A Phase II Study of Capecitabine/Oxaliplatin With Concurrent Radiotherapy in Locally Advanced Squamous Cell Carcinoma of the Anal Canal

IntroductionSquamous cell carcinoma of the anal canal (SCCA) presents a rising incidence in the United States. Standard of care for locally advanced disease is comprised of infusional 5-fluorouracil with mitomycin C or cisplatin concurrent with radiation therapy (RT). We designed this trial to evaluate the efficacy and safety of a more convenient regimen composed of capecitabine and oxaliplatin.Patients and MethodsThis was a single-arm, phase II trial, with treatment-naive stage II to IIIB (TX,1-4NxM0) SCCA patients. The regimen was composed of capecitabine (825 mg/m² twice per day for 5 days) and oxaliplatin (50 mg/m² weekly) during weeks 1 through 6, concurrent with RT (XELOX-XRT; group 1). After the first 11 patients, the study was amended to omit chemotherapy during the third and sixth weeks (group 2). The primary objective was 3-year time to treatment failure (TTF) and safety. Secondary objectives were complete response (CR) rate, locoregional control, colostomy-free survival (CFS), and overall survival (OS).ResultsTwenty patients were enrolled. Seven patients of group 1 (63%) developed Grade 3 toxicity, which reduced to 22% in Group 2. No Grade 4 toxicities were noted. The median RT dose was 55 Gy. CR occurred in 100% of the 19 patients evaluable for response at 12 to 14 weeks. After a median follow-up of 47.6 months, 2 patients had local recurrence and 1 had distant recurrence. Three-year TTF was 90.0%, with similar rates between groups 1 and 2 (respectively, 90.9% vs. 88.8%, P = .984). Three-year CFS was 90.0%. The median OS has not been reached.ConclusionThe XELOX-XRT regimen is safe, with promising efficacy, and should be explored in larger trials for the treatment of locally advanced SCCA.     

新型SD大鼠压迫性三叉神经痛动物模型建立及其作用研究

目的    本实验探讨建立一种新型SD大鼠压迫性三叉神经痛（TN）动物模型。方法    本研究于2014年6月于中国医科大学附属口腔医院中心实验室进行。雄性SD大鼠30只随机分为2组：实验组15只经脑定位仪3D定位至三叉神经根处,利用微量注射器将5%琼脂溶液10 μL注射到三叉神经根;对照组15只注射等量生理盐水。术前1 d和术后1、2、3、5、7、10、14、21、28、35、42 d分别进行行为学观察,Von Frey纤维测定大鼠机械性刺激反应阈值,利用方差分析及t检验对机械刺激阈值进行统计学分析。同时取压迫处三叉神经行苏木精—伊红（HE）及嗜银染色,并进行三叉神经节（TG）内星形胶质细胞胶质纤维酸性蛋白（GFAP）的免疫荧光检测。结果    实验组大鼠术侧机械刺激反应阈值在术后逐渐降低并稳定持续约30 d（P＜0.05）,HE及嗜银染色显示神经纤维肿胀、脱髓鞘样改变;实验组大鼠术侧TG内星形胶质细胞GFAP表达明显增强。结论    琼脂压迫大鼠三叉神经根可以建立稳定的TN动物模型,为未来进一步研究TN病因及治疗提供一种可靠而有效的动物模型。     

止痛一号方联合羟苯磺酸钙与甲钴胺治疗三叉神经痛50例

目的从改善微循环角度评价止痛一号方联合羟苯磺酸钙与甲钴胺治疗三叉神经痛的临床疗效。方法将98例患者随机分为治疗组和对照组。治疗组50例予中药止痛一号方联合羟苯磺酸钙与甲钴胺;对照组48例予卡马西平加甲钴胺;两组疗程均为8周,观察临床疗效及VAS评分变化情况。结果治疗组、对照组总有效率分别为86.0%、68.8%,治疗组临床疗效优于对照组（P〈0.05）。两组VAS评分在治疗后均明显下降（P〈0.05）,组间治疗后差异有统计学意义（P〈0.05）。治疗组不良反应发生率为12.0%,明显低于对照组的31.25%（P〈0.05）。结论止痛一号方联合羟苯磺酸钙与甲钴胺治疗三叉神经痛安全、有效。     

3D-TOF MRA联合双激发B-FFE对三叉神经血管压迫的诊断价值

目的 探讨3D-TOF MRA联合双激发B-FFE结合后处理技术对三叉神经血管压迫的诊断价值.方法 回顾性分析自贡市第一人民医院2013年5月至2016年8月间经临床手术证实的26例原发性血管压迫性三叉神经痛患者的MRI图像,运用3D-TOF MRA联合双激发B-FFE序列扫描获得的原始图像并结合多平面重建(MPR)及多方位最大密度投影(MIP)分析责任血管与三叉神经的空间关系及责任血管起源,并与手术结果对照.结果 26例原发性血管压迫性三叉神经痛患者中,MRI均能明确责任血管与三叉神经的关系,并与手术结果一致;责任血管分别为小脑上动脉(SCA)16例,小脑前下动脉(AICA)3例,小脑后下动脉(PICA)3例,岩静脉2例,桥脑横静脉1例,小脑上动脉及岩静脉同时压迫2例,椎动脉、小脑上动脉、小脑下前动脉、岩静脉共5组血管分支压迫1例;神经根进入区(REZ)是三叉神经最易受血管压迫的部位.结论 3D-TOF MRA联合双激发B-FFE序列扫描并结合图像后处理技术可清楚显示责任血管与神经的关系及责任血管起源,具有较高的临床价值.     

磁共振T2加权成像联合弥散加权成像在老年直肠癌术前TN分期中的应用价值

目的探讨磁共振T2加权成像联合弥散加权成像在老年直肠癌术前TN分期中的应用价值。方法以2018年1月～2020年12月肿瘤科收治的74例老年直肠癌手术患者为研究对象,全部患者术前均接受磁共振检查,采用常规T2加权成像与弥散加权成像,以术后病理诊断结果为金标准,评价磁共振联合成像进行TN分期的准确率与一致性。结果磁共振T2加权成像联合弥散加权成像诊断T分期:T₁期7例、T₂期14例、T₃期28例、T₄期25例,基于金标准,诊断准确70例,准确率94.59%,误诊4例,均为高估,一致性检验Kappa值为0.832(P <0.05)。诊断N分期:N₀期13例、N₁期37例、N₂期24例(32.43%),基于金标准,诊断准确64例,准确率86.49%,误诊10例,包括7例高估和3例低估,一致性检验Kappa值为0.755(P <0.05)。结论磁共振T2加权成像联合弥散加权成像术前诊断老年直肠癌TN分期准确率较高,与术后病理诊断结...     

爱维治对烧伤患者心肌组织缺血缺氧的保护作用

目的:研究爱维治对烧伤患者心肌组织缺血缺氧的影响。方法:本研究为随机、开放、对照性多中心研究。选择烧伤总面积在30%~70%总体表面积(TBSA)且血清乳酸值异常的患者作为研究对象,将70例患者随机分为两组:试验组(n=36)给予爱维治30 mL 生理氯化钠溶液250 mL,静脉滴注,qd,给药7 d;对照组(n=34)仅给予生理氯化钠溶液250 mL,静脉滴注,qd,共7 d。取患者用药前、用药后48 h,72 h和7 d的血样,以血清乳酸值、心肌型肌酸激酶同工酶和肌钙蛋白作为主要监测指标,评价爱维治对烧伤后患者心肌组织的影响。结果:两组血清乳酸值、心肌型肌酸激酶同工酶、肌钙蛋白阳性率在观测期内均有下降,但试验组下降的时间早且幅度大,有统计学意义。结论:爱维治能够有效而且快速改善大面积烧伤患者心肌组织缺血缺氧状况。     

MRI 常规成像序列结合 DWI 对直肠癌 术前 TN 分期的诊断价值

〔摘 要〕 目的：探讨直肠癌术前 TN 分期诊断中磁共振成像（MRI）常规成像序列结合弥散加权成像（DWI）检 查的应用价值。方法：回顾性分析 2018 年 9 月至 2020 年 9 月舞钢市人民医院收治的经术后病理组织学明确诊断为 直肠癌患者 85 例,所有患者均行 MRI 常规成像序列检查及 DWI 检查。分析 MRI 常规成像序列结合 DWI 检查在直 肠癌术前 TN 分期诊断中的应用价值。结果：经术后病理组织学检查,85 例患者术前 TN 分期中 N0 期 51 例,N1 期 19 例,N2 期 15 例;T1 期 6 例,T2 期 8 例,T3 期 58 例,T4 期 13 例;MRI 常规成像序列结合 DWI 检查在 T 分期 中诊断灵敏度及准确度均高于 N 分期。结论：MRI 常规成像序列与 DWI 两种检查相互补充,在直肠癌术前 TN 分期 中具有较高的应用价值     

Factors affecting the perception of intoxication: dose, tolerance, and setting

The present experiment was designed to investigate whether changes in internal sensations and affect are used to discriminate intoxication and to determine how the discriminability of these cues is affected by dose, acquired tolerance, and the setting in which alcohol is consumed. Setting varied according to whether subjects were distracted or not distracted from attending to alcohol induced changes. Furthermore, subjects drank either a placebo beverage or one of two doses of alcohol. The results showed an interaction between dose and setting, which suggested that subjects who participated in a distracting task were less accurate in the evaluation of their intoxication and were more easily misled into believing that they had consumed alcohol when they had actually received a placebo. Additional measures suggested that the distracted subjects did not base their intoxication ratings as closely on changes associated with alcohol consumption. Acquired tolerance to alcohol also affected the perception of intoxication and influenced the discriminability of changes in internal sensations and affect. The findings on tolerance are related to motives for increasing alcohol consumption over time and to the inefficacy of blood alcohol level discrimination training with alcoholics.