吃主食护大肠

英国剑桥大学最近在一项研究中,分析了10多个国家的人的饮食习惯和癌症之间的关系,结果发现,食用淀粉类食物越多,小肠、结肠和直肠癌的发病率越低.比如,以肉类食物为主食的澳大利亚人,结肠癌发病率是以淀粉类食物为主食的中国人的4倍.     

凉菜拌出夏日风情

不知不觉又进入了夏季,南方的潮湿,北方的燥热,常常使人食欲不振,精神委靡,尤其是对于康复期的病友来说,怎一个"热"字了得.夏季的饮食调养,应选择清凉爽口、少油腻、易消化的食物.这时从配角一跃成为主角的凉菜就闪亮登场了,不论生拌、热炝,每道菜都做足了开胃功夫,它们少油,少盐,对我们的健康大有裨益;省时省力,让我们减轻在厨房的劳动强度.只要掌握烹饪技巧,制作起来还是很简单的.     

过敏体质,怎么吃?

什么是过敏呢?过敏反应又称作变态反应,是患者身体对一种或多种物质的过强反应.其主要机制是由于过敏性素质患者的体内产生了过多的过敏抗体——免疫球蛋白E,它和环境中的过敏原相互作用,刺激机体产生和释放某些过敏介质,导致不同组织的损伤,继而产生各种症状.     

文艺汇演群星璀璨

2006年1月8日,中国抗癌协会癌症康复会在"北京展览馆剧场"圆满成功地举办了"阿斯利康首届全国癌症康复者文艺汇演--生命恋歌".这次文艺汇演有26个省、市上报节目50多个,经筹备组认真筛选,选出正式参加演出的节目16个,特邀节目3个,出演的癌症患者近300人.     

钻石之光--山药

"每个人都能在自家的后院找到钻石",有人借用此言,把山药比做养生的钻石. 山药是一种薯科植物,它的根茎垂直而颀长,往往盈尺,生长在坚硬的山冈的土质中,旋转攀缘.阳光下,山药的叶子很美,颜色从浓到浅,绿得缤纷,但被我们称之为钻石的是它营养丰富的块状根茎.山药的外观看上去粗糙,细小密布的根须如刺如须,但削了皮,却洁白得如水生荸荠,分泌一些透明的黏液,柔滑得抓它不住,仿佛泥鳅从手中挣脱.     

苦参碱对HepG2细胞杀伤作用及机制研究

Objective:To investigate the death mode of human hepatoma cells exposed to matrine and the role of glutathione (GSH) and cytochrome c.Methods:The MTT test and Cell Death Detection ELISA were used to identify cell death mode and viability of cells exposed to matrine.The volume of intracellular GSH was detected by GSH reductase.Finally Western blotting was chosen to analyze the expression of cytochrome c and Caspase-9 in HepG2 cells treated by matrine.Results:The apoptotic cell death induced by matrine in Hep G2 cells dramatically increased in the time-,dose-dependent manner.Matrine can exhaust intracellular GSH effectively to change the redox state in cells.Furthermore it affect the cytotoxicity of matrine.Results of Western blotting showed that matrine induced the release of cytochrome c from mitochondria to cytoplasm,and then stimulate the cleavage of Cespese-9 in a time-dependent manner.Conclusion:Matrine induced apoptosis in Hep G2 cells through the mitochondrial pathway,and oxidative stress via depletion of GSH is directly involved in the apoptotic process.     

Benefit of adjuvant chemoradiotherapy in patients with pathologically lymph node-positive and locally advanced gastric cancer

Objective This study aimed to compare the effectiveness of adjuvant chemoradiotherapy(CRT)and adjuvant chemotherapy(ChT)for T3–4/N+gastric cancer(GC)following D2/R0 dissection,and identify the specific subgroups that could benefit from adjuvant CRT.Methods All eligible patients were divided into the CRT group and ChT group.We assessed the survival outcomes and patterns of recurrence for each group,and determined the prognostic factors for survival by performing Cox proportional risk regression analyses.Results A total of 192 gastric cancer patients were included in the study.The estimated 3-year and 5-year disease-free survival(DFS)probabilities in the CRT and ChT groups were 52.9%vs.36.7%(P=0.024)and 41.2%vs.31.1%(P=0.148),respectively,and the estimated 3-year and 5-year overall survival(OS)probabilities were 82.4%vs.70.0%(P=0.044)and 52.0%vs.35.6%(P=0.022).Patients in the CRT group had a lower risk of locoregional recurrence than those in the ChT group(20.6%vs.34.4%;P=0.031).The subset analyses revealed that patients with stage N1–2 disease were more likely to benefit from adjuvant CRT than from adjuvant ChT(DFS:53.1%vs.36.4%;P=0.039;OS:53.1%vs.38.6%;P=0.036).Conclusion For locally advanced gastric cancer patients with LN+,adjuvant CRT showed superior survival benefits compared with adjuvant ChT alone.Patients with N1–2 achieved better survival from adjuvant CRT.     

肺癌放疗新技术

肺癌是危害人类生命的最主要的癌肿,是名副其实的"癌王",特别是在发达国家更是如此.简单地说美国男性死于恶性肿瘤患者中约每3人中有1例是肺癌,女性中每4人中有1人是肺癌.中国随着城市化进度的加快和吸烟人群的增多,肺癌患者会越来越多.笔者在美国最著名的癌症医院--德州安德森肿瘤中心做客座教授期间接触了来自世界各地的放疗科医生,他们都在努力研究如何延长肺癌患者的生存期,提高生存质量.下面介绍一下这方面的最新技术.     

熏烤煎炸不安全

据说人类发现用火是由于森林起火烧焦了动物而引起的,从那时起,便尝到了烧烤味道的鲜美.时至今日,熏烤煎炸食品气味香,味道美,仍不免会令人垂涎三尺,颇受嘴馋的人或一些儿童、少女青睐,从而造就许多中国人有喜食这类食品的习惯.这类食品如在聚餐酒桌上品尝助兴,少量吃点在所难免,如果大量贪食则可能会对健康不利.化学家在研究癌症病因时,发现一种很强的致癌物质苯并芘,它属于多环芳烃类化合物,与熏烤煎炸食物有关,并引起人们的关注.     

造血干细胞移植治疗外周T 细胞淋巴瘤的进展

外周T 细胞淋巴瘤（PTCL）,其免疫表型提示来源于胸腺后（或成熟）T 细胞,包括大组非特异性PTCL。在全球范围内,PTCL约占非霍奇金淋巴瘤（NHL ）的10％,在我国约占20% ～30% ,明显高于西方国家。大多数PTCL侵袭性强,恶性程度高,传统的化疗方法与B 细胞NHL 相比疗效不佳、预后不良,５年生存率低。近年来研究表明造血干细胞移植（HSCT）对PTCL有较好的疗效,优于传统的化疗方法。本文主要总结自体造血干细胞移植（ASCT）、异基因造血干细胞移植（allo-SCT ）和自体外周血干细胞移植联合自体骨髓移植（APBHSCT+ABMT）三种方式及其优劣。ASCT无供受者之间的免疫排斥反应,造血重建快,但其复发率相对较高;allo-SCT 具有移植物抗淋巴瘤作用,但其有较高的治疗相关死亡率;APBHSCT+ABMT对于年龄偏大、造血功能差而难以采集足够外周血干细胞、有潜在出血和感染风险较大PTCL患者意义较大。HSCT的移植方法、移植时机、预处理方案及强度等多种因素对移植疗效均有影响,如何根据不同PTCL患者的具体情况选择不同的移植方式、选择合适的移植时机等问题还值得进一步深入的研究。      

外周T细胞淋巴瘤的治疗新策略

 外周T细胞淋巴瘤（peripheral T-cell lymphoma,PTCL）是亚洲国家发病率较高的非霍奇金淋巴瘤。T细胞淋巴瘤各亚型具有明显的异质性,疗效和预后截然不同。目前尚没有标准的治疗方案。传统的治疗多采用CHOP或CHOP样方案,但疗效欠佳。第二、三代剂量强度方案（m-BACOD、ProMACE-CytaBOM及 MACOP-B方案）与CHOP方案比较,并未显示出生存优势。新的治疗研究包括细胞毒性药物吉西他滨,无论是作为一线治疗还是针对复发和难治的PTCL患者都显示出了良好的疗效,有望成为治疗PTCL患者的新策略。阿仑单抗在PTCL的治疗中取得良好的效果。Zanolimumab单抗在复发和难治PTCL II期临床试验中疗效突出。地尼白介素、新型抗叶酸药Pralatrexate、蛋白酶体抑制剂硼替佐米及抗血管生成药物贝伐单抗在Ⅱ、Ⅲ期临床试验中显示了颇有前景的疗效。自体干细胞移植可作为具有高危因素的PTCL患者缓解后的巩固治疗。     

维布妥昔单抗治疗CD30阳性外周T细胞淋巴瘤的研究进展

维布妥昔单抗（brentuximab vedotin,BV）是一种新型的靶向抗体-药物偶联物（antibody-drug conjugate,ADC）,最早被美国食品药品监督管理局（FDA）批准用于复发难治性霍奇金淋巴瘤（Hodgkin's lymphoma,HL）和系统性间变大细胞淋巴瘤（systemic anaplastic large cell lymphoma ,sALCL）的治疗,2018年11月美国FDA批准BV 联合化疗方案用于初治的CD30+外周T细胞淋巴瘤（peripheral T-cell lymphoma,PTCL）患者。PTCL是一类具有异质性、侵袭性强及恶性程度高和疗效差特点的淋巴系统肿瘤。CD30在PTCL亚型中有不同的表达,检测CD30可以为诊断和治疗决策提供指导。BV在新诊断和复发难治性PTCL患者中均表现出显著的抗肿瘤活性,在sALCL患者中的疗效显著并且持续。BV临床应用的总体耐受良好,临床主要的不良反应是周围神经病变。本文旨在综述BV治疗PTCL的有效性和安全性。      

Should Eligible Patients with T-Cell Lymphoma Receive High-Dose Therapy and Autologous Stem Cell Transplant in the Upfront Setting?

Peripheral T-cell lymphomas (PTCL) are rare and aggressive subtypes of non-Hodgkin’s lymphoma. Compared to B cell lymphomas, the immunologic phenotype of PTCL portends a poorer prognosis, with the exception of anaplastic large cell lymphoma bearing the anaplastic lymphoma kinase protein. Patients with PTCL tend to present clinically in advanced disease states, show lower response rates to chemotherapy, and suffer from more frequent relapses and shorter remissions. The rarity of these lymphomas has made it difficult to carry out prospective, randomized trials delineating optimal treatments. Conventional and intensified chemotherapy have led to reasonable responses, but in many studies, frequent relapses. Consequently, high-dose chemotherapy and autologous stem cell transplantation (ASCT) have been actively studied in both the relapsed and upfront setting. In addition, the impact of disease status at transplantation is being investigated, though the optimal disease state at transplant is still a matter of debate, as is the timing of transplant. This article seeks to review the literature on the role of ASCT in PTCL, as well as to clarify what may be the optimal disease state in which to offer patients with PTCL autologous transplantation, if at all.     

外周T细胞淋巴瘤研究进展:第57届美国血液学会年会报道

外周T细胞淋巴瘤(PTCL)约占所有非霍奇金淋巴瘤(NHL)的10%~15%,呈高度异质性且侵袭性强,容易出现耐药和疾病进展,目前尚无标准的治疗方案.第57届美国血液学会年会关于PTCL的报告涵盖了基础和临床多个方面.基础研究方面,新型ALK伙伴基因的发现进一步完善了ALK阳性间变性大细胞淋巴瘤(ALK+ALCL)的发病机制.预后指标方面,免疫组织化学检测GATA3表达等为PTCL的预后监测提供了新的指标.治疗方面,belinostat联合CHOP、brentuximab vedotin联合CHP、罗米地辛联合ICE等新方案及移植的合理使用为PTCL患者的治疗提供了新方向,以alisertib、darinaparsin及denileukin diftitox等为代表的新型药物开展了初期临床试验,为PTCL的治疗提供了新希望.     

Stem cell transplantation for peripheral T-cell lymphomas

Peripheral T-cell lymphomas (PTCL) consist of many subtypes with variable clinical presentation. Long-term prognosis of most subtypes is unfavorable and novel therapeutic approaches are needed. This review attempts to summarize what is known on the feasibility and efficacy of high-dose therapy supported by stem cell transplantation (SCT) in PTCL. In patients with relapsed or refractory PTCL, the outcome of autologous SCT (ASCT) seems to be comparable to that of patients with aggressive B-cell lymphomas. Although excellent treatment results have been encountered with ASCT in patients with anaplastic large cell lymphoma (ALCL), the superiority of this approach over chemotherapy alone needs confirmation in randomized studies. In less favorable subtypes (e.g. alk-negative ALCL, PTCL not otherwise specified, enteropathy-associated T-cell lymphoma, and angioimmunoblastic T-cell lymphoma) high-dose consolidation of the first remission should be studied in prospective trials. Minimal experience is currently available on allogeneic SCT in patients with PTCL. Given the high relapse rate after ASCT in high-risk patients and potential for graft-vs.-lymphoma effect, also this approach should be studied. Due to rarity of PTCL, international collaboration is mandatory in order to study the various aspects of SCT in this patient population.     

The role of high dose chemotherapy and autologous stem-cell transplantation in peripheral T-cell lymphoma: A review of the literature and new perspectives

Peripheral T-cell lymphoma (PTCL) is a heterogeneous group of non-Hodgkin’s lymphoma that carries, except for ALK-positive anaplastic large cell lymphoma, a poor prognosis. Only a third of patients live 5 years past diagnosis. The incidence of PTCL has been increasing during the last two decades. In recent years, there was a rising interest in PTCL manifested by the abundance of publications dedicated exclusively to this disease. The international T-cell lymphoma project was formed with an aim of unifying efforts towards a better understanding of the diagnosis and management of this disease. Given the poor outcomes of PTCL patients, high-dose chemotherapy and autologous stem-cell transplantation (HDT/ASCT) have been used in the up-front and salvage settings, with different success rates. However, there are no prospective randomized controlled trials addressing the role of HDT/ASCT in a PTCL-restricted population. This article critically reviews the data available from the retrospective and prospective studies addressing this topic. We will emphasize the favorable prognostic factors of HDT/ASCT such as a solid remission at the time of transplantation, a chemotherapy sensitive disease and a low prognostic index score. As novel agents and new therapeutic strategies are introduced, there is a continued need for prospective randomized trials to define the optimal use of HDT/ASCT in managing PTCL.     

外周T细胞淋巴瘤治疗进展:第56届美国血液学会年会报道

外周T细胞淋巴瘤(PTCL)是一组高度异质性的侵袭性非霍奇金淋巴瘤,在目前的治疗框架下大部分患者预后较差.第56届美国血液学会年会关于PTCL治疗的研究报告涵盖多个领域,其中针对PTCL患者高效低毒新型治疗策略的探索成为会议的一大热点.THP-COP方案、罗米地辛单用或联合其他药物、硼替佐米联合帕比司他、brentuximab vedotin及移植等新方案的组合和合理使用为PTCL治疗提供了新方向,同时以Duvelisib(IPI-145)、克唑替尼和抗程序性细胞死亡-1(PD-1)抗体等为代表的新型药物出现也为PTCL的治疗提供了新的希望.     

Impact of high-dose chemotherapy on peripheral T-cell lymphomas.

PURPOSE: To evaluate the outcome of high-dose chemotherapy (HDCT) and autologous or allogeneic hematopoietic transplantation in patients with peripheral T-cell lymphoma (PTCL) who experienced disease recurrence after prior conventional chemotherapy. PATIENTS AND METHODS: We performed a retrospective analysis of 36 PTCL patients from the University of Texas M.D. Anderson Cancer Center treated between 1989 and 1998 with HDCT and autologous or allogeneic hematopoietic transplantation. RESULTS: A total of 36 patients were studied (29 received autologous transplantation, and seven received allogeneic transplantation). The overall survival rate at 3 years was 36% (95% confidence interval [CI], 23% to 59%), and the progression-free survival (PFS) rate was 28% (95% CI, 16% to 49%). The pretransplant serum lactate dehydrogenase level was the most important prognostic factor for both survival and PFS rates (P < .001). A Pretransplant International Prognostic Index score of < or = 1 indicated a superior survival rate (P = .036) but not an improved PFS rate. A median follow-up of 43 months (range, 13 to 126 months) showed 13 patients (36%) were still alive with no evidence of disease. CONCLUSION: Our results are comparable to the published data on HDCT in B-cell non-Hodgkin's lymphoma (NHL) patients despite the fact that patients with PTCL are known to have a worse outcome compared with B-cell NHL patients. Considering the dismal outcome of conventional chemotherapy in PTCL patients, these data suggest the hypothesis that the poor prognostic implication of T-cell phenotyping in NHL might be overcome by frontline HDCT and transplantation.     

Direct comparisons of peripheral T-cell lymphoma with diffuse B-cell lymphoma of comparable histological grades--should peripheral T-cell lymphoma be considered separately?

Peripheral T-cell lymphoma (PTCL) forms a morphologically heterogeneous group of non-Hodgkin's lymphomas (NHL) with distinct immunophenotypes of mature T cells. Progress has been slow in defining specific clinicopathological entities to this particular group of NHL. In order to elucidate the specific characteristics of PTCL, a direct comparison of PTCL with a group of diffuse B-cell lymphomas (DBCL) was performed. Between June 1983 and December 1987, we studied 114 adults with NHL, using a battery of immunophenotyping markers. Adult T-cell leukemia/lymphoma, lymphoblastic lymphoma, mycosis fungoides/Sézary syndrome, follicular lymphoma, well-differentiated lymphocytic lymphoma, and true histiocytic lymphoma were excluded from this study since these are distinct clinicopathologic entities with well-recognized immunophenotypes. Of the remaining 75 patients, 70 who had adequate clinical information were analyzed, and of these, 34 were PTCL and 36 were DBCL. Classified according to the National Cancer Institute (NCI) Working Formulation (WF), 68% of PTCL and 31% of DBCL were high-grade lymphomas. Clinical and laboratory features were similar, except PTCL had a characteristic skin involvement and tended to present in more advanced stages with more constitutional symptoms. Induction chemotherapy was homogeneous in both groups, and complete remission rates were 62% for PTCL and 67% for DBCL. Patients with DBCL had a better overall survival than patients with PTCL, but the survival benefit disappeared after patients were stratified according to intermediate- or high-grade lymphoma. A subgroup of PTCL patients who had received less intensive induction chemotherapy was found to have a very unfavorable outcome. We conclude that (1) PTCL follows the general grading concept proposed in WF classification; (2) within a given intermediate or high grade, PTCL and DBCL respond comparably to treatment; (3) the intensity of induction chemotherapy has a crucial impact on the outcome of PTCL patients; and (4) with a few exceptions, the clinical and laboratory features of PTCL and DBCL are comparable.