資源描述:
《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(huì)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(kù)。
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