肝癌的病理生理学研究的新发现

根据这些发现，研究人员得出结论：“延长干扰素治疗能预防肝细胞癌，甲胎蛋白增高和／或严重肝硬化的病人，能耐受干扰素有关副作用者，建议延长使用。”     

一种实用的基于GPU的Katsevich算法的实现

Katseivch算法是精确地解决锥束螺旋CT“长物体”问题的滤波反投影（FBP）形式的CT重建算法,不过它依然是非常耗时的,实际应用中必须考虑如何加速的问题。本文给出了一个使用通用显卡（GPU）对该算法进行并行加速的方法。同已有的方法相比较,几乎所有的计算都在GPU上完成,并且重建时所使用的积分范围是由PI线决定的,并且给出了算法所需要的精确地显存大小,10次数也被最大可能地降低。本文使用了标准数值模型对方法的速度、准确性和稳定性进行了验证。     

从美国的临终关怀想到的……

我在美国斯隆凯瑟琳癌症纪念医院学习期间,接触了很多姑息治疗与临终关怀的临床和教学工作,有很多感触,写来和大家一起讨论,希望能够对我们的临终关怀工作有所启发.     

美丽的肥皂泡——女儿的自述

一直以来我认为自己的生活完美无缺。妈妈患癌只是一时的脱发．短暂的生病．在她和我们全家的生活中只是一个偶然的插曲．就像看每周1次的电视秀一样．每周二我和姐姐都要回家．围坐在妈妈身边．听她讲述过去的1周里发生的事情。妈妈的故事好像一部肥皂剧．剧中的人物有令人轻松愉快的女护士、友善的男服务员．享誉世界的医生和患者。从来没有想过我们忙碌而温馨的生活与剧情有什么关系．更没有想过剧中出现的患者是我的妈妈。     

恶性肿瘤休眠的相关因素的研究

恶性肿瘤是可以休眠的,它与以下因素有关:①温度;②年龄;③组织器官;④组织分化程度;⑤供血因素;⑥精神因素;⑦早期肿瘤比晚期肿瘤休眠率高;⑧良性肿瘤比恶性肿瘤休眠率高;⑨基因;⑩人体的免疫系统."癌症休眠理论"的提出导致饿死肿瘤疗法的产生.癌症永久休眠不再复苏可能是攻克癌症的好方法.     

温暖的陪伴 隽永的告别

1950年阿姨出生在安徽省一个山明水秀的小山村,她家有4个孩子,她排行老三,上有大她20岁的哥哥和大她18岁的姐姐,下有小她3岁的弟弟,父母的疼爱和哥哥姐姐的呵护使阿姨的童年无忧而快乐。     

健康的身体需要合理的晚餐

饮食是我们生活中非常重要的一个环节,一日三餐,为我们人体提供每日必不可少的营养物质,从而维持人体的各种生理功能。一直以来,在中国人的饮食习惯当中,晚餐便是一日三餐中最重要的,而且随着社会节奏的加快,人们在忙碌的生活中,使得早餐显得有些匆忙,而午餐又因工作、环境、家庭等原因,比较容易被忽视,所以晚餐自然就更被人们当做重中之重了。     

肺癌的抗体治疗的研究进展

肺癌的传统疗法效果不够理想，用抗体治疗肺癌是一较为有效的方法。目前主要有5类抗体用于治疗肺癌：（1）西妥昔单抗(Cetuximab)、ABXEGF(Panitumumab)、Matuzumab（EMD72000）和曲妥珠单抗(Herceptin)等，这类抗体通过结合肿瘤细胞表面分子抑制细胞生长，具有较好的疗效，     

上帝造的与人造的

我现在越来越喜欢使用类比这种思考方式,也越来越喜欢采用比喻的说法。我频繁使用上帝这个词,并不意味着我相信一个有人格的上帝,一个可以与人沟通的神。我只是采用了“上帝”这个比喻性的、拟人的说法。当然我也可以辩称,我所说的上帝是爱因斯坦或者斯宾诺莎的上帝,就是自然（规律）本身。     

健康的鸡生出健康的蛋

近些年来随着饲料工业的发展及生产技术的提高,使得养鸡业也得到了大发展,同时也创造出了一些"奇迹".例如肯德鸡的工场化快速生长的鸡,在其"高效管理"下,以惊人的33天生产出来的鸡不断走入人们的日常生活.国内的普通饲养水平大约是40天左右上市.     

化疗联合深部热疗治疗胸腔恶性积液的临床观察

目的：恶性胸腔积液是晚期肺癌的常见并发症，全身化疗联合胸腔内药物注射是治疗恶性胸腔积液最常用的方法之一，但存在疗效不稳定、药物毒副反应大等问题。本研究的目的是观察热疗联合化疗治疗恶性胸腔积液的疗效、毒副反应和患者的生活质量。方法：确诊为晚期肺癌所致恶性胸腔积液的初治患者60例，分为热化疗和单纯化疗两组。热化疗组：采用胸腔穿刺置入中心静脉导管术尽可能排尽胸水后，给予吉西他滨1000mg／m^2，d1、d8，胸腔注射顺铂40mg／次，隔日1次，共3次。胸腔局部化疗24h后采用TYHP700-Ⅰ体外高频热疗机进行患侧胸腔的深部热疗，根据患者实际耐受情况设定治疗功率300～1000W，治疗时间40～60min，每21天为1周期，共治疗4个周期。单纯化疗组：给予吉西他滨1000mg／m^2，d1、d8，胸腔注射顺铂40mg／次，隔日1次，共3次，每21天为1周期，共治疗4个周期。结果：热化疗组控制胸水的总有效率为90．0％，单纯化疗组为66．7％（P=0．024）。两组毒副反应仅见一过性发热、轻度气胸和胸膜反应等。两组生活质量好转率分别为72．0％和40．0％（P=0．013）。结论：采用热疗联合化疗治疗恶性胸腔积液疗效确切，毒副反应小，安全性高。     

应用ATP生物荧光肿瘤体外药敏检测技术研究大肠癌药敏的异质性

目的探讨用ATP生物荧光肿瘤体外药敏检测技术(ATP-TCA)研究大肠癌药敏的异质性和个体化疗的可行性.方法用ATP-TCA检测58例大肠癌标本对16种单药或联合用药的敏感性.结果个体之间的药物敏感性存在着明显的异质性.单药中最有效的药物为长春瑞滨、羟基喜树碱、氟尿嘧啶和紫杉醇.联合用药最有效的是氟尿嘧啶 丝裂霉素 阿糖胞苷,91.6%(11/12)的标本对其敏感,其次是氟尿嘧啶 顺铂 阿霉素,健择 顺铂和5-FU氟尿嘧啶 长春新碱 卡氮芥.结论大肠癌对抗癌药物的敏感程度存在着异质性.ATP生物荧光肿瘤药敏检测技术可用于为大肠癌选择合适的化疗药物.     

顺铂胸腔灌注联合化疗治疗肺癌恶性胸水的疗效观察

目的:观察顺铂胸腔灌注联合静脉吉西他滨或培美曲塞化疗治疗非小细胞肺癌并恶性胸水的临床疗效。方法:41例非小细胞肺癌并恶性胸水患者,顺铂按75mg/m2胸腔灌注,同时行常规剂量的静脉吉西他滨或培美曲塞化疗,评价肺部肿瘤和胸水的控制情况、生活质量及不良反应。结果:17例肺鳞癌患者中,胸水治疗RR 76.5%,肺部肿瘤RR 29.4%,DCR 76.5%。24例肺非鳞癌患者中,胸水治疗RR 75%,肺部肿瘤RR 37.5%,DCR 83.3%。胸水治疗RR与肺部肿瘤DCR有相关性。90.2%患者生活质量获得改善。治疗不良反应轻。结论:顺铂胸腔灌注联合静脉吉西他滨或培美曲塞化疗治疗非小细胞肺癌并恶性胸水的临床疗效肯定,不良反应轻。     

Intrapleural cisplatin and mitomycin for malignant mesothelioma following pleurectomy: pharmacokinetic studies.

PURPOSE: Intrapleural cisplatin-based chemotherapy has been used in the treatment of patients with malignant pleural mesothelioma and malignant pleural effusions, but the pharmacokinetics of this form of chemotherapy have not been previously evaluated. We performed pharmacokinetic studies on 12 patients who received both intrapleural cisplatin and mitomycin immediately following pleurectomy/decortication for malignant pleural mesothelioma. PATIENTS AND METHODS: Simultaneous pleural fluid and plasma samples were collected at 15 and 30 minutes, and at 1, 2, 3, 4, and 24 hours after administration of the intrapleural chemotherapy (cisplatin 100 mg/m2 and mitomycin 8 mg/m2), and after cisplatin (total and free) and mitomycin levels were measured. The mean peak levels, the areas under the concentration-time curve (AUC) and the drug half-lives (t1/2s) in plasma and pleural fluid were compared using the paired t test. Differences were considered significant if P less than or equal to .05. RESULTS: Systemic absorption was rapid, with peak plasma levels being reached within 1 hour of administration of the intrapleural chemotherapy. Peak plasma levels measured after intrapleural chemotherapy approximated those reportedly attained during systemic administration of these drugs at similar doses. However, the mean peak cisplatin and mitomycin levels, and their mean AUCs, were significantly higher in the pleural fluid than in the plasma. There was a three- to fivefold advantage (on a logarithmic scale) for pleural to plasma AUCs for both cisplatin and mitomycin. The mean t1/2s for cisplatin and mitomycin were significantly longer in the plasma than in the pleural fluid. CONCLUSIONS: The pharmacokinetics of intrapleural cisplatin-based chemotherapy are analogous to those of intraperitoneal chemotherapy. Our findings show that intrapleural cisplatin-based chemotherapy has a distinct local pharmacologic advantage, but also produces significant and sustained drug plasma levels.     

化疗药物敏感试验指导原发性肝细胞癌术后化疗的临床研究

目的:探讨体外化疗敏感试验ATP-TCA系统对化疗药物疗效的评估作用,利用该系统指导肝细胞癌(hepatocelluarcarcinoma,HCC)患者的临床个体化疗。方法:获取50个HCC手术标本,采用ATP-TCA系统评估5-氟尿嘧啶(5-FU)、丝裂霉素(MMC)、顺铂(DDP)、草酸铂(OXA)、表阿霉素(EPI)、健择(GEM)、伊利替康(CPT-11)、依托泊苷(Vp-16)和多西他赛(PTX)化疗药物的疗效。23例HCC患者接受术后ATP-TCA指导临床化疗,同时以20例HCC患者作为对照,观察临床疗效。结果:ATP-TCA系统可评估率为90·8%。对各种化疗药物部分-强敏感率分别为PTX46%、CPT-1144%、GEM36%、MMC14%、EPI12%、DDP8%、Vp-166%、OXA6%和5-FU4%;观察终点ATP-TCA组疗效指标(CR、PR、SD和PD)获得较好结果,P=0·008;观察期实验组和对照组患者死亡率差异无统计学意义,P=0·763;实验组较对照组在病情缓解率(ORR)以及手术后生存期及无疾病进展生存方面表现出明显的优势,P值分别为0·0430、0·0057和0·0045。结论:ATP-TCA系统可以成功地应用于HCC患者。PTX、CPT-11和GEM对HCC具有较高疗效;根据体外药物敏感方案进行个体化疗,部分患者在病情缓解时间(TTP)以及手术后生存期方面获益。肿瘤防治杂志,2005,12(19):1457-1461     

胸腔内注射卡提素治疗恶性胸腔积液的临床观察

目的探讨胸腔内注射卡提素治疗胸腔积液的近期疗效和毒副反应。方法 45例经病理学确诊的恶性胸腔积液患者随机分为常规治疗组（22例,丝裂霉素、顺铂胸腔内注射）；卡提素组（23例,在常规治疗基础上加用卡提素）,比较2组患者胸腔积液变化情况。结果 45例恶性胸腔积液患者的总有效率86.7%。卡提素组近期疗效优于常规治疗组（P〈0.05）。2组毒副反应相近（P〉0.05）。治疗后,卡提素组生活质量优于常规治疗组（P〈0.05）。结论在丝裂霉素、顺铂胸腔内注射等常规治疗的基础上,加用卡提素治疗恶性胸腔积液疗效优于常规治疗。     

吉西他滨或培美曲塞静脉化疗联合顺铂胸腔灌注在非小细胞肺癌合并恶性胸腔积液中的应用研究

目的 探究吉西他滨或培美曲塞静脉化疗联合顺铂胸腔灌注对非小细胞肺癌合并恶性胸腔积液患者的疗效.方法 选取非小细胞肺癌合并恶性胸腔积液患者130例,根据治疗方案的不同将患者分为观察组与对照组,每组各65例.观察组患者接受培美曲塞静脉化疗联合顺铂胸腔灌注治疗,对照组患者接受吉西他滨静脉化疗联合顺铂胸腔灌注治疗.观察比较两组患者治疗前后白细胞计数(WBC)、血小板计数(PLT)、谷丙转氨酶(ALT)水平、癌胚抗原(CEA)水平、治疗效果、胸腔积液改善情况及不良反应发生率.结果 治疗前,两组患者的WBC、PLT、ALT及CEA水平比较,差异均无统计学意义(P﹥0.05);治疗后,观察组患者的WBC、PLT水平均高于对照组,ALT、CEA水平均低于对照组,差异均有统计学意义(P﹤0.05);治疗过程中,观察组患者的皮疹、口腔炎及蛋白尿发生率均低于对照组(P﹤0.05);观察组患者的治疗效果及胸腔积液改善情况均优于对照组(P﹤0.05).结论 培美曲塞静脉化疗联合顺铂胸腔灌注治疗非小细胞肺癌合并恶性胸腔积液的骨髓抑制及肾毒性较轻,可明显改善胸腔积液情况及疗效,且其他不良反应发生率低.     

Gemcitabine and cisplatin versus mitomycin, ifosfamide, and cisplatin in advanced non-small-cell lung cancer: A randomized phase III study of the Italian Lung Cancer Project.

PURPOSE: To compare gemcitabine and cisplatin (GC) with mitomycin, ifosfamide, and cisplatin (MIC) chemotherapy in patients with stage IIIB (limited to T4 for pleural effusion and N3 for supraclavicular lymph nodes) or stage IV non-small-cell lung cancer (NSCLC). The end points were the evaluation of quality of life (QoL), response rates, survival, and toxicity. PATIENTS AND METHODS: Three hundred seven patients were randomized to receive either gemcitabine 1,000 mg/m(2) on days 1, 8, and 15 plus cisplatin 100 mg/m(2) on day 2, every 28 days, or mitomycin 6 mg/m(2), ifosfamide 3,000 mg/m(2), and mesna on day 1 plus cisplatin 100 mg/m(2) on day 2, every 28 days. The whole-blood cell count was repeated on day 1 in both arms and weekly in the GC arm before each gemcitabine administration. RESULTS: No major differences in changes in QoL were observed between the two treatment arms. The objective response rate was 38% in the GC arm compared with 26% in the MIC arm (P =.029). The median survival time was 8.6 months in the GC arm and 9.6 months in the MIC arm (P =.877, log-rank test). Grade 3 and 4 thrombocytopenia was significantly worse in the GC arm (64% v 28%, P <.001), whereas grade 3 and 4 alopecia was reported more commonly in the MIC arm (39% v 12%, P <. 001). CONCLUSION: We report an increased response rate without changes in QoL and a similar overall survival, time to progression, and time to treatment failure for the GC when compared with the MIC regimen in the treatment of advanced NSCLC.     

人膀胱癌原代培养体外药敏试验的研究

目的:探讨用ATP生物荧光肿瘤体外药敏检测技术(ATP-TCA)研究膀胱癌药敏的异质性和个体化疗的可行性。方法:用ATP-TCA检测来自45例初发和6例复发膀胱癌患者的手术标本对4种化疗药物的敏感程度。结果:51例标本中有49例获得药敏结果,可评价率为96·0%。最有活性的药物是吡柔比星,有43·8%(21/48)的标本对它表现强敏感;28·6%(14/49)的标本无强敏感药物;69·4%(34/49)的标本无耐药药物。结论:膀胱癌对抗癌药物的敏感程度存在着异质性。ATP生物荧光肿瘤药敏检测技术可用于为膀胱癌选择合适的化疗药物。     

Secretion of MCP-1 and other paracrine factors in a novel tumor-bone coculture model

Background

NSCLC exhibits considerable heterogeneity in its sensitivity to chemotherapy and similar heterogeneity is noted in vitro in a variety of model systems. This study has tested the hypothesis that the molecular basis of the observed in vitro chemosensitivity of NSCLC lies within the known resistance mechanisms inherent to these patients' tumors.

Methods

The chemosensitivity of a series of 49 NSCLC tumors was assessed using the ATP-based tumor chemosensitivity assay (ATP-TCA) and compared with quantitative expression of resistance genes measured by RT-PCR in a Taqman Array? following extraction of RNA from formalin-fixed paraffin-embedded (FFPE) tissue.

Results

There was considerable heterogeneity between tumors within the ATP-TCA, and while this showed no direct correlation with individual gene expression, there was strong correlation of multi-gene signatures for many of the single agents and combinations tested. For instance, docetaxel activity showed some dependence on the expression of drug pumps, while cisplatin activity showed some dependence on DNA repair enzyme expression. Activity of both drugs was influenced more strongly still by the expression of anti- and pro-apoptotic genes by the tumor for both docetaxel and cisplatin. The doublet combinations of cisplatin with gemcitabine and cisplatin with docetaxel showed gene expression signatures incorporating resistance mechanisms for both agents.

Conclusion

Genes predicted to be involved in known mechanisms drug sensitivity and resistance correlate well with in vitro chemosensitivity and may allow the definition of predictive signatures to guide individualized chemotherapy in lung cancer.