扶正调平汤减轻化疗毒副反应的临床观察

目的研究在化疗过程中运用扶正调平汤对减轻肿瘤患者的骨髓抑制，消化道症状等化疗副反应的作用。方法通过临床对60例手术及非手术胃癌患者随机分成两组，即治疗组和对照组，观察化疗前后两组的血象变化、消化道反应情况，及其生活质量进行评定，比较、分析。结果实验证明化疗同时配合扶正调平汤对改善化疗副反应的作用显著化于对照组（P〈0．05）。结论说明扶正调平汤对减轻化疗毒副反应方面具有较好的临床疗效。提高了患者生活质量，使惠者顺利完成化疗疗程。     

宫颈癌患者外周血树突状细胞的体外扩增和鉴定

 目的 探索体外扩增宫颈癌患者外周血来源的成熟树突状细胞(denelritic cell，DC)的方法，并鉴定DC的形态、结构、表型及生物学活性。方法 淋巴细胞分离液分离宫颈癌患者外周血，得到DC前体细胞(PBMC)，以(3M-CSF、IL-4、TNF-α诱导培养。用光镜和透射电镜观察形态结构，流式细胞仪检测细胞表面特异性分子，MTT法测定DC刺激T细胞增殖的活性。结果 联合应用细胞因子可诱导扩增出源自宫颈癌患者外周血的成熟DC，具有典型形态特征，较高表达HLA-DR、CD1a、CD80，能强烈激发同种异体T细胞增殖反应。结论 宫颈癌患者外周血体外培养可成功获得成熟的DC，为开展宫颈癌临床免疫治疗奠定了基础。     

EGFR mutation testing on cytological and histological samples in non-small cell lung cancer: a Polish,single institution study and systematic review of European incidence

The targeted treatment of advanced non-small-cell lung cancer (NSCLC) depends on confirmation of activating somatic EGFR mutation. The aim of the study was to evaluate the incidence of EGFR mutations in NSCLC detected in cytological and histological material and present literature review on European EGFR mutation incidence. 273 patients with confirmed NSCLC were entered into the study: 189 histological, paraffin-embedded materials, 12 fresh and 72 fixed cytological specimens. DNA was extracted from both types of material and the EGFR mutation in exons 18-21 was analyzed by direct sequencing. In addition the EGFR gene copy number in cases with sufficient histological material (110 patients) was evaluated by fluorescent in situ hybridization (FISH) technique. The percentage of EGFR somatic mutations was 10.62%. FISH positive results (amplification or high polysomy of EGFR gene) were identified in 33 patients (30.0%). The strongest clinicopathological correlation with the EGFR mutation was found for histological type (adenocarcinoma; p < 0.01), gender (females; p < 0.01) and FISH positive result (p < 0.05). This is the first, single institution study that estimates the EGFR mutation incidence in the Polish population. Cytological material recovered from fixed preparations and stained with hematoxylin and eosin showed DNA quality comparable to fresh tumor cells and histological samples.     

Nationwide analysis on surgical procedures for patients with endometrial cancer in Germany: Results of the AGO pattern of care studies from the years 2013, 2009, and 2006

Purpose

In 2013, 2009, and 2006, the Arbeitsgemeinschaft Gynäkologische Onkologie evaluated the therapeutic approaches and the adherence to their guidelines for endometrial carcinoma (EC) in Germany. Here, we present the results concerning the surgical procedures.

Methods

A questionnaire was developed and sent to 682 German gynecological departments in 2013 (775 in 2009 and 500 in 2006). The results were compared with the recommendations of the guideline and with each other.

Results

Responses were available in 40.0 % in 2013, 33.3 % in 2009, and 35.8 % in 2006, respectively. Pelvic lymphadenectomy (LAN) was performed in accordance with the guidelines with some exceptions in 2013, 2009, and 2006, whereas paraaortic LAN was performed in accordance with the guideline only in 2009. Histological high-risk subtypes of EC received pelvic and paraaortic LAN in 2013, 2009, and 2006 in accordance with the guidelines with small exceptions. LAN for Patients, who were postoperatively upstaged or upgraded, was not conducted in accordance with the guidelines in 2013, 2009, and 2006. In 2013, 84.6 % of the participants offered the laparoscopic approach (LSA) for hysterectomy and bilateral salpingo-oophorectomy, 63.3 % for pelvic LAN, and 49.1 % for paraaortic LAN, respectively. More participants offered the LSA in 2013 compared to 2009 and 2006 (p values <0.014).

Conclusions

The paraaortic LAN was the second operation on patients, who are postoperatively upstaged, and the LSA was not conducted in accordance with the guideline. Improvements concerning surgical treatment are possible and might lead to higher survival rates and a reduction of morbidity in patients with EC in Germany.     

同化疗药物刺激对HEPG2增殖蛋白表达的影响

目的探讨3种常用化疗药物连续刺激对人肝癌细胞株HEPG2增殖蛋白表达的影响。方法HEPG2细胞株经阿霉素（ADM）、氟尿嘧啶（5-FU）、顺铂（DDP）、联合化疗刺激。应用流式细胞术分别检测增殖相关蛋白erbB-2和c-myc的阳性细胞数及平均荧光强度，以此推算出不同药物连续作用细胞株后以上增殖蛋白总表达量。结果HEPG2细胞株正常培养过程中，各蛋白表达本身存在极大不确定性；各化疗药物组以及联合化疗药物纽连续刺激细胞株6个周期，erbB-2和c-myc蛋白表达总量变化无明显规律。将各组不同周期表达的增殖蛋白总量进行相关性分析，未发现组间相关有统计学意义（P〉0.05）。结论不同药物作用下肝癌细胞增殖蛋白表达完全不同，提示临床进行个体化精确化疗的必要性。     

A novel method for orthotopic testicular transplantation in rats

Rat testis transplantation with a segment of donor abdominal aorta end-to-side anastomosed to recipient‘s abdominal aorta was first reported by Lee. But thrombus was formed in the donor abdominal aorta segment. Goldsein and Lee improved this technique using end-to-side anastomosis of an aortic patch with the testicular artery to the recipient‘s aorta and the testicular vein was anastomosed to the vena cava of the recipient. With this method,     

2021欧洲Graves眼病临床管理指南解读

Graves眼病（Graves' orbitopathy,GO）也称为甲状腺眼病（Thyroid eye disease,TED）或甲状腺相关性眼病（Thyroid associated ophthalmopathy,TAO）,是Graves病（Graves' disease,GD）的主要甲状腺外表现。目前GO的发病率为男性0.54~0.90例 /10万/年,女性2.67~3.30例/10万/年[1]。GO严重影响着患者的生活质量,中重度和极重度GO是当前治疗的难题,现有的药物并不能对所有患者产生效果。自2016年欧洲甲状腺协会（ETA）/欧洲GO专家组（EUGOGO）GO管理指南[2]推出后,有关新型生物制剂治疗中重度活动期GO的随机临床试验（RCT）研究相继发表。这促使委员会致力于对GO 管理指南进行更新,EUGOGO于2021年7月发布了新版GO临床管理指南[3]。为方便广大临床医师理解和把握最新的GO治疗建议,现将该指南解读如下。     

Checking in on Lenalidomide in Diffuse Large B Cell Lymphoma

Lenalidomide has modest single-agent activity comparable with other newer drugs in recurrent diffuse large B cell lymphoma with response rates between 19% and 28%. Retrospective series and 1 prospective study suggest that clinically significant responses were predominantly limited to patients with activated B cell (ABC) lymphoma, a finding in agreement with lenalidomide's potent inhibition of nuclear factor κB, the key driver of ABC lymphomas. Recently completed trials will determine whether the additional use of lenalidomide with R/CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) enhances survival compared with R/CHOP alone and whether this activity is limited to ABC lymphomas. Lenalidomide also appears to have activity in the maintenance setting regardless of cell of origin and might play an important role in patients with recurrent disease who are not transplantation candidates. Similarly, because of the ability of lenalidomide to cross the blood–brain barrier, it needs to be further explored in patients with high risk for central nervous system spread. The results of lenalidomide combination studies with chemotherapy and with checkpoint inhibitors are eagerly awaited.     

手术联合同步放化疗治疗早期鼻咽癌的前瞻性研究

目的:探讨手术联合同步放、化疗治疗早期鼻咽癌的疗效。方法:将早期鼻咽癌患者按患者意愿分为手术组(31例)和常规组(73例)。手术组采用手术加同步放、化疗方案治疗,常规组采用同步放、化疗方案治疗。观察指标为:①5年生存率、无瘤生存率;②鼻咽部放射剂量;③口干症的发生率。结果:①总的5年随访率为97.12%,其中手术组失访1例,5年随访率为96.77%;常规组失访2例,5年随访率为97.26%;②104例患者的5年生存率为83.65%(87/104),局部复发率及远处转移率均为9.62%(10/104);③5年生存率和无瘤生存率手术组分别为96.77%(30/31)、93.55%(29/31),常规组分别为78.08%(57/73)、73.97%(54/73),2组比较均差异有统计学意义(均P<0.05);④手术组、常规组鼻咽部放射剂量分别为(63.90±5.56)Gy、(71.48±4.18)Gy,2组比较差异有统计学意义(P<0.05);⑤口干症的发生率手术组为22.58%(7/31),明显低于常规组的65.75%(48/73),2组比较差异有统计学意义(P<0.05)。结论:手术联合放、化疗治疗早期鼻咽癌,既可提高患者远期生存率,又可减少鼻咽部的放射剂量,降低放射并发症的发生,是早期鼻咽癌有效的综合治疗方案,值得进一步研究。