Objective To study the mechanism of high intensity focused ultrasound (HIFU) and discuss its clinical significance in the treatment of mid-late stage liver cancer. Methods The patients with mid-late stage liver cancer were treated with HIFU. The changes of photography, pathology and immunology after operation were evaluated. Results It was shown that the results of the photographic, pathologic and immunologic examinations changed during the treatment of the patients with HIFU. Conclusion HIFU is effective and safe for the treatment of mid-late stage liver cancer.
【摘要】 目的 探索针灸治疗慢性功能性便秘的特点及规律,以期为制定针灸治疗功能性便秘优选方案提供参考。方法 运用文献计量学方法,通过回顾分析1999年—2008年的针灸治疗慢性功能性便秘文献,以中国期刊全文数据库为资料来源,对这些文献进行定量分析。结果 共纳入86篇文献,分布在41种期刊上；针灸治疗功能性便秘最常用的穴位是天枢、大肠俞、足三里、支沟、上巨虚。结论 针灸治疗本病操作方法繁多,临床研究水平普遍较低,需进一步探讨针灸治疗的优化方案。
ObjectiveTo explore the values of CA19-9, CA242, CEA, and CA125 single or combined detection on clinical diagnosis and prognosis for patients with pancreatic cancer. MethodsSerum tumor markers CA199, CA242, CEA, and CA125 of 63 patients with pancreatic cancer, 33 patients with cancer of bile duct, and 27 patients with benign pancreatic disease were detected, and those patients were followed up after operation. ResultsThe levels of CA19-9, CA242, CEA, and CA125 in patients with pancreatic cancer were significantly higher than those in patients with benign pancreatic disease and cancer of bile duct (Plt;0.05). The sensitivity of CA19-9 alone was the highest in the four tumor markers for the patients with pancreatic cancer 〔79.4% (50/63)〕, but the specificity (61.9%) was lower than that of CA242 (83.3%) and CEA (80.0%). The specificity of combined detection of CA199+CA242+CEA was the highest 〔93.3% (56/60)〕. The level of CA19-9 in carcinoma of body/tail of pancreas was significantly higher than that of carcinoma of pancreas head or whole pancreas (Plt;0.05). The serum levels of CA19-9 and CA242 in patients with stage Ⅳ were significantly higher than those in stage Ⅰ or Ⅱ/Ⅲ (Plt;0.05). Fifteen patients were lost to follow up, 48 patients were followed up 2－12 months with an average 6 months. The levels of CA242 and CA199 in patients with pancreatic cancer on 0.5 month and 3 months after operation were lower than those before operation (Plt;0.05). ConclusionsSingle detection of CA19-9 can improve the diagnostic sensitivity, and combined detection of tumor markers CA199+CA242+CEA can improve the diagnostic specificity. CA19-9 or CA242 is a valuable marker for evaluating treatment effects and estimating prognosis.
The article titled "The global burden of lung cancer: Current status and future trends" which is recently published in Nature Reviews Cinical Oncology has provided a detailed analysis of the current global status of lung cancer. This article focuses on the global burden of lung cancer, risk factors, related prevention, control measures and treatment progress. Based on the current situation of lung cancer in the world, this paper analyzes the current situation of lung cancer in China, and briefly interprets the key points of prevention as well as control measures in the article.
通过与首都医科大学、南京医科大学、中山医科大学、四川大学的康复医学研究人员2000年1月至2008年3月止发表在康复医学主要五种杂志上的期刊论文,从论文年代分布、领域论文分布、核心期刊发文率、基金资助研究情况、主题分布情况等方面进行了全面的统计分析,比较客观地揭示和描述了新世纪初四川大学华西医院康复医学中心康复医学研究与发展的基本状况,并提出发展的可能策略。
ObjectiveTo study the clinical manifestations, pathologic characteristics, imaging features, diagnosis and treatment of adenomas of extrahepatic bile duct.MethodsTwo cases of adenomas of extrahepatic bile duct in our hospital and 14 cases reported in the literatures were analyzed retrospectively.ResultsThe patients’(male 5, female 11) mean age was 58.4 years (range 21-85). The main manifestations included jaundice (n=11), abdominal pain (n=8),fever (n=6),dyspepsia (n=4),body weight loss (n=3) and claycolored stool (n=1). The locations of tumors were in the left hepatic duct (n=1), right hepatic duct (n=3), hepatic common bile duct(n=3）,the junction of cystic duct and common bile duct (n=1），distal common bile duct (n=8). The pathologic types were tubular adenomas (n=5), papillary (villous) adenomas (n=10),and mucous adenoma (n=1). All the patients underwent surgical therapy. The tumors were identified by postoperative histopathologic examination.ConclusionIt is difficult to correctly diagnose adenomas of extrahepatic bile duct before operation, because the clinical manifestations are usually atypical. The definite diagnosis should depend on histopathologic examination. It is the key to completely resect the tumors. Postoperative followup should be done on regular basis.
ObjectiveTo evaluate the therapeutic effect of liver transplantation (LT) combined with adenovirus-mediated delivery of herpes simplex virus thymidine kinase / ganciclovir (ADV-TK/GCV) in treatment of patients with hepatocellular carcinoma (HCC), so as to benefit more patients with HCC beyond the Milan criteria. MethodsThe clinicopathologic data of patients with HCC underwent LT by the author team since 2007 were collected and analyzed. The patients were assigned into simple LT group and LT+ADV-TK/GCV group. The 5-year cumulative overall survival rate and relapse free survival rate of all LT patients and the patients with LT beyond the Milan criteria by simple LT and LT+ADV-TK/GCV therapy were compared. Meanwhile, Cox regression was used to analyze the risk factors affecting long-term overall survival rate and relapse free survival rate of all patients with HCC after LT. ResultsA total of 216 patients eligible for inclusion were collected in this study, including 134 patients in the simple LT group and 82 patients in the LT+ADV-TK/GCV group, 162 of whom beyond the Milan criteria, including 101 patients underwent the simple LT and 61 patients underwent the LT+ADV-TK/GCV. There were no statistical differences in the baseline data between the simple LT and LT+ADV-TK/GCV in all patients and patients beyond the Milan criteria (P>0.05). There were no statistical differences in 5-year overall survival rate and relapse free survival rate of all patients with HCC (P>0.05). The 5-year cumulative overall survival rate of the LT+ADV-TK/GCV group was better than that of the simple LT group in the patients beyond the Milan criteria (χ2=4.11, P=0.047), but it was not found that the 5-year cumulative relapse free survival rate had statistical difference (27-month survival time as the critical value, P=0.46, P=0.06). Cox regression multivariate analysis results showed that the larger cumulative tumor diameter, the preoperative elevated serum alpha fetoprotein (>400 μg/L), later TNM stage, and without combination of ADV-TK/GCV therapy increased the probability of shorter overall survival of patients after LT; and the patient’s older age, the larger cumulative tumor diameter, and later TNM stage increased the probability of shorter relapse free survival after LT, and it was not found that the combination of ADV-TK/GCV therapy had an impact on the relapse free survival. ConclusionLT combined with ADV-TK/GCV therapy can obviously improve overall survival among patients beyond the Milan criteria, more patients with advanced HCC will be candidates for LT combined with ADV-TK/GCV therapy.
Objective To review recent studies in molecular biology of gastric cancer. Methods Relevant references were reviewed. Results The development and progression of gastric cancer were correlated with oncogenes, growth factors, cyclins, tumor suppressor genes, cell adhesion molecules and unstability of genes.Conclusion Gastric cancer is related to much mutation of genes.
【摘要】 目的 探讨胰管结石的诊断和治疗方法。 方法 回顾性分析2000年1月－2009年1月收治的50例胰管结石患者临床资料。其中男37例，女13例；年龄36~70岁，平均49岁。病程7 d~10年，平均6.8年。46例出现腹正中及左上腹间歇疼痛，伴腰背部放射痛。50例均行B型超声和CT检查，诊断阳性率分别为90%（45/50）和96%（48/50）；27例行磁共振胰胆管成像检查，诊断阳性率为92.6%（25/27）。所有患者均行手术治疗，包括胰十二指肠切除术8例；胰管切开取石、胰空肠Roux-Y吻合术42例，同时行胆囊切除术12例，Oddi括约肌切开、T管引流术6例，胆肠Roux-Y吻合术2例。 结果 所有患者均取出胰管结石，结石大小为0.2~2.0 cm，结石数目为1~50枚。1例患者术后发生切口感染，经积极抗感染及伤口换药处理后治愈。46例治愈出院，2例好转出院， 2例术后出现并发症死亡。术后40例获随访，随访时间1~48个月，平均24个月。随访期间2例胰管结石伴胰头癌患者因术后胰头癌复发死亡。余38例中有8例术后胰管结石复发，再次行手术治疗后治愈；其中有2例术后仍有腹痛，但较术前有明显好转。 结论 影像学检查是诊断胰管结石的重要手段，准确率高，一旦诊断应根据合并症和胰管扩张程度选择合适的手术方式，可取得良好治疗效果。【Abstract】 Objective To investigate the diagnosis and treatment methods for pancreatolithiasis. Methods The clinical data of 50 patients with pancreatolithiasis from January 2000 to January 2009 were retrospectively analyzed. Among them, there were 37 males and 13 females aged between 36 and 70 averaging at 49.3. The course of the diseases ranged from 7 days to 10 years with an average time period of 6.8 years. Forty-six patients had intermittent pain in the median abdomen and left upper quadrant combined by ectopic pain in the back. Various image examinations including abdomen ultrasonography, CT scan, and magnetic resonance cholangiopancreatography (MRCP) were performed in 50, 50, and 27 patients, respectively. Pancreatic duct stones were found in 45 of 50 cases (90％) with ultrasonograhy, 48 of 50 cases (96%) with CT scan, and 25 of 27 cases (92.5%) with MRCP. All patients received surgeries including 8 cases of pancreatodudenectomy, 42 cases of pancreatolithotomy plus side to side pancreatojejunostomy. At the same time, there were 12 cases of cholecystectomy, 6 cases of sphincterotomy and T-duct drainage, and 2 cases of Roux-Y anastomosis. Results Pancreatic duct stones were successfully removed in all cases, and the size of the stones ranged from 0.2 to 2.0 cm in diameter. The number of stones removed from each patient ranged from 1 to 50. Symptoms of all patients ameliorated obviously. One patient had incision infection after surgery, and recovered through active antibiotic treatment. Forty-six patients were cured and discharged from the hospital; 2 patients had their conditions improved and were discharged from the hospital; and the other 2 patients died of postoperative complications. Forty patients were followed up for 1 to 48 months with an average time of 24 months. During the follow-up, 2 patients with pancreatolithiasis and carcinoma of head of pancreas died of the recurrence of the cancer. Eight patients had recurrence of pancreatic stones and were cured after a second operation. Among the 8 cured patients, 2 still had abdominal pain, but their conditions were greatly improved after surgery. Conclusion Imaging techniques are important methods in diagnosing pancreatolithiasis with a high precision. Once the diagnosis of pancreatolithiasis is made, surgical procedures should be selected according to the combined diseases and the level of pancreatic duct dilation.
目的:探讨Mirizzi综合症的诊断治疗特点，以提高其诊断和治疗水平。方法：对35例经手术证实为Mirizzi综合症的临床资料进行回顾性分析。结果:35例Mirizzi综合症患者中仅4例（11.4%）术前确诊。Ⅰ型7例，Ⅱ型17例，Ⅲ型9例，Ⅳ型2例。5例行胆囊切除术，2例行胆囊大部分切除术；胆囊切除、胆囊瓣瘘口修补6例，12例行胆囊切除、胆总管探查、瘘口修补、T管引流术；胆囊切除、胆肠吻合术10例。术后恢复好，随访结果，无严重并发症.结论：Mirizzi综合症术前确诊困难，B超结合MRCP/ERCP检查可以提高Mirizzi综合症的术前确诊率，手术容易损伤胆管，手术方式应据病理损伤程度决定。