两种设计不同的涂层支架的生物相容性研究

目的　评估两种不同结构设计的国产铂 -铱合金明胶蛋白涂层支架置入兔颈动脉后长期的生物相容性。方法　铂 -铱合金支架由 90 %铂和 10 %铱合金制成 ,一代支架为金属丝直径 0 13mm单丝缠绕的螺旋形结构 ,二代支架为金属丝直径为 0 175mm单丝缠绕的“之”字形结构。将两代支架浸入 10 %明胶溶液中经干燥后制成明胶蛋白涂层支架。将支架直视下置入 3 2只正常兔右颈动脉 ,术后 7、14、3 0、90d进行病理形态分析及电镜观察。　结果　 3 2只兔均成功置入支架 ,组织病理学检查显示 :术后 7d一代和二代支架组各有一例不完全性血栓形成。所有支架置入血管段均有不同程度新生内膜增生 ,偶见炎性细胞浸润。随观察时间延长 ,两组平均新生内膜厚度与新生内膜面积呈持续增加趋势 ,且二代明胶蛋白涂层支架组显著小于一代明胶蛋白涂层支架组 (P均 <0 0 0 0 1)。扫描电镜显示 :7d时二代涂层支架表面附着少量单层红细胞 ,几乎完全内皮化 ;14d时透射电镜观察显示血管平滑肌细胞呈典型的合成型改变。结论　不同金属丝直径、不同结构设计的两代国产铂 -铱合金明胶蛋白涂层支架置入兔颈动脉后均具有良好的生物相容性 ,且二代支架引起的新生内膜增殖反应较轻     

Chimiothérapie des cancers épithéliaux de l’ovaire

Chemotherapy is fundamental in the management of epithelial ovarian carcinomas both for early and advanced stages (rarely surgical treatment alone) and in almost every step of the disease. The reference schema combines carboplatin and paclitaxel intravenously. Intraperitoneal chemotherapy also proved its efficacy after complete surgery for advanced disease and should be reserved to trained teams due to its technical constraints and toxicity issues. Modalities of treatment in relapsed and progressive disease depend mainly on the free interval between this diagnosis and the last dose of platinum. Bevacizumab has proven its effectiveness in prolonging progression-free survival in 1st line setting in association with chemotherapy followed by maintenance and in case of relapse or progression both fore platinum sensitive or resistant disease. Finally, a better understanding of ovarian cancer biology will allow us to consider new molecular-targeted agents guided by the specific characteristics of each patient and each tumor.