肺癌发病率和死亡率已居各种癌症之首位.需要探索新的治疗模式,免疫治疗以其低毒,高特异性等优点有望成为肺癌治疗的重要辅助治疗方式。本文综述了肺癌的过继免疫治疗、单克隆抗体疗法、基因治疗、肿瘤疫苗、细胞因子治疗、生物反应调节剂六个方面现状及最新进展。

The morbidity and mortality of lung cancer have been reached the first place in all cancers. It is necessary to explore a new treatment mode for lung cancer. Immunotherapy with lower toxicity and higher specificity is expected to become the important auxiliary treatment for lung cancer. We reviewed the present situation for lung cancer in six aspects:the adoptive immunotherapy, monoclonal antibody therapy, gene therapy, tumor vaccine, cytokine therapy and biological response regulator.

目的探讨新辅助同步放化疗联合全直肠系膜切除(TME)加术后辅助化疗三联疗法治疗中低位局部进展期直肠癌的疗效及安全性。方法选择局部进展期中低位直肠癌Ⅱ、Ⅲ期(T2N+M0,T3-4N0-2M0期)65例,术前放疗总剂量50~54 Gy,术前采用Xelox方案化疗3个疗程,放化疗结束后6~8周根据TME原则行直肠癌根治术。术后采用Forfox4方案辅助化疗6个疗程。结果 65例均完成新辅助同步放化疗、手术治疗及术后辅助化疗。其中48例行Dixon’s手术,17例行mile’s手术,保肛率73.85%,术后并发症发生率23.08%,其中伤口感染延期愈合6例,吻合口瘘4例,吻合口狭窄5例,手术后病理完全缓解(pCR)11例,占16.92%。结论新辅助放化疗+TME手术治疗+术后辅助化疗三联疗法治疗中低位进展期直肠癌安全有效,可以降低肿瘤分期,减少局部复发及远处转移,中远期疗效好。

Objective To evaluate the efficacy and safety of neoadjuvant concurrent chemoradiotherapy combined with TME( total mesorectal excision ) for the treatment of locally advanced middle and lower rectal cancer .Methods 65 patients with stage Ⅱ( T2 N+M0 ) and Ⅲ( T3-4 N0-2 M0 ) locally advanced middle and lower rectal cancer were recruited .All patients received neoadjuvant concurrent chemoradiotherapy ( the total dose of preoperative radiotherapy was 50-54 Gy,concurrently combined with 3 cycles of Xelox regimen ) .The surgical operation was performed 6-8 weeks later ,following the principle of TME .All patients af-ter operation received 6 cycles of Folfox4 regimen.Results All patients completed the neoadjuvant concurrent chemoradiothera -py,operation and neoadjuvant concurrent chemotherapy .48 patients received low/ultra-low anterior resection(Dixon),and 17 pa-tients received abdominoperineal resection (Miles).The sphincter preservation rate was 73.85%.11 patients (16.92%) obtai

脑胶质瘤是颅内最常见的肿瘤。近年来关于神经胶质瘤的生物学研究取得了一定进展。首先是脑肿瘤干细胞的发现,其次是开展了肿瘤全基因组测序,这对于发现新的分子标记物是非常有用的,这些标记物(如IDH1基因突变)的发现甚至导致了基于分化和间质转化状况对神经胶质瘤的重新分类。此外,利用1p/19q标记及O6-甲基鸟嘌呤-DNA甲基转移酶基因(MGMT)是否被甲基化能为胶质瘤患者选择疗法和进行个性化药物治疗提供有意义的指导。作为治疗策略,替莫唑胺几年前已被确定为治疗脑胶质瘤的标准药物。最近在临床上贝伐单抗已开始用于脑胶质瘤的治疗。其他一些疗法目前还处于临床前开发和临床试验阶段,比如癌症疫苗、溶瘤腺病毒的研究等,这些潜在的疗法将来有可能成为胶质瘤治疗的手段或辅助手段。这些研究不仅揭示了神经胶质瘤的细胞起源,也为胶质瘤的诊断、治疗和预后判断提供了有用的信息和参考。

Glioma is the most common intra-cranial tumor. Several important advances in biology of the neurological gliomas have been made in recent years. First, there were advances in the discovery of brain tumor stem cells in year 2004. Second, the Cancer Genome Atlas project has been very useful in discovery of new molecular markers, and these markers such as mutations in the IDH1 gene has caused in a re-classification of gliomas, based on gliomal differentiation status and mesenchymal transformation. In addition, use of the 1p/19q marker and O6-methylguanine-DNA methyl-transferase methylation status have been identified as guidance for patient treatments and are useful of patients with gliomas for personalized medical management. Progress has been made since last decade in treatment strategies such as temozolomide as standard care for glioma, then the use of bevacizumab, and development in experimental biological therapies including oncolytic adenoviruses and vaccines, which could influence

胶质瘤是中枢神经系统难治性肿瘤,冷冻消融治疗作为一种新兴的肿瘤治疗技术在胶质瘤治疗中的价值正逐渐被重视。本文回顾了大量文献,从病理及分子生物学角度总结了冷冻消融治疗胶质瘤的机制;通过众多临床病例分析了冷冻疗法的适用范围、临床疗效和存在的问题;基于国内外前瞻性研究展望了冷冻治疗胶质瘤的发展方向及前景。冷冻消融可以通过直接导致坏死和凋亡、改变局部微循环和调节抗肿瘤免疫等机制摧毁肿瘤细胞;在影像学技术实时监控下冷冻可以成为很好的手术辅助手段,现已取得了满意的临床效果;另外冷冻技术与化疗、放疗、免疫治疗等方法联合应用可更有利于发挥其治疗作用。随着冷冻设备的改进和冷冻技术的完善,冷冻消融将在胶质瘤治疗中占有重要的地位。

Glioma is one of the most refractory tumors affecting the central nervous system. As a new technique, cryoablation has been considered for the treatment of glioma. Considering previous studies, we summarized the mechanism of cryoablation to treat glioma based on pathology and molecular biology perspectives. We also analyzed the indications, effects, and problems of cryoablation in clinical practice. Furthermore, we proposed that this technique may be used in future trends and applications. The mechanism of eradicating tumor cells by cryoablation involves the following:(1) using an ultralow temperature to induce necrosis and apoptosis;(2) changing the local microcirculation of tumors;and (3) adjusting anti-tumor immunity. As an alternative surgical treatment, cryoablation could improve the therapeutic effects by real-time medical imaging. Cryoablation combined with chemotherapy, radiotherapy, immunotherapy, and other methods could provide a more effective treatment for gliomas. Therefor

微针是具有不同的材料和形状的针状结构,作用于皮肤形成微米尺寸的小孔,利于药物穿透角质层吸收的一种新型经皮给药系统,伴随着微电子工业和材料学的发展而发展.传统的基于微针的经皮胶原蛋白诱导疗法,在痤疮、皮肤色素沉着、瘢痕、皱纹以及改善肤色等美容治疗方面发挥了作用.近年来,微针辅助治疗皮肤肿瘤也有新的研究进展.由于其独特的经皮给药模式、高安全性和便携性,对于某些顽固难治的浅表性皮肤疾病,微针结合外用药物具有广阔的临床应用前景.

Microneedles are a new transdermal drug delivery system(TDDS)derived from microelectro-mechanical systems.The needle-like structures in different materials and shapes,which have improved with the development of microelectronics industry and material science,can remarkably increase the permeability of drugs by forming minimal pores in stratum corneum.The traditional microneedle-based percutaneous collagen induction therapy is currently used to treat acne,as well as to improve cutaneous pigmentation,scars,wrinkles and skin tone.Recently,some advances have been achieved in the treatment of superficial skin tumors with microneedles.Due to their unique transdermal delivery mode,high security and portability,microneedles combined with topical medications will have a wide range of clinical applications in the treatment of some intractable superficial skin diseases.