方案治疗非霍奇金淋巴瘤患者的疗效及其对血清sFas及FasL表达的影响

[目的]探究化毒祛邪汤辅助CHOP化疗方案治疗非霍奇金淋巴瘤患者的疗效及其对血清可溶性凋亡相关蛋白因子(sFas)和凋亡相关蛋白因子受体(FasL)表达的影响.[方法]将120例非霍奇金淋巴瘤患者随机分为观察组和对照组,每组各60例.2组患者入院后均行CHOP化疗方案化疗,观察组患者在此基础上加用化毒祛邪汤辅助治疗,2...     

左氧氟沙星治疗呼吸系统感染病人不同给药方案的比较

 目的对左氧氟沙星(levofloxacin,LVFX)在治疗呼吸系统感染病人中不同给药方案进行比较。方法病人被分为2组,按照不同给药方案给药,组1为静脉输注给药200mg,每12h1次;组2为左氧氟沙星400mg,静脉输注给药,每24h1次。高效液相色谱法测定病人血药浓度。根据不同给药方案中左氧氟沙星的PK-PD特点,评价2种不同给药方案临床疗效。结果药动学研究结果表明,组1的药物峰浓度(c_max)明显低于组2(P<0.001),组1的谷浓度明显高于组2(P<0.001)。PK-PD研究结果表明,与体外抗菌活性研究结果比较,c_max/MIC₉₀值显示,组1给药方案对于肺炎克雷伯菌和变形杆菌抗菌作用较强,组2对肺炎克雷伯菌、肠杆菌、变形杆菌、β-溶血链球菌和不动杆菌可产生有效的抗菌作用(c_max/MIC₉₀≥10)。2组临床疗效如体温,白细胞检查及X-光学检查方面,无明显差异。2组间不良反应发生率无差异。结论组1的给药方案血药浓度波动较小,组2的给药方案峰浓度较高,抗菌作用较强,给药次数少,2组临床疗效及不良反应发生率无差异。