麦粒灸对佐剂性关节炎大鼠细胞免疫功能的影响

目的　探讨麦粒灸对佐剂性关节炎 ( A A)大鼠细胞免疫功能的影响。方法　以佐剂性关节炎作为类风湿关节炎大鼠模型 ,分为正常对照组、模型组、麦粒灸治疗组、麦粒灸加去肾上腺组、麦粒灸加假手术组。麦粒灸“肾俞”、“足三里”,检测IL-1、IL-2、IL-6含量变化。结果　模型组大鼠腹腔巨噬细胞 IL-1、IL-6的活性比正常大鼠明显升高 ( P<0 .0 1)。麦粒灸组大鼠 IL-1、IL-6活性较模型组比明显下降 ( P<0 .0 5 )。麦粒灸加去肾上腺组 IL-1、IL-6活性未见明显变化 ( P>0 .0 5 ) ,假手术组IL-1活性极显著降低 ( P<0 .0 1) ,IL-6比模型组明显为低 ( P<0 .0 5 )。模型组大鼠脾脏 IL-2活性降低 ( P<0 .0 5 ) ,麦粒灸治疗后可使 IL-2活性极显著升高 ( P<0 .0 1) ,麦粒灸加去肾上腺组 IL-2活性与麦粒灸组及假手术组比 ( P<0 .0 5 ) ,但与模型组比无显著性差异 ( P>0 .0 5 )。假手术组 IL-2活性亦明显提高 ( P<0 .0 1) ,而与正常组无差异。结论　麦粒灸可抑制 AA大鼠 IL-1、IL -6活性。摘除肾上腺后则麦粒灸不能降低 IL -1、IL -6活性 ;麦粒灸可明显提高 IL -2活性 ,摘除肾上腺后麦粒灸则对 IL -2活性无明显影响 ;麦粒灸对 A A细胞免疫功能的调整与下丘脑 -垂体 -肾上腺的完整有关     

和血祛风冲剂对类风湿关节炎大鼠细胞因子的影响

目的：通过对大鼠福氏完全佐剂性关节炎动物模型进行观察,探讨和血祛风冲剂对该动物模型细胞因子的影响。方法：观察和血祛风冲剂不同剂量组与寒湿痹冲剂对大鼠福氏完全佐剂性关节炎动物模型白介素1（IL－1）、肿瘤坏死因子α（TNF－α）、类风湿因子（RF)、免疫球蛋白G、A、M（IgG,IgA,IgM)进行观察。结果;和血祛风冲剂各剂量组及寒湿痹冲剂均有消肿作用,均楫IL-1、TNF－α、RF、IgG水平,对IgG抑制作用前者优于后者。结论：和血祛风冲剂治疗类风湿关节炎的机理 可能是抑制炎性细胞因子及免疫球蛋白的水平。     

A comparative study on the efficacy of rofecoxib in monoarticular arthritis induced by latex of Calotropis procera and Freund’s complete adjuvant

The role of prostaglandins in Calotropis procera latex induced inflammation and hyperalgesia has been well established. The acute inflammation induced by the dried latex (DL) of this plant could be effectively ameliorated by standard anti-inflammatory drugs. In present study we have evaluated the efficacy of rofecoxib, a COX-2 inhibitor in monoarthritis induced by intra-articular injection of DL and compared it with that against Freund’s Complete Adjuvant (FCA). DL and FCA were injected into the right ankle joint of the rat and the joint diameter was measured by a micrometer screw gauge on day 0, 4, 8, 12, 20 and 28. Concomitantly the hyperalgesic response was also evaluated by motility test, stair climbing ability test, dorsal flexion pain test and compression test. The effect of rofecoxib was evaluated on these parameters in both the models. Both DL and FCA produced peak inflammation on day 4 that was associated with decreased pain threshold and functional impairment. Although rofecoxib was more effective in improving motility in the DL model, its effect on joint inflammation, hyperalgesia and stair climbing ability was comparable in both the models. Thus, our study indicates that DL induced monoarthritis could be used as a model for the screening and evaluation of anti-inflammatory and anti-arthritic drugs.     

局部晚期宫颈癌临床治疗新进展

宫颈癌是严重威胁女性健康的恶性肿瘤之一,其中局部晚期宫颈癌（LACC）有病灶大、手术困难、预后差等特点,关于其治疗方案争议不断,主要推荐的治疗方案有：盆腔外照射+顺铂同期化疗+阴道近距离放疗,广泛性子宫切除术+盆腔淋巴结切除±主动脉旁淋巴结取样,放化疗后进行辅助性子宫切除术。而在临床治疗中,由于各地区放疗水平不同和患者个体化差异,目前对LACC的治疗方案仍存在多样性。预防性半扩展区域调强适形放疗可以在达到与传统扩展区域放疗相似治疗效果的同时减少并发症的发生,同步放化疗同时加局部热疗可以增强患者对治疗的耐受性。腹主动脉旁淋巴结清扫或活检不一定改善LACC的预后,但可帮助判断预后,对已有髂总动脉旁淋巴结转移的患者有积极意义。对于腔内放疗技术不成熟地区的患者,盆腔外照射加同步化疗后行Ⅰ型筋膜外子宫切除术是可行的治疗方案。     

万灵五香巴布膏活血通络与消肿止痛的药理作用

目的：观察万灵五香巴布膏活血通络与消肿止痛的药理作用。方法：采用小鼠光热法与扭体法镇痛试验观察止痛作用；小鼠巴豆油耳肿胀试验与大鼠佐剂关节炎抗炎试验观察消肿作用；小鼠耳廓微循环试验和大鼠急性软组织损伤试验观察活血通络作用。结果：万灵五香巴布膏能显提高小鼠光热法测得的痛阈和减少冰醋酸所致小鼠扭体反应次数；减轻巴豆油所致小鼠耳肿胀和大鼠佐剂性关节炎的肿胀度；改善小鼠耳廓微循环和减轻打击所致大鼠急性软组织损伤。结论：万灵五香巴布膏有明显的活血通络与消肿止痛药理作用。     

乳腺癌辅助化疗及激素治疗的药物不良反应

目的：了解乳腺癌辅助化疗及激素治疗的药物不良反应。方法：查阅文献进行综述。结果：辅助治疗的主要不良反应是可逆的。结论：对早期浸润性乳腺癌妇女，使用辅助治疗还是有益的。     

晚期鼻咽癌放疗联合辅助性化疗的临床研究

目的 分析评价晚期（N2,N3期）鼻咽癌放疗加辅助化疗的疗效.方法 86例N2,N3期鼻咽癌患者随机分为放化组（A组,46例）和单放组（B组,40例）,均首先接受根治性放疗,其后放化组46例接受辅助化疗（LV＋5Fu＋DDP）3～4个疗程.结果 放化组5年生存率43.5%,单放组37.5%（P＞0.05）;放化组远处转移发生率19.6%,单放组45%（P＜0.05）;放化组远处转移发生时间平均放疗后18.3个月,单放组7.8个月;放疗后达到CR的放化组与单放组的5年生存率为42.9%、56.5%（P＞0.05）,非CR的放化组与单放组的5年生存率为44.4%、11.8%（P＜0.05）.结论 放疗加辅助性化疗N2,N3期鼻咽癌有助于延缓远处转移发生时间,减少远处转移;对于根治性放疗后未达CR者,辅助化疗能提高生存率.     

2014—2015年南京市胸科医院肺癌化疗辅助用药的使用情况分析

目的 对南京市胸科医院肺癌化疗辅助用药的使用情况进行分析,为用药干预提供依据.方法 调取南京市胸科医院2014年1月-2015年6月肺癌化疗辅助用药的有关数据,并进行统计分析.结果 肺癌化疗辅助用药中销售总金额和每例平均金额最高的为中成药,使用例次最多的为抑酸止吐药.中成药中总金额和使用例次最多的均为参芪扶正注射液;止痛类药物使用金额和使用例次的排序均靠后;抑酸止吐类药中总金额排序较前的为帕洛诺司琼注射液和奥美拉唑注射剂,使用例次排序为第5和第2位,但每例平均金额较低;每例平均金额最高的为细胞刺激因子类药物重组人血小板生成素注射液;保肝类药物中,使用例次最多的为还原型谷胱甘肽注射剂.结论 中成药、抑酸止吐药以及保肝药的应用均存在一些不合理现象,且癌痛的治疗仍然存在不足,因此化疗辅助用药需要加强干预,促进合理使用.     

Role of adjuvant chemoradiotherapy and chemotherapy in patients with resected gallbladder carcinoma: a multi-institutional analysis (KROG 19-04)

Objective:The effectiveness of adjuvant treatments for resected gallbladder carcinoma (GBC) has remained unclear due to lack of randomized controlled trials; thus, the aim of present study was to evaluate the role of adjuvant treatments, including chemoradiotherapy (CRT) and/or chemotherapy (CTx), in patients with resected GBC.Methods:A total of 733 GBC patients who received curative-intent surgical resection were identified in a multi-institutional database. Of 733 patients, 372 (50.8%) did not receive adjuvant treatment, whereas 215 (29.3%) and 146 (19.9%) received adjuvant CTx and CRT, respectively. The locoregional recurrence-free survival (LRFS), recurrence-free survival (RFS), and overall survival (OS) of the adjuvant treatment groups were compared according to tumor stage (stage II vs. stage III–IV).Results:In stage II disease (n = 381), the 5-year LRFS, RFS, and OS were not significantly different among the no-adjuvant therapy, CTx, and CRT groups, and positive resection margin, presence of perineural invasion, and Nx classification were consistently associated with worse LRFS, RFS, and OS in the multivariate analysis (P < 0.05). For stage III–IV (n = 352), the CRT group had significantly higher 5-year LRFS, RFS, and OS than the no-adjuvant therapy and CTx groups (67.8%, 45.2%, and 56.9%; 37.9%, 28.8%, and 35.4%; and 45.0%, 30.0%, and 45.7%, respectively) (P < 0.05).Conclusions:CRT has value as adjuvant treatment for resected GBC with stage III–IV disease. Further study is needed for stage II disease with high-risk features.     

Triple-Negative Breast Cancer: A Review of Current Curative Intent Therapies

Breast cancer is the most commonly diagnosed malignancy in women, with triple-negative breast cancer (TNBC) accounting for 10–20% of cases. Historically, fewer treatment options have existed for this subtype of breast cancer, with cytotoxic chemotherapy playing a predominant role. This article aims to review the current treatment paradigm for curative-intent TNBC, while also reviewing potential future developments in this landscape. In addition to chemotherapy, recent advances in the understanding of the molecular biology of TNBC have led to promising new studies of targeted and immune checkpoint inhibitor therapies in the curative-intent setting. The appropriate selection of TNBC patient subgroups with a higher likelihood of benefit from treatment is critical to identify the best treatment approach.