丝裂霉素胸膜腔灌注治疗肺癌恶性胸膜腔积液初报

目的 观察胸膜腔内灌注丝裂霉素治疗恶性胸膜腔积液的疗效。方法 对15例恶性胸膜腔积液病人采用胸膜腔闭式引流术，1-2d排空胸膜腔积液，后注入100mL生理盐水＋20mg丝裂霉素，夹闭引流管4h后开放，间隔1d再同样方法用1次，引流无液体后拔出引流管，4wk后评价疗效。结果 病人呼吸困难明显好转，生活质量明显改善。CR10例，PR3例，NC2例，总有效率86．7％（13／15）。结论 胸膜腔内灌注丝裂霉素能有效控制恶性胸膜腔积液，对晚期肿瘤所致恶性胸水的病人有重要意义。     

丝裂霉素C化学稳定性的研究

在广泛ＰＨ范围内对丝裂霉素Ｃ的化学稳定性进行了研究，测定不同温度下不同ｐＨ时的速率常数，得到不同ｐＨ时的分解活化能及不同温度下的稳定ｐＨ值。活化能数据在ｐＨ５．５及７．８时出现极大值，而不同温度下的两上最稳定（ｐＨ）ｍ恰恰位于两个ｐＨ范围内。     

Refractory hemolytic uremic syndrome improved by plasmapheresis using cryosupernatant fraction as a replacement fluid: A case report

A 52-year-old woman who had had 6 months of chemotherapy using mitomycin C and cisplatin for cervical cancer presented with hemolytic uremic syndrome. Conventional plasmapheresis using whole-plasma fraction was ineffective. However, plasmapheresis using the cryosupernatant fraction dramatically improved symptoms of hemolytic anemia and thrombocytopenia in this case. The activity of factor VIII in the cryosupernatant fraction of plasma as a replacement fluid decreased after removal of cryoprecipitate, indicating effective removal of von Willebrand factor. The pathogenesis of her hemolytic uremic syndrome may have been associated with von Willebrand factor multimers contained in the cryoprecipitate of plasma. Similar use of the cryosupernatant fraction of plasma could not be found in other reports of cases of hemolytic uremic syndrome. Plasmapheresis using the cryosupernatant fraction of plasma may improve refractory hemolytic uremic syndrome.     

斯奇康联合丝裂霉素顺铂胸腔内注射治疗肺癌恶性胸水的疗效观察

目的　探讨斯奇康联合丝裂霉素、顺铂胸腔内注射治疗肺癌恶性胸水的有效性和安全性。方法　对我科1999年以来确诊为肺癌恶性胸水的 5 3例患者 ,随机分为斯奇康组 ( 2 7例 )和对照组 ( 2 6例 ) ,进行胸腔内注药 ,观察治疗的有效率、Karnofsky评分及不良反应。结果　斯奇康组与对照组治疗有效率分别为 88 8%和 5 3 9%,两组比较有显著性差异 (P <0 0 1) ;两组治疗后生存质量均有改善 ,但Karnofsky评分 70分以上治疗组为 66 7%,对照组为 3 0 8%,两组比较差异显著 (P <0 0 1) ;两组均出现不同程度的白细胞、血小板减少 ,但治疗组与对照组相比反应明显较轻 ,有显著性差异 (P <0 0 5 )。结论　斯奇康联合丝裂霉素、顺铂胸腔内注射治疗肺癌恶性胸水疗效较好 ,毒副反应较轻。     

小梁切除联合丝裂霉素术后晚期滤泡相关并发症的临床分析

目的：探讨小梁切除联合丝裂霉素术后晚期滤泡相关并发症的发生率及处理。 方法：1994-05／2000．05接受小梁切除手术联合丝裂霉素治疗青光眼65例65眼，采用Kaplan-Meier生存分析法估计晚期滤过泡渗漏、滤泡炎、眼内炎的发生概率。 结果：随访2．5～7．1（平均5．6）a，发生滤过泡渗漏16眼（16／65，24．6％），出现滤泡炎5眼（5／65，7．7％），发生眼内炎1眼，出现复合性滤泡并发症1眼，出现持久性低眼压9眼（9／65，13．8％）。Kaplan-Meier生存分析法估计晚期滤泡并发症5a发生概率为40．0％。多数眼通过门诊处理获得成功，部分眼需手术治疗。 结论：小梁切除联合丝裂霉素术后晚期滤泡相关并发症的发生率可高达40．0％，单纯滤过泡渗漏是一相对良性的状况，只要及时处理，可被修复，滤泡炎或眼内炎可以被控制，而获得正常眼内压。一相对良性的状况，只要及时处理，可被修复，滤泡炎或眼内炎可以被控制，而获得正常眼内压。     

小剂量卡介苗、丝裂霉素交替灌注预防浅表性膀胱癌术后复发

目的 观察小剂量卡介苗(BCG)、丝裂霉素C(MMC)交替灌注预防浅表性膀胱癌术后复发的疗效和安全性。方法 回顾性分析自2000年5月～2001年6月的45例浅表性膀胱癌患的临床资料，29例行膀胱部分切除术，16例行经尿道膀胱肿瘤电切术(TuRBt)，术后定期应用卡介苗60mg、丝列霉素C 10mg交替膀胱灌注，每周1次共6次，间歇3个月，再每月1次，持续12个月。其中Ta、T1期22例、T2期23例。结果 所有病人随访12～24个月，45例患中，共有2例复发，均为TURBt后T2病人，总有效率95．2％，无全身不良反应，仅2例应用BCG后出现轻度膀胱刺激症状。结论 小剂量MMC、BCG交替膀胱内灌注，预防浅表性膀胱癌术后复发，效果好、病人耐受性强、副作用小。     

丝裂霉素C在复发性青光眼中的应用

目的 :观察丝裂霉素C(MMC)在抗青光眼手术中应用的近期及远期效果。方法 :4 2只复发性青光眼在二次手术中一次性应用MMC术后观察及随访。结果 :术前眼压 34.0 5± 4 .0 5mmHg ,明显高于随访半年期 13.13± 3.30mmHg以及随访 2年期 14 .33± 3.30mmHg ,差异有显著性 (P <0 .0 1)。术后近期眼压 6 .75± 1.4 3mmHg ,明显低于随访半年期 (P <0 .0 1)。功能性滤过泡所占比率为 95 .2 %。结论 :术中一次性应用MMC ,远期观察其降压效果明显 ,且无严重并发症发生     

丝裂霉素C在翼状胬肉切除联合自体结膜瓣移植术中的应用

目的 讨论安全有效浓度下，丝裂霉素C在翼状胬肉切除联合体自体结膜移植术中的应用，观察对翼状胬肉的复发的防治效果。方法 对54例64眼原发性胬肉者施行显微镜下胬肉切除带蒂结膜瓣转位移植联合术中或术后丝裂霉素C（mitomycin C MMC)的应用，经5－12月随诊，与单纯手术组（27例33眼）原发性胬肉术后复发情况作对比分析。结果 复发率要术中用药组为3．33％，术后用药组5．88％，对照组18．18％，经X^2检验，术中、术后用药与对照组 差异有显著性（P＜0．05），而术中或术后应用MMC的复发率差异无性，均可降低胬肉的复发率。结论 适时、适量应用MMC对有效防止翼状胬肉的复发有着非常重要的意义。     

The haemotoxicity of mitomycin in a repeat dose study in the female CD-1 mouse

Mitomycin (MMC), like many antineoplastic drugs, induces a predictable, dose-related, bone marrow depression in man and laboratory animals; this change is generally reversible. However, there is evidence that MMC may also cause a late-stage or residual bone marrow injury. The present study in female CD-1 mice investigated the haematological and bone marrow changes induced by MMC in a repeat dose study lasting 50 days. Control and MMC-treated mice were dosed intraperitoneally on eight occasions over 18 days with vehicle, or MMC at 2.5 mg/kg, autopsied (n = 6-12) at 1, 7, 14, 28, 42 and 50 days after the final dose and haematological changes investigated. Femoral nucleated bone marrow cell counts and levels of apoptosis were also evaluated and clonogenic assays carried out; serum levels of FLT3 ligand (FL) were assessed. At day 1 post-dosing, MMC induced significant reductions in RBC, Hb and haematocrit (HCT) values, and there were decreases in reticulocyte, platelet, and femoral nucleated cell counts (FNCC); neutrophil, lymphocyte and monocyte values were also significantly reduced. On days 7 and 14 post-dosing, all haematological parameters showed evidence of a return towards normal values, but at these times, and at day 28, values for RBC and FNCC remained significantly reduced in comparison with controls. At days 42 and 50 post-dosing, many haematological parameters in MMC-treated mice had returned to control levels; however, there remained evidence of late-stage effects on RBC, Hb and HCT values, and FNCC also continued to be significantly decreased. Results for granulocyte-macrophage colony-forming units and erythroid colonies showed a profound decrease immediately post-dosing, but a return to normal values was evident at day 50. Serum FL concentrations demonstrated very significant increases in the immediate post-dosing period, but a return to normal was seen at day 50 post-dosing; a relatively similar pattern was seen in the number of apoptotic femoral marrow nucleated cells. The histopathological examination of kidney tissues from MMC animals at day 42 and 50 post-dosing showed evidence of hydronephrosis with cortical glomerular/tubular atrophy and degeneration. It is therefore concluded that MMC administered on eight occasions over 18 days to female CD-1 mice at 2.5 mg/kg induced profound changes in haematological and bone marrow parameters in the immediate post-dosing period with a return to normal levels at day 50 post-dosing; however, there was evidence of mild but significant late-stage/residual effects on RBC and FNCC, and on cells of the erythroid lineage in the bone marrow.     

Handling of biological samples in the determination of the anti-neoplastic drug mitomycin C

A study to ascertain suitable conditions for handling biological samples from patients, treated with the antibiotic mitomycin C (MMC), with the objective of improving the accuracy and reliability of the determination is described. Situations frequently occurring in medical practice are simulated to optimize procedures for reliable and reproducible sampling, sample treatment and determination of MMC. Continuation of drug partitioning in whole blood after sampling can be prevented by immediate cooling in ice before the separation of plasma from cells. The adjustment of the pH of urine samples is shown to be particularly important since a low urinary pH causes decomposition of MMC; moreover, it may decrease extraction recovery. Furthermore, long-term exposure of samples to daylight induces drug decomposition. Frozen storage of plasma and urine samples for periods greater than 3 weeks is to be avoided as this results in a considerable drop in MMC concentration. Repeated cycles of freezing and thawing are shown to have no effect upon the analytical results (6 cycles tested). The analysis of extracts of biological samples may take place up to at least 24 h after their preparation without measurable loss of analyte.