紫杉醇用于治疗胃癌的临床进展分析

目的对最近几年用紫杉醇抗癌的研究文献进行总结,并分析我院最近几年收治胃癌患者给予紫杉醇治疗的疗效。方法选取2011年1月一2013年10月在我院接受治疗的胃癌患者45例为研究对象,上述选取对象均为胃癌晚期,将其随机分成对照组和观察组,对照组采取FOLXFOX4方案进行治疗。观察组采取紫杉醇联合卡倍他滨进行治疗,观察两种治疗方式的疗效。结果经过两个周期的治疗后,观察组总缓解明显高于对照组,差异有统计学意义（尸〈0．05）;但两组间在不良反应发生隋况对比差异上无统计学意义（P〈0．05）。结论紫杉醇作为一种抗癌药物,其在治疗胃癌、乳腺癌等癌症效果明显,对于癌症晚期患者,给予紫杉醇联合卡倍他滨进行治疗,有助于减轻癌痛、提升患者生活质量,有较高的研究价值和推广价值。     

微小RNA-422a在胃癌组织中的表达及参与多柔比星耐药的机制研究

摘 要 目的：研究微小RNA-422a（miR 422a）在胃癌组织中的表达及参与多柔比星耐药的机制研究。 方法: 检测46例胃癌及癌旁组织中miR 422a的表达水平,分析其与胃癌临床特征和预后的相关性。将miR 422a转染到SGC-7901/多柔比星细胞中,检测不同浓度多柔比星对SGC-7901细胞增殖的影响,计算耐药指数（RI）,同时检测miR 422a和肌细胞增强因子2D（MEF2D）的表达以及细胞凋亡情况。 结果: miR 422a在胃癌组织的表达水平显著低于癌旁组织（P＜0.05）;根据miR 422a的表达水平将患者分为高表达组和低表达组,发现miR 422a的表达水平在分化程度、淋巴结转移和TNM分期有显著差异（P＜0.05或P＜0.01）;与预后良好组患者相比,预后不良组患者miR 422a表达显著降低（P＜0.05）;SGC-7901的半抑制浓度（IC50）为0.33 μg·ml-1,SGC-7901/多柔比星的IC50为12.08 μg·ml-1,RI为36.61;miR 422a mimic组的IC50为4.01 μg·ml-1,RI为2.74;通过转染miR 422a mimic,miR 422a显著上调,同时抑制MEF2D,SGC 790/多柔比星细胞在多柔比星诱导的情况下细胞凋亡率显著升高（P＜0.01）。 结论: miR 422a在胃癌组织中低表达,并与胃癌患者预后不良密切相关,上调miR 422a水平可以增加SGC-7901对多柔比星的敏感性,这一发现可能为逆转肿瘤耐药性提供新的治疗靶点。     

大黄素对胃癌细胞增殖、凋亡及ERK1/2-PKM2/P53通路的影响

摘 要 目的：探讨大黄素对胃癌细胞增殖、凋亡及ERK1/2-PKM2/P53通路的影响。 方法: 实验分为MGC803胃癌细胞组、氟尿嘧啶组、大黄素低剂量组、大黄素高剂量组,测定并比较各组细胞癌细胞活力、癌细胞单克隆形成数目、癌细胞凋亡率、穿膜孔数、以及MGC803胃癌细胞ERK1/2、PKM2、P53mRNA、蛋白水平。 结果: 与MGC803细胞组比较,氟尿嘧啶组、大黄素低、高剂量组吸光度（A）值、存活率水平、克隆形成数目、穿膜数、p ERK1/2、p PKM2 mRNA及蛋白表达水平降低,凋亡率、P53 mRNA及蛋白表达水平升高（P<0.05）。与氟尿嘧啶组比较,大黄素低剂量组A值、存活率水平、克隆形成数目、穿膜数、p ERK1/2、p PKM2 mRNA、蛋白升高,凋亡率、P53 mRNA、蛋白表达水平降低（P<0.05）。与大黄素低剂量组比较,大黄素高剂量组A值、存活率、细胞克隆形成数目、穿膜数、P ERK1/2及P PKM2 mRNA及蛋白表达水平明显降低,凋亡率、P53 mRNA及蛋白表达水平明显升高（P<0.05）。 结论: 大黄素可能通过抑制ERK1/2-PKM2通路诱导P53高表达从而抑制胃癌细胞的增殖及迁徙,促进胃癌细胞的凋亡。     

功能性消化不良病儿应用双歧杆菌三联活菌胶囊联合多潘立酮的胃动力学指标分析

目的 探讨双歧杆菌三联活菌胶囊联合多潘立酮对功能性消化不良(FD)病儿胃动力学的影响。方法 选取2015年6月至2016年8月在石家庄市第三医院儿科门诊诊治的108例FD病儿,按照随机数字表法分成对照组与治疗组,每组54例。对照组予多潘立酮片(吗丁啉)口服每次10 mg,3次/天;治疗组在此基础上再予双歧杆菌三联活菌胶囊口服(每粒0.21 g)2粒/次,2次/天。检测血清胃肠激素,评估胃动力学相关指标,评价临床症状评分,比较临床效果。结果 治疗组治疗前胃动素(MTL)、神经肽Y(NPY)、血管活性肠肽(VIP)分别为［(206.84±27.14)、(1.40±0.20)、(24.09±3.30)］ pg/mL,治疗后为［(338.29±46.42)、(2.34±0.31)、(10.87±1.43)］ pg/mL;对照组治疗前为［(206.73±26.58)、(1.41±0.18)、(24.17±3.28)］ pg/mL,治疗后为［(281.42±40.02)、(1.88±0.24)、(16.22±2.12)］ pg/mL。与治疗前比较,两组病儿胃动素(MTL)、神经肽Y(NPY)升高(P＜0.01),血管活性肠肽(VIP)降低(P＜0.01)。两组对比,治疗组病儿MTL、NPY较高(P＜0.01),VIP较低(P＜0.01)。胃动力学变化:治疗后治疗组、对照组胃排空时间为［(25.58±3.39)、(30.78±4.33)］ min,较治疗前［(52.62±7.50)、(52.49±7.43)］ min缩短(P＜0.05),胃窦收缩频率治疗后为［(4.74±0.66)、(3.69±0.47)］次/分,较治疗前［(1.80±0.22)、(1.81±0.23)］次/分升高(P＜0.05),胃窦收缩幅度治疗后为［(60.43±8.57)、(51.17±7.07)］ mm,较治疗前［(37.01±5.20)、(36.94±5.12)］ mm变大(P＜0.05);两组对比,治疗组病儿胃排空时间较短(P＜0.05),胃窦收缩频率较高(P＜0.05),胃窦收缩幅度较大(P＜0.05)。临床症状积分两组治疗后均降低(P＜0.01),与对照组比较,治疗组积分降低较明显(P＜0.01),总有效率较高(P＜0.05)。结论 双歧杆菌三联活菌胶囊联合多潘立酮治疗小儿FD效果显著,可能与其调节胃肠激素、胃动力的作用有关。     

Medicinal plants commonly used against cancer in traditional medicine formulae in Sri Lanka

Cancer is a global burden. In low- and middle-income countries around 70% of deaths are due to cancer. For a number of years natural products have been a good source of agents for combatting cancer and plants have played a huge role in anti-cancer product development. For many centuries, indigenous cultures around the world have used traditional herbal medicine to treat a myriad of diseases including cancer. In Sri Lanka, a number of plants have been reported to have anti-cancer properties and some of the commonly used plants are described in this review with an account of their compounds and modes of action. Only a small number of the plants in Sri Lanka have been tested for their bioactivity and more research is required to determine their medicinal activity with the aim of developing novel drugs to fight this disease.     

Therapeutic drug monitoring of monoclonal antibodies: Applicability based on their pharmacokinetic properties

Monoclonal antibodies (mAbs) have dramatically improved clinical outcomes for inflammatory and malignant diseases. The elimination route of mAbs is cellular uptake by nonspecific pinocytosis or receptor-mediated endocytosis followed by proteolytic degradation which is protected by neonatal Fc-receptor or mediated by antigenic target. There is a wide-interindividual variability in mAbs exposure due to target burden and other factors affecting unique their pharmacokinetics. It has been reported that higher exposures are correlated with better clinical outcomes of various therapeutic mAbs. On the other hand, flat exposure-efficacy relationships of anti-PD-1 antibodies nivolmab and pembrolizumab mean ensuring absolute maximum efficacy in each patient by the approved dose regardless of their large interpatient variability in pharmacokinetics. Administration of mAbs can induce production of anti-drug antibodies (ADAs), which impact on their pharmacokinetics and pharmacodynamics. In therapeutic drug monitoring (TDM) of mAbs, when total (free, soluble target bound and ADAs bound) mAbs concentration is measured, ADAs content (concentration/titer) should be also monitored because mAbs exists in inactive complex with ADAs. Along with determination of appropriated therapeutic windows taking into account ADAs content, treatment algorithms for TDM-guided clinical decision-making must be developed and prospectively shown to be superior to traditional clinical care for each mAb in each indication.     

MRI对合并子宫内膜病变的卵巢肿瘤的诊断价值

目的探讨MRI对合并子宫内膜病变的卵巢肿瘤的诊断价值。方法回顾性分析27例经病理证实的合并子宫内膜病变的卵巢肿瘤患者的临床特征及MRI表现。结果27例卵巢肿瘤患者中,卵巢颗粒细胞瘤6例,其中2例(2/6)合并子宫内膜增生,3例(3/6)合并子宫内膜息肉,1例(1/6)合并子宫内膜浆液性癌;卵泡膜纤维瘤15例,其中9例(9/15)合并子宫内膜增生,5例(5/15)合并子宫内膜息肉,1例(1/15)合并子宫内膜浆液性癌;卵巢子宫内膜样癌6例,其中2例(2/6)合并子宫内膜增生,4例(4/6)合并子宫内膜样癌。27例患者卵巢肿瘤的MRI特点卵巢颗粒细胞瘤表现为附件区囊实性占位,具有海绵样外观;卵泡膜纤维瘤T1WI及T2WI常呈等低信号;卵巢子宫内膜样癌常表现为盆腔内体积较大的带有壁结节的囊实性肿块,增强扫描表现为“火焰征”。结论卵巢颗粒细胞瘤、卵泡膜纤维瘤及卵巢子宫内膜样癌均可同时合并子宫内膜病变,它们的MRI表现具有一定特征性,当MRI检查发现卵巢肿瘤与子宫内膜病变并存时,根据其影像特点,能够作出较明确的诊断。