射频消融联合吉非替尼治疗晚期非小细胞肺癌的临床分析

目的:观察射频消融术(RFA)联合吉非替尼(Gefitinib)对晚期非小细胞肺癌(NSCLC)治疗的临床效果。方法:26例晚期NSCLC(III、IV期)患者用RFA联合Gefitinib治疗,与23例单独使用RFA治疗的对照组进行比较,观察两组之间有效率、生活质量和不良反应。结果:根据疗效、生活质量评分等指标进行评价,联合治疗组有效率为65.4%,高于单纯RFA治疗组的34.8%,两组之间有显著性差异(P<0.01),对接受治疗的患者进行生活质量评价结果表明,所有接受RFA和Gefitinib联合治疗组中有71.3%的病人生活质量良好,而接受单纯RFA治疗组中只有47%的患者生活质量良好,两组之间有显著性差异(P<0.01),两组患者不良反应主要是疼痛、发热、腹泻等,只需对症处理。结论:RFA联合Gefitinib综合治疗NSCLC方案优于单纯采用RFA的治疗方案。     

Numerical study to establish relationship between coagulation volume and target tip temperature during temperature-controlled radiofrequency ablation

The present study aims at proposing a relationship between the coagulation volume and the target tip temperature in different tissues (viz., liver, lung, kidney, and breast) during temperature-controlled radiofrequency ablation (RFA). A 20-min RFA has been modelled using commercially available monopolar multi-tine electrode subjected to different target tip temperatures that varied from 70°C to 100°C with an increment of 10°C. A closed-loop feedback proportional-integral-derivative (PID) controller has been employed within the finite element model to perform temperature-controlled RFA. The coagulation necrosis has been attained by solving the coupled electric field distribution, the Pennes bioheat and the first-order Arrhenius rate equations within the three-dimensional finite element model of different tissues. The computational study considers temperature-dependent electrical and thermal conductivities along with the non-linear piecewise model of blood perfusion. The comparison between coagulation volume obtained from the numerical and in vitro experimental studies has been done to evaluate the aptness of the numerical models. In the present study, a total of 20 numerical simulations have been performed along with 12 experiments on tissue-mimicking phantom gel using RFA device. The study revealed a strong dependence of the coagulation volume on the pre-set target tip temperature and ablation time during RFA application. Further, the effect of target tip temperature on the applied input voltage has been studied in different tissues. Based on the results attained from the numerical study, statistical correlations between the coagulation volume and treatment time have been developed at different target tip temperatures for each tissue.     

The single‐subunit RING‐type E3 ubiquitin ligase RSL1 targets PYL4 and PYR1 ABA receptors in plasma membrane to modulate abscisic acid signaling

Membrane‐delimited events play a crucial role for ABA signaling and PYR/PYL/RCAR ABA receptors, clade A PP2Cs and SnRK2/CPK kinases modulate the activity of different plasma membrane components involved in ABA action. Therefore, the turnover of PYR/PYL/RCARs in the proximity of plasma membrane might be a step that affects receptor function and downstream signaling. In this study we describe a single‐subunit RING‐type E3 ubiquitin ligase RSL1 that interacts with the PYL4 and PYR1 ABA receptors at the plasma membrane. Overexpression of RSL1 reduces ABA sensitivity and rsl1 RNAi lines that impair expression of several members of the RSL1/RFA gene family show enhanced sensitivity to ABA. RSL1 bears a C‐terminal transmembrane domain that targets the E3 ligase to plasma membrane. Accordingly, bimolecular fluorescent complementation (BiFC) studies showed the RSL1–PYL4 and RSL1–PYR1 interaction is localized to plasma membrane. RSL1 promoted PYL4 and PYR1 degradation in vivo and mediated in vitro ubiquitylation of the receptors. Taken together, these results suggest ubiquitylation of ABA receptors at plasma membrane is a process that might affect their function via effect on their half‐life, protein interactions or trafficking.     

Stereotactic body radiation therapy and radiofrequency ablation for the treatment of liver metastases: How and when?

Limited liver metastases represent a clinical challenge. Surgical approach is the most frequently reported treatment option, however, some patients are not eligible for surgical interventions. Relatively recent technologic advances have permitted the safe use of ablative techniques employed in the cure of hepatic metastases. Among these, radiofrequency ablation (RFA) and stereotactic body radiotherapy (SBRT) have emerged as valid treatments in a significant proportion of patients with intrahepatic oligometastatic disease. This review offers an up-to-date of current available literature on this issue focusing on the use and outcomes of RFA and SBRT, according to the PICO (Population, Intervention, Comparison and Outcomes) criteria.     

射频消融联合DC-CIK治疗肝癌40例的临床观察

目的:探讨射频消融联合DC-CIK治疗原发性肝癌的临床效果及其毒副作用.方法:将我院2009年1月-2010年1月收治的80例原发性肝癌患者随机分为观察组和对照组各40例,均给予射频消融治疗,观察组患者在此基础上给予DC-CIK治疗.观察和比较两组患者的治疗效果、生存质量、免疫功能、癌胚抗原(AFP)的变化及患者3年生存率.结果:观察组患者的治疗总有效率为92.5％,显著高于对照组72.5％(P＜0.05);观察组患者治疗后外周血T细胞亚群中CD3+、CD4+,、CD4+/CD8+比值及NK(CD16+CD56+)均较治疗前显著上升(P＜0.01),且显著高于对照组;而T细胞亚群CD8+及甲胎蛋白(AFP)水平均显著下降(P＜0.01),且显著低于对照组(P＜0.01).治疗后,两组患者的自觉症状均减轻、食欲增加、精神状态有所改善,观察组患者的生存质量平均分(167.2±15.8)显著高于对照组(133.5±12.9)(P＜0.01).治疗期间,两组患者均部分出现腹痛、恶心、发热症状,对症处理后24h内均可缓解,不良反应发生率比较无显著差异(P＞0.05);观察组患者6个月内的死亡率为5.0％,显著低于对照组40.0％(P＜0.05),3年生存率为22.5％,显著高于对照组2.5％(P＜0.01).结论:DC-CIK辅助射频消融治疗原发性肝癌可显著提高其治疗效果,增强患者的免疫功能,改善患者的生存质量,并延长患者生存时间.     

Insights of synthetic analogues of anti-leprosy agents

Today, the emergence of the phenomenon of drug or multidrug-resistance for community-associated diseases represents a major concern in the world. In these contexts, the chronic infectious disease, leprosy, grounded by a slow-growing bacterium called Mycobacterium leprae or Mycobacterium lepromatosis is a leading cause of severe disfiguring skin sores and nerve damage in the arms, legs, and skin areas around the body. Even, over 200,000 new leprosy cases are being accounted every year along with the relapsed leprosy cases. Nonetheless, this has been considered a curable disease with a higher dose of multidrug therapy (MDT) for a long period of time. The prolonged action of a high dose of combination drugs administration may cause an adverse reaction that can significantly affect patient compliance, particularly the outbreak of multidrug-resistance in the infected person. To overcome these shortfalls or prevent the resistance-associated problems, researchers are diligently involved in the structural modifications of the clinically used anti-leprosy drugs or the allied compounds for the structure-antimycobacterial activity relationship study. This review article described the detailed synthesis and biological assays of different anti-leprosy compounds reported by several research groups.     

利用共振频率分析牙种植体骨愈合期稳定性变化 与早期边缘骨吸收的关系

目的:利用共振频率测量仪(Osstell)连续监测骨愈合期种植体稳定性变化与早期边缘骨吸收的关系。方法:本研究于2010-2011年期间根据纳入及排除标准连续纳入32名成年男性患者作为实验对象共植入45枚Strauman种植体,每名患者选择一颗(4.8mm×10mm)种植体,共计32颗种植体,种植区位于下颌后牙(骨质均为Ⅱ或Ⅲ类骨)。利用共振频率分析仪(Osstell)测量种植体的稳定性,测量时间点为植入时以及术后第1,2,3,4,6,8,12周。另外,影像学分析测量32颗种植体12周时的边缘骨吸收;结果:本实验中所有种植体在12周均实现骨结合,并成功完成种植修复。通过重复性方差分析,见表1,在种植体植入时,初期稳定系数(ISQ)均值为(79.03±6.756)。术后一周,种植体稳定系数(ISQ)均值均呈下降趋势,至术后第2周时达到最低点,与植入时稳定性有统计学差异(P<0.05)。从术后第3周开始种植体稳定系数(ISQ)均值逐渐上升。其中,稳定系数(ISQ)均值在第6周时与第12周无统计学差异,已达到延期稳定期。32颗种植体在第12周的边缘骨吸收均值为(0.86±0.068mm),而在第12周的种植体的稳定系数均值与种植体植入时的稳定系数均值无统计学差异。结论:本实验通过共振频率测量仪(OsstellTM)连续监测,目前的结果认为种植体愈合期边缘骨吸收对种植体愈合期稳定性变化没有影响。     

Arrhythmogenicity of radiofrequency ablation: Symptomatic non-sustained ventricular tachycardia and frequent premature ventricular ectopics after accessory pathway ablation

Radiofrequency ablation (RFA) has emerged as the preferred treatment modality with high success rate in cases with WPW syndrome. Arrhythmogenic complications are rarely reported after RFA, except for early or late recurrence of accessory pathway (AP) conduction. We present a unique case where the AP was successfully ablated, however, a new monomorphic PVC of similar morphology to the pre-excited beats developed within 30 min of RFA. She required medical management with sotalol to overcome her worsening symptom on follow-up. The ectopics resolved after 4 months.     

Chemical Composition and Aroma Evaluation of Essential Oils from Evolvulus alsinoides L.

The aim of this study was to investigate the chemical composition and the odor‐active compounds of the essential oils from Evolvulus alsinoides, which is a well‐known edible and medicinal plant. The volatile compounds in the oils were identified by hydrodistillation (HD) and solvent‐assisted flavor evaporation (SAFE) in combination with GC, GC/MS, GC/O (=olfactometry), aroma extract dilution analysis (AEDA), and relative flavor activities (RFA values). The most abundant compound in the HD oil was cis‐α‐necrodol (12.62%), an irregular monoterpene with a cyclopentane skeleton, which is very unusual in the plant kingdom. In the SAFE oil, the main components included 2‐butoxyethanol (9.01%), benzyl alcohol (8.01%), and γ‐butyrolactone (7.37%). Through sensory analysis, 21 aroma‐active compounds were identified by GC/O. The most intense aroma‐active compounds in the HD oil were hexan‐1‐ol and γ‐nonalactone, both of which showed high RFA values. α‐Methyl‐γ‐butyrolactone and dimethyl sulfone contributed more strongly to the aroma of the SAFE oil. These results imply that the essential oils of E. alsinoides deserve further investigation in the food industry.     

微波灭活与射频消融术中联合应用于治疗四肢骨肉瘤的疗效分析

目的:探讨微波灭活与射频消融技术联合应用治疗骨肉瘤的临床疗效。方法:回顾性分析我院自2007年至2012年间手术治疗的具有完整临床资料的骨肉瘤患者29例,其中发生于肱骨上端9例,股骨远端12例,胫骨上段5例,盆腔3例,并经TNM分期。术前采取动脉植入式化疗泵化疗2疗程,并于术中给以微波灭活与射频消融方法联合灭火肿瘤瘤体,刮除肿瘤后行骨水泥填充。术后随访8-60个月,平均50±2月。结果:29例患者中死亡1例,局部复发3例,远端转移2例。结论:微波灭活与射频消融术中联合应用于恶性骨肿瘤术中瘤体灭活,可以达到良好的肿瘤灭活效果,减少术中出血,大大提高患者生存率及降低复发率。