钴60多野适形放射治疗晚期非小细胞肺癌临床研究

目的：探讨立体定向放射治疗晚期非小细胞肺癌的近期疗效和放疗副反应。方法：采用钴60多野适形放射治疗系统（-刀）治疗58例（82个病灶）晚期非小细胞肺癌患者。50%等剂量线覆盖PTV,95%等剂量线包绕100%GTV,照射剂量以50%等剂量线作为处方剂量,单次剂量3Gy至5Gy,1次/天,5次/周,共照射8次至14次,总剂量30Gy至50Gy。结果：55例78个病灶根据CT复查肿瘤退缩情况确定CR为21.8%,PR为69.2%,总有效率为91.0%;临床获益率为76.5%;1年以上生存率为38.5%。结论：SRT使肿瘤局部受到准确照射,周围正常组织损伤小,近期疗效满意。     

紫杉醇卡铂化疗联合放射治疗局部晚期非小细胞肺癌临床观察

目的 :观察紫杉醇卡铂化疗联合放射治疗局部晚期非小细胞肺癌 (NSCL C)的近期疗效及毒副反应。方法 :3 2例局部晚期NSCLC患者 ,采用紫杉醇加卡铂联合化疗 (紫杉醇 13 5 mg/m2 ,静滴 ,第 1天 ;卡铂 3 0 0 mg/m2 ,静滴 ,第 2天 ,每 2 1天为 1周期 ,共 2～ 3周期 ) ,并与放射治疗 (常规分割 ,DT62～ 68Gy/3 1～ 3 4次 )交替进行 (夹心疗法 )。结果 :全组 CR2例 ,PR16例 ,总有效率 (CR PR) 5 6.3 % ,无严重毒副反应。平均生存期 14 .5月。结论 :紫杉醇卡铂化疗联合放射治疗局部晚期 NSCLC能提高近期疗效 ,远处转移有降低趋势 ,且毒副作用可耐受 ,值得临床进一步观察研究     

基于CT影像组学的非小细胞肺癌预后分析方法

为了辅助医生规划非小细胞肺癌（Non-Small Cell Lung Cancer,NSCLC）患者治疗和复查方案,提出了一种基于CT影像组学的NSCLC预后分析方法.首先,对患者肺部CT影像中的肿瘤区域进行分割;然后,对肿瘤区域进行影像组学特征提取、优化;最后,将优化后的特征数据与患者的预后生存情况作为输入,利用机器学习的方法构建预后分析模型,预测患者的预后生存时间范围.选用124例NSCLC患者数据进行实验,以具有临床意义的3年生存期为预测界限,对患者预后生存时间范围进行预测.实验结果表明,预后分析模型的预测准确率达到91.9%,可以有效地辅助医生对非小细胞肺癌患者的预后情况进行更加精准的评估,制定出更具个性化的治疗与复查方案.     

非小细胞肺癌新辅助化疗后的光镜和电镜观察

目的：评价非小细胞肺癌（ＮＳＣＬＣ）术前化疗后的疗效和观察其病理学的表现。方法：随机选择２２例ＮＳＣＬＣ病人,其中１１例术前行ＭＶＰ方案化疗１～２个周期,外科手术切除标本进行光镜和电镜的观察并评定其疗效,与临床评价进行比较。结果：化疗组有不同程度的病理变化,原发灶的肿瘤细胞显示不同程度的变性和坏死,化疗反应率Ⅰ、Ⅱ和Ⅲ级分别为０．０％、６３．６％和３６．４％,总有效率（Ⅰ级和Ⅱ级）为６３．６％（７／１１）,低分化肿瘤患者的有效率占总有效率的８５．７％（６／７）,临床评价与病理学评价的符合率为７２．７％,两种评价方法之间无显著性差异（Ｐ〉０．０５）,在非化疗组没有明显的肿瘤细胞的消失。结论：对非小细胞肺癌术前行ＭＶＰ方案辅助化疗与单纯手术相比有更好的治疗效果,伴有纤维化的变性和坏死是原发灶化疗后的主要表现形式,超     

氮分子激光用于治疗肺癌的初步结果

本文报导了我们在动物实验基础上，从1980年4月起至1981年2月止，对不宜手术治疗的晚期肺癌（在化疗、中药及免疫疗法上，再加上氮激光照射，进行综合治疗，治疗了十个病例。治疗结果与1978年-1980年内只用化疗、中药及免疫疗法联合作用治疗的1d病例进行疗效对比。它们除了加与不加氮激光照射这点不同外，     

香砂六君子汤对小细胞肺癌化疗患者的相关中医症状改善*

摘 要:目的 通过对小细胞肺癌(small cell lung cancer,SCLC)患者化疗间期联合中药治疗,分析香砂六君子汤对SCLC患者疲乏状态、化疗后相关中医证候、化疗相关不良反应的影响。方法 将110例SCLC患者随机分为2组,治疗组56例先行化疗,于化疗间歇期（D8-21）联合香砂六君子汤。对照组54例进行单纯化疗;两组均化疗6个周期。结果 癌症疲乏量表（Cancer Fatigue Scale,CFS)评定:治疗组乏疲乏症状评分低于对照组,P＜005;中医症状:治疗组食少纳呆、神疲乏力、恶心呕吐症状显著低于对照组（P＜0．05）,治疗后症状总积分有显著差异（P＜005）。在整个治疗过程中,两组不良事件(Adverse Event,AE）主要均为低钠血症和消化道毒性,血液毒性等,发生率为治疗组42.33%,对照组55.46%,治疗组明显低于对照组P＜0.05,有统计学意义。没有出现因药物原因所引起的严重不良事件(Serious Adverse Event,SAE）。无进展生存期（Progression free survival,PFS）治疗组为11.7个月,对照组为10.2个月,P＞0.05。结论 SCLC香砂六君子汤辅助改善患者疲乏、食欲不振、恶心呕吐症状,总体生活质量优于化疗组。香砂六君子汤未增加患者恶心呕吐等副反应。     

基于VGG网络多模态融合的非小细胞肺癌复发预测

传统方法预测肺癌患者术后复发通常使用PET/CT图像或临床数据等单一模态信息,而文章在卷积神经网络VGG模型的基础上研究了多模态融合的潜力,通过结合PET/CT图像信息、临床数据和影像组学信息对肺癌复发实现了更好的预测。实验结果表明,对160名患者的NSCLC放射基因组学数据集进行研究时使用三种模态信息预测NSCLC患者复发性能达到最佳,其准确率为84.38%,精确率为82.76%,召回率为68.75%,AUC为79.69%。     

SOSNet:一种非对称编码器-解码器结构的非小细胞肺癌CT图像分割模型

非小细胞肺癌严重损害人类健康,早期非小细胞肺癌CT(Computed Tomography)图像中的肿瘤结节体积小,不易发现,极易造成漏诊和误诊.为了精确分割非小细胞肺癌CT图像中的小体积肿瘤结节,本文提出SOSNet(Small Object Segmentation Networks)自动分割模型,利用ResNet(Residual Network)基础层和空洞卷积构造非对称编码器-解码器结构作为分割主网络,利用轴向取反注意力模块ARA(Axial Reverse Attention)逐步擦除背景中对分割有影响的结构,再使用结构细化模块SR(Structure Refinement)对主网络输出的粗略特征图进行结构细化,从而实现非小细胞肺癌肿瘤结节分割.在非小细胞肺癌公开数据集的实验测试表明,本文提出的小目标自动分割模型SOSNet可以有效分割出非小细胞肺癌CT图像中的小体积肿瘤结节,其mDice(mean-Dice)、mIoU(mean Intersection over Union)、Sensitivity、F1、Specificity、平均绝对误差MAE(Mean Absol...     

“黄芪 半夏”药对治疗非小细胞肺癌 作用机制研究

摘 要:目的 运用网络药理学方法及分子对接技术探讨黄芪 半夏”药对治疗非小细胞肺癌(NSCLC)的作用机制。方法 通过文献查找及TCMSP数据库筛选“黄芪-半夏”药对主要成分及作用靶点,在GeneCards、 PharmGKB、DrugBank、OMIM数据库获取 NSCLC相关靶点,利用 Cytoscape软件分别构建“中药-成分-靶点”“中药-成分-靶点-疾病”相互作用网络;运用 STRING数据库构建蛋白互作网络,并根据拓扑学参数筛选“黄芪-半夏”药对治疗NSCLC的关键靶点;对关键靶点进行GO功能富集和KEGG通路分析,并构建“成分-靶点-通路”网络图,运用Auto Dock Vina 1.1.2将得到的主要活性成分与关键靶点进行分子对接,运用PyMOL软件进行结果可视化。结果 共获得“黄芪-半夏”药对有效成分33个,作用于227个潜在靶点,NSCLC靶点1253个,拓扑分析得到关键靶点97个,其中度值≥中位数的靶点有48个,包括TP53、AKT1、CASP3、JUN等。GO功能富集分析得到生物过程主要涉及细胞因子介导的信号通路,基因表达的正向调控,RNA聚合酶II启动子转录的正调控;KEGG通路富集分析主要包括Pathways in cancer通路、肿瘤坏死因子信号通路、PI3K-Akt通路等,分子对接结果显示,“黄芪-半夏”药对主要活性化合物与5个核心靶点的结合能力皆良好。结论 “黄芪-半夏”药对可能通过槲皮素、山奈酚、黄芩素等主要活性成分,作用于TP53、AKT1、CASP3、JUN、VEGFA等相关靶点,干预Pathways in cancer、肿瘤坏死因子、PI3K Akt等信号通路,协同产生调控肿瘤细胞周期、介导肿瘤细胞凋亡、抑制其增殖分化及转移等来防治NSCLC。     

一种基于L_1范数的非局部变分图像复原模型

针对L_2范数的非局部变分模型在迭代过程中未考虑图像局部梯度信息,模糊图像细节信息的缺点,提出了一种基于L_1范数的非局部变分模型。首先,对基于L_1范数的非局部变分模型的扩散性能进行了详细的分析。接着,将该模型应用于退化图像的复原中,并推导出该模型的Bregman交替迭代求解过程。最后,通过对比实验,证明本文提出的L_1范数的非局部变分复原模型能更好地重构图像的细节信息,相对于L_2范数的非局部变分模型峰值信噪比提高大于1dB,图像复原性能更优。     

中晚期鼻咽癌同步放化疗临床疗效观察

目的：观察同步放化疗治疗中晚期鼻咽癌的临床疗效。方法：我科于2001年至2004年收治的中晚期鼻咽癌83例,放射治疗方案为双侧面颈联合常规分割到36Gy至40Gy后避脊髓,鼻咽部缩野光子线照射至DT70Gy。颈部淋巴结行常规分割放疗后局部加量至66Gy至70Gy。同步化疗采用PF方案,放疗的前、中、后期各行1周期化疗,间隔时间为21天。观察同步放化疗疗效及各种毒副反应。结果：原发灶1个月、6个月、12个月的完全缓解率为88．0％、90．4％、94．0％,颈部淋巴结完全缓解率分别为92．1％、94．7％、98．7％,1年、3年、5年总生存率为91．5％、79．6％、61．3％。毒副反应患者可耐受。早期反应主要为骨髓抑制、口于和口腔黏膜炎;晚期反应主要为张口困难和颈部纤维化。结论：同步放化疗临床疗效好,毒副反应经有效的对症支持治疗和护理后患者可耐受,有较高的临床推广应用价值。     

伊班膦酸钠分别联合放疗和化疗治疗骨转移癌的临床评价

目的:比较伊班膦酸钠分别联合放疗和化疗治疗骨转移癌的疗效和毒副反应。方法:90例患者随机分为两组,伊班膦酸钠 放疗组(联合放疗组)45例,伊班膦酸钠 化疗组(联合化疗组)45例。采用伊班膦酸钠6mg加入生理盐水500mL静滴4h以上,每4周重复,每例病人应用4~6次。放疗方法骨转移灶剂量为30~40Gy/2~3周,化疗根据原发肿瘤类型选择相应方案。结果:联合放疗组和联合化疗组1、3、6月疼痛缓解率、骨转移灶有效率分别为91.1%、86.7%、82.1%;84,4%、82.2%、82.9%和40.0%、48.9%、59.0%;37.8%、44.4%、61.0%。两组比较P>0.05,差异无统计学意义。结论:伊班膦酸钠分别联合放疗和化疗治疗骨转移癌的疗效相似,毒副作用可以耐受。     

GSH-Responsive Radiosensitizers with Deep Penetration Ability for Multimodal Imaging-Guided Synergistic Radio-Chemodynamic Cancer Therapy

Radiotherapy (RT) utilizes the non-invasive and high penetration X-ray as the energy source to eliminate deep-seated tumors. The efficacy of RT can be optimized by designing effective radiosensitizers and synergizing with other treatment methods. Glutathione (GSH)-responsive radio-sensitizing nanovesicles are designed with size-transformability via self-assembly of gold-manganese oxide Janus nanoparticles (JNPs) encapsulating the near-infrared fluorescence (NIR) dye (IR1061). In the presence of GSH, JNP vesicles (Ves) dissociate into smaller gold (Au) NPs and manganese ion (Mn²⁺) that not only penetrate into the deeper layers of the tumor but also deplete the GSH and trigger chemodynamic therapy (CDT) through a Fenton-like reaction, which augments the efficacy of RT. In addition, the IR1061 released from the disintegrated nanostructures fluoresces in the NIR-II window, and along with photoacoustic (PA) and magnetic resonance imaging (MRI) enables high precision tumor detection. The combination of JNP Ve and X-ray irradiation achieves multimodal image-guided ablation of subcutaneous as well as deep-seated tumors in murine models. Therefore, this novel multimodal image-guided RT/CDT therapeutic platform is a promising strategy in high-precision tumor therapy.     

Tumor-Activated Prodrug with Synergistic Anti-Stemness Chemical and Photodynamic Therapies

Photodynamic therapy (PDT) has received extensive attention as a promising cancer treatment approach. Still, challenges to in vivo photodynamic therapy have existed for decades. First, the “always on” nature of conventional photosensitizers will cause damage to normal tissues thereby limiting the treatment efficiency of PDT. Second, the hypoxic TME protects cancer stem cells (CSCs) deeply harbored in the center of tumors from PDT administration, thus contributing to the recrudescence and metastasis of tumors. Herein, a ROS-triggered self-immolative therapeutic prodrug ( Mu-PS ) is reported, comprising of an activatable photosensitizer, an indomethacin (IMC) part, and a ROS-responsive trigger, for the anti-stemness chemical and photodynamic therapy of tumors. Intriguingly, Mu-PS can target the tumor and selectively release the photosensitizer and IMC upon the activation of TME-related ROS, generating massive phototoxic ¹O₂ to kill most non-CSCs tumor cells under the action of PDT and block the growth of CSCs by IMC, hence, it multiplies the therapeutic index. Noteworthy, the anti-stemness mechanism of IMC in tumors is confirmed and elucidated for the first time. Overall, this study introduces a self-immolatative prodrug for combined CSCs-involved chemical therapy and activatable PDT for tumors and provides a design paradigm of prodrug for the precise prognosis and treatment of tumors.     

92例老年胰腺癌的临床资料及预后分析

目的探讨影响老年胰腺癌患者生存时间的预后因素。方法对112例老年胰腺癌患者的临床参数、治疗方法及生存时间进行回顾性研究,并进行单因素及多因素预后分析。结果92例老年胰腺癌患者获访,1、2、3年生存率分别为20%、6%、4%,中位生存期为5个月。Kaplan-Meier生存率曲线分析:TNM分期Ⅰ期、Ⅱ期患者的生存率高于Ⅲ期、Ⅳ期的患者(P=0.001),根治性手术患者高于姑息手术患者,姑息手术患者高于未手术患者(P=0.000),放化疗可以提高生存率(P=0.001)。Cox多因素分析:TNM分期、手术方式及放化疗是长期生存的独立预后因素,性别、肿瘤部位、吸烟、饮酒、合并糖尿病与生存时间无关。结论TNM分期、手术方式及是否进行放化疗可能是影响老年胰腺癌患者长期生存的重要因素。     

Engineering Metal Nanoclusters for Targeted Therapeutics: From Targeting Strategies to Therapeutic Applications

Metal nanoclusters (NCs) have recently attracted great interest in biomedical applications due to their ultrasmall size, good biocompatibility, and unique molecule-like physical and chemical properties. Metal NCs can be rationally designed and integrated with various targeting moieties to achieve unique physicochemical properties and functions. For therapeutic applications, these multifunctional surface-modified NCs can provide distinctive advantages over native metal NCs, such as improved therapeutic effects and reduced side effects. In this review, the design principles of targeting strategies for metal NCs and their composites, including passive and active targeting, and physical and chemical targeting are first discussed. The authors then focus on the recent achievements in the application of metal NCs in targeted therapeutics, including chemotherapy, phototherapy, and radiotherapy. Finally, the authors’ perspectives on the challenges and opportunities of developing metal NCs in targeted therapeutics, further paving their way for potential clinical applications are provided.     

Gold‐Coated Fe3O4 Nanoroses with Five Unique Functions for Cancer Cell Targeting,Imaging, and Therapy

The development of nanomaterials that combine diagnostic and therapeutic functions within a single nanoplatform is extremely important for molecular medicine. Molecular imaging with simultaneous diagnosis and therapy will provide the multimodality needed for accurate diagnosis and targeted therapy. Here, gold‐coated iron oxide (Fe₃O₄@Au) nanoroses with five distinct functions are demonstrated, integrating aptamer‐based targeting, magnetic resonance imaging (MRI), optical imaging, photothermal therapy. and chemotherapy into one single probe. The inner Fe₃O₄ core functions as an MRI agent, while the photothermal effect is achieved through near‐infrared absorption by the gold shell, causing a rapid rise in temperature and also resulting in a facilitated release of the anticancer drug doxorubicin carried by the nanoroses. Where the doxorubicin is released, it is monitored by its fluorescence. Aptamers immobilized on the surfaces of the nanoroses enable efficient and selective drug delivery, imaging, and photothermal effect with high specificity. The five‐function‐embedded nanoroses show great advantages in multimodality.     

Surface-Engineered Extracellular Vesicles with CDH17 Nanobodies to Efficiently Deliver Imaging Probes and Chemo-Photothermal Drugs for Gastric Cancer Theragnostic

Extracellular vesicles (EVs) are widely used as natural nanoparticles to deliver various cargos for disease diagnosis and therapy. However, unmodified EVs cannot efficiently transport the cargos to desired sites due to non-specific uptake. Here, a delivery system is designed to display nanobodies against cadherin 17 (CDH17) on the surface of EVs isolated from HEK-293 cells and loaded with dye Indocyanine green (ICG) and/or anti-cancer drug dinitroazetidine derivative RRx-001, a blocker for CD47/ signal regulatory protein alpha (SIRPα) axis. CDH17 is a promising target for gastric cancer (GC) therapy. In this study, ICG loaded in the EVs engineered with CDH17 nanobodies can realize rapid tumor imaging in a CDH17-positive GC model and can produce significant anti-tumor photothermal therapeutic (PTT) effect after irradiation. Meanwhile, PTT effect can induce immunogenic cell death and macrophage polarization from M2 to M1 phenotype. The engineered EVs loaded with RRx-001 can significantly repress GC tumor growth. Finally, dual loading of ICG/RRx-001 in engineered EVs show maximal anti-tumor efficacy in both cancer cell and patient-derived GC models after only single injection. Collectively, CDH17 nanobody-functionalized EVs loaded with ICG and/or RRx-001 hold great promise to image and treat GC by combining fluorescent dye-induced PTT with chemotherapy.     

综合判别函数相关器实验研究

本文采用综合判别函数(SDF)构成了一个畸变不变相关滤波系统,并利用它进行了一系列实验研究,实验结果证明:以SDF技术与相干光空间匹配滤波相结合的光电混合相关器能够实现畸变(旋转、比例、方位和位移)不变相关识别.