Gynecologic examination and cervical biopsies after (chemo) radiation for cervical cancer to identify patients eligible for salvage surgery

PURPOSE: The aim of this study was to evaluate efficacy of gynecologic examination under general anesthesia with cervical biopsies after (chemo) radiation for cervical cancer to identify patients with residual disease who may benefit from salvage surgery. METHODS AND MATERIALS: In a retrospective cohort study data of all cervical cancer patients with the International Federation of Gynecology and Obstetrics (FIGO) Stage IB1 to IVA treated with (chemo) radiation between 1994 and 2001 were analyzed. Patients underwent gynecologic examination under anesthesia 8 to 10 weeks after completion of treatment. Cervical biopsy samples were taken from patients judged to be operable. In case of residual cancer, salvage surgery was performed. RESULTS: Between 1994 and 2001, 169 consecutive cervical cancer patients received primary (chemo) radiation, of whom 4 were lost to follow-up. Median age was 56 years (interquartile range [IQR], 44-71) and median follow-up was 3.5 years (IQR, 1.5-5.9). In each of 111 patients a biopsy sample was taken, of which 90 (81%) showed no residual tumor. Vital tumor cells were found in 21 of 111 patients (19%). Salvage surgery was performed in 13 of 21 (62%) patients; of these patients, 5 (38%) achieved long-term, complete remission after salvage surgery (median follow-up, 5.2 years; range, 3.9-8.8 years). All patients with residual disease who did not undergo operation (8/21) died of progressive disease. Locoregional control was more often obtained in patients who underwent operation (7 of 13) than in patients who were not selected for salvage surgery (0 of 8 patients) (p < 0.05). CONCLUSIONS: Gynecologic examination under anesthesia 8 to 10 weeks after (chemo) radiation with cervical biopsies allows identification of those cervical cancer patients who have residual local disease, of whom a small but significant proportion may be salvaged by surgery.     

穴位贴敷对恶性肿瘤患者化疗致便秘的临床疗效观察

目的观察穴位贴敷对恶性肿瘤患者化疗所致便秘的临床疗效。方法采用随机对照的方法,将2017年1月-2018年12月在我院接受化疗并符合纳入标准的60例恶性肿瘤化疗患者按随机数字表分为观察组和对照组各30例,对照组采用常规护理方法进行护理,观察组在常规护理基础上给予穴位贴敷。分别于治疗前后采用便秘症状积分量表和焦虑自评量表评估两组患者治疗情况。结果观察组患者便秘症状积分和焦虑自评量表得分均低于对照组,差异有统计学意义(P<0.05)。结论穴位贴敷可减轻恶性肿瘤患者化疗期间便秘及焦虑等负性情绪的严重程度。     

nm23-H1基因对口腔癌Acc-M细胞株的转移能力及化疗敏感性影响的体外研究

目的　通过 nm2 3- H1的转化及导入 Acc- M细胞株 ,建立稳定、高效、低毒的转染方法 ,观察 nm2 3- H1对 Acc- M细胞株侵袭转移能力及化疗敏感性的影响。方法　采用基因转化技术 ,制备高纯度的 nm2 3- H1真核表达质粒。用阳离子脂质体介导的转染技术 ,将 nm2 3- H1基因转染到口腔腺样囊性癌 Acc- M细胞株。用免疫组化技术检测转染前后的 nm2 3- H1的表达。并用 transwell小室和冲刷实验 ,观察转染前后细胞的侵袭、粘附、趋化运动能力的变化。采用 MTT法观察 nm 2 3- H1对 Acc- M化疗敏感性影响。结果　 1使用重组的 p CMV - Neo- Bam的真核表达载体 ,将 nm 2 3- H 1转染口腔癌细胞 ,并获得稳定表达。 2 Acc- M细胞株 nm2 3- H 1基因的转染前后表达水平有明显差异。 3转染后的 Acc- M细胞侵袭、粘附、趋化运动能力均显著降低。 4转染前后使用 C- DDP的 L D50 分别为2 .6 4± 0 .4 7,1.85± 0 .4 1(P<0 .0 1)。结论　 nm2 3- H1对 Acc- M细胞的侵袭转移能力具有显著抑制作用 ,同时具有对铂类药物的化疗增敏功能     

Carisolv(伢典)微创化学机械去龋法治疗幼儿龋齿的临床研究

目的:评价伢典微创化学机械去龋齿治疗幼儿龋齿的有效性、安全性和实用性。方法:门诊幼儿龋齿病人50例,随机分为伢典治疗组30例和对照组20例,分别采用伢典凝胶去龋和常规磨牙去龋,比较两组幼儿的感受、治疗所用时间、治疗效果、幼儿感受程度。结果:伢典治疗组病儿痛苦小、安全、愿意接受,只是所用时间长于对照组。结论:伢典微创化学机械去龋治疗幼儿龋齿安全、有效、无痛。     

肾动脉内化疗加栓塞在肾癌中应用（附19例分析）

目的 探讨肾动脉内化疗加栓塞作为肾癌辅助治疗的意义。方法 本组术前辅助肾动脉内化疗加栓塞11例，按Robson分期：Ⅰ期3例，Ⅱ期5例，Ⅲ期1例，Ⅳ期2例。肾癌细胞分级：G12例，G26例，G33例。姑息性肾动脉内化疗加栓塞8例，按Robson分期：Ⅲ期6例，Ⅳ期2例。结果 11例行肾切除术的病人术中出血平均150ml，肿瘤较栓塞前缩小，易于切除，无手术并发症，术后1年、3年生存率分别为90.9%和72.7%。姑息性化疗加栓塞组病人疼痛血尿症状改善，1年、3年生存率分别为75％和25％。结论 肾动脉内化疗加栓塞安全有效且能耐受，可用于肾癌术前辅助治疗及晚期肾癌的姑息治疗。     

优质护理对行甲氨蝶呤化疗白血病患儿真菌性口腔炎的预防效果

目的探讨优质护理对行甲氨蝶呤化疗白血病患儿真菌性口腔炎的预防效果。方法选取2019年1月至2020年6月于中国科学技术大学附属第一医院西区行甲氨蝶呤化疗的72例白血病患儿作为研究对象,按照随机数字表法将其分为对照组(36例)与观察组(36例)。对照组采用常规护理方法,观察组采用优质护理方法。比较两组的真菌性口腔炎发生率以及愈合时间、真菌性口腔炎程度。结果观察组真菌性口腔炎发生率为5.56%,低于对照组的41.67%,真菌性口腔炎愈合时间[(5.03±1.84)d]短于对照组[(9.38±2.38)d],观察组真菌性口腔炎程度轻于对照组,差异有统计学意义(P<0.05)。结论为行甲氨蝶呤化疗白血病患儿提供优质护理服务,可有效控制真菌性口腔炎的出现,有利于促进患儿口腔炎愈合。     

一氧化氮供体和阿霉素的共递送系统用于逆转肿瘤低氧耐药研究

目的构建一种一氧化氮供体和阿霉素的共递送系统,以逆转肿瘤低氧耐药。方法利用酰胺反应合成一氧化氮供体单硝酸异山梨酯(IM)修饰的透明质酸(HA-IM),再通过硫化学作用将其嫁接于二硫化钼(MoS₂)纳米片,制备出载体二硫化钼-单硝酸异山梨酯修饰的透明质酸(MoS₂-HA-IM),考察此载体的理化特性。通过疏水作用装载抗癌药阿霉素(DOX),构建一氧化氮供体和抗癌药物的共递送系统,并在细胞水平上考察此系统的抗肿瘤效果。结果二硫化钼-单硝酸异山梨酯修饰的透明质酸-阿霉素(MoS₂-HA-IM-DOX)可通过透明质酸受体介导的内吞作用有效地将装载的单硝酸异山梨酯和阿霉素输送到肿瘤细胞内,且在肿瘤弱酸性内环境和近红外光照射的双重刺激下迅速将药物释放出来,提高胞内游离药物的浓度。同时,装载的单硝酸异山梨酯能够逆转肿瘤细胞的低氧耐受性,进一步增强二硫化钼-单硝酸异山梨酯修饰的透明质酸-阿霉素的化疗效果,再联合基于二硫化钼材料产生的光热,共使肿瘤细胞的生长抑制率高达93.6%,明显高于其他组。结论二硫化钼-单硝酸异山梨酯修饰的透明质酸-阿霉素能够靶向输送一氧化氮供体和抗癌药物至肿瘤细胞内,双重响应控制药物释放,逆转肿瘤低氧耐药,最大限度地提高化疗效果,结合光热治疗,显示出优异的抗肿瘤效果。     

Detection of head and neck squamous cell carcinoma with diffusion weighted MRI after (chemo)radiotherapy: correlation between radiologic and histopathologic findings

PURPOSE: To investigate the value of diffusion weighted magnetic resonance imaging (DW-MRI) in differentiating persistent or recurrent head and neck squamous cell carcinoma (HNSCC) from nontumoral postradiotherapeutic alterations. METHODS AND MATERIALS: In 26 patients with suspicion of persistent or recurrent HNSCC, MRI of the head and neck was performed, including routine turbo spin-echo (TSE) sequences and an additional echo-planar DW-MRI sequence, using a large range of b-values (0-1000 s/mm(2)). Apparent diffusion coefficient (ADC) maps were calculated. In the suspect areas at the primary site and in the suspect lymph nodes, signal intensity was measured on the native b0 and b1000 images and ADC values were calculated for these tissues. The same was done for surrounding irradiated normal tissue. Imaging results were correlated to histopathology. RESULTS: Signal intensity on native b0 images was significantly lower for HNSCC than for nontumoral postradiotherapeutic tissue (p < 0.0001), resulting in a sensitivity of 66.2%, specificity of 60.8%, and accuracy of 62.4%. Signal intensity on native b1000 images was significantly higher for HNSCC than for nontumoral tissue (p < 0.0001), resulting in a sensitivity of 71.6%, specificity of 71.3%, and accuracy of 71.4%. ADC values were significantly lower for HNSCC than for nontumoral tissue (p < 0.0001), resulting in a sensitivity of 94.6%, specificity of 95.9%, and accuracy of 95.5%. When compared with computed tomography, TSE-MRI and fluorodeoxyglucose-positron emission tomography, DW-MRI yielded fewer false-positive results in persistent primary site abnormalities and in persistent adenopathies, and aided in the detection of subcentimetric nodal metastases. CONCLUSIONS: Diffusion weighted-MRI accurately differentiates persistent or recurrent HNSCC from nontumoral tissue changes after (chemo)radiotherapy.