自杀基因联合中医药疗法治疗肿瘤的设想

自杀基因疗法是一种具有良好应用前景的肿瘤治疗新措施。但如何有效提高疗效是目前仍须解决的关键性问题。由于免疫机制在自杀基因疗法旁杀伤效应中的重要作用，激活荷瘤机体的免疫功能，改善自杀基因抗肿瘤作用的炎症免疫微环境，是提高肿瘤自杀基因疗法疗效的主要策略。中医中药在调节机体免疫状态方面具有肯定的作用，与其他方法比较具有明显优势。因而，将自杀基因疗法与中医中药联合应用，有可能起到提高肿瘤自杀基因疗法疗效，防止肿瘤复发的作用。提出了自杀基因联合中医药疗法治疗肿瘤的新设想，为肿瘤基因治疗提供了一种新的思路和模式。     

HNE1细胞株光动力学治疗前后形态学的动态变化

目的 探讨体外光动力学治疗（ＰＤＴ）引起鼻咽癌（ＮＰＣ）细胞死亡的作用机制。方法对鼻咽癌细胞株ＨＮＥ１体外光动力学治疗前后形态学变化进行动态观察。结果 对照组ＨＮＥ１细胞培养３ｈ,６ｈ,１２ｈ,２４ｈ和４８ｈ后细胞形态与正常培养组ＨＮＥ１细包开始变形皱缩,细胞界限模糊,细胞透光度和立体感较差,治疗２４～４８ｈ后细胞发生凋亡。结论 体外光动力学治疗对ＨＮＥ１具有明显的杀伤效应并ＨＮＥ１细胞凋亡。ＰＤ     

The tissue level of dexamethasone in human brain tumors is about 1000 times lower than the cytotoxic concentration in cell culture

Abstract

In glioblastoma patients dexamethasone is routinely administered as an antiedematous drug. In contrast to its empirically proven effect, the biochemical way of action remains poorly understood. In order to assess whether a direct cytotoxic effect is present in vivo we compared dexamethasone levels in brain tumor specimens with its cytotoxic concentrations in cell culture. Biopsy specimens were taken during microsurgical tumor removal, homogenized and dexamethasone levels were measured by high pressure liquid chromatography. In cell culture we tested different concentrations of dexamethasone on A172, U87, U373 cells and on eleven primary glioblastoma cell lines. Furthermore a pilocytic astrocytoma I, an astrocytoma II and an oligodendroglioma III and a meningioma were examined. Cell viability was assessed using the Alamar Blue assay and the concentrations resulting in loss of 50% of the cell population were calculated (LD50). The average brain tumor tissue concentration of dexamethasone was 225 nanogram g^-1. The mean LD50 in cell culture ranged at 222 microgram ml^-1. We conclude that a direct cytotoxic effect of dexamethasone on brain tumor cells is not present in vivo because the tissue levels of the drug are about 1000 times lower than the LD50 in cell culture. [Neurol Res 2002; 24: 479-482]     

Case Report: Determination of Primary Foci of Metastatic Tumors by p53 Mutational Analysis in Intraesophageal Multiple Carcinomas

It is well known that squamous carcinomasfrequently develop multifocally, either synchronously ormetachronously, in the upper aerodigestive tract (1).Such phenomena were first reported by Slaughter et al in 1953, and they were named fieldcancerization (2). Using recent molecular biologytechniques, these multiple carcinomas have been revealedto arise from independent origins (3). Esophagealcarcinomas have been reported to frequently metastasize tothe lymph nodes even at the early stage of tumorextension (4). Furthermore, simultaneous multifocalcancer development is not rare in the esophagus (5). In cases of intraesophageal multiple carcinomaswith lymph node metastases, the primary focus of themetastatic tumors cannot be identified by conventionalhistologic examination. Here we report a case of intraesophageal multiple carcinomas in whichthe attributed foci of lymph nodal metastases could beclearly identified by analyzing the p53 gene mutationalstatus used as a clonal marker.     

黄芪注射液对化疗副作用的拮抗作用的临床观察

【目的】观察黄芪注射液在调节化疗后患者免疫功能的作用。【方法】观察34例确诊为急性髓系白血病患者进行2个周期化疗的情况。第1周期予单纯DA方案化疗,第2周期在DA方案化疗的同时,加用黄芪注射液20 mL静滴,1次／d, 连用2周。观察两个周期化疗期间患者的骨髓抑制情况和免疫功能情况。【结果】2个周期化疗后进行对比,第1周期化疗后患者出现明显的骨髓抑制及疲乏、虚汗、食欲减退、精神不振等机体免疫力下降表现;患者外周血免疫球蛋白IgA、IgG、 IgM和补体C3均呈不同程度下降(P<0．01)。第2周期化疗后患者骨髓抑制有所减轻,大多数患者疲乏、虚汗等不适较轻微;外周血免疫球蛋白IgA、IgG、IgM和补体C3含量较第1周期化疗下降程度减少(P<0．05或P<0．01)。【结论】黄芪注射液能减少化疗的毒副作用,增强机体的免疫功能。     

Hydrocephalus in posterior fossa lesions: Ventriculostomy and permanent shunt rates by diagnosis

Abstract

Objectives: The rate of ventriculostomy for acute hydrocephalus and progression to shunt-dependent chronic hydrocephalus in patients with posterior fossa lesions are not well known.

Methods: We retrospectively reviewed 104 consecutive cases with posterior fossa lesions on admission to the University of Illinois Hospital from June 2002 to December 2005. We recorded the rate of ventriculostomy and permanent ventricular shunting, which were compared among etiologic groups, using chi-squared and Fisher's exact tests.

Results: Overall, 35 patients had ventriculostomy for acute hydrocephalus and 16 had permanent shunting for shunt-dependent chronic hydrocephalus. Of those with primary posterior fossa intracranial hemorrhage (ICH) (42 cases), 19 (45%) required ventriculostomy, with five (26%) requiring subsequent permanent shunting; 13 patients had hematoma evacuation, with two having permanent shunting. Of those with cerebellar infarction (14 cases), four (29%) required ventriculostomy and one (25%) had a permanent shunt; two had a decompressive craniectomy. Of those with neoplasms (43 cases, 33 surgically resected), ten (23%) required ventriculostomy and nine (21%) required permanent shunting. In addition, two of the three cases with infectious processes required ventriculostomy and one required a permanent shunt. In-hospital mortality was 21% (9/42 cases) for patients with ICH, 14% (2/14 cases) for patients with infarction and 0% for all others.

Discussion: Acute primary posterior fossa hemorrhage has the highest rate of ventriculostomy for acute hydrocephalus and highest inpatient mortality but a surprisingly low rate of permanent shunt-dependency. When hydrocephalus was caused by a neoplasm, there was a higher rate of permanent shunt placement.     

Fatigue,Weakness, and Sexual Dysfunction after Bariatic Surgery – Not an Unusual Case but an Unusual Cause

Background: Malabsorptive bariatic surgery for morbid obesity has been very effective in producing weight loss. However, patients may experience some degree of malnutrition, which may lead to various clinical symptoms, such as fatigue and weakness. Morbid obesity is often associated with impaired reproductive function, and weight loss generally improves sexual function in both sexes. However, women with extreme weight loss may experience secondary amenorrhea. In men, zinc deficiency may lead to impaired testosterone synthesis resulting in hypogonadism and impotency. Case Report: A 43-year-old male 5 years after jejunoileal bypass for morbid obesity performed in a foreign institution presented with a recent history of progressive fatigue, general weakness, and declining libido and potency. Unexpectedly, his symptoms were not related to the operation or to his weight loss but rather to a structural cause. Endocrine and radiologic evaluations revealed a cystic tumor in the sella turcica causing partial hypopituitarism and secondary hypogonadism. Conclusion: Long-term follow-up is mandatory in patients after bariatic surgery. Non-specific symptoms and findings should be further investigated. A loss of sexual activity and performance may have causes other than the previous bariatic operation.