《广州医药》
点击关注官方服务号追踪稿件状态

【重要服务提醒】《广州医药》杂志服务号已上线稿件查询功能

各位作者、审稿专家:
本刊官方微信服务号新增稿件状态查询服务,无需反复登录投稿系统,微信即可随时查看审稿进度、修回通知、录用结果,稿件更新实时推送提醒,同步接收期刊征稿、学术资讯。

操作方式

微信搜索关注广州医药杂志服务号 → 点击菜单栏「绑定账号」→ 输入投稿邮箱完成账号关联;请关闭微信消息免打扰,避免遗漏稿件通知。

《广州医药》编辑部

广州医药杂志服务号
论著

CT、MRI 影像学表现对原发性肝细胞癌微血管侵犯的诊断价值

Diagnostic value of CT and MRI imaging manifestations for microvascular invasion in primary hepatocellular carcinoma

:681-688
 
       目的   探讨CT、MRI影像学表现对原发性肝细胞癌(HCC)微血管侵犯(MVI)的诊断价值。方法   选取2018年1月—2024年7月江门市第二人民医院(江门市中心医院蓬江分院)和江门市中心医院120例(共158个病灶)HCC患者,均行上腹部CT、MRI平扫+增强及弥散加权成像(DWI)检查;以术后病理结果为金标准。比较CT、MRI平扫+增强及DWI对HCC MVI诊断效能;分析HCC MVI诊断中CT、MRI平扫+增强及DWI检查与术后病理确诊结果之间的一致性;比较HCC MVI与无HCC MVI患者影像学表现及表观扩散系数(ADC)值。结果    DWI检查对HCC MVI的诊断效能(灵敏度、特异度、准确度、阳性预测值、阴性预测值)均显著性高于CT、MRI平扫+增强(P<0.05);CT、MRI、DWI对原发性肝细胞癌患者微血管侵犯的诊断效能比较,差异均无统计学意义(P>0.05)。在HCC MVI诊断效能中,CT、MRI影像学表现与术后病理确诊结果之间为中度一致性;DWI与术后病理确诊结果之间为高度一致性。HCC MVI患者的强化方式在非边缘动脉期强化、强化包膜、晕状强化、结中结、门脉分支癌栓占比均显著性高于无HCC MVI患者(P<0.05)。在不同b值(400、800、1 000、1 500 s/mm2 )下,HCC MVI患者的ADC值均显著性高于无HCC MVI患者(P<0.05)。结论    CT、MRI平扫+增强及DWI对HCC MVI均具有较好的诊断效能,而MRI诊断结果与病理诊断一致性更佳,尤其DWI图中ADC值可更加精准地判断HCC的患者是否发生微血管侵犯,有助于指导临床医生建立“个体化”精准诊疗策略。
       Objective  To explore the diagnostic value of CT and MRI imaging manifestations for microvascular invasion(MVI)in primary hepatocellular carcinoma(HCC).Methods  A total of 120 patients(158 lesions in total)with HCC in the Second People’s Hospital of Jiangmen(Pengjiang Branch of Jiangmen Central Hospital)and Jiangmen Central Hospital were selected from January 2018 to July 2024,all underwent CT and MRI plain + enhanced and diffusion-weighted imaging(DWI)of the upper abdomen;postoperative pathology results was used as the diagnostic gold standard.The diagnostic efficacy of CT,MRI plain + enhanced and DWI for HCC MVI was compared.The concordance among CT,MRI plain + enhanced and DWI examinations with postoperative pathological diagnostic findings in the diagnosis of HCC MVI.Imaging manifestations and apparent diffusion coefficient(ADC)values in patients with and without HCC MVI were compared.Results  Diagnostic effectiveness of DWI examination for HCC MVI(sensitivity,specificity,accuracy,positive predictive value,negative predictive value)were all significantly higher than those of CT and MRI plain + enhanced(P<0.05);none of the differences were statistically significant(P>0.05)in the comparison of diagnostic effectiveness of CT,MRI,and DWI for the diagnosis of MVI in patients with primary HCC.In HCC MVI diagnostic effectiveness,moderate concordance was found among CT,MRI imaging phenotypes and postoperative pathology results;high concordance was found between DWI and postoperative pathology results.In HCC MVI patients,the proportion of non-marginal arterial reinforcement,enhanced envelope,halo reinforcement,nodal in nodal and portal branch cancer thrombi was significantly higher than that in patients without HCC MVI(P<0.05).At different b-values(400,800,1 000,1 500 s/mm2 ),ADC values were all significantly higher in patients with HCC MVI than in patients without HCC MVI(P<0.05).Conclusions  CT,MRI plain + enhanced and DWI have good diagnostic effectiveness for HCC MVI,while MRI diagnostic results are in better concordance with pathologic diagnosis.In particular,ADC values in DWI maps can more accurately determine whether MVI occurs in patients with HCC,which helps to guide clinicians to establish“individualized”and precise diagnosis and treatment strategies.
论著

重楼皂苷Ⅰ通过 p53 信号通路诱导慢性粒细胞白血病细胞铁死亡

Ferroptosis of chronic myeloid leukemia cells induced by polyphyllin I through p53 signal pathway

:605-615
 
       目的  探讨重楼皂苷Ⅰ(PPI)对慢性髓系白血病细胞(K562)细胞的抑制作用及可能的作用机制。  采用CCK-8法筛选药物最适浓度,将培养时间为24 h的药物最适浓度作为后续实验的干预浓度。分组如下:(1)空白组;(2)PPI组;(3)抑制剂组;(4)PPI+抑制剂组。采用CCK-8法检测细胞增殖率;AO/EB染色观察细胞形态;流式细胞术检测凋亡率;ROS检测试剂盒检测活性氧(ROS)含量、还原型谷胱甘肽含量检测试剂盒检测谷胱甘肽(GSH)含量、细胞亚铁比色法测试盒检测细胞亚铁(Fe2+)含量;qRT-PCR法和蛋白免疫印迹法检测各组肿瘤蛋白53(p53)、钠氯离子依赖性氨基酸转运蛋白11(SLC7A11)、谷胱甘肽过氧化物酶4(GPX4)mRNA及蛋白表达量。结果  PPI抑制K562细胞的生长,且呈一定的剂量及时间依赖性(与同时间段的对照组0μmol/L比较,均P<0.01)。与空白组相比,PPI抑制K562细胞的增殖,提高了凋亡率,而铁死亡抑制剂(Ferrostian-1)的使用逆转了PPI对K562凋亡的促进作用(P<0.01)。与空白组相比,PPI组ROS、Fe2+含量升高,GSH含量下降,而铁死亡抑制剂的使用可下调ROS、Fe2+,上调GSH的含量(P<0.01)。PPI组较空白组p53 mRNA和蛋白表达水平升高,而SLC7A11、GPX4 mRNA和蛋白表达水平下降(P<0.05);PPI+抑制剂组细胞较重楼皂苷组p53 mRNA和蛋白表达水平下降,而SLC7A11、GPX4 mRNA和蛋白表达水平升高(P<0.05)。结论  PPI能够有效抑制K562细胞增殖,促进K562细胞铁死亡,其分子机制可能与p53信号通路的调控有关。
       Objective  To investigate the inhibitory effect of polyphyllin I(PPI)on chronic myeloid leukemia cells(K562)and its possible mechanism.Methods  K562 cell line was cultured in suitable environment,and the optimal concentration of the drug was screened by CCK-8 method.The optimal concentration of the drug cultured for 24 hours was used as the intervention concentration of the follow-up experiment.Cells were divided into the following groups:(1)blank group,(2)saponins group,(3)inhibitor group and(4)saponins + inhibitor group.The cell proliferation rate was detected by CCK-8 method.The cell morphology was observed by AO/EB staining.The apoptosis rate was detected by flow cytometry.The contents of  reactive oxygen species(ROS),glutathione(GSH)and ferrous(Fe2+)in different groups were detected,and the expression of mRNA and protein in different groups were detected by qRT- PCR and Western blot respectively.Results  PPI significantly inhibited the growth of K562 cells in a dose-and time-dependent manner.Compared with the blank group,PPI significantly inhibited the proliferation of K562 cells and increased the apoptosis rate of K562 cells,while the use of ferroptosis inhibitor(Ferrostian-1)reversed the promoting effect of PPI on apoptosis of K562 cells.Compared with the blank group,the contents of reactive oxygen species(ROS)and ferrous iron(Fe2+)increased and the content of glutathione(GSH)decreased in the saponins group.The use of Ferrostian-1 could down-regulate the contents of ROS and Fe2+ and increase the content of GSH in the cells treated with the drug.Compared with the blank group,the expression of p53 mRNA and protein in the saponins group increased,while the expression of SLC7A11,GPX4 mRNA and protein decreased.The expression of p53 mRNA and protein in the saponins + inhibitor group was lower than that in the saponins group,while the expression levels of SLC7A11,GPX4 mRNA and protein increased.Conclusions  PPI can effectively inhibit the proliferation of K562 cells and promote ferroptosis in K562 cells.The molecular mechanism can be related to the regulation of p53 signal pathway.
论著

CT 增强延迟扫描技术在非小细胞肺癌术前诊断中的应用价值

The application value of CT enhanced delayed scanning in preoperative diagnosis of non-small cell lung cancer

:547-552
 
       目的     探讨CT增强延迟扫描技术在非小细胞肺癌术前诊断中的应用价值。方法    对2021年5月—2024年5月商丘市第一人民医院收治的82例非小细胞肺癌手术治疗患者进行回顾性分析,将其分为观察组,另选取82例肺部良性肿瘤患者作为对照组,收集其术前CT增强延迟扫描结果,以术后病理诊断结果为金标准,分析CT增强延迟扫描技术在非小细胞肺癌术前诊断中的应用价值。并对比不同临床病理特征非小细胞肺癌患者CT增强延迟扫描的CT增强值,采用Spearman相关性分析法分析CT增强值与非小细胞肺癌病理特征的关系。结果  CT增强延迟扫描显示观察组患者分叶征(12.50% vs 53.57%)、内部空泡征数量(6.25% vs 39.29%)低于对照组(χ 2 =26.560、24.680,P<0.05),观察组患者边缘毛刺(56.25% vs 17.86%)、胸部凹陷征(59.38% vs 14.29%)、高于对照组(χ 2 =43.330、64.600,P<0.05);82例非小细胞肺癌通过CT增强延迟扫描共确诊79例,CT增强延迟扫描诊断对非小细胞肺癌的准确率为96.34%(79/82),与病理诊断结果100.00%对比差异无统计学意义(χ 2 =3.060,P=0.080);82例非小细胞肺癌平均CT增强值为(39.14±7.31),不同性别、年龄、肿瘤最大直径、淋巴结浸润情况患者CT增强值对比差异无统计学意义(P>0.05),不同病理类型[腺癌(43.75±7.15)vs 鳞癌(34.74±6.12)]、细胞分化程度[中、低分化(45.71±7.21)vs 高分化(32.81±5.11)]、临床分期[Ⅰ期(31.03±2.12)vs Ⅱ期(36.61±3.13)vs Ⅲa期(46.32±6.83)]患者、淋巴结转移[是(42.75±4.21)vs (35.77±8.13)]CT增强值对比差异有统计学意义(t/F=5.243、8.804、84.828、4.378,P<0.05);Spearman相关分析结果显示:病理类型、细胞分化程度、临床分期、淋巴结转移与非小细胞肺癌患者CT增强值呈正相关(r=0.431,P=0.021;r=0.511,P=0.009;r=0.586,P=0.005;r=0.579,P=0.008,P<0.05)。结论  CT增强延迟扫描技术对非小细胞肺癌术前确诊具有重要价值,其诊断准确率与病理诊断并无显著差异,且可通过CT增强延迟扫描技术确定患者CT增强值,从而为非小细胞肺癌患者术后病理特征判断提供参考。
      Objective  To explore the application value of CT enhanced  delayed  scanning in  preoperative  diagnosis of non-small cell lung cancer(NSCLC).Methods  A retrospective analysis was conducted on 82 patients with NSCLCwho underwent surgical treatment in a hospital from May 2021 to May 2024.They were included into  an  observation  group and another 82 patients with benign lung tumors were included in the control group.The  preoperative CT enhanced  delayed scanning results were collected,and the postoperative pathological diagnosis was used as the “gold standard” to analyze the application value of CT enhanced delayed scanning in the preoperative diagnosis of NSCLC.And the CT enhancement values of delayed CT scans in NSCLC patients with different clinical and pathological features were compared,and Spearman correlation analysis was used to analyze the relationship between CT enhancement values and pathological features of NSCLC.Results  CT enhanced delayed scanning showed that the number of lobular(12.50% vs 53.57%)and internal vacuolar signs(6.25% vs39.29%)in the observation group was significantly lower than that in the control group(χ 2 =26.560,24.680,P<0.05),while the edge spicules(56.25% vs 17.86%)and chest depression signs(59.38% vs 14.29%)in the observation group were significantly higher than that in the control group(χ 2 =43.330,64.600,P<0.05).A total of 79 cases of 82 NSCLC were diagnosed by CT-enhanced delayed scan,and the accuracy of CT-enhanced delayed scan diagnosis for NSCLC was 96.34%(79/82),with no significant difference from the pathological diagnosis result of 100.00%(χ 2 =3.060,P=0.080).The average CT enhancement value of 82 NSCLC cases was(39.14±7.31).There was no significant difference in CT enhancement values among patients of different genders,ages,maximum tumor diameter,and lymph node infiltration(P>0.05).Patients with different pathological types [adenocarcinoma(43.75±7.15)vs squamous cell carcinoma(34.74±6.12)],degree of cell differentiation [moderate,and low differentiation(45.7±7.21)vs high differentiation(32.81±5.11)],clinical stage [I(31.03±2.12)vs II(36.61±3.13)vs IIIa(46.32±6.83)] and lymph node metastasis [yes(42.75±4.21),vs no(35.77±8.13)] CT enhancement had significant difference(t/F=5.243,8.804,84.828,4.378,P<0.05).The Spearman correlation analysis results showed that pathological type,degree of cell differentiation,clinical stage,lymph node metastasis were positively correlated with CT enhancement values in NSCLC patients(r=0.431,P=0.021;r=0.511,P=0.009;r=0.586,P=0.005;r=0.579,P=0.008).Conclusions  CT enhanced delayed scanning has important value in preoperative diagnosis of NSCLC.Its diagnostic accuracy is not significantly different from pathological diagnosis,and the CT enhanced value of patients can be determined through CT enhanced delayed scanning,providing reference for postoperative pathological feature judgment of NSCLC patients.
综述

双硫死亡与其他细胞死亡在卵巢癌治疗中的研究进展

Research progress on disulfideptosis and other cell death pathways in ovarian cancer treatment

:452-456
 
       卵巢癌是导致女性死亡的全球第五大原因,其治疗效果受限于早期诊断和治疗方案的有限性。近年来,随着靶向治疗的不断发展,细胞死亡途径作为治疗靶点受到广泛关注,其中双硫死亡作为一种新发现的程序性细胞死亡形式,为癌症治疗提供了新的思路。文章探讨了双硫死亡及其他主要细胞死亡途径包括自噬、细胞焦亡、坏死性凋亡、铁死亡和铜死亡在卵巢癌治疗中的研究进展,有望为卵巢癌患者提供更有效的治疗选择。
    Ovarian cancer ranks as the fifth deadliest cancer among women worldwide,with treatment efficacy hampered 
by limited early diagnosis and therapeutic options.In recent years,with the continuous development of targeted therapies,cell death pathways have gained widespread attention as therapeutic targets.Among them,disulfideptosis,a newly discovered form of programmed cell death,offers a novel avenue for cancer treatment.This review aims to explore the research progress of disulfideptosis and other major cell death pathways including autophagy,apoptosis,necroptosis,ferroptosis,and cuproptosis in ovarian cancer therapy,with the potential to provide more effective treatment options for ovarian cancer patients.
专家述评

嗜酸性粒细胞在心血管疾病中的研究进展

Research progress of eosinophils in cardiovascular diseases

:429-438
 
      嗜酸性粒细胞(EOS)作为过敏反应中关键的先天免疫细胞,在心血管疾病的发生与发展进程中也扮演着至关重要的角色。大量证据显示,血液EOS计数与诸多心血管疾病之间存在紧密联系,但临床研究得出的结论不尽相同。基础研究发现,EOS一方面可通过释放白细胞介素-4(IL-4)、IL-13及阳离子蛋白等细胞因子,对心肌梗死、心肌肥厚、心力衰竭或腹主动脉瘤发挥保护作用;另一方面,EOS表达的阳离子蛋白和血小板活化因子会促进平滑肌细胞增殖和钙化,进而加速动脉粥样硬化的形成。因此,EOS在不同心血管疾病中所发挥的作用存在差异,这与疾病的演变进程、EOS的数量均密切相关。本文对现有的临床和基础研究成果进行汇总,阐述EOS在各类心血管疾病中的不同作用。
       Eosinophils(EOS),as key innate immune cells in allergic reactions,play a crucial role in the occurrence and development of cardiovascular diseases.Ample evidence shows that the count of blood EOS is closely related to many cardiovascular diseases.However,the conclusions drawn from clinical studies are inconsistent,and these contradictory observational  results still cannot be reasonably explained so far.Basic research has found that,on the one hand,EOS can exert protective effects on myocardial infarction,myocardial hypertrophy,heart failure,or abdominal aortic aneurysm by releasing cytokines such as interleukin-4(IL-4),IL-13,and cationic proteins;on the other hand,the cationic proteins and platelet activating factors expressed by EOS can promote the proliferation and calcification of smooth muscle cells,thereby accelerating the formation of atherosclerosis.Therefore,the roles played by EOS in different cardiovascular diseases vary,which is closely related to the evolution process of the disease and the number of EOS.This article will summarize the existing clinical and basic research results to elaborate the different roles of EOS in various cardiovascular diseases.
论著

类风湿因子、T 淋巴细胞亚群与类风湿关节炎病情程度的关系研究

Relationship between rheumatoid factor,T lymphocyte subsets and the degree of rheumatoid arthritis

:361-365
 
       目的   分析类风湿因子(RF)、T淋巴细胞亚群(CD3+ 、CD4+ 、CD8+ 、CD4+ /CD8+ )与类风湿关节炎病情程度的关系。方法   选取2023年1月—2024年4月收治的90例类风湿关节炎患者作为观察组,同期到院的90例健康体检者为对照组,均接受RF、CD3+ 、CD4+ 、CD8+ 、CD4+ /CD8+ 检测,并按照类风湿关节炎患者病情评价(DAS28)判定观察组患者病情的严重程度,应用Pearson相关性分析RF、CD3+ 、CD4+ 、CD8+ 、CD4+ /CD8+ 与患者病情严重程度的关系。结果   与对照组比较,观察组RF及CD8+ 水平较高,CD3+ 、CD4+ 及CD4+ /CD8+ 水平较低(P<0.05);不同病情的RF及CD8+ 水平比较,重度患者最高,其次为中度、轻度,而CD3+ 、CD4+ 及CD4+ /CD8+ 水平比较,轻度患者最高,其次为中度、重度,两两比较均有差异统计学意义(P<0.05);经Pearson相关性分析,RF及CD8+ 水平与病情程度呈正相关,CD3+ 、CD4+ 及CD4+ /CD8+ 水平与病情程度呈负相关(P<0.05)。结论  RF、T淋巴细胞亚群指标与类风湿关节炎发生、发展有密切关系,可为医师准确评估患者病情严重程度提供可靠参考。
       Objective  To analyze the relationship between rheumatoid factor(RF),T lymphocyte subsets(CD3+CD4+ ,CD8+ ,CD4+ /CD8+ )and the severity of rheumatoid arthritis.Methods  A total of 90 patients with rheumatoid arthritis from January 2023 to April 2024 were selected as the observation group,and 90 healthy checkup individuals who came to the hospital during the same period were selected as the control group.All patients underwent RF,CD3+ ,CD4+ ,CD8+ ,and CD4+ /CD8+  tests,and the severity of their condition was determined based on the evaluation of rheumatoid arthritis patient condition(DAS28).Pearson Correlation analysis was used to analyze the relationship between RF,CD3+ ,CD4+ ,CD8+ ,CD4+ /CD8+  and the disease severity of the patients.Results  Compared with the control group,RF and CD8+  levels in the observation group were higher,while the levels of CD3+ ,CD4+  and CD4+ /CD8+  were low(P<0.05).Comparison of RF and CD8+  levels for different conditions,the RF and CD8+  levels of the severe patients was highest,followed by moderate and mild.However,the CD3+ ,CD4+  and CD4+ /CD8+levels were highest in mild patients,followed by the moderate and sereve patients.Statistical significance was found in both pairwise comparisons(P<0.05).After the Pearson correlation analysis,RF and CD8+  levels were positively correlated with the degree of disease,while CD3+ ,CD4+ ,and CD4+ /CD8+  levels were inversely associated with the degree of disease condition(P<0.05).Conclusions  RF and T lymphocyte subsets are closely related to the occurrence and development of rheumatoid arthritis,and can provide reliable references for physicians to accurately evaluate the severity of patients’ conditions.
论著

MR 引导的海马保护用于小细胞肺癌全脑放疗

Hippocampal avoidant whole brain radiotherapy guided by MR of small cell lung cancer

:330-337
 
       目的   研究核磁共振(MR)引导的海马保护技术应用于小细胞肺癌全脑放射治疗(放疗)的效果。  对确定行全脑放疗的30例小细胞肺癌脑转移患者,行常规放疗CT定位后以定位体位行全头颅MR平扫,将计算机断层扫描(CT)和MR的T1加权像在Monaco 5.1计划系统上进行精准融合,勾画全脑放疗及海马区域,在海马区域三维方向上分别外扩5、15 mm作为海马与计划靶区之间的剂量跌落,每一例患者在Monaco 5.1计划系统上按照不保护海马组织以及外扩5、15 mm进行保护设计3个容积旋转调强技术(VMAT)放疗计划,观察海马组织的平均及最大放疗剂量。结果  增加保护海马组织之后,3个放疗计划的D100均≥95%,每例的3个放疗计划间D100比较差异无统计学意义(P>0.05);设置外扩5、15 mm的剂量跌落区后,左、右海马的平均剂量、最大剂量均明显降低,而且3个放疗计划的海马平均剂量、最大剂量之间对比差异有统计学意义。结论   小细胞肺癌脑转移患者进行全脑放疗时,利用MR引导的海马保护技术并设置外扩15 mm的剂量跌落区,能够显著降低海马的剂量,达到保护目的。
       Objective  To explore the application of MR guided hippocampal avoidant whole brain radiotherapy(WBRT)for small cell lung cancer(SCLC).Methods  Thirty SCLC patients with brain metastases who underwent WBRT were enrdled.After routine CT localization was performed,and a head MR was performed in a the same position.T1 weighted images of MR and CT images were accurately fused on the Monaco 5.1 planning system.The entire brain tissue and hippocampus region were delineated.The dose drop areas between the hippocampusand the planned target area were expanded 5mm and 15mm in the three-dimensional direction of the hippocampus,respectively.Three volumetric modulated arc therapy(VMAT)radiotherapy plans were designed for each patient on the Monaco 5.1 planning system based on whether the hippocampal tissue was avoid.The average and maximum doses of hippocampal tissue were observed.Results  After the avoidance of hippocampal tissue,the D100 of the three radiotherapy plans reached ≥95%,and there was no significant difference in D100 between the three radiotherapy plans in each case.After setting dose drop areas of 5mm and 15mm for external expansion,the average and maximum doses of the left and right hippocampus were significantly reduced,and there was a significant difference in the comparison between the average and maximum doses in the hippocampus of the three radiotherapy plans.Conclusions  MR guided hippocampal avoidant technology and the setting of a 15 mm dose drop area can significantly reduce the dose to the hippocampus in patients with SCLC undergo whole brain radiotherapy.
论著

安罗替尼联合不同 ALK 抑制剂治疗非小细胞肺癌的疗效比较

Comparion of the therapeutic effect of anlotinib combined with ALK inhibitors in treating non-small cell lung cancer

:171-178
 
       目的 评价不同间变性淋巴瘤激酶(ALK)抑制剂联合安罗替尼治疗非小细胞肺癌(NSCLC)的疗效。方法 收集ALK突变阳性NSCLC患者的临床资料,筛选服用ALK抑制剂疗效不佳再加用安罗替尼的病例。根据不同的用药方案分为阿来替尼+安罗替尼,塞瑞替尼+安罗替尼和克唑替尼+安罗替尼三个组别。记录患者联合用药前最近一次的影像学检查结果,并以此为基线按Recist1.1评价疗效,以病情进展、患者死亡、停药、改变治疗方案为终点计算各组患者的无事件生存期(EFS),收集肿瘤标志物、血常规和肝功、心功能、肾功能生化检测等指标数据,统计分析患者联合用药前后各项指标的变化。结果 经筛选,共纳入49例患者的临床数据。阿来替尼+安罗替尼组有23例,疾病控制率(DCR)为86.96%;平均EFS为(10.8±3.6)个月,中位EFS为8.3个月;塞瑞替尼+安罗替尼组有14例,DCR为71.43%;平均EFS为(6.5±2.9)个月,中位EFS为5.6个月;克唑替尼+安罗替尼组有12列,DCR为66.67%;平均EFS为(7.7±3.2)个月,中位EFS为7.2个月。阿来替尼+安罗替尼组的平均EFS长于另外两组(P<0.05)。各研究组肿瘤标志物仅有CyFra21-1在克唑替尼+安罗替尼组在联合用药后升高(P<0.05),生化检测和血常规指标在用药前后差异无统计学意义(P>0.05)。  ALK抑制剂与安罗替尼联用,疗效最好为阿来替尼,其次为塞瑞替尼,最后为克唑替尼。三种ALK抑制剂与安罗替尼联用后,均未导致心、肝、肾功能和血细胞损害。
      Objective  To evaluate the efficacy of different anaplastic lymphoma kinase(ALK)inhibitors combined with anlotinib in the treatment of non-small cell lung cancer(NSCLC).Methods  Clinical data of drug resistant NSCLC patients with ALK positive mutation was collected who were treated with ALK inhibitors and anlotinib synchronously.According to different regimens,three groups were set,alectinib+anlotinib,ceritinib+anlotinib,and crizotinib+anlotinib.The latest imageological examination  results of the patient before the synchronous therapy was set as the baseline to evaluate the therapeutic effect according to Recist1.1.The event free survival(EFS)of each group was calculated with disease progression,patient death,treatment discontinuation and changing regimen as endpoints.Data of tumor markers,hematology test,liver function,cardiac function,renal function biochemical examination was collected and analyzed statistically before and after the combination therapy,with P<0.05 as the statistically significant difference.Results  After screening,clinical data of 49 patients were collected.Twenty-three patients in the alectinib+anlotinib group,with a disease control rate(DCR) of 86.96%;mean EFS was(10.8±3.6)months,median EFS of 8.3 months;14 patients in the ceritinib+anlotinib group,with a DCR of 71.43%,mean EFS was(6.5±2.9)months,median EFS was 5.6 months;12 patients in the crizotinib+anlotinib group,with a DCR of 66.67%,mean EFS was(7.7±3.2)months,median EFS was 7.2 months.EFS of alectinib+anlotinib group was longer significantly than the other two groups(P<0.05).Only CyFra21-1,increased significantly after the combination of crizotinib and anlotinib(P<0.05).No statistically significant difference in biochemical test and hematology test before and after the treatment(P>0.05).Conclusions  The therapeutic effect of ALK inhibitors with anlotinib was ordered,alectinib being the most effective,followed by ceritinib and finally crizotinib.The combination of ALK inhibitors with anlotinib did not cause any abnormal results in the examination of heart,liver,kidney and blood cells.
论著

SUZ12 通过调控肝癌细胞及人脐静脉内皮细胞的血管生成发 挥抑癌作用

Anti-cancer role of SUZ12 by regulating angiogenesis of liver cancer cells and human umbilical vein endothelial cells

:71-76
 
       目的   探讨多梳蛋白SUZ12对肝细胞肝癌(HCC)细胞增殖、血管生成拟态形成和人脐静脉内皮细胞(HUVECs)血管生成的影响。方法 分别利用MTT比色法及体外血管生成实验检测SUZ12表达水平改变对HCC细胞SMMC-7721、Hep3B增殖、血管生成拟态形成和HUVECs血管生成的影响。结果  MTT结果显示,在HCC细胞中分别敲低或过表达SUZ12均对HCC细胞的增殖能力无明显影响。将SUZ12低表达HCC细胞与HUVECs共培养后,HCC细胞的血管生成拟态管样结构形成增多。此外,将SUZ12敲低组HCC细胞的培养上清用于培养HUVECs后,HUVECs的血管生成拟态管样结构形成也明显增多。结论  SUZ12对HCC细胞的增殖无影响,其在HCC中可抑制HCC细胞和HUVECs的血管生成拟态管样结构形成。上述结果提示SUZ12可能通过调控HCC细胞及HUVECs的血管生成发挥抑癌作用。
      Objective  To investigate the effects of SUZ12 on cell proliferation of hepatocellular carcinoma(HCC),vasculogenic mimicry formation and human umbilical vein endothelial cells(HUVECs)angiogenesis.Methods  MTT assay was performed to detect the proliferation of SMMC-7721 and Hep3B cells.The effects of SUZ12 on the angiogenesis of HCC cells and HUVECs cells were studied by in vitro angiogenesis experiment.Results  The result of MTT assay showed that SUZ12 knockdown or overexpression in HCC cells had no significant effect on the proliferation of HCC cells.We found that when HCC cells with low SUZ12 expression were co-cultured with HUVECs cells,the formation of vasculogenic mimicry tubular structures in HCC cells increased.In addition,we also found that after the culture supernatant of HCC cells in the SUZ12 knockdown group was used to culture HUVECs cells,the formation of vasculogenic mimicry tubular structures in HUVECs cells also increased significantly.Conclusions  SUZ12 has no effect on the proliferation of HCC cells,but it can inhibit the formation of vasculogenic mimicry tubular structures in HCC cells and HUVECs cells.These results suggest that SUZ12 plays a role in cancer inhibition by regulating the angiogenesis of HCCcells and HUVECs cells.
综述

浆细胞性乳腺炎的中西医结合治疗进展

Progress of integrated traditional Chinese and Western medicine treatment of plasma cell mastitis

:56-61
 
       近年来浆细胞性乳腺炎的发病率逐渐升高,已占乳腺疾病的4%~5%,该病易反复发作,经久不愈,抗生素、糖皮质激素、抗结核药、他莫昔芬等治疗效果不明显,单纯手术切除如切除范围小极易复发,而切除范围大则乳腺外形变化较大,严重者甚至需要切除乳腺。乳腺外形的缺损改变对患者身心健康造成伤害。随着研究不断深入,采用中西医结合治疗浆细胞性乳腺炎,可取得较好的治疗效果,降低复发率,而且对乳腺外观无影响。该文通过对文献的整理,对中西医结合治疗浆细胞性乳腺炎进行论述。
       In recent years,the incidence of plasma cell mastitis has gradually increased,accounting for 4 % ~ 5 % of breast diseases.The disease is prone to repeated attacks and unhealed for a long time.The treatment effect of antibiotics,glucocorticoids,anti-tuberculosis drugs and tamoxifen is not obvious.Simple surgical  resection is easy to  relapse if the  resection range is small,while the shape of the breast changes greatly,if the resection range is large.And even the breast needs to be removed in severe cases.The defect change of breast shape is harmful to the physical and mental health of patients.With the deepening of research,the combination of traditional Chinese and Western medicine in the treatment of plasma cell mastitis can achieve better therapeutic effect,reduce the recurrence rate,and has no effect on the appearance of breast.This article discusses the treatment of plasma cell mastitis with integrated traditional Chinese and Western medicine by sorting out the literature.
出版者信息








《广州医药》公众号