摘要：目的 讨论了氢质子磁共振波谱(1H-MRS)用于预测的非小细胞肺癌及脑移动奥希替尼治疗效果的临床及使用价值。方法 先测定非小细胞肺癌及脑转移患者在奥希替尼治疗前1H-MRS扫描的各参数(肿瘤长径、Cho、Cr、NAA)平均值,再依据奥希替尼治疗后效果将患者分成病情控制组与病情发展组,并比较二组治疗前的肿瘤长径、Cho、Cho/Cr、NAA、NAA/Cr值的差异。结论 疾病发展组NAA值显著大于疾病控制组NAA值,而疾病发展组NAA/Cr值则显著超过于疾病控制组NAA/Cr值,此差异有统计意义(P<0.05)。其疾病进展组及疾病控制组的长径值差异、Cho值差异和Cho/Cr值差别,均不具有统计学价值(P>0.05)。结论 治疗前NAA值及NAA/Cr值有望作为EGFR-TKIs 治疗NSCLC 脑转移疗效的预测指标。

摘要：目的 探讨氢质子磁共振波谱（1H-MRS）评价非小细胞肺癌脑转移奥希替尼治疗疗效的临床应用价值。方法 检测非小细胞肺癌脑转移病人奥希替尼治疗前后 1H-MRS 扫描的相关参数（Cho、Cr、Cho/Cr、NAA）值，计算治疗后与治疗前的比值，与传统疗效评估标准的评价结果和肿瘤长径进行相关性分析。结果 奥希替尼治疗有效组的Chod14/Chod0、(Cho/Crd14)/(Cho/Crd0)均明显低于奥希替尼治疗无效组的Chod14/Chod0、(Cho/Crd14)/(Cho/Crd0)（P<0.001）；Chod14/Chod0、(Cho/Crd14)/(Cho/Crd0)与LDd60/LDd0之间存在显著的正相关关系P<0.001。结论 Chod14/Chod0、(Cho/Crd14)/(Cho/Crd0)可以预测奥希替尼治疗NSCLC脑转移后脑转移瘤的长径的变化。

目的:对比羟考酮缓释片联合吗啡即释片与单用吗啡即释片在重度癌痛滴定中的镇痛效果、安全性及对免疫功能的影响.方法:选取2017年12月至2019年2月在我科住院的重度癌痛患者60例,按1:1随机分为对照组(吗啡即释片滴定)与实验组(羟考酮缓释片联合吗啡即释片滴定),对比两组的疼痛缓解率、平均滴定时间、功能状态、不良反应及免疫功能.结果:滴定24小时后实验组的疼痛缓解率明显高于对照组(P<0.05),在滴定3天及1周后,两组疼痛缓解率无明显差异(P>0.05);实验组平均滴定时间明显短于对照组(P<0.05);滴定治疗3天后实验组功能状态评分明显高于对照组(P<0.05);与对照组相比,实验组对细胞免疫功能抑制较轻(P<0.05).结论:羟考酮缓释片联合吗啡即释片在重度癌痛滴定中能更快达到疼痛缓解,且对免疫功能抑制较轻.

目的:观察复方苦参注射液联合多西他赛+顺铂方案(DP方案)治疗晚期非小细胞肺癌对患者血清血管内皮生长因子的影响.方法:136例晚期非小细胞肺癌患者,随机分为对照组68例和观察组68例,观察组应用复方苦参注射液静脉滴注联合DP方案化疗,对照组仅DP方案化疗,2个周期后按RESISTE1.1疗效评估标准评价疗效,按WHO标准评估毒副作用,应用KPS中的相关评分法则对患者的行为状态进行评分,同时测定治疗前后患者外周血血清血管内皮生长因子(vascular endothelial growth factor,VEGF)的水平.结果:观察组治疗总有效率明显高于对照组(P＜0.05),观察组患者的KPS评分改善状况明显优于对照组(P＜0.05),观察组治疗过程中不良反应发生率显著低于对照组(P＜0.05),治疗后2组血清VEGF水平均相比治疗前显著降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论:复方苦参注射液可增强晚期非小细胞肺癌患者DP方案化疗的疗效,降低毒副作用,还可以显著降低血管内皮生长因子的水平,阻止癌细胞的扩散以及增殖.

Objective To investigate the clinical efficacy and safety of liposome paclitaxel in maintenance therapy of advanced squamous cell lung carcinoma patients. Methods After 4-6 cycles of first-line treatment, 57 patients with advanced squamous cell lung carcinoma were randomized into liposomal paclitaxel monotherapy maintenance treatment group(experimental group, n=29) and follow-up observation group(control group, n=28). Efficacy and side effects were observed in experimental group. PFS and OS were compared between two groups. Results CR, PR, SD, PD rates of experimental group were 0, 13.8%, 44.8%, 41.4%, and disease control rate(DCR) was 58.6%. The major toxicities were myelosuppression and gastrointestinal reactions. PFS and median survival time(MST) of two groups were 5.7 vs. 2.4 months and 7.3 vs. 4.9 months(both P < 0.05). The patient's quality of life(QOL) was better in experimental group, compared with control group. Conclusion As a maintenance therapy after the first-line treatment of advanced squamous cell lung carcinoma, liposomal paclitaxel could significantly improve PFS, OS and QOL of patients, and the adverse reactions are tolerable.

目的 探讨康莱特联合GP方案在晚期非小细胞肺癌患者中的应用效果以及对患者体内炎症因子的影响.方法 选取我院收治的确诊为晚期非小细胞肺癌的患者68例,随机分为研究组和对照组,对照组患者接受GP方案治疗,研究组在对照组的基础上联合康莱特治疗,对比两组患者的治疗效果以及体内炎症因子水平.结果 研究组患者的治疗有效率和KPS评分明显高于对照组(P<0.05),不良反应发生率明显低于对照组(P<0.05),治疗前两组患者的IL-6、IL-1、CRP、TNF-α等炎症因子水平差异无统计学意义(P>0.05),治疗后均明显下降,且研究组下降幅度明显大于对照组(P<0.05).结论 GP方案联合康莱特可明显提高晚期非小细胞肺癌的短期疗效,降低不良反应发生率以及患者体内炎症因子水平,减轻患者的疼痛程度,值得临床推广应用.

Objective To investigate the effect of thymosin combined with chemotherapy in the treatment of elderly patients with gastric cancer and its impact on peripheral blood T lymphocyte subsets.Methods A retrospective study was performed on 80 cases of elderly patients with gastric cancer who were admitted from October 2011 to December 2015.Patients were randomly divided into the observation group and control group,with 40 cases in each group.Two groups of patients were treated with oxaliplatin combined with capecitabine chemotherapy,the patients in the observation group were combined with thymosin,and the total efficiency were compared between the two groups after treatment,and T cells subsets (CD3 +,CD4 +,CD8 + and CD4 +/CD8 +)were compared and analyzed between the two groups before and after treatment.Results After treatment,the total effective rate of observation group was 75.0％ (30/40),the control group was 52.5％ (21/40),and the difference had statistical significance between the two groups(P ＜ 0.05).After treatment,serum CD3 +,CD4+ and CD4+/CD8 + in the two groups of patients were significantly higher than those before treatment (P ＜ 0.05);CD8 + had no obvious change(P ＞ 0.05).The serum CD3 +,CD4 + and CD4 +/CD8 + in the observation group after treatment increased more significantly than those in the control group (P ＜ 0.05).CD8 + had no obvious change after treatment (P ＞0.05).Conclusion α1 thymosin combined with chemotherapy in the treatment of elderly patients with gastric cancer can significantly improve the curative effect and improve immune function,and is worthy of clinical promotion.

Objective:To investigate the clinical efficacy of Mannatide in the treatment of primary leukopenia and its impact on the immune function of patients.Methods:80 patients with primary leukopenia admitted to the hospital from January 2009 to October 2012 were randomly divided into treatment group and control group according to the random number table.40 patients in the control group received Diyushengbai tablets,patients in the treatment group were given Mannatide tablets for a course of four weeks,a total of two courses.Results:The effective rate of treatment group was 92.50%,which was significantly better than 75.00%of the control group (P<0.05). The treatment group had rapid effect,only took 6~9 days to see significant improvement in clinical symptoms,while the control group took 15 to 22 days.Tlymphocyte subsets CD3+, CD4+, CD4+/CD8+were also significantly higher (P<0.05) than the control group at the end of treatment.Conclusion:Mannatide can improve immune function in patients with primary leukopenia and elevate peripheral blood leukocytes.

Objective The predictive values of TS and DPD mRNA in advanced gastric cancers treated with S-1.Methods The study population consisted of 24 patients with advanced gastric cancer.All of the patients treated by S-1,TS and DPD mRNA in peripheral blood were measured by the real-time reverse transcription PCR(RT-PCR) method.Results The response rate in the low TS mRNA group(25%),with significant difference(50%) was higher than that in the high TS mRNA group(25%) with significant difference(P<0.05).Patients with low TS mRNA survived longer(8.4 months) than those with high TS mRNA(3.5 months),with significant difference(P<0.05).But there was no statistical difference in the response rates between low DPD mRNA group(42%) and high TS mRNA group(33%),with significant difference(P<0.05).There was no statistical difference(P>0.05) in the statistical survivals between low DPD mRNA group(6.5 months) and high DPD mRNA group(7.2 months).Conclusion The treatment effect of S-1 for advanced gastric cancer was negatively correlated with the status of TS mRNA,and there was no significant correlation between the treatment effect of S-1 and the status of DPD mRNA.

Objective:To investigate the efficacy of recombinant human interleukin-11 (rhIL-11) in the treatment of radiotherapy-induced thrombocytopenia in patients diagnosed terminal cancer. Methods:One hundred and sixty diagnosed terminal cancer patients were randomly divided to intra-hypodermic(ih) injection of 50 ug/kg or 1.5 mg/d of rhIL-11 was given when their platelet count was lower than 50×109/L after radiotherapy(treatment group,A) or the same above therapy was given except rhIL-11(control group, B).Results:Upon completion of the radiotherapy, the rates of the thrombocytopenia between the two groups(24.4%and 24.4%) were not significantly different(P>0.05),the effective rate of the treatment group(80%) was higher than the spontaneous recovery rate of control group(31.6%),(P<0.01). Conclusion:Administration of rhlL-11 can significantly increase platelet count in patients.

Objective:To observe the effect of sequential therapy of mannatide combined with chemotherapy to treat gastric cancer.Methods:102 hospitalized patients with gastric cancer were randomized into treatment group and control group.Each group received conventional therapy(DCF chemotherapy).The treatment group was given the sequential therapy of mannatide.The control group received the sequential therapy of thymosin.Outcome measures:(1) Quality of life(QOL) : To evaluate the QOL of median survival time and one year after the treatment.(2) Immunological parameters: CD4,CD8,CD4/CD8,peripheral blood leukocytes,antibody(IgA,IgG,IgM),alexin(C3),neutrophil.(3) Adverse reactions: chemoradiotherapy common adverse reactions such as nausea and vomiting.Results:Compared with the control group,the KPS and the median survival time of the treatment group were significantly different(P<0.05) after a year of treatment,and the immune index of the treatment group were significant improved;especially the ratio of CD4/CD8,the count of complement(C3),peripheral leukocyte and the neutrophilic granulocyte were significantly different(P<0.01).The incidence rate of adverse chemotherapy reactions of treatment group were significant decreased contrast with the control group(29% to 71%,P<0.01).Conclusion:The application of sequential therapy of mannatide combined with chemotherapy significantly improved the patients’ life quality;enhanced the immunologic function comprehensively;reduced the incidence rate of adverse chemotherapy reactions;and had a better effect than the sequential therapy of thymosin.

目的探讨不同方法治疗恶性胸腔积液的临床疗效。方法将86例恶性胸腔积液随机分为观察组和对照组,每组43例,对照组采用传统方法胸腔穿刺抽液加顺铂局部化疗;观察组采用中心静脉导管引流加顺铂局部化疗。结果观察组总有效率76.7%,显著高于对照组55.8%(P<0.01)。观察组穿刺次数、胸腔积液基本消失时间、住院时间、气胸和胸膜反应等的并发症发生率均明显低于对照组(P<0.01)。结论中心静脉导管引流加顺铂局部化疗治疗恶性胸腔积液效果较好,可控性强,患者耐受性较好,并发症发生率低。

目的观察复方苦参注射液联合化疗对晚期胃癌疼痛的疗效。方法 80例Ⅲ～Ⅳ度晚期胃癌患者随机分为A组与B组,分别用化疗和化疗加用复方苦参注射液,4周后观察疼痛及骨髓毒性副作用。结果 A组疼痛缓解程度为30%,Ⅲ～Ⅳ度骨髓损害38%,而使用复方苦参注射液的B组疼痛缓解程度为75%,Ⅲ～Ⅳ度骨髓损害35%。结论复方苦参注射液联合化疗对晚期胃癌止痛疗效较好且不增加骨髓毒性副作用。

Objective To investigate the efficacy,toxicity and side-effect of FLO and FLP proteocds on advanced gastric cancer.Methods 62 cases of advanced gastric cancer were randomly treated with FLO(group A) or FLP(group B) respectively.Each cycle lasted for 2 weeks and the procedure was 8 cycls.To observe the rate of CR+PR and the incidence rates of myelosuppression,vomiting and neurotoxicity.Results The rate of(CR+PR) was 41% in group A and 17% in group B(P0.01);the incidence rate of myelosuppression was 38% in group A and 37% in group B(P0.05);the incidence rate of vomiting between Ⅲ-Ⅳ degree was 9% in group A and 30% in group B(P0.01);the incidence rate of peripheral nervous lesion between Ⅰ-Ⅱdegree was 72% in group A and 7% in group B(P0.01);the incidence rate of peripheral nervous lesion between Ⅲ-Ⅳ degree was 3% in group A and 0% in group B(P0.05).Conclusion In the treatment of advanced gastric cancer,FLO has better efficacy,less vomiting reaction,more neuroloyical effect but mild clinical symptoms compared with FLP.

米托蒽醌(MTZ)为一种新的蒽环类抗肿瘤药物,它的结构和作用机制与阿霉素相似,但与阿霉素又有不完全的交叉赖药性,这使许多对阿霉素无效的患者仍可用MTZ治疗,它对肺癌、淋巴瘤、乳腺癌、白血病等有明显的疗效[1].自1995年1月至2000年12月,我们用四川升和制药有限公司生产的MTZ治疗复治非何杰金淋巴瘤62例,取得较满意的结果.