目的:探討經導管肝動脈灌注化療栓塞(TACE)與TACE聯合三維適形放射治療(TACE + 3DCRT)原發性肝細胞癌(HCC)的療效.方法:隨機分成兩組的HCC患者,均不能手術、門脈無癌栓、無遠處臟器轉移。50例患者行單純TACE 2次(TACE組)。40例患者在TACE 2次后第四周再行三維適形放射治療(TACE + 3DCRT組),放療采用6MVX射線,4～6 Gy/次,隔日一次,3次/周,總劑量45～60 Gy。TACE采用碘化油、順鉑、5氟尿嘧啶、表阿霉素及明膠海綿。結果:TACE組與TACE+3DCRT組近期療效有效率(完全緩解+部分緩解)分別為68.0%(34/50)、87.5%(35/40),1年生存率分別為78.0%(39/50)、95.0%(38/40),兩組差異均有統計學意義(Plt;0.05)。TACE的治療反應主要為栓塞綜合征,3DCRT有7.5%(3/40)發生急性放射性肝炎,經對癥、保肝處理后緩解。兩組患者均能耐受。結論:TACE + 3DCRT治療不能手術、門脈無癌栓、無遠處臟器轉移的HCC的療效較單純TACE治療HCC的療效好。
【摘要】 目的 探討后程適形放射治療（3 dimensional comformal radiation therapy，3D-CRT）同步化學療法治療Ⅲ期非小細胞肺癌（non-small-cell lung cancer，NSCLC）的近期療效。 方法 搜集2005年1月-2008年6月NSCLC患者共115例，其中53例行單純后程3D-CRT（單放組），62例行后程3D-CRT聯合同步化學療法（聯合組），所有患者均經病理證實為Ⅲ期NSCLC。兩組放射治療方案均采用常規分割治療加后程3D-CRT，DT 62～72 Gy。聯合組化學療法采用TP（紫杉醇 + 順鉑）方案。 結果 單放組和聯合組近期療效（完全緩解+部分緩解）分別為75.47%、91.94%，差異有統計學意義（Plt;0.05）。單放組和聯合組的治療不良反應主要有白細胞、血小板減少，放射性食管炎，放射性氣管炎，惡心、嘔吐等胃腸道反應。骨髓抑制和消化道反應，聯合組稍高于單放組。經對癥治療后，所有患者均可耐受。 結論 后程3D-CRT聯合TP方案化學療法較單純后程適形放射治療明顯提高Ⅲ期NSCLC近期療效。患者耐受性尚可。【Abstract】 Objective To observe the recent therapeutic effect of late course 3 dimensional conformal therapy concomitant with chemotherapy on locally advanced stage Ⅲ non-small-cell lung cancer (NSCLC). Methods From January 2005 to June 2008, 115 patients with stage Ⅲ NSCLC were confirmed by pathology, in whom 53 only underwent late course conformal therapy (radiotherapy group), and another 62 underwent late course conformal therapy concomitant with chemotherapy (combined group). The radiotherapy schema of the two groups was routine division plus late course conformal therapy (with DT 62-72 Gy). The chemotherapy schema in the combined group was performed with TP (paclitaxel and DDP). Results The recent curative effect (complete remission plus partial remission) in radiotherapy group and combined group was 75.47% and 91.94%, respectively (Plt;0.05). The frequent adverse reactions in the two groups included leucocytopenia, thrombocytopenia, radioactive esophagitis, radioactive tracheitis, nauseated, and emesia. The rate of bone marrow depression and alimentary canal reaction in combined group was higher than that in the radiotherapy group. In the two groups, all patients could tolerance the treatments. Conclusion Late course 3 dimensional conformal therapy concomitant with TP schema chemotherapy for NSCLC could raise the recent curative effect. The patients could tolerance the treatments.
【摘要】 目的 探討瑞舒伐他汀對慢性腎病患者抗炎療效。 方法 選取2009年11月-2010年12月90例慢性腎病患者，隨機分為A、B兩組，A組50例，給予瑞舒伐他汀鈣10 mg/d；B組40例，給予阿托伐他汀鈣10 mg/d，兩組患者的年齡和性別相匹配。分別測定其治療前及治療后12周時血白細胞、高敏反應蛋白、纖維蛋白原、白介素-6、腫瘤壞死因子-α。 結果 兩組治療前各炎癥指標水平差異無統計學意義（Pgt;0.05）。與治療前相比，兩組患者治療12周后炎癥指標水平均較前明顯下降（Plt;0.01），瑞舒伐他汀鈣組比阿托伐他汀鈣組炎癥指標下降更為明顯。 結論 瑞舒伐他汀可有效改善慢性腎病患者的炎癥反應。【Abstract】 Objective To explore the anti-inflammatory effect of rosuvastatin on chronic kidney disease (CKD) patients. Methods Ninety CKD patients treated in our hospital between November 2009 and December 2010 were randomly divided into two groups. One group was given rosuvastatin calcium 10 mg/d, which the other group was given atorvastatin calcium 10 mg/d. The two groups matched in terms of age and gender. We determined blood leukocyte (WBC), high sensitivity reactive protein (hs-CRP), fibrinogen (FIG), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) of the patients before and after treatment for 12 weeks. Results The inflammatory marker levels of both groups before treatment had no significant difference (Pgt;0.05). The inflammatory marker levels of two groups after treatment for 12 weeks were significantly decreased compared with the levels before treatment (Plt;0.01), and rosuvastatin calcium group decreased more apparently than atorvastatin calcium group. Conclusion Rosuvastatin can improve the anti-inflammatory response in CKD patients.
ObjectiveTo explore the characteristics of blood pressure variability (BPV) in maintenance hemodialysis (MHD) patients with and without diabetes mellitus and the effects of BPV on cardiac function based on the research of clinical data. MethodsOne hundred MHD patients treated in the Hemodialysis Center of the People’s Hospital of Taixing City between January 2013 and January 2015 were recruited and divided into diabetes group (n=46) and non-diabetes group (n=54). Interdialytic and intradialytic BPV and cardiac function were monitored and compared between the two groups. Standard deviation (SD) and coefficient of variation (CV) were used for the evaluation of BPV. ResultsTriacylglycerol, cholesterol and plasma albumin were significantly different between the diabetes group and non-diabetes group (P<0.05), while hemoglobin, serum calcium, phosphorus and parathyroid hormone were not significantly different between the two groups (P>0.05). Forty-two patients in the diabetes group and 53 in the non-diabetes group took antihypertensive drugs. The varieties of antihypertensive drugs and the proportion of patients who used antihypertensive drugs were not significantly different between the two groups. The ambulatory blood pressure monitoring displayed 40 patients (86.9%) with reverse dipper or non-dipper blood pressure in the diabetes group and 35 (64.8%) in the non-diabetes group, and the difference was significant (P<0.05). The interdialytic mean systolic blood pressure (SBP), SBP-SD and SBP-CV in the diabetes group were all significantly higher than those in the non-diabetes group (P<0.05), and the mean diastolic blood pressure (DBP), DBP-SD and DBP-CV were also significantly different between the two groups (P<0.05). The intradialytic mean SBP, SBP-SD and SBP-CV in the diabetes group were significantly higher than those in the non-diabetes group (P<0.05), but there were no significant differences in intradialytic mean DBP, DBP-SD and DBP-CV between the two groups. In patients with reverse dipper or non-dipper blood pressure, the interventricular septal thickness, left ventricular end-diastolic diameter and ejection fraction were significantly different between the diabetes group and the non-diabetes group. However, in patients with dipper blood pressure, the cardiac function parameters were not significantly different between the two groups. Conclusion MHD patients with diabetes have higher ratio of reverse dipper or non-dipper blood pressure, more significant blood pressure variability and more severe cardiac function damage.