重组人血管内皮抑素联合FoLFox4方案治疗结直肠癌肝转移的临床观察

目的观察重组人血管内皮抑制素（恩度）联合FoLFox4方案治疗结直肠癌肝转移的临床疗效和安全性。方法临床及病理组织学检查确诊的结直肠癌肝转移患者21例,均接受恩度联合FoLFox4方案治疗。恩度15rag加入生理盐水500m1静脉缓慢滴注,第1、14d间膈7天重复给药。FoLFox4方案具体为：奥沙利铂（L-OHP）85mg／m2,静脉滴入2h,第ld;亚叶酸钙（CF）200mg／m2,静脉滴入2h,氟尿嘧啶（5-FU）400mg／m2静脉推注后予以600mg／m2持续静脉滴入22h,第1、2d,每两周重复,28天为1周期。结果21例患者均可评价客观疗效和安全性,共完成42周期,平均为2周期,获CR2例,PR10例,SD3例,PD6例,客观有效率为57．1％（12／21）,疾病控制率71．4％（15／21）。主要毒副反应为骨髓抑制、消化道反应和周围神经毒性,无4级毒副反应,无心率失常及出血发生。结论恩度联合FoLFox4方案治疗结直肠癌肝转移疗效较好,毒性低,安全可靠。     

联合方案与吉西他滨加顺铂单纯化疗方案治疗晚期非小细胞肺癌的对比研究

①目的 比较TM-GP方案、[timogpntin(胸腺五肽)、MA(megestrol acetate,甲地孕酮)、吉西他滨与顺铂(DDP)联合的生物化疗方案]与GP方案(即吉西他滨加DDP的单纯化疗方案)对初治Ⅲ～Ⅳ期非小细胞肺癌(NSCLC)患者的疗效、毒性及生活质量的改善情况.②方法 A组(33例)接受TM-GP方案治疗;B组(35例)接受GP方案治疗.两组均以4周为1周期,重复3个周期.客观疗效与毒性反应按世界卫生组织(WHO)标准进行评价,生活质量根据临床受益疗效来评价.③结果 A、B两组客观疗效总有效率(CR+PR)分别为27.3%及22.9%(P>0.05);中位生存期A组32周,B组27周(P<0.01);白细胞减少及恶心呕吐反应B组均较A组明显(P<0.01);短暂性寒战、发热症状多见于A组(P<0.01);两组均未发现其他严重的毒性反应.临床受益疗效A组高于B组(P<0.05).④结论 胸腺五肽、甲地孕酮配合GP方案与单纯GP方案治疗晚期NSCLC的客观疗效无明显差异性,但前者毒副反应小,中位生存期长,患者生活质量改善明显.     

百合固金汤联合卡瑞利珠单抗及PP方案治疗气阴两虚型晚期非鳞非小细胞肺癌的疗效观察

目的:探讨百合固金汤联合卡瑞利珠单抗及PP方案(培美曲塞+顺铂)治疗气阴两虚型晚期非鳞非小细胞肺癌(NSCLC)的临床疗效以及其对患者外周血T淋巴细胞亚群水平和血清糖类抗原125(CA125)、微小核糖核酸-19b(miR19b)、巨噬细胞炎性蛋白-3α(MIP-3α)、Ⅰ型胶原羧基端肽β特殊序列(β-CTX)水平的影响。方法:选择我院2018年6月—2021年8月收治的80例气阴两虚型晚期非鳞NSCLC患者作为研究对象,采用随机数字表法分成观察组与对照组各40例。对照组给予PP方案联合卡瑞利珠单抗治疗,在此基础上,观察组联合百合固金汤内服治疗,所有对象均以21 d为1个疗程。连续治疗6个疗程后观察两组疗效及安全性。比较治疗前后两组中医证候积分、外周血T淋巴细胞亚群水平及血清CA125、miR-19b、MIP-3α、β-CTX水平。结果:观察组客观有效率(ORR)、中医疗效总有效率比对照组(分别为75.0% vs 50.0%、90.0% vs 65.0%)均显著提高,差异有统计学意义(P<0.05)。与治疗前相比,两组治疗后各项主症(咳嗽、咯痰、气短喘粗、口干咽燥、神疲乏力)积分和血清CA125、miR-19b、MIP-3α浓度均显著下降(P<0.05),外周血CD3+、CD4+和CD4+/CD8+水平均显著升高(P<0.05);且观察组改善更显著(P<0.05)。两组治疗前后血清β-CTX水平组内及组间比较差异均无统计学意义(P>0.05)。观察组白细胞减少、恶心呕吐的发生率比对照组[分别为52.5%(21/40)vs 75.0%(30/40)、42.5%(17/40) vs 70.0%(28/40)]均显著降低,差异有统计学意义(P<0.05)。结论:百合固金汤联合卡瑞利珠单抗及PP方案治疗气阴两虚型晚期非鳞NSCLC能有效缓解患者的临床症状体征,改善细胞免疫功能,提高临床疗效,并能减轻化疗药物引起的不良反应。     

FOLFOX4联合参麦注射液治疗中晚期肝癌术后存活质量的影响

目的探究FOLFOX4联合参麦注射液治疗中晚期肝癌术后存活质量的影响。方法选取2012年3月~2014年2月我院收治的90例原发性肝癌患者为研究对象,按随机数字表法分为观察组和对照组,每组45例,对照组患者单独给予FOLFOX4方案(奥沙利铂~+亚叶酸钙~+5-氟尿嘧啶)治疗,观察组在对照组基础上联合参麦注射液,治疗2个疗程后评价两组患者治疗疗效,同时分别检测治疗前后患者血液T淋巴细胞亚群(CD3~+、CD4~+、CD8~+)变化情况,比较两组患者治疗前后细胞免疫指标。观察两组患者治疗前后生存质量评分和KPS评分改善程度和毒副反应。结果观察组患者治疗总有效率为57.78%,对照组患者治疗总有效率为35.56%,两组差异具有统计学意义(P0.05)。治疗后两组患者CD3~+、CD4~+、CD8~+、CD4~+/CD8~+细胞免疫指标差异显著,观察组患者CD3~+、CD4~+、CD4~+/CD8~+细胞免疫指标明显明显高于对照组,CD8~+指标明显低于对照组,差异具有统计学意义(P0.05)。治疗后两组患者生活质量评分和KPS评分总改善率差异显著,观察组生活质量评分和KPS评分总改善率显著高于对照组,差异具有统计学意(P0.05)。两组患者在骨髓抑制、神经毒性、肝功能方面等毒副反应差异具有统计学意义(P0.05),而在胃肠道反应、口腔炎上差异不具有统计学意义(P0.05)。结论参麦注射液联合FOLFFOX4方案治疗中晚期原发性肝癌具有良好疗效,能够改善患者免疫力和提高患者生活质量,降低化疗引起的毒副反应,其疗效明显优于单独FOLFFOX4方案治疗。     

茯苓抗衰、养生与美容作用诠析

茯苓是一味常用的抗衰老、养生与美容中药之一,就茯苓的相关作用机制进行了诠析。认为,茯苓通过健脾与渗湿作用达到抗衰老、养生与美容的目的。深入研究茯苓的抗衰老机制及其养生与美容作用,在当前关注养生与美容的今天,具有十分重要的意义。     

Long‐term efficacy and safety of ranibizumab administered pro re nata in Japanese patients with neovascular age‐related macular degeneration in the EXTEND‐I study

Purpose: To evaluate the long‐term efficacy and safety of ranibizumab administered pro re nata (PRN) in Japanese patients with choroidal neovascularization secondary to age‐related macular degeneration during the extension phase of the EXTEND‐I study. Methods: EXTEND‐I, an open‐label, multicenter, Phase I/II study comprised: a single‐injection (Group A); a multiple‐injection (Groups A and B; the latter consisted of patients who did not participate in the single‐injection phase); and an extension phase. In the extension phase, a PRN regimen of ranibizumab (0.3 or 0.5 mg) guided by monthly best‐corrected visual acuity (BCVA) score and other ophthalmic examinations was employed. The efficacy variables included the mean BCVA change from Month 12 to the last visit in Group B. Safety was assessed in all patients. Results: In the extension phase, efficacy was assessed only in Group B patients. The number of ranibizumab injections per year in the 0.3 and 0.5 mg Group B patients was 4.19 and 4.27, respectively. The mean BCVA change (SD) from Month 12 to the last visit was ?3.6 (14.82) letters for 0.3 mg (n = 28) and ?2.2 (7.92) letters for 0.5 mg groups (n = 33) in Group B. Conjunctival haemorrhage and nasopharyngitis were the most commonly reported adverse events. Of the 13 serious adverse events reported, cerebral infarction (two incidences) was suspected to be study‐drug related. Conclusions: Pro re nata regimen of ranibizumab guided by monthly BCVA and other ophthalmic examinations appears effective in sustaining the BCVA gained with 12 monthly injections while reducing the number of injections during the extension phase. Ranibizumab was well tolerated during the extension phase.     

A phase I and pharmacokinetic study of lapatinib in combination with infusional 5-fluorouracil, leucovorin and irinotecan.

BACKGROUND: This study determined the optimally tolerated regimen (OTR) of oral lapatinib administered in combination with infusional 5-fluorouracil (5-FU), leucovorin and irinotecan (FOLFIRI) and assessed the safety, tolerability and pharmacokinetics of the combination. PATIENTS AND METHODS: Twenty-five patients were enrolled; 12 patients were treated at three dose levels to determine OTR; then 13 patients were treated at OTR to evaluate the pharmacokinetics of the combination. RESULTS: The 2-weekly OTR comprised lapatinib 1250 mg/day with irinotecan 108 mg/m(2) (day 1) and leucovorin 200 mg/m(2), 5-FU bolus 240 mg/m(2) and 5-FU infusion 360 mg/m(2) (days 1 and 2); doses of 5-FU and irinotecan represent a 40% reduction in dose compared to conventional FOLFIRI. Dose-limiting toxicities were grade 3 diarrhoea and grade 4 neutropenia. Co-administration of lapatinib increased the area under the plasma concentration-time curve of SN-38, the active metabolite of irinotecan, by an average of 41%; no other pharmacokinetic interactions were observed. Of 19 patients evaluable for disease response assessment, four patients had partial response and nine patients had stable disease. CONCLUSION: The combination of lapatinib and FOLFIRI is safe and demonstrates clinical activity; the documented PK interaction can effectively be compensated by lowering the doses of 5-FU and irinotecan. This regime may be further tested in a phase II trial.     

CHOPE方案治疗侵袭性非霍奇金淋巴瘤(NHL)40例

目的：观察CHOPE方案治疗侵袭性NHL的近期疗效。方法：80例侵袭性NHL患者，分成对照组与治疗组，每组各40例，对照组为CHOP方案：CTX 750mg／m^2静脉注射，d1；VCR1．4mg／m^2，静脉注射，d1；ADM 40mg／m^2，静脉注射，d1；强的松100mg／d，d1～5。治疗组为CHOPE方案：CHOP（同对照组）＋VP-16 100mg／d，静脉滴注，d1～3 21天为1个周期，完成2个周期以上者做疗效评价。结果：治疗组40例患者中，CR21例，PR12例．NC4例．PD3例，总有效率（CR＋PR）为82．5％。结论：CHOPE方案治疗侵袭性NHL的近期疗效满意，不良反应可耐受。     

小儿急性上呼吸道感染3种治疗方案的成本-效果分析

目的:评价3种用药方案治疗小儿急性上呼吸道感染的成本-效果。方法:将96例患儿随机分成3组,A组(34例)给予莪术油治疗,B组(32例)给予双黄连治疗、C组(30例)给予银黄清治疗,观察其疗效并进行成本-效果分析。结果:3组成本分别为61.50元、80.40元、18.00元,总有效率分别为73.53%、96.88%、86.67%,成本-效果比分别为0.84、0.83、0.21,A、B组相对于C组的增量成本-效果比分别为-3.31、6.11。结论:C组方案是小儿急性上呼吸道感染的最佳治疗方案。