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《大劑量rmhtnf治療惡性心包積液或惡性胸腔積液的臨床研究》由會員上傳分享，免費(fèi)在線閱讀，更多相關(guān)內(nèi)容在學(xué)術(shù)論文-天天文庫。
1、第二軍醫(yī)大學(xué)碩+學(xué)位論文system，hematologicalsystem，nervoussystem，digestivesystemandrespiratorysystem，especiallyuesdinalloverthebody．Becausetheseadverseevents，theclinicalapplicationofTNF0【hasbeenlimited．From1990s，inordertOimprovethecurativeeffectanddecreasetoxicity,thestudyofmutatedTNFahasbeenextensi
2、velydevolped．RecombinantmutatedhumanTNFaisakindofmutaedTNFahavingimprovedanti—tumoractivityanddecreasedtoxicity，whichisinventedbyTheForthMiilitaryMedcineUnivercity(FMMU)．InAugust2003，thefirstmutatedTNFawhichcouldbeuesdinalloverthebodywaslicensed．WefoundthatrmhTNFainducedonlythoracalgiaan
3、dfebrile，seldomreactionofgastrointestinaltract，whenusedintherapyingnonsmall—celllungcancer(NSCLC)．IfwegaveantipyreticanalgesicbeforeTNF0twasused，theseadverseeventscouldberelieved．Becausethehalf-lifeofnaturalTNFaisonly10-15min，andithasnospecificaffinitytOtumor，theconcentrationofTNFacannot
4、beelevatedintumor．Inordertoimprovethecurativeeffect，manypeopleinjectnaturalTNFo【Eintotumororcavityandfindthatthecurativeeffectisimprovedandthetoxityisnotincreased．ThemalignantpleuralefusionstherapyingmechanismofrmhTNFaissimilartOnaturalTNFa，includingsupressingtheexpressionofoncogene，dire
5、ctlykillingtumorcells，inducingnecrosisoftumorandfinallyreducingtheproductionofmalignantpleuralefusions．ThehighconcentrationofrmhTNFacaninducestrongerinflammatoryreaction，andleadtothenecrosisandfibrosisoftumor．ItwasalsoprovedthathighconcentrationofrmhTNFacouldinhibittheangiogenesisoftumor
6、．SowepresumedthatrmhTNFacouldbeusedinntracavitaryinicetionandtheconcentrationcouldbeincreasedtoimprovethecurativeeffectmeanwhilethetoxitymightnotbeincreased．Ifthehypothesiscouldbeapproved，theclinicalindicationofrmhTNFacouldbeexpanded，andtherewouldbeanewmethodtocontrolmalignantpleuralefus
7、ions．Toapproveourhypothesis，wecarriedoutthisstudyafterliscencedbyEthicsCommittee．Methods：I．DataofpatientsMalignantpericardialefusions：56patientswithmalignantpericardialefusions，whichwerefinallydiagnosedthroughpathologyorcytology,wererandomlyseperatedintoAgroupandBgroup(28
