胶质母细胞瘤切除术后同步放化疗的疗效

目的探讨胶质母细胞瘤切除术后同步放化疗的疗效。方法研究对象选择我院神经外科2014年1月～2016年8月经手术切除治疗并经病理确诊的胶质母细胞瘤患者50例,根据术后是否行同步放化疗将其分为观察组与对照组,其中观察组患者术后实施同步放化疗,对照组患者术后拒绝行放化疗,比较两组患者的存活率。结果治疗后,观察组患者的术后3个月存活率及术后6个月存活率、术后9个月存活率明显高于对照组,术后1年存活率和术后2年存活率明显高于对照组,差异有统计学意义(P0.05)。结论对于胶质母细胞瘤患者给予手术切除,术后同步进行放疗和化疗,能明显提高患者的术后1年和术后2年存活率。     

多维康复健康教育对胶质母细胞瘤术后同步放化疗患者日常生活能力、运动功能和生存质量影响

目的 探讨多维康复健康教育对胶质母细胞瘤术后同步放化疗患者日常生活能力(ADL)、运动功能和生存质量影响.方法 选取2018年3月至2021年3月台州市肿瘤医院收治的胶质母细胞瘤术后放化疗患者82例,采用随机数字表法分为观察组与对照组各41例.观察组在常规健康教育基础上结合多维康复健康教育,对照组仅采用常规健康教育.两...     

螺旋断层放射治疗联合替莫唑胺治疗脑胶质母细胞瘤的疗效分析

目的 对恶性脑胶质瘤术后螺旋断层放射治疗联合口服化疗药物替莫唑胺(TMZ)的疗效进行分析.方法 收集2011年10月～2012年8月就诊于沈阳军区总医院的23例脑胶质母细胞瘤术后患者的相关信息,所有患者均应用螺旋断层放射治疗技术调强放射治疗,同步给予替莫唑胺胶囊化疗,其中13例继续服用替莫唑胺胶囊辅助化疗6个周期,5例辅助化疗＞6个周期,5例仅同步放化疗未辅助化疗.23例平均随访14个月,对治疗的疗效、不同影响因素与恶性胶质瘤预后的影响和治疗的相关副反应进行分析.结果 患者中位总生存期(OS)为17.2个月,中位无疾病进展生存期(PFS)为8.6个月,其中KPS评分较高(＞80)患者的PFS明显延长;辅助化疗≥6个周期患者的PFS和OS明显延长;手术至放疗时间＜4个周期患者的OS明显延长.所有患者均未出现Ⅲ～Ⅳ级毒副反应,耐受性良好.结论 应用螺旋断层放疗技术同步放化疗治疗胶质母细胞瘤安全、有效,具有可行性,为临床治疗提供了新的方向.     

基因芯片技术在脑胶质瘤诊疗中的研究进展

胶质母细胞瘤(GBM)是神经系统最常见的高度恶性肿瘤,手术切除加同步放化疗后的平均生存期也仅为1a余。对基因芯片在GBM中的相关信号通路的研究,分子表达特征及个体化治疗进行综述,旨在为胶质母细胞瘤诊断、治疗以及预后有关的基因通路表达的研究拓展思路。     

MMP-13在胶质母细胞瘤中的表达及对患者术后生存期的影响

目的 探讨基质金属蛋白酶13 (Matrix metalloproteinase 13,MMP-13)的表达对胶质母细胞瘤患者术后生存期的影响.方法 免疫组化法检测31例胶质母细胞瘤患者肿瘤组织标本中MMP-13的表达,Kaplan-Meier生存曲线和Log-rank检验比较MMP-13强表达组与弱表达组患者术后生存期之间的差异.结果 MMP-13在胶质母细胞瘤中总表达率为77.4％,强表达组术后生存期明显短于弱表达组(P＜0.0001,x2=18.275).结论 MMP-13有潜力作为胶质母细胞瘤患者预后的影响因素.     

治疗首次术后脑胶质母细胞瘤“放化疗同步”优于“单纯放疗”

首都医科大学附属北京天坛医院胶质瘤治疗中心教授江涛、放疗中心主任邱晓光最近通过对60例胶质母细胞瘤患者术后放、化疗跟踪研究发现,放疗加化疗同步治疗首次术后胶质母细胞瘤,在提高局部控制率、延缓肿瘤复发与提高患者无瘤生存期方面都明显优于传统的单纯放疗,而不良反应均较轻微,两组间没有明显差异。该研究发表在2008年7月《中华神经外科杂志》上。     

短程放疗联合替莫唑胺在老年胶质母细胞瘤患者中的生存获益分析

目的 探讨短程放疗联合替莫唑胺(TMZ)方案在术后KPS评分较差的老年胶质母细胞瘤(GBM)患者治疗中的生存获益情况.方法 回顾分析行完整切除但术后KPS评分不佳的新诊断老年GBM患者71例,对不同MGMT状态下各辅助治疗方案进行生存分析和比较.结果 71例患者年龄65~85岁,平均(71.10±5.19)岁,其中男50例,年龄(71.36±5.35)岁,女21例,年龄(70.48±4.90)岁;其中62例在随访截止日期前死亡,总体平均生存期(OS)(11.92±0.51)个月,2年生存率0;接受短程同步放化疗联合TMZ辅助治疗组平均生存期显著提高(P=0.002),与单纯短程放疗组相比差异性最大(P=0.001),而单纯短程放疗与单纯TMZ辅助治疗组之间OS差异无统计学意义(P>0.05);术后免疫组化MGMT阴性表达组患者更能从短程同步放化疗联合TMZ辅助化疗中获得生存获益(P=0.004).结论 对于≥65岁接受肿瘤切除后功能状态不佳的老年GBM患者,短程同步放化疗联合TMZ辅助治疗可能是一种能获得更多生存获益的术后辅助治疗方案,在MGMT启动子甲基化患者中,这种获益优势更加明显.     

胶质母细胞瘤术后同步放化疗临床疗效观察

目的 观察胶质母细胞瘤术后,替莫唑胺(TMZ)同步放化疗的临床疗效.方法 2006年4月～2007年4月收治55例手术后病理证实为胶质母细胞瘤的病人,随机分为2组:①辅助化疗组(30例),术后放疗后予TMZ辅助化疗,第1周期化疗[150 mg/(m2·d),d1～5,间隔28d];第2～4周期[200 mg/(m2·d),d1～5],间隔28 d);②同步放化疗组(25例),放疗开始便予TMZ第一周期化疗[(150 mg/(m2·d),d1～5)],放疗28 d时予TMZ第2周期化疗[(200 mg/(m2·d),d1～5)1,以后再予TMZ辅助化疗2周期.术后放疗剂量均为DT60Gy/30次.随访至2009年4月,观察总生存时间、无进展生存时间以及毒副反应.结果 辅助化疗组的中位生存时间为7.6月,同步放化疗组的中位生存时间为13.8月.中位无进展生存时间分别为:4.25月和6.65月.2年总生存率分别为:13.33%和24%(P=0.0420).2年无进展生存率分别为:10%和16%(P=0.0231).差别均有统计学意义.且没有发现明显毒副反应.结论 胶质母细胞瘤术后予TMZ同步放化疗疗效优于术后放疗后辅助化疗,且病人能很好的耐受.     

立体适形放疗在治疗脑胶质母细胞瘤术后患者的应用

脑胶质母细胞瘤的治疗以手术加放疗、化疗的综合治疗为主,由于脑胶质母细胞瘤的生物学特性为浸润性生长,无明确边界,手术治疗难以彻底清除病变,术后必须配合放疗。但术后放疗的剂量因受正常脑组织耐受剂量的限制,很难达到较高的剂量以控制复发。如何提高照射剂量是提高脑胶质母细胞瘤术后病例的局部控制率、延长生存期的关键所在。立体适形放射治疗为照射剂量的提高提供了有利途径。笔者对本院1999—2002年收治的12例脑胶质母细胞瘤术后进行立体适形放疗的患者资料进行回顾性分析,报告如下。1资料与方法1.1一般资料脑胶质母细胞瘤术后患者12…     

功能区低级别胶质瘤患者生存影响因素分析

目的 探讨功能区低级别胶质瘤(LGGs)患者生存影响因素.方法 回顾性分析2011年1月至2015年6月安徽医科大学第一附属医院神经外科新诊断的62例功能区LGGs患者的临床资料,统计分析患者生存影响因素.结果 单因素分析发现年龄<40岁、术前KPS≥70分、肿瘤全切、少突胶质细胞瘤、术后进行联合放化疗的功能区LGGs患者无进展生存期(PFS)和总生存期(OS)优于年龄≥40岁、术前KPS<70分、非全切、星形细胞瘤或混合性少突-星形细胞瘤、术后不放化疗或单独放疗/化疗患者,差异有统计学意义(P<0.05);多因素分析示年龄、术前KPS评分、手术切除程度、病理类型是影响生存的独立因素(P<0.05).结论 年龄较轻、术前高KPS评分及含有少突胶质细胞成分的功能区LGGs患者预后较佳,手术全切及术后放化疗能延长患者生存期.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.