腺性膀胱炎经尿道等离子电切加羟基喜树碱膀胱灌注与单纯羟基喜树碱膀胱灌注疗效对比观察

目的:比较腺性膀胱炎经尿道等离子电切加羟基喜树碱膀胱灌注与单纯羟基喜树碱膀胱灌注的临床疗效.方法:选64例腺性膀胱炎患者,随机分为单纯羟基喜树碱膀胱灌注组(灌注组,31例)和经尿道电切加羟基喜树碱膀胱灌注组(联合组,33例),随访1～2年,比较两组有效率、复发情况、不良反应及并发症的发生.结果:联合组有效率明显高于灌注...     

兔脾动脉插管和耳静脉穿刺灌注氟尿嘧啶门静脉检测的药代动力学研究

对比研究经脾动脉和耳静脉灌注氟尿嘧啶时经门静脉测定的药代动力学,以评价在肝恶性肿瘤的血管内介入治疗中,经脾动脉灌注化疗药的临床治疗价值。对脾动脉灌注组（IA组）和耳静脉灌注组（IV组）均行门静脉插管取样测定,采用高效液相色谱仪检测门静脉血中氟尿嘧啶,进行药代动力学对比分析。结果显示,IA组各血样的血药浓度均高于IV组,前者之血药峰值比后者高64％,前者曲线下面积比后者大42％,提示经脾动脉灌注化疗药,门静脉内可达较高血药浓度,有利于对由门静脉供血的肝恶性肿瘤外围部分的控制。     

肝动脉灌注羟基喜树碱合并栓塞治疗原发性肝癌

目的：观察以羟基喜树碱（ＨＰＴ）为主的化疗药经肝动脉灌注合并栓塞治疗中、晚期原发性肝癌的疗效。方法：采用ＨＰＴ、吡柔比星、卡铂或５－氟脲嘧啶与碘化油联合经肝动脉灌注栓塞,治疗不能手术的中、晚期肝癌４１例。结果：４１例患者共接受１０２次介入治疗。部分缓解２１例,稳定１６例,进展４例,总有效率５１．２％。３０例患者血清ＡＦＰ≥２００μｇ．Ｌ＾－１,经治疗后２２例ＡＦＰ明显下降或恢复正常。生存率６个月为８７．２％,１年５８．１％,２年１９．０％。不良反应主要为骨髓抑制（Ⅰ～Ⅲ度）和消化道反应（Ⅰ～Ⅱ度）。结论：肝动脉灌注以ＨＰＴ为主的药物合并栓塞治疗中、晚期肝癌,疗效好,毒副反应小。     

髂内动脉化疗联合手术治疗膀胱癌

目的：提高膀胱癌手术治疗的效果，尽可能保留有功能的膀胱，降低膀胱癌术后复发率。方法：对72例不同分期、分级的膀胱移行细胞癌患者随机分为两组，Ⅰ组40例行膀胱部分切除术或经尿道膀胱肿瘤电切术（TUR—Bt），术后加丝裂霉素膀胱灌注化疗；Ⅱ组32例术前行卡铂配伍阿霉素髂内动脉灌注化疗2次，后行膀胱部分切除术或经尿道膀胱肿瘤电切术，术后加丝裂霉素膀胱灌注化疗。均随诊2年，比较两组间治疗后膀胱癌复发率。结果：Ⅰ组，2年膀胱癌复发18例，复发率45％。Ⅱ组，2年膀胱癌复发6例，复发率18．75％。两组复发率比较差异有显著性（P〈0．05）。Ⅱ组髂内动脉灌注化疗前后膀胱癌细胞分级（G）降低15例，分期（T）降低16例。结论：术前加用卡铂配伍阿霉素髂内动脉灌注化疗可使部分膀胱癌降级、降期，提高手术切除率，降低术后膀胱癌复发率，术前加用卡铂配伍阿霉素髂内动脉灌注化疗结合保留膀胱的手术是治疗膀胱癌的有效方法。     

家兔氟尿嘧啶胃左动脉灌注与静脉化疗药物动力学比较

目的　评价氟尿嘧啶动物胃左动脉灌注和外周静脉化疗药物动力学的基础实验比较。方法　实验家兔 18只 ,随机分 6个时间组 ,由胃左动脉注入氟尿嘧啶 (按 5 0mg/kg) ,于不同时间点 ,留取门静脉及外周静脉血 ,同时处死动物 ,取部分胃组织。血样及组织样经处理后采用高效液相色谱测定 ,对照组由耳缘静脉注入氟尿嘧啶 (5 0mg/kg) ,不同时间取血和组织 ,同上处理后测定。 结果　两种途径给药后的门静脉及外周静脉的药时曲线均为 5min达到高峰值 ,之后迅速下降 ,30min后下降缓慢 ,符合二室模型 ;动脉灌注组门静脉血药浓度明显高于外周血药浓度 ,亦明显高于静脉注药组的门静脉浓度 ,而且持续时间较长 ;5min后动脉灌注组胃组织药物浓度 11倍于静脉给药组 ,2h后两者浓度接近。结论　经胃左动脉灌注在门静脉及胃组织中的药物浓度在较长时间内维持相对高的水平 ,而且能使局部药物相对集中 ,可以在很大程度上提高疗效     

动脉化疗与静脉-动脉联合化疗治疗眼内晚期视网膜母细胞瘤的有效性与安全性

目的：比较晚期视网膜母细胞瘤（RB）经眼动脉灌注化疗（IAC）与静脉化疗联合眼动脉灌注化疗（IV-IAC）的安全性与有效性。 方法：选取2012年9月-2016年11月我院收治的眼内晚期(D/E期)初诊RB患者80例。42例进行经眼动脉灌注化疗,为IAC组;38例行2次静脉化疗后联合经眼动脉灌注化疗,为IV-IAC组;比较两组治疗方法的有效性与安全性。 结果：（1）保眼与复发转移情况：IAC组42人46只眼球,平均随访20.2个月,39只眼成功保留,总体保眼率为84.7%。1例患者转移并死亡,转移率和死亡率为2.2%;IV-IAC组38人44只眼,平均随访21.4个月,34只眼成功保留,总体保眼率为77.3%,1例转移并死亡,转移率和死亡率为2.3%;两组复发率分别为13.0%（6/46）及15.9%（7/44）。两组保眼率、复发率、转移率、死亡率差异均无统计学意义（P>0.05）。（2）并发症：IAC组眼球内陷发生率为41.3%（19/46）,4例患眼并发白内障,17只患眼眼睑水肿,12只眼睑下垂,1患眼斜视,1患眼玻璃体出血;IV-IAC组眼球内陷发生率为22.7%（10/44）,15例眼睑水肿,12例眼睑下垂。IAC组眼球内陷发生率高于IV-IAC组（P=0.007）。 结论：两次静脉化疗联合动脉化疗治疗晚期视网膜母细胞瘤对比单纯动脉化疗可能不会降低患者的总体转移率,但会降低患者眼球内陷和白内障的发生率。     

动脉灌注化疗治疗并发于肺癌的上腔静脉综合症

目的：评估经血动脉灌注化疗药物治疗肺癌合并上腔静脉综合征（ＳＶＣＳ）的疗效,并与静脉全身化疗效果进行比较,材料与方法：肺癌合并ＳＶＣＳ患者２８例,研究组１４例行动脉灌注化疗,对照组１４例行静脉全身化疗,比较两组的肿瘤退缩率及临床症状改善率。结果：治疗前后ＫＰＳ平均分差研究组增１２．９,姐增加１．４,胸片评估近期有效率,研究组为２９％,对照组为０％,经卡方检验,两职效差异显著,结论：动脉灌注化疗治疗     

髂内动脉化疗辅助经尿道电切治疗浸润性膀胱癌的临床研究

目的评价动脉介入化疗辅助经尿道电切治疗浸润性膀胱癌的效果。方法对13例病理证实为肌层浸润性的膀胱移行细胞癌（T2-T3）的患者行经尿道电切术＋辅助动脉介入化疗。经骼内动脉灌注的化疗药物为顺铂80mg、表柔比星50mg,氟尿嘧啶1g或喜树碱30mg。经辅助动脉介入化疗后,所有病例定期随访,观察其生存期、无病生存期以及化疗副作用等。结果13例患者完成治疗,年龄68.3±7.4岁,平均随访26.46个月,肿瘤复发5例（38.46%）,对复发肿瘤行再次经尿道切除,1例远处转移行全身化疗。2例患者因癌死亡。结论选择辅助介入化疗结合经尿道切除的治疗对部分肌层浸润性的膀胱移行细胞癌（T2-T3）的患者具有一定的疗效,并具有保留膀胱功能、较好生活质量的优点。     

参耳合剂对大鼠创伤后红细胞免疫粘附的影响

参耳合剂对大鼠创伤后红细胞免疫粘附的影响方国恩，华积德，郭峰，胡和平材料与方法（１）材料：ＳＤ系雌性大白鼠，体重１５０～２００ｇ，Ｃ３ｂ补体致敏酵母菌，补体非致敏酵母菌，经炮制中药６味。（２）动物模型分为：Ａ组（１２只）为正常对照组；Ｂ组（１０只）、...     

静脉动脉化对下肢动脉广泛性闭塞症患者血液流变学的影响

目的：观察两种手术方法对下肢动脉闭塞性病变血液流变学的影响。方法：下肢动脉广泛闭塞症Ⅱ期患者２８（３０肢）例,随机分为治疗组１（静脉动脉化）１８肢,组２（带蒂大网膜移植）１２肢,对照组选健康人３５例,分别于治疗前、治疗后７ｄ、１４ｄ取患肢股静脉血检测。结果：下肢动脉闭塞组治疗前ＢＶ、ＰＶ、ＰＦＣ、ＭＥＴ、ＡＩ均显著高于对照组（Ｐ〈０．０５～０．０１）,静脉动脉化治疗后上述各指标明显下降（Ｐ〈００５     

Hepatic intra-arterial injection of 3-bromopyruvate in rabbit VX2 tumor

PURPOSE: To evaluate the antitumoral effects of an intra-arterial injection of 3-bromopyruvate (3-BrPA) on liver VX2 tumor in rabbits. MATERIAL AND METHODS: Twenty rabbits with surgically implanted liver VX2 tumors were used. The rabbits were divided into three groups: a control, a saline, and a 3-BrPA group. Four rabbits were not treated at all, and they served as the control group. The saline group (n = 6) received only intra-arterial saline injection. The 3-BrPA group (n = 10) received an intra-arterial injection of 3-bromopyruvate through the hepatic artery. The delivered amounts of 3-bromopyruvate were as follows: 25 ml of 0.5 mM in six rabbits, 25 ml of 1.0 mM in two rabbits, and 25 ml of 2.0 mM in two rabbits. Four days after intra-arterial injection, the rabbits were sacrificed and histopathologic analysis of the explanted livers was performed with comparison of the tumor necrosis ratio (a percentage of the necrotic area versus the entire tumorous area) in each group. RESULTS: The mean tumor necrosis ratio was 12.5+/-4.2%, 44.8+/-24.7%, and 49.4+/-14.3% in the control, saline, and 3-BrPA groups, respectively. Between the control and the saline group, and between the control and the 3-BrPA group the mean tumor necrosis ratio appeared to be significantly different (P<0.05). However, there was no statistical difference in the mean tumor necrosis ratio between the saline and the 3-BrPA group (P = 0.416). CONCLUSION: A single session of intra-arterial injection of 3-BrPA showed no better results in terms of tumor necrosis than that of saline injection in a rabbit VX2 tumor model.     

动、静脉结合r-tPA溶栓治疗早期脑梗死

目的 评价动、静脉结合r-tPA溶栓治疗急性脑梗死的方法和临床疗效.方法 共15例急性脑梗死患者,术前均行CT、MR 和DSA检查证实颅内动脉闭塞部位：M1段4例,M2段2例,M3、4段2例,A1、2段1例,颈内动脉2例, P1段1例,豆纹动脉1例,其他穿支2例.其中术前经DSA证实12例.溶栓治疗时间在发病后3～7 h,采用动脉内药物灌注和机械疏通相结合方法溶栓,另外经静脉术前和术后持续滴注r-tPA辅助.术后观察临床症状和影像表现.结果 15例患者溶栓治疗中微导管和溶栓导管均到位满意,DSA所示闭塞段血管均有效再通.术后CT检查发现片状渗血2例,异位脑梗死1例.术后肢体功能即刻明显改善6例.临床观察3个月,症状基本完全恢复6例,较好改善7例,2例无明显改善;生活能力完全自理13例,有效率达87%（13/15）,生活能部分自理者1例,失去生活自理能力 1例,无患者死亡.结论 动、静脉结合溶栓治疗急性颅内动脉栓塞是一种有效、安全的治疗方法;局部动脉内灌注和机械疏通有效结合以及术前各项影像学检查的综合分析,将有利于动脉溶栓治疗的进行.     

Computed tomography of rabbit V2 carcinoma after intraarterial contrast enhancement.

Changes in X-ray attenuation of rabbit V2 carcinoma, as determined by computed tomography (CT) scanning, were assessed following the intraarterial and intravenous administration of a water soluble contrast agent. After intraarterial contrast medium administration, a significant increase in CT attenuation values occurred in both blood and V2 carcinoma, and the attenuation values remained above control values for at least 120 min. A similar, although less pronounced, increase in VA attenuation values occurred following intravenous contrast medium administration. Comparison of V2 CT enhancement values after intraarterial and intravenous administration suggested that tumor enhancement was greater after intraarterial administration.     

Intraarterial infusion of hypoxic radiosensitizer RK28 in rabbit VX2 tumor system

The effect of regional intra-arterial infusion of a hypoxic cell radiosensitizer RK28 (2-nitro-imidazole nucleoside analogue) on rabbit VX2 tumor was evaluated. Rabbits each weighing 2.5-3 kg were implanted with VX2 tumor in the left hind legs. Solid tumors grown up to 3 cm in diameter were treated with X-ray irradiation. Tumor volumes were assayed weekly by computed tomography (CT). Six rabbits were treated with 15 Gy of X-ray irradiation alone, and the other six rabbits were treated with intra-arterial infusion of RK28 (80 mg/kg) two minutes before 15 Gy of irradiation. The latter tumors regressed more rapidly than the former (p less than 0.01), and the latter rabbits seemed to survive longer than the former. The pharmacokinetics of RK28 and its metabolites in tumor tissue and serum were measured by high performance liquid chromatography (HPLC) using six rabbits. During irradiation, a high concentration of the agent was achieved in tumor tissue. It is suggested that a successful radiosensitizing effect will be obtained when regional intra-arterial infusion of RK28 is clinically combined with intraoperative radiation therapy and brachytherapy.     

Intraarterial doxorubicin infusion treatment with and without occlusion of the renal artery in rabbit renal VX-2 carcinoma. Establishing an animal model

The aim of this investigation was to establish an animal model for studying fractionated intraarterial treatment of a rabbit kidney VX-2 carcinoma. As repeated catheterizations and drug infusions may cause vascular lesions, we wanted to find whether the rabbit renal artery could be catheterized several times within a short period of time with acceptable iatrogenic vascular trauma. Each of 3 groups of rabbits with implanted renal VX-2 carcinoma were treated 3 times with either 1) temporary renal artery occlusion combined with infusion (occlusion infusion) of a) physiologic saline (OIS) or b) doxorubicin (OID), or 2) with renal artery infusion of doxorubicin. OID was administered in 20 of 21 attempts, OIS in 21 of 24, and infusion of doxorubicin in 20 of 21 attempts. Renal arterial spasm was seen in 5 of 22 rabbits, rarely at the first catheterization, more frequently during the second and third. Permanent iatrogenic vascular trauma occurred in 4 of 15 rabbits after the second and third occlusion infusion. We conclude that the rabbit kidney with implanted VX-2 carcinoma may be a useful model for testing fractionation schemes for multiple intraarterial infusions of antineoplastic drugs.     

Effects of the type of embolization particles on carboplatin concentration in liver tumors after transcatheter arterial chemoembolization in a rabbit model of liver cancer

PURPOSE: To study the effect of particle type used during transarterial hepatic chemoembolization (TACE) on carboplatin concentration after TACE in an animal model of liver cancer (VX2) and to determine the concentration of carboplatin within tumor, liver, and plasma. MATERIALS AND METHODS: The VX2 tumors were grown in the livers of 23 rabbits. Carboplatin (5 mg/kg) was selected because of its known potency against VX2 tumor. Group 1 was treated with TACE with tris-acryl gelatin microspheres (100-300 microm), group 2 was treated with TACE with polyvinyl alcohol (PVA; 150-250 microm), group 3 (control) was treated with intraarterial saline solution, and group 4 (pharmacokinetic) was treated with intraarterial carboplatin. Animals were killed after 48 hours, and concentrations of carboplatin were measured by atomic absorption spectroscopy from samples of blood and liver (central and peripheral zones of tumor and nontumorous liver tissue). RESULTS: In group 1 (tris-acryl gelatin microspheres) and group 2 (PVA), the mean carboplatin concentrations were 117 microg/g and 31.8 microg/g, respectively, within the central zone of the tumor and 38.5 mug/g versus 7.9 microg/g, respectively, in the peripheral zone. No carboplatin was detected in nontumorous liver tissue and plasma concentrations were low in both treated groups (<0.079 microg/mL). CONCLUSIONS: Carboplatin concentration was significantly greater (by a factor of two to four) within the central zone of the tumor compared with the peripheral zone in both treated groups. The overall tumor carboplatin concentrations were significantly greater in the tris-acryl gelatin microsphere group than in the PVA group (P < .001), which could translate into greater potency and tumor kill. Administration of tris-acryl gelatin microspheres may be clinically advantageous during TACE, as it contributed to greater delivery of chemotherapy to tumor in the present study.     

Simplified intraarterial infusion and angiographic method for rabbit VX-2 hind limb tumor via the saphenous artery

We developed a new simplified intraarterial infusion and angiographic method for rabbit VX-2 hind limb tumors. A 24 gauge cannula was placed in the saphenous artery of the tumor-bearing leg (not supplying the tumor) and used for intraarterial drug infusion or angiography. This method has several advantages as follows: 1) easy and time-saving in manipulation (about 15 minutes per a rabbit); 2) selective drug infusion into the tumor-supplying artery without fluoroscopy; 3) sequential follow-up angiographies available for weeks.     

Local toxicity of hepatic arterial infusion of hexokinase II inhibitor, 3-bromopyruvate: In vivo investigation in normal rabbit model

RATIONALE AND OBJECTIVES: 3-Bromopyruvate (3-BrPA), an hexokinase II inhibitor, is known to have high necrotic rate in hyperglycolytic liver tumor models without apparent damage to the normal liver parenchyma. The toxicity of intra-arterial delivery of 3-BrPA in various concentrations has not been specifically investigated using a normal rabbit model. MATERIALS AND METHODS: Twenty rabbits treated with intra-arterial 3-BrPA were divided into four groups according to its dose and infusion level: 1 mM at the left hepatic artery (group I), 5 mM at the left hepatic artery (group II), 25 mM at the left hepatic artery (group III), and 25 mM at the common hepatic artery (group IV). After selective catheterization, 30 ml of 3-BrPA was infused for 2 minutes. As a control group, five rabbits were treated with normal saline. During 1-week follow-up, toxicities were evaluated with blood laboratory results, mortality, and histopathologic examination. RESULTS: All 10 rabbits treated with 25 mM 3-BrPA and 2 rabbits treated with 5 mM 3-BrPA died within 3 days after treatment. In 10 of the 12 deaths, hemorrhagic pyloric or duodenal necrosis was noted. Hepatotoxicities on blood laboratory results were dose dependent but transient in the surviving rabbits. CONCLUSION: Selective intra-arterial administration of 25 mM 3-BrPA can cause considerable toxicities not only in the liver but also in the gastrointestinal system and are dose dependent and can cause death in high doses.     

Experimental intra-arterial administration of SR-2508 in the rabbit V2 carcinoma model

The use of the nitroimidazole radiation sensitizers, misonidazole and SR-2508, has been limited by a variety of side-effects, principally peripheral neuropathies. In order to increase the effectiveness of radiosensitization and thereby reduce the administered dose of the sensitizers, intra-arterial delivery of SR-2508 was performed and followed with 10 Gy of 4 MeV photon beam radiotherapy in the rabbit V2 carcinoma tumour model. Comparison was made with rabbits treated with an identical dose of SR-2508 given intravenously prior to photon beam radiotherapy. Control animals were treated with radiation therapy only, intra-arterial SR-2508 only, or had no treatment. Neither the radiation therapy alone nor the SR-2508 alone had any effect on tumour growth. In the intra-arterial group, the tumour growth was slower and the size was significantly smaller than all other groups. The results suggest that the intra-arterial infusion of the radiation sensitizer produces greater response of the tumour than intravenous infusion when each is combined with radiation therapy.