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1.
目的:研究食管癌后程加速超分割放疗联合应用参芪扶正注射液增敏和降低放疗反应。方法:60例食管癌患者随机平均分成两组,一组行单纯后程加速超分割放疗(单放组),1次/天,2Gy/次,5次/周,总剂量达40Gy,20次后改为2次/天,1.5Gy/次,10次/周,总剂量64Gy。另一组在后程加速超分割放疗的同时加用参芪扶正注射液(综合组),参芪扶正注射液250ml静脉滴注,每日1次,连用28天。结果:放射治疗结束时食管片的分级综合治疗组1级占56.7%,明显高于单放组26.7%(P<0.05);综合组1年生存率80.0%,明显高于单放组43.3%(P<0.05);1级以上胃肠道反应综合组为6.7%,明显低于单放组30.0%(P<0.05);白细胞Ⅰ~Ⅱ级下降综合组占20.0%,明显低于单放组63.3%(P<0.05)。结论:食管癌后程加速超分割放疗联合应用参芪扶正注射液具有增敏和降低放疗反应作用。  相似文献   

2.
目的:后程加速超分割放疗联合同步化疗治疗中晚期鼻咽癌疗效的研究。方法:2003年5月-2005年5月,86例确诊为鼻咽癌患者分为常规组(全程常规分割放疗)和后加速组(化疗+后程加速超分割),每组43例。常规组照射2Gy/次,1次/天,每周5d,总剂量为70Gv.后加速组采用化疗方案为顺铂(DDP)(20mg/m2,第1—5天)+5-氟脲嘧啶(5.Fu)(500mg/m2,第1~5天),每4周1疗程,共3疗程;于第l疗程结束时开始放疗,先常规分割:2Gy/d,每周5d,放疗剂量至36Gv后改为后程加速超分割照射:3Gy/d,总剂量66~69Gy。结果:放疗后1、3个月常规组和后加速组鼻咽部原发病灶和颈淋巴结完全缓解率、部分缓解率差异无统计学意义(P〉0.05);第1、3年后加速组局部控制率高于常规组(P〈0.05);后加速组无瘤生存率显著高于常规组(P〈0.05),而生存率差异无统计学意义;后加速组急性黏膜反应明显重于常规组(P〈0.01),但远期后遗症的发生两者差异无统计学意义;后加速组复发率显著低于常规组(P〈0.05),平均复发时间也显著延长,但两组的转移率和平均转移时间差异无统计学意义。结论:后程加速超分割联合化疗的综合治疗能提高鼻咽癌局部控制率,降低其复发率。  相似文献   

3.
新辅助化疗加后程加速超分割放疗治疗鼻咽癌的临床研究   总被引:1,自引:0,他引:1  
目的:评价新辅助化疗加后程加速超分割放疗治疗鼻咽癌的近期疗效及急性放射反应。方法:将同期收治的43例经病理确诊且无远处转移的鼻咽癌患者随机分为研究组(n=23)和对照组(n=20)。研究组先按FP方案(5-Fu DDP)行1周期新辅助化疗,然后行放疗。放疗又分两个阶段,首先设面颈联合野加下颈切线野,行常规分割放疗,照射36.0-40.0Gy后缩野,而后改用面颈分野,研究组行加速超分割放疗,每次1.4-1.6Gy,每日2次,间隔时间≥6小时,鼻咽部总剂量照射至68.0-70.0Gy;对照组仅行常规分割放疗,鼻咽部总剂量照射至68.0-70.0Gy。放疗结束后1月,两组再行3-4周期辅助化疗,方案同前。结果;研究组口腔粘膜急性放射反应较对照组重(P<0.05),而皮肤和血液学急性放射反应两组无显著性差异(P>0.05),放疗结束时CT检查显示两组鼻咽部和颈部肿瘤的完全消退率分别为78.26%和65.00%,无显著性差异(P>0.05)。但在放疗结束后3个月和6个月,两组鼻咽癌和颈部肿瘤的完全消退率分别为95.65%比70.00%及95.65%比75%,均有显著性差异(P<0.05)。放疗结束后6个月,两组中、晚期(Ⅲ期+ⅣA+B期)病例肿瘤的完全消退率分别为92.31%和50.00%,有显著性差异(P<0.05)。结论:本研究结果提示,新辅助化疗后加程加速超分割放疗能提高鼻咽癌的局部控制率,适合局部晚期鼻咽癌的治疗,其急性放射反应患者也可以耐受。  相似文献   

4.
鼻咽癌后程加速超分割放疗的临床观察   总被引:4,自引:0,他引:4  
目的:观察鼻咽癌后程加速超分割放疗的急性反应和近期疗效。方法:对经病理证实为鼻咽癌患者63例,随机分为常规分割放疗组(对照组)及后程加速超分割放疗组(研究组),研究组后程放疗采用同期缩野加量(野中野)技术。结果:放疗结束后3个月,研究组和对照组原发灶CR、PR率分别为78.8%,21.2%和53.3%,46.7%(P<0.05),两组差别有显著意义。研究组急性口咽放射反应较对照组明显(P>0.05),但无统计学意义。结论:后程加速超分割放疗较常规分割放疗鼻咽癌具有更好的近期疗效,并为患者所耐受。  相似文献   

5.
目的 探讨中上段食管癌后程加速外照射联合腔内放疗的疗效。方法112例中上段食管癌患者随机分为56例后程加速超分割放射治疗(后超组),开始常规分割放疗,为5次/周,2.0Gy/次,总量30Gy/3周,然后改2次/天,1.5Gy/次,间隔6小时以上,共2周。56例后程加速1周,腔内放疗2周(腔内组),腔内放疗采用低剂量率192Ir,食管黏膜参考点剂量3.0Gy/次,每周一、周五,共2周,总量12Gy/4次。结果后超组和腔内组近期有效率分另q为98.2%、100%(P〉0.05)。3、5年生存率分别为48.2%、51.7%(P〉0.05);35.7%、37.5%(P〉0.05),两组无差异显著性,3、5年局部控制率分别为69.6%、73.2%;53.5%、57.1%(P〉0.05),两组无差异显著性。结论后程加速联和腔内放疗,能有效控制肿瘤,值得临床应用。  相似文献   

6.
目的 随机对照研究后程加速超分割三维适形放疗食管癌的近远期疗效、不良反应及失败原因。方法 将120例食管鳞癌患者用信封法随机均分至后程加速超分割三维适形放疗组(后超组)和后程常规分割三维适形放疗组(对照组)。放疗方法:两组前2/3疗程均为普通模拟机定位常规放疗40Cy,后1/3疗程后超组改为CT模拟定位加速超分割三维适形放疗(1.5Gy/次,2次/d,18-27Gy),总剂量为58-67Gy,32-38次,全疗程36-39d;对照组CT模拟定位常规分割三维适形放疗至上述相当剂量。结果 后超组5年生存率,3、4、5年无瘤生存率,1、2、3、4、5年局部控制率均明显高于对照组(均P〈0.05)。后超组中位复发时间也高于对照组(P〈0.01)。结论 常规放疗后进行后程加速超分割三维适形放疗可作为颈段、胸上段和蕈伞型食管癌的首选方法之一,它可提高局部控制率和远期生存率,且不会明显增加反应。  相似文献   

7.
后程(野中野)加速超分割放射治疗鼻咽癌的临床研究   总被引:2,自引:0,他引:2  
目的:观察后程加速超分割放射治疗鼻咽癌的临床疗效和放射反应。方法:对经病理证实为鼻咽癌思者63例,分为常规分割放疗组(对照组)及后程加速超分割放疗组(研究组),研究组后程放疗采用同期缩野加量(野中野)技术。结果:①放疗后3个月,研究组和对照组原发灶CR、PR率分别为78.8%、21.2%和53.3%、46.7%(P<o.05);②研究组和对照组的1年原发灶局控率分别为100%、83.3%(P<0.05);②研究组和对照组的1年生存率分别为90.9%、86.7%(P>0.05);④研究组急性口咽放射反应高于对照组(P>0.05)。结论:后程加速超分割放疗鼻咽癌的疗终肿瘤消退率和1年局控率高于常规放疗,且能耐受。  相似文献   

8.
目的:观察鼻咽癌后程加速超分割的近期疗效。方法选取120例局部晚期鼻咽癌患者,随机分为后程加速超分割组(研究组)和常规分割组(对照组)(n=60),2组均行同期顺铂化疗。2组开始均常规分割,50 Gy/25次后,研究组鼻咽每天照射2次,每次1.5 Gy,颈部CTV 1(Clinic Target Volume 1)上午照射1.8~2.0 Gy,GTVnd(Gross Tumour Volume nord)下午照射1.0~1.2 Gy,间隔6 h以上,鼻咽总剂量71~73 Gy,颈部CTV 1至59~60.8 Gy,GTVnd至65~68 Gy;对照组鼻咽及颈部仍常规分割,鼻咽剂量70~74 Gy,CTV 1至60 Gy,GTVnd至66~68 Gy。结果研究组、对照组放疗结束时、放疗后3、6个月鼻咽控制率分别为91.7%、95.0%、96.7%及78.3%、80.0%、83.3%(P<0.05),颈部控制率分别为93.3%、96.7%、98.3%及80.0%、86.7%、86.7%。(P<0.05)。研究组耳及口咽黏膜2、3级急性放射损伤增加较明显(50%vs 30%及53%vs 35%,均P<0.05),但均能耐受。结论后程加速超分割并同期化疗能提高局部晚期鼻咽癌的原发灶及颈部淋巴结局控率,耐受性好。  相似文献   

9.
目的对比研究常规放疗和后程加速超分割放射治疗食管癌的近期、远期疗效。方法对134例食管鳞癌患者进行前瞻性随机分组研究,其中67例进入常规组,67例进入后程加速超分割组。常规组治疗开始2.0Gy/次,1次/d,5d/周,照射40Gy后缩野继续上述方式治疗,总量66Gy,33次,6,3周完成。后程加速超分割组开始为常规分割:2.0Gy/次,1次/d,5d/周,照射至40.0Gy,20分次缩野改为1.2Gy/次,2次/d,2次照射相隔≥6h,5d/周,总剂量66.4Gy,42分次,6、1周完成任务。结果近期疗效:常规组、后程加速超分割组分别为65.7%、86.6%%,两组差异有统计学意义(P〈0.05)。1、3、5年生存率常规组分别为49.3%、19.4%、8.9%,后程加速超分割组分别为71.6%、40.3%、22.3%,两组差别有统计学意义(P〈0.05)。两组晚期放射反应主要为放射性食管狭窄和肺纤维化。结论后程加速超分割组近期、远期疗效较常规组明显提高,晚期放射损伤相似。  相似文献   

10.
目的评价局部晚期食管鳞癌适形放疗并后程加速超分割的疗效。方法将82例食管鳞癌患者随机分为两组:常规分割常规照射组(CF)40例,2Gy/次,5次/周,总剂量60~68Gy,30~34分次,6~7周完成。适形放疗加速后超组(CRT)42例,先常规分割照射2Gy/次,5次/周,40Gy/4周;从第5周起行加速超分割放疗1.4Gy/次,2次/天,间隔6h以上,总剂量59.6~68Gy,34~40分次,5~6周完成。结果CRT组和cF组的1、3年局部控制率分别为76.2%、58.6%和66.7%、28.6%;1、3年生存率分别为69.1%、44.3%和48.5%、24.7%。急性放射性损伤两组无显著性差异。结论在局部晚期食管鳞癌放射治疗中采用适形放疗并后程加速超分割较常规放疗能提高局部控制率和生存率,并不增加放射治疗不良反应。  相似文献   

11.
Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P < 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (>0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P <0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P < 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.  相似文献   

12.
Objective: To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods: SD rats served as both donors and recipients. 4℃ sodium lactate Ringer's was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava (IVC) inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results: Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion: This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.  相似文献   

13.
Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P< 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P< 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.  相似文献   

14.
目的:评价使用安心颗粒对急诊经皮冠状动脉介入术(PPCI)术后生活质量的影响.方法:将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组(术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次)和对照组(仅接受基础药物治疗).所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表(MIDAS)、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果:入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异(P>0.05);出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低(P<0.05);组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低(P<0.05).两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血(P>0.05).两组发生轻度血小板减少症的患者数比较无差异(P>0.05).结论:PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.  相似文献   

15.
Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.  相似文献   

16.
Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.  相似文献   

17.
A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care(~'4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.  相似文献   

18.
Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.  相似文献   

19.
FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…  相似文献   

20.
Journal of Nanjing Medical University (English Edition) JNMU, sponsored by Nanjing Medical University, was established in 1987. It is a bimonthly comprehensive English medical journal published locally and abroad.Since 2007, Journal of Nanjing Medical University (English Edition )was granted Elsevier the full publishing and distribution rights worldwide for the Electronic Edition, excluding the People's Republic of China.  相似文献   

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