茯苓萜类的高效液相色谱指纹图谱研究

目的 建立茯苓三萜化合物的指纹图谱。方法 反相高效液相色谱法。结果 道地药材茯苓及不同地区收集的市场商品具有相当稳定的、相似程度很高的指纹图谱。结论 可利用液相色谱的特征峰控制茯苓及其制剂的质量。     

宫颈癌盆腔淋巴结转移相关因素分析

目的 :了解子宫颈癌盆腔淋巴结转移的相关因素。方法 :对 3 0 5例ⅠA～ⅡB期宫颈癌行根治术的临床资料进行回顾性分析。结果 :ⅠA期宫颈癌盆腔淋巴结转移率 0 ,ⅠB期为 9 8% ,ⅡA期为 18 5 2 % ,ⅡB期为 5 7 14 % ;宫颈鳞癌盆腔淋巴结转移率为 8 2 % ,宫颈腺癌为42 2 7% ;宫颈癌高分化组盆腔淋巴结转移率为 0 ,中分化组为 11 16% ,低分化组为 40 62 % ;宫颈间质浸润深度 <1/ 2组盆腔淋巴结转移率为 1 2 3 % ,≥ 1/ 2组为2 1 88% ;宫颈癌糜烂型盆腔淋巴结转移率为 17 0 2 % ,外生型为 13 95 % ,内生型为 18 5 2 % ,溃疡型为 41 67% ;宫颈肿瘤≥ 4cm者盆腔淋巴结转移率为 2 0 0 % ,<4cm者为 12 14 % ;手术前予化疗者盆腔淋巴结转移率为 7 4% ,未行化疗者为19 5 6% ;手术前行放疗者盆腔淋巴结转移率为 4 76% ,未行放疗者为 19 5 6%。结论 :宫颈癌患者的临床分期、病理分级、组织类型、宫颈间质浸润深度、生长方式及术前化疗或放疗与盆腔淋巴结转移有直接关系 ,而肿瘤大小与盆腔淋巴结转移关系不明显。     

5-Fu、MTX、VP16-213联合方案治疗恶性妊娠滋养细胞肿瘤的研究

目的 探讨5-Fu、MTX、VP16—213联合化学治疗恶性妊娠滋养细胞肿瘤患者的疗效。方法 对1992年4月至2003年4月11年本院91例恶性妊娠滋养细胞肿瘤(包括侵蚀性葡萄胎和绒癌)患者采用5-Fu、MTX、VP16—213三联化疗方案治疗，其中绒癌36例，有2例为复发性绒癌；侵蚀性葡萄胎(侵葡)55例。Ⅰ期16例，Ⅱ期26例，Ⅲ期56例。结果 91例患者中，采用此三联化疗方案治疗有86例获治愈，总治愈率高达94．51％。此三联化疗方案的主要毒副反应是骨髓抑制和胃肠道反应，其中Ⅲ～Ⅳ度粒细胞减少占27．3％，Ⅲ～Ⅳ度血小板减少占7．4％，Ⅲ度恶心呕吐占19．80%，Ⅲ度腹泻占2．4％，Ⅰ度肝功损害占2．1％，在19．69％的疗程中发生口腔溃疡，其中Ⅲ度占8．36％。结论 5-Fu、MTX、VP16—213联合方案治疗恶性妊娠滋养细胞肿瘤可达满意的临床效果，对其他药物耐药或复发病例也可获得满意的疗效。     

Efficacy of preoperative intracavitary brachytherapy and surgery in patients with stage ⅠB2 and ⅡA bulky cervical cancer

Objective To analyze the outcomes of preoperative intracavitary brachytherapy plus sur-gery in patients with stage ⅠB2 and ⅡA bulky cervical cancer. Methods From January 2001 to January 2007, 77 patients with stage ⅠB2 and ⅡA bulky cervical cancer were included. The diameter of primary tumor was greater than 4 cm. Preoperative intracavitary brachytherapy with the total dose of 20-30 Gy (0.5 cm below the vaginal mucosa) was delivered by 2-3 fractions, one fraction per week. After an interval of 10-14 days, the efficacies of radiotherapy were evaluated and radical hysterectomy with pelvic lymphade-nectomy was performed. Then the treatment complications, clinicopathological characteristics, survival and recurrence were analyzed. Results The tumor shrinkage was observed in all the patients after intracavitary brachytherapy. The CR, PR and SD were 5% (4/77), 36% (28/77) and 58% (45/77), respectively. Radical hysterectomy was successfully performed in all patients. The complications of the combined therapy were mild and only 5 patients had grade Ⅱ or less hematological or gastrointestinal toxicities. The 5-year o-verall survival rate and pelvic recurrence rate were 83% and 12%, respectively. Conclusions Preoperative intracavitary brachytherapy of 20-30 Gy plus surgery is effective in the treatment of stage ⅠB2 and ⅡA bulky cervical cancer without increasing the treatment complications.     

趋化因子受体CCR5在食管上皮癌变过程中作用的初步探讨

目的　探讨 CC趋化因子受体 5 (CCR5 )是否介导食管上皮炎性病变与其癌变过程的关系。方法　用免疫组化检测 40例食管鳞状细胞癌 (SCC)、癌旁炎症、不典型增生组织及 10例正常食管黏膜的 CCR5表达情况。结果　食管 SCC的 CCR5表达阳性率高于正常黏膜、慢性炎症及不典型增生的表达率 (P<0 .0 5 )。在 CCR5表达阳性的食管 SCC中 ,癌间质的单核淋巴细胞 CCR5阳性表达率分别低于癌旁炎症的单核淋巴细胞 CCR5阳性表达率(P<0 .0 5 )。结论　 CCR5在食管癌变进程中表达呈升高趋势 ,提示食管 SCC细胞可能通过表达 CCR5受体与间质浸润的单核细胞、淋巴细胞共同竞争趋化因子配体 ,从而实现了食管 SCC发生进程的免疫逃逸现象     

99mTcN(NOEt)2与99mTc-MIBI在肿瘤模型显像中的对比研究

目的　探讨99mTc 氮 二 (N 乙基 N 乙氧基二硫代氨基甲酸盐 ) [99mTcN (NOEt) 2 ]应用于肿瘤诊断的可能性并与99mTc 甲氧基异丁基异腈(99mTc MIBI)肿瘤模型显像进行比较。方法　制备99mTcN (NOEt) 2 ,用上行薄层色谱法测定放化纯。各取 4只移植性艾氏腹水癌小鼠分别尾静脉注射99mTc MIBI或99mTcN(NOEt) 2 ,30min、2h、4h后进行全身后位静态显像。利用感兴趣区技术 ,分别计算不同时相肿瘤与头部 (T/H)、胸部 (T/C)、及健侧肢体对称部位 (T/L)的放射性比值。 4h后处死99mTcN (NOEt) 2 显像组小鼠 4只 ,取血并剥离脏器组织及肿瘤组织 ,称重 ,测量放射性计数 ,计算肿瘤与各脏器放射性比值。结果　99mTcN (NOEt) 2 室温下 4h保持稳定。99mTcN (NOEt) 2 选择性地有效的聚集于肿瘤组织。除腹部外其它组织靶 /非靶比值较高 ,注射2h后T/L比值达最高 ,为 4.87。99mTcN (NOEt) 2 显像组与99mTc MIBI显像组比较T/L比值差异有显著性 (P <0 .0 1)。体外测量肿瘤与血、肌肉、肺等脏器的单位重量放射性比值较高 ,与肝、小肠等腹部脏器的单位重量放射性比值较低。结论　在移植性艾氏腹水癌小鼠模型中99mTcN (NOEt) 2 从血液中清除很快 ,肿瘤摄取率高 ,有一定的滞留量 ,靶与非靶比值高 ,图像质量明显优于99mTc MIBI肿瘤     

三种反义c-myc RNA的瞬时表达对血管平滑肌细胞的体外生物学效应的影响

目的 了解癌基因c-myc分子中各个区域的作用,找出最佳的反义封闭靶区,为c-myc表达增高相关疾病的基因治疗提供依据。方法 系统地构建了人类3种反义c-myc重组逆转录病毒表达载体（aM1、aM2和aM3）,分别载有c-myc第1、2和3外显子的反义片段,经脂质体转染大鼠主动脉平滑肌细胞,并于转染后48 h采用流式细胞仪对细胞进行瞬时表达检测。结果 与对照组相比,aM2使c-myc表达量减少了37.6%,aM1为对照组的98.8%,而aM3却使c-myc表达增高21.7%;与此同时,aM1和aM2组增殖细胞核抗原（PCNA）表达分别下降了36.0%和30.9%,而aM3组PCNA表达增高。DNA分析则表明3种载体均使处于G0/G1期的细胞比例略为增高（aM2>aM1>aM3）,S 期比例略下降（aM1>aM2>aM3）,但尚未有DNA合成量的明显改变。结论 反义基因的导入在瞬时表达时可影响细胞中靶蛋白及其他生长相关蛋白的表达,但对细胞周期和DNA合成的影响尚小。     

Anemia is associated with decreased survival and increased locoregional failure in patients with locally advanced head and neck carcinoma: a secondary analysis of RTOG 85-27

Purpose: The purpose of the present study is to investigate the strength of association between anemia and overall survival, locoregional failure, and late radiation therapy (RT) complications in a large prospective study of patients with advanced head and neck cancer treated with conventional radiotherapy with or without a hypoxic cell sensitizer.

Methods and Materials: Between March 1988 and September 1991, 521 patients with Stage III or IV squamous cell carcinoma of the head and neck were entered into a randomized trial examining the addition of etanidazole (SR 2508) to conventional radiation therapy (RT) (66–74 Gy in 33–37 fractions, 5 days a week). Patients with hemoglobin (Hgb) levels measured and recorded prior to the second week of RT were included in this secondary analysis. Hemoglobin levels were stratified as normal (≥ 14.5 gm% for men, ≥ 13 gm% for women) or anemic (< 14.5 gm% for men, < 13 gm% for women). Locoregional failure rates were calculated using the cumulative incidence approach. Overall survival was estimated according to the Kaplan-Meier method. Late RT toxicity was scored according to the RTOG morbidity scale. Differences in rates of overall survival, locoregional failure, and late complications were tested by the Cox proportional hazard model.

Results: Of 504 eligible patients, 451 had a Hgb level measured and recorded prior to the second week of RT. One hundred sixty-two patients (35.9%) were considered to have a normal Hgb level and 289 patients (64.1%) were considered to be anemic. The estimated survival rate is 35.7% at 5 years in patients with a normal Hgb, versus 21.7% in anemic patients (p = 0.0016). The estimated locoregional failure rate is 51.6% at 5 years in patients with a normal Hgb, versus 67.8% in anemic patients (p = 0.00028). The estimated rate of grade 3 or greater toxicity is 19.8% at 5 years in patients with a normal Hgb, versus 12.7% in anemic patients (p = 0.063). On multivariate analysis, several variables were found to be independent predictors of survival including: T stage, Karnofsky performance status, N stage, age, total radiation dose to the primary, and Hgb level. Independent predictors of locoregional control included T stage, Karnofsky performance status, N stage, radiation dose, and Hgb level. The only variables which predicted for the development of late RT complications were gender (p = 0.0109) and age (p = 0.0167). These findings were consistent regardless of whether Hgb level was considered a dichotomous or continuous variable.

Conclusion: Low Hgb levels are associated with a statistically significant reduction in survival and an increase in locoregional failure in this large prospective study of patients with advanced head and neck cancer. Hgb level should be considered as a stratification variable in subsequent studies of head and neck cancer. Strategies to increase Hgb prior to RT in patients with head and neck cancer may lead to improved survival and loco-regional control.     

贝伐单抗治疗转移性结直肠癌研究进展

贝伐单抗(bevacizumab)是一种重组人源化抗血管内皮生长因子的单克隆抗体,可与肿瘤细胞上的血管内皮生长因子(VEGF)特异性结合,通过抑制血管生成而抑制肿瘤生长.贝伐单抗已于2004年2月获FDA批准,与5-氟尿嘧啶为基础的化疗方案联合一线治疗转移性结直肠癌.推荐剂量为5 mg/kg,每14天给药1次,静脉滴注.贝伐单抗的耐受性良好,较常见的不良反应有高血压、出血和血栓形成.