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To observe the effect of Shenlong Oral Liquid(SLOL)combined with radiotherapy in treating nasopharyngeal carcinoma (NPC). Methods: Effects of the combined therapy, including clinical effects, changes of cellular immunity and side effects, in treating 60 NPC patients (in the treated group) were observed and compared with those of the other 60 patients treated with radiotherapy alone (in the control group). Results: (1)The side effects of radiation in the treated group were lower than those in the control group significantly (P<0.05). (2) The short-term remission rate of nasopharyngeal and neck metastatic tumor in the two groups was not significantly different (P>0.05). (3) The dose for complete remission of nasopharyngeal and neck tumor in the treated group was lower than that in the control group (P<0.01). (4) No change of T-lymphocyte subsets was found in the treated group after treatment, but in the control group , OKT3,OKT4,and OKT4/OKT8 ratio were markedly decreased (P<0.05). (5) The survival rate in the treated group was higher than that in the control group, but with no statistical significance (P=0.0518). Conclusion: The combined therapy of NPC with SLOL and radiotherapy is able to reduce side-effect of radiotherapy, improve the cellular immunity, reduce the dose of radiation for tumor remission and enhance the therapeutic effect of radiotherapy. It showed a trend of raising the long-term survival rate of NPC patients.
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水蛭等活血化瘀中药与放疗联合治疗晚期鼻咽癌41例
我们于1996年2月-1998年2月用水蛭等活血化瘀的中药与放疗的综合疗法,治疗晚期鼻咽癌,随防已5年以上,现就其近期和远期疗效观察报告如下.
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Even though radiotherapy is a therapy of first choice in the treatment of nasopharyngeal carcinoma, its radiotoxicity is often difficult to bear for patients in addition to the unsatisfactory effect in some patients. Therefore, an important problem in the treatment of nasopharyngeal carcinoma is to abate radiotherapeutic toxicity and improve its effect. Some progresses in promoting the effect of radiotherapy and abating its toxicity have been made through application of traditional Chinese medicine (TCM) which is briefly reviewed as follows.
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Even though radiotherapy is a therapy of first choice in the treatment of nasopharyngeal carcinoma, its radiotoxicity is often difficult to bear for patients in addition to the unsatisfactory effect in some patients. Therefore, an important problem in the treatment of nasopharyngeal carcinoma is to abate radiotherapeutic toxicity and improve its effect. Some progresses in promoting the effect of radiotherapy and abating its toxicity have been made through application of traditional Chinese medicine (TCM) which is briefly reviewed as follows.
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鼻咽癌的病理组织学分类
鼻咽癌是鼻咽黏膜被覆上皮(鳞状、柱状和移形上皮)和小涎腺发生的恶性肿瘤[1-2].有关全人群鼻咽癌病理方面,尤其是有关其流行趋势方面的研究甚少,现有人群中鼻咽癌病理类型构成的研究多是医院内鼻咽癌病理诊断构成[3-6].
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外科手术在鼻咽癌治疗中的作用
鼻咽癌是我国常见的头颈部恶性肿瘤,尤其在东南沿海地区.它的首选治疗方式应采用放射治疗(简称放疗).随着放疗技术的不断提高,鼻咽癌的5年生存率有所提高,但仍徘徊于60%,仍有不少患者出现局部或颈部复发或残留.对鼻咽癌根治性放疗后局部或颈部复发或残留的患者的治疗尚有不少争议.本文目的是介绍外科手术在复发鼻咽癌治疗中的作用.
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我国鼻咽癌诊治30年的变迁与进步
鼻咽癌(nasopharyngeal carcinoma,NPC)的发病具有明显的地区聚集性,我国南方的广东省是全世界高发的地区,其男性世界人口标化发病率高达30/10万,女性达13/10万.放射治疗(简称放疗)一直是其首要的治疗手段.鼻咽癌放疗的历史虽不足百年,但5年生存率已由初期的15%左右提高到近期的70%左右,其疗效提高与放疗设备的更新、影像诊断技术的进步、放疗技术的不断完善,以及个体化的综合放、化疗有着密不可分的联系.现将我国鼻咽癌诊治30年的变迁与进步叙述如下.
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Objective: To compare gene expression profiles of nasopharyngeal carcinoma (NPC) tissue with that of control tissue by cDNA Array and to discuss possible reasons of TP53 accumulation in NPC tissue. Methods: (1) hybridization of Atlas Human Cancer cDNA Expression Array 7742-1; (2) analysis of Atlas Arrays using Atlasimage 1.01a; (3) verification of results of array by RT-PCR; (4) verification of protein expression alterations by immuno- histochemistry. Results: (1) Of 588 tumor-related genes, 134 genes were upregulated, 88 downregulated; (2) Of 32 TP53-regulated genes, 13 genes were shown differential expression, 11 upregulated, 2 downregulated; (3) ATM and JNK2 were upregulated; (4) mRNA expression of ubiquitin-conjugating enzyme E2 (M74524) and ubiquitin- conjugating enzyme E2 (L22005) has no evident changes; Conclusion: (1) TP53 dysfunction exists in NPC tissues; (2) ATM and JNK might be the important causes of TP53 accumulation.
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Objective: This study was designed to clone candidate tumor suppressor genes down-expressed in Nasopharyngeal Carcinoma (NPC). Methods: Differentially expressed cDNA fragments (AF152605 and AF091517) were labeled by PCR, and Northern blot was used to confirmed transcript length of these genes. Skeleton muscle cDNA library was screened with PCR-labeled probe mixture. By sequencing the positive clones directly, three novel genes (Genbank accession number: AF179285, AF170307 and AF194971), with transcripts of 2.1 Kb, 1.1 Kb and 1.4 Kb respectively, were isolated successfully. Conclusions: Library screening using PCR-labeled probes mixture is an efficient method to get full-length cDNA from multi-cDNA fragment simultaneously and quickly.
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To detect genetic alterations in nasopharyngeal carcinoma (NPC) in Cantonese, the population with the highest incidence of NPC, and to correlate the findings with clinical staging. Methods: Comparative genomic hybridization (CGH) was performed on 35 primary nasopharyngeal carcinomas and a nonparametric χ2 test was used to analyze relationship between chromosome changes and clinical staging. Results: The identified common chromosomal alterations in NPC included gain of chromosomes 12q (21 cases, 60%), 4q (19cases, 43%), 3q (18 cases, 51%), 1q (15 cases, 43%),8q (14 cases, 40%), and 2q (12 cases, 30%). The most frequently detected loss of chromosomal materials involved chromosome 1p (24 cases, 69%), chromosome 3p (21 cases, 60%), 11q (20 cases, 57%), 14q (18 cases, 51%), 16q (14 cases, 40%), 13(12 cases, 34%), and 9p(11 cases, 31%). The high frequency (>50%) 4q gain and 1p loss were novel findings. Compared by nonparametric χ2 test, gains on 12q and 8q were found mainly in stages Ⅲ/Ⅳ and there were significant differences between two clinical stage groups ( stagesⅠ/Ⅱvs stages Ⅲ/Ⅳ). Conclusions: Current analysis has revealed a comprehensive profile of the chromosomal regions showing DNA copy number changes, which may harbor oncogenes or tumor suppressor genes involved in the development of primary NPC.
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鼻咽癌患者放疗前及放疗期间黏液纤毛输送功能及其形态学观察
我们观察了鼻咽癌(nasopharyngeal carcinoma,NPC)患者放疗前后的黏液纤毛系统清除功能的改变,尤其是放疗期间放疗剂量与其功能改变之间的关系,以便发现黏液纤毛系统清除功能改变的时间点,为寻找减轻放疗损伤鼻黏膜的干预时机提供理论依据.
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鼻咽癌患者外周血γδT细胞对鼻咽癌细胞的细胞毒活性测定
T细胞受体(T cell receptor,TCR)γδ表型细胞与TCRαβ细胞不同,识别抗原的方式类似于免疫球蛋白,以主要组织相容性复合体非限制性方式识别抗原分子[1,2],无需抗原呈递分子配合,直接识别广谱肿瘤抗原.我们以抗体固相法体外扩增7例鼻咽癌(nasopharyngeal carcinoma,NPC)患者及6例健康人外周血的γδT细胞,经原代NPC细胞同步培养,得到高纯度的NPC细胞.流式细胞仪检测γδT细胞纯度,研究两种来源的γδT细胞对Daudi、CNE1、CNE2和新建的传代培养NPC细胞的细胞毒作用,探讨NPC患者外周血中γδT细胞的抗肿瘤作用.
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鼻咽癌患者和海洛因吸毒者三种病毒的感染观察
鼻咽癌是广西壮族自治区的高发恶性肿瘤之一,另外由于地处边陲,又面临吸毒者猛增的趋势[1].研究显示鼻咽癌的发生发展与EB病毒(Epstein-Barr virus ,EBV)有密切关系[2,3],海洛因吸毒者的EBV感染率高,但未见鼻咽癌出现.病毒与癌的关系,一种病毒感染与多种病毒感染的关系,值得病毒学家和临床医生的关注.为此,我们对地方性高发的鼻咽癌及海洛因吸毒者的几种常见病毒的感染情况进行分析观察.
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He-Ne激光治疗鼻咽癌放疗后继发性化脓性中耳炎
鼻咽癌(nasopharyngeal carcinoma,NPC)是我国常见的头颈部恶性肿瘤,在我国南方地区尤为多见.放射治疗是首选方法,但放射治疗后由于电离辐射引起咽鼓管功能障碍,继发化脓性中耳炎的发生率较高,严重影响了患者的生活质量.笔者自1994-2004年利用He-Ne激光治疗鼻咽癌放疗后化脓性中耳炎,与对照组比较,结果显示疗效满意,现报告如下.
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Nasopharyngeal carcinoma (NPC) is a high morbidity tumor of otorhinolaryngology. The usual clinical manifestations are well known by the specialists. But the bizarre and confusing nature of NPC has misled clinicians and contributed to delayed diagnosis. Recently our department treated a case with unusual nasopharyngeal carcinoma.
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鼻咽癌常规放疗中电子线L形野照射技术应用研究
目的探讨电子线L形野照射技术用于鼻咽癌常规放疗中射野之间衔接的问题。方法回顾我院在2011年04月至2013年10月住院治疗的120例鼻咽癌患者,随机分成观察组和对照组,每组各60例,观察组的布野使用三维计划系统,在系统中模拟鼻咽癌2D-适形放疗(CRT)或3D-CRT治疗中电子线L形野照射技术,对照组则使用常规颈后电子线野照射技术进行布野,所有患者放疗过程中均需记录各个区域的照射剂量。结果两组120例鼻咽癌患者均完成放射治疗,其中观察组和对照组的的靶区剂量的包绕体积超过6000cGy剂量的达到95%以上,符合临床上治疗肿瘤的剂量,但对照组(颈后电子线野照射技术)患者出现明显的剂量热点,平均剂量高达8700±360cGy,而观察组(电子线L形野照射技术)平均剂量为6500±290cGy,两组相比较,差异具有显著性,P<0.05;观察组(电子线L形野照射技术)咽喉部剂量超过6500cGy的平均包绕体积只有17.32±3.12%,而对照组(颈后电子线野照射技术)却高达37.83±5.39%,两组相比较,差异具有显著性,P<0.05。结论观察组(电子线L形野照射技术)在临床上治疗肿瘤的剂量需要与对照组(颈后电子线野照射技术)相比差异无显著性,P>0.05,但观察组(电子线L形野照射技术)在照射野之间的衔接和剂量均匀分布方面具有明显的优势,且安全有效,值得临床推广应用。
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放化疗联合治疗局部中晚期鼻咽癌临床观察
鼻咽癌为我国常见的恶性肿瘤之一,在世界上多数国家发病率约为1/10万.但在我国发病率为10/10万-30/10万[1],其中又以南方地区为甚.由于其发病部位特殊,手术根治困难.病理类型多为低分化鳞癌,放疗效果好,故放疗为其首选治疗方法.但是,在日前放疗设备已日臻完善的情况下,单纯放疗的5年生存率仍在50%~60%.
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护理干预对重组人P53腺病毒联合放化疗治疗的鼻咽癌患者疲乏的影响
目的:探讨护理干预对重组人P53腺病毒联合放化疗治疗的鼻咽癌患者癌因性疲乏和生存质量的影响.方法:60例采用重组人P53腺病毒联合放化疗治疗的鼻咽癌患者随机分为两组,对照组进行常规护理,观察组在常规护理的基础上,由专业护士实施护理干预.在治疗开始及结束时,60例患者均采用BF I量表及EORTC QLQ-C30量表进行调查,结果用统计学方法对两组患者癌因性疲乏、生存质量进行比较分析.结果:治疗开始时,实验组与对照组癌因性疲乏、生存质量无显著性差异;治疗结束时,观察组疲乏程度低于对照组,生存质量高于对照组,差异有统计学意义(p<0.01).结论:健康宣教、心理干预、有氧运动、饮食调养,提高睡眠质量等护理干预,可以消除或缓解疲乏程度,提高患者的生存质量.
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牛奶冰棒加中药茶防治鼻咽癌病人放射性口腔黏膜反应的临床研究
口腔黏膜炎是指口腔黏膜上皮组织的一类炎症和溃疡反应,表现为口腔黏膜的红斑、脱皮、溃疡形成、出血和渗血[1,2].放射性口腔黏膜炎已经成为鼻咽癌放疗中为严重的制约因素,其发生率几乎是100%.发生口腔黏膜炎后,由于口腔不适、疼痛、咀嚼及吞咽困难,给病人带来很大的痛苦,影响营养的摄入及放疗的顺利进行,是导致放疗中断乃至失败的常见原因,严重影响病人的生存质量及治疗效果[3-6].我科采用中药泡茶饮用、放疗后吃牛奶冰棒等方法防治鼻咽癌放疗所致的口腔黏膜反应,效果较好.现报告如下:
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晚期鼻咽癌病人放化疗期间护理
目前,同期放化疗已成为治疗晚期鼻咽癌病人的重要手段之一,与单一手段的治疗方法相比疗效大有提高,但在增加疗效的同时,也增加了毒副反应.因此,在治疗过程中若不及时解决潜在的或已存在的护理问题病人就很难顺利完成治疗,终将影响到治疗的效果.从2008年3月-2009年6月观察54例晚期鼻咽癌病人行同期放化疗出现的不良反应,并采取相应的护理措施,使病人均如期完成治疗.现将护理总结报告如下.