超声检查在肝胆胰手术中的应用

Objective： To explore the reference value of intraoperative ultrasonography in the operative procedure and postoperative treatment with relation to hepatopancreatobiliary surgery. Methods： 103 cases of hepatopancreatobiliary operations were collected in our hospital from January 1996 to October 2005, in which 68 cases were males and the others were females, age ranged from 45 to 76 years. Hepatocellular carcinoma were 26 cases, gallbladder carcinoma were 5 cases, cholangiocarcinoma were 6 cases, pancreatic carcinoma were 10 cases and other 56 cases were gall stone and/or choledocholithiasis. Intraoperative ultrasonography with high frequency probe was used in all cases. Results： Some minimal occult focuses was found by intraoperative ultrasonography. We found vascular tumor thrombosis in 70% cases of hepatocellular carcinomas. One case was diagnosed as pancreatic carcinoma before operation and found choledochal tract dilatation concurrently with cholangitis by intraoperative ultrasonography. Eight cases of gallstones with no choledochal stones before operation were found by intraoperative ultrasonography that stone lain in low segment of common bile duct. Conclusion： The image data of high quality obtained by intraoperative ultrasonography could not only direct our more proper operative practice but also favor us to make more reasonable postoperative treatment plan.     

超声检查在肝胆胰手术中的应用

目的:探讨术中应用超声高频率探头检查方法在肝胆胰手术中的价值。方法:1996年~2005年10月选择肝胆胰手术103例,其中男性68例,女性35例,年龄45~76岁;肝癌26例,胆囊癌5例,胆管癌6例,胰腺癌10例,胆囊结石及胆总管结石56例,术中应用超声高频率探头检查。结果:术中发现术前超声检查未发现的微小病灶及发现肝癌患者中有70%左右伴有血管内肿瘤栓子。另1例术前诊断为胰头癌,经术中超声检查为胆总管囊性扩张合并炎症。胆管结石患者8例,术前超声检查胆总管无异常,术中超声发现胆总管下段结石。结论:术中应用超声高频率探头检查获得高质量的影像,探察目标更为清晰,对术中及术后治疗方案有重要指导意义。     

乳腺超声检查新技术的临床应用进展

乳腺癌是女性常见的恶性肿瘤之一,早期发现和治疗乳腺癌,是提高患者生存和预后,降低死亡率的关键。现有的乳腺辅助检查包括红外线、超声多普勒、钼靶X线及MRI等,其中高频彩色多普勒因其安全性高、操作简便、无放射性、费用经济及可重复性,在乳腺检查的过程中,可以根据乳腺组织不同成分的声学特性产生不同的反射及散射图像,得到层次丰富的解剖和病理细节,已成为中国乳腺疾病筛查的首选方法,在乳腺肿瘤的早期发现、乳腺肿块性质判定及介入性诊断穿刺过程中发挥重要作用。     

TRAIL在肿瘤临床研究中的应用进展

摘 要：TRAIL是肿瘤坏死因子（tumor necrosis factor,TNF）超家族成员之一,可作为抗肿瘤因子选择性诱导肿瘤细胞发生凋亡。由于TRAIL在诱导肿瘤细胞凋亡的同时对正常细胞无明显毒副作用,所以临床上TRAIL被用于多种癌症的治疗且已取得显著的成果。但TRAIL的临床治疗效果渐渐受到体内半衰期短、靶向性差等因素的限制,导致一些癌细胞对TRAIL产生抗性,进而限制其在临床上的应用。因此,人们对TRAIL与递送载体和敏化剂的联合应用进行研究,以此增强其敏感性和靶向杀伤癌细胞的能力。全文对临床治疗中TRAIL与其递送载体及敏化剂联合应用的进展进行综述。     

骨质疏松症的临床及研究进展(二)有关生物力学的骨生理与骨质疏松

如果说,能够支持我们的身体以及与其他组织协作产生运动是骨骼的基本生理作用之一。那么我们在研究骨骼生理学和研究骨骼异常     

超声造影在浅表淋巴结疾病诊断中的应用及进展

浅表淋巴结（头颈、锁上、腋窝、腹股沟）肿大在临床上很常见,全身性和局部性感染、结核、淋巴瘤和转移癌等都可表现为淋巴结肿大。目前用于评价浅表淋巴结肿大病变常用的影像学方法包括CT、MRI、正电子发射计算机断层显像（PET）及超声（US）,其中US以其检查方便、经济、     

超声造影在乳腺肿瘤诊断中的应用及进展

超声造影（contrast-enhanced ultrasound,CEUS）是通过静脉注射造影剂来增加组织血管的对比度,实时动态显示组织器官和肿瘤微血管的形态、结构及分布特征,增加组织器官和病变显示,提高微细血管的检出率和肿瘤诊断的准确率。目前,CEUS已在乳腺肿瘤鉴别诊断、组织活检、新辅助化疗疗效评估、乳腺癌术后瘢痕与肿瘤复发等方面得到一定的应用。本文将对超声造影在乳腺肿瘤诊断中的应用及进展进行综述。     

日本早期胃癌临床研究进展(二)

2.8EMR临床研究进展2.8.1EMR适应证的扩大与分割切除EMR作为早期胃癌的微创外科治疗方法,其根治性是非常重要的。对于EMR适应证的扩大,有多种多样的分歧。但实际上,日本国立癌中心及癌研究会附属病院已经将其适应证扩大,并在临床上研究应用。分化型M癌,UL(-),肿瘤大小≤5.0cm且     

日本早期胃癌临床研究进展(一)

日本是世界上胃癌发病率最高的国家之一。到目前为止,其病因尚不完全明确。但在日本,由于市民公开讲座的普及及推广,社区医疗体系的建立及完善,消化道内视镜的普及及应用,对高危人群及易患人群的定期筛查,早期胃癌的诊断率明显提高。早期胃癌的诊断率达45%~55%。日本胃癌的临床     

超声检查在肺癌术前和术中的应用

术前经食管超声检查(EUS)和术中超声检查(IUS)能准确估计原发性肺癌浸润邻近脏器的范围,为术前分期、可手术性及切除范围提供重要的帮助。作者探讨了此两种技术用于肺癌手术的诊断灵敏性、特异性和准确性。EUS纵隔浸润的阳性诊断标准包括:(1)超声显示肿瘤浸润纵隔脏器;(2)邻近脏器的组织结构层变形或消失;(3)实时观察时肿瘤不随正常呼吸及心脏跳动活动。具有其     

骨质疏松性骨折的研究进展

骨折是骨质疏松最常见的并发症。随着人口老年化的形成,骨质疏松性骨折对个人乃至于社会造成了很大的影响。在老年人当中,近端肱骨、前臂、腕部骨折约占了骨质疏松性骨折的1/3。在美国,25％的绝经期妇女会发生骨质疏松性骨折。在澳大利亚的Dubbo,1989-1996年对60岁以上患者的随访资料表明,每一万人年中,肱骨以及前臂和腕部的骨折发生率,在男性中分别是22.6和33.8,在女性中分别是54.8和124.6。髋部骨折在这些骨折中是花费最多的,预计到2050年,仅治疗这种骨折,全世界就要花费1.31×1011美元;其发病率在高加索人中最高,亚洲人其次,黑人中最低。其中,股骨近端骨折的致残率、致死率及在医疗上的费用往往超过其他类型的骨质疏松性骨折。在这种骨折中,男女比例大约是3.3:1。骨质疏松性骨折有如下临床特点:(1)绝大多数为老年人,55岁以     

The use of gene therapy in cancer research and treatment

Gene therapy involves identifying a gene of interest and then manipulating the expression of this gene through a variety of techniques. Here we specifically address gene therapy's role in cancer research. This paper will encompass thoroughly investigated techniques such as cancer vaccines and suicide gene therapy and the latest advancements in and applications of these techniques. It will also cover newer techniques such as Antisense Oligonucleotides and small interfering RNAs and how these technologies are being developed and used. The use of gene therapy continues to expand in cancer research and has an integral role in the advancement of cancer treatment.     

乳腺癌新辅助化疗的临床研究进展

乳腺癌是全身性疾病,通过手术、放疗、化疗、内分泌等综合治疗可提高疗效。近年乳腺癌新辅助化疗（NCT）引起了肿瘤学界极大的兴趣,一系列的临床研究都希望这一疗法不但能提高保乳,而且能延长总生存期。现就NCT在乳腺癌治疗中的研究进展作一综述。     

Progress in treatment and risk stratification of neuroblastoma: impact on future clinical and basic research

Close international collaboration between pediatric oncologists has led to marked improvements in the cure of patients, seen as a long-term overall survival rate of about 80%. Despite this progress, neuroblastoma remains a challenging disease for both clinicians and researchers. Major clinical problems include lack of acceptable cure rates in high-risk neuroblastoma and potential overtreatment of subsets of patients at low and intermediate risk of the disease. Many years of intensive international cooperation have recently led to a promising joint effort to further improve risk classification for treatment stratification, the new International Neuroblastoma Risk Group Classification System. This approach will facilitate comparison of the results of clinical trials performed by different international collaborative groups. This, in turn, should accelerate refinement of risk stratification and thereby aid selection of appropriate therapies for individual patients. To be able to identify new therapeutic modalities, it will be necessary to elucidate the pathogenesis of the different subtypes of neuroblastoma. Basic and translational research have provided new tools for molecular characterization of blood and tumor samples including high-throughput technologies for analysis of DNA, mRNAs, microRNAs and other non-coding RNAs, as well as proteins and epigenetic markers. Most of these studies are array-based in design. In neuroblastoma research they aim to refine risk group stratification through incorporation of molecular tumor fingerprints and also to enable personalized treatment modalities by describing the underlying pathogenesis and aberrant signaling pathways in individual tumors. To make optimal use of these new technologies for the benefit of the patient, it is crucial to have a systematic and detailed documentation of both clinical and molecular data from diagnosis through treatment to follow-up. Close collaboration between clinicians and basic scientists will provide access to combined clinical and molecular data sets and will create more efficient steps in response to the remaining treatment challenges. This review describes the current efforts and trends in neuroblastoma research from a clinical perspective in order to highlight the urgent clinical problems we must address together with basic researchers.     

溶瘤病毒T-Vec应用于肿瘤治疗的临床研究进展

[摘要] T-Vec（talimogene laherparepvec）是由Ⅰ型单纯疱疹病毒（HSV-1）改造而来的一种溶瘤病毒,能够选择性地在恶性肿瘤细胞中复制而不伤及其他正常细胞。T-Vec 在治疗晚期黑色素瘤患者的Ⅲ期临床试验中显示出良好的安全性和肿瘤治疗效果,已于2015 年经美国FDA批准用于治疗晚期黑色素瘤。为了提高T-Vec 的疗效,扩大其应用范围,T-Vec 联合其他抗肿瘤疗法以及应用于其他肿瘤的临床试验仍在陆续开展。近期,T-Vec 联合免疫检查点抑制剂在治疗晚期黑色素瘤的临床试验中取得新进展,临床数据显示T-Vec 联合疗法具有更强的抗肿瘤活性。此外,T-Vec 在治疗头颈癌、胰腺癌、肝癌等肿瘤的临床研究中也取得了一定进展。本文对近年来T-Vec治疗肿瘤的临床试验的相关研究进展做一综述。     

Progress in anti-invasion and anti-metastasis research and treatment

Invasion and subsequent establishment of distant metastasis is the most life threatening consequence for patients with cancer. Last decade has seen a major expansion in our knowledge and the understanding of the molecular and cellular mechanisms in tumour invasion and metastasis. Such understanding may also lead to the exploration of anti invasion/metastasis strategies. Some agents have already shown early promise in combating these processes. This article summarises progress in the anti-invasion and metastasis research and treatment.     

地榆粉栓塞子宫动脉治疗子宫肌瘤的临床疗效

目的探讨子宫动脉中药地榆粉栓塞对子宫肌瘤的治疗效果。方法对32例子宫肌瘤患者行超选择性子宫动脉造影和栓塞治疗,并进行术后随访。其中随访3个月者4例,6个月者11例,24个月者17例。同时观察子宫肌瘤的血供情况,栓塞治疗疗效以及对患者生理、生育情况和肌瘤复发率的影响。结果子宫动脉造影显示子宫肌瘤以一侧动脉供血者75%,两侧动脉同时供血者21.88%,卵巢动脉参与供血者为3.12%。随访患者中,治愈者12.5%,显效者65.62%,有效者18.75%,无效者3.13%。有3例患者自然受孕或避孕失败而受孕。随访6~12个月,未见术后再发生肌瘤。结论地榆粉子宫动脉栓塞治疗子宫肌瘤较其它疗法更加安全、可靠,是一种行之有效的方法,特别是对粘膜下肌瘤的治疗,基本可达到治愈效果。     

Diagnostic potential of ultrasound examination for tumor recurrence and metastasis

Ultrasound examination was carried out in 252 patients following specific treatment of uterine and ovarian malignancies. To compare the effectiveness of diagnostic procedures, transabdominal and transvaginal examinations were performed in succession in all the patients using ultrasound (Doppler) technique. Transvaginal study proved relatively more sensitive (98.9%) and diagnostically accurate (97.2%) in detecting relapse. Transabdominal examination carried out in conjunction with color Doppler imaging was best for metastasis detection.