Manejo del mesotelioma peritoneal maligno con citorreducción quirúrgica más quimioterapia hipertérmica intraperitoneal en el Instituto Nacional de Cancerología, Colombia: reporte de un caso y revisión bibliográfica / Peritoneal malignant mesothelioma treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy at the National Cancer Institute, Colombia: case report and literature review

El mesotelioma peritoneal es una neoplasia que se origina en las células mesoteliales del peritoneo. Histórica-mente, la supervivencia de los pacientes con mesotelioma peritoneal maligno sin tratamiento, es menor de 12 meses y se considera una neoplasia resistente a la quimioterapia. La citorreducción quirúrgica y la quimioterapia regional administrada como quimioterapia hipertérmica intraperitoneal (Hyperthermic Intraperitoneal Chemothe-rapy, HIPEC) se asocia con mejor supervivencia a largo plazo.Se presenta el caso de un paciente con antecedentes de exposición al asbesto y con diagnóstico de mesotelioma peritoneal maligno de tipo epitelioide, que fue tratado con cirugía citorreductora más quimioterapia hipertérmica intraperitoneal en el Instituto Nacional de Cancerología con una supervivencia de un año libre de enfermedad

Peritoneal mesothelioma is originated at the mesothelial cells of the peritoneum. Historically the survival of patients with this disease is less than 12 months without treatment and it is considered a neoplasm resistant to chemotherapy. Citorreductive surgery with hiperthermic intraperitoneal chemotherapy (HIPEC) is associated with an increased long-term survival. Here we present the case of a patient who had a past history of asbestos exposure and who was diagnosed with peritoneal mesothelioma of the epithelioid subtype. The patient was treated with cytoreductive surgery and HIPEC at the Instituto Nacional de Cancerología (Bogotá, Colombia) and has had a 12 month disease free survival

Quimioterapia hipertérmica intraperitoneal transoperatória: o que a enfermagem precisa saber / Intraoperative hyperthermic intraperitoneal chemotherapy: what nurses should know / Quimioterapia intraperitoneal hipertérmica transoperatória: qué necesita saber la enfermería

Objetivo: apresentar o estado do conhecimento científico sobre quimioterapia hipertérmica intraperitoneal transoperatória no tratamento da carcinomatose peritoneal e os cuidados de enfermagem pós-operatórios para pacientes submetidos a essa terapia. Métodos: apresentam-se aspectos técnicos da quimioterapia hipertérmica intraperitoneal transoperatória, suas complicações potenciais e cuidados de enfermagem pós-operatórios envolvidos. Resultados: destaca-se a importância dos cuidados de enfermagem, quais sejam: monitorar sinais vitais, perfusão periférica, débito cardíaco e pressão venosa central; avaliar dor; encorajar tosse e realização de exercícios de respiração profunda; registrar drenagem de ferida operatória e drenos; investigar ruídos intestinais; medir volume residual gástrico; promover mudanças de decúbito; avaliar resultados laboratoriais de exames sanguíneos; instituir balanço hídrico e; aferir peso corporal. Conclusão: a quimioterapia hipertérmica intraperitoneal transoperatória é terapia promissora no tratamento de pacientes com carcinomatose peritoneal. Entretanto, para ser bem-sucedida, a prestação de cuidados de enfermagem é fundamental.

Objective: to present the current state of scientific knowledge about intraoperative hyperthermic intraperitoneal chemotherapy for the treatment of peritoneal carcinomatosis, and postoperative nursing care for patients undergoing this therapy. Methods: the study describes technical aspects of intraoperative hyperthermic intraperitoneal chemotherapy, the potential complications and post-operative nursing care involved. Results: emphasis was placed on the importance of nursing care, viz.: monitoring of vital signs, peripheral perfusion, cardiac output, and central venous pressure; pain assessment; encouraging coughing and deep breathing exercises; recording drainage of surgical wound and drains; investigating bowel sounds; measuring gastric residual volume; ensuring change of decubitus; evaluating laboratory blood test results; establishing water balance; and measuring body weight. Conclusion: intraoperative hyperthermic intraperitoneal chemotherapy has been shown to be a promising therapy in treatment of patients with peritoneal carcinomatosis. However, to be successful, the nursing care provided is fundamental.

Objetivo: presentar el estado del conocimiento científico sobre quimioterapia intraperitoneal hipertérmica transoperatoria en el tratamiento de la carcinomatosis peritoneal y los cuidados de enfermería posoperatorios para pacientes sometidos a ella. Métodos: se presentan aspectos técnicos de la quimioterapia intraperitoneal hipertérmica transoperatoria, sus complicaciones potenciales y cuidados de enfermería posoperatorios involucrados. Resultados: se destaca la importancia de los cuidados de enfermería: monitorear señales vitales, perfusión periférica, débito cardíaco, presión venosa central; evaluar dolor; estimular la tos y realización de ejercicios de respiración profunda; registrar drenaje de herida operatoria y drenes; investigar ruidos intestinales; medir volumen residual gástrico; promover cambios de decúbito; evaluar resultados de análisis de sangre en laboratorio; establecer balance hídrico; verificar peso corporal. Conclusión: la quimioterapia intraperitoneal hipertérmica transoperatoria es terapia prometedora en el tratamiento de pacientes con carcinomatosis peritoneal. Sin embargo, para ser exitosa, la prestación de cuidados de enfermería es fundamental.

Segunda citorreducción más quimioterapia hipertérmica intraperitoneal por recaída de seudomixoma peritoneal / Second cytoreduction plus intraperitoneal hyperthermic chemotherapy in recurrence of pseudomyxoma peritonei

Introducción. El seudomixoma peritoneal es una condición rara caracterizada por la presencia de ascitis mucinosa e implantes peritoneales, en la mayoría de los casos, provenientes de tumores mucinosos del apéndice. El tratamiento primario de esta enfermedad es quirúrgico, y la citorreducción más quimioterapia hipertérmica intraperitoneal es el estándar de tratamiento actual, con supervivencia global a 5 y 10 años hasta de 96 y 68 %, respectivamente. No obstante, es una cirugía con alta morbilidad y considerable mortalidad, que apenas se está introduciendo en Colombia y la experiencia es incipiente. El porcentaje de recaída es de 28 a 44 % y existen pocos reportes sobre su manejo; la segunda citorreducción más quimioterapia hipertérmica intraperitoneal parece tener resultados aceptables en cuanto a supervivencia, morbilidad y mortalidad. Resultados. No hay estudios de segundas intervenciones por recaída peritoneal del seudomixoma en Colombia y, por esta razón, se decidió reportar la experiencia de dos casos del Instituto Nacional de Cancerología, donde, después de una primera citorreducción más quimioterapia hipertérmica intraperitoneal, los pacientes presentaron recaída peritoneal diagnosticada con imágenes durante el seguimiento y fueron sometidos a una nueva cirugía con buen resultado quirúrgico. Conclusión. La citorreducción secundaria más quimioterapia hipertérmica intraperitoneal es un procedimiento complejo con morbilidad considerable, que debe practicarse en lugares con experiencia y que proporciona al paciente un tratamiento radical y, posiblemente, se convierta en el manejo estándar de la recaída

Introduction: Peritoneal pseudomyxoma is a rare condition characterized by mucinous ascitis and peritoneal implants, originating from mucinous tumors of the apendix in the majority of cases. Primary treatment is surgical resection, with cytoreduction surgery plus hiperthermic intraperitoneal chemotherapy as the current standard of care, with 96% and 68% 5 and 10 year overall survival rates. Nonetheless, it is a surgical procedure associated with high morbidity and considerable mortality, with initial experience in Colombia. Recurrence is estimated between 28% and 44% and few reports address the management of recurrence peritoneal pseudomyxoma; second cytoreduction surgery plus hiperthermic intraperitoneal chemotherapy (CRS + HIPEC) seems to have acceptable results in terms of survival, morbidity and mortality. No studies of second CRS + HIPEC have been reported in Colombia; this is why we decided to publish two cases treated at the Instituto Nacional de Cancerología, Bogotá, Colombia, who had recurrence after a fist CRS + HIPEC, diagnosed by follow up images and who were taken to a second surgical treatment with good results. Conclusion: Second CRS + HIPEC is a technically challenging procedure with considerable morbidity that should only be performed in specialized and experienced centers, a radical form of treatment that could possibly become the standard of choice for recurrence.

Outcomes of radical TURBt plus chemotherapy for the treatment of the patients with muscle-invasive bladder cancer / 中华泌尿外科杂志

ObjectiveTo evaluate the efficacy of radical transurethral bladder tumor resection plus chemotherapy for the treatment of muscle-invasive bladder cancer. Methods Thirty-two patients,who were diagnosed muscle-invasive bladder cancer by preoperative CT and cystoscopy and not tolerating or rejecting radical cystectomy were treated by transurethral resection of bladder tumor (TURBt).The maximum diameter of tumor ranged from 1 - 5 cm,3 cm on average.After conventional intravenous chemotherapy ( docetaxel 75 mg/m2 + oxaliplatin 130 mg/m2),and given intravenous therapy (HCPT 20 mg + 20 ml saline).Regular cystoscopy was used to monitor tumor recurrence.The examination was performed quarterly in the first 2 years post operation,twice a year since the third year.ResultsThe tumors of 32 cases were resected completely.Operative time were 15 -70 min,the blood loss was 10 -150 ml,without serious complications during the operation.Pathological report showed 32 cases of transitional cell carcinoma.Clinical stages were T2a 20 cases,T2b 12 cases.Pathological grade were G2 13 cases,G3 19 cases.There was no bone marrow suppression,anemia or other severe complications was seen in 32 cases that received chemotherapy.3 of which manifested as low fever,mild nausea,and headache,respectively,having a rest 2 to 3 days the symptoms disappeared.32 patients were followed up for 3 - 60 months,a mean of 28 months.After 1 year the recurrence rate was 9.4％ (3/32),after 2 years was 12.5％ (4/32).The TNM stage of these recurrence cases were 4 cases with T2a and 3 cases with T2b.12 patients died,5 patients died of bladder cancer metastasis.Other 20 patients were survival with no recurrence.ConclusionRadical TURBt plus chemotherapy could be a treatment for the selected patients with muscle invasive bladder cancer.

Perfusión aislada de extremidades: experiencia inicial del Instituto Nacional de Cancerología, 2007-2008 / Isolated limb perfusion: initial experience at the National Cancer Institute of Colombia, 2007-2008

Objetivo: Presentar la experiencia inicial del Instituto Nacional de Cancerología con la aplicación de la técnica de perfusión aislada de extremidades. Métodos: Se recolectaron 13 pacientes desde el 2007 hasta el 2008 y se documentó tanto su patología como su respuesta a la intervención. Resultados: El salvamento de la extremidad fue del 76%, y las complicaciones locales, del 16%. Cinco pacientes (41,7%) presentaron repuesta parcial; otros cinco (41,7%), presentaron enfermedad estable, y dos más, (16,7%) progresión de enfermedad. No hubo pacientes con respuesta clínica completa. Conclusiones: La perfusión aislada de extremidades es una buena alternativa de tratamiento en los pacientes con melanoma y sarcomas avanzados de las extremidades con indicación de amputación para lograr conservar la extremidad. Dado el número de pacientes presentado en este artículo, y con el fin lograr conclusiones más sólidas, es necesario realizar un seguimiento cuidadoso de los pacientes, planteando un trabajo de investigación prospectivo que tenga como resultados finales el tipo de respuesta, el tiempo libre de enfermedad, la supervivencia global y las escalas de calidad de vida para los pacientes que reciben esta terapia.

Objective: To describe the initial experience of isolated limb perfusion at the National Cancer Institute. Methods: Pathology and response to intervention was documented in the cases of 13 patients taken from years 2007 to 2008. Results: Limb salvage was 76%; local complications, 16%. Five patients (41.7%) had partial response; two more (16.7%), disease progression. No patients had complete clinical response. Conclusions: Isolated limb perfusion provides a good alternative for treating melanoma and advanced sarcomas in limbs; possibly sparing them from amputation. Due to the number of patients included in this article, and to the need to establish more solid conclusions, it is necessary to carry out closer patient follow-up by setting up a prospective research project whose results will establish type of response, disease free interval, overall survival and a quality-of-life scale for patients who receive this kind of treatment.

The protective role of hypothermic protective solution during surgey for the tetralogy of Fallot / 中华胸心血管外科杂志

Objective The incidence of acute pulmonary injury occurred after cardiopulmonary bypass for fallot tetrad has been high. The severity of pulmonary ischemia-reperfusion has been found to be reduced with ulinastatin (UTI) in the animal models and clinical practice. We evaluated the effect of pulmonary artery perfusion with a hypothermic protective solution containing ulinastatin on the inflammatory response in the lung during cardiopulmonary bypass. Methods 30 children with tetralogy of Fallot (TOF) were randomly assigned into control group and protective group, 15 cases in each group. Patients would be excluded if they had signs of infections, such as the white blood cell count was over 12000 per microliter, the temperature was above 38 centi-degree and the c-reaction protein was more than 8 mg/L. Operation with routine approaches was performed in the control group and the pulmonary artery was infused with 4℃ protective solution in the protective group while the heart stoped beating. Plasma tumor necrosis factor α (TNF-α) 、CD11b and Myeloperoxidase (MPO) were measured intraoperatively and postoperatively. Blood gas、pulmonary function and clinic index of the patients were also monitored. Results The level of TNF-α was lower in the protective group as compared with that in the control group immediately and 3 hours after closing the sternum [(11.15±2.47) pg/ml vs. (14.21 ±5.55) pg/ml, P<0.05; (12.01 ±2.69) pg/ml vs. (15.94 ±4.86)pg/ml,P <0.01]. The MFI of CD11b was lower in the protective group as compared with that in the control group at 3 and 6 hoursafter closing the sternum (126.23±36.05 vs. 156.98±48.34, P<0.05; 137.27±38.85 vs. 173.27±67.43, P<0.05). The level of MPO was lower in protective group as compared with that in the control group at 3 hours, 6 hours and 24hours after closing the sternum [(156.52±17.57)U/L vs.(178.45±35.68)U/L, P<0.05; (178.28±23.63) U/L vs.(224.66±49.66)U/L, P<0.01;(130.52±57.50)U/L vs. (96.50±14.49)U/L, P<0.05]. The duration of mechanical ventilation was significantly shorter in the protective group than that in the control group (17.60±6.39 vs. 23.70±8.51,P<0.05). Alveolar-arterial oxygen pressure difference (A-aDO2, calculated as [FiO2×713-5/4×PaCO2]-PaO2) in the protective group was less than that in the control group at 3 and 6 hours after closing the sternum [(120.92±33.08)mm Hg vs. (145.52±39.38)mmHg, P<0.05;(74.76±40.16)mm Hg vs. (112.50±44.16)mmHg, P<0.01]. Dynamic compliance (Cdyn) in protective group was lower than that in control group at 3 and 6 hours after closing the sternum [(0.59±0.11)ml·cmH2O-1·kg-1 vs. (0.46±0.17)ml·cmH2O-1·kg-1, P<0.05;(0.67±0.09)ml·cmH2O-1·kg-1vs. (0.53±0.18)ml·cmH2O-1·kg-1,P<0.05). Conclusion Perfusion with hypothermic protective solution containing UTI to the pulmonary artery during cardiopulmonary bypass may reduce the inflammatory responses substantially in the lung after bypass and had a role in the lung protection.

Influence of lung inflation on arterial spin labeling signal in MR perfusion imaging of human lungs / 第二军医大学学报

Objective: To investigate the influence of lung inflation on MR perfusion imaging of human lung using an arterial spin labeling sequence called flow sensitive alternating inversion recovery (FAIR). Methods: Coronal perfusion-weighted images were obtained at different respiratory phases from 10 healthy volunteers on a 1.5T whole body scanner (GE medical system) using FAIR sequence. The changes of tagging efficiency of pulmonary parenchyma (ΔSI%), pulmonary blood flow and area of the scanning slice of different respiratory phases were analyzed. Results: (1) Significant difference was found in ΔSI% between different respiratory phases(right lung P=0.021 5, left lung P=0.008 4), with that at end expiration greater than that at end inspiration. (2) Significant difference was also found in pulmonary blood flow at different respiratory phases (right lung P= 8. 92 X 10-5, left lung P=0.000 2), with that at end expiration higher than that at end inspiration. (3) The areas of the scanning slice were also significantly different at different respiratory phases (right lung P=2.94 X 10-5, left lung P=0.000 5), with that at end inspiration larger than that at end expiration. Conclusion: Pulmonary blood flow during expiration is higher than that during inspiration, which might be due to the decreased lung volume and increased vascular density during expiration.

Clinical significance of CT perfusion image on post-operative follow-up of glioma / 国际肿瘤学杂志

Objective To assess the clinical value of multi-slice helical CT perfusion on the post-operative follow-up of glioma.Methods CT perfusion image was applied to 32 patients with glioma after operation.Various perfusion parameters,include cerebral blood volume(CBV),permeability surface(PS),relative cerebral blood volume(rCBV)and relative permeability surface(rPS)were measured on recurrent area,nonrecurrent area and normal cerebral area respectively.SPSS 12.0 statistical software was used.Independent t test was used to compare the differences.Results In the recurrent group(16 cases),the value of CBV in creased in 12 cases and was normal in the other 4 cases.The value of PS increased in all the cases of recurrent group.The value of rCBV exceeded 2.6 in 10 cases,among which the biggest value of rCBV was 4.01.The mean value of rCBV was 2.67 and the mean value of rPS was 6.32;In the non-recurrent group(16 cases),the value of CBV was nearly normal in 7 cases,increased in 2 cases and decreased in the remaining 7 cases.The value of PS was nearly normal in 11 case,decreased in 3 cases and increased in the remaining 2 cases.The values of rCBV were all less than 2.6 and the biggest value of rCBV was 2.14.The mean value of rCBV was 0.99 and the mean value of rPS was 1.42.The statistic significance was obtained for all the parameters when compared the recurrent group with the non-recurrent group(P＜0.01)and with the normal cerebral area(P＜0.01).When compared the non-recurrent group with the normal cerebral area,none of the parameters had statistic significance(P＞0.05);The statistic significance was obtained for rCBV and rPS when compared the recurrent group with the non-recurrent group(P＜0.01).Conclusion CT perfusion image is valuable in determining glioma recurrence after operation.

Clinical efficacy of transurethral drugs perfusion combined with ultrashort wave for treatment of chronic bacterial prostatitis / 中国基层医药

Objeetive To explore a new therapeutic way of transurethral drugs perfusion combined with ultrashort wave on treating chronic bacteria prostatitis.Methods 241 cases with chronic bacteria prostatltis were randomly divided into two groups.the treatment group were treated with transurethral perfusion combined with ultrashort wave.the control group were treated with transurcthral drugs perfusion.Results Total effective rate in the treatment group was 85.9%.that of the control group was 36.7%.It had a significant difference between two groups(P＜0.01).Conclusion Transurethral drugs perfusion combined with ultrashort wave could promote the curative effect of antibiotic maximumly,so it is an effective method to treat chronic bacterial prostatitis.

An efficacy comparison of pirarubicin with other intravesicai chemotherapeutic agents in preventing blad der tumor recurrence:a Meta-analysis / 中华泌尿外科杂志

Objective To compare the efficacy of pirarubicin with other intravesical chemothera peutic agents in preventing bladder tumor recurrence. Methods Databases such as Medline,EM Base,CBMDisc and PubMed,ScienceDirect,LWW,Springer,CJFD(Chinese Journal Fulhext Data base)and Chinese Periodicals Database of Science and Technology were systematicallv searehed for controlled studies involved with intravesical pirarubicin for the treattnent of bladder cancer.Eligible studies according to inclusion and exclusion criteria were selected,then recurrence data from included studies were retrieved for a meta-analysis. Results Fifteen studies met the inclusion criteria.Of these studies 10 compared efficacy of pirarubicin with mitomycin C,and the meta-analysis based on these 10 studies showed that pirarubicin was statistically superior to mitomycin C(OR=0.41,95%CI 0.27～0.61,P＜0.01).Of 6 studies,pirarubicin was compared with thiotepa(OR=0.35,95%CI 0.11～1.13,P＞0.05),adriamyein(OR=0.15,95% CI 0.03～O.76,P＜0.05),epirubicin(OR=0.53,95% CI 0.23～1.23,P＞0.05),hydroxycamptothecin(OR=0.25,95% CI 0.10～0.64,P＜0.05)and blank control respectively,statistical analysis indicated pirarubicin was significantly better than adriamycin,hydroxycamptothecin and blank control,and not statistically different from thiotepa and epirubicin. Conclusion Pirarubicin is effective in preventing bladder tumor recurrence,with efficacy better than chemotherapeutic agents such as mitomycin C,hydroxyeamptothecin,and adriamycin,thus can be a novel optional intravescial chemotherapeutic agent for bladder cancer.

The safety assessment of amniotic infusion therapy in severe preeclampsia / 中国基层医药

Objective To explore safety of severe preeclampsia by amniotic infusion therapy.Methods 58 cases with severe preeclampsia during 28 to 34 weeks pregnancy had been practised intravenous infusion as controls(37 cases).Results Ultrasound guided amnioinfusion were all succesful in therapy group,there was no maternal complication.Statistical difference was found in premature infant apgar score between therapy group and control group.The incidence of respiratory distress syndrome was 3.4%,whereas that of the control group was 35.1%(P

Norwood Procedure on Beating Heart / 대한흉부외과학회지

Modified Norwood procedure with maintaining cardiac beat was done in a 30-day-old neonate. Procedure was done with regional perfusion of innominate and coronary artery. Postoperative course was uneventful. Second-stage operation (bi-directional cavopulmonary shunt) was done 4 months later. The diameter of ascending aorta was more than 5 mm, Norwood procedure can be done in beating hearts.

Effects of pulmonary artery perfusion with hypothermic protective solution on pulmonary vascular endothelial cell injury during cardiopulmonary bypass / 中华胸心血管外科杂志

Objective: To evaluate the effects of hypothermic protective solution perfusion to pulmonary artery on lung vascular endothelial cell injury during cardiopulmonary bypass. Methods: 64 children with tetrogy of Fallot were randomly divided into lung protect group (n=34) and control group (n=30). The way of lung protection was to perfuse with hypothermic protective solution to pulmonary artery. Routine approach was used in control group. Plasma ET and vWF were measured. Lung biopsy specimens were obtained at end of operation in order to study histological changes of lung vascular endothelium. The expression of ICAM 1 on lung vascular endothelium was detected. Patients' hemodynamics and lung functions were monitored. Results: ET and vWF were lower in lung protect group when compared with control group at 0 hour after operation (P

Aortic arch surgery: methods and clinical experience (Report of 75 cases) / 中华胸心血管外科杂志

Objective To summarize the methods and experiences of aortic arch surgery. Methods In 75 aortic arch operations, 74 were performed by using deep hypothermic circulatory arrest (DHCA), including retrograde cerebral perfusion (RCP) in 54 cases and antegrade selective cerebral perfusion (SCP) in 20 cases. Surgical procedures included ascending aortic and hemiarch grafting in 53 cases, which concomitantly included stent placement intra decending aorta in 11, patching of arch intimal tear in 6 and of decending aortic one in 3. Ascending and total arch grafting in 20 cases,which concomitantly included traditional elephant trunk procedure in 12 and stent placement intra decending aorta in 4. Simple arch aneurysm resection in 1 and arch grafting in 1. Concomitant procedures included Bentall procedure in 17 cases, AVR in 12, Cabrol procedure in 3, mitral valvuloplasty in 5 and aortic valvuloplasty in 9. DHCA time ranged from 9 to 120 min (mean 42.3 min). Results Operative mortality was 6.7%. The most common complications were respiratory insufficiency(11 cases), renal insufficience(7 cases) and temporary mental anomaly(9 cases). Conclusion DHCA+RCP and DHCA+SCP are both effective while the latter is more suitable for complex aortic arch surgery. The choice of surgical procedures depends on the nature of lesion and location of intimal tear. Preoperative condition and surgical technique are the essential factors to success in aortic arch surgery.

Perfusion of pulmonary artery with hypothermic protective solution reduces the inflammatory response of lung during cardiopulmonary bypass / 中华胸心血管外科杂志

Objective: To evaluate the effect of perfusion of pulmonary artery using hypothermic protective solution on the inflammatory response of lung during cardiopulmonary bypass. Methods: 40 children with TOF were divided into control group (n=20) and protective group (n=20). The basic parameters (age, weight, C/T ratio, oxygen saturate) were not different between both groups. In control group, the operation was performed using routine approaches. While in protective group pulmonary artery were infused with 4℃ protective solution during CPB. Plasma TNF-?, IL-6 and IL-8 of tracheal suction was measured. Lung biopsy specimens were obtained after operations for study on histological changes. At same time, patients' pulmonary functions and clinic index were monitored. Results: TNF-? was lower in protective group when compared with control group immediately and at 24h after operations (P

The effects of different protective methods with DHCA on neuron apoptosis in hippocampus / 中华胸心血管外科杂志

Objective: This study is to examine the effects of different protective methods with DHCA on neuron injury of hippocampus. Methods: Sixteen pigs (22-25 kg) were divided randomly into four groups. Group I: DHCA; group II: ACP; group III: RCP; group IV: RCP+Nim. All animals were under deep hypothemia (18℃) and total circulatory arrest for 90 minutes, and then rewarmed 120 minutes until the pharyneal temperature to 36℃. End of the study, left hippocampi were removed and then dissociated. These dissociated cells were stained with Annexin V-FITC and then measured with flow cytometry to analyze neuron apoptosis. The morphological changes were examined by electron microscope. Results: Normal cell percentage was the lowest in group I. Compared with group III, normal cell percentage was higher in group II. There were no significant differences between group II and group IV, or group III and group IV. Early apoptotic cell percentage was higher in group I than that in the other three groups, and it is higher in group II than that in group III. There were no significant differences between group II and group IV, or group III and group IV. Both necrotic cell percentage and dead cell percentage were higher in group I than that in the other three groups and there was no significant difference between the other three groups (P=0.05). Conclusion: Apoptosis, necroses and death of neuron after DHCA is the main cause of postoperative nervous dysfunction. ACP has better protective effect on neuron by decreasing cell apoptosis and death. RCP could also reduce cell apoptosis and death but the effect is not as good as that of ACP. Nimodipine depresses partly calcium influx by blocking up VDCC and its protective effect is slight.

Study of multi-slice helical CT perfusion imaging in cerebral neoplasms / 中华放射学杂志

Objective To study the potential of multi-slice spiral CT perfusion imaging in the assessment of cerebral neoplasms.Methods Multi-slice helical CT perfusion imaging was performed in 38 patients with cerebral tumors.The perfusion imaging of the tumor was carried out by cine scan technique (ls/1 rotation) with slice thickness 5 mm/4i,reconstructed slice thickness 10 mm/2i.Contrast injection was done by using 50 ml nonionic contrast agent(300 mg I/ml),at a flow rate of 3.5 ml/s with a power injector,and 5 seconds delay,and data acquisition lasted for 45 seconds.The scanning images were processed in ADW 4.0 workstation.BF、BV、PS values of tumors were calculated and statistically analysed. Results 38 patients with cerebral neoplasms included 9 cases of gradeⅠ—Ⅱgliomas(group 1),10 cases of gradeⅢ—Ⅳgliomas (group 2),9 eases of metastases (group 3)and 10 cases of meningiomas (group 4).All raw data was transformed to square root so as to be consistent with normal distribution.BF~(1/2) values for groupl to group 4 were (5.99?1.03)、(7.55?1.57)、(7.72?2.02 )、(11.40?2.13)ml?rain~(-1)?kg~(-1).The differences in BF~(1/2) were statistically significant between group 1 and group 2,between group 1 and group 3,between group 1 and group 4,between group 2 and group 4,between group 3 and group 4(t_(1,2)=6.89,t_(1,3)=4.59,t_(1,4)=11.03,t_(2.4)=10.58,t_(3,4)=7.65,P＜0.05),and there was no statistically significant difference between group 2 and group 3(t_(2.3)=1.17,P＞0.05);BF~(1/2) values for groupl to group 4 were (1.01?0.19)、(1.42?0.38)、(1.25?0.33)、(1.60?0.24)ml?kg~(-1).The differences in BF~(1/2) were statistically significant between every two groups (t_(1,2)=7.15,t_(1.3)=3.71, t_(1.4)=5.93,t_(2.3)=2.94,t_(2,4)=2.72,t_(3.4)=4.46,P＜0.05 );PS~(1/2) values for groupl to group 4 were (1.70?0.37)、(3.63?0.95)、(4.29?1.30)、(5.69?1.03)ml?min~(-1)?kg~(-2).The differences in PS~(1/2) were statistically significant between every two groups(t_(1.2)=11.53,t_(1.3)=10.61,t_(1.4)=16.77,t_(2.3)=3.69, t_(2,4)=9.94,t_(3,4)=5.52,P＜0.05).Conclusion Multi-slice helical CT perfusion imaging is very useful to evaluate tumor vessels of cerebral neoplasmas and it can provide information of incremental benefit in diagnosis,in staging of tumor grade,in the distinction of benign from maglignant cerebral neoplasmas and in differentiating intracerebral neoplasmas from extracerebral neoplasmas.

Cisplatin blood concentration of patients with malignant bone tumor of lower extremity with out discarding blood after hyperthermic antiblastic perfusion / 中华骨科杂志

Objective To explore the possibility of non-discarding blood after cisplatin hyperther-mic antiblastic perfusion(HAP)in treating the patients with malignant bone tumor of lower extremity.Methods Forty patients consisted of 31osteosarcomas and9malignant fibrous histiocytomas of bone.The clinical stages were wholly classified intoⅡB stage according to Ennekings surgical staging system for muscu-loskeletal tumors.The patients were divided into three groups:group1:discarding blood group(10cases),in whom200ml of the400ml blood remaining in heart-lung machine was discarded after HAP;group2:Non-discarding blood group(25cases),the blood remaining in heart-lung machine was not discarded after HAP and re-infused into systemic circulation;group3:systemic chemotherapy group(5cases),cisplatin was infused intravenously.The regional and the systemic blood cisplatin concentrations were determined at3,30and60minutes during HAP,and the systemic blood cisplatin concentrations were determined at0,0.5,1,2,4,8,12,24,48and72hours after HAP in the group1and group2.While1h after cisplatin infusion in-tra venously in the group3,the blood cisplatin concentration were also measured.Results The regional blood cis platin concen tra tions were high er than that in systemic blood at the time during HAP.The systemic blood cisplatin concen trations after HAP,ex cept at0minute in the group2were higher than that in the group1,there were sig nificant statistic differences between the two groups.The systemic blood cisplatin con-cen trations after HAP in the group2were simi lar to that after systemic chemotherapy.No severe adverse ef-fects in the group1were found.The Ennek ings surgical stagings for the tumors were turned fromⅡB intoⅡA in all the patients.Conclusion The method of non-discarding blood after HAP is available,it is not only local treatment ,but also systemic chemotherapy in the patients with malignant bone tumor of lower ex-tremi ty for limb-salvage surgery.

Single intravesical instillation of epirubicin for primary superficial bladder carcinoma:long-term results / 中华泌尿外科杂志

0.05 ).Side effects of group A,17%(2/14),were lower than that of group B or C,53%(8/15)and 47%(7/15),respectively(? 2 test=12.21, P

CHEMOTHERAPY VIA HEPATIC ARTERY AND PORTAL VEIN FOR THE PREVENTION OF LIVER METASTASIS OF COLORECTAL CANCER / 解放军医学杂志

Objective To evaluate the clinical effect of chemotherapy via both hepatic artery and portal vein on liver metastasis of colorectal cancer. Methods Forty-eight patients with colorectal cancer (admitted to our hospital from Jan, 1994 to Dec, 2000)were divided into group Ⅰ, in which 17 patients received chemotherapy via both hepatic artery and portal vein, group Ⅱ in which 16 patients received simple hepatic artery chemotherapy, and group Ⅲ in which 15 patients received simple portal vein chemotherapy. Chemotherapy was begun 2 weeks after operation. The drugs used in chemotherapy regime were 5-fluorouracil(5-FU) 500mg/m 2 + Mitomycin(MMC) 4mg/m 2 + Epirubicin(EPI) 60mg/m 2, once per week, 2-3 times as a course. The chemotherapy regime was the same for the 3 groups. Results The respective effective rate for liver metastasis was 76.5%, 62.5%, 46.7% in group Ⅰ, group Ⅱ, and group Ⅲ. The 0.5, 1 and 2 year survival rates were 100%, 82.4% and 52.9% respectively in group Ⅰ, 87.5%, 62.5% and 43.7% respectively in group Ⅱ, and 93.3%, 60% and 33.3% respectively in group Ⅲ. There were statistically significant differences between group Ⅰ and groups Ⅱ and Ⅲ (P