Search

平阳霉素瘤体内注射治疗牙龈瘤52例的临床疗效观察

摘要:目的:观察平阳霉素瘤体内注射治疗牙龈瘤并保留牙龈瘤所波及的活髓牙齿的临床疗效。方法:选择牙龈瘤患者171例,采用随机分组方法,选择52例平阳霉素瘤体内注射治疗为观察1组,48例微波治疗为观察2组, 71例手术切除治疗为对照组,分别观察临床治愈疗效、复发等情况。结果:观察1组临床治愈率100%;观察2组临床治愈率89.6%;对照组临床治愈率83.1%;观察1组治愈率高于对照组、观察2组。结论:平阳霉素瘤体内注射治疗应用于治疗牙龈瘤并保留牙龈瘤所波及的活髓牙齿创伤性小、方便易掌握,且效果可靠,无复发,对人体无不良影响,操作技术要求不高,更适合于基层推广应用。

Advantages and disadvantages of surgical resection for primary liver cancer

75岁以上高龄食管、贲门癌患者的外科治疗

目的 评价高龄食管、贲门癌患者手术切除对术后并发症发生、治疗及其预后的影响，总结治疗经验。 方法 回顾性分析1995年1月至2005年12月收治的376例食管、贲门癌患者的临床资料，选择75岁以上高龄食管、贲门癌患者54例作为研究对象，其中中下段食管癌31例、贲门癌23例。行右侧开胸食管癌切除颈部吻合2例，胸腔内吻合4例，左侧开胸主动脉弓下吻合37例，主动脉弓上吻合11例；1例合并左肝外侧段转移行左半肝部分切除。 结果 52例患者在术后24 h内发生高血压，血压最高达210/120 mm Hg，需静脉泵入硝酸甘油或压宁定治疗；38例发生急性心律失常，以快速心房颤动为主，静脉泵入胺碘酮后缓解；4例出现肺不张，经纤维支气管镜吸痰后恢复；3例出现不明原因的一过性胸闷、气促并有缺氧表现而不排除急性肺梗死（未作磁共振成像检查），其中2例经气管内插管呼吸机辅助呼吸后恢复，另1例给予普通吸氧后好转。术后常规给予经颈内静脉置管全静脉营养（30 kcol/kg·d）；全部患者均无吻合口瘘、胸腔或纵隔感染、无幽门排除障碍。随访32例，1例术后4个月因吻合口狭窄在外院行支架植入, 2周后出现大呕血死亡，其余患者无近期内死亡及其它并发症。 结论 对高龄食管癌、贲门癌患者，虽然其本身合并症较多，术后并发症出现频率较高，但手术仍应为治疗的首选方法，可以提高患者的生活质量和生存期。

Longitudinal Research of MRI in Evaluating Removed Intracranial Gliomas

目的　探讨脑胶质瘤术后不同时期的MRI增强表现，客观分析其术后的手术切除程度。 方法　2009年2月－2012年10月32例脑胶质瘤患者均在术后1 d～2周进行第1次MRI平扫及增强扫描（其中21例在术后3 d内进行检查），术后1～3个月随访复查21例，术后6～12个月随访复查18例，术后1～3年MRI随访16例。分析不同时期的MRI平扫及增强表现，以期发现正确评价手术切除程度的指标。 结果　术后3 d内行MRI增强检查仅有4例出现反应性强化，肿瘤残余有7例，结合其影像学表现可较准确地区分术后反应性强化及肿瘤残余。 结论　胶质瘤术后早期（3 d内）进行MRI增强检查可准确评价肿瘤术后切除程度，便于制订下一步治疗计划。

Analysis of Operative Resection Combined with Liquid Nitrogen Frozen on 21 Patients with Conjunctival Squamous Cell Carcinoma

目的 探讨手术切除联合液氮冷冻治疗结膜鳞状细胞癌的临床效果。 方法 分析1998年-2008年收治的21例眼睑结膜鳞癌患者的临床资料。对肿瘤局限在眼球结膜和部分穹窿结膜受侵犯者行单纯手术切除联合液氮冷冻治疗；部分或全部结膜及眼睑受侵犯者行局部肿瘤切除联合眼睑重建及液氮冷冻治疗；眼睑和球结膜广泛受累，无法进行眼睑重建者行眼眶内容物剜除术。 结果 21例中，7例行单纯肿瘤切除合并冷冻治疗，其中5例痊愈，2例复发；10例行局部肿瘤切除并进行眼睑重建，其中7例痊愈，3例复发，复发病例作眶内容摘除；4例肿瘤侵犯范围较宽而无法保留眼球者行眼眶内容物摘除。术手3例死于肝肺转移。 结论 眼睑结膜鳞状细胞瘤的外科手术切除是唯一有效的方法，眼睑重建视肿瘤侵犯范围而定，冷冻治疗作为辅助治疗可提高疾病的治愈率。

The Analysis on Curative Effect after Hepatectomy on 112 Cases of Hepatocellular Carcinoma

目的:分析原发性肝癌手术切除的方法及效果。方法:对手术切除的原发性肝癌112例从肿瘤部位、大小、人肝血流阻断、切除方式、失血量、手术时间等方面进行分析。结果:手术切除率26.23%,手术死亡率0.89%,5年生存率18.75%,10年生存率仅2例。结论:原发性肝癌患者就诊时多数已为中晚期或大肝癌,手术切除后疗效较差。提高生存率关键是:小肝癌的切除、切除方式、术后TACE、复发再切除及术后生物治疗等。

Systemic Chemo-Immunotherapy for Hepatocellular Carcinoma

Surgical Treatment of Metastatic Hepatic Cancer (Report of 208 Cases )

【Abstract】ObjectiveTo explore the effect of surgical treatment of metastatic hepatic cancer. MethodsTwo hundred and eight patients with metastatic hepatic cancer received surgical treatment in our department during the past seven years, and their information were analyzed retrospectively in this paper. The ages of these patients ranged from 19 years to 82 years, and 133 of them were male, 75 of them were female. Two of them were complicated with hepatocirrhosis, and 5 with polycystic liver. The metastatic cancer originated from gastrointestinal tract in 121 cases (58.2%), and from other parts of the body in 87 cases (41.8%). One hundred and sixteen of the patients received resection treatment (resection group), and 92 of them received nonresecton treatment (nonresection group). The survival rates of the two groups were compared through Chi square test.ResultsThe 1, 3 and 5year survival rates for all patients were 56.3%,23.1% and 13.0%, respectively. The 1, 3 and 5year survival rates were 74.1%,39.7% and 23.3% in the resection group respectively and 33.7%， 2.2% and 0 in the nonresection group， respectively. Resection group had a higher survival rate than that of the nonresection group (P＜0.05). The main postoperative complications include pulmonary infection (6 cases), subphrenic infection (2 cases), incisional infection (4 cases).ConclusionSurgical resection is an effective treatment method for the patients with metastatic hepatic cancer. Resection should be conducted as long as they could withstand the surgery.

New Progress of Conversion Therapies on Increasing Surgical Resection Rate of Patients with Liver Metastasis from Colorectal Carcinoma

ObjectiveTo understand the latest progress of conversion therapies on increasing surgical resection rate of patients with liver metastasis from colorectal carcinoma, evaluate the clinical value of prognostic evaluation model in surgical resection of patients with liver metastasis from colorectal carcinoma, further offer guidance in comprehensive treatment to control disease and improve the quality of life. MethodsThe literatures about new progress in surgical treatment of liver metastasis from colorectal carcinoma at domestic and abroad were reviewed, including the indication of operation, prognostic evaluation model, and how to increase the resection rate for liver metastasis from colorectal carcinoma patients with conversion therapies. ResultsPart of patients with liver metastasis from colorectal carcinoma could get surgeries after accepting positive conversion therapies.For the patients with liver metastases from colorectal carcinoma did not accepted surgeries all the way, it was a safe and effective treatment method by different conversion therapies such as neoadjuvant chemotherapy, molecular targeted therapy, transcatheter arterial chemoembolization, radiofrequency ablation, and so on, and it could improve the quality of life and prolong the survival time. ConclusionsDoctors should pay attention to conversion therapies of patients with liver metastasis from colorectal carcinoma, and promote the usage of the prognostic evaluation model in liver metastasis from colorectal carcinoma.

Efficacy and safety of neoadjuvant chemotherapy containing tegafur gimeracil oteracil potassium combined with surgery in the treatment of advanced gastric cancer: a meta-analysis

ObjectiveTo systematically review the efficacy and safety of neoadjuvant chemotherapy containing tegafur gimeracil oteracil potassium (S-1) combined with surgery in the treatment of advanced gastric cancer.MethodsWe searched EMbase, PubMed, The Cochrane Library, Web of Science, CBM, CNKI and WanFang Data from inception to February 2017, to collect randomized controlled trials (RCTs) about neoadjuvant chemotherapy containing S-1 combined with surgery in the treatment of advanced gastric cancer. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 11 RCTs involving 971 advanced gastric cancer patients were included. The results of meta-analysis showed that the neoadjuvant chemotherapy containing S-1 combined with surgery group was superior to the control group in R0 resection rate (OR=2.75, 95%CI 1.91 to 3.95, P<0.000 01), 2 year survival rate (OR=1.72, 95%CI 1.01 to 2.93, P=0.05) and 3 year survival rate (OR=1.64, 95%CI 1.12 to 2.41, P=0.01), while there were no statistical differences in response rate (OR=1.33, 95%CI 0.70 to 2.51, P=0.39), 1 year survival rate (OR=1.50, 95%CI 0.64 to 3.53, P=0.35) and the incidence of postoperative complications (OR=1.00, 95%CI 0.66 to 1.51, P=0.98).ConclusionNeoadjuvant chemotherapy containing S-1 combined with surgery can improve the R0 resection rate, 2-year survival rate and 3-year survival rate without increase postoperative complications rate. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.