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目的探讨桥小脑角肿瘤枕下乙状窦后入路骨瓣开颅改进方法与经验。方法自2009年12月至2013年3月,北京天坛医院对枕下乙状窦后骨瓣开颅的技术细节加以改进。术中采用直切口,在星点钻单孔,暴露横窦乙状窦连接部。根据静脉窦的解剖特点,用铣刀直接铣开骨瓣,不刻意暴露状窦。术毕利用钛片将骨瓣复位。结果共切除桥小脑角肿瘤46例。除早期4例乙状窦出血外,开颅过程顺利,手术时间为(30±5)min。肿瘤显露满意,全切除43例,大部切除3例。骨瓣复位良好,骨质缺损少,无脑脊液漏等常见并发症。结论改良后的枕下乙状窦后入路安全,快捷,微创。 相似文献
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目的 研究桥小脑角肿瘤的显微外科治疗效果。方法 对26例听神经瘤,4例脑膜瘤,4例上皮样囊肿进行显微外科切除。其中28例行枕下路,6例行幕上下联合入路,在显微镜下将肿瘤壁与其周围组织分离并切除,如切除困难应予以充分电灼。结果 本组肿瘤全切除28例,部分切除6例,面神经保留25例,术后死亡3例,2例死于脑干损伤,1例死于上消化道出血合并肺部感染,术后症状改善25例,无变化4例,症状加重5例。随访10个月-3年,复发2例,均再次手术,再无复发。结论 显微外科能提高桥小脑角肿瘤手术全切率和疗效。在最大限度内切除肿瘤的同时,有效地保护了其周围的脑干,颅神经,静脉窦及重要血管。 相似文献
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吕然博 《临床合理用药杂志》2011,(15):111-111
目的探讨颞枕经小脑幕入路切除岩斜区肿瘤的方法和手术技巧。方法对13例经颞枕经小脑幕切除岩斜区肿瘤患者的临床效果进行分析。结果行肿瘤全切9例,近全切3例,大部分切除1例。术后症状完全缓解8例,好转5例。结论该入路具有创伤小、解剖关系简单、对小脑牵拉轻且显露范围广的优点,值得临床推广应用。 相似文献
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吕然博 《临床合理用药杂志》2011,4(22)
目的 探讨颞枕经小脑幕入路切除岩斜区肿瘤的方法 和手术技巧.方法 对13例经颞枕经小脑幕切除岩斜区肿瘤患者的临床效果进行分析.结果 行肿瘤全切9例,近全切3例,大部分切除1例.术后症状完全缓解8例,好转5例.结论 该入路具有创伤小、解剖关系简单、对小脑牵拉轻且显露范围广的优点,值得临床推广应用. 相似文献
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Yu-Jie Liu Xiao-Qian Dou Fang Wang Jing Zhang Xiao-Lin Wang Gui-Li Xu 《Journal of drug targeting》2017,25(3):275-283
Tumour immunosuppressive microenvironments inhibit antigen-specific cellular responses and interfere with CpG-mediated immunotherapy. Overcoming tumour microenvironment (TME) immunosuppression is an important strategy for effective therapy. This study investigated the ability of a tumour-targeting IL-4Rα aptamer-liposome-CpG ODN delivery system to introduce CpG into tumours and overcome the immunosuppressive TME. The IL-4Rα-liposome-CpG delivery system was prepared. FAM-CpG visualisation was used to demonstrate tumour targeting in vitro and in vivo. Anti-tumour effects of this delivery system were evaluated in CT26 tumour-bearing mice. Mechanisms for conquering the TME were investigated. FAM-CpG was better distributed into the tumours upon treatment with IL-4Rα-liposome-FAM-CpG compared to distribution in the control group in vitro and in vivo. IL-4Rα-aptamer-liposome-CpG treatment inhibited distinct myeloid-derived suppressor cell populations in tumours and bone marrow. Similar profiles were observed for regulatory T cells in tumours. In CT26 tumour-bearing mice, IL-4Rα-liposome-CpG treatment exhibited enhanced anti-tumour activity. Increased mRNA levels of TNF-α, IL-2, and IL-12, and decreased mRNA levels of VEGF, IL-6, IL-10, MMP9, arginase-1, inducible NOS, CXCL9, p-Stat3, and NF-κB were observed in tumours upon IL-4R-liposome-CpG-treatment. The results suggested that pharmacologic targeting by the IL-4R aptamer-liposome-CpG system improves TME therapeutic benefit and provides a rationale for cancer immunotherapies. 相似文献
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对1959年9月~1993年4月行肝癌肝切除588例进行回顾,第一阶段(1959年9月~1985年12月)施行传统肝切除术142例,均为直径>5cm中晚期肝癌,手术死亡率11%,术后3年和5年生存率分别为18%、7%。第二阶段(1986年1月~1993年4月)行肝癌肝切除术446例,以肝段切除及癌肿局部切除为主,采用多种技术改良及高新医疗设备,并予以化疗、免疫治疗等综合措施,手术死亡率<2%,术后1年、3年、5年生存率分别为89%、55%、26%。 相似文献
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M V W Wijnands M J van Erk R P Doornbos C A M Krul R A Woutersen 《Food and chemical toxicology》2004,42(10):1629-1639
The effects of different dietary compounds on the formation of aberrant crypt foci (ACF) and colorectal tumours and on the expression of a selection of genes were studied in rats. Azoxymethane-treated male F344 rats were fed either a control diet or a diet containing 10% wheat bran (WB), 0.2% curcumin (CUR), 4% rutin (RUT) or 0.04% benzyl isothiocyanate (BIT) for 8 months. ACF were counted after 7, 15 and 26 weeks. Tumours were scored after 26 weeks and 8 months. We found that the WB and CUR diets inhibited the development of colorectal tumours. In contrast, the RUT and BIT diets rather enhanced (although not statistically significantly) colorectal carcinogenesis. In addition, the various compounds caused different effects on the development of ACF. In most cases the number or size of ACF was not predictive for the ultimate tumour yield. The expression of some tumour-related genes was significantly different in tumours from the control group as compared to tumours from the treated groups. It was concluded that WB and CUR, as opposed to RUT and BIT, protects against colorectal cancer and that ACF are unsuitable as biomarker for colorectal cancer. Effects of the different dietary compounds on metalloproteinase 1 (TIMP-1) expression correlated well with the effects of the dietary compounds on the ultimate tumour yield. 相似文献
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目的:观察消痔灵与曲安缩松的混合液治疗海绵状血管瘤的疗效。方法:使用消痔灵与曲安缩松的混合液,对134例157个瘤体进行筛选性(主要选海绵状血管瘤为治疗对象)注射治疗,并总结理想的配方比例。结果:134例157个瘤体经选用4:1配方比例(即消痔灵原液4ml;曲安缩松1ml)疗效最为理想,经2~4次注射后全部治愈,经半年~2年随访的64例患儿中,无1例复发,未见疤痕及局部皮肤异常。结论:消痔灵与曲安缩松混合液治疗海绵状血管瘤,有操作简单易行,成本低,不良反应少,损伤小,治愈率高,一旦治愈不再复发,无明显后遗症等优点,是一种较为理想的新的治疗方法。 相似文献
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K Lapis I Kavalsky A Jeney G Pogány G Molnár D Répássy A Szécsény S Karácsonyi 《The Tokai journal of experimental and clinical medicine》1990,15(2-3):155-165
Glycosaminoglycans were investigated in surgically removed human liver and kidney tumours by applying biochemical methods. Four liver adenoma, 6 focal nodular hyperplasia and 9 primary hepatocellular carcinoma samples were compared with normal liver from autopsy cases and also with liver tissue adjacent to PHC. The studies on kidney included 14 renal cell carcinoma and 4 wilms' tumour samples. Three findings emerged from the quantitative and qualitative characterization of the tumours with epithelial origin. 1) The rise in the amount of total GAG was not limited to the malignant lesion. Similar increase was observed in benign liver tumours and also in the tissue adjacent to liver or kidney malignant tumours. 2) The dominant type of the GAG subclasses varies with the histology of the tumours. In benign liver tumours dermatan sulfate, in PHC and renal cell carcinoma chondroitin sulfate, but in Wilms' tumour hyaluronate was the prominent GAG subclass. 3) In all tumour-affected tissues dermatan and chondroitin sulfates had lower degree of sulfation. However, in the histologically different tumours various disaccharides showed reduced level of sulfation. The GAG alteration in renal cell carcinoma was compared with the prognostic factors of each individual case. This analysis showed a good correlation between HS/CS ratio and the prognostic factors of the kidney tumour cases. 相似文献
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D L Greenman R L Kodell B Highman G J Schieferstein M J Norvell 《Food and chemical toxicology》1987,25(3):229-232
C3H/HeN-MTV+ female mice were fed diets containing 320 or 640 ppb diethylstilboestrol (DES). DES feeding was started at 3 wk of age and was either continued throughout life or discontinued after 4, 8 or 26 wk of administration. A control group consisted of mice fed the same diet without DES, for the duration of the experiment. Mice were killed when palpable body masses (presumed to be mammary adenocarcinomas) reached a diameter of 1 cm. Adenocarcinomas developed in 79% of control mice and 96% of the mice exposed to DES for 26 wk, irrespective of the dose. The frequency and rate of removal of tumour-bearing mice were not increased further with lifetime exposure at a given dose. The time at which the first tumour occurred was largely dependent on the duration of exposure, not dose. The rate of occurrence of subsequent tumours was dependent on dose and duration of exposure; the rate of removal of mice with mammary adenocarcinomas was significantly greater at 640 ppb than at 320 ppb DES. Tumour frequency was 83% in mice exposed to 320 ppb DES for 8 wk and in those exposed for 4 wk; however, tumours developed at a faster rate in mice exposed for 8 wk. Tumour frequency was 94-96% in mice exposed to 640 ppb DES for 4 wk and 8 wk, and tumours developed more rapidly in mice exposed for 8 wk than in those exposed for 4 wk. When data were plotted as log-dose v. log-t50 (time to a probability that half the mice would be removed with mammary tumours) linear extrapolation to the control log-t50 gave an estimate of the no-effect level of exposure to DES. This estimate was remarkably consistent for all data sets (40-93 ppb) and was independent of the duration of exposure. 相似文献
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目的:探讨骨筋膜室综合征的病因,诊断及治疗,方法:总结分析26例骨筋膜综合征发生的病因,临床表现,诊断及治疗,结果:胫腓骨骨折并软组织挫伤4例,骨折合并胫后动脉断裂出血血肿6例,骨折出血血肿8例,Guo动静脉挫伤栓塞4例,尺桡骨近端骨折并软组织挫伤2例;头压伤前臂1例,刀砍伤前臂清创缝合后包扎过紧并感染1例,经手术探查,清除血栓,吻合血管,清除血肿,止血,引流,减压,术后抗凝,扩容,脱水,抗炎等治疗后功能无缺失20例,发生缺血性肌挛缩4例,截肢2例,结论:早期正确判断伤肢缺血的病因,进行相应的手术及术后抗凝,扩容,脱水,抗炎等治疗是防治骨筋膜室综合征的根本措施,切不可单纯行切开减压术。 相似文献
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目的 探讨成人肠套叠的螺旋CT征象及其临床应用价值.方法 回顾分析26例成人肠套叠的螺旋CT表现及其病理改变.结果 26例肠套叠患者的CT表现为:靶征11例、彗星尾征或肾形征9例、肿块样改变6例.26例成人肠套叠的病因分别为:原发癌15例,,转移瘤2例,淋巴瘤2例,息肉3例,阑尾炎4例.按套入部类型分为结-结套15例,回-结套6例,回-回套5例.结论 螺旋CT对肠套叠的表现有一定特征性,能很好地显示肠套叠的套入部,尤其增强对成人肠套叠的诊断、治疗有重要的指导作用. 相似文献
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目的探讨能够提高妇科门诊外阴、阴道及宫颈病变检出率的方法。方法对2006年6月至2008年6月间268例患者行阴道镜结合病理检查,阴道镜检查按说明操作诊断。结果早期宫颈癌阴道镜图像表现为局部表面结构不清,呈云雾状、脑回状或猪油状,醋酸试验时病变组织呈白色煮熟状,涂碘不着色,血管异常增生,失去正常分支,走向紊乱,从多点取材送病检46例的诊断是:宫颈腺囊肿26例,占56%:宫颈鳞状上皮非典型增生12例,占26%;宫颈浸润癌2例,占4.3%;宫颈原位腺癌5例,占10.8%;阴道癌1例,占2.3%。结论临床应用阴道镜检查宫颈病变比较可靠,可使外阴、阴道及宫颈病变检出率明显提高,并能提高早期cIN及宫颈癌的诊断率。 相似文献
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目的探讨低侵袭经肛超声刀局部切除治疗直肠腺瘤恶变和早期直肠癌的疗效和优越性。方法对15例直肠腺瘤恶变和早期直肠癌患者经肛门行局部切除术,采用5mm超声刀将直肠肿瘤完整切除(黏膜下或肌浅层),手术创口在腔内连续缝合。结果15例直肠腺瘤恶变、早期直肠癌均完整切除,切缘及基底均阴性,手术时间30—180min,平均60min,术中出血0~30ml,平均10ml;手术并发症:暂时性排气失控2例,急性尿潴留1例。术后病理:绒毛状腺瘤伴高级别上皮内瘤变8例,混合性腺瘤恶变2例,黏膜内癌5例。15例随访4—48个月,平均18个月,肿瘤无原位复发。结论低侵袭经肛超声刀局部切除治疗直肠腺瘤恶变和早期直肠癌是一种安全有效的手术方法,且保肛,提高了患者的生存质量。 相似文献