The effect of transcatheter arterial chemoembolization combined with ultrasound-guided radiofrequency ablation on the efficacy and immune function in patients with primary liver cancer / 中国医师进修杂志

Objective:To investigate the effect of transcatheter arterial chemoembolization (TACE) combined with ultrasound-guided radiofrequency ablation (RFA) on the efficacy and immune function in patients with primary liver cancer.Methods:The clinical data of 152 patients with primary liver cancer from February 2019 to February 2021 in the Second Affiliated Hospital of Xi′an Jiaotong University were retrospectively analyzed. Among them, 76 patients were treated with TACE combined with RFA (combined group), and 76 patients were treated with TACE (control group). The efficacy was compared; the α-L fucosidase, T lymphocyte subsets (CD 3, CD 4, CD 8 and CD 4/CD 8), B lymphocyte subsets (CD 19) and tumor markers (alpha-fetoprotein, AFP; carcinoembryonic antigen, CEA; carbohydrate antigen 125, CA125) before treatment and 1 month after treatment were detected. Results:The total clinical effective rate in combined group was significantly higher than that in control group: 81.58% (62/76) vs. 52.63% (40/76), and there was statistical difference ( χ2 = 4.54, P<0.05). There were no statistical difference in all indexes before treatment between 2 groups ( P>0.05); the α-L fucosidase, AFP and CD 8 1 month after treatment in combined group were significantly lower than those in control group: (18.06 ± 5.33) U/L vs. (26.58 ± 7.75) U/L, (87.93 ± 22.55) μg/L vs. (146.83 ± 21.85) μg/L and 0.295 ± 0.052 vs. 0.367 ± 0.064, the CD 3, CD 4 and CD 4/CD 8 were significantly higher than those in control group (0.489 ± 0.054 vs. 0.462 ± 0.063, 0.363 ± 0.059 vs. 0.303 ± 0.075 and 1.43 ± 0.27 vs. 0.89 ± 0.14), and there were statistical differences ( P<0.01 or<0.05); there was no statistical difference in CEA, CA125 and CD 19 1 month after treatment between 2 groups ( P>0.05). Conclusions:TACE combined with RFA in the treatment of primary liver cancer patients can not only improve the total clinical effective rate, but also significantly improve the immune function, and help to reduce level of the liver tumor marker of AFP.

A preliminary model of case management for pregnancy-associated breast cancer / 中华护理杂志

To explore the model of case management for patients with pregnancy-associated breast cancer in accordance with China's national conditions,and to improve the patients' compliance and satisfaction with the treatment.Case managers for patients with pregnancy-associated breast cancer were trained,and posts of case managers were established.Case managers,with the aid of multidisciplinary treatment teams and multi-specialized nursing groups,provided comprehensive,sustainable and coordinated care for patients with pregnancy-associated brcast cancer from diagnosis to 6 months after surgery.The model of case management for pregnancy-associated breast cancer could promote the treatment effectively,serving as important guarantee for multidisciplinary cooperation and providing patients with comprehensive,sustainable and coordinated care through mobilization of available resources.

Antiviral treatment and long-term clinical outcome of decompensated cirrhotic patients with hepatitis C virus infection / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the efficacy and safety of antiviral treatment in patients with hepatitis C virus (HCV) infection and decompensated cirrhosis and determine the effects of virological response on long-term prognosis.</p><p><b>METHODS</b>Sixty-six consecutive,interferon (IFN)-na(i)ve patients with HCV infection and decompensated cirrhosis were enrolled in this prospective study. All patients were given a 48-to 72-week course of IFN plus ribavirin (RBV) combined therapy,with a low accelerating dosage regimen using either:pegylated (PEG)-IFNa-2b at 1.0-1.5 mug/kg/week,PEG-IFNa-2a at 90-180 mug,or standard IFN-a-2b at 3MU,every other day.RBV was given at 800 to 1000 mg/day. All patients were routinely monitored for adverse drug reactions and virological response.Effects of treatments on patient survival were assessed by Kaplan-Meier analysis.</p><p><b>RESULTS</b>At the end of treatment,74.2% of patients were HCV RNA-negative,with 45.5% having achieved sustained virological response and 28.8% having relapsed;the remaining 25.7% of patients showed non-virological response (NVR). Among the patients with HCV genotype 1, 65.9% achieved end-of-treatment virological response (ETVR) and 34.1% achieved SVR;among the patients with HCV genotype 2,90.9% achieved ETVR and 68.2% achieved SVR. The positive and negative predictive values of early virological response (EVR) for ETVR were 95.7% and 75.0% respectively, and for SVR were 65.2% and 100% respectively. Compared with baseline,patients who achieved ETVR had better liver function,as evidenced by changes in levels of total bilirubin,alanine aminotransferase and albumin,as well as prothrombin activity and Child-Pugh score (t =4.564,11.486,2.303,2.699,3.694 respectively, all P less than 0.05).Compared with the NVR patients, the ETVR patients had lower risk of hepatic decompensation and hepatocellular carcinoma, and had improved survival (x2=18.756,6.992,7.580, respectively, all P less than 0.05).Twelve (18.2%) patients experienced serious adverse events,with 10 requiring premature treatment withdrawal and 2 dying.</p><p><b>CONCLUSION</b>Antiviral treatment for patients with HCV infection and decompensated cirrhosis using interferon in a low accelerating dosage regimen in combination with ribavirin is feasible.Patients who achieved ETVR had significantly improved long-term prognosis.</p>

Laparoscopic cholecystectomy for high-risk cholecystolithiasis:surgical key points and analysis of 115 cases / 临床肝胆病杂志

Objective To investigate the characteristics of high-risk cholecystolithiasis and summarize the experience of laparoscopic chol-ecystectomy for this disease.Methods A retrospective analysis was performed on the clinical data of 1 15 patients with high-risk cholecys-tolithiasis who underwent laparoscopic cholecystectomy in our hospital from October 2008 to March 2012.Results Of the 1 15 patients,47 had stones filling the gallbladder as well as atrophy of the gallbladder and porcelain gallbladder,42 had acute suppurative and gangrenous cholecystitis,20 had stone incarceration in the gallbladder neck,3 had cystic duct stones,2 had cholecystoduodenal fistula,and 1 had Mi-rizzi syndrome;all patients were cured and discharged.Conclusion For patients with high-risk cholecystolithiasis,laparoscopic cholecys-tectomy is feasible,given active preoperative preparation,strengthened perioperative management,and accurate,standard,and skilled sur-gical operation.

Detection to changes in hyoid and tongue positions, and pharyngeal airway following mandibular setback surgery by cone beam CT / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To observe changes in tongue and hyoid position, and pharyngeal airway in patients with skeletal class III malocclusion after the combined orthodontic and orthognathic treatment.</p><p><b>METHODS</b>Twenty patients were involved in this study. Cone beam CT (CBCT) was performed on patients one week before and six months after treatment. Raw data were reconstructed into three-dimensional model. To set up a three-dimensional reference frame, which was based by point "S", the sagittal and transversal measurements, cross sectional areas, partial and total volumes were computed. The three-dimensional position changes of chin, hyoid bone and tongue were measured in order to analyze the amount of mandibular setback relationship with the changes of pharyngeal airway, hyoid bone and tongue positions.</p><p><b>RESULTS</b>After treatment, the pharyngeal airway was constricted significantly. The hyoid significantly moved inferoposteriorly by 5.72 mm (backward) and 2.76 mm (downward) and the tongue moved posteriorly by 4.04 mm after surgery (P < 0.05). Among the 19 correlated indexes between the amount of mandibular setback and other measurements, 14 of which were significantly correlated (P < 0.05). The strongest correlation was found between the amount of mandibular setback and total volumes of pharyngeal airway (r = 0.834, P < 0.01).</p><p><b>CONCLUSION</b>Following combination therapy, the pharyngeal airway space decreased, the hyoid moved inferoposteriorly and tongue moved posteriorly. There were great correlations between the amount of mandibular setback and the changes.</p>