王诚喜运用补肺固元膏治疗哮喘缓解期的临床经验

哮喘为反复发作性肺系疾病,部分患者需终生用药,西药随着使用频率的上升,不良反应也相应增加,中医学也在此方面已经形成完善体系,发作期控制症状,缓解期补益正气,调整阴阳,减少发作频次,恩师王诚喜教授根据多年临床经验,对于哮喘缓解期患者推崇使用补肺固元膏,不仅疗效肯定,而且患者依从性良好,治疗效果令人满意。     

Predictors of Survival after Yttrium-90 Radioembolization of Chemotherapy-Refractory Hepatic Metastases from Breast Cancer

PurposeTo determine predictors of survival after transarterial radioembolization of hepatic metastases from breast cancer.Materials and MethodsTwenty-four patients with chemotherapy-refractory hepatic metastases from breast cancer who underwent radioembolization from 2013 to 2018 were evaluated based on various demographic and clinical factors before and after treatment. Overall survival (OS) was estimated by Kaplan–Meier method. Log-rank analysis was performed to determine predictors of prolonged OS from the time of first radioembolization and first hepatic metastasis diagnosis.ResultsMedian OS times were 35.4 and 48.6 months from first radioembolization and time of hepatic metastasis diagnosis, respectively. Radioembolization within 6 months of hepatic metastasis diagnosis was a positive predictor of survival from first radioembolization, with median OS of 38.9 months vs 22.1 months for others (P = .033). Estrogen receptor (ER)–positive status predicted prolonged survival (38.6 months for ER⁺ vs 5.4 months for ER⁻; P = .005). The presence of abdominal pain predicted poor median OS: 12.8 months vs 38.6 months for others (P < .001). The presence of ascites was also a negative predictor of OS (1.7 months vs 35.4 months for others; P = .037), as was treatment-related grade ≥ 2 toxicity at 3 months (5.4 months vs 38.6 months for others; P = .017).ConclusionsIn patients with metastatic breast cancer, radioembolization within 6 months of hepatic metastasis diagnosis and ER⁺ status appear to be positive predictors of prolonged survival. Conversely, baseline abdominal pain, baseline ascites, and treatment-related grade ≥ 2 toxicity at 3 months after treatment appear to be negative predictors of OS.     

浅谈“七损八益”与三阴性乳腺癌雌激素受体、雄激素受体的表达

乳腺癌是我国女性发病率第一的恶性肿瘤[1],其中三阴性乳腺癌较其他类型乳腺癌相比,具有治疗棘手、预后更差的特点。"七损八益"是以阴阳损益之道来谈保身长全的理论思想。文章将结合"七损八益"的观点,从其损益转化的角度来讨论三阴性乳腺癌的治疗方法。其中以七损对应三阴性乳腺癌雌激素受体阴性,八益为应用雄激素受体治疗三阴性乳腺癌的手段。试以《内经》"七损八益"理论来探讨三阴性乳腺癌的关系,为研究治疗乳腺癌提供更多的思路。     

基于肝与雌激素相互关系探讨膀胱过度活动症

膀胱过度活动症是泌尿系的常见疾病,目前尚无理想的治疗方案。本文基于肝与雌激素相互关系论治膀胱过度活动症,从中医基础理论、膀胱过度活动症的病因病机、膀胱过度活动症与雌激素的关系、肝郁与雌激素的联系等方面进行阐述,为从肝郁-雌激素角度论治膀胱过度活动症提供依据。     

五色培元固本膏对维持性血液透析患者细胞免疫功能的影响

目的:探讨五色培元固本膏对维持性血液透析(MHD)患者细胞免疫功能的影响。方法:90例MHD患者随机分为对照组和治疗组,两组血透方法相同。对照组给予一般治疗及血透治疗,治疗组在对照组基础上口服五色培元固本膏,连续治疗3个月; 20例健康志愿者作为正常组,三组观察时间均为3个月。治疗前后用流式细胞技术检测各组T细胞亚群表达水平,酶联免疫吸附法检测各组白介素-2(IL-2)和可溶性白介素-2受体(sIL-2R)蛋白表达水平。结果:治疗前与正常组比较,对照组与治疗组CD₄⁺、CD₄⁺/CD₈⁺和IL-2表达水平均明显下降,CD₈⁺和sIL-2表达水平均上升,差异有统计学意义(P<0.05)。治疗后,与对照组相比较,治疗组CD₄⁺、CD₄⁺/CD₈⁺、IL-2表达水平明显升高,CD₈⁺和sIL-2表达水平均降低,差异有统计学意义(P<0.05)。治疗组相较正常组CD₄⁺T淋巴细胞、CD₄⁺/CD₈⁺、IL-2表达水平,差异无统计学意义(P>0.05),CD₈⁺、sIL-2表达水平升高。结论:五色培元固本膏调节T淋巴细胞和IL-2表达改善MHD的细胞免疫功能。     

Menstrual and reproductive characteristics and breast cancer risk by hormone receptor status and ethnicity: The Breast Cancer Etiology in Minorities study

We pooled multiethnic data from four population-based studies and examined associations of menstrual and reproductive characteristics with breast cancer (BC) risk by tumor hormone receptor (HR) status [defined by estrogen receptor (ER) and progesterone receptor (PR)]. We estimated odds ratios and 95% confidence intervals using multivariable logistic regression, stratified by age (<50, ≥50 years) and ethnicity, for 5,186 HR+ (ER+ or PR+) cases, 1,365 HR− (ER− and PR−) cases and 7,480 controls. For HR+ BC, later menarche and earlier menopause were associated with lower risk in non-Hispanic whites (NHWs) and Hispanics, and higher parity and longer breast-feeding were associated with lower risk in Hispanics and Asian Americans, and suggestively in NHWs. Positive associations with later first full-term pregnancy (FTP), longer interval between menarche and first FTP and shorter time since last FTP were limited to younger Hispanics and Asian Americans. Except for nulliparity, reproductive characteristics were not associated with risk in African Americans. For HR− BC, lower risk was associated with later menarche, except in African Americans and older Asian Americans and with longer breast-feeding in Hispanics and Asian Americans only. In younger African Americans, HR− BC risk associated with higher parity (≥3 vs. 1 FTP) was increased fourfold in women who never breast-fed, but not in those with a breast-feeding history, suggesting that breast-feeding may mitigate the adverse effect of higher parity in younger African American women. Further work needs to evaluate why menstrual and reproductive risk factors vary in importance according to age and ethnicity.