30例儿童卵黄囊瘤临床预后因素分析

目的:对影响儿童卵黄囊瘤预后因素进行分析讨论.方法:自1989年到2002年随访30例,对年龄、性别、原发部位、Brodeur分期、血清AFP、化疗方案等进行多因素和单因素统计学分析.结果:Brodeur分期、化疗方案的选择是影响卵黄囊瘤2年无事件生存率的独立临床因素.Ⅰ到Ⅳ期的2年无事件生存率分别为76.92%、66.67%、40.00%和0:VAC及不规则化疗方案和铂类方案的2年EFS分别为18.18%和73.68%,有统计学差异.结论:儿童卵黄囊瘤的治疗为手术加辅助化疗的综合治疗,手术应以达到无肿瘤残留为目标.铂类方案的辅助化疗有助于提高疗效,但复发和转移病例的疗效仍有待提高.     

Selections of appropriate regimen of high-dose chemotherapy combined with adoptive cellular therapy with dendritic and cytokine-induced killer cells improved progression-free and overall survival in patients with metastatic breast cancer: reargument of such contentious therapeutic preferences

Background

We hypothesized that combination of dendritic cell (DC) with autologous cytokine-induced killer (CIK) immunotherapy in setting of high-dose chemotherapy (HDC) would be effective for selected metastatic breast cancer (MBC) patients.

Patients and methods

Our previous work showed thiotepa could eradicate breast cancer stem cells. From 2004 to 2009, 79 patients received standard dose chemotherapy (SDC) of 75 mg/m² docetaxel and 75 mg/m² thiotepa versus 87 patients of HDC + DC/CIK: 120 mg/m² docetaxel to mobilize peripheral CD34⁺ progenitor cells, a sequence of HDC (120 mg/m² docetaxel, plus 175 mg/m² thiotepa) + DC/CIK, with or without 400 mg/m² carboplatin depending upon bone marrow function. The endpoints were response rates (RR), progression-free survival (PFS), and overall survival (OS).

Results

Compared with SDC, PFS and OS were improved in HDC + DC/CIK (median PFS 10.2 vs. 3.7 months, P < 0.001; median OS 33.1 vs. 15.2 months, P < 0.001). Patients of pre-menopausal, HDC as first-line treatment after metastasis, or with visceral metastasis showed prolonged PFS and OS. SDC group also achieved the similar response as previous reports.

Conclusion

Our study demonstrated the novel combination of HDC with DC/CIK to be an effective choice for the selected MBC population, in which choosing appropriate chemo regimens played important roles, and also specific HDC regimen plus DC/CIK immunotherapy showed the clinical benefits compared with chemotherapy alone.     

高频超声在睾丸肿瘤诊断中的应用

睾丸肿瘤占男性全身肿瘤的1%～2%,绝大多数为恶性[1].睾丸肿瘤较早即可发生转移,故早期发现并了解有无转移,对睾丸肿瘤的临床治疗有重要意义.我们对43例睾丸肿瘤的超声检查资料进行了回顾性分析,以探讨高频彩色多普勒超声对睾丸肿瘤诊断的应用价值.     

Opposing effects of arsenic trioxide on hepatocellular carcinomas in mice

Arsenic trioxide (As2O3) is a potent antitumor agent used to treat acute promyelocytic leukemia (APL) and, more recently, solid tumors. However, the dose of As2O3 required to suppress human xenographs in mice is markedly higher than that used to treat APL in humans. Paradoxically, low doses of As2O3 stimulate angiogenesis, which might be expected to promote tumor growth. Clearly, appropriate dosages of As2O3 are required to treat human patients to avoid toxicity and undesirable side effects. In the present study, we investigated As2O3 with respect to its toxicity and effects on tumor growth, angiogenesis and cell apoptosis using H22 hepatocellular carcinoma (HCC) cells in a mouse model of HCC. As2O3 inhibited tumor growth and angiogenesis, and enhanced tumor cell apoptosis at doses greater than 1 mg/kg, but mice lost weight and failed to thrive at doses of 4 mg/kg and greater. In contrast, low doses (<1 mg/kg) of As2O3 promoted tumor growth, upregulated the expression of vascular endothelial growth factor and tumor angiogenesis, and had no effect on tumor cell apoptosis. In vitro studies demonstrated that As2O3 inhibited the proliferation of H22 tumor cells and bovine aortic endothelial cells, and induced their apoptosis in a dose- and time-dependent fashion, suggesting that the mechanism of As2O3-mediated inhibition of tumor growth is due to direct effects of the drug on both tumor cells and endothelia. In summary, different doses of As2O3 have opposing effects on tumor growth and angiogenesis. The results demonstrate that As2O3 has a narrow window of therapeutic opportunity with respect to dosage, and that low doses of the drug as used in metronomic therapy should be used with extreme caution.     

关于中医临床疗效评价的若干思考

中医临床疗效评价研究是中医药研究领域内热点及难点问题,但是当前相关研究的整体水平还有待提高,在中医临床疗效评议研究领域内还存在着不少学术争议。笔者认为在开展中医临床疗效评价研究之前,要对其核心问题进行梳理,主要包括中医临床疗效的概念及其评价。近年来,已有国内学者围绕这些问题开展了一系列研究,并取得相应成绩,对这些问题的思考与回答将为解决中医临床疗效评价问题提供重要的支撑作用。     

中药蛋白质组学研究策略

蛋白质组学在中药研究中的应用已十分广泛,有许多较为成功的实例。作者回顾了前人应用蛋白质组学技术对中药复杂体系的研究工作,并提出建立一门专门针对中药研究的蛋白组学,即中药蛋白质组学。该文对中药蛋白质组学的研究策略及未来的研究方向进行了综述和思考,希望为从事中药蛋白质组学研究者提供一点思路。     

HPLC法同时测定不同产地广陈皮中5种活性黄酮成分

目的 建立HPLC法测定12批不同产地广陈皮中5种活性黄酮的量.方法 采用超声法提取药材,通过对提取工艺及色谱条件进行优化建立测定方法,同时测定不同产地广陈皮中橙皮苷(1)、川陈皮素(2)、3,5,6,7,8,3',4'-七甲氧基黄酮(3)、橘皮素(4)和5-羟基-6,7,8,3',4'-五甲氧基黄酮(5)5种活性黄酮的量.结果 12批广陈皮中橙皮苷的量在38.021～70.735 mg/g,均符合药典标准(≥35 mg/g),其中,产于新会的广陈皮中橙皮苷的量低于广东其他两个产地(高要和龙门);另外,广陈皮中多甲氧基黄酮类成分的量以川陈皮素、橘皮素为高.结论 该方法简单、准确,其结果可为广陈皮质量标准的制定提供一定的依据.     

电针"合谷""三阴交"穴促分娩作用机理的实验研究

目的：通过动物实验探讨电针“合谷”“三阴交”穴促分娩的作用机理。方法：选健康成年Wistar大鼠55只,分正常对照组、模型对照组、“合谷”组、“三阴交”组、“合谷”加“三阴交”组。以子宫颈及子宫体组织前列腺素E2(PGEa)、血清及羊水雌二醇(E2)和孕酮(P)为指标。结果：电针“合谷”穴使晚孕大鼠宫体及宫颈组织PGEa、血清E2、羊水中P含量显著升高;电针“三阴交”穴仅使晚孕大鼠羊水中P含量显著升高;同时电针“合谷”“三阴交”穴对本实验所测各项内分泌指标影响不显著。     

三七皂苷积累规律的研究

目的 :研究三七皂苷的积累规律 ,为确定三七的最佳采收期提供依据。方法 :定期定点采集三七样品 ,分析三七总皂苷和主要单体皂苷含量。结果 :4～7月三七皂苷含量减少 ,8～12月 ,三七皂苷含量增加。结论 :10～12月为三七最佳采收期 ,与传统确定的采收期相吻合。     

益肾蠲痹法治疗系统性红斑狼疮临床报道

目的:研究益肾蠲痹法治疗系统性红斑狼疮的疗效.方法:本研究应用"益肾蠲痹法"对54例曾用激素或免疫抑制剂治疗系统性红斑狼疮,因副作用而改用益肾蠲痹法治疗3年以上的患者,观察治疗前后临床疗效、症状积分、激素剂量、血沉、C反应蛋白、ENA系列等指标变化.结果:54例系统性红斑狼疮患者治疗后的症状积分显著下降,ESR、CRP明显下降;激素用量逐渐撤减至停服,ENA系列指标阴转率最高达96.3%.结论:益肾蠲痹法对难治性系统性红斑狼疮,具有疗效高、毒副作用小、症状及实验室指标改善明显等理想疗效,是一种易于推广使用、具有良好产业化前景的治疗方法.