乳腺癌骨转移同位素与双膦酸盐治疗的对比研究

目的对比分析同位素（^89SrCl2）与双膦酸盐（帕米膦酸二钠）治疗乳腺癌骨转移的疗效。方法以108例乳腺癌骨转移患者为研究对象，其中^89SrCl2组41例，帕米膦酸二钠组36例，联合用药组31例。进行临床对比观察。结果^89SrCl2组和帕米膦酸二钠组对镇痛总有效率分别为80．5％和80．6％，对骨转移病灶总有效率分别为17．1％和8．3％，生活质量总改善率分别为48．9％和44．4％，以上两组3个指标比较差异均无统计学意义（P〉0．05）。而联合用药组镇痛总有效率为90．6％，和^89SrCl2组、帕米膦酸二钠组相比差异无统计学意义（P〉0．05），但是联合用药组对骨转移病灶有效率和生活质量总改善率分别为48．4％和74．2％，并且和^89SrCl2组、帕米膦酸二钠组比较差异有统计学意义（P〈O．05）。108例患者不良反应均较小。结论^89SrCl2和帕米膦酸二钠在治疗乳腺癌骨转移中，对镇痛及骨转移病灶和生活质量改善有同等较好的疗效。应用^89SrCl2和帕米膦酸二钠联合治疗不仅可以显著提高疗效而且不良反应无明显增加。     

帕米膦酸二钠联合化疗治疗多器官晚期癌症骨转移疼痛的临床研究

目的 观察帕米膦酸二钠联合化疗治疗多器官晚期癌症骨转移疼痛的临床疗效.方法 105例多器官晚期癌症骨转移患者分为治疗组55例和对照组50例.治疗组静脉滴注帕米膦酸二钠45 mg/次,连用2d,d3开始应用化疗.对照组仅静脉滴注帕米膦酸二钠45 mg/次,连用2d.全组均每4周1个疗程,连续3个疗程.治疗前均需采用口服或肌注镇痛药.结果 105例患者应用帕米膦酸二钠治疗后,两组疼痛控制总有效率为76.19％;其中治疗组帕米膦酸二钠联合化疗疼痛控制总有效率为78.18％,对照组帕米膦酸二钠对骨痛治疗的疼痛控制总有效率为74.00％ (P＞0.05).全组患者应用帕米膦酸二钠治疗后活动能力变化总有效率为64.76％ (68/105);其中治疗组总有效率为60.00％,对照组总有效率为70.00％ (P＞0.05).结论 帕米膦酸二钠能有效地缓解多器官晚期癌症骨转移疼痛,改善活动功能,提高患者生活质量;但帕米膦酸二钠联用化疗后不能继续提高多器官晚期癌症骨转移疼痛患者的镇痛疗效和活动功能;对于不能耐受化疗或已放弃化疗的晚期癌症骨转移疼痛患者的姑息镇痛治疗,也可单独应用帕米膦酸二钠进行治疗.     

帕米膦酸二钠同期放化疗治疗乳腺癌骨转移的疗效观察

目的:研究帕米膦酸二钠同期放化疗治疗乳腺癌骨转移的临床治疗效果.方法:将本院肿瘤科2013.03～2016.03收治的58例乳腺癌骨转移患者随机分为2组,对照组29例,观察组29例.对照组采用放化疗治疗,观察组采用帕米膦酸二钠同期放化疗的治疗方案.观察2组患者的治疗效果.结果:经过4个月的治疗后,观察组患者的生活质量评分明显高于对照组(P＜0.05),观察组患者的疼痛缓解总有效率为96.55％优于对照组的数据75.86％ (P ＜0.05).结论:对乳腺癌骨转移采用帕米膦酸二钠同期放化疗治疗的方案疗效显著,能有效改善患者的生活质量.     

89SrCl2联合唑来膦酸治疗转移性骨肿瘤的疗效观察

目的 探讨放射性核素二氯化锶(89SrCl2)及89SrCl2联合唑来膦酸治疗转移性骨肿瘤的临床效果.方法 采用随机方法将43例转移性骨肿瘤患者分为两组,单纯采用89 SrCl2治疗组21例,89 SrCl2与唑来膦酸联合治疗组22例.观察治疗后骨痛缓解疗效、转移病灶疗效、生活质量的情况及血液毒性反应.采用SPSS 14.0统计软件对数据进行x2检验.结果 单纯89SrCl2治疗组,治疗后疼痛缓解总有效率为71.4％ (15/21),病灶治疗有效率为33.3％ (7/21),全身状况KPS评分提高率57.1％(12/21):89SrCl2与唑来膦酸联合治疗组疼痛缓解总有效率为95.5％ (21/22),病灶治疗有效率为54.5％ (12/22),全身状况KPS评分提高率86.4％ (19/22).联合治疗组的疗效优于单项治疗组,差异有统计学意义(P＜0.05).血液毒性反应分别为19.0％和22.7％,差异无统计学意义(P＞0.05).结论 89SrCl2联合唑来膦酸对转移性骨肿瘤有明显疗效,不良反应小,联合治疗效果优于单纯89 SrCl2治疗.     

唑来膦酸与帕米膦酸二钠治疗肺癌骨转移疼痛的疗效与安全性对比分析

[目的]对比分析唑来膦酸与帕米膦酸二钠治疗肺癌骨转移疼痛的疗效与安全性。[方法]2008年9月～2010年9年,86例肺癌骨转移疼痛患者随机分为唑来膦酸组和帕米膦酸二钠组,每组43例,比较观察两组的临床疗效和药物作用效果。[结果]两组疼痛缓解总有效率和活动改善总有效率比较,差异无统计学意义(P﹥0.05)。两组患者用药后止痛起效时间和止痛维持时间比较,差异无统计学意义(P﹥0.05)。两组均无严重不良反应,发生率比较差异无统计学意义(P﹥0.05)。[结论]唑来膦酸和帕米膦酸二钠在治疗肺癌骨转移疼痛具有相似的效果,但唑来膦酸与帕米膦酸二钠相比,具有简单、方便的优势,值得临床推广应用。     

三种双膦酸盐治疗恶性肿瘤骨转移骨痛的成本-效果分析

目的：对帕米膦酸二钠、唑来膦酸及伊班膦酸治疗恶性肿瘤骨转移骨痛进行成本-效果分析。方法：选择55例恶性肿瘤并发骨转移患者,所有患者均存在不同程度的骨痛症状。将所有患者随机分为三组,帕米膦酸二钠组19例,唑来膦酸组18例,伊班膦酸组18例,分别给予相应药物治疗2疗程后评价各组的止痛效果,汇总治疗成本,运用药物经济学原理进行成本-效果分析。结果：三组治疗方案止痛疗效的总体有效率分别为63.16%、72.22%及83.33%,其任意两组间差异均无统计学意义（P〉0.05）。帕米膦酸二钠组、唑来膦酸组及伊班膦酸组的成本-效果比（C/E）分别为（22.80±0.23）、（44.31±0.25）和（65.28±0.34）。以帕米膦酸二钠组（最低成本）为参照,唑来膦酸组及伊班膦酸组与之对比的增量成本-效果比（△C/△E）分别为（194.26±0.41）及（198.31±0.36）。结论：三种方案的总体止痛疗效无差异性,以帕米膦酸二钠最为经济,但从肿瘤综合治疗及疗效考虑,推荐唑来膦酸方案。     

唑来膦酸治疗肺癌骨转移疼痛的药物经济学评价

目的：对唑来膦酸治疗肺癌骨转移疼痛进行药物经济学评价。方法：78例肺癌骨转移患者随机分为试验组和对照组，试验组（n=40）采用唑来膦酸治疗，对照组（n=38）采用帕米膦酸二钠治疗，2组均单次给药后观察10d。结果：2组止痛有效率差异无统计学意义（P〉0．05），试验组费用低于对照组，差异有统计学意义（P〈0．05）。结论：唑来膦酸治疗肺癌骨转移疼痛安全、有效、经济。     

89SrCl2联合云克、美施康定治疗骨转移瘤疼痛的临床疗效评价

目的 观察89SrCl2联合云克与美施康定在治疗多发性骨转移瘤、缓解重度骨痛、改善生活质量等方面的疗效比较. 方法 对84例骨转移瘤重度疼痛的病人分别用89SrCl2、美施康定治疗,并对照观察疗效. 结果 89SrCl2治疗组,有效率为94%;美施康定治疗组,有效率为76%. 结论 89SrCl2联合云克比美施康定在治疗骨转移瘤重度骨痛、改善病人生活质量方面有更佳的疗效.     

~(89)SrCl_2联合云克、美施康定治疗骨转移瘤疼痛的临床疗效评价

目的观察89SrCl2联合云克与美施康定在治疗多发性骨转移瘤、缓解重度骨痛、改善生活质量等方面的疗效比较。方法对84例骨转移瘤重度疼痛的病人分别用89SrCl2、美施康定治疗,并对照观察疗效。结果89SrCl2治疗组,有效率为94%;美施康定治疗组,有效率为76%。结论89SrCl2联合云克比美施康定在治疗骨转移瘤重度骨痛、改善病人生活质量方面有更佳的疗效。     

博宁与大剂量超分割放疗治疗肺癌骨转移疼痛的疗效观察

我们应用深圳海王药业公司生产的新一代双膦酸盐制剂一博宁(帕米膦酸二钠)和超分割放射治疗对28例肺癌骨转移患者进行了观察,取得了较满意的临床疗效.     

缪刺法与巨刺法的临床应用

目的:探讨缪刺法与巨刺法的临床应用指征.方法:把用常规经刺法治疗无效的病例按是否存在瘀络分为两组:有瘀络组用缪刺法,非瘀络组用巨刺法,然后将两组结果进行比较分析,所有病例治疗前均切按左右寸口脉象,并做记录.结果:瘀络组中脉象无异常者采用缪刺法疗效好,非瘀络组中脉象异常者采用巨刺法疗效好.结论:对疼痛类疾病,若左右脉象正常者适宜采用缪刺法,若左右脉象异常且异常脉象与病痛部位左右相对者适宜采用巨刺法.     

植物雌激素与激素替代治疗的比较

过去10年大量证据表明绝经后妇女长期应用激素替代治疗弊大于利。天然的植物雌激素做为一种甾体激素以外的性激素替代物引起了人们的广泛关注。其在改善围绝经期症状,降低血脂水平,防止骨质疏松,预防尿失禁等方面有着有益作用,但其对是否增加乳腺癌、子宫内膜癌风险,对认知功能及对生育能力的影响存在争议。该文就当前研究进行综述。     

Occupational therapy students’ perceptions of occupational therapy

Background/aims: An understanding of students’ perceptions of occupational therapy on entry is required to recognise how professional socialisation occurs through curriculum. Findings pertain to a qualitative study investigating students’ perceptions of occupational therapy upon entry to two occupational therapy programmes in Australia. Methods: Students commencing Bachelor of Occupational Therapy and Masters of Occupational Therapy Studies programmes participated in the study (n = 462). A purpose‐designed questionnaire was distributed to students in the first lecture of each programme. Preliminary analysis comprised identification of keywords/phrases and coding categories were generated from patterns of keywords. Frequency counts and percentages of keywords/phrases within categories were completed. Results: Students’ responses were categorised as ‘what’ occupational therapists do; ‘how’ they do it; ‘why’ they do it; and ‘who’ they work with. In ‘what’ occupational therapists do students frequently described ‘helping’ people. Both undergraduate and graduate entry masters students used the term ‘rehabilitation’ to describe how occupational therapy is done, with graduate entry students occasionally responding with ‘through occupation’ and ‘modifying the environment’. Students perceived the ‘why’ of occupational therapy as getting back to ‘everyday activities’, with some students emphasising returning to ‘normal’ activities or life. Regarding the ‘who’ category, students also thought occupational therapists worked with people with an ‘injury’ or ‘disability’. Conclusions: Students entered their occupational therapy programmes with perceptions consistent with the general public’s views of occupational therapy. However, graduate entry students exposed to a pre‐reading package prior to entry had more advanced occupational therapy concepts than undergraduate students.     

Limitations of therapy

Researchers at the National Institute of Allergy and Infectious Diseases (NIAID) say the immune system's CD4+ T-cells become progressively less diverse as HIV continues to attack the immune system. The information gives more credence to those advocating early treatment of HIV. The cells rebound through antiretroviral drugs but are limited to those types that were present when treatment began. Early treatment is recommended before elements of the immune system are significantly depleted.     

The use of art therapy in marital and sex therapy

The literature pertaining to the use of art therapy in marital and sex counseling of couples is reviewed. All articles in this area are based on case study reports; therefore, their conclusions must be considered with caution. Art therapy techniques which have been developed for use in marriage counseling are identified, and several advantages to the use of these procedures are cited. Suggestions for research to validate these procedures are discussed.     

Lithium therapy

Affective (mood) disorders are common in all ages often chronic or recurrent, destructive of personal and social functioning with significant morbidity and mortality. Diagnosis still rests on the clinical skills of interview, observation and a knowledge of the disorders. Lithium is simple, cheap and effective although underused. It is the main pharmacological agent currently used in bipolar disorders and as an adjunct in other affective disorders. While it does have a narrow therapeutic window and can cause serious morbidity itself, it is safe when delivered properly reducing both morbidity and mortality. Lithium therapy should only be started in a specialist psychiatric setting but other clinicians will be involved either in maintenance treatment or in treating patients for separate disorders who happen also to be on lithium.     

Futile therapy

Poet's Corner

Futile therapy