ObjectiveTo compare clinical effect of percutaneous radiofrequency ablation (RFA) and open repeated hepatectomy (ORH) in treatment of liver cancer with late recurrence (recurrence time >12 months) and single tumor diameter ≤5 cm.MethodsThe patients with advanced intrahepatic recurrence after first operation for liver cancer in this hospital from January 2013 to December 2019 were retrospectively collected, who were treated with ORH (ORH group) or percutaneous RFA (RFA group) and met the inclusion criteria. The overall survival rate and disease-free survival rate of the two groups were compared after 1∶1 matching by propensity score matching (PSM), while the factors affecting survival were stratified.ResultsA total of 244 patients with recurrent liver cancer were collected, including 134 patients in the ORH group, 110 patients in the RFA group. The patients in the two groups were matched with 1∶1 by PSM, 90 patients in each group. The median overall survival time of the ORH group and the RFA group was 54 months and 45 months, respectively. There were no significant differences in the curves of cumulative overall survival and cumulative disease-free survival between the two groups (P=0.221, P=0.199). The incidence of severe complications in the ORH group was higher than that in the RFA group (10.00% versus 2.22%, P=0.029). A further subgroup analysis showed that the overall survival time of the ORH group was longer than that of the RFA group when the diameter of recurrent liver cancer was 3 to 5 cm (P=0.035), which had no significant differences for the patients with AFP (>400 μg/L or ≤400 μg/L), tumors number (single or multiple), and tumor diameter ≤3 cm between the two groups (P>0.05).ConclusionsPercutaneous RFA is effective and safe in treatment of advanced recurrent liver cancer, its overall survival and disease-free survival are similar to ORH treatment. However, when diameter of recurrent tumor is3–5 cm, ORH treatment has a advantage in prolonging survival time of patients.
The Wireless Body Area Network (WBAN) is a key part of the wearable monitoring technologies, which has many communication technologies to choose from, like Bluetooth, ZigBee, Ultra Wideband, and Wireless Human Body Communication (WHBC). As for the WHBC developed in recent years, it is worthy to be further studied. The WHBC has a strong momentum of growth and a natural advantage in the formation of WBAN. In this paper, we first briefly describe the technical background of WHBC, then introduce theoretical model of human-channel communication and digital transmission machine based on human channel. And finally we analyze various of the interference of the WHBC and show the AFH (Adaptive Frequency Hopping) technology which can effectively deal with the interference.
This study aims to propose a multifrequency time-difference algorithm using spectral constraints. Based on the knowledge of tissue spectrum in the imaging domain, the fraction model was used in conjunction with the finite element method (FEM) to approximate a conductivity distribution. Then a frequency independent parameter (volume or area fraction change) was reconstructed which made it possible to simultaneously employ multifrequency time-difference boundary voltage data and then reduce the degrees of freedom of the reconstruction problem. Furthermore, this will alleviate the illness of the EIT inverse problem and lead to a better reconstruction result. The numerical validation results suggested that the proposed time-difference fraction reconstruction algorithm behaved better than traditional damped least squares algorithm (DLS) especially in the noise suppression capability. Moreover, under the condition of low signal-to-noise ratio, the proposed algorithm had a more obvious advantage in reconstructions of targets shape and position. This algorithm provides an efficient way to simultaneously utilize multifrequency measurement data for time-difference EIT, and leads to a more accurate reconstruction result. It may show us a new direction for the development of time-difference EIT algorithms in the case that the tissue spectrums are known.
Objective To compare the effects of high frequency oscillatory ventilation (HFOV) and conventional mechanical ventilation (CMV) whith or without pulmonary surfactant(PS) supplement on water vapour inhalation injury.Methods New Zealand rabbits model of severe acute lung injury with acute respiratory failure caused by steam inhalation was established.Then the animals were treated by CMV，HFOV，CMV+PS or HFOV+PS，respectively while animals in control group did not ventilated and supplemented with PS.Femoral arterial blood samples were obtained at 1，2，3，4 h after treatment for blood gas analysis.4 h after treatment ,the lowest lobe of right lung was weighed for calculating wet-to-dry weight ratio (W/D).Four different parts including dependent areas and non-dependent areas of the middle lobe of right lung were excised for histological observation.Results (A) After ALI established PaO2 in the five groups decreased below 60mmHg (Plt;0.01) but intergroup differences were found.Meanwhile the change of PaCO2 showd no statistical significance(Pgt;0.05).(B) PaO2 in the four treatment groups had increased since one hour after treatmentand sustained at favorite levels during treatment period.PaO2 in the HFOV and HFOV+PS groups were higher than those in CMV and CMV+PS groups,respectively (Plt;0.01，Plt;0.05).PaO2 in the CMV+PS group at 2 h and HFOV+PS group at 2 h and 3 h were significantly higher than those in corresponding non-PS groups at the same timepoints (Plt;0.05).P（A-a）O2 in the HFOV and HFOV+PS groups were lower than those in CMV and CMV+PS groups (Plt;0.05).P（A-a）O2 in the two groups with PS at 2 h，3 h and 4 h t were statistically lower than those in the two corresponding groups without PS (Plt;0.05).The pH and PaCO2 as well as circulatory function in the four groups were not significantly different at different treatment timepoints (Pgt;0.05).(C) Lung W/D was not different between CMV and HFOV groups (Pgt;0.05)，or CMV+PS and HFOV+PS.But lung W/D in the two groups treated with PS showed statistically decrement than that in non-PS groups (Plt;0.05).(D) Histological injury score was lowest in HFOV+PS group and highest in CMV group.Conclusion HFOV combined with exogenous PS supplement can improve arterial oxygenation and alleviate pulmonary edema and injury，which may be a optimal method for the treatment of acute lung injury with acute respiratory failure caused by water vapour inhalation.
ObjectiveTo understand the latest progress of transcatheter arterial chemoembolization (TACE)-based combination therapies for unresectable liver metastasis from colorectal carcinoma, and to explore the safe and effective combination therapies in order to controlling the rapid progress of disease and improving the quality of life of patients. MethodsThe literatures about TACE-based combination therapies of liver metastasis from colorectal carcinoma and the latest advance in researches of this field at home and abroad were collected, and the application of combination therapies, the advantages and features of the combined treatments were reviewed. ResultsTACE was a safe and effective therapeutic modality in treating primary liver cancer or secondary liver cancer.Compared with a single treatment, TACE-based combination therapies had distinct advantages to patients with liver metastasis from colorectal carcinoma not only improved the quality of life but also prolonged the survival time.With the emerging of various kinds of new drugs and the rapid development of a variety of interventional treatments, it could bring long-term survival benifit for patients with liver metastasis from colorectal carcinoma. ConclusionsDoctors should pay attention to the combined treatments of patients with liver metastasis from colorectal carcinoma, improve the knowledge of personalized medication about advanced tumors and actively promote more usage of combination therapies.
Objective To report the preliminary results of intraoperative saline-irrigated radiofrequency modified maze procedure for chronic atrial fibrillation (AF) in mitral valve diseases. Methods From May 2003 to April 2004 forty-one patients underwent intraoperative saline-irrigated modified maze procedure. The patients included 13 male and 28 female. Their age ranged from 27-65 years (46±10 years). The duration of AF varied from 5 months to 15 years (4.5±3.6 years).The left atrial diameter varied from 37-93 mm (54±11mm). There were mitral stenosis 20, mitral regurgitation 1 and mitral stenosis with regurgitation 20 cases. Cardiopulmonary bypass (CPB) was established as usual. Ablation lines were made with Cardioblate (Medtronic, 25-30 W, 180-240ml/h). Having finished right-sided maze procedure, the aorta was cross-clamped and cold crystalloid or blood cardioplegia were used for myocardial protection. Left atrial incision was performed through the interatrial groove. The ablation lines were created to encircle the orifices of the left and right pulmonary veins respectively. The ablation lines were also performed from the left encircling line to the posterior mitral valvular annulus and to the orifice of left atrial appendage respectively. A ablation line was used to connect left and right pulmonary veins circumferential line. Concomitant procedures were performed (there were double valve replacement 10 cases, mitral valve replacement 31 cases, tricuspid annuloplasty 6 cases, removing the left atrial thrombi 6 cases). Results CPB time varied from 71-160 min (105±24 min) and cross-clamping time varied from 32-106 min (62±20 min). The ablation time varied from 4-22 min (11±4 min). One patient died during hospitalization and the death was caused by acute mechanic valve obstruction. During follow-up at discharge and 3 months 35% patients (14/40) were free of AF and the others were not. But at 6 months 67% patients (10/15) were free of AF. Conclusion The intraoperative saline-irrigated radiofrequency modified maze procedure is comparatively simpler and its efficacy is satisfactory.
【Abstract】ObjectiveTo investigate the effect of high intensity focused ultrasound (HIFU) on the immunity of patients with advanced primary liver cancer (PLC). MethodsForty cases of PLC admitted to our institution from Mar. 2003 to Dec. 2003 were included in this study. Patients were divided into 2 groups and received either HIFU or radiofrequency ablation (RFA) treatment randomly. CD3, CD4, CD8, CD4/CD8, NK, IL-2, TNF were chosen to assess the immune status before and after treatment. The results were compared statistically. ResultsThe survival rate after HIFU was 80.0%, 61.1%, 42.9%, 33.3% at 3 months, 6 months, 9 months and 1 year respectively, which was similar to that after RFA treatment. The changes of immunity parameters of CD3, CD4, CD8, CD4/CD8, NK, IL-2 and TNF were not significant after HIFU treatment. In addition, the differences of those parameters between HIFU group and RFA group were insignificant. ConclusionThere are no detrimental effects on immunity in the early period after HIFU treatment.
ObjectiveTo evaluate surgical outcomes of combined off-pump coronary artery bypass grafting (OPCAB)and bipolar radiofrequency ablation (RFA)for atrial fibrillation (AF). MethodsFrom January 2008 to October 2013, 49 patients with coronary artery disease and AF underwent OPCAB and concomitant Atricure bipolar RFA for AF in Beijing Anzhen Hospital. According to their AF duration, all the 49 patients were divided into 2 groups. In group A, there were 14 patients with permanent AF including 9 males and 5 females with their age of 56.7±7.5 years. In group B, there were 35 patients with paroxysmal AF including 27 males and 8 females with their age of 60.2±10.5 years. AF duration was 9.4±6.0 months. Coronary artery stenosis was 85%-100%. Ambulatory electrocardiogram and echocardiography were performed to observe AF recurrence during follow-up. ResultsNone of the patients received intraoperative conversion operation under cardiopulmonary bypass, and there was no in-hospital death. Postoperatively, 81.6% (40/49)patients had conversion to sinus rhythm (SR)or junctional rhythm, 18.4% (9/49)patients remained AF, but none of the patients had second or third-degree atrioventricular block. A total of 139 distal anastomoses were performed with a mean of 2.8 distal anastomoses per patient. Length of hospital stay was 10-15 (12±3)days. SR was observed in 34 patients (69%)before discharge including 9 patients (64%)in group A and 25 patients (71%)in group B. All the patients (100%)were followed up for 5-12 months. 39 patients (80%)maintained SR over 6 months, including 10 patients (71%)in group A and 29 patients (83%)in group B. 44 patients (90%)maintained SR over 12 months, including 11 patients (79%)in group A and 33 patients (94%)in group B. There was no statistical difference in SR maintenance rate between the 2 groups (P > 0.05). ConclusionOPCAB and concomitant bipolar RFA for AF is safe, efficacious and feasible.
ObjectiveTo investigate the application of critical flicker fusion frequency (CFF) in non-arteritic anterior ischemic optic neuropathy (NAION). MethodsA cross-sectional study. From January 2021 to September 2021, a total of 58 NAION patients (105 eyes) (NAION group) and 33 cases (63 eyes) in the healthy control (HC) group were included from Department of Ophthalmology of First Medical Center, PLA General Hospital. Patients underwent best-corrected visual acuity (BCVA), optical coherence tomography (OCT), visual field, CFF and flash visual evoked potential (F-VEP) examinations. BCVA examination was performed using a Snellen decimal visual acuity chart and was converted to logarithm of the minimum angle of resolution visual acuity. In the affected eyes group, there were 56 cases (72 eyes), 31 cases (43 eyes) male and 25 cases (29 eyes) female, with an average age of 49.28±11.42 years old. And the affected eyes were divided into 4 groups: ＜1, 1-＜3, 3-＜6 and ＞6 months according to the time interval from onset to CFF examination, which were 20 (27.8%), 26 (36.1%), 17 (23.6%) and 9 (12.5%) eyes, respectively. According to the BCVA ≥0.5, 0.1-0.5, ＜0.1 in CFF examination, the affected eyes were divided into a mild, moderate, and severe degree, 33 (45.8%), 32 (44.4%) and 7 (9.8%) eyes, respectively. Sixty-three eyes of 33 cases were in the HC group. There were 17 cases (31 eyes) males and 16 cases (32 eyes) females, with an average age of 35.18±10.96 years. Hand-held CFF detector type 2 (Japan, NEITZ company) was used for the CFF examination. The thickness of peripheral retinal nerve fiber layer (pRNFL), macular inner limiting membrane retinal pigment epithelium (mILM-RPE), F-VEP peak time and peak value and mean visual field defect (MD) values were recorded within 1 week of CFF examination. The CFF value of the above subgroups was analyzed in order using one-way ANOVA. Pearson correlation analysis was used for the correlation between CFF and F-VEP peak time, peak value, BCVA and MD. The correlations between BCVA, visual field, F-VEP, and CFF were analyzed. ResultsThe trichromatic values of red, green and yellow in NAION affected eyes were 22.56±10.30, 24.10±11.51, 24.81±11.41 Hz, respectively, which was significantly reduced compared with the HC group (t=－10.53,－11.11,－11.36; P＜0.05). There was no significant difference in CFF-red, green, and yellow values at different time points after the onset of the disease (F=2.075, 1.893, 2.073; P＞0.05). Compared CFF-red, green, and yellow values in NAION-affected eyes with different degrees, the difference was statistically significant (F=31.579, 27.332, 32.055; P＜0.05). The results of correlation analysis showed that the peak time of F-VEP (r=－0.362, －0.379,－0.357; P＜0.05), BCVA (r=－0.705,－0.695,－0.714; P＜0.05), and which was negatively correlated with CFF three color. MD and CFF were positively correlated (r=0.486, 0.435, 0.450; P＜0.05). ConclusionThe CFF value of the affected eye is decreased significantly in NAION-affected eyes, and CFF is more sensitive than F-VEP in reflecting visual impairment, and has a good correlation with visual function and latency of F-VEP.
In order to study the variation of complex impedance and characteristic parameters on human normal and tumor lung tissue during the extracorporeal time, we established a real part-imaginary part chart of complex impedance on lung tissue which provided the basic theory and the reference data for research on elementary medicine and clinical diagnosis of lung cancer and meanwhile provided prior information for electrical impedance tomography (EIT) research. In the experiment carried out in our laboratory, when operation was finished, we kept the lung cancer tissue and normal tissue neatly separated into the cylindrical testing cavities and kept the temperature and humidity at expected values. Then the measurements of complex impedance property are performed at frequency from 1 000 Hz to 30 MHz using 4294A impedance analyzer of Aglient Company. With time changing, the results showed that there was a significant change occurring on the complex impedance of human normal and tumor lung tissue. However, the impedance of normal lung tissue is greater than that of tumor lung tissue. We consider that this change should be related to the change in extracellular fluid, intracellular fluid and cell membrane.