目的 探讨高强度聚焦超声联合单药吉西他滨化疗治疗局部晚期胰腺癌的临床效果及不良反应.方法 将2010年6月至2017年6月六安市人民医院收治的42例局部晚期胰腺癌病人依据治疗措施的不同分为两组,对照组(19例)用单药吉西他滨化疗,吉西他滨1000 mg/m2静脉滴注.观察组(23例)用单药吉西他滨化疗的同时加高能聚焦超声刀治疗.结果(1)对照组治疗前功能状态评分(KPS评分)均值为(74.74±9.05)分,治疗后KPS评分均值为(76.32±8.95)分,组内差异无统计学意义(t=1.000,P=0.331);观察组治疗前KPS评分均值为(72.61±10.10)分,治疗后KPS评分均值为(83.48±7.75)分,组内差异有统计学意义(t=4.800,P=0.000),两组组间比较差异有统计学意义(t=2.896,P=0.006).(2)对照组治疗后的总缓解率为43.75％,观察组为83.33％,组间差异有统计学意义(P=0.030).(3)对照组治疗后的临床受益率为26.32％,观察组为65.22％,差异有统计学意义(χ2=6.313,P=0.012).(4)两组不良反应均为Ⅰ～Ⅱ级骨髓抑制,差异无统计学意义(P>0.05).结论 高能聚焦超声刀联合单药吉西他滨化疗是治疗局部晚期胰腺癌的安全有效方法.

目的 探讨激素依赖性乳腺癌中人表皮生长因子-2(HER-2)、增殖细胞核抗原Ki67的表达与临床病理因素的关系及临床意义.方法 选取安徽医科大学附属六安医院2012年10月至2016年10月接受标准手术治疗的激素依赖性乳腺癌患者术后组织标本,采用免疫组化En Vision二步法检测93例激素依赖性乳腺癌组织标本HER-2和Ki67表达情况,免疫组化结果为HER-2(++)标本给予FISH检测进一步验证HER-2表达,分析HER-2和Ki67表达与临床病理因素的关系.结果 HER-2和Ki67阳性表达率分别为22.58%(21/93)和67.74%(63/93),两者共同阳性表达率为20.43%(19/93),不同年龄、淋巴结有无转移、不同临床分期组间HER-2阳性表达率差异无统计学意义(P>0.05),不同肿瘤直径组间HER-2阳性表达率差异有统计学意义(P<0.05);不同年龄、不同肿瘤直径、淋巴结有无转移、不同临床分期组间的Ki67阳性表达率差异无统计学意义(P>0.05);HER-2和Ki67共同阳性表达率在不同肿瘤直径组间差异有统计学意义(P<0.05),在不同年龄、淋巴结有无转移、不同临床分期组间差异无统计学意义(P>0.05).结论 HER-2和Ki67可用作判断激素依赖性乳腺癌生物学行为的标志物.

目的:探讨鸦胆子油乳对卵巢癌患者血清CA125、CA199及临床疗效的影响.方法:收集我院收治的卵巢癌患者18例,随机分为对照组和实验组,每组各9例,对照组患者采用PT化疗方案,具体采用紫杉醇和顺铂.实验组患者在此基础上给予鸦胆子油乳静脉滴注,20～30 mL/次,1次/d,化疗期间不间断应用.治疗连续8周.治疗结束后,对患者CEA、CA125、CA199以及临床疗效进行检测并比较.结果:与治疗前相比,治疗后患者的CEA、CA125、CA199水平均下降(P＜0.05);与对照组相比,实验组患者的CEA、CA125、CA199水平较低,临床治疗总有效率较高(P＜0.05).结论:鸦胆子油乳能够降低卵巢癌患者血清CEA、CA125、CA199水平,临床疗效较好,对临床有指导意义.

Objective:To evaluate the efficacy and side effects of chemotherapy with GDP regimen in patients with relapsed or refractory Non-Hodgkin's lymphoma. Methods: Twenty-three patients with relapsed or refractory non-Hodgkin's lymphoma were enrolled from January 2008 to March 2010. They received gemcitabine 1000mg/m2 ,d1,d8 and cisplatin 25mg/m2,d1-d3, in combination with dexamethasone 20-40mg d1-d3 every 21 days. Efficacy assessment was conducted after two cycles therapy. Results: Among 23 patients,5 cases achieved complete response (21.7%) and 9 cases achieved partial response (39.1%).The median time to progression (TTP) was 5 months (95%CI:3-8 months).The major adverse events were mild to moderate gastrointestinal reaction and myelosuppression which included 2 cases of grade 3-4 leukopenia and 1case of grade 4 thrombopenia with hemorrhage and 1 case of grade 3-4 hemophthisis. Conclusion: GDP regimen is effective and well-tolerated for relapsed or refractory non-Hodgkin's lymphoma.

Objective:To observe the effect and side effects of topotecan in combination with carboplatin in the treatment of recurrent small cell lung cancer.Methods:Twenty-nine patients of recurrent small cell lung cancer enrolled in the study.Topotecan was given at the dose of 1.2mg/m2 on d1-5 and carboplatin was administered at the dose of 300mg/m2 on d5 in a cycle of 21 days.The patients were evaluated at least after 2 cycles.Results:One patient got complete response and eleven patients got partial response.The overall response rate was 41.38%,and the response rates of sensitive group and refractory groups were 47.62% and 25% respectively.Conclusion:The regimen of topotecan and carboplatin shows better activity in retreated small cell lung cancer patients.The main toxicity is hematological toxicity and can be tolerated.

Objective:To evaluate the therapeutic effects and side effects of lyophized nocardiarubra-cell wall skeleton and cisplatin in maligant pleural effusion.Methods:Forty-seven patients with maligant pleural effusion were randomized into threatment group and control group,and treated by closed thoracic drainage with central venous catheters and intrathoracic therapy with drugs.After drainage,400mg of lyophized nocardiarubra-cell wall skeleton and 80-100mg of cisplatin were injected into pleural cavity in treatment group and only 80-100mg of cisplatin in control group weekly for 3 weeks.One month later,the efficacy and toxicities were evaluated.Results:The effective rates of treatment group and control group were 84.6%and 66.7%,respectively.The quality of life of the treatment group was higher than that in the control group.Conclusion:The closed thoracic drainage and thoracic cavity injection of lyophized nocardiarubra-cell wall skeleton and cisplatin in maligant pleural effusion is an effective and safe way.

目的 观察周剂量紫杉醇(PTX)加顺铂(DDP)联合化疗治疗晚期食管癌的近期疗效和毒副反应.方法 晚期食管癌患者48例分为两组,PTX+DDP组:PTX 80mg/m2静滴第1,8天;顺铂20mg/d静滴第1～5天.5-Fu+DDP+CF组:5-Fu 500mg/m2静滴,第1～5天;DDP 20mg/d静滴第1～5天,CF 100mg/次静滴,在5-Fu前2h内给药第1～5天,21天为1周期,2周期后按UICC标准评价近期疗效和毒副反应.结果 PTX+DDP方案治疗20例食管癌患者有效率为70%;5-Fu+DDP+CF方案治疗28例的有效率为50%.前一联合方案总有效率高于后者,有显著性差异(P＜0.05),不良反应也较后者重,但大多数患者能耐受,主要为剂量限制性毒性.表现为Ⅱ～Ⅲ度为主的骨髓抑制.结论 周剂量紫杉醇联合顺铂治疗晚期食管癌近期疗效显著,毒副反应小.

Objective:To observe analgesic effect and main side effects of Oxycodone Hydrochloride Controlled-release Tablets(Oxycontin)in management of the moderate and severe cancer pain.Methods:Sixty patients with cancer pain were randomly divided into Oxycontin group(30 cases)and MS-contin group(30 cases).Oxycontin was administered at an initial dose of 10 mg every 12h and titrated upwards according to the extent of pain relief.Results:In [KG(-*9]Oxycontin group effective rate was 96.1%.The quality of life was significantly improved after treatment(P0.01).The common side effects were constipation dizziness nausea,vomitiny,sedation.No serious side effect was found.Oxycontin didn't show obvious affection to the function of liver,kidney and blood pressure,heart rate.Conclusion:Oxycontin display a comparable or slightly superior efficiency MS-contin and works quickly,safely and can improve the quality of life for the treatment of patients with moderate to severe cancer pain.

卵巢上皮性癌为死亡率最高的妇科恶性肿瘤.多数病例确诊时已为晚期,理想的肿瘤细胞减灭术和静脉化疗配合腹腔内化疗等综合治疗可提高疗效,改善预后.