经皮肝穿刺射频消融治疗包膜下肝肿瘤与非包膜下肝肿瘤效用与安全性的前瞻性对照研究

目的评价经皮肝穿刺射频（RF）消融治疗包膜下肝肿瘤的效用与安全性。方法本研究经伦理委员会批准，所有受试者都签署了知情同意书。18t例病人（男79例，女102例，年龄36～85岁）的361个原发或继发（转移的）肝肿瘤进行了超声引导下的经皮RF消融治疗。44例病人有1个或1个以上包膜下肿瘤（组1），137病人仅有非包膜下肿瘤（组2）。总共80个包膜下结节和281个非包膜下结节。RF消融后1个月进行增强CT扫描评价消融的完整性。如果CT显示肿瘤残留，则再次进行RF消融。所有1次或2次RF消融治疗后的病人，每3个月进行CT或增强US进行监控。     

微波与射频消融治疗小肝癌的实验和临床研究的疗效分析

目的对使用改良后的微波(MW)消融与射频(RF)消融在活体猪肝脏和小肝癌(SHCC)病人中的前瞻性比较。方法在动物实验中,使用水冷轴探针或内部冷却电极在活体猪肝脏进行MW和RF消融。对两种消融方法的消融直径进行了比较。在临床研究中,42例小肝癌病人采用MW或RF治疗,在完全消融(CA)和肿瘤局部进展(LTP)方面进行了比较。结果 MW消融和RF消融在猪的肝脏和小肝癌的消融量分别为(33.3±15.6)cm3和(18.9±9.1)cm3、(109.3±58.3)cm3和(48.7±30.5)cm3,MW消融的消融范围更显著。MW消融和RF消融的CA率分别为95.5%(21/22)和95.0%(19/20)。在5.1个月的随访中,LTP率在MW消融组为18.2%(4/22),在RF消融组为15.0%(3/20)。结果使用改良后的MW消融比RF消融产生更大的消融范围,并且在肿瘤局部控制方面与射频消融疗效相似。MW消融对于治疗小肝癌是一种安全和前景良好的治疗方法。     

大孔径1．5TMRI引导和监控肾细胞癌的射频消融：可行性的初步研究

本研究探讨了一些病人需要连续2期经皮射频（RF）消融治疗肝细胞癌（HCC）的原因。回顾6a内1179例（1624次治疗）超声（US）引导下经皮RF消融治疗HCC的资料，对第1期治疗后需要第2期治疗的80例病人进行分析，研究其病案与CT随访的资料。评估了第2期治疗的理由及其结果。1642次经皮RF消融治疗HCC中需要第2期治疗的共80例（4．8％）。需第2期治疗的原因包括：由于病人或操作原因的技术性失败（n=26），因肿瘤残余造成的技术性失败（n=40），     

磁共振引导下消融治疗乳腺癌的应用进展

【摘要】 MRI引导下消融治疗是一种新兴的微创治疗手段,随着乳腺癌的检出率逐渐升高,消融治疗以其微创、并发症少、疗效好和可重复等优势成为乳腺癌的可选治疗方案。MRI引导下消融治疗包括射频消融、高强度聚焦超声、微波消融、冷冻消融及激光消蚀,本文就MRI引导下消融技术对乳腺癌治疗的应用进展作一综述。     

肝肿瘤MR引导下射频消融基于阈值序列温度图中凝固区的表现

正摘要目的评价不同截止温度水平对MR引导下肝肿瘤射频(RF)消融凝固区基于阈值的显示。方法24例(原发性6例、继发性18例)肝脏病变病人在RF消融时进行了温度敏感测量采集,应用宽孔径的1.5T MR设备,与介入治疗后凝固区的表现进行对照。采用质子共振频移法在能量消融后直接行温度测量     

肾细胞癌US引导下经皮微波消融的中期治疗结果

正摘要目的回顾性复习肾细胞癌(RCC)微波消融(MWA)后中期(中位数20.1个月)的临床结果。材料与方法此项回顾性研究由学院审查委员会批准。复习2006年4月-2010年12月间46例病人49个RCC结节[直径0.6~7.7cm,平均(3.0±1.5)cm]超声(US)引导下冷却轴针天线经皮MWA治疗的结果。2cm的     

超声引导下经皮微波凝固术治疗小乳腺癌的临床研究

正摘要目的评价经皮微波凝固术(PMC)治疗孤立性小乳腺癌的可行性。材料与方法本研究获得医院伦理委员会批准和病人知情同意。41例粗针穿刺活检证实为乳腺癌,经乳腺超声检查,病灶直径≤3cm的病人被纳入研究。病人在全麻下行超声引导下经皮微波凝固术,随后立即行乳腺切除术。     

比较全数字乳腺成像与荧光胶片乳腺成像：英国乳腺筛查计划和发表资料系统性回顾分析

目的评估新研制的人体乳腺癌射频（RF）消融系统在活体内对人小乳腺癌的治疗效果,包括诱导完全坏死、重复性消融病灶大小和形状及美容效果。方法该研究获得机构伦理委员会批准,病人签署知情同意书。34例经活检证实为侵袭性小导管癌（≤2cm）的绝经后女性[平均年龄（53＋5）岁,范同：49-62岁]为研究对象。RF能量通过一个25mm可调温的15G单极冷针电极传输。根据乳腺摄影确定的乳腺类型将病例分为3组．明确凝固区的体积和形状以及消融时间。将组织病理学表现与术后3．0T对比增强MR检查结果进行比较,     

乳腺癌肝转移:超声引导经皮射频消融——中期和长期生存率

<正>目的回顾评估乳腺癌肝转移病人经超声引导射频消融治疗后局部病灶的控制和中长期疗效。材料与方法该研究得到医院伦理委员会的批准,所有病人均签署书面知情同意书。52例女性病人(平均年龄55岁)的87个乳腺癌肝转移灶(平均直径2.5cm)使用射频消融。纳入标准如下:肝转移灶少于5个,病灶最大     

射频消融与肝脏切除术治疗直径≤2cm肝细胞癌效果的比较:回顾性对比研究

目的回顾性比较经皮射频(RF)消融与肝脏切除术治疗直径≤2cm肝细胞癌(HCC)的效果。材料与方法本研究获机构伦理委员会批准,所有病人在治疗前签署知情同意书。于2003年12月—2008年12月间,对145例直径≤2cm的可切除性HCC病人进行研究。66例病人为中央型HCC     

Dealing with cancer--conversations with radiotherapy patients

Thirty in-patients treated by radiotherapy were questioned in qualitative interviews about the information they had received from the physicians and their way to deal with the disease and the physicians. Furthermore 18 persons out of this group were accompanied continuously. The confidential relationships between the patients and the author of the study brought about spontaneous conversations showing some new aspects of the way to experience disease and therapy. Despite a poor prognosis and an initially insufficient information, the patients formulated their questions openly. Generally they desired a clearer communication. They criticized above all the lack of information and attention from the physicians. A need for confidence, frankness, and the conveyance of a justified hope was expressed. The physician's stress and resulting lack of time was complained of. During the time of accompanying which lasted several weeks, it became evident that information means a way to deal with the disease to which the patient can make his individual contribution. The majority of questions as well as emotional reactions as fear or depression came from those patients who seemed to be quiet persons.     

Radiochemotherapy with temozolomide for patients with glioblastoma

Background

The objective of this retrospective analysis was to assess long-term outcome and prognostic factors of unselected patients treated for glioblastoma (GB) at a single center with surgery, standard radiotherapy (RT), and concomitant temozolomide (TMZ). From 1999?C2005, the institutional protocol included surgery and RT with TMZ. From 2005 on, adjuvant TMZ was routinely added.

Patients and Methods

Between April 1999 and September 2009, 181 patients with GB were treated with RT (60 Gy in 30 fractions) and concomitant TMZ (75 mg/m²/day throughout RT). Biopsy only had been performed in 53 patients (29.3%), 128 patients (70.7%) had undergone resection, which was complete based on postoperative MRI in 51 patients (28.2%). Adjuvant TMZ was applied in 67 of 181 patients (37%).

Results

Median overall survival (OS) and progression-free survival (PFS) were 15.0 (95% CI, 13.1?C16.8) and 7.2 months (95% CI, 5.9?C8.5), respectively. After complete resection, partial/subtotal resection and biopsy, median OS was 23.20, 14.75, and 7.89 months (p < 0.001), respectively. In multivariate Cox proportional hazards regression models, extent of resection (p < 0.0001), Karnofsky??s performance score (p < 0.0001) and adjuvant TMZ (p = 0.001) were significant independent prognostic factors for OS. RT with concomitant TMZ was well tolerated in the majority of patients and could be completed as scheduled in 146 patients (80.7%), while 11 patients (6.1%) discontinued RT. Another 35 patients (19.3%) interrupted concomitant chemotherapy.

Conclusion

RT with concomitant TMZ is a feasible regimen with acceptable toxicity in routine practice. Our data are compatible with a beneficial effect of adjuvant TMZ on OS and PFS.     

湿润烧伤膏与手术联合治疗褥疮的护理

目的 :减少溃疡期褥疮的术前准备时间 ,缩短褥疮的总病程。方法 :将 1996年 5月至 2 0 0 2年 5月收住院的 4 2例溃疡期褥疮病人按随机原则分为 2组 ,2 1例术前用湿润烧伤膏纱换药处理 ,为A组 (试验组 ) ;2 1例用庆大霉素紫草油纱布换药处理 ,为B组 (对照组 )。 2组病例的年龄、性别、发病原因、病灶部位、病灶范围等经统计学处理 ,无显著性差别 ,有可比性。两组病人均换药至创面新鲜行皮瓣转移手术 ;比较两组平均术前换药时间 ,及换药 +手术的总住院日。术前术后两组患者均运用护理程序施行整体护理。结果 :A组术前平均换药时间为 8 4 9± 2 2 3天 ,B组为 15 6 0± 6 70天 ;A组平均治愈时间为 2 0 5 0± 4 81天 ,B组为 35 31± 7 70天。结论 :湿润烧伤膏换药与庆大霉素紫草油纱布换药比较 ,前者可明显缩短褥疮手术的术前准备时间及病人的总住院天数。     

Bronchogenic carcinoma: staging with MR compared with staging with CT and surgery

Thirty-three patients suspected of having bronchogenic carcinoma were studied prospectively using magnetic resonance (MR). In this group, 30 underwent examination with computed tomography (CT), 15 underwent thoracotomy, six had mediastinal biopsy procedures performed, and eight underwent bronchoscopy. MR studies, which included transaxial spin-echo imaging (TR, 0.5 and 2.0 sec; TE, 28 and 56 msec) of all patients and sagittal or coronal imaging of 18, were performed without knowledge of CT findings, using only plain radiographs as a guide. CT and MR studies were interpreted separately. CT and MR provided comparable information regarding the presence and size of mediastinal lymph nodes. MR better discriminated mediastinal nodes from vascular structures. However, in two of 11 patients who had multiple mediastinal lymph nodes that were normal in size at CT examination and surgery, MR suggested a confluent abnormal mass, probably because of its poorer spatial resolution. MR was superior to CT in showing enlarged hilar lymph nodes, but CT was better for demonstrating bronchial abnormalities. In three of four patients who had a proved hilar mass with distal obstructive pneumonia, MR (TR, 2.0 sec) helped distinguish between the mass and collapsed lung.     

多虑平、雷尼替丁治疗消化性溃疡81例临床观察

1995年 1月～ 1 998年 2月 ,我们采用多虑平、雷尼替丁治疗消化性溃疡 (ＰＵ) ,并与雷尼替丁为对照组进行治疗观察 ,疗效满意 ,现总结报告如下。1　临床资料1 1　一般资料　本组 81例ＰＵ均因上腹痛、返酸、腹胀及食欲不振等症状 ,经胃镜诊断为溃疡活动期患者。病程 2个月～ 5ａ,平均 1 7ａ。伴有焦虑、抑郁及夜眠欠佳等症者59例。随机分为 2组 :治疗组 4 1例 ,男 3 8例 ,女 3例 ;年龄 1 8～ 3 6岁 ,平均 2 4岁。其中胃溃疡 1 1例 ,十二指肠球部溃疡 3 0例。对照组 4 0例 ,男 3 7例 ,女 3例 ;年龄 1 9～ 3 5岁 ,平均 2 4 5岁 ;胃溃疡 1 2…     

臭氧治疗船员下肢损伤89例

2006年10月至2007年4月,我科采用引进的德国赫尔曼Medozon型臭氧发生装置系统产生的臭氧治疗船员下肢损伤89例,疗效满意.现报告如下.     

Tumor Burden Assessment with Positron Emission Tomography with

Objective: In patients with advanced cancer, total tumor burden affects the likelihood of tumor response and has important implications for prognosis. The aim of this study was to select the optimum 2-[F-18]fluoro-2-deoxy-D-glucose-positron emission tomography (FDG PET) tumor uptake parameter to accurately measure tumor burden in advanced metastatic renal cell cancer, in comparison with volumes measured with computed tomography (CT), as a reference test.Materials and Methods: Six patients with metastatic renal cell carcinoma measurable on CT were studied. CT and FDG PET scans were carried out on all patients within 4 weeks prior to their entry into a phase I-II radioimmunotherapy trial. CT-based evaluation of disease extent (tumor volume) and 4 PET-based measurements (standardized uptake value[SUVmax], SUVav, volume, and total lesion glycolysis [TLG]) were performed independently by a radiologist (VN) and a nuclear medicine physician (TA). The degree of correlation between conventional (CT) extent of disease and parameters describing tumor concentration of FDG was then determined.Results: Fifty-seven CT-measurable metastatic lesions in lung, abdomen, and scalp were evaluated in 6 patients. There was a high correlation between CT and FDG PET volume estimates for lesions greater than 5 cm(3) in size. However, a PET-derived parameter that embodies both FDG uptake and lesion size, the TLG, correlated better with CT-derived tumor volume than did FDG PET volume alone.Conclusion: Using CT volume as a gold standard, the optimal PET-based estimate of total tumor burden in patients with metastatic renal cancer is the sum over all lesions of the total lesion glycolysis.     

MEBO药纱门诊治疗烧(烫)伤71例的体会

作者报道用MEBO药纱敷盖门诊治疗烧（烫）伤71例，均获治愈。经随访1年，深Ⅱ度创面疤痕发生率为15％（3／20），浅Ⅲ度创面疤痕发生率为38．9％（7／18）。