XELOX方案联合恩度一线治疗晚期胆系肿瘤的临床观察

目的 观察卡培他滨和奥沙利铂（XELOX方案）联合重组人血管内皮抑制素（恩度）一线治疗晚期胆系肿瘤的临床疗效及毒副反应。方法 收集2008年1月至2013年12月我院肿瘤科收治的胆系肿瘤Ⅳ期患者42例,随机分为联合组（n=18）和单纯化疗组（n=24）。单纯化疗组应用XELOX方案化疗：卡培他滨1.25 g/m2 口服,d1~d14;奥沙利铂85 mg/m2 静脉滴注,d1。联合组在应用以上药物的同时给予恩度15 mg静滴3~4 h,d1~d14。21 d为1个周期,每2个周期评价疗效、生活质量（QOL）及毒副反应,比较两组有效率（RR）、疾病控制率（DCR）、中位无疾病进展生存期（mPFS）和中位生存时间（mOS）。结果 单纯化疗组患者获CR 0例,PR 6例,SD 8例,PD 10例,RR为25.0%,DCR为58.3%;mPFS为 5个月,mOS 为9.5个月,QOL改善稳定率为66.7%。联合组患者获CR 0例,PR 5例,SD 6例,PD 7例,RR为27.8%,DCR为61.1%;mPFS为7.5个月,mOS为14个月,QOL改善稳定率为77.8%。两组mPFS、mOS和QOL改善稳定率比较,差异均有统计学意义（P均<0.05）。两组毒副反应主要为消化道反应、手足综合征、骨髓抑制、神经毒性及口腔黏膜炎,多为Ⅰ级/Ⅱ级,Ⅲ级/Ⅳ级少见,差异均无统计学意义（P均＞0.05）。结论 XELOX方案联合恩度一线治疗晚期胆系肿瘤的疗效较好,毒副反应可耐受,安全性良好,值得进一步观察及临床推广应用。     

食管鳞癌及其癌前病变组织p63与Ki-67蛋白共表达临床意义的探讨

目的:研究食管癌高发区食管鳞癌组织及癌前病变标本中p63和Ki-67蛋白的联合表达,探讨其共表达与食管癌变的关系及作为早期癌变生物学标志的可能性.方法:应用免疫组化技术对来自食管癌高发区的正常食管黏膜组织和轻度、中度、重度不典型增生上皮以及癌组织共203例组织中p63和Ki-67蛋白的异常表达进行研究.结果:在正常黏膜、轻度、中度、重度不典型增生及癌组织中,p63蛋白异常表达的阳性率分别为15.0%(3/20)、36.8%(14/38)、47.1%(24/51)、65.2%(30/46)和83.3%(40/48);Ki-67异常表达检出率分别为10.0%(2/20)、28.9%(11/38)、41.2%(21/51)、56.5%(26/46)和81.3%(39/48),等级相关分析结果显示,p63、Ki-67表达异常与组织学分级均显著相关(r分别为0.553和0.583,P<0.01),而且p63蛋白与Ki-67蛋白表达之间也具有相关性(r=0.690,P<0.01).结论:p63和Ki-67蛋白共表达与食管癌癌变过程显著相关,p63及Ki-67表达改变的时相分布,有可能成为在食管癌前人群中确立高危个体和选择重点化学预防个体的分子生物学标志.     

玉屏风胶囊治疗玫瑰糠疹疗效观察

玫瑰糠疹(PR)是一种较常见的急性炎性皮肤病,至今病因不明目前认为与感染后导致细胞免疫和或体液免疫失衡有关[1].玫瑰糠疹具有自限性,大多数患者持续6～8周而自愈,但临床上,由于玫瑰糠疹的治疗,多数采用传统的抗组织胺、激素类药物治疗,尤其是激素的应用,往往缺乏正确治疗原则的指导,致使部分患者症状反复发作、病程迁延;另外,许多患者因为各种自身的原因不能使用皮质激素,导致病情迁延、症状反复加重.笔者采用玉屏风胶囊治疗攻瑰糠疹76例,取得了良好的效果.现报告如下.     

心肌梗死后移植骨髓间充质干细胞后全身细胞的分布

Objective To study the systemic distribution of bone marrow derived mesenchymal stem cells (MSCs) 24 h and 2 weeks after cell injection into the border zone of myocardial infarction area. Methods MSCs from male SD rats were labeled with Bromodeoxyuridine (BrdU). Three weeks after in-duction of myocardial infarction,female SD rats were randomized into 2 groups. Labeled cells (3 × 10 ,50 μl) were injected into the border zone of infarcted area in the one group (n = 12) ,and PBS of equal vol-ume was injected into the border zone of infarcted area in the other group ( n = 8 ). The systemic distribu-tion of MSCs was evaluated through real-time PCR and immunohistochemistry at time points of 24 h and 2 weeks after injection, respectively. Results Cells injected into border zone of infarcted area were distribu-ted to extra-cardiac organs such as spleen,lung and liver. Twenty-four h after injection,cells mainly con-centrated in the heart (467 467 ± 191 387) ,while obvious cell loss was noted in all organs including the heart ( 112 388 ±43 751 ) 2 weeks after injection. Of immunostaining were consistent with those of real-time PCR. Conclusion After injected into the border zone of infarcted area, MSCs mainly gathered in the heart with distributions into spleen, lung, and liver. However, substantial number of cells lost with pro-longed time span.     

神经妥乐平治疗含紫杉醇方案化疗所致周围神经损伤的疗效观察

<正>在肿瘤内科进行化疗的患者中,出现周围神经损伤是较常见的不良反应之一,很多化疗药物都可引起,如长春新碱、紫杉醇、奥沙利铂等。近年来较常用的新药奥沙利铂等均能引起,患者多数表现为四肢末端麻木及感觉异常,严重的还会导致肢体功能障碍而致化疗中断或延迟。紫杉醇是一种新的抗微管药物,其作用机制是能特异的结合到微管的β位上,导致微管聚合成团块和束状使其稳定,这些作用能抑制微管的正常重组。神经妥乐平是近年来应用比较广泛的一种药     

TFF3在贲门肠化组织中的蛋白表达及其与癌变的相关性

目的: 探讨TFF3蛋白在贲门肠化及肠化伴不典型增生组织中的表达与贲门癌变的相关性.方法: 采用免疫组织化学SP法, 检测河南贲门癌高发区贲门炎组织24例、肠化组织52例、肠化伴不典型增生组织65例及贲门癌组织35例中TFF3蛋白的表达变化.结果: 在贲门炎及肠化组织中, TFF3蛋白主要表达在柱状细胞的纹状缘, 肠化伴不典型增生及癌变组织中, 主要表达在细胞质中.TFF3蛋白在贲门炎、肠化组织、肠化伴不典型增生及癌变组织中的阳性表达率分别为20.8%、44.2%、46.2%和54.3%, 贲门黏膜组织从正常至不典型增生再至癌变这一过程与TFF3表达阳性率呈正相关( r = 0.232, P<0.05).TFF3蛋白表达的位点与病理类型相关(Kappa= 0.490).结论: TFF3蛋白在细胞质中的过表达参与了贲门癌变过程, 有可能成为贲门组织早期癌变的预警分子.     

特发性乙状结肠破裂14例诊治体会

特发性乙状结肠穿孔又称乙状结肠自发性破裂,是指乙状结肠本身无任何病变或无外伤所致突然穿孔,继发弥漫性腹膜炎。本病临床上比较少见,我院于2001年7月至2008年10月共收治经手术及病理检查证实为乙状结肠自发性破裂14例,现分析报告如下。     

心肌梗死后移植骨髓间充质干细胞后全身细胞的分布

Objective To study the systemic distribution of bone marrow derived mesenchymal stem cells (MSCs) 24 h and 2 weeks after cell injection into the border zone of myocardial infarction area. Methods MSCs from male SD rats were labeled with Bromodeoxyuridine (BrdU). Three weeks after in-duction of myocardial infarction,female SD rats were randomized into 2 groups. Labeled cells (3 × 10 ,50 μl) were injected into the border zone of infarcted area in the one group (n = 12) ,and PBS of equal vol-ume was injected into the border zone of infarcted area in the other group ( n = 8 ). The systemic distribu-tion of MSCs was evaluated through real-time PCR and immunohistochemistry at time points of 24 h and 2 weeks after injection, respectively. Results Cells injected into border zone of infarcted area were distribu-ted to extra-cardiac organs such as spleen,lung and liver. Twenty-four h after injection,cells mainly con-centrated in the heart (467 467 ± 191 387) ,while obvious cell loss was noted in all organs including the heart ( 112 388 ±43 751 ) 2 weeks after injection. Of immunostaining were consistent with those of real-time PCR. Conclusion After injected into the border zone of infarcted area, MSCs mainly gathered in the heart with distributions into spleen, lung, and liver. However, substantial number of cells lost with pro-longed time span.     

心肌梗死后移植骨髓间充质干细胞后全身细胞的分布

Objective To study the systemic distribution of bone marrow derived mesenchymal stem cells (MSCs) 24 h and 2 weeks after cell injection into the border zone of myocardial infarction area. Methods MSCs from male SD rats were labeled with Bromodeoxyuridine (BrdU). Three weeks after in-duction of myocardial infarction,female SD rats were randomized into 2 groups. Labeled cells (3 × 10 ,50 μl) were injected into the border zone of infarcted area in the one group (n = 12) ,and PBS of equal vol-ume was injected into the border zone of infarcted area in the other group ( n = 8 ). The systemic distribu-tion of MSCs was evaluated through real-time PCR and immunohistochemistry at time points of 24 h and 2 weeks after injection, respectively. Results Cells injected into border zone of infarcted area were distribu-ted to extra-cardiac organs such as spleen,lung and liver. Twenty-four h after injection,cells mainly con-centrated in the heart (467 467 ± 191 387) ,while obvious cell loss was noted in all organs including the heart ( 112 388 ±43 751 ) 2 weeks after injection. Of immunostaining were consistent with those of real-time PCR. Conclusion After injected into the border zone of infarcted area, MSCs mainly gathered in the heart with distributions into spleen, lung, and liver. However, substantial number of cells lost with pro-longed time span.