培美曲塞联合小剂量顺铂二线化疗晚期非小细胞肺癌的疗效观察

目的探讨培美曲塞联合小剂量顺铂二线化疗晚期非小细胞肺癌（NSCLC）近期疗效和毒副反应。方法 32例初次治疗缓解后复发或再进展的晚期NSCLC患者接受采用培美曲塞＋小剂量顺铂方案化疗。结果全组32例中,有效率为21.88%,疾病控制率为68.75%,生活质量改善率为78.12%,主要毒副反应为骨髓抑制、胃肠道反应和皮疹,均可耐受,无相关性死亡发生。结论培美曲塞联合小剂量顺铂二线化疗晚期NSCLC安全有效,值得推广应用。     

小剂量异维A酸联合2%超分子水杨酸治疗中重度痤疮疗效观察

目的:探讨口服小剂量异维A酸联合外用2%超分子水杨酸治疗中重度痤疮的临床疗效。方法:共选取74例中重度痤疮患者作为研究对象,口服小剂量异维A酸10mg,1次/d。治疗组:37例,联合外用2%新型超分子水杨酸治疗;对照组:37例,联合外用夫西地酸乳膏及阿达帕林凝胶治疗。对两组患者治疗前后的皮损数量变化及治疗效果进行对比分析。结果:经过8周的治疗,两组研究对象的总皮损数量较治疗前均显著减少(P<0.05),且治疗组与对照组比较,无明显差异(P>0.05)。针对不同类型的皮损,治疗组对粉刺的疗效比对照组更具优势,对丘疹与结节的疗效无明显差异。结论:治疗中重度痤疮,小剂量异维A酸联合外用2%超分子水杨酸临床疗效较好,副作用小,可作为痤疮治疗的新选择。     

Association between absolute volumes of lung spared from low-dose irradiation and radiation-induced lung injury after intensity-modulated radiotherapy in lung cancer: a retrospective analysis

The aim of this study was to investigate the association between absolute volumes of lung spared from low-dose irradiation and radiation-induced lung injury (RILI) after intensity-modulated radiotherapy (IMRT) for lung cancer. The normal lung relative volumes receiving greater than 5, 10, 20 and 30 Gy (V5–30) mean lung dose (MLD), and absolute volumes spared from greater than 5, 10, 20 and 30 Gy (AVS5–30) for the bilateral and ipsilateral lungs of 83 patients were recorded. Any association of clinical factors and dose–volume parameters with Grade ≥2 RILI was analyzed. The median follow-up was 12.3 months; 18 (21.7%) cases of Grade 2 RILI, seven (8.4%) of Grade 3 and two (2.4%) of Grade 4 were observed. Univariate analysis revealed the located lobe of the primary tumor. V5, V10, V20, MLD of the ipsilateral lung, V5, V10, V20, V30 and MLD of the bilateral lung, and AVS5 and AVS10 of the ipsilateral lung were associated with Grade ≥2 RILI (P < 0.05). Multivariate analysis indicated AVS5 of the ipsilateral lung was prognostic for Grade ≥2 RILI (P = 0.010, OR = 0.272, 95% CI: 0.102–0.729). Receiver operating characteristic curves indicated Grade ≥2 RILI could be predicted using AVS5 of the ipsilateral lung (area under curve, 0.668; cutoff value, 564.9 cm³; sensitivity, 60.7%; specificity, 70.4%). The incidence of Grade ≥2 RILI was significantly lower with AVS5 of the ipsilateral lung ≥564.9 cm³ than with AVS5 < 564.9 cm³ (P = 0.008). Low-dose irradiation relative volumes and MLD of the bilateral or ipsilateral lung were associated with Grade ≥2 RILI, and AVS5 of the ipsilateral lung was prognostic for Grade ≥2 RILI for lung cancer after IMRT.     

Safety data from the MenB-FHbp clinical development program in healthy individuals aged 10 years and older

BackgroundThe MenB-FHbp vaccine (Trumenba®) is licensed in various countries for the prevention of meningococcal serogroup B disease in individuals ≥ 10 years of age. The clinical development program included 11 completed trials where, in each trial, MenB-FHbp had an acceptable safety profile after a primary vaccination series was administered to individuals 10–65 years of age. However, the detection of potential rare events was limited because of individual clinical trial size. The current safety analysis evaluates pooled reactogenicity and other adverse events (AEs) reported in these trials to identify new safety signals not detectable in individual trials.MethodsEleven trials contributed safety data, of which 10 recorded local and systemic reactogenicity events; 8 of the trials were controlled, and reactogenicity data were pooled for 7 of these 8 trials. Additional AE evaluations included immediate AEs (IAEs), medically attended AEs (MAEs), serious AEs (SAEs), newly diagnosed chronic medical conditions (NDCMCs), and autoimmune or neuroinflammatory conditions.ResultsLocal and systemic reactions were more frequent in the MenB-FHbp group (n = 15,294) compared with controls (n = 5509), although most reactions were transient and mild to moderate in severity. Frequencies of IAEs, SAEs, MAEs, NDCMCs, and autoimmune or neuroinflammatory conditions were similar between the MenB-FHbp and control groups.ConclusionsMenB-FHbp demonstrated a favorable safety and tolerability profile in the clinical development program of > 15,000 vaccine recipients ≥ 10 years of age. No new safety signals were identified in the pooled analysis compared with data from the individual trials. Continued postmarketing safety surveillance is important for the identification of rare events.Clinicaltrials.gov: NCT01299480; NCT000808028; NCT00879814; NCT00780806; NCT01352845; NCT01352793; NCT01461993; NCT01323270; NCT01830855; NCT01461980; NCT01768117.     

Low-dose aspirin does not improve ovarian responsiveness or pregnancy rate in IVF and ICSI patients: a randomized, placebo-controlled double-blind study

BACKGROUND: Poor ovarian and endometrial responses to gonadotrophin stimulation in assisted reproduction techniques lead to decreased pregnancy rates. The aim of the present study was to test the hypothesis that low-dose aspirin started prior to controlled ovarian stimulation improves ovarian responsiveness, pregnancy rate (PR) and pregnancy outcome. METHODS: A total of 374 women who were to undergo IVF/ICSI were randomized to receive 100 mg of aspirin (n=186) or placebo (n=188) daily. Treatment was started on the first day of controlled ovarian stimulation. It was continued until menstruation or a negative pregnancy test. Pregnant women continued the medication until delivery. The main outcome measures were the number of oocytes, number and quality of embryos, the clinical PR and pregnancy outcome. RESULTS: The mean (+/-SD) number of oocytes (12.0+/-7.0 versus 12.7+/-7.2), the total mean number of embryos (5.82+/-4.35 versus 5.99+/-4.66), the mean number of top quality embryos (0.99+/-1.39 versus 1.18+/-1.51) and the number of embryos transferred (1.64+/-0.64 versus 1.63+/-0.71) did not differ in the aspirin and placebo groups. Between the aspirin and placebo group, there was no statistically significant difference in clinical PR per embryo transfer (25.3%, n=44 out of 174 versus 27.4%, n=48 out of 175) or clinical PR per cycle initiated (23.7% versus 25.5%). Birth rate per embryo transfer did not differ significantly between the aspirin (18.4%) and placebo (21.1%) groups. The incidence of poor responders [12 (6.5%) versus 13 (6.9%)] was similar in both groups. CONCLUSIONS: The present results indicate that low-dose aspirin treatment does not have any beneficial effect on ovarian responsiveness, PR and pregnancy outcome in unselected women undergoing IVF/ICSI.     

低浓度茶碱在慢性阻塞性肺部疾病中的免疫调节作用

作者观察了缓解期的慢性阻塞性肺部疾病(COPD)患者经低浓度茶碱治疗五周后,白介素2,6,8变化.结果表明:经茶碱治疗后,患者白介素6,8呈下降趋势,白介素2呈上升趋势.提示茶碱除了扩张支气管作用外,还有抗炎和疫疫调节作用.     

低剂量阿替普酶溶栓治疗急性缺血性脑卒中研究进展

阿替普酶静脉溶栓是目前医治急性缺血性脑卒中的最佳措施.虽然各大指南推荐的阿替普酶应用剂量为0.9 mg/kg(最大剂量90 mg),但近年来越来越多的观察性研究认为,低剂量阿替普酶(0.6 mg/kg)溶栓治疗可取得与标准剂量同样的疗效,并可减少症状性颅内出血的发生,不过目前循证医学证据不足.本文围绕低剂量阿替普酶治疗急性缺血性脑卒中现有研究进行综合阐述,希望为临床医生提供参考.