高强度聚焦超声波对细粒棘球绦虫原头节酶活性的影响

目的探索高强度聚焦超声波(HIFU)对体外分离的细粒棘球绦虫原头节的酶活性的影响作用。方法用不致原头节即刻杀伤的高强度聚焦超声剂量照射原头节,行酶组织化学染色观察酸性磷酸酶(ACP)、葡萄糖6-磷酸酶(G-6-P)和琥珀酸脱氢酶(SDH)的活性,了解高强度聚焦超声对体外培养的原头节3种代谢酶活性的影响作用。结果细粒棘球绦虫原头节具有酸性磷酸酶、葡萄糖6-磷酸酶和琥珀酸脱氢酶活性。不致原头节即刻杀伤的高强度聚焦超声波作用后,辐照组原头节葡萄糖6-磷酸酶和琥珀酸脱氢酶活性较对照组明显减弱,而酸性磷酸酶反应产物与对照组相比无明显变化。阴性对照组无酶反应产物产生。结论高强度聚焦超声波辐照对原头节酸性磷酸酶活性无影响,而对葡萄糖6-磷酸酶和琥珀酸脱氢酶的活性有明显的抑制,这可能是影响原头节的代谢功能,最终抑制其增殖的原因之一。     

高强度聚焦超声联合肝动脉化疗栓塞治疗门静脉癌栓的临床研究

目的 探讨高强度聚焦超声（HIFU）联合肝动脉化疗栓塞（TACE）治疗门静脉癌栓（PVTT）的安全性和有效性。方法将42例原发性肝癌（HCC）合并门静脉癌栓（PVTT）患者分为两组,A组（22例）采用HIFU联合TACE进行治疗,B组（20例）单纯采用TACE治疗。结果HIFU联合TACE组治疗后PVTT有5例消失,12例缩小,比TACE组疗效明显（P〈0．05）。HIFU联合TACE组,有11例患者恢复门静脉血流,癌栓内血供较单纯TACE治疗组明显减少（P〈0．05）。联合治疗组中位生存期13．8个月,较同期TACE组中位生存期7．9个月明显延长（P〈0．05）。结论HIFU联合TACE治疗PVTT是一种新的安全、有效、微创的治疗方法,能明显提高患者生活质量,延长寿命。     

肋骨切除术在HIFU联合TACE治疗中晚期肝癌中的临床价值

目的:探讨肋骨切除术在高强度聚焦超声(Hihg intensity focused ultrasound,HIFU)联合经导管动脉栓塞化疗(Tran-seatheter arterial chemoembolization,TACE)治疗中晚期肝癌中的临床价值.方法:68例右叶中晚期肝癌分为肋骨切除组(36例,43病灶)和非肋骨切除组(32例,40病灶),随访两组患者HIFU联合TACE后的疗效,并进行比较.结果:总平均随访(11.9±11.4)月,两组中位生存期及1、2年生存率分别依次为13月、52.3%、21.8%与12月、46.8%、17.6%,两组比较无统计学意义(P=0.8155);其病灶完整消融率和消融体积>80%比例分别依次为46.5%、79.1%与37.5%、67.5%,两组比较无统计学意义(P>0.05).结论:肋骨切除术不能有效提高HIFU联合TACE治疗中晚期肝癌的疗效.     

新型相控聚焦超声声场测量实验研究

目的:相控聚焦超声是热物理治疗领域的研究热点之一,而对其声场的研究是其中最重要的技术环节.本文分析了新型相控聚焦超声声场仿真和实验测量的声场结果.方法:运用LabVIEW虚拟仪器平台开发了超声声场测量系统.该系统用水听器声场扫描法测量了单焦点模式下新型相控聚焦超声声场分布,并用MATLAB等工具包对单焦点模式下的声场分布进行仿真.结果:仿真数据和实验结果基本一致.结论:本文验证了理论模型的正确性及本系统测量相控型聚焦超声声场可行性和有效性.     

Transrectal high-intensity focused ultrasound for the treatment of localized prostate cancer: Eight-year experience

Objective:   To report on the long-term results of high-intensity focused ultrasound in the treatment of localized prostate cancer.
Methods:   A total of 517 men with stage T1c–T3N0M0 prostate cancer treated with Sonablate devices (Focus Surgery, Indianapolis, IN, USA) between January 1999 and December 2007 were included in the study. Biochemical failure was defined according to the Phoenix definition (prostate-specific antigen nadir + 2 ng/mL).
Results:   The median follow-up period for all patients was 24.0 months (range, 2 to 88). The biochemical disease-free rate (BDFR) in all patients at 5 years was 72%. The BDFR in patients with stage T1c, T2a, T2b, T2c and T3 groups at 5 years were 74%, 79%, 72%, 24% and 33%, respectively ( P  < 0.0001). BDFR in patients in the low, intermediate and high-risk groups at 5 years were 84%, 64% and 45%, respectively ( P  < 0.0001). The BDFR in patients treated with or without neoadjuvant hormonal therapy at 7 years were 73% and 53% ( P  < 0.0001), respectively. In multivariate analysis, pretreatment prostate-specific antigen levels (hazard ratio 1.060; P  < 0.0001; 95% confidence interval 1.040–1.080), neoadjuvant hormonal therapy (hazard ratio 2.252; P  < 0.0001; 95% confidence interval 1.530–3.315) and stage ( P  = 0.0189) were demonstrated to be statistically significant variables. Postoperative erectile dysfunction was noted in 33 out of 114 (28.9%) patients who were preoperatively potent.
Conclusions:   High-intensity focused ultrasound therapy appears to be minimally invasive, efficacious and safe for patients with localized prostate cancer, particularly those with low- and intermediate-risk cancer.     

Rectal fistulae after salvage high‐intensity focused ultrasound for recurrent prostate cancer after combined brachytherapy and external beam radiotherapy

OBJECTIVE

To report on the high rectal fistula rate associated with salvage high‐intensity focused ultrasound (HIFU) after the failure of combined brachytherapy and external beam radiotherapy (EBRT) for prostate cancer; salvage ablative therapy for prostate cancer is indicated when there is local recurrence after RT, brachytherapy or their combination.

PATIENTS AND METHODS

We retrospectively reviewed all men with prostate cancer treated with HIFU between 1 March 2005 and 31 May 2007, and identified five men treated after the failure of both brachytherapy and EBRT for localized prostate cancer.

RESULTS

Three of the five men had iodine‐seed implantation brachytherapy combined with EBRT as primary treatment, one had high‐dose rate brachytherapy combined with EBRT and one had salvage iodine‐seed brachytherapy for failed EBRT. Three of the five patients developed a recto‐urethral fistula after HIFU.

CONCLUSIONS

The high rate of recto‐urethral fistula formation in this group might reflect an impaired blood supply or HIFU‐associated near‐field heating of the rectal wall. Tissue viability and healing might affect this group regardless of the salvage method. Careful patient selection and avoidance of rectal diagnostic biopsies might minimize the risk. Emerging ablative therapies regarded as less invasive than traditional therapies must be used with caution.     

Higher Dosage of HIFU Treatment May Lead to Higher and Longer Efficacy for Moderate to Severe Perennial Allergic Rhinitis

Objectives: This study was to compare the efficacies and side effects of high intensity focused ultrasound (HIFU) treatment for perennial allergic rhinitis (PAR) with regular and increased dosage.Study design: A prospectively assembled cohort was retrospectively analyzed through visual analogue scale (VAS).Methods: Regular dosage of HIFU treatment was applied to 56 PAR patients in group A. An increased dosage as twice as the regular one was applied to 48 patients in group B. Nasal obstruction, sneezing, rhinorrhea and rhinocnesmus, which were recognized as the four main symptoms of allergic rhinitis (AR), were evaluated before treatment, 3 months after treatment, and 1 year after treatment. The satisfaction of patients was also evaluated at 1 year postoperatively. Biopsy of the inferior turbinate and morphometric analysis were applied to 11 patients in group A and 10 in group B before HIFU treatment and 3 months after treatment.Results: Comparing the AR symptoms before treatment, There is no statistical difference observed between group A and B (p>0.05). The four main symptoms at 3 months and 1 year after treatment were all significantly improved (p<0.01) in both group A and B. The VAS scores of AR symptoms in Group B were lower than those in Group A at the same stage after treatment, especially at 1 year after treatment (p<0.05). Comparing the results at 3 months and 1 year after treatment, a tendency of recurrence of these symptoms was observed statistically in group A (p<0.05), but not in group B (p>0.05). More cases of nasal dryness and perirhinal swelling were found in group B than those in group A (p<0.05), while all side effects were mild and temporary. Patients in group B were more satisfied than those in group A (p=0.0866 >0.05), though not statistically significant. More reduction of the eosinophils, other inflammatory cells, and the submucosal glands was observed after HIFU treatment in group B than that in group A (p<0.05).Conclusions: A proper increment of HIFU dosage may be recommended to meet the needs of more improvement of AR symptoms and less recurrence.     

高强度聚焦超声治疗胰腺癌疼痛的疗效观察

目的探讨高强度聚焦超声(HIFU)治疗胰腺癌疼痛的疗效。方法对37例胰腺癌患者在HIFU治疗后疼痛程度采用视觉模拟评分法(VAS)进行评分,对疗效进行分析。结果 HIFU治疗前平均疼痛的VAS评分为5.18±1.36,治疗后平均疼痛的评分为4.37±1.43,二者差异有统计学意义,止痛总有效率为100%。全部患者全部没有不良反应发生。结论 HIFU治疗胰腺癌能控制肿瘤进展,有效缓解疼痛,提高生活质量。     

镇静镇痛方案用于高强度聚焦超声治疗子宫肌瘤的临床研究

目的 评价阶梯式逐步给药的镇静、镇痛方案用于高强度聚焦超声（HIFU）治疗子宫肌瘤的安全性和可行性.方法 82例ASAⅠ～Ⅱ级的子宫肌瘤患者,在采用阶梯式逐步给药的镇静镇痛方案进行镇静和镇痛的条件下,用HIFU治疗子宫肌瘤.结果 82例患者镇静深度Ramsy评级平均值为（2.58±0.62）分,无镇静评级大于4级,无苏醒延迟.82例患者疼痛评分平均值为（3.43±0.70）分,评分低于4分的患者80例,镇痛有效率为97.6% （80/82）.治疗中的平均动脉压、心率、氧饱和度,与治疗前比较差异无显著性.呼吸平均次数治疗中较治疗前下降,差异有显著性.结论 阶梯式逐步用药的镇静、镇痛方案,用于HIFU治疗子宫肌瘤是安全和可行的.     

海扶超声聚焦刀治疗肝癌116例的临床护理

通过对1999年6月至2001年2月,应用海扶超声聚焦刀治疗116例肝癌患者的护理,总结了术前,术中及术后的护理方法,强调了术前病人的心理准备;术中生命体征监测,治疗体位的合理摆放及治疗区皮肤的监测和术后的观察与处理为护理的重点。