^89SrCl2和^153Sm—EDTMP治疗转移性骨肿瘤骨痛的疗效比较

目的：对比评价^89SrCl2和^153Sm—EDTMP治疗转移性骨肿瘤的临床疗效和不良反应。方法：对124例有不同程度骨痛,伴或不伴有活动受限的广泛转移性骨肿瘤患者分成二组,40例应用^89SrCl2（^89Sr组）治疗,84例用^153Sm—EDTMP（^153Sm组）治疗。结果：^89SrCl2和^153Sm—EDTMP对骨痛止痛总有效率分别为80％和78．6％,差异无显著性,但前者的病灶变化例数明显高于后者。结论：对经济条件好,存活时间较长,不便到医院治疗的多发转移性骨肿瘤骨痛患者可首选^89SrCl2治疗     

153Sm-EDTMP与89SrCl_2治疗骨转移癌疗效比较

目的探讨比较153Sm-EDTMP与89SrCl2治疗骨转移癌疗效。方法184例广泛骨转移癌患者随机分成153Sm-EDTMP治疗组和89SrCl2治疗组,分别为126例和58例,153Sm-EDTMP按0.8~1 mci/kg8、9SrCl2按0.04~0.06 uci/kg静注给药,治疗后每周复查血常规,连续两个月,3~6月复查骨显像,对止疼效果、     

骨瘤胶囊联合核素89Sr治疗骨转移瘤临床分析

目的 观察骨瘤胶囊联合核素⁸⁹Sr治疗骨转移瘤的临床疗效。方法 采用随机分组法,以中药骨瘤胶囊联合⁸⁹Sr及单纯⁸⁹Sr治疗骨转移瘤患者各50例,观察患者疼痛程度、骨质修复、外周血象及生存质量等情况。结果 治疗组与对照组止痛有效率分别为94.0%和76.0%(P<0.05;生存质量的提高稳定率分别为94.0%和74.0%(P<0.05);治疗后两组间转移病灶骨代谢情况及血液毒性反应均具有显著差异(P<0.05,P<0.01)。结论 ⁸⁹Sr联合骨瘤胶囊治疗骨转移瘤,可提高止痛作用及患者的生存质量,降低血液毒性反应,是一种疗效确切的联合治疗方法。     

89SrCl2 治疗11 例肿瘤骨转移的临床观察

 目的　探讨⁸⁹SrCl₂ 治疗转移性骨肿瘤的临床应用价值。方法　 1 1例经证实为肿瘤骨转移患者接受 ⁸⁹SrCl₂ 4 mci静脉注射治疗 ,治疗后至随访时间为 3个月～ 1年。结果　止痛总有效率72 .8% ;显效 45.5% ( 5/1 1 ) ;有效 2 7.3% ( 3/1 1 ) ;止痛起效时间较快 ,缓解骨痛持续时间较长 ,骨髓抑制不明显。结论　⁸⁹SrCl₂治疗肿瘤骨转移患者有缓解疼痛、提高生存质量的作用.     

经鼻高流量预充氧可保障老年患者全麻气管插管诱导期的安全

目的评估经鼻高流量预充氧在老年患者全麻气管插管诱导期的安全性研究。方法56例非困难气道老年患者，采用随机数字表法分为经鼻高流量吸氧组（HF组）和传统面罩经口鼻吸氧组（M组），28例/组。全麻气管插管诱导给药前预充氧5 min，HF组喉镜检查期间维持给氧，M组通气持续到喉镜检查。观察并记录两组患者基本资料，预充氧前（T1）、预充氧5 min（T2）及插管成功即刻（T3）的超声下胃窦横截面积（CSA）和动脉血气分析指标：PaO₂、PaCO₂、cSO₂，窒息安全时间，插管时间，面罩通气的次数及术后并发症。结果两组患者的基本资料差异无统计学意义。预充氧5 min，两组患者的PaO₂和cSO₂均明显升高，且HF组PaO₂较M组明显（F=118.108vs 9.511，P < 0.05），插管成功后PaO₂和cSO₂均下降，HF组的PaO₂值较M组下降缓慢，且仍高于其T1时点，而M组的cSO₂值下降显著，低于其T1时点值。HF组窒息安全时间显著高于M组（t=5.305，P < 0.05），且HF组面罩通气次数少于M组（χ²=6.720，P < 0.05）。两组插管后的PaCO₂值均增高，但两组比较差异无统计学意义（F=3.138，P > 0.05），其余结果差异也无统计学意义（P > 0.05）。结论经鼻高流量吸氧是一种安全简单有效的预充氧方式，与传统的面罩预充氧相比，能提高老年患者的动脉氧分压，延长患者窒息安全时间，可保障老年患者全麻诱导插管时气道管理的安全。     

核素153Sm、89Sr和化疗治疗多发性骨转移癌疗效对比

目的观察化学疗法及核素153Sm-EDTMP、89SrCl2治疗骨转移癌的疗效。方法对骨转移癌患者分别予以化学疗法及核素153Sm-EDT-MP、89SrCl2治疗,观察不同方法的疗效。结果化学疗法治疗组中骨痛的缓解率分别是完全缓解(CR)0%,部分缓解(PR)8.3%;骨显像的变化是CR0%,PR7.7%,稳定0%;而核素治疗骨转移癌的疗效明确,骨痛的缓解率达到70.3%,骨显像异常浓聚点虽然CR为0%,但PR为45.9%,稳定为43.3%。结论核素153Sm-EDTMP、89SrCl2治疗骨转移疗效明确,其中153Sm-EDTMP疗效更优于89SrCl2。     

放疗联合免疫治疗对肺癌脑转移的疗效和安全性的meta分析

背景与目的免疫治疗(immunotherapy, IT)被推荐用于治疗晚期非小细胞肺癌(non-small cell lung cancer, NSCLC)，而脑放疗(radiation therapy, RT)是脑转移(brain metastasis, BM)患者的主流治疗方法。本研究旨在调查RT和IT联合使用的疗效及安全性。方法检索时限截至2022年5月1日，在中国知网、万方、PubMed、EMBASE、Cochranc数据库中进行了文献检索。异质性采用I²检验和P值进行判断。发表偏倚采用漏斗图评价。采用纽卡斯尔-渥太华量表(Newcastle Ottawa Scale, NOS)评估纳入研究的质量。采用Stata 16.0软件进行统计分析。结果纳入17篇文献共涉及2,636例患者。在RT+IT组和RT组的比较中，总生存期(overall survival, OS)(HR=0.85, 95%CI: 0.52-1.38, I²=73.9%, P_异质性=0.001)和颅内远距离控制(distant brain control, DBC)(HR=1.04, 95%CI: 0.55-1.05, I²=80.5%, P_异质性 < 0.001)未发现明显差异，但RT+IT组颅内控制(local control, LC)优于RT组(HR=0.46, 95%CI: 0.22-0.94, I²=22.2%, P_异质性=0.276)，发生放射性坏死/治疗相关影像学改变(radionecrosis/treatment related imaging changes, RN/TRIC)风险高于RT组(HR=1.72, 95%CI: 1.12-2.65, I²=40.2%, P_异质性=0.153)。在RT+IT同步治疗组和序贯组的比较中，未发现OS(HR=0.62, 95%CI: 0.27-1.43, I²=74.7%, P_异质性=0.003)和RN/TRIC(HR=1.72, 95%CI: 0.85-3.47, I²=0%, P_异质性=0.388)在两组中存在差异。但同步治疗组DBC优于序贯治疗组(HR=0.77, 95%CI: 0.62-0.96, I²=80.5%, P_异质性 < 0.001)。结论RT联合IT并未改善NSCLC BM患者的OS，而且还会增加RN/TRIC的风险。此外，相对于RT与IT序贯治疗，RT与IT同步治疗可改善DBC的疗效。     

抗生素89－07对前庭器功能形态影响的观察

给豚鼠肌注抗生素８９－０７并用旋转试验评价前庭功能。２８天后用扫描电镜观察前庭壶腹嵴、椭园囊斑、球囊斑的形态改变，检测比较８９－０７与ＡＭＫ及ＧＭ对前庭器的影响，结果表明：８９－０７对前庭无明显损害，对前庭功能的影响与生理盐水组相比较没有显著差异，在大剂量时８９－０７虽对耳石膜有损害，并使感觉毛细胞的纤毛粘连，但８９－０７对前庭的毒性作用仍比庆大霉素及丁胺卡那霉素小得多。     

双极雄激素序贯免疫检查点抑制剂治疗转移性去势抵抗性前列腺癌4例

The relationship between androgen and prostate cancer treatment has plagued the field of urologic oncology. To investigate the efficacy and safety of bipolar androgen therapy (BAT) followed by immune checkpoint inhibitor therapy in patients with metastatic castration resistant prostate cancer (mCRPC). In August 2020, Beijing Hospital conducted an investigator-initiated study: Bipolar androgen therapy followed by immune checkpoint inhibitor therapy in metastatic castration resistant prostate cancer. Up to now, the study has included 4 patients who completed the entire cycle of treatment. The mean age of the patients was 74.5 (68 to 82) years old, the mean prostate-specific antigen (PSA) was 20.8 (9.9 to 8.36) μg/L, the mean testosterone was 0.50 (0.00 to 1.81) μg/L, and the Gleason score were 10 and 9, 7, 7 respectively. The pain scale score before treatment was 1.5 (1 to 2). In this study, 4 patients completed the entire cycle of treatment, and the treatment effect of the patients showed great heterogeneity. PSA in case 1 decreased from 24.0 μg/L to 0.47 μg/L, testosterone increased from 0.175 6 μg/L to 2.62 μg/L. PSA in case 2 increased from 9.939 μg/L to 168.536 μg/L, and testosterone increased from 0.0 μg/L increased to 2.85 μg/L. PSA increased from 13.31 μg/L to 39.278 μg/L in case 3, testosterone increased from 0.0 μg/L to 2.54 μg/L. and PSA increased from 36.0 μg/L to 350.2 μg/L in the case 4, testosterone increased from 1.81 μg/L to 3.85 μg/L. Except for one patient who showed significant PSA remission, the PSA levels of the remaining three patients remained high overall. There were no adverse reactions reported in 4 patients. In the follow-up, case 1 continued to use PD-1 monoclonal antibody (median progression free survival time was 10 months). Two patients who had previously been resistant to enzalutamide received enzalutamide again after the whole cycle of treatment, and their PSA decreased again, which indicated that the patient was sensitive to enzalutamide again. BAT had a certain therapeutic effect on mCRPC patients, and the safety was controllable. Its tumor control effect still needed long-term follow-up verification in large-sample clinical trials. BAT has a certain therapeutic effect on mCRPC patient, especially the resensitivity of tumors to enzalutamide can be restored. Immune checkpoint inhibitors may have therapeutic potential in patients with prostate cancer treated with BAT and enzalutamide.