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非酒精性脂肪性肝炎(non—alcoholicsteatohepatitis,NASH)现已成为肝移植愈来愈重要的基础肝病。鉴于晚期NASH患者常并存多种影响肝移植转归的临床问题,而至今尚无针对NASH患者进行肝移植的评估和治疗指南,为此英国移植学会(British Transplant Society,BTS)邀请相关专家制定了指南,以指导肝移植前后NASH患者的处理。 相似文献
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陈孝平|||黄志勇||陈义发||张必翔||张志伟||张万广|梅斌|朱鹏|张伟 《中国普通外科杂志》2013,22(1):8-9
外科手术切除是肝门部胆管癌最有效和首选的治疗方法,笔者根据该病的4种类型提出合理的手术切除范围选择,旨在进一步规范肝门部胆管癌的外科治疗。 相似文献
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Maximilian Burger Willem Oosterlinck Badrinath Konety Sam Chang Sigurdur Gudjonsson Raj Pruthi Mark Soloway Eduardo Solsona Paul Sved Marko Babjuk Maurizio A. Brausi Christopher Cheng Eva Comperat Colin Dinney Wolfgang Otto Jay Shah Joachim Thürof J. Alfred Witjes 《European urology》2013
Context
Our aim was to present a summary of the Second International Consultation on Bladder Cancer recommendations on the diagnosis and treatment options for non–muscle-invasive urothelial cancer of the bladder (NMIBC) using an evidence-based approach.Objective
To critically review the recent data on the management of NMIBC to arrive at a general consensus.Evidence acquisition
A detailed Medline analysis was performed for original articles addressing the treatment of NMIBC with regard to diagnosis, surgery, intravesical chemotherapy, and follow-up. Proceedings from the last 5 yr of major conferences were also searched.Evidence synthesis
The major findings are presented in an evidence-based fashion. We analyzed large retrospective and prospective studies.Conclusions
Urothelial cancer of the bladder staged Ta, T1, and carcinoma in situ (CIS), also indicated as NMIBC, poses greatly varying but uniformly demanding challenges to urologic care. On the one hand, the high recurrence rate and low progression rate with Ta low-grade demand risk-adapted treatment and surveillance to provide thorough care while minimizing treatment-related burden. On the other hand, the propensity of Ta high-grade, T1, and CIS to progress demands intense care and timely consideration of radical cystectomy. 相似文献115.
Keisuke Usui Akira Isobe Naoya Hara Naoto Shikama Keisuke Sasai Koichi Ogawa 《Medical Dosimetry》2019,44(4):344-353
Total body irradiation (TBI) using helical tomotherapy (HT) has advantages over the standard linear accelerator-based approach to the conditioning regimen for hematopoietic cell transplantation. However, the radiation field has to be divided into two independent irradiation plans to deliver a homogeneous dose to the whole body. A clinical target volume near the skin increases the skin surface dose; therefore, high- or low-dose regions arise depending on the set-up position accuracy because the two radiation fields are somewhat overlapped or separated. We aimed to determine an adequate treatment planning method robust to the set-up accuracy for the field joint dose distribution using HT-TBI. We calculated treatment plans reducing target volumes at the interface between the upper and lower body irradiations and evaluated these joint dose distributions via simulation and experimental studies. Target volumes used for the optimization calculation were reduced by 0, 0.5, 1.0, 2.0, 2.5, and 3.0 cm from the boundary surface on the upper and lower sides. Combined dose distributions with set-up error simulated by modifying coordinate positions were investigated to find the optimal planning method. In the ideal set-up position, the target volume without a gap area caused field junctional doses of up to approximately 200%; therefore, target volumes reduced by 2.0–3.0 cm could suppress the maximum dose to within 150%. However, with set-up error, high-dose areas exceeding 150% and low-dose areas below 100% were found with 2.0 and 3.0 cm target volume reduction. Using the dynamic jaw (DJ) system, dose deviations caused by set-up error reached approximately 20%, which is not suitable for HT-TBI. Moreover, these dose distributions can be easily adjusted when combined with the intensity modulation technique for field boundary regions. The results of a simulation and experimental study using a film dosimetry were almost identical, which indicated that reducing the target volume at the field boundary surface by 2.5 cm produces the most appropriate target definition. 相似文献
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