CAPV方案化疗治疗55例晚期NSCLC临床观察

目的　研究CPAV方案治疗晚期非小细胞肺癌的疗效及毒性。方法　选择 1995年 7月～ 2 0 0 1年 6月晚期非小细胞肺癌患者 5 5例 ,采用CAPV方案予以治疗 ,观察有效率及毒副反应。结果　完全缓解(CR) 3例 ,部分缓解 (PR) 2 8例 ,总有效率 (CR +PR) 5 6 .3% ,其中腺癌 4 4例 ,CR3例 ,PR2 3例 ,有效率 5 9% ,鳞癌 11例 ,PR5例 ,有效率 4 5 .5 %。结论　CAPV方案治疗晚期非小细胞肺癌疗效较高 ,毒副作用可耐受 ,可作为治疗NSCLC的一线方案。     

西艾克联合化疗与G-CSF联用治疗难治复发性非霍奇金淋巴瘤临床观察

目的：观察西艾克（VDS）联合化疗与重组粒细胞集落刺激因子（G－CSF）联合治疗难治复发性非霍奇金淋巴瘤（NHL）的疗效。方法：采用VDS替代长春新碱（VCR）组成CHOP＋足叶乙苷（VP16）方案联合化疗,72h后加用G－CSF治疗难治复发性NHLⅢ－Ⅳ期12例,观察其临床疗效及毒副作用。结果：12例中完全缓解（CR）5例（41.66%),部分缓解（PR）3例（25％）,稳定（S）1例（8.3%),总有效率74.96%,主要副作用为骨髓抑制。结论：VDS联合化疗与G－CSF联用治疗难治复发性NHL是一种有效的挽救方案。     

TP与MVP方案治疗晚期非小细胞肺癌疗效比较

目的观察比较泰素加顺铂与丝裂霉素加顺铂及西艾克治疗晚期非小细胞肺癌的近期疗效及不良反应。方法58例晚期非小细胞肺癌患者随机分为Taxol DDP组(A组)及MMC VDS DDP组(B组),治疗2个周期后进行疗效及不良反应评估。结果A组30例,有效率46.7%;B组28例,有效率42.9%。A组的骨髓抑制与周围神经炎较B组为轻。结论TP与MVP方案在治疗晚期非小细胞肺癌方面均有较好疗效,但TP方案不良反应较轻,可作为首选方案。     

长春地辛及含长春地辛方案治疗晚期恶性肿瘤的二期临床研究

使用长春地辛（ＶＤＳ）和长春碱（ＶＬＢ）治疗恶性肿瘤５６例。结果ＶＤＳ单药有效率为２２．７％，ＶＤＳ联合组有效率４２．１％，ＶＬＢ联合组有效率３５．７％，其中ＶＤＳ＋顺铂（ＤＤＰ）治疗非小细胞肺癌有效率达５０％，稍高于国外相同方案的结果，ＶＬＢ＋ＤＤＰ则为３７．５％。ＶＤＳ和ＶＬＢ的主要毒性为骨髓抑制，白细胞下降（Ⅰ＋Ⅱ＋Ⅲ＋Ⅳ）分别为７３．３％和７４．９％，外周神经毒性轻，所有毒性可以耐受。     

以VDS为主化疗方案的近期疗效

 作者报告以VDS为主的化疗方案治疗多种恶性肿瘤37例。结果总有效率为40.5%，其中肺癌有效率为31.3%，非何杰金氏恶性淋巴瘤有效率为85.7%，食管癌有效率为50.0%；初治病例有效率50.0%，既往经VCR治疗失败病例有效率为38.5%。作者认为VDS对多种恶性肿瘤，特别是对化疗较不敏感的肺腺癌、食道癌等有较好疗效，且与VCR无完全交叉耐药性。其神经毒性低，但要警惕其骨髓毒性。     

Glutathione synthetase deficient human fibroblasts in culture

Cultured skin fibroblasts from patients with 5-oxoprolinuria caused by hereditary deficiency of glutathione synthetase have decreased levels of the corresponding enzyme as well as of glutathione. Fibroblasts from the same patients accumulated gamma-glutamyl cysteine, but the levels were lower than those of glutathione in control fibroblasts. The uptake of [35S]cystine was equally rapid in control and patient fibroblasts. In the acid-soluble fraction gamma-glutamyl-[35S]cysteine accumulated in fibroblasts from patients but not from controls. Appreciable turnover of gamma-glutamyl cysteine and glutathione in the respective cell strains was observed, the half-lives of these pools being approximately 5 hours. The growth rate of mutant fibroblasts in culture was significantly slower than that of control fibroblasts. There was no significant accumulation of 5-oxoproline in the culture medium.     

Vitamin D and prognosis in acute myocardial infarction

Background

Vitamin D status (VDS) has been linked to mortality and incident acute myocardial infarction (AMI) in healthy cohorts. Associations with recurrent adverse cardiovascular events in those with cardiovascular disease are less clear. Our objective was to assess the prevalence and prognostic impact of VDS on patients presenting with AMI.

Methods

We measured plasma 25-(OH)D₃ and 25-(OH)D₂ using isotope dilution tandem mass spectrometry, in 1259 AMI patients (908 men, mean age 65.7 ± 12.8 years). The primary endpoint was major adverse events (MACE), a composite of death (n = 141), heart failure hospitalisation (n = 111) and recurrent AMI (n = 147) over median follow-up of 550 days (range 131–1095). Secondary endpoints were fatal and non-fatal MACE.

Results

Almost 74% of the patients were vitamin D deficient (< 20 ng/ml 25-(OH)D). Plasma 25-(OH)D existed mainly as 25-(OH)D₃ which varied with month of recruitment. Multivariable survival Cox regression models stratified by recruitment month (adjusted for age, gender, past history of AMI/angina, hypertension, diabetes, hypercholesterolaemia, ECG ST change, Killip class, eGFR, smoking, plasma NTproBNP), showed 25-(OH)D₃ quartile as an independent predictor of MACE(P < 0.001) and non-fatal MACE(P < 0.01), but not death. Using the lowest 25-(OH)D₃ quartile(< 7.3 ng/ml) as reference for MACE prediction, the 2nd, 3rd and 4th quartiles showed significantly lower hazard ratios (HR 0.59(P < 0.002), 0.58(P < 0.001), and 0.59(P < 0.003) respectively). For non-fatal MACE prediction, the 2nd, 3rd and 4th 25-(OH)D₃ quartiles were all significantly different from the lowest reference quartile (HR 0.69(P < 0.05), 0.54(P < 0.003) and 0.59(P < 0.014) respectively).

Conclusions

VDS is prognostic for MACE (predominantly non-fatal MACE) post-AMI, with approximate 40% risk reduction for 25-(OH)D₃ levels above 7.3 ng/ml.     

HMVP、MVP和 HVP方案治疗晚期NSCLC的前瞻性随机研究

背景与目的非小细胞肺癌( non-small cell lung cancer,NSCLC)对常用的一、二线化疗方案敏感性较低,在化疗中联用喜树碱类衍生物已引起国内外的研究兴趣.本研究旨在观察羟基喜树碱( hydroxycamptothecin,HCPT)联合丝裂霉素( mitomycin,MMC)、长春花碱酰胺( vindesine,VDS)和顺铂( cisplatin,DDP)组成的 HMVP、 MVP和 HVP方案治疗晚期 NSCLC的近期、远期疗效和不良反应.方法 134例晚期 NSCLC患者随机分为 HMVP组( 46例)、 MVP组( 44例)和 HVP组( 44例),接受相应方案的化疗,观察各组的近期及远期疗效、不良反应和生存情况.结果 HMVP、 MVP和 HVP三组的有效率分别为 39.54%、 36.59%和 26.19%,三组之间无显著性差异( P >0.05);三组的中位缓解期、中位生存期、 1年及 2年生存率亦无明显差别.三组之间的Ⅲ～Ⅳ度白细胞减少、Ⅲ～Ⅳ度血小板减少、Ⅲ～Ⅳ度恶心 / 呕吐及Ⅲ～Ⅳ度便秘发生率均无显著性差异( P >0.05).结论 MVP方案治疗晚期 NSCLC的疗效略低于 HMVP方案,但后者未显示出明显的疗效优势,且可能增加白细胞抑制、恶心 /呕吐和便秘的发生率. MVP方案疗效略高于 HVP方案.     

Effect of different surgical strategies on screw forces after correction of scoliosis with a VDS implant

Pullout of the cranial end-vertebra screw following the correction of a scoliosis with the VDS implant is a common complication. Very little is known about the forces acting on the screws during ventral derotation spondylodesis (VDS) in ventral scoliosis surgery. These forces determine the risk of screw-loosening. The purpose of this study was to identify implant properties and to determine surgical correction strategies that reduce the risk of cranial end-vertebra screw pullout. For this aim, a three-dimensional nonlinear finite element model of a scoliotic thoracic spine was created with a Cobb angle of 61° and 32° rotation. The VDS implant was inserted between T5 and T9. The longitudinal rod diameter, the implant material and seven surgical correction strategies were examined to determine their influence on the Cobb angle as well as on derotation and on axial and transverse forces in the screws. A stiffer implant achieves a better correction but causes higher axial and transverse screw forces. Axial tensile forces act on the screws fixed to the cranial end vertebra and the middle vertebra, while axial compressive forces act on the other screws. A strong correction at the cranial segment leads to high axial and transverse screw forces in the farthest cranial screw and thus to a high risk of screw pullout. The resultant transverse force is often much higher than the axial force component. Simulation of local trunk muscle forces has only a minor effect on the results. The axial tensile forces and thus the risk of screw pullout are highest at the cranial end vertebra. A strategy in which surgical correction is strong in the middle segments and moderate in the outer ones leads to a good reduction of the Cobb angle, a wide derotation angle, and relatively low axial tensile forces at the cranial end vertebra screw.     

去乙酰基长春花碱酰胺硫酸盐大鼠生殖毒性研究

Ｗｉｓｔａｒ雌、雄大鼠在酱前每周一次ｉｖ给予去乙酰基长基花碱酰胺硫酸盐（ｖｉｎｄｓｅｉｎｅ ｓｕｌｆａｔｅ,ＶＤＳ）,共分别给药３次和９次,各组剂量分别为０．０５ｍｇ／ｋｇ、０．１ｍｇ／ｋｇ、０．２ｍｇ／ｋｇ。１：１同笼交配２ｗｋ,期间继续按前给药,孕鼠于孕期第６、１２ｄ各给药一次．结果各剂量组雄鼠体重增重明显减少;高剂量组孕鼠死胎率增加,胎仔尾长和体重明显小于对照组;各剂量组胎仔骨骼发育迟缓,未