原发性肝癌切除术前后的肝动脉化疗栓塞

我国原发性肝癌的治疗已取得显著的进展，肝癌切除术是根治性治疗的最有效手段，也是肝癌患者获得长期生存的最主要途径。然而切除率低和复发率高仍是制约肝癌手术治疗的关键。近年来，以外科治疗为中心与各种非手术治疗方法优化组合的综合治疗日益发展，成为进一步提高肝癌疗效的新途径。肝动脉化疗栓塞（ＴＡＣＥ）在肝癌的综合治疗中具有举足轻重的作用。 人体肝脏接受肝动脉和门静脉双重血供，原发性肝癌的血供９０％以上来自肝动脉。肝动脉阻断后，肝癌血流减少９０％～９２％，肿瘤发生严重缺血坏死而缩小，但正常肝组织血流量仅减少…     

动脉化疗栓塞术治疗126例原发性肝细胞肝癌的疗效观察

目的探讨原发性肝细胞肝癌(HCC)的非肝动脉供血规律及介入治疗技术。方法对解放军第305医院2000—2006年收集的126例HCC患者,常规行腹腔动脉、肝总动脉、肠系膜上动脉、胃左动脉和膈动脉造影,并行超选择性插管,同时进行肝动脉、非肝动脉双动脉化疗栓塞术。结果126例HCC患者中,111例为肝脏本身固有的寄生性供血,其余15例由肝动脉闭塞引起侧支动脉供血。非肝动脉供血与肝脏肿瘤的部位、大小密切相关。用肝动脉导管或Cobra导管配合SP导管行非肝动脉超选择性插管成功率达92%。随访74例,1年及2年存活率分别为61%和25%。结论在HCC介入治疗中,除了肝动脉以外,还要积极寻找非肝动脉供血支。对具有非肝动脉供血的HCC采取双动脉内化疗栓塞是治疗成功的关键。在介入治疗操作过程中,要尽量预防肝动脉闭塞,减少侧支供血形成。     

肝动脉栓塞治疗肝癌48例护理体会

临床证实，肝癌血供主要来自肝动脉，故选择性的减少或阻断肝动脉血供可使肝癌组织缺血、坏死、癌肿缩小。2001年8月～2002年12月，我院采用肝动脉栓塞术治疗肝癌患者48例，效果满意。现将护理体会报告如下。     

原发性肝癌患者肝动脉结扎加栓塞前后入肝血流量的变化

作者观察了41例原发性肝癌患者肝动脉结扎加栓塞前后的入肝血流量、肝功能和血中AFP浓度变化。结果:原发性肝癌患者的肝固有动脉和门静脉血流量均高于对照组;肝固有动脉结扎加栓塞后门静脉血流量明显增加,肝功能变化和AFP下降显著;一侧肝动脉结扎加栓塞后肝固有动脉血流量仅减少四分之一,门静脉血流量有所增加,对肝功能的影响不明显,AFP的下降也明显差于上组。提示了肝癌的血供特点和肝动脉阻断后经门静脉化疗的必要性。     

原发性肝癌的综合序贯介入治疗

近年来介入技术进步很快，使肝癌的治疗手段有了许多新的发展及突破，目前经皮动脉栓塞化疗（TAE）及无水乙醇肝内注射（PEI）已在临床普遍应用，使肝癌的预后明显改善，半年生存率约为50％左右。采用B超引导下的综合序贯治疗可望进一步提高疗效，值得推荐。一、TAE的优点及不足肝癌时癌肿血供90％来自肝动脉，门静脉供血量仅10％，因此阻断肝动脉后癌肿出现缺血、坏死、机化及疤痕形成；此外碘油选择性的在肿瘤组织内存留。并把与之相混的化疗药带进肿瘤内发挥持久效应。TAE的疗效与病变大小、栓塞剂剂型、血流阻断程度等因素有关。…     

葡聚糖微球肝栓塞治疗肝癌疗效的病理学评估

病理组织学评估葡聚糖微球栓塞治疗肝癌的疗效。11例原发性肝癌行葡聚糖微球肝栓塞治疗，栓塞后择期作有切除术。切除后的肝瘤标本作组织病理研究以观察肿瘤的坏死程度及葡聚糖微球在人体内的状况。7例肝癌病灶为完全坏死，未见存活癌细胞；另4例为不完全坏死。两者相比，完全坏死组肿瘤较为远离膈面、肝裂、及胆囊窝等动脉侧支吻合丰富的区域。葡聚糖微球能产生均一的末梢性动脉栓塞。微球在体内191天仍未被吸收。门脉系统内未见栓子微球。部分远离肝侧支循环的肝癌可通过葡聚糖微球肝栓塞得到临床治愈。     

肝动脉-右膈下动脉介入治疗块状型肝癌17例临床分析

肝动脉化疗栓塞术(TACE)是目前肝癌的主要治疗手段之一。当肿瘤增大直接侵犯黏连邻近器官，肿瘤可直接从该器官供养动脉中获得血供。由于解剖上右肝后有一部分无腹膜覆盖，直接与膈粘附的肝裸区，因此最常见的非肝动脉供血是右膈下动脉。本文通过分析17例肝动脉-右膈下动脉血供的块状型肝癌的联合化疗栓塞，以探讨其治疗块状型肝癌的价值。     

肝癌的介入治疗：肝胃间动脉变异在血管内介入治疗中的意义

目前，肝动脉化疗栓塞术(TACE)对于失去手术机会的肝癌已成为首选方法，而异位栓塞所致的并发症已成为影响其疗效的重要因素之一。肝胃间存在许多侧支通路或一些变异的动脉血管交通，认清这些血管非常重要，可有效地提高TACE的疗效，预防和尽量减少胃肠道并发症的发生。     

晚期肝癌的一种新的有效治疗方法—反复暂时性肝动脉门静脉阻断并介入治疗

在反复暂时性肝动脉阻断治疗肝癌的基础上，作设计了反复暂时性肝动脉、门静脉阻断并双介入治疗方法对12例晚期肝癌患进行了临床观察，发现患经去血供等介入治疗后．临床症状改善．AFP下降．生活质量提高，生存期明显延长。本方法既发挥反复暂时性肝动脉阻断治疗肝癌的优点，又可以阻断肿瘤内的门脉供血，同时配合双介入治疗，对门静脉癌栓有一定效果，因此不失为晚期肝癌的一种新的有效的辅助治疗方法。     

充分或分级栓塞供血动脉治疗原发性肝癌67例临床观察

1999年12月至2001年9月,我们采用前瞻性设计对67例原发性肝癌患者103支肿瘤供血动脉给予不同程度的栓塞,疗效满意.现报告如下.     

Control of intraabdominal hemorrhage and shock: a comparison of fluid resuscitation, MAST, and balloon occlusion

Our study examined the efficacy of four treatment modalities in controlling hemorrhage and achieving hemodynamic stabilization in hemorrhagic shock: intravenous fluid replacement (IV); military antishock trousers used concomitantly with fluids (MAST); balloon occlusion at the level of the diaphragm with concomitant fluid replacement (balloon); and a combination of MAST inflation, balloon occlusion, and fluid resuscitation (MAST and balloon). Twenty-eight mongrel dogs were anesthetized, and the spleen was exposed and completely crushed. The abdomen was closed, and treatment was initiated and continued for four hours or until the dog died. For all conditions the hematocrit dropped during the course of the experiment; balloon occlusion was effective at slowing this drop (P less than .0001), but MAST had no statistically significant effect. Animals with balloons bled more slowly into the abdominal cavity than did animals in the other two groups (P less than .0001). MAST also were effective at slowing the bleeding (P less than .05). Of the balloon and the MAST and balloon dogs, all except one survived the entire four hours; this difference between balloon and nonballoon dogs is significant (P = .002). MAST did not have a statistically significant effect on survival. Perfusion pressure (PP) declined during the course of the experiment, and the balloon was effective at slowing this decline (P less than .0001); none of the other comparisons was statistically significant.     

Use of fab fragments of digoxin-specific antibodies in the therapy of massive digoxin poisoning

A case of massive digoxin ingestion with multiple arrhythmias, consisting of high grade A-V block and ventricular ectopy not responsive to lidocaine, is described. The arrhythmias ceased following administration of digoxin-specific Fab fragments. The patient improved and was transferred to the psychiatric unit.     

Comparison of intravenous and oral routes of theophylline loading in acute asthma

In a prospective, randomized clinical trial, 19 patients with an acute exacerbation of asthma were given a loading dose of aminophylline by the IV (n = 10) or oral route (n = 9) of administration following treatment with epinephrine. Plasma concentrations of theophylline were measured prior to giving the loading dose, and one, two, three, and 24 to 48 hours later. Therapeutic effectiveness was evaluated by analyzing spirometric measurements prior to giving the loading dose, and one, three, and 24 to 48 hours later. Side effects also were recorded. In the IV group, the mean peak plasma theophylline concentration was 15.1 micrograms/mL one hour after loading, and in the oral group the mean peak serum theophylline concentration was 14.2 micrograms/mL three hours after loading. There was no correlation between theophylline concentrations and normalized change in spirometric values. There was no significant difference in spirometric values between the IV and oral groups. Nausea was slightly more common in the IV group. We conclude that there is no therapeutic advantage to giving a loading dose of aminophylline by the IV route rather than orally in patients with mild-to-moderate exacerbation of asthma initially treated with epinephrine.     

Application of Granular Biocomposites Based on Homogenised Peat for Absorption of Oil Products

Among the various methods for collecting oil spills and oil products, including from the water surface, one of the most effective is the use of sorbents. In this work, three-component bio-based composite granular adsorbents were produced and studied for oil products’ pollution collection. A bio-based binder made of peat, devulcanised crumb rubber from used tyres, and part fly ash as cenospheres were used for absorbent production. The structure, surface morphology, porosity, mechanical properties, and sorption kinetics of the obtained samples were studied. Composite hydrophobicity and sorption capacity to oil products, such as diesel fuel (DF) and motor oil (MO), were determined. The obtained pellets are characterised by a sufficiently pronounced ability to absorb oil products such as DF. As the amount of CR in the granules increases, the diesel absorption capacity increases significantly. The case of 30-70-0 is almost three times higher than the granules from homogenised peat. The increase in q is due to two factors: the pronounced surface hydrophobicity of the samples (Θ = 152°) and a heterogeneous porous granule structure. The presence of the cenosphere in the biocomposite reduces its surface hydrophobicity while increasing the diesel absorption capacity. Relatively rapid realisation of the maximum saturation by the MO was noted. In common, the designed absorbent shows up to 0.7 g·g⁻¹ sorption capacity for MO and up to 1.55 g·g⁻¹ sorption capacity for diesel. A possible mechanism of DF absorption and the limiting stages of the process approximated for different kinetic models are discussed. The Weber–Morris diffusion model is used to primarily distinguish the limiting effect of the external and internal diffusion of the adsorbate on the absorption process.     

Role of microRNA in regulation of myeloma-related angiogenesis and survival

Multiple myeloma (MM) is a malignant disease caused by clonal proliferation of plasma cells that result in monoclonal gammopathy and severe end organ damage. Despite the uniform clinical signs, the disease is very diverse in terms of the nature and sequence of the underlying molecular events. Multiple cellular processes are involved in helping the malignant cells to remain viable and maintain proliferative properties in the hypoxic microenvironment of the bone marrow. Specifically, the process of angiogenesis, triggered by the interactions between the malignant MM cells and the stroma cells around them, was found to be critical for MM progression. In this review we highlight the current understanding about the epigenetic regulation of the proliferation and apoptosis of MM cells and its dependency on angiogenesis in the bone marrow that is carried out by different microRNAs.     

RNA-Seq在老年神经退行性疾病研究中的应用

阿尔茨海默病及帕金森病是老年人最常见的两种神经退行性疾病,但其发病机制及治疗是研究的热点。随着高通量测序技术的进步及成本的下降,RNA-Seq也成为神经退行性疾病机制研究及生物标志物发现的有力手段。RNA-Seq相对于microarray具有高灵敏度、高准确性、高重复性以及噪声低等优势,在阿尔茨海默病及帕金森病研究中有较为广泛的应用,包括检测差异表达基因,可变剪接、新长链非编码RNA预测分析和miRNAs调控等,但是容易受病理复杂性及样本等因素影响。目前阿尔茨海默病及帕金森病转录组研究相比于癌症等还不够深入,在临床诊断及治疗应用还面临较大挑战。但是随着新技术及新方法的发展,RNA-Seq将进一步推动神经退行性相关疾病的研究和临床转化。     

安徽巢湖市丝虫病控制、消除历程和监测报告

【摘要】 目的  回顾并总结巢湖市丝虫病的流行、控制,以及消除丝虫病的历程。 方法  统计分析1970~1989年在该市采取以消灭传染源、切断传播途径为主的防治策略,以及展开大规模防治的各个阶段。 结果  1989年,采用分层整群抽样调查方法调查,微丝蚴率下降至0.032%,以行政村为单位,微丝蚴率已控制在1.0%以下,达到卫生部规定的基本消灭丝虫病标准;1991年,经省级调查考核,认定全市已达到卫生部规定的基本消灭丝虫病标准。1996年,省级审评确认已达到卫生部颁布的消灭丝虫病标准。经过10年的监测和跟踪治疗,到2005年,全市丝虫病病原学监测未查见微丝蚴阳性者,解剖镜检人房内淡色库蚊1 348只,蚊体内均未查见人体幼丝虫。 结论  巢湖市达到了消除丝虫病的标准。     

Advanced Evaluation of the Freeze–Thaw Damage of Concrete Based on the Fracture Tests

This paper presents the results of an experimental program aimed at the assessment of the freeze–thaw (F–T) resistance of concrete based on the evaluation of fracture tests accompanied by acoustic emission measurements. Two concretes of similar mechanical characteristics were manufactured for the experiment. The main difference between the C1 and C2 concrete was in the total number of air voids and in the A300 parameter, where both parameters were higher for C1 by about 35% and 52%, respectively. The evaluation of the fracture characteristics was performed on the basis of experimentally recorded load–deflection and load–crack mouth opening displacement diagrams using two different approaches: linear fracture mechanics completed with the effective crack model and the double-K model. The results show that both approaches gave similar results, especially if the nonlinear behavior before the peak load was considered. According to the results, it can be stated that continuous AE measurement is beneficial for the assessment of the extent of concrete deterioration, and it suitably supplements the fracture test evaluation. A comparison of the results of fracture tests with the resonance method and splitting tensile strength test shows that all testing methods led to the same conclusion, i.e., the C1 concrete was more F–T-resistant than C2. However, the fracture test evaluation provided more detailed information about the internal structure deterioration due to the F–T exposure.