术前同步放化疗与单纯手术治疗食管癌的临床对比观察

目的:评价中晚期食管癌新辅助同步放、化疗(紫杉醇 顺铂)并手术治疗的近远期疗效及安全性。方法:60例中晚期食管癌随机分为两组,每组30例。观察组采用新辅助同步放、化疗并手术治疗,对照组2组采用单纯手术治疗。观察组放疗采用常规分割方式,临床靶区剂量38～44Gy,化疗采用紫杉醇 顺铂(TAX135mg/m2,d1,d22;DDP20～30mg/m2,d1～d5,d22～d26,化疗后2～4周手术)。比较两组的根治性手术切除率,治疗并发症发生率,3年总生存率的差异。结果:观察组根治性手术切除率为93.3%(28/30),对照组为70.0%(21/30)。两组比较,χ2=5.455,P=0.020,差异有统计学意义。观察组术后并发症发生率为36.7%(11/30),对照组为20.0%(6/30),均无围手术期死亡,两组术后并发症发生率比较,χ2=2.052,P=0.152,差异无统计学意义。观察组与对照组1和3年总生存率分别为83.3%,56.7%和53.3%,26.7%,两组比较差异有统计学意义,χ2=5.613,P=0.018。观察组3年总生存率高于对照组。结论:与单纯手术相比,中晚期食管癌术前紫杉醇 顺铂化疗并同步放疗结合手术治疗能显著提高根治性手术切除率,明显提高患者的3年总生存率,且不增加术后并发症的发生率。     

CIK细胞联合顺铂对卵巢癌耐药细胞SKOV3/CDDP的杀伤作用

目的：探讨细胞因子诱导的杀伤（cytokine-induced killer,CIK）细胞联合顺铂对卵巢癌顺铂耐药细胞SKOV3/CD-DP小鼠腹腔移植模型的体内外杀伤作用。方法：取正常人的外周血单个核细胞（PBMC）,加入IFN-γ、IL-2、CD3McAb和IL-1,体外诱导成CIK细胞。用MTT法测定CIK细胞、顺铂及两者联合对人卵巢癌细胞株SKOV3/CDDP细胞的杀伤活性。在SCID小鼠腹腔内接种卵巢癌SKOV3/CDDP细胞,观察CIK细胞对荷瘤鼠的体内抑瘤作用,并用RIA法检测各组血清中CA125的含量。结果：顺铂对SKOV3/CDDP细胞的IC50为315.5μg/ml,较其对SKOV3细胞的IC50（85μg/ml）增加了4倍;CIK细胞对SKOV3与SKOV3/CDDP细胞的杀伤活性均在48h最高,且随效靶比的增高而增强,其对SKOV3/CDDP细胞的杀伤活性明显高于SKOV3（P〈0.05）。仅25μg/ml的顺铂即可使效靶比为12.5∶1组中的联合杀伤率比单纯顺铂组增加5.8倍,比单纯加CIK（相同效靶比）细胞杀伤率增加2.3倍,且随效靶细胞比值和顺铂浓度的升高呈依赖性增加。与对照组相比,CIK组与CIK＋顺铂组均能显著抑制癌性结节的生长,抑瘤率达100%,且3组SCID鼠血中CA125值有显著性差异（P〈0.05）。结论：正常人CIK细胞联合顺铂对清除晚期卵巢癌表达耐药蛋白的腹腔种植转移病灶可能会有较好的效果,并有希望成为前景良好的综合治疗方案。     

奈达铂或顺铂联合紫杉醇同步放化疗局部晚期食管癌的近期疗效比较

目的探讨奈达铂替代顺铂与紫杉醇化疗联合同步放疗局部颈段食管癌的疗效及耐受性。方法实验组（TN组）30例,采用紫杉醇135 mg/m2,静脉滴注,第1天,奈达铂100 mg/m2静脉滴注,第1天,诱导化疗,每3周为1个化疗周期,共2个疗程,同期行根治性放疗。对照组（TP组）30例,采用顺铂（30 mg/m2第1～3天）代替奈达铂,其余治疗方法同实验组。结果有效率实验组和对照组分别是66.7%和64.0%,P〉0.05,差异无统计学意义;不良反应显示实验组和对照组白细胞减少的发生率分别为53.3%（16/30）和48.0%（12/25）,贫血发生率分别为26.7%（8/30）和36.0%（9/25）,血小板下降的发生率分别为40.0%（12/30）和32.0%（8/25）,肝功损害发生率分别是6.7%（2/30）和12.0%（3/25）,实验组和对照组比较,P〉0.05,差异均无统计学意义。由于对照组将顺铂分为3日小剂量连续使用,故2组肾毒性发生率都很低,差异无统计学意义。恶心呕吐发生率实验组明显低于对照组,差异有统计学意义。结论奈达铂联合紫杉醇结合同步放疗治疗局部颈段食管癌疗效确切,且患者耐受性良好。     

奈达铂或顺铂联合紫杉醇同步放化疗局部晚期鼻咽癌的疗效比较

目的探讨奈达铂替代顺铂与紫杉醇联合同步放化疗局部晚期鼻咽癌的疗效及患者耐受性。方法实验组（TN组）30例,采用紫杉醇135 mg/m2静脉滴注d1＋奈达铂100 mg/m2静脉滴注第1天诱导化疗,每3周为1个化疗周期,共2个疗程,以后行同样方案同期放化疗,仍然每3周为1个化疗周期,共2个疗程。对照组（TP组）30例,采用顺铂（30 mg/m2静脉滴注第1～3天）代替奈达铂,其余治疗方法与实验组相同。结果诱导化疗2个周期后评价疗效：鼻咽部原发灶有效率实验组和对照组分别是78.6%和73.3%,P〉0.05,差异无统计学意义;颈部淋巴结转移灶有效率实验组和对照组分别是82.1%和80.0%,P〉0.05,差异无统计学意义。治疗后3个月鼻咽原发灶和颈部淋巴结转移灶的有效率均是100%。不良反应显示实验组和对照组白细胞减少的发生率分别为50.0%（14/28）和86.7%（13/15）（P=0.02）,差异有统计学意义;贫血发生率分别为17.9%（5/28）和53.3%（8/15）（P=0.02）,差异有统计学意义;血小板下降的发生率分别为42.9%（12/28）和20.0%（3/15）（P=0.09）,差异无统计学意义。肝肾功能损害差异无统计学意义;恶心呕吐发生率实验组明显低于对照组,差异有统计学意义;体重下降（〉10%）的发生率实验组明显低于对照组,差异有统计学意义。结论奈达铂联合紫杉醇结合同步放疗治疗局部晚期鼻咽癌疗效确切,且患者耐受性良好。     

重组人血管内皮抑素联合顺铂腹腔灌注治疗恶性腹水的临床观察

目的：观察腹腔内注入抗肿瘤新药重组人血管内皮抑制素注射液（恩度）联合顺铂（cisplatin,DDP）治疗恶性腹水的临床疗效和不良反应。方法：于2010年1月至2011年1月收集120例恶性腹水患者按腹水严重程度平均分为4组,治疗组腹部经B超定位后行腹腔穿刺置单腔中心静脉导管引腹水后,治疗组1采用恩度30mg/m2＋生理盐水500ml,腹腔灌注3小时,第三日放腹水后予以顺铂45mg/m2＋生理盐水500ml腹腔灌注,夹管两日后放腹水,7天为一个疗程,连续5个疗程。治疗组2以恩度30mg/m2＋生理盐水500ml,腹腔灌注3小时,夹管两日后放水为一个疗程,每7天一次,连续5个疗程;治疗组3以顺铂45mg/m2＋生理盐水500ml腹腔灌注,夹管两日后放水为一个疗程,每7天一次,连续5个疗程;对照组为临终关怀对症处理组,不进行针对肿瘤及腹水的治疗,5周后评价。结果：治疗组1、2、3和对照组的RR分别为57.5%、30.0%、22.5%和0%（P〈0.05）,疾病控制率（DCR）分别为75.0%、45.0%、35%和5.0%（P〈0.05）。毒性反应4组比较（P〉0.05）。结论：重组人血管内皮抑制素注射液联合顺铂能较好地控制恶性腹水,减轻临床症状;不增加化疗药物的不良反应。     

替吉奥联合静脉和腹腔化疗方案治疗胃癌腹水的临床观察

目的：观察口服国产替吉奥联合静脉（多西他赛）和腹腔（顺铂）化疗治疗晚期胃癌腹水的近期疗效及不良反应。方法：将56例晚期胃癌合并癌性腹水患者随机分为2组：治疗组28例采用口服替吉奥,联合静脉滴注多西他赛全身化疗和腹腔内灌注顺铂局部化疗方案;对照组28例采用持续静脉滴注氟尿嘧啶,联合与治疗组相同的静脉用多西他赛和腹腔灌注顺铂化疗方案;均3个周期后评价近期疗效、临床受益及不良反应。结果：56例均可评价;治疗组和对照组的腹水近期有效率（RR）、中位疾病进展时间（TTP）分别为78.6%（22/28）和6.4个月、67.9%（19/28）和5.9个月,差异均无统计学意义（P〉0.05）,但从数值上看治疗组似乎更有优势,且治疗组的临床受益反应（CBR）为92.9%（26/28）,优于对照组的71.4%（20/28）,差异有统计学意义（P〈0.05）;治疗组的不良反应及严重反应发生率均明显低于对照组（P〈0.05）。结论：含口服国产替吉奥联合静脉和腹腔化疗是治疗晚期胃癌腹水的有效手段,不良反应可以耐受,值得临床进一步推广应用。     

奈达铂治疗晚期非小细胞肺癌临床观察

目的：观察吉西他滨联合奈达铂与联合顺铂方案治疗晚期非小细胞肺癌（NSCLC）的疗效和安全性。方法：60例中晚期非小细胞肺癌患者,其中吉西他滨联合奈达铂化疗方案组（GN组）30例,吉西他滨1000mg/m^2,第1、8天,静脉滴注30分钟,奈达铂80mg/m^2,第2天,滴注时间大于1小时;吉西他滨联合顺铂化疗方案组（GP组）30例,吉西他滨1 000mg/m^2,第1、8天,静脉滴注30分钟,顺铂80-100 mg/m^2,分3d,常规水化利尿。以上2组方案均21天为一个周期。结果：GN组有效率36.67%,GP组有效率40.00%,两组间无显著差异（P〉0.05）;GP组胃肠道反应（80%）发生率明显高于GN组（56.7%）（P〈0.05）;两组肾脏毒性无明显差异;两组白细胞下降发生率分别为56.7%和50.0%,奈达铂组明显（P〉0.05）;血小板下降GN组（73.3%）较GP组（66.7%）显著（P〉0.05）,但无统计学差异。结论：吉西他滨联合奈达铂治疗晚期NSCLC的有效率不低于吉西他滨联合顺铂方案,胃肠道毒性较轻,不良反应主要为骨髓抑制及过敏反应。     

顺铂加5-氟尿嘧啶联合同步放疗治疗局部晚期非小细胞肺癌临床研究

目的评价顺铂及5-氟尿嘧啶化疗联合同步放疗治疗局部晚期非小细胞肺癌的疗效和毒副作用。方法50例不可手术切除的期非小细胞肺癌患者随机分为治疗组和对照组,治疗组给予顺铂、5-氟尿嘧啶化疗两周期（顺铂20mg/m^2,d1-4、d25-28静滴;5-氟尿嘧啶750mg/m^2,d1-4、d25-28持续静滴）,同时联合局部常规放疗60Gy/1.8～2Gy/6-7周。对照组给予顺铂、依托泊甙化疗两周期（顺铂50mg/m^2,d1、8;d29、36;依托泊甙50mg/m^2,d1-5;d29-33）,放疗剂量同治疗组。同时放化疗后,两组分别再给予顺铂及依托泊甙化疗两周期。结果治疗组总有效率为64.0%,中位生存期达15.3月;1年、2年、3年生存率分别为64.0%、40.0%、28.0%,与对照组比较差异无统计学意义。主要不良反应为血液学毒性等,治疗组中性粒细胞减少发生率为36.0%,而对照组为64.0%,治疗组血液学毒性发生率明显低。结论顺铂加5-氟尿嘧啶联合同步放疗治疗局部晚期非小细胞肺癌有效率高、毒副反应较轻、患者耐受性较好,可为进一步的相关研究提供证据。     

放疗联合化疗治疗骨转移癌的研究

目的探讨放疗联合化疗（小剂量顺铂）对转移性骨癌的止痛效果。方法将符合条件的转移性骨癌患者随机分成放疗联合顺铂组和单纯放疗组,观察止痛疗效。结果放疗联合顺铂组与单纯放疗组1、2级疼痛止痛疗效相似（P〉0.05）。3级疼痛完全缓解率放疗联合顺铂组优于单纯放疗组（P〈0.05）。结论放疗联合顺铂治疗转移性骨癌,对重度骨痛者疗效明显,可提高完全缓解率,不明显增加毒副作用,值得临床推广应用。     

雷替曲塞联合顺铂方案与多西他赛联合顺铂方案二线治疗晚期/复发宫颈癌的疗效比较

目的:比较雷替曲塞联合顺铂与多西他赛联合顺铂对一线化疗失败的晚期/复发宫颈癌患者的近期疗效、生活质量及不良反应。方法: 将2015年1月至2016年12月确诊为一线化疗失败的晚期/复发宫颈癌患者共93例,随机分为两组。治疗组49例:雷替曲塞 2.5~3 mg/m2, 第1天+顺铂 25~30 mg/m2,第1~3天。对照组44例:多西他赛 60 mg/m2 第1天+顺铂 25~30 mg/m2,第1~3天。治疗组和对照组均21天为一疗程,连续治疗四疗程。结果:治疗组有效率为51.02%,对照组为29.55%,差异有统计学意义（P<0.05）。治疗组疾病控制率为73.47%,对照组为47.73%,两组比较差异有统计学意义（P<0.05）。治疗组患者生活质量改善率（83.67%）明显高于对照组（56.82%）,差异有统计学意义（P<0.05）。治疗组主要不良反应有:乏力（63.27%）、恶心（59.18%）、贫血（46.94%）、白细胞下降（44.90%）。对照组主要不良反应有:贫血（84.09%）、白细胞下降（75.00%）、脱发（47.73%）、恶心（40.91%）。在发生III-IV度不良反应中,治疗组主要为恶心（12.24%）和乏力（14.29%）,对照组主要为骨髓抑制（20.46%）和恶心（13.64%）。结论:雷替曲塞联合顺铂方案治疗一线化疗失败的患者,取得比多西他赛联合顺铂更好的疗效和可接受的不良反应,可在一定程度上提高患者生活质量,可作为晚期或复发宫颈癌患者二线化疗的可选方案。     

Ringworm in animals in a farm in Assiut

Bericht über das Auftreten von Hautmykosen bei Tieren auf der Farm der Landwirtschaftlichen Fakultät der Universität Assiut. Von 70 Kälbern waren 42 pilzkrank, davon 22 durch T. mentagrophytes, 20 durch T. verrucosum. Von 180 Kühen waren 8 pilzbefalien, sämtlich durch T. mentagrophytes. Von 2 kranken Bullen wurde T. verrucosum isoliert. Auch die 3 Pferde und 2 Maultiere der Farm waren pilzinfiziert; Erreger war in diesen Fällen T. equinum. Auch ein Kalb war von T. equinum befallen. Die gleiche Pilzart wurde ferner von 3 Tierpflegern isoliert, die Pilzherde am Hals und an den Armen aufwiesen.     

Statistical challenges in preprocessing in microarray experiments in cancer

Many clinical studies incorporate genomic experiments to investigate the potential associations between high-dimensional molecular data and clinical outcome. A critical first step in the statistical analyses of these experiments is that the molecular data are preprocessed. This article provides an overview of preprocessing methods, including summary algorithms and quality control metrics for microarrays. Some of the ramifications and effects that preprocessing methods have on the statistical results are illustrated. The discussions are centered around a microarray experiment based on lung cancer tumor samples with survival as the clinical outcome of interest. The procedures that are presented focus on the array platform used in this study. However, many of these issues are more general and are applicable to other instruments for genome-wide investigation. The discussions here will provide insight into the statistical challenges in preprocessing microarrays used in clinical studies of cancer. These challenges should not be viewed as inconsequential nuisances but rather as important issues that need to be addressed so that informed conclusions can be drawn.     

Trends in zygomycosis in children

Zygomycosis, or mucormycosis, is associated with significant morbidity and mortality in both children and adults. Studies in adults have shown an increase in the incidence of zygomycosis, particularly among haemtopoietic stem cell transplant (HSCT) recipients and patients with haematologic malignancies. There is a paucity of data on the epidemiology of zygomycosis in children. We performed a retrospective analysis to describe trends in zygomycosis between 1 January 2003 and 31 December 2010. We used the Pediatric Health Information System (PHIS) database to identify paediatric patients who were diagnosed with zygomycosis during the study period. Administrative data on diagnoses, demographics, underlying conditions and clinical experiences were collected. Summary statistics were calculated and tests for trend were conducted. We identified 156 unique patients with zygomycosis. The prevalence of zygomycosis did not significantly increase over time (P=0.284). The most common underlying condition was malignancy (58%) and over half received intensive care. Voriconazole utilisation among all hospitalised children significantly increased during the period (P=0.010). Our study demonstrates that the incidence of zygomycosis is not significantly increasing. During the time period there was a significant increase in the use of voriconazole among children.     

Hemoglobin in lymphogranulomatosis in children

The peculiarities of hemoglobin content and properties in lymphogranulomatosis were studied in children by different methods. In most patients the content of fetal hemoglobin and methhemoglobin was found to increase and the rate of ferricyanide oxidation of hemoglobin also increases. Simultaneously, the rate of non-homogenicity of basic hemoglobin fractions was observed to increase on account of immunologically different components.     

Dermatomycosis in Goats in India

Summary: In an extensive survey involving 2176 goats 1.56% of goats manifested clinical lesions of ringworm infection. Animals below the age of 6 months were affected most (4.20%). The incidence of infection was higher during the winter months. T. verrucosum, T. mentagrophytes and M. gypseum were isolated from the skin scrapings of 12, 4, and 2 goats respectively. It is suggested that the infected animals could be a source of disease to human population in which the zoophilic dermatophyte invasion is characterized by severe inflammatory lesions of the skin. The zoonotic importance of different dermatophytes is stressed.
Zusammenfassung: In einer ausgedehnten Untersuchung an 2176 Ziegen wurden bei 1,56% klinische Zeichen einer Hautmykose festgestellt. Tiere, die jühger als 6 Monate alt waren, zeigten mit 4,20% am häfigsten Krankheitssymptome. In den Wintermonaten war die Erkrankungshäufigkeit am gröBten. T. vermcosum, T. mentagrophytes and M. gypseum wurden jeweils von 12,4 bzw. 2 Ziegen isoliert. Die inflzierten Tiere köinnen eine Infektionsquelle für die menschliche Bevölkerung darstellen und dort Mykosen mit stark entzündlichen Veränderungen auslösen. Die Bedeutung verschiedener Dermatophyten als Erreger von Zoonosen wird hervorgehoben.     

Sex hormones in women in rural China and in Britain

Plasma concentrations of certain hormones linked to breast cancer risk were measured in age-pooled samples from 3,250 rural Chinese women in 65 counties, and 300 British women, all aged 35-64. In age-groups 35-44, 45-54 and 55-64 respectively, mean oestradiol concentrations were 36% (P = 0.043), 90% (P less than 0.001) and 171% (P = 0.001) higher in the British than in the Chinese women, and mean testosterone concentrations were 48% (P less than 0.001), 68% (P less than 0.001) and 53% (P = 0.001) higher in the British than in the Chinese women. The difference in testosterone concentrations between the two countries appeared to be due largely to the lower average body weight in the Chinese women. Sex hormone binding globulin did not differ significantly between the two countries in age groups 35-44 and 45-54, but was 15% (P = 0.002) lower in the British than in the Chinese women at ages 55-64. Prolactin concentrations did not differ significantly between the two countries in any age group.     

Temozolomide treatment in glioma--experiences in two university hospitals in Finland

Thirty-two patients with relapsing glioma were treated with temozolomide in two university hospitals in Finland. One patient (3%) had complete response and 9 (28%) partial response, with 8 patients (25%) showing stable disease. Median progression-free survival for these 18 patients (56%) was 7 months (range 2-11+). The remaining either had progressive disease (25%) or only clinical evaluation (19%). Karnofsky score improved in 34% of patients and decreased in 3%. Symptoms were alleviated in 44% and deteriorated in 9%. Grade 3-4 toxicity was detected in 9% of the patients. Only 4% of the days in treatment were spent in hospital. An average 1.8 neuroradiological investigations, 6.9 laboratory visits, and 5.3 visits to the oncologist were made. This study confirms that temozolomide has positive effects on the outcome of often heavily pretreated glioma patients. High drug costs are compensated by prolonged home care and even the possibility to maintain working capacity.