TEC方案与EC-T序贯化疗方案对乳腺癌患者白细胞计数的影响

目的探讨TEC方案、EC-T序贯化疗方案对机体白细胞计数的影响情况。方法选取2015年3月至2016年1月女性乳腺癌患者100例,依据化疗方案将其分为研究组与对照组,每组50例。研究组实施EC-T序贯化疗方案,对照组行TEC化疗方案。结果研究组总有效率(58.00%)高于对照组(42.00%),差异有统计学意义(P0.05);对照组中位生存期短于研究组,差异有统计学意义(P0.05);两组治疗前白细胞水平比较,差异未见统计学意义(P0.05),治疗1个周期、治疗4个周期、治疗结束研究组白细胞水平下降幅度低于对照组,组间、组内比较差异均有统计学意义(P均0.05))。结论利用EC-T方案可显著提高乳腺癌患者疗效及预后,有利于减少化疗所致白细胞水平下降幅度。     

3种新辅助化疗方案治疗乳腺癌的有效性和安全性比较

目的探讨EC序贯wP方案(EC-wP)、T方案(EC-T)和TEC方案治疗乳腺癌的疗效和安全性。方法 108例Ⅱ～Ⅲ期单侧原发性乳腺癌患者均接受新辅助化疗,根据化疗方案分为EC-T组38例、TEC组36例和EC-wP组34例。比较3组临床疗效、病理完全缓解(pathologic complete remission, pCR)率和不良反应发生率,并比较不同分子分型对临床疗效和pCR的影响。结果 EC-T组、TEC组和EC-wP组临床有效率(81.6%、88.9%、79.4%)和pCR率(10.53%、8.33%、5.89%)比较差异均无统计学意义(P0.05);TEC组患者中性粒细胞减少发生率(38.9%)高于EC-T组(23.7%)和EC-wP组(5.9%)(P0.05),EC-T组高于EC-wP组(P0.05);雌激素受体阴性者临床有效率(91.4%)和pCR率(10.3%)高于阳性者(74.0%、6.0%)(P0.05),孕酮受体阴性者临床有效率(95.1%)和pCR率(11.5%)高于阳性者(68.1%、4.3%)(P0.05),人表皮生长因子受体-2阳性者临床有效率(88.2%)和pCR率(11.8%)高于阴性者(78.9%、5.3%)(P0.05),Ki-6714%者临床有效率(93.3%)和pCR率(15.6%)高于Ki-67≤14%者(76.2%、3.2%)(P0.05)。结论对Ⅱ～Ⅲ期乳腺癌患者的新辅助化疗,EC-T、TEC和EC-wP方案疗效相当,EC-wP方案中性粒细胞减少发生率较低。     

多烯紫杉醇、表阿霉素与环磷酰胺联合化疗与序贯化疗对乳腺癌患者空腹血糖的影响

目的探讨多烯紫杉醇、表阿霉素与环磷酰胺联合化疗与序贯化疗对乳腺癌患者空腹血糖的影响。方法选取乳腺癌患者100例将其分为两组。所选患者均接受化疗,其中50例(观察组)接受序贯化疗,50例(对照组)则接受多烯紫杉醇、表阿霉素与环磷酰胺联合化疗,观察分析两组患者化疗前后空腹血糖水平及其胰岛β细胞功能变化情况。结果观察组患者空腹血糖阳性率低于对照组,差异有统计学意义(P0.05);化疗后,观察组空腹胰岛素水平低于对照组,其胰岛素抵抗稳态模型评价指数(HOME-IR)及胰岛β细胞稳态模型评价指数(HOME-β)水平均低于对照组,差异有统计学意义(P0.05)。结论在乳腺癌患者治疗过程中采用以多烯紫杉醇、表阿霉素及环磷酰胺为主的序贯化疗方案较联合化疗方案可有效减小患者血糖波动,降低治疗过程中患者胰岛β细胞功能受损程度,对于改善患者预后具有十分积极的作用。     

TE方案与TEC方案在乳腺癌新辅助化疗中的疗效比较

探讨在乳腺癌新辅助化疗中采用TE方案与TEC方案的近期疗效及安全性。选取80例于2012年9月~2016年9月我院接收的乳腺癌患者,随机分为对照组(给予TEC方案治疗,n=40)与观察组(给予TE方案治疗,n=40),观察两组临床疗效。两组患者化疗后进行疗效评价发现,两组临床有效率比较基本一致(P>0.05);化疗后,两组患者均出现血小板减少、白细胞低下、胃肠道反应、脱发、肝功能异常等不同程度的毒副作用,两组化疗后在白细胞骨髓抑制方面比较有明显差异(P<0.05),而两组在肝功能损伤、胃肠道反应及脱发、心脏毒性方面比较无明显差异(P>0.05)。乳腺癌患者在新辅助化疗中采用TEC与TE方案疗效相似,其中TE方案较TEC方案骨髓抑制要轻,具有推广价值。     

辅助化疗对非糖尿病乳腺癌患者血糖的影响

目的 探讨全身化疗对非糖尿病乳腺癌患者血糖代谢的影响.方法 2010年1月至2012年3月收治的接受全身化疗的乳腺癌患者（除外四期癌及合并糖尿病患者）共113例,收集每周期化疗前的空腹血糖及相关临床资料,并对其进行回顾性分析.结果 113例患者中,化疗前血糖正常的104例中,化疗后空腹血糖受损为15例,糖尿病为5例,化疗前空腹血糖受损9例中,化疗后空腹血糖受损为2例,糖尿病为4例,差异具有统计学意义（P＜0.05）.化疗前血糖正常患者,高BMI者易发生血糖损害.在104例血糖正常的患者中,接受蒽环或紫杉类药物化疗患者44例,发生血糖异常3例;接受蒽环及紫杉类药物化疗患者60例,发生血糖异常17例,差异有统计学意义（P＜0.05）;接受4周期化疗者共30例,其中血糖异常2例,＞4周期化疗者74例,其中血糖异常18例,差异有统计学意义（P＜0.05）.结论 非糖尿病乳腺癌患者接受化疗后可能会出现空腹血糖受损,甚至发生糖尿病.化疗后血糖异常相关危险因素包括化疗前空腹血糖受损、患者BMI高、既接受蒽环又接受紫杉类化疗及化疗周期数长,对此应予以重视.     

探讨乳腺癌术后接受EC-T方案化疗患者放疗开始时间对无进展生存期（PFS）的影响

目的 探讨乳腺癌术后接受EC-T方案化疗患者放疗开始时间对无进展生存期(PFS)的影响。方法 回顾性分析2014年1月—2019年9月太仓市第一人民医院收治的81例乳腺癌患者的临床资料,全部患者均出现腋窝淋巴结转移。根据手术至放疗间隔时间分为对照组和治疗组。对照组(40例)在EC-T方案化疗后6个月内实施术后辅助放疗,治疗组(41例)在EC-T方案化疗后6～8个月之间实施术后辅助放疗,开展为期2年的随访,比较两组预后情况。结果 两组复发率(12.50%vs 14.63%)、远处转移率(10.00%vs 12.20%)和PFS[(22.62±3.54)个月vs (21.80±3.84)个月]比较,差异无统计学意义(χ²=0.079、0.001,t=0.998,P>0.05)。结论EC-T化疗方案序贯放疗用于乳腺癌手术患者时,手术至放疗间隔时间未超过8个月,不会对患者的PFS产生影响。     

化疗药物对头颈部鳞癌患者血糖代谢的影响

目的:探讨化疗药物对头颈部鳞癌患者血糖代谢的影响。方法:收集2000年1月~2005年12月收治的320例放化综合治疗及282例单纯放疗的头颈部鳞癌患者的血糖检验报告及相关临床资料,并对其进行回顾性分析。结果:320例放化综合治疗患者中,化疗前合并糖尿病6例,其余化疗前血糖水平正常。化疗后空腹血糖升高42例,占13.12%。42例中明确诊断为糖尿病11例,糖耐量减低14例,一过性血糖升高18例,分别占同期接受化疗的患者的3.43%、4.37%和5.62%。其中,接受以紫杉醇类药物为主的化疗患者123例,发生血糖异常24例,占同类化疗19.51%(24/123),占同期化疗7.50%(24/320);接受以铂类药物为主的化疗患者197例,发生血糖异常18例,占同类化疗9.13%(18/197),占同期化疗5.60%(18/320)。以紫杉醇类为主化疗与以铂类为主化疗引起的血糖异常的发生率相比较,差异有显著性(P<0.05)。而接受单纯放疗的282例患者中放疗前有12例糖尿病患者,放疗后没有新增病例。结论:头颈部恶性肿瘤患者接受化疗后可能会出现血糖异常,甚至发生糖耐量低减或糖尿病,以紫杉醇类为主的化疗方案治疗中这种情况更加常见。     

局部晚期乳腺癌新辅助化疗FEC与TEC方案近期疗效观察

目的比较表阿霉素联合氟尿嘧啶和环磷酰胺(FEC)、多西他赛联合表阿霉素及环磷酰胺(TEC)两种不同新辅助化疗方案治疗局部晚期乳腺癌的近期疗效。方法用FEC、TEC化疗方案治疗Ⅱ、Ⅲ期乳腺癌共122例,FEC 62例,TEC 60例,3周为1个周期。除因疾病进展而更换方案的患者外,均行6个疗程的化疗,每2个疗程评估疗效。结果 FEC组的总有效率为77.4%(48/62),其中完全缓解(CR)6例,部分缓解(PR)42例;TEC组的总有效率为93.3%(56/60),其中CR16例,PR40例。FEC组病理完全缓解率3.2%(2/62),TEC组病理完全缓解率16.7%(10/60)。结论两种新辅助化疗方案对乳腺癌治疗均有效,TEC方案疗效高于FEC方案。     

TP与EC-T新辅助化疗方案治疗三阴性乳腺癌的pCR率及不良反应比较

目的比较TP(紫杉醇+卡铂)与EC-T(表柔比星+环磷酰胺序贯紫杉醇)新辅助化疗(NAC)方案治疗三阴性乳腺癌(TNBC)的病理学完全缓解(pCR)率及临床不良反应。方法回顾性分析我院收治的126例TNBC患者的临床资料,应用TP方案的患者为观察组(n=65),应用EC-T方案的患者为对照组(n=61)。观察组与对照组均行8周期化疗,术后评估pCR率及临床不良反应发生情况。结果观察组的pCR率为33.85%,高于对照组的16.39%(P<0.05)。两组患者的各项不良反应发生率比较,差异均无统计学意义(P>0.05)。结论TNBC患者术前NAC应用TP方案治疗,pCR率明显优于EC-T方案,不良反应发生率无明显增加,值得临床应用。     

化疗诱发糖尿病32例临床分析

在恶性肿瘤的化疗中我们发现随着治疗周期的延长有越来越多的患者出现空腹血糖增高，其中部分病人诊断为糖尿病。为进一步探讨化疗药物能否诱发糖尿病，我们对我科近2年收治的735例恶性肿瘤患者化疗后血糖水平及相关资料进行分析，现报道如下。     

Interaction of peptidoglycans with anti-IgGs and with complement.

This report describes the interaction of peptidoglycan (Streptococcus group A, Staphylococcus epidermidis and Micrococcus lysodeikticus) with 2 serum mediator systems, namely with the anti-IgG system and with complement. The observation that the majority of rabbits hyperimmunized with A-variant streptococcal vaccine produced anti-group carbohydrate antisera containing anti-IgGs and antibodies directed to peptidoglycan suggested that the production of these 2 latter antibodies was related. This view was supported by the finding of a monoclonal 7S anti-IgG with antibody specificity for the pentapeptide of peptidoglycan as evidenced by inhibition of the coprecipitation of 7S anti-IgG with antigen-antibody complexes by the pentapeptide. Inhibition of the anti-idiotype reaction by the pentapeptide provided further evidence for the antibody specificity of 7S anti-IgG for peptidoglycan. When added to normal human sera all peptidoglycan preparations inhibited the hemolytic activity of the sera. Consumption of C3 in C2 deficient serum and consumption of C2 in normal serum indicated the activation of both known complement pathways. Activation of the classical pathway of complement was more efficient since 50 mug of peptidoglycan consumed approximately 70% of C2 per ml normal serum whereas more than 2 mg of the same preparations was required to inactivate 17-24% of C3 in C2 deficient sera. Each of the different peptidoglycan preparations consumed similar amounts of complement in all 20 sera tested. This finding suggested that activation of the classical complement pathway by peptidoglycan was not mediated by anti-peptidoglycan antibodies present in only 20-40% of normal human sera.     

The comparison of effects of rapid opiate detoxification with ketamine complex and with tramadol and naltrexone under general anesthesia with propofol

Objective To release the heroin addicts‘ sufferings,we made rapid opiate detoxification by injecting naloxine under the general anesthesia.Method 160 volunteers were divided at randon into two groups:Group A were performed under the combined anesthesia with propofol,midazolam and kelamine.Group B were performed under the combined anesthesia with propofol with midazolam and tramadol.The vital signs were recorded and the withdrawal syndrome of the volunteers were assessed during the whole process.Result All of the withdrawal symptoms scores 24 hours after ROD in group B were lower than its pre-treatment;The symptoms of the thirs,tsleeping disturbance,nausea and vomiting,skeletal muscular pains and anorexia scores in group A were also lower than its pre-treatment;and no too much differeence belween group A and group B.But tearing,anxiety and diarrhea scores in group A were almost the same as the pre-treatment and higher than group B.Both groups received of the naloxone treatment smoothly,and remained in the hospital for about 3 days.Conclusion The effect of rapid opiate detoxification of naltrexone with the ketamine or tramadol under anesthesia is obvious.The tramadol is better than others.     

替吉奥联合亚叶酸钙及奥沙利铂治疗晚期结直肠癌病人的观察与护理

[目的]总结替吉奥联合亚叶酸钙及奥沙利铂治疗晚期结直肠癌病人的观察与护理。[方法]对25例无法手术切除的晚期结直肠癌病人采用替吉奥胶囊联合亚叶酸钙、奥沙利铂方案进行治疗,同时加强心理护理、毒副反应的观察与护理等。[结果]治疗过程中出现Ⅰ级和Ⅱ级神经毒性8例,恶心、呕吐、食欲下降12例,骨髓抑制5例,变态反应1例,经处理后均好转;1例病人死亡,其余病人均顺利进行治疗。[结论]加强替吉奥联合亚叶酸钙及奥沙利铂治疗晚期结直肠癌病人的护理,可保证治疗的顺利进行。     

异病酚静脉全麻下复合氯胺酮或曲马多行纳屈酮快速阿片脱毒的效果比较

Toreleasetheseverewithdrawalsymptomsoftheheroinad-dicts,weinjecttheNaloxineinthegeneralanesthesia.160volun-teersreceivedRODwereperformedunderthecombinedanesthesiawithpropofol,midazolamandketamine.1Subjectsandmethods1.1Subjects160volunteerswhoaccordingwiththediagnosticstandardoftheICD-10abouttheopiate-addiction,male:145,fe-male15.Age:(30±6),theeldestwas45yearsold.Themeanbodyweightwasabout(58±8)kg.Educationalbackground:pri-maryschool118cases,juniorhighschool:24casesandseniorhighschool/seco…     

缩腺液治疗扁桃体炎的疗效观察及其护理

扁桃体炎是儿童常见病、多发病,传统药物治疗可暂缓症状,但不能根治;手术治疗痛苦大、出血多、费用高,常合并有并发症。我科运用缩腺液治疗扁桃体炎3 0例收到了良好的效果。现报告如下。1　对象与方法1.1　对象　本科于2 0 0 2年—2 0 0 3年共收治扁桃体炎病人5 0例,年龄为7岁～2 0岁,分两组进行。缩腺液治疗组3 0例,男13例,女17例;其中重度12例,中度9例,轻度9例;对照组2 0例,男9例,女11例;其中重度8例,中度7例,轻度5例。两组病人年龄、性别、病情严重程度基本一致,差异无统计学意义(P >0 .0 5 )。1.2　方法　对照组采用药物治疗,静脉输注…     

艾滋病合并结核病及马尔尼菲青霉病患者的护理

目的 通过分析艾滋病合并结核病及马尔尼菲青霉病患者的临床资料,提高对三病并存的护理认识.方法 分析并总结26例艾滋病合并结核病及马尔尼菲青霉病住院患者的临床特点、治疗及护理方法.结果 本组患者治愈5例,好转13例,死亡8例.存活患者随访6～30个月均未复发.结论 三病并存时临床表现复杂,无特异性,护理难度大,应仔细观察病情,及早诊治,精心护理,对改善预后有重要意义.     

艾滋病合并结核病及马尔尼菲青霉病患者的护理

目的通过分析艾滋病合并结核病及马尔尼菲青霉病患者的临床资料,提高对三病并存的护理认识。方法分析并总结26例艾滋病合并结核病及马尔尼菲青霉病住院患者的临床特点、治疗及护理方法。结果本组患者治愈5例,好转13例,死亡8例。存活患者随访6～30个月均未复发。结论三病并存时临床表现复杂,无特异性,护理难度大,应仔细观察病情,及早诊治,精心护理,对改善预后有重要意义。     

Comparison of platelet immunity in patients with SLE and with ITP

Idiopathic thrombocytopenic purpura (ITP) is characterized by the development of a specific anti-platelet autoantibody immune response mediating the development of thrombocytopenia. Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by the production of a wide variety of autoantibodies. In 15-20% of SLE cases, patients develop thrombocytopenia which appears to be autoimmune in nature (SLE-TP). To better understand the pathogenesis of the thrombocytopenia associated with SLE, we investigated the overlapping platelet and cellular immune features between SLE and ITP. Thirty-one patients with SLE, eight with SLE-TP, and 17 with ITP, were studied and compared to 60 healthy controls. We evaluated platelet-associated IgG, platelet microparticles, reticulated platelets, platelet HLA-DR expression, in vivo cytokine levels, lymphocyte proliferation, and the T lymphocyte anti-platelet immune response in these patients. Patients with SLE-TP and those with ITP had increased platelet-associated IgG, an increased percentage of platelet microparticles, a higher percentage of reticulated platelets and larger platelets, suggesting antibody-mediated platelet destruction and increased platelet production. More than 50% of patients with ITP had increased HLA-DR on their platelet surface whereas subjects with SLE-TP did not. Analysis of serum cytokines demonstrated increased levels of IL-10, IL-15 and TNF-alpha in patients with SLE, but in those with ITP, only increased levels of IL-15 were seen, no increases in any of these cytokines were observed in patients with in SLE-TP. The ability of lymphocytes to proliferate in response to phorbol myristate acetate (PMA) stimulation was increased in SLE-TP, but was normal in both SLE and ITP. Lymphocytes from subjects with ITP displayed an increased ability to proliferate on exposure to platelets, in contrast, those with SLE-TP did not. While the number of subjects evaluated with SLE-TP was small, these data reveal a number of differences in the immunopathogenesis between SLE-TP and ITP.     

肿瘤血液透析患者的心理分析及护理

目的评价为肿瘤血液透析患者实施心理护理的效果。方法肿瘤血液透析患者38例实施自身对照,观察心理护理前后其心理状态的变化。结果经过心理护理,患者心态变得平稳,依从性增强,能更好地配合治疗。结论有针对性的心理护理能帮助患者以积极的心态面对困难,增强战胜疾病的信心,更好地配合治疗,并有助于血液透析治疗的顺利进行。