Efficacy,effectiveness and side effects of medications used to prevent fractures

There is an increasing number of effective therapies for fracture prevention in adults at risk of osteoporosis. However, shortcomings in the evidence underpinning our management of osteoporosis still exist. Evidence of antifracture efficacy in the groups of patients who most commonly use calcium and vitamin D supplements is lacking, the safety of calcium supplements is in doubt, and the safety and efficacy of high doses of vitamin D give cause for concern. Alendronate, risedronate, zoledronate and denosumab have been shown to prevent spine, nonspine and hip fractures; in addition, teriparatide and strontium ranelate prevent both spine and nonspine fractures, and raloxifene and ibandronate prevent spine fractures. However, most trials provide little information regarding long‐term efficacy or safety. A particular concern at present is the possibility that oral bisphosphonates might cause atypical femoral fractures. Observational data suggest that the incidence of this type of fracture increases steeply with duration of bisphosphonate use, resulting in concern that the benefit–risk balance may become negative in the long term, particularly in patients in whom the osteoporotic fracture risk is not high. Therefore, reappraisal of ongoing use of bisphosphonates after about 5 years is endorsed by expert consensus, and ‘drug holidays’ should be considered at this time. Further studies are needed to guide clinical practice in this area.     

Pterygium excision with free conjunctival autograft (FCG) versus postoperative strontium 90 (90Sr) beta-irradiation. A prospective study

In a prospective study the results of a pterygium excision in 54 patients (57 eyes) who underwent a superficial free conjunctival autograft (FCG) were compared to those of patients who were treated with postoperative90Sr-irradiation. In 51 cases the minimum follow-up was six months, the maximum follow-up seven years. We divided the study up into a randomized part and an open part. In the randomized part, surgery of a primary pterygium was performed in 25 eyes, of which 16 were treated with a FCG and compared with 9 eyes with primary pterygium surgery and postoperative90Sr beta-irradiation. In the same period 16eyes were treated because of a recurrent pterygium: 8 with FCG and 8 with90Sr-irradiation. In the open part of the study16 eyes with primary pterygium were successively treated with FCG alone. The results showed in the randomized, as well as in the open study on primary surgery with a minimum follow-up of six month, one recurrence in each of the FCG-groups (2 out of 31 eyes =6.4%), and no recurrences in the 90Sr-group(0%). In the randomized group of patients treated for a recurrent pterygium one recurrence developed in the FCG group (1 out of 8 eyes =12.5%) and one in the 90Sr-group (1 out of 7 =14.6%). Analysis of other clinical parameters showed that postoperative treatment with corticosteroids, nonsteroidal anti-inflammatory drugs, and artificial tears was necessary for a longer period in the FCG group than in the90Sr-group. This revised version was published online in August 2006 with corrections to the Cover Date.     

A study on contents of trace elemants Sr、Ni、Se~(4＋)in different parts of Jilinpanaxginseng

$ＢａｓｉｃＣｏｌｌｅｇｅｏｆｍｅｄｉｃａｌＳｃｉｅｎｅｓ；ＩｎｓｔｉｔｕｔｅｏｆＥｎｄｅｍｉｃＤｉｓｅａｓｅｓ     

饮水锶对大鼠骨骼生长发育影响的实验研究

研究了高锶饮水对大鼠骨骼生长发育的影响。结果表明，饮水中锶浓度为５～５００ｍｇ／Ｌ达１２周可引起Ｗｉｓｔａｒ大鼠血清、尿、股骨、颌骨和牙齿中锶含量增高，呈明显的剂量－反应关系。同时，锶还可使骨骼钙含量降低，牙齿钙含量和骨骼的骨密度增高，以及除第１２周雌性大鼠外血清钙水平下降。尚未发现锶对动物体重、体长、血清ＡＫＰ活性、尿钙水平以及股骨弯曲断裂载荷的影响。然而，锶对动物骨骼生长发育影响性别之间存在差异，如在第１２周染锶组雄性大鼠血清钙含量降低，而雌性大鼠升高；在第４周和第８周时，仅雄性大鼠尿Ｈｏｐ／Ｃｒ比值增高，而雌性大鼠维持于正常水平；Ｓｒ２＋还使雄性大鼠颌骨骨密度增加，而雌性大鼠股骨骨密度增加。上述改变提示可能是动物性别之间在内分泌调节和代谢过程上不同的结果。     

Supercritical fluids in medical radioisotope processing and chemistry,Part II: Applications – real and demonstrated

In Part I of this review series, an overview was presented on what the basic properties of supercritical fluids are and how they can, and are being used in many of today's industries as solvents for extraction, chromatography and reaction. A good part of this overview detailed the kinds of equipment needed, and techniques on how to use them for optimal performance. Part II of this series will delve into specific applications of supercritical fluid technology as it relates to aspects of medical isotope processing. The reader will note that very few applications of this technology to Nuclear Medicine have been published. Many potential applications cited within the context of this review derive from preliminary studies carried out in the author's laboratory. These examples are presented to spark interest in future developments of this nature. Copyright © 2003 John Wiley & Sons, Ltd.     

EFFECTS OF STROPHANTHIDIN ON THE SLOW INWARD CURRENT IN GUINEA-PIG ISOLATED VENTRICULAR MYOCYTES

1. The effect of strophanthidin on the slow inward current (Isi) and on contractile force were studied in guinea-pig isolated ventricular myocytes and intact papillary muscles, respectively. In myocytes, both low (10 nmol/L) and high (1-10 mumols/L) concentrations had small or no effects in either direction on Isi whereas norepinephrine (10-100 nmol/L) increased it. To determine whether the same results are obtained after decreasing or increasing intracellular calcium or sodium, the same concentrations of strophanthidin were tested in different procedures that are known to (i) increase [Ca]i and decrease [Na]i (high [Ca]o, 3.6-5.4 mmol/L; low [Na]o, 112 mmol/L; (ii) decrease [Ca]i and increase [Na]i (low [Ca]o, 0.45-1 mmol/L; Sr, 1 mmol/L; (iii) decrease [Ca]i and [Na]i (Cd, 0.1-0.2 mmol/L); and (iv) increase [Ca]i and [Na]i (veratridine, 0.2 mumol/L). High [Ca]o and veratridine increased whereas low [Ca]o and Cd decreased Isi. In contrast, during these various procedures, strophanthidin had small and inconsistent effects at a low or high concentration. In intact papillary muscles, low strophanthidin decreased whereas high strophanthidin increased contractile force. It is concluded that strophanthidin has little direct or indirect effect on Isi and that the decrease in force by low and increase in force by high concentrations in intact muscle are probably related to demonstrated decrease and increase, respectively, in intracellular sodium activity.     

放射性肾图及肾有效血浆流量对移植肾功能监测的临床价值

对 16例肾移植术后病人进行肾图及肾有效血浆流量 (Effectiverenalplasmaflow ,ERPF)测定 ,同时收集临床资料及血生化检查结果进行比较。结果 9例正常肾图 ,其ERPF正常 ,临床资料也正常 ;5例肾图呈梗阻图形 ,ERPF减少 ,血生化异常 ;2例肾图呈低水平延长型 ,ERPF明显减少 ,血肌酐、尿素氮明显升高。表明肾图和ERPF能较好反映移植肾的功能状况 ,是监测移植肾功能的敏感指标 ,是肾移植术后监测病情变化的好方法     

鼻咽癌面颈联合野放疗对唾液腺功能影响的临床分析

目的 :利用放射性核素99mTcO4-动态显像唾液腺定量测定鼻咽癌面颈联合野放疗前、中、后唾液腺功能的变化并探讨与放疗剂量之间的关系。方法 :2 0 0 3年 2月 1日～ 2 0 0 3年 10月 3 1日 ,分别对 2 0例鼻咽癌面颈联合野放疗患者于放疗前、放疗至 10、3 6～ 40、70Gy时进行99mTcO4-动态显像定量测定其唾液腺(腮腺、颌下腺 )摄锝率 (UR)、泌锝率 (ER)变化 ,同时观察其口干程度进行临床分级。结果 :2 0例鼻咽癌面颈联合野放疗剂量为 10和3 6～ 40Gy时 ,其泌锝率明显低于放疗前 ,P <0 0 5 ,在放疗 70Gy时降到最低 ,P <0 0 1。与临床观察到的口干严重程度一致 ,而其摄锝率在 3 6～ 40Gy照射以前变化不明显 ,无统计学意义。结论 :鼻咽癌面颈联合野照射患者放疗前无明显唾液腺功能障碍 ,随着放疗剂量的增加 ,唾液腺功能明显下降 ,其ER较UR下降明显 ,在确保患者放疗疗效的同时 ,应尽可能提高放疗技术 ,减少唾液腺照射剂量和放疗体积 ,保护唾液腺功能 ,以提高患者的生活质量。