《傅青主女科》“种子”辨治特色探析

《傅青主女科》为中国清代医家傅山所著,具有鲜明的学术特色,受后世医家推崇,为中医妇科学的继承和发展作出巨大贡献。该书中《种子篇》论治不孕尤具特色,擅抓主症,辨证详明,理法严谨,用药精简。其种子理念重视脏腑辨证,以补肾益精为主,在此基础上注重健脾疏肝养血,交通心肾,灵活应用阴阳、五行学说及经络理论协调各脏腑关系,进而促进孕育,对临证治疗不孕症具有一定的指导意义。     

Oral and intestinal microflora in 5‐fluorouracil treated rats,translocation to cervical and mesenteric lymph nodes and effects of probiotic bacteria

Serious systemic infections may occur during cancer chemotherapy due to disturbances in the oropharyngeal and gastrointestinal microflora, impaired mucosal barrier functions and immunosuppression. Bacteria may spread from the gastrointestinal tract to the regional lymph nodes. The routes for bacterial spread from the oral cavity are less well known. In the present study we investigated changes in the oral and intestinal microfloras in rats given 50 mg/kg 5‐fluorouracil (5‐FU) i.v. for 6 days. Bacterial dissemination to the lymph nodes draining the oral cavity and the lymph nodes draining the gastrointestinal tract was examined. Effects of adding the probiotic strain Lactobacillus plantarum 299v in the drinking water to the rats were measured. 5‐FU treatment caused an increase in the number of facultative and strictly anaerobic bacteria in biopsies from the oral cavity and an increase in the number of facultative anaerobes in the large intestine. The proportion of facultative gram‐negative rods increased in both the oral cavity and intestine. Bacteria translocated to both the cervical and mesenteric lymph nodes in untreated animals and increased in numbers after 5‐FU treatment due to an increase in the number of facultative gram‐negative rods. Treatment with L. plantarum 299v improved food intake and body weight in 5‐FU‐treated rats. It also reduced the 5‐FU‐induced raise in the total numbers of facultative anaerobes in the intestine, but did not reduce translocation and did not prevent diarrhea. This study reinforces the oral cavity, along with the gastrointestinal tract, as a source for bacterial dissemination. The use of probiotic bacteria may reduce some side effects of 5‐FU treatment.     

Diverse immune functions of hemocyanins

Substantial evidence gathered recently has revealed the multiple functionalities of hemocyanin. Contrary to previous claims that this ancient protein is involved solely in oxygen transport within the hemolymph of invertebrates, hemocyanin and hemocyanin-derived peptides have been linked to key aspects of innate immunity, in particular, antiviral and phenoloxidase-like activities. Both phenoloxidase and hemocyanin belong to the family of type-3 copper proteins and share a high degree of sequence homology. While the importance of phenoloxidase in immunity and development is well characterised, the contribution of hemocyanin to biological defence systems within invertebrates is not recognised widely.     

Síndrome coronária aguda em doente oncológico: um problema evitável?

5-Fluorouracil is a first‐line agent in several cancer‐therapy regimens. Cardiotoxicity is common, with coronary artery disease being an important risk factor. We report the case of an acute coronary syndrome presumably induced by 5‐FU, in a patient with previously unknown and asymptomatic coronary artery disease, with an estimated intermediate risk for cardiovascular events. Pre‐chemotherapy risk evaluation and optimal patient care are still not standardized in this clinical scenario.     

Surface expression of anti‐CD3scfv stimulates locoregional immunotherapy against hepatocellular carcinoma depending on the E1A‐engineered human umbilical cord mesenchymal stem cells

Tumor antigens is at the core of cancer immunotherapy, however, the ideal antigen selection is difficult especially in poorly immunogenic tumors. In this study, we designed a strategy to modify hepatocellular carcinoma (HCC) cells by surface expressing anti‐CD3scfv within the tumor site strictly, which depended on the E1A‐engineered human umbilical cord mesenchymal stem cells (HUMSC.E1A) delivery system. Subsequently, membrane‐bound anti‐CD3scfv actived the lymphocytes which lysed HCC cells bypassing the expression of antigens or MHC restriction. First, we constructed the anti‐CD3scfv gene driven by human α‐fetoprotein (AFP) promoter into an adenoviral vector and the E1A gene into the lentiviral vector. Our results showed that anti‐CD3scfv could specifically express on the surface of HCC cells and activate the lymphocytes to kill target cells effectively in vitro. HUMSC infected by AdCD3scfv followed by LentiR.E1A could support the adenoviral replication and packaging in vitro 36 h after LentiR.E1A infection. Using a subcutaneous HepG2 xenograft model, we confirmed that AdCD3scfv and LentiR.E1A co‐transfected HUMSC could migrate selectively to the tumor site and produce considerable adenoviruses. The new generated AdCD3scfv infected and modified tumor cells successfully. Mice injected with the MSC.E1A.AdCD3scfv and lymphocytes significantly inhibited the tumor growth compared with control groups. Furthermore, 5‐fluorouracil (5‐FU) could sensitize adenovirus infection at low MOI resulting in improved lymphocytes cytotoxicity in vitro and in vivo. In summary, this study provides a promising strategy for solid tumor immunotherapy.     

Sequential Treatment with High-Dose Methotrexate and Fluorouracil in Advanced Colorectal Cancer. Experience of The Southern Italian Oncology Group (GOIM)

Summary

A total of 101 patients with advanced colorectal cancer in two consecutive Southern Italian Oncology Groups (GOIM) studies (8501 and 8801- arm A) were treated with a sequential combination of high dose methotrexate (HDMTX) and fluorouracil (FU). Of the 92 eligible patients, 2 achieved complete response (2%) and 27 partial response (30%), with a median duration of 7 months. When classified according to the time interval between administration of the two drugs, retrospective analysis showed significant improvement (p = 0.04) in overall survival in the shorter time interval group (6 hours). The observed toxicities were generally mild and transient. Our data confirm the efficacy of the synergism between the two chemotherapeutic agents, in particular when administered with a 6-hour interval. Further studies are necessary to establish the possibility of enhancing the efficacy of sequential treatment with the modulation of FU with high-dose folinic acid.     

加味参附颗粒对慢性心功能不全患者心功能及血浆脑钠肽的影响

[目的]观察加味参附颗粒对慢性心功能不全(CCI)患者心功能及血浆脑钠肤(BNP)的影响.[方法]将100例CCI患者随机分为治疗组和对照组各50例,对照组采用常规西医治疗,治疗组在此基础上加用加味参附颗粒剂(由红参、熟附子、三七、葶苈子、车前子等组成)治疗,以1个月为1个疗程.根据纽约心脏协会(NYHA)心功能分级法...     

Modulation of multidrug resistance by andrographolid in a HCT‐8/5‐FU multidrug‐resistant colorectal cancer cell line

OBJECTIVE To develop an HCT‐8/5‐FU multidrug‐resistant colorectal cancer cell line and to elucidate the effect of Andrographolid (AG), an extract from Andrographis paniculate, a medicinal herb on the HCT‐8/5‐FU multidrug‐resistant colorectal cancer cell line. METHODS An HCT‐8 colorectal cancer cell line was used and a high concentration of 5‐Fluorouracid (5‐FU) was introduced at the beginning to induce drug resistance, then the concentration of 5‐FU was increased in gradients. Approximately 7 months later, the cells grew stably in 2.0 µg/mL of 5‐FU, and the cell line was named HCT‐8/5‐FU multidrug‐resistant colorectal cancer cell line. The resistant index of HCT‐8/5‐FU cells to 5‐FU, adriamycin (ADM), cisplatin (DDP) was checked by MTT test, and a growth curve was drawn. The morphological changes were observed by both light and electron microscope. The function of P‐170 was detected by rhodamine staining. After the application of AG and co‐administration of 5‐FU, ADM and DDP, the growth curves and inhibition rate as well as apoptosis rate of HCT‐8/5‐FU at different concentrations of AG were evaluated by MTT and flow cytometry. Rhodamine staining was used to investigate the possible mechanism involved by AG. RESULTS The resistance index of HCT‐8/5‐FU to 5‐FU was 16.6, and a cross‐resistance to ADM and DDP was noticed. Compared with parental cells, HCT‐8/5‐FU cell's growth rate did not change significantly but the cell's morphology was remarkably changed as compared with parental cells. Overexpression of P‐170 by HCT‐8/5‐FU cell was indicated through rhodamine staining. AG at a low concentration showed weak inhibitory effect on HCT‐8/5‐FU. However, a remarkable inhibitory and apoptosis rate was shown when AG was co‐administered with 5‐FU, ADM and DDP, respectively. Interestingly AG alone could not induce apoptosis and change the cell cycles. AG might affect the expression of P‐170, which was indicated by rhodamine staining. CONCLUSIONS The HCT‐8/5‐FU multidrug‐resistant colorectal cancer cell line has been successfully developed and because it has cross‐resistance to 5‐FU, ADM and DDP, it might serve as an ideal multidrug resistance (MDR) model for colorectal cancer research. The mechanism of HCT‐8/5‐FU resistance to chemotherapeutic agents might be related to the overexpression of P‐170. Low concentrations of AG alone have no significant inhibition on HCT‐8/5‐FU and fail to induce apoptosis and to change cell cycles. AG might act as a chemosensitizer when co‐administered with 5‐FU, ADM and DDP, and the mechanism of reversal modulation of multidrug resistance by AG in the HCT‐8/5‐FU resistant cell line might be related to its downregulation of overexpression of P‐170.