醋酸戈舍瑞林缓释植入剂联合比卡鲁胺片治疗高龄前列腺癌患者的疗效及预后分析

目的探讨醋酸戈舍瑞林缓释植入剂联合比卡鲁胺片治疗高龄前列腺癌患者的临床疗效和预后。方法选择我院2016年7月至2018年3月收治的高龄前列腺癌患者60例,随机分为两组各30例。对照组采用手术去势治疗,治疗组在对照组基础上采用醋酸戈舍瑞林缓释植入剂联合比卡鲁胺片治疗。比较两组患者的临床疗效、治疗前后的血清PSA水平、1年生存率。结果治疗组的总有效率为86.67%,显著高于对照组的63.33%(P<0.05)。治疗前,两组的PSA水平比较,差异无统计学意义(P>0.05);治疗后,两组的PSA水平均较治疗前下降(P<0.05),且治疗组的PSA水平显著低于对照组(P<0.05)。治疗组的1年生存率为93.33%,显著高于对照组的63.33%(P<0.05)。结论醋酸戈舍瑞林缓释植入剂联合比卡鲁胺片治疗高龄前列腺癌患者可有效提高临床疗效,降低PSA水平,提高1年生存率。     

Elastic intramedullary nailing combined with methylprednisolone acetate injection for treatment of unicameral bone cysts in children: a retrospective study

PurposeThe aetiology of unicameral bone cysts (UBCs) is unclear. This study aims to evaluate the feasibility of elastic intramedullary nailing (EIN) combined with injections of methylprednisolone acetate (MPA) for the treatment of UBCs in children.MethodsWe retrospectively analyzed 53 children with UBCs in our hospital between January 2010 and April 2016. A total of 24 patients (Group A) were treated by EIN and MPA, whilst 29 patients (Group B) were treated by curettage, bone grafts and EIN fixation. The radiographs of the UBCs were evaluated following the Capanna criteria. All patients were followed-up on the third, sixth, 12th, 24th and 36th months. Fixation time, hospitalization time and complications were evaluated.ResultsIn Group A, the mean number of MPA injections was 1.8 (1 to 3). Based on radiographic evaluation, eight patients were healed (Capanna grade I), 14 were healed with residual cysts (Capanna grade II), one showed recurrence (Capanna grade III) and one showed no response to the treatment (Capanna grade IV). In Group B, 11 patients were evaluated as Capanna grade I, 12 as Capanna grade II, three as Capanna grade III and three as Capanna grade IV. There was significant difference in the early postoperative function activity (p < 0.001), hospitalization time (p = 0.028), blood loss during surgery (p < 0.001) and surgery time (p < 0.001).ConclusionThe combination of EIN and MPA for the treatment of UBCs in children is feasible, has little operative trauma, short surgery time, short hospitalization time, less blood loss and a low risk of incision infection.Level of evidence:III     

Combined Hormonal Contraceptive Use and Risk of Breast Cancer in a Population of Women With a Family History

Background

We estimated the association between combined hormonal contraceptive (CHC) use and breast cancer (BC) incidence in a well-selected population of women at familial risk of BC at the Modena Family Cancer Clinic.

动脉瘤栓塞剂醋酸纤维素的重新估价

目的 通过动物实验对醋酸纤维素（ｃｅｌｌｕｌｏｓｅ ａｃｅｔａｔｅ ｐｏｌｙｍｅｒ,ＣＡＰ）的安全性、有效笥和病理反应等方面进行重新估价。方法 ＣＡＰ栓塞３０只大鼠的右侧颈动脉,在栓塞后４月内的７个时间阶段各取２只栓塞后的血管标本行病理检查。采用静脉移植的方法建立犬动脉瘤模型１５枚,以ＣＡＰ栓塞１２枚模型,栓塞后１周、２周、２月行造影复查,并随机抽取１只动物行病理检查。病理检查方法包括ＨＥ染色、Ⅷ     

The effect of leuprolide acetate on steroidogenesis by granulosa and theca cells in vitro

Enhancement of follicular response to controlled ovarian hyperstimulation for human in vitro fertilization (IVF) has been suggested following pretreatment with leuprolide acetate (LA). However, additional human menopausal gonadotropin (hMG) is required to achieve follicle maturity in the presence of LA. We studied the effect of LA on steroidogenesis of granulosa and theca cells in vitro. Human granulosa cells obtained from IVF follicular fluid aspirations were cultured for 14 days in the presence and absence of human chorionic gonadotropin (hCG). hCG significantly enhanced progesterone (P) and estradiol (E₂) production by the cells, however, the addition of LA in concentrations of 10, 100, and 1000 ng/ml had no effect. Porcine granulosa cells were cultured for 48 hr in the presence and absence of follicle stimulating hormone (FSH) with the addition of LA at the same doses. LA did not affect the FSH-induced increase in P production. Porcine theca cells were cultured for 48 hr in the presence and absence of hCG. The addition of LA did not affect androstenedione (A) production by these cells. We conclude that in this dynamic model in vitro, LA does not inhibit or stimulate P or E₂ production by granulosa or A production by theca cells.     

Long versus standard prednisone therapy for initial treatment of idiopathic nephrotic syndrome in children

Two regimens of steroid treatment for the initial attack of idiopathic nephrotic syndrome (NS) in children were compared in a controlled prospective multicentre study. Long prednisone therapy consisted of 60 mg/m² per 24 h for 6 weeks, followed by alternate day 40 mg/m² per 48 h for 6 weeks. The standard prednisone therapy was 60 mg/m² per 24 h for 4 weeks, followed by 40 mg/m² per 48 h for 4 weeks. A total of 71 children with an initial attack of idiopathic NS were allocated at random to the two groups. The cumulative rate of patients with sustained remissions after 2 years was significantly higher after the long course than after the standard treatment (49% vs 19%,P=0.0079). The mean relapse rate per patient at intervals of 3, 6 and 12 months was lower in the long-course prednisone group than in the standard prednisone group, and the proportion of children with frequent relapses during any subsequent 6 months period was lower in the long-course group than in the standard group (29% vs 57%,P=0.03). Mild side-effects of corticosteroid therapy were observed more frequently after long-course prednisone treatment. It is concluded that long-course prednisone therapy of the initial attack of steroid responsive NS is preferable to the standard regimen because it reduces the rate of subsequent relapses without increasing the risk for severe steroidal side-effects. Contributing investigators and centres were: Prof. F. R. Egli (Basel, Switzerland); Prof. G. Mau, Dr. J. Zimmermann (Braunschweig, Germany); Dr. W. Marg (Bremen, Germany); Dr. R. Mallmann (Bonn, Germany); Dr. K. Witzel (Düsseldorf, Germany); Prof. D. Michalk (Erlangen, Germany); Prof. H. Olbing (Essen, Germany); Dr. E. Bopp (Flensburg, Germany); Prof. J. Dippel (Frankfurt, Germany); Dr. H. Zappel (Göttingen, Germany); Dr. D. Schwarke (Hamburg, Germany) Prof. J. Brodehl (Hannover, Germany); Prof. K. Schärer (Heidelberg, Germany); Prof. F. Schindera (Karlsruhe, Germany); Dr. M. Kirschstein (Lübeck, Germany); Prof. H. P. Weber (Lüdenscheid, Germany); Prof. M. Brandis (Marburg, Germany); Prof. R. Eife (München, Germany); Dr. F. K. Hübner (München, Germany); Dr. K. Gellissen (Neuwied, Germany); Prof. W. Rauh (Trier, Germany).     

甲地孕酮硅橡胶阴道环突破性出血机制的初步探讨

本文测定了16例放置甲地孕酮硅橡胶阴道环妇女外周血及子宫内膜组织中的雌二醇(E_2)和孕酮(P)含量,正常对照组8例。结果表明各组间外周血E_2、P 水平无显著差异;使用甲硅环发生突破性出血(BTB)者内膜组织中E_2含量显著低于正常对照组及放环未出血组(P<0.05);各组内膜组织中的P 含量无显著差异。研究结果提示使用甲硅环是否发生BTB与外周血中E_2、P 水平无关;而子宫内膜组织中E_2含量低可能是BTB 发生的主要原因。     

Progesterone induction of mammary carcinomas in BALB/c female mice

Summary We have demonstrated that medroxyprogesterone acetate (MPA), when administered in high doses, induces mammary carcinomas in virgin female BALB/c mice. Since one of the possible explanations for this effect was its progestagenic effects, we decided to investigate whether progesterone (Pg) alone could also induce mammary adenocarcinomas in our model and if MPA at doses lower than those used to establish the model was also carcinogenic. A total of 136 mice were subdivided into 3 groups: Group 1, 44 mice were implanted s.c. with 40 mg Pg silastic pellets at the beginning of the experiment, and 6 months later with a 20 mg Pg pellet; Group 2, 45 mice were similarly treated with MPA pellets; Group 3, 47 mice were inoculated s.c. with 40 mg MPA every three months. At the end of 20 months, 9 animals had developed mammary tumors in Group 1, 18 in Group 2 and 34 in Group 3 (actuarial incidence = 28%, 58%, and 98%, respectively); tumor latency was similar in all groups: 46.2 ± 13.1, 51.3 ± 9.9, and 50.1 ± 2.1 weeks, respectively. Seven (Group 1), 14 (Group 2), and 25 (Group 3) tumors were transplanted into syngeneic mice to determine progestin dependence. All tumors, except one from Group 1, were histologically characterized. In Group 1 (Pg 60 mg), 4 tumors (67%) were infiltrating lobular carcinomas and 2 were ductal carcinomas (33%). In Group 2 (MPA 60 mg), 2 tumors (14%) were lobular and 12 were ductal adenocarcinomas (86%) (Group 1 vs Group 2: p < 0.05), whereas in Group 3 (MPA 160 mg), 8 were lobular carcinomas (32%) and 17 were ductal carcinomas (68%). In syngeneic passages all lobular tumors behaved as progestin independent (PI) and ductal tumors as progestin dependent (PD). All ductal tumors, except one, expressed estrogen receptors (ER) and progesterone receptors (PR), whereas receptor expression was variable in lobular carcinomas. It can be concluded that Pg induces mostly lobular, PI mammary tumors in BALB/c female mice. The fact that most MPA-induced tumors are ductal and PD suggests that the two hormones use different carcinogenic pathways.     

Diabetes mellitus and exocrine pancreatic insufficiency in a girl with auto-immune haemolysis

A 7-year-old girl developed diabetes mellitus and exocrine pancreatic insufficiency after 3.5 years of almost continuous treatment with azathioprine and/or prednisone for idiopathic auto-immune haemolytic anaemia. Although both drugs have been reported to preserve endogenous insulin secretion and to interrupt the diabetogenic process they may be responsible for diabetes and exocrine pancreatic insufficiency in our patient.     

新型环柱状催化剂气相法合成醋酸乙烯宏观反应动力学

采用内循环无梯度反应器,在工业气相法合成醋酸乙烯操作条件下研究了工业颗粒新型环柱状催化剂上乙烯氧乙酰化合成醋酸乙烯的宏观动力学。获得了可供实用的宏观动力学方程,为工业反应器的优化设计和操作提供了可靠的依据。