中晚期宫颈癌三维适形与调强放射治疗的临床研究

目的评价三维适形（3DCRT）与调强放射治疗（IMRT）在中晚期宫颈癌治疗中的临床疗效及放疗副反应。方法将2011年12月至2012年7月新疆医科大学附属肿瘤医院收治的105例Ⅱb-Ⅳa期宫颈癌患者,随机分为IMRT组及三维适形放射治疗组,同步给予铂类为主化疗及后装放疗,观察两种治疗方法近期疗效和毒副反应。结果两组治疗近期疗效相当（P〉0.05）1年生存率（OS）、无局部复发生存率（LRFS）和无远处转移生存率（DMFS）的差异无统计学意义（P〉0.05）;IMRT组肿瘤靶区平均剂量和3DCRT组无显著差异（P〉0.05）危及器官如直肠、膀胱、小肠、乙状结肠、股骨头、双肾及脊髓等受照射剂量及体积均低于3DCRT组（P〈0.01）;IMRT组急慢性放射性直结肠炎及放射性膀胱炎发病率均低于3DCRT组（P〈0.05）;IMRT组骨髓抑制发生率略低于3DCRT组,但差异无统计学意义（P〉0.05）。结论 IMRT与3DCRT治疗宫颈癌近期疗效相同,但IMRT能更好地保护正常器官,有效降低放射损伤。     

食管癌全程三维适形放射治疗疗效观察

目的研究三维适形放射治疗（3D-CRT）食管癌的近期疗效和治疗反应。方法选择85例食管癌患者,其中男性55例,女性30例;年龄40～87岁,平均年龄64.64岁。分为3D-CRT组和常规放射治疗组。3D-CRT组：40例;常规放射治疗组：45例。放射治疗总剂量均为60～66Gy,常规分割,每次2Gy,5次/周,6～7周完成。结果 3D-CRT组和常规放射治疗组总有效率（CR＋PR）分别为97.50%、82.20%,差异有统计学意义（P〈0.05）。3D-CRT组和常规放射治疗组的1、2、3年局部控制率分别为72.6%、56.8%、48.4%和60.9%、36.3%、28.6%,差异有统计学意义（P〈0.05）。3D-CRT组和常规放射治疗组的1、2、3年生存率分别为68.5%、49.5%、38.0%和51.8%、32.3%、16.4%,差异有统计学意义（P〈0.05）。两组急性放射性气管炎、放射性食管炎差异均无统计学意义（P〉0.05）。结论 3D-CRT食管癌能提高局部控制率和生存率,近期反应和远期反应均可耐受。     

TACE联合三维适形放疗治疗晚期肝癌临床疗效及对患者近远期生存的影响

目的:探讨肝动脉化疗栓塞术(Transcatheter arterial chemoembolization,TACE)联合三维适形放疗(Three-dimensional conformal radiotherapy,3-DCRT)治疗晚期肝癌(Hepatocellular carcinoma,HCC)临床疗效及对患者近远期生存的影响.方法:回顾性分析我院2016年2月～2019年2月接收到的92例HCC晚期患者作为研究对象,将其分为对照组43例(TACE)和观察组49例(TACE+3-DCRT),对比分析两组治疗后的临床疗效、近远期生存率;治疗前后AFU、AFP、ALT、TBil含量变化;治疗期间发生毒副反应的情况.结果:治疗后1个月,观察组ORR为75.51％,明显高于对照组(P<0.05).治疗后1个月,两组AFU、AFP水平明显降低,ALT、TBil水平明显升高(P<0.05),且观察组各指标明显低于对照组(P<0.05).两组患者治疗期间出现毒副反应差异无统计学意义(P>0.05).观察组半年、一年、一年半、两年生存率均高于对照组(P<0.05).结论:TACE联合3-DCRT治疗不仅能控制肿瘤增长率,降低对肝功能的影响,还具有一定的安全性,延长生存期.     

中国胃癌患者时辰化疗疗效及安全性的Meta分析

目的:总结目前国内已有的胃癌时辰化疗的临床研究,探讨时辰化疗对于中国胃癌患者的疗效及安全性。方法:在PubMed、Cochrane Library、CNKI、维普、中国生物医学文献数据库、万方数据库中检索已公开发表的胃癌患者时辰化疗的随机对照试验(randomized controlled trials,RCTs),提取符合标准文献中的相关临床效应指标后进行Meta分析。结果:经筛选共纳入6篇研究,Meta分析显示:对于国内胃癌人群,时辰化疗能有效提高治疗效果,同时使部分常见毒副反应发生率显著降低(P0.05)。结论:时辰化疗可以有效提高国内胃癌患者近期治疗效果,同时还能减轻多种常规化疗所致重度毒副反应,是值得进一步研究的治疗方法。     

食管癌放疗技术的研究进展

目的：探讨食管癌放射治疗的最新进展及目前存在的问题。方法：广泛查阅近五年来有关食管癌放射治疗最新进展方面的文章,并进行分析和总结。结果：食管癌常规放疗因存在肿瘤放疗剂量与周围器官组织损伤的矛盾,其疗效一直不能令人满意。三维适形放射治疗（3D—CRT）、调强放疗（IM—RT）和影像引导放疗（IGRT）具有精确定位、精确计划、精确治疗的优点,可解决两者之间的矛盾,提高食管癌患者的肿瘤局部控制率和远期生存率。结论：3D—CRT、IMRT和IGRT在食管癌的放射治疗中具有广阔的临床应用前景。     

三维适形放疗在食管癌患者中的应用价值分析

目的三维适形放疗在食管癌患者中的应用价值分析。方法选择我院2017年1月至2018年11月收治的80例食管癌患者作为研究对象,按照随机法将其分为观察组和对照组,每组各40例。对照组患者采用常规放疗方法进行治疗,观察组患者采用3D-CRT方法进行治疗。比较两组患者治疗后的临床疗效和毒副反应发生情况。结果观察组患者的临床总有效率为70.00%,对照组患者的临床总有效率为52.50%,两组患者临床总有效率比较,差异无统计学意义(P0.05);观察组患者的放射性食管炎Ⅱ级、放射性肺炎Ⅱ级、白细胞减少Ⅱ级等毒副反应合计发生率为15.00%,明显低于对照组45.00%(P0.05)。结论三维适形放疗方案治疗食管癌患者剂量把控更准确,能有效减低患者的毒副反应。     

恩度联合周剂量多西紫杉醇治疗老年性非小细胞肺癌的临床观察

目的观察恩度（重组人血管内皮抑制素）联合周剂量多西紫杉醇治疗70岁以上老年非小细胞肺癌的近期临床疗效及毒副反应。方法试验组恩度＋周剂量多西紫杉醇和对照组单用多西紫杉醇周剂量方案治疗老年性非小细胞肺癌60例,2～4周期,按照RECIST标准和NCI—CTC标准分别评价两组的疗效和毒副反应。结果试验组有效率66．6％,疾病控制率86．6％;对照组有效率36．6％,疾病控制率56．6％,近期毒副反应有骨髓抑制白细胞减少、血小板减少、纳差、乏力、肌肉关节酸痛等。结论恩度联合周剂量多西紫杉醇治疗老年性非小细胞肺癌近期疗效较高,毒副反应轻,安全性好。     

同步加量调强与常规调强放射治疗食管癌的效果比较

目的：探讨同步加量调强与常规调强放射治疗食管癌的效果。方法：回顾分析149例食管癌患者的临床资料，根据治疗方式不同将其分为同步组（n=77）和常规组（n=72），同步组患者予以同步加量调强放射治疗，常规组患者予以常规调强放射治疗。比较两组患者治疗后临床疗效、血清肿瘤因子鳞状细胞癌抗原（SCC）、糖类抗原125(CA125)、癌胚抗原（CEA）水平、体力状况评分（Karnofsky评分）、生活质量评分（SF-36评分）、不良反应。结果：治疗后，同步组临床总有效率高于常规组（93.51%vs 81.94%, P<0.05）；同步组血清肿瘤因子SCC、CA125、CEA水平均低于常规组（P<0.05）；同步组Karnofsky评分和SF-36评分均高于常规组（P<0.05）；同步组不良反应轻于常规组。结论：同步加量调强与常规调强放射治疗食管癌均有一定临床效果，但相较于常规调强放射治疗，同步加量调强放射治疗对食管癌患者临床效果更为理想，能有效控制血清肿瘤因子高表达，改善预后，且不良反应相对较少。     

伊立替康联合顺铂化疗治疗局部晚期食管癌患者的疗效分析

目的：探讨伊立替康联合顺铂化疗治疗局部晚期食管癌的临床疗效,以供参考。方法将我院2011年7月~2013年6月收治的局部晚期食管癌患者97例纳入本研究,根据随机法分组。对照组患者接受顺铂+5-氟尿嘧啶标准方案化疗,实验组患者接受伊立替康+顺铂方案化疗。对比两组在治疗效果和毒副反应方面的差异性。结果与对照组对比,我们发现实验组临床缓解率和控制率均明显较高,芋度以上严重毒副反应发生率明显较低,组间差异经统计学分析后认为有意义(<0.05)。结论伊立替康联合顺铂化疗治疗局部晚期食管癌疗效确切、毒性较小,今后可将其作为晚期食管癌治疗的有效方案进行临床推广。     

热化疗对Ⅳ期结直肠癌患者临床疗效和免疫功能的影响

目的：探讨热化疗对Ⅳ期结直肠癌患者临床疗效和免疫功能的影响。方法：连续性纳入自2015年1月至2016年12月我院所收治的Ⅳ期结直肠癌110例,随机分为研究组及对照组,每组各55例。对照组给予单纯静脉化疗,研究组在此基础上联合热疗治疗。比较两组在近期疗效、外周血淋巴细胞、血清肿瘤标记物、毒副反应以及生命质量之间的差异。结果：根据RECIST1.1实体瘤疗效评估法对两组近期疗效进行评估,研究组客观有效率（P=0.001）及疾病控制率（P=0.007）均显著性优于对照组。外周血淋巴细胞方面,治疗后研究组外周血CD4⁺T细胞明显升高（P=0.000）;CD4+/CD8+T细胞比例显著升高（P=0.002）,明显优于对照组。血清肿瘤标记物方面,治疗后研究组血清癌胚抗原(CEA),糖类蛋白19-9(CA19-9),糖类抗原125(CA125)均显著性低于对照组,差异具有统计学意义（P＜0.05）。毒副反应方面,两组毒副反应未见统计学差异（P＞0.05）。生命质量方面,研究组在功能维度中的体力功能（P=0.009）、情感功能（P=0.015）以及社会功能（P=0.000）评分明显高于于对照组;在症状维度中的疲劳（P=0.010）、疼痛（P=0.000）、便秘（P=0.001）评分明显低于对照组;研究组综合生命质量评分明显优于对照组（P=0.002）。结论：热化疗可以有效提高Ⅳ期结直肠患者的近期疗效,改善患者免疫功能和生命质量,且不增加患者风险。     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

The case for allele‐specific recognition by the TCR

There is a sharp difference in how one views TCR structure–function–behaviour dependent on whether its recognition of major histocompatibility complex‐encoded restriction elements (R) is germline selected or somatically generated. The generally accepted or Standard model is built on the assumption that recognition of R is by the V regions of the αβ TCR, which is not driven by allele specificity, whereas the competing model posits that recognition of R is allele‐specific. The establishing of allele‐specific recognition of R by the TCR would rule out the Standard model and clear the road to a consideration of a competing construct, the Tritope model. Here, the case for allele‐specific recognition (germline selected) is detailed making it obvious that the Standard model is untenable.