输卵管妊娠治疗方式及其对未来生育影响的研究进展

输卵管妊娠是一种临床常见的妇科急腹症。输卵管妊娠如能在包块尚未破裂前早期诊断，其相关的病死率大大降低。输卵管妊娠的治疗方式有很多，无论哪种治疗方式，都会导致患者生育功能的下降。临床中对于有生育要求的患者，选择哪种治疗方式更好地保护患者的生育功能并减少并发症仍是有争议的话题。近年有学者做了大量研究比较输卵管妊娠不同治疗方式的并发症及其对患者未来生育前景的影响，甚至提出更新的治疗方式以弥补传统治疗方式的不足。现就输卵管妊娠的治疗方式、并发症及对未来生育的影响的研究进展进行综述。     

经子宫动脉氨甲蝶呤灌注及栓塞 在宫颈妊娠保守治疗中的应用

目的探讨经子宫动脉氨甲蝶呤灌注化疗及栓塞术在宫颈妊娠保守治疗中的应用价值.方法 6例宫颈妊娠患者,孕龄36～68天,经阴道超声检查明确诊断后,行双侧子宫动脉氨甲蝶呤灌注及栓塞治疗.结果所有患者均一次治疗成功,术后患者的阴道出血明显减少或中止,血β-HCG水平迅速下降.患者的宫颈形态及月经周期于治疗后4个月内恢复正常.结论子宫动脉氨甲蝶呤灌注化疗及栓塞术是保守治疗宫颈妊娠的有效方法.     

氨甲喋呤、米非司酮和丙酸睾丸酮联合治疗异位妊娠的研究

目的　探讨氨甲喋呤 (MTX)、米非司酮 (MST)和丙酸睾丸酮 (TP)联合治疗异位妊娠的效果。方法　对 76例病人随机分为 3组 ,A组 (2 7例 )给予MTX 5 0mg加 30ml生理盐水隔日静注× 3d ,隔日用 15mg四氢叶酸钙 (CF)肌注解毒 ,同时口服MST 5 0mgBid× 6d ,肌注TP 5 0mgqd× 3d。B组 (2 6例 )用MTX和CF和MST。C组 2 3例 (对照组 )单用MTX和CF。治疗期间所有病例均定期查B超和血 β -hCG结果。 结果　A组和B组的成功率分别为 85 2 %和 84 6 % ,二者之间无显著性差异 (P >0 0 5 ) ,但显著高于C组 73 9% (P <0 0 1)。结论　氨甲喋呤、米非司酮和丙酸睾丸酮联合治疗异位妊娠的效果较佳 ,值得临床推广应用。其应用的适应症是肝、肾和凝血功能正常 ,B超检查异位妊娠包块直径 <4cm ,无急性内出血 ,血 β -hCG <5 0 0 0U/L。     

Development of patient derived organoids for cancer drug screening applications

Cancer is a disease characterised by abnormal cell growth that can invade or spread to other regions of the body. Organoids are three-dimensional ex vivo tissue cultures made from embryonic stem cells, induced pluripotent stem cells, progenitor cells or tissue that serve as a physiological model for cancer research. These are designed to recapitulate the in vivo properties of tumours. Importantly, effective recapitulation of the structure of tissues and function is believed to predict patient response, allowing for the creation of personalised therapy in a timely manner that may be used in the clinic. This Review discusses the pre-clinical model and different types of human organoids as models for the development of high throughput drug screening and also aims to highlight how organoids are shaping the future of cancer research.     

Circulating interleukin 10 and interleukin-6 serum levels in rheumatoid arthritis patients treated with methotrexate or gold salts: Preliminary report

In order to evaluate the relationship between serum concentrations of interleukin-10 (IL-10), IL-6, and acute phase proteins in rheumatoid arthritis (RA) patients treated with methotrexate (MTX) or intramuscular gold (IMG) we determined IL-10, IL-6, C-reactive protein (CRP), alpha-1-acid glycoprotein (AGP) and alpha-1-antichymotrypsin (ACT) in the sera of 35 RA patients. IL-10 and IL-6 levels were evaluated using an enzyme-linked immunoassay (ELISA). AGP and ACT level were measured using rocket immunoelectrophoresis. IL-10 serum level was not increased in RA patients as compared to controls (58.7 ± 18.1 pg/ml vs. 57.2 ± 11.9 pg/ml). IL-6 level was significantly elevated (91.6 ± 46.9 pg/ml vs. 45 ± 19 pg/ml, p < 0.05). CRP was significantly increased as compared to healthy controls (35 ± 19 mg/l vs. 3 ± 2 mg/l, p < 0.05). Patients treated with MTX or IMG presented an increased level of IL-10 and decreased amounts of IL-6, as compared to those treated with NSAID only. However, only changes between patients treated with IMG and NSAID were found to be statistically significant. A good negative correlation between IL-10 and IL-6 serum level was found (r = –0.75, p < 0.05). A positive significant correlation between IL-6 serum level and CRP (r = 0.62, p < 0.05), AGP (r = 0.78, p < 0.05) and ACT (r = 0.45, p < 0.05) was established. On the other hand, a negative correlation between IL-10 and serum level of CRP (r = –0.76, p < 0.05), AGP (r = –0.64, p < 0.05) and ACT (r = –0.38, p < 0.05) was also observed. Moreover, these relationships were maintained when patients treated with MTX, IMG, or NSAID were analyzed independently. According to the data thus far obtained, it seems that IL-10 decreases IL-6 production, and thereby indirectly affects the acute phase response, decreasing CRP, AGP, and ACT concentration in RA patients.Abbreviations ACT -1-antichymotrypsin - AGP ₁-acid glycoprotein - APP acute phase protein - CRP C-reactive protein - CSF colony stimulating factor - IFN interferon - IL interleukin - IMG intramuscular gold - MTX methotrexate - NSAID non-steroidal anti-inflammatory drug - RA rheumatoid arthritis     

Pharmacokinetic study of methotrexate,folinic acid and their serum metabolites in children treated with high-dose methotrexate and leucovorin rescue

Summary The pharmacokinetics of methotrexate (MTX), 7-hydroxymethotrexate (7-OHMTX), 2,4-diaminomethylpteroic acid (APA), folinic acid, and 5-methyltetrahydrofolate (5-MTHF) have been studied during 21 high-dose MTX (HDMTX) infusions (5 g·m^–2 in 24 h) with leucovorin (LCV) rescue, a component of the therapy of 5 children with acute lymphoblastic leukemia (ALL).The median steady-state concentration of MTX was 66 mol·l^–1. Three elimination half-lifes were determined for MTX: 1.8 h, 6.4 h and a terminal 15 h. The median systemic MTX clearance was 110 mg·m^–2·min^–1.The 7-OHMTX level increased during each infusion and a C_max of 19 mol·l^–1 was achieved at the end. Its initial half-life was 5 h and the terminal half-life was 12 h. Thus, the peak serum concentration ratio of 7-OHMTX to MTX was reached 24 h after the end of the infusion at a median ratio of 8.The MTX metabolite APA was detected in concentrations less than 0.06 mol·l^–1. The median folinic acid level during rescue, 48 h after starting the infusion, was 7.0 mol·l^–1 and 18 h following the last dose of LCV it was 0.44 mol·l^–1, leading to ratios of folinic acid to MTX of 31 and 6, respectively. The median 5-MTHF level during rescue was 0.44 mol·l^–1 with a median ratio of 5-MTHF to MTX of 2.Twenty infusions with 48 h MTX levels of less than 0.5 mol·l^–1 were without marked toxicity. Only one patient with a 48 h MTX concentration of 5.5 mol·l^–1 and a ratio of 5-MTHF to MTX of 0.08 suffered from ulcerating mucositis and septicaemia despite increased and prolonged LCV rescue.     

联合给药法治疗强直性脊柱炎

目的 采用氨甲喋呤（ＭＴＸ）、抑氮磺胺吡啶（ＳＡＳＰ） 非甾体类药（ＮＳＡＩＤｓ）“递减法”联合给药治疗７８例强直性脊柱炎（ＡＳ的临床疗效观察。方法 ＳＡＳＰ０．５ｇ,２次／日,服１周后改为０．７５ｇ,２次／日,第２周后改为１．０ｇ,２次／日,以后每周１．０ｇ,２次／日,疗程２年,ＭＴＳ５ｍｇ,１次／周,每周递增５ｍｇ,加量至１５～２０ｍｇ／周时维持０．５～１年,ＮＳＡＩＤｓ疗程为３个月左右减半量