改良RECIST标准更适用经TACE治疗的肝癌患者的预后评价

【摘要】 目的 本研究拟确定采用哪一种短期疗效评价标准能够客观、有效、准确地预测经TACE治疗的肝癌患者的预后。方法 回顾性分析59例行TACE治疗的肝癌患者，收集治疗前及治疗后1个月的增强CT或增强MRI影像学资料。分别依据RECIST 1.1标准和mRECIST标准行短期疗效评价，分析两种标准评价结果的一致性；然后依据不同的评价结果，将所有患者分为有效组和无效组，分别分析两组患者中位生存时间和2年生存率的差异。结果 对所有患者进行短期疗效评价，依据RECIST 1.1标准评价为CR、PR、SD、PD的患者；依据mRECIST标准评价为CR、PR、SD、PD的患者；两种标准内部一致性极差（κ=0.19，95%CI，0.16~0.26）。依据RECIST 1.1标准，有效组和无效组患者中位生存时间分别为25个月和20个月，2年生存率分别为62%和80%，两组差异无统计学意义（P>0.05）；依据mRECIST标准，有效组和无效组患者中位生存时间分别为25个月和14个月，2年生存率分别为84%和68%，两组差异有显著统计学意义（P<0.001）。多因素分析，mRECIST标准评价结果是预后的独立预测因素（P=0.02）。结论 采用mRECIST标准评价经TACE治疗的肝癌患者较RECIST标准更有优势。

     

异常凝血酶原联合甲胎蛋白评价原发性肝癌TACE治疗价值

【摘要】 TACE是肝癌非手术切除最常用的治疗方法之一。目前，原发性肝癌（PHC）患者TACE治疗的评估主要依靠影像学检查且仍存在诸多局限性，结合特定的血清肿瘤标志物可弥补这种局限性。研究表明血清肿瘤标志物的下降程度与mRECIST标准强相关，如异常凝血酶原（PIVKA- Ⅱ，protein induced by vitamin K antagonist- Ⅱ， abnormal prothrombin）、甲胎蛋白（AFP）。本文就PIVKA- Ⅱ联合AFP在原发性肝癌患者TACE治疗的疗效及预后评价价值方面进行论述。

     

经肝动脉化疗栓塞联合射频消融治疗原发性肝癌远期疗效的荟萃分析

【摘要】 目的 探讨经肝动脉化疗栓塞（TACE）联合射频消融（RFA）与单独行TACE治疗原发性肝癌的远期疗效的区别。方法 检索CBM、CNKI、PubMed、EMBASE、ElsevierSciencedirect、Lippincott,Williams & Wilkins、Springer数据库,收集所有TACE联合RFA治疗原发性肝癌与单独性TACE治疗的临床随机对照试验（RCT）文献。按照纳入标准选择文献,提取相关数据,应用STATA11.0软件进行统计学处理。结果 共纳入中外文献8篇,分别行亚组分析显示,TACE联合RFA治疗组的1、2、3年生存率均明显优于TACE单独治疗组［1年生存率:OR = 0.49,95%CI（0.33,0.75）,P = 0.001;2年生存率:OR = 0.40,95%CI（0.23,0.70）,P = 0.001;3年生存率:OR = 0.50,95%CI（0.36,0.69）,P = 0.000］。结论 与单独行TACE治疗相比,TACE联合RFA治疗方案能明显提高原发性肝癌患者的远期生存率。
     

肝动脉化疗栓塞序贯冷循环射频消融治疗原发性肝癌的体会

目的评价肝动脉化疗栓塞术(TACE)联合冷循环射频消融术(RFA)治疗原发性肝癌的临床价值.方法65例原发性肝癌分为单纯TACE治疗组31例,TACE联合冷循环射频消融术治疗组(TACE+RFA组)34例.治疗后通过DSA、CT、超声检查及血清甲胎蛋白(AFP)测定评价.结果单纯TACE组的肿瘤完全坏死率、复发率、1年生存率分别为16.1%、48.4%、48.4%,TACE+RFA联合组分别为47.1%、17.7%、79.4%,两组比较有极显著统计学差异(P＜0.01);单纯TACE组的肿瘤缩小率、AFP     

肾上腺动脉化疗栓塞治疗肝癌肾上腺转移瘤的疗效评价

【摘要】 目的 评价超选择性肾上腺TACE治疗肝癌肾上腺转移瘤的疗效。方法 2012年1月至2016年12月,42例原发性肝癌并肾上腺转移患者接受TACE治疗,治疗后随访复查,观察患者生存时间及肾上腺转移瘤初次治疗后缓解时间。 结果 所有患者均成功接受TACE治疗,1年生存率为54.7%,中位生存时间14个月;肾上腺转移瘤初次治疗后缓解中位时间10个月。 结论 超选择性肾上腺TACE是治疗肝癌肾上腺转移瘤安全、经济、有效的手段,值得在临床推广。

     

经肝动脉化疗栓塞与射频消融和无水乙醇注入对大肝癌的疗效评价及预后分析

【摘要】 目的 探讨肝动脉化疗栓塞（TACE）联合射频消融（RFA）及无水乙醇注入术（PEI）治疗原发性大肝癌的临床效果及预后情况。方法 选取2006年至2010年诊治的原发性大肝癌92例,其中15例行TACE联合RFA（Ⅰ组）,29例行TACE联合PEI（Ⅱ组）,21例行TACE、RFA联合PEI（Ⅲ组）,仅行TACE 27例（Ⅳ组）。分析比较4组的临床疗效及总生存时间（OS）,用COX比例风险模型分析预后因素。结果 4组相比,肿瘤缩小及肿瘤坏死率均有统计学意义（P = 0.008,P = 0.026）;Ⅰ、Ⅱ、Ⅲ和Ⅳ组OS分别为18、14、20和10个月,差异有统计学意义（P = 0.000）;多因素结果分析显示,门脉癌栓及术前AFP值是影响总生存时间的预后因素（P = 0.028,P = 0.031）。结论 TACE、RFA联合PEI治疗大肝癌与TACE联合RFA/PEI或TACE相比,可明显提高肿瘤缩小、坏死率,延长生存期。

     

Laves-phase formation criterion for high-entropy alloys

In this study, we have analysed Laves-phase formation in high-entropy alloys (HEAs). For that purpose, the AlCr_xNbTiV and Al_xCrNbTiVZr (x?=?0, 0.5, 1, 1.5) alloys were produced and examined. It was found that the AlNbTiV and AlCr_0.5NbTiV alloys had single-phase body-centred cubic structure, while the other alloys contained Laves phase. Analysis has demonstrated that Laves-phase formation in the produced and in the other HEAs, which are predominantly composed of Al and the elements of 4–6 groups and tend to form body-centred cubic solid solutions, can be predicted by the atomic size mismatch, δ_r, and the Allen electronegativity difference, Δχ_Allen, parameters. It was shown that Laves-phase formation is observed when δ_r?>?5.0% and Δχ_Allen?>?7.0%.     

A criterion for selecting renewable energy processes

We propose that minimum incremental cost per unit of greenhouse gas (GHG) reduction, in essence the carbon credit required to economically sustain a renewable energy plant, is the most appropriate social criterion for choosing from a myriad of alternatives. The application of this criterion is illustrated for four processing alternatives for straw/corn stover: production of power by direct combustion and biomass integrated gasification and combined cycle (BIGCC), and production of transportation fuel via lignocellulosic ethanol and Fischer Tropsch (FT) syndiesel. Ethanol requires a lower carbon credit than FT, and direct combustion a lower credit than BIGCC. For comparing processes that make a different form of end use energy, in this study ethanol vs. electrical power via direct combustion, the lowest carbon credit depends on the relative values of the two energy forms. When power is 70$ MW h^?1, ethanol production has a lower required carbon credit at oil prices greater than 600$ t^?1 (80$ bbl^?1).     

A new criterion to design reactive coal stockpiles

This paper proposes a new criterion to design the self-heating coal stockpiles. The generated heat can be removed if air is blown to the self-heating stockpile. At the same time, introducing more air to the system boosts the aforementioned chemical reactions. Hence, there is a tradeoff between the two opposing effects. Monitoring such a tradeoff, which pinpoints both qualitatively and quantitatively the safe characteristics (geometry, porosity, and permeability) of a stockpile, can be referred to as a design criterion to be implemented in industry. In order to validate the application of the newly-proposed criterion, two independent numerical solvers are used being a FORTRAN code and the commercially available software CFD-ACE. Different key parameters including approaching wind speed, porosity, and permeability are examined. Finally, application of energy flux vectors for convection visualization is also illustrated for a more comprehensive analysis of the problem.     

Determination of the optimal solar investment decision criterion

This paper deals with the validity of the solar investment decision criteria employed in various studies. We begin by examining the life-cycle cost criterion (or positive net present value criterion) commonly used by solar analysts, and subsequently show that, given the theoretical hypotheses of dynamic investment planning and decision making, this criterion is suboptimal for evaluating the economic viability of fuel saver solar systems. The optimal “present cost competitive” criterion is then established and analyzed. The effect of uncertainty is introduced into the analysis by an examination of the payback period criterion. To highlight the differences between these criteria, a comparison of the timing of and net benefits derived from investments in a residential solar space and water heating system made under each criterion is presented.     

联合循环电厂机组运行状态判据选取方法的探讨

探讨了联合循环电厂DCS组态中机组运行状态判据的选择方法，分析了不恰当判据选择对运行和维护的影响，并提出了解决方法。     

An onset of nucleate boiling criterion for horizontal flow boiling

A model to predict the onset of nucleate boiling has been successfully developed to differentiate purely convective evaporation from mixed nucleate and convective boiling during evaporation inside a horizontal tube of 14 mm I.D. Based on an extensive database collected for the natural refrigerant ammonia (R-717) over mass velocities from 10 to 140 kg · m ⁻²· s ⁻¹ , the analysis of the stratified, stratified–wavy and mainly annular flow patterns during evaporation with different heat flux ranges showed very accurate predictions in terms of the local heat transfer coefficient using this new onset of nucleate boiling criterion.     

A plugging criterion for steam generator tubes based on leak-before-break

Degradation of steam generator tubes is occurring in Spanish nuclear power plants. Degradation causes are different and give occasion for leakages.

General Criteria of Design, technical specifications and availability are concepts which must be harmonized. Historic behaviour of certain tube defects together with experiments and studies made by the Spanish Owner Group of Pressurized Water Reactors and approved by Consejo de Seguridad Nuclear have led to a new plugging criterion based on the Leak-Before-Break concept and a new limit for leakages is in operation in some plants.