肝动脉化疗栓塞治疗富血供肝癌碘油灌注剂量的研究

目的:探讨肝动脉化疗栓塞治疗富血供肝癌的碘油灌注剂量.方法:120例富血供的肝癌患者,实验组用大剂量碘油,对照组用常规剂量碘油经肝动脉化疗栓塞肿瘤,一个月左右后,用CT扫描观察肿瘤区碘油沉积程度.结果:实验组碘油沉积良好率优于对照组.结论:大剂量碘油灌注化疗栓塞治疗富血供肝癌,碘油沉积更密集,栓塞更彻底,疗效更好.     

肝动脉化疗栓塞后碘油在肝癌内聚积、存留和消失的血管造影、CT与病理对照研究

用血管造影和ＣＴ对照分析肝动脉化疗栓塞后碘油在肝癌内的初期聚积特点，用ＣＴ动态观察碘油在肝癌内的存留和消失时间，同时与栓塞后切除标本行病理对照研究。结果表明：碘油能选择性聚积于多血供的肝癌内，且聚积量与肿瘤血供有关。少血供肝癌无或少有碘油聚积。碘油能选择性聚积并持续存留部是肿瘤栓后坏死区，一般存留２～６月甚至更长，伴肿瘤明显缩小；碘油虽能选择性聚积但逐渐消失部是肿瘤栓后存活区，一般１～２月消失，肿瘤缩小不明显或反增大。少量碘油在非癌肝实质一般２周消失。对碘油聚积、存留物消失问题的阐明，为肝癌的介入治疗提供了理论依据。     

锥体束CT三维肝动脉造影在TACE术中判断原发性肝癌肿瘤供血动脉的临床价值

目的：准确判断肿瘤供血动脉是实现肝癌超选择性肝动脉化疗栓塞（TACE）的基础。本研究探讨原发性肝癌 TACE 术中,锥体束 CT 三维肝动脉造影（cone-beam computed tomography hepatic arteriography,CBCT-HA）对比DSA肝动脉造影（DSA-HA）在判断肿瘤供血动脉的价值。方法23例原发性肝癌患者入组研究。术中分别进行DSA-HA、CBCT-HA、碘油-TACE（Lip-TACE）、碘油 CBCT（Lip-CBCT）。2名有经验的介入科医师共同分析DSA-HA和CBCT-HA影像学资料,判断肿瘤供血动脉。卡方检验进行统计学分析。结果75个肿瘤通过金标准确定肿瘤供血动脉。 DSA-HA确认肿瘤供血动脉（阳性）40个,其中真阳性32个,假阳性8个。 CBCT-HA确认肿瘤供血动脉（阳性）72个,其中真阳性68个,假阳性4个。CBCT-HA对肿瘤供血动脉判断的灵敏度为68/75（90．7%）,明显高于DSA-HA（32/75,42．7%）（P<0．001）;阳性预测值（68/72,94．4%）,亦高于后者（32/40,80．0%）（P=0．040）。结论 CBCT-HA对肝癌肿瘤供血动脉的判断明显优于传统DSA-HA,对超选择性TACE治疗有明显的临床指导意义。     

经肝动脉栓塞治疗转移性肝癌的方法探讨及疗效分析

目的探讨经肝动脉化疗并栓塞治疗转移性肝癌的方法及效果。方法180例转移性肝癌患者经造影后根据血供情况分别采用单纯灌注化疗(HAI)、化疗并用稠度不同的碘油化疗药乳剂栓塞治疗(TACE),并观察其临床效果。结果临床效果以肝癌和直肠癌肝内转移最佳,有效率分别为87.5%、84.3%。少血管型化疗栓塞组有效率为86.3%,明显高于单纯灌注化疗组的73%(P<0.01)。结论经肝动脉化疗栓塞是治疗转移性肝癌的一种有效方法,对少血供型患者采用稀碘油化疗药乳剂适量栓塞可以明显提高治疗效果。     

巨大肝癌的多支动脉供血及其在栓塞治疗中的意义

目的：探讨巨大肝癌的多支动脉供血规律以及多支动脉供血在肝癌动脉栓塞治疗中的意义。材料与方法：７２例巨大（直径≥１０ｃｍ）肝癌，动脉栓塞术前选择性肝动脉及肝外动脉造影，观察多支动脉供血情况，并同时进行多支动脉栓塞治疗。结果：７５．０％（５４／７２）巨大肝癌存在多支动脉供血，其多支动脉来源为规则的肝总动脉的肝动脉、变异性动脉及肝外动脉三种类型，且多支动脉供血与肿瘤部位密切相关；随访２７例化疗栓塞效果，     

碘油肝动脉栓塞后在肝癌内的选择性聚积、持续存留和逐渐消失（血管造影、CT和病理对照研究）

本文用血管造影和ＣＴ对照分析肝动脉化疗栓塞后碘油在肝癌内的初期聚积特点，用ＣＴ动态观察碘油在肝癌内的存留和消失时间，同时与栓后切除标本行病理对照研究，结果表明：碘油能选择性聚积于多血供的肝癌内，聚积量与肿瘤血供相关而与肿瘤的组织类型无相关。少血供肝癌无或少有碘油聚积。碘油能选择性聚积并持续存留部是肿瘤栓后坏死区，一般存留达２～６月甚至更长，伴肿瘤明显缩小；碘油虽能选择性聚积但逐渐消失部是肿瘤栓后存活区，一般１～２月消失，肿瘤缩小不明显或反增大。少量碘油在非癌实质一般２周消失。对碘油聚积、存留和消失问题的阐明，为肝癌介入诊治提供了理论依据，本文还探讨了碘油在肝癌内聚积、存留和消除的转归模式。     

膈下动脉碘油化疗药物栓塞治疗肝癌

目的　评价膈下动脉碘油化疗药物栓塞对肝癌治疗的疗效及膈下动脉供血的肿瘤的部位。方法　 2 5例肝癌 ,巨块型 12例、结节型 8例、多发结节型 5例。均采用Seldingers法行肝动脉和膈下动脉碘油化疗药物及明胶海绵颗粒栓塞。结果　膈下动脉发自于腹腔干起始处者 16例 ,占 6 4 % ,直接发自主动脉腹腔干周围者 8例 ,占 32 %。其中供应右叶 (Ⅶ ,Ⅷ段 ) 2 3例 ;肿瘤位于左叶 (Ⅳ段 )膈下者2例。膈下动脉碘油化疗药物栓塞后累积 1、2年生存率分别是 84 %和 6 8%。未出现严重并发症。结论　经膈下动脉碘油化疗药物栓塞治疗肝癌是一种安全有效的方法。当肿瘤位于膈下 ,邻近膈肌 ,肝韧带或肝裸区 ,特别是肝动脉造影时肿瘤染色有缺损或无肿瘤染色 ,但肿瘤在CT上有增强或血AFP升高时 ,应考虑到肿瘤由膈下动脉供血。     

外生性肝癌的血供特点及介入治疗

目的探讨外生性肝癌血供特点及经肿瘤供血动脉化疗栓塞术的疗效。方法5例外生性肝癌经股动脉插管,肿瘤供血动脉造影、化疗栓塞治疗,用榄香烯350 mg肿瘤血管内热灌注化疗和顺铂60～80 mg加碘油8～15 ml乳剂及明胶海绵化疗栓塞。结果5例患者共行10次经血管途径的化疗栓塞术。造影显示肿瘤供血动脉以肝外血管为主,肝动脉部分参与供血。5例患者术后瘤体缩小30%～50%,4例AFP下降。结论外生性肝癌有不同于肝内肝癌的血供特点,经肿瘤供血动脉化疗栓塞术对外生性肝癌同样有效,是可供选择的治疗方法之一。     

膈下动脉供血在肝肿瘤介入治疗中的价值

目的：分析膈下动脉侧支形成原因和膈下动脉供血病灶的分布范围，探讨膈下动脉供血在肝癌介入化疗加碘油栓塞（TACE）术中的价值。资料与方法：膈下动脉供血的肝癌21例，男16例，女5例，年龄41－67岁，平均58岁，其中原发性肝癌17例，结肠癌肝转移3例，乳腺癌肝转移1例，术前行CT或MRI平扫及增强扫描，术中发现膈下动脉供血后，行膈下动脉造影，在确认供血范围后将导管超选择至供血支，灌注化疗药，注入碘油，明胶海绵栓塞血管，并摄肝内碘油平片。结果：膈下动脉造显示接受膈下动脉供血的肝内病灶沿膈下动脉走行分布，供血以右膈下动脉为主，病灶多发，多数与其他动脉支同时供养肿瘤组织，注入碘油后，病灶内碘油沉积良好，结论：膈下动脉是供养肝肿瘤的重要侧支血管，原发于肝动脉的供血支闭塞是促其形成的主要原因，在肝癌介入治疗中具有重要意义。     

大鼠肝癌肝动脉碘油柱塞后的门脉血供

采用软Ｘ线摄影技术和硅酮灌注技术，对二乙基亚硝胺诱发的大鼠肝癌模型作碘油肝动脉栓塞后的肿瘤门脉血供进行了研究。结果显示：碘油肝动脉栓塞后，较大肿瘤结节（＞５ｍｍ）的周边部分可见门脉血供存在，而较小肿瘤结节内（＜５ｍｍ），其肿瘤血供呈现部分或完全来自门脉。作者认为，碘油肝动脉栓塞不可能产生完全性的肿瘤双重血供的栓塞；门脉血供的存在可能是碘油肝动脉栓塞后部分肿瘤细胞残存的一个重要原因。因此，在碘油肝动脉栓塞后有必要进行经门静脉途径的介入治疗。     

成批煤气爆燃烧伤的救治体会

报道治疗因煤气泄漏爆炸烧伤病员7例，经应用MEBT技术积极救治，其中6例于伤后17天痊愈出院，另一例特重伤员也于伤后30天康复出院。作者认为：应严格按照MEBT／MEBO要求进行规范治疗，正确处理生命体征、休克、感染、脏器功能和创面的辨证关系。同时，不能忽视外科营养在过程中的重要作用，它是创面修复的物质保证。     

Glutamine supplementation in vitro and in vivo,in exercise and in immunodepression

In situations of stress, such as clinical trauma, starvation or prolonged, strenuous exercise, the concentration of glutamine in the blood is decreased, often substantially. In endurance athletes this decrease occurs concomitantly with relatively transient immunodepression. Glutamine is used as a fuel by some cells of the immune system. Provision of glutamine or a glutamine precursor, such as branched chain amino acids, has been seen to have a beneficial effect on gut function, on morbidity and mortality, and on some aspects of immune cell function in clinical studies. It has also been seen to decrease the self-reported incidence of illness in endurance athletes. So far, there is no firm evidence as to precisely which aspect of the immune system is affected by glutamine feeding during the transient immunodepression that occurs after prolonged, strenuous exercise. However, there is increasing evidence that neutrophils may be implicated. Other aspects of glutamine and glutamine supplementation are also addressed.     

新疆石河子地区奶牛隐性乳房炎的调查与分析

采用LMT法对新疆石河子地区三个规模化奶牛场泌乳牛群进行了隐性乳房炎检测,共检测994头泌乳牛3976个乳区.结果表明:奶牛隐性乳房炎阳性率为81.9%,乳区阳性率为49.1%.数据分析表明,不同年龄、胎次以及有无卧床奶牛的隐性乳房炎阳性率差异显著(P<0.05),后乳区的隐性乳房炎感染率显著高于前乳区感染率(P<0.05),隐性乳房炎乳区发生数也明显影响当日产奶量(P<0.05).     

Sex differences in neuromuscular fatigability in response to load carriage in the field in British Army recruits

Objectives

Women are resistant to neuromuscular fatigue compared to men in response to a range of exercise tasks. The sex differences in the neuromuscular responses to load carriage have yet to be investigated.

Decrease in eccentric hamstring strength in runners in the Tirol Speed Marathon

Background

The local muscular endurance of knee flexors, during eccentric work in particular, is important in preventing or delaying kinematic changes associated with fatigue during treadmill running. This result, however, may not be transferable to overground running.

Objective

To test the hypothesis that overground running is associated with eccentric hamstring fatigue.

Methods

Thirteen runners (12 male and one female) performed an isokinetic muscle test three to four days before and 18 hours after a marathon. Both legs were tested. The testing protocol consisted of concentric and eccentric quadriceps and hamstring contractions.

Results

There were no significant differences between peak torque before and after the race, except that eccentric peak hamstring torque (both thighs) was reduced.

Conclusion

Overground running (running a marathon) is associated with eccentric hamstring fatigue. Eccentric hamstring fatigue may be a potential risk factor for knee and soft tissue injuries during running. Eccentric hamstring training should therefore be introduced as an integral part of the training programme of runners.     

肺心病慢性呼吸性酸中毒合并代谢性酸碱失衡判断方法探讨(附80例次血气分析)

目的：对42例肺心病慢性呼吸性酸中毒患者的80例次血气测定结果。方法：用不同的酸碱图（卡）及代偿公式进行酸碱类型的初步差别分析。结果：结合临床表现、各种影响因素与治疗反应等作出综合判定。结论：比较二种判定的差异，并提出较为实用、可靠的判断建议，以助于复合型呼吸性酸碱失衡的临床诊断与处理。     

Oxalosis in primary hyperoxaluria in infancy

Primary hyperoxaluria (PH1) is a rare inborn autosomal recessive metabolic disorder due to the deficiency of hepatic alanine-glyoxylate-aminotransferase. This deficiency results in excessive synthesis and urinary excretion of oxalate, inducing renal stone formation and deposition of calcium oxalate in the kidney, bone, myocardium, and vessels (systemic oxalosis, SO) in the most severely affected individuals. We report renal and skeletal changes in a 3-month-old girl with PH1 and SO. Intense cortico-medullary hyperechogenicity and increased homogeneous radiopacity of normal-sized kidneys suggested the diagnosis of SO. Skeletal survey showed osteopenia and characteristic symmetrical metaphyseal transverse bands in long bones, progressively becoming more dense and migrating towards the diaphysis. Multiple pathological and slowly healing fractures of the limbs occurred at the dense band level. A radiopaque rim was then observed in flat bones, epiphyseal nuclei, and vertebral bodies. Inflammatory granulomatous reaction, induced by the presence of oxalate crystals in the marrow spaces, coexisted with progressively evident radiological signs of secondary hyperparathyroidism, with partially overlapping features. The patient was treated by peritoneal dialysis and hemodialysis until combined liver–kidney transplantation. There are no previous reports of infants treated with hemodialysis for more than 2 years.     

Interventional radiology in oncology in private practice

Interventional oncology in private practice requires expert training and can be performed in a stand-alone facility for type 1 procedures in a hospital setting for type 2 and 3 procedures where subspecialized radiologists, state-of-the-art equipment, and postprocedure hospital monitoring are available. A multidisciplinary effort with oncologists, internal medicine physicians and anesthesiologists is necessary. The practice of interventional oncology requires around the clock availability, meticulous and established protocols and procedures and a financial investment. On the other hand, it is professionally gratifying because of constant technical advances and the impact on patients.