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1.
XinjiangUygurAutonomousRegioninChinaisoneofthelongevityareasintheworldAccordingtosomereports,mostXinjiangcentenariansoftheUygurnationalityhadfewchangesinbodyform,andsomeofthemretainedtheabilitytowork1AstomotologicalstudyinUygurcentenariansshowedthatmo…  相似文献   

2.
BrainMRIhasbroughtonrevolutionarychangesinthemanagementofpatientswithepilepsy AlargenumberofpatientswhowerepreviouslydiagnosedtohavecryptogenicepilepsyarenowreclassifiedassymptomaticepilepsysincecausescanbeidentifiedafterbrainMRI Thisnotonlyimprovesth…  相似文献   

3.
ethods LowdensitylipoproteinwasisolatedfromnormalheparinizedbloodbydensitygradientultracentrifugationandoxidizedbyCuCl2 TotalRNAwasextractedfromhumanumbilicalveinendothelialcells (HUVECs)exposedtoLDLorOX LDL ,usingtheguanidiniumisothiocyanatemethod Thequ…  相似文献   

4.
Dilatedcardiomyopathy(DCM)andischemiccardiomyopathy(CADCM)mayhavesimilarclinicalpresentations,suchascardiomegaly,impairedleftventricularfunctionandcongestiveheartfailureThedifferentiationofDCMfromCADCMsometimesisdifficultbutimportant,sinceprognosisandtr…  相似文献   

5.
Management of cerebral ischemia due to Takayasu''''s arteritis   总被引:2,自引:0,他引:2  
Aortoarteritis ,alsocalledTakayasu’sarteritis ,isachronicidiopathicinflammatorydiseasethataffectslargeandmediumsizearteries Clinicalfeaturesreflectlimbororganischemiaresultingfromstenosistoobliterationofinvolvedarteries Thisdisease ,describedbyTakayasuin…  相似文献   

6.
Asnewmaterialsandtechnologyinthedentalfieldaredeveloped,porcelainlaminateveneershavebecomeanidealrestorationtechniqueforteeth Wehaveusedcerinateporcelainlaminateveneersinourorthopedicrestorationpracticesince1996 ,andhaveclinicallyobservedandevaluateditsu…  相似文献   

7.
Clinicallyavailablemethodsofbonedensitometry ,suchasdual energyX rayabsorptiometry (DEXA) ,andquantitativecomputedtomography ,measuretheonlyquantitativevaluesofbonemineraldensity (BMD) However ,qualitativefactors,likeelasticity ,fatiguedamage ,andmicroarchitec…  相似文献   

8.
Methods AnimmunohistochemicalmethodwasusedtolocalizeULF 2 50inratuteriduringeachphaseoftheestrouscycle ,andinuteriofovariectomizedratstreatedwithestradiolandprogesterone Results PositiveimmunostainingofULF 2 50occurredintheepithelialcellsoftheuterusatallph…  相似文献   

9.
Inindividualclinicaltrials ,fewpatientsmayexperienceoutcomessuchasdeath Treatmentrelatedtotheserareeventsmaybedifficulttoassess Ameta analysisofmultipleclinicaltrialsisastatisticalprocedureinwhichseveralindependentstudiesareintegratedwiththeaimofbeinga…  相似文献   

10.
Clinical evaluation of physical fitness in male obese Japanese   总被引:1,自引:0,他引:1  
Severelyobesesubjectshavebeenshowntohaveahighmortalityrate ,1 andhighincidencesofdiseasessuchascoronaryheartdisease ,type 2diabetesmellitus ,hyperlipidemiaandhypertension 2  Adiposetissueaccumulationintheabdomenorvisceraiscloselyrelatedtoinsulinresistancea…  相似文献   

11.
Jin X  Shi XJ  Wang MQ  Wei LX  Ye HY  Liang YR  Luo Y  Dong JH 《中华医学杂志》2011,91(14):950-955
目的 探讨大肝癌经肝动脉插管化疗栓塞降期治疗后,实施二期肝切除和肝脏移植手术的可行性.方法 回顾性分析2006年6月至2010年3月58例首次诊断为切除困难的大肝癌患者(直径>5 cm),实施肝动脉插管化疗栓塞降期治疗后,分别实施肝移植术(36例),二期肝切除(22例).利用Kaplan-Meier法和COX风险比例模型计算累积总体生存率、无瘤生存率和影响预后的因素.结果 58例患者术后中位随访22个月,平均生存时间为(23.57±1.54)个月.肝移植组(36例)1、2、3年总体生存率(OS)、无瘤生存率(RFS)分别是94%、84%、73%和88%、75%、64%.肿瘤平均复发时间为(12.3±6.4)个月(3~23个月).其中28例患者降期至Milan标准,1、2、3年总体生存率和无瘤生存率优于非降期组(OS%%、88%、75%vs 92%、48%、48%P=0.067;RFS95%、95%、79%vs 76%、40%、40%P=0.002).肝切除组1、2、3年总体生存率、无瘤生存率分别为100%、64%、52%和72%、49%、49%,平均复发时间为(9.3±4.5)个月.经TACE肝移植组患者远期预后优于肝切除组(OS,P=0.178;RFS,P=0.139).多因素分析只有病理肿瘤总直径≥7 cm(P=0.002,RR=6.578)、微血管侵犯(P=0.001,RR=5.737)、低分化(P=0.048,RR=4.335)因素与肿瘤复发显著相关.结论 部分大肝癌经肝动脉栓塞化疗治疗降期后可以成功实施根治性肝切除和肝移植,并获得满意的远期预后.
Abstract:
Objective To evaluate the feasibility of sequential liver resection or liver transplantation following downstaging of larger hepatocellular carcinoma (HCC) by transcatheter arterial chemoembolization (TACE). Methods A retrospective study was conducted. And a total of 58 patients with unresectable larger HCC (diameter >5 cm) from June 2006 to March 2010 underwent TACE. According the outcomes of TACE, they received liver transplantation ( LT, n = 36) and liver resection ( LR, n = 22) respectively. The overall survival (OS) and recurrence-free survival (RFS) rates were calculated by the Kaplan-Meier method. The multivariate analyses for the influencing factors were evaluated by the Cox proportional hazard model. Results The median follow-up period of 58 cases was 22 months and the median survival time 23.57±1.54 months. The 1 -, 2 - , 3 - year OS and RFS rates after LT was 94%, 84% & 73% and 88% , 75%& 64% respectively. The median recurrence time was 12. 3 ± 6. 4 months ( range: 3 - 23). Twenty-eight patients had adequate downstaging to qualify for LT under the Milan criteria The 1 - , 2 - , 3 - year OS and RFS of the downstaging group was better than those of the non-downstaging group (OS: 96%, 88%, 75%vs92%,48%,48% P=0.067; RFS:95%,95%,79% vs76%,40%, 40% P=0.002). The1-,2 -, 3 -years OS and RFS after LR was 100%, 64% & 52% and 72%, 49% & 49% respectively. The median recurrence time was 9.3 ±4.5 months (range:3 -23). The long-term results of LT group following TACE were better than those of LR group( OS, P =0. 178; RFS, P =0. 139). The multivariate analyses showed that only pathologic total tumor diameter >7 cm (P =0. 002, RR =6. 578) , microvascular invasion ( P =0. 001, RR = 5. 737 ) and poor differentiation (P=0.048, RR = 4. 335 ) were significantly correlated with tumor recurrence. Conclusion Sequential liver resection and liver transplantation after downstaging by TACE are feasible for some larger HCCs. And the long-term prognosis is satisfactory.  相似文献   

12.
Xiao E  Li D  Shen S  Zhou S  Tan L  Wang Y  Luo J  Wu Y  Tan C  Liu H  Zhu H 《中华医学杂志(英文版)》2003,116(2):203-207
Hepatocellularcarcinoma (HCC)isoneofthemostcommonmalignancies SurgicalresectionisrecognizedasthemosteffectivemethodforpatientswithHCC Unfortunately,onlyaminorityofpatientscurrentlydiagnosedwithHCCmaybenefitfromthisradicaloption Transcatheterarterialchem…  相似文献   

13.
目的探讨肝硬化伴肝癌肝移植前等待期经过肿瘤灭活对其移植术后生存率的影响。方法对19例肝硬化伴肝癌病人14例术前用动脉化疗栓塞(TACE)或射频消融(RFA)进行肿瘤灭活并与同组5同期未行肿瘤灭活者比较其对术后肿瘤复发及生存率的影响。结果本组19例,随访6~61月,18例获无瘤存活,其中术前行RFA的4例病理见肿瘤坏死;10例TACE中有9例肿瘤有坏死,已平均存活18.1月。未行治疗的6例中1例于术后4个月骨转移,带瘤存活12个月后死亡。结论肝硬化伴肝癌在移植术前等待期用TACE或射频消融行肿瘤灭活,对提高肝癌肝移植远期疗效、提高术后生存率有显著意义。  相似文献   

14.
目的 探讨动脉栓塞化疗(TACE)与高强度聚焦超声(HIFU)联合治疗大肝癌的临床应用疗效.方法 68例原发性大肝癌患者分为两组:(1)TACE与HIFU联合组38例,在TACE治疗后2~3周,接受HIFU治疗;(2)单纯TACE组30例.肿瘤最大径5.0~14.5 cm,平均(9.3±3.2)cm,总计88个瘤块,多发病灶者选其中最大径肿瘤为观察目标.两组病例的平均年龄、病灶大小、肿瘤TNM分期以及肝功能分级差异无统计学意义.全部患者随访3~24个月,平均(13±7)个月.观察治疗前后患者临床症状、肿瘤标志物(AFP)、肿瘤影像学(CT或MRI或PET)等变化,对患者进行随访以评估治疗后肿瘤凝固性坏死、肿瘤大小、局部复发率和生存预后.结果 TACE与HIFU联合治疗后患者的临床症状缓解率为90.6%(29/32).TACE与HIFU联合组的肿瘤坏死率为73.7%,肿瘤缩小率为68.4%,单纯TACE组分别为26.7%、33.3%,两组比较,差异有统计学意义(P<0.01).两组局部复发率分别为21.1%、33.3%,二者差异无统计学意义(P>0.05).联合组中位生存期为18个月,明显高于TACE组(10个月),二者差异有统计学意义(P<0.05).结论 TACE与HIFU联合治疗大肝癌的疗效明显优于单纯TACE,可提高肿瘤坏死率并延长患者生存期.  相似文献   

15.
Surgical resection (SR) is recommended as a radical procedure in the treatment of hepatocellular carcinoma (HCC). However, postoperative recurrence negatively affects the long-term efficacy of SR, and preoperative adjuvant therapy has therefore become a research hotspot. Some clinicians adopt transcatheter arterial chemoembolization (TACE) as a preoperative adjuvant therapy in patients undergoing SR to increase the resection rate, reduce tumor recurrence, and improve the prognosis. However, the findings of the most relevant studies remain controversial. Some studies have confirmed that preoperative TACE cannot improve the long-term survival rate of patients with HCC and might even negatively affect the resection rate. Which factors influence the efficacy of preoperative TACE combined with SR is a topic worthy of investigation. In this review, existing clinical studies were analyzed with a particular focus on several topics: screening of the subgroups of patients most likely to benefit from preoperative TACE, exploration of the optimal treatment regimen of preoperative TACE, and determination of the extent of tumor necrosis as the deciding prognostic factor.  相似文献   

16.
目的:采用随机对照研究评价可切除大肝癌术前肝动脉插管化疗(TACE)对术后肝功能恢复及患者生存率的价值。方法:采用随机对照实验的方法,将2001年7月至2003年12月符合纳入标准的108例可切除大肝癌(直径≥5 cm)患者随机分为一期手术组(OP组,n=56)和TACE+手术组(TACE+OP组,n=52)。比较两组患者术中情况,肿瘤切除率,手术前后肝功能变化,术后1、3、5年无瘤生存率及总生存率的差异。结果:术前两组患者基线情况一致。TACE+OP组插管化疗后γ-球蛋白水平明显高于OP组(P=0.046),手术切除后第7天前白蛋白水平明显低于OP组(P=0.031)。OP组平均手术时间明显短于TACE+OP组(P=0.042),肿瘤切除率明显高于TACE+OP组(P=0.017),肿瘤转移患者明显少于TACE+OP组(2vs9,P=0.018)。两组患者术中肝血流阻断时间及出血量以及术后1、3、5年无瘤生存率及总生存率均无统计学差异。结论:可切除大肝癌术前TACE并不能延长术后无瘤生存期及总生存期,且可能促进肿瘤转移,损害肝功能。  相似文献   

17.
目的探讨术前经导管肝动脉化疗栓塞(TACE)对可切除大肝癌手术的影响。方法将108例大肝癌病例分成术前TACE组(52例)与一期手术组(56例),术前TACE组经TACE后行手术的为二期手术组(47例),比较两组肿瘤大小、手术探查情况及手术相关因素和并发症情况。结果术前TACE组经TACE后5例失去手术机会,手术探查见肿瘤周围粘连明显增加,肝硬化加重,手术时间延长;两组肝门阻断时间、术中平均出血量、术后并发症等指标无统计学差异,二期手术组TACE后平均肿瘤直径缩小并不显著。结论大肝癌术前TACE增加手术难度及手术风险,并有可能耽误手术时机,应首选手术治疗。  相似文献   

18.
CT导向下射频消融联合TACE治疗原发性肝癌   总被引:4,自引:0,他引:4       下载免费PDF全文
目的 回顾性评价CT导向下射频消融(RFA)联合肝动脉化疗栓塞术(TACE)治疗原发性肝癌的临床疗效及并发症情况.方法 原发性肝癌患者46例,单个肿瘤直径≤5 cm,总数不超过3个,其中19例患者直接行CT导向下经皮经肝穿刺肝内瘤灶射频消融(RFA组),27例在RFA治疗前1~3周先行肝动脉化疗栓塞术(TACE RFA组).结果 TACE RFA组的肿瘤完全毁损率21/27例(77.8%)明显高于单纯RFA组11/19例(57.9%)(P<0.01).TACE RFA组局部复发率为22.2%(6/27),明显低于RFA组的42.1%(8/19)(P<0.01).TACE RFA组和RFA组血清AFP转阴率分别为73.9%和43.8%(P<0.01).术后常见并发症包括发热、疼痛和不同程度肝功能损害,经护肝和对症治疗后多可缓解和恢复.3例患者术后出现肝包膜下出血,经卧床和止血治疗后停止.结论 RFA术前联合TACE治疗可明显提高肿瘤的完全坏死率,获得更为确切的临床疗效,减少术后肿瘤的复发;CT导向下经皮穿刺射频消融治疗原发性肝癌是一种安全有效的治疗手段.  相似文献   

19.
目的:探讨术前选择性经肝动脉化疗栓塞对肝癌患手术治疗效果的影响。方法:回顾性分析126例肝癌患资料,术前选择性经肝动脉化疗栓塞(TACE组)62例,术前未行经肝动脉化疗栓塞(对照组)64例,比两组术后病理检查结果,术后1、2、3年复发率及生存率变化,评价可切除肝癌术前选择性经肝动脉栓塞的作用。结果:术后病理报告TACE组有13例肿瘤完全坏死,对照组则无1例、第1、3年复发率两组无差异,第2年复发率TACE组为29.8%、对照组为58.3%,TACE组明显低于对照组(P<0.05)。术后1、2年生存率两组无差异,3年生存率TACE为54.4%,对照组为33.3%,TACE组明显于对照组(P<0.05)。结论:可切除肝癌术前严格掌握条件选择性TACE可在一定程度上提高手术治疗的效果。  相似文献   

20.
目的 研究肝动脉化疗栓塞与微波热凝固疗法联合全身化疗治疗转移性肝癌的疗效及安全性.方法 20例经组织学证实的转移性肝癌患者中,8例为大肠癌转移,4例为胃癌转移,8例为小肠癌转移.共30枚结节,肝动脉栓塞化疗后1~2周内进行超声引导下微波热凝固治疗.联合全身化疗方案为奥沙利铂,亚叶酸钙,氟尿嘧啶.结果 21枚直径<5.0...  相似文献   

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