左卡尼汀预防紫杉醇周围神经毒性的临床观察

目的观察左卡尼汀预防紫杉醇引起的周围神经毒性作用。方法将64例接受紫杉醇化疗的肿瘤患者随机分为两组,预防性治疗组患者在应用紫杉醇化疗同时给予左卡尼汀治疗,对照组化疗方案与前组相同但未接受左卡尼汀预防性治疗。分别比较两组患者的周围神经毒性发生率。结果预防性治疗组周围神经毒性发生率低于对照组,差异有统计学意义（P〈0.05）。结论应用紫杉醇联合化疗中预防性给予左卡尼汀,可减少化疗相关的周围神经毒性。     

左卡尼汀对预防奥沙利铂周围神经毒性作用的临床观察

目的观察左卡尼汀对奥沙利铂引起的周围神经毒性反应的预防性治疗作用。方法 70例接受奥沙利铂化疗的肿瘤患者随机分为两组,预防性治疗组患者在应用奥沙利铂化疗同时给予左卡尼汀治疗,对照组化疗方案与前组相同但未接受左卡尼汀预防性治疗。分别比较两组患者的神经毒性总发生率、外周感觉神经毒性级别、出现外周神经毒性时间及肿瘤相关性疲劳分级和体力状况评分。结果预防性治疗组神经毒性发生率、外周感觉神经毒性级别均低于对照组,且差异有统计学意义(P<0.05)。结论应用奥沙利铂联合化疗中预防性给予左卡尼汀,可减少化疗相关的神经毒性,值得进一步研究。     

紫杉醇心脏毒性研究进展

紫杉醇主要通过促进微管聚合、诱导细胞凋亡及体内免疫调节、抑制血管生成等机制发挥抗肿瘤作用。该药目前主要与其他药物联合用于肿瘤的化疗。该文详细介绍了紫杉醇与多柔比星、表柔比星、铂类化合物等联合应用时的心脏毒性,对紫杉醇心脏毒性发生率、临床特征、危险因素和防治进行综述。     

右丙亚胺对表柔比星所致心脏毒性防治作用的观察

目的 观察右丙亚胺(Dexrazoxane,DEX)对表柔比星(Epirubicin,EPI)所致心脏毒性的防治作用.方法 选择化疗方案中含EPI的60例经病理学确诊的乳腺癌、胃癌与恶性淋巴瘤的患者,按病种选择相应方案化疗2个周期后,随机分为对照组和观察组,每组各30例,对照组继续原方案化疗4个周期,观察组则在原化疗方案上加用DEX(DEX∶ EPI=10∶1),2组患者均按要求完成4个化疗周期,观察心电图、左心室射血分数(LVEF),肌钙蛋白I(cTnI)定性检测的变化.结果 2组心电图异常差异、LVEF变化从第4周期开始均有统计学意义(P ＜0.05 ～P ＜0.01);2组的cTnI定性检测无统计学差异.结论 右丙亚胺对表柔比星所致心脏毒性的发生有一定的防治作用.     

参麦注射液防治含紫杉醇化疗方案所致神经毒性的临床观察

目的:观察参麦注射液防治含紫杉醇化疗方案所致神经毒性的效果。方法:将125例应用含紫杉醇化疗方案化疗的癌症患者随机分为2组,试验组64例,对照组61例。试验组化疗前1d开始加用参麦注射液50mL加入5%葡萄糖注射液200mL中静脉滴注,qd,连用14d为1个周期。4个周期后评价疗效并观察神经毒性反应的变化、测定周围神经功能。结果:试验组神经毒性发生率为26.6%(17/64),对照组为57.4%(35/61),2组比较差异有统计学意义(P<0.05)。周围神经功能测定,试验组和对照组腓神经运动神经传导速度(MNCV)分别为(41.9±2.2)m·s-1和(36.3±3.2)m·s-1;感觉神经传导速度(SNCV)分别为(42.5±4.2)m·s-1和(35.5±3.3)m·s-1;运动神经末端潜伏期分别为(4.1±1.5)ms和(4.7±1.1)ms;感觉神经动作电位波幅分别为(9.1±4.2)μV和(7.3±3.3)μV,2组比较差异有统计学意义(P<0.05)。结论:参麦注射液对含紫杉醇化疗方案所致的神经毒性具有明显的防治作用。     

表柔比星联用右丙亚胺和多柔比星脂质体对化疗所致心脏毒性的临床研究

目的观察表柔比星联用右丙亚胺和多柔比星脂质体对化疗所致心脏毒性的保护作用。方法将96例乳腺癌术后患者分为右丙亚胺组、多柔比星脂质体组和对照组,三组患者均接受以蒽环类药物为基础的术后辅助化疗方案4周期,通过监测各时期心电图异常率、心脏彩超左心室射血分数（LVEF）、短轴缩短率（SF）来评估心脏功能。结果对照组化疗后心电图异常率最高,右丙亚胺组、多柔比星脂质体组均能明显降低心电图异常率,且从化疗后1周期就显示出心脏保护作用;而LVEF及SF的变化在三组患者化疗前后差异无统计学意义（P〉0.05）。结论表柔比星化疗时加用DEX或者使用多柔比星脂质体对减轻蒽环类药物心脏毒性是有效且安全的。     

黄芪注射液防治含奥沙利铂化疗方案所致神经毒性效果的临床观察

例,Ⅰ级毒性10例,Ⅱ级毒性6例,Ⅲ级毒性2例;试验组中0级毒性14例,Ⅰ级毒性6例.试验组与对照组神经毒性发生率分别为30%和90%,2组比较差异有统计学意义(P< 0.01).试验组、对照组化疗前NGF值分别为:(167±10)和(204±19)ng/ml,化疗后第2天NGF的值分别为(152±8)和(133±12)ng/ml,对照组化疗后第2天与化疗前比较,NGF值下降明显,2组差异有统计学意义(P＜0.01).结论:黄芪注射液防治含奥沙利铂化疗方案所致神经毒性有一定效果.     

参麦注射液防治含奥沙利铂化疗方案所致神经毒性效果的临床观察

目的:观察参麦注射液防治含奥沙利铂化疗方案所致神经毒性的效果。方法:将96例应用含奥沙利铂化疗方案化疗的胃癌或大肠癌患者随机分为2组,试验组46例,对照组50例。试验组化疗前一天开始将参麦注射液50 mL加入5%葡萄糖注射液200 mL中静脉滴注,qd,连用14 d为1个周期。对照组不加用参麦注射液,单纯化疗。4个化疗周期(每个化疗周期21 d)后评价疗效,观察神经毒性反应的变化,并测定周围神经功能。结果:试验组神经毒性发生率32.6%(15/46),对照组为72.0%(36/50),2组比较差异有统计学意义(P<0.05)。周围神经功能测定,试验组和对照组腓神经感觉神经传导速度(SCV)分别为(40.5±3.2)m.s-1和(34.3±3.1)m.s-1,感觉神经动作电位波幅分别为(9.0±3.8)μV和(7.2±3.3)μV,2组比较差异有显著性(P<0.05)。结论:参麦注射液对含奥沙利铂化疗方案所致的神经毒性具有明显的防治作用。     

含表柔比星化疗方案作为乳腺癌术后辅助治疗的疗效观察

目的探讨含表柔比星化疗方案作为乳腺癌术后辅助治疗的疗效。方法对555例接受含表柔比星方案辅助化疗的乳腺癌患者的总生存率(OS)及不良反应进行分析。结果 380例接受5-氟脲嘧碇/表柔比星/环磷酰胺(FEC组)方案、56例接受长春瑞滨/表柔比星(NE组)方案、82例接受紫杉醇/表柔比星(TE组)方案、37例接受紫杉醇/表柔比星/环磷酰胺(TEC组)方案,四种方案的5年生存率分别为83.6%、89.3%、86.7%和91.7%。Ⅲ度以上骨髓抑制、消化道反应及心脏事件发生率:FEC方案组分别为37.0%、24.9%、0.2%,NE方案组分别为34.6%、19.6%、0%,TE方案组分别为38.8%,17.0%,1.2%,TEC方案组分别为37.8%,18.9%,2.7%。结论含表柔比星的四种辅助治疗方案均能延长生存期,毒副作用可耐受。     

表柔比星和环磷酰胺联合紫杉醇周疗在三阴性乳腺癌化疗中的应用

目的探讨表柔比星和环磷酰胺联合紫杉醇周疗在三阴性乳腺癌化疗中的应用价值。方法选取我院2013年7月至2016年7月收治的78例三阴性乳腺癌化疗患者为研究对象,将所有患者根据不同的化疗药物分为对照组和研究组,每组39例,对照组化疗前口服地塞米松预处理,并给予表柔比星和环磷酰胺静脉滴注;研究组在对照组的基础上联合紫杉醇静脉滴注,观察两组患者的近期疗效及不良反应。结果两组患者的CR、PR以及SD之间比较无显著性差异(P>0.05),但研究组的p CR显著优于对照组,两组比较差异有统计学意义(P<0.05),两组患者中过敏反应、外周神经毒性、中性粒细胞下降、脱发、恶心呕吐、心脏毒性、血小板减少、贫血以及肝肾功能异常的发生率比较无显著性差异(P>0.05)。结论对三阴性乳腺癌采用表柔比星和环磷酰胺联合紫杉醇进行周疗,有助于提高病理完全缓解率,且不增加不良反应,具有一定的临床应用价值。     

Analgesia induced by brief footshock is inhibited by 5-hydroxytryptamine but unaffected by antagonists of 5-hydroxytryptamine or by naloxone

Exposure to footshock (1 mA) for 30 sec induced a marked analgesia that was enhanced by pretreatment with the 5HT synthesis inhibitor, p-chlorophenylalanine, and attenuated by the 5HT releasing drugs p-chloroamphetamine and fenfluramine, by the 5HT re-uptake inhibitor, fluoxetine and by the 5HT agonists, 5-methoxy-N,N-dimethyltryptamine and MK212. However, agonists, quipazine and trifluoromethylphenylpiperazine, with greated reported affinities for 5HT binding sites on rat brain membranes than MK212 were without effect as were the antagonists metergoline, methysergide, cyproheptadine, mianserine and methiothepin. The specific opioid antagonist naloxone was also without effect. The results in general indicate that analgesia induced by brief footshock (1 mA, 30 sec) is inversely related to 5HT availability but thereis little evidence of involvement of known 5HT receptors.     

Synergism by caffeine and by cocaine of the motor control deficit produced by midazolam

To evaluate the effects of caffeine and cocaine on the impairment of discriminative motor control produced by midazolam, rats were trained to hold a force transducer operated with a paw so that it remained between upper and lower limits of a force band for a continuous 1.5-s period to deliver each food pellet. Acute doses of 3 mg/kg midazolam SC impaired motor performance. Except for one animal, caffeine (10-40 mg/kg IP) had little or no effect on performance, while cocaine (3.75-22.5 mg/kg IP) produced dose-related impairment. When each dose of caffeine was combined with 3 mg/kg midazolam, a marked synergism in motor performance impairment occurred. Cocaine plus midazolam produced mainly an additive synergism. The conspicuous synergistic action of caffeine on the motor control deficit produced by midazolam contrasts with the typical antagonism found between the benzodiazepines and methylxanthines when performance is evaluated by psychomotor tests not requiring fine motor control.     

Deamination of beta-phenylethylamine by monoamine oxidase--inhibition by imipramine

The oxidative deamination of tyramine (Tyr), 5-hydroxytryptamine (5-HT), and β-phenylethylamine (PEA) by mitochondrial preparations of rabbit lung and brain was inhibited by imipramine. This tricyclic iminodibenzyl antidepressant drug was most effective in decreasing the deamination of PEA: at 1 × 10^?4M imipramine, deamination of PEA, Tyr and 5-HT was inhibited by approximately 70, 45 and 45 per cent, respectively, when either lung or brain mitochondrial monoamine oxidase (MAO) preparations were used. Imipramine-induced inhibition of MAO was shown to be of a mixed type based on Lineweaver-Burk plots, but was found to be completely reversible. The desmcthyl and didesmethyl derivatives of imipramine were equally as effective as the parent drug in inhibiting the deamination of PEA, whereas the N-oxide analog of imipramine was less effective as an inhibitor of this reaction. These results support the premise that the action of imipramine as a clinically effective antidepressive agent may be related to its inhibitory effect on the specific form of MAO which deaminates PEA.     

Augmentation by serrapeptase of tissue permeation by cefotiam

Cefotiam (CTM) is a new cephalosporin with a broad spectrum of activity against both Gram-positive and Gram-negative microorganisms. Cephalosporins are widely used for prophylaxis of infections in patients undergoing thoracotomy. Augmentation by serrapeptase on tissue permeation of CTM was examined in 35 thoracotomy patients with lung cancer. The subjects were divided into two groups according to the method of the administration of CTM. Group I consisted of 17 subjects, each of whom received a single dose of 2 g of CTM alone by an instillation for 30 minutes. Group II consisted of 18 subjects, each of whom received a combination of CTM and serrapeptase; serrapeptase was given 2 tablets (10 mg) each time for three times/day until the day before surgery, and then CTM was administered by the same procedure. The following results were obtained: Individual difference was observed for the permeation of CTM into tissues. Pathologic differences also affected the permeation. Nevertheless, the CTM levels in pulmonary tissues reached about a half of those in the blood in both the single dose group and the combination group, hence sufficient concentrations exceeding MIC80 for main microorganisms that caused infections in the lung were obtained. The concentrations of CTM in inflammatory tissues have showed lower levels than those of normal tissues in both CTM single dose and the combination groups. Decrease of blood flow volume may have contributed to the reduction in levels of CTM in the inflammatory tissues. The ratio of the concentration of the drug in pulmonary tissues to that in the blood was 29.1 +/- 2.5% in the single dose group, and 44.2 +/- 6.0% in the combination group, the latter showing quite a significant increase (P less than 0.05). Combined administrations of CTM and serrapeptase deserves more trials in the case when surgical treatments of the lung are performed. An antiinflammatory effect of serrapeptase in the respiratory system is expected, and in addition, the combined use of CTM and serrapeptase should stimulate permeation of the antibiotic into tissues.     

Immunomodulation by non-absorbable antibiotics given by the intragastric route

To test the role of bacterial fractions released from intestinal flora during immunomodulation by antimicrobial agents, BALB/c mice were treated with the non-absorbable antibiotics polymyxin B or teicoplanin by the intragastric route. The composition of faecal microbiota and the capacity of spleen cells to proliferate in response to B-cell and T-cell mitogens were assessed at several times during the treatment. Both antibiotics lowered the count of some bacteria of the intestinal flora and induced significant modifications in spleen cell ability to proliferate in response to mitogens. Thus, the active fractions released from intestinal bacteria during antibiotic treatments may be able to induce immunomodulating effects.