急性白血病患者化疗后应用白介素-2对T淋巴细胞亚群的影响

目的探讨急性白血病患者化疗后应用白介素-2治疗对细胞免疫功能的影响及其临床意义。方法将79例急性白血病患者随机分为两组,化疗加白介素-2组(治疗组)40例和单纯化疗组(对照组)39例,治疗组于化疗后第1天加用白介素-2 40万U静脉滴注,连用14 d;对照组单用常规化疗,化疗前后均未予白介素-2治疗。检测化疗前及治疗后T淋巴细胞亚群的变化。结果治疗后14 d,治疗组的CD4~+、CD4~+/CD8~+水平明显高于对照组(P0.05),化疗后白细胞谷值、中性粒细胞谷值,对照组明显低于治疗组(P0.05)。结论白介素-2能明显提高患者化疗后CD4~+、CD4~+/CD8~+水平,从而改善接受化疗机体的免疫状态。白介素-2对急性白血病化疗后骨髓抑制具有防治作用。     

白血病患者化疗后应用白介素-2治疗的临床观察

目的：探讨白血病患者化疗后应用白介素-2（IL-2）治疗的临床疗效.方法：将50例白血病患者随机分治疗组和对照组,治疗组化疗后加入IL-2 100万U/d×14 d,对照组单用化疗,监测两组治疗前、后T淋巴细胞亚群及化疗后患者的临床疗效、不良反应.结果：治疗组治疗2周后T淋巴细胞亚群水平明显高于治疗前及对照组化疗后（P＜0.05）.治疗组完全缓解（CR）率与总有效（OR）率与对照组相近,但粒细胞缺乏发生率、持续时间及感染发生率低于对照组（P＜0.05）.结论：应用IL-2对化疗后患者进行治疗可明显提高T淋巴细胞亚群水平,并可减少化疗后不良反应.     

驱动蛋白家族成员2C与卵巢癌化学药物治疗耐药的相关性

目的 探讨驱动蛋白家族成员2C(kinesin family proteins 2C,KIF2C)与卵巢癌化学药物治疗(以下简称化疗)耐药的相关性。方法 选取2010年1月至2020年12月于首都医科大学附属北京同仁医院接受手术治疗的上皮性卵巢癌患者151例。其中铂类化疗敏感患者98例，铂类化疗耐药患者53例。利用免疫组化染色法检测KIF2C在化疗敏感及化疗耐药卵巢癌组织中的表达情况。结果 卵巢癌化疗耐药组织中KIF2C明显低表达。KIF2C及病理分期ⅢC期是影响卵巢癌化疗耐药的危险因素。结论 KIF2C有可能成为预测卵巢癌患者化疗敏感性的指标，并可能成为治疗化疗耐药卵巢癌患者的新型治疗靶点。     

探讨胃癌腹腔热灌注化疗联合静脉化疗治疗恶性腹水的临床效果

目的探讨胃癌腹腔热灌注化疗联合静脉化疗治疗恶性腹水的临床效果。方法选取本院2014年5月至2015年5月收治的胃癌伴恶性腹水患者100例,根据治疗方法不同,分为2组,观察组患者50例,给予腹腔热灌注化疗联合静脉化疗治疗,对照组患者50例,给予常规腹腔化疗联合全身化疗治疗,均行2个周期以上治疗,比较2组临床效果。结果与对照组比较,观察组总有效率、完全缓解例较高,(P0.05)差异显著。结论胃癌腹腔热灌注化疗联合静脉化疗治疗恶性腹水的临床效果较好,值得在临床推广。     

健脾益气养阴活血方联合改良DCF方案对中晚期胃癌患者生活质量影响研究

目的:在首次化疗前2周及化疗期间给予中药干预配合化疗方案治疗中晚期胃癌,并与单纯化疗相比,验证我们提出的"中医药化疗前干预治疗"的概念,寻找中医药参与化疗最佳时机,以提高胃癌临床治疗疗效。方法:随机将中晚期胃癌患者分为2组,治疗组(采用健脾益气、养阴活血方加改良DCF方案)30例,对照组(采用单纯改良DCF方案)30例,观察2组生活质量指标。结果:2组治疗后比较,生活质量指标差异有统计学意义,提示健脾益气养阴活血方可改善患者生活质量。结论:在提前干预前提下健脾益气养阴活血方可以改善胃癌患者化疗后脾胃气虚、阴虚血瘀证的症状,在提高患者生活质量方面优于单纯化疗。     

心理治疗提高非小细胞肺癌患者化疗依从性的临床研究

目的 研究心理治疗对非小细胞肺癌化疗患者依从性的影响.方法 采用对比研究分析,将112例患者随机分为2组:对照组56例单用化疗,治疗组56例在化疗基础上同时进行心理治疗.观察2组的化疗依从性、化疗完成率.结果 治疗组化疗依从性好,化疗完成率87.5％(49/56);对照组化疗依从性差,化疗完成率62.5％ (35/56).治疗组化疗依从性及化疗完成率均优于对照组,差异有统计学意义(P均＜0.05).结论 心理治疗可提高非小细胞肺癌化疗的依从性及化疗完成率.     

博宁联合化疗治疗骨转移所致疼痛的临床观察

目的选择理想的治疗骨转移疼痛的有效方法。方法将48例恶性肿瘤骨转移患者随机分为2组,每组24例。治疗组接受博宁联合化疗;对照组单用化疗。2组化疗方案相同。结果治疗组疼痛缓解率79.2%,对照组疼痛缓解率58.3%,治疗组明显优于对照组。结论博宁联合化疗是治疗恶性肿瘤骨转移的最佳方案。     

As2O3治疗ANLL-M2的疗效分析

目的回顾性分析应用As2O3治疗ANLL-M2的疗效,为进一步扩大临床适应证提供依据.方法选择我院确诊为ANLL-M2的患者91例(分为M2a、M2b两部分),分析不同治疗方法单纯As2O3治疗、As2O3+化疗及单纯化疗的疗效.结果无论是否达CR,As2O3治疗后骨髓幼稚细胞有不同程度的下降,M2a以原粒下降明显(P<0.05),M2b以中幼粒下降明显(P<0.05).M2a中单纯As2O3治疗12例,其中难治或复发58.3%,CR 25.0%,有效33.3%;M2b中单纯As2O3治疗8例,其中难治或复发62.5%,CR 25.0%,有效50.0%.As2O3治疗组分别与化疗对照组比较,P>0.05;单纯As2O3组与As2O3+化疗组比较,P>0.05.结论用As2O3治疗效果虽不优于化疗,但有效.可以作为供选方案用于难治或复发患者、不能耐受化疗的初治或化疗间歇期患者的治疗,以扩大其临床适应证.     

胃癌根治术后辅助放疗的价值比较

目的：对行胃癌根治性手术后的患者采用放疗与化疗联合应用的效果进行分析探讨。方法选取接受胃癌根治性手术治疗的100例患者作为研究对象,将其随机分为单纯化疗组与放疗联合化疗组2组,各50例。分别采用单纯化疗辅助治疗与化疗联合放射线辅助治疗两种方法进行治疗,对比分析2组患者的临床治疗效果以及并发症发生情况。结果放疗联合化疗组患者的总有效率（98.00%）显著高于单纯化疗组（64.00%）,差异有统计学意义（P<0.05）。放疗联合化疗组的并发症发生率（4.00%）显著低于单纯化疗组（32.00%）,差异有统计学意义（P<0.05）。结论采用化疗联合放疗治疗胃癌根治手术后患者效果显著,安全可靠,值得广泛推广。     

伊班膦酸钠联合化疗治疗骨转移所致疼痛的临床观察

目的选择理想的治疗骨转移疼痛的有效方法。方法将48例恶性肿瘤骨转移患者随机分为2组,每组24例。治疗组接受伊班膦酸钠联合化疗;对照组单用化疗。2组化疗方案相同。结果治疗组疼痛缓解率79.2%,对照组疼痛缓解率58.3%,治疗组明显优于对照组。结论伊班膦酸钠联合化疗是治疗恶性肿瘤骨转移的最佳方案。     

透过现象看本质：腺癌国际新分类更有利于肺癌个体化治疗吗?

国际肺癌研究协会（International Association for the Study of Lung Cancer,IASLC）／美国胸科学会（American Thoracic Society,ATS）／欧洲呼吸学会（European Respiratory Society,ERS）于今年2月份颁布了肺腺癌的国际多学科分类新标准（Travis,et al．JTO 2011）。     

HIV-Specific IL-2^＋ and/or IFN-γ^＋ CD8^＋ T Cell Reponses during Chronic HIV-1 Infection in Former Blood Donors

Objective Conflicting data have been generated from previous studies to determine which kind of relationship exists between HIV-1 specific CD8 Tcell responses and HIV-1 viral load or CD4 count over the course of infection.In this study,153 HIV-1 infected LTNPs were enrolled to investigate the role of HIV-1 specific CD8 T-cell responses in chronic HIV-1 infection among HIV-1 infected former blood donors.Methods The patients were stratified into three groups according to CD4 count：CD4≥500 cells/μL;350 cells/μL≤CD4〈500 cells/μL;CD4〈350 cells/μL.PBMCs were isolated from the patients＇ anticoagulated blood samples.IL-2 and IFN-γ secretions of CD 8 T cells against 17 HIV-1 consensus B full peptide pools were analyzed by using ICS assay.Results An overall inverse correlation were observed between CD4 count and plasma viral load.Although no significant difference was observed during the comparisons of frequency/breadth of HIV-1 specific CD8 T cell responses,CD4 count stratification analysis showed that different correlation pattern existed in three strata：as for patients whose CD4 counts were less than 350 cells/μL,no significant correlations were identified between frequency/breadth of HIV-1 specific CD8 T cell responses and CD4 count/viral load;as for patients whose CD4 counts ranged from 350 cells /μL to 500 cells/μL,significant correlation was only observed between the response breadth of IL-2＋IFN-γ＋ CD8 T cells and CD4 count;however,as for patients whose CD4 counts were more than 500 cells/μL,direct correlations were identified between IL-2＋IFN-γ＋/IL-2＋/IFN-γ＋ CD8 T cells and viral load or CD4 count.Conclusions Universal consistent inverse correlation was only indentified between CD4 count and viral load.The relationship between HIV-1 specific CD8 T cell responses and CD4 count/viral load varied in different CD4 strata,which showed that better preserved CD4 T cells were correlated with better CD8 T cell functions.     

基于SUV的PET对 4周期化疗后的弥漫大B细胞淋巴瘤患者预后的评估

在过去的十来年中,18氟脱氧葡萄糖（fluorodeoxyglucose,FDG）PET已经成为多种淋巴瘤疗效评价的有力工具,它主要通过视觉分析来评估疗效。修订后的判读标准适合评估化疗结束后的疗效。而不适用于化疗期间的疗效评价。     

Effect of ALA-PDT on the expressions ofMMP-9, MMP-13 TIMP-1 of hypertrophic scar model in rabbit ears

Objective： To investigate the effect of 5-aminolevulinic （ALA）-photodynamic therapy （PDT） on the expressions of MMP-9, MMP-13 and TIMP-1 of hypertrophic scar model in rabbit ears, and analyze the possible therapeutic mechanisms of ALA-PDT treatment to hypertrophic scars of rabbit ears. Methods： The experimental animals were randomly divided into normal control negative control, high concentration of ALA-PDT, low concentration of ALA-PDT and PDT groups. The latter three groups received ALA-PDT treatment or PDT treatment once a week for 3 weeks. The specimens of the rabbits were collected respectively 1, 2 and 3 months after treatment to be used for RT-PCR and Western-blot test. Results： 1, 2 and 3 months after PDT treatment, the expressions of MMP-9 and MMP-13 （including mRNA and protein） in hypertrophic scar tissues of three treatment groups were significantly higher than those of the negative control group （P〈0.01）, and the expression of TIMP-1 mRNA and protein of three treatment groups were significantly lower than that of the negative control group （P〈0.01）. There were also significant differences between high-concentration ALA-PDT treatment group and the low one （P〈0.05）. Conclusion： ALA-PDT is effective in treating hypertrophic scars of rabbit ears, and its possible therapeutic mechanisms are that ALA-PDT treatment generates oxidation activation effect to activate the activity of MMPs and induces the photoaging of fibroblasts of hypertrophicscar tissues of rabbit ears to inhibit the activity of TIMPs, which causes the up-regulation of MMPs and the down-regulation of TIMPs. Because of this, the degradation of collagen and ECM is accelerated and the formation of scars is suppressed     

TGF-β1 Precursor and CD8 Are Potential Prognostic and Predictive Markers in Operated Breast Cancer简

The transforming growth factor β1（TGF-β1） and CD8-positive T cells are two important immune factors that function at opposite directions. The purpose of this study was to verify the relationship between the two factors and their associations with long-term effects of adjuvant chemotherapy or endocrine therapy in breast cancer. Expression of TGF-β1 precursor and CD8 was immunohistochemically detected on surgically-obtained tumor samples of 130（stageⅠ–Ⅲ） invasive breast carcinomas from Chinese subjects, who were followed up for a mean time of 112 months. Interstitial CD8-positive cells and TGF-β1 precursor-positive cells adjacent to tumor nests were counted. Infiltration of CD8-positive lymphocytes into tumor nests and TGF-β1 precursor expression in tumor cells were observed and survival analysis was performed. Our results showed that density of interstitial CD8-positive lymphocytes was an independent adverse prognostic factor for distant disease-free survival（DDFS）（HR=8.416, 95% CI=1.636–43.292, P=0.011） in hormone receptor-positive patients who were on adjuvant endocrine therapy. For breast cancer patients who did not receive adjuvant chemotherapy, those without infiltration of CD8-positive cells into tumor nests had a shorter overall survival（OS） than their counterparts with CD8-positive cell infiltration into tumor nests（Log-Rank, P=0.003）. But OS of patients without infiltration of CD8-positive cells into tumor nests was significantly prolonged by adjuvant chemotherapy（Log-Rank, P=0.013） and paralleled that of patients with CD8-positive cell infiltration. Although OS was shorter in the tumor cell TGF-β1 precursor（t-TGF-β1-pre）-positive patients than in the negative patients in patients without recieiving chemotherapy（P=0.053）, OS of t-TGF-β1-pre-positive patients was significantly prolonged by adjuvant chemotherapy（P=0.035） and was longer than that of t-TGF-β1-pre-negative patients. Analysis showed that t-TGF-β1-pre was an independent positive prognostic factor for DDFS（HR=0.392 95% CI=0.157–0.978, P=0.045） in patients who received adjuvant chemotherapy. This study suggested that density of interstitial CD8-positive lymphocytes was of prognostic value in hormone receptor-positive patients who received adjuvant endocrine therapy. Our study verified that adverse immunologic signatures consisting of absence of CD8-positive cells in tumor nests or expression of TGF-β1 precursor in tumor cells in breast cancer were associated with worse prognosis and significantly improved long-term survival with adjuvant chemotherapy, respectively.     

吉非替尼与标准化疗对EGFR突变的晚期非小细胞肺癌患者疗效和安全性的比较

1文献来源 Makoto M, Akira I, Kunihiko K, et al. Gefitinib or chemotherapy for non-small cell lung cancerwith mutated EGFR [J]. N Engl J Med, 2010, 362（25） ： 2380-2388.     

Protective Effects of Sphingosine 1-phosphate and FTY720 on Rat Pulmonary Microvascular Endothelial Cells Stimulated by TNFα

Objective In this study, the effects of sphingosine 1-phosphate （S1P） and its analogue FTY720 on lactate dehydrogenase （LDH）, prostacyclin and PGE2 release, monolayer paracellular permeability, and F-actin structural changes of cultured rat pulmonary microvascular endothelial cells stimulated by TNFα were examined. Methods Rat pulmonary microvascular endothelial cells（rPMECs） were isolated, cultured and identified by immunofluorescent stain of yon Willebrand-associatedan-antigen （vWF）. Incubation with TNFα at a dose of 150 ng/ml for 12 hours induced a significant increase in paracellular permeability determined by measurement of a paracellular solute flux, 3-kDa FD-3. Results PGE2, PGF2α and LDH productions by cell cultures exposed to TNFα for 12 hours increased significantly compared with control cells. Also, the 12-hour exposure to TNFα resulted in reorganization and retraction of the rat pulmonary microvascular endothelial cells that was visible both by phase contrast microscopy and cytoskeletal F-actin stain. Paracellular permeability of the monolayers, PGE2, PGFα and LDH productions were significantly reduced following pretreatment with S 1P or FTY-720. Moreover, S 1P or FTY-720 pretreatment prevented the changes of morphologic and cytoskeletal F-actin induced by TNFa. Conclusion S 1P and FTY-720 can inhibited the LDH, PGF2α and PGE2 release by strengthening the cytoskeleton and protecting the barrier function, and may represent a novel therapeutic method for pulmonary vascular barrier damage.     

Competition between TRAF2 and TRAF6 Regulates NF-κB Activation in Human B Lymphocytes

Objective To investigate the role of TNF receptor-associated factor 2 （TRAF-2） and TRAF6 in CD40-induced nuclear factor-κB （NF-κB） signaling pathway and whether CD40 signaling requires TRAF2. Methods Human B cell lines were transfected with plasmids expressing wild type TRAF2 or dominant negative TRAF2,TRAF2-shRNA,or TRAF6-shRNA. The activation of NF-κB was detected by Western blot,kinase assay,transfactor enzyme-linked immunosorbent assay （ELISA）,and fluorescence resonance energy transfer （FRET）. Analysis of the role of TRAF-2 and TRAF-6 in CD40-mediated NF-κB activity was examined following stimulation with recombinant CD154. Results TRAF2 induced activity of IκB-kinases （IKKα,IKKi/ε）,phosphorylation of IκBα,as well as nuclear translocation and phosphorylation of p65/RelA. In contrast,TRAF6 strongly induced NF-κB activation and nuclear translocation of p65 as well as p50 and c-Rel. Engagement of CD154-induced nuclear translocation of p65 was inhibited by a TRAF6-shRNA,but conversely was enhanced by a TRAF2-shRNA. Examination of direct interactions between CD40 and TRAFs by FRET documented that both TRAF2 and TRAF6 directly interacted with CD40. However,the two TRAFs competed for CD40 binding. Conclusions These results indicate that TRAF2 can signal in human B cells,but it is not essential for CD40-mediated NF-κB activation. Moreover,TRAF2 can compete with TRAF6 for CD40 binding,and thereby limit the capacity of CD40 engagement to induce NF-κB activation.     

吉非替尼/厄洛替尼联合同期放疗治疗晚期肺癌

1文献来源 Chang CC, Chi KK, Kao SJ, et al. Upfront Gefitinib/Erlotinib treatment followed by concomitant radiotherapy for advanced lung cancer： A mono- institutional experience [J]. Lung Cancer, 2011,73 （2） ： 189-194. 2 证据水平