补肾解毒化瘀方联合CPT化疗方案治疗老年多发性骨髓瘤临床观察

目的 观察补肾解毒化瘀方联合CPT化疗方案治疗老年多发性骨髓瘤的临床疗效及其对免疫功能的影响。方法 将40例老年多发性骨髓瘤患者随机分为治疗组与对照组,每组20例,两组均采用CPT化疗方案,28 d为1个周期,6个周期评价疗效;治疗组同时加用补肾解毒化瘀方治疗。观察临床疗效、生活质量变化及中医临床症状改善情况,治疗前后分别观察血管内皮生长因子（vascular endothelial growth factor, VEGF）、白细胞介素-6（interleukin-6, IL-6）及调节性T细胞的水平变化情况。结果 治疗组与对照组近期疗效分布差异无统计学意义(P＞0.05);治疗组骨痛缓解效果显著优于对照组（P<0.05）;治疗组生活质量改善效果优于对照组(P＜0.05);中医临床证候改善方面,治疗组优于对照组(P＜0.05)。治疗前两组VEGF、IL-6水平差异无统计学意义(P＞0.05),治疗3个月及6个月后均显著下降（P＜0.05）,且治疗组VEGF、IL-6水平较对照组下降显著(P＜0.05)。调节性T细胞表达比较,治疗前患者CD4+CD25+、CD4+CD25high、CD4+CD25highCD127low细胞比例均显著升高（P＜0.05）,但治疗后两组细胞比例均显著下降(P＜0.05),且治疗组细胞比例较对照组下降更明显(P＜0.05)。结论 补肾解毒化瘀方联合CPT化疗方案治疗多发性骨髓瘤有助于改善患者临床症状,提高免疫功能。     

化学治疗合臭氧穴位注射对中晚期非小细胞肺癌患者生命质量的影响

目的 观察臭氧穴位注射合化学治疗对中晚期非小细胞肺癌患者生存质量的改善作用。方法 将65例原发性非小细胞肺癌患者分为对照组（32例）和观察组（33例），分别采用常规化学治疗和常规化学治疗联合臭氧穴位注射治疗，以Karnofsky评分变化评估两组患者的生命质量。 结果 观察组Karnofsky评分升高率显著高于对照组（P<0.05）；观察组白细胞分级显著优于对照组（P<0.05），其白细胞分级显著偏于0级和Ⅰ级。结论 臭氧穴位注射联合常规化学治疗方案可显著改善中晚期非小细胞肺癌患者的生存质量，降低化学治疗药物的不良反应。     

丹参注射液联合5-氟脲嘧啶腹腔化疗抗鼠胃肿瘤的实验研究

目的:观察丹参注射液对5-氟脲嘧啶(5-FU)抗肿瘤活性的增强作用及其对5-FU毒性和不良反应的减轻作用,为中药对抗肿瘤药的增效减毒作用提供实验依据。方法:应用Walker-256细胞株建立鼠种植性胃肿瘤模型,将60只Wistar雄性胃肿瘤大鼠随机分为3组:9.0 g/L氯化钠注射液(NS)组、5-FU组、5-FU 丹参组。接种后第7天,NS组每只每天腹腔注入NS,5-FU组每只每天腹腔注入5-FU,5-FU 丹参组每只每天腹腔注入5-FU 丹参,3组均连用5 d。于腹腔化疗结束后第7天每组处死10只大鼠。观察肿瘤体积抑制率、血常规、肝肾功能、细胞凋亡、大鼠生存时间。结果:①5-FU组和5-FU 丹参组鼠胃肿瘤生长明显缓慢,肿瘤体积较NS组明显减小(P(0.05,P(0.01),肿瘤体积抑制率分别为36.57%、59.44%(P(0.05);5-FU组和5-FU 丹参组鼠生存时间明显延长,生存时间延长率分别为23.7%、38.7%(P(0.05)。②与NS组相比,5-FU组和5-FU 丹参组外周血WBC、PLT明显减少,血清ALT、AST、Cr、BUN明显升高,差异均有显著性(P(0.05,P(0.01);与5-FU组相比,5-FU 丹参组WBC、PLT显著升高,而ALT、AST、Cr、BUN显著下降(P(0.05,P(0.01)。③与NS组相比,5-FU组和5-FU 丹参组凋亡面积增大,光密度明显升高(P(0.05,P(0.01);而5-FU 丹参组与5-FU组比较,差异也有显著性(P(0.05,P(0.01)。结论:丹参注射液可增强5-FU诱导肿瘤细胞分化与凋亡,并能减轻5-FU所致的骨髓抑制和肝肾功能损害。     

Cardiac Sudden Death as a Result of Acute Coronary Artery Thrombosis During Chemotherapy for Testicular Carcinoma

Abstract: We report the first acute coronary fibrin thrombus arising upon atherosclerosis detected at autopsy in a man receiving chemotherapy for testicular carcinoma. The decedent was a smoker with no other known atherosclerotic risk factors. Histology revealed superficial atherosclerotic plaque erosion with endothelial necrosis and no intraplaque hemorrhage. A focus of intimal lymphoid infiltrates was noted away from the plaque. These findings raise the possibility of chemotherapy‐induced vascular damage as a factor in thrombogenesis. A review of Pubmed was performed which documented clinical reports of an association of chemotherapy with acute cardiac ischemia but no well described autopsy findings. Our case highlights the need for careful assessment of the coronary system in chemotherapy patients dying suddenly, particularly in the absence of significant atherosclerotic risk factors. Such postmortem examination will ensure thorough death investigation and may elucidate the pathogenesis of thrombosis with potential reduction in cardiac ischemic risks of chemotherapy patients.     

Dental and Chronological Age in Children Under Oncological Treatment

The current oncology treatment has improved the survival of children with several types of cancer, and the effect of radiotherapy and/or chemotherapy treatment on dental maturation in comparison with chronological age is not widely known. The aim of this work was to evaluate and compare the impact of radiotherapy and/or chemotherapy treatment during dental maturation with chronological age in Chilean children diagnosed with cancer. Study Design was cross‐sectional study on children diagnosed with different types of cancer and treated with radiotherapy and/or chemotherapy when they were ages of 0.1 to 13 years. Demirjian tables for both girls and boys are used to determine the dental age. The association between chronological and dental age was highly significant. Nevertheless, a linear relation between chronological and dental age was not observed when the data were stratified by BMI and type of treatment. This study confirmed that dental age is an indicator of chronological age but that other variables, such as body mass index, in children with cancer could be confounder variables. Thus, further studies are necessary to investigate the influence of BMI on tooth eruption/maturation in children under oncological treatment.     

微调三号方合化学疗法对Ⅳ期胃癌患者生存质量的影响

目的 观察微调三号方联合XELOX方案（希罗达+奥沙利铂）对Ⅳ期胃癌患者生存质量的疗效。方法 将51例Ⅳ期胃癌患者随机分为治疗组和对照组，治疗组26例采用微调三号方联合XELOX方案化学治疗，对照组25例单纯接受XELOX方案化学治疗。采用欧洲癌症研究与治疗组织生命质量核心量表（European organization for research and treatment of cancer quality of life core questionnaire 30，EORTC QLQ-C30）及体力状况Karnofsky评分标准，进行两组生存质量的对照观察。结果 治疗组在改善Ⅳ期胃癌患者EORTC QLQ-C30量表的乏力、恶心呕吐、失眠、食欲丧失、腹泻、总体健康状况及提高Karnofsky评分方面显著优于对照组（P＜0.05，或P<0.01）。结论 微调三号方联合XELOX方案治疗能够提高Ⅳ期胃癌患者的生存质量。     

辨证治疗化疗相关性腹泻26例

目的 观察化疗相关性腹泻(chemotherapy induced diarrhea,CID)中医辨证论治的疗效.方法 将38例CID患者分为治疗组和对照组,治疗组26例采用中医辨证治疗,对照组12例采用黄连素、思密达或易蒙停治疗.结果 治疗组脾虚型、湿热型、脾肾阳虚型、肝郁脾虚型分别为14、10、1、1例,有效例数分别为11、7、1、1例;治疗组和对照组总有效率分别为76.9%、50.0%,两组总有效率比较,差异无统计学意义(P>0.05).结论 CID的常见证型为脾虚型、脾肾阳虚型,辨证治疗有较好的疗效.     

216例辅助化学治疗期乳腺癌患者中医证候分布和演变规律研究

目的探讨辅助化学治疗期乳腺癌患者的中医证候及其变化规律。方法采集216例辅助化学治疗期乳腺癌患者的四诊信息,通过聚类分析结果结合专家经验归纳出中医证候的分布和演变规律。结果化学治疗开始前患者多表现为脾虚与肝郁两证,第2周期化学治疗结束后患者表现为脾气虚证、肝郁化火证、心肝实热证,第4周期化学治疗结束后患者表现为肝、脾、胃三脏阴血不足为主的证候,第6周期化学治疗结束后患者出现心、肝、脾、胃等多脏腑不足的证候。结论在辅助化学治疗期,患者中医证型总体以虚证为主;在化学治疗前期,主要为肝脾两脏的气病;随着化学治疗的延续,由阳病转为阴病;后期患者逐渐表现为类似五脏羸弱的证候。