肠道黏膜机械屏障在酒精性肝损伤中的作用研究进展

目的综述肠道黏膜机械屏障在酒精性肝损伤的发生、发展及其治疗方面所起的作用,为酒精性肝损伤的防治奠定理论基础。方法以"肠道黏膜屏障"、"酒精性肝损伤"和"肠黏膜通透性"作为CNKI数据库和万方数据库的检索词,以"Intestinal barrier function"、alcoholic liver injury作为Pub Med数据库的检索词,参考文献29篇。结果酒精可通过本身及其代谢产物的毒作用、氧化应激反应、内毒素激活Kupffer细胞促进细胞因子释放等促使肠道黏膜受损,尤其是机械屏障结构和功能的改变,加速内毒素入血,引发内毒素血症对肝脏产生"二次攻击",诱导和加重肝损伤,同时又加剧肠道黏膜机械屏障的损害,形成恶性循环。结论肠道黏膜机械屏障和ALD的发生密切相关,但在临床应用和大数据研究资料匮乏,因此,未来还需更深入的研究去阐释肠道机械黏膜屏障在ALD发生中的作用机制。     

雷替曲塞联合顺铂及放疗治疗中晚期食管癌的疗效及对患者血清SCC、CEA的影响

目的探究雷替曲塞联合顺铂及放疗对错失最佳手术时期或不愿手术的食管癌患者的疗效及血清肿瘤标志物SCC、CEA水平的影响。方法 82例初治的中晚期食管癌患者随机分为研究组42例,对照组40例。研究组采用雷替曲塞联合顺铂及放疗,化疗方案:静脉滴注雷替曲塞2.5 mg/m^2,d1;顺铂25 mg/m^2,d1~d3,间隔21天后进行第2轮治疗。对照组采用5-氟尿嘧啶联合顺铂及放疗,化疗方案:静脉滴注,5-氟尿嘧啶450 mg/m^2,d1;顺铂25 mg/m^2,d1~d3,间隔21天后进行第2轮治疗。观察2组患者的近期治疗效果、1年生存率、不良反应以及研究组治疗前后血清SCC、CEA的变化。结果研究组的有效率、1年生存率略高于对照组(80.95%vs 72.50%,P=0.248和78.57%vs 72.50%,P=0.522),但差异无统计学意义。研究组放射性食管炎、恶心呕吐、骨髓抑制发生率显著低于对照组(P<0.05);研究组治疗后患者血清肿瘤标志物SCC、CEA的水平明显低于治疗前,与对照组比较,治疗组降低水平更加显著(P<0.05)。结论雷替曲塞联合顺铂及放疗对错失最佳手术时期或不愿手术的食管癌患者具有较好的耐受率,值得进一步的临床研究。     

瘢痕疙瘩术后放射治疗32例疗效观察

瘢痕疙瘩是皮肤损伤后引起的一种特异性疾病,常见于皮肤创伤后。因其影响美观,妨碍功能,影响了患者的身心健康和生活质量。治疗方法有手术、冷冻、药物注射、外用药物等,但疗效不佳,复发率高。2008年3月～2011年3月,笔者科室对32例瘢痕疙瘩患者行术后放射治疗,取得了满意效果,现报道如下。     

大分割放疗联合EP方案化疗治疗局限期小细胞肺癌的临床疗效及安全性

Objective To investigate the efficacy and safety of hypofractionated thoracic radiotherapy combined with EP chemotherapy in the treatment of limited-stage small-cell lung cancer (LS-SCLC). Methods A total of 117 patients with LS-SCLC were enrolled and randomly divided into test group (n=59) and control group (n=58). Patients in the experiment group were given hypofractionated thoracic radiotherapy combined with EP chemotherapy, while patients in the control group were given hyperfractionation radiotherapy combined with EP chemotherapy. Objective response rate (ORR), 2-year overall survival (OS), 2-year progression free survival (PFS), and immune cell level were used to evaluate clinical efficacy. We compared the incidence of side effects between the two groups. Results After the treatment, the ORR of patients in the test group was higher than that in the control group (P>0.05). The mean OS and PFS of patients in the test group were significantly longer than those in the control group (P<0.05). The levels of CD3+, CD4+, CD4+/CD8+, and NK cells in the test group were significantly higher, whereas the levels of CD8+ were significantly lower than those in the control group (P<0.05). The incidence of radiation pneumonitis, radiation esophagitis, and severe dermatitis in the test group was significantly lower than that in the control group (P<0.05). Conclusion Hypofractionated radiotherapy combined with EP chemotherapy for treatment of LS-SCLC can effectively improve the anticancer efficacy and patient survival, reduce the damage to the body’s immune function, and alleviate adverse reaction of radiotherapy. © 2023, CHINA RESEARCH ON PREVENTION AND TREATMENT. All rights reserved.