Predictive value of the albumin-bilirubin grade on long-term outcomes of CT-guided percutaneous microwave ablation in intrahepatic cholangiocarcinoma

Purpose: To assess the efficacy of the albumin-bilirubin (ALBI) grade on assessing long-term outcomes of computed tomography (CT)-guided percutaneous microwave ablation (CT-PMWA) in the treatment of patients with intrahepatic cholangiocarcinoma (ICC).

Methods: Between April 2011 and March 2018, 78 patients who underwent CT-PMWA were enrolled in this study. Overall survival (OS) and recurrence-free survival (RFS) were compared in the groups stratified by the ALBI grade and Child–Pugh score. Cox proportional hazard regression analyses were performed to determine independent predictors of OS and RFS.

Results: After a median follow-up of 22.7?months (range 1–86.7?months), 67 patients had died. The cumulative 1-, 3-, and 5-year OS rates were 89.5%, 52.2%, and 35.0%, respectively. Stratified by the ALBI grade, the cumulative 1-, 3-, and 5-year OS rates were 100%, 69.2%, and 25.6% for patients with the grade 1, respectively. For patients with the ALBI grade 2, the cumulative 1-, 3-, and 5-year OS rates were 41.0%, 10.3%, and 10.3%, respectively. Patients with a hepatic function of the ALBI grade 1 had significantly higher OS rates than patients with the ALBI grade 2 (p?<?.001). The multivariate analysis showed tumor size (Hazard Ratio[HR] 95% Confidence Interval[CI]:9.03[1.01–80.52], p?=?.049) and the ALBI grade (HR[95%CI]:9.56[1.58–58.00], p?=?.014) were associated with OS, and tumor size (HR: 2.03[0.69–8.04], p?=?.049) was associated with RFS.

Conclusions: The preliminary data of this study showed the ALBI grade was effective to predict long-term outcomes of CT-PMWA in ICCs. Further study is necessary to validate our results by a large, multi-center patient cohort.     

超早期显微手术治疗Hunt-Hess Ⅳ、Ⅴ级大脑中动脉动脉瘤

目的探讨超早期（发病12 h内）显微手术治疗Hunt-Hess分级Ⅳ、Ⅴ级大脑中动脉动脉瘤的效果。方法回顾性分析20例入院时Hunt-Hess分级Ⅳ、Ⅴ级大脑中动脉动脉瘤患者的临床资料,均在超早期行显微手术治疗。结果20例动脉瘤均成功手术夹闭。术后随访4-12个月,按照GOS分级,预后良好13例,中残3例,重残2例,植物生存1例,死亡1例。结论对于Hunt-Hess分级Ⅳ、Ⅴ级大脑中动脉动脉瘤患者进行超早期显微手术治疗,能够取得良好的预后。     

宫颈癌骨转移临床相关因素分析及探讨

目的探讨宫颈癌骨转移相关因素。方法回顾分析2008年6月-2011年8月收治的352例宫颈癌患者的临床资料,其中鳞癌326例,腺癌26例;临床分期Ⅰ期60例、Ⅱ期184例、Ⅲ期90例、Ⅳ期18例。比较不同期别、不同病理类型、不同组织分级患者的骨转移情况。结果 352例宫颈癌中有18例发现骨转移,转移率为5.1%;转移时间为3～48个月,2例于骨转移后1年内死亡。鳞癌326例,骨转移率为5.2%;腺癌26例,骨转移率为3.8%。Ⅰ、Ⅱ、Ⅲ和Ⅳ期患者的骨转移率分别为0.0%、3.8%、5.6%和33.3%,晚期与早期相比有统计学意义(P<0.05);高、中和低分化患者骨转移率分别为3.1%、3.1%和6.3%,高分化与中分化相比,差异无统计学意义(P>0.05),低分化与高中分化相比差异有统计学意义(P<0.05)。结论宫颈癌骨转移与宫颈癌临床分期、病理类型、细胞分级密切相关。在宫颈癌的治疗过程中,做到早发现、早治疗,可提高患者的治疗效果,延长生存时间。     

以三甲医院评审为契机促进医学装备规范化管理

本文根据三甲医院评审要求，从医学装备管理模式探讨、管理制度建设、质量控制等方面，探讨医学装备规范化管理，希望能为完善医学装备管理机制，促进医学装备规范化管理提供借鉴。