三维适形放疗联合肝动脉化疗栓塞治疗原发性肝癌临床研究

目的评价肝动脉化疗栓塞结合三维适形放射治疗对原发性肝癌的疗效。方法将68例原发性肝癌患者分为两组，对照组32例，仅给予肝动脉化疗栓塞；观察组36例，先行肝动脉化疗栓塞后给予三维适形放射治疗，观察疗效及生存率。结果治疗后3个月肿瘤局部控制率观察组为86．1％（31／36），对照组为62．5％（20／32），1、2、3年生存率观察组分别为86．1％，52．8％，22．2％，对照组分别为65．6％、46．9％、18．8％。结论肝动脉化疗栓塞结合三维适形放射治疗是治疗原发性肝癌的有效无创治疗手段。     

三氧化二砷持续区域肝动脉灌注治疗肝癌的临床研究

目的探讨三氧化二砷（As2O3）注射液单药连续区域动脉灌注化疗原发性肝癌的临床疗效。方法55例手术不能切除的非晚期原发性肝癌患者,随机分为两组：（1）As2O3治疗组26例：患者采用经股动脉肝动脉碘油栓塞后埋置皮下化疗泵,予以连续区域灌注As2O3化疗,20mg/d,每天1次,共7d,间隔4周重复,共5疗程。（2）对照组29例：采用经股动脉肝动脉栓塞化疗（TACE）,2次TACE15例,3次TACE14例。结果As2O3治疗组总有效率为34.6%（9/26）、肿瘤复发率为15.4%（4/26）、1年生存率为80.7%（21/26）;TACE组分别是31.0%（9/29）、37.9%（11/29）、51.7%（15/29）。统计学分析表明,两组的总有效率差异无统计学意义,P〉0.05;肿瘤复发率和1年生存率差异有统计学意义,P〈0.05。As2O3治疗组较对照组不良反应轻微,未见不可逆不良反应。结论经股动脉肝动脉碘油栓塞后埋置皮下化疗泵予以连续区域灌注As2O3化疗用于治疗原发性肝癌不良反应轻微、疗效确切,具有一定的临床应用前景。     

肝动脉化疗、栓塞治疗原发性肝癌的临床研究

肝动脉化疗、栓塞治疗原发性肝癌的临床研究目的：研究原发性肝癌肝动脉化疗、栓塞的疗效及其影响因素。材料与方法：回顾性分析１８８例肝癌肝动脉化疗、栓塞的临床随访资料。结果：总疗效为症状缓解占５９．６％，肿瘤缩小占５５％，ＡＦＰ下降占３７．８％，半年及１、...     

化疗栓塞联合三维适形放疗治疗原发性肝癌（附50例报告）

目的 评价肝动脉化疔栓塞结合三维适形放射治疗（3D—CRT）对原发性肝癌（PHC）的疗效。方法将50例原发性肝癌患者分为两组，对照组25例，仅给予化疗栓塞；观察组25例，先行化疗栓塞后给予3D—CRT，观察疗效及生存率。结果治疗后3个月肿瘤局部控制率观察组为84％（21／25），对照组为64％（16／25），1、2年生存率观察组分别为84％、51％，对照组分别为64％、45％。结论化疗栓塞联合3D—CRT能提高原发性肝癌的疗效，毒副反应可以耐受。     

肝动脉化疗栓塞术联合脾栓塞术治疗肝癌脾亢的临床应用价值

目的 探讨肝动脉化疗栓塞术联合脾部分栓塞术治疗原发性肝癌伴脾功能亢进的临床应用价值.方法 确诊为原发性肝癌伴脾功能亢进患者60例,2013年10月至2014年6月就诊于解放军总医院第一附属医院介入科.60例患者被随机分配到A、B两组.A组为对照组,30例患者接受肝动脉化疗栓塞术;B组为实验组,30例患者接受肝动脉化疗栓塞术及脾部分栓塞术.治疗前后检测血常规、血凝四项、肝功能、T细胞亚群,免疫球蛋白及CT扫描.观察两组患者并发症的情况.结果 实验组患者术后外周血象、肝功能、凝血功能及免疫功能较术前有所改善,差异有统计学意义(P＜0.05);两组患者术后并发症间比较无显著地差异性(P＜0.05),并未发生严重并发症.结论 肝动脉化疗栓塞术联合脾部分栓塞术是一种安全且有效的治疗方法,它能有效改善患者血细胞减少状况,改善肝功能,提高免疫力,且术后患者发生严重并发症的概率较低.     

合并HBV阳性的肝癌围手术期抗病毒治疗的初探

原发性肝癌（HCC）是我国常见的恶性肿瘤,其治疗原则主要是以外科治疗（包括肝癌切除,肝动脉结扎,肝动脉栓塞化疗,肝移植等）为基础的综合治疗。根据近年的临床统计,发现部分合并HBV感染的HCC患者经过外科治疗后无法达到预期的治疗效果,仅有10％～30％的患者可获手术切除,根治性切除术后仍具有较高复发率,     

TAE+32P与TAE治疗原发性肝癌患者sIL-2R、T淋巴细胞亚群改变的比较

肝动脉栓塞化疗术(TAE)是治疗晚期原发性肝癌的首选方法,患者1年生存率34.3%.我们TAE基础上加用核素32P磷酸铬胶体溶液(核素组)在治疗晚期原发性肝癌取得显著效果,患者1年生存率53.8%[1].为了观察两种治疗方法对原发性肝癌患者免疫功能影响,测定了两种治疗后肝癌患者血液sIL-2R、T淋巴细胞亚群的改变.     

TACE联合PEI治疗原发性肝癌48例临床分析

目的 观察TACE联合PEI治疗原发性肝癌的疗效。方法 48例原发性肝癌患者在X线监护下采用股动脉入路，明确肝脏病变部位及范围后，应用碘化油及抗癌药物进行栓塞化疗，1月后在超声引导下进行无水酒精瘤内注射治疗。结果 48例进行经皮肝动脉栓塞化疗联合超声介入下无水酒精瘤内注射后，直径〈3cm的肝癌患者1年和3年的生存率分别为90％和82％，直径3～10cm的肝癌患者1年和3年的生存率分别为85.50％和46％。结论 TACE联合PEI治疗原发性肝癌明显提高患者生存率，是一种安全、有效、更符合临床治疗学的综合方案，具有较高的临床价值。     

肝癌破裂出血的急诊介入治疗

目的：评价急诊肝动脉栓塞术（Transcatheter arterial embolization，TAE）治疗肝癌破裂出血的疗效。方法：采用Seldinger技术穿刺，使用明胶海绵、碘化油对14例肝癌破裂出血患者行肝动脉栓塞术，其中4例同时加用表阿霉素行栓塞化疗。结果：14例肝癌破裂出血患者全部止血成功，无严重并发症，术后无复发出血。其中2例术后2个月死于肝功能衰竭，其余12例生存4～25（平均7．6）个月。结论：TAE是治疗肝癌破裂出血的有效方法。     

块状型肝癌化疗栓塞后血液动力学改变的临床意义

目的：探讨块状型肝癌化疗栓塞（TACE）后肝内血管血流动力学改变的临床意义。方法：对51例肝右叶块状型肝癌患者行TACE治疗,采用Seldinger技术将微导管超选择至肿瘤的供血动脉,经栓塞-化疗-再栓塞后再次行DSA造影检查。TACE术前、术后两次造影条件相同,观察肿瘤区和非肿瘤区血流动力学变化。结果：51例中,肿瘤组织内动脉有增生或显著增生的血管网43例（84．3％）,主瘤栓塞后DSA检出1～3个大小不等的次瘤34例（66．7％）。TACE后,肿瘤区血管密度减小、非肿瘤区血管密度增大,肝固有动脉、肝右动脉和胃十二指肠动脉管径增粗、血流量增多。结论：TACE后肝肿瘤区血流速度减慢,有利于化疗药物和栓塞剂的存留。主瘤栓塞后次瘤的发现,对于手术治疗的取舍有重要的参考价值。观察TACE前后血流动力学的变化为肿瘤综合治疗方案的拟定提供了有价值的临床信息。     

肝硬化失代偿期病人体感诱发电位观察

目的 :探讨肝硬化失代偿期病人的神经功能状态。方法 :对 30例肝硬化失代偿期病人进行体感诱发电位 (SEP)检查 ,刺激部位均为右腕正中神经。结果 :肝硬化失代偿期病人的SEP有着不同程度的改变 ,其中P15、N2 0 、P2 5、N3 5的潜伏期延长和N13 -P15的波间期延长分别占本组异常数的 85 %、40 %、35 %、2 5 %和 2 0 %。这些值与正常人组相比较 ,其两组间差异均有极显著性意义 (P <0 0 1)。结论 :SEP可为研究亚临床肝性脑病提供电生理学的客观依据。     

P300等诱发电位对亚临床肝性脑病早期诊断的意义

目的:观察事件相关电位P_(300)、体感诱发电位、视觉诱发电位和脑干听觉诱发电位在亚临床肝性脑病诊断中的意义。方法:50例亚临床肝性脑病患者进行了心理测验,并做了头颅CT和视觉诱发电位、体感诱发电位、脑干听觉诱发电位和事件相关电位检查,30例正常人做为对照组。结果:亚临床肝性脑病的心理测验,韦氏法智力低下率为76％,视觉诱发电位异常率为13％,脑干听觉诱发电位异常率为20％,体感诱发电位异常率为40％,事件相关电位异常率为71％,正常对照组四种诱发电位的正常率是100％。头颅CT结果与亚临床肝性脑病无关。结论:视觉诱发电位、体感诱发电位、脑干听觉诱发电位和事件相关电位在亚临床肝性脑病中是异常的。事件相关电位更为敏感,对亚临床肝性脑病的早期诊断有重要意义。     

癫癎患者听觉事件相关电位的检测报告

目的:探讨听觉事件相关电位(ERP)在癫癎患者中的应用价值。方法:对40例癫癎患者和30名正常人进行ERP检测比较,并将癫癎患者ERP的结果与其发作类型、用药情况等进行比较分析。结果:40例癫癎患者的ERP P300潜伏期较对照组延长(P<0．05),但其P300波幅差异无统计学意义(P>0．05)。全身强直阵挛性发作的28例癫癎患者,P300潜伏期延长尤著。多药治疗组较单药治疗组P300潜伏期延长。结论:癫癎患者存在认识功能障碍,ERP可作为癫癎患者认知功能障碍诊断的参考指标,对指导临床,及早给予干预和治疗有一定意义。     

气功锻炼辅助治疗对帕金森病患者事件相关电位的影响

目的：观察帕金森病人气功辅助治疗前后事件相关电位（ＥＲＰ）的变化。方法：对３３例药物治疗中期的帕金森病人作气功辅助治疗３个月,观察治疗前后的听觉ＥＲＰ的Ｐ３００,并与正常对照组２４例比较。结果：帕金森病人ＥＲＰ与对照组存在多指标差异,以Ｐ３潜伏期延长为甚,气功锻炼后其Ｎ２、Ｐ３潜伏期缩短,与对照组比较无显著性差异;同时临床症状也获得改善。结论：帕金森病人有认知功能受损,气功辅助治疗可使其获得改善或恢复。     

亚临床肝性脑病患者多种形式诱发电位联合检测的临床意义

目的:探讨事件相关电位(P300),脑干听觉诱发电位(BAEP),体感诱发电位(SEP),视觉诱发电位(VEP)对亚临床肝性脑病(SHE)的临床诊断价值.方法:根据临床分级,对36例临床诊断为亚临床肝性脑病(SHE)的患者进行P300、BAEP、SEP、VEP检测分析.结果:36例SHE患者中P300异常者26例(72%),BAEP异常者23例(64%),SEP异常者17例(47%),VEP异常者9例(25%).结论:P300、BAEP、SEP、VEP的检测有助于亚临床肝性脑病(SHE)的早期诊断.     

神经梅毒患者的临床特征及神经电生理检测

目的：评价临床特征和神经电生理检测在神经梅毒诊断中的价值。方法：回顾性分析经临床和实验室检查确诊的10例神经梅毒病人的有关资料。结果：10例病人均为男性，平均年龄58岁，间质性梅毒占60％，CT／MRI表现以多发散在病灶多见，脑脊液检查50％病人细胞数升高，所有患者蛋白升高，脑脊液细胞学检查均异常，脑脊液梅毒螺旋体血凝试验(TPHA)均( )，60％快速血浆反应素试验(RPR)( )。EEG异常率为100％，而ERP的P300、VEP、BAEP亦有较高的异常率。结论：神经梅毒临床表现多样性，实验室检查是早期诊断的重要依据；神经电生理检测能提供临床及临床下损害的证据。     

Functional relationship between brain regions in schizophrenia evaluated with Pearson's correlation between event-related potentials.

As part of a study of the somatosensory P300 event-related potential (ERP) in paranoid and nonparanoid schizophrenic patients (8) Pearson's product-moment correlations between ERP waveforms were calculated to study the functional relationship between brain areas. ERP were recorded from F3, F4, P3 and P4; interhemispheric (F3 to F4; P3 to P4) and intrahemispheric (F3 to P3; F4 to P4) correlations were obtained. There was no significant difference among the paranoid and nonparanoid patients and healthy controls for both the interhemispheric and the intrahemispheric correlations. The lack of disruption of functional relationship between brain areas on the patients do not support the hypofrontality and the laterality hypothesis of schizophrenia. However, the use of neuroleptics by the patients, the study of the whole waveforms and not parts of them and the use of linked-ears reference could account for these negative results.     

梗塞性脑血管病事件相关电位研究

脑血管病是老年期痴呆的常见原因。脑梗塞患者约有2％～5％出现智能障碍。利用听觉刺激序列诱发的事件相关电位(P_(300)),对32例脑梗塞患者进行了临床研究。32例患者采用长谷川智测量表(HDS)评分。其中9例小于20分,其P_(300)潜伏期与正常对照组均延长,而23例HDS评分正常者其中10例P_(300)潜伏期延长。研究结果提示利用事件相关电位检测技术可早期发现脑梗塞患者亚临床痴呆。     

Feedback EEG in the detection of subclinical hepatic encephalopathy: a preliminary report

The detection, monitoring, and quantification of subclinical hepatic encephalopathy present difficult problems for the clinician caring for patients with liver disease. Traditionally, pencil and paper tests such as signature-writing have been used at the bed-side to measure early encephalopathy. More recently, the Trail-making test has been employed to detect and quantify encephalopathic changes. While the electroencephalogram has provided information about the extent of clinically-obvious encephalopathy, it has only recently proved useful in the detection of subclinical disease. In these cases, evoked potentials and spectral analysis methods have discriminated between 35 and 62% of patients with subclinical hepatic encephalopathy. The present study used the method of feedback electroencephalography to detect and quantify differences in cortical arousal in 5 cirrhotic patients and 5 normal age-matched controls. Subject were also compared with respect to baseline measures of cortical arousal. Finally, arousal during feedback EEG stimulation was correlated with Trail-making test performance. The data revealed that cirrhotic patients can be discriminated from normal controls by baseline (80% detection) and feedback stimulation conditions (100% detection). In addition, feedback EEG reactivity (cortical arousal) was inversely correlated with Trail-making test performance (-0.86, P less than 0.01). The results indicate that simple features of the conventional EEG can reliably discriminate cirrhotic patients from normals. Clinical application of the feedback method in other metabolic encephalopathies, as well as in hypoaroused states secondary to, for example, narcolepsy, is discussed.     

Crossmodal influences on early somatosensory processing: interaction of vision, touch, and task-relevance

Previous research suggests that somatosensory cortex is subject to modulation based on the relevancy of incoming somatosensory stimuli to behavioural goals. Recent fMRI findings provide evidence for modulation of primary somatosensory cortex when simultaneous visual and tactile stimuli were relevant to the performance of a motor task. The present study aimed to (1) determine the temporal characteristics of this modulation using event-related potentials (ERPs) and (2) investigate the role of task-relevance in mediating such a modulation. Electroencephalography was collected from healthy subjects during visual, vibrotactile or bimodal stimulation as they performed a sensory-guided motor task. Experiment 1 tested the hypothesis that simultaneous bimodal stimuli would be associated with modulation of somatosensory ERPs, and Experiment 2 tested the hypothesis that such effects would only be seen when both modalities are relevant. ERPs were time-locked to stimulus onset, and mean ERP amplitudes and latencies were extracted for the P50, P100, and N140. The bimodal condition in the first experiment was associated with larger amplitudes at both early and mid-latency components. The manipulation of task-relevance under bimodal conditions produced more complex results for the mid-latency components. For the P50, this enhancement was observed only when both stimuli were relevant, whereas the P100 was smallest when the tactile stimuli were not relevant to the response. These results provide evidence that crossmodal stimuli can modulate early somatosensory event-related potentials and that these effects are mediated by stimulus relevance.