自噬通路基因多态性与晚期非小细胞肺癌含铂化疗疗效的相关性分析

对晚期非小细胞肺癌患者采用含铂化疗是肺癌临床治疗中非常重要的方法,然而不同患者对含铂化疗的敏感性却存在着明显的个体差异,这提示发现潜在的分子标志物对预测临床中含铂化疗疗效具有关键作用。本研究旨在探索自噬通路基因多态性与晚期非小细胞肺癌含铂化疗疗效之间的相关性,以期寻找可能影响含铂化疗药物敏感性的分子标记。本研究纳入了1004例接受含铂化疗的晚期非小细胞肺癌患者,分析了自噬通路中13个基因上的99个SNP位点与含铂化疗临床获益、无疾病进展时间及总生存时间之间的相关性。研究发现,位于ULK1基因的位点rs7953348(G>A) (P=0.017, OR:0.67, 95%CI:0.49~0.93)和rs12303764(A>C) (P=0.009, OR:0.63, 95%CI:0.45-0.89)及位于ATG14基因上的位点rs17742719(C>A) (P=0.002, OR:1.83, 95%CI:1.26~2.66)、rs8003279(A>G) (P=0.006, OR:1.65, 95%CI:1.16~2.35)和rs1009647(G>A) (P=0.002, OR:1.70, 95%CI:1.22~2.37)与临床获益存在显著关联,位于DRAM基因上的位点rs7955890(G>A) (P=0.004, HR:0.63; 95%CI:0.46~0.86)和rs17032060(G>A) (P=0.006, HR:0.65, 95%CI:0.48~0.88)及位于ATG3基因上的位点rs13082005(G>A) (P=0.012, HR:1.27,95%CI:1.05~1.53)与含铂化疗的无疾病进展时间显著相关,位于ULK1基因的位点rs7953348(G>A) (P=0.011, HR:0.74, 95%CI:0.58~0.93)和位于ATG10基因上的位点rs1864183(G>A) (P=0.016, HR:0.42, 95%CI:0.21~0.85)对含铂化疗的总生存时间有着显著影响。研究结果提示自噬通路在含铂化疗敏感性中发挥着重要作用,自噬通路基因多态性可能是预测含铂化疗疗效的潜在分子标志物,这可能为临床上肺癌的个体化医疗提供一定的理论基础。     

老年广泛期小细胞肺癌患者化疗与预后的分析

目的:在老年人群中,小细胞肺癌的治疗难度大,缺乏有临床指导意义的研究数据,本文旨在通过对老年广泛期小细胞肺癌患者预后因素的分析寻找适合老年患者的化疗策略.方法:回顾性分析106例老年广泛期小细胞肺癌患者资料,应用SPSS13.0统计软件对数据进行单因素及COX回归多因素分析,探讨年龄、PS评分、化疗周期、化疗方案、血液学毒性等因素对生存的影响.结果:①单因素分析显示PS评分、化疗与否、化疗周期数、血液学毒性等因素对预后有影响,单药化疗与联合用药预后无明显差别.②COX回归多因素分析显示PS评分(P＜0.001)、化疗周期数(P=0.002)是影响预后的因素.③单药化疗的血液学毒性明显低于联合用药,化疗周期数更多.结论:老年广泛期小细胞肺癌患者可从化疗中受益,四周期以上的化疗可明显延长生存时间,对于PS评分较差的患者,单药化疗可能是一个好的选择.     

78 例肺癌脑转移患者临床分析

目的:探讨与肺癌脑转移预后相关的影响因素,为更好的治疗肺癌脑转移提供参考依据。方法:回顾性分析2002年~2009年唐都医院收治的78例肺癌脑转移的临床资料。结果:患者年龄、性别、病理类型、脑转移灶数目、颅外有无转移性病灶、患者的行为状态(PS评分)对患者生存期无显著影响(P>0.05)。但放疗+化疗治疗组疗效显著优于单纯放疗组及单纯化疗组(P<0.05),症状消失者(CR)或明显缓解者(PR)生存较无明显改善者(SD)或加重者(PD)生存期显著延长。结论:对肺癌脑转移患者应采取放疗联合化疗综合方案治疗,同时,应及时关注其症状缓解情况并指导治疗。     

肺癌脑转移预后的多因素分析

目的:探索肺癌患者脑转移的预后影响因素。方法:回顾性分析我院2001~2010年216例肺癌患者的临床资料。运用SPSS软件包,通过比例风险模型(Cox模型)进行单因素和多因素分析,采用Kaplan-Merer法进行生存分析并描绘生存曲线和进行Log-rank时序检验。结果:通过单因素分析显示PS评分(p=0.006)、脑转移病灶数目(P=0.038)、有无脑转移的症状(P=0.001)、有无颅外器官转移(P=0.037)和治疗方法(P=0.045)等对生存期有影响,而年龄(P=0.887)、性别(P=0.207)、病理类型(P=0.727)、肺癌的部位(P=0.104)、脑转移病灶部位(P=0.401)对生存期无影响。多因素分析显示影响肺癌脑转移预后的主要因素依次为PS评分、有无脑转移的症状和治疗方法,而有无颅外器官转移和脑转移灶的数目等因素被削弱。结论:PS评分、有无颅外器官转移和脑转移病症灶的多少是脑转移肺癌患者的独立预后因素。     

非小细胞肺癌脑部转移瘤适形与调强放疗的剂量研究

为探讨NSCLC脑部转移瘤调强放疗与适形放疗的剂量特点,本研究选取57例非小细胞肺癌脑转移瘤患者,其中单个脑转移灶患者5例,多个脑转移灶患者52例,分别设计全脑放疗+适形放疗与调强放疗计划,用均匀指数(HI)和适形指数(CI)评价靶区剂量,危及器官(OAR)剂量用近似最大剂量D_2%(串联)和中位剂量D_50%(并联)进行评价。研究发现,单个脑转移灶IMRT与WBRT+CRT比较中,CI为(PTV,(0.80±0.15) cGy,(0.34±0.19) cGy, p=0.00),HI为(PTV,(0.52±0.03) c Gy,(0.71±0.12) cGy, p=0.24),两者OARs剂量比较:脑干为((4 348±236) cGy,(4 593±149) cGy, p=0.01),脑垂体为((4 258±166) cGy,(4 581±123) cGy, p=0.02);在多个脑转移灶中,IMRT与WBRT+CRT比,较CI为(PTV,(0.59±0.33) cGy,(0.49±0.27) cGy, p=0.03),HI为(PTV,(0.93±0.01) cGy,(0.58±0.03) cGy, p=0.19),两者OARs剂量比较:脑干为((4 946±132) cGy,(4 843±196) cGy, p=0.51),脑垂体为((4 597±180) cGy,(4 705±149) cGy, p=0.70)。本研究的结果说明,单个脑转移灶患者,IMRT较WBRT+CRT有更好的靶区适形性、稍差的靶区异质性,脑干和垂体的IMRT剂量低于WBRT+CRT,而眼球、晶体的剂量两者差别不明显。多个脑转移灶患者,IMRT较WBRT+CRT有更好的靶区适形性、稍差的靶区异质性,而OARs剂量,IMRT较WBRT+CRT差异不明显。在临床实践过程中,应当根据患者不同的病灶情况选择合适的放疗方案,以获取更优的临床治疗效果。     

78例肺癌脑转移患者临床分析

目的：探讨与肺癌脑转移预后相关的影响因素,为更好的治疗肺癌脑转移提供参考依据。方法：回顾性分析2002年~2009年唐都医院收治的78例肺癌脑转移的临床资料。结果：患者年龄、性别、病理类型、脑转移灶数目、颅外有无转移性病灶、患者的行为状态（PS评分）对患者生存期无显著影响（P〉0.05）。但放疗＋化疗治疗组疗效显著优于单纯放疗组及单纯化疗组（P〈0.05）,症状消失者（CR）或明显缓解者（PR）生存较无明显改善者（SD）或加重者（PD）生存期显著延长。结论：对肺癌脑转移患者应采取放疗联合化疗综合方案治疗,同时,应及时关注其症状缓解情况并指导治疗。     

小细胞肺癌化疗和放疗进展

近年来,小细胞肺癌(small cell lung carcer,SCLC)的发病率呈上升趋势,现已占肺癌总数的20%~30%[1]。SCLC病程短,发展快,对化疗和放疗敏感,因此,化疗和放疗已成为SCLC治疗的主要手段[2]。现将近年来SCLC化疗和放疗的治疗进展概述如下。1局限期SCLC治疗1·1化疗SCLC对化疗敏感的特点早已被发现,许多化疗方案被应用于SCLC,中位生存期约12个月,2年生存率为10%~15%,化疗持续时间4~6个月,长期维持化疗对生存没有影响[3]。文献[4]指出,85%~90%局限期SCLC患者经化疗后获得缓解,50%~60%的患者能达到完全缓解。尽管几种药物单独或联合使…     

中性粒细胞-淋巴细胞比率与老年NSCLC患者临床病理及预后的相关性分析

目的:研究中性粒细胞-淋巴细胞比率(NLR)与老年非小细胞肺癌(NSCLC)患者临床病理及预后的相关性分析。方法:回顾性分析我院收治的68例老年NSCLC患者的临床病理资料。根据化疗前NLR分为低NLR组(2.95)、高NLR组(≥2.95)。比较两组患者临床病理特点及无病生存期(DFS),并分析预后的影响因素。结果:与低NLR组比较,高NLR组临床分期Ⅳ期、吸烟及淋巴转移的比例更大(P0.05),而两组间年龄、性别、病理类型及合并症比较差异均无统计学意义(P0.05)。低NLR组中位DFS为7.2个月(95%CI:5.9~8.4),显著高于高NLR组中位DFS 6.7个月(95%CI:5.4~7.9)(P0.05)。淋巴转移、NLR是老年NSCLC患者DFS的独立危险因素,而年龄、化疗次数则是独立保护因素(P0.05)。结论:NLR与老年NSCLC患者的临床分期和淋巴结转移有明显相关性,并可作为预后评估参考指标之一。     

155例复发小细胞肺癌患者首诊临床特征分析

目的探讨小细胞肺癌(SCLC)一线含铂方案治疗后短期内疾病复发进展的相关临床因素。方法对2009年1月至2013年12月于大连医科大学附属第二医院接受一线含铂方案治疗的SCLC病例进行回顾性分析,根据疾病复发进展时间将病例分为难治复发组和敏感复发组,分析比较两组病例首诊临床特征。结果相比敏感复发组病例,难治复发组病例更多见于首诊时广泛期、肝转移、骨转移、LDH(乳酸脱氢酶)300U/L、NSE(神经元特异性烯醇化酶)65.2ng/mL、CYFRA21-1(细胞角蛋白19片段)9.9ng/mL的患者。Logistic多因素相关性分析显示,广泛期是SCLC一线含铂方案治疗后短期内疾病复发进展的独立影响因素(OR=4.1,[95%CI:1.731-9.740],P=0.001)。结论广泛期是SCLC一线含铂方案治疗后短期内疾病复发进展的独立影响因素,首诊广泛期的SCLC患者,要注意一线含铂方案治疗后疾病短期内复发进展可能。     

培美曲塞联合顺铂化疗对晚期非小细胞肺癌患者疗效及血清肿瘤标志物的影响

目的:探究培美曲塞联合顺铂化疗对晚期非小细胞肺癌患者疗效及血清肿瘤标志物的影响。方法:选取于2012年7月~2016年2月期间我院收治的89例非小细胞肺癌患者为研究对象,采用随机数字法将研究对象分为观察组(45例)和对照组(44例);观察组采用培美曲塞联合顺铂化疗,对照组采用多西他赛联合顺铂化疗,观察并比较两组患者治疗前后细胞角质素片段抗原(CYRAF211)、血清癌胚抗原(CEA)、糖类抗原125(CA125)、神经元特异性烯醇化酶(NSE)表达水平。结果:观察组疗效优于对照组,比较有统计学差异(Z=1.940,P=0.026),观察组治疗的总有效率(55.66%)显著高于对照组(36.37%),差异有统计学意义(χ2=5.432,P=0.034);化疗后,两组CEA、CYFRA21-1、CA125及NSE水平均较化疗前较有显著下降,同时观察组各指标水平均显著低于对照组(P0.05);化疗前,Ⅲ期患者肿瘤标志物CEA、CYFRA21-1、CA125及NSE水平均显著低于Ⅳ期患者(P0.05);化疗后,Ⅲ期和Ⅳ期患者肿瘤标志物CEA、CYFRA21-1、CA125及NSE水平较治疗前均有显著降低(P0.05),且Ⅲ期水平显著低于Ⅳ期(P0.05)。结论:培美曲塞联合顺铂治疗晚期非小细胞肺癌具有显著疗效,血清CEA、CYFRA21-1、CA125及NSE水平经化疗后显著降低,可作为分期和评价化疗疗效的可靠指标。     

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.