唑来膦酸与帕米膦酸二钠治疗恶性肿瘤骨转移性疼痛比较分析

目的比较唑来膦酸与帕米膦酸二钠治疗恶性肿瘤骨转移性疼痛的近期疗效及毒副反应。方法将46例恶性肿瘤骨转移患者随机分为2组,唑来膦酸组(24例):唑来膦酸注射液4 mg,加入100 mL生理盐水内,静脉滴注不少于15 min;帕米膦酸二钠组(22例):帕米膦酸二钠注射液60 mg,加入500 mL生理盐水内,静脉滴注4 h。2组均每4周给药1次,共3次。结果唑来膦酸组、帕米膦酸二钠组治疗有效率分别为75.0%、72.7%,比较差异无统计学意义(P>0.05)。毒副反应多为轻中度,主要表现为发热、恶心、呕吐、肌痛等,2组比较差异无统计学意义(P>0.05)。结论唑来膦酸与帕米膦酸二钠治疗恶性肿瘤骨转移性疼痛的疗效及毒副反应相近,但唑来膦酸使用更为方便。     

唑来膦酸注射液治疗恶性肿瘤骨转移疼痛的临床观察

目的:评价唑来膦酸注射液治疗肿瘤骨转移疼痛的疗效及安全性.方法:将80例因恶性肿瘤骨转移引起中度以上疼痛患者随机分为两组,研究组(45例)予唑来膦酸注射液4 mg溶于100 ml生理盐水中静脉滴注15 min.对照组(35例)予帕米膦酸二钠注射液60 mg溶于500 ml生理盐水中静脉滴注4 h.研究期为14 d.结果:两组在治疗后第14 d的疼痛评分唑来膦酸优于帕米膦酸二钠(3.63 vs.4.95,P=0.02).疼痛完全缓解率、部分缓解率及总疗效率两组基本相似.在达到完全缓解时间上唑来膦酸比帕米膦酸二钠要短,在达到PR时间上唑来膦酸注射液与帕米膦酸二钠注射液相似.结论:唑来膦酸相对于帕米膦酸二钠给药时间短、给药剂量小、起效快,并具有良好的耐受性和安全性.     

唑来膦酸与帕米膦酸二钠治疗乳腺癌骨转移性疼痛的近期疗效观察

目的 评价唑来膦酸与帕米膦酸二钠治疗乳腺癌骨转移性疼痛的近期疗效及不良反应。方法 所有病例均为乳腺癌骨转移患者，其中唑来膦酸组29例，帕米膦酸二钠组25例。给药方法：唑来膦酸4mg＋生理盐水50ml静脉滴注15min；帕米膦酸二钠60mg＋生理盐水500ml静脉滴注4h；均每4周1次，共3次。记录治疗效果及不良反应。结果 疼痛缓解情况：唑来膦酸组完全缓解（CR）15例（51．7％），部分缓解（PR）9例（31．0％），临床获益[CR＋PR＋轻度缓解（MR）]93．0％；帕米膦酸二钠组CR11例（44．0％），PR7例（28．0％），临床获益88．0％。主要不良反应为发热、感冒样症状、低钙血症。结论 唑来膦酸与帕米膦酸二钠对乳腺癌转移性骨痛有较好的疗效；两药的治疗效果及不良反应相似，但唑来膦酸使用更为方便。     

唑来膦酸与帕米膦酸二钠治疗肺癌骨转移疼痛的对比研究

为了评价唑来膦酸注射液治疗肺癌骨转移所致骨痛的疗效及安全性,将临床确诊的肺癌骨转移患者50例随机分为唑来膦酸组25例和帕米膦酸二钠组25例.结果:唑来膦酸组和帕米膦酸二钠组治疗骨痛总有效率为76%(19/25)和72%(18/25),差异无统计学意义,P=0.798.止痛起效时间:唑来膦酸组1～11d(中位时间5d),帕米膦酸二钠组2～13d(中位时间5d),差异无统计学意义,P=0.702.止痛疗效维持时间:唑来膦酸组2～32d(中位时间24d),帕米膦酸二钠组1～29d(中位时间23d),差异无统计学意义,P=0.509.初步研究结果提示,唑来膦酸注射液治疗肺癌骨转移疼痛疗效确切,与帕米膦酸二钠相比疗效和不良反应相似.     

唑来膦酸注射液治疗恶性肿瘤骨转移疼痛的临床观察

目的：评价唑来膦酸注射液治疗肿瘤骨转移疼痛的疗效及安全性.方法：将80例因恶性肿瘤骨转移引起中度以上疼痛患者随机分为两组,研究组（45例）予唑来膦酸注射液4 mg溶于100 ml生理盐水中静脉滴注15 min.对照组（35例）予帕米膦酸二钠注射液60 mg溶于500 ml生理盐水中静脉滴注4 h.研究期为14 d.结果：两组在治疗后第14 d的疼痛评分唑来膦酸优于帕米膦酸二钠（3.63 vs.4.95,P=0.02）.疼痛完全缓解率、部分缓解率及总疗效率两组基本相似.在达到完全缓解时间上唑来膦酸比帕米膦酸二钠要短,在达到PR时间上唑来膦酸注射液与帕米膦酸二钠注射液相似.结论：唑来膦酸相对于帕米膦酸二钠给药时间短、给药剂量小、起效快,并具有良好的耐受性和安全性.     

唑来膦酸治疗恶性肿瘤骨转移44例临床观察

目的观察唑来膦酸注射液治疗转移性骨肿瘤的疗效及安全性。方法44例恶性肿瘤骨转移患者采用唑来膦酸(天晴依泰)注射液4mg加入0.9%氯化钠注射液100ml静脉滴注15分钟以上;同时以35例恶性肿瘤骨转移患者使用帕米膦酸二钠(博宁)注射液60mg加入0.9%氯化钠注射液500ml静脉滴注4小时以上作为对照。两组均一次性给药后观察14天。结果治疗骨痛有效率唑来膦酸组为81.08%,帕米膦酸二钠组为69.70%,两组疗效差异有显著性(P<0.05)。活动能力有效率唑来膦酸组为40.91%,帕米膦酸二钠组为45.71%,两组疗效差异无显著性(P>0.05)。不良反应发生率唑来膦酸组为45.45%,帕米膦酸二钠组为42.86%,差异无显著性(P>0.05),均主要表现为发热、低钙血症、肌肉酸痛,予对症处理后症状消失。结论唑来膦酸是一种有效的第三代双膦酸盐制剂,可方便安全地用于恶性肿瘤骨转移的治疗。     

唑来膦酸治疗骨转移癌疼痛的临床观察

目的观察唑来膦酸治疗恶性肿瘤骨转移导致疼痛的疗效及安全性。方法恶性肿瘤骨转移伴中重度疼痛患者38例,随机双盲分为A组(治疗组)20例唑来膦酸4mg溶于生理盐水50ml,静脉滴注(15min);安慰剂 生理盐水500ml,静脉滴注(4h);B组(对照组)18例安慰剂 生理盐水50ml,静脉滴注(15min);帕米膦酸二钠60mg 生理盐水500ml,静脉滴注(4h)。结果A组显效率85.0%,B组为83.4%,差异无显著性(P>0.05)。起效时间分别为5.2d与5.5d。结论唑来膦酸缓解恶性肿瘤骨转移所致疼痛有效,副作用小,患者可耐受,其有效性和安全性与帕米膦酸二钠相似。     

唑来膦酸治疗骨转移疼痛的临床研究

[目的]观察唑来膦酸治疗恶性肿瘤骨转移疼痛的临床疗效.[方法]21例恶性肿瘤骨转移患者,分为实验组(11例)和对照组(10例),分别给予唑来膦酸和帕米膦酸二钠进行治疗.[结果]实验组和对照组有效率分别是54.55%和30.00%.临床获益率分别是63.64%和30.00%,两者差异无显著性(P＞0.05).唑来膦酸组在疗效维持时间上明显长于帕米膦酸二钠组(P＜0.05).[结论]唑来膦酸可缓解肿瘤骨转移的疼痛,疗效维持时间长,副作用小,耐受性好.     

唑来膦酸治疗实体瘤骨转移或多发性骨髓瘤中重度骨痛的Ⅲ期临床研究

目的 评价唑来膦酸治疗实体瘤骨转移或多发性骨髓瘤引起的中重度骨痛的效果和安全性.方法 采用随机、双盲、双模拟、多中心的实验设计方法.将228例实体瘤骨转移或多发性骨髓瘤引起中重度骨痛[视觉模拟评分(VAS)＞50 mm]的患者随机分为唑来膦酸组(116例)和帕米膦酸二钠组(112例),分别接受静脉输注唑来膦酸(4 mg)或帕米膦酸二钠(90 mg)的单剂量治疗.检测唑来膦酸对疼痛及尿液中I型胶原交联氨基末端肽(NTX)/肌酐(Cr)、Ⅰ型胶原交联羧基末端肽(CTX)/Cr的影响,并观察不良反应,评价其安全性.结果 228例患者中202例完成试验,其中唑来膦酸组104例,膦酸二钠组98例.用药后两组VAS评分逐渐下降,唑来膦酸组第8、15、22、28天对基线的平均变化百分比分别为-11.77%、-24.60%、-28.50%和-32.37%,帕米膦酸二钠组则分别为-10.87%、-21.06%、-25.67%和-31.26%,两组各时间点相对基线变化的百分比均有统计学意义(均P≤0.0001),但两组间相对基线变化的百分比差异无统计学意义(P=0.6587).用药后两组尿NTX/Cr均快速下降,第8天降到最低点,与基线相比,唑来膦酸组用药后第28天的变化百分比中位值为-36.9%(P=0.0002),帕米膦酸二钠为-32.1%(P=0.0018),两组问差异无统计学意义(P=0.7922).用药后两组尿CTX/Cr均快速下降,第8天时降到最低点,与基线相比,唑来膦酸组用药后第28天变化百分比中位值为-63.2%(P＜0.0001),帕米膦酸二钠组为-47.9%(P＜0.0001),两组间差异无统计学意义(P=0.834).唑来膦酸和帕米膦酸二钠组中常见的不良反应为发热(19.0%和31.3%)、呕吐(6.0%和8.9%)、恶心(4.3%和4.5%)、乏力(3.4%和2.7%)、便秘(2.6%和1.8%)、低钙血症(5.2%和3.6%),均未出现血肌酐值升高.结论 4 mg唑来膦酸单剂量治疗中国人实体瘤骨转移或多发性骨髓瘤,在缓解骨痛和降低骨吸收标记物方面与帕米膦酸二钠同样有效,患者耐受性好.     

帕米膦酸二钠与氯甲膦酸二钠治疗晚期肿瘤骨转移的随机对照临床研究

为了评价帕米膦酸二钠对骨转移所致高血钙和骨痛的治疗作用。方法；本临床研究为随机化对照研究，共收治有溶骨性骨转移病二的闰人５８例。病人随机分为两组，治疗组３０例，采用帕米膦酸二钠３０ｍｇ／天，共用１天；对照组２８例，采用骨磷３００ｍｇ／天，共用５天。帕米膦酸二钠和骨膦均加入５％的葡萄糖溶液５００ｍｌ中静脉滴注４个小地。血钙下降率和骨痛的缓解率作为评价指标。     

Schwannomas of Head and Neck and Review of Literature

Benign nerve cell tumours have been given various names like schwannoma, neurilemmoma, neurinoma, neurofibroma, spindle cell tumours etc. Extra cranial head and neck schwannomas usually present as solitary and well-demarcated lesions. The lesion can cause secondary symptoms, such as nasal obstruction, dysphasia, and hoarseness, depending upon the location of the lesion. Fine needle aspiration cytology, CT scans, and MRI may be of limited help in the diagnosis of schwannomas. The treatment is complete surgical excision of the benign tumour and postoperative histopathological examination establishes the final diagnosis.     

A comparative study of knowledge and awareness of colorectal and breast cancerA comparative study of knowledge and awareness of colorectal and breast cancer

Aims: To assess and compare knowledge and awareness of colorectal cancer and breast cancer in a sample of the general population. Methods: Eleven hundred visitors to six different outpatient clinics, in a University Hospital, were given a study-specific questionnaire, based on educational material from the British Association of Cancer United Patients (CancerBACUP). The questionnaire consisted of 12 statements on the incidence, presentation, detection, treatment and prognosis of colorectal and breast cancer. Results: One thousand and sixty-eight individuals returned the questionnaire. One thousand and four completed questionnaires were analysed. The mean age (SD) of respondents was 50.1 (17.2) years, and the male to female ratio was 2:3. Respondents had read more about breast than about colorectal cancer (60.3%vs 32.4%,P <0.0001, McNemar's test). The proportion of correct answers for each statement on breast cancer was higher than for answers to corresponding items on colorectal cancer. Mean overall scores (95% CI) for breast and colorectal cancer were 88.1 (86.9, 89.2) and 64.4 (62.5, 66.3) respectively, the mean difference (95% CI) being 23.7 (22.0, 25.5). Scores were higher for breast cancer irrespective of age or gender. Conclusion: There is a low level of understanding of colorectal cancer in the general population when compared to breast cancer. This highlights the importance of public education in this common cancer.     

Quality of life and care in leukemia,myeloma and non-malignant disease. Opinions of patients and relatives,and effects of geography and time

In a questionnaire study 140 subjects answered 4200 questions in 1980 and 1986. They consisted of patients with myeloma, acute leukemia, lung carcinoma, and non-malignant disease and their relatives. In 22 additional cases the questionnaire was not answered. The results show that myeloma patients are less content with the general care than leukemia patients (P < 0.05). Similarly, relatives of deceased myeloma patients are less satisfied with the information given to them than relatives of deceased leukemia patients (P < 0.001). The information has improved with time, however, since the patients were more satisfied in 1986 than in 1980 (P < 0.001) and relatives of myeloma patients still alive were more satisfied than relatives of patients who had died earlier (P < 0.001).     

miRNA与肿瘤侵袭转移

目前,microRNA (miRNA)已成为肿瘤研究中最基本的参与者,主要通过与靶标基因3 'UTR(非翻译区)的完全或不完全配对,降解靶标基因mRNA或抑制其翻译,从而参与调控个体发育、细胞凋亡、增殖及分化等生命活动.miRNA作为调控基因表达的重要分子在肿瘤侵袭转移中的作用越来越受到重视,表明miRNA在肿瘤侵袭和转移中的作用机制具有重要的理论意义,同时也可为肿瘤的诊断和治疗提供新方法.本文就miRNA通过调控上皮间质转化及肿瘤干细胞导致肿瘤侵袭转移的最新研究进展作一综述.     

芦荟大黄素及芦荟提取物的诱变性和抗诱变性

目的:用L5178Y小鼠淋巴瘤细胞体外微核试验评价芦荟大黄素和芦荟提取物的诱变和抗诱变作用,为其安全性评价提供依据。方法:设溶剂对照、阳性对照和抗诱变对照,芦荟大黄素和芦荟提取物诱变和抗诱变试验各设4个剂量组,处理L5178Y细胞12 h后按常规方法进行体外微核试验分析。结果:较高浓度(6.67μg/ml)的芦荟大黄素可致微核细胞率增加,与对照组比较,差异有统计学意义(P0.05);而芦荟提取物未见此效应。在一定剂量范围内,芦荟大黄素(0.22～6μg/ml)和芦荟提取物(20～180μg/ml)对甲磺酸甲酯(MMS)所致微核细胞率均有一定程度的拮抗作用,与对照组比较,差异有统计学意义(P0.01)。结论:芦荟大黄素具有一定的诱变作用,而在本实验剂量范围内的芦荟提取物未见遗传毒性。两种受试物在一定范围内均能较好地拮抗MMS所致的染色体损伤。     

Erythrocyte levels of cadmium and lead and risk of B-cell non-Hodgkin lymphoma and multiple myeloma

Cadmium and lead are persistent environmental toxins that are known or probable carcinogens, based on evidence for causality for nonhematologic cancers. Associations of these metals with risk of non-Hodgkin lymphoma (NHL) and multiple myeloma (MM) are unknown but biologically plausible. To examine the associations of circulating levels of lead and cadmium exposure with risk of B-cell NHL (B-NHL) and multiple myeloma, we conducted a nested case-control study among 299 incident B-cell NHLs and 76 MM cases within the Cancer Prevention Study-II Nutrition Cohort (CPS-II NC). Each case was incidence-density matched to two eligible controls on age, race, sex and blood draw date. Conditional logistic regression was used to estimate relative risks (RR) and 95% confidence intervals (CI) for lymphoid malignancies overall and stratified by subtype. We observed a significant positive association between high erythrocyte lead concentration and risk of lymphoid malignancies overall (RR = 1.16, 95% CI: 1.02-1.33 per 17.6 μg/L (1 standard deviation [SD])) and follicular lymphoma in particular (RR = 1.80, 95% CI: 1.15-2.80 per SD). In contrast, there was no association between erythrocyte cadmium and risk of B-NHL (RR = 0.89, 95% CI: 0.75-1.06 per 0.37 μg/L [1 SD]), or any B-NHL subtypes; but a strong inverse association with MM risk (RR = 0.59, 95% CI: 0.38-0.89, per SD). Results from our study suggest a positive association between erythrocyte lead level and risk of lymphoid malignancies and a possible inverse association between cadmium and myeloma. Additional research is needed to confirm and further explore these findings.     

甲胎蛋白与自噬在肝癌发生发展中的作用及其相互关系

甲胎蛋白（AFP）作为临床诊断肝癌最常用的肿瘤标志物,有抑制免疫、促进细胞生长、抑制癌细胞凋亡的作用。自噬是一种维持细胞生存的重要途径之一,其与肝癌的发生发展及治疗有着密切联系,对肝癌既有抑制又有促进作用。PI3K/AKT作为两者共有的信号通路,它们是否有着相互关系来促进肝癌的发展尚需进一步研究。     

甲状腺手术的技巧及副损伤的预防和处置

鉴于甲状腺手术是普外科的常见手术，为求其日渐完美，以有益于病人，现根据作者的体会，并结合阅读相关文献，就其手术操作、喉返神经处理、甲状旁腺处理进行扼要阐述。     

Comparison of the Efficacy and Safety of Ceftibuten and Cefaclor in the Treatment of Pneumonia and Bronchiectasis

Summary

In a multicentre, international study of 187 adult patients with bacterial pneumonia or bronchiectasis, the safety and efficacy of a regimen of 200 mg ceftibuten administered twice-daily was compared with cefaclor given in a dosage of 500 mg three times a day. Of the 94 evaluable patients, 66 received ceftibuten and 28 received cefaclor. The overall bacteriological response was similar in the two treatment groups with elimination of the original pathogen in 91% and 89% of the patients receiving ceftibuten and cefaclor, respectively. The overall clinical response mirrored the bacteriological results with a successful clinical outcome in 92% of ceftibuten-treated patients compared with 93% in patients receiving cefaclor. Adverse experiences were, in general, few and mild, being reported in 8% and 17% of patients receiving ceftibuten and cefaclor, respectively.