丝裂霉素C及可调整缝线在小梁切除术中的应用

目的 观察丝裂霉素C联合可调整缝线在青光眼小梁切除术中应用的效果。方法 我院近3年来小梁切除术98例,术中采用巩膜瓣下放置含丝裂霉素C棉片2～5分钟,然后迅速以平衡盐溶液冲洗,切除2mm×3mm包括小梁在内的深层角巩膜缘组织,并做虹膜根部切除,用10-0尼龙线间断缝合巩膜瓣2～4针后,再于巩膜瓣一侧或两侧作1条或2条型巩膜瓣缝合。形成前房。术后2周、3月、1年及1.5年检查视力、眼压、前房、滤过泡等情况。结果 术后眼压控制良好,Ⅰ、Ⅱ度浅前房发生率低,滤过泡形成良好,43％视力保持不变或改善,炎症反应轻,并发症少。结论 丝裂霉素C可提高小梁切除术后眼压控制率,联合可调整缝线,可有效控制术后滤过水平,减少术后并发症,提高成功率。     

Pharmacokinetic Study of Mitomycin C with Emphasis on the Influence of Aging

Mitomycin C (MMC) at a dose of 8 mg/m² was administered by short intravenous infusion to 14 cancer patients. All patients had normal renal, hepatic, cardiac and bone marrow functions. The plasma level of MMC, which was determined by high-performance liquid chromatography over a 24–h period after the infusion, fitted the 2-compartment model curve except for one patient. There was a significant correlation between the area under the time versus concentration curve (AUC) of MMC and the age of patients ( r = 0.558, P < 0.05). Pharmacokinetic parameters in one of the older (a 69-year-old male) patients were extremely different from those of the other 13 patients. This patient experienced severe myelosuppression, probably due to the markedly increased AUC of MMC. Our results suggest that a patient's age has a significant influence on the pharmacokinetics of MMC in patients with normal major organ functions and that in some patients, MMC pharmacokinetics may be altered, possibly due to interpatient variation in the activation or metabolic pathway of MMC.     

可控性丝线留置术治疗体表难治性海绵状静脉畸形的实验及临床研究

目的研究可控性丝线的致栓效果及其治疗体表难治性海绵状静脉畸形的初步疗效。方法将丝线一端留置于不同管腔大小的静脉内,另一端挂于血管壁埋于皮下,实现其可控性,用经过不同处置的丝线,分别留置于兔耳缘静脉、股静脉,观察其引起血管栓塞的效果。选择致栓效果较好的丝线组,用于临床治疗难治性体表海绵状静脉畸形的患者。结果几种经不同处置的丝线,均能不同程度地起到闭塞血管的作用,对于管腔稍大,血流较快的静脉(兔股静脉),浸泡丝裂霉素并打结的丝线组,致栓效果最好;临床初步应用证实,可控性丝线治疗体表难治性静脉畸形,安全有效。结论可控性丝线静脉内留置术,是一种安全、有效、损伤小、操作简便的治疗体表难治性海绵状静脉畸形的新方法。     

丝烈霉素C诱发小白鼠骨髓细胞姐妹染色单体互换和染色体畸变

丝裂霉素C(MMc)诱导的姐妹染色单体互换(SCE)可反映出细胞DMA损伤修复的基本过程。有关MMC诱发活体的SCE研究不多。本实验目的,就是探讨MMC诱发小白鼠骨髓细胞SCE的剂量—效应关系,并对SCE指标与染色体畸变指标,在检测机体DNA损伤上的差异作一比较研究。结果证明,MMC诱发染色体畸变能办远低于诱发SCE的能力,MMC可诱发小白鼠骨髓细胞SCE产生,SCE值随MMC剂量的增加而增加。SCE即使在低剂量诱变剂的作用下也是敏感的。     

Dendritic Cells Coinjected with Tumor Cells Treated with an Anticancer Drug to Induce Tumor Rejection

Purpose: We examined whether bone marrow-derived dendritic cells (DCs) could induce antitumor immunity when a chemotherapeutic drug was added. Methods: CT26 (a murine colon cancer cell line syngeneic with BALB/c) and CT26-bearing mice were treated with mitomycin C (MMC) intraperitoneally (i.p.). Next, mice immunized with a coinjection of DCs and MMC-treated CT26 (i.p.) were given an intradermal inoculation of CT26. Finally, CT26-bearing mice were treated with MMC (i.p.) with or without DCs, given peritumorally. Results: Although the inoculated tumor was not rejected in the control mice, CT26 was rejected in 50% of the mice injected with MMC alone. Apoptosis was observed in the MMC-treated CT26 cells in vitro and in vivo. Immunization with DCs and apoptotic CT26 cells, but not with apoptotic CT26 alone, gave protection against tumor challenge in 7 of 13 mice. A significantly higher level of cytotoxic T-cell activity and interferon-γ production was seen in the protected mice. When MMC (i.p.) treatment was followed by peritumoral DC injection in the CT26-bearing mice, remarkable therapeutic effects were observed. Conclusion: DCs can collaborate with chemotherapy-induced apoptotic tumor cells and elicit improved antitumor immunity, probably through the acquisition of tumor-associated antigens from apoptotic tumor cells. Received: January 7, 2002 / Accepted: September 3, 2002 Acknowledgments. We thank Dr. Kazuo Kinoshita for his useful advice on using flow cytometry. This research was partly supported by the Ministry of Education, Culture, Sports, Science and Technology (No. 11671160). Reprint requests to: S. Yamasaki     

丝裂霉素C与5—Fu用于抗青光眼滤过性手术的对比研究

采用随机、双讯，前瞻对照的方法比较了丝裂霉素Ｃ（ＭＭＣ）和５－氟尿嘧啶对难治性青光眼小梁切除手术的安全性和有效性。３９例病人随机分成二组，一组使用ＭＭＣ，另一组使用５－Ｆｕ。结果提示：（１）ＭＭＣ组手术成功率高于５－Ｆｕ组；（２）ＭＭＣ组角膜上皮缺损发生率，结膜创口渗漏率明显低于５－Ｆｕ组。     

Klinefelter综合征患者和双亲对诱变剂敏感性研究

为了解诱变剂对Ｋｌｉｎｅｆｅｌｔｅｒ综合征发生的影响，对Ｋｌｉｎｅｆｅｌｔｅｒ综合征患者，患者双亲及对照进行丝裂霉素Ｃ，乙醛或乙醇诱导非二倍体，染色体结构畸变及微核观察，发现丝裂霉素Ｃ诱导的患者当色体结构畸变和微核均显著多于对照和双亲，乙醛和乙醇能诱导非二倍体和微核增加，但患者和双亲增加的程度极显著高于对照，提示Ｋｌｉｎｅｆｅｌｔｅｒ综合征患者对于丝裂霉素Ｃ，乙醛和乙醇诱导染色体畸变更敏感。双亲对     

丝裂霉素稳定性的研究

目的：研究丝裂霉素在3种不同pH溶液中的配伍稳定性。方法：观察配伍后外观变化及用紫外分光光度法测定丝裂霉素配伍后含量的变化,用pH计测定配伍前后溶液的pH值,并进行配伍稳定性加速实验。结果：丝裂霉素在pH6.47,pH8.8,pH9.2溶液中25℃时t0.9分别是74h,371h及552h。在这3种溶液中丝裂霉素在室温8h内其含量大于90％,结论：丝裂霉素在pH6.47-9.2溶液中室温下是稳定的,但丝裂霉素在酸性溶液中的稳定性较在碱性溶液中的稳定性差。     

A combination therapy with mitomycin c, etoposide, doxifluridine and medroxyprogesterone acetate as second line therapy for advanced breast cancer refractory to combination chemotherapy of cyclophosphamide, doxorubicin and 5 fluorouracil

Thirty-two patients with advanced breast cancer refractory to combination chemotherapy with cyclophosphamide (CPA), doxorubicin (ADR) and 5-fluorouracil (5-FU) (CAF) were treated with the combination of mitomycin C, etoposide, doxifluridine and medroxyprogesterone acetate as second line therapy. Observed responses included 6 patients (18.7%) with complete response (CR) and 7 (21.9%) with partial response (PR). Two (50%) out of 4 patients who had bone pain due to bone metastasis noted pain relief. CR or PR were obtained in 4 out of 12 patients who had not responded to the previous CAF therapy. While grade III myelosuppression was observed in 3 patients, other adverse effects were minimal. It is suggested that this combination therapy may be recommended for advanced breast cancer patients as a second therapy.     

丝裂霉素C在青光眼滤过性手术中的应用

目的通过在青光眼滤过性手术中应用丝裂霉素Ｃ（ＭＭＣ）的临床疗效分析,寻求提高青光眼手术疗效的途径。方法１９９４～１９９５年本院２６例２９眼各种类型青光眼施行小梁切除术的病例,术中应用ＭＭＣ,对其术后疗效进行临床观察及随访。结果本组青光眼术后９６％眼压得到有效控制,所有病例术前术后视力不变或增减一行,视野基本保持不变,随访６～１２个月眼压仍保持正常者７２％。讨论ＭＭＣ可有效抑制术后成纤维细胞增生,只需术中一次性用药,不引起眼内组织损害,优于其他抗代谢药物。对年龄在５０岁以下青光眼患者,普遍宜在滤过性手术中应用ＭＭＣ,以抑制术后瘢痕形成,提高抗青光眼手术的成功率。