羟基喜树硷联用顺铂、5-氟脲嘧啶、亚叶酸钙治疗晚期胃癌的临床观察

目的 观察羟基喜树碱联用顺铂、5—氟脲嘧啶、亚叶酸钙治疗62例晚期胃癌疗效。方法 羟基喜树碱：10mg／m^2静滴第1—5d，顺铂20mg/m^2静滴第1—5d；亚叶酸钙100mg/d静滴第6—10d，5—氟脲嘧啶750mg/d或500mg／d静滴第6—10d。28天1周期，完成3周期评价疗效。结果 完全缓解(CR)4例，部分缓解(PR)25例，总有效率(CR PR)46．8％。毒副反应主要是白细胞减少、恶心呕吐和腹泻。结论 羟基喜树碱联用顺铂、5—氟脲嘧啶、亚叶酸钙治疗晚期胃癌疗效好，毒副反应轻，值得临床上进一步观察使用。     

奥沙利铂联合亚叶酸钙、氟尿嘧啶及吡柔比星治疗晚期胃癌的临床观察

目的观察奥沙利铂联合亚叶酸钙、氟尿嘧啶及吡柔比星治疗晚期胃癌的临床疗效和毒副反应。方法采用奥沙利铂(L-OHP)130 mg/m2静滴2 h,第1天;亚叶酸钙(CF)200 mg/m2静滴2 h,d1~5;氟尿嘧啶(5-Fu)500 mg/m2静滴4 h,d1~5;吡柔比星(THP)45 mg/m2静注,d1。21 d为1个周期。结果32例患者中,CR 5例,PR 12例,总有效率(CR PR)53.1%;Karnofsky评分改善率68.8%。主要的不良反应为骨髓抑制、消化道反应和感觉神经毒性。其中白细胞减少Ⅲ度3例,胃肠道反应Ⅲ度仅1例。结论奥沙利铂联合亚叶酸钙、氟尿嘧啶及吡柔比星治疗晚期胃癌疗效肯定,毒副反应较轻,并能改善生活质量,值得临床进一步观察。     

国产奥沙利铂与氟尿嘧啶、亚叶酸钙联合治疗晚期大肠癌

[目的]研究奥沙利铂(L-OHP)与氟尿嘧啶(5-Fu)及亚叶酸钙(CF)联合治疗晚期大肠癌的疗效和毒副反应.[方法]38例晚期大肠癌,国产奥沙利铂130mg/m2,静脉滴注2h,d1;亚叶酸钙200 mg/d,静脉滴注2h,d1～5;氟尿嘧啶500mg/m2,静脉滴注4h,d1～5(CF滴完后);21天为1个周期,治疗2个周期后评定疗效.[结果]37例可评定疗效患者中,CR1例,PR11例,SD22例,PD3例,有效率(CR PR)32.4%.毒副反应以Ⅰ～Ⅱ度消化道症状、骨髓抑制、感觉神经毒性为主,有一定的肝损害.[结论]奥沙利铂与氟尿嘧啶、亚叶酸钙联合治疗大肠癌疗效确切,毒副反应能耐受.     

奥沙利铂联合亚叶酸钙及5-氟尿嘧啶治疗晚期大肠癌的临床观察

目的观察奥沙利铂(L-OHP)联合亚叶酸钙(CF)及5-氟尿嘧啶(5-Fu)治疗晚期大肠癌的疗效及不良反应。方法将我院2002年10月~2005年10月收治的65例晚期大肠癌,随机分为A组和B组,A组奥沙利铂130mg/m2静脉滴注2小时,第1天;亚叶酸钙200mg/m2持续静滴24小时,第1~5天;5-氟尿嘧啶500mg/m2持续静滴24小时,第1~5天;每3周重复。B组羟基喜树碱(HCPT)8mg/m2静脉滴注,第1~5天;亚叶酸钙200mg/m2,静脉滴注2小时,第1~5天;5-氟尿嘧啶500mg/m2持续静滴24小时,第1~5天,每3周重复。所有病例均接受2周期化疗。结果A组CR2例,PR12例,SD11例,DD8例,总有效率42.4%,B组CR1例,PR5例,SD16例,PD10例,总有效率18.8%,A组的主要不良反应是周围神经炎及恶心呕吐、骨髓抑制。结论奥沙利铂联合亚叶酸钙及5-氟尿嘧啶疗效优于羟基喜树碱、亚叶酸钙、5-氟尿嘧啶联合化疗,不良反应轻,值得临床推广。     

国产奥沙利铂联合氟尿嘧啶和亚叶酸钙治疗晚期结直肠癌的临床观察

目的评价奥沙利铂(L-OHP)联合氟尿嘧啶(5-Fu)、亚叶酸钙(CF)方案治疗晚期结直肠癌的疗效与毒副反应.方法奥沙利铂130 mg/m2,静滴4 h,第1天;亚叶酸钙200 mg静脉滴注2 h,5-Fu 300 mg/m2,持续静滴6～8 h,第1～5天(亚叶酸钙滴完后用);21 d为1周期,行2周期治疗后评价疗效.结果全组完全缓解(CR)1例,部分缓解(PR)12例,总有效率(CR PR)为43.3%.毒性反应以骨髓抑制、感觉性神经毒性为主,多为Ⅰ～Ⅱ度,其中白细胞减少发生率为46.7%,感觉性神经毒性发生率为77.7%,无化疗相关死亡.结论奥沙利铂联合氟尿嘧啶、亚叶酸钙治疗晚期结直肠癌疗效肯定,毒副反应能耐受.     

奥沙利铂联合氟尿嘧啶及亚叶酸钙治疗晚期胃癌的临床研究

目的观察奥沙利铂联合氟尿嘧啶及亚叶酸钙治疗晚期胃癌的疗效和不良反应。方法采用奥沙利铂130mg/m2,静滴2 h,第1天;亚叶酸钙(CF)200 mg/m2,静滴,连续5天;5_Fu 500 mg/m2,静滴4 h,连续5天,21天为1周期。结果35例患者中CR 1例,PR 13例,总有效率40.0%。主要的不良反应为消化道症状、骨髓抑制和感觉神经毒性。结论奥沙利铂联合氟尿嘧啶及亚叶酸钙治疗晚期胃癌疗效肯定,毒副作用较轻,值得推广应用。     

羟基喜树碱与氟尿嘧啶/亚叶酸钙联合奥沙利铂治疗晚期胃癌的随机对照临床观察

目的观察比较羟基喜树碱联合奥沙利铂方案（HCPTOX）与氟尿嘧啶/亚叶酸钙联合奥沙利铂方案（FOLFOX4）治疗晚期胃癌的临床疗效及毒副反应。方法47例晚期胃癌患者随机分成HCPTOX组与FOLFOX4组。HCPTOX组24例,予羟基喜树碱联合奥沙利铂方案化疗,HCPT 6mg/m2,静脉滴注,第1~5天;奥沙利铂130 mg/m2,静脉点滴,第1天;21 d为1周期。FOLFOX4组23例,予氟尿嘧啶、亚叶酸钙联合奥沙利铂方案化疗,奥沙利铂85 mg/m2,静脉点滴,第1天;亚叶酸钙200 mg/m2,静滴2 h后予氟尿嘧啶400 mg/m2,推注,后续600 mg/m2持续静滴22 h,第1、2天;每2周重复,4周为1周期。两组均治疗2周期以上。按WHO标准评价客观疗效和毒副反应。结果入组47例均可评价疗效,HCPTOX组有效率50.0%,中位TTP 5.8个月,MST10个月;FOLFOX4组有效率47.8%,中位TTP 5.7个月,MST9.8个月。两组近期有效率差异无显著性。毒副反应比较,Ⅲ~Ⅳ级恶心呕吐发生率以FOLFOX4组显著（P〈0.05）,余毒副反应除腹泻外发生率以FOLFOX4组稍高,但无统计学意义。结论HCPTOX方案与FOLFOX4方案治疗晚期胃癌疗效确切,毒副反应能耐受。两组近期疗效相似,毒副反应以HCPTOX组更易耐受,尤其对一般情况欠佳及老年患者的耐受性好。     

奥沙利铂联合亚叶酸钙和氟尿嘧啶治疗晚期胃癌

目的:观察奥沙利铂(L-OHP)联合亚叶酸钙(CF)和氟尿嘧啶(5-Fu)治疗晚期胃癌的疗效和毒副反应。方法:33例晚期胃癌患者,静脉滴注奥沙利铂130 mg/m2,第1天;亚叶酸钙200 mg,第1~5天,氟尿嘧啶300mg/m2第1~5天;21或28天为1周期。进行3周期后评价疗效。结果:完全有效(CR)2例,部分有效(PR)14例,稳定(SD)10例,进展(PD)7例,近期有效率(CR PR)48.4%。结论:奥沙利铂联合CF/5-Fu方案疗效较高,毒副反应轻,耐受性好。     

奥沙利铂联合氟尿嘧啶及亚叶酸钙治疗晚期胃癌的临床研究

目的观察奥沙利铂联合氟尿嘧啶及亚叶酸钙治疗晚期胃癌的疗效和不良反应。方法采用奥沙利钔130mg／m^2，静滴2h，第1天；亚叶酸钙（CF）200mg／m^2，静滴, 连续5天；5-Fu 500mg/m^2静滴4h，连续5天，21天为1周期。结果35例患者中CR 1例，PR 13例，总有效率40．0％。 主要的不良反应为消化道症状、骨髓抑制和感觉神经毒性。结论奥沙利铂联合氟尿嘧啶及亚叶酸钙治疗晚期胃癌疗效肯定，毒副作用较轻，值得推广应用。     

周剂量多西紫杉醇、奥沙利铂联合5-氟尿嘧啶/亚叶酸钙治疗晚期胃癌疗效观察

目的:观察周剂量多西紫杉醇、奥沙利铂联合5-氟尿嘧啶/亚叶酸钙治疗晚期胃癌的近期疗效,毒副作用及生活质量改善情况.方法:18例晚期胃癌患者以多西紫杉醇25mg/m2d1、d8、d15静脉滴注1小时,奥沙利铂65mg/m2d1、d8静脉滴注3小时,亚叶酸钙100mgd1～d5静脉滴注2小时,5-氟尿嘧啶500mg/m2d1-d5静脉滴注4小时.4周为1个周期, 2周期为1个疗程.所有病人至少接受2周期以上.客观疗效(CR PR)和毒副作用按WHO进行评价,生活质量按临床受益反应(CBR)进行评价.结果:18例均可评价疗效,完全缓解(CR)0例,部分缓解(PR)10例,总有效率55.6%,临床受益反应有效率72%,中位TTP 5.6月.主要毒副反应为骨髓抑制,消化道反应和神经毒性,大部分为Ⅰ～Ⅱ级,可以耐受.结论:每周低剂量多西紫杉醇、奥沙利铂联合5-氟尿嘧啶/亚叶酸钙治疗晚期胃癌近期疗效好,毒副反应轻,耐受性好,病人生活质量明显改善.     

Selenium, lycopene, alpha-tocopherol, beta-carotene, retinol, and subsequent bladder cancer

To examine the association between serum nutrients and the development of bladder cancer we measured selenium, alpha-tocopherol, lycopene, beta-carotene, retinol, and retinol-binding protein in serum collected from 25,802 persons in Washington County, MD, in 1974. Serum samples were kept frozen at -70 degrees C. In the subsequent 12-year period, 35 cases of bladder cancer developed among participants. Comparisons of serum levels in 1974 among cases and two matched controls for each case showed that selenium was significantly lower among cases than controls (P = 0.03), lycopene was lower among cases at a borderline level of significance (P = 0.07), and alpha-tocopherol was nonsignificantly lower (P = 0.13). For selenium there was a nearly linear increase in risk with decreasing serum levels (P = 0.03). When examined by tertiles, the odds ratio associated with the lowest tertile of selenium compared to the highest tertile was 2.06. Serum levels of retinol, retinol-binding protein, and beta-carotene were similar among cases and controls. These results support a role for selenium in the prevention of bladder cancer.     

Susceptibility of Ureaplasma urealyticum to Tetracycline,Doxycycline, Erythromycin,Roxithromycin, Clarithromycin,Azithromycin, Levofloxacin and Moxifloxacin

Abstract

The in vitro activity of tetracycline, doxycycline, erythromycin, roxithromycin, clarithromycin, azithromycin, levofloxacin and moxifloxacin was tested against 63 clinical isolates of Ureaplasma urealyticum. The minimal inhibitory concentrations (MICs) and the minimal bactericidal concentrations (MBCs) were determined by the broth microdilution method in A7 medium. The miC50 and miC90 of the tested agents after 24 h of incubation were as follows: Tetracycline, 0.5 and 2.0 μg/ml; doxycycline, 0.125 and 0.25 μg/ml; erythromycin, 2.0 and 8.0 μg/ml; roxithromycin, 2.0 and 4.0 μg/ml; clarithromycin, 0.25 and 1.0 μg/ml; azithromycin, 2.0 and 4.0 μg/ml; levofloxacin, 1.0 and 2.0 μg/ml; and moxifloxacin, 0.5 and 0.5 μg/ml, respectively. The MIC values after 24 h and 48 h incubation differed by no more than one dilution for all the agents with the exception of doxycycline (two dilution difference for MIC₉₀). Overall, moxifloxacin was the most active agent in vitro against U. Urealyticum, with the narrowest difference between MIC and MBC values, followed closely by levofloxacin. Clarithromycin was the most active macrolide.     

80岁以上合并肠梗阻的结直肠癌患者的外科治疗

目的 探讨80岁以上合并肠梗阻的结直肠癌患者的外科治疗策略。方法 回顾性分析中国医学科学院结直肠外科2007年1月—2018年12月行结直肠癌手术且术前合并肠梗阻的77例80岁以上患者的临床病理资料,按照手术方式分为根治组（n=58）与非根治组（n=19）,比较两组患者临床病理特征、围手术期相关指标和预后。采用Kaplan-Meier法进行生存分析,Log rank检验进行生存时间比较;应用Cox比例风险模型进行多因素分析,对影响预后的因素进行分析。结果 根治组TNM分期为Ⅳ期患者的比例明显低于非根治组（8.6% vs. 57.9%, P<0.001）。根治组患者的5年生存率明显高于非根治组（65.5% vs. 26.3%, P<0.001）。单因素分析显示TNM分期和是否行根治性手术与合并肠梗阻的老年结直肠癌患者预后相关。多因素分析表明是否行根治性手术是影响80岁以上合并肠梗阻的结直肠癌患者预后的独立因素。结论 是否行根治性手术是影响80岁以上合并肠梗阻的结直肠癌患者预后的独立因素。     

Etoposide, dexamethasone, cytarabine, and cisplatin in vincristine, doxorubicin, and dexamethasone-refractory myeloma

Based on remarkable activity in refractory lymphomas, a combination of etoposide, cisplatin (both administered by 4-day continuous infusions), cytarabine (Ara-C), and dexamethasone (EDAP) was evaluated in 20 patients with advanced myeloma refractory to standard melphalan and prednisone (MP) and/or vincristine, Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH), and dexamethasone (VAD) and even to high doses of melphalan (HDM) (seven patients). Forty percent of patients responded regardless of previously recognized risk factors (eg, duration of drug resistance, tumor mass, and serum lactic dehydrogenase [LDH] level). While the median survival was only 4.5 months, patients with good performance (Zubrod less than 2) and low or intermediate tumor stage survived more than 14 months compared with only 2 months for the remaining group. EDAP could be readily administered in the outpatient clinic, but neutropenic fever prompted hospital admission in 80% of patients, half of whom developed penumonia and sepsis, a fatal outcome in four patients. Severe myelosuppression was of short duration, so that subsequent cycles could be administered every 3 to 4 weeks. No serious extramedullary toxicity, including renal toxicity, was encountered. Marrow toxicity and hence infectious complications may be reduced by elimination of Ara-C without compromising treatment efficacy. We conclude that the lack of cross-resistance with VAD and even HDM makes EDAP or a similar combination an attractive regiment to be formally explored in an alternating sequence with VAD in high-risk myeloma.     

Susceptibility of Ureaplasma urealyticum to tetracycline, doxycycline, erythromycin, roxithromycin, clarithromycin, azithromycin, levofloxacin and moxifloxacin

The in vitro activity of tetracycline, doxycycline, erythromycin, roxithromycin, clarithromycin, azithromycin, levofloxacin and moxifloxacin was tested against 63 clinical isolates of Ureaplasma urealyticum. The minimal inhibitory concentrations (MICs) and the minimal bactericidal concentrations (MBCs) were determined by the broth microdilution method in A7 medium. The MIC(50) and MIC(90) of the tested agents after 24 h of incubation were as follows: tetracycline, 0.5 and 2.0 μg/ml; doxycycline, 0.125 and 0.25 μg/ml; erythromycin, 2.0 and 8.0 μg/ml; roxithromycin, 2.0 and 4.0 μg/ml; clarithromycin, 0.25 and 1.0 μg/ml; azithromycin, 2.0 and 4.0 μg/ml; levofloxacin, 1.0 and 2.0 μg/ml; and moxifloxacin, 0.5 and 0.5 μg/ml, respectively. The MIC values after 24 h and 48 h incubation differed by no more than one dilution for all the agents with the exception of doxycycline (two dilution difference for MIC(90)). Overall, moxifloxacin was the most active agent in vitro against U. urealyticum, with the narrowest difference between MIC and MBC values, followed closely by levofloxacin. Clarithromycin was the most active macrolide.