共查询到20条相似文献,搜索用时 109 毫秒
1.
目的:探讨磁共振弥散加权成像(DWI)及表观扩散系数(ADC)值在鼻咽癌颅底放疗中的临床价值。方法:收集我院于2013年6月~2014年6月复查的40例鼻咽癌患者,分别于放疗前及放疗结束12个月以后对所有患者行常规核磁共振成像(MRI)及DWI检查,测量放疗前、后ADC值,根据影像学检查以及临床诊断结果分为复发组(n=5)及未复发组(n=35)。结果:复发组放疗前ADC值为(0.797±0.031)×10~(-3)mm~2/s,与未复发组放疗前ADC值(0.805±0.028)×10~(-3)mm~2/s比较,差异无统计学意义(P0.05)。复发组放疗结束12个月以后ADC值为(1.097±0.091)×10~(-3)mm~2/s,与未复发组放疗结束12个月以后ADC值(1.705±0.128)×10~(-3)mm~2/s比较,差异有统计学意义(P0.05)。结论:DWI作为一种新兴的磁共振成像技术,对于鼻咽癌颅底放疗疗效的评价具有重要价值,通过DWI对ADC值的测量,可有效的预测患者预后是否良好。 相似文献
2.
目的:探讨磁共振灌注加权成像(perfusion weighted imaging,PWI)与弥散加权成像(diffusion weighted imaging,DWI)在脑胶质瘤分级诊断中的应用价值。方法:选取2012年1月-2017年6月在我院就诊并经病理证实为脑胶质瘤患者100例,其中高、低级别胶质瘤患者各44、56例。对所有患者行PWI、DWI检查,比较肿瘤不同区域表观扩散系数(apparent diffusion coefficient,ADC)、局部脑血流量(regional cerebral blood flow,rCBF),不同级别肿瘤实质区、瘤周水肿区rADC、rrCBF,根据ROC曲线分析rADC、rrCBF对不同级别胶质瘤的诊断阈值、敏感性、特异性。结果:与对侧相应正常脑实质比较,瘤周水肿区及肿瘤实质区ADC、rCBF均显著升高(P0.05);与瘤周水肿区比较,肿瘤实质区ADC、rCBF均显著升高(P0.05)。高级别肿瘤实质区rADC显著低于低级别肿瘤实质区(P0.05),rrCBF显著高于肿瘤实质区(P0.05)。高级别瘤周水肿区与低级别瘤周水肿区rADC间无显著差异(P0.05),高级别瘤周水肿区rrCBF显著高于低级别瘤周水肿区(P0.05)。在对高、低级别脑胶质瘤的分级中,rADC、rrCBF的曲线下面积(under the receiver operating characteristic curve,AUC)分别为0.957、0.978,均0.9。rADC诊断不同分级胶质瘤的敏感度是90.12%,特异度是95.26%,诊断阈值是13.12;rrCBF诊断不同分级胶质瘤的敏感度是92.31%,特异度是98.57%,诊断阈值是2.62。rADC与rrCBF诊断不同分级胶质瘤敏感度、特异度间无显著差异(P0.05)。结论:PWI、DWI能够为脑胶质瘤的分级诊断提供参考依据。 相似文献
3.
目的:探讨CT、MR几种功能成像(包括CT灌注、MR灌注和DWI成像)综合应用在肝脏疾病的诊断价值。方法:37例常规CT和/或MR诊断信心不足的患者,补充进行了DWI成像、CT和MR灌注成像以辅助诊断。其中,18例为肝癌术后或TACE、RFA、PEI等方法治疗后,对肝脏复发或原病灶治疗后活性情况的判断;7例为对肝内多发病灶的检出及诊断;4例肝脓肿;肝腺瘤3例,FNH5例。结果:37例患者在结合了功能成像后做出的综合影像诊断,较单纯常规CT和/或MR扫描,诊断准确率和病灶检出率均有提高。7例肝癌术后患者,常规平扫及增强扫描对术区是否有有活性的肿瘤残存还是局部复发诊断困难,DWI成像诊断为术后的炎性增生或肝脏局限性灌注异常。后患者经随访3-6个月,一般状况和生化指标无明显异常,且影像表现基本无变化。11例原发性肝癌TACE、RFA、PEI等方法治疗后的患者,CT和/或MR常规平扫及增强扫描可疑病灶仍有部分活性区但不能确定,加扫了DWI成像,其中的7例进行了MR灌注成像,6例进行了CT灌注成像。经ADC值以及灌注值的评估,病灶坏死区和残留活性区的区分更加明确。7例肝内多发病灶的患者,DWI图像较MR常规扫描检出病灶数目多且病灶显示更为清晰;4例肝脓肿、3例肝腺瘤,5例FNH患者常规CT/MR表现不典型,未能明确良恶性诊断,经DWI和灌注扫描均获明确定性,3例肝脓肿经超声导引下肝穿刺证实,2例肝腺瘤和3例FNH经受术证实,其余病例经临床及影像随访证实。结论:功能成像作为常规扫描的有益补充,其诊断价值不容忽视,可以提高病灶检出率和诊断准确率。 相似文献
4.
目的:探讨胶质母细胞瘤术后瘤周梗塞的MRI特征,并评价其临床意义.方法:收集54例胶质母细胞瘤患者的临床、病理及影像学资料,全部患者于术后72小时内进行了MRI检查,并在6个月内进行MRI随访复查,回顾性分析术后临床及MRI表现.结果:术后72小时内MRI研究发现39例存在DW1局灶性弥散受限,病变位于肿瘤切除后空穴区附近.随访MRI研究发现90%的弥散受限病灶已发展成为囊性脑软化,提示原来的局灶性弥散受限为脑梗塞表现,增强扫描44%的梗塞区有异常强化.9例手术后并发神经功能缺失,其中6例与MRI梗塞的分布区域密切相关.结论:恶性胶质瘤术后DWI弥散受限是一种脑梗塞表现,并具有一定临床意义,MRI随访观察中梗塞区异常强化容易误诊为肿瘤复发. 相似文献
5.
双指数模型在高b值弥散加权成像中的初步研究 总被引:1,自引:0,他引:1
目的采用双指数分析模型探讨弥散加权信号强度的衰减规律,揭示脑组织的弥散信息。材料和方法对豆状核、内囊、额叶自质、丘脑等感兴趣区的每一像素,使用Matlab优化工具箱中的lsqcurvefit()函数对b值从500s/mm。到3500s/mm。共计7个b值图像的信号强度值进行拟合,并与单指数拟合的结果进行比较。结果双指数模型对信号强度的拟合优于单指数模型,并能获得三个新参数。结论双指数模型能更好的拟合高b值时图像信号强度.所得的三个参数能从不同角度提供大脑的弥散信息.但其生理基础有待于进一步研究。 相似文献
6.
磁共振成像是诊断早期前列腺癌及评价分期最好的影像学技术之一,然而常规MRI-T2WI在诊断中存在较低的特异性缺陷.随着核磁技术的发展,对前列腺癌的诊断发展到从定性到定量、从形态到功能的变化,本文主要就近年来的磁共振功能成像技术在前列腺癌诊断中的研究进展作一论述. 相似文献
7.
摘要 目的:研究3.0 T磁共振扩散加权成像在乳腺良恶性病变鉴别中的价值及较优b值下ADC值与预后因子的相关性。方法:选取2017年11月~2019年11月于我院接受诊治的乳腺病变患者50例进行研究,将其按照良恶性差异分成恶性组40例与良性组10例,另取同期于我院体检的健康志愿者50例作为对照组。对所有人员均进行3.0 T磁共振扩散加权成像,比较不同b值下ADC值在不同乳腺组织中的差异,比较不同b值下诊断乳腺良恶性病变的效能,分析较优b值下ADC值和乳腺癌患者各项预后因子的相关性。结果:对照组、良性组、恶性组在不同b值下的ADC值均呈逐渐降低趋势(P<0.05);对照组、良性组、恶性组b值为1000 s/mm2下的ADC值均低于b值为600 s/mm2(P<0.05)。b值为1000 s/mm2时诊断乳腺恶性病变的敏感度、特异度、准确度分别为92.50%、100.00%、94.00%,高于b值为600 s/mm2的70.00%、60.00%、68.00%(P<0.05)。b值为1000 s/mm2下雌激素受体、孕激素受阳性患者的ADC值低于阴性患者,而人类表皮生长因子受体2阳性患者的ADC值高于阴性患者(P<0.05)。经Spearman相关性分析可得,b值为1000 s/mm2下ADC值与雌激素受体、孕激素受体阳性表达均呈负相关关系,而与人类表皮生长因子受体2阳性表达呈正相关关系(P<0.05)。结论:3.0 T磁共振扩散加权成像在乳腺良恶性病变鉴别中的价值较高,且以b值为1000 s/mm2的诊断能效较优。此外,b值下ADC值和乳腺癌部分预后因子表达状态密切相关。 相似文献
8.
目的:探讨健康志愿者不同性别各年龄组人体多脏器全身弥散加权成像的图像特征。方法:对50例健康志愿者行全身弥散加权成像扫描,其中,20.30岁、30.40岁、40—50、50.60、60岁以上各二十例,每组内男女各十例。所得图像均经nDeMR后处理工作站(AW4.3)行MIP重建和黑白反转显示技术,并重建ADC图,观察不同性别各年龄组人体多脏器弥散加权图像的特点,并测定不同部位的ADC值,测量的部位主要包括脑灰质、脑白质、尾状核头、丘脑、桥脑、腮腺、肝脏、脾脏、T8椎体、T8—9椎间盘、L2椎体、L2.3椎间盘、前列腺、乳腺、子宫颈等,每个部位重复测量三次取平均值,单位为×10^-3mm^2/S。结果:1、WB-DWI的正常表现。2、不同性别及年龄组间各组织器官ADC值的统计学分析脑白质、T8椎体ADC值在不同性别及年龄组之间存在统计学差异(P〈0.05);T8.9椎间盘、L2.3椎间盘及女性乳腺ADC值在不同年龄组之间存在统计学差异(P〈0.05);L2椎体ADC值在男女之间存在统计学差异(P〈0.05)。3、不同部位ADC值平均值。结论:正常人体不同组织器官弥散加权图像特点及ADC值受到性别、年龄的影响,不同性别各年龄组的正常WB-DWI表现存在差异。了解健康成人正常WB-DWI的表现对于准确判断各组织器官的疾病有着重要的意义。 相似文献
9.
目的探讨rCBV、rCBF和rMTT在评估急性期脑梗死IP中的价值。方法对临床确诊的29例脑梗死患者行PWI及常规MRI检查。并从PWI上计算出rCBV、rCBF和rMTT值。结果①核心、内缘和外缘区的rCBV、rCBF低于镜像区,rMTT高于镜像区,有统计学差异(P<0.05),周围与镜像区无差异,rCBV、rCBF按核心→内缘→外缘→周围区顺序逐渐增高,rMTT逐渐缩短。②核心与内缘区、内缘与外缘区及外缘与周围区各参数无统计学差异(P>0.05);核心与周围区有统计学差异(P<0.05);外缘与周围区的P值=0.05;内缘的rCBV、rCBF明显低于周围区(P<0.05),而rMTT则无统计学差异(P>0.05)。③PWI得出的IP区域与溶栓治疗后复查结果基本一致。结论 PWI能有效地对急性期脑梗死IP进行评估,rCBV、rCBF及rMTr是有用的参数。 相似文献
10.
目的:探讨基于磁共振(Magnetic Resonance Imaging,MRI)多b值弥散加权成像(Diffusion Weighted Imaging,DWI)对严重胸外伤预后的预测价值.方法:2018年2月-2020年6月选择在本院诊治的严重胸外伤患者76例(开放性损伤38例,闭合性损伤38例),所有患者都给予... 相似文献
11.
12.
目的:检测乳腺癌患者外周血单核细胞(PBMC)中循环肿瘤细胞(CTC)和具有癌干细胞(CSC)标志的CTC(CSC-CTC),探讨患者外周血微转移与CSC的相关性。方法:患者和健康者PBMC与磁珠偶联上皮细胞黏附分子单抗孵育后,用磁性分离法富集PBMC中的上皮细胞。以CK+为患者PBMC中CTC标志,用流式细胞术(FCM)检测健康者和患者的PBMC中CK+细胞及CK+/CD44+/CD24-细胞含量,并比较各组间CTC、CSC-CTC含量的差异。结果:用FCM在73.07%的患者中检测到CTC,在19例检测到CTC的患者中18例有CSC-CTC(94.74%),CTC中CSC数量比例平均为19.01%,且患者PBMC中CTC和CSC-CTC比例与临床TNM分期相关。结论:初步建立了患者外周血CSC-CTC的检测方法,结果显示乳腺癌患者外周血微转移中有CSC-CTC的参与,临床分期越晚的患者CTC和CSC-CTC的数量越多。 相似文献
13.
目的:探讨临床上检测前列腺特异性抗原(PSA)的变化情况对前列腺增生和前列腺癌等疾病的诊断价值。方法:采用回顾性分析的方法,选取2010年6月至2012年4月在我院泌尿科接受治疗的前列腺增生患者64例定义为前列腺增生组(BPH),前列腺癌患者83例定义为前列腺癌组(PCa),另选取同期接受体检的健康人群137例作为对照组。分别检测三组患者入院时的游离前列腺特异性抗原和总前列腺特异性抗原的水平变化情况。对比并分析三组检测结果。结果:经检测,前列腺增生患者的血清总PSA明显高于对照组健康人群的正常值,而前列腺癌患者的血清总PSA比前列腺增生患者增高的更为明显。对照组游离PSA为(2.78±0.94)ng/mL,总PSA(1.05±0.57)ng/mL,游离PSA与总PSA的比值为,(0.38±0.61);前列腺增生患者游离PSA为(6.36+3.24)ng/mL,总PSA为(1.64±0.76)ng/mL,游离PSA与总PSA的比值为(0.26±0.23);前列腺癌患者游离PSA为(12.42±4.97)ng/mL,总PSA为(1.44±0.78)ng/mL,游离PSA与总PSA的比值为(0.12±0.16)。组间比较差异明显,具有统计学意义(P〈0.05)。结论:对患者的PSA进行检测,对前列腺增生和前列腺癌的诊断具有良好的辅助作用和,临床价值。 相似文献
14.
目的:评估非小细胞肺癌患者血清淀粉样蛋白A(SAA)水平与发生放射性肺炎(RP)的相关性。方法:选取我院确诊为非小细胞肺进行肺部病灶放射治疗的患者118例,评价是否发生放射性肺炎,并在放疗前及放疗剂量达到43 GY时分别抽取患者血清样本,应用酶联免疫法(ELISA)检测患者血清淀粉样蛋白A含量。结果:43例患者发生了放射性肺炎,发生放射性肺炎组患者的放疗前血清淀粉样蛋白A水平明显高于未发生放射性肺炎组,两组对比,差异有统计学意义(P0.05)。而在放疗剂量达到43Gy时,发生放射性肺炎组患者的血清淀粉样蛋白A水平与未发生放射性肺炎组患者相比,差别无统计学意义。结论:对于非小细胞肺癌患者,通过检测放疗前血清淀粉样蛋白A水平可以预测放射性肺炎的发生。 相似文献
15.
OBJECTIVE: Diagnosis of breast cancer in young patients (≤ 35) correlates with a worse prognosis compared to their older counterparts (> 35). The aim of this study is to evaluate the relevance of clinical-pathologic factors and prognosis in young (≤ 35) breast cancer patients. METHODS: One hundred thirty-two patients of operable breast cancer who were younger than 35 are analyzed in this study. They were treated in our hospital between January 2006 and December 2012. Patients are classified into four molecular subtypes based on the immunohistochemical profiles of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki-67. Clinical and pathologic factors have been combined to define a specific classification of three risk levels to evaluate the prognosis of these young women. RESULTS: Patients whose ages are less than 30 have poorer prognosis than patients whose ages are between 31 and 35. The status of lymph nodes post-surgery seems to be the only factor related to patient age in young patients. The patients in level of ER + or PR + and HER2 −/+ status have the worst prognosis in hormone receptor–positive breast cancer. Group 3 in risk factor grouping has the poorer prognosis than the other two groups. CONCLUSIONS: Patient age and axillary lymph nodes post-surgery are the independent and significant predictors of distant disease-free survival, local recurrence-free survival, and overall survival. The absence of PR relates to poor prognosis. The risk factor grouping provides a useful index to evaluate the risk of young breast cancer to identify subgroups of patients with a better prognosis. 相似文献
16.
Su Jin Lee Jung Eun Kim Seung Tae Kim Jeeyun Lee Se Hoon Park Joon Oh Park Won Ki Kang Young Suk Park Ho Yeong Lim 《Translational oncology》2018,11(2):353-357
BACKGROUND: Biliary tract cancers (BTCs) are known to have a dismal prognosis. A number of chemokines play important roles in the progress of BTCs. However, the serum levels of chemokines in BTCs have not yet been explored. METHODS: The sera of healthy donors (n = 8) and patients with BTCs who were enrolled in second line sunitinib trials (n = 27) were collected. The concentrations of three kinds of chemokines (CXCL5, CXCL8 and CXCL12) were measured using ELISA assay. The median concentrations of chemokines were compared between healthy donors and BTC patients and the role of chemokines as a prognostic biomarker was examined. RESULTS: BTC patients generally had higher serum levels of CXCL5 and CXCL12 compared to healthy donors. Patients with cholangiocarcinoma showed significantly higher levels of serum CXCL12 than patients with gallbladder cancer. In survival analysis, only CXCL12 level showed a prognostic impact on overall survival (median OS: 6.9 vs. 0.9 months in low CXCL12 vs. high CXCL12, respectively; P = .008). High CXCL5 levels were also correlated with poor survival without statistical insignificance (median OS: 6.2 vs. 2.0 months in low CXCL5 vs. high CXCL5, respectively; P = .070). CONCLUSIONS: There was a significant difference in OS according to the level of CXCL12, suggesting that serum CXCL12 levels may be a useful surrogate marker for clinical outcome in advanced BTCs. 相似文献
17.
目的:探讨非小细胞肺癌(NSCLC)患者K-ras基因突变与预后的相关性。方法:回顾分析2006年3月~2008年7月江西省肿瘤医院收治的92例NSCLC患者的临床资料,所有患者均采用蝎形探针扩增阻遏突变系统(ARMS)法行K-ras基因突变检测。结果:92例NSCLC患者中,11例K-ras基因突变阳性,阳性率为11.96%,包括Gly12Cys(GGTTGT)突变3例、Gly12Val(GGTGTT)突变2例、Gly12Ala(GGTGCT)突变2例、Gly12Arg(GGTCGT)突变2例、Gly12Cys(GGTTGT)突变与Gly12Val(GGTGTT)突变并存1例、Gly12Cys(GGTTGT)突变与Gly12Ala(GGTGCT)突变并存1例;K-ras基因突变阳性组与阴性组之间的患者性别、年龄、病理类型、吸烟史相比,差异无统计学意义(P0.05);K-ras基因突变阳性组Ⅲa~Ⅳ期患者中位生存期显著低于K-ras基因突变阴性组Ⅲa~Ⅳ期患者,差异有统计学意义(P0.05)。结论:NSCLC患者K-ras基因突变阳性率较低,但它可以对NSCLC患者预后产生负性影响。 相似文献
18.
Bettina Schlick Petra Massoner Angelika Lueking Pornpimol Charoentong Mirjam Blattner Georg Schaefer Klaus Marquart Carmen Theek Peter Amersdorfer Dirk Zielinski Matthias Kirchner Zlatko Trajanoski Mark A. Rubin Stefan Müllner Peter Schulz-Knappe Helmut Klocker 《PloS one》2016,11(2)
Background
Chronic inflammation is frequently observed on histological analysis of malignant and non-malignant prostate specimens. It is a suspected supporting factor for prostate diseases and their progression and a main cause of false positive PSA tests in cancer screening. We hypothesized that inflammation induces autoantibodies, which may be useful biomarkers. We aimed to identify and validate prostate inflammation associated serum autoantibodies in prostate cancer patients and evaluate the expression of corresponding autoantigens.Methods
Radical prostatectomy specimens of prostate cancer patients (N = 70) were classified into high and low inflammation groups according to the amount of tissue infiltrating lymphocytes. The corresponding pre-surgery blood serum samples were scrutinized for autoantibodies using a low-density protein array. Selected autoantigens were identified in prostate tissue and their expression pattern analyzed by immunohistochemistry and qPCR. The identified autoantibody profile was cross-checked in an independent sample set (N = 63) using the Luminex-bead protein array technology.Results
Protein array screening identified 165 autoantibodies differentially abundant in the serum of high compared to low inflammation patients. The expression pattern of three corresponding antigens were established in benign and cancer tissue by immunohistochemistry and qPCR: SPAST (Spastin), STX18 (Syntaxin 18) and SPOP (speckle-type POZ protein). Of these, SPAST was significantly increased in prostate tissue with high inflammation. All three autoantigens were differentially expressed in primary and/or castration resistant prostate tumors when analyzed in an inflammation-independent tissue microarray. Cross-validation of the inflammation autoantibody profile on an independent sample set using a Luminex-bead protein array, retrieved 51 of the significantly discriminating autoantibodies. Three autoantibodies were significantly upregulated in both screens, MUT, RAB11B and CSRP2 (p>0.05), two, SPOP and ZNF671, close to statistical significance (p = 0.051 and 0.076).Conclusions
We provide evidence of an inflammation-specific autoantibody profile and confirm the expression of corresponding autoantigens in prostate tissue. This supports evaluation of autoantibodies as non-invasive markers for prostate inflammation. 相似文献19.
Anders Fagerlund Luigi Cormio Lina Palangi Richard Lewin Fabio Santanelli di Pompeo Anna Elander Gennaro Selvaggi 《PloS one》2015,10(8)
Introduction
Gynecomastia and/or mastodynia is a common medical problem in patients receiving antiandrogen (bicalutamide or flutamide) treatment for prostate cancer; up to 70% of these patients result to be affected; furthermore, this can jeopardise patients’ quality of life.Aims
To systematically review the quality of evidence of the current literature regarding treatment options for bicalutamide-induced gynecomastia, including efficacy, safety and patients’ quality of life.Methods
The PubMed, Medline, Scopus, The Cochrane Library and SveMed+ databases were systematically searched between January 1, 2000 and December 31, 2014. All searches were undertaken between January and February 2015. The search phrase used was:”gynecomastia AND treatment AND prostate cancer”. Two reviewers assessed 762 titles and abstracts identified. The search and review process was done in accordance with the PRISMA statement. The PICOS (patients, intervention, comparator, outcomes and study design) process was used to specify inclusion criteria. Quality of evidence was rated according to GRADE.Main Outcome Measures
Primary outcomes were: treatment effects, number of complications and side effects. Secondary outcome was: Quality of Life.Results
Eleven studies met the inclusion criteria and are analysed in this review. Five studies reported pharmacological intervention with tamoxifen and/or anastrozole, either as prophylactic or therapeutic treatment. Four studies reported radiotherapy as prophylactic and/or therapeutic treatment. Two studies compared pharmacological treatment to radiotherapy. Most of the studies were randomized with varying risk of bias. According to GRADE, quality of evidence was moderate to high.Conclusions
Bicalutamide-induced gynecomastia and/or mastodynia can effectively be managed by oral tamoxifen (10–20 mg daily) or radiotherapy without relevant side effects. Prophylaxis or therapeutic treatment with tamoxifen results to be more effective than radiotherapy. 相似文献20.
刘青山姜晨荆涛任禹霏刘军刘勇 《现代生物医学进展》2012,12(12):2352-2355
目的:探讨国人前列腺癌患者前列腺体积与肿瘤分级之间的关系。方法:回顾我院及武汉大学人民医院2005年1月-2011年10月70例确诊为前列腺癌并行根治性前列腺切除术(RP)患者的临床病理资料,采用SPSS13.0软件总结并分析前列腺癌患者前列腺体积与肿瘤分级之间的关系。结果:经直肠前列腺穿刺活检获得肿瘤病理分级与根治性前列切除术获得最终病理分级具有显著差异(P=0.003);在活检及根治性前列腺切除标本中,前列腺体积与高级别肿瘤发生率均呈负相关(P<0.05);小前列腺与阳性手术切缘、前列腺外侵犯及高级别肿瘤在单变量分析中具有相关性(P<0.05),而与精囊腺侵犯及淋巴结侵犯则无相关性(P>0.05);在校正了年龄、体重指数及术前前列腺特异性抗原水平后,前列腺体积与阳性手术切缘、前列腺外侵犯、精囊腺侵犯及高级别肿瘤发生率均呈负相关(OR<1,P<0.05),而与淋巴结侵犯则无相关性(P>0.05)。结论:前列腺体积是高级别前列腺癌的重要预测因子,利用其对高级别肿瘤风险的预测能力可帮助选择最佳治疗方案并进一步提高治疗效果。 相似文献