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ObjectiveTo investigate the efficacy and safety of cryoablation combined with Camrelizumab monoclonal antibody in the treatment of hepatocellular carcinoma （HCC）. MethodsA total of 103 HCC patients who were admitted to our hospital from June 2020 to June 2023 were enrolled and randomly divided into combined treatment group with 53 patients and control group with 50 patients. The patients in the control group received percutaneous argon-helium cryoablation， and those in the combined treatment group received percutaneous argon-helium cryoablation combined with Camrelizumab monoclonal antibody. The two groups were compared in terms of short-term response， changes in T lymphocyte subsets after treatment， changes in liver function and alpha-fetoprotein （AFP） after treatment， and progression-free survival and overall survival during follow-up. The t-test was used for comparison of normally distributed continuous data between groups， and the chi-square test was used for comparison of categorical data between groups. The Kaplan-Meier method was used to plot survival curves， and the log-rank test was used for comparison of survival time between the two groups. ResultsThe combined treatment group had significantly higher overall response rate and disease control rate than the control group （χ2=4.156 and 4.348， P=0.042 and 0.037）. After treatment， the combined treatment group had significant increases in the percentages of CD3+ and CD4+ T lymphocytes and CD4+/CD8+ ratio （P<0.05） and a significant reduction in the percentage of CD8+ T lymphocytes （P<0.05）， while the control group had no significant changes in T lymphocyte subsets after treatment （P>0.05）， and compared with the control group after treatment， the combined treatment group had significantly higher percentages of CD3+ and CD4+ T lymphocytes and CD4+/CD8+ ratio （all P<0.05） and a significantly lower percentage of CD8+ T lymphocytes （P<0.05）. After treatment， both groups had significant reductions in the levels of alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， and AFP （all P<0.05） and a significant increase in the level of albumin （Alb） （P>0.05）， and compared with the control group after treatment， the combined treatment group had significantly lower levels of ALT， AST， and AFP （all P<0.05） and a significantly higher level of Alb （P<0.05）. There were no significant differences in the incidence rates of grade Ⅲ—Ⅳ （moderate to severe） adverse reactions between the two groups （P>0.05）. Compared with the control group， the combined treatment group had significantly better median progression-free survival （21.32 months vs 15.31 months， χ2=4.689， P=0.030） and median overall survival （28.36 months vs 20.75 months， χ2=5.030， P=0.025）. ConclusionArgon-helium cryoablation combined with Camrelizumab monoclonal antibody can effectively improve short-term response， enhance immune function， and prolong survival time， with a favorable safety profile.
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Objective To determ ine the norm al reference values of 33 elem ents, Ag, Al, As, Au, B , B a, Be, Ca, Cd, Co, Cr, Cs, Cu, Fe, G a, H g, Li, Mg, Mn, Mo, N i, Pb, Rb, Sb, Se, Sr, Th, Ti, Tl, U , V , Zn and Zr, in the blood and urine sam ples from the general population in Sanm en County of Zhejiang province, a typical coastal area of eastern China. Methods The 33 elem ents in 272 blood and 300 urine sam ples w ere determ ined by inductively coupled plasm a-m ass spectrom etry (ICP-MS ). The norm ality test of data w as conducted using SPSS 17.0 Statistics.The data w as com pared w ith other reports. Results The norm al reference values of the 33 elem ents in the blood and urine sam ples from the general population in Sanm en County w ere obtained, w hich of som e elem ents w ere found to be sim ilar w ith other reports, such as Co, Cu, Mn and Sr, w hile As, Cd, H g and Pb w ere generally found to be higher than those previously reported. There w as a w ide variation betw een the reports from different countries in blood B a. Conclusion The norm al reference values of the 33 elem ents in the blood and urine sam ples from the general population in Sanm en County are established, and successfully applied to tw o poisoning cases.
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Objective T o determine the normal range of the 33 elements (Li, Be, B, mg, Al, Ca, Ti, V , Cr, mn, Fe, Co, Ni, Cu, Zn, Ga, As, Se, Rb, Sr, Zr, mo, Ag, Cd, Sb, Cs, Ba, Au, Hg, Tl, Pb, Th and U ) in human whole blood of general population in Hunan province. Methods Blood samples were ana-lyzed by inductively coupled plasma-mass spectrometry (ICP-mS ) to determine the normal range. T he influences of district, gender and age to the element content in blood samples were also observed. Re-sults T he normal range of 33 elements in blood samples fromgeneral population in Hunan province were obtained. Gender was shown to statistically influence the concentrations of B, mg, Ca, Ti, mn, Fe, Co, Cu, Zn, As, Se, Rb, Sr, Ag, Cd, Cs, Hg and Pb (P<0.05), while age was shown to influence the concentrations of Co, Ni, Cs and Hg in women (P<0.05) as well as Cu, Se and Hg in men(P<0.05). Conclusion Although there are variables in different districts, the normal ranges of trace element in blood of the four cities in Hunan province are established.
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In order to guarantee the safety and accuracy of the whole treating process as well as better link up of each section during the treatment, we did research in order to establish a project concerning the process quality control (PQC) of treating liver cancer with CyberKnife. From the safety and accuracy point of view, we divided the whole process of treating liver cancer with CyberKnife into ten links, i.e. the registration of patients' information, the im plantation of fiducial markers, fixation of body posture, CT localization, target delineation, design of the treatment plan, quality assurance in physics, implementation of the treatment plan, inspection on the correctness and data archiving. We analyzed the possible mistakes in each link and the consequences brought by them. To smoothly connect all the links, a special part "Attention" was added between every two links. Various wrong operations which may influence the safety and accuracy of treatment were illustrated, and the consequences brought by them were also ex plained. The "Attention" part among links offers important information for the next step, and gives us reminding and warnings. The project of quality control covers all the important links when treating liver cancer with Cy berKnife. It offers regulations, reminding and warning for us so that the safety and accuracy of treatment can be guaranteed, and the work of all staff could be closely connected.
Subject(s)
Humans , Liver Neoplasms , General Surgery , Quality Control , Radiosurgery , MethodsABSTRACT
Objective To analyze the factors influencing fiducial number used for tracking abdominal tumor with stereotactic body radiation therapy (SBRT),which was implemented by CyberKnife.Methods 254 abdominal tumor patients chosen which adopted fiducial tracking and classified the fiducials.We gathered data of the patients with ＜ 3 fiducials used for tracking and patients with ≥ 3 fiducials respectively,and analyzed the reason why ＜ 3 fiducials were left for tracking.Results Among 254 patients,22 patients were showed that the number of fiducial implantation were equal to play number of fiducial;232 patients with no equation which 49 patients (21.1％) used ＜ 3 fiducials for tracking,183 patients (78.9％) used ≥3 fiducials for tracking.Among the 49 patients with ＜3 fiducials for tracking,9 patients had fiducials migrated,1 patient had an unrecognizable fiducial,23 patients had the implantation not qualified for tracking,and 16 patients had the rigid error surpassing the threshold.Conclusions 78.9％ patients were implanted ≥ 3 fiducials and thus qualified for fiducial tracking.Major reasons of disqualification include insufficient implanted fiducials,unqualified implantation and rigid error surpassing the threshold.
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Objective:To give the test in cases of changing the conditions of measurement and reference value, compare the test results, and detect the capacity of QuickCheck, so as to offer reference for the daily morning check of accelerator and the evaluation of test results. Methods:Change the output dose, field size, SSD, angle of collimator and gantry angle of the accelerator, and then evaluate QuickCheck’s capacity of monitoring accelerator accordingly. Compare the field parameters measured by QuickCheck with the data from the 3D water tank. Results:When the output dose was 1 cGy higher than the reference value or 6 cGy lower than it, the field size expanded or contracted more than 2 cm simutaneouly, SSD was 2 cm higher or 1 cm lower than reference value, the collimator rotated more than 2 °, the gantry angle rotated more than 6 °, and then the test results of QuickCheck surpassed threshold. Comparing the measuring results of QuickCheck with 3D water tank, the difference between the flatness of the two was 3.84%, symmetry (G/T) 0.67%, symmetry (L/R) 0.47%and dose rate 1.2 MU/min. Conclusion:QuickCheck is rather accurate in testing the output dose, field size, angle of collimator, flatness, symmetry and dose rate, so it could meet the requirement of accelerator’s daily QA. However, its capability is relatively poor on examining SSD and the deviation of gantry angle.
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Objective To investigate the effect of transjugular intrahepatic portosystemic stent shunt (TIPS) on gastrointestinal bleeding after portal hypertension and portal vein wide embolism.Methods Three patients with acute upper gastrointestinal bleeding were diagnosed by CT with wide embolus formation in portal vein and superior mesenteric vein,of which,1 case was with spleen vein embolism formation.TIPS hemostatic treatment was applied to stop bleeding,and stents was placed where distal embolus can be observed by angiography.Results After TIPS treatment,no patients were re-bleeding during following-up periods (4-6 weeks).Uncomfortable symptoms of 3 cases were disappeared.Conclusion TIPS was a safe and effective way to treat gastrointestinal bleeding caused by portal hypertension and wide embolus formation.