高强度聚焦超声联合放射治疗对猪胰腺及超声声窗组织与脏器损伤作用的观察研究

目的观察高强度聚焦超声(HIFU)联合放射治疗对猪胰腺目标的治疗作用及腹部声窗上组织和脏器的损伤情况。方法实验猪共12头,每组3头,分为对照组、HIFU组、放疗组和联合治疗组(HIFU与放疗)。放射治疗及HIFU治疗均参照临床治疗参数进行,对大体标本根据不同损伤程度评为0～3分,组织病理学根据细胞变性坏死情况分为0～4分进行评分,根据损伤及评分情况评价胰腺目标及超声和放射治疗通路上组织、器官的损伤情况。结果 (1)胰腺损伤病理观察评分结果:联合治疗组评分值高于HIFU组,两组评分结果比较差异有统计意义(t=4.161,P=0.003)。(2)胃壁损伤病理观察评分结果:联合治疗组评分值略高于HIFU组及放疗组,但评分结果比较差异无统计学意义。(3)肠壁损伤病理观察评分结果:联合治疗组及放疗组评分值均高于HIFU组,评分结果比较差异有统计学意义(t=2.827,P=0.022),联合治疗组与放疗组评分结果比较差异无统计学意义。各组实验动物耐受性好,未发生严重并发症。结论与HIFU组及放疗组相比,对活体猪行HIFU联合放射治疗增加了在体胰腺组织的治疗性损伤作用;但HIFU联合放疗治疗未增加HIFU对非目标区组织的损伤,主要损伤表现与放射治疗有关。     

高强度聚焦超声辐照猪胰腺实验研究

目的探讨改善胰腺HIFU辐照超声通道的方法,并了解不同能量HIFU辐照对猪胰腺组织的损伤及对胃肠道的影响。方法以2头新鲜离体猪胰腺和16头在体猪胰腺体部为靶目标,活体实验中,HIFU辐照前在12头猪胃内放置球囊并注入800~1200ml脱气水,分别以高、中、低能量HIFU进行辐照,4头猪未放置球囊并以中等能量辐照,通过光镜和电镜检查观察胰腺病理损伤程度,并观察副损伤发生情况。结果胃内放置水囊后高能量组4头猪胰腺凝固性坏死程度最重,1头发生皮肤烧伤,2头结肠坏死或穿孔,4头胃黏膜损伤;中等能量组4头猪胰腺凝固性坏死程度较轻,1头发生结肠坏死;低能量组胰腺组织凝固性坏死不明显,但电镜下可见细胞器损伤,1周后出现胰腺坏死现象,未发生皮肤、胃及结肠损伤;未放置水囊组4头猪中只有1头光镜下见胰腺点状坏死,皮肤、胃及结肠的损伤较放置水囊组明显加重。结论通过胃内放置水囊的方法可有效改善猪胰腺HIFU超声通道,高能量HIFU辐照猪胰腺更易发生凝固性坏死,但对胃、结肠的损伤较重;中低能量HIFU可引起猪胰腺发生多种形式损伤或坏死,损伤程度相对较轻,但相对安全。     

建立猪胰腺高强度聚焦超声通道的探讨

目的探索高强度聚焦超声（HIFU）辐照正常猪胰腺超声通道的建立方法，提高HIFU辐照胰腺的有效性和安全性。 方法以猪胰体部为HIFU靶目标进行辐照，实验组在猪胃内放置水囊并注入800～1200ml脱气水，对照组未放置水囊，通过病理和电镜检查比较两组之间胰腺损伤程度，并观察并发症发生情况。 结果实验组胰腺的HIFU超声通道明显改善，HIFU对胰腺组织的损伤程度较对照组重，同时HIFU对超声通道的损伤较对照组轻。 结论胃内放置水囊并注入脱气水是建立猪胰腺HIFU超声通道的可行方法。     

急性胰腺炎胰腺内源性RAS的活化与局部微循环P选择素表达变化规律的研究

目的 :探讨急性胰腺炎 (AP)胰腺内源性肾素 -血管紧张素系统 (RAS)的活化与胰腺局部微循环中P选择素 (P -selectin)表达之间的关系 ,为进一步阐明AP时胰腺局部微循环损伤的机制提供实验依据。方法 :采用放免、流式细胞分析、免疫组化等方法检测胰腺急性炎症时局部微循环血浆及胰腺局部组织AngⅡ的含量变化、血小板以及胰腺血管内皮细胞P -selectin的表达。结果 :急性胰腺炎的疾病过程中 ,胰腺局部微循环血浆及局部组织AngⅡ的含量明显增加 ,血小板以及胰腺血管内皮细胞P -selectin的表达随病程的进展显著上调 ,局部组织AngⅡ含量的变化与血小板及血管内皮细胞P -selectin的表达呈显著性正相关 ,(r =0 6 5 2 ,P <0 0 5 ;r =0 5 4 8　P <0 0 5 )。结论 :胰腺内源性RAS可能参与了AP早期微循环损伤的病理过程     

3.0TMR动态增强扫描对正常胰腺及胰腺癌的定量分析

目的 对正常胰腺和胰腺癌患者的3.0T MR快速三维动态增强扫描序列进行定量分析,探讨其对胰腺癌诊断的临床应用价值.方法 对34例经病理证实的胰腺癌患者(胰腺癌组)及31例非胰腺疾病患者(对照组)行全胰腺LAVA九期动态增强序列扫描,将所得数据传至ADW 4.2工作站处理,分别测量对照组胰腺的头、体、尾及胰腺癌组病变区域及非病变区域的30 s强化率(SER_(30))、90 s强化率(SER_(90))、阳性强化积分值(PEI)、达峰时间(TTP)、最大强化斜率(MSI),并进行t检验.结果 对照组胰腺头、体、尾的SER_(30)、SER_(90)、PEI、TTP及MSI差异无统计学意义.胰腺癌组病变区与非病变区的SER_(30)、PEI、TTP、MSI差异均有统计学意义.对照组任意区域与胰腺癌组非病变区域或病变区域的TTP差异有统计学意义.结论 正常胰腺的不同部位间无灌注差异,胰腺癌病变区域与非病变区域的灌注差异可以反映癌组织浸润范围.胰腺癌非病变区域与正常胰腺间TTP的差异可能反映潜在病变的可能.     

25～45Gyγ射线辐照对红细胞制品质量的影响

目的　研究不同剂量辐照对红细胞的活性及功能的即刻损伤及保存损伤 ,确定辐照血液的保存时间。方法　将CPDA 全血 4 0 0ml分成 4组 ,于采血后 1d进行 0 (为对照组 )、2 5、35、4 5Gyγ射线辐照。在辐照后 0、4、7、1 4、2 1、2 8、35d取样测定红细胞活性、功能指标。结果　 0～ 35d保存过程中 ,①红细胞功能 :各辐照组的 2 ,3 DPG含量与对照组比较均无显著性差异 (P >0 .0 5 ) ;②红细胞活性 (ATP含量 ) :2 5Gy辐照组在 35d保存过程中与对照组差异无显著性 (P >0 .0 5 ) ;35、4 5Gy组分别于 35d(84 .7% )及 2 8d(83.6 % )起低于对照组 (P <0 .0 5 ) ;③红细胞脆性 :红细胞最小抵抗力 ,2 5、35、4 5Gy组分别自 35、2 8、2 1d起低于对照组 (P <0 .0 5 ) ;红细胞最大抵抗力 ,保存过程中 2 5Gy组与对照组差异无显著性 (P >0 0 5 ,35、4 5Gy组分别自 35及 1 4d起低于对照组 (P <0 .0 5 ) ;④游离K+ :2 5Gy组自辐照后 1d ,35、4 5Gy组自辐照后 0d起即高于对照组 (P <0 .0 5 ) ;K+ 含量与剂量呈正相关性 (r为 0 .96 6～ 0 .999) ;⑤游离血红蛋白 :在保存过程中显示出一定的剂量关系 ,但差异尚无统计学意义。结论　辐照对红细胞有一定的损伤 ,损伤程度与剂量有一定的相关性 ,但总体来说损伤不大 ,对红细胞活性     

高强度聚焦超声介导脂质体pEGFP-N1质粒转染胰腺癌细胞的实验研究

目的通过观察高强度聚焦超声(HIFU)介导脂质体增强型绿色荧光蛋白质粒pEGFP-N1转染辐照后残余活细胞的效率,探讨HIFU联合基因治疗胰腺癌的可行性。方法 HIFU辐照胰腺癌PANC-1、CFPAC-1细胞,热电偶测温仪记录温度变化,锥虫蓝染色试验检测辐照后即刻杀伤效应,CCK-8试剂盒测定存活细胞生长曲线。辐照后立即加入脂质体pEGFP-N1质粒转染48h,荧光显微镜观察存活细胞中GFP瞬间转染阳性率。比较在不同发射功率及时间作用下温度、细胞活力与转染效率变化特征。结果辐照功率30、50、70W/cm2的平台期温度及达到平台期时间分别为47℃、61s,62℃、44s,82℃、33s。在辐照功率为70W/cm2、辐照10s时温度为56.51℃。胰腺癌PANC-1、CFPAC-1细胞即刻活力分别为(85.91±2.23)%、(84.35±1.65)%;辐照后48h存活细胞的增殖抑制率分别为56.47%、44.60%;存活细胞中脂质体pEGFP-N1质粒瞬间转染率分别为(68.31±2.61)%、(65.85±6.70)%,较对照组分别增加3.7倍和4.3倍。两株细胞在温度变化、细胞破坏、细胞增殖及抑制、质粒转染效率等方面没有统计学差异。结论 HIFU在灭活胰腺癌细胞的同时,可促进辐照区域存活细胞的基因转染,HIFU联合基因治疗具有可行性。     

高强度聚焦超声对SD大鼠感染耻垢分枝杆菌病灶损伤效应的实验研究

目的探究高强度聚焦超声(HIFU)对SD大鼠感染耻垢分枝杆菌(MS)结核动物模型的损伤效应。方法 20只SD大鼠臀部皮下分别注射MS悬液1 ml建立感染MS结核动物模型。选取10只成功建立模型的SD大鼠分为HIFU组和对照组,每组5只。HIFU组行HIFU辐照15 s(频率1 MHz,声强6369 W/cm2);对照组行假照15 s(频率1 MHz,声强0 W/cm2)。观察两组辐照前后结节B超灰度变化。对结节组织分别进行HE染色和抗酸染色,光学显微镜下观察结节组织病理变化;激光共聚焦显微镜及扫描电镜下观察HIFU辐照对结节的损伤效应。结果 HIFU组HIFU辐照前后SD大鼠结核结节的B超灰度值比较差异有统计学意义(P=0.004);对照组辐照前后结节的B超灰度值无明显变化。HE染色:对照组光学显微镜下见皮肤组织结构完整,皮肤附件结构正常,未发现明显的炎症浸润;HIFU组光学显微镜下见皮肤组织结构完整,真皮层组织未见损伤,皮肤附件正常,炎性细胞浸润加重,呈急性损伤表现。抗酸染色:对照组中MS聚集成团,HIFU组中MS较分散,呈短棒状。对照组和HIFU组MS存活率分别为93.61%和48.60%。经HIFU辐照后,MS菌体表面变得粗糙,菌体细胞壁破裂。结论一定剂量的HIFU辐照能有效抑制SD大鼠感染MS的结核结节,有望成为治疗结核病的新方法。     

巯基物质对大鼠急性坏死性胰腺炎胰腺细胞保护作用

目的：探讨巯基物质在胰腺细胞损伤中的变化及外源性巯基物质对胰腺细胞的保护作用。方法：Wistar大鼠（n=105)随机分为三组，A组为急性坏死性胰腺炎模型组（ANP）（5％牛磺胆酸钠逆行胰胆管注射），B组为硫普罗宁（巯基物质）预先处理组，C组为正常对照组，三组动物分别于2、4、6、12、24h杀死，检测胰腺组织巯基包括总巯基（TSH）、非蛋白巯基（NPSH）、蛋白巯基（PSH）、丙二醛（MDA）、血清淀粉酶（SAm)、C反应蛋白（CRP）水平，并观察胰腺组织细胞形态学改变。结果：A、B两组均有SAm和CRP水平的升高，病理组织学上有相应的ANP变化；A组胰腺组织的TSH、NPSH、PSH明显下降（P＜0．01），MDA显著升高（P＜0．01）；B组则NPSH下降幅度较小，4，6h与A组比较，差异有显著性（P＜0．05），MDA几乎无升高。结论：ANP时胰腺组织巯基化合物显著下降，巯基物质是参与胰腺细胞保护的重要部分，外源性巯基物质可作为氧自由基清除剂保护胰腺细胞。     

高强度聚焦超声照射正常离体心肌组织的实验研究——局部心肌的凝固损伤范围与声辐照剂量的关系

目的　探讨高强度聚焦超声 (HIFU)非侵入性凝固局部心肌组织的能量 -效应关系。方法　采用不同强度 (110 0 0W /cm2 、15 80 0W /cm2 和 2 2 2 0 0W /cm2 )的HIFU ,在不同辐照时间 (1s、3s、5s和 8s)的作用下 ,对 2 0只正常猪离体心脏进行定位损伤 ,观察并测定损伤区的形态及体积 ,损伤区及其与周围正常组织交界处的组织同时送病理学检查。结果　不同剂量下HIFU所致的损伤体积范围分布在 (11.2± 1.9)mm3 ～(2 83 .2± 4.5 )mm3 之间 ,不同处理因素间的损伤体积差异具有显著性意义 (P <0 .0 5 )。损伤形态随剂量增大趋向不规则。组织学观察可见损伤区与周围正常组织分界明显。结论　HIFU可有效地使心肌组织发生凝固性坏死 ,但不侵及周围组织     

HIFU联合金属胆道支架置入治疗胰腺癌的初步临床观察

目的探讨HIFU联合金属胆道支架置入治疗胰腺癌的安全性和有效性。 方法8例肝外胆道梗阻和疼痛患者支架减黄后HIFU治疗。治疗后1、3、7d分别行肝功、血糖、血尿淀粉酶、大便常规及隐血检查。HIFU后腹部X-片、CT或MRI随访。 结果HIFU后8例中7例疼痛减轻,其中6例疼痛控制满意。所有患者无黄疸加重和淀粉酶、大便异常。腹部X-片、CT随访,无支架变形、移位、闭塞。增强MRI随访,3例肿瘤完全坏死,2例坏死体积〉80%,2例坏死体积〉50%,1例坏死体积〈50%。 结论HIFU联合金属胆道支架置入治疗胰腺癌是安全、有效的,是肝外胆道梗阻胰腺癌可选择的一种局部治疗方法。     

Effect of emeriamine on exocrine and endocrine pancreatic function in normal and diabetic rats.

The effects of emeriamine, a new anti-diabetic drug, on exocrine and endocrine pancreatic function in normal and diabetic rats have been studied both in vivo and in vitro. It was found that emeriamine dose-dependently normalized the symptoms of hyperingestion and hyperposia in streptozotocin (STZ)-induced diabetic rats, with fasting glucose levels significantly decreased and insulin levels not changed. In STZ-induced diabetic rats, there was a significant increase in pancreatic lipase and trypsin contents and a sharp decrease in amylase content. These changes in lipase and trypsin, but not in amylase were normalized by administration of emeriamine. In the normal rat, emeriamine had no effect on either serum glucose or insulin levels, but significantly decreased the pancreatic amylase, lipase as well as trypsin contents by 68%, 58% and 51%, respectively. In vitro, emeriamine (10(-8) - 10(-4) mol l-1) had no effect on enzyme release from pancreatic acini either under basal or carbachol-stimulated conditions. Emeriamine inhibited glucose-induced insulin release from isolated pancreatic islets. In conclusion, emeriamine has an inhibitory effect on synthesis of pancreatic enzymes and on glucose-stimulated insulin release.     

Nordkem–An organization to promote the collaboration between clinical laboratories in the Nordic countries

The effects of emeriamine, a new anti-diabetic drug, on exocrine and endocrine pancreatic function in normal and diabetic rats have been studied both in vivo and in vitro. It was found that emeriamine dose-dependently normalized the symptoms of hyperingestion and hyperposia in streptozotocin (STZ)-induced diabetic rats, with fasting glucose levels significantly decreased and insulin levels not changed. In STZ-induced diabetic rats, there was a significant increase in pancreatic lipase and trypsin contents and a sharp decrease in amylase content. These changes in lipase and trypsin, but not in amylase were normalized by administration of emeriamine. In the normal rat, emeriamine had no effect on either serum glucose or insulin levels, but significantly decreased the pancreatic amylase, lipase as well as trypsin contents by 68%, 58% and 51%, respectively. In vitro, emeriamine (10^?8-10^?4 mol l^?1) had no effect on enzyme release from pancreatic acini either under basal or carbachol-stimulated conditions. Emeriamine inhibited glucose-induced insulin release from isolated pancreatic islets. In conclusion, emeriamine has an inhibitory effect on synthesis of pancreatic enzymes and on glucose-stimulated insulin release.     

Orthotopic pancreas transplantation with portal venous drainage in rats Surgical technique and metabolic effects

Heterotopic pancreas transplantation in type I diabetic patients does not correct hyperglucagonemia, which is thought to be due to insufficiently suppressed glucagon release by the host pancreas. The diabetogenic effects of glucagon then have to be corrected by higher than normal insulin secretion from the transplant, with the attendant risk of earlier loss of islet cell function, and development of atherosclerosis. To establish whether this situation can be prevented, we investigated glucose homeostasis and blood lipids, as well as fecal fat and chymotrypsin as indicators for pancreatic exocrine function 14 weeks after orthotopic pancreas transplantation in inbred rats. The pancreas was resected before orthotopic transplantation of the donor pancreas with portal venous drainage (n=8). Laparotomized animals served as controls (n=8). Basal plasma glucagon, basal plasma insulin to glucagon molar ratio, and basal and integrated incremental responses of plasma glucose, insulin, and C-peptide after an oral glucose load (2 g/kg body weight) were similar in both groups. However, hepatic insulin clearance was slightly but significantly lower in the transplanted group (1.1± 0.1 vs 1.6±0.2; P<0.05). Basal plasma levels of free fatty acids, phospholipids, triglycerides, cholesterol, low-density lipoproteins, and high-density lipoproteins were unchanged after transplantation. Also unchanged were fecal fat and chymotrypsin levels, thus indicating preserved pancreatic exocrine function. We concluded that orthotopic pancreas transplantation with portal venous drainage achieves almost optimal metabolic control with respect to endocrine and exocrine pancreatic function as well as blood lipids. This technique could therefore be used to treat combined endocrine and exocrine     

Discrepancies between the Doses of Cholecystokinin or Caerulein-Stimulating Exocrine and Endocrine Responses in Perfused Isolated Rat Pancreas

The effects of highly purified natural porcine cholecystokinin (CCK) and synthetic caerulein on the rate of flow of pancreatic juice, the rate of output of amylase, and the rate of release of immunoreactive insulin (IRI) and immunoreactive glucagon (IRG) were simultaneously investigated in the isolated perfused rat pancreas.The maximal flow rate of pancreatic juice was obtained with concentrations of CCK ranging from 0.5 to 10 mU/ml, whereas amylase output was maximal at CCK concentrations from 1 to 10 mU/ml. Caerulein at concentrations of 0.05-1 ng/ml induced a similar maximal flow rate and amylase secretion. Supramaximal stimulatory concentrations of these peptides resulted in lower rates of release of fluid and amylase than with the maximally effective concentrations. Stimulation of IRI and IRG release was elicited only with concentrations of peptides supramaximal for effects on the exocrine responses.The demonstration of very similar discrepancies between the doses of caerulein required to elicit maximal exocrine responses and those required to elicit endocrine responses provide strong evidence that the pattern of the effect of the porcine CCK is accounted for by CCK itself.Although caerulein had no influence on IRI response when superimposed on 100 or 150 mg/100 ml glucose stimulation, preperfusion of caerulein led to a significant enhancement of IRI response to a subsequent glucose stimulation in both phases. The augmentation effect was completely separate from the direct IRI-stimulating effect of caerulein, because the CCK-like peptide requires no glucose for insulinotropic action.Because the concentrations of the peptides necessary for stimulation of endocrine responses were inhibitory in their effects on exocrine responses, it may be inferred that it is unlikely that the endocrine effect is physiologically important, though the results of caerulein for augmenting glucose-stimulated IRI release suggests a possible role for CCK in carbohydrate metabolism.     

The perfused porcine pancreas as a model for testing organ protective solutions

The present study was designed to establish an in vitro perfused porcine pancreas preparation as a model for testing the effect of organ protective solutions on stimulated pancreatic endocrine and exocrine secretion. The pancreas was prepared and perfused for 10 min with Euro Collins solution, thereafter it was stored in the cold (4 degrees C) for various times. After 3-h and 6-h ischemia pancreatic insulin release in response to glucose was not significantly affected. After 12-h ischemia reduced pancreatic insulin secretin, increased perfusion pressure, and increased amylase and lipase release indicated pancreatic damage. Complete pancreatic dysfunction was seen after 24-h and 48-h ischemia with massive increase in perfusion pressure and low insulin secretion which did not follow a glucose-dependent release pattern, while amylase and lipase concentrations in the perfusion medium increased. Stimulated exocrine pancreatic secretion was significantly decreased already after 3-h ischemia and completely lost after 12 h.     

清胰汤对轻症急性胰腺炎的临床疗效及对炎症因子的影响

目的观察中药复方清胰汤对轻症急性胰腺炎（MAP）的临床疗效及对血清炎症因子水平的变化,并探讨中药复方清胰汤治疗MAP的可能机制。方法对MAP患者随机分为两组,对照组采用单纯西医疗法,治疗组在西医治疗基础上给予清胰汤口服;另选健康者20例,作为正常对照组。取外周血检测血淀粉酶,并检测肿瘤坏死因子（TNF-α）、白介素-6（IL-6）、超敏C．反应蛋白（hs—CRP）。结果MAP患者治疗组总有效率高于MAP患者对照组（P〈0．05）。治疗第3天开始两组的血淀粉酶均较治疗前明显下降（P〈0．05）;治疗第5天开始治疗组的血淀粉酶显著低于对照组（P〈0．05）。治疗组患者腹痛、腹胀、排气、通便等症状和体征,以及血淀粉酶恢复正常的时间、住院时间均少于对照组（P〈0．05）。对照组和治疗组治疗前的TNF-α、IL-6、hs．CRP水平较正常组均显著升高（P〈0．05）;治疗7d后治疗组的TNF-α、IL-6、hs-CRP水平均显著低于治疗前,并显著低于同期对照组（P〈0．05）。结论清胰汤联合西医治疗MAP疗效较好,能减轻患者症状和体征,降低血淀粉酶,作用机制可能与抑制炎症因子释放及减轻炎症因子的级联瀑布效应有关。     

生长抑素联合白蛋白治疗急性胰腺炎患者的效果及对胰腺功能和免疫功能的影响

目的 观察生长抑素联合白蛋白治疗急性胰腺炎(acute pancreatitis,AP)患者的效果及对胰腺功能和免疫功能的影响.方法 回顾性分析采用生长抑素联合白蛋白治疗(观察组)及采用生长抑素治疗(对照组)的AP各38例的临床资料.观察比较两组临床症状消失时间,治疗后临床效果,治疗前后内皮功能、胰腺功能及免疫功能指标...     

Elevated serum levels of pancreatic secretory proteins in cigarette smokers after secretin stimulation.

The secretory pancreatic proteins in serum were analyzed in a group of cigarette smokers and a control group of nonsmokers before and after intravenous secretin stimulation. None of these persons had any signs of pancreatic disease. In the control group, serum total amylase activity, pancreatic isoamylase, cationic trypsinogen, and pancreatic secretory trypsin inhibitor concentrations varied within the normal range before and after secretin injection. In contrast, the concentrations of these pancreatic proteins in all the cigarette smokers elevated from normal to abnormally high serum concentrations after secretin stimulation. The results indicate a probable toxic effect of cigarette smoking on the exocrine pancreas.     

高强度聚焦超声联合吉西他滨治疗不可手术切除的胰腺癌临床效果观察

目的探讨高强度聚焦超声（HIFU）消融热疗联合吉西他滨静脉滴注化疗治疗不可手术切除的胰腺癌的有效性及安全性。方法41例不可手术切除的胰腺癌患者随机分为两组,实验组21例和对照组20例。实验组采用HIFU联合吉西他滨静脉滴注化疗治疗;对照组单纯接受HIFU治疗。比较两组的临床治疗效果、临床受益率、肿瘤标记物CA19-9的变化及治疗过程中的不良反应。采用Kaplan—Meier法进行生存分析（中位生存时间,6个月生存率及12个月生存率）,Log—rank法检验生存率。结果实验组中位生存时间为10．22个月,6个月及12个月的生存率分别为76．2％（16／21）和42．9％（9／21）;对照组中位生存时间为7．43个月,6个月及12个月的生存率分别为50．0％（10／20）和15．0％（3／20）,实验组12个月生存率优于对照组,差异有统计学意义（χ^2=4．00,P〈0．05）。实验组临床受益率76．2％（16／21）优于对照组的45．0％（9／20）,差异有统计学意义（χ^2=4．20,P〈0．05）;实验组疼痛缓解率66．7％（14／21）较对照组的45．0％（9／20）为高,但差异无统计学意义（P〉0．05）。治疗后2、3、4、5、6个月实验组血清肿瘤标志物CA19-9与对照组比较差异有统计学意义（t值分别为2．225、2．133、1．743、2．599、2．278,P均〈0．05）。结论HIFU联合吉西他滨静脉滴注化疗较单纯应用HIFU治疗疗效为优,具有更好的临床疗效。