Oral uracil‐tegafur plus leucovorin vs fluorouracil bolus plus leucovorin for advanced colorectal cancer: a meta‐analysis of five randomized controlled trials

Aim The aim of this study was to evaluate systematically the efficacy and safety of oral uracil‐tegafur (UFT) plus leucovorin (LV) compared with infusional fluorouracil (5‐FU) plus LV for advanced colorectal cancer. Method Eligible studies were identified from Medline, Embase and the Cochrane Library. The end‐points included overall survival and overall tumour response rate, and toxicity including leucopenia, febrile neutropenia, stomatitis/mucositis and diarrhoea. Results Five randomized controlled trials were identified. Pooled data demonstrated no difference in overall survival between the oral UFT plus LV regimen and the 5‐FU bolus plus LV regimen [hazard ratio 1.013; 95% confidence interval (CI) 0.911–1.127].The fixed‐effect pooled estimate for overall tumour response rate showed no significant difference between the two regimens (relative risk 0.893; 0.672–1.187). Grade 3–4 leucopenia [odds ratio (OR) 0.126; 955 CI 0.048–0.326], grade 1–4 leucopenia (OR 0.089; 95% CI 0.067–0.119) and grade1–4 febrile neutropenia (OR 0.020; 95% CI 0.004–0.102) were significantly less prominent in the oral UFT regimens. For nonhaematological toxicities, grade 3–4 stomatitis/mucositis (OR 0.075; 95% CI 0.039–0.146), grade 3–4 infection (OR 0.484; 95% CI 0.310–0.758), grade 1–4 infection (OR 0.672; 95% CI 0.547–0.826, P < 0.001), grade 1–4 diarrhoea (OR 0.743; 95% CI 0.626–0.881) were also less likely to happen in patients in the oral UFT plus LV regimen, while there was no significant difference between the two treatment regimens with respect to grade 1–4 stomatitis/mucositis (OR 0.278; 95% CI 0.053–1.456) and grade 3–4 (OR 1.174; 95% CI 0.983–1.403) diarrhoea. Conclusion Oral UFT or 5‐FU bolus combined with LV results in similar overall survival and tumour response rates for advanced colorectal cancer. The former treatment regimen is greatly superior in terms of toxicity, especially haematological toxicity.     

酶处理急性分离技术用于研究果蝇成虫中枢神经细胞钾电流

目的 建立急性分离果蝇成虫中枢神经细胞技术,并记录分析其钾电流。方法 取S、R或H品系果蝇成虫3—5只,分离出果蝇脑组织。胶原酶消化处理后,加入10％的胎牛血清果蝇培养基终止酶反应。巴氏吸管吹打,细胞悬液静置1h后用于电生理实验。全细胞电压钳记录并分析其外向钾电流。结果 酶消化法成功急性分离出果蝇成虫中枢神经细胞。85％以上为Ⅱ型神经细胞,少部分为Ⅰ型和Ⅲ型神经细胞。记录到快失活与持续复合型、慢失活型、快失活和持续型四种全细胞钾电流。结论 本技术可成功急性分离三品系果蝇成虫中枢神经细胞,并记录到四种钾电流。     

骨质疏松与类风湿关节炎

类风湿关节炎和骨质疏松在我国都属于常见病和多发病,而二者之间又有着非常重要的联系。但是目前临床上还没有一个广泛应用的药物可以同时对两者都产生很好的治疗效果。为了进一步了解骨质疏松和类风湿关节炎的关系,将来能够找到更好的治疗药物,笔者从流行病学、发病机制以及治疗方法等方面分别进行了论述。     

华南地区某眼科医院的感染性角膜炎病原菌谱特征

目的 探讨华南地区某眼科医院感染性角膜炎的病原菌谱及其特点。方法 回顾性系列病例研究。选择2013年7月1日至2017年12月31日在中山大学中山眼科中心进行角膜取材和微生物检测的角膜感染患者3 914例。表面麻醉后刮取病灶边缘的病灶组织,进行细菌、真菌培养及鉴定。培养结果阳性的细菌采用生化比色或质谱进行种属鉴定;真菌依据形态学进行种属鉴定。各季节菌谱阳性率差异比较采用卡方检验。结果 感染性角膜炎患者中,男2 468例（63.1%）,女1 446例（36.9%）,年龄（49.5±16.8）岁。病原菌培养阳性的患者共1 673例（42.7%）,其中单纯细菌749例（44.8%）,单纯真菌849例（50.7%）,混合感染75例（4.5%）。最常见的细菌是葡萄球菌属（20.1%）,其次是假单胞菌属（7.5%）;最常见的真菌是镰刀菌属（25.5%）,其次是曲霉菌属（10.3%）。细菌的阳性率在5-8月明显高于1-2月和9-12月（P<0.05）,真菌的阳性率在5-6月明显低于1-2月和9-12月（P<0.05）。结论 在华南地区一所三甲眼科医院的感染性角膜炎中,真菌感染略高于细菌感染,且细菌和真菌感染存在季节性差异。     

qMRI relaxometry of mandibular bone marrow: A monomodal distribution in sickle cell disease

Purpose:

To identify and characterize sickle cell disease (SCD)‐related changes in the composition of mandibular bone marrow using qMRI relaxometry histograms.

Materials and Methods:

Thirteen SCD patients and 17 controls underwent brain MR imaging with the mixed turbo spin‐echo (TSE) pulse sequence at 1.5T. The mandible was manually segmented and divided into body, angle, ramus, and condyle. T1 and T2 histograms of each mandible were modeled with Gaussian functions. The relaxation time histogram peaks were calculated, and the number of monomodal versus bimodal curves was compared.

Results:

SCD patients exhibited monomodal distributions on both T1 and T2 histograms, consistent with a composition of predominantly red hematopoietic marrow. Eighty‐eight percent of mandibles in control subjects exhibited a bimodal distribution in T1 and all showed a bimodal distribution in T2, indicating mixed but predominantly yellow marrow composition. The second peak in control subjects was shorter in T1 and longer in T2, consistent with yellow marrow composition.

Conclusion:

Instead of physiological fatty replacement, SCD patients exhibit red marrow persistence in the mandible, likely due to the increased demand for hematopoiesis. This phenomenon can be manifested by a monomodal curve in both T1 and T2 relaxometric histograms. J. Magn. Reson. Imaging 2013;37:1182–1188. © 2012 Wiley Periodicals, Inc.     

Waist-to-thigh ratio is a predictor of internal organ cancers in humans: findings from a cohort study

ObjectiveStudies have shown that some specific body measures are associated with the occurrence of cancers. Few studies have demonstrated the relationship with more comprehensive approaches. This study aims to explore body measures and the combinations associated with internal organ cancers.MethodsThree-dimensional anthropometric body surface scanning data collected 10,215 participants from the health examination department in a medical center of Taiwan during 2000–2010. Follow-up was conducted for an average of 8 years, and 244 internal organ cancer cases were identified.ResultsAn increased risk of internal organ cancers was observed among the subjects with larger waist circumference/smaller thigh circumference, in which waist-to-thigh ratio (WTR) was constructed. Comparing the subjects in the fourth quartile for WTR to the subjects in the first quartile with multiple Cox regression analysis yielded a hazard ratio of 1.842 (95% confidence interval, 1.131～2.999). The association between WTR quartile and internal organ cancers was stronger among male participants, older participants, and participants with chronic conditions.ConclusionsThe study has revealed that WTR is the most significant predictor for the occurrence of cancer in Asian populations. Because it is easy to measure and open to modification, WTR may be more useful in clinical and preventive medicine in the future.     

不同方式缺氧预处理对心肌细胞线粒体的影响

目的研究不同缺氧方式预处理对心肌细胞线粒体功能的影响,为探讨心肌缺血缺氧病理生理过程中的一些现象提供依据。方法原代培养乳鼠心肌细胞,经过几种不同的缺氧预处理后,继续培养24h,再次给予较严重的缺氧损伤处理,在不同钓时间点用用流式细胞仪检测罗丹明123标记线粒体的膜电位。结果Ⅰ组和Ⅱ组在缺氧预处理后的荧光强度通过成组t检验。t=10．16,P〈0．05;Ⅰ组和Ⅱ组在24h后再次经过缺氧损伤后荧光强度通过成组t检验,t=6．23,P〈0．05;Ⅰ组和Ⅲ组在缺氧预处理后的荧光强度通过成组t检验,t=34．12,P〈0．05;Ⅰ组和Ⅲ组在24h后再次经过缺氧损伤后荧光强度通过成组t检验,t=18．84．P〈0．05;Ⅰ组和Ⅳ组在缺氧预处理后的荧光强度通过成组t检验,t=26．25,P〈0．05;Ⅰ组和Ⅳ组在24h后再次经过缺氧损伤后荧光强度通过成组t检验,t=17．69,P〈0．05。再次损伤后Ⅱ组的细胞线粒体内的电位较对照组高。Ⅲ组和Ⅳ组的细胞线粒体内的电位明显较对照组低。结论在经过不同方式的缺氧预处理后,心肌细胞对再次严重缺氧损伤的反应性是不同的。预处理后的心肌细胞可以对再次损伤的抵抗力增强,即产生了我们所认识的预适应保护效应;也能产生心肌细胞对再次损伤的抵抗力减弱,即产生了我们所认识的缺氧损伤增敏效应。     

正交试验法优选水杨酸滴丸的制备工艺

摘 要 目的：考察影响水杨酸滴丸制备的因素,确立其最佳成型工艺。方法: 考察环境因素、加热温度、基质配比与试验步骤对滴丸制备工艺的影响。以丸重差异、溶出时限及外观质量为综合评价指标,通过正交试验进一步优化滴丸的制备工艺。结果: 基质单独加热熔化后再与药液在避光密封的条件下进行混合,可防止药液迅速氧化变红。滴丸的最佳制备工艺为：聚乙二醇400与聚乙二醇6000的比例为1∶5,药液温度为50℃,滴距为8 cm,滴制速度为70滴·min^-1。结论:该工艺简单可行,制得滴丸的丸重差异、溶出时限及外观质量均符合质量要求。