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Objective To explore the treatment of locally advanced pancreatic cancer(LAPC)by Nanoknife,and the demonstrations on contrast enhanced ultrasonography(CEUS)after the procedures. Methods Four patients were enrolled.Each of them was percutaneously inserted 3-5 Nanoknife electrodes to ablate the lesions with 2-3 sessions under the guidance of ultrasound.After the procedures,CEUS, contrast enhanced CT,contrast enhanced MRI or computed tomography angiography (CTA) were performed to assess the efficacy.Results All patients uneventfully were able to tolerate the high-voltage Nanoknife procedures.However,the endurable pain or discomfort in abdomen was complained.For one patient with obstructive jaundice and mild liver dysfunction,pancreatic amylase in serum increased slightly at the first day after treatment.Furthermore,C response protein in serum elevated,and biliary tract infection happened at the third day.Moreover,thromboses in portal and splenic vein were found at the seventh day.The survival time for all cases were 3-8 months.According to the findings of CEUS,a well-defined no contrast enhancement was detected at ablative zone for all the patients within one week.Yet, contrast enhancement was sporadically detected at the periphery in 3 patients 1-2 months late.Meanwhile, on contrast enhanced CT or MRI,an area of absent enhancement was also depicted at the ablation zone with heterogeneously decreased enhancement at periphery of the lesion.Base on CTA findings,local stenosis of splenic vein and superior mesenteric vein with varices of collateral vascularity were found in one patient at the fiftieth day,and superior mesenteric vein obstruction accompanied by varices of collateral vascularity was also found in another patient at the seventieth day.Conclusions For patients with LAPC,Nanoknife treatment is a safe and convenient procedure that can be percutaneously completed under the guidance of ultrasound.Along with enhanced CT,MRI or CTA,CEUS is a promising way to evaluate the efficacy of this procedure.
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Background: Tumor markers are widely used in clinical practice and have become important indicators in assessing cancer progress. There is increasing concern that chemotherapy combined with traditional Chinese medicine has effects in decreasing the level of tumor markers. Objective: To investigate the effects of chemotherapy combined with Kangliu Zengxiao Decoction (KLZX), a compound Chinese herbal drug, on tumor markers carbohydrate antigen 50 (CA 50), cytokeratin 19 fragment (CYFRA21-1) and carcinoembryonic antigen (CEA) in patients with advanced non-small-cell lung cancer (NSCLC) and to explore the relationships between clinical efficacy and tumor markers. Design, setting, participants and interventions: Patients were included from Punan Hospital of Shanghai Pudong New District and Longhua Hospital between October 2008 and December 2009. Seventy-four subjects with advanced NSCLC were randomly assigned into treatment group (n=37) and control group (n=37). Patients in the control group were treated with chemotherapy alone while patients in the treatment group were treated with chemotherapy combined with KLZX. Chemotherapy of NP (vinorelbine + cisplatin) was given for two cycles and patients in the treatment group were administered with KLZX during chemotherapy. Main outcome measures: Levels of CA50, CYFRA21-1 and CEA before and after treatment were evaluated and the relationship between changes in levels of tumor makers and tumor size, clinical symptoms and living condition score (Karnofsky score) was analyzed. Results: No patients achieved a complete remission. The disease control rates (complete remission (CR)+partial remission (PR)+no change (NC)) were 89.20% (33/37) and 70.30% (26/37) in the treatment and control group respectively (P<0.05). The levels of CA50, CYFRA21-1 and CEA were clearly decreased in the treatment group after treatment (P<0.05) while also decreased in the patients without progression of disease. There were no obvious changes of CA50, CYFRA21-1 and CEA in the control group, and there was even a trend of increase. Furthermore, the improvement rates of clinical syndrome were 51% (19/37) vs 11% (4/37) (P<0.05) in the treatment group and control group respectively. The total response rates of quality of life were 91.89% (34/37) vs 56.76% (21/37) (P<0.01) in the treatment and control group respectively. Conclusion: Combined chemotherapy with KLZX in treating advanced NSCLC can acquire better stabilizing tumor foci, decrease levels of tumor markers and improve the clinical symptoms and Karnofsky score.
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Objective In order to know the harm of indoor environment pollutants to the human health. Methods Formaldehyde, benzene, dimethylbenzene, ? radiation and radon were selected as the factors of indoor environment pollution assessment, considering about the inhale and exposure path of indoor air, assessment model which from the production of inland and overseas was used to evaluate the health risk during Mar.-Oct.2005. Results The average risk of the indoor air pollution in Jiangxi province was 1.93?10-4/a, radiation (? radiation, radon) was 1.32?10-4/a, accounted for 68%. Formaldehyde was 4.64?10-5/a, accounted for of 24%. Benzene was 1.41?10-5/a, accounted for 7%. Dimethylbenzene was 1.32?10-9/a, which could be ignored. Conclusion The health risk of indoor environmental air pollutants in each city of Jiangxi province is higher than the acceptable lever(10-5/a).
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Objective To assess the value of 16-slice spiral CT perfusion in the diagnosis of hyperacute cerebral infarction.Methods Routine and perfusion CT of brain were performed in 20 cases suspected with hyperacute cerebral stroke within 6 hours of symptom onset,the images of plain scan,rCBV,rCBF,MTT and TTP were observed and evaluated. All cases were followed-up with CT after one week.Results Ischemic lesions were found in routine CT in 5 cases,15 cases had negative results at routine CT, and ischemic lesions were showed in all of them by perfusion CT images.rCBV,rCBF distinctly decreased, MTT and TTP obviously prolonged in infarction area,and rCBF decreased, MTT and TTP prolonged and rCBV was normal or up lightly in the penumbra area. The infarction lesions were detected in 15 cases by follow-up CT.Conclusion 16-slice spiral CT perfusion in diagnosis of hyperacute cerebral infarction may be a valuable tool in predicting clinical prognosis.