低温常压等离子技术在肿瘤学中的应用

等离子医学是研究等离子技术在医学领域应用的一门新兴科学。简述低温常压等离子技术,着重介绍其在肿瘤学中的应用。在肿瘤学领域中,等离子技术通过直接处理肿瘤细胞,产生大量活性物质引起肿瘤细胞的凋亡、坏死和自噬,从而发挥对肿瘤组织的直接致死性作用;等离子技术也可通过活化液体,使活化液体具备细胞毒性作用,从而发挥对肿瘤组织的间接致死性作用;同时等离子技术也具有诸多对肿瘤组织的非致死性作用;此外等离子技术也可参与构建化疗药物的缓释系统,协助药物跨生物膜转运,与传统化疗药物产生协同抗肿瘤的作用等,在肿瘤药物学领域发挥重要作用。     

A novel gold nanorods-based pH-sensitive thiol-ended triblock copolymer for chemo-photothermo therapy of cancer cells

Currently an effective strategy in nanomedicine for cancer therapy is the combination of photothermal therapy with chemotherapy. Because combination cancer therapy improve the therapy efficiency by synergistic effects and overcoming drug resistance as compared to monotherapy possesses. According to these facts, gold nanorods-cored biodegradable micelles were prepared by coating gold nanorods (AuNRs) with synthesized pH-sensitive thiol-ended amphiphilic triblock copolymer (PAA-b-PDMAEMAQ-b-PCL-SH). The synthesized AuNRs@polymer was loaded with methotrexate (MTX) as an anticancer drug through electrostatic interactions to afford AuNRs@polymer-MTX. The success of the coating was investigated by means of atomic force microscopy (AFM), thermogravimetric analysis (TGA), transmission electron microscopy (TEM), Fourier transform infrared (FTIR) spectroscopy, ultraviolet-visible (UV-vis) spectroscopy, as well as dynamic light scattering (DLS), and zeta potential measurements. MTX-loading capacity, and pH triggered in vitro drug release behavior of the synthesized nanocomposites were also investigated. In vitro cytotoxic effects was comprehensively evaluated among free MTX, AuNRs@polymer, and AuNRs@polymer–MTX, with or without NIR light irradiation (1064?nm, 125?mJ/pulse, and 4?min) to improve curative effect of AuNRs@polymer–MTX led by the combination of photothermal therapy and chemotherapy.     

重离子放射治疗技术及临床应用

重离子的细胞杀伤作用大,有倒转剂量分布优势,而且具有拓展布拉格峰、高传能线密度、高相对生物效应等特点。将其应用于癌症治疗,可使深部区域肿瘤细胞因高剂量辐射而被有效杀灭,而对周围组织因低剂量分布、相对危害较小,能实现精确靶向治疗,这也被认为是最有前景的肿瘤放疗技术。本文简要介绍了重离子放射治疗的物理和生物学特征,回顾了重离子放射治疗的发展历程及现状;重点阐述了重离子放射治疗技术在临床的应用现状及优势,以期为重离子辐射生物学的研究人员提供一定的数据参考和未来方向参考,更好地促进重离子放射治疗在临床治癌中的良好应用。     

HER2在上皮性卵巢癌中的研究进展

HER2是原癌基因HER2/neu编码的跨膜糖蛋白,可以通过IHC、FISH和分子影像等方法测定。这种癌基因在不同组织学分型和临床分期的上皮性卵巢癌中的表达对预后和治疗靶值的临床应用已被广泛研究,但是目前尚无一致意见。近期的文献中表明HER2过度表达与低分化晚期肿瘤及化疗耐药和生存期缩短有关。对于晚期卵巢癌患者,最初先行减压手术和紫杉醇、铂类药物组合的标准治疗,但后来发展为化疗耐药性疾病,因此需要更多的治疗方法来提高患者生存率。近年来针对HER2的靶向治疗成为临床研究的热点。     

Pharmacological treatment options for severe hypertriglyceridemia and familial chylomicronemia syndrome

Introduction: A spectrum of disorders, ranging from rare severe cases of homozygous null lipoprotein lipase deficiency (LPLD)–familial chylomicronemia syndrome (FCS) to heterozygous missense LPLD or polygenic causes, result in hypertriglyceridemia and pancreatitis. The effects of mutations are exacerbated by environmental factors such as diet, pregnancy, and insulin resistance.

Areas covered: In this review, authors discuss chronic treatment of FCS by ultra-low fat diets allied with the use of fibrates, omega-3 fatty acids, niacin, statins, and insulin-sensitizing therapies depending on the extent of residual lipoprotein lipase (LPL) activity; novel therapies in development target triglyceride (TG)-rich lipoprotein particle clearance. Previously, a gene therapy approach to LPL-alipogene tiparvovec showed that direct targeting of LPL function reduced pancreatitis events. An antisense oligonucleotide to apolipoprotein-C3, volanesorsen has been shown to decrease TGs by 70–80% and possibly to reduce rates of pancreatitis admissions. Studies are underway to validate its long-term efficacy and safety. Other approaches investigating the role of LPL modulating proteins such as angiopoietin-like petide-3 (ANGPTL3) are under consideration.

Expert opinion: Current therapeutic options are not sufficient for management of many cases of FCS. The availability of antisense anti-apoC3 therapies and, in the future, ANGPTL3 therapies may remedy this.     

男性乳癌31例临床分析

目的探讨男性乳癌的诊断和综合治疗方法.方法对1985年10月～1999年9月收治的31例男性乳癌患者的临床资料进行回顾性分析总结.结果随访至2004年9月,2例局部复发,8例出现远处转移.5年生存率71.0%(22/31).结论男性乳癌是一种少见的恶性肿瘤.诊断主要依靠术后病理,淋巴结转移是主要的预后因素.综合治疗可能有助于提高生存率.     

The Role of Patient–Provider Communication in Engagement and Re-engagement in HIV Treatment in Bamako,Mali: A Qualitative Study

Mounting evidence in sub-Saharan Africa suggests poor patient-provider communication (PPC) negatively impacts patient engagement (retention in care and adherence to medication) in antiretroviral therapy (ART) programs. In Bamako, Mali, where 36% of ART patients are lost to follow-up within 12 months of initiating treatment, we aimed to define features of positive PPC according to patient values and explore the mechanisms by which these features may sustain engagement and re-engagement according to patient and provider experiences. We conducted 33 in-depth interviews and 7 focus groups with 69 patients and 17 providers in five ART clinics. Regarding sustaining engagement, participants highlighted “establishing rapport” as a foundational feature of effective PPC, but also described how “responding to emotional needs”, “eliciting patient conflicts and perspective” and “partnering to mitigate conflicts” functioned to address barriers to engagement and increase connectedness to care. Patients who had disengaged felt that “communicating reacceptance” may have prompted them re-engage sooner and that tailored “partnering to mitigate conflicts” would be more effective in sustaining re-engagement than the standard adherence education providers typically offer. Optimizing provider skills related to these key PPC features may help maximize ART patient engagement, ultimately improving health outcomes and decreasing HIV transmission in sub-Saharan Africa.