雄激素对前列腺癌细胞系泌乳素相关蛋白表达的影响

目的:探讨泌乳素相关蛋白(PIP)在前列腺癌不同细胞系中的表达情况,以及雄激素对其表达的影响.方法:应用不同浓度(0、0.1、1、10、100 nmol/L)双氢睾酮(Dihydrotestosterone,DHT)或睾酮(Testosterone,T)及不同时间(6、24和48 h)对前列腺癌细胞系(LNCaP、PC-3、DU145)及人乳腺癌细胞系T47D进行处理,通过RT-PCR及实时荧光定量PCR法检测PIP及雄激素受体(AR) mRNA表达情况.通过Western blot法检测各细胞系(LNCaP、PC-3、DU145、T47D)中PIP蛋白表达情况.结果:雄激素依赖性前列腺癌细胞系LNCaP中有PIP mRNA及蛋白表达,PIPmRNA的表达随DHT或T浓度增加而增加,且于10 nmol/L浓度DHT或T时达到最大峰值.而AR mRNA的表达差异无统计学意义.雄激素非依赖性前列腺癌细胞系PC-3与DU145中无PIP mRNA及蛋白表达,并且AR表达较少或无AR表达.结论:PIP在前列腺癌发生发展机制中,以及鉴别前列腺癌是否具有雄激素依赖性方面有一定作用.     

间歇雄激素阻断治疗晚期前列腺癌的疗效观察

<正>随着生态环境和生活方式的改变,我国前列腺癌的发病率有逐年升高的趋势。近年来对前列腺肿瘤认识的加深,间歇性雄激素阻断治疗方法被提出。通过借鉴国外研究进展的资料[1],2005年1月至2011年5月我院开展了间歇性雄激素阻断治疗的临床观察,研究间歇性雄激素阻断治疗在雄激素依赖的晚期前列腺癌患者治疗的可行性及其     

f/t PSA与PSAD对tPSA灰区前列腺癌诊断价值的Meta分析

目的:系统评价当总前列腺特异性抗原(PSA)处于诊断灰区(4~10μg/L)时,游离PSA/总PSA(f/tPSA)与前列腺特异抗原密度(PSAD)对前列腺癌的诊断价值。方法:利用计算机检索Cochrane图书馆、PubMed、中国生物医学文献数据库等中外文数据库,收集有关利用f/tPSA和PSAD诊断前列腺癌的文献,采用QUADAS进行质量评价,用MetaDisc1.4软件进行Meta分析。结果:共纳入7篇文献,1013例患者。f/tPSA和PSAD诊断前列腺癌的敏感度分别为0.78、0.79,特异度分别为0.54、0.57,两者的综合受试者工作特征曲线下面积分别为0.7761和0.7821,Q指数分别为0.7153和0.7204。结论:总PSA处于4~10μg/L时,f/tPSA与PSAD对前列腺癌的诊断效能无明显差异。     

间歇性雄激素治疗晚期前列腺癌的疗效评价

目的探讨间歇性雄激素治疗晚期前列腺癌的疗效及毒副作用。方法 120例确诊为晚期前列腺癌患者随机分成间歇性雄激素阻断治疗（intermittent androgen blockade,IAB）组及持续雄激素阻断治疗（continuous androgen blockade,CAB）组各60例,观察两组患者的疗效及治疗期间副反应。结果 IAB组患者共完成72个周期,52例（86.67%）完成第1个治疗周期,已进入第2周期,平均2.1个周期,其中36例患者疾病进展。CAB组中32例患者疾病进展。IAB组和CAB组疗效比较,差异无统计学意义（χ2=0.07,P=0.77）。IAB的患者在潮热（23.3%VS.70.0%,χ2=13.13,P=0.00）、转氨酶升高（10.00%VS.33.33%,χ2=4.81,P=0.03）、骨质疏松（10.00%VS.36.67%,χ2=5.96,P=0.01）、乳房胀痛（16.67%VS.43.33%,χ2=5.08,P=0.02）和性功能下降（60.00%VS.83.33%,χ2=4.02,P=0.04）等方面的副作用的发生率较CAB的患者明显少。结论 IAB治疗晚期前列腺癌是可行、有效的,而且与CAB相比较可以降低药物的毒副作用,提高患者生存质量。     

Jevtana可提高晚期前列腺癌患者的生存率

赛诺菲一安万特公司开发的新型紫杉烷类化疗药物Jevtana（cabazitaxel）在一项名为TROPIC的Ⅲ期临床研究中获得成功,该研究结果显示,Jevtana作为二线治疗药,对目前尚无标准治疗方案且可选药物很少的激素难治性前列腺癌（HRPC）有显著疗效,可延长患者总体生存期中位数达2个月。Jevtana于近期获得美国FDA的快速审批资格。     

度他雄胺治疗良性前列腺增生安全性的Meta分析

目的：以安慰剂为对照,评价度他雄胺治疗良性前列腺增生（BPH）的安全性。方法：检索CNKI、CBM、CMCC、VIP、WANGFANG和PubMed、Ovid、EMBASE、Science Direct、EBSCO、Elsevier等数据库收录的关于度他雄胺治疗BPH安全性的随机临床对照试验,采用RevMan5.2进行Meta分析。结果：共纳入4篇文献进行药物相关不良反应发生率的Meta分析,5篇文献进行性欲减退和勃起功能障碍（阳痿）发生率的Meta分析。在药物相关不良反应发生率分析中,合并OR值为1.21（95%CI:0.82～1.78,P=0.33）,性欲减退和勃起功能障碍（阳痿）发生率的合并OR值分别为1.77（95%CI:0.83～3.78,P=0.14）和1.40（95%CI:0.87～2.25,P=0.16）。结论：与安慰剂相比,度他雄胺在药物相关不良反应发生率、性欲减退发生率和勃起功能障碍（阳痿）发生率方面均无显著性差异,度他雄胺治疗BPH具有良好的安全性。     

总前列腺特异性抗原及游离前列腺特异性抗原/总前列腺特异性抗原对高龄老年人前列腺癌的诊断与鉴别诊断

目的探讨总前列腺特异性抗原(t-PSA)及游离前列腺特异性抗原(f-PSA)/t-PSA比值在高龄老年人(≥80岁)中的表现,并评价其在前列腺癌(PCA)和前列腺增生(BPH)鉴别诊断中的作用。方法对经直肠超声引导下前列腺穿刺活检诊断为BPH和PCA的高龄患者234例,结合其术前的PSA检测结果,进行回顾性分析和统计。结果 t-PSA≥4.0μg/L者高达85.5%(BPH 40.6%,PCA 41.9%,其他3.0%),而t-PSA≥10.0μg/L者达59.4%(BPH 23.9%,PCA32.9%,其他2.6%)。在t-PSA<4.0μg/L的患者中,BPH 26例,平均f-PSA/t-PSA值0.26±0.14;PCA 6例,平均f-PSA/t-PSA值0.24±0.13。4.0≤t-PSA<10.0μg/L的患者中,BPH 39例,平均f-PSA/t-PSA值0.26±0.09;PCA 21例,平均f-PSA/t-PSA值0.11±0.06。t-PSA≥10.0μg/L的患者中,BPH 56例,平均f-PSA/t-PSA值0.25±0.07;PCA 77例,平均f-PSA/t-PSA值0.13±0.05。结论对于高龄老年人,用t-PSA≥4.0μg/L或t-PSA≥10.0μg/L来鉴别BPH和PCA差异无统计学意义;对4.0≤t-PSA<10.0μg/L和t-PSA≥10.0μg/L者,BPH和PCA患者的f-PSA/t-PSA值差异具有统计学意义。     

奥希替尼治疗晚期非小细胞肺癌患者颅内转移性疾病疗效和安全性的Meta分析

目的 系统评价奥希替尼治疗晚期非小细胞肺癌(NSCLC)患者颅内转移性疾病(IMD)的疗效和安全性.方法 检索PubMed、Embase、Cochrane Library、SinoMed、万方数据和中国知网数据库从建库到2020年9月关于奥希替尼治疗晚期NSCLC患者IMD的观察性研究和随机对照试验(RCT),筛选文献...     

游离前列腺特异性抗原、总前列腺特异性抗原联合检测对前列腺疾病的诊断价值

目的探讨血清游离前列腺特异性抗原（F—PSA）、总前列腺特异性抗原（T-PSA）和F—PSA／T-PSA比值在良性前列腺增生和前列腺癌诊断价值。方法选取前列腺疾病患者190例。以化学发光法测定其血清中F-PSA、T-PSA的含量,计算F．PSA／T—PSA比值,并与100例健康体检者进行比较。结果前列腺增生（BPH）患者血清F—PSA、T-PSA含量分别为（1．72±0．87）μg／L、（7．83±6．02）μg/L;前列腺癌（PCa）患者血清F-PSA、T-PSA含量分别为（3．19±1．24）μg／L、（26．34±10．56）μg／L、与健康对照组比较差异均有统计学意义（t’=9．099、14．024,均P〈0．05）。当T-PSA介于4～10μg/L时,BPH、Pca患者血清T—PSA含量分别为（6．44±1．46）μg/L、（7．02±1．72）μg／L,差异无统计学意义（t’=2．118,P〉0．05）,但其F．PSA／T-PSA分别为（0．33±0．11）、（0．08±0．07）差异有统计学意义（t’=13．573,P〈0．05）。结论PSA在前列腺疾病的诊断具有较高的价值,联合检测F—PSA、T-PSA以及F／T比值明显优于单项检测PSA。     

中西医结合治疗对中晚期结直肠癌生存期影响的荟萃分析

目的:评价中药配合化疗与单纯化疗或单纯中药比较对中晚期结直肠癌患者生存率的提高作用。方法:采用Cochrane系统评价方法,计算机检索CNKI、VIP和万方;同时手检相关期刊和会议论文集,纳入有关中药配合化疗治疗结直肠癌,观察其对结直肠癌患者生存影响的随机对照临床试验,并按Jadad评价标准评价纳入研究质量,对同质的研究进行Meta分析。结果:共检索到符合纳入标准的中文文献14篇(1081例患者)。文献质量评价结果显示,1篇文献为5分,属高质量研究,其余均为低质量研究。Me-ta分析合并结果显示:与单纯化疗和单纯中药相比,中药配合化疗对结直肠癌患者0.5、1、1.5、2、3、4、5年生存率的提高明显,差异有统计学意义;单项分析结果显示:3个试验中西医结合治疗结直肠癌,其1年生存率高于单纯化疗对照组,差异有统计学意义。1个试验中西医结合治疗结直肠癌,其2、3、4、5年生存率高于单纯化疗对照组,差异有统计学意义。而其余试验均未能说明其试验用药合并化疗与单纯化疗相比,对治疗结直肠癌对其生存的延长有较好的作用。结论:中药配合化疗在延长结直肠癌患者生存与单纯化疗相比有一定的优势。但由于试验用药的不同,纳入试验研究的方法学质量偏低,并不能将某一试验中药推广到临床使用,期待同一试验用药的研究设计更合理、方法更科学、样本量更大、多中心的随机双盲对照临床试验,为中药推广到临床提供更为可靠地证据。     

进展期胃癌术后长期生存影响因素的研究

目的:探讨影响进展期胃癌术后长期生存的主要因素。方法:收集64例长生存组和65例短生存组的进展期胃癌患者资料。免疫组化检测胃癌局部浸润的CD8+T和FOXP3+T淋巴细胞。结果:CD8+T淋巴细胞主要分布于癌巢的间质中,部分呈巢状分布。FOXP3着色位于淋巴细胞核内。长生存组的CD8+T高表达率高于短生存组,FOXP3+T高表达率低于短生存组,差别有统计学意义(P<0.05)。2组患者的性别、年龄、组织类型、肿瘤直径和清扫范围间的差异无统计学意义(P>0.05)。在肿瘤部位、浸润深度、淋巴结分期及转移率、切除方式方面,2组差异均有统计学意义(P<0.05或P<0.01)。Logistic回归结果显示FOXP3+T细胞阳性表达率、切除方式、浸润深度和淋巴结转移率是影响长期生存的因素。结论:FoxP3+T细胞、切除方式、浸润深度和淋巴结转移率与进展期胃癌术后长生存有关。     

A Systematic Review and Meta-analysis of the Incidence of Cancer in Randomized,Controlled Trials of Verapamil

We conducted a systematic review of all published randomized, controlled trials to assess the risk of cancer or death in patients receiving verapamil for hypertension, angina pectoris, or cardiac arrhythmias. Meta-analysis comparing the risk of new cancers, cancer deaths, and all deaths was performed. Thirty-nine trials comprising 11,201 patients were eligible. Study durations ranged from 8 days-6 years (mean 29.5 wks). Nine trials (6507 patients) were 24 weeks in duration or longer. For cancer and cancer death, OR was 1.20 (95% CI = 0.60–2.42) for verapamil versus active controls and 0.73 (95% CI = 0.39–1.39) for verapamil versus placebo. For all deaths, OR was 1.13 (95% CI = 0.70–1.82) for verapamil versus active controls and 0.85 (95% CI = 0.71–1.00) for verapamil versus placebo. Sensitivity analysis for the 9 trials 24 weeks' duration or longer gave similar results. There is no statistically significant increased risk of cancer or deaths with verapamil compared with active controls or placebo.     

局部晚期鼻咽癌调强放疗联合同期化疗的比较

比较局部晚期鼻咽癌行调强放疗（IMRT）同期FP、TP方案化疗的差异。将我院2010年5月至2012年10月收治的120例Ⅲ期、Ⅳa期局部晚期鼻咽癌患者分为2组,观察组行IMRT同期FP化疗,对照组行IMRT同期TP化疗。比较2组的疗效和不良反应。随访率100%,观察组1年生存率为100.00%,2年生存率为95.0%;对照组1年生存率为100.00%,2年生存率为91.7%,2组比较无显著性差异（P＞0.05）。≥3级白细胞减少、血小板减少发生率观察组分别为28.3%和15.0%,对照组分别为65.0%和23.3%,2组比较有显著性差异（P＜0.05）。2组生存率无明显差异,但IMRT同期TP化疗的不良反应较高。     

贝伐珠单抗治疗转移性结直肠癌不良反应的Meta分析

目的 评价贝伐珠单抗联合化疗在转移性结直肠癌(mCRC)中不良反应的发生率,并分析各种不良反应的总体风险。方法 制定文献纳入、排除标准,全面检索Cochrane Library,Pubmed,EMBASE,CNKI,CBM以及万方数据库,纳入相关文献。采用Cochrane协作网提供的RevMan 5.1专用软件进行数据合并与统计分析。结果 共纳入7项研究(n=3 493),贝伐珠单抗联合化疗组患者1 889例,单纯化疗组患者1 604 例。比较各项不良反应的发生率,结果接受贝伐珠单抗治疗的mCRC患者患高血压(RR=3.93,P<0.001)、蛋白尿(RR=3.76,P=0.009)、胃肠穿孔和瘘管(RR=4.10,P=0.02)、3~4级的出血(RR=1.94,P=0.01)和血栓栓塞(RR=1.33,P=0.008)的危险性增高;肺栓塞(RR=0.78,P=0.44)、中性粒细胞减少(RR=1.15,P=0.14)和腹泻(RR=1.17,P=0.09)等风险在两组中无明显差别。所有3~4级的不良反应(RR=1.16,P<0.001)在贝伐珠单抗联合化疗组轻度增加。两组mCRC患者中治疗相关的致死性不良反应发生率相当(RR=1.09,P=0.74),贝伐珠单抗治疗组患者因不良反应中断治疗(RR=1.25,P=0.003)的风险更高。结论 与单纯接受化疗相比,接受贝伐珠单抗联合化疗治疗的mCRC患者出现高血压、蛋白尿、胃肠穿孔、血栓栓塞和出血的危险性更高,但并未增加致死性不良反应发生率。     

Effect of Ropinirole on Sleep Outcomes in Patients with Restless Legs Syndrome: Meta-Analysis of Pooled Individual Patient Data from Randomized Controlled Trials

Study Objective. To compare the effects of ropinirole with those of placebo on sleep, as evaluated by specific domains of the Medical Outcomes Study (MOS) sleep scale, as well as the Clinical Global Impression-Improvement (CGI-I) scale, in patients with restless legs syndrome (RLS). Design. Meta-analysis of six randomized, double-blind, placebo-controlled, parallel-group trials conducted in the United States and Europe. Patients. A total of 1679 patients aged 18–79 years with primary moderate-to-severe RLS who received ropinirole (835 patients) or placebo (844 patients). Measurements and Main Results. A systematic review of MEDLINE (January 1980-January 2007) and clinical trial registers was performed to identify placebo-controlled trials of ropinirole that used the 12-item MOS sleep scale to assess sleep in patients with RLS. Individual patient data from both published and nonpublished trials were pooled for meta-analysis. In the eligible studies, immediate-release ropinirole 0.25-6 mg or placebo had been given for at least 12 weeks. In addition, sleep scale summary scores for the domains of sleep quantity, adequacy, disturbance, and daytime somnolence had to have been assessed at baseline and at 12 weeks. Our meta-analysis found that at baseline study patients slept an average of 5.8 hours/night. At the end of 12 weeks, ropinirole-treated patients slept a mean of 2.5 hours/week more and had a 21% greater improvement from baseline in sleep adequacy scores compared with patients receiving placebo. Ropinirole-treated patients also had 14% less sleep disturbance and 8% less daytime somnolence than patients receiving placebo. Clinicians rated 63% of ropinirole-treated patients and 47% of patients receiving placebo as responders based on the CGI-I scale. Mixed effects analysis of covariance was used to estimate treatment effect adjusting for study center as a random effect, as well as the following fixed effects known to affect sleep: baseline sleep characteristics, age, sex, and chronic medical conditions. All differences were statistically significant (p<0.05), even after adjusting for multiple comparisons. Conclusion. Pooled data from six similarly designed clinical trials provide evidence that ropinirole improves sleep quantity and adequacy, and lessens sleep disturbance and daytime somnolence in patients with primary RLS.     

Effect of Vortioxetine on Cognitive Impairment in Patients With Major Depressive Disorder: A Systematic Review and Meta-analysis of Randomized Controlled Trials

BackgroundDementia and depression are increasingly common worldwide, and their effective control could ease the burden on economies, public health systems, and support networks. Vortioxetine is a new antidepressant with multipharmacologic actions that elevate the concentration of serotonin and modulate multiple neurotransmitter receptors in the brain. We conducted a meta-analysis to explore whether the cognitive function of patients with major depressive disorder (MDD) treated with vortioxetine would improve.MethodsWe systematically reviewed randomized controlled trials (RCTs) in the PubMed, Embase, and Cochrane databases to assess the treatment effects of vortioxetine on the cognitive function of patients with MDD. The outcome measures included the Digit Symbol Substitution Test (DSST), Perceived Deficits Questionnaire (PDQ), and Montgomery-Åsberg Depression Rating Scale (MADRS) scores. Pooled results were calculated using a fixed-effects or random-effects model according to the heterogeneity of the included trials.ResultsSix RCTs with a total of 1782 patients were included in the meta-analysis, which demonstrated that vortioxetine improved DSST, PDQ, and MADRS scores in patients with MDD. The results were consistent at the 10- and 20-mg doses. In the 20-mg group, the decrease in MADRS scores was more significant than that in the placebo group.ConclusionsBoth the 10- and 20-mg doses of vortioxetine can significantly increase DSST scores and decrease PDQ and MADRS scores in patients with MDD and cognitive dysfunction, but further studies with longer follow-up periods to assess mental function are required.     

Botulinum Toxin for Essential Tremor and Hands Tremor in the Neurological Diseases: A Meta-Analysis of Randomized Controlled Trials

Tremor is a common movement disorder. Essential tremor (ET) is the most common etiology of tremor, while hands tremor is the most disabling type of tremor. This study aimed to explore the effects of Botulinum toxin (BoNT) on tremor within 6 weeks of treatment, and the muscular weakness adverse effect within 6 weeks specifically in randomized controlled trials. PubMed, Embase, and Cochrane Library databases were searched. Tremor severity and grip strength after BoNT treatment were investigated. BoNT significantly attenuated hand tremor severity in patients with either essential tremor (ET), Parkinson’s disease or multiple sclerosis (Standardized mean difference [SMD] = −0.59, 95% confidence interval [CI], −0.95 to −0.24, p = 0.001, I² = 46%). Regarding people with ET, BoNT significantly reduced their tremor severity, including hands tremor and head tremor within 6 weeks of treatment (SMD = −0.58, 95% CI, −0.28 to −0.88, p = 0.002, I² = 0%). Electromyography (EMG) but not anatomical guidance BoNT injection provided significant benefit on the relief of tremor in both conditions. The principal adverse event was weakness, but it did not worse within 6 weeks of BoNT treatment (SMD = −0.35, 95% CI, −0.83 to 0.12, p = 0.07, I² = 57%), as assessed by the subjective grip strength. In conclusion, BoNT was an effective treatment for the hand tremor and ET, and EMG guidance injection was preferred. In addition, the muscular weakness adverse effect was not significant.     

手术联合放射治疗对宫颈癌患者生存率与生存质量的影响

目的探讨提高宫颈癌患者生存率与生存质量的治疗方法。方法对86例宫颈癌患者根据其具体病情,采取广泛子宫切除加盆腔淋巴结清扫术68例,次广泛子宫切除7例,全子宫切除11例,术后采用放疗。结果FIGO分期Ⅰ期患者5年生存率为79.2%,Ⅱ期5年生存率为61.9%;Ⅰ期患者5年生存率显著高于Ⅱ期(P<0.05)。鳞癌5年生存率为82.8%,腺癌为25.0%。QOL-UCC治疗前总得分为(2.51±0.79)分,治疗后总得分为(3.42±0.37)分,治疗后得分显著高于治疗前得分(P<0.05)。结论对宫颈癌患者进行手术后结合放射治疗可在一定程度提高患者的生存率,改善生存质量。