【Abstract】ObjectiveTo study the effect of preoperative gastric arterial chemoembolization on apoptosis of lymph node metastasis of gastric cancer. MethodsForty patients with gastric cancer and lymph node metastasis underwent curative resection, among which there were 20 patients who received the preoperative gastric arterial chemoembolization, and they constituted the treatment group. The rest of the patients were included in the control group. The expressions of p53, CD95 and bcl-2 were examined by immunohistochemistry and apoptosis in the lymph node metastasis was examined by in situ terminal transferasemediated dUTP nick end labeling （TUNEL）. ResultsThe expression intensity of p53 and CD95 in lymph node metastasis of treatment group increased more significantly than that of control group, whereas the expression intensity of bcl-2 decreased in treatment group. There was a significantly positive correlation between the expressions of p53 and CD95 and the apoptosis.ConclusionPreoperative gastric arterial chemoembolization may affect the expressions of p53, CD95 and bcl-2 and may induce the apoptosis of lymph node metastasis. It may be helpful to improve the effect of curative resection of gastric cancer.
摘要:目的:探討床旁超聲檢查在肝移植術后下腔靜脈(IVC)并發癥診斷中的應用價值。方法:對424例肝移植術后患者進行床旁超聲檢查,對下腔靜脈并發癥,包括狹窄及栓塞的資料進行回顧性分析和總結。結果:床旁超聲檢查發現下腔靜脈并發癥患者18例,其中狹窄6例,栓塞12例。結論:床旁超聲檢查在肝移植術后,尤其是對術后早期發生的下腔靜脈并發癥的診斷及監測具有重要的作用,為臨床診斷和治療提供及時、有價值的影像學依據。Abstract: Objective: To evaluate the value of bedside ultrasound in diagnosis and monitoring of inferior vena cava (IVC) complications after liver transplantation. Methods: 424 cases with liver transplantation were examined by bedside ultrasound after the operations. The results of IVC complications,including thrombosis and stenosis, were analyzed and summarized. Results: 18 cases with IVC complications were detected by bedside ultrasound, including 6 cases of stenosis and 12 cases of thrombosis. Conclusion: Bedside ultrasound is important for diagnosing and monitoring IVC thrombosis and stenosis after liver transplantation, especially in the earlier period. It could provide valuable imaging for clinical diagnosis and treatment promptly.
目的 探討脾動脈栓塞治療親體肝移植術后脾動脈竊血所致小肝綜合征的療效。方法 我院2007年4月至2009年9月期間共完成親體肝移植25例，其中有2例發生脾動脈竊血致小肝綜合征，均采用介入技術經皮行脾動脈栓塞治療。結果 行脾動脈栓塞術后，2例患者腹水逐漸減少，轉氨酶水平、血小板及白蛋白水平及肝功能較快恢復正常。栓塞術后1個月復查，肝功能仍基本正常。結論 脾動脈栓塞是治療肝移植術后脾動脈竊血所致小肝綜合征的有效措施。
OBJECTIVE To investigate the mechanism of electrothrombosis by copper needle, in order to supply the referential data for clinical treatment of vessel deformity. METHODS The mechanism and condition of thrombus formation by copper needle were studied in vivo and in vitro using electrophysics, atom absorption spectrophtometry, histological, and histochemical methods. RESULTS Great deal of copper ion was dissociated, and agglutination of red blood cells(RBC) in blood could be observed in vitro after the current applied by copper needles. Formation of stable thrombus was related to voltage and time of application of electric current. CONCLUSION Dissociation of copper ion and agglutination of RBC are the basic principle of electrothrombosis with copper needle. A 4V direct current and 17.5 minutes are the safe and effective conditions for thrombus formation in the blood vessels.
ObjectiveTo explore the clinical application value of antithrombin Ⅲ (ATⅢ) in pulmonary thromboembolism (PTE).MethodsA retrospective study included 204 patients with confirmed PTE who were admitted to Fujian Provincial Hospital from May 2012 to June 2019. The clinical data of the study included basic conditions, morbilities, laboratory examinations and scoring system within 24 hours after admission. The relationship between ATⅢ and PTE in-hospital death was analyzed, and the value of ATⅢ to optimize risk stratification was explored.ResultsFor ATⅢ, the area under receiver operating characteristic curve (AUC) of predicting in-hospital mortality was 0.719, with a cut-off value of 77.7% (sensitivity 64.71%, specificity 80.21%). The patients were divided into ATⅢ≤77.7% group (n=48) and ATⅢ>77.7% group (n=156) according to the cut-off value, and significant statistically differences were found in chronic heart failure, white blood cells count, platelets count, alanine aminotransferase (ALT), albumin and troponin I (P<0.05). According to the in-hospital mortality, patients were divided into a death group (n=17) and a survival group (n=187), and the differences in count of white blood cells, ATⅢ, D-dimer, ALT, albumin, estimated glomerular filtration rate and APACHEⅡ were statistically significant. Logistic regression analysis revealed that ATⅢ≤77.7% and white blood cells count were independent risk factors for in-hospital death. The risk stratification and the risk stratification combined ATⅢ to predict in-hospital death were evaluated by receiver operating characteristic curve, and the AUC was 0.705 and 0.813, respectively (P<0.05). A new scoring model of risk stratification combined with ATⅢ was showed by nomogram.ConclusionsATⅢ≤77.7% is an independent risk factor for in-hospital death, and is beneficial to optimize risk stratification. The mechanism may be related to thrombosis, right ventricular dysfunction and inflammatory response.
Objective To evaluate the efficacy of transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) in treating primary hepatocellular carcinoma (HCC). Methods From March 2004 to March 2006, 137 patients with primary HCC underwent TACE alone (n=87) and TACE+RFA (n=50), respectively, after the interventional treatment, all patients periodically received CT reexaminations and alpha fetoprotein (AFP) measurement. The therapeutic efficacy, AFP level and survival rate between two groups were compared with each other. Results In TACE group the effective rate (CR+PR) was 34.5%, AFP decreasing amplitude was 54.2%, and 2 years survival rate was 43.7%. While in TACE+RFA group, the effective rate (CR+PR) was 70.0%, AFP decreasing amplitude was 78.0%, and 2 years survival rate was 62.0%, there were significant differences between two groups (P＜0.05). Conclusion Combined application of TACE and RFA is significantly superior to TACE alone in treatment of primary HCC.
Six patients with moderate to advanced primary carcinoma of the liver were treated in this hospital with perfusion chemotherapy and embolization through the regional portal vein under the guidance of B-ultrasongraph rather than (with) operatie catheteization of the portal vein. The results show that all the tumor masses were reduced in size after the treatment (1.2-3.2cm, average value 1.9cm). It might be a new way for treating the primary carcinom of liver. The detailed procedure is descibed and the effects are also discussed in this article.
目的 探討急診行子宮動脈灌注藥物栓塞術治療剖宮產后切口妊娠的可行性和臨床價值。 方法 2009年10月－2011年12月，對17例臨床證實切口瘢痕妊娠并陰道出血患者，急診行雙側子宮動脈灌注甲氨蝶呤并超選擇栓塞術，術后通過觀察人絨毛膜促性腺激素（HCG）水平、陰道出血及術后清宮術來評價療效。 結果 17例患者急診行子宮動脈灌注栓塞術成功，術后陰道出血均停止或減少，HCG水平均明顯下降，3例因孕囊自行排除而未行清宮，14例術后2～4 d行胚胎鉗刮術，術中出血量較少。所有患者1周后均治愈出院。 結論 子宮動脈灌注栓塞術是治療剖宮產術后切口瘢痕妊娠的一種有效方法，可及時治療陰道大出血，促進殺胚，并為術后清宮提供安全保障。
【摘要】 目的 探討磁共振動態增強掃描及磁共振彌散加權成像（diffusion weighted imaging，DWI）對肝癌經導管動脈內化學栓塞（transcatheter arterial chemoembolization，TACE）治療后的腫瘤殘余及復發的判斷價值。 方法 2009年1月-2010年10月，對28例經證實的肝癌患者在TACE治療前、治療后3~7 d及治療后1~2個月、3~6個月行磁共振動態增強及DWI掃描，動態測量表觀彌散系數（apparent diffusion coefficient，ADC）值，與數字減影血管造影（digital substraction angiography，DSA）檢查對照，評價動態增強掃描及DWI對腫瘤殘留或復發的檢出能力。〖HTH〗結果 對腫瘤殘余及復發的顯示，動態增強掃描靈敏度為90.0%，特異度為96.9%；DWI靈敏度為96.7%，特異度為93.8%；動態增強掃描與DWI相結合的靈感度為100.0%，特異度為99.5%；DSA靈敏度和特異度分別為96.7%、100.0%。TACE治療前所有腫瘤實質的ADC值為（1.134±0.014）×10-3 mm2/s；TACE治療后3~7 d ADC值為（1.162±0.016）×10-3 mm2/s；TACE治療后1~2個月碘油沉積較好，無明顯殘余或復發病灶的ADC值為（1.175±0.015）×10-3 mm2/s，3~6個月后隨訪病灶ADC值為（1.179±0.017）×10-3 mm2/s；TACE治療后1~2個月碘油沉積不完全或無明顯沉積病灶ADC值為（1.147±0.016）×10-3 mm2/s，3~6個月后隨訪病灶實質平均ADC值（1.142±0.012）×10-3 mm2/s。 結論 將動脈增強掃描與DWI相結合可提高對TACE治療后肝癌殘余及復發判斷的靈敏度及特異度；對腫瘤組織平均 ADC值的動態測量、觀察可及早判斷腫瘤復發的可能性。【Abstract】 Objective To evaluate the dynamic contrast-enhanced MRI and diffusion weighted imaging (DWI) in judging the remnant and recurrence on hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE). Methods Between January 2009 and October 2010, 28 patients with HCC underwent dynamic contrast-enhanced MRI and DWI before and after TACE 3-7 days, 1-2 months and 3-6 months, respectively, and the apparent diffusion coefficient (ADC) value of the tumor were also measured at above mentioned time points. The sensitivity and specificity of dynamic contrast-enhanced MRI and DWI in diagnosis of residual tumor and recurrent cancer was qualitatively evaluated by comparing with the DSA results. Results Compared with DSA, the sensitivity and specificity of dynamic contrast-enhanced MRI were 90.0% and 96.9% by revealing the remnant and recurrence of HCC, while the sensitivity and specificity of DWI were 96.7% and 93.8% respectively. Combining dynamic contrast-enhanced MRI and DWI the sensitivity and specificity were improved to 100.0% and 99.5%, respectively. The mean ADC value of tumor before and after 3-7 days of TACE were (1.134±0.014)×10-3 and (1.162±0.016)×10-3 mm2/s, respectively. The mean ADC value of tumor without and with remnant and recurrence after 1-2 months and 3-6 months follow up were (1.175±0.015)×10-3, and (1.179±0.017)×10-3 mm2/s; (1.147±0.016)×10-3 and (1.142±0.012)×10-3 mm2/s, respectively. Conclusions Combining dynamic contrast-enhanced MRI and DWI could improve the sensitivity and specificity to detect the remnant and recurrence of HCC after TACE. Measuring the ADC value during follow up of HCC patients after TACE could predict the probability of tumor recurrence.