晚期胃腺癌放疗联合化疗与单纯化疗的疗效比较

胃癌的术后5年生存率很低,大约有2/3的全胃切除术后患者局部复发[1-2].由于胃癌起病隐匿,早期症状不典型,确诊时许多患者已属晚期,失去手术机会,需要采用以全身化疗为主的综合治疗[3].我们对2003年1月至2006年12月收治的、不能手术的晚期胃癌患者分别行三维适形放疗联合紫杉醇、奥沙利铂化疗和单纯化疗,并进行疗效比较,现将结果报告如下.     

多西紫杉醇二线治疗紫杉醇耐药的晚期非小细胞肺癌15例

目的 观察紫杉醇(泰素)耐药的晚期非小细胞肺癌(NSCLC)患者接受多西紫杉醇(泰素帝)二线治疗后的疗效及毒副反应.方法 回顾性分析2005年1月至2008年5月在上海市胸科医院接受多西紫杉醇二线化学治疗的15例NSCLC患者.评价其疗效及不良反应,并随访无疾病进展时间(PFS)及总生存期(OS).结果 15例患者的疾病控制率为66.7%,中位无疾病进展时间为6个月,中位生存期为17.3个月,1年生存率达到63.3%.主要不良反应包括白细胞减少8例(53.3%),胃肠道反应8例(53.3%),呃逆6例(40%),均属可耐受范围.结论 多西紫杉醇二线治疗在紫杉醇耐药的晚期NSCLC患者中显示了良好疗效,且毒副反应可以耐受.     

Radiologically placed temporary hepatic artery catheter for treatment of liver cancer

Hepatic artery infusion (HAI) chemotherapy is associated with higher response rates compared to systemic chemotherapy in those patients with unresectable liver malignancies. Operative hepatic artery catheter (HAC) insertion has significant morbidity and mortality, especially in patients with high‐volume disease, some of whom may not respond to HAI chemotherapy. We report our experience in 45 patients with high‐volume liver disease who were initially treated with HAI chemotherapy via a radiologically placed temporary HAC to try to select the responders who then went on to have an operative HAC. In these 45 patients who had 62 radiologically placed HAC, we found very few major complications, and certainly no complications such as cholecystitis, vascular or malperfusion problems.     

Synthesis of 2‐[(2‐chloro‐2′‐[18F]fluoroethyl)amino]‐2H‐1,3,2‐oxazaphosphorinane‐2‐oxide (18F‐fluorocyclophosphamide), a potential tracer for breast tumor prognostic imaging with PET

A fluorine‐18 labeled analog of the widely used chemotherapeutic agent cyclophosphamide was synthesized as a tracer for prognostic imaging with positron emission tomography. 2‐[(2‐Chloro‐2′‐[¹⁸F]fluoroethyl)amino]‐2H‐1,3,2‐oxazaphosphorinane‐2‐oxide (¹⁸F‐fluorocyclophosphamide), was prepared by direct halogen exchange reaction from the parent cyclophosphamide. In small‐scale syntheses, radiochemical yields of up to 4.9% and specific activities of 960 Ci/mmol were achieved in a total synthesis time of 60–75 min. The [¹⁸F]‐labeled cyclophosphamide analog with radioactive purity >99% and chemical purity >96% was suitable for in vivo (microPET imaging) and ex vivo studies of a murine model of human breast tumors. Copyright © 2005 John Wiley & Sons, Ltd.     

田七注射液治疗慢性肾功能衰竭疗效观察

目的:研究田七注射液在治疗慢性肾功能衰竭中的作用。方法:选择符合诊断标准的CRF患者52例,随机分为治疗组28例及对照组24例,两组病例在常规治疗的基础上,治疗组予以田七注射液静脉滴注,对照组予以肾安注射液静脉滴注,以4周为1疗程,观察治疗前后两组患者血脂及肾功能的变化。结果:治疗组总有效率为85.71%,优于对照组的58.33%,两组比较差异有显著性意义(P<0.01)。治疗组治疗后血清总胆固醇(TC),甘油三酯(TG),低密度脂蛋白(LDL)明显降低(P<0.01或P<0.05),且优于对照组(P<0.01),对照组TC、高密度脂蛋白(HDL)治疗后改善不明显;两组治疗后各项肾功能指标均有改善,治疗组疗效优于对照组(P<0.01或P<0.05)。结论:田七注射液能明显改善CRF患者血脂及肾功能,延缓CRF进程,值得临床推广应用。     

Embolization for gastrointestinal hemorrhages

Retrospective evaluation of interventional embolization therapy in the treatment of gastrointestinal hemorrhage over a long-term observation period from 1989 to 1997. Included in the study were 35 patients (age range 18–89 years) with gastrointestinal bleeding (GI) referred for radiological intervention either primarily or following unsuccessful endoscopy or surgery. Sources of GI bleeding included gastric and duodenal ulcers (n = 7), diverticula (n = 3), erosion of the intestinal wall secondary to malignancy (n = 6), vascular malformations (n = 4), and hemorrhoids (n = 2), as well as from postoperative (n = 6), posttraumatic (n = 2), postinflammatory (n = 4) or unknown (n = 1) causes. Ethibloc (12 cases) or metal coils (14 cases) were predominantly used as embolisates. In addition, combinations of tissue adhesive and gelfoam particles and of coils and Ethibloc were used (six cases). Finally, polyvinyl alcohol particles, a coated stent, and an arterial wire dissection were utilized in one case each. Bleeding was stopped completely in 29 of 35 cases (83 %). In one case (3 %) the source of bleeding was recognized but the corresponding vessel could not be catheterized. In five other cases (14 %) there was partial success with reduced, though still persistent, bleeding. The rate of complications was 14 %, including four instances of intestinal ischemia with fatal outcome in the first years, and, later, one partial infarction of the spleen without serious consequences. Gastrointestinal hemorrhage can be controlled in a high percentage of patients, including the seriously ill and those who had previously undergone surgery, with the use of minimally invasive interventional techniques. The availability of minicoils instead of fluid embolization agents has reduced the risk of serious complications. Received: 21 June 1999; Revised: 24 August 1999; Accepted: 28 September 1999     

可调控的胰岛素基因表达载体的构建及其体外表达研究

目的构建四环素调控的胰岛素基因表达载体 ,并研究其体外转移后的表达情况。方法通过基因重组技术构建胰岛素基因的四环素调控表达系统 ,用脂质体转移法导入成肌细胞 ,以不同浓度的强力霉素诱导 ,检测诱导后胰岛素原mRNA表达及胰岛素 /胰岛素原水平。结果RT PCR显示此基因能在真核细胞内表达。细胞培养液中胰岛素水平在加药 2 4h后开始增加 ,至第 7天仍在增加 ,撤药后迅速下降 ,至撤药后第 5天下降到基础水平。不同诱导药物浓度诱导的胰岛素产量明显不同 (P <0 .0 5 ) ,而细胞内和培养基中的胰岛素浓度无明显差异 (P >0 .0 5 )。结论单一四环素调控的胰岛素原表达系统能在真核细胞内表达 ,并呈现强力霉素浓度依赖性     

乌司他丁在体外循环中应用对机体的保护作

目的 :探讨体外循环 (CPB)中应用乌司他丁对机体的保护作用及其剂量 效应相关性。方法 :择期CPB下心内直视术 30例 ,分为 2组。乌司他丁(UTI)组 (n =1 5) ,于麻醉后、CPB开始前将UTI2 0万U溶于 2 0mL氯化钠注射液中静脉推注 (约1 0min) ;如CPB时间超过 4h ,可在CPB开始 4h后追加一次 ,剂量用法同前。对照组 (n =1 5) ,不用UTI。分别于麻醉前及CPB后检测 β 葡萄糖醛酸酶(β GCD)、粒细胞弹性蛋白酶 (GEL)、纤维连接蛋白(FN)及肾功能各指标。结果 :CPB后 ,UTI组病人β GCD[(2 5 .1±s 2 .8) μmol·h-1 ·L-1 ]活性及GEL[(1 .3± 0 .5) μg·L-1 ]含量均较对照组低 ,但FN[(2 1 7± 39)mg·L-1 ]含量较对照组高 (P <0 .0 5)。UTI剂量与△β GCD ,△GEL及△FN均呈负相关 ,且相关性显著。UTI组尿N 乙酰氨基葡萄糖苷酶、视黄醇结合蛋白、γ 谷氨酰转肽酶、α1 微球蛋白均低于对照组 ,但排尿量/输液量高于对照组(P <0 .0 5)。结论 :体外循环中应用UTI通过抑制β GCD活性和GEL含量的升高及抑制FN含量的下降达到对机体的保护作用 ,且这种保护作用呈剂量依赖性     

乌司他丁注射液治疗急性胰腺炎

目的 :观察乌司他丁注射液治疗急性胰腺炎的疗效。方法 :6 4例病人 ,分为 2组。治疗组 32例 ,男性 2 1例 ,女性 11例 ,年龄 (4 8±s18)a ,给予乌司他丁 30万U加入氯化钠注射液 2 5 0mL ,iv ,gtt ,qd。对照组 32例 ,男性 2 0例 ,女性 12例 ,年龄(4 7± 17)a ,给予奥曲肽 0 .1mg ,sc ,q12h。其余治疗 2组相同。结果 :治疗d 4 ,治疗组疗效优于对照组 (P <0 .0 5 ) ,d 8时 2组疗效相当 (P >0 .0 5 )。治疗d 4和d 8,2组病人血、尿淀粉酶均明显下降 ,白细胞计数治疗组下降了 (6 .3± 2 .3)× 10 9·L- 1和(10 .3± 2 .2 )× 10 9·L- 1,对照组下降了 (5 .3±1.1)×10 9·L- 1和 (7.3± 1.2 )× 10 9·L- 1(P <0 .0 5 ,P <0 .0 1)。 2组治疗期间均无明显不良反应。结论 :乌司他丁治疗急性胰腺炎见效早、疗效确切、安全性好。     

4种给药方案治疗良性前列腺增生症的成本—效果分析

目的:探讨4种口服给药方案治疗良性前列腺增生(BPH)所产生的成本-效果比.方法:选择我院门诊轻中度良性前列腺增生患者168例,随机分为4组,分别给予非那雄胺(A纽)、坦索罗辛(B组)、坦索罗辛多沙唑嗪加非那雄胺(C组)、普适泰(D组),运用药物经济学方法进行分析.结果:在成本相当的前提下,C组方案有效率最高.结论:坦索罗辛多沙唑嗪 非那雄胺治疗BPH不仅疗效好,可降低患者需要手术的危险性,而且可降低急性尿潴留发生率.