89锶治疗骨转移瘤对患者肝功能的影响

目的临床观察89锶治疗骨转移瘤对患者肝功能的影响。方法将87例骨转移瘤患者随机分为观察组39例和对照组48例。观察组静脉注射核素二氯化锶(89SrCl2)注射液治疗,3个月后可重复;对照组予吗啡缓释片口服,连服3个月。3月后对比2组治疗前后肝功能各项指标[总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、谷氨酰转移酶(GGT)、碱性磷酸酶(ALP)]的变化情况。结果观察组治疗前后各项肝功能指标无显著变化(P>0.05);对照组治疗后肝功能指标较治疗前明显增高,差异有统计学意义(P<0.05)。结论 89锶治疗骨转移瘤,止痛效果持久且不损害肝功能,值得临床推广应用。     

The efficacy of 89Sr combined with 99Tc-MDP in the treatment of the advanced breast cancers with bone metastases

Objective： The aim of our study was to evaluate the efficacy of 89Sr combined with Technetium [^99Tc] Methylene- diphosphonate Injection （^99Tc-MDP） in the treatment of cancer pain in the advanced breast cancers with bone metastases. Methods： A total of 80 patients with various degrees of bone pain due to multiple metastases of breast cancer were treated with ^89Sr combined with ^99Tc-MDP. ^89Sr was given intravenously at 4mCi on day 1 during the 3-month schedule. After 7 days, ^99Tc-MDP was given at 22 rag/day on days 1-10 during the 1-month schedule, for 3 to 6 months. Results： The effective rate of relieving pain was 83.75%. The effective rate of curing bone metastases was 81.25%. So there was a significant improvement in the quality of life of the patients. Conclusion： ^89Sr combined with ^99Tc-MDP are effective in the treatment of cancer pain in the breast cancers with bone metastasis, and can obviously repair the bone destruction caused by metastases, thereby improving the quality of life in advanced breast cancer patients with bone metastases.     

89Srcl2对骨转移癌的治疗应用

目的 探讨^89Srcl2对恶性肿瘤骨转移的治疗效果。方法 对52例骨转移癌病人两次静脉注射^89Srcl2治疗,每次2．2MBq／kg,两次治疗间隔时间为3月。结果 第1次治疗骨痛缓解率为69．23％,两次治疗后缓解率为86．54％;第1次^89Srcl2治疗后对骨转移癌有效率为26．9％,第2次治疗后有效率为42．3％。结论 ^89Srcl2不仅可以缓解骨转移癌所致的骨痛,而且对转移灶也有一定的治疗作用,连续两次治疗更为有效。     

骨转移癌治疗药物~（89）SrCl_2对患者血象的影响

目的 89SrCl2治疗转移性骨肿瘤58例,观察患者外周血象的变化。方法选择2001年1月～2006年12月在我科治疗的转移性骨肿瘤患者,分析治疗后红细胞、血小板、白细胞总数及其中性、淋巴细胞的变化情况的影响。结果 58例患者治疗后骨痛改善52例（89.66%）。红细胞、血小板、白细胞总数及其中性、淋巴细胞均较治疗前有下降（P〈0.01）。未经过特殊处理,1～3个月后均能恢复至治疗前水平。其中4例患者在89 SrCl2治疗期间同时应用化疗,发现全血降低,骨髓抑制。结论 89SrCl2治疗转移性骨肿瘤疗效好,对患者血象影响小,但在化疗期间应慎重使用89SrCl2。     

H89抑制降钙素基因相关肽促兔成骨细胞OPG表达的实验研究

目的：探讨降钙素基因相关肽（CGRP）对兔成骨细胞骨保护素（OPG）表达的影响以及用特异性PKA抑制剂H89抑制cAMP/PKA信号通路后OPG表达的变化。方法：将体外培养的兔颅骨成骨细胞在使用或不使用H89预处理后,加入外源性CGRP孵育48 h,提取各组细胞mRNA,通过半定量逆转录聚合酶链反应（RT-PCR）来观察成骨细胞OPG mRNA表达强度的变化。结果：CGRP显著刺激兔成骨细胞OPG mRNA的表达,这种刺激作用在24h时达到峰值。使用H89抑制cAMP/PKA信号通路后,CGRP诱导的OPG mRNA的表达下降了约50%。结论：CGRP对骨代谢的调节作用部分是通过促进成骨细胞OPG的合成与分泌,并且这种调节作用可能是通过激活cAMP/PKA级联信号而实现的。     

Comparison of Transcallosal Inhibition Between Hemispheres and Its Relationship with Motor Behavior in Patients with Severe Upper Extremity Impairment After Subacute Stroke

ObjectiveTo compare corticospinal excitability and transcallosal inhibition between contralesional primary motor cortex (M1) and ipsilesional M1. We also investigated the correlation between transcallosal inhibition and upper extremity motor behavior.Materials and methods19 individuals with unilateral ischemic subacute stroke who had severe upper extremity impairment participated in this study. Corticospinal excitability was assessed by measuring the resting motor threshold, active motor threshold and motor evoked potential amplitude. Transcallosal inhibition was investigated by measuring the duration and depth of the ipsilateral silent period (ISP). The data from the two hemispheres were compared and the relationships of transcallosal inhibition with upper extremity motor impairment, grip strength and pinch strength were analyzed.ResultsResting motor threshold (p = 0.001) and active motor threshold (p = 0.001) were lower and motor evoked potential amplitude was higher (p = 0.001) in the contralesional M1 compared to the ipsilesional M1. However, there were no differences between the two M1s in ISP duration (p = 0.297) or ISP depth (p =0. 229). Transcallosal inhibition from the contralesional M1 was positively associated with motor impairment (ISP duration, p = 0.003; ISP depth, p = 0.017) and grip strength (ISP duration, p = 0.016; ISP depth, p = 0.045).ConclusionsSymmetric transcallosal inhibition between hemispheres and positive association of transcallosal inhibition from contralesional M1 with upper extremity motor behavior indicate that recruitment of contralesional M1 may be necessary for recovery in patients with severe upper extremity impairment after subacute ischemic stroke.     

ECFS standards of care on CFTR-related disorders: Updated diagnostic criteria

This paper is the first in a series providing updated guidance on the definition, evaluation and management of people with a Cystic Fibrosis Transmembrane conductance Regulator (CFTR)-Related Disorder (CFTR-RD). The need for this update relates to more precise characterisation of CFTR gene variants and improved assessment of CFTR protein dysfunction. The exercise is co-ordinated by the European CF Society Standards of Care Committee and Diagnostic Network Working Group and involves stakeholder engagement. This first paper was produced by a core group using an extensive literature review and papers graded for their quality. Subsequent wider stakeholder agreement was achieved.The definition of a CFTR-RD remains “a clinical condition with evidence of CFTR protein dysfunction that does not fulfil the diagnostic criteria for CF”. Clearer guidance on CFTR dysfunction and relevant CFTR variants will be provided. Thresholds for clinical presentations are presented and the paradigm that pathobiological processes may be evident in more than one organ is agreed. In this paper we reflect on the early patient journey, highlighting that CF specialists as well as other relevant specialists should be involved in the care of people with a CFTR-RD.