放疗同步替莫唑胺化疗治疗恶性胶质瘤临床观察

目的研究术后放疗同步替莫唑胺(RT-TMZ)治疗恶性胶质瘤的近期疗效和不良反应。方法收集2008年11月-2009年5月在我院确诊的61例恶性胶质瘤术后患者,按照患者自愿选择的治疗方案分为RT-TMZ组和单纯放疗(RT)组。RT-TMZ组31例,行放疗(总剂量60Gy,共治疗6周)期间同时持续口服替莫唑胺(Temozolomide,TMZ)化疗(75mg/(m2·d),共42d),放疗结束后续行TMZ辅助化疗150-200mg/(m2·d),共4-6个周期;RT组30例,单纯放疗6周,总剂量60Gy。结果RT-TMZ组与RT组有效率(CR+PR)分别为79.3%(23/29)、53.3%(16/30),疾病控制率(CR+PR+SD)分别为89.7%(26/29)、83.3%(25/30),P<0.05。RT-TMZ组6个月无疾病进展生存率为71.0%(22/31),患者对治疗的耐受性良好;不良反应为恶心、呕吐和乏力,白细胞和血小板下降基本限于I-Ⅱ度。结论恶性胶质瘤术后放疗同步替莫唑胺治疗近期疗效良好,不良反应较轻,是切实可行的治疗方案。     

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     

窄波UVB联合外用0.05%丙酸氟替卡松乳膏治疗手部汗疱疹的近期临床疗效观察

探讨窄波UVB联合口服抗组胺药物和局部外用0.05%丙酸氟替卡松乳膏治疗手部汗疱疹的近期临床疗效及安全性。将我院2013年3月至2014年9月诊治的60例手部汗疱疹患者随机分为两组,每组各30例。两组均给予口服氯雷他定片和局部外用丙酸氟替卡松乳膏。其中治疗组同时给予每周三次的窄波UVB照射,对照组无。治疗3周后对两组进行疗效评定及观察不良反应。治疗组有效26例,对照组有效19例;治疗组总有效率(86.67%)明显高于对照组(63.33%),两组间差异有统计学意义(P<0.05)。应用窄波UVB联合口服抗组胺药物和局部外用0.05%丙酸氟替卡松乳膏治疗手部汗疱疹的近期疗效较好,且不良反应少,是临床治疗汗疱疹较好的疗法之一。     

普乐安片联合氟罗沙星治疗慢性前列腺炎临床观察

目的:探索普乐安片联合氟罗沙星胶囊治疗慢性前列腺炎(CP)的效果。方法:患者随机分组,治疗组采用普乐安片﹢氟罗沙星胶囊治疗,对照组单用抗生素治疗,两组疗程相同。治疗前后对每一例患者进行前列腺液检查及NIH-CPSI评分。结果:治疗50天后,治疗组有效率为88.0%;对照组的有效率为37.0%。结论:普乐安片﹢氟罗沙星治疗慢性前列腺炎较单用抗生素效果好。     

体部伽玛刀联合热化疗治疗中晚期肝癌25例临床观察

目的探讨利用体部伽玛刀联合全身热化疗和微量泵化疗对中晚期原发性肝癌进行综合治疗的疗效。方法入院后经检查无全身热疗及化疗禁忌症晚期肝癌患者25例,全身热疗时予氟尿嘧啶1g、羟基喜树碱10mg、奥沙利铂100mg;以后予奥沙利铂100mg/d,8d,静脉滴注;热化疗后第2d起予氟尿嘧啶0.25g/d,14d;羟基喜树碱2mg/d,9d。热化疗3d后进行体部伽玛刀治疗,50～65%的等剂量曲线包绕计划靶区PTV,单次剂量3.2～4.0Gy,10～12次,总剂量为36～44Gy。其中化疗泵治疗间隔2周重复,共4～6周期;全身热疗1～3次,于每次化疗第1天进行。热化疗及伽玛刀治疗结束后分别观察不良反应和近期疗效。结果部分缓解(PR)20例;1年局部病变无进展率为56%(14/25)。1年生存率为76%(19/25),2年生存率40%(10/25)。全身热疗中6例出现下肢或腹部局部皮肤红斑,2例出现小水泡;肝脏急性不良反应Ⅰ级1例。结论伽玛刀联合全身热化疗治疗肝细胞癌安全可靠,有利于提高疗效。     

糖皮质激素联合小剂量三尖杉酯碱治疗系统性红斑狼疮的临床观察

目的观察糖皮质激素联合三尖杉酯碱治疗系统性红斑狼疮(SLE)的疗效。方法36例SLE患者给予强的松0.8~1mg(kg/d),4~8周后开始按每周5mg减量,维持量10~20mg/d;三尖杉酯碱1mg+0.9%氯化钠注射液500ml静脉滴注,5~7d为1个疗程,间隔2~3周,共3~6个疗程。定期检测血常规、24h尿蛋白定量、血肌酐、白蛋白、免疫球蛋白、C3、C4、抗ANA抗体、抗ds-DNA抗体及抗SM抗体水平,比较治疗前后各项指标的变化。结果狼疮活动积分表(SLEDAI)评分由治疗前平均14.36分降至5.16分,24h尿蛋白定量、ESR水平较治疗前明显下降(P<0.05),抗ANA抗体转阴率87.5%,抗ds-DNA抗体、抗SM抗体转阴率分别为87.5%和83.3%。结论糖皮质激素联合三尖杉酯碱治疗SLE具有疗效高,不良反应小,价格低的特点,值得临床应用。     

硼替佐米为主方案治疗难治/复发轻链型多发性骨髓瘤

目的了解硼替佐米对难治／复发性轻链型多发性骨髓瘤的疗效。方法采用BD／BP、BAD／BAP、BAEP及BVAD方案治疗14例轻链型MM患者。结果14例患者中,CR1例,nCR2例,PR5例,ORR8例。6例合并肾功能不全患者与8例肾功能正常患者的疗效相近。不良反应主要有乏力、胃肠道反应、末梢神经炎、血小板减少等,均可耐受。结论硼替佐米对部分已对化疗耐药的难治／复发性轻链型MM仍然有效,且效果显著。     

TDP照射及喜辽妥联合尿激酶对动静脉内瘘并发症的疗效观察及护理

目的:观察TDP照射及喜辽妥联合尿激酶对动静脉内瘘并发症的疗效。方法:采用随机数字法,将96例动静脉内瘘由于穿刺失败等原因所致皮下血肿伴疼痛等并发症的血液透析患者随机分成观察组和对照组,每组48例,观察组采用TDP照射及喜辽妥联合尿激酶局部注射,对照组采取单纯湿热敷后涂抹喜辽妥治疗动静脉内瘘并发症;在治疗3个月后,观察两组患者发生肿胀、内瘘狭窄、栓塞、血管硬化等动静脉内瘘并发症的情况。结果:两组患者在血管弹性、血管杂音、血流量等方面,差异有统计学意义(P﹤0.05)。结论:TDP照射及喜辽妥联合尿激酶治疗对动静脉内瘘保护作用较强,能明显降低动静脉内瘘并发症的发生。     

超脉冲CO2激光点阵疗法联合曲安奈德治疗增生性瘢痕的疗效观察

目的：观察超脉冲CO2激光点阵疗法联合曲安奈德治疗增生性瘢痕的效果。方法：对60例增生性瘢痕患者,采用超脉冲CO2（能量50至100mJ／脉冲,频率10至20脉冲／min）每间隔0．5cm麝削增性瘢痕0．5＊O．5—F大小面积至正常皮肤平面,然后以激光焦点距离每间隔0．1cm呈点阵状打孔约0．1cm,再涂抹40mg／ml曲安奈德,约10至15天创面愈合后、进行间隔部位治疗,间隔周期均为10至15天。结果：接受该方案治疗的60例患者中,治愈53例,显效7例,无效0例,总有效率100．00％。不良反应的有2例患者（3．3％）,为创面延迟愈合,其余患者未见明显不良反应。结论：超脉冲CO2激光点阵疗法联合曲安余德治疗增生性瘢痕,具有疗效显著、操作简单、并发症少等优点。     

氦氖激光并伐昔洛韦联合优质护理干预对带状疱疹96例的疗效影响

目的:探讨氦氖激光并伐昔洛韦联合优质护理干预治疗带状疱疹的临床疗效。方法:采用回顾性分析来我院皮肤科就诊并确诊的96例带状疱疹患者临床诊治资料,随机将患者平均分为干预组和对照组。两组均予以肌肉注射维生素B1,B12作为基础治疗;对照组单用伐昔洛韦治疗,干预组使用氦氖激光并伐昔洛韦联合优质护理干预。治疗后4周观察其疗效。结果:干预组患者皮损愈合时间及疼痛解除时间明显少于对照组,干预组患者总愈显率91.67%,明显高于对照组66.67%。随访干预组患者无遗留神经痛。结论:氦氖激光并伐昔洛韦联合优质护理干预治疗带状疱疹,可缩短炎症反应和渗出时间,促使局部蛋白质更新,加速组织愈合,临床疗效显著,安全可靠,值得临床推广。     

Monoclonal antibodies ICO-02 to blast cell antigens in patients with chronic myeloleukemia in blast crisis

Mice were immunized with blood cells of a patient with chronic granulocytic leukemia, and their cells were subsequently used for the preparation of hybridoma ICO-02. This hybridoma is continuously producing monoclonal antibodies which reacted with cells in 4 out of 13 patients with blastic crisis of chronic granulocytic leukemia and in 6 out of 38 patients with acute lymphoblastic leukemia. Antibodies reacted with blast cells in 2 out of 3 patients with undifferentiated blastic crisis of chronic myelocytic leukemia and in 2 out of 5 patients with lymphoid variant of blastic crisis of chronic granulocytic leukemia. Cells of 6 patients with acute lymphoblastic leukemia which reacted with the monoclonal antibodies had immunological markers of T lymphocytes bone-marrow precursors. Monoclonal antibodies did not react with cells of blood and bone marrow from healthy people and from patients with chronic lymphocytic leukemia, acute myeloblastic leukemia, acute myelomonocytic leukemia, acute monoblastic leukemia and lymphosarcoma.     

Ribosome content, spontaneous damage and repairing DNA synthesis in patients with chronic B-lymphocytic leukemia depending on stage and form of disease

The ribosome content (84 patients), DNA alkaline-labile sites or strand breaks (21 patients) and unscheduled DNA synthesis in lymphocytes under normal and B-cell chronic lymphocytic leukemia (B-CLL) were studied. It has been shown that the alkaline-labile DNA damages increased about 3-5 fold while the ribosome content was normal at an early (corresponding to Rai's O-I stages) and an advanced (II-III stages by Rai) stages of B-CLL. In the course of B-CLL, the DNA strand breaks and number of ribosomes per cell decreased with the correlation coefficient r = 0.72. The slowing down of the unscheduled DNA synthesis at the advanced and terminal (IV stage by Rai) B-CLL stages does not correlate with the DNA strand breaks. In the advanced stage with its established clinical variability of forms, when an adequate treatment was necessary, the lymphocyte ribosome levels drop following the expansion of main compartments involved by the leukemic spread.     

Lymphocyte proliferation and differentiation in chronic lympholeukemia

Proliferative activity and differentiation levels of lymphocytes of lymph nodes and peripheral blood of practically healthy people and patients with chronic lymphocytic leukemia have been studied using the present physicochemical methods (autoradiography with labelled DNA and RNA precursors, microspectrocytometry, NMR spectroscopy, kinetic formaldehyde method, etc.). The following points have been stated: stage character of changes in normal and leukemic cells, differences in synthesis of nucleic acids in different periods of the cell cycle in norm and under chronic lymphocytic leukemia, proliferation peculiarities of lymphocytes in lymph nodes and in blood, presence of DNA defects in the process development, changes in lipids of lymphocytes and blood plasma at early stages of the disease and in the process of its development.     

Mast cell-affinity lymphocytes as indicator cells of the forms of hemoblastoses

The formation of mastolymphocyte rosettes was used to determine that in chronic lymphocytic leukemia and bovine leukemia, unlike healthy people and animals as well as patients with solid tumours of different localization and Hodgkin's disease, a large amount of cells appear among peripheral blood lymphocytes having membrane affinity for mast cells. This may be used as an additional criterion in laboratory diagnosis of these diseases.     

Monoclonal antibodies IPO-4 recognizing antigen-activated human T and B lymphocytes

Spleen cells from BALB/c mice previously immunized with B-lymphoblastoid cell line RPMI-1788 were fused with P3-X-63-Ag8.653 myeloma cells. Monoclonal antibodies (Ab) IPO-4 were screened on 18 cell lines by the indirect immuno-fluorescence method. Cryostat sections of tissues were stained according to the PAP technique. The Mab IPO-4 were tested for reactivity with blood cells of 17 healthy persons and 102 patients with chronic lymphocytic leukemia, acute lymphoblastic and myeloblastic leukemias, hairy cell leukemia, multiple myeloma, non-Hodgkin's lymphomas and Hodgkin's disease and mitogen stimulated lymphocytes. MAb IPO-4 were found to be directed against antigen expressed on activated T and B cells.     

后路经椎弓根椎体楔形截骨矫形治疗胸腰椎陈旧性骨折伴后凸畸形

目的：探讨后路经椎弓根椎体楔形截骨矫形治疗胸腰椎陈旧性骨折伴后凸畸形的临床疗效。方法：回顾性分析我科于2006年1月至2010年10月收治的胸腰椎陈旧性骨折伴后凸畸形患者23例,男15例,女8例;年龄23岁至88岁;胸113例,胸127例,腰19例,腰24例;胸腰段（胸10~腰2）后凸畸形Cobb角为32°至66°,平均为46°±2.4°;伤椎后凸Cobb角为16°至42°,平均30°±1.8°。术前神经损伤程度按照ASIA分级：C级3例,D级11例,E级9例;腰背痛VAS评分平均7.84±0.28。23例患者均采用经椎弓根椎体楔形截骨矫形、减压、椎弓根钉系统内固定植骨融合手术治疗。结果：术后胸腰段后凸Cobb角平均12°±1.7°,矫正率74%;伤椎Cobb角为0°至4°,平均2.8°,矫正率91%;术后随访X片,胸腰段Cobb角矫正丢失角度不明显（2°至5°）。术后神经功能ASIA分级：3例C级2例改善至E级,1例为D级;11例D级均改善至E级;腰背痛VAS评分平均为2.9±0.13;内固定物无松动或断裂,无假关节形成等并发症。结论：后路经椎弓根椎体楔形截骨矫形治疗胸腰椎陈旧性骨折伴后凸畸形可重建胸腰段矢状面生理曲度,改善临床症状。     

Different antitumor immunity roles of cytokine activated T lymphocytes from naive murine splenocytes and from dendritic cells-based vaccine primed splenocytes: implications for adoptive immunotherapy

AIM: The aim of the study is to explore the antitumor capacity of effector cells generated from murine splenocytes with sequential addition of a cocktail of cytokines and the possible contribution of dendritic cells to the antitumor capacity of these effector cells. METHODS AND RESULTS: Interferon-gamma, interleukin (IL)-1 beta, anti-CD3 mAb and IL-2 were used to activate murine splenocytes either from naive mice (termed cytokine activated T cells, CAT) or from DC based vaccine primed mice (termed specific effector T cells, SET). The antitumor roles of SET and CAT were analyzed in murine L615 T lymphocytic leukemia. Both CAT and SET were CD4(+)-predominant phenotypically and didn't show any significant cytotoxicity against a variety of syngeneic and allogeneic target cell lines using 51Cr release assay. When injected in vivo in combination with CY, CAT can cure a large proportion of leukemia mice. The cured mice couldn't establish specific antitumor immunity. However, in contrast to the roles of CAT, SET show far superior antitumor efficacy on a per cell basis compared with CAT. Moreover, the SET cured mice developed tumor specific long term memory immunity which was sufficient to reject a subsequent otherwise lethal tumor cells rechallenge and was transferable to naive immunocompetent mice. CONCLUSION: Our data demonstrate that there remain fundamentally different antitumor functions of CAT and SET which might be useful in the immunotherapy strategy choices.     

ILLLI对急性缺血性脑血管病患者血液纤溶功能的影响

急性ICVD患者，随机分入激光综合治疗组和常规药物组，两组患者均予通脉液500ml.川芎嗪100mg静脉滴注，每天一次，十天为一疗程，激光组同时予ILLLI，波长632.8nm，末端输出功率1.5～2.0mW，每次60分钟，每天一次，十天为一疗程。两组患者均在治疗前后四次取血作纤溶功能动态检测。结果表明，ILLLI具有降低血浆纤维蛋白原含量，降低PAI活性，增强t—PA活性，增加血浆FDP和D—Dimer含量的作用。能够激活患者的纤溶功能.是ILLLII治疗ICVD的机理之一。     

Enhanced antitumor action of 5-fluorouracil when used in combination with 4-methylmercaptopyrazolo[3,4-d]pyrimidine 1-nucleoside

Mice BDF1 with L 1210 or mice BALB/c with plasmacytoma MOPS-406 after pretreatment with ineffective doses of 1-beta-D-ribofuranosyl-4-methylmercaptopyrazolo(3,4-d)pyramidin e (25 to 100 mg/kg per 5 days) were treated with 5-fluorouracil at the optimal dose 100 mg per day. This combination produced a 1.5-2-fold or 2 to 4 fold enhancement of the antitumour effect of 5-fluorouracil without simultaneous increase of lethal toxicity.     

ICO-10 monoclonal antibodies to the Thy-1 antigen

Mouse monoclonal antibodies (MAB) ICO-10 to Thy-1 antigen were obtained. MAB ICO-10 reacted in indirect immunofluorescence test with 5.7 +/- 0.8% human thymocytes. Antibodies did not react with granulocytes, monocytes, T- and non-T cells from peripheral blood, and with marrow cells of healthy donors. MAB ICO-10 reacted with blast cells from 25 of 53 patients with T-cell acute lymphoblastic leukemia (ALL), from 2 of 5 patients with B-cell ALL. This antigen was absent on blood and marrow cells from some patients with ALL, 80 patients with chronic lymphoid leukemia, 54 patients with chronic granulocytic leukemia at the stage of blastic crisis, 128 patients with acute nonlymphoblastic leukemia. Antibodies are specifically bound to thymocytes and spleen cells of Thy 1.1 and Thy 1.2 mice. MAB ICO-10 detect Thy-1 antigen expressed on human hematopoietic cells. MAB ICO-10 may be applied for human leukemia and lymphoma immune diagnosis.