洛铂联用多西他赛与顺铂联用多西他赛治疗晚期非小细胞肺癌疗效与安全性对比

目的:对比洛铂、顺铂联用多西他赛治疗晚期非小细胞肺癌(NSCLC)的临床疗效和安全性。方法:以我院2010年1月至2015年6月间收治的135例NSCLC患者为研究对象,依据治疗方案不同分为洛铂组和顺铂组,治疗2~3个疗程,对比2组患者临床疗效和不良反应。结果:洛铂组与顺铂组的控制率分别为83.33%和83.46%,差异无统计学意义(P>0.05)。顺铂组的不良反应发生率高于洛铂组,且2组的胃肠道反应、白细胞减少、便秘的发生率差异具有统计学意义(P<0.05)。结论:洛铂联合多西他赛和顺铂联合多西他赛治疗NSCLC的临床疗效接近,但洛铂联用多西他赛的不良反应较少。     

晚期非小细胞肺癌化疗方案成本-效果比较

目的 :比较长春瑞滨、多西他赛、吉西他滨联合顺铂三种化疗方案治疗晚期非小细胞肺癌(Non small cell lung cancer,NSCLC)的成本-效果,为临床化疗方案的选择提供参考。方法 :于我院接受化疗且近期疗效可评价的168例晚期NSCLC患者,按照治疗方案分为NP组(长春瑞滨联合顺铂),TP组(多西他赛联合顺铂),GP组(吉西他滨联合顺铂)。统计3组患者治疗成本、临床疗效、不良反应,比较三种治疗方案的成本-效果比(C/E)、增量成本效果比(△C/△E)并计算其敏感度。结果 :NP组、TP组、GP组临床总有效率分别为37.29%、40.00%、44.44%,组间差异无统计学意义;3组患者不良反应均以Ⅰ~Ⅱ度为主,不良反应发生率组间差异无统计学意义;NP组、TP组、GP组直接成本分别为9254.60元、10985.65元、14430.68元。NP组C/E、△C/△E低于TP组、GP组,且化疗药物费用降低10%后,结果未受影响。结论 :NP、TP、GP三种方案治疗NSCLC的疗效与安全性接近,由成本-效果角度分析,NP方案为优选方案。     

多西紫杉醇联合顺铂新辅助化疗对食管癌疗效分析

目的 :探讨多西紫杉醇联合顺铂新辅助化疗治疗食管癌的疗效及应用价值。方法:以2010年6月至2012年6月在我院治疗的120例食管癌患者作为研究对象。随机分为对照组60例和观察组60例,对照组给予手术治疗;观察组给予术前多西紫杉醇联合顺铂新辅助化疗与手术治疗。比较2组食管癌患者根治性切除率、肿瘤标志物水平、6个月及1年生存率。结果:观察组近期疗效治疗有效率为53.3%,且毒副反应较轻。观察组根治性切除率RO高达97.6%,显著高于对照组81.7%,组间差异具有统计学意义。观察组CEA下降水平显著高于对照组,差异具有统计学意义。观察组6个月生存率与1年生存率高于对照组,但差异不具有统计学意义。结论:多西紫杉醇联合顺铂新辅助化疗治疗食管癌毒副反应较轻,可显著提高手术RO切除率,控制肿瘤发展,提高患者生存率,值得临床进一步深入探讨及推广应用。     

多西他赛为主的联合化疗方案治疗转移性乳腺癌

目的 :分析多西他赛为主的联合化疗方案治疗转移性乳腺癌的临床疗效与安全性。方法 :选取我院2013年7月—2015年7月收治的82例无手术指征的ⅢC/Ⅳ期转移性乳腺癌患者,按照随机数字表法分为观察组、对照组,各41例。观察组接受多西他赛+环磷酰胺+氟尿嘧啶化疗,对照组接受吡柔比星+环磷酰胺+氟尿嘧啶化疗,21d为1周期。于治疗2周期后检测两组患者肿瘤标志物变化,评价其临床疗效与不良反应。结果 :两组患者治疗后CA153、CEA均降低,观察组降低更为明显,差异有统计学意义(P<0.05)。观察组客观有效率、临床受益率分别为53.66%、85.37%,均高于对照组的21.95%、48.78%,差异有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论 :应用多西他赛为主的联合化疗方案治疗转移性乳腺癌有着良好的疗效,且不良反应可耐受。     

顺铂腹腔热灌注联合静脉化疗治疗中晚期胃癌的临床效果观察

目的:探讨顺铂腹腔热灌注联合静脉化疗治疗中晚期胃癌的临床效果。方法 :选取2011年3月至2012年6月在我院接受治疗的66例中晚期胃癌患者为研究对象,采用单双号数字表法将其随机分成A、B两组。B组采用单一静脉化疗法,A组采用顺铂腹腔热灌注联合静脉化疗法,对比分析两组患者治疗效果、不良反应发生情况、并发症发生情况等各项指标。结果 :(1)A组总有效率为47%,明显高于B组的18.7%,组间对比具有统计学意义(P<0.05);(2)两组中无一例患者出现严重超敏反应或治疗相关性死亡,严重并发症及不良反应发生情况差异无统计学意义(P>0.05)。结论:对中晚期胃癌患者行顺铂腹腔热灌注联合静脉化疗方案,疗效显著,不良反应率及并发症发生率低,安全可靠。     

培美曲塞联合顺铂一线治疗恶性胸膜间皮瘤疗效

目的:分析培美曲塞联合顺铂一线治疗恶性胸膜间皮瘤(Malignant pleural mesothelioma,MPM)的临床疗效与安全性,将其与吉西他滨联合顺铂方案进行比较。方法:回顾性分析2010年5月~2014年5月收治的89例MPM患者资料。按照患者一线治疗方案,将接受培美曲塞联合顺铂治疗者纳入培美曲塞组(n=47),将接受吉西他滨联合顺铂治疗者纳入吉西他滨组(n=42),比较两组患者近期疗效、不良反应发生情况及生存期。结果:培美曲塞组、吉西他滨组近期ORR、DCR比较,差异无统计学意义(P>0.05)。两组患者不良反应以Ⅰ~Ⅱ级恶心呕吐为主,其不良反应发生情况比较,差异无统计学意义(P>0.05)。培美曲塞组中位PFS、OS分别为5.93个月、11.95个月,吉西他滨组中位PFS、OS分别为5.84个月、11.86个月,组间比较差异无统计学意义(P>0.05)。结论:培美曲塞联合顺铂治疗MPM与吉西他滨联合顺铂疗效与安全性类似,亦可作为MPM的一线化疗方案。     

雷替曲塞在TACE治疗中晚期原发性肝癌中疗效观察

目的 :探讨雷替曲塞在TACE治疗中晚期原发性肝癌中的疗效。方法 :选取2011年5月—2014年1月我院收治的中晚期原发性肝癌患者86例,随机分为观察组和对照组,每组43例。观察组采用雷替曲塞联合奥沙利铂、吡柔比星治疗,对照组采用氟脲苷联合奥沙利铂、吡柔比星治疗。比较两组疗效及治疗后6个月、12个月生存率。结果 :观察组和对照组有效率比较差异无统计学意义(P>0.05),观察组疾病控制率显著高于对照组(P<0.05),差异有统计学意义。两组治疗后6个月及12个月生存率比较差异无统计学意义(P>0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:与氟脲苷比较,雷替曲塞在TACE治疗中晚期原发性肝癌中疾病控制率略高,不良反应可耐受。     

重组人血管内皮抑制素联合血管介入治疗难治性晚期肺癌的临床研究

目的 :评价动脉内灌注重组人血管内皮抑制素联合支气管动脉介入化疗栓塞治疗临床难治性晚期肺癌的有效性和安全性。方法:临床放化疗失败的44例晚期肺癌患者随机分为治疗组和对照组。对照组22例仅接受常规介入化疗栓塞治疗,治疗组22例患者除接受常规介入化疗栓塞外,术中化疗药物灌注加用重组人血管内皮抑制素治疗。治疗每2周期后评价疗效和生活质量,每周期后评价毒副反应。结果 :对照组客观有效率为31.8%,疾病控制率为86.3%;治疗组客观有效率为59.1%,疾病控制率为95.4%。治疗组客观有效率高于对照组,两组间差异有统计学意义。对照组和治疗组生活质量改善率分别为45.5%和68.2%,两组改善率比较差异无统计学意义。无严重介入栓塞并发症发生,化疗相关毒副反应常见血液学毒性和消化道反应,血液学毒性以白细胞和血小板减少为主,两组毒副反应发生比较,差异无统计学意义。结论 :重组人血管内皮抑制素联合血管介入化疗栓塞能提高难治性晚期肺癌客观有效率,且不增加化疗毒副反应,具有重要的临床价值。     

贝伐单抗联合化疗治疗转移性结肠癌患者血清VEGF变化及其与疗效关系

目的:分析贝伐单抗联合化疗治疗转移性结肠癌患者疗效,观察血清血管内皮生长因子(VEGF)变化及其与疗效关系。方法:根据221例结肠癌患者意愿单纯化疗的105例为对照组,联合贝伐单抗化疗的116例为观察组,并按照观察组患者近期疗效将其分为有效组、无效组,比较各组患者临床疗效、不良反应发生情况及治疗前后血清VEGF变化。结果:患者不良反应均以Ⅰ~Ⅱ级恶心呕吐、中性粒细胞减少、贫血、血小板减少为主,两组不良反应发生率差异无统计学意义(P>0.05)。观察组客观有效率为46.55%,高于对照组的22.86%,差异有统计学意义(P<0.05)。有效组、无效组、对照组治疗后血清VEGF水平均较治疗前下降,有效组治疗后VEGF下降率为(27.24±6.09)%,其VEGF下降率高于无效组,无效组VEGF下降率高于对照组,差异有统计学意义(P<0.05)。结论:贝伐单抗联合化疗能够在保证安全性的基础上提高结肠癌治疗近期客观有效率,血清VEGF水平下降越明显,患者预后质量更佳,可根据VEGF变化早期评估调整方案。     

腹腔热灌注联合静脉化疗治疗进展期胃肠道恶性肿瘤并腹水临床研究

目的 :观察并探讨腹腔热灌注(HIPC)联合全身静脉化疗(SVC)治疗进展期胃肠道恶性肿瘤并腹水的近远期临床疗效。方法 :选取2010年1月至2012年12月间110例晚期胃肠道恶性肿瘤伴腹水患者,据随机数字表分为观察组(58例)与对照组(52)例,观察组予HIPC+SVC化疗方案,对照组予常规腹腔灌注化疗PPC+SVC方案,腹腔灌注药物选用顺铂(DDP)+5-氟尿嘧啶(5-FU),SVC药物选用奥沙利铂(L-OHP)+亚叶酸钙(LV)+5-FU,两组均腹腔灌注2次,全身化疗3个周期,对比两组近远期临床疗效与毒副反应。结果 :化疗结束后2个月,观察组KPS得分(74.5±5.2)明显高于对照组(71.8±4.9)(u=2.803 p=0.006)。观察组与对照组近期肿瘤控制总有效率为(70.1%vs.55.8%)(χ2=1.529 p=0.216)、腹水控制总有效率为(86.2%vs.69.2%)(χ2=4.632 p=0.031)。两组胃肠道反应、骨髓抑制、肝肾功能损害、腹膜刺激征等毒副反应发生率差异均无统计学意义(p>0.05)。观察组治疗后2年内中位生存时间(17.2±1.5)月、2年生存率37.9%均高于对照组(15.6±2.1)月、(19.2%)(u=4.525 p<0.001;χ2=4.648 p=0.031)。结论 :HIPC+SVC较之PPC+SVC方案治疗进展期胃肠道恶性肿瘤伴腹水患者能明显提高患者生存状态与腹水控制水平,延长存活时间,并有降低毒副反应的趋势。     

腹腔镜下CA724表达与新辅助化疗在进展期胃癌中的应用

目的:探索CA724表达与新辅助化疗结合腹腔镜D2根治术治疗进展期胃癌疗效及预后的相关性。方法:回顾性分析我院2017年1月-2018年1月期间收治的局部进展期胃癌患者68例临床资料,根据治疗方案的不同分为对照组30例、研究组38例,对照组采取单纯腹腔镜D2根治术治疗,研究组在腹腔镜D2根治术的基础上结合新辅助化疗治疗,对比两组总有效率、预后情况、CA724表达水平以及阳性率差异,采用Spearman相关性分析法检验CA724水平与患者疗效及预后的关系。结果:研究组患者的总有效率(60.53%)高于对照组患者(43.33%),但差异无统计学意义(χ²=1.989,P=0.158);研究组患者的3年生存率(78.95%)明显高于对照组患者(56.67%),复发转移率(18.42%)则明显低于对照组患者(46.67%),差异有统计学意义(χ²=3.899、6.266,P=0.048、0.012);两组患者术后的CA724表达水平和阳性率均较本组治疗前明显下降,且研究组的下降幅度大于对照组(χ²/t=5.643、6.546,P<0.001);CA724的表达平与患者的疗效及三年生存率呈负相关(r=-0.625、-0.732和-0.832、-0.839,P均<0.001),与患者的复发、转移率呈正相关(r=0.662和0.873,P均<0.001)。结论:血清CA724的表达水平及阳性率变化可在一定程度上反映行新辅助化疗结合腹腔镜D2根治术治疗进展期胃癌患者的疗效及预后情况,当CA724的表达水平及阳性率较低时,提示患者的疗效及预后情况较好,具有一定的临床意义。     

帕尼单抗与西妥昔单抗对结肠癌自噬过程影响及临床疗效比较

目的探讨帕尼单抗与西妥昔单抗对结肠癌自噬过程的影响,并分析其临床治疗效果。方法选择34例患者使用西妥昔单抗联合化疗作为观察组,与34例帕尼单抗联合化疗作为对照组。统计2组患者临床效果、不良反应,以及检测2组患者Beclin-1和LC-3在癌组织中的表达情况。结果观察组疾病控制率显著优于对照组(P<0.05),观察组发生皮疹的比例显著高于对照组(P<0.05),而发生肺部感染的比率显著低于对照组(P<0.05),观察组Beclin-1和LC3在结肠癌病理切片组织中的表达水平均显著低于对照组(P<0.05)。结论西妥昔单抗联合化疗疗效优于帕尼单抗,并可提高患者体内自噬能力。西妥昔单抗组发生皮疹的比例显著高于对照组,皮疹可作为判断治疗效果的指标之一。     

A combination of stereological methods,biochemistry and electron microscopy for the investigation of drug treatment effects in experimental animals

Some chemotherapeutic agents used for breast cancer (BC) treatment can induce severe side effects in the ovarian tissue. The combination of cyclophosphamide and docetaxel (TC) is widely used for BC treatment; however, its late effects in the ovary are not completely understood. The main purpose of this study was to evaluate the structural and ultrastructural alterations in the ovarian stroma induced by TC treatment. Wistar rats were divided into two groups: a control group and a TC group. They were euthanized 5 months after the end of treatment, and their plasma and ovaries were collected. Important alterations were noted. The serum estradiol level was significantly reduced in the TC group compared with the control group. Additionally, the number of apoptotic nuclei was higher in the TC group. The role of the inflammatory response in the development of ovarian damage was investigated, and we found an increased number of mast cells and increased expression of TNF‐α in the TC group. The involvement of fibrosis was also investigated. The results showed that the TC group had increased expression levels of TGF‐β1, collagen type I (col‐I) and collagen type III (col‐III) compared with the control group. Ultrastructural analysis revealed the presence of collagen fibrils in the treated group and illustrated that the ovarian tissue architecture was more disorganized in this group than in the control group. The results from this study are important in the study of chemotherapy‐induced ovarian failure and provide further insight into the mechanisms involved in the development of this disease.     

A549/DDP derived exosomes can affect cisplatin chemosensitivity via transporting CXCR4 to A549 cells

The resistance of cancer cells to the anti-cancer drugs is the most important reason that affecting the efficacy of the non-small cell lung cancer (NSCLC) chemotherapy; thus, to explore the underlying mechanism of drug resistance of NSCLC medications is urgently needed for improving the therapeutic efficacy of current anti-NSCLC chemotherapies. The aim of the present study is to explore the roles of exosomes in the chemosensitivity of A549 cells and the related mechanism. A549 cells and cisplatin resistant cell line A549/DDP derived exosomes were isolated, and the expressions of CXCR4 were compared. Then, after cisplatin treatment, A549 cells were treated with exosomes, and the proliferation, apoptosis, migration, and invasion of the cells were examined. Finally, the tumorigenic effect of A549/DDP derived exosomes were also evaluated by cisplatin treated xenograft tumor mice models in vivo. We found that A549/DDP derived exosomes increased the proliferation, migration, and invasion, and inhibited the apoptosis and cisplatin sensitivity of A549 cells. CXCR4 was also significantly increased in cells treated with A549/DDP derived exosomes. Furthermore, A549/DDP derived exosomes may also decrease the chemosensitivity of NSCLC cells to cisplatin in vivo. Our data suggested that A549/DDP derived exosomes can affect the chemosensitivity of A549 cells to cisplatin, possibly by transporting CXCR4 to A549 cells. Our data may provide novel evidence for the investigation of drug resistance of NSCLC.     

<i>XRCC1</i> Arg399Gln and Arg194Trp polymorphisms regulate XRCC1 expression and chemoresistance of non-small cell lung cancer cells

X-ray repair cross-complementing protein 1 (XRCC1) could repair cisplatin-induced DNA damage. XRCC1 Arg399Gln and Arg194Trp variants alter XRCC1 expression and function, leading to changes in cancer sensitivity to cisplatin treatment. This study aimed to investigate the effects of XRCC1 Arg399Gln and Arg194Trp polymorphisms on cell viability, apoptosis and XRCC1 expression in cisplatin-sensitive A549 and cisplatin-resistant A549/DDP nonsmall cell lung cancer (NSCLC) cells. Plasmids carrying XRCC1 Arg399Gln and Arg194Trp were constructed and transfected into A549 and A549/DDP cells. RT–PCR, Western blot, MTT assay, and flow cytometry analysis were performed to assess cell viability, apoptosis, and XRCC1 expression. Compared to control cells, the viability of A549 and A549/DDP cells transfected with XRCC1 Arg399Gln and Arg194Trp was higher and the apoptosis rate was lower, and XRCC1 mRNA and protein expression levels were significantly higher. In conclusion, our results suggest that XRCC1 Arg399Gln and Arg194Trp polymorphisms change XRCC1 expression in NSCLC cells and alter the sensitivity of NSCLC to cisplatin-based chemotherapy     

Evaluation of testicular tissue of adult rats treated with cisplatin incorporated into the liposome

Cisplatin (CPL) is one of the most widely used and effective chemotherapeutic agents for the treatment of several human malignancies. However, it causes serious side effects, especially on reproduction. In order to reduce the undesirable effects caused by many drugs, liposomes have been used as a good system for drug delivery. The aim of this study was to investigate, for the first time, the effects of CPL incorporated into the dipalmitoyl phosphatidylcholine liposome (DPPC) on the testicular tissue of adult Wistar rats. The animals (n = 20) were distributed into four experimental groups: (a) control (distillated water); (b) liposome (DPPC, 1 mL), (c) cisplatin incorporated into liposome (CPL/DPPC), and (d) CPL (8 mg/kg body weight). The animals received a single intraperitoneal injection and were killed 10 days after each treatment for histopathological analysis of testes. The results showed that the testicular histomorphometric parameters in rats of DPPC and CPL/DPPC groups were similar to those of the control group. Meanwhile, rats of the CPL‐treated group showed a variety of morphological alterations, including atrophy of seminiferous tubules and presence of multinucleated cells in the germinal epithelium. The incorporation of CPL into the liposome had no influence on the testicular weight or any other stereological parameters, but it was beneficial in maintaining the body weight of the animals. In conclusion, the liposome suppressed the cytotoxic effects caused by cisplatin in the testes of rats, suggesting a possible use in chemotherapy against cancer to reduce the side effects seen on reproduction. Microsc. Res. Tech. 78:323–329, 2015. © 2015 Wiley Periodicals, Inc.     

The progress of combination therapy with immune checkpoint inhibitors in breast cancer

Immunotherapy targets the dysfunctional immune system to induce cancer cell killing by CD8-positive T cells. Immune checkpoint inhibitors (ICIs), specifically anti-PD-1 antibodies, anti-PD-L1 antibodies, and anti-CTLA4 antibodies, have revolutionized the management of many malignancies due to their significant role in generating a durable clinical response. However, clinical data suggest that response rates to ICI monotherapy are low due to the immunologically silent characteristics of breast cancer (BC). Chemotherapy, surgery, radiotherapy, and targeted therapy were recently reported to alter the tumor microenvironment and enhance the ICI response. Some clinical studies supported that ICIs, in combination with other treatment strategies, show superior efficacy in BC control, especially triple-negative breast cancer. Therefore, seeking a reasonable combination therapy is a promising way to improve ICI response. The present review highlights the clinical efficacy of ICIs treatment options in combination with standard-of-care therapies, such as chemotherapy and targeted therapy.     

6RA70、S7-400PLC在同步电动机励磁系统数字化改造中的应用

文章针对线材厂中轧同步电动机原励磁系统的缺点,结合生产实际及新的控制要求,制定了合理可行的励磁系统及自动化网络改造方案。分析了新的励磁系统的组成结构及工作原理,并运用先进的西门子6RA70整流器、S7-400PLC及PROFIBUS-DP现场总线技术对中轧同步电动机励磁系统进行了成功的数字化改造,取得了良好的经济效益。     

CRIP1生物学功能的定量蛋白质组学分析

CRIP1（cysteine-rich intestinal protein 1）是含有双锌指结构域的蛋白,在很多肿瘤细胞中高表达,但其在肺癌细胞中的生理学功能尚不明确。本研究应用定量蛋白质组学探究CRIP1过表达对肺癌顺铂耐药细胞（A549/DDP）的影响及作用机制。运用慢病毒载体系统构建了CRIP1过表达的A549/DDP稳转细胞系,利用Western Blotting证实了单克隆细胞系中CRIP1的过表达。发现CRIP1过表达能够加快细胞增殖,增加细胞的耐药性。通过定量蛋白质组学分析,鉴定了CRIP1过表达引起的蛋白质组的变化,并且对上调和下调的蛋白进行聚类分析。结果表明,CRIP1过表达上调了烟酰胺磷酸核糖转移酶（NAMPT）和NAD依赖型氧化还原酶的表达,从而促进细胞的增殖,并且提高了细胞的耐药性。     

五行音疗对晚期癌症患者生存质量影响

目的探讨临床新技术中医五行音乐对晚期肿瘤患者生存质量改善的作用。方法收集病例数67例全部来自2008年11月至2010年1月在中国中医科学院西苑医院肿瘤科住院患者,采用照随机化设计,按照2:2:1比例,分别随机分配到3组,观察期为21天,中医五行音乐组与西洋乐组每接受5天音乐治疗休息2天。治疗前后分别聆听中医五行音乐和西洋乐,对照组不接受任何音乐治疗。以肿瘤患者生活质量评分(QOL),Karnofsky(KSP)评分及患者症状日记分别进行测试,并记录测评参数。结果校正年龄分层因素后,治疗后生活质量指数积分、KPS积分改善3组比较差异有统计学意义(P<0.05),3组两两比较,中医五行音乐组与西洋乐和空白对照组比较差异有统计学意义(P<0.05)。结论中医五行音乐在提高老年及非老年肿瘤患者生存质量方面与西洋乐及不接受音乐治疗者之间存在疗效差异。中医五行音乐暂时优于西洋乐。中期结果显示出老年肿瘤患者症状日记评分作为一种评价生活质量的指标其敏感度仍有待考证。