中医药及微波热疗联合化疗治疗卵巢癌腹水的临床疗效

目的:探讨中医药及微波热疗联合化疗对卵巢癌腹水的临床疗效及安全性.方法:将80例卵巢癌腹水患者作为研究对象,随机分成对照组和治疗组,每组各40例.对照组单纯进行化疗,而治疗组在对照组的基础上联合中医药及微波热疗.结果:全部患者顺利完成治疗,治疗后在中医症候改善方面对照组总有效27例(67.5％),治疗组总有效36例(90％),两组差异有统计学意义(P<0.05);治疗后患者的腹围、体重都较治疗前减小,差异有统计学意义(P<0.05);与对照组比较,治疗组腹围明显减小,差异有统计学意义(P<0.05);治疗后两组的肿瘤标志物水平都有不同程度的下降,而治疗组CA125,HE4降低明显,差异有统计学意义(P<0.05).结论:中医药及微波热疗联合化疗对卵巢癌腹水的临床疗效明显,能够有效控制疾病的进展,并且毒副作用低,为治疗卵巢癌腹水提供一定的临床依据.     

血清人附睾蛋白4和糖类抗原125检测在早期卵巢癌诊断中的应用

目的:检测分析肿瘤标志物人附睾蛋白4(HE4)和糖类抗原125(CA125)在早期卵巢癌诊断中的应用价值。方法:临床病检确诊早期卵巢癌患者32例为卵巢癌组,女性良性肿块患者79例为良性肿块组,另选30例健康女性作为健康对照组。术前采血,应用电化学发光法平行检测各组血清HE4和CA125水平,分析HE4、CA125单独和联合检测对卵巢癌的诊断效能。结果:卵巢癌组HE4和CA125水平均显著高于良性肿块组和健康对照组(P均0.01);HE4和CA125诊断卵巢癌的受试者工作特征曲线下面积(AUC)分别为0.935和0.896,差异无统计学意义(P0.05);HE4、CA125单独和联合检测诊断卵巢癌的敏感度分别为84.38%、87.50%和81.25%,差异无统计学意义(P0.05),HE4单独和HE4、CA125两者联合检测的特异性分别为96.20%和98.73%,均显著高于CA125单独检测(P0.01)。结论:HE4是特异性较高的卵巢癌血清标志物,其与CA125联用可以提高对早期卵巢癌的诊断准确性。     

卵巢癌患者手术前后血清HE4、CA125和SIL-2R检测的临床意义

目的:探讨卵巢癌患者手术治疗前后血清HE4、CA125和SIL-2R水平的变化及临床意义。方法:应用放射免疫分析、酶联法对33例卵巢癌患者进行治疗前后血清HE4、CA125和SIL-2R检测,并与35名正常健康人作比较。结果:卵巢癌患者手术前血清HE4、CA125和SIL-2R水平非常显著地高于正常人组(P<0.01)。手术治疗3个月后则与正常人组比较无显著性差异(P>0.05)。血清HE4水平与CA125、SIL-2R水平呈显著正相关(r=0.5784、0.6122,P<0.01)。结论:检测卵巢癌患者手术治疗前后血清HE4、CA125和SIL-2R水平的变化与该病的发生和发展密切相关。     

NACT联合IDS对卵巢上皮性癌肿瘤指标及疗效的影响

目的:探讨新辅助化疗(Neoadjuvant chemotherapy,NACT)联合间歇性肿瘤细胞减灭术(Interval debulking surgery,IDS)对卵巢上皮性癌肿瘤指标、疗效的影响.方法:选取2018年5月至2020年5月我院收治的97例卵巢上皮性癌患者,根据治疗方案分为对照组(n=48)和研究组(n=49),对照组予以NACT联合初始肿瘤细胞减灭术进行治疗,研究组予以NACT联合IDS进行治疗.于治疗结束后观察治疗效果,采用电化学发光法测定治疗前、后糖类抗原125(Carbohydrate antigen 125,CA125)和人附睾蛋白4(Human epidiymis protein 4,HE4)水平;同时观察治疗期间的不良反应.结果:研究组总缓解率(91.84％)高于对照组(75.00％)(P<0.05);与治疗前相比,两组治疗后CA125、HE4水平均明显降低,其中以研究组最为显著(P<0.05);两组骨髓抑制、肝肾功能不全及胃肠道反应发生情况对比无显著差异(P>0.05).结论:对卵巢上皮性癌患者予以NACT联合IDS治疗可有效提高患者近期疗效,降低CA125、HE4的表达,具有一定安全性.     

HE4与CA125联合检测在女性卵巢癌诊断中的应用

目的：探讨血清HE4与CA125联合检测在女性卵巢癌诊断中的应用价值,为卵巢癌的诊断提供参考。方法选取我院2012年7月~2014年7月收治的75例疑似卵巢癌患者作为研究对象,根据病理检查结果将患者分为良性病变组25例、卵巢癌组50例,对两组患者血清HE4及CA125水平进行测定,分析两组患者血清HE4水平的差异及与CA125联合检测的灵敏度。结果卵巢癌组患者血清HE4及CA125水平显著高于良性病变组(<0.05),在50例卵巢癌患者中,血清HE4及CA125联合诊断的敏感性为96%,显著优于血清HE4单项检测的40%,及CA125单项检测的50%。结论随着学界对HE4的深入研究,其对于卵巢癌发病风险的预测及预后判断均可起到重要的临床作用,HE4联合CA125检测灵敏性及特异性较高,有助于卵巢癌的早期发现。     

血清CA125、HE4和IGF-Ⅰ水平对卵巢癌的诊断价值

目的:探讨血清CA125、HE4和IGF-Ⅰ水平对卵巢癌的诊断价值。方法:应用放射免疫分析、酶联法对32例卵巢癌患者进行了血清CA125、HE4和IGF-Ⅰ测定,并与35名正常健康人作比较。结果:卵巢癌患者血清CA125、HE4和IGF-Ⅰ水平均非常显著地高于正常人组(P<0.01),且血清CA125水平与HE4、IGF-Ⅰ水平呈显著正相关(r=0.5012、0.6137,P<0.01)。结论:检测血清CA125、HE4和IGF-Ⅰ水平的变化对卵巢癌的疗效及预后判断提供重要的临床诊断价值。     

血清HE4、CA125和ROMA指数评估卵巢癌风险性的初步评价

目的:评价血清HE4、CA125和ROMA指数在判断卵巢癌高风险性中的价值并分析三项指标与卵巢癌临床分期和病理特征的相关性.方法:临床回顾并随访从2011年1月到2011年9月期间在福建省肿瘤医院就诊的96例原发性卵巢癌病人、74例良性卵巢肿瘤患者及60例健康女性体检者.采用酶联免疫吸附(ELISA)法测定受试者手术前血清HE4和CA125水平.用卵巢癌风险性评估软件计算ROMA指数.以卵巢良性肿瘤+健康人为参照绘制ROC曲线以评价HE4、CA125和ROMA指数的诊断价值,并以单变量统计分析治疗前血清HE4、CA125水平和ROMA指数与临床病理学参数之间的关系.结果:卵巢良性肿瘤组和正常对照组患者血清HE4、CA125和ROMA指数水平均在正常范围内,而卵巢癌组三项指标的中位水平分别为240.40 pmol/L、88.37 U/ml和79.70％,与卵巢良性肿瘤组和正常对照组比较,差异均有统计学意义(P值均＜0.05).以卵巢良性肿瘤为对照,卵巢癌组中ROMA指数的敏感性和阴性预测值最高(83.33％和82.95％),HE4的特异性、阳性预测值和准确性最高(100％、100％和82.82％).以良性肿瘤+健康人为参照人群,HE4、CA125和ROMA指数单项检测的受试者工作特征曲线下面积分别为0.896、0.869和0.922.三项指标的阳性率随着临床分期的升高而升高,但CA125在Ⅰ期的的阳性率仅为36.36％,与HE4和ROMA指数相比(60.61％和78.79％),差异均有统计学意义(P值均＜0.05).CA125 、HE4和ROMA指数的阳性率均与卵巢癌病理特征(术前转移状态、组织学分级、肿物大小、肿瘤病理类型)显著相关,此外HE4的阳性率还与患者年龄显著相关,ROMA指数的阳性率则与患者年龄、绝经状态显著相关(P值均＜0.05);HE4和ROMA指数在上皮类卵巢癌的阳性率均显著高于非上皮性卵巢癌(76.54％ VS 6.67％,90.12％ VS 46.67％),ROMA指数在上皮性卵巢癌的阳性率最高(90.12％),尤其是浆液性腺癌阳性率高达97.92％.而CA125在两组间差异无统计学意义.同时在子宫内膜癌组,CA125的阳性率显著低于HE4和ROMA指数,而在粘液性腺癌组,则是CA125的阳性率显著高于HE4和ROMA指数.结论:血清HE4、CA125的联合检测及ROMA指数的计算有助于评估腹盆腔肿块患者患卵巢癌的风险性,对于早期以及上皮性卵巢癌尤其是浆液性卵巢癌具有更好的预测价值,可提高卵巢癌的早期诊断效率,进而提高五年生存率.     

卵巢癌患者肿瘤标志物和纤溶指标水平变化及其诊断价值分析

目的:探讨卵巢癌患者纤溶指标水平和糖类抗原125(CA125)/人附睾蛋白4 (HE4)水平变化及临床意义。方法:收集2021-2022年在本院妇产科就诊并病理检查确诊的妇科肿瘤患者100例，其中卵巢癌50例(卵巢癌组),妇科良性肿瘤50例(对照组)。采用全自动凝血分析仪检测纤维蛋白原(FIB)水平，用免疫比浊法测定纤维蛋白降解产物(FDP)和D-二聚体(D-D)含量，采用电化学发光法检测CA125和HE4水平，采用Logistic回归筛选卵巢癌的危险因素，通过受试者工作特征曲线(ROC)分析相关指标对卵巢癌的诊断价值。结果:卵巢癌组血浆FIB、FDP、D-D以及血清CA125和HE4水平均显著高于对照组(均P<0.01);多因素分析结果显示，FIB (OR=2.375)和CA125 (OR=1.060)为卵巢患者的危险因素(P<0.01);ROC曲线分析显示，FIB、CA125以及二者联合检测(联合模型)诊断卵巢癌的ROC曲线下面积(AUC)分别为0.831、0.957和0.962(均P<0.01),其中联合模型的AUC最大，诊断价值最高。结论:FIB和CA125为...     

HE4、AFP、CA125和CEA在卵巢癌中的诊断意义

目的：探讨人附睾蛋白4（HE4）、甲胎蛋白（AFP）、糖类抗原125（CA125）和癌胚抗原在卵巢癌（CEA）中的联合诊断作用和意义。方法：选取2015年7月~2017年7月本院收治的100 例卵巢癌患者为实验组,选取同期健康体检女性患者50例为对照组。收集患者血清,并检测血清中HE4、AFP、CA125 和CEA水平变化进行统计分析。结果：卵巢癌血清中HE4、AFP、CA125和CEA水平显著高于对照组和良性病变组患者,差异具有统计学意义（P<0.05）。且卵巢癌患者血清中HE4、AFP、CA125 和CEA联合检出率、灵敏度和特异度显著高于各指标的单独检出率,差异具有统计学意义（P<0.05）。结论：卵巢癌患者血清中HE4、AFP、CA125 和CEA含量呈过度表达状态;HE4、AFP、CA125 和CEA的联合检测在卵巢癌的诊断中具有重要的临床意义。     

HE4和CA125联检在卵巢癌中的应用价值

目的：探讨联检血清人附睾蛋白4（HE4）和CA125水平在卵巢癌诊断中的应用价值。方法：用ELISA测定47例卵巢癌患者、65例卵巢良性疾病患者和109例健康对照者血清HE4水平,同时测定CA125,并对结果进行比较分析。结果：卵巢癌组血清HE4、CA125水平均显著高于健康对照组,差异有统计学意义（P〈0.01）,HE4在早期卵巢癌（Ⅰ～Ⅱ期）阳性率高于CA125,两者联检可提高诊断卵巢癌的敏感性。结论：HE4是一种良好的预测早期卵巢癌的肿瘤标志物,其联合CA125的测定有助于卵巢癌的诊断。     

Improved bronchodilation with levalbuterol compared with racemic albuterol in patients with asthma

Background: Racemic albuterol is an equal mixture of (R)-albuterol (levalbuterol), which is responsible for the bronchodilator effect, and (S)-albuterol, which provides no benefit and may be detrimental. Objective: We sought to compare 2 doses of a single enantiomer, levalbuterol (0.63 mg and 1.25 mg), and equivalent amounts of levalbuterol administered as racemic albuterol with placebo in patients with moderate-to-severe asthma. Methods: This was a randomized, double-blind, parallel-group trial. Three hundred sixty-two patients 12 years of age or older were treated with study drug administered by means of nebulization 3 times daily for 28 days. The primary endpoint was peak change in FEV₁ after 4 weeks. Results: The change in peak FEV₁ response to the first dose in the combined levalbuterol group was significantly greater compared with the combined racemic albuterol group (0.92 and 0.82 L, respectively; P = .03), with similar but nonsignificant results after 4 weeks (0.84 and 0.74 L, respectively). Improvement in FEV₁ was similar for levalbuterol 0.63 mg and racemic albuterol 2.5 mg and greatest for levalbuterol 1.25 mg. Racemic albuterol 1.25 mg demonstrated the weakest bronchodilator effect, particularly after chronic dosing. The greatest increase in FEV₁ was seen after levalbuterol 1.25 mg, especially in subjects with severe asthma. All active treatments were well tolerated, and β-adrenergic side effects after administration of levalbuterol 0.63 mg were reduced relative to levalbuterol 1.25 mg or racemic albuterol 2.5 mg. At week 4, the predose FEV₁ value was greatest in patients who received levalbuterol or placebo when compared with those who received racemic albuterol. The difference was more evident and was statistically significant in patients who were not receiving inhaled corticosteroids. Conclusion: Levalbuterol appears to provide a better therapeutic index than the standard dose of racemic albuterol. These results support the concept that (S)-albuterol may have detrimental effects on pulmonary function. (J Allergy Clin Immunol 1998;102:943-52.)     

Satellite RNA associated with bamboo mosaic potexvirus shares similarity with satellites associated with sobemoviruses

Summary A putative nonstructural protein encoded by a satellite RNA associated with bamboo mosaic potexvirus shares 46% identity with the capsid protein of satellite virus of panicum mosaic sobemovirus. The sequence similarity among satellite plant viruses which have no apparent relationship implies a common origin.     

拉米夫定与泛昔洛韦联合治疗乙型肝炎病毒慢性感染的临床研究

目的 观察拉米夫定与泛昔洛韦联合治疗乙型肝炎病毒(HBV)慢性感染的临床疗效。方法 慢性乙型肝炎患者90例。设联合治疗组28例，单用拉米夫定组30例，单用泛昔洛韦组32例。联合治疗组给予口服拉米夫定0．1g／d(PO)，泛昔洛韦1．5g／d(PO)，24周。拉米夫定、泛昔洛韦单用组剂量及疗程分别同联合治疗组。结果 3组均无明显副反应，丙氨酸转氨酶(ALT)复常率无差异。3组HBV DNA阴转率分别为89．3％、66．7％、40．6％，差异有显著性。乙型肝炎表面抗原(HBeAg)阴转率分别为28．6％、23．3％、21．9％，差异无显著性。结论 拉米夫定与泛昔洛韦联合用药安全、耐受性好，临床显示联合治疗对HBV DNA的抑制作用显著优于单用药。     

Infectious diseases and immunological markers associated with patients with non-Hodgkin lymphoma treated with rituximab

Background: The use of rituximab (RTX) is increasing, even in developing countries. It has become the first-line therapy or adjuvant to chemotherapy (CHOP; cyclophosphamide, hydroxydaunorubicin, oncovin and prednisone) for various diseases, including B cell lymphoma and autoimmune diseases.

Aim: We describe the infectious diseases and immunological markers associated with RTX treatment of patients with non-Hodgkin lymphoma (NHL).

Methods: Serum immunoglobulins were determined before and after intravenous immunoglobulin (IVIg) administration. Pneumo-23IgG-specific anti-pneumococcal antibodies were evaluated before and after vaccination. Immunophenotyping and lymphocyte proliferation were determined in the course of the treatment.

Results: Seven patients were followed and median age was 56.0?±?5.0?years (range, 41.9–71.6?years). At baseline, the mean level of IgG was 333.7?±?40.8?and IgM 40.9?±?11.3?mg/dL, respectively; immunoglobulin A and E (IgA and IgE) were under the limit of detection. Two patients had reduced or absent B cells and T cell subsets were at normal levels in five patients. All patients failed to mount an efficient post-vaccination immune response against hepatitis B virus, tetanus, diphtheria and against the 23-valent pneumococcal polysaccharide vaccine. During RTX/CHOP treatment, human-IgG-immunoglobulin (IVIg) therapy was introduced in six patients after recurrent infections, including community-acquired pneumonia (85.7%), chronic sinusitis (85.7%) and gastroenteritis (42.9%).

Conclusion: Poor response against pneumococcal vaccines increases the susceptibility of respiratory diseases in these patients. In patients with NHL treated with RTX, the benefits achieved with IVIg replacement for the control of recurrent infectious diseases is of paramount importance. Clinicians dealing with monoclonal antibodies against cancer therapy, especially RTX, should be aware of the increasing risks for symptomatic induced hypogammaglobulinemia and respiratory infections.     

Gynecomastia with marked cellular atypia associated with chemotherapy

Gynecomastia is a common benign male breast disease, which may exhibit mild cellular atypia in cytology specimens. However, marked cytologic atypia can be seen in gynecomastia superimposed by chemotherapy. The case described in this report demonstrated severe cytologic atypia of gynecomastia mimicking carcinoma in a patient treated with chemotherapy for acute leukemia. A distinct cytologic feature helpful in avoiding the diagnostic error is described, namely, atypical cells admixed with bland ductal cells and appearing at a different plane. The importance of applying strict diagnostic criteria in breast cytology and clinical correlation is also emphasized.