CT 引导下乙醇消融术治疗肝转移瘤

目的探讨CT引导下无水乙醇消融术（PEI）在肝转移性肿瘤治疗中的价值。方法５３例肝转移性肿瘤，共计８７个病灶。１８个病灶直径≤１cm；５６个病灶直径１～３cm；１３个病灶直径３～５cm。采用CT引导下无水乙醇瘤内注射进行治疗，经过１次或多次治疗，观察肝转移瘤的坏死情况。结果PEI治疗后１个月MR或CT复查，１８个直径≤１cm的病灶完全坏死率为１００％；直径１～３cm５６个病灶完全坏死率为８７．５％，再次治疗后完全坏死；１３个病灶直径３～５cm的病灶完全坏死率为６１．５％，经过２～３次治疗，病灶彻底坏死。结论CT引导下无水乙醇消融术治疗肝转移性肿瘤疗效满意，尤其适用于直径≤３cm的单个病灶。     

CT引导置管引流治疗单发性腹膜后脓肿

目的探讨单发性腹膜后脓肿CT引导下经皮穿刺置管引流治疗的疗效。方法回顾性总结采用CT引导下经皮穿刺引流治疗的１３例腹膜后单发性脓肿，脓肿位于胰尾部４例，胰头旁３例，肾周间隙３例，肾后间隙２例，腰大肌旁１例；脓肿最大径３．５～８．０cm。结果８例患者行１次穿刺引流，３例行２次穿刺引流，２例行３次穿刺引流。１３例患者平均引流１６d，经过临床、超声及CT随访未发现残存感染灶或复发。结论CT引导下经皮穿刺引流治疗腹膜后脓肿疗效确切、创伤小。     

Physical properties of ethylene vinyl acetate copolymer (EVA)/natural rubber (NR) blend based foam

In this study an attempt was made to improve the rebound resilience and to decrease the density of ethylene‐vinyl acetate copolymer (EVA) foam. For this purpose, EVA was blended with natural rubber (NR), and EVA/NR blends were foamed at 155°C, 160°C, and 165°C. To investigate the correlation between crosslinking behavior and physical properties of foams, crosslinking behavior of EVA/NR blends was monitored. The physical properties of the foams were then measured as a function of foaming temperatures and blend compositions: 165°C was found to be the optimal temperature for a crosslinking of EVA/NR foam. As a result, the density of EVA/NR blend foamed at 165°C was found to be the lowest. EVA/NR (90/10) blend, foamed at 165°C, showed lower density, better rebound resilience, and greater tear strength than EVA foam. © 2004 Wiley Periodicals, Inc. J Appl Polym Sci 94: 2212–2216, 2004     

Effect of substrate on the phase transformation of TiO2 in pearlescent pigment

The TiO₂/substrate pearlescent pigments were prepared by the hydrolysis of TiOCl₂ on the substrate followed by a calcinations process. The natural mica (muscovite), synthetic mica (fluorophlogopite) and -alumina flake were selected as the substrates for pearlescent pigments. The effect of substrate on the anatase to rutile (A–R) phase transformation of TiO₂ was studied. The A–R phase transformation of TiO₂ during the preparation of pearlescent pigments and their proportion in the TiO₂ layer have been analyzed by XRD measurements. The phase compositions of TiO₂ layer in each pearlescent pigment are quite different depending on the substrates. The TiO₂ layer deposited on -alumina has higher rutile fraction than those on the natural and synthetic mica. The XPS analysis showed that the cations originally present in the substrates diffused into the TiO₂ layer. The TiO₂ layer deposited on -alumina contains Al, while those on the natural and synthetic mica substrates contain Si and K in addition to Al. The metal cations diffusing from the substrate into TiO₂ layer might retard the A–R phase transformation of TiO₂. The suppressing effect on the A–R transformation of TiO₂ by mixed cations seems to be much stronger than that of single cation, resulting in relatively higher rutile fraction in the case of TiO₂ layer deposited on -alumina.     

DSA在急性缺血性脑血管病介入治疗中的应用

目的探讨DSA在急性缺血性脑血管病介入检查及治疗中的应用价值。方法分析５５０例急性缺血性脑血管病患者进行介入治疗过程中DSA设备使用情况,总结合理利用DSA设备的经验。结果DSA的应用将有助于急性缺血性脑血管病快速诊断和介入治疗疗效评价;DSA实用投照角度的应用能够清晰显示目标血管狭窄病变的形态、程度等信息,为介入治疗提供最佳工作位置,有助于缺血性脑血管病的影像诊断和介入治疗;旋转DSA图像采集及图像三维重建技术的应用将有助于成功地开展介入治疗手术;应用DSA图像测量技术能够为操作医师选择介入材料提供精确的数据信息。结论合理利用DSA设备对于急性缺血性脑血管病的诊断和介入治疗手术成败起着至关重要的作用。DSA设备为介入治疗提供了良好的操作平台,DSA是诊断急性缺血性脑血管病的金标准。     

胰腺癌综合治疗现状及其价值

任何单一疗法治疗胰腺癌都难以获得理想的疗效。目前,可切除胰腺癌的治疗仍以根治性切除为主。放射治疗与手术联合应用,可提高手术切除率,减少肿瘤扩散;术中放疗可以缓解疼痛,提高生存率;对术后辅助放化疗的作用仍有争议。区域性化疗理论上有诸多优势,但仍需数据支持。物理治疗和生物治疗在胰腺癌的治疗中也已经得到广泛的重视。但只有建立以手术切除为主,联合放疗、化疗、物理及生物治疗的综合治疗体系,才有可能根本改变治疗现状,显著提高长期生存率,并改善生活质量。介入治疗作为重要的姑息治疗方法之一,近年来得到了长足的发展。     

急性肠系膜上动脉栓塞动物模型的建立

目的制作一种适合后续去栓治疗的急性肠系膜上动脉栓塞动物模型。方法８只杂种犬,体外制作动物自体血栓,采用经皮股动脉穿刺入路,选择性插入８F动脉长鞘至犬肠系膜上动脉主干后注入自体血凝块,造影复查直至肠系膜上动脉主干完全闭塞。分别在栓塞后２、４、６和８h于肠系膜上动脉开口部造影复查,观察自体血栓是否稳定,肠系膜上动脉有无自行再通,并经腹部切口探察,取病理活检。结果８只实验犬均成功建立急性肠系膜上动脉栓塞致肠缺血模型。大体观察及镜下可见随栓塞时间的延长,肠管损伤逐渐加重,组内一致性良好。结论采用本实验方法可成功建立适合后续去栓治疗研究的急性肠系膜上动脉栓塞动物模型。     

经导管肺动脉化疗栓塞术介入治疗不能切除的转移性肺癌

【摘要】 经导管动脉化疗栓塞术已经被认为是手术不能切除肝癌的一线治疗方法。然而,此技术也被认为是不能手术切除转移性肺癌新的治疗方法。本文对该技术的历史、转移性肺癌的血供、适应证、禁忌证、操作步骤、并发症、疗效和局限性等进行综述。
     

改良溶栓方案治疗静脉窦血栓形成

目的探讨改良溶栓方案（最低静脉窦内微量持续泵点尿激酶１０万u／２４h）治疗脑静脉窦血栓形成的疗效和安全性。方法对２１例患者（合并出血性梗死５例,其中病史超过１个月２例,超过３个月１例）进行机械性破栓、静脉窦内留置微导管行最低量尿激酶１０万u／２４h静脉窦直接泵点滴４８～９６h治疗。术后积极治疗原发病,抗凝治疗６个月。术后随访６～１２个月,平均１０个月。结果２１例脑静脉窦血栓形成患者,脑静脉窦均获得再通（其中１２例患者应用尿激酶１０万u／２４h效果良好,９例患者在应用尿激酶１０万u／２４h,４８h复查后增量至２５万u／２４h）,无一例并发或加重脑出血,预后良好。结论改良溶栓方案可有效治疗脑静脉窦血栓形成,有效规避了大量应用溶栓药物的问题,在达到同样疗效情况下更为安全。     

原位肝移植术后肝动脉狭窄导致缺血型胆管损伤的治疗

目的探讨原位肝移植术后肝动脉狭窄导致缺血型胆管损伤的治疗方法及预后。方法回顾性分析我院２００４年６月至２００８年６月,１１例肝移植术后肝动脉狭窄导致胆管损伤,接受肝动脉支架成形联合内镜逆行胰胆管造影术（ERCP）和（或）经皮经肝胆管引流（PTCD）处理患者的临床资料。结果１１例患者成功植入１２枚冠脉支架,５例单独采用胆道ERCP引流,３例采用PTCD,３例ERCP疗效欠佳后改用PTCD。随访４个月至４年,６例死于感染,其中５例１年内死亡,３例再次接受移植,２例生存至今。结论肝移植术后肝动脉狭窄导致缺血型胆管损伤总体疗效欠佳。肝动脉支架联合胆道长期引流可延长移植物存活期,为再次肝移植提供机会