温热(60℃)化疗栓塞对肝癌患者红细胞免疫功能的影响

目的 观察经肝动脉热化疗栓塞对肝癌患者红细胞免疫功能的影响.资料与方法 采用"郭峰法"检测30例原发性肝癌经肝动脉热化疗栓塞前后患者外周血中红细胞C3b受体花环率(RBC-C3bRR);红细胞免疫复合物花环率(RBC-ICR),并与健康对照组比较分析.结果 肝癌组RBC-C3bRR(14.72±3.45)明显低于对照组(22.38±2.59)(P＜0.01),RBC-ICR(16.82±4.72)明显高于对照组(5.21±2.67)(P＜0.01);肝癌治疗后RBC-C3bRR(19.5±3.35)明显增高(P＜0.01),RBC-ICR(10.71±5.26)明显降低(P＜0.01).结论 肝动脉热化疗栓塞可改善肝癌患者红细胞免疫功能.     

原发性肝癌肝动脉热化疗栓塞后病人T细胞亚群及SIL-2R的改变

目的 :研究肝癌病人肝动脉热化疗栓塞前后 T细胞亚群及 s IL- 2 R的变化及其临床意义。方法 :采用免疫荧光染色法及双抗体夹心法 ,检测 30例原发性肝癌病人治疗前后的 T细胞亚群及 s IL- 2 R的改变 ,并与健康对照组比较分析。结果 :肝癌组治疗前 Th降低 ,Ts和 s IL- 2 R增高 ,与对照组比较有显著差异 ,P<0 .0 1 ,治疗后 Th升高 ,Ts和 s IL- 2 R降低 ,治疗前后比较有显著差异 P<0 .0 1。结论 :检测肝癌病人 T细胞亚群 ,s IL - 2 R的情况 ,有助于了解病人的免疫状况 ,对判断病人预后 ,指导综合治疗有一定价值。热化疗栓塞的疗效优于文献报道的单纯化疗栓塞     

吐温80温热灌注化疗栓塞治疗转移性肝癌的临床研究

目的　探讨吐温 80温热灌注化疗栓塞治疗转移性肝癌的可行性。方法　选择转移性肝癌 32例 ,分为吐温 80温热灌注化疗栓塞组 (15例 ,治疗组 )和常规化疗栓塞组 (17例 ,对照组 )。治疗组采用加温至 6 2°C的吐温 80、化疗药液和碘油进行化疗栓塞。对照组在室温下用常规化疗栓塞治疗。结果　治疗组的肿瘤生长率 (- 0 .4 1± 0 .2 5 )小于对照组 (- 0 .12± 0 .4 5 ) ,差异有显著性 (P <0 .0 5 )。近期有效率于治疗组为 6 0 % ,对照组为 4 1/2 % ,差异无显著性 (P >0 .0 5 )。治疗组中 ,不良反应轻度 3例(2 0 % ) ,中度 8例 (5 3.3% ) ,重度 4例 (2 6 .7% ) ;对照组中轻度 4例 (2 3.5 % ) ,中度 10例 (5 8.8% ) ,重度3例 (17.7% ) ,两者差异亦无显著性 (P >0 .0 5 )。结论　经导管肝动脉的吐温 80温热灌注化疗栓塞 ,是治疗转移性肝癌的安全有效的方法。     

温热化疗栓塞治疗肝癌患者T细胞亚群动态变化

目的 观察温热化疗栓塞治疗肝癌前后的患者T细胞亚群变化。方法 经肝动脉温热化疗栓塞治疗肝癌患者16例，分别于治疗前及治疗后1、2周采集患者外周静脉血，用流式细胞仪检测T淋巴细胞亚群，与同期18例常规化疗栓塞治疗的肝癌患者比较。结果 治疗后2周，治疗组CIM细胞比例增加、CD8细胞比例下降，且CD4／CD8比值增加明显高出对照组CD4／CD8增加值(P=0．01)。结论 温热化疗栓塞治疗可进一步增强肝癌患者的免疫功能。     

高原地区进展期胃癌患者红细胞免疫功能和T淋巴细胞亚群的研究

目的：研究高原地区进展期胃癌（AGC）患者的红细胞免疫功能和淋巴细胞免疫功能;方法：对我科住院手术治疗的32例进展期胃癌患者作了红细胞C3b受体花环（RBC－C3bRR)、红细胞免疫复合物花环（RBC－ICR）及淋巴细胞亚群CD3、CD4、CD8、CD4／CD8的检测,并与20例正常人结果进行比较;结果：高原地区进展期胃癌患者RBC－C3bRR,CD3,CD4,CD8、CD4／CD8比值均低于正常人（P＜0．01）,RBCICR高于正常人（P＜0．01）;结论：高原地区进展期胃癌患者红细胞免疫系统与淋巴细胞免疫系统均处于抑制状态,2个免疫系统的改变有着密切的关系,对高原地区进展期癌患者应给予免疫支持。     

介入热化疗栓塞术治疗中晚期肝癌的临床应用分析

目的：探讨介入热化疗栓塞术治疗中晚期肝癌的临床疗效。方法将收治的52例原发性中晚期肝癌患者随机分为治疗组和对照组,其中治疗组采用介入热化疗栓塞术治疗。结果治疗组患者中CR12例,PR12例,有效率达92．31％;而对照组患者中CR10例,PR8例,有效率为69．23％,经统计学分析发现治疗组患者的治疗有效率明显高于对照组,且差异具有统计学意义（x2＝4．46,P ＜0．05）。治疗组患者中血清AFP水平明显下降6例,中度下降10例,轻度下降7例,升高3例;而对照组患者中血清A F P水平明显下降3例,中度下降7例,轻度下降5例,升高11例,经统计学分析发现治疗组患者的血清A FP下降率（88．46％）明显高于对照组（57．69％）,且差异具有统计学意义（x2＝6．26, P ＜0．05）。两组均有部分患者出现轻度化疗反应等表现。结论原发性中晚期肝癌患者采用介入热化疗栓塞术治疗可明显改善近期症状,具有明显的临床疗效。     

肝脾双介入治疗原发性肝癌伴脾功能亢进临床应用研究

目的：探讨经肝内动脉热灌注化疗栓塞及部分性脾动脉栓塞治疗原发性肝癌伴脾功能亢进临床应用。方法：研究组和对照组按肝癌分型随机分组，行肝内动脉热灌注化疗栓塞及部分性脾动脉栓塞治疗，比较两组病例治疗疗效差异。结果：研究组经栓塞后WBC、PLT变化均有显著差异，治疗后生存率均有明显提高。结论：经肝内动脉热灌注化疗栓塞及部分性脾动脉栓塞治疗原发性肝癌伴脾功能亢进作为一种新的治疗手段已广泛应用于临床。     

热化疗栓塞术治疗中晚期原发性肝癌的疗效观察

目的 探讨热化疗栓塞术治疗中晚期原发性巨块型肝痛的疗效.方法 163例中晚期原发性巨块型肝癌患者,分成A、B 2组.A组123例,按化疗和碘油乳剂栓塞行经皮经导管肝动脉栓塞术(TACE)治疗;B组40例,按最大剂量的碘油乙醇乳剂栓塞 热灌注化疗 栓塞和间接门静脉化疗法进行治疗,并进行治疗前后肿瘤大小及AFP变化的对比分析.结果 2组治疗前后肝内肿瘤大小变化及AFP变化的比较均有显著性差异(P＜0.01),经6～36 月随访,A组和B组6、12、24、36月生存率分别为82.9%、72.4%、33.3%、13.0%和97.5%、90.0%、70.0%、37.5%(P＜0.05).结论 肝动脉热化疗栓塞组治疗中晚期原发性巨块型肝癌效果优于常规的TACE组,安全有效.     

介入治疗对胰腺癌患者血清sTNFR-I和IAP的影响

目的　探讨胰腺癌患者介入治疗前后血清可溶性肿瘤坏死因子受体 Ⅰ (sTNFR Ⅰ )和免疫抑制酸性蛋白 (IAP)水平的变化及其临床意义。方法　分别用双抗体夹心酶联免疫法 (ELISA)和单向免疫扩散法测定 5 5例中晚期胰腺癌患者行动脉栓塞化疗前后血清sTNFR Ⅰ和IAP的改变 ,并与健康对照组比较分析。结果　胰腺癌组介入治疗前sTNFR Ⅰ和IAP均增高 ,与对照组比较差异有显著性(P <0 .0 1) ;行化疗栓塞术后 ,患者血清sTNFR Ⅰ和IAP均降低 ,治疗前后差异有显著性 (P <0 .0 5 ) ;应用免疫调节剂组较未用组血清sTNFR Ⅰ和IAP均下降更显著 (P <0 .0 5 )。结论　检测胰腺癌患者血清sTNFR Ⅰ和IAP的水平 ,有助于了解患者的免疫状况 ,介入治疗能改善机体免疫功能 ,辅以合理的过继免疫治疗能增强这种作用     

肝癌经肝动脉化疗栓塞及门静脉持续灌注化疗的临床研究

目的　将经肝动脉化疗栓塞 (TACE)和经门静脉植入化疗药盒持续灌注化疗药 (VPC) 2种方法结合 ,观察原发性肝癌(HCC)经肝动脉化疗栓塞和经门静脉植入化疗药盒持续灌注化疗药的疗效。方法　对照组 83例中晚期患者 ,用表柔比星 (EPI) 40mg和顺铂 (CDDP) 80mg与碘化油配制成碘油———化疗药物乳化剂 ,经导管向肝癌供血动脉注入 ,后用明胶海绵 (GS)颗粒栓塞该动脉。治疗组 5 9例中晚期HCC患者 ,用上述方法治疗后 ,再经皮下埋置式药盒经门静脉定期灌注化疗药。结果　对照组与治疗组有效率 (完全缓解 部分缓解 )分别为 45 .8%和 61.0 % (P <0 .0 5 ) ,2组治疗后Ⅱ期手术切除率分别为 3 .6%和 11.9% (P <0 .0 5 )。对照组 1年、2年、3年生存率分别为 69.9%、60 .2 %和 2 0 .5 % ;治疗组分别为 96.6%、67.8%和 42 .4% (P <0 .0 5 )。并发症差异无显著性意义。结论　经肝动脉化疗栓塞和经门静脉植入化疗药盒持续灌注化疗药是治疗原发性肝癌的较好方法 ,能提高疗效     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）