目的 观察改良INP方案对肺腺癌伴有脑转移患者的临床疗效及毒副作用,并探讨该方案疗效与Ⅲ型β微管蛋白(β-tubulin-Ⅲ)在肺癌组织中表达水平的关系。方法 收集2010年4月—2013年1月广州医科大学附属第一医院胸外科收治的15例肺腺癌伴有脑转移患者的临床资料。所有患者均采用改良INP方案治疗,使用RECIST 1.0标准进行判定。结果 脑转移瘤取得CR 1例(1/15),PR 5例(5/15),SD 4例(4/15),PD 5例 (5/10),该方案对脑转移瘤的总缓解率(overall response rate,ORR)为40%,疾病控制率(disease control rate,DCR)达66.7%,毒副作用轻度可控;Ⅲ型β微管蛋白低表达对该方案的疗效有优于高表达的趋势。结论 肺腺癌伴有脑转移患者采用改良INP方案进行化疗,脑转移瘤临床疾病控制率较高,耐受性良好;肿瘤组织β-tubulin-Ⅲ表达水平可能与该方案的疗效相关。
Objective To investigate the efficacy and toxicity of chemotherapy of modified INP regimen in the treatment of adenocarcinoma with brain metastases. At the same time,to explore the relationship between expression of β-tubulin-Ⅲ in NSCLC biopsies and sensitivity to this modified INP regimen. Methods The clinical data of 15 adenocarcinoma with brain metastases patients who had been admitted to the first affiliated hospital of Guangzhou medical university from April 2010 to January 2013 were retrospectively analyzed. All patients received modified INP regimen.RECIST 1.0 was taken to know the result. Results For brain metastasis of the 15 patients, complete response (CR) and partial response(PR) were 1 and 5 patients, respectively. 4 patients were stable disease (SD) and progression disease(PD) in 5 patients. The overall response rate(ORR) was 40% and the disease control rate(DCR) was 66.7%. The toxicity was mild. Furthermore, we found NSCLC patients with low β-tubulin-Ⅲexpression had better ORR than those with high expression. Conclusion The modified INP regimen is effective and well-tolerable for brain metastases of adenocarcinoma. The β-tubulin-Ⅲ expression may be associated with the efficacy of this regimen.
目的 基于最佳矫正视力（BCVA）、角膜水肿程度对比改良与常规小梁切除术治疗急性闭角型青光眼（AACG）的疗效。方法 回顾性收集2021年12月—2023年6月期间信阳爱尔眼科医院收治的112例AACG患者作为研究对象，依据1∶1匹配原则，将接受常规小梁切除术的56例患者作为对照组，接受改良小梁切除术的56例患者作为观察组，统计两组围术期BCVA、眼压、术后浅前房形成状况、角膜水肿程度以及并发症状况。结果 术后3个月，观察组视力为（0.63±0.04）logMAR，高于对照组（0.50±0.03）logMAR，眼压为（16.22±2.28）mmHg，低于对照组（19.95±2.31）mmHg（t=19.457、8.600，均P＜0.05）；观察组浅前房发生率为8.93%，低于对照组的26.79%（χ 2 =6.087，P=0.014）；观察组角膜水肿状况优于对照组（Z=2.737，P=0.006）；观察组脉络膜脱离率、滤道阻塞率、前房积血率、虹膜炎症率依次为1.79%、5.36%、16.07%、10.71%，均低于对照组17.86%、23.21%、32.14%、35.71%（χ 2 =8.166、7.292、3.953、9.818，均P＜0.05）。结论 较常规小梁切除术，改良小梁切除术治疗AACG患者，有助于改善视力、降低眼压、减轻角膜水肿、减少浅前房发生，且安全性较高。
Objective To compare the efficacy of modified and conventional trabeculectomy in the treatment of acute angle-closure glaucoma（AACG）based on best-corrected visual acuity（BCVA）and degree of corneal edema．Methods A total of 112 patients with AACG admitted to the hospital during December 2021 to June 2023 were retrospectively selected as study objects．According to the 1∶1 matching principle，56 patients receiving conventional trabeculectomy were selected as control group，and 56 patients receiving modified trabeculectomy were selected as observation group．Perioperative BCVA，intraocular pressure，postoperative shallow anterior chamber formation，degree of corneal edema and complications were analyzed．Results At three months postoperatively，visual acuity in the observation group was（0.63±0.04）logMAR，which was higher than that in the control group（0.50±0.03）logMAR，and intraocular pressure was（16.22±2.28）mmHg，which was lower than that in the control group（19.95±2.31）mmHg（t=19.457，8.600，P＜0.05）；the incidence of shallow anterior chamber in the observation group was 8.93%，which was lower than that of the control group（26.79%）（χ 2 =6.087，P=0.014）；the corneal edema status in the observation group was better than that of the control group（Z=2.737，P=0.006）；the rates of choroidal detachment，filtering channel obstruction，hyphema，and iris inflammation in the observation group were 1.79%，5.36%，16.07%，and 10.71%，respectively，which were lower than those of the control group（17.86%，23.21%，32.14%，and 35.71%）（χ 2 =8.166，7.292，3.953，and 9.818，P＜0.05）．Conclusions Compared with conventional trabeculectomy，modified trabeculectomy can improve visual acuity，reduce intraocular pressure，relieve corneal edema，and reduce the occurrence of shallow anterior chamber in patients with AACG，with higher safety．
