肿瘤诊断的告知对前列腺癌患者心理状态的影响

目的评估前列腺癌患者面对恶性肿瘤诊断时的心理反应状况,为心理干预提供依据。方法选择2006年8月至2008年8月在长征医院接受手术治疗的前列腺癌患者为观察对象,随机分成试验组（术前告知组）和对照组（术后告知组）,采用焦虑自评量表（SAS）、抑郁自评量表（SDS）和自编症状困扰自评量表10项进行问卷调查。在入院当天填写自编症状困扰自评量表10项问卷,每位患者分4个时间点测试焦虑自评量表SAS和抑郁自评量表SDS,采用SSPS10．0统计学软件进行统计。结果问卷收回有效率为100％,均进入统计分析。两组患者的焦虑、抑郁评分却均高于中国人常模。试验组焦虑、抑郁评分在前3个时段均高于对照组（P〈0．05）;在术后出院当日对照组焦虑、抑郁评分数值虽高于试验组,但无统计学意义（P〉0．05）。试验组患者睡眠障碍、食欲不振、头痛、疲倦和便秘指标的评分显著高于对照组（P〈0．05）,而尿频、血尿、尿急、排尿困难、体重减轻指标的评分与对照组无显著性差异（P〉0．05）。结论前列腺癌患者在术前被告知肿瘤诊断时会产生很强烈的心理应激反应并随之出现躯体化症状。因此,知情告知与心理状态评估、干预并重有利于患者保持心理状态的积极、稳定,提高疗效。     

R-CHOP方案与CHOP方案治疗初治弥漫性大B细胞淋巴瘤的临床研究

为比较利妥昔单克隆抗体联合标准CHOP方案与标准CHOP方案治疗初治CD20阳性的弥漫慢大B细胞淋巴瘤（DLBCL）患者的疗效和安全性，采用同期（2003年7月至2006年12月）非随机对照的前瞻性研究方法，将69例在我院住院的初治DLBCL患者分为R—CHOP组和CHOP组，其中CHOP组36例，R—CHOP组33例，比较两组的完全缓解率、生存期及不良反应情况。结果显示：R—CHOP组23例（69．7％）获完全缓解（CR），部分缓解（PR）6例（18.2％），总有效率为88．5％，高于CHOP组；CHOP组17例（47．2％）获CR，11例（30．6％）获PR，总有效率77．8％（P=0.049）。尤其在男性、AnnArbor Ⅲ—Ⅳ和IPI3—5分的患者中，R—CHOP方案的CR率明显高于CHOP方案，且差异具有统计学意义（P=0．017、P=0．005和P=0．000）。R—CHOP组预计的平均生存时间（OS）为45．7个月，长于CHOP组的35．2个月，但经Log—Rank检验，差异无统计学意义（P=0．145）；R—CHOP组预计的平均无疾病进展生存时间（PFS）为38．5个月，长于CHOP组的24．6个月，经Log—Rank检验，差异有统计学意义（P=0.017）。R—CHOP组的不良反应主要为发热等输注相关的不良反应，而骨髓抑制情况与CHOP组类似：结论：利妥昔单克隆抗体联合CHOP方案治疗CD20阳性的DLBCL与单纯CHOP方案相比，能显著提高疗效，同时并不增加化疗的毒副反应。     

CEM为预处理方案的自体外周血造血干细胞移植治疗晚期神经母细胞瘤相关毒性及疗效观察

目的　观察以CEM (卡铂 +VP 16 +马法兰 )为预处理方案的自体外周血造血干细胞移植治疗晚期神经母细胞瘤患儿的毒性和疗效。方法　研究经大剂量放、化疗及手术治疗达完全缓解的IV期神经母细胞瘤患儿 6例 ,采用CEM预处理方案 (卡铂每日 4 2 5mg/m2 共 4d ,VP 16每日 338mg/m2 共 4d ,马法兰每日 70mg/m2 共 3d)的自体外周血造血干细胞移植 ,并依据Bearman标准对预处理毒性进行评价 ,对其造血重建、并发症及预后进行观察。结果　预处理后髓外毒性除 1例为I级肝损害外 ,主要表现在口腔粘膜 (I级 6例 )和胃肠道 (I级 5例 ,II级 1例 )损害。白细胞于移植后 3± 0 .5d达到 0 ,移植后 33± 3.1d稳定于 1× 10 9/L以上。除 1例患儿移植后 11个月颅内转移外 ,余 5例患儿均健康存活。随诊时间分别为 8、10、2 3、36及 4 8个月。结论　以CEM为预处理方案的自体外周血造血干细胞移植可以安全、有效的治疗IV期神经母细胞瘤。     

A novel protocol for postpartum magnesium sulphate in severe pre-eclampsia: a randomized controlled pilot trial

Objective: Magnesium sulphate is the preferred anticonvulsant used to prevent the development of fits in severe pre-eclampsia; we aim to compare between three different protocols of postpartum magnesium sulphate in the effectiveness of preventing the development of fits in severe pre-eclampsia.

Methods: Double-blind randomized controlled pilot trial, done in Cairo university hospital, Cairo, Egypt during 2013–2014, on 240 women with severe pre-eclampsia. Magnesium sulphate intravenous infusion was given in the postpartum period to all the patients, women were randomly allocated to group I (Single loading dose only), group II (12?h abbreviated protocol) or group III (24?h standard protocol) (n?=?80 in each group).

Results: There were no significant difference between the three groups as regards the incidence of eclampsia, elevated liver enzymes and low platelets syndrome, maternal ICU admission and; however The incidence of flushing was significantly higher in group III than group II and I (24 [30%] versus 12 [15%] versus 4 [5%]; p?<?0.001) respectively.

Conclusion: The pilot study demonstrates that the single-loading dose of postpartum magnesium sulphate is a promising alternative to the standard and the abbreviated protocol in preventing eclampsia; however, a large clinical trial is necessary to prove this.     

Influence of tumours on normal cells and optimal chemotherapy regimens: the case of several drugs and toxicity constraints.

Cancer chemotherapy with the application of several drugs is studied. The negative and inhibiting effect of the tumour on normal cells is taken into account. Under certain hypotheses, we determine the optimal regimen that minimizes the tumour burden at the end of a fixed period of therapy while maintaining several normal cell populations above prescribed levels. More precisely, it is demonstrated that the optimal drug administration corresponds to the strategy of intensive chemotherapy.     

Determination of the Kinetic Constants of the Telomerization of 10‐Undecenol with Alkyl Hydrogenphosphonate

Summary: The telomerization of 10‐undecenol with alkyl hydrogenphosphonate was studied in order to synthesize telomers of different molecular weights. The study showed that telomers from 10‐undecenol could be obtained despite the fact that the double bond has a low reactivity. The kinetic constant Kp²/K_Te was determined to be 7 × 10^?4 l · mol^?1 · s^?1 at 135 °C and the transfer constant C_T was 0.057. These values are normal for a low activity telogen such as hydrogenphosphonate and for slightly reactive monomers like 10‐undecenol.

SEC chromatogram of telomers obtained in the reaction of 10‐undecenol addition.     

Properties of HTLV-I transformed CD8 T-cells in response to HIV-1 infection

HIV-1 infection studies of primary CD8⁺ T-cells are hampered by difficulty in obtaining a significant number of targets for infection and low levels of productive infection. Further, there exists a paucity of CD8-expressing T-cell lines to address questions pertaining to the study of CD8⁺ T-cells in the context of HIV-1 infection. In this study, a set of CD8⁺ T-cell clones were originated through HTLV-I transformation in vitro, and the properties of these cells were examined. The clones were susceptible to T-cell tropic strains of the virus and exhibited HIV-1 production 20-fold greater than primary CD4⁺ T-cells. Productive infection resulted in a decrease in expression of CD8 and CXCR4 molecules on the surface of the CD8⁺ T-cell clones and antibodies to these molecules abrogated viral binding and replication. These transformed cells provide an important tool in the study of CD8⁺ T-cells and may provide important insights into the mechanism(s) behind HIV-1 induced CD8⁺ T-cell dysfunction.     

The expression and role of c-Myc in mouse hair follicle morphogenesis and cycling

Although the function of c-Myc has been clarified in many tissues, until now its expression and role in hair follicle morphogenesis and the hair cycle remains unknown. In this study we detected c-Myc expression pattern in the process of mouse hair follicle development and normal cycle. We found that during hair follicle morphogenesis, the stage-specific expression of c-Myc was detected in mouse skin and was predominantly localized to the hair follicle epithelium. c-Myc expression was also consistently found in mouse skin throughout the hair follicle cycle. Through the in vivo injection of c-Myc inhibitory peptide and c-Myc expression plasmid, we also investigated the direct effects of c-Myc on the hair follicle structures during the hair follicle cycle. Our results showed that c-Myc inhibitory peptide significantly restrained the development of anagen hair follicles, while the injection of plasmid DNA encoding c-Myc in vivo clearly promoted anagen development. Our data indicate that c-Myc may play an important role in the proliferation and differentiation of the hair follicle keratinocytes during hair follicle development. c-Myc also was shown to participate in the regulation of the mouse hair growth cycle and could promote the proliferation of the hair matrix keratinocytes as well as the differentiation of the inner root sheath.