早期宫颈癌前哨淋巴结检测的意义

宫颈癌是女性生殖系统最常见的恶性肿瘤.近年来,由于普查手段的改进,早期宫颈癌的患者正在逐渐增多.治疗多采用子宫广泛切除及盆腔淋巴结清除术,但淋巴结转移率在Ⅰ期及Ⅱ期患者中最高达30%,这就使大多数无转移的淋巴结受到了清除,不仅易产生术后并发症,也影响了患者的免疫功能.为了更好地研究早期宫颈癌淋巴结转移的规律,突出个体化治疗特点,我们将在浅表肿瘤研究中较成功的前哨淋巴结(Sentinel Lymphnode,SLN)引入早期宫颈癌治疗评价中,以期使患者得到更好的治疗.本研究通过核素定位法进行SLN检测,探讨SLN在早期宫颈癌治疗中的应用价值.     

Lipid based nanocarriers: a translational perspective

Over the recent couple of decades, pharmaceutical field has embarked most phenomenal noteworthy achievements in the field of medications as well as drug delivery. The rise of Nanotechnology in this field has reformed the existing drug delivery for targeting, diagnostic, remedial applications and patient monitoring. The convincing usage of nanotechnology in the conveyance of medications that prompts an extension of novel lipid-based nanocarriers and non-liposomal systems has been discussed. Present review deals with the late advances and updates in lipidic nanocarriers, their formulation strategies, challenging aspects, stability profile, clinical applications alongside commercially available products and products under clinical trials. This exploration may give a complete idea viewing the lipid based nanocarriers as a promising choice for the formulation of pharmaceutical products, the challenges looked by the translational process of lipid-based nanocarriers and the combating methodologies to guarantee the headway of these nanocarriers from bench to bedside.     

Methylene Blue Absorption in Sentinel Lymph Node Biopsy for Early Breast Cancer after Neoadjuvant Chemotherapy

Introduction: Chemotherapy is claimed to cause lymphatic drainage damage because of the tumor cell’s apoptosis process. This event might cause decreased marker (radioactive solution and/or blue dye) absorption on sentinel lymph nodes (SLN). In this study, the researchers used methylene blue only and wished to evaluate the methylene blue absorption of the SLNB procedure on early-stage breast-cancer patients after neoadjuvant chemotherapy (NAC). Materials and methods: The method used was the historical cohort study conducted from 2016-2019 in Indonesia. Samples were collected from 117 patients of stage I and II breast cancer with clinically negative axillary lymph nodes, who were then grouped into post-NAC and no-NAC (control group), in which SLNB procedures were conducted on the two groups by using single-method methylene blue. The results of methylene blue absorption were then analyzed by the Chi-square hypothesis test. Results: From the total of 564 early-stage patients who were referred to surgical oncologists, 117 patients were found to meet criteria of inclusion, consisting of the control group (52 patients) and the post-NAC group (65 patents). Of 65 patients who had undergone NAC treatment and SLNB procedure, it was found that 40 patients (61.5%) showed positive blue SLN. Of 52 pre-NAC breast-cancer patients, it was found that 47 patients (90.4%) showed methylene blue absorption on SLN with the p-value of 0.000 (P<0.05, significant). The relative risk value amounted to 0.522. Post-NAC patients had a tendency of decreased absorption of methylene blue. Conclusion: Neoadjuvant chemotherapy can cause the decrease of methylene blue absorption on SLNB procedure.     

叶酸受体靶向β-榄香烯固体脂质纳米粒的制备及其大鼠体内分布

 目的研究叶酸复合物修饰β-榄香烯固体脂质纳米粒(SLN)制剂在大鼠体内的药动学与组织分布情况。方法脂质中加入聚乙二醇单甲醚胆固醇琥珀酸酯(CHS-PEG)和N-硬脂酰基-N′-蝶酰谷氨酰基-聚乙二醇二胺(FA-PEG-S),采用超声-挤压过滤法制备叶酸受体靶向β-榄香烯SLN制剂(FA-PEG-SLN)并加以表征。大鼠尾静脉给药,HPLC测定该制剂的药动学特征及组织分布情况,与普通β-榄香烯SLN(SLN-1)及榄香烯注射乳剂的相比较。结果静脉给药后,FA-PEG-SLN在血浆中的消除半衰期为44.0min,显著长于SLN-1和乳剂的15.6和15.4min。与SLN-1相比,FA-PEG-SLN5min时在肝肾中的药物浓度较高,在脾中稍低。30和60min时,FA-PEG-SLN组在除肺外的各组织中的β-榄香烯浓度皆显著高于SLN-1组和乳剂组。结论FA-PEG-SLN能够在血浆中较长时间循环,在主要器官中的浓度较高且消除速度较慢,有进一步研究的价值。     

Pulmonary delivery of siRNA against acute lung injury/acute respiratory distress syndrome

The use of small interfering RNAs (siRNAs) has been under investigation for the treatment of several unmet medical needs, including acute lung injury/acute respiratory distress syndrome (ALI/ARDS) wherein siRNA may be implemented to modify the expression of pro-inflammatory cytokines and chemokines at the mRNA level. The properties such as clear anatomy, accessibility, and relatively low enzyme activity make the lung a good target for local siRNA therapy. However, the translation of siRNA is restricted by the inefficient delivery of siRNA therapeutics to the target cells due to the properties of naked siRNA. Thus, this review will focus on the various delivery systems that can be used and the different barriers that need to be surmounted for the development of stable inhalable siRNA formulations for human use before siRNA therapeutics for ALI/ARDS become available in the clinic.     

喷雾干燥法固化黄豆苷元固体脂质纳米粒的研究

目的：建立一种干燥的固体脂质纳米粒的制备方法。方法：采用超声分散法制备黄豆苷元固体脂质纳米粒的混悬液,然后采用喷雾干燥法将其制成干燥的、可再分散的固体脂质纳米粒。结果：在混悬液中黄豆苷元固体脂质纳米粒为球形粒子,平均粒径约为280 nm,喷雾干燥后得到的纳米粒仍为球型,分散后的粒径与喷干前相比有所增大,平均粒径约为720 nm,稳定性较好。结论：喷雾干燥法制备黄豆苷元固体脂质纳米粒是可行的。     

阿克拉霉素A固体脂质纳米粒冻干针剂在家兔体内药动学

目的:研究阿克拉霉素A固体脂质纳米粒(ACM-SLN)冻干针剂在家兔体内的药物动力学。方法:用RP-HPLC法测定家兔耳缘静注ACM-SLN冻干针剂和阿克拉霉素A(ACM-A)注射剂后不同时间血浆中ACM-A的浓度,绘制药-时曲线,计算药物动力学参数。结果:ACM-SLN冻干针剂和ACM-A注射剂的体内过程均符合二室模型,ACM-SLN冻干针剂的t1/2β与MRT显著延长,AUC增高,CL降低。结论:ACM-SLN冻干针剂有利于增加药物与肝脏肿瘤组织的接触时间,从而提高ACM-A的抗肝癌作用。     

Adverse Reactions to Isosulfan Blue During Selective Sentinel Lymph Node Dissection in Melanoma

Background: Selective sentinel lymph node (SLN) dissection can spare about 80% of patients with primary melanoma from radical lymph node dissection. This procedure identifies the SLN either visually by injecting isosulfan blue dye around the primary melanoma site or by handheld gamma probe after radiocolloid injection.Methods: During selective SLN mapping, 1 to 5 ml of isosulfan blue was injected intradermally around the primary melanoma. From November 1993, to August 1998, 406 patients underwent intraoperative lymphatic mapping with the use of both isosulfan blue and radiocolloid injection. Three cases of selective SLN dissection, in which adverse reactions to isosulfan blue occurred, were reviewed.Results: We report three cases of anaphylaxis after intradermal injection with isosulfan blue of 406 patients who underwent intraoperative lymphatic mapping by using the procedure as described above. The three cases we report vary in severity from treatable hypotension with urticaria and erythema to severe cardiovascular collapse with or without bronchospasm or urticaria.Conclusions: In our series, the incidence of anaphylaxis to isosulfan blue was approximately 1%. Anaphylaxis can be fatal if not recognized and treated rapidly. Operating room personnel who participate in intraoperative lymphatic mapping where isosulfan blue is used must be aware of the potential consequences and be prepared to treat anaphylaxis.     

Mitotic Rate as a Predictor of Sentinel Lymph NodePositivity in Patients With Thin Melanomas

Background Lymphatic mapping and sentinel lymphadenectomy (LM/SL) provide important prognostic information for patients with early-stage melanoma. Although the use of this technique in patients with thin melanomas (1.00 mm) is not routine, risk factors that may predict sentinel lymph node (SLN) positivity in this patient population are under investigation. We sought to determine whether mitotic rate (MR) is associated with SLN positivity in thin-melanoma patients and, therefore, whether it may be used to risk-stratify and select patients for LM/SL.Methods Clinical and histopathologic variables were reviewed for 181 patients with thin melanomas who underwent LM/SL from January 1996 through January 2004. Univariate and multivariate logistic regression analyses were performed to identify factors associated with SLN positivity. Risk groups were defined on the basis of the development of a classification tree.Results The overall SLN positivity rate was 5%. All patients with positive SLNs had an MR of >0. By univariate analysis, MR and thickness were significant predictors of SLN positivity. The association between MR and SLN positivity remained significant controlling for each of the other variables evaluated. On the basis of a classification tree, patients with an MR >0 and tumor thickness .76 mm were identified as a higher-risk group, with an SLN positivity rate of 12.3%.Conclusions In patients with thin melanomas, MR >0 seems to be a significant predictor of SLN positivity that may be used to risk-stratify and select patients for LM/SL. To confirm these results, the predictive value of MR for SLN positivity needs to be validated in other populations of thin-melanoma patients.Published by Springer Science+Business Media, Inc. © 2005 The Society of Surgical Oncology, Inc.