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71.
自美国国家骨髓库(NMDP)开展第一例无关供者移植以来,至今已有20年.NMDP目前的库容量已逾700万,已为6大洲提供了30 000多份无关供者造血干细胞.这一辉煌成就是美国国家骨髓库600多名工作人员共同努力的结果,同时也得益于广泛的国际合作,包括171个移植中心,73个供者中心,24个脐血库,97个骨髓采集中心,91个血液净化中心,26个HLA分型实验室和26个合作供者登记处.本文回顾了美国国家骨髓库的历史,阐述了20年来移植病人、移植物来源和预处理方案几方面的主要变化趋势. 相似文献
72.
73.
R Krempien MW Muenter PE Huber S Nill H Friess C Timke B Didinger P Buechler S Heeger KK Herfarth A Abdollahi MW Buchler J Debus 《BMC cancer》2005,5(1):1-11
Background
Pancreatic cancer is the fourth commonest cause of death from cancer in men and women. Advantages in surgical techniques, radiation therapy techniques, chemotherapeutic regimes, and different combined-modality approaches have yielded only a modest impact on the prognosis of patients with pancreatic cancer. Thus there is clearly a need for additional strategies. One approach involves using the identification of a number of molecular targets that may be responsible for the resistance of cancer cells to radiation or to other cytotoxic agents. As such, these molecular determinants may serve as targets for augmentation of the radiotherapy or chemotherapy response. Of these, the epidermal growth factor receptor (EGFR) has been a molecular target of considerable interest and investigation, and there has been a tremendous surge of interest in pursuing targeted therapy of cancers via inhibition of the EGFR.Methods/design
The PARC study is designed as an open, controlled, prospective, randomized phase II trial. Patients in study arm A will be treated with chemoradiation using intensity modulated radiation therapy (IMRT) combined with gemcitabine and simultaneous cetuximab infusions. After chemoradiation the patients receive gemcitabine infusions weekly over 4 weeks. Patients in study arm B will be treated with chemoradiation using intensity modulated radiation therapy (IMRT) combined with gemcitabine and simultaneous cetuximab infusions. After chemoradiation the patients receive gemcitabine weekly over 4 weeks and cetuximab infusions over 12 weeks. A total of 66 patients with locally advanced adenocarcinoma of the pancreas will be enrolled. An interim analysis for patient safety reasons will be done one year after start of recruitment. Evaluation of the primary endpoint will be performed two years after the last patient's enrolment.Discussion
The primary objective of this study is to evaluate the feasibility and the toxicity profile of trimodal therapy in pancreatic adenocarcinoma with chemoradiation therapy with gemcitabine and intensity modulated radiation therapy (IMRT) and EGFR-targeted therapy using cetuximab and to compare between two different methods of cetuximab treatment schedules (concomitant versus concomitant and sequential cetuximab treatment). Secondary objectives are to determine the role and the mechanism of cetuximab in patient's chemoradiation regimen, the response rate, the potential of this combined modality treatment to concert locally advanced lesions to potentially resectable lesions, the time to progression interval and the quality of life. 相似文献74.
Sinha I Hannawa KK Eliason JL Ailawadi G Deogracias MP Bethi S Ford JW Roelofs KJ Grigoryants V Henke PK Stanley JC Upchurch GR 《Surgery》2004,136(2):176-182
OBJECTIVE: The objective of this study was to determine the significance of membrane type 1 matrix metalloproteinase (MT1-MMP) activation of MMP-2 in experimental abdominal aortic aneurysms. METHODS: Rat aortas were perfused with either saline as a control or elastase, and harvested on 2, 4, or 7 days after perfusion (n = 5 per treatment group/day). Aortic MT1-MMP and MMP-2 expression and protein were determined by real time polymerase chain reaction and Western blotting, respectively. Aortic explants were used to measure MMP-2 activity by zymography. Rat aortic smooth muscle cells in vitro were exposed to increasing doses of elastase and analyzed for MT-1 MMP expression. RESULTS: Aneurysms formed in 80% of the elastase-perfused aortas at 7 days, whereas none formed in the saline-perfused aortas. Significantly increased MT1-MMP expression was observed only on day 4, when levels were 6.5-fold higher in elastase-perfused aortas compared with saline-perfused aortas (P < .01). By day 7, MT1-MMP protein was present only in the elastase-perfused aortas (P = .02). By immunohistochemistry, MT1-MMP was detectable only in the elastase-perfused group at day 7. Cleaved MMP-2 activity (P = .045) was increased in elastase-perfused aortas compared with saline perfused aortas at day 7. In rat aortic smooth muscle cells, MT-1 MMP expression increased in response to elastase (P = .02). CONCLUSION: The rodent aortic aneurysm model exhibits upregulation of MT1-MMP expression and protein with subsequent increased conversion of MMP-2 from the latent to the cleaved form. 相似文献
75.
Gadolinium enhanced Magnetic Resonance Imaging (MRI) for the evaluation of the post operative lumbo-sacral spine is a sensitive and specific imaging technique. A need for establishing a specific protocol for Failed Back Surgery Syndrome (FBSS) for use in the service hospitals is highlighted for convenience of patient management and preservation of active manpower. The MR scan of 50 patients performed over a span of six months, who complained of persistent low backache even after surgery, were retrospectively analysed. The specificity of this series using MRI in indicating the exact cause of FBSS was clocked at only 30%. The conditions diagnosed were rectifiable. The balance of the patients who could not be offered any specific diagnosis towards the cause, were being managed conservatively / placed in low medical category for a considerable period. It was noted with concern that there was non prevalence of sequence like the fast spin echo with gadolinium enhancement as a routine.KEY WORDS: Gadolinium, Magnetic Resonance Imaging, Post-operative spine 相似文献
76.
Lau EMC; Cooper C; Fung H; Lam D; Tsang KK 《Journal of public health (Oxford, England)》1999,21(3):249-250
77.
4-S-(5″-烃基-4″-氨基-1″,2″,4″-三唑-3″-基)-4-去氧-4′-去甲基表鬼臼毒素衍生物的合成及抗肿瘤活性 总被引:1,自引:0,他引:1
许多有显著抗肿瘤活性的鬼臼毒素类化合物,其母核C-4侧链上往往连接有刚性较强的脂环或芳香环结构,而且侧链多含有一定数量的杂原子[1~3]。另外,三氮唑类化合物大都有广泛的生物活性,如抗菌[4~5]、抗病毒[6]、抗肿瘤[7]等,据此,我们设计并合成了8个三氮唑杂环取代的表鬼臼毒素衍生物,以期寻找活性高、毒副作用小的鬼臼毒素类药物,并进一步考察此类化合物的构效关系。 合成路线如图1所示,三氮唑3a~3h和4′-去甲基-表鬼臼毒2分别按文献[8,9]方法合成;我们选择三氟乙酸作为缩合剂,基于它不仅能催化缩合反应,而且能保护三唑上的氨基官能团,使其不能充当进攻基团;最后一步缩合反应显然经历了一个SN1历程,4′-去甲基-表鬼臼毒
的C-4位上很容易形成一个苄基型碳正离子,由于C-1位有庞大的芳环,加之,进攻的基团也较大,可以预料,这个反应有很强的立体选择性,使C-4β-构型成为主要产物,事实确实如此,在TLC上几乎看不到C-4α-构型的产物。 相似文献
78.
Barthelman M; Bair WB rd; Stickland KK; Chen W; Timmermann BN; Valcic S; Dong Z; Bowden GT 《Carcinogenesis》1998,19(12):2201-2204
Green tea polyphenols have been shown to inhibit cancer in a variety of
tumor models, including ultraviolet B (UVB)-induced non-melanoma skin
cancer. In green tea extracts, the major dry mass constituent is the family
of catechins, of which (-)-epigallocatechin-(3)-gallate (EGCG) is
considered to be important for the chemopreventive activity. EGCG has been
shown to have antioxidant properties, but there has been little progress
toward identifying the specific targets and mechanisms of its action. Using
cultured human keratinocytes, we show that UVB- induced AP-1 activity is
inhibited by EGCG in a dose range of 5.45 nM to 54.5 microM. EGCG is
effective at inhibiting AP-1 activity when applied before, after or both
before and after UVB irradiation. EGCG also inhibits AP-1 activity in the
epidermis of a transgenic mouse model. This work begins to define a
mechanism by which EGCG could be acting to inhibit UVB-induced tumor
formation.
相似文献
79.
The question of payment to egg donors has recently focused the attention of
both the Human Fertilisation and Embryology Authority (HFEA) and licensed
clinics. An acute shortage of egg donors and the rising costs of assisted
conception treatment are matters of grave concern to many patients. To
understand the emotional and social effects of egg sharing and egg
donation, we conducted a survey of attitudes in a group of women who had
some knowledge or experience of egg donation. A total of 750 questionnaires
were sent out of which 217 were returned within the specified time limit.
From these, 107 respondents had experience of egg donation and 110 had made
enquiries about donation. The data from these questionnaires were collated
and tabulated by the National Opinion Polls (NOP) Research Group. An
analysis of the data produced the following key findings: (i) donating or
sharing eggs is a social issue, 94% discuss it with
partners/family/friends; (ii) altruistic motives are not the prerogative of
non-patient volunteers-egg share donors felt that helping the childless was
as important as having a chance of in-vitro fertilization (IVF) for
themselves; (iii) the treatment procedure causes the most anxiety for egg
donors. The recipients were most concerned about delays, donor
characteristics and how the eggs were allocated; (iv) most respondents
(65%) with prior experience of egg sharing would do it again - 63% of egg
share donors, 72% of egg share recipients; (v) cash rewards to egg donors
and outright advertising for donors were rejected by 64 and 62% of the
sample respectively; and (vi) counselling was highly valued and there were
no instances of 'shattered lives' after treatment. The findings do not
support the recently announced intentions of the HFEA to disallow payment
to gamete donors on the grounds of devalued consent. There is no precedent
in modern medicine for egg sharing. The patients surveyed drew a clear
distinction between egg sharing and financial rewards. As long as egg
donation is not covered by the National Health Service, it is fairer to
offer egg sharing than to refuse treatment to those unable to pay.
相似文献
80.
Pregnancy following intracytoplasmic sperm injection treatment with dead husband's spermatozoa: ethical and policy considerations 总被引:1,自引:1,他引:1
Ahuja KK; Mamiso J; Emmerson G; Bowen-Simpkins P; Seaton A; Simons EG 《Human reproduction (Oxford, England)》1997,12(6):1360-1363
This paper describes the first pregnancy in a childless widow after
intracytoplasmic sperm injection (ICSI) treatment with her deceased
husband's spermatozoa which had been stored for nearly 3 years before use.
Before his death the husband had received treatment for testicular cancer
and he had given the appropriate written consent for the future use of his
spermatozoa. Of the 10 eggs injected, six resulted in normal embryos. Three
embryos were transferred and the remaining three embryos are currently
stored for possible future use. The treatment resulted in a continuing
singleton pregnancy. The case demonstrated the suitability of ICSI in those
difficult cases where the sperm quality is extremely poor. This success is
also compared with a widely debated case of another widow who was refused
permission to use her deceased husband's spermatozoa. It is concluded that
in the case of posthumous use of frozen spermatozoa, the current laws are
conveniently applicable in a chronic illness but not so in an acute illness
leading to death. In the light of the wide public debate on the issues
raised by this legal case, the UK Government has also decided to conduct a
review of consent procedures involving the storage and use of genetic
material.
相似文献