碘油栓塞联合CT导向下125碘放射性粒子植入治疗肝癌

目的 评价碘油栓塞联合CT导向下125碘(125I)放射性粒子植入治疗肝癌的临床价值.方法 肝癌病例16例,其中肝细胞癌11例,肝转移瘤5例.病例均经CT、MRI检查或病理穿刺活检证实.全部病灶在接受碘油栓塞治疗2周后,在CT导向下将125I放射性粒子植入肿瘤碘油栓塞区内及其周围.结果 2个月后增强CT复查,发现完全缓解(CR)1例;部分缓解(PR)12例;无变化(NC)1例;进展(PD)2例.总有效率(CR PR)81.2%.术后6个月随访,除1例死于远处转移外,其余患者生存.随访未见大出血、胆汁瘘、肠瘘、肠出血等严重并发症.结论 碘油栓塞后联合CT导向下放射性粒子植入治疗肝脏肿瘤,并发症发生率低,治疗效果较好,是治疗肝脏肿瘤的一种有效方法.     

CT引导下125I粒子植入联合TACE治疗原发性肝癌合并门静脉癌栓的价值

目的探讨CT引导下125I粒子植入联合TACE治疗原发性肝癌合并门静脉癌栓的临床价值。方法抽取佛山南海社会福利中心康复医院放射科2010年1月～2013年10月收治的18例原发性肝癌合并门静脉癌栓患者作为研究对象,并给予6个月～2年的随访,同时结合其临床资料进行回顾性分析。结果经治疗后随访发现,18例患者中,共有14例获得有效治愈,总有效率为77.8%。结论给予原发性肝癌合并门静脉癌栓患者CT引导下125I粒子植入联合TACE治疗,能够有效保证临床治疗效果,值得推广。     

CT导引下125I粒子植入治疗胰腺癌

目的评价CT导向下125I粒子植入治疗胰腺癌的临床价值.方法回顾性分析2003年6月至2004年5月中山大学肿瘤防治中心26例经CT导向下125I粒子植入治疗胰腺癌患者的临床资料,重点总结此手术的经验和技巧.本组26例中,男21 例,女5例,年龄47～73 岁.中位年龄为60岁±13岁.病灶平均直径为6.1(1.0～8.5) cm.其中腹痛较剧者15例,黄疸10例.全部病例经CT、 MRI检查(14例)或病理穿刺活检(12例)后临床诊断为胰腺癌.病理分期(TNM, pTNM)Ⅱ期3例,Ⅲ期20例, Ⅳ期3 例.采用计算机立体定位计划系统(treatment plan system,TPS)计算布源,在CT导向下将125I粒子植入胰腺瘤灶内,采用(2.2～3.3)×107 Mq活度的125I粒子相隔1.0～1.5 cm平面播植.125I在1.7 cm内具有杀灭肿瘤的作用.结果 9例患者疼痛完全缓解,2例部分缓解,4例无效,平均术后3～7 d疼痛缓解.4例死于局部进展,2例死于远处转移,全组中位生存时间11个月.2个月后CT复查,完全缓解(CR)2例;部分缓解(PR)13例;无变化(NC)5例;进展(PD)6例.总有效率(CR+PR) 57.7%.2个月随访过程中发现3粒粒子(2例患者)迁徙至肝脏内;白细胞轻度下降1例.未见胰瘘、胰腺炎、肠出血、腹腔内脓肿等严重并发症.结论 CT导向下放射性粒子植入治疗胰腺癌创伤小,并发症发生率低,生活质量改善明显,近期效果好,具有很好的姑息止痛疗效,是一种治疗中晚期胰腺癌的简单、安全、有效的方法.     

肝癌肝移植术后复发及肝外转移瘤的125I粒子植入治疗

目的评价CT导向下^125I粒子植入术治疗肝癌肝移植术后复发及肝外转移瘤的临床价值。方法肝癌肝移植术后复发及肝外转移瘤患者11例行^125I粒子植入术共33人次,年龄35—68岁,中位年龄56岁。所有患者病灶总数为45个,平均每人4．09个病灶,病灶平均直径为2．5cm。术前采用治疗计划系统（TPS）计算布源,术中将活度为30MBq的^125I粒子在CT导向下植入肿瘤病灶内。粒子按照0．5—1．0cm平面插植。肿瘤周边匹配剂量（MPD）100—150Gy,每个患者植入粒子数10—100颗不等。结果45个病灶,完全缓解（CR）17个;部分缓解（PR）20个;无变化（NC）7个;进展（PD）1个。总有效率为82．2％。术中1例出现气胸,肺压缩在30％以内,经保守治疗好转,手术中少量出血者3例;术后1周痰中带血,体温升高者5例。2个月随访过程中发生粒子移位2例;白细胞下降2例,程度较轻。未见大出血、胆汁瘘、胰瘘等严重并发症。结论CT导向下^125I粒子植入术治疗肝癌肝移植术后复发及转移瘤疗效确切,创伤小,并发症少。     

碘-125粒子组织间植入治疗恶性肿瘤的效果

目的 评价组织间植入碘-125(¹²⁵I)粒子治疗恶性肿瘤的临床价值。方法 27例恶性肿瘤患者,其中肝癌肺转移10例、原发性肝癌4例、肝癌椎体转移3例、结肠癌肺转移3例、胰腺癌3例、肺癌2例、肝癌腹壁转移1例、十二指肠乳头癌术后局部复发并不全肠梗阻1例,在CT导向下植入¹²⁵I粒子,利用治疗计划系统(TPS)确定植入粒子的数量及位置,术后2个月复查CT评估疗效。结果 27例中,完全缓解(CR)5例,部分缓解(PR)13例,稳定(SD)7例,进展(PD)2例,总有效率66.7%,无严重并发症发生。结论 碘-125粒子植入治疗恶性肿瘤安全、微创,近期疗效肯定。     

CT引导下^125I粒子植入联合肝动脉栓塞化疗治疗原发性肝癌

目的探讨125I粒子植入联合肝动脉栓塞化疗治疗原发性肝癌的疗效与安全性。方法 38例经病理确诊的原发性肝癌患者,先行肝动脉栓塞化疗,2周后用放射性粒子计算机治疗计划系统制定治疗方案,在CT引导下经皮穿刺,将125I粒子植入肝脏病灶内。粒子植入后定期行肝动脉栓塞化疗。粒子植入前后进行血常规、肝功能检测,每2个月复查1次CT和X线平片。结果 38例放射性粒子植入按计划植入到位,植入过程无粒子丢失。1周后血常规、肝功能与植入前接近,无严重并发症。治疗4个月总有效率94.74%。结论原发性肝癌125I粒子植入联合肝动脉栓塞化疗提高了局部控制率,且安全性、可操作性确切。     

p53基因瘤内注射联合I~(125)粒子植入治疗肝癌残余灶近期疗效观察

目的:评价重组人p53基因腺病毒注射液(rAd-p53)瘤内注射联合I125粒子组织间植入对肝癌残余灶的近期疗效。方法:38例经TACE及物理消融治疗后的肝癌患者,发现肝癌残余灶69个。17例患者行rAd-p53瘤内注射联合I125粒子植入;21例行单独I125粒子植入。结果:两组治疗后1、2和6个月有效率(CR+PR)差异有统计学意义(P<0.05)。同一组患者治疗前、后Karuafsky评分差异有统计学意义(P<0.05)。结论:rAd-p53瘤内注射联合I125粒子植入对肝癌残余灶的疗效优于单独的I125粒子植入术。     

CT导向下125Ⅰ粒子植入术治疗晚期恶性肿瘤的疗效观察

目的 评价CT导向下125I粒子植入术治疗晚期恶性肿瘤的临床价值.方法 共108例晚期肿瘤患者接受放射性125I粒子植入术治疗.术前采用治疗计划系统(TPS)计算后布源,术中将活度为0.76～0.84 mCi的125I粒子在CT导向下植入肿瘤内.粒子按照1.0～1.5 cm平面插植.肿瘤周边匹配剂量(MPD)100～150 Gy,每例患者植入10～100颗粒子.2个月后CT复查评价疗效.结果 完全缓解23例,部分缓解56例,稳定16例,进展13例.客观应答率(response rate,RR)为73.14%.经随访发现,大多数毒性反应轻微并可耐受,未见出血、胆瘘、胰瘘、腹膜炎等严重并发症.结论 CT导向下125I粒子植入术治疗晚期恶性肿瘤疗效确切、创伤小、并发症发生率低.     

放射性粒子~(125)I在肺癌治疗中的临床探讨

目的:探讨在CT引导下组织间植入125I粒子治疗肺部恶性肿瘤的方法和疗效。方法:选取2008年5月-2011年2月的36例肺癌患者(其中鳞癌22例,腺癌11例,肺泡细胞癌3例,均为周围型肺癌,病灶直径2.0～12cm大小不等)采用治疗计划系统(TPS)计算布源,在螺旋CT导引下将125I粒子植入病灶内,术后2～6个月CT复查,随访6个月。结果:36例肺癌患者的52个病灶粒子植入均顺利完成,52个病灶共植入粒子2 340粒,平均每个瘤体内植入45粒。术后2～6个月CT复查,完全缓解(CR)14例,部分缓解(PR)20例,无变化(NC)2例,总有效率(CR+PR)为94%。仅在粒子植入后,8例出现少量气胸,保守治疗后痊愈。未见其他严重并发症和治疗相关的放射性损伤。结论:在CT引导下经皮穿刺125I粒子植入治疗肺癌是一种简便易行、疗效好、安全且发病症少的微创治疗手段。     

CT导向下^125I粒子植入术治疗晚期恶性肿瘤的疗效观察

目的评价CT导向下125I粒子植入术治疗晚期恶性肿瘤的临床价值。方法共108例晚期肿瘤患者接受放射性125I粒子植入术治疗。术前采用治疗计划系统(TPS)计算后布源,术中将活度为0.76~0.84mCi的125I粒子在CT导向下植入肿瘤内。粒子按照1.0~1.5cm平面插植。肿瘤周边匹配剂量(MPD)100~150Gy,每例患者植入10~100颗粒子。2个月后CT复查评价疗效。结果完全缓解23例,部分缓解56例,稳定16例,进展13例。客观应答率(responserate,RR)为73.14%。经随访发现,大多数毒性反应轻微并可耐受,未见出血、胆瘘、胰瘘、腹膜炎等严重并发症。结论CT导向下125I粒子植入术治疗晚期恶性肿瘤疗效确切、创伤小、并发症发生率低。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

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…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…