热灌注化疗在恶性胸腔积液中的近期疗效观察

目的探讨热灌注化疗对恶性胸腔积液的近期疗效。方法将48例恶性胸腔积液患者随机分为两组,其中24例为观察组,采用顺铂40mg注入胸腔30min,7d1次直至控制胸水为止;其余24例为对照组,采用单纯顺铂60mg胸腔内灌注法,两组进行近期疗效对比。结果观察组总有效率和CR均优与对照组(P<0.05);而对照组的造血功能抑制和肾脏的毒副作用均明显高与观察组(P<0.01)。结论热疗合并应用化疗有互补和增效作用,热灌注化疗对恶性胸腔积液的近期疗效优于单纯化疗灌注。     

腹腔化疗在卵巢癌中的临床应用

目的观察与比较腹腔化疗在卵巢癌患者间的疗效与副反应情况。方法选择2004年1月至2008年5月间我院收治卵巢癌患者54例卵巢癌患者随机分成A、B两组。应用系统化疗pp方案,A、B组分别通过腹腔给药和静脉给药,观察各组的疗效与副反应。结果A组有效率稍高于B组,但统计学显示无明显差异(P>0.05)。A组1～2疗程后即能明显控制腹水生成,腹胀明显减轻。B组第3疗程仍有部分病例出现腹水。结论腹腔化疗直接作用于肿瘤细胞,达到杀灭作用,减少腹水的生成,提高患者的生活质量。     

两种方法治疗胃肠肿瘤化疗所致呕吐的成本效果分析

目的评价多潘立酮与恩丹西酮防治胃肠肿瘤化疗所致呕吐的价值。方法80名患者随机分成两组,多潘立酮组与盐酸恩丹西酮组,前组口服多潘立酮10mg每日三次,后组化疗前半小时肌注盐酸恩丹西酮8mg,两组按需使用盐酸恩丹西酮止吐。应用5-Fu LV方案化疗5天,观察5天内两种方法的疗效及成本-效果比。结果多潘立酮组与盐酸恩丹西酮组止吐效果比较无显著性差异(P>0.05),但两组药物经济学比较,多潘立酮组增量成本-效果比(ΔC/ΔE)为52.6,调整后敏感度分析ΔC/ΔE为45.7,均有显著差异。结论多潘立酮联合按需使用恩丹西酮疗效高,药物性价比低,是化疗时使用止吐的合适用药方式。     

热疗联合胸腔灌注化疗药物治疗恶性胸腔积液临床观察

近年来,热疗成为恶性胸腔积液治疗的重要手段。热疗产生的热效应使肿瘤组织局部增温,能在相对较短的时间内杀灭癌细胞,同时使细胞膜通透性增加,更有利于化疗药物的渗透吸收。本研究通过热疗联合胸腔灌注化疗药物治疗恶性胸腔积液,以期减轻患者临床症状,提高患者生存质量。     

腹腔引流在困难腹腔镜切除术中的作用

目的 探讨腹腔引流在困难腹腔镜切除术(LC)中的作用.方法 对我院自2002年至2003年间进行的困难LC中的306饲病人的临床资料进行回顾性分析.结果 引流182例无死亡病例,并发症2例(1.09%),再手术1例(0.55%),未引流组124例,死亡1例(0.81%),并发症10倒(8.06%),再手术4例(3.23%).两组并发症发生率存在明显差别.结论 对困难LC应常规放置腹腔引流.     

胃癌肿瘤标志物CDX2研究与应用进展

胃癌是最常见的肿瘤之一,胃癌的早期症状不明显,出现严重病情时,已是晚期病变。随着分子标志物的研究和发展,并将其应用到恶性肿瘤的诊断,具有很高的临床应用价值。因此针对CDX2在胃癌诊断中的现状及进展做简要综述。     

基质金属蛋白酶在肿瘤侵袭转移作用中的研究

肿瘤细胞的侵袭与转移是肿瘤的恶性生物学行为,其作用机制多样且复杂。基底膜是机体的重要组织屏障,多种基质蛋白酶纷纷参与了肿瘤细胞降解基底膜和细胞外基质的过程,其中以基质金属蛋白酶类的作用最为突出。该文对基质金属蛋白酶类在肿瘤细胞侵袭与转移中的作用机制、相关转录因子以及国内外研发的抑制剂做了综述。     

气相组分在热回收炼焦工艺中的作用研究

热回收焦炉在实际生产中配入大量无烟煤或动力煤仍可生产出优质焦炭,但其结焦理论基础缺乏深入研究。通过研究气相组分在热回收炼焦工艺中的作用,说明了热回收焦炉较传统机焦炉能够配入更多无烟煤与动力煤生产优质焦炭的关键原因。最后进行了成焦试验,结果表明热回收焦炉实际成焦率较理论成焦率平均提高了2.0%。     

区域动脉灌注联合腹腔灌洗治疗重症急性胰腺炎临床应用研究

目的研究不同给药途径治疗重症急性胰腺炎(severe acute pancreatitis SAP)的疗效。方法将符合入选条件45例SAP患者随机分三组,分别行区域动脉灌注联合腹腔灌洗,即治疗组;常规治疗联合腹腔灌洗,即对照组Ⅰ;一般常规治疗,即对照组Ⅱ。并根据CT结果,选择不同病变部位置管进行药物灌注治疗,观察腹部症状,血淀粉酶,血常规,并发症率,死亡率等指标。结果区域动脉灌注联合腹腔灌洗组在腹痛缓解,腹膜刺激征缓解,血氧饱和度恢复,血常规恢复及淀粉酶恢复时间上明显短于对照组Ⅰ和对照Ⅱ,并发症率及死亡率均低于对照组。P<0.05,差异具有显著性。结论区域动脉灌注联合腹腔灌洗在治疗SAP疗效显著。     

p53在胃肠肿瘤的表达及预后意义的研究

p53蛋白是反映细胞增殖活性的重要指标,与胃肠肿瘤的发生发展密切相关。结合病理形态学观察,检测p53蛋白的表达,能更客观、准确地判断胃肠肿瘤的恶性程度和预后。对胃肠肿瘤的诊断和预后有较高的临床实用价值。     

Clinical Advances in Molecular Biomarkers for Cancer Diagnosis and Therapy

Cancer diagnosis is currently undergoing a paradigm shift with the incorporation of molecular biomarkers as part of routine diagnostic panel. The molecular alteration ranges from those involving the DNA, RNA, microRNAs (miRNAs) and proteins. The miRNAs are recently discovered small non-coding endogenous single-stranded RNAs that critically regulates the development, invasion and metastasis of cancers. They are altered in cancers and have the potential to serve as diagnostic markers for cancer. Moreover, deregulating their activity offers novel cancer therapeutic approaches. The availability of high throughput techniques for the identification of altered cellular molecules allowed their use in cancer diagnosis. Their application to a variety of body specimens from blood to tissues has been helpful for appreciating their use in the clinical context. The development of innovative antibodies for immunohistochemical detection of proteins also assists in diagnosis and risk stratification. Overall, the novel cancer diagnostic tools have extended their application as prognostic risk factors and can be used as targets for personalized medicine.     

Nanoparticles in Clinical Translation for Cancer Therapy

The advent of cancer therapeutics brought a paradigm shift from conventional therapy to precision medicine. The new therapeutic modalities accomplished through the properties of nanomaterials have extended their scope in cancer therapy beyond conventional drug delivery. Nanoparticles can be channeled in cancer therapy to encapsulate active pharmaceutical ingredients and deliver them to the tumor site in a more efficient manner. This review enumerates various types of nanoparticles that have entered clinical trials for cancer treatment. The obstacles in the journey of nanodrug from clinic to market are reviewed. Furthermore, the latest developments in using nanoparticles in cancer therapy are also highlighted.     

Effect of Cerenkov Radiation-Induced Photodynamic Therapy with 18F-FDG in an Intraperitoneal Xenograft Mouse Model of Ovarian Cancer

Ovarian cancer (OC) metastases frequently occur through peritoneal dissemination, and they contribute to difficulties in treatment. While photodynamic therapy (PDT) has the potential to treat OC, its use is often limited by tissue penetration depth and tumor selectivity. Herein, we combined Cerenkov radiation (CR) emitted by ¹⁸F-FDG accumulated in tumors as an internal light source and several photosensitizer (PS) candidates with matched absorption bands, including Verteporfin (VP), Chlorin e6 (Ce6) and 5′-Aminolevulinic acid (5′-ALA), to evaluate the anti-tumor efficacy. The in vitro effect of CR-induced PDT (CR-PDT) was evaluated using a cell viability assay, and the efficiency of PS was assessed by measuring the singlet oxygen production. An intraperitoneal ES2 OC mouse model was used for in vivo evaluation of CR-PDT. Positron emission tomography (PET) imaging and bioluminescence-based imaging were performed to monitor the biologic uptake of ¹⁸F-FDG and the therapeutic effect. The in vitro studies demonstrated Ce6 and VP to be more effective PSs for CR-PDT. Moreover, VP was more efficient in the generation of singlet oxygen and continued for a long time when exposed to fluoro-18 (¹⁸F). Combining CR emitted by ¹⁸F-FDG and VP treatment not only significantly suppressed tumor growth, but also prolonged median survival times compared to either monotherapy.     

Nanoliposomes in Cancer Therapy: Marketed Products and Current Clinical Trials

The drugs used for cancer treatment have many drawbacks, as they damage both tumor and healthy cells and, in addition, they tend to be poorly soluble drugs. Their transport in nanoparticles can solve these problems as these can release the drug into tumor tissues, as well as improve their solubility, bioavailability, and efficacy, reducing their adverse effects. This article focuses on the advantages that nanotechnology can bring to medicine, with special emphasis on nanoliposomes. For this, a review has been made of the nanoliposomal systems marketed for the treatment of cancer, as well as those that are in the research phase, highlighting the clinical trials being carried out. All marketed liposomes studied are intravenously administered, showing a reduced intensity of side-effects compared with the nonliposomal form. Doxorubicin is the active ingredient most frequently employed. Ongoing clinical trials expand the availability of liposomal medicines with new clinical indications. In conclusion, the introduction of drugs in nanoliposomes means an improvement in their efficacy and the quality of life of patients. The future focus of research could be directed to develop multifunctional targeted nanoliposomes using new anticancer drugs, different types of existing drugs, or new standardized methodologies easily translated into industrial scale.     

Autophagy Modulators in Cancer Therapy

Autophagy is a process of self-degradation that plays an important role in removing damaged proteins, organelles or cellular fragments from the cell. Under stressful conditions such as hypoxia, nutrient deficiency or chemotherapy, this process can also become the strategy for cell survival. Autophagy can be nonselective or selective in removing specific organelles, ribosomes, and protein aggregates, although the complete mechanisms that regulate aspects of selective autophagy are not fully understood. This review summarizes the most recent research into understanding the different types and mechanisms of autophagy. The relationship between apoptosis and autophagy on the level of molecular regulation of the expression of selected proteins such as p53, Bcl-2/Beclin 1, p62, Atg proteins, and caspases was discussed. Intensive studies have revealed a whole range of novel compounds with an anticancer activity that inhibit or activate regulatory pathways involved in autophagy. We focused on the presentation of compounds strongly affecting the autophagy process, with particular emphasis on those that are undergoing clinical and preclinical cancer research. Moreover, the target points, adverse effects and therapeutic schemes of autophagy inhibitors and activators are presented.     

Recent Advances in Preclinical Research Using PAMAM Dendrimers for Cancer Gene Therapy

Carriers of genetic material are divided into vectors of viral and non-viral origin. Viral carriers are already successfully used in experimental gene therapies, but despite advantages such as their high transfection efficiency and the wide knowledge of their practical potential, the remaining disadvantages, namely, their low capacity and complex manufacturing process, based on biological systems, are major limitations prior to their broad implementation in the clinical setting. The application of non-viral carriers in gene therapy is one of the available approaches. Poly(amidoamine) (PAMAM) dendrimers are repetitively branched, three-dimensional molecules, made of amide and amine subunits, possessing unique physiochemical properties. Surface and internal modifications improve their physicochemical properties, enabling the increase in cellular specificity and transfection efficiency and a reduction in cytotoxicity toward healthy cells. During the last 10 years of research on PAMAM dendrimers, three modification strategies have commonly been used: (1) surface modification with functional groups; (2) hybrid vector formation; (3) creation of supramolecular self-assemblies. This review describes and summarizes recent studies exploring the development of PAMAM dendrimers in anticancer gene therapies, evaluating the advantages and disadvantages of the modification approaches and the nanomedicine regulatory issues preventing their translation into the clinical setting, and highlighting important areas for further development and possible steps that seem promising in terms of development of PAMAM as a carrier of genetic material.     

三维适形放疗配合TP方案同步化疗治疗食管癌临床研究

目的探讨食管癌TP方案同步放化疗的疗效。方法94例食管癌患者根据入选标准随机分组,46例进入化疗 放射治疗组(放化组),48例进入单纯放射治疗组(单放组)。放化组:化疗为TP方案,即Taxol 40mg/m2d1,DDP20mg/m2d1;放疗从第1天即开始,放疗方案为三维适形放射治疗:DT64Gy-70Gy/32-35Fr/6-7W。单放组:放射治疗方案同综合组。结果放化组的3年生存率及局控率分别为54.35%、56.52%,单放组的3年总生存率及局控率分别为33.33%、27.08%,两组显示出显著统计学差异。同步放化组远处转移率为15.21%,单放组远处转移率为31.25%。放化组的毒性反应大于单放组,但患者均能耐受。结论以TP方案化疗配合放射治疗食管癌降低了远处转移发生率,同时提高局远期生存率,虽毒性反应增加,但患者均能耐受,有进一步研究的价值。     

Clinical Relevance of CDH1 and CDH13 DNA-Methylation in Serum of Cervical Cancer Patients

This study was designed to investigate the DNA-methylation status of E-cadherin (CDH1) and H-cadherin (CDH13) in serum samples of cervical cancer patients and control patients with no malignant diseases and to evaluate the clinical utility of these markers. DNA-methylation status of CDH1 and CDH13 was analyzed by means of MethyLight-technology in serum samples from 49 cervical cancer patients and 40 patients with diseases other than cancer. To compare this methylation analysis with another technique, we analyzed the samples with a denaturing high performance liquid chromatography (DHPLC) PCR-method. The specificity and sensitivity of CDH1 DNA-methylation measured by MethyLight was 75% and 55%, and for CDH13 DNA-methylation 95% and 10%. We identified a specificity of 92.5% and a sensitivity of only 27% for the CDH1 DHPLC-PCR analysis. Multivariate analysis showed that serum CDH1 methylation-positive patients had a 7.8-fold risk for death (95% CI: 2.2-27.7; p = 0.001) and a 92.8-fold risk for relapse (95% CI: 3.9-2207.1; p = 0.005). We concluded that the serological detection of CDH1 and CDH13 DNA-hypermethylation is not an ideal diagnostic tool due to low diagnostic specificity and sensitivity. However, it was validated that CDH1 methylation analysis in serum samples may be of potential use as a prognostic marker for cervical cancer patients.     

年轻宫颈癌77例临床分析

目的分析35岁以下年轻妇女宫颈癌(以下简称年轻宫颈癌)的发病趋势、临床病理特点、治疗措施及预后。方法对77例年轻宫颈癌患者的临床资料、病理学诊断结果进行回顾性分析。结果2001年10月至2006年10月泸州医学院附属医院的年轻宫颈癌例数与同期宫颈癌总数之比逐年上升,差异有极显著性(P<0.01)。年轻宫颈癌中宫颈腺癌及其它非鳞癌总的构成比明显高于同期中老年宫颈癌中非鳞癌所占比例,两者有显著性差异(P<0.01)。结论年轻宫颈癌发病率呈上升趋势,其原因可能与性传播有关;年轻宫颈癌的病理类型亦发生了明显变化,故应更好地对年轻宫颈癌患者进行预后估计,并采取相应的综合治疗措施,以改善患者的预后。     

Bacteriophage-Mediated Cancer Gene Therapy

Bacteriophages have long been considered only as infectious agents that affect bacterial hosts. However, recent studies provide compelling evidence that these viruses are able to successfully interact with eukaryotic cells at the levels of the binding, entry and expression of their own genes. Currently, bacteriophages are widely used in various areas of biotechnology and medicine, but the most intriguing of them is cancer therapy. There are increasing studies confirming the efficacy and safety of using phage-based vectors as a systemic delivery vehicle of therapeutic genes and drugs in cancer therapy. Engineered bacteriophages, as well as eukaryotic viruses, demonstrate a much greater efficiency of transgene delivery and expression in cancer cells compared to non-viral gene transfer methods. At the same time, phage-based vectors, in contrast to eukaryotic viruses-based vectors, have no natural tropism to mammalian cells and, as a result, provide more selective delivery of therapeutic cargos to target cells. Moreover, numerous data indicate the presence of more complex molecular mechanisms of interaction between bacteriophages and eukaryotic cells, the further study of which is necessary both for the development of gene therapy methods and for understanding the cancer nature. In this review, we summarize the key results of research into aspects of phage–eukaryotic cell interaction and, in particular, the use of phage-based vectors for highly selective and effective systemic cancer gene therapy.