恶性肿瘤患者行双热源全身热疗围治疗期的护理

目的：探索双热源全身热疗治疗恶性肿瘤的护理措施。方法：对194例肿瘤患者应用SRI全身热疗系统行双热源全身热疗的护理工作进行总结分析。结果：在SRI全身热疗系统下行双热源全身热疗的肿瘤患者均能安全完成治疗无明显烫伤,无化疗药物外渗,无呼吸、循环、中枢系统并发症。结论：SRI全身热疗系统行双热源全身热化疗,是治疗恶性肿瘤的一个安全可行的治疗手段。严格执行治疗适应证和禁忌证、积极的术前术中护理尤其全程的舒适护理是全身热疗安全顺利完成的保证。     

Developmental pharmacology of benzodiazepines under normal and pathological conditions

Benzodiazepines are allosteric agonists of GABA_A receptors (GABA_AR), pentameric ligand‐gated Cl^? channels, which serve both an important neurodevelopmental role but are also the principal inhibitory system in the brain. However, their subunit composition, channel properties, and function, as well as their region‐specific expression patterns, change through development. These processes have been extensively studied in rodents and to some extent confirmed in higher species. Specifically, GABA_ARs acquire faster kinetics with age and their pharmacology changes rendering them more sensitive to drugs that have higher affinity for α1 subunit‐containing GABA_ARs, such as benzodiazepines, but also, their inhibitory function becomes more potent as they shift from having depolarising to hyperpolarising responses due to a shift in Cl^? gradient and cation chloride cotransporter expression. Concerns have been raised about possible pro‐apoptotic and paradoxical effects of benzodiazepines in the neonatal normal rat brain, although it is unclear, as yet, whether this extends to brains exposed to seizures. Growing evidence indicates that the pharmacology and physiology of GABA_ARs may be altered in the brain of rats or humans with seizures or epilepsy, or different aetiologies that predispose to epilepsy. These changes follow different paths, depending on sex, age, region, cell type, aetiology, or time‐point specific factors. Identification of dynamic biomarkers that could enable these changes in vivo to be monitored would greatly facilitate the selection of more effective agonists with fewer side effects.     

Acute tumor lysis syndrome in high grade lymphoblastic lymphoma after a prolonged episode of fever

Acute tumor lysis syndrome occurs in rapidly growing lymphoid malignancies, usually as a consequence of chemotherapy or corticosteroids. We present what appears to be the first reported case of tumor lysis occurring after a sustained episode of high fever of 42.0°C in a patient with high grade lymphoblastic lymphoma and a high tumor burden. © 1996 Wiley-Liss, Inc.     

Multiple mitochondrial DNA deletions and persistent hyperthermia in a patient with Brachmann-de Lange phenotype

In a newborn boy with characteristics of Brachmann-de Lange syndrome (BDLS) high temperatures were observed on the second day after birth and recurred 2-6 times daily during the 7 months of the patient's life. After transient hypertonia hypotonia developed. In muscle biopsy specimen taken on the 51st day of life, serious and progressive distortion of mitochondria was observed. In several mitochondria the cristae structure was broken, other mitochondria were shrunken and the damage progressed towards further deterioration in other organelles. At several points between the myofibrils amorphous material was seen possible debris of destroyed mitochondria. Most myofibrils seemed to be intact; however, in some areas myolytic signs were present. Analysis of the mitochondrial DNA (mtDNA) showed multiple deletions in skeletal and heart muscles, liver, lung and kidney. Since the mtDNA encodes several proteins of the respiratory complexes, the deleted mtDNA certainly affected the integrity of the mitochondrial oxidative phosphorylation process by synthesis of abnormal proteins. In the present case the hyperthermia may have been a result of the mtDNA damage. © 1996 Wiley-Liss, Inc.     

高温对小鼠神经元骨架蛋白及热休克蛋白70表达的影响

目的:观察39℃环境对体外培养的小鼠皮层神经元骨架蛋白(β-tubulin)和热休克蛋白70(HSP70)表达的影响,探讨HSP70的神经保护作用. 方法:取小鼠胚胎大脑皮层进行神经元原代培养,将培养好的神经元分为37℃培养的对照组和39℃刺激30 min后0, 2, 6, 24和72 h的高温组. 分别进行荧光免疫染色,应用激光共聚焦扫描观察神经元β-tubulin和HSP70的表达. 结果:39℃刺激后,高温组神经元β-tubulin荧光强度均低于37℃对照组,且随着恢复时间的延长其荧光强度值逐渐升高. 高温组神经元HSP70荧光强度均高于37℃对照组,且随着恢复时间的延长其荧光强度值先升高后降低,于2 h时达高峰,24 h仍维持在较高的水平. 高温可导致HSP70荧光分布转移至细胞核,并随着恢复时间的延长逐渐转移至细胞浆. 结论:高温可以导致神经元形态变化,骨架蛋白结构紊乱可能是神经元形态变化的重要原因之一,HSP70可能参与并起到保护作用.     

热疗对舌鳞癌Tca8113细胞及其耐药细胞株耐药性的影响

目的 探讨热疗对舌鳞癌Tca8113细胞和耐药的Tca8113/CBDEA细胞耐药性的影响。方法 采用实时定量逆转录PCR（RT-PCR）检测42 ℃,0.5 h热疗对Tca8113细胞 和耐药的Tca8113/CBDEA细胞多药耐药基因1（MDR1）、多药耐药相关蛋白1基因（MRP1）和谷胱甘肽硫-转移酶π基因（GST-π）表达的影响以及检测热疗对细胞内阿霉素浓度的影响。结果 Tca8113/CBDEA细胞在热疗后4 h和24 hMDR1、MRP1、GST-π耐药基因表达量明显下降（P<0.01）,Tca8113细胞的MDR1、MRP1耐药基因表达在4 h和24 h时亦有明显下降（P<0.05）,GST-π在24 h有明显下降（P<0.01）。热疗以后肿瘤细胞内阿霉素（ADM）浓度有明显上升（P<0.01）。结论 热疗抑制了耐药基因的表达,增加了细胞内的药物浓度, 热疗可能是逆转肿瘤细胞耐药,提高化疗效果的一种有效手段。     

曲妥珠单抗联合微波热疗治疗HER-2阳性晚期乳腺癌的临床疗效分析

目的:探讨曲妥珠单抗联合微波热疗治疗HER-2阳性晚期乳腺癌患者的临床疗效。方法:选取我院2018年1月至2018年12月收治的HER-2阳性晚期乳腺癌患者54例,按随机表法分为治疗组与对照组,每组27例。两组均采用曲妥珠单抗治疗,治疗组同时给予微波热疗。比较两组患者免疫功能、循环肿瘤细胞（CTCs）、生存质量、近期疗效、总生存期及不良反应情况。结果:治疗组免疫功能和生存质量提高（P<0.05）,CTCs数量下降（P<0.05）;治疗组近期疗效及总生存期优于对照组（P<0.05）;两组不良反应发生率比较差异无统计学意义（P>0.05）。结论:曲妥珠单抗联合微波热疗治疗HER-2阳性晚期乳腺癌患者具有良好的临床疗效且安全性较高。     

Blood flow distribution during heat stress: cerebral and systemic blood flow

The purpose of the present study was to assess the effect of heat stress-induced changes in systemic circulation on intra- and extracranial blood flows and its distribution. Twelve healthy subjects with a mean age of 22±2 (s.d.) years dressed in a tube-lined suit and rested in a supine position. Cardiac output (Q), internal carotid artery (ICA), external carotid artery (ECA), and vertebral artery (VA) blood flows were measured by ultrasonography before and during whole body heating. Esophageal temperature increased from 37.0±0.2°C to 38.4±0.2°C during whole body heating. Despite an increase in Q (59±31%, P<0.001), ICA and VA decreased to 83±15% (P=0.001) and 87±8% (P=0.002), respectively, whereas ECA blood flow gradually increased from 188±72 to 422±189 mL/minute (+135%, P<0.001). These findings indicate that heat stress modified the effect of Q on blood flows at each artery; the increased Q due to heat stress was redistributed to extracranial vascular beds.     

体内γ刀、体外高频热疗、化疗联合治疗晚期肺癌36例疗效观察

目的 观察CT引导下组织间植入125I粒子联合体外高频热疗及化疗对晚期肺癌的疗效.方法 患者入院后先行肺穿刺活检或经支气管镜活检以明确肿瘤病理类型,经TPS计划系统计划后行体内γ刀治疗.3 d后行化疗(EP方案或顺铂 紫衫醇方案,每4周1次)及体外高频热疗(每周2次,共4周).所有患者术后第1、2、3、6、9、12个月内分别行胸部CT检查随访.根据肿瘤变化将疗效分为4级.Ⅰ级,明显缓解(肿瘤缩小50%以上).Ⅱ级,缓解(肿瘤缩小25%～50%).Ⅲ级,轻度缓解(肿瘤缩小1%～25%).Ⅳ级,无效(肿瘤无变化或增大,临床症状亦无缓解).V级,复发或转移.结果 术后第1、2、3、6、9、12个月明显缓解,分别占38.9%、66.7%、77.8%、83.3%、83.3%和77.8%.结论 体内γ刀、体外高频热疗、化疗联合治疗晚期肺癌是一种安全、可靠、疗效显著的治疗方法.