rhGM-CSF对小鼠口腔粘膜损伤的防治作用

目的：探讨rhGM-CSF促进口腔腔溃愈合的作用机制。方法：取体外培养的胎儿口腔粘膜成纤维细胞，用rhGM-CSF刺激成纤维细胞后第2、4、6天用细胞计数及^3H－胸腺嘧啶掺入法（^3H-TdR）测定其增殖情况，结果rhGM-CSF对胎儿口腔粘膜成纤维细胞增殖及DNA合成有刺激作用，在80－100ng/ml时，细胞生长达到最佳状态，过高浓度rhGM-CSF的刺激作用反而下降。结论：rhGM-CSF可以通过刺激成纤维细胞增殖及DNA合成促进口腔溃疡愈合。     

Marked improvement of delayed methotrexate-induced leukoencephalopathy treated with high-dose folinic acid

We report the case of a patient with delayed methotrexate (MTX)-induced leukoencephalopathy who showed a marked improvement both in clinical and neuroimaging findings after a high-dose of the active form of folinic acid (leucovorin) treatment. The patient developed progressive affective impairment accompanied by headache, nausea and vomiting after treatment with MTX during the chemotherapy for acute lymphoblastic leukemia, and diagnosed as delayed type MTX-induced leukoencephalopathy. After an intravenous injection of high-dose folinic acid (total 1920 mg), neurological deficits and white matter changes dramatically improved in a few weeks. Although delayed MTX-induced leukoencephalopathy may cause irreversible brain damage, an early treatment with high dose leucovorin may thus facilitate the marked improvement of clinical findings and white matter abnormalities.     

异位妊娠152例临床分析

目的：回顾性总结本院近年来异位妊娠的诊疗情况,并对临床常用诊疗手段进行临床分析,方法：152例经B超,测定尿－HCG和血β-hCG或／和后穹窿穿刺诊断为异位妊娠患,手术治疗143例,9例输卵管妊娠未破裂,我活动性内出血且生命体征稳定的病人,采用米非司酮及MTX药物保守治疗,结果：手术组病人均痊愈出院,非手术组 人除1例病人因包块增大而行择期手术治疗外,其余8例病人的疗效满意,未见明显严重并发症,结论：手术治疗仍是治疗异位妊娠最常采用的手段,对较早发现未破裂型异位妊,娠,采用MTX和米非司酮进行保守治疗不失为一种有用的选择,但应注意适应证以提高疗效和安全性。     

替尼油甙为主的联合方案配合氨甲喋呤椎管内化疗治疗肺癌转移

目的：研究以替尼泊甙（Ｖｍ－２６）为主的联合化疗方案配合氨甲喋呤（ＭＴＸ）椎管内注射治疗非上细胞肺癌脑转移的疗效,方法：联合应用替尼泊甙为主的化疗方案配合氨甲喋呤椎管内化疗,每４周为１周期,治疗２～３周期。结果：颅内瘤灶有效率５２％,肺内瘤灶有效率６０％,症状,体征缓解率８４％,结论：替尼泊甙为主的联合方案配合氨甲喋呤椎管内化疗治疗非小细胞肺癌脑转移,疗效显著。     

Effect of de novo purine synthesis inhibitors on 5-fluorouracil metabolism and cytotoxicity

Methotrexate pretreatment of L1210 cells had been shown previously by us to cause an enhancement of the intracellular accumulation of 5-fluorouracil and of the formation of 5-fluorouracil nucleotides which was correlated with synergistic cytotoxicity. This effect of methotrexate was associated with increases in 5-phosphoribosyl-1-pyrophosphate, the cofactor required for the conversion of 5-fluorouracil to 5-fluorouridine-5'-monophosphate (FUMP). Because these influences on 5-fluorouracil metabolism were most likely mediated by the activity of methotrexate as an inhibitor of purine synthesis, the effects of other agents that inhibit purine synthesis were examined. An inhibitor of amidophosphoribosyltransferase, 6-methylmercaptopurine ribonucleoside, the glutamine antagonists, azaserine and 6-diazo-5-oxo-L-norleucine (DON), and the L-aspartate analogue inhibitor of adenylsuccinate synthetase, L-alanosine, all reduced the incorporation of [1-14C]glycine into adenine and guanine bases isolated from nucleic acids. Each drug also resulted in intracellular elevations of 5-phosphoribosyl-1-pyrophosphate that were 15- to 25-fold greater than control levels. These alterations in de novo purine nucleotide synthesis were associated with enhanced intracellular 5-fluorouracil accumulation and synergistic cytotoxicity.     

RP-HPLC进行甲氨蝶呤血药浓度监测时保留时间校准方法研究

目的 建立RP—HPLC进行MTX血药浓度监测时保留时间校准方法。方法应用容量因子与流动相比例的三次方多项式模型，建立MTX流动相比例与保留时间的函数，并通过此函数用保留时间求算流动相比例，与理论流动相比例比较，从而计算流动相应该补充组分的量，达到调整保留时间的目的。结果四种不同色谱条件下容量因子与流动相比例的三次方多项式模型拟合关系良好，R0均为1．000，保留时间经校准后RSD为0.9％(n=5)。结论本方法能准确校准因流动相比例引起变化的保留时间，适用于MTX血药浓度监测时保留时间的校准，方法新颖、有效、简单。     

天花粉、甲氨蝶呤、米非司酮对异位妊娠保守治疗的研究

目的:探索异位妊娠保守治疗的最佳疗效方案。方法:对昆明市延安医院1253例异位妊娠,其中676例行保守治疗。按用药分为用天花粉(A组310例)、甲氨蝶呤(MTX,B组70例)、米非司酮(C组60例)、MTX加米非司酮(D组184例)、天花粉加MTX加米非司酮(E组52例),观察疗效。结果:异位妊娠的保守治疗中E组成功率为94.0%,D组成功率为85.87%,A组成功率为85.16%,B组成功率为81.42%,C组成功率为60.00%。结论:临床显示,异位妊娠疗效方案E组疗效最佳,D组和A组有较高的临床应用优势。其次是B组,疗效最差的是C组。     

中西医结合治疗异位妊娠两种方法比较

目的:比较研究氨甲喋呤(MTX)与MTX配伍米非司酮联合中药治疗异位妊娠的疗效及副反应.方法:将57例异位妊娠患者随机分为MTX联合中药组(Ⅰ组)28例,MTX配伍米非司酮联合中药组(Ⅱ组)29例,观察比较疗效.结果:治疗成功率Ⅰ纽78.6%,Ⅱ组86.2%,差异元显著性(P＞0.05);血HCG＞3000mIU/ml时,Ⅱ组成功率(84.6%)显著高于工组(20%)(P＜0.05).血HCG降至正常平均时间Ⅰ组为(25.6±1.3)天,Ⅱ组为(19.16±2.1)天,Ⅱ组显著短于Ⅰ组(P＜0.05);月经复潮时间Ⅰ组(33.6±5.7)天,Ⅱ组(36.4±3.8)天,差异显著(P＜0.05);两组均无明显副作用.结论:MTX与MTX配伍米非司酮联合中药治疗异位妊娠疗效相似,在HCG水平高时,后者成功率高,且后者HCG下降快,疗程短.     

More than skin deep

We present the case of a woman in her 50s with past medical history significant for psoriasis treated with methotrexate on a stable dose for the past 20?years, diabetes mellitus and chronic kidney disease. In the setting of a long flight, dehydration and non steroidal anti-inflammatory drug consumption, the patient presented to the emergency department with oral mucositis and cutaneous erosions and ulcers of the psoriasis plaques. MTX levels were normal corroborated by three different measurements in 24?h. Initially the complete blood count tests were significant for macrocytic, thrombocytopenia (82.000 10³/L) and impaired kidney function. The patient was diagnosed of acute methotrexate toxicity and started on intravenous folinic acid. In 24?h the patient developed severe pancytopenia. She required treatment with colony-stimulating factors, platelet and blood transfusions. After 10?days, the CBC improved to normal levels and the cutaneous lesions resolved.