两种方案治疗晚期非小细胞肺癌的药物经济学分析

目的：用药物经济学方法分析NP和GP两种常用晚期非小细胞肺癌一线化疗方案，为临床选择疗效较好且费用较低的化疗方案提供依据。方法：选择我院2005～2007年采用NP或GP方案治疗非小细胞肺癌病历86例，应用药物经济学最小成本分析法进行分析。结果：NP和GP两种方案疗效与不良反应相近，但是成本分析显示NP低于GP，主要差异发生在药品费用上（分别为18534．04元、27051．99元），药品费用经两样本检验有显著性差异（t=40，P〈0．001）。结论：最小成本分析提示，NP方案与GP方案相比是比较好的晚期非小细胞肺癌的一线化疗方案。     

Evaluation of the evidence that tobacco-specific nitrosamines (TSNA) cause cancer in humans

Considerable evidence exists that TSNA may cause cancer in humans. Strong evidence suggests that the NNN and NNK in snuff are at least partially responsible for the excess of oral cancer among snuff dippers. Tobacco smoke, because it is a combustion product, is a far more complex matrix than is smokeless tobacco. Nonetheless, NNK is well established as a lung carcinogen in laboratory animals at levels similar to those experienced by heavy smokers. Although the epidemiology of the smoking/lung cancer association has been studied extensively and is well established as a causal relationship, few attempts have been made to determine the effective constituents in tobacco smoke, much less to quantify them and to reduce their levels in consumer products. More work is needed to determine TSNA uptake in smokers and users of smokeless tobacco and to determine the factors involved in the possible endogenous formation of TSNA and in their metabolic activation or inhibition of their formation. Exploratory work is in progress with various biological markers that may prove useful in quantifying the levels of TSNA exposure in humans. Epidemiologic evidence indicates that in addition to tobacco use other factors are causally related to the development of cancers of the oral cavity, lung and esophagus and that these factors (e.g., radon exposure in uranium miners who smoke) can act synergistically. Experimental investigation of some of these synergistic effects may prove to be a step in the direction of determining the proportion of various cancers that are likely to be attributable to various causes and ultimately to the various constituents of tobacco exposure.     

Discovery of Autophagy Inhibitors with Antiproliferative Activity in Lung and Pancreatic Cancer Cells

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非小细胞肺癌Ki—67的表达及其意义

目的：探讨非小细胞肺癌Ki-67的表达及其意义。方法：采用免疫组化EnVision二步法对46例非小细胞肺癌石蜡标本进行Ki-67检测，并结合临床病理资料作结果分析。结果：Ki-67阳性表达率为65．2％（30／46），与性别、年龄、肿瘤直径大小、组织学类型及分化程度无明显相关性，但与淋巴结转移情况密切相关，随着淋巴结转移程度的进展，其阳性率也逐渐升高，N2、N3组与N0组比较差异显著（P＜0．05）。结论：在非小细胞肺癌中检测Ki-67的表达对判断和预测淋巴结转移或评估预后有一定指导意义。     

Epidemiologic Evidence on the Relationship between Mists Containing Sulfuric Acid and Respiratory Tract Cancer

Abstract

This review identified and evaluated 25 epidemiologic studies pertaining to the carcinogenicity of mists containing sulfuric acid (MSA). Few studies were designed with acid mists as the principal exposure under investigation, and in all studies exposure assessment was limited. The results of the follow-up studies from industries with high or moderate exposure potential and the case-control studies indicate, in aggregate, a moderate association between MSA and larynx cancer. The data suggest a dose-response relationship. However, many of the results from individual studies are imprecise, and confounding by smoking, alcohol, and other occupational agents is not adequately adjusted for. The biologic plausibility and the possible carcinogenic mechanism remain uncertain. There is little evidence in support of a causal relationship between exposure to MSA and lung cancer. Information is inadequate for drawing any meaningful inference about the association between exposure to MSA and nasal cancer.     

培美曲塞二线治疗晚期非小细胞肺癌的疗效观察

目的：探讨分析培美曲塞二线治疗晚期非小细胞肺癌（NSCLC）的临床疗效及不良反应。方法：经病理学或细胞学确诊,一线化疗后出现复发或进展的晚期NSCLC患者56例。治疗方案为培美曲塞二钠500mg·m-2,从第1天给药,21d为1个周期。完成2个周期以上化疗后评价疗效。结果：56例患者中,完全缓解（CR）0例,部分缓解（PR）4例,稳定（SD）32例。进展（PD）20例,有效率（RK）为7．1％（4／56）,疾病控制率（DCR）为64．3％（36／58）。主要不良反应为骨髓抑制、皮疹、肝功能异常,经对症处理后不影响化疗进行。结论：培美曲塞二线治疗晚期NSCLC疗效较好．不良反应较轻。耐受性较好。     

A systematic review of epidemiologic studies of styrene and cancer

Previous epidemiology reviews of exposure to styrene and the risk of cancer considered studies published through 13 November 2013. Since then, additional relevant research has been published. No review has included meta-analyses. The current systematic review considered research published through June 2017; included meta-analyses of the relationship between any exposure to styrene and cancers identified as being of concern, including non-Hodgkin lymphoma (NHL), leukemia and cancers of the esophagus, pancreas, lung and kidney; and evaluated several other forms of cancer. Meta-relative risks for all studies were 1.14 (95% confidence interval (CI), 0.91–1.43) for NHL, 1.00 (95% CI, 0.80–1.26) for multiple myeloma, 0.98 (95% CI, 0.87–1.09) for all leukemia, 1.03 (95% CI, 0.92–1.15) for esophageal cancer, 1.02 (95% CI, 0.93–1.12) for pancreatic cancer, 1.09 (95% CI, 0.95–1.24) for lung cancer and 1.10 (95% CI, 0.99–1.22) for kidney cancer. Individual studies provided little evidence of exposure-response or induction time trends. Limitations of the available research and of the meta-analyses included reliance in most studies on mortality data rather than on incidence data, lack of quantitative estimates of styrene exposure for individual subjects and lack of information on lifestyle factors. Consideration of all pertinent data, including substantial recent research, indicates that the epidemiologic evidence on the potential carcinogenicity of styrene is inconclusive and does not establish that styrene causes any form of cancer in humans.     

培美曲塞二线治疗非小细胞肺癌的疗效评价

目的:观察培美曲塞单药二线治疗晚期复发或进展非小细胞肺癌的临床疗效及不良反应。方法:经病理学或细胞学确诊、一线化疗后出现复发或进展的晚期非小细胞肺癌患者50例,治疗方案为培美曲塞二钠500mg·m-2,第1天给药,21d为1个周期,完成2个周期以上化疗后评价疗效和不良反应。结果:治疗有效率为8.0%(4/50),疾病控制率为76.0%(38/50),1年生存率为55.3%(26/47),中位生存期为12.5个月,中位无进展生存期为2.1个月。主要不良反应为肝功能损伤、皮疹、骨髓抑制。结论:培美曲塞单药二线治疗晚期非小细胞肺癌疗效较好,不良反应较轻。     

有无吸烟史的晚期非小细胞肺癌4种化疗方案的临床比较

目的 研究比较长春瑞滨、紫杉醇、多西紫杉醇、吉西他滨分别联合顺铂方案对有吸烟史和无吸烟史的晚期非小细胞肺癌的疗效及毒副作用.方法 共277例患者,有吸烟史组185例,无吸烟史组92例.长春瑞滨25 mg/m^2,吉西他滨1 000 mg/m^2,第1,8天使用;紫杉醇135 mg/m^2,多西紫杉醇75 mg/m^2,第1天使用;顺铂25 mg/m^2,第1,2,3天使用.21 d或28 d为1个周期.结果 有吸烟史组NP方案（47例）有效率为34.0%,PP方案（57例）有效率为35.1%,DP方案（35例）有效率为37.1%,GP方案（46例）有效率为30.4%,总有效率为34.1%;无吸烟史组NP方案（27例）有效率为33.3%,PP方案（23例）有效率为30.4%,DP方案（24例）有效率为37.5%,GP方案（18例）有效率为33.3%,总有效率为33.7%两组均有血液学毒性和非血液学毒性.结论 有吸烟史和无吸烟史的晚期非小细胞肺癌患者化疗疗效相近.     

小细胞肺癌的治疗进展评价

目的:对小细胞肺癌的化疗、放疗、预防性全脑放疗及靶向治疗等方面的进展进行探讨。方法:收集国外相关文献进行归纳分析。结果及结论:小细胞肺癌恶性度高,常常快速播散和转移,联合化疗是主要的治疗方法,依托泊苷联合铂类的2药联合化疗4个～6个周期是标准的一线治疗;身体状况好的局限期患者推荐同步化放疗(EP方案),超分割放疗优于每日1次放疗,序贯治疗时患者也宜早期接受放疗,放疗可在化疗的第1或第2周期开始(1.5Gy,每日2次,总量45Gy;或是1.8Gy,每日1次,总量50Gy);预防性全脑放疗可使完全缓解的局限期患者生存延长;靶向治疗仍需要进一步探索。     

PARP抑制剂在胰腺癌应用中的现状与前景

胰腺癌一种是消化道恶性肿瘤,具有进展快、预后差等特点.因为病情的复杂多变,胰腺癌的治疗没有特定有效的治疗方式,因此识别与胰腺癌发生相关的分子机制对于理解胰腺癌的本质及探索新的治疗方式至关重要.BRCA1/2基因是目前已知的与胰腺癌相关的突变基因,BRCA的基因突变会显著增加胰腺癌的患病风险.针对该靶点的PARP抑制剂显...     

EP方案联合清肺胶囊治疗小细胞肺癌

目的　评价中成药清肺胶囊与EP方案 (VP16 +DDP)联合应用在小细胞肺癌治疗中的近期和远期疗效。方法　 12 6例小细胞肺癌的患者 ,随机分为单纯化疗组和化疗中药联合治疗组 ,对照组采用标准EP方案 ,联合治疗组用EP方案 +清肺胶囊 ,进行前瞻性对比观察和为期 5年的远期疗效评价。结果　联合治疗组获得 34 4 %的完全缓解率和 89 1%的总有效率 ,对照组分别为 2 4 2 % ,70 3% ,两组差异显著 (P <0 .0 5 ) ;远期疗效 1,2 ,3,5年的生存率联合组分别为 5 4 7% (35 /6 4 ) ,2 9 4 % (15 /5 1) ,19 4 % (7/36 ) ,15 1% (5 /33) ,对照组分别为 4 6 8% (2 9/6 2 ) ,11 4 % (5 /4 4 ) ,5 7% (92 /35 ) ,3 1% (1/32 )。两组比较 ,2 ,3,5年生存率均有统计学意义。 (P <0 .0 5 )。结论　用EP方案联合中药清肺胶囊治疗小细胞肺癌具有较好的耐受性和安全性 ,其近期疗效和远期疗效均优于单纯化疗组 ,说明化疗联合中药治疗小细胞肺癌是一条有效的治疗途径     

Enhancing the efficiency of bortezomib conjugated to pegylated gold nanoparticles: an in vitro study on human pancreatic cancer cells and adenocarcinoma human lung alveolar basal epithelial cells

ABSTRACT

Objectives: Gold nanoparticles have become promising vectors for cancer diagnosis and treatment. The present study investigates the effect of bortezomib (BTZ), a proteasome inhibitor, conjugated with pegylated gold nanoparticles (PEGAuNPs) in pancreatic and lung cancer cells.

Methods: Synthesized gold nanoparticles (PEGAuNPs) were conjugated with bortezomib antitumor drug. We investigated the cytotoxicity induced by BTZ conjugated with functionalized gold nanoparticles in vitro, in the human pancreatic (S2-013) and lung (A549) cancer cell lines.

Results: We found an efficient of conjugation of BTZ with PEGAuNPs. In vitro assays showed that after 72 h’ incubation with PEGAuNPs-BTZ cancer cells revealed alterations in morphology; also for S2-013 and A549 cancer cells, the IC₅₀ value of free BTZ is respectively 1.5 and 4.3 times higher than the IC₅₀ value of PEGAuNPs-BTZ. Furthermore, for TERT-HPNE, the IC₅₀ value is around 63 times lower for free BTZ than the conjugated nanovehicle. Cell growth inhibition results showed a remarkable enhancement in the effect of BTZ when conjugated with AuNPs.

Conclusions: Our findings showed that conjugation with PEGAuNPs enhance the BTZ growth-inhibition effect on human cancer cells (S2-013 and A549) and decreases its toxicity against normal cells (TERT-HPNE).     

肺癌中耐药相关因子的表达与吸烟的关系

目的 :研究肺癌患者中耐药相关因子表达情况与吸烟习惯的相关性。方法 :运用免疫组织化学方法对71例放化疗前肺癌外科手术标本进行3种耐药相关因子 (Pgp、GSTπ和MT)表达水平检测。结果 :单独表达时 ,各耐药因子表达均与吸烟相关 (P<0 05)。同时观察3者的总体表达时 ,有耐药因子表达 (至少有1种 )和多个耐药因子共同表达 (2种与2种以上 )亦与吸烟相关 (P=0 021 ,P=0 006)。结论 :吸烟导致肺癌中耐药因子表达增加 ,在治疗有吸烟史的肺癌患者时更应重视耐药问题 ,对其进行耐药相关检测 ,有助于选择合理治疗方案 ,提高疗效。     

得力生注射液联合放疗治疗晚期非小细胞肺癌的临床观察

目的观察得力生注射液联合放疗治疗晚期非小细胞肺癌的临床效果。方法60例晚期非小细胞肺癌患者随机分为两组.对照组30例单纯放射治疗;治疗组30例在放疗基础上给予得力生注射液40mL加入5%GS或NS500mL稀释,静脉滴注,1次/d,21d为一疗程,每疗程之间间隔7～14d,治疗结束后4周评价近期疗效。结果对照组总有效率和生活质量改善率分别为40.0%和36.67%,治疗组分别为66.7%和53.33%,两组比较有显著性差异(P<0.05);对照组白细胞减少为36.67%,高于治疗组的13.33%(P<0.05);对照组治疗后CD_3~+、CD_4~+、CD_4~+/CD_(?)~+降低,CD_(?)~+增高,治疗前后对比有非常显著性差异(P<0.01),而治疗组治疗前后无显著性差异.结论得力生联合放疗可显著提高放疗疗效,增强机体免疫功能,改善患者的生存质量,且不增加骨髓抑制。     

回生口服液对晚期非小细胞肺癌患者血清IL-6 和IL-18 的影响

目的检测回生口服液对晚期非小细胞肺癌患者血清IL-6和IL-18水平的影响,探讨其抗肿瘤的可能机制。方法将82例晚期非小细胞肺癌患者随机分为联合化疗组（NP方案化疗＋回生口服液,42例）和单纯化疗组（NP方案,40例）,化疗2个周期后评价其临床疗效,并用酶联免疫法（V．LISA）检测各组治疗前后血清IL-6和IL-18的水平。结果联合化疗组总有效率为38．1％（16／42）,单纯化疗组总有效率35．0％（14／40）,差异无统计学意义（P=0．697）。单纯化疗组治疗前后血清IL-6和IL-18水平无显著性变化（P=0．623）。与治疗前比较,联合化疗组治疗后血清IL-6和IL-18水平明显升高（P=0．005）。结论回生口服液辅助治疗可提高晚期非小细胞肺癌患者的血清IL-6和IL-18水平．增强其免疫力。     

血清标志物联合检测在肺癌诊断中的应用研究（附60例报告）

目的探讨血清中肿瘤标志物胃泌素释放肽前体（Pro-GRP）、水溶性细胞角蛋白19片段（CYFRA21-1）、血管内皮生长因子（VEGF）和癌胚抗原（CEA）在肺癌诊断中的应用。方法健康对照组70例,肺癌组80例,均同时检测Pro-GRP、GYFRA21-1、VEGF和CEA。结果肺癌组Pro-GRP、CYFRA21-1、VEGF、CEA和对照组比较,差异有统计学定义（P〈0.01）。且CYFRA21-1、VEGF、CEA在非小细胞肺癌中的敏感性和诊断准确性较高。结论血清肿瘤标志物能敏感、特异地进行肺癌的诊断,并对肺癌的分型有重要主义。     

An Evaluation of the Evidence that Methamphetamine Abuse Causes Cognitive Decline in Humans

Methamphetamine (MA) is one of the most commonly abused illicit substances worldwide. Among other problems, abuse of the drug has been associated with reduced cognitive function across several domains. However, much of the literature has not attempted to differentiate cognitive difficulties caused by MA abuse from preexisting cognitive difficulties that are likely caused by other factors. Here, we address this question, evaluating evidence for a priori hypotheses pertaining to six lines of research: (a) animal studies; (b) cross-sectional human studies; (c) a twin study; (d) studies of changes in cognition with abstinence from MA; (e) studies of changes in brain structure and function with abstinence from MA; and (f) studies of the relationship between the severity of MA abuse and the extent of cognitive deficits observed. Overall the findings were mixed, with some support for a causal relationship between MA abuse and cognitive decline, and other findings suggesting that there is no relationship. The preponderance of the data, however, does support the possibility that MA abuse causes cognitive decline, of unknown duration, in at least some users of the drug. When averaged across individuals, this decline is likely to be mild in early-to-middle adulthood. However, moderator variables are likely to contribute to the presence and/or severity of cognitive decline exhibited by a given individual.