腹腔镜联合醋酸亮丙瑞林对子宫内膜异位症合并不育症疗效

目的:探讨腹腔镜联合醋酸亮丙瑞林治疗子宫内膜异位症(EMS)合并不育症对患者妊娠结局的影响。方法:选取2017年3月-2019年3月本院收治的80例EMS合并不育症患者,随机分为对照组(n=40)和观察组(n=40),对照组给予腹腔镜治疗,观察组给予腹腔镜联合醋酸亮丙瑞林治疗,比较两组临床疗效、绝经症状(Kupperman)评分、盆腔疼痛程度(VAS)评分、血清学指标以及1年内复发率和妊娠率。结果:治疗后观察组治疗有效率(95.0%)高于对照组(67.5%),Kupperman(5.80±2.11分)、VAS评分(1.59±0.22分),低于对照组(8.52±3.84分、2.04±0.51分),血清卵泡刺激素、黄体生成素、雌二醇、基质金属蛋白酶-9、基质金属蛋白酶抑制剂-1、人附睾蛋白、糖类抗原125、糖类抗原199水平均低于对照组(均P<0.05),1年复发率(5.0%)低于对照组(25.0%),1年受孕率(45.0%)高于对照组(20.0%)(P<0.05)。结论:腹腔镜联合醋酸亮丙瑞林治疗EMS合并不育症疗效显著,可缓解临床症状和疼痛程度,改善性激素水平,降低复发率,提高受孕率。     

Relationship between a novel human cytotoxin (factor 2) produced by a B cell line (Karpas 160) and phorbol-myristate-acetate-associated cytotoxicity.

We found that 160b cells, a subclone of Karpas 160 human B cell line, spontaneously secreted a novel cytotoxin, factor 2 (F2). F2 was also extracted from the cells by 60% ammonium sulphate, 0.5% CHAPS and 0.28% Triton X-114. We were able to show that phorbol myristate acetate (PMA) greatly enhanced the production of F2, and PMA may also account for part of the putative F2 cytotoxic activity to K562 cells in crude preparations. We compared the cytotoxic effect of F2 with PMA-associated F2-like cytotoxicity to K562 cells as well as the adequacy of our schemes to purified F2 with regard to its separation from PMA. We found that it was possible to separate PMA from F2 preparations by gel filtration and Rotofor preparative isoelectric focusing. The fate of PMA was also monitored with 3H-PMA and chromatographic profiles of 3H-PMA were studied using DE52 and gel filtration chromatography. We were able to establish that less than 2.9% of the cytotoxicity to K562 was due to PMA. We also found that the radioactive peaks and cytotoxicity peaks to K562 were not well correlated, indicating that the cytotoxicity was not mainly due to remaining PMA. Activated charcoal removed virtually all F2 and PMA but not tumour necrosis factor activity. Our results also showed that cytotoxicity to K562 resulting from F2 or PMA-associated proteins had different physicochemical properties, indicating that they are different molecular entities. These findings are consistent with the earlier observation that 160 cells produce F2 spontaneously and that PMA can amplify its production significantly.     

Cyclical use of tamoxifen and high-dose medroxyprogesterone acetate in advanced estrogen receptor positive breast cancer

Summary One-hundred and seventy patients with estrogen receptor positive (10 pmol/g protein) advanced breast cancer have been treated in a prospective randomized study either with continuous tamoxifen 30 mg × 1 daily (TAM), or with TAM 30 mg × 1 daily for 8 weeks alternating with medroxyprogesterone acetate 500 mg × 2 daily for 8 weeks (TAM/HD-MPA). The response rate was 62% in the group treated with cyclic TAM/HD-MPA versus 41% in the TAM alone group (p = 0.02). There was no significant difference in duration of remissions or survival.     

甲孕酮合并化疗改善晚期肺癌患者生活质量的临床观察

目的　观察患者服用甲孕酮后改善化疗所致的厌食、体重下降、ECOG下降、骨髓抑制及胃肠道反应的作用及止痛和促进蛋白同化作用。方法　 130例接受化疗的晚期肺癌患者 ,分成单用化疗组及化疗 甲孕酮组。结果　在化疗 甲孕酮组治疗的 160个周期中有 4 3.1%食量增加 ;4 5%体重增长 ,平均每周期体重增加 0 .74± 1.56kg;血浆白蛋白升高 1.2± 2 .9g/ L、88.1%疼痛减轻及 2 8.1% ECOG改善。化疗的毒副作用 ,出现 度以上的白细胞下降占 33.8%、血红蛋白下降占 15.6%及胃肠道反应占 18.1%。结论　甲孕酮如能正确合理地用于晚期癌症的治疗 ,可以全面改善化疗期癌症患者的生活质量。     

强的松对大白鼠心肺肝脾肾影响的病理改变

为了解强的松对心肺肝脾肾影响的病理改变,应用正常Wistar大白鼠28只,分实验组及对照组各14只。实验组给予相当于人2mg/kg.d等效剂量的强的松片剂溶入当日饮水中,对照组饮自来水,共10周,之后解剖光镜见对照组心肺肝脾肾及实验组心肺均无异常。实验组肝肾轻度充血,脾充血明显,且见较多舍铁血黄素沉着,以红髓边缘明显。证实常规剂量的强的松对肝脾肾也有一定不良影响,应用激素时要注意及时调整剂量和给药方式与时间,尽量减少副作用。     

A combination therapy with mitomycin c, etoposide, doxifluridine and medroxyprogesterone acetate as second line therapy for advanced breast cancer refractory to combination chemotherapy of cyclophosphamide, doxorubicin and 5 fluorouracil

Thirty-two patients with advanced breast cancer refractory to combination chemotherapy with cyclophosphamide (CPA), doxorubicin (ADR) and 5-fluorouracil (5-FU) (CAF) were treated with the combination of mitomycin C, etoposide, doxifluridine and medroxyprogesterone acetate as second line therapy. Observed responses included 6 patients (18.7%) with complete response (CR) and 7 (21.9%) with partial response (PR). Two (50%) out of 4 patients who had bone pain due to bone metastasis noted pain relief. CR or PR were obtained in 4 out of 12 patients who had not responded to the previous CAF therapy. While grade III myelosuppression was observed in 3 patients, other adverse effects were minimal. It is suggested that this combination therapy may be recommended for advanced breast cancer patients as a second therapy.     

Experimental study and clinical use of poly(vinyl acetate) emulsion as liquid embolisation material

A new material, an emulsion of poly(vinyl acetate) was experimentally developed and clinically used to overcome several disadvantages in currently used liquid embolisation materials. The emulsion microparticles, 0.3–0.7 m in size, possessed cationic charge on the surface and hence aggregated immediately on contact with fluids containing anions. This inert polymer has the advantage that it does not induce a deleterious reaction in living tissue. Moreover, its medium is water and it is not adhesive, like the cyanoacrylates. Several concentrations of emulsion were injected into the renal arteries of dogs. For the investigation of tissue reactions and the possibility of recanalisation, the emulsion was injected into rats both subcutaneously and into the renal arteries. The renal artery injections in dogs showed adequate radiopacity and consistent complete occlusion. The lower the concentration of the emulsion, the smaller the arteries which could be occluded. Even at very low concentrations, however, venous occlusion did not occur. Histological study of the embolised rat kidney revealed no detectable damage in the vessel wall and no recanalisation for up to 6 months. The subcutaneously injected PVAc emulsion elicited mononuclear cell infiltration and gradual centripetal fibrosis, without any deleterious effect on the surrounding tissue. A cerebral arteriovenous malformation (AVM) was embolised using the material. Histology of the resected nidus showed findings similar to those in the animal experiments.     

Comparison between nafarelin acetate andd-Trp6-LHRH for temporary pituitary suppression in in vitro fertilization (IVF) patients: A prospective crossover study

Purpose Nafarelin acetate is a new gonadotropin releasing (GnRH) agonist analogue with unique potency, intranasal administration, and convenient storage. Hence, nafarelin was considered as an alternative for temporary pituitary suppression in patients undergoing ovulation induction in IVF. A crossover treatment in a prospective study was performed including 40 women with bilateral obstructed tubes and normal ovarian function, treated in 80 ovulation induction cycles using the long protocol. Twenty patients used nafarelin acetate 600 g/daily in their first cycle and received d-Trp6-LHRH, 0.5 mg/daily, in their following cycle. The other 20 women used decapeptyl in their first cycle and received nafarelin in the second.Results Estradiol suppression was achieved by both d-Trp6-LHRH and nafarelin at equal time intervals. The average total number of ampoules (P=0.0005) and the length of administration of hMG required for ovarian stimulation (P=0.0002) and the time interval between GnRHa initiation to oocyte retrieval (P=0.04) was significantly lower in nafarelin cycles. The number and the distribution between large and small follicles as well as the average number of oocytes retrieved did not differ between the two GnRH analogues.Conclusion Our results demonstrate that nafarelin acetate is comparable to d-Trp6-LHRH for temporary pituitary suppression used for controlled ovarian stimulation in IVF patients. However, using nafarelin ovarian stimulation was achieved with fewer ampoules of hMG, administered for a shorter period of time, thus with a lesser cost.     

Pharmacokinetic evaluation of two different formulations of megestrol acetate in patients with advanced malignancies

The bioequivalence of two megestrol acetate formulations, 160-mg tablets and 160-mg sachets, was investigated in a single-dose, open-label, balanced-for-sequence cross-over study involving 12 advanced-cancer patients. The observed plasma megestrol-acetate time course obtained with both formulations was consistent with the literature data. The main source of variability in the pharmacokinetic parameters was intersubject variability; drug formulation played only a minor (and nonsignificant) role. The width of the 90% confidence interval of the areaunder-the-curve (AUC) ratio (sachets: tablets) computed according to Schuirmann (0.9–1.4) was mainly due to the presence of a single outlier, showing an AUC ratio of 2.7. The trend to higher bioavailability of the new formulation was not significant, especially as compared with the doseresponse data reported in the literature.     

雷公藤与糖皮质激素治疗重症甲亢疗效比较

目的：为探讨用雷公藤多甙（ＴⅡ）和泼尼松治疗重症甲状腺功能亢进（简称重症甲亢）的效果。　方法和结果：共选４７例重症甲亢,分别用雷公藤多甙和泼尼松进行治疗,疗程１２周。根据主要临床表现改善程度累计判断疗效,ＴⅡ治疗组显效率为５９．８％ ,明显高于泼尼松组（Ｐ＜ ０．０１）,总有效率为９１．１％ ,亦高于泼尼松组（Ｐ＜ ０．０５）,而无效率仅８．９％ ,低于泼尼松组（Ｐ＜ ０．０５）,ＴⅡ剂量为每天３０ ｍ ｇ 时不良反应少于泼尼松。　结论：小剂量ＴⅡ用于重症甲亢的免疫治疗具有疗效高、不良反应小的优点,有较好的应用前景。