剂量调整的EPOCH方案治疗初治血管免疫母T细胞淋巴瘤的前瞻性研究

  目的  前瞻性研究剂量调整的EPOCH方案对初治血管免疫母T细胞淋巴瘤（AITL）患者的疗效及不良反应。   方法  选择2008年9月至2012年9月中国军事医学科学院附属307医院确诊的初治AITL患者9例。全组患者均接受剂量调整的EPOCH方案一线化疗。   结果  全组患者发病中位年龄54岁,男:女为2:1,88.9%为Ann-Arbor stage Ⅲ~Ⅳ期,77.8%合并B症状。初诊时伴有贫血的患者占66.7%,LDH或β2微球蛋白升高占55.6%。EPOCH方案近期疗效CR率22.2%,总反应率66.7%。中位随访20个月,4年PFS和OS分别为11.1%和33.3%,中位生存时间19个月。EPOCH方案化疗主要不良反应为血液学毒性,3~4度粒细胞减少和血小板减少分别为77.8%和33.3%,44.4%的患者出现粒细胞缺乏伴发热。   结论  剂量调整的EPOCH方案一线治疗AITL患者较传统CHOP方案未见明显生存获益。主要不良反应为血液学毒性,并可以耐受。      

五柱绞股蓝总皂苷和总黄酮的季节性变化

目的 测定五柱绞股蓝茎和叶中的总皂苷和总黄酮的量，并揭示其在不同季节内的动态变化规律。方法 以绞股蓝皂苷和芦丁为对照品，采用紫外可见光分光光度计在 550 nm 处测定皂苷吸光度，在 510 nm 处测定黄酮吸光度。结果 五柱绞股蓝茎、叶中的总皂苷和总黄酮的量在5月至11月的生长发育季节内，均表现为先上升后下降的变化规律，以9月的量最高，且叶中的量高于茎中的量。结论 五柱绞股蓝采收可安排在8～9月的花果期进行。     

塞来昔布对SK-N-SH细胞增殖和凋亡影响的研究

目的:探讨特异性环氧化酶-2(COX-2)抑制剂塞来昔布(celecoxib)对人神经母细胞瘤细胞系SK-N-SH细胞生长的影响及其分子生物学作用机制。方法:不同浓度塞来昔布(12.5、25、50和75μmol/L)用不同时间(24、48和72h)处理SK-N-SH细胞,MTT法检测细胞增殖,DNA ladder法及AO/EB染色法分析细胞凋亡,Western blot检测COX-2、Bcl-2蛋白表达。结果:MTT法显示,12.5、25、50和75μmol/L组在3个时间点对细胞的抑制率分别为(7.38±1.12)%、(10.33±1.97)%和(25.16±5.58)%;(34.46±6.76)%、(30.12±6.71)%和(57.54±3.06)%;(61.85±4.01)%、(50.78±2.85)%和(85.67±2.17)%;(83.85±5.56)%、(90.06±5.71)%和(98.04±4.43)%。组间差异均有统计学意义,P<0.05。结论:塞来昔布抑制SK-N-SH细胞的生长并诱导其凋亡,其机制除了抑制COX-2外还可能与抑制Bcl-2有关,有一定的临床应用价值。     

43例淋巴母细胞淋巴瘤患者临床特点及疗效分析

Objective To investigate the clinical features and treatment outcomes of different regimens in Chinese patients with lymphoblastic lymphoma(LBL). Methods Forty-three patients with LBL were retrospectively analysed, of which 30 were T-LBL, and 13 B-LBL. Results ①Most patients were young men with a median age of 21, and 63.0％ of the T-LBL patients had mediastinal masses. ② Treatment outcome could be assessed in 37 cases, of which the response rate (RR) was 81.1％ and complete remission (CR) rate was 67.6％. The RR and CR rates in patients treated with regimens for ALL (ALL-like group) and those treated with regimens for NHL(NHL-like group) were 94.4％ , 68.4％ and 83.3％ , 52.6％ , respectively. ③The estimated median overal survival(OS) and progression free survival (PFS) of hematopoietic stem cell transplantation (HSCT) group were significant longer than those of ALL-like group(P =0.018, P=0.025) and NHL-like group(P = 0. 016, P = 0. 011). The OS at 5 years in NHL-like group, ALL-like group and HSCT group were (14.4 ± 9.4) ％ , (20.2 ± 12.7) ％ and (79.5 ± 13.1) ％, respectively. Conclusion ①LBL is more common in young men, with less involvement of peripheral blood. Compared with B-LBL, T-LBL often has a mediastinal mass and serious cavity effusion. ② Intensive treatment regimens for ALL should be used in LBL. HSCT at CR1 can improve outcome obviously.     

43例淋巴母细胞淋巴瘤患者临床特点及疗效分析

Objective To investigate the clinical features and treatment outcomes of different regimens in Chinese patients with lymphoblastic lymphoma(LBL). Methods Forty-three patients with LBL were retrospectively analysed, of which 30 were T-LBL, and 13 B-LBL. Results ①Most patients were young men with a median age of 21, and 63.0％ of the T-LBL patients had mediastinal masses. ② Treatment outcome could be assessed in 37 cases, of which the response rate (RR) was 81.1％ and complete remission (CR) rate was 67.6％. The RR and CR rates in patients treated with regimens for ALL (ALL-like group) and those treated with regimens for NHL(NHL-like group) were 94.4％ , 68.4％ and 83.3％ , 52.6％ , respectively. ③The estimated median overal survival(OS) and progression free survival (PFS) of hematopoietic stem cell transplantation (HSCT) group were significant longer than those of ALL-like group(P =0.018, P=0.025) and NHL-like group(P = 0. 016, P = 0. 011). The OS at 5 years in NHL-like group, ALL-like group and HSCT group were (14.4 ± 9.4) ％ , (20.2 ± 12.7) ％ and (79.5 ± 13.1) ％, respectively. Conclusion ①LBL is more common in young men, with less involvement of peripheral blood. Compared with B-LBL, T-LBL often has a mediastinal mass and serious cavity effusion. ② Intensive treatment regimens for ALL should be used in LBL. HSCT at CR1 can improve outcome obviously.     

五柱绞股蓝总皂苷和总黄酮的季节性变化

目的 测定五柱绞股蓝茎和叶中的总皂苷和总黄酮的量,并揭示其在不同季节内的动态变化规律.方法 以绞股蓝皂苷和芦丁为对照品,采用紫外可见光分光光度计在550 nm处测定皂苷吸光度,在510 nm处测定黄酮吸光度.结果 五柱绞股蓝茎、叶中的总皂苷和总黄酮的量在5月至11月的生长发育季节内,均表现为先上升后下降的变化规律,以9月的量最高,且叶中的量高于茎中的量.结论 五柱绞股蓝采收可安排在8～9月的花果期进行.     

吴茱萸和制吴茱萸的饮片、水煎液、配方颗粒UPLC特征图谱研究

目的:建立吴茱萸和制吴茱萸饮片、水煎液、配方颗粒的超高效液相色谱(UPLC)特征图谱,比较其相关性和差异性。方法:采用UPLC法。色谱柱为YMC Triart C₁₈,流动相为乙腈-0.1%磷酸水溶液(梯度洗脱),流速为0.3 mL/min,检测波长为254nm,柱温为30℃,进样量为1μL。以柠檬苦素为参照,绘制吴茱萸和制吴茱萸饮片、水煎液、配方颗粒(各10批,共60批)的特征图谱,利用《中药色谱指纹图谱相似度评价系统(2012版)》进行相似度评价,确定共有特征峰;采用方差分析评价共有特征峰峰面积占比的差异,并采用SPSS 20.0软件对吴茱萸和制吴茱萸的饮片、水煎液、配方颗粒进行聚类分析和主成分分析。结果:吴茱萸样品和制吴茱萸样品(饮片、水煎液和配方颗粒)的特征图谱中分别均含有共有特征峰16、17个,指认8、9、11、17号峰分别为柠檬苦素、吴茱萸碱、吴茱萸次碱和甘草酸;与饮片比较,水煎液和配方颗粒的特征峰相似度均低于0.55,而水煎液与配方颗粒特征峰的相似度均高于0.95。聚类分析和主成分分析结果显示,吴茱萸饮片和制吴茱萸饮片聚为一类,吴茱萸水煎液、配方颗粒...     

带蒂横形岛状包皮瓣一期手术治疗先天性尿道下裂

先天性尿道下裂是泌尿外科常见病，男婴中发病率约为0．3％。治疗方法唯有行尿道成形术，矫止阴茎下曲畸形及重建尿道，以满足正常排尿及成年后婚育需求。尿道成形术式多达200余种，各种术式均存在各种各样的并发症，目前仍难以找出一种完美的术式。近3年来我们应用Duckett术一期治疗先天性尿道下裂6例，手术方式相对简单，并发症少，疗效满意，现报告如下。     

荧光原位杂交检测多发性骨髓瘤患者A13及其临床意义

目的 总结100例多发性骨髓瘤(MM)患者荧光原位杂交(FISH)检测△13(13q-/-13)阳性率及其临床意义.方法 对100例MM患者采用RB-1探针行FISH检测,并结合常规染色体(CC)结果分析其临床意义.结果 (1)△13 FISH检出率为19.0%,CC检出率为10.0%,差异未达统计学显著性(P=0.053).(2)单因素分析示FISH检测△13阳性率>50%、CC检测克隆性A13(C13A)、非超二倍体核型、FISH检测和CC检测双阳性、血β2-MG≥3.5 mg/L为不良预后因素.(3)多因素分析示FISH检测△13阳性率>50%和血β2-MG≥3.5 mg/L是独立预后因素.(4)根据上述两个独立预后因素,可将患者分为低、中、高危3组,两两比较总体生存时间(OS),差异均有统计学意义.结论 (1)FISH检测提高了初治MM遗传学异常的检出率.(2)预后分析示FISH检测△13阳性率>50%和血β2-MG水平为独立预后因素.     

43例淋巴母细胞淋巴瘤患者临床特点及疗效分析

Objective To investigate the clinical features and treatment outcomes of different regimens in Chinese patients with lymphoblastic lymphoma(LBL). Methods Forty-three patients with LBL were retrospectively analysed, of which 30 were T-LBL, and 13 B-LBL. Results ①Most patients were young men with a median age of 21, and 63.0％ of the T-LBL patients had mediastinal masses. ② Treatment outcome could be assessed in 37 cases, of which the response rate (RR) was 81.1％ and complete remission (CR) rate was 67.6％. The RR and CR rates in patients treated with regimens for ALL (ALL-like group) and those treated with regimens for NHL(NHL-like group) were 94.4％ , 68.4％ and 83.3％ , 52.6％ , respectively. ③The estimated median overal survival(OS) and progression free survival (PFS) of hematopoietic stem cell transplantation (HSCT) group were significant longer than those of ALL-like group(P =0.018, P=0.025) and NHL-like group(P = 0. 016, P = 0. 011). The OS at 5 years in NHL-like group, ALL-like group and HSCT group were (14.4 ± 9.4) ％ , (20.2 ± 12.7) ％ and (79.5 ± 13.1) ％, respectively. Conclusion ①LBL is more common in young men, with less involvement of peripheral blood. Compared with B-LBL, T-LBL often has a mediastinal mass and serious cavity effusion. ② Intensive treatment regimens for ALL should be used in LBL. HSCT at CR1 can improve outcome obviously.