Randomized phase II trial of carboplatin versus paclitaxel and carboplatin in platinum-sensitive recurrent advanced ovarian carcinoma: a GEICO (Grupo Espanol de Investigacion en Cancer de Ovario) study.

BACKGROUND: The aim of this study was to determine whether the response rate for the paclitaxel-carboplatin combination is superior to carboplatin alone in the treatment of patients with platinum-sensitive recurrent ovarian carcinoma. PATIENTS AND METHODS: Patients with recurrent ovarian carcinoma, 6 months after treatment with a platinum-based regimen and with no more than two previous chemotherapy lines, were randomized to receive carboplatin area under the curve (AUC) 5 (arm A) or paclitaxel 175 mg/m(2) + carboplatin AUC 5 (arm B). The primary end point was objective response, following a 'pick up the winner' design. Secondary end points included time to progression (TTP), overall survival, tolerability and quality of life (QoL). RESULTS: Eighty-one patients were randomized and included in the intention-to-treat analysis. The response rate in arm B was 75.6% [26.8% complete response (CR) + 48.8% partial response (PR)] [95% confidence interval (CI) 59.7% to 87.6%] and 50% in arm A (20% CR + 30% PR) (95% CI 33.8% to 66.2%). No significant differences were observed in grade 3-4 hematological toxicity. Conversely, mucositis, myalgia/arthralgia and peripheral neurophaty were more frequent in arm B. Median TTP was 49.1 weeks in arm B (95% CI 36.9-61.3) and 33.7 weeks in arm A (95% CI 25.8-41.5). No significant differences were found in the QoL analysis. CONCLUSIONS: Paclitaxel-carboplatin combination is a tolerable regimen with a higher response rate than carboplatin monotherapy in platinum-sensitive recurrent ovarian carcinoma.     

血清白蛋白水平与食管癌再程放疗预后关系的研究

目的:评估血清白蛋白水平在预测食管癌再程放疗预后中的价值.方法:收集病理学确诊的需要接受再程放疗的局部复发食管癌患者,放疗前行血清白蛋白检测,采用Kaplan-Meier法和Log-rank检验进行生存率计算,Cox回归模型分析预后影响因素.结果:血清白蛋白水平与分期有关(P=0.002),差异具有统计学意义(P ＜0.05);62例患者血清白蛋白高值组(≥35 g/L)的1、3、5年总生存率均高于低值组(＜35 g/L)(P =0.001),高值组的6个月和12个月的复发后生存率均高于低值组(P =0.026),以上差异均具有统计学意义(P＜0.05);血清白蛋白水平和复发时间是影响总生存时间的独立预后因素(P =0.015和P=0.000),差异具有统计学意义(P＜0.05).结论:食管癌再程放疗前行血清白蛋白检测对预测患者预后具有重要意义.     

乳腺癌术后复发24例临床分析

目的：探讨乳腺癌术后复发的影响因素。方法：回顾性分析2000年-2010年诊治的248例乳腺癌,其中包括24例复发患者的临床资料。结果：原发肿瘤〈5cm和≥5cm的患者复发率分别为6.45%、31.57%;患者腋窝淋巴结转移阴性和阳性的复发率分别为3.77%、16.94%;激素受体阳性和阴性的复发率分别为10.52%、11.76%;规范化疗和未行化疗患者复发率分别为8.82%、50.0%;行规范内分泌治疗和未行内分泌治疗患者复发率分别为6.14%、17.10%,行规范放疗和未行放疗患者复发率分别为2.43%、71.42%。结论：乳腺癌复发与肿瘤大小,淋巴结有无转移以及术后是否规范化疗、放疗和内分泌治疗有显著相关性,而与激素受体情况无显著相关性。     

“保胎Ⅰ冲剂”提高反复自然流产患者免疫功能的临床观察

为探讨中药对反复自然流产患者的免疫调节作用 ,用自制“保胎Ⅰ冲剂”治疗反复自然流产患者 3 6例 ,观察治疗前后患者血清中封闭抗体对配偶外周血T淋巴细胞CD3 、CD4及CD8抗原反应的变化。结果 :治疗后抗CD3 、抗CD8明显升高 ,抗CD4/CD8下降 ;妊娠成功率 91 67%。提示中药对母胎免疫有调节作用 ,且作用安全     

针灸大师张缙

目的：探讨人类非物质文化遗产传承人张缙教授针灸学术人生和学术成就。方法：从张缙教授幼年经历、立志学中医针灸、苦志攻＂针经＂、研究针刺手法等方面入手,对其学术观点和成就进行分析。结果：张缙教授对针刺手法的研究深入透彻。结论：张缙教授作为＂全国名老中医＂及全国针灸界＂人类非物质文化遗产——中医针灸项目代表性传承人＂之一,在针灸研究领域贡献甚宏,堪称针灸大师。     

Good performance of p16/ki‐67 dual‐stained cytology for surveillance of women treated for high‐grade CIN

Women treated for high‐grade cervical intraepithelial neoplasia (CIN) are at risk of recurrent CIN Grade 2 or worse (rCIN2+). Currently, posttreatment monitoring is performed using cytology or cytology/high‐risk (hr)HPV cotesting. This study aimed to evaluate the performance of p16/Ki‐67 dual‐stained cytology (p16/Ki‐67) for posttreatment monitoring. Three hundred and twenty‐three women treated for high‐grade CIN in the SIMONATH study underwent close surveillance by cytology, hrHPV and DNA methylation marker testing up to 12 months posttreatment. Histological endpoints were ascertained by colposcopy with biopsy at 6 and/or 12 months. p16/Ki‐67 dual‐staining was performed on residual liquid‐based cytology samples obtained at, or shortly before biopsy collection. Clinical performance estimates of cytology, hrHPV, p16/Ki‐67 testing and combinations thereof for the detection of rCIN2+ were determined and compared to each other. Sensitivity of p16/Ki‐67 for rCIN2+ (69.2%) was nonsignificantly lower than that of cytology (82.1%; ratio 0.84, 95% CI: 0.71–1.01), but significantly lower than that of hrHPV testing (84.6%; ratio 0.82, 95% CI: 0.68–0.99). Specificity of p16/Ki‐67 for rCIN2+ (90.4%) was significantly higher compared to both cytology (70.8%; ratio 1.28, 95% CI: 1.19–1.37) and hrHPV testing (76.2%; ratio 1.19, 95% CI: 1.12–1.26). Overall, hrHPV testing showed very high sensitivity, along with a good specificity. When considering cotesting, combined p16/Ki‐67/hrHPV testing showed rCIN2+ sensitivity comparable to cytology/hrHPV cotesting (87.2% vs. 89.7%; ratio 0.97, 95% CI: 0.92–1.03), but with significantly increased specificity (74.2% vs. 58.1%; ratio 1.28, 95% CI: 1.19–1.38). Thus, when considered in combination with hrHPV, p16/Ki‐67 might be an attractive approach for surveillance of women treated for high‐grade CIN.     

络病学说探析

"久病入络"是络病的主要病机,"络脉阻滞"是络病最基本的病理改变.络脉为病均有不同程度的气郁、血阻或痰结等"络瘀"表现,"通络"是总治则,细之又有"祛邪通络"、"扶正通络"两大类及宣络、透络、清络、活络、柔络、通络、搜络诸法.     

复发性阿弗他溃疡患者唾液中表皮生长因子和病损区表皮生长因子受体的定量研究

目的探讨复发性阿弗他溃疡（RAU）患者溃疡期和间隙期唾液表皮生长因子（EGF）质量浓度的变化以及病损区表皮生长因子受体（EGFR）的表达有无缺陷。方法选择27例在溃疡期和间隙期均成功获取唾液样本的轻型RAU患者作为RAU1组,采集33例正常人的唾液样本作为对照1组,采用酶联免疫吸附法检测两组唾液样本中EGF质量浓度。另外选择31例轻型RAU溃疡期患者在溃疡基底部剪取小块组织样本作为RAU2组,采集35例无RAU者的正常黏膜组织作为对照2组,采用荧光定量逆转录聚合酶链反应检测两组组织样本内EGFR的RNA表达情况。结果RAU1组溃疡期患者唾液EGF质量浓度高于RAU1组间隙期和对照1组,而间隙期EGF质量浓度低于对照1组（P<0.05）。RAU1组和对照1组唾液EGF质量浓度在不同性别间差别不大,与年龄也没有相关性（P>0.05）。RAU2组EGFR的RNA表达强度高于对照2组,两组间有统计学差异（P<0.05）。结论RAU患者口腔溃疡的复发性可能与间隙期唾液EGF质量浓度减少有关;口腔溃疡的自愈性可能与溃疡期唾液EGF质量浓度增加和溃疡区EGFR表达增加有关。     

立体定向适形放射治疗鼻咽癌复发或残留病变50例疗效分析

目的:探讨立体定向适形放射治疗对鼻咽癌放射治疗后残留病变或复发患者的临床疗效。方法:50例经根治放疗后的鼻咽癌复发或残留患者,全部采用WDVE-XKY808立体定向适形放射治疗。6MVX线总剂量DT30~48Gy,设1~4个中心,参考剂量曲线选定为70%~90%。4~6Gy/次,每次间隔1~3d。结果:肿瘤完全控制48例,无法评价2例,局部控制率为96%。1、2和3年总生存率分别为83·6%、65·0%和59·6%。1、2和3年无瘤生存率分别为75·0%、64·9%和54·1%。结论:立体定向适形放射治疗是鼻咽癌放射治疗后残留病变或复发患者“挽救性”治疗的适应证,有较好的局部控制效果和较高的安全性,是治疗复发或残留癌患者的有效方法之一。     

硅油取出后视网膜脱离复发危险因素分析

目的探讨硅油取出术后视网膜脱离复发的主要危险因素。方法回顾分析重庆医科大学第二附属医院眼科2005年1月至2007年6月行硅油取出术的病例共143眼,对疾病原因、硅油在眼内存在的时间、硅油取出后有无眼底出血以及第一次玻璃体切割手术后患眼玻璃体残留皮质的情况进行统计学分析。结果硅油取出后视网膜脱离复发的病例40眼,增殖性玻璃体视网膜病变的再脱率与糖尿病视网膜病变的视网膜再脱离率比较χ^2=5.02,P〈0．05;复发病例中发生眼底出血比例与未复发病例中发生眼底出血比例的比较,P〈0．05,视网膜脱离复发的病例中有残留玻璃体皮质比例与未脱离的病例中有残留玻璃体皮质比例的比较,P〈0．05,复发病例中硅油眼内填充的平均时间与未复发病例硅油眼内填充的平均时间相比,P〉0．05。结论硅油取出后视网膜脱离的危险因素主要是增殖性玻璃体视网膜病变、手术后有残留的玻璃体皮质、术后眼底出血的发生,这些因素直接导致了玻璃体的增殖,牵拉形成新裂孔。引起视网膜脱离的复发。