贝伐单抗治疗实体肿瘤的临床研究进展

血管内皮生长因子(vascular endothelial growth factor,VEGF)在肿瘤的发病机制中起着关键作用,其作为抗肿瘤治疗的重要靶点,已得到越来越多的关注.贝伐单抗(Bevacizumab,BEV)是一种血管内皮生长因子的单克隆抗体,是目前最受关注的分子靶向药物之一,自2004年经美国FDA批准上市以来,BEV已被用于多种实体肿瘤的治疗.本文就BEV关于治疗几类实体肿瘤的临床研究进展作一综述.     

4例肾上腺区局限性Castleman病临床诊治分析

探讨肾上腺区局限性Castleman病的临床特点及诊治方法。回顾性分析4例经术后病理证实的肾上腺区局限性 Castle-man病患者的临床资料,并结合文献复习讨论Castleman病的临床特点及诊治方法。结果4例肾上腺区局限性Castleman病均顺利手术切除,术后随访1个月～22个月,未见肿瘤复发。Castleman病临床上少见,表现为不明原因的淋巴结肿大,临床表现无特异性,最终确诊依靠病理诊断。病变可发生在淋巴组织的任何部位,肾上腺区罕见,手术切除为首选治疗。     

Performance-based and parent ratings of attention in children treated for a brain tumor: The significance of radiation therapy and tumor location on outcome

Children are at increased risk for cognitive difficulties following the diagnosis and treatment of a brain tumor. Radiation therapy (RT) and tumor location are commonly-cited predictors of neurocognitive functioning. Disruptions to foundational neurocognitive processes such as attention, working memory, and processing speed underlie declines on measures of general intellectual functioning. While several studies have examined visual sustained attention in pediatric brain tumor patients, auditory sustained attention has yet to be examined. This study employs a longitudinal design to examine performance-based and parent ratings of attention in children undergoing surgical resection of a brain tumor (n = 29) and treated with (n = 11) or without (n = 18) RT at 6.79 months post-surgery (baseline) and then again at 30.56 months post-surgery (follow-up). The measures include an auditory continuous performance test (CPT) and parent ratings of attention and hyperactivity on a behavior rating scale. Ultimately, children treated with and without RT performed similarly on performance-based and parent ratings of attention. However, the performance on the auditory CPT differed according to tumor location, with children with infratentorial tumors committing more inattention and inhibitory control errors compared to children with supratentorial tumors. Parent ratings did not differ according to tumor location, and parent ratings and auditory sustained attention performance are not significantly correlated. The findings are interpreted in the context of neurocognitive and brain development.     

肿瘤防治的自然观与适度治疗

近年来,科技的进步未能阻止世界范围内肿瘤死亡率的攀升。自然稳态失衡在肿瘤防治中扮演重要的角色。肿瘤作为自然存在的一种生物学现象,传统根治性的肿瘤治疗思路与策略客易造成肿瘤的过度治疗、引起机体免疫的崩溃与生存质量的低下。严峻的现实已为我们敲响警钟,肿瘤治疗思维须从对抗转向和谐。本文从自然观的角度去探究肿瘤与机体、肿瘤与自身微环境的关系,反思肿瘤研究思路和治疗手段,以为进一步肿瘤的防治提供一个更为广泛的、确切的思路。     

抑癌基因ARIDlA的研究进展

SWI／SNF复合物是一种ATP依赖的染色质重塑复合物。ARIDlA蛋白是SWI／SNF的亚基之一,具有非序列特异性DNA结合活性,参与DNA的复制、转录、修复、重组等。在消化道肿瘤、妇科肿瘤、肺腺癌等多种肿瘤中存在频繁的基因突变。可能通过上调P21、P53及下调c—Myc、E2F反应基因等发挥抑癌作用。本文介绍了ARIDlA基因的分子特征、作用机制及与多种肿瘤的关系,以期对该抑癌基因有全面深入的了解。     

Tumor Locus Moderates Anxiety Symptoms in a Pediatric Neuro-Oncologic Sample

Despite the prevalence of pediatric Central Nervous System (CNS) solid tumors, little is understood about patients' disease-related anxiety experience. Data from 25 remitted pediatric CNS tumor patients posttreatment were collected. Significant symptoms of anxiety were reported by 32% of patients. MRI studies showed all anxious patients had right cortical tumors or left cerebellar tumors. Confound analyses suggest these results are not better accounted for by demographic, disease, or treatment variables. These results evidence the risk some pediatric neuro-oncologic patients face for developing significant anxiety symptoms.     

高凝状态肿瘤患者抗凝联合化疗的临床观察

观察伴高凝状态恶性肿瘤患者抗凝联合化疗的临床疗效.观察组68例,给予一线标准方案化疗,同时给予低分子肝素钙6 000U,1次/d,皮下注射,阿司匹林100mg口服,1次/d,21d为1个周期,共2个周期.对照组56例,给予一线标准方案化疗.结果显示,治疗组和对照组有效率分别为23.69％和19.44％,两组比较,差异无统计学意义(P＞0.05);治疗组和对照组生存状态评分(KPS)改善率分别为64.71％和35.39％,两组比较,差异有统计学意义(P＜0.05).治疗组出现了纤维蛋白原(Fbg)、组织因子(TF)和D-二聚体(D-D)含量的降低,与对照组相比差异有统计学意义(P＜0.01).从而得出伴高凝状态恶性肿瘤患者进行抗凝联合化疗,临床疗效较好,同时可以降低血液高凝状态和血栓形成的风险.     

急性心理应激对多囊卵巢综合征患者的影响

为了了解PCOS患者易患抑郁症、肥胖、代谢综合征、心血管疾病、糖尿病的原因。通过对28例PCOS患者和28例体重指数、年龄匹配的健康对照组回应公众演讲压力进行分析,在回应公众演讲压力时,PCOS组和对照组均有比较显著的焦虑程度、ACTH、皮质醇、心率和血压升高（P均〈0．01）;但PCOS患者焦虑程度、ACTH、皮质醇...     

阴式手术在卵巢良性肿瘤手术中的地位

为了探讨阴式手术在卵巢良性肿瘤手术中的重要性,通过回顾性分析解放军总医院2003年～2006年间收治的卵巢良性肿瘤患者60例(阴式、腹腔镜、开腹手术各20例),对3种术式的手术时间、术中出血量、术后病率、术后肛门排气时间、住院时间进行比较,进而拓展到我院多种疑难阴式手术情况和结局。结果显示,对于卵巢良性肿瘤,阴式组手术时间短,恢复快,术后病率少。提示阴式手术在卵巢良性肿瘤手术中居于非常重要的地位。     

重症免疫性血小板减少性紫癜紧急救治方案的探讨

为了探讨重症免疫性血小板减少性紫癜(ITP)的治疗方案,回顾性分析118例接受激素(92例)或丙种球蛋白(16例)或rhTPO(10例)治疗患者的临床资料,分析疗效及不良反应。结果显示:(1)激素组、丙种球蛋白组和rhTPO组总有效率分别为76.1%、81.3%和70%,组间差异无统计学意义。复发组有效率(67.3%)明显低于初治组(83.3%,P0.05),PAIgG伴PAIgM升高组有效率明显低于不伴PAIgM升高组(P0.05);(2)血小板达峰时间:激素组为(5.70±3.68)d,丙种球蛋白组为(4.31±0.75)d,rhTPO组为(5.00±1.63)d,激素组与丙种球蛋白组间差异有统计学意义(P0.05);(3)不良反应:激素组均出现类库欣综合征表现,丙种球蛋白组未见不良反应,1例(10%)rhTPO组患者出现轻度转氨酶增高。总之,丙种球蛋白和rhTPO治疗成人重症ITP疗效好,不良反应轻微。