康莱特联合化学药物动脉灌注治疗转移性肝癌的临床研究

目的：观察康莱特联合化学药物动脉灌注治疗转移性肝癌的疗效。方法：152例转移性肝癌患者随机分为治疗组(康莱特联合化学药物动脉灌注)79例、对照组(化学药物动脉灌注)73例。结果：治疗组的稳定率为87．3％，1年生存率为73．4％，2年生存率为50．6％，均明显高于对照组；并可减低血液高凝状态，提高患者的细胞免疫功能，缓解化疗药物的毒副反应，改善患者的生活质量。结论：康莱特联合化学药物动脉灌注治疗转移性肝癌有较好的疗效。     

两种过滤方法对输液中微粒的影响

目的 :比较超滤法和常规三级过滤法对输液中微粒的影响。方法 :用光阻法检查两种不同的过滤方法滤过的输液中微粒数。结果 :常规三级过滤法滤过的 4 7批次的输液平均微粒数为 6 .5 6个 /ml(>10 μm)和 0 .71个 /ml(>2 5 μm) ,超滤法滤过的 6 3批次的输液平均微粒数为 2 .2 9个 /ml(>10 μm)和 0 .2 8个 /ml(>2 5 μm) ,两种方法有显著性差异 (P <0 .0 0 1)。结论 :超滤法明显优于常规三级过滤法。     

安痫宁冲剂抗惊厥作用的实验研究

目的：研究安痫宁冲剂的抗惊厥作用。方法：选用电惊厥及药物性惊厥法观察惊厥潜伏期、惊厥百分数、死亡率。结果：安痫宁高剂量可明显延长小鼠惊厥潜伏期，中、低剂量有延长小鼠惊厥潜伏期的趋势，安痫宁高剂量组惊厥百分率为75％，与空白组相比有差异。结论：安痫宁具有抗惊厥作用。     

静脉输注地尔硫治疗冠状动脉搭桥术前不稳定性心绞痛

目的 :评价静脉输注地尔硫治疗冠状动脉搭桥 (CABG)术前不稳定性心绞痛的疗效和安全性。方法 :68例CABG术前不稳定性心绞痛病人停服肾上腺素 β受体阻滞剂、钙通道阻滞剂及抗血小板药物 ,静脉给予地尔硫 ,以 33～ 167μg·min- 1,持续微泵注入 72h以上。观察心绞痛症状、心电图、血压、心率及不良反应。结果 :65例 (96% )病人有效。与用药前相比 ,心绞痛发作平均次数减少 (5 .4±s 1.8)次·d- 1(P <0 .0 1) ,发作持续时间缩短 (7.6± 2 .5 )min(P <0 .0 1)。心肌耗氧指数降低。心电图异常者ST T明显改善 ,4 9例病人在病情稳定后 1wk内接受CABG。无严重不良反应。结论 :静脉输注地尔硫为CABG术前不稳定性心绞痛提供了一种较为安全有效的药物治疗手段     

Calcium-Induced Natriuresis: Physiologic and Clinical Implications

Assessment of the tubular reabsorption of calcium (Ca) by infusion is complicated by suppression of parathyroid hormone (PTH) secretion, and by activation of the serpentine Ca sensing receptor in the renal tubule, which inhibits Ca and sodium reabsorption, but little is known about the magnitude of the natriuretic effect of Ca in human subjects. Accordingly, we reanalyzed the relationship between serum Ca and urine Ca and sodium excretion expressed per unit of creatinine clearance (CaE and NaE), and per unit of time (UCa and UNa), during a standard Ca infusion, in 14 healthy volunteers and in 8 primary hyperparathyroid patients. In healthy subjects we observed a large effect of Ca infusion on NaE, which rose as high as 8 mmol/liter GFR. In patients with primary hyperparathyroidism both CaE and NaE during Ca infusion were significantly lower overall than in healthy subjects for comparable values of serum Ca (P < 0.05 by covariance analysis), due mainly to a decline or reversal of the slopes at the highest serum Ca levels. In both controls and primary hyperparathyroid subjects the variance of CaE as dependent variable was explained by both serum Ca and by NaE as independent variables (P < 0.001). We conclude that (1) The natriuretic effect of hypercalcemia was unexpected large and if maintained would lead to substantial depletion of extracellular fluid. (2) Patients with chronic hypercalcemia, including primary hyperparathyroidism, probably have mild sodium depletion, and are more susceptible to volume depletion. (3) Calcium reabsorption during Ca infusion is reduced by suppression of PTH secretion and increased by volume contraction due to sodium depletion. Discrimination between different basal levels of parathyroid function is successful because these effects usually cancel out. (4) The increase in tubular reabsorption of Ca due to volume contraction can initiate a vicious circle, of importance to the pathogenesis and treatment of severe hypercalcemia. Received: 11 May 1999 / Accepted: 13 January 2000     

磁导向载体阿霉素介入治疗原发性肝癌的临床研究

目的：观察磁导向载体阿霉素(MTC-DOX)肝动脉介入治疗原发性肝癌的有效性和安全性。方法：将Seldinger导管超选择插入肿瘤供血肝动脉，以脉冲给药的方式注入MTC-DOX，21天为一周期，连续用药2周期以上按照WHO标准进行评价。结果：不能手术的原发性肝癌患共11例入组，10例可以评价疗效，治疗后NC7例，PD3例，中位肿瘤进展时间(TTP)为182天，有3例临床症状减轻，有4例生活质量改善，1年生存率达到54．5％；11例可以评价毒性，毒副反应均较轻，主要为轻中度的肝区疼痛和发热，少数患有胃肠道反应和一过性转氨酶升高。结论：采用磁导向载体阿霉素介入治疗原发性肝癌靶向性特别好，疗效明显，同时毒性反应轻微，值得进一步研究。     

术前动脉灌注化疗结合手术治疗直肠癌疗效分析

目的 :总结和分析直肠癌术前介入灌注化疗 (Pre operativeArteraInfusionChemotherapy ,PAIC)的疗效及其优点 ,探讨直肠癌综合治疗的远期疗效。方法 :应用Seldinger方法经皮右侧股动脉穿刺 ,选择肠系膜下动脉或骼内动脉造影确定肿瘤位置后 ,注入化疗药物。术后一周进行直肠癌根治术。术后采用 5 氟尿嘧啶加甲酰四氢叶酸钙进行 6个疗程的化疗。以同期未行介入灌注治疗而手术的直肠癌患者作为对照组。结果 :PAIC组大多数患者症状、体征减轻 ,肿块缩小。介入灌注化疗前后病理检查发现肿瘤细胞有变性坏死 ,细胞核变性 ,胞浆凝固 ,间质炎细胞浸润及纤维增生等不同程度的改变。术后五年生存率 75 0 0 % ,对照组为 4 5 2 4 % ,对比差异有显著性意义 (P <0 0 5 )。结论 :术前介入灌注化疗作为直肠癌新辅助化疗方法之一是有效、安全的 ,并能提高直肠癌患者的术后长期生存时间。     

Multimodal therapy with intravenous biweekly leucovorin, 5-fluorouracil and irinotecan combined with hepatic arterial infusion pirarubicin in non-resectable hepatic metastases from colorectal cancer (a European Association for Research in Oncology trial).

BACKGROUND: The purpose of this study was to evaluate the tolerance and efficacy of combining i.v. irinotecan, 5-fluorouracil (5-FU) and leucovorin (LV) with hepatic arterial infusion (HAI) of pirarubicin in non-resectable liver metastases from colorectal cancer. PATIENTS AND METHODS: Thirty-one patients were included in a phase II trial with i.v. irinotecan/5-FU/LV administered every 2 weeks, combined with HAI pirarubicin 60 mg/m(2) on day 1 every 4 weeks. In most cases HAI was administered via a percutaneous catheter. RESULTS: The main grade 3/4 toxicity was neutropenia, encountered in 78% of the patients. When all patients were considered in the analysis, tumour response rate was 15 out of 31 [48%; 95% confidence interval (CI) 32% to 65%]. Liver resection was made possible in 11 patients (35%; 95% CI 21% to 53%). There were no toxic death. Median overall survival was 20.5 months, and median progression-free survival was 9.1 months. In patients with completely resected metastases, median overall survival was not reached and median progression-free survival was 20.2 months. CONCLUSION: The multimodality approach used in the present study was well-tolerated and yielded dramatic responses. An aggressive approach combining i.v. and HAI chemotherapy deserves further investigation.     

替尼泊甙-司莫司汀序列给药治疗恶性脑胶质瘤

目的 探讨替尼泊甙（VM26）与司莫司汀（MeCCNU）序列给药治疗恶性脑胶质瘤的疗效及其并发症的防治。方法 对145例经病理证实的恶性胶质瘤病人术后采用超选择性动脉内灌注加静脉滴注VM26及口服MeCCNU化疗,通过比较化疗前后影像学表现评价近期疗效。结果 本组145例病人治疗后完全缓解21例（14.5%）、部分缓解72例（49.6%）、无变化31例（21.4%）、恶化21例（14.5%）。1、2、3年存活率分别为90.3%、74.5%和22.8%。全部病人无严重并发症及毒性反应。结论 VM26-MeCCNU联合序列给药可延长脑胶质瘤病人生存时间,并发症及毒副作用少。     

Feasibility trial of high-dose 7-day continuous-infusion ifosfamide given on an outpatient basis

 High-dose ifosfamide (HD-IFX) has shown significant antitumor activity in advanced sarcoma and breast carcinoma. The use of uroprotective agents and the availability of ambulatory continuous-infusion pumps has allowed dose escalation in the administration of ifosfamide (IFX) on an outpatient schedule. We report the results of a phase II trial of IFX given at high doses to heavily pretreated patients. IFX was infused at 2 g/m² per day for a total of 7 days through a central venous access, with cycles being repeated every 21 days. Mesna was given concomitantly at equimolar doses. No hematopoietic support was used. A total of 27 heavily pretreated patients whose disease had progressed during conventional-dose chemotherapy were included (14 sarcomas, 10 breast carcinomas, and 3 bladder carcinomas). Reversible neutropenia and gastrointestinal toxicity were the most frequently encountered toxicities. Only two patients developed transient renal failure, and two others developed central nervous system toxicity. No treatment-related death was observed. Of 22 patients who were evaluable for response, 6 (27%) showed an objective response (OR), all ORs being partial responses (PRs) with a median duration of 6 months, and 12 patients had stable disease (SD; 55%) with a median duration of 3.5 months. The median overall survival (OS) was 6 months. Three patients underwent high-dose chemotherapy after showing a response to our IFX schedule. We conclude that continuous-infusion IFX given in an outpatient setting is a feasible and active regimen that produces, a manageable toxicity profile in heavily pretreated breast cancer and sarcoma patients. Early institution of this schedule in less advanced stages could improve the results obtained. Received: 30 June 1996 / Accepted: 20 January 1997