沙利度胺联合MP方案治疗多发性骨髓瘤的疗效评价

目的 比较沙利度胺联合美法仑+泼尼松方案(MPT)与美法仑+泼尼松方案(MP)治疗多发性骨髓瘤(MM)的疗效与患者不良反应.方法 采用回顾性分析,MPT组26例,美法仑每天9 mg/m2口服,第1天至第4天,泼尼松60 mg/m2,第1天至第4天,或者美法仑每天4 mg/m2口服,第1天至第7天;泼尼松每天40 mg/m2口服,第1天至第7天,28 d为1个疗程,沙利度胺白化疗开始持续给药,100～200 mg/d,每4周为1个疗程,MP组21例,美法仑及泼尼松用法用量同MPT组,6个疗程后评价总疗效结果 MPT组的总有效率(ORR)为65.4%,明显高于MP组的42.9%(P＞0.05);MPT组中位反应时间为2个月,MP组为3个月;MPT组患者治疗后血红蛋白及清货白升高明显高于MP组(P＜0.05);MPT组不良反应的发生率高于MP组(P＜0.05),但两组3度以上的不良反应差异无统计学意义;MPT组中位无进展生存时间(PFS)为11个月,2年PFS为66.18%.结论 与MP方案相比,MPT方案可以提高MM患者的有效率,改善生活质量,延长生存时间,耐受性良好.     

复方肠泰联合FOLFOX4对大肠癌术后的作用的临床观察

Objective: The aim of the study was to observe the therapeutic effect of FOLFOX4 regimen plus Fufangchangtai decoction on postoperative colorectal cancers. Methods: Thirty postoperative colorectal cancer patients were allocated into control and experiment groups respectively. Patients in experiment group were given Fufangchangtai decoction combined with FOLFOX4 regimen. Patients in control group were given FOLFOX4 regimen alone. Efficacy was evaluated after 2 periods of treatment. Results: The improvement rate of symptoms were 86.6% in experiment group compared to 53.3% in control group. KPS was stable in experiment group, and decreased in control group. QOL was increased in experiment group, and stable in control group after the treatment. For impact of immunity parameters, there were enhancements of CD3+ and CD4+ in experiment group, while they did not change in control group. In experiment group, WBC reduction was slighter than that of control group. The differences were not remarkable in PLT reduction, alimentary response, and toxicity of liver and kidney and nervous system. Conclusion: The clinical observation showed that Fufangchangtai decoction plus FOLFOX4 regimen could effectively enhance KPS, improve the symptoms, the quality of life and the immunity state, and down-regulate the side effects. In conclusion, Fufangchangtai decoction can decrease the toxicity so as to increase the treatment effect.     

EMRS在晚期鼻咽癌患者放化疗中的应用价值

目的:观察并分析基于电子病历系统(electronic medical record system,EMRS)对晚期鼻咽癌患者放化疗期间干预质量的影响。方法:选取2019年1月-2020年12月太和县人民医院收治的84例晚期鼻咽癌患者,随机分为常规组和观察组,各组42例,常规组给予常规干预方法,观察组在常规组基础上给予基于电子病历系统的干预方法。对比2组干预前后患者自我感受负担、舒适度;对比2组干预期间患者依从性和干预后满意度。结果:干预前2组患者照顾、经济、家庭、情感、治疗负担评分及总评分比较差异无统计学意义(P>0.05),与干预前相比,干预后2组患者照顾、经济、家庭、情感、治疗负担评分及总评分均降低(P<0.05),且干预后观察组评分均低于常规组(P<0.05);干预前2组患者生理、心理、社会、环境舒适状况评分及总分差异,无统计学意义(P>0.05),与干预前相比,2组患者干预后生理、心理、社会、环境舒适状况评分和总分均有所增加(P<0.05),且干预后观察组评分均高于常规组(P<0.05);2组患者依从性和满意度等级分布比较差异有统计学意义(P<0.05),且观察组完全依从率和总满意率均高于常规组(P<0.05)。结论:晚期鼻咽癌患者放化疗期间应用基于电子病历系统的干预方法,能够减轻患者自我感受负担,增强舒适度,提升干预质量,并且提高患者依从性和满意度,可推广使用。     

靶向抑制肠道菌β-葡萄糖醛酸苷酶在肿瘤预防和治疗中的应用

肠道菌β-葡萄糖醛酸苷酶（BGUSs）是肠道菌群产生的一类重要水解酶,其通过水解内源性和外源性葡萄糖醛酸苷影响肿瘤发生发展以及化疗药物的疗效（药效/毒性）。近年来,越来越多的研究尝试通过抑制肠道BGUSs降低患癌风险和减轻化疗药物引起的毒副作用。但由于BGUSs具有基因和结构的多样性、生理病理功能的复杂性以及对特定抑制剂响应的差异性,表征介导特定疾病或药物不良反应的BGUSs并发展有效的选择性抑制剂面临巨大的挑战。本文概述了BGUSs的结构和功能的最新进展,汇总了近年来在BGUSs介导的致癌物和肿瘤化疗药物代谢方面的发现、BGUSs抑制剂的研发及其预防肿瘤和缓解化疗药物不良反应的临床前研究结果,并讨论了将抑制BGUSs作为肿瘤预防和药物治疗新策略的前景。     

Molecular encapsulation of thalidomide with sulfobutyl ether-7 beta-cyclodextrin for immediate release property: enhanced in vivo antitumor and antiangiogenesis efficacy in mice

Thalidomide's reported ability to inhibit tumor angiogenesis has led to clinical trials determining its effectiveness in combating various types of cancer. Since thalidomide exhibits low oral bioavailability due to limitations in solubility, inclusion complexation using sulfobutyl ether-7 β-cyclodextrin was used to improve the delivery of thalidomide. Our main goals were to increase the solubility, bioavailability as well as chemical stability of thalidomide through complexation with anionic β-cyclodextrin, to characterize the complex in solid state using differential scanning calorimetry, X-ray powder diffractometry, and to explore thalidomide's antitumorigenic and antiangiogenesis potential when administered orally as free and in combination with cyclodextrin to experimental animals. The aqueous solubility and aqueous alkaline stability of thalidomide was markedly increased by the SBE7βCD complexation. Thalidomide administered orally in combination with SBE7βCD, led to a significant delay in tumor formation as a result of improved cellular drug absorption, distribution through solubilization in experimental animals. The improved pharmacological efficacy of the thalidomide-cyclodextrin complex compared to free thalidomide in mouse melanoma model suggest that such a delivery system may be useful for the improved therapeutics of thalidomide, in vivo.     

吉西他滨联合卡铂治疗老年晚期非小细胞肺癌的疗效分析

目的评价老年晚期非小细胞肺癌患者吉西他滨联合卡铂化疗的疗效、毒副反应及耐受性。方法对住院治疗的21例老年晚期非小细胞肺癌患者采用吉西他滨1.0g/m2 d1,d8静滴,卡铂AUC=5 d1静滴,21d为一周期,至少治疗2个周期。2个周期后评价疗效及毒副反应,并随访评判缓解期及生存期。结果21例患者中,无CR病例,PR10例,SD6例,PD5例,总有效率(CR PR)为47.6%,中位生存时间10.6个月(7～23个月),1年生存率46%。主要毒副反应:骨髓抑制,Ⅲ～Ⅳ度白细胞、血小板下降发生率分别为14.3%和4.8%。结论吉西他滨联合卡铂治疗晚期非小细胞肺癌疗效较好,毒副反应轻,患者耐受好,是一个较理想的化疗方案。     

奥美拉唑在晚期非小细胞肺癌患者化疗中的疗效观察

目的观察奥美拉唑在晚期非小细胞肺癌患者化疗中的临床应用价值。方法将67例晚期非小细胞肺癌（Ⅳ期）患者按随机数字表法分为观察组（n=37）和对照组（n=30）,2组均给予含铂两药联合化疗方案进行治疗。对照组在化疗第1天给予常规止吐药恩丹西酮、地塞米松、胃复安等;观察组在化疗第1天给予常规止吐药后,另给予奥美拉唑40mg静脉注射,开始每12h1次,1～2d后改为每日1次,用至化疗结束后1～2d。对2组患者出现的胃肠道反应和原始化疗方案疗程次数进行比较。结果观察组恶心、呕吐总有效率分别为89．2％、75．7％,对照组恶心、呕吐总有效率分别为66．7％、63．3％,2组比较差异均有统计学意义（均P〈0．05）。观察组原始化疗方案疗程次数多于对照组（P〈0．05）。结论奥美拉唑对化疗药物引起的胃肠道反应有一定的预防作用,对延缓化疗药物耐药可能有一定作用。     

~（125）碘粒子植入联合化疗治疗中晚期肺癌

目的探讨125碘（125I）粒子植入联合化疗治疗中晚期肺癌的临床价值。方法选择不同病理类型中晚期非小细胞肺癌181例：CT引导下经皮穿刺植入125I粒子,3d后给予顺铂＋吉西他滨化疗（Ⅰ组,26例）;单纯给予顺铂＋吉西他滨化疗（Ⅱ组,66例）;在给予50～70Gy外照射同时给予顺铂＋吉西他滨化疗（Ⅲ组,89例）。治疗6个月后评价3组疗效及毒副作用。结果Ⅰ组有效率76.9%（20/26）,其中完全缓解率（CR）7.7%（2/26）,部分缓解率（PR）69.2%（18/26）,无效率（NC）15.4%（4/26）,进展率（PD）7.7%（2/26）;Ⅱ组有效率53.0%（35/66）,其中CR、PR、NC、PD分别为3.0%（2/66）、50.0%（33/66）、31.8%（21/66）和15.2%（10/66）;Ⅲ组有效率84.3%（75/89）,其中CR、PR、NC、PD分别为7.9%（7/89）、71.9%（64/89）、16.9%（15/89）和3.3%（3/89）。Ⅱ组与Ⅰ、Ⅲ组有效率比较,差异有统计学意义（P〈0.05）,Ⅲ组与Ⅰ组有效率比较,差异无统计学意义（P〉0.05）。粒细胞减少发生率Ⅰ、Ⅱ、Ⅲ组分别为38.5%（10/26）、34.8%（23/66）、60.7%（54/89）,Ⅰ组与Ⅱ组比较差异无统计学意义（P〉0.05）,Ⅲ组与Ⅰ、Ⅱ组比较差异有统计学（P〈0.05）。结论 125I粒子植入联合化疗治疗晚期肺癌有效率高,且毒副作用低。     

In Vitro Evaluation of Rigosertib Antitumoral and Radiosensitizing Effects against Human Cholangiocarcinoma Cells

Cholangiocarcinoma is the first most common cancer of the biliary tract. To date, surgical resection is the only potentially curative option, but it is possible only for a limited percentage of patients, and in any case survival rate is quite low. Moreover, cholangiocarcinoma is often chemotherapy-resistant, and the only drug with a significant benefit for patient’s survival is Gemcitabine. It is necessary to find new drugs or combination therapies to treat nonresectable cholangiocarcinoma and improve the overall survival rate of patients. In this work, we evaluate in vitro the antitumoral effects of Rigosertib, a multi-kinase inhibitor in clinical development, against cholangiocarcinoma EGI-1 cell lines. Rigosertib impairs EGI-1 cell viability in a dose- and time-dependent manner, reversibility is dose-dependent, and significant morphological and nuclear alterations occur. Moreover, Rigosertib induces the arrest of the cell cycle in the G2/M phase, increases autophagy, and inhibits proteasome, cell migration, and invasion. Lastly, Rigosertib shows to be a stronger radiosensitizer than Gemcitabine and 5-Fluorouracil. In conclusion, Rigosertib could be a potential therapeutic option, alone or in combination with radiations, for nonresectable patients with cholangiocarcinoma.     

Low-Molecular-Weight Fucoidan as Complementary Therapy of Fluoropyrimidine-Based Chemotherapy in Colorectal Cancer

This study investigated the roles of low-molecular-weight fucoidan (LMWF) in enhancing the anti-cancer effects of fluoropyrimidine-based chemotherapy. HCT116 and Caco-2 cells were treated with LMWF and 5-FU. Cell viability, cell cycle, apoptosis, and migration were analyzed in both cell types. Potential mechanisms underlying how LMWF enhances the anti-cancer effects of fluoropyrimidine-based chemotherapy were also explored. The cell viability of HCT116 and Caco-2 cells was significantly reduced after treatment with a LMWF-–5FU combination. In HCT116 cells, LMWF enhanced the suppressive effects of 5-FU on cell viability through the (1) induction of cell cycle arrest in the S phase and (2) late apoptosis mediated by the Jun-N-terminal kinase (JNK) signaling pathway. In Caco-2 cells, LMWF enhanced the suppressive effects of 5-FU on cell viability through both the c-mesenchymal–epithelial transition (MET)/Kirsten rat sarcoma virus (KRAS)/extracellular signal-regulated kinase (ERK) and the c-MET/phosphatidyl-inositol 3-kinases (PI3K)/protein kinase B (AKT) signaling pathways. Moreover, LMWF enhanced the suppressive effects of 5-FU on tumor cell migration through the c-MET/matrix metalloproteinase (MMP)-2 signaling pathway in both HCT116 and Caco-2 cells. Our results demonstrated that LMWF is a potential complementary therapy for enhancing the efficacies of fluoropyrimidine-based chemotherapy in colorectal cancers (CRCs) with the wild-type or mutated KRAS gene through different mechanisms. However, in vivo studies and in clinical trials are required in order to validate the results of the present study.