奈达铂联合调强放疗对局部晚期鼻咽癌的疗效的作用分析

目的：分析奈达铂联合强调放疗在局部晚期鼻咽癌患者中的疗效。方法：选择我院局部晚期鼻咽癌患者87 例,随机分为两个组,分别是奈达铂组（A组）和顺铂组（B组）,对两组患者接受治疗后的近期疗效、远期疗效以及毒性反应进行比较分析。结果：A、B两组患者鼻咽原发灶完全缓解（CR）率分别为91.8%、86.8%（P=0.632〉0.05）,颈部淋巴结转移灶的完全缓解（CR）率分别为87.8%、84.2%（P=0.864〉0.05）,均不存在统计学显著性差异。A、B 两组患者3 年的总生存率（OS）分别为：81.6%、78.9%,P=0.762;局部控制率（LC）分别为：93.9%、94.7%,P=0.890;两组患者3 年的区域控制率（RC）分别为：98.0%、97.3%,P=0.849;两组患者3年的无远处转移生存率（DMFS）分别为：79.6%、76.3%,P= 0.724。A 组患者Plt 下降发生率为46.9%显著高于B 组发生率34.2%（P〈0.05）,具有统计学显著性差异;A 组患者恶心呕吐的发生率36.7%显著低于B 组患者的发生率76.3%（P〈0.05）,具有统计学显著性差异;其余毒性反应的发生率均不存在统计学显著性差异（P〉0.05）。结论：奈达铂联合强调放疗治疗局部晚期鼻咽癌的近期疗效与远期疗效与顺铂相当,但是奈达铂胃肠道不良反应发生率较顺铂低,血小板的降低程度比顺铂更加严重。     

奈达铂或顺铂联合依托泊苷治疗小细胞肺癌的临床研究

目的:比较奈达铂和顺铂联合依托泊苷治疗小细胞肺癌(SCLC)的近期疗效和安全性。方法:选择2012年5月至2013年8月在我院确诊为小细胞肺癌的59例患者为研究对象,将其随机分为两组。奈达铂组给予奈达铂80 mg/m2静滴,d1;依托泊苷100mg/m2静滴,d1;3周为1周期。顺铂组给予顺铂25 mg/m2静滴,d1~3;依托泊苷剂量及用法同奈达铂组。参照RECIST 1.0和NCI 3.0标准评价和比较两组的近期疗效和不良反应的发生情况。结果:奈达铂组的客观有效率为51.6%,顺铂组为46.4%,两组比较差异无统计学意义(P=0.691)。奈达铂组与顺铂组血小板、白细胞降低及贫血的发生率比较差异无统计学意义(P0.05),但奈达铂组胃肠道反应及肾功能异常的发生率明显低于顺铂组,差异有统计学意义(P0.05)。结论:奈达铂联合依托泊苷治疗小细胞肺癌的疗效与顺铂联合依托泊苷相当,但其胃肠道反应和肾毒性的更少,安全性更高。     

奈达铂联合5 氟尿嘧啶对晚期食管癌患者CEA及SCC 水平的影响及其临床疗效

目的:探讨奈达铂联合5-氟尿嘧啶对食管癌晚期患者CEA,SCC及临床疗效的影响。方法:收集我院收治的食管癌晚期患者60例,随机分为对照组和实验组,每组各30例,对照组患者给予顺铂+5-氟尿嘧啶的化疗方案,实验组患者给予奈达铂+5-氟尿嘧啶方案化疗。观察并比较两组患者治疗前后血清CEA及SCC水平的变化情况、毒副反应发生率以及临床疗效。结果:与治疗前相比,两组患者治疗后CEA及SCC水平均降低,差异具有统计学意义(P0.05);与对照组相比,实验组患者治疗后CEA及SCC水平较低,差异具有统计学意义(P0.05);与对照组比较,实验组患者毒副反应发生率较低,差异具有统计学意义(P0.05);与对照组比较,实验组患者治疗有效率较高,差异具有统计学意义(P0.05)。结论:奈达铂联合5氟尿嘧啶能够降低食管癌晚期患者CEA、SCC以及毒副反应发生率,提高治疗效果。     

周剂量奈达铂联合调强放疗对复发鼻咽癌的近期疗效分析

目的:探讨周剂量奈达铂化疗联合调强放疗对于复发鼻咽癌患者的近期疗效及安全性.方法:将2009年2月至2012年2月本院收治的56例鼻咽癌复发患者随机分为联合治疗组与单纯放疗组,两组患者均给予适形调强放疗,联合治疗组患者在此基础上给予周剂量奈达铂化疗治疗,比较两组患者的临床疗效、并发症的发生情况及近期生存情况.结果:联合治疗组和单纯放疗组的有效率分别为78.6％和50.0％,联合治疗组有效率显著高于单纯放疗组(P＜0.05);联合治疗组白细胞减少发生率显著高于单纯放疗组(P＜0.05),其他并发症的发生率比较无显著差异(P＞o.05);联合治疗组1年、2年生存率分别为85.7％、64.3％,显著高于单纯放疗组的60.7％、42.9％(P＜0.05).结论:联合周剂量奈达铂化疗能够显著提高复发鼻咽癌患者调强放疗的临床疗效,且未增加严重并发症风险,值得临床推广应用.     

紫杉醇联合洛铂治疗LACC患者的疗效评价

为了探讨紫杉醇联合洛铂在局部晚期宫颈癌(LACC)患者术前新辅助化疗中的效果以及对患者血清肿瘤标记物和预后的影响。本研究选取在我院实施新辅助化疗的58例LACC患者进行研究,其中29例患者采用紫杉醇联合洛铂新辅助化疗方案(A组)、29例患者采用紫杉醇联合顺铂治疗(B组),两组患者均实施根治性宫颈癌手术治疗,对比两组患者的近期疗效、血清肿瘤标记物、毒副反应发生率及远期预后。研究发现,A组患者的缓解率82.75%、总有效率100%,B组患者的缓解率68.97%、总有效率96.55%,两组间比较差异均不具有统计学意义(p0.05);化疗后,A组和B组患者的血清CYFRA21-1、SCCAg水平较化疗前均显著的降低(p0.05);化疗过程中,A组患者的恶心呕吐、腹泻发生率分别为17.24%、6.90%,B组患者的恶心呕吐、腹泻发生率分别为48.28%、62.07%,两组比较差异具有统计学意义(p0.05);36个月随访,A组总生存率为68.97%(20/29)、B组患者的总生存率为62.07%(18/29),两组比较差异无统计学意义(χ~2=0.305,p=0.5810.05);两组患者的生存函数曲线分析,生存时间比较差异无统计学意义(z=0.381,p=0.5370.05)。说明紫杉醇联合洛铂在LACC患者术前新辅助化疗中与紫杉醇联合顺铂的效果相当,但是紫杉醇联合洛铂相对毒副反应发生率更低,提高了患者的治疗依从性,可以成为目前LACC治疗的首选方案,但未来还需进一步研究来提高其治疗效果。     

TP新辅助化疗方案治疗Ib-Ⅱa期局部晚期宫颈癌的临床效果观察

目的：观察并探讨宫颈癌术前行TP与PF两种新辅助化疗方案的临床效果,优选新辅助化疗方案。方法：将2008年1月-2010年12月间入选的91例Ib-Ⅱa宫颈癌患者随机分为A（n=46）、B（n=45）两组,A组患者子宫切除术前予TP新辅助化疗方案,B组予PF方案,各2个周期,对比化疗结束后两组临床疗效、化疗期间药物毒性反应及术后2年内宫颈癌复发率。结果：①A、B两组总体有效率分别为89.1%、82.2%,差异不具有统计学意义（P〉0.05）,但前者化疗后瘤体直径明显小于B组（P〈0.05）;②两组药物毒性反应构成不具有统计学差异（P〉0.05）,但A组胃肠道反应与肝脏毒性发生率明显低于B组（P〈0.05）;③A、B两组组术后2年内宫颈癌复发率分别为2.2%、11.9%,复发率无统计学差异（P〉0.05）。结论：宫颈癌术前TP新辅助化疗方案较之BIP方案具有比较优势,更具备临床推广价值。     

培美曲塞+顺铂方案诱导化疗联合同期放化疗对局部晚期非小细胞肺癌的近期疗效及安全性观察

目的:探究培美曲塞+顺铂方案诱导化疗联合同期放化疗对局部晚期非小细胞肺癌的近期疗效及安全性。方法:收集我院肿瘤科2009年7月到2011年7月住院治疗的局部晚期非鳞癌非小细胞癌患者54例,按照随机数字表法分为研究组和对照组,每组27例,研究组给予培美曲塞+顺铂方案诱导化疗联合同期放化疗,对照组仅给予培美曲塞+顺铂方案化疗联合同期放疗,治疗2个周期,随访2年,对比两组患者的近期疗效及安全性。结果:研究组的近期有效率和控制率分别为55.56%、77.78%,高于对照组的50.33%和59.26%,有效率和控制率差异具有统计学意义(P0.05)。随访2年,研究组的中位生存期为12.77个月,1年生存率为48.15%,高于对照组中位生存期11.28个月,1年生存率40.74%,但差异无统计学意义(P0.05),研究组2年生存率为43.46%,高于对照组的25.38%,差异具有统计学意义(P0.05);研究组白细胞减少以及脱发发生率分别为37.0%、25.9%,低于对照组的81.5%和55.5%,差异具有统计学意义(均P0.05);研究组中血小板减少、血红蛋白减少、呕吐、肝功能损害、肾功能损耗、皮疹等发生率分别为40.7%、22.2%、59.2%、11.1%、7.4%、14.8%,高于对照组中各不良反应发生率分别为33.3%、18.5%、55.5%、14.8%、11.1%、7.4%,但两组间差异无统计学意义(P0.05)。结论:培美曲塞+顺铂方案诱导化疗联合同期放化疗对局部晚期非小细胞肺癌治疗效果明显,且不良反应少,可作为临床上晚期非小细胞肺癌化疗一线药物。     

替吉奥联合顺铂治疗晚期胃癌临床疗效研究

目的:研究替吉奥联合顺铂治疗晚期胃癌的疗效和安全性.方法:42例晚期胃腺癌患者随机分为观察组(21例)与对照组(21例)两组,观察组采用替吉奥联合顺铂,对照组采用卡培他滨联合顺铂.结果:两组患者疗效间差异无统计学意义(P＞0.05).两组的不良反应主要为骨髓抑制、消化道反应和乏力,观察组Ⅲ～Ⅳ度血小板减少发生率显著低于对照组(P＜0.05),Ⅲ～Ⅳ度手足综合征的发生率亦显著低于对照组(P＜0.05).结论:替吉奥联合顺铂治疗晚期胃癌疗效与卡培他滨联合顺铂相当,但其患者耐受性更好,值得临床进一步研究推广使用.     

调强适形放疗联合化疗治疗局部晚期食管癌的疗效观察

目的:观察调强适形放疗(intensity modulated radiation therapy,IMRT)联合多西他赛、奈达铂方案化疗同步治疗局部晚期食管癌的疗效及安全性。方法:选择66例局部晚期食管癌患者为研究对象,将其随机分为2组,其中常规放疗组(A组)共30例,采用常规照射方法,6/8 MV高能X线,2.0 Gy/次,5次/周;40 Gy/20次后再次定位剂量达60~66 Gy,强调放疗组(B组)共36例,采用强调适应性放疗,6/8MV-X射线照射,以95%等剂量线包绕PTV(计划靶区),处方剂量GTV(肿瘤区)66 Gy/30次,CTV(临床靶区)60 Gy/30次,PTV 60 Gy/30次,每天1次,每周5次。强调放疗组同期接受IMRT和多西他赛、柰达伯化疗,21天1个周期,连续2个周期。治疗结束后根据实体瘤疗效评价标准(RECIST)评定临床疗效;参照WHO毒性反应分度标准评价毒副反应。结果:常规放疗组和强调放疗组的总有效率分别为46.66%和91.67%(x2=17.26,P0.05);常规放疗组的毒副反应发生率显著高于强调放疗组,包括骨髓抑制、放射性食管炎和消化道反应的发生率存在显著差异(P0.05)。结论:调强适形放疗联合多西他赛、奈达铂化疗同步治疗局部晚期食管癌疗效较好,毒副反应可耐受,具有潜在的推广应用价值,值得临床进一步研究。     

多西紫杉醇与紫杉醇联合顺铂同步放化疗治疗晚期宫颈癌的疗效比较

目的:比较多西紫杉醇与紫杉醇联合顺铂同步放化疗治疗晚期宫颈癌的疗效。方法:选择2006年6月至2012年6月我院收治的宫颈癌晚期患者180例作为研究对象,依据随机数字表将患者分为紫杉醇组(n=90)和多西紫杉醇组(n=90),两组患者在放疗基础上分别接受紫杉醇135 mg/m~2,每周1次,多西紫杉醇25 mg/m~2,每周1次,4周一疗程,维持两个疗程,比较两组患者的近期疗效、生存时间和毒副作用发生情况。结果:紫杉醇和多西紫杉醇组近期治疗的总有效率分别为81.11%和87.78%,差异无统计学意义(P=0.217);且均未出现进展期的病例。紫杉醇组3年生存率为58.89%,明显低于多西紫杉醇组的75.56%,差异有统计学意义(P=0.017);紫杉醇组骨髓抑制和消化道反应的发生率分别为35.56%和37.78%,明显高于多西紫杉醇组的22.22%和26.67%,差异有统计学意义(均P0.05)。结论:多西紫杉醇联合顺铂同步放化疗治疗晚期宫颈癌能显著提高患者3年生存率,降低毒副作用发生率,且用药量更少,相对安全、合理,患者可耐受,值得进一步临床研究。     

Recent advances in the study of Kaposi's sarcoma-associated herpesvirus replication and pathogenesis

It has now been over twenty years since a novel herpesviral genome was identified in Kaposi's sarcoma biopsies. Since then, the cumulative research effort by molecular biologists, virologists, clinicians, and epidemiologists alike has led to the extensive characterization of this tumor virus, Kaposi's sarcoma-associated herpesvirus(KSHV; also known as human herpesvirus 8(HHV-8)), and its associated diseases. Here we review the current knowledge of KSHV biology and pathogenesis, with a particular emphasis on new and exciting advances in the field of epigenetics. We also discuss the development and practicality of various cell culture and animal model systems to study KSHV replication and pathogenesis.     

A Unique Protease Cleavage Site Predicted in the Spike Protein of the Novel Pneumonia Coronavirus (2019-nCoV) Potentially Related to Viral Transmissibility

正Dear Editor,In December 2019, a novel human coronavirus caused an epidemic of severe pneumonia(Coronavirus Disease 2019,COVID-19) in Wuhan, Hubei, China(Wu et al. 2020; Zhu et al. 2020). So far, this virus has spread to all areas of China and even to other countries. The epidemic has caused 67,102 confirmed infections with 1526 fatal cases     

Curcuminoids as inhibitors of thioredoxin reductase: A receptor based pharmacophore study with distance mapping of the active site

Curcumin is the yellow pigment of turmeric that interacts irreversibly forming an adduct with thioredoxin reductase (TrxR), an enzyme responsible for redox control of cell and defence against oxidative stress. Docking at both the active sites of TrxR was performed to compare the potency of three naturally occurring curcuminoids, namely curcumin, demethoxy curcumin and bis-demethoxy curcumin. Results show that active sites of TrxR occur at the junction of E and F chains. Volume and area of both cavities is predicted. It has been concluded by distance mapping of the most active conformations that Se atom of catalytic residue SeCYS498, is at a distance of 3.56 from C13 of demethoxy curcumin at the E chain active site, whereas C13 carbon atom forms adduct with Se atom of SeCys 498. We report that at least one methoxy group in curcuminoids is necessary for interation with catalytic residues of thioredoxin. Pharmacophore of both active sites of the TrxR receptor for curcumin and demethoxy curcumin molecules has been drawn and proposed for design and synthesis of most probable potent antiproliferative synthetic drugs.     

The structure, reproduction and taxonomy of Vidalia and Osmundaria (Rhodophyta, Rhodomelaceae)

Comprises species occurring mostly in subtidal habitats in tropical, subtropical and warm-temperate areas of the world. An analysis of the type species, V. spiralis (Sonder) Lamouroux ex J. Agardh, a species from Australia, establishes basic characters for distinguishing species in the genus. These characters are (1) branching patterns of thalli, (2) flat blades that may be spiralled on their axis, (3) width of the blade, (4) primary or secondary derivation of sterile and fertile branchlets and (5) position of sterile and fertile branchlets on the thalli. Application of the latter two characters provides an important basic method for separation of species into three major groups. Osmundaria , a genus known only in southern Australia, was studied in relation to Vidalia , and its separation from the Vidalia assemblage is not accepted. Species of Vidalia therefore are transferred to the older genus name, Osmundaria. Two new species, Osmundaria papenfussii and Osmundaria oliveae are described from Natal. Confusion in the usage of the epithet, Vidalia fimbriala Brown ex Turner has been clarified, and Vidalia gregaria Falkenberg, described as an epiphyte on Osmundaria pro/ifera Lamouroux, is revealed to be young branches of the host, Osmundaria prolifera.     

New or rare chromosome counts in Artemisia L. (Asteraceae, Anthemideae) and related genera from Kazakhstan

Fifteen chromosome counts of six Artemisia taxa and one species of each of the genera Brachanthemum, Hippolytia, Kaschgaria, Lepidolopsis and Turaniphytum are reported from Kazakhstan. Three of them are new reports, two are not consistent with previous counts and the remainder are confirmations of very scarce (one to four) earlier records. All the populations studied have the same basic chromosome number, x = 9, with ploidy levels ranging from 2x to 6x. Some correlations between ploidy level, morphological characters and distribution are noted.