43例口腔癌平阳霉素术前化疗效果相关因素分析

目的 :通过对平阳霉素术前化疗效果的相关因素分析 ,早期判断平阳霉素对口腔鳞癌的效果 ,为确定进一步治疗方案提供指导。方法 :对本院近 3年来接受平阳霉素 (总量为 80mg)化疗的 4 3例口腔癌患者进行直线相关和回归分析 ,观察化疗期间体温改变、发热持续时间、胃肠道反应时间及WBC改变与疗效的关系。结果 :①接受平阳霉素化疗有效的患者多在第 3～ 6天出现局部反应 ;②发热的程度及胃肠道反应与化疗效果密切相关 (P<0 .0 5 )。结论 :化疗早期出现的发热、胃肠道症状及局部反应可以作为早期判断预期疗效的方法。     

平阳霉素联合地塞米松治疗颌面部大面积海绵状血管瘤

目的：观察平阳霉素（ＰＹＭ）联合地塞米松（ＤＸＭ）治疗颌面部大面积海绵状血管瘤的临床疗效和不良反应。方法：对９例临床确诊的颌面部范围６ｃｍ×７ｃｍ～１０ｃｍ×１２ｃｍ之间的大面积海绵状血管瘤,采用每周１次多点多方向瘤腔内注射药物,比较治疗前后患者的反应和肿瘤的形成变化。结果：全部病例肿瘤消失,无明显不良反应,经８个月～４６个月观察,临床治愈率为１００％。结论：ＰＹＭ联合ＤＸＭ能够治愈颌面部大面积海绵状血管瘤,具有完整保存组织正常形态和功能的特点,克服了单独使用ＰＹＭ带来的不良反应,提示两药在治疗上有协同作用。     

Synergistic effects of verapamil on pingyangmycin-induced cytotoxicity and apoptosis in KB cells

OBJECTIVES: Previous studies have shown that pingyangmycin (PYM; bleomycin A5) can induce two distinct modes of cell death (necrosis, apoptosis). At high concentrations, PYM can be considered as an apoptosis mimetic drug. In this study, we explored the possibility that the membrane-modifying agent verapamil might affect the transport function of PYM through the plasma membrane, resulting in inducing apoptosis of tumor cells at low concentration of PYM. METHODS: Cytotoxicity, flow cytometry and DNA fragmentation assays were used to detect the interaction of verapamil and PYM in human oral carcinoma cell line KB cells. RESULTS: Our results indicated that verapamil can enhance the cytotoxicity of PYM against KB cells with the non-toxic doses (P<0.05). The cell viability at a concentration of 500 microg ml-1 of PYM was 35+/-2% compared with control and 10 microg ml-1 verapamil decreased the cell viability lower to 28+/-1%. In addition, because of the synergistic effect of verapamil, KB cells apoptosis was found to be induced when treated with a lower concentration of PYM (50 microg ml-1) for 24 h by flow cytometry and DNA fragmentation assays. CONCLUSIONS: Verapamil was found to enhance PYM-induced cytotoxicity and apoptosis in KB cells. The responsiveness of PYM might be explained by the effective accumulation of PYM by verapamil in KB cells mediated by the inhibition of PYM efflux function of the cells.     

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目的评价不同浓度平阳霉素局部注射治疗口腔颌面部淋巴管畸形的临床疗效。方法回顾分析2006年1月至2013月5月在中国医科大学附属口腔医院口腔颌面外科采用平阳霉素局部注射治疗的82例淋巴管畸形患者的临床资料。对不同类型、同一类型不同大小的淋巴管畸形采用不同浓度的平阳霉素治疗,具体如下：微囊型淋巴管畸形为8 mg/8 mL;病损直径〈5 cm的大囊型及混合型淋巴管畸形为8 mg/5 mL;病损直径〉5 cm的大囊型淋巴管畸形为8 mg/3 mL。随访时间为6个月至3年。结果微囊型淋巴管畸形治愈率为43.3%;病损直径〈5 cm的大囊型淋巴管畸形治愈率为93.3%;病损直径〉5 cm的大囊型淋巴管畸形治愈率为88.9%;混合型淋巴管畸形的治愈率为60.0%。所有患者术后均出现局部肿胀、疼痛,出现全身发热4例,出现局部溃疡1例,均未见肺纤维化及严重不良反应发生。结论对不同类型、同一类型不同大小的淋巴管畸形采用适宜浓度的平阳霉素进行治疗,不仅可以提高疗效、缩短疗程,而且可以减少不必要的并发症发生,治疗相对安全。     

平阳霉素局部注射并手术切除治疗血管瘤和血管畸形

目的：总结用平阳霉素局部注射并手术切除治疗血管瘤和血管畸形的经验。方法：本组287例患者,其中血管瘤134例,血管畸形153例。先用平阳霉素混合液进行瘤体腔内注射,每一进针部注入2-3ml混合药物。对血管瘤患者行多点注射,至瘤体稍发白为宜。一般经3～5次注射后进行手术治疗。对部分未能完全切除或完全切除后有可能导致严重继发畸形的患者,则于术中和术后继续应用平阳霉素治疗。结果：205例经平阳霉素注射后直接切除治愈（71．43％）,72例经术后3～5次注射治愈（25．09％）,有效8例（2．79％）,无效2例（0．70％）,总治愈率为96．52％。注射平阳霉素后发热21例,局部溃疡形成8例,术区血肿7例,伤口边缘局部愈合不良5例,经换药、血肿清除、对症处理等未影响最终治疗效果。结论：用平阳霉素局部注射并手术切除能有效减少术中出血,降低手术难度和风险,提高血管瘤和血管畸形的治愈率。     

Superselective uterine arterial embolization with pingyangmycin-lipiodol emulsion for management of symptomatic uterine leiomyoma

Background Uterine arterial embolization (UAE) is a safe and effective therapy for symptomatic uterine leiomyoma. This study was to assess the effectiveness and the feasibility of pingyangmycinlipiodol emulsion (PLE) for the management of symptomatic uterine leiomyoma.Methods One hundred consecutive patients (aged 21-53 years, with 38 in average ) with symptomatic uterine leiomyoma underwent superselective UAE with PLE. Clinical symptoms of the patients (including menorrhagia, bulk-related symptoms, and postprocedure-related abdominal pain) and the changes in uterine volume and tumor size after the embolization were analyzed. The patients were followed up for 8-21 months (mean, 15 months).Results Ninety-nine patients (99%,99/100) were interviewed in their first menses circle after embolization, showing improvements in their abnormal bleeding and bulk-related symptoms to some extent. Imagiological results during follow-up showed a mean of 48% reduction in uterine volume at 6 months and a mean of 75% reduction in tumor size at 9 months. Eighty-three percent of the patients reported complete resolution of postprocedure pain within 7 days.Conclusions PLE is effective in the management of uterine leiomyoma, having superiority in alleviating postprocedure-related pain.     

平阳霉素治疗眼眶部海绵状血管瘤170例观察

[目的]观察平阳霉素(PYM)瘤内注射治疗眼眶部海绵状血管瘤的疗效.[方法]PYM注射治疗眼眶部静脉畸形170例.7～10d注射1次,3～5次一个疗程.[结果]经6个月至12年随访,治愈155例(91.18%),好转15例(8.82%),有效率为100%.[结论]PYM治疗眼眶部静脉畸形疗程短,是一种简便、安全的有效方法.     

平阳霉素加唯尔本腔内给药治疗老年恶性胸水的研究

目的　观察平阳霉素加唯尔本腔内给药治疗老年恶性胸水的效果。方法　采用胸腔穿刺 ,置入中心静脉导管引流胸腔积液。灌注平阳霉素加唯尔本 ,并以单用平阳霉素及唯尔本做对照。结果　平阳霉素加唯尔本组有效率 95 % ,唯尔本组有效率 4 0 % ,平阳霉素组有效率 70 %。结论　平阳霉素加唯尔本腔内给药治疗老年恶性胸水疗效优于单用平阳霉素或唯尔本。     

支气管动脉灌注-栓塞法治疗肺咯血的临床应用

目的：研究平阳霉素溶液灌注支气管动脉后加明胶海绵颗粒（条）栓塞支气管动脉分支及主干治疗肺咯血的临床价值。方法：32例经内科治疗无效的咯血患者对其支气管动脉、肋间动脉或胸廓内动脉等供血动脉行灌注-栓塞法治疗。全部随访6个月以上。结果：有效率为100％，治愈率为62．5％。未出现1例严重并发症。结论：灌注-栓塞法对内科治疗无效的肺咯血患者是一种更为有效、安全、简便的治疗方法。     

复方倍他米松联合平阳霉素及氟尿嘧啶治疗瘢痕疙瘩

目的观察复方倍他米松注射液联合平阳霉素及氟尿嘧啶治疗瘢痕疙瘩的临床疗效。方法将260例患者随机分为治疗组130例,对照组130例,治疗组局部用复方倍他米松注射液联合平阳霉素及氟尿嘧啶注射治疗,对照组单纯用曲安奈德注射液注射治疗。结果两组总有效率相比,差异有显著性（P〈0.05）,治疗组疗效优于对照组。结论复方倍他米松注射液联合平阳霉素及氟尿嘧啶注射液治疗瘢痕疙瘩疗效显著。