高强度聚焦超声对中晚期肝癌患者机体免疫细胞及其活性的影响

目的观察高强度聚焦超声（HIFU）对中晚期肝癌患者的机体免疫细胞及其活性的影响。方法HCC患者３０例,经全身麻醉、超声肿瘤定位进行HIFU治疗,采用流式细胞仪及双抗体夹心法检测治疗前、后外周血T细胞亚群（CD３ ＋ 、CD４ ＋ 、CD８ ＋ ）、NK细胞的百分率及sIL－２R的变化。采用LDH释放法检测NK细胞的杀伤活性。结果HIFU治疗后CD３ ＋ 、NK细胞的百分率明显升高（P＜０．０５）,NK细胞杀伤活性也升高（P＜０．０５）,而CD８ ＋ 细胞的百分率及sIL－２R的水平明显降低（P＜０．０５）。结论HIFU具有激活机体免疫细胞活性作用,可使机体的免疫功能得到一定程度的改善。     

氩氦刀冷冻消融术对荷瘤兔T细胞免疫的近期影响

目的比较氩氦刀治疗荷瘤兔前、后的T淋巴细胞亚群的变化,探讨氩氦刀治疗荷瘤兔T细胞免疫的早期影响。方法①将３０只荷瘤兔随机分为３组,氩氦刀治疗组（A组）、手术切除组（B组）、肿瘤对照组（C组）。②测定治疗前、后外周血T淋巴细胞亚群。结果T细胞淋巴亚群结果（Th、TS及Th／Ts ）:CD４（Th）:A组有明显增加（P＜０．０５）,B、C组有明显下降（P＜０．０５）。CD８（Ts ）:A、B、C组均有明显减低（P＜０．０５）。CD４／CD８（Th／Ts ）:A组有明显升高（P＜０．０５）,B、C组无明显变化（P＜０．０５）。结论从T淋巴细胞亚群指标分析,A组早期的细胞免疫效应好于手术切除组。     

动脉化疗栓塞联合CI K细胞过继免疫治疗对中晚期肝癌患者免疫功能的影响

目的 分析肝动脉化疗栓塞（ＴＡＣＥ）联合细胞因子诱导的杀伤细胞（ＣＩＫ）过继免疫治疗对中晚期肝癌患者外周血Ｔ淋巴细胞亚群及ＮＫ细胞的影响及临床意义。方法 回顾天津肿瘤医院１３６例中晚期原发性肝癌患者（均为ＴＡＣＥ术后, 经影像学检查显示无远处转移）资料,依据治疗方式分为两组:ＴＡＣＥ联合ＣＩＫ治疗６７例为研究组,单纯ＴＡＣＥ治疗６９例为对照组。分别于治疗前、治疗后相同时间点取外周血,测定ＡＦＰ、Ｔ淋巴细胞亚群及ＮＫ细胞计数变化;术后１个月采用增强ＣＴ、ＭＲＩ或ＰＥＴ ＣＴ评价肿瘤坏死程度。结果 研究组与对照组近期疗效及ＡＦＰ下降率比较,差异无统计学意义（Ｐ ＞ ０．０５）。对照组治疗前后比较,ＣＤ３＋、ＣＤ４＋、ＮＫ细胞比率及ＣＤ４＋／ＣＤ８＋分别由（５０．２６ ± ６．３７）％、（５３．２０ ± ９．２９）％、（２１．０３ ± ８．５８）％、１．５８ ± ０．４３下降至（４８．９５ ± ８．８３）％（Ｐ ＞ ０．０５）、（５０．０９ ± ９．９９）％（Ｐ ＜ ０．０１）、（１９．６３ ± ８．４２）％（Ｐ ＞ ０．０５）、１．４４ ± ０．５２（Ｐ ＜ ０．０１）,ＣＤ８＋、Ｔｒｅｇ细胞比率分别由（３５．７０ ± ８．７１）％、（６．５５ ± １．４７）％上升至（３８．０４ ± １０．５０）％（Ｐ ＜ ０．０５）、（６．７６　±　１．６７）％（Ｐ ＞ ０．０５）。研究组治疗前后比较,ＣＤ３＋、ＣＤ４＋、ＮＫ细胞比率及ＣＤ４＋／ＣＤ８＋分别由（５０．５１ ± １２．３７）％、（５２．４８ ± １５．５５）％、（２０．６７ ± １０．９２）％、１．７６ ± ０．９０上升至（５３．６２ ± １１．３７）％（Ｐ ＜ ０．０１）、（５５．６２±１４．６３）％（Ｐ ＜ ０．０５）、（２３．２３ ± １０．３７）％（Ｐ ＜ ０．０１）、１．９４ ± ０．８４（Ｐ ＜ ０．０１）,ＣＤ８＋、Ｔｒｅｇ细胞比率分别由（３５．６１±１２．９０）％、（６．５７ ± ４．８８）％下降至（３２．６８ ± １０．５６）％（Ｐ ＜ ０．０５）、（４．７７ ± １．９９）％（Ｐ ＜　０．０１）。结论 ＴＡＣＥ术后联合ＣＩＫ细胞过继性免疫治疗可以改善患者免疫状态,提高机体的抗肿瘤免疫效应,有可能降低中晚期ＨＣＣ患者ＴＡＣＥ术后的复发和转移机会。     

氩氦刀联合支气管动脉灌注治疗中晚期非小细胞性肺癌的疗效评估

目的探讨氩氦刀冷冻消融联合支气管灌注化疗（BAI ）治疗中、晚期非小细胞性肺癌的方法、疗效及临床意义。方法将符合入选的２０例肺癌患者分为A组（单纯氩氦刀组）和B组（氩氦刀联合BAI 组）,分别行经皮氩氦刀冷冻治疗及氩氦刀＋BAI 治疗。治疗后４周开始行CT或DSA随访,通过肿瘤区CT值变化、CT灌注成像、实体瘤治疗评价标准及生存期评价两组的临床疗效。生存期分析采用Breslow方法,分别计算中位生存时间并绘制生存期曲线图。结果本研究８０％（１６／２０）的病例冰球覆盖率＞９０％。两组间冰球覆盖率差异无统计学意义（P＞０．０５）。A组CT值变化（１６．７３±９．４３）Hu ,B组（１５．２９±６．９８）Hu ,差异无统计学意义（P＞０．０５）。A、B两组治疗前后BF、BV、PS差异有统计学意义（P＜０．０５）,两组间BV差异有统计学（P＜０．０５）。B组疗效优于A组。２０例患者随访期间死亡１０例,生存期７～２０个月,A组中位生存期为９个月,B组为１４个月,两组间差异有统计学意义（P＜０．０５）,B组生存率优于A组。结论氩氦刀冷冻联合BAI 治疗直径＞３cm的中、晚期非小细胞肺癌是一种安全、有效的方法,疗效优于单纯氩氦刀。CT灌注成像是评估肺癌氩氦刀冷冻治疗疗效的新手段,具有准确、敏感、直观的优点。     

介入动脉化疗加放射治疗鼻咽癌的近期疗效

目的探讨经颈动脉灌注化疗药物治疗加放疗对鼻咽癌的疗效。方法２２例患者经临床（包括鼻咽镜检）、影像学（CT、MR）和病理学检查确诊为鼻咽癌，经颈外动脉介入化疗后加放射治疗。化疗药物为阿霉素（ADM）或吡柔比星、５-氟尿嘧啶（５-FU）和顺铂（DDP）或卡铂（CBP）。同时随机选择同期单纯放疗的２５例作为对照，比较其疗效。结果介入组总有效率为１００．０％，其中CR为９０．９％（２０／２２），对照组总有效率为１００．０％，其中CR为６８．０％（１７／２５）熏两组分别比较差异有统计学意义（P＜０．０５）。结论介人动脉化疗后加放射治疗能显著提高鼻咽癌治疗的疗效。     

不同介入模式治疗伴失代偿性肝硬化肝癌

目的探讨伴失代偿性肝硬化原发性肝癌（HCC）不同介入模式的临床价值。方法在内科治疗稳定后，１３２例伴肝功能失代偿HCC患者接受不同介入模式治疗；３６例采用肝动脉化疗栓塞穴TACE，A组雪，５４例采用肝动脉节段性化疗栓塞治疗穴S-TACE，B组雪，４２例采用S-TACE后序贯射频消融穴RFA雪和无水乙醇局部注射穴PEI雪的综合介入治疗（C组）。结果随访３～４８个月，A组、B组和C组患者AFP复常率分别为２３．３％、６０．５％（P＜０．０５）和７５．０％（P＜０．０１），瘤体缩小（＞５０％）分别占８．３％、３１．５％（P＜０．０５）和５４．８％（P＜０．０１和P＜０．０５），中位生存期分别为４．１个月、９．４个月（P＜０．０５）和１４．１个月（P＜０．０１和P＜０．０５），累计生存率６个月分别为２２．２％、５１．８％（P＜０．０５）和７８．６％（P＜０．０５和P＜０．０１），１２个月分别为５．６％、３１．５％（P＜０．０５）和４０．５％（P＜０．０５），２４个月分别为０、９．３％和１９．１％（P＜０．０５）；单变量分析显示包括HBV DNA在内的１４项因素与预后显著相关，多因素COX模型分析显示肝功能Child-Pugh分级、ICGR１５、门静脉癌栓、治疗模式及AFP术前升高者介入治疗后变化与预后显著相关。结论综合介入治疗是伴肝功能失代偿HCC的有效治疗方法，对HBV DNA阳性患者应该考虑抗病毒治疗。     

改良髂内动脉化疗联合放疗治疗Ⅲ~Ⅳa期 子宫颈癌32例

【摘要】 目的 探讨改良髂内动脉化疗联合放疗治疗Ⅲ　～　Ⅳａ期宫颈癌的疗效。方法　　　回顾分析２００５年５月至２００９年８月在广东省茂名农垦医院妇产科、肿瘤放疗科住院治疗７０例Ⅲ　～　Ⅳａ期子宫颈癌患者的完整资料,其中行改良髂内动脉化疗术联合放疗（介入　＋　放疗,Ａ组）患者３２例,单纯放疗（Ｂ组）患者３８例。Ａ组患者采用Ｓｅｌｄｉｎｇｅｒ技术穿刺右股动脉,先行右子宫动脉化疗栓塞术;再超选至左髂内动脉化疗,保留导管连续化疗３ ｄ;化疗药有顺铂、氟尿嘧啶。放疗用直线加速器远距离外照射　＋　１９２Ｉｒ高剂量率腔内放疗。Ｂ组只进行外照射和腔内放疗,剂量稍增减。结果　　　１年生存率比较,Ａ组为 ７８．１％,高于Ｂ组（５５．３％, Ｐ　＜　０．０５）;３年生存率比较,Ａ组为５９．４％,高于Ｂ组３４．２％（Ｐ　＜　０．０５）;两组１、３年生存率比较差异有统计学意义;５年生存率两组比较差异无统计学意义（Ｐ　＞　０．０５）。两组放疗并发症发生率比较,差异无统计学意义（Ｐ　＞　０．０５）。结论　　　改良髂内动脉化疗术联合放疗对Ⅲ　～　Ⅳａ期宫颈癌的近期疗效较单纯放疗为好,生存质量较高;两组５年生存率比较则差异无统计学意义。
     

脑胶质瘤术后超选介入化疗联合系统化疗的临床研究

目的 探讨术后超选择介入化疗联合系统化疗治疗脑胶质瘤的优势。方法　　　２００６年至２００９年山东济宁市第一人民医院介入科收治４６例脑胶质瘤的患者,据患者自愿入组的原则分为两组。治疗组:２５例患者手术后先行常规放疗,然后行超选介入化疗,同期进行系统化疗。对照组:２１例患者手术后先行常规放疗,然后只进行系统化疗。定期随访,复查颅脑ＣＴ,测量肿瘤的体积,并进行Ｋａｒｎｏｆｓｋｙ预后评分。比较肿瘤体积变化及两组间Ｋａｒｎｏｆｓｋｙ预后评分的差异。结果　　　平均随访２．３年,两组均无死亡病例。化疗前两组肿瘤的体积差异无统计学意义,（Ｐ ＞ ０．０５）。化疗１年后介入化疗联合系统化疗组肿瘤缩小率为６７．１１％,系统化疗组肿瘤缩小率为４５．７９％,两组肿瘤体积经独立样本ｔ检验显示肿瘤体积差异有统计学意义（Ｐ ＜ ０．０５）。治疗组在化疗期间出现癫痫３例,眼痛５例,头痛９例,恶心呕吐８例,血小板下降１例。对照组出现癫痫１例,头痛７例,血小板下降３例,恶心呕吐６例。Ｗｉｌｃｏｘｏｎ秩和检验Ｋａｒｎｏｆｓｋｙ预后评分显示介入化疗结合系统化疗组的预后优于单纯系统化疗组。（Ｐ ＜０．０５）。结论　　　术后放疗结合介入化疗联合系统化疗的治疗方法,与术后放疗结合系统化疗的治疗方法相比,可以更有效的控制肿瘤的生长,改善临床症状,提高生活质量,是值得进一步探讨的化疗方法。     

氩氦刀联合介入治疗复发、难治性非小细胞肺癌的临床分析

目的探讨复治性非小细胞肺癌的治疗方法。方法对６２例放化疗后未控制病情的非小细胞肺癌患者进行氩氦刀冷冻联合介入治疗，测定治疗前后血清肿瘤标志物（NSE、CEA、CY２１-１）含量及细胞核仁组成区相关蛋白（Ag-NORs）值（I．S％、I．O．D％），观察其疗效及１年生存率。结果治疗后血清标志物测定明显降低，（P＜０．０１）；I．S％、I．O．D％值明显降低，（P＜０．０５）；有效率７９．０％（４９／６２），１年生存率８０．６％（５０／６２）。结论氩氦刀联合介入对复治性非小细胞肺癌仍然有效。是解决复发难治性非小细胞肺癌的新途径。     

经导管化疗栓塞联合放疗治疗中晚期宫颈癌

目的探讨介入性动脉化疗栓塞序贯盆腔根治性放疗治疗中晚期宫颈癌的临床应用价值。方法１９５例临床Ⅱb期以上的中晚期宫颈癌患者，根据治疗方法不同分为介入化疗栓塞联合放疗组（联合组）９９例和单纯放疗组（放疗组）９６例，比较治疗后的近、远期疗效及并发症等各项指标，评价两组在治疗中晚期宫颈癌上的效果和差异。结果治疗后两组瘤体均出现不同程度缩小，但近期缓解率联合组高于放疗组，组间比较差异有统计学意义（P＝０．０１２）；联合组介入术后贫血纠正明显，术前、术后血红蛋白水平差异有显著统计学意义（P＜０．０１）。远期随访３年生存率联合组高于放疗组（P＝０．０３２），１、３年肿瘤复发转移率联合组明显低于放疗组（P＜０．０５）；１、５年生存率及５年肿瘤复发率两组差异无统计学意义。近期并发症主要表现为消化道反应，骨髓抑制及肝、肾毒性等不良反应，经临床积极对症处理后均能缓解。远期并发症以放射性皮炎、膀胱炎和（或）直肠炎为主，其中联合组放射性膀胱炎和直肠炎的发生率均低于放疗组（P＜０．０５）。结论介入化疗栓塞序贯放疗是治疗中晚期宫颈癌的有效方法，可以提高近远期疗效，改善临床症状，降低远期并发症，提高患者生活质量，延长患者生存期。     

底层与顶层MCFC-MGT联合循环系统性能分析

在IPSEpro仿真环境下建立了熔融碳酸盐燃料电池/微型燃气轮机联合循环系统顶层循环和底层循环仿真模型.利用该模型对两种不同型式的联合循环系统在额定工况和变工况下的稳态性能进行了研究,并对两种联合循环系统的主要性能参数进行了对比分析.结果表明:熔融碳酸盐燃料电池/微型燃气轮机顶层联合循环系统具有较高的发电效率,而底层循环具有良好的变负荷特性.     

风力发电并入微网电能质量分析与检测

风力发电并网引发的电能质量问题不仅是限制风电机组装机规模的重要因素,而且对微网的安全稳定运行产生了很大的影响,因此有必要对风力发电并网引发的电能质量问题进行深入的分析,而分析的前提就是对其进行准确的检测。首先简要介绍微网的定义,并在此基础上给出风力发电机并入微网的结构示意图,其次对风力发电并网引发的电压波动与闪变、谐波以及电压偏差的机理进行分析,得出引发这些电能质量问题的根本原因。最后针对风力发电并网引发的电压偏差现象,提出采用Hilbert-Huang变换的方法对其进行检测。仿真测试结果表明了该方法的有效性。     

Thermal behavior of buildings with curved roofs as compared with flat roofs

In this paper, a detailed finite element model dealing with heat transfer through a domed or vaulted roof is suggested based on a three-dimensional heat transfer equation and solar geometry. This model allows a comparison of the thermal behavior of curved and flat roofs in terms of heat flux and daily heat flow through them into an air-conditioned building under different climatic conditions. The results of numerical calculations show that the ratio of daily heat flow through curved roofs to that through flat ones is not affected by the curve radius, thickness and construction material of the roof, but is significantly influenced by the half rim angle θ₀ of the roofs and the ambient temperature. Compared to a flat roof, under typical hot dry climatic conditions, the daily heat flow through a domed roof of θ₀=90° is about 40% higher, whereas the daily heat flow through a south–north oriented and an east–west oriented vault of θ₀=90° is about 20 and 27% higher, respectively. The reason for this is mainly attributed to the convective heat transfer between the enlarged curved roof and ambient air. However, when θ₀<50°, heat flux and daily heat flow through a curved roof is close to that through a flat roof. The results also confirm that curved roofs are not suitable for areas with higher air temperature and intense sky diffuse radiation typical of hot humid areas.     

Comparison of carbon capture IGCC with pre-combustion decarbonisation and with chemical-looping combustion

Carbon capture from conventional power cycles is accompanied by a significant loss of efficiency. One process concept with a potential for better performance is chemical-looping combustion (CLC). CLC uses a metal oxide to oxidize the fuel, and the reduced metal is then re-oxidized in a second reactor with air. The combustion products CO₂ and water remain unmixed with nitrogen, thereby avoiding the need for energy intensive air separation. In this paper, the performance of various configurations of CLC used in integrated gasification combined cycle power plants (CLC-IGCC) are analyzed and compared to a conventional IGCC design with pre-combustion carbon capture by physical absorption. The analysis is based on process simulation using Aspen Plus and GateCycle. Key design parameters are varied, and the results are interpreted using exergy analysis. The CLC-IGCC offers the advantages of higher plant efficiency and more complete carbon capture. The efficiency is very sensitive to changes in the gas turbine inlet temperature for both the CLC and the conventional IGCC designs. The development of oxygen carrier particles with a high thermal stability is therefore crucial for capitalizing on the potential efficiency advantage of CLC.     

Co-combustion of sludge with coal

Utilisation of waste-water sludge is one of the most difficult processes of environment protection because of the high moisture and contents of harmful substances. The waste-water treatment systems in Poland, especially in small towns, are often not separate from industrial sewage systems and this causes relatively large contents of heavy metals and other toxic substances in the sludge. Incineration is the only effective method of utilisation of such waste material. From the other side, coal is still the most popular fuel in Poland, and it is often used in many boilers producing hot water for the central heating of buildings or parts of the towns. Mostly they are stoker fired boilers of old construction, and they need urgent modernisation. The use of stoker-fired boilers for incineration of the sludge in small towns is the object of the analysis presented in this paper. There are two important points in the co-combustion of sludge with coal in a stoker-fired boilers: ecological and exploitation requirements. The important restriction of the sludge/coal ratio is the emission of harmful substances with the flue gas. There are substances originating from the components of the sludge: SO₂, NO_x, HCl, heavy metals and dust. Their concentrations in the flue gas should meet the environmental regulations. The other factor influencing the co-combustion process is the change of physical and thermal properties of the fuel: heating value, moisture content and ash composition. These influence the thermal output of the boiler, the amount of air required for combustion, the volume of flue gases and dust concentration and particle distribution. In this paper, the results of experiments performed with an experimental boiler are presented. The effects of the following parameters are considered: composition and thermal parameters of the sludge and their change during the year, emissions of SO₂, NO_x, CO and dust from the experimental boiler for various compositions of the fuel (sludge/coal ratio, moisture content). As a result of the analysis, the parameters limiting the amount of sludge in a mixture with coal are identified.     

Operation of offshore wind farms connected with DRU-HVDC transmission systems with special consideration of faults

The diode rectifier unit (DRU)-based high-voltage DC (DRU-HVDC) system is a promising solution for offshore wind energy transmission thanks to its compact design, high efficiency, and strong reliability. Herein we investigate the feasibility of the DRU-HVDC system considering onshore and offshore AC grid faults, DC cable faults, and internal DRU faults. To ensure safe operation during the faults, the wind turbine (WT) converters are designed to operate in either current-limiting or voltage-limiting mode to limit potential excessive overcurrent or overvoltage. Strategies for providing fault currents using WT converters during offshore AC faults to enable offshore overcurrent and differential fault protection are investigated. The DRU-HVDC system is robust against various faults, and it can automatically restore power transmission after fault isolation. Simulation results confirm the system performance under various fault conditions.     

Modeling of laminar pulverized coal flames with speciated devolatilization and comparisons with experiments

In an earlier mathematical model of laminar pulverized coal–air combustion, supported by added CH₄, it was assumed that the volatiles from the coal consisted solely of CH₄ and HCN. A revised model is introduced with speciated devolatilization rate constants for tar, CH₄, CO, CO₂, H₂O, H₂, and HCN. It is assumed that these rate constants can also be applied to the devolatilization of the tar. In addition, it is assumed that the soot is predominantly carbon and is oxidized by the attack of O, H, OH, and O₂, in the same way as the coal char. Because the devolatilization rate is strongly dependent on particle temperature, the latter has to be determined accurately from the momentum and energy equations of the particle. The model is one-dimensional, with axial radiative transfer. The introduction of soot formation and speciation of the volatiles results in much improved accuracy in the prediction of species and temperature profiles in subatmospheric combustion on a flat flame matrix burner. It is possible to derive an overall global devolatilization rate constant that agrees reasonably with the measurements. These computations suggest that the effective area of the assumed spherical coal char particles is four times greater than that of the assumed sphere. Modeling of atmospheric pressure flames suggests that in this case, the value of 4 should be reduced, probably because, as pressure increases, the diffusion flux of reactant is reduced. Subatmospheric pressure laminar burning velocities are predicted with satisfactory accuracy over the full range of overall equivalence ratios. Previous measurements of laminar burning velocity at atmospheric pressure are reviewed. However, the various means of supporting a stable coal flame and the associated uncertain geometries make it impossible to apply the present model to the different conditions. It is suggested that burning velocities measured on a flat flame burner, with a controlled amount of methane to support the combustion of a pulverized coal/air mixture, would provide a good test of the reactivities of different coals.     

Lithium batteries with voltage compatibility with conventional systems

The possibility of using lead or lead—bismuth mixed oxides as positive materials in organic electrolyte lithium cells with a working voltage similar to those of conventional systems (1.5 V) has been considered. Performances and main characteristics of this new class of lithium batteries are described.     

Possibility of forming continuous solid solutions of silicon and germanium with compounds with defective diamond-like structures

The possibility is considered of forming continuous solid subtraction solutions by substituting clusters of silicon or germanium atoms by molecules of III₂VI₃ and II III₂VI₄ compounds that are defective tetrahedral phases. The alloying of Si and Ge with admixtures of these compounds is of interest for creating nanodefects and researching impurity voltaic effects.