109例成人软组织肉瘤化疗的疗效分析

背景与目的:成人软组织肉瘤(soft tissue sarcoma,STS)发病率低,化疗效果不肯定.本研究通过分析成人软组织肉瘤病例的临床特征,探讨化疗在成人软组织肉瘤综合治疗中的意义.方法:回顾性分析2000年1月至2005年12月在中山大学肿瘤防治中心诊断为软组织肉瘤,并接受化疗的109例患者的临床资料和化疗情况,统计各一线化疗方案的有效率及患者的生存资料.结果:109例患者中有66例行姑息化疗,40例行辅助化疗,3例行新辅助化疗.姑息化疗患者一线化疗方案的总有效率为22.7%,中位生存期16.9个月,1年和2年生存率分别为63.6%和33.3%,中位无进展生存期为3.4个月.仅发生肺转移的患者中位生存期为25.1个月,仅发生肝转移的患者中位生存期为11.8个月,两者比较差异有统计学意义(P＜0.05).MAID方案是最常用的一线化疗方案,其次是CYVADIC方案,有效率(完全缓解 部分缓解)分别为28.0%和22.2%.确诊后半年内发生转移的患者比半年后转移的患者中位生存期短(11.8个月vs.42.9个月),两者之间差异有统计学意义(P=0.04).结论:MAID和CYVADIC均为有效的化疗方案,既往使用过常规剂量的阿霉素±异环磷酰胺后进展的患者仍可能从大剂量异环磷酰胺化疗中获益.肝转移患者比肺转移患者对化疗更不敏感,确诊后半年内出现转移的患者预后较确诊半年后转移者差.     

痿证中药方抑制线粒体内质网应激减轻大鼠脊髓损伤

目的 研究痿证中药方对脊髓损伤(SCI)大鼠模型中氧化应激反应及内质网应激相关蛋白表达的调节作用.方法 SPF级SD大鼠30只随机分为为假手术组、脊髓损伤模型组及痿证中药方组,痿证中药方组予以痿证中药方干预.术后第3～4天、1周、2周、3周、4周进行下肢运动功能评分,干预后30 d,取脊髓组织并采用HE染色法检测脊髄损...     

CyclOBEAP (cyclophosphamide, vincristine, bleomycin, etoposide, doxorubicin, prednisolone) regimen with granulocyte colony-stimulating factor (G-CSF) for patients with aggressive non-Hodgkin's lymphoma: a pilot study. The Adult Lymphoma Treatment Study Group (ALTSG)

We conducted a multi-institutional collaborative study to examine the usefulness and safety of third-generation chemotherapy CyclOBEAP (cyclophosphamide, vincristine, bleomycin, etoposide, doxorubicin, prednisolone) combined with granulocyte colony-stimulating factor (G-CSF) in the treatment of aggressive non-Hodgkin's lymphoma (NHL). Subjects included patients with aggressive NHL who were 60 yr of age or younger and had been diagnosed as having a low-intermediate, high-intermediate, or high risk using the International Prognostic Index (IPI). A total of 24 patients were enrolled in the study between May 1997 and March 1998, including 9 low-intermediate-risk cases, 13 high-intermediate-risk cases and 2 high-risk cases. Although all 24 patients were originally enrolled in the study, one adult T-cell leukemia/lymphoma case was subsequently excluded. Thus, in the end, 23 cases were evaluated. Evaluation of the efficacy of therapy revealed complete remission in 20 patients (87%). Of these 20 patients, 8 were low-intermediate-risk cases (89%) and 12 were either high-intermediate- or high-risk cases (86%). Partial remission was achieved in 2 patients (8.7%). The 2-yr survival rate was 91.3%, and the 2-yr disease-free survival rate was 81.8%. Grade 3 or higher adverse reactions were granulocytopenia (87%), thrombocytopenia (17.4%) and liver dysfunction (4.3%). CyclOBEAP therapy has been associated with a high remission rate for aggressive NHL. When combined with G-CSF, a high relative dose intensity was maintained for each drug administered (0.94-0.97). Furthermore, although the observation period was short, both the survival rate and disease-free survival rate were good. Hence, we concluded that there were no problems associated with the procedure in terms of safety.     

TP方案治疗NP方案化疗失败的非小细胞肺癌的疗效观察

目的评价NP方案化疗后进展的晚期非小细胞肺癌（NSCLC）应用TP方案化疗的疗效和毒副反应。方法34例NSCLC均曾接受过NP方案化疗2周期,出现病情进展后接受TP方案化疗,紫杉醇135mg／m^2,d1,顺铂20mg／m^2,d1-4,21d为1周期,完成2周期评价疗效,观察毒副反应。结果34例中CR0例,PR3例（8．82％）,SD6例（17．65％）,PD25例（73．53％）,总有效率为8．82％。主要毒副反应是骨髓抑制和胃肠道反应。结论TP方案对NP方案化疗失败的晚期NSCLC有一定疗效,但有效率较低,提示有交叉耐药性。     

基于文献分析的欧龙马滴剂儿童国内给药方案调查

目的 分析欧龙马滴剂在儿童中的给药方案,为临床安全合理用药提供数据支持.方法 检索2005年1月1日至2020年6月30日期间,中国期刊全文数据库、中文科技期刊全文数据库、万方数据库和中国生物医学文献等数据库中有关欧龙马滴剂的文献,对文献报道的儿童患者诊断、年龄、用量、给药途径、疗程、合并用药等方面进行汇总分析,以探讨...     

A phase I trial to assess the value of recombinant human granulocyte colony stimulating factor (r-MetHuG-CSF,filgrastim) in accelerating the dose rate of chemotherapy for intermediate and high-grade non-Hodgkin's lymphoma (NHL)

In a multi-centre phase I study we investigated the possibility of reducing the interval between courses of standard CHOP (cyclophosphamide 750 mg/mdoxorubicin 50 mg/mvincristine 2 mgs day 1, and prednisolone 40 mg/m² days 1–8) from 21 days to 15 days and then 10 days using granulocyte colony stimulating factor (r-MetHuG-CSF (Amgen)-filgrastim) to accelerate neutrophil recovery. Patients received CHOP followed by G-CSF 5 μg/kg s.c. from day 2 to the day before the next course (e.g. days 2–14 for the 15-day interval). A total of 28 patients with newly diagnosed intermediate grade or high grade NHL were studied. Four patients were studied at a 21-day interval, six patients were treated at a 15-day interval and subsequently six patients at a 10-day interval. Following analysis of this initial cohort, a further 12 patients were evaluated; four at the 15-day interval, and eight at the 10-day interval. No dose-limiting toxicity was seen in the four patients receiving 21-day CHOP. Dose-limiting toxicity was seen in 4/10 patients treated at the 15-day interval (M:F 7:3, median age 55·5, range 39–67 years). This consisted of infection in two patients, recurrent infection and debility in a third, and mucositis in a fourth. Seven patients experienced one or more infectious episodes requiring antibiotics (median number of episodes: 2, range 1–4). Fourteen patients (M:F 4:3, median age 47·5, range 25–63 years) were treated at the 10-day interval. Dose-limiting toxicity was seen in six patients. This consisted of severe mucositis in three patients, neutropenia and thrombocytopenia on two separate occasions in one patient, and steroid-induced gastritis in two patients. Nine patients had one or more documented infections (median: 2, range 1–3) requiring antibiotics, of which six were severe (WHO grade 3 or 4). One patient died of Pneumocystis carinii (PCP) pneumonia. In summary, G-CSF (filgrastim) will facilitate the shortening of the dosage interval between cycles of CHOP chemotherapy due to accelerated hematological recovery. However, non-hematological toxicity due to the shorter dosage interval is increased and infective episodes are frequent. © 1996 John Wiley & Sons, Ltd.     

NGF和CGRP对局灶性脑缺血再灌注后大鼠皮质CHOP蛋白表达的影响

目的探讨外源性神经生长因子(NGF)和降钙素基因相关肽(CGRP)对局灶性脑缺血再灌注后大鼠顶叶皮质神经元CHOP蛋白表达的影响及其作用机制。方法用线栓法制备大鼠大脑中动脉阻塞(MCAO)模型,应用免疫组织化学方法,免疫印迹法(W estern B lotting)测定CHOP蛋白表达;M etamoph图像分析系统对结果进行分析。结果假手术组大鼠顶叶皮质未见CHOP蛋白表达;缺血组CHOP蛋白在缺血再灌注后12 h明显表达,24 h达高峰,72 h显著下降,缺血组较假手术组CHOP蛋白表达显著增加(P<0.01);NGF组和CGRP组CHOP蛋白表达分别弱于缺血组(P<0.01);NGF和CGRP合用组CHOP蛋白表达明显弱于缺血组(P<0.01),也分别弱于NGF组和CGRP组(P<0.01)。结论NGF和CGRP能分别下调局灶性脑缺血再灌注大鼠顶叶皮质CHOP蛋白表达,联合应用则作用更强,二者对保护脑缺血神经元可能有协同作用。     

黄芪多糖对毒胡萝卜素诱导人结肠癌系HT29细胞内质网应激的影响

目的探讨黄芪多糖(Astragalus polysaccharides,AP)对毒胡萝卜素内酯(Thapsigargin,Tg)诱导人结肠癌系HT29细胞发生内质网应激(Endoplasmic Reticulum Stress,ERS)时内质网结构变化及相关分子GRP78和CHOP的影响。方法常规培养HT29细胞后,将细胞分为4组:①空白细胞组(Control组):细胞不做任何药物处理;②细胞模型组(Model组):采用1μmol/L Tg诱导HT29细胞建立ERS模型;③黄芪多糖低浓度组(AP-L组);④黄芪多糖高浓度组(AP-H组)。CCK8法检测黄芪多糖对HT29细胞活性,透射电镜观察内质网结构变化,Real-time PCR法检测ERS时GRP78、CHOP mRNA表达情况。结果黄芪多糖浓度分别为1、10μg/mL,且分别作用HT29细胞12、24、36、48 h时,细胞存活率随着浓度的增加而增加,说明对细胞无明显毒副作用。透射电镜观察Control组内质网结构呈网膜状结构,网膜腔不扩张;Model组内质网形态迥异,大小不一,呈空泡状改变,部分可见融合成簇现象;AP-L组内质网网膜腔扩张程度减轻,空泡体积减小和数量减少;AP-H组内质网形态基本恢复正常,呈网膜状结构,可见数量较少,形态较小的空泡状结构。Real-time PCR法检测结果:与Control组相比,Model组HT29细胞GRP78、CHOP mRNA表达明显增加(P<0.05);与Model组比较,AP-L组和AP-H组HT29细胞GRP78、CHOP mRNA表达均减少(P<0.05);与AP-L组比较,AP-H组HT29细胞GRP78、CHOP mRNA表达减少(P<0.05)。结论黄芪多糖能够抑制Tg诱导HT29细胞发生ERS,其机制可能与降低GRP78和CHOP的表达、减轻内质网应激有关。     

Ag85B DNA/H37Ra序贯免疫效果的探讨

目的：初步探讨含结核分枝杆菌Ag85B成熟蛋白的DNA（pTB30m）和结核菌H37Ra序贯免疫小鼠产生的特异性免疫应答。方法：重组质粒pTB30m用碱裂解法制备后进行质量鉴定。用pTB30m肌注初次免疫小鼠2周后,H37Ra皮内加强免疫作为DNA-85B/H37Ra组,同时设定DNA-85B/BCG组、H37Ra组、BCG组及未免疫组。免疫4周或8周后,用ELISA法检测小鼠血清中抗PPD IgG抗体的水平和MTT法检测其脾淋巴细胞的刺激指数（SI）。结果：酶切鉴定pTB30m所含外源基因片段大小正确,并且纯度较高。DNA-85B/H37Ra组小鼠血清中抗PPD IgG水平、脾淋巴细胞的SI均显著高于未免疫组（P〈0.05）;其抗PPD IgG水平稍高于DNA-85B/BCG组、H37Ra组及BCG组,但它们之间无显著性差异（P〉0.05）;其脾淋巴细胞的SI显著高于H37Ra、BCG组（P〈0.05）,而与DNA-85B/BCG组比较,仅在4周有显著性差异。在DNA-85B/H37Ra组内,SI在4周显著高于8周（P〈0.05）,而血清中抗PPD IgG水平8周均显著高于4周（P〈0.05）。结论：DNA-85B/H37Ra序贯免疫策略可以诱导小鼠产生特异性体液免疫和细胞免疫,初步证明其免疫效果略优于BCG。     

不同药物方案治疗儿童双相情感障碍疗效比较及代谢指标观察

目的 探讨儿童双相情感障碍经不同药物方案治疗后代谢指标的变化及治疗疗效。方法 回顾性分析2017年1月至2020年1月于该院就诊的220例儿童双相情感障碍患儿的临床资料。根据治疗方法分组,单纯采用非典型抗精神病药物治疗的112例患儿纳入对照组,采用非典型抗精神病药物联合心境稳定剂治疗的108例患儿纳入研究组。比较两组基线资料水平,治疗前后代谢指标空腹胰岛素（FIN）、糖化血红蛋白（HbAlc）、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）水平变化,以及代谢综合征发生情况及临床疗效。结果 两组患儿年龄、性别、病程等基线资料比较差异均无统计学意义（P > 0.05）。研究组总有效率为92.6%,高于对照组（82.1%,P < 0.05）。治疗前,两组FIN、HbAlc水平比较差异无统计学意义（P > 0.05）;治疗后,对照组FIN水平高于治疗前,且高于研究组（P < 0.05）;但研究组治疗前后FIN水平比较差异无统计学意义（P > 0.05）;两组治疗前后HbAlc水平比较差异无统计学意义（P > 0.05）。治疗前,两组TC、TG、HDL-C、LDL-C水平比较,差异无统计学意义（P > 0.05）;治疗后,对照组TC、TG水平均高于治疗前,且高于研究组（P < 0.05）;但研究组治疗前后TC、TG水平比较差异无统计学意义（P > 0.05）;两组治疗前后HDL-C、LDL-C水平比较差异无统计学意义（P > 0.05）。研究组代谢综合征发生率（2.8%）低于对照组（9.8%）（P < 0.05）。结论 儿童双相情感障碍采用非经典抗精神病药物联合心境稳定剂治疗对代谢指标水平影响较小,且疗效显著。