不同化疗方案治疗晚期胃癌的疗效评价

目的比较FAM、UFTM、FEP和LFP／M四种化疗方案治疗晚期胃癌的效果。方法应用回顾性分析,总结出每个方案的近期和远期疗效,作出统计学处理。结果近期疗效：四种方案的有效率分别为FAM34．4％,UFTM32．6％,FEP47．0％和LFP／M44．0％。经统计学处理各组间P值均大于0．05,无显著差异。远期疗效：有效病例治后中位缓解期和生存期分别为FAM5月和11．5月,UFTM4．5月和8．5月,FEP5月和10月,LEP／M4月和9月,毒副反应在骨髓抑制方面以FAM和LFP／M为重,UFTM最轻。消化道反应以FEP和LFP／M为重,UFTM最轻．结论四种方案治疗晚期胃癌,近期疗效各组间无显著差异。但以FEP和LFP／M方案的有效率更高一些,仍可作为首选方案。UFTM方案的不良反应最轻,适用于全身状况较差,体质较弱的患者。FAM方案的生存期较长,副反应也不大,对心脏无病变的患者仍不失为较好的治疗方案。     

10-羟基喜树碱腔内注射治疗恶性胸腹水

目的观察１０－羟基喜树碱腔内注射治疗恶性胸（腹）水的疗效。方法腔内灌注１０－羟基喜树碱治疗２７例恶性胸（腹）腔积液患者。结果ＣＲ９例,ＰＲ１３例,ＮＲ５例。有效率８１．５％（２２／２７）。此局部治疗耐受性好,无明显毒副反应。结论与其它胸（腹）水治疗方法比较,该方法具有疗效高、毒副反应低的特点。     

MVP方案治疗非小细胞肺癌21例临床分析

[目的]评价以VDB为主的MVP方案治疗非小细胞肺癌（NSCIC）的疗效和毒副反应。[方法]每一病人给予2周期MVP方案进行化疗,每周期用VDB3mg/m2静注第1、8天;DDP30mg/m2静滴第1－3天;MMC6mg/m2静注第1天。[结果]3例完全缓解,8例部分缓解,总有效率52．38%。不同病期之间、不同组织类型之间的疗效差别无显著性差异（P＞0．05）。本方案主要毒副反应为骨髓抑制。[结论]MVP方案对NSCLC疗效是好的,其骨髓抑制的毒副作用应引起重视。     

Experience with and attitudes to chemotherapy among newly employed nurses in oncological and surgical departments

Based on questionnaires, attitudes to chemotherapy were compared between newly employed nurses in oncology departments and surgical departments. Comparisons were made as they started in their new jobs and after 6 and 12 months. In total, 76 nurses were included in the study; 41 were employed in oncology departments and 35 in surgical departments. The questionnaires presented a hypothetical situation involving a toxic chemotherapy regimen. The subjects were asked to indicate the minimal benefit with respect to percentage chance of cure, length of life prolongation, and percentage symptom relief they would demand before accepting the toxic chemotherapy. The groups were well matched. On starting in their new jobs, both groups demanded identical chances of cure (23%) for the hypothetical treatment to be acceptable. Nurses ≤30 years demanded less chance of cure than those >30 years. There were no differences in wishes about life prolongation and symptom relief. The groups reported equivalent job satisfaction during the first year. At 6 months, 60% of the oncology nurses and 11% of the surgical nurses reported altered attitudes to chemotherapy, and approximately 70% of these in both groups had become more positive. At 6 months surgical nurses demanded less chance of symptom relief than the oncology nurses to accept the chemotherapy regimen. Otherwise, there were no differences between the groups during the first year. Attitudes to chemotherapy showed no differences between newly employed nurses in oncology and in surgical departments, and there were no changes in either group during the first year in their new jobs.     

Spinal space occupying lesions in thalassemia major

A 17 year old patient suffering from thalassemia, who had been dependent on transfusions since the age of three, showed an increasing incomplete sensory and motor transverse cord lesion below T-10. The causes were found to be multiple epidural erythropoietic foci, confirmed by myelography, CT, and biopsy. The lesions were located in the thoracic, lumbar, and sacral regions. Complete remission of the neurological symptoms was achieved by an immediate hypertransfusion regimen and subsequent local radiation therapy of the neuroaxis. Thirty-six cases of thalassemia and spinal space occupying lesions have been reported in the literature. The therapeutic results of these are presented and compared with our findings.     

左旋18-甲基炔诺酮用于紧急避孕的效果与不良反应评价

目的和方法:对100例月经规律,未避孕或避孕措施失败性交后72小时内的妇女,口服左旋18-甲基炔诺酮(LNG),观察避孕效果与不良反应,并以50例妇女应用紧急避孕的经典方法Yuzpe法作对照。结果:LNG组2例妊娠,Yuzpe组1例妊娠,按Wilcox方法推算,避孕有效率分别为83％和82％,但LNG组的不良反应明显降低,P<0.001,优于经典的Yuzpe法。结论:推广使用LNG法将有利于减少非意愿妊娠,保障妇女身心健康。     

全肺照射联合PF方案对鼻咽癌肺转移的疗效分析

目的:探讨全肺照射联合PF方案对鼻咽癌肺转移的疗效。方法:回顾分析81例鼻咽癌肺转移的随访资料,根据治疗方法不同分为小剂量全肺照射联合PF方案组和单纯化疗组,应用χ2检验分析肿瘤的缓解率和患者生存率。结果:放疗联合化疗组于病灶消失、缩小方面优于单纯化疗组,未控/进展情况少于单纯化疗组,两者差异有显著意义(P<0.05～0.01),而疗后病情稳定两组差异无显著性(P>0.05);放疗联合化疗组与单纯化疗组的12个月生存率差异无显著意义(P>0.05),而放疗联合化疗组18个月、24个月、≥36个月生存率明显高于单纯化疗组(P<0.05～0.01)。结论:小剂量全肺照射联合PF方案对鼻咽癌肺转移的治疗是目前较为理想的治疗方案。     

丽珠胃三联根除幽门螺杆菌的临床观察

目的：观察丽珠胃三联治疗幽门螺杆菌（HP）的效果。方法：采用同类对象，不同方法分组对照试验，观察HP根除情况，溃疡愈合情况及不良反应，结果：HP根除率两组分别为86．7％、85．0％，差异无显著性（P＞0．05），十二指肠溃疡的总有效率分别为88．9％、92．5％，差异无显著性（P＞0．05），结论：丽珠胃三联具有药物剂量小，疗程短，疗效高，价格低，便于携带等特点，是较为理想的根除Hp的方案。     

CAG方案清除T细胞急性淋巴细胞白血病细胞株A3细胞作用机制的研究

本研究主要探讨CAG方案清除T细胞性急性淋巴细胞白血病（T-ALL）细胞株A3细胞的作用机制及G-CSF／G—CSFR配体受体系统在清除过程中的作用。以单克隆抗体结合流式细胞术测定A3细胞表面G—CSFR表达率；以A3细胞为体外实验模型，分组加入不同浓度的G—CSF作用48小时后收集细胞，碘化丙锭细胞核染色法分析细胞周期变化；用Cell Counting Kit（CCK-8）检测不同浓度阿糖胞苷（Ara—C）和G-CSF组合作用48小时后对细胞生长抑制率的影响；用AnnexinV试剂盒结合流式细胞术检测Ara—C、阿克拉霉素（ACR）及G-CSF联合作用48小时后细胞凋亡水平。结果表明：T—ALL细胞株A3细胞表面高表达G—CSFR（94．2％）；G—CSF作用48小时后S期A3细胞比例在一定浓度范围内随G—CSF浓度的增加而升高；CCK-8检测显示Ara—C＋G—CSF组较单药Ara—C组抑制细胞生长更明显（Ara—C浓度10^-5mmol／L和10^-6mmol／L时P〈0．05）；凋亡检测显示Ara—C＋ACR＋G-CSF组细胞早期凋亡率高达38％，显著高于Ara—C＋ACR组。结论：T—ALL细胞株A3细胞表面高表达G-CSFR；G-CSF／G—CSFR配体受体系统在CAG方案清除A3细胞的过程中与化疗药物具有协同作用，即通过动员G0期细胞进入细胞增殖周期使细胞对化疗药物的敏感性增强、导致细胞凋亡，从而清除细胞。诱导凋亡是CAG方案清除T—ALL细胞株A3细胞的机制之一。