外生性肝癌的血供特点及介入治疗

目的 探讨外生性肝癌血供特点及经肿瘤供血动脉化疗栓塞术的疗效.方法 5例外生性肝癌经股动脉插管,肿瘤供血动脉造影、化疗栓塞治疗,用榄香烯350 mg肿瘤血管内热灌注化疗和顺铂60～80 mg加碘油8～15 ml乳剂及明胶海绵化疗栓塞.结果 5例患者共行10次经血管途径的化疗栓塞术.造影显示肿瘤供血动脉以肝外血管为主,肝动脉部分参与供血.5例患者术后瘤体缩小30%～50%,4例AFP下降.结论 外生性肝癌有不同于肝内肝癌的血供特点,经肿瘤供血动脉化疗栓塞术对外生性肝癌同样有效,是可供选择的治疗方法之一.     

经导管肝动脉化疗栓塞术后胆管损伤的临床意义

目的观察经导管肝动脉化疗栓塞术(TACE)治疗肝脏恶性肿瘤后继发胆管损伤的发生率、影响因素和临床过程.方法对1 240例患者做TACE 2 680次,术前影像学检查均无明确胆系异常表现,18例于术后3周～3个月出现胆管损伤并发症.采用回顾性调查,观察TACE术后胆管损伤的发生率、临床表现、转归以及影响因素.结果肝转移性肿瘤TACE后胆管损伤的发生率为8.8%(13/148),肝细胞性肝癌(HCC)组为0.5%(5/1092).胆管损伤的影像学表现有局灶性胆管扩张4例、多发性肝内胆管扩张8例、囊性病灶或胆汁     

肝癌动脉化疗栓塞致截瘫病例分析

目的 探讨化疗栓塞术后发生截瘫的病因、临床特点和预防.方法 2003年3月-2005年2月共有2 758例肝肿瘤患者施行经导管动脉化疗栓塞术(TACE),术后发生截瘫4例.本研究详细回顾手术过程和术后病程.结果 4例患者TACE术后4 h内出现截瘫症状,截瘫发生率为0.145%,并在24～48 h症状进行性加重,5～7 d后病情逐渐平稳,2个月后症状明显改善.结论 肝肿瘤患者多次栓塞化疗后及远处转移瘤行供血动脉化疗栓塞时需慎重,尽量预防脊髓动脉栓塞.     

内乳动脉参与肝癌供血的介入治疗

目的探讨内乳动脉（IMA）对肝癌的供血及其介入栓塞在肝癌治疗中的价值。评价经导管作IMA栓塞化疗的安全性和效果。方法对８６例经血管造影确认有IMA参与肝癌供血患者进行TACE。全部病例均曾行TACE治疗，１６例曾行经皮微波固化治疗，４例有外科手术史。术前行CT或MRI平扫及增强扫描，术中行IMA造影，在确认供血范围后将导管超选择至供血支，先用碘油－抗癌乳剂栓塞肿瘤末梢血管，然后注入明胶海绵碎粒或PVA颗粒，并摄肝区平片，观察肝区碘油分布及术后临床经过、相关实验室检查和影像学表现，并与血管造影进行对照分析。结果本组病例病灶均为巨块型，均位于肝脏前部接近膈肌或（和）肝包膜。５７例累及S４、S５、S８段，２９例累及S５、S７、S８。８０例为右侧IMA参与供血，５例为左侧IMA参与供血，１例为双侧IMA参与供血。８６例参与供血的IMA栓塞全部成功。未出现皮肤损伤并发症。结论IMA参与肿瘤供血一般多见于过去曾多次行TACE的巨块型肝癌患者，且肿块位于肝前部。IMA TACE方法安全，技术可行，但应警惕皮肤损伤并发症。     

支气管动脉栓塞术治疗支气管扩张大咯血失败原因之一:膈下动脉参与供血

目的观察膈下动脉（IPA）参与支气管扩张所致咯血供血的表现，评价经导管栓塞IPA的安全性和疗效。方法５年期间用经导管支气管动脉栓塞术（BAE）治疗支气管扩张所致大咯血６２例，１０例经选择性血管造影证实有IPA参与病变供血。对参与肺部病变供血的IPA进行选择性栓塞术，栓塞剂用明胶海绵颗粒８例、明胶海绵颗粒＋微型钢丝圈２例。分析观察IPA参与肺部供血的表现、影响因素，评价栓塞IPA的安全性和临床意义。结果选择性IPA造影均显示IPA管径增粗、分支增多、紊乱和不同程度的新生血管，IPA供血区对比剂外溢４例、非特异性片状对比剂染色６例，IPA与肺动脉异常交通或分流者８例。１０例患者病灶与胸膜关系密切:病变贴近膈胸膜和纵隔胸膜者６例、纵隔胸膜为主者４例。对１０例患者均行供血IPA栓塞术，同时栓塞胸廓内动脉４例、肋间动脉２例，术后咯血停止。随访８个月～３年，２例分别于术后２、３个月复发少量咯血，经保守治疗后停止。８例未再咯血。结论IPA可参与支气管扩张症所致大咯血的供血，是造成BAE治疗咯血失败的原因之一。如发现IPA参与肺部病变供血，补充IPA栓塞术是安全和有价值的。     

小剂量与常规剂量化疗药物经导管栓塞化疗对肝癌患者血清肝纤维化指标的影响

目的比较应用小剂量和常规剂量化疗药物经导管栓塞化疗(TACE)对肝细胞癌(HCC)患者血清肝纤维化指标的影响.方法将40例HCC患者分为两组分别行选择性TACE.A组(n=20)给予小剂量化疗药物:肿瘤8 cm时,给予MMC 6～8 mg, EPI 10 mg,卡铂(CBP)100 mg.B组(n=20)给予常规剂量化疗药物(MMC 10 mg,CBP 300 mg,EPI 40 mg).经导管向供血动脉内注入碘油、化疗药物乳化剂,随后用明胶海绵粒或PVA微球栓塞该动脉.TACE前、后7 d分别检测患者血     

肝动脉化疗栓塞术中胆囊动脉及胆囊显影的意义

目的探讨肝动脉化疗栓塞术中胆囊动脉及胆囊显影与术后胆囊炎的关系。方法回顾性分析１８３例肝肿瘤患者接受肝动脉化疗栓塞术动脉造影时出现胆囊动脉和（或）胆囊显影的临床资料,对出现术后胆囊炎的４８例所采用的治疗方式、次数与发生胆囊炎的关系进行相关性分析。结果４８例患者（肝癌４２例,肝血管瘤６例）TACE后并发胆囊炎（２６．２％）,４２例并发胆囊炎的肝癌患者化疗方案为:FUDR（或５－FU）＋HCPT＋BLM１１例,FUDR（或５－FU）＋HCPT＋DDP（或CP）９例,FUDR＋HCPT＋BLM＋DDP（或CP）６例,FUDR＋HCPT＋EPI ７例,FUDR＋MMC＋CP４例,含草酸铂（L－OHP）方案５例（其中２例发生２次以上胆囊炎）。６例并发胆囊炎的血管瘤患者治疗方案均为BLM粉８～２４mg 溶于超液化碘油５～１０ml 内栓塞。结论肝TACE时胆囊动脉及胆囊显影者术后发生胆囊炎的概率增高,化疗、栓塞方案（栓塞剂）含DDP、BLM及L－OHP粉剂的发生率更高,越过胆囊动脉后进行化疗栓塞可降低其发生。     

肝癌肝动脉化疗栓塞术后影响甲胎蛋白下降因素探讨

为了探讨肝癌介入治疗后影响甲胎蛋白(AFP)下降的有关因素,本文对40例原发性肝癌经肝动脉化疗栓塞术(TACE)后 AFP 浓度变化进行分析,结果发现多结节型肝癌以及 TACE 后肿块不变或增大者,出现肝内及肝外转移者、血清蛋白增高者,病情加重者,其 AFP 值不易下降。上述指标在TACE 后 AFP 仍≥400ng/ml 组与 TACE 后 AFP≤250ng/ml 组之间存在显著差异性(P0.05)。提示TACE 后检测 AFP 有助于肝癌临床过程的观察随诊和治疗评价。     

肝癌经肝动脉化疗栓塞术中肝动脉损伤的原因、表现及处理

目的 探讨肝癌TACE术中肝动脉损伤的原因、临床与DSA表现及其预防和治疗.方法 前瞻性研究肝TACE术164例次,观察术中肝动脉痉挛、内膜损伤及动脉穿孔情况,分析其与术中操作、导管类型、位置及注射对比剂速度的关系.结果 164例次中发生动脉性事件57例次(34.8%),其中47例次(28.7%)发生血管痉挛,其中29例次为动脉造影时痉挛,18例次为超选择插管过程中发生;7例次(4.3%)发生血管穿孔,其中6例次为老年患者;2例次为肝外穿孔,5例次为肝内穿孔;3例(1.8%)发生内膜掀起.超选择插管引起的动脉痉挛可有疼痛或药物反流至非靶动脉,经导管注射适量利多卡因有一定作用.动脉内膜掀起(夹层)时患者有疼痛、腹胀,透视下见对比剂滞留,需要退出导管重新仔细超选插管或使用微导管.动脉穿孔时有疼痛、腹胀,透视下见导丝或导管偏离动脉走行,注射对比剂有外溢,退导管至上一级动脉并注射对比剂,若无外溢或外溢对比剂无消散,则无需特别处理,否则需要将动脉栓塞.结论 肝癌TACE血管损伤的发生与术者操作技术、导管类型及导管头位置、患者年龄及血管条件等因素有关,应根据不同情况进行预防、处理.     

亚段性经导管动脉化疗栓塞术治疗中晚期原发性肝癌的临床研究

目的探讨亚段性经导管动脉化疗栓塞术(STACE)治疗中、晚期原发性肝细胞癌(HCC)的临床价值.方法 93例中、晚期肝癌分为两组,48例亚段性肝动脉超选者行STACE治疗,45例未超选到位者在肝总、肝固有或肝左、右动脉内行TACE治疗.结果 STACE组肿瘤缩小率、血清AFP下降率优于TACE组,两组比较差异有显著性(P<0.01).0.5、1、1.5、2年生存率,STACE组分别为100%、81.3%、64.6%、56.4%,TACE组为86.7%51.1%、26.7%、6.7%.结论 STACE是中、     

Photovoltaic materials, past, present, future

This paper traces briefly the history of this photovoltaic materials and it tries to look at possible future scenarios. A large part of the paper is concerned with silicon although from solid-state physics we know that silicon is not the ideal material for photovoltaic conversion. From the first solar cell developed at Bell Laboratories in 1954 photovoltaics was dominated by silicon. The reasons for this dominating position are investigated. Crystalline silicon today has a market share of 86% which is almost equally distributed between single crystal and cast silicon. Amorphous silicon has another 13%. The main endeavor is to reduce cost. Present trends in the crystalline field are reviewed. The conventional technology still has significant potential for cost reduction but this comes only with increasing volume. A problem to be solved is the supply of solar-grade silicon material. Other future possibilities include thin film crystalline silicon on different substrates. Because of the low absorption coefficient of silicon light trapping is required. True thin film materials need only 1–2 μm of material. Amorphous silicon, copper indium diselenide (CIS) and CdTe are hopeful approaches for very cost-effective solar cells. Some other, more speculative materials and concepts are described at the end of this paper     

Hydrogen dissociation and diffusion on transition metal (= Ti,Zr, V,Fe, Ru,Co, Rh,Ni, Pd,Cu, Ag)-doped Mg(0001) surfaces

The kinetics of hydrogen absorption by magnesium bulk is affected by two main activated processes: the dissociation of the H₂ molecule and the diffusion of atomic H into the bulk. In order to have fast absorption kinetics both activated processed need to have a low barrier. Here we report a systematic ab initio density functional theory investigation of H₂ dissociation and subsequent atomic H diffusion on TM (= Ti, V, Zr, Fe, Ru, Co, Rh, Ni, Pd, Cu, Ag)-doped Mg(0001) surfaces. The calculations show that doping the surface with TMs on the left of the periodic table eliminates the barrier for the dissociation of the molecule, but the H atoms bind very strongly to the TM, therefore hindering diffusion. Conversely, TMs on the right of the periodic table do not bind H, however, they do not reduce the barrier to dissociate H₂ significantly. Our results show that Fe, Ni and Rh, and to some extent Co and Pd, are all exceptions, combining low activation barriers for both processes, with Ni being the best possible choice.     

Flexible, long-lived, large-area, organic solar cells

We report herein large area (>10 cm²), interconnected organic solar cell modules both on glass substrates as well as on flexible ultra-high barrier foils, reaching 1.5% and 0.5% overall power conversion efficiency under AM1.5 conditions. Series connection is described, as these modules consist of up to three cells. Using our flexible barrier material, a shelf lifetime of polythiophene-based solar cells of 6000 h could be realized. Furthermore, we compare the photovoltaic performance of efficient conjugated polymer:fullerene solar cell modules with established technologies. Under typical indoor-office lighting, our modules are competitive with these systems.     

Solar optical properties of thin films of Cu, Ag, Au, Cr, Fe, Co, Ni and Al

The optical properties of metal coated glass substrates have been investigated. Thin films of various thicknessesof the noble metals: Cu, Ag, Au, the transition metals: Cr, Fe, Co, Ni and the free electron-like metal Al were thermally evaporated onto glass substrates. The front and backside reflectance and the transmittance between 0.35 and 15 μm were measured. The obtained data were used to calculate the integrated values of solar reflection and transmission as a function of metal film thickness. The application of metal films on domestic windows as sun-screens and heat-mirrors are discussed. It is concluded that Cu is the best coating in a window system if good heat insulating properties are desired. This is due to its ability to remain continuous at very thin film thicknesses. An infra-red reflectance of 86 per cent combined with a solar transmittance of 55 per cent was obtained for a 70film. For solar heat-protection Au-films are found to be superior owing to their transmittance peak in the middle of the visible wavelength region. The transition metals are less selective than the noble metals, but due to their flat response-curves in the visible range they cause a smaller change in colour of the transmitted and reflected light.     

阳光·希望·成长——2009太达杯国际太阳能建筑设计竞赛作品评析

立足于灾后重建的建筑设计,必须注重低造价、低技术策略的运用,充分利用自然资源,适应可持续发展的要求.太阳能等绿色技术的融入,丰富了建筑设计的内涵,增加了可实施性.介绍了2009国际太阳能建筑设计竞赛获奖作品从基地调研、环境应对、建筑组合到技术融入的系列构思过程,从而在灾后重建过程中通过建筑传递给人们阳光与希望.