153Sm-EDTMP对骨转移癌患者血浆TXB2,6-K-PGF1α水平的影响

目的 :观察153 Sm -EDTMP对骨转移癌患者血浆TXB2 、6 -K -PGF1α水平的影响。方法 :5 5例骨转移癌患者 ,肘静脉注射153 Sm -EDTMP ,剂量按 (18 5～ 37)MBq/kg ,放射免疫分析治疗前后不同时间血浆TXB2 、6 -K -PGF1α的浓度。结果 :血浆TXB2 治疗前、治疗 (1～ 2 )月与治疗 3月后无显著差异 ;6 -K -PGF1α治疗后 (1～ 2 )月较治疗前明显降低 ,3月后升高 ,骨痛缓解率高。结论 :153 Sm -EDTMP可调节 6 -K -PGF1α水平 ,这可能与其治疗骨转移癌骨痛的作用有关。     

153Sm-EDTMP对骨转移癌患者血浆ET、CGRP水平的影响

目的：观察^153Sm-EDTMP对骨转移癌患者血浆ET、CGRP水平的影响。方法：55例骨转移癌患者，按18.5～37MBq／kg的剂量，肘静脉注入^153Sm-EDTMP，放免法测定治疗前后不同时间血浆ET、CCRP的浓度。结果：血浆ET水平治疗后1～2月较治疗前下降，治疗3月后显著升高；CGRP治疗后1--2月较治疗前明显升高，3月后降低。结论：^153Sm-EDTMP可调节ET、CGRP的水平，这可能与其治疗骨转移癌的作用密切相关。     

153Sm-EDTMP联合唑莱磷酸治疗骨转移疼痛的探讨

肿瘤发生骨转移后,由于骨内膜和骨外膜受到肿瘤生长产生的张力以及肿瘤直接累及骨膜,临床上常出现明显的难以控制的疼痛。麻醉止痛药品副反应较多,且易成瘾。局部放疗对于局限的骨转移灶可起到镇痛的作用,但对于广泛多发的骨转移灶,局部放疗的作用是有限的。本文观察153Sm-     

体外循环中血浆ET-1、TXB2及6-Keto-PGF1α水平变化的探讨

目的:探讨体外循环心内直视手术期间血浆内皮素-1(ET-1)、血栓素B2(TXB2)和6-酮-前列腺素F1α(6-Keto-PGF1α)水平变化及临床意义.方法:采用放射免疫分析分别于8个时点测定20例心内直视手术病人血浆ET-1、TXB2和6-Keto-PGF1α水平.结果:血浆ET-1水平从开放主动脉后即刻(T3)开始明显升高,至CPB停机后6h(T6)达高峰,之后逐渐下降,但仍明显高于手术前(T1)水平(P＜0.01);TXB2水平在阻断主动脉即刻(T2)时逐渐升高,在T3时点达到最高峰,之后水平逐渐下降,至CPB停机后12h(T7)降至正常水平;血浆6-Keto-PGF1α水平从T2时点起急剧升高,T3时点时达最高峰,之后水平逐渐下降,至CPB停机后24h(T8)基本恢复至正常水平.结论:在CPB期间及CPB后动态监测病人血浆ET-1、TXB2及6-Keto-PGF1α可帮助综合判断病人情况,并可根据不同的激素代谢水平变化进行相应处理,如加入内皮素、血栓素A2拮抗剂或前列环素合成剂等,削弱缩血管效应,利于病人早期恢复.     

永久性心房颤动患者血清TXB2、6-K-PGF1α和PGE2改变的探讨

目的:探讨永久性心房颤动(PAF)患者血清血栓素B2(TXB2)、6-酮-前列腺素F1α(6-K-PGF1α)和前列腺素E2(PGE2)水平的变化及其临床意义.方法:采用放射免疫分析158例PAF患者和40例健康对照组的血清TXB2、6-K-PGF1α和PGE2水平,进行对照统计分析.结果:PAF组血清TXB2水平[(80.89±18.86)ng/L vs (51.38±7.66)ng/L]和 PGE2水平[(11.48±4.20)ng/L vs (7.15±1.26)ng/L]显著高于健康对照组( P<0.01;P<0.01),6-K-PGF1α水平[(49.81±7.53_ng/L vs (81.12±9.02)ng/L]显著低于健康对照组(P<0.01),三者之间均无显著相关性(P均＞0.05).NYHA心功能Ⅰ、Ⅱ、Ⅲ和Ⅳ级组PAF患者血清TXB2和PGE2水平依次升高,具有统计学意义(P均<0.01),6-K-PGF1α水平变化无统计学差异(P>0.05)(方差检验F TXB2=52.75,P<0.01;F 6-K-PGF1α=0.949,P>0.05;F PGE2=62.04;P<0.01).合并脑梗死组血清TXB2水平显著高于无合并组(P<0.01),但6-K-PGF1α和PGE2无统计学差异(P均>0.05).结论:PAF组血清TXB2和PGE2水平显著高于健康对照组,6-K-PGF1α水平显著低于健康对照组;心功能Ⅰ、Ⅱ、Ⅲ和Ⅳ级组PAF患者血清TXB2和PGE2水平依次升高,合并脑梗死组血清TXB2水平显著升高.     

慢性房颤患者TXB2、6-K-PGF1α和PGE2的变化探讨

目的：研究慢性心房纤颤（CAF）患者血清血栓素B2（TXB2）、6-酮-前列腺素F1α（6-K-PGF1α）和前列腺素E2（PGE2）水平的变化及其临床意义。方法：放射免疫分析测定162例CAF患者、印例无CAF患者和40例对照组的血清TXB2、6-K-PGF1α和PGE2水平,并进行统计分析。结果：CAF组血清TXB2水平显著高于无CAF组和对照组（P均〈0．01）,6-K-PGF1α显著低于对照组（P〈0．01）,PGE2三组间无显著差异（P均〉0．05）,CAF组中TXB2与6-K-PGF1α成显著正相关（P〈0．01）。CAF患者中Ⅰ、Ⅱ、Ⅲ、Ⅳ级心功能组间平均血清TXB2和6-K-PGF1α水平均呈依次显著性递增（P均〈0．01）,PGE2无显著性改变（P〉0．05）;伴脑血栓组血清TXB2和6-K-PC-F1α水平均显著高于无脑血栓组（P均〈0．01）;住院死亡组血清TXB2水平显著高于好转出院组（P〈0．01）。结论：CAF患者血清TXB：水平显著增高,并随心功能分级依次递增,伴脑血栓组更高,死亡组TXB2也明显增高;CAF患者血清6-K-PGF1α水平明显降低;PGE2则无明显改变。     

血浆前列环素和血栓素A2与某些消化系恶性肿瘤关系的探讨

有关血浆或组织中6-酮-前列腺素F1α(PGF1α)及血栓素B2(TXB2)浓度与肺癌、乳腺癌、前列腺癌等之间的关系已有不少研究，但其与消化系恶性肿瘸的关系报告不多。本文旨在对某些消化系癌肿时这两种物质浓度的变化作一探讨。     

哮喘与慢支患者血浆和肺泡灌洗液中TXB2与6-K-PGF1α测定的临床意义

观察TXB2(血栓素B2)、6-K-PGF1α(6-酮-前列腺素F1α)在支气管哮喘、慢支喘息型和慢支单纯型患者体内的变化. 对照组30名, 支气管哮喘组30例,慢支喘息型组30例, 慢支单纯型组30例, 均用RIA法测定血浆和BALF(支气管肺泡灌洗液)中的TXB2、6-K-PGF1α.三组患者血浆和BALF中的TXB2、6-K-PGF1α均增高, 其中支气管哮喘组增高最为显著, 与慢支两组比较有显著意义(P＜0.01);慢支喘息型组BALF中的增高较单纯型组明显(P＜0.05).TXB2、6-K-PGF1α在支气管哮喘中起重要作用, 在慢支喘息型中也有明显作用. BALF中的TXB2、6-K-PGF1α两项指标的变化对区别慢支喘息型和单纯型提供一定的参考依据.     

心房颤动患者血浆TXB2,6-K-PGF1α浓度测定及意义

目的 :研究心房颤动 (房颤 )病人血浆血栓素B2 (TXB2 )、6 -酮 -前列腺素F1α(6 -K -PGF1α)浓度变化 ,探讨房颤引起血栓前状态 (Prethromboticstate ,PTS)的机制。方法 :用放射免疫分析对 2 1例孤立性阵发性房颤者 (IPAF)分别于房颤发作及终止后 1周测定外周静脉血浆TXB2 、6 -K -PGF1α浓度 ,并与 2 8例孤立性持续性房颤 (ISAF)、2 7例二尖瓣狭窄伴持续性房颤 (RHD)、32例阵发性室上性心动过速 (PSVT)及 35例健康志愿者相比较。结果 :IPAF房颤发作时 ,ISAF及RHD病人血浆TXB2 浓度和TXB2 / 6 -K -PGF1α比IPAF房颤终止后 1周、PSVT、正常对照组明显上升 ,而 6 -K -PGF1α无差别。TXB2 浓度及TXB2 / 6 -K -PGF1α比值与IPAF房颤发作时间呈正相关 ,而与患者年龄、性别及左心房内径等临床参数无关。结论 :房颤时血小板的激活和血管内皮细胞功能状况的改变参与房颤PTS的发生     

益气通络丹对应激诱发大鼠血小板聚集性、血浆血栓素B2和6-酮-前列腺素F1α变化的影响

应激在心血管疾病发病中占有重要地位，其机理有待阐明。鉴血于小板聚集和血栓素B2(Thromboxane B2，TXB2)／6-酮-前列腺素F1a(6-keto-Prostaglandin F1α，6-keto-PGF1α)的平衡失调与动脉粥样硬化(Atherosuerotosis，AS)、血栓形成的发生和发展关系极为密切，我们在电击造成大鼠应激诱发上述指标变化的基础上，观察益气活血补肾中药——益气通络丹(Yiqitongluodon，YOTLD)作用，为寻找防治心血管应激性损伤的有效中药提供线索。     

Single Fraction versus Multiple Fraction Radiotherapy for Palliation of Painful Vertebral Bone Metastases: A Prospective Study

Context:

Metastatic bone disease is a commonly encountered problem in oncology practice. The most useful and cost effective treatment is radiotherapy (RT). Different fractionation schedule of RT can be used to treat such condition.

Aims:

Assessment of pain response in patients with vertebral bone metastasis after treating them with various radiation fractionations and to compare the toxicity profile in the treatment arms.

Settings and Design:

A prospective randomized study was designed to include total 64 patients from July 2010 to May 2011. Patients with histopathologically proven primary malignancy having symptomatic secondary deposits to vertebra were selected for the study. Patients were randomized to two arms receiving multiple fraction of RT with 30 Gy in 10 fractions and 8 Gy in single fraction RT, respectively.

Materials and Methods:

Patients with age >75 years, Karnofsky Performance Status (KPS) <40, features of cord compression were excluded from study. Initial pain response was assessed using Visual Analogue Scale (VAS) and compared using the same scale at weekly interval up to 1 month after treatment completion.

Results:

Arm A comprised of 33 patients while 31 patients were enrolled in Arm B. Baseline patient characteristics were comparable. Eleven patients were lost to follow-up. Initial pain scores were 7.23 ± 0.765 and 7.51 ± 0.55 in arm A and arm B, respectively. Pain scores reduced significantly in both the arms after 1 month (4.39 ± 1.82 in arm A; 5.25 ± 2.39 in arm B). Time of initiation of pain response was earlier in arm A (P = 0.0281), statistically significant. Mild G-I toxicity was noted in both the arms but differences in two arms were not statistically significant (P = 0.49), no interruption of treatment was required because of side effects.

Conclusions:

Different fractionation of radiation has same response and toxicity in treatment of vertebral bone metastasis. Single fraction RT may be safely used to treat these cases as this is more cost effective and less time consuming. Studies may be conducted to find out particular subgroup of patients to be benefitted more by either fractionation schedule; however, our study cannot comment on that issue.     

SPECT 与X线联合诊断鼻咽癌骨转移的临床价值

目的探讨SPECT联合X线诊断鼻咽癌骨转移的临床应用价值.方法选择60例鼻咽癌初诊患者行SPECT全身骨核素显像和X线检查.结果 60例鼻咽癌经SPECT和X线共同诊断为骨转移53.3% (32/60), SPECT显像阳性率为78.3%(47/60), 假阳性率为16.7% ;X 线诊断阳性率为45%(27/60), 骨转移的部位以脊柱多见,其余依次为胸部、骨盆、肢体和颅骨.结论 SPECT全身骨显像与X线联合检查对于临床诊断分期及治疗有重要意义,可作为鼻咽癌治疗前的常规检查.     

SPECT与X线联合诊断鼻咽癌骨转移的临床价值

目的 探讨SPECT联合X线诊断鼻咽癌骨转移的临床应用价值。方法 选择60例鼻咽癌初诊患者行SPECT全身骨核素显像和X线检查。结果 60例鼻咽癌经SPECT和X线共同诊断为骨转移53．3％(32／60)，SPECT显像阳性率为78．3％(47／60)，假阳性率为16．7％；X线诊断阳性率为45％(27／60)，骨转移的部位以脊柱多见，其余依次为胸部、骨盆、肢体和颅骨。结论 SPECT全身骨显像与X线联合检查对于临床诊断分期及治疗有重要意义。可作为鼻咽癌治疗前的常规检查。     

正畸与正颌联合治疗骨性颌骨前突的研究进展

成人生长发育基本停止,单纯应用正畸治疗不能彻底解决骨性颌骨前突的问题,需要结合正颌手术按照正畸-正颌-正畸的顺序治疗才能达到满意的矫治效果。目前口腔正畸医生与颌面外科医生在合作过程中总结了许多新的理念,骨性颌骨前突的治疗已经取得了阶段性的成果,正向着更高水平发展。本文将围绕正畸与正颌联合治疗骨性颌骨前突所需投影测量指标、治疗时机的发展以及正畸与正颌联合治疗骨性上颌前突、骨性下颌前突及骨性双颌前突的进展进行综述。     

骨骼肌在重复电刺激下生理行为研究

为得到肌张力特性与其电生理特性间的实验关系,本文在0.1 ms的波宽下,用不同频率的三种强度的重复脉冲电流,对家兔的胫神经进行电刺激,用生物材料试验机和肌电仪记录其腓肠肌的肌张力和复合动作电位.结果表明,肌张力与脉冲电流频率呈较好的正相关关系,而肌张力随刺激电流强度的增加似乎并不明显.     

A Complementary Method for the Detection of Osteoblastic Metastases on Digitized Radiographs

Purpose This study was conducted to evaluate the diagnostic usefulness of gray level parameters in order to distinguish healthy bone from osteoblastic metastases on digitized radiographs. Materials and methods Skeletal radiographs of healthy bone (n = 144) and osteoblastic metastases (n = 35) were digitized using pixels 0.175 mm in size and 4,096 gray levels. We obtained an optimized healthy bone classification to compare with pathological bone: cortical, trabecular, and flat bone. The osteoblastic metastases (OM) were classified in nonflat and flat bone. These radiological images were analyzed by using a computerized method. The parameters (gray scale) calculated were: mean, standard deviation, and coefficient of variation (MGL, SDGL, and CVGL, respectively) based on gray level histogram analysis. Diagnostic utility was quantified by measurement of parameters on healthy and pathological bone, yielding quantification of area under the receiver operating characteristic (ROC) curve, AUC. Results All three image parameters showed high and significant values of AUC when comparing healthy trabecular bone and nonflat bone OM, showing MGL the best discriminatory ability (0.97). As for flat bones, MGL showed no ability to distinguish between healthy and flat bone OM (0.50). This could be achieved by using SDGL or CVGL, with both showing a similar diagnostic ability (0.85 and 0.83, respectively). Conclusion Our results show that the use of gray level parameters quantify healthy bone and osteoblastic metastases zones on digitized radiographs. This may be helpful as a complementary method for differential diagnosis. Moreover, our method will allow us to study the evolution of osteoblastic metastases under medical treatment.     

碳酸化羟基磷灰石水泥修复骨缺损的实验研究

目的通过动物实验观察一种新型的骨修复材料———碳酸化羟基磷灰石水泥修复骨缺损的效果。方法在10只杂种犬肱骨近端制作骨缺损动物模型,采用碳酸化羟基磷灰石水泥修复骨缺损,并以高温烧结羟基磷灰石陶瓷作为对照,分别于术后5天、4周、8周、12周和16周处死动物,通过X线和组织学观察其修复效果。结果碳酸化羟基磷灰石水泥完全充填骨缺损,界面与骨结合紧密,生物相容性良好,并且随着植入时间的延长可逐渐降解并被新生骨爬行替代,与骨整合为一体。而羟基磷灰石陶瓷不能紧密充填骨缺损,在实验期间与骨界面清晰,并且没有见到降解现象。结论碳酸化羟基磷灰石水泥具有原位固化性能,是一种较为理想的新型骨缺损修复材料。