肺癌脑转移放疗患者的临床护理

目的 探讨肺癌脑转移全脑放射治疗患者的护理措施.方法 总结35例肺癌脑转移患者行放射治疗专科护理方法.结果 本组35例患者中除了2例患者死亡,33例顺利完成治疗计划,临床症状得到不同程度的缓解.结论 肺癌脑转移患者放射治疗,护理人员加强病情观察和做好整体护理,可使患者减轻痛苦,延长生命,提高生活质量.     

VM-26+DDP/CBP联合全脑放疗治疗肺癌脑转移的护理

目的观察积极的护理支持对接受全脑放疗联合化疗的肺癌脑转移患者的治疗耐受性的影响。方法采用威猛（VM-26）为主的化疗方案联合全脑放疗治疗肺癌脑转移109例，在放化疗治疗期间给予心理护理、放疗化疗护理、对症护理等措施，观查患者的治疗毒性反应及耐受情况。结果所有病例均完成治疗计划，临床症状较治疗前明显改善，中位生存期为9．6个月，有效率61．7％，1年生存率47％，2年生存率11．7％。常见的毒性反应有骨髓抑制、胃肠道症状和脱发。结论采取积极的护理支持能有效减轻肺癌脑转移的放、化疗毒性反应．提高患者的治疗耐受性。     

以脑转移为首发症状的肺癌临床分析

目的探讨以脑转移为首发症状的肺癌治疗的效果及影响预后的因素。方法对2001-2003年46例以脑转移为首发症状的肺癌患者的临床资料进行回顾性分析。结果7例行手术切除脑转移灶。1例仅行化疗症状未缓解．所有行全脑照射后的病例均有一定疗效，症状缓解23例，症状减轻16例，全组中位生存12个月，0．5、1、2年生存率分别为69．6％、47．8％。19．6％。结论肺癌脑转移一旦确诊应进行以放射治疗为主的综合治疗．可以改善症状和延长生存时间。预后与脑转移灶单发和多发无关，全脑放疗加X刀或局部小野推量能提高生存率。单有脑转移较伴有颅外转移的患者预后要好。     

三维适形推量照射配合全脑放射治疗肺癌脑转移患者的临床疗效

目的探究分析三维适形推量照射配合全脑放射治疗肺癌脑转移患者的临床疗效。方法选取2014年1月至2016年2月我院收治肺癌脑转移患者71例为研究对象,随机分为采用全脑放射治疗的对照组(36例),与选择三维适形推量照射配合全脑放射治疗的观察组(35例),比较分析两组患者的治疗效果,且1年后随访,比较两组患者生存率。结果经过治疗后观察组患者的缓解32例,缓解率为91.43%,明显优于对照组患者的缓解27例,占75%,差异显著(P<0.05)。且1年后随访,观察组患者存活21例,占60%,明显优于对照组存活14例,占38.89%,差异显著(P<0.05)。结论三维适形推量照射配合全脑放射治疗肺癌脑转移患者的效果显著,能够有效缓解患者的恶化情况,提高患者的生存率,改善患者的生存质量,效果显著,值得临床推广实践。     

替莫唑胺联合同步放疗对肺癌脑转移的临床观察

目的 探讨肺癌脑转移患者采取替莫唑胺联合同步化疗治疗的疗效.结果 选取80例于2012年3月至2013年3月期间我院收治的肺癌伴脑转移患者,根据治疗方案的不同分为对照组与实验组,两组均采用6 MeVX线照射行全脑照射,实验组加用替莫唑胺治疗,观察两组疗效.结果 实验组较对照组临床缓解率明显要高(P＜0.05),中位生存期明显长于对照组(P＜0.05);在不良反应上,治疗期间及随访中,主要有轻度骨髓抑制、恶心呕吐等,患者均能耐受.结论 肺癌脑转移患者采取替莫唑胺联合同步放疗,疗效显著,不良反应轻微,患者可耐受,具有推广价值.     

替莫唑胺联合全脑放疗治疗非小细胞肺癌脑转移瘤的疗效

目的:探讨非小细胞肺癌脑转移瘤采取替莫唑胺联合全脑放疗治疗的疗效.方法:选取62例于2013年10月～2015年10月我院接收的非小细胞肺癌脑转移瘤患者,根据治疗方式不同分为对照组与实验组,均给予全脑放疗,实验组加用替莫唑胺治疗,观察两组疗效.结果:实验组较对照组临床疗效显著更佳(P＜0.05),中位生存时间明显长于对照组(P＜0.05),实验组较对照组不良反应发生率明显要高(P＜0.05).结论:非小细胞肺癌脑转移瘤采取替莫唑胺联合全脑放疗治疗,可取得显著疗效,延长中位生存时间,不良反应轻微患者基本可耐受,值得推广.     

常规放疗联合三维适形放疗治疗肺癌脑转移瘤的护理研究

目的探讨常规全脑放疗联合三维适形放疗治疗肺癌脑转移瘤的护理效果。方法对确诊为肺癌脑转移瘤的患者30例,在进行全脑放疗的基础上加上三维适形放疗,同时进行围放疗期的护理观察包括心理护理、放疗期间的护理、并发症的预防与处理、放疗后的健康教育指导等。结果本组病例均能按计划完成放疗治疗,完全缓解7例,部分缓解17例,神经系统症状临床缓解率96.7%。结论对肺癌脑转移瘤行常规全脑放疗联合三维适形放疗,配合积极细致的护理措施,能提高疗效,减少了放疗副作用,保证放疗计划的完成。     

全脑照射加司莫司汀治疗多发脑转移瘤疗效分析

1999年1月至2002年12月,我科共收治多发性脑转移瘤患者16例,采用全脑照射加司莫司汀口服治疗,取得了较好的疗效,报告如下. 1 临床资料 1.1 一般资料共收治多发性脑转移瘤患者16例,其中男10例,女6例;年龄42～71岁,平均年龄62.3岁.其中病理证实15例;小细胞肺癌7例,非小细胞肺癌4例,乳腺癌3例,食管癌1例,原发灶不明的转移瘤1例.     

全脑照射加适形放疗治疗脑转移癌30例疗效分析

目的:总结我院近年来脑转移癌30例的临床表现、治疗经过及疗效.方法:我科共收治各类脑转移癌患者30例,均采用全脑放疗加适形放疗.方法:全脑放疗DT40Gy,2.0Gy/次,4周完成.完成后加病灶适形放疗DT10Gy,1周完成.结果:其中完全缓解(CR)5例,占16.6%,部分缓解(PR)16例,占55%,稳定(NC)6例,占20%.恶化(PD)3例,占10%,总有效率(CR+PR)70%.全脑照射加适形放疗后神经系统症状、体征改善21例,中位生存期6个月.复查CT显示病变消失和缩小分别是5例、16例.7例死于脑部病变进展,23例因其他部位病变进展或病变广泛伴全身衰竭死亡.结论:脑转移癌行全脑照射加适形放疗,对减轻患者痛苦、改善生存质量、延长生存期有重要意义,是治疗脑转移癌的有效方法之一.     

特殊单发脑转移单纯照射病灶32例临床观察

肿瘤患者约30%发生脑转移.临床上以肺癌脑转移为多见,其次是乳腺、结肠及直肠、肝脏、胰腺等恶性肿瘤[1].脑转移患者预后很差,未经治疗的脑转移中位生存期1～2个月,经过治疗的中位生存也仅4～6个月[2].脑转移瘤的治疗方案以姑息治疗为主,传统治疗方法主要采用全脑放疗.全脑放疗可改善患者神经症状,提高生存质量,适当提高生存期,其治疗有效率在60%以上.     

Brain effects of melanocortins

The melanocortins (α, β and γ-melanocyte-stimulating hormones: MSHs; adrenocorticotrophic hormone: ACTH), a family of pro-opiomelanocortin (POMC)-derived peptides having in common the tetrapeptide sequence His-Phe-Arg-Trp, have progressively revealed an incredibly wide range of extra-hormonal effects, so to become one of the most promising source of innovative drugs for many, important and widespread pathological conditions.The discovery of their effects on some brain functions, independently made by William Ferrari and David De Wied about half a century ago, led to the formulation of the term “neuropeptide” at a time when no demonstration of the actual production of peptide molecules by neurons, in the brain, was still available, and there were no receptors characterized for these molecules.In the course of the subsequent decades it came out that melanocortins, besides inducing one of the most complex and bizarre behavioural syndromes (excessive grooming, crises of stretchings and yawnings, repeated episodes of spontaneous penile erection and ejaculation, increased sexual receptivity), play a key role in functions of fundamental physiological importance as well as impressive therapeutic effects in different pathological conditions.If serendipity had been an important determinant in the discovery of the above-mentioned first-noticed extra-hormonal effects of melanocortins, many of the subsequent discoveries in the pharmacology of these peptides (feeding inhibition, shock reversal, role in opiate tolerance/withdrawal, etc.) have been the result of a planned research, aimed at testing the “pro-nociceptive/anti-nociceptive homeostatic system” hypothesis.The discovery of melanocortin receptors, and the ensuing synthesis of selective ligands with agonist or antagonist activity, is generating completely innovative drugs for the treatment of a potentially very long list of important and widespread pathological conditions: sexual impotence, frigidity, overweight/obesity, anorexia, cachexia, haemorrhagic shock, other forms of shock, myocardial infarction, ischemia/reperfusion-induced brain damage, neuropathic pain, rheumathoid arthritis, inflammatory bowel disease, nerve injury, toxic neuropathies, diabetic neuropathy, etc.This review recalls the history of these researches and outlines the pharmacology of the extra-hormonal effects of melanocortins which are produced by an action at the brain level (or mainly at the brain level). In our opinion the picture is still incomplete, in spite of being already so incredibly vast and complex. So, for example, several of their effects and preliminary animal data suggest that melanocortins might be of concrete effectiveness in one of the areas of most increasing concern, i.e., that of neurodegenerative diseases.     

脑多形性黄色星形细胞瘤

报告３例罕见的脑多形性黄色星形细胞瘤，观察了其临床、光镜、电镜及免疫组化特征。结果显示，本瘤好发于脑表浅部位，界限清楚，有囊腔形成。光镜下瘤细胞奇形怪状，提示恶性的组织学形态，酷似巨细胞胶质母细胞瘤，以往均 被误诊。然而多形性黄色星形细胞瘤预后良好，存活期长，且光镜下缺乏坏死，核分裂相当少。随访２例，术后生存时间为１３年７个月和７年９个月。     

Brain levels of tryptamine

A modification of the method of Hess and Udenfriend (1959) for the extraction and identification of tryptamine, as well as a gas chromatographic method for identifying tryptamine, has been described. Tryptamine, using these methods, as well as thin layer chromatography, has been identified in steer, dog and human brain. Tryptamine was not found in the rat brain. In the dog, isocarboxazid increased brain and spinal cord tryptamine levels two or three times. In view of the fact that tryptamine resembles LSD-like hallucinogens in many of its actions, it is suggested that tryptamine may be a naturally occurring hallucinogen that may play a role both in normal and pathologic functioning of the brain.A preliminary report of this work was presented at the meeting of the Federation of American Societies for Experimental Biology, April 1971 [Fed. Proc. 30, 271 (1971)].     

脑出血和重型颅脑伤术后的高血糖控制

目的观察高血压性脑出血和重型颅脑损伤术后患者血糖变化,并对胰岛素辅助治疗的疗效进行观测。方法对所有高血压性脑出血和重型颅脑损伤术后的患者,常规给予胰岛素皮下注射(6U/Q6h),应用one touchⅡ型血糖仪连续2周动态检测患者血糖水平。结果高血压性脑出血和重型颅脑损伤术后患者应激性高血糖得到有效控制,且控制不良者预后极差。结论在高血压性脑出血和重型颅脑损伤术后,采用正规胰岛素皮下注射法和血糖仪的连续监测,确实简单易行,安全有效,有助于对术后病情的评估和预后的判断。