不同模式新辅助治疗食管癌的疗效分析

目的 探讨食管癌不同模式新辅助治疗的疗效分析。方法 回顾性分析2015年1月至2022年5月于安阳市肿瘤医院行新辅助治疗的食管鳞癌(ESCC)患者的资料,共纳入542例患者,其中放化疗(NCRT)组137例,化疗(NCT)组241例,免疫加化疗(NICT)组164例;女性198例,男性344例;≤65岁289例,＞65岁253例。首要研究终点包括主要病理缓解(MPR)率、病理完全缓解(pCR) 率,次要研究终点包括总生存(OS)、无进展生存(PFS)和安全性。生存分析采用Kaplan-Meier方法,并采用Log-rank检验进行组间比较。采用Cox比例风险回归模型进行预后因素分析。结果 NCRT组的MPR率和pCR率分别为66.4%(91/137)和35.8%(49/137),NCT组分别为35.3%(85/241)和6.6%(16/241),NICT组分别为63.4%(104/164)和31.1%(51/164)(χ²=1.67, P＜0.001)。NCRT组的1、2、3年的OS分别为89.8%、82.3%、72.3%,NCT组分别为85.9%、71.4%、61.4%,NICT组分别为91.9%、81.5%、77.8%,差异有统计学意义(χ²=9.20,P＜0.01);NCRT组的1、2、3年的PFS分别为81.5%、67.9%、66.6%,NCT组分别75.9%、61.0%、53.5%,NICT组分别为80.1%、65.5%、65.3%,差异有统计学意义(χ²=4.62,P＜0.05)。多因素分析显示,治疗方式、T分期、N分期是OS的独立影响因素(P＜0.05)。3组不良反应及术后并发症差异无统计学意义(P＞0.05)。结论 与NCT对比,NICT与NCRT有更高的pCR、MPR和生存获益,因此新辅助免疫可作为食管癌术前治疗手段之一,但仍需大型的随机对照研究进一步证实。     

清热化毒丸的薄层色谱鉴别研究

目的:建立清热化毒丸的薄层色谱鉴别方法,为制定其质量控制标准提供试验依据。方法:采用薄层色谱鉴别法鉴别处方中的主要药味。结果:处方中的赤芍、甘草、荆芥、青黛四味药的薄层色谱具有鉴别特征。结论:薄层色谱鉴别方法简便可靠,专属性、重现性好,可作为清热化毒丸的质量控制指标。     

Rapid and Severe Idiopathic Aseptic Necrosis of the Contralateral Femoral Head after Unilateral Total Hip Arthroplasty

BackgroundOsteonecrosis of the femoral head (ONFH) is a multifactorial disease, and agnogenic ONFH, otherwise known as idiopathic ONFH, is rare in clinic. Idiopathic ONFH that exhibits severe necrosis and progresses extremely rapidly is called rapidly destructive hip disease (RDHD). RDHD greatly affects patients but is rarely reported in clinical practice and literature.Case PresentationIn this study, a 64‐year‐old male patient with complete collapse and necrosis of the right femoral head complicated with severe bone destruction at 10 months after left total hip arthroplasty (THA) was reported. The period from the intact structure of the right femoral head to the first discovery of its complete collapse, according to imaging results, was 7 months. The duration from the occurrence of symptoms in the right hip joint to the first discovery of complete collapse and necrosis of the femoral head was only 5 months. At present, the cause has not been determined based on medical history, symptoms, signs, imaging evaluation results, laboratory examination results, and pathological examination results, though it has been identified as severe idiopathic aseptic necrosis of the femoral head with rapid progression, or RDHD. Finally, right THA was performed, and a good outcome was observed in the patient at present.ConclusionsAs a rare hip joint disease, RDHD greatly influences the normal life of patients. RDHD of the contralateral side after unilateral THA is even scarcer. Left THA may be one of the important factors accelerating the necrosis of the right femoral head. Hopefully, with this case report, more attention will be paid to the contralateral hip joint in patients undergoing unilateral THA by clinicians and rehabilitation physicians, and a clinical reference will be provided for the research on RDHD.     

异补骨脂素对体外培养大鼠成骨细胞增殖分化成熟的影响

目的:研究异补骨脂素(Isopsoralen,IP)对体外培养大鼠颅骨成骨细胞(rat calvarial osteoblasts,ROB)增殖与分化成熟的影响。方法:取新生SD大鼠颅骨,多次酶消化法获得成骨细胞,培养于含10%FBS的MEM培养液中,3 d后首次换液,铺满90%皿底后传代培养;增殖分析采用96孔板,加入在培养液中终浓度分别为1×10-4、1×10-5、1×10-6、1×10-7mol/L的异补骨脂素,MTT法分析;分化分析采用24孔板,于成骨性诱导培养第3、6、9、12、15天分别测碱性磷酸酶(Alkaline Phosphatase,ALP)活性、钙含量、骨钙素,第12天进行ALP组织化学染色,第14天进行茜素红染色和钙化结节计数。结果:终浓度为1×10-4mol/L的异补骨脂素对细胞增殖有抑制作用,而1×10-5mol/L浓度虽对ROB增殖无明显影响,但能显著提高细胞ALP活性、增加钙含量、促进骨钙素分泌,并增加钙化结节数量。结论1×10-5mol/L异补骨脂素能促进ROB分化成熟,应为中药补骨脂抗骨质疏松的有效成分。     

非穿透性小梁手术超声生物显微镜检查

目的：应用超声生物显微镜（ＵＢＭ）检查技术,探讨非穿透性小梁手术联合透明质酸钠生物胶植入手术区域解剖特点和房水引汉机制。方法：对１４例１６只眼行非穿透性小梁手术联合透明质酸钠生物胶植入的患者,在术后１～３个月内进行手术区域ＵＢＭ检查。检查的指标（项目）包括：巩膜瓣下形成液间腔的大小（宽和高）、透明质酸钠生物胶吸收的情况、剩余角膜小梁膜的厚度以及滤过泡的形态,并对结果进行分析。结果：１６只眼术前平均     

子宫内膜异位症患者γδT细胞及NK细胞的功能分析

目的 :分析子宫内膜异位症患者中γδT细胞和天然杀伤 (NK)细胞功能的变化 ,并探讨患者腹腔液对正常人γδT细胞和NK细胞功能的影响。方法 :采用免疫荧光细胞检测及细胞毒活性检测法分析 2 2例子宫内膜异位症患者外周血、腹腔液中的γδT细胞及NK细胞的表型与功能。结果 :子宫内膜异位症 (疾病组 )患者外周血、腹腔液中CD56+细胞与正常对照组无明显差异 ,而疾病组腹腔液中γδ+T细胞分别高于外周血和正常对照组。疾病组腹腔液中的γδT细胞及NK细胞的功能低于外周血及正常对照组。疾病组的腹腔液对正常人外周血γδT细胞及NK细胞的功能具有负相调节作用。结论 :子宫内膜异位症患者的γδT细胞及NK细胞的功能低下 ,处于被抑制状态 ,提示子宫内膜异位症患者的腹腔中存在γδT细胞及NK细胞功能的抑制因子。     

MMP-2、TIMP-2、Ki-67在库肯勃氏瘤中的表达及意义

目的 :探讨MMP 2、TIMP 2、Ki 67表达与库肯勃氏瘤病理生物学行为的关系。方法 :采用免疫组化SP法对 32例库肯勃氏瘤组织和 10例正常卵巢组织进行MMP 2、TIMP 2和Ki 67表达的检测。结果 :MMP 2、TIMP 2、Ki 67在库肯勃氏瘤组织中的表达量显著高于正常卵巢组织 (P <0 .0 1)。有合并转移的库肯勃氏瘤中MMP 2、Ki 67高于无合并转移者 (P <0 .0 5 ) ,TIMP 2低于无合并转移者 (P <0 .0 5 )。MMP 2、Ki 67与术后生存时间呈负相关 (P <0 .0 1) ,TIMP 2与术后生存时间呈正相关 (P <0 .0 1)。结论 :MMP 2、TIMP 2、Ki 67在库肯勃氏瘤发生、发展中起重要作用 ,可作为判断卵巢转移癌恶性程度、临床分期和评估预后的临床参考指标     

重组瑞替普酶对犬冠脉血栓的溶栓作用研究

目的 评价溶栓新药注射用瑞替普酶的溶栓活性。方法 采用麻醉开胸犬电刺激冠脉左旋支引起的冠脉血栓形成模型,并与国外同类产品reteplase进行比较　结果 犬静脉给予注射用瑞替普酶20.0×104、10.0×104、50×104IU/kg对冠脉血栓产生显著的溶栓效果,栓塞冠脉血管很快出现再通,残存血栓较溶剂对照组分别减少了73.5％、38.0％、25.3％;心肌梗死范围明显缩小,与等剂量(10.0×104IU/kg)reteplas溶栓(62.2％)作用相似。结论瑞替普酶溶栓作用肯定,与国外同类产品溶栓作用相似。     

EGFR mutation types and abundance were associated with the overall survival of advanced lung adenocarcinoma patients receiving first-line tyrosine kinase inhibitors

BackgroundEpidermal growth factor receptor tyrosine kinases inhibitors (EGFR-TKIs) are currently recognized as the standard treatment for advanced non-small cell lung cancer (NSCLC) patients with EGFR mutations. Clinically found patients with different EGFR mutational status have different prognosis.MethodsA retrospective cohort study was performed to explore the relationship between EGFR mutations and abundance with patient survival by using patient data from the Affiliated Cancer Hospital of Zhengzhou University between January 2013 and November 2016. All patients involved in the present study had sensitive EGFR mutations [either exon 19 deletion (DEL) or exon 21 L858R] and treated by EGFR-TKIs. They were followed up every three months until lost or dead. Mutation abundance was calculated as the copies of EGFR mutation divided by copies of EGFR locus, and the cut-off values for 19DEL and L858R were 4.9% and 9.5%, respectively.ResultsTotal of 236 patients were included, comprising 116 (49.2%) patients with 19DEL mutation and 120 (50.8%) patients with L858R mutation. The median follow-up duration was 23.2 months (95% CI: 14.9–26.7 months). Overall survival (OS) was significantly longer in patients with 19DEL mutation (20.9 months, 95% CI: 17.7–24.1 months versus 17.0 months, 95% CI: 14.4–19.6 months in patients with L858R; P=0.008) and in patients with high mutation abundance (20.9 months, 95% CI: 18.3–23.5 months versus 13.0 months, 95% CI: 10.3–15.7 months in patients with low mutation abundance; P<0.001). Multivariate Cox regression including age, performance status and tumor stage revealed that longer OS was independently associated with 19DEL mutation (HR: 0.48, 95% CI: 0.39–0.67, P=0.033) and high mutation abundance (HR: 0.62, 95% CI: 0.50–0.79, P=0.027).ConclusionsEGFR mutation types and abundance was associated with the patients’ survival which might be used to predict the efficacy of targeted therapy by EGFR-TKIs.