ABSTRACT
OBJECTIVE:To explore the clinical efficacy and safety of nalmefene combined with monosialotetrahexosylganglio-side sodium in the treatment of patients in brain tumor operation. METHODS:64 patients in brain tumor operation were randomly divided into observation group and control group,32 cases in each group. Control group received brain cell protection,reducing in-tracranial pressure,anti-infective,vasodilator and other conventional treatment;observation group additionally received 0.7μg/(kg· h) nalmefene combined with 100 mg/d monosialotetrahexosylganglioside sodium from the first day of operation,for continuous 7 d. The plasma cortisol,adrenocorticotropic hormone (ACTH) before and 3,7 d after treatment,changes of serum IL-6,TNF-αand Barthel index (BI) in 2 groups were observed,improvement of neurological function and ADR were observed;Karnofsky (KPS)score was determined after 90 d follow-up used to assess the patient’s ability to take care of themselves. RESULTS:After treatment,plasma cortisol and ACTH content,serum TNF-αand IL-6 levels in 2 groups significantly decreased than before,the dif-ference was statistically significant(P<0.05);cortisol,ACTH and TNF-α levels 3,7 d after treatment,IL-6 level 7 d after treat-ment in observation group decreased more significantly than control group,the differences were statistically significant(P<0.05). After treatment,BI score in 2 groups significantly increased,and observation group increased more significantly than control group,the differences were statistically significant (P<0.05). 7 d after treatment,improvement rate of neurological function was 50.00%,which was significantly higher than that of the control group(18.75%),the difference was statistically significant(P<0.05). There was no significant ADR occurred of 2 groups in the study. Following-up for 90 d,the KPS score in observation group with not less than 70 points accounted for 71.88%,which was significantly higher than the control group(46.87%),the difference was statistically significant (P<0.05). CONCLUSIONS:Nalmefene combined with monosialotetrahexosylganglioside sodium can promote the recovery of patients in brain tumor operation,reduce cortisol,ACTH,IL-6 and TNF-α levels and improve prognosis of patients.
ABSTRACT
Purpose To evaluate the CT features and pathological manifestations of the solid components of mixture ground-glass opacity (GGO) in adenocarcinoma in situ (AIS), minimally invasive adenocarcinom (MIA) and invasive adenocarcinoma (IAC), to analyze the qualitative diagnosis value of solid components of mixture GGO in the diagnosis of AIS, MIA and IAC, to provide reference for the selection of clinical treatment.Materials and Methods Eighteen patients with AIS, 53 patients with MIA and 28 patients with IAC (the maximum diameter smaller than 2 cm) proved by surgery and pathology with CT features appearing as mixture GGO were retrospectively analyzed, CT features of the solid components in three groups were analyzed and compared with pathology.Results The solid components in AIS mainly appeared as punctiform or polygon, with extensive distribution, solid nodules were usually single (17 cases, 94.44%), located in the middle of the lesion (14 cases, 77.78%), with clear binderies (16 cases, 88.89%) and the same density with vessels in the same axis (13 cases, 72.22%); the majority of solid components in MIA appeared as circular or elliptical (33 cases, 62.26%), less than or equal to 5 mm (48 cases, 90.57%), with eccentric or multi-point distribution (45 cases, 84.90%), the boundaries were less sharp (40 cases, 75.47%), with slightly lower density than that of the vasculars in the same level (34 cases, 64.15%); the solid components in IAC mainly appeared as irregular lesions (21 cases, 75.00%), lager than 5 mm (24 cases, 85.71%), with eccentric growth (20 cases, 71.43%) and less sharp boundary (15 cases, 53.57%), the integration of multiple nodules could also be observed. There were statistically significant differences in the CT features of solid components within the lesions among the three groups (P<0.01).Conclusion It is possible to predict the pathological typing and the prognosis of pulmonary mixture GGO in a certain extent according to the different CT features of the solid components in it, and to guide clinical treatment principles.