碳酸氢钠+载药微球经肝动脉化疗栓塞治疗中晚期肝癌的临床效果

目的:探讨碳酸氢钠+载药微球经肝动脉化疗栓塞治疗中晚期肝癌的临床效果及安全性。方法:选择2015年2月到2018年6月在我院诊治的中晚期肝癌患者78例,根据随机数字表法将其均分为两组,每组各39例。对照组给予载药微球经肝动脉化疗栓塞治疗,实验组给予碳酸氢钠+载药微球经肝动脉化疗栓塞治疗,比较两组的临床疗效,治疗前后CD3~+CD4~+、CD3~+CD8~+T细胞比例的变化,治疗期间不良反应的发生情况及预后。结果:治疗后,实验组与对照组的治疗总有效率分别为74.4%和43.6%,实验组显著高于对照组(P0.05)。实验组治疗期间的发热、腹痛、腹胀、呕吐等不良反应发生情况与对照组的对比差异无统计学意义(P0.05)。两组治疗前后CD3CD4~+T比例对比差异无统计学意义(P0.05),两组治疗后的CD3~+CD8~+T比例显著低于治疗前,且实验组明显低于对照组(P0.05)。治疗后,实验组的躯体功能、心理功能、社会功能、共性症状及副作用评分都低于对照组(P0.05)。结论:碳酸氢钠+载药微球经肝动脉化疗栓塞治疗中晚期肝癌能提高治疗效果,改善机体的免疫功能,提高患者的生活质量,且不会增加不良反应。     

仑伐替尼联合TACE对不可切除肝细胞癌患者肿瘤标志物、凋亡分子和血清ST6GAL1、ANG-2、HGF的影响

摘要 目的：探讨仑伐替尼联合肝动脉化疗栓塞术（TACE）对不可切除肝细胞癌患者肿瘤标志物、凋亡分子和血清唾液酸转移酶1（ST6Gal1）、血管生成素-2（ANG-2）、肝细胞生长因子（HGF）的影响。方法：采用随机数字表法将四川绵阳四0四医院2020年3月~2022年12月期间收治的114例不可切除肝细胞癌患者分为对照组（n=57,TACE治疗）和研究组（n=57,仑伐替尼联合TACE治疗）。对比两组疗效、肿瘤标志物[甲胎蛋白（AFP）、糖类抗原199（CA199）、癌胚抗原（CEA）]、血清凋亡分子[B淋巴细胞瘤-2相关X蛋白（Bax）、B淋巴细胞瘤-2基因（Bcl-2）、存活素（Survivin）、半胱氨酸天冬氨酸蛋白酶-4（Caspase-4）]和血清ST6Gal1、ANG-2、HGF水平,并观察两组治疗期间不良反应发生情况。结果：与对照组相比,研究组的临床总有效率更高（P<0.05）。与对照组相比,研究组治疗后AFP、CA199、CEA水平更低（P<0.05）。与对照组相比,研究组治疗后Bcl-2、Survivin水平更低,Bax、Caspase-4水平更高（P<0.05）。与对照组相比,研究组治疗后ST6Gal1、ANG-2、HGF水平更低（P<0.05）。两组不良反应总发生率组间对比未见差异（P>0.05）。结论：仑伐替尼联合TACE用于不可切除肝细胞癌患者,可提高临床治疗效果,调节肿瘤标志物、凋亡分子和血清ST6Gal1、ANG-2、HGF水平,安全性较好。     

Inadvertent Lead Placement In The Left Ventricle: A Case Report And Brief Review

Inadvertent lead placement in the left ventricle (LV) is an uncommon and often under-diagnosed complication of cardiac device implantation. Thromboembolic (TE) events are common and usually secondary to fibrosis or thrombus formation on or around the lead. Anticoagulation can prevent TE events. Percutaneous and surgical LV lead extractions have been performed successfully, but the risks of percutaneous lead removal are not well-defined. In this report, we describe a case of inadvertent LV lead placement and briefly review the contemporary literature.     

Tilt-table testing of patients with pacemaker and recurrent syncope

The diagnosis of recurrent syncope in patients with pacemakers (PM) is quite challenging and the etiology of syncope is often multifactorial. To portray the mechanism of syncope in PM patients, we report the results of head-up tilt table testing (HUT) in a series of patients with PM, originally implanted for reasons other than neurally mediated syncope, referred due to syncope or pre-syncope (aborted syncope, vertigo, suspected orthostatic hypotension).Forty-one patients with PM undergoing a HUT in our syncope unit between January 1st, 2007 and December 31st 2011 were included. A standard HUT protocol with nitroglycerine provocation was used and the test results were classified according to current guidelines. Baseline data were retrieved from the medical records.Overall, 54% of patients had a positive response to HUT. Vasodepressor or orthostatic hypotensive response were the most prevalent responses accounting for 72% of patients with a positive test. There were no differences between groups with positive or negative test result regarding age, gender, resting blood pressure and heart rate, daily fluid intake, pacing mode, pacing indication or pacing rhythm at rest.HUT in patients with pacemakers has a high diagnostic yield. Although, the majority of patients had a vasodepressor or orthostatic hypotensive response, cardioinhibitory response leading to syncope was also seen.     

右室间隔部起搏患者起搏QRS 波时限与心功能的关系

目的:探讨右室间隔部起搏患者起搏QRS波时限与心功能的关系。方法:回顾性分析植入右室间隔部起搏的双腔起搏器患者(111例),起搏器平均植入时间(4.52±3.65)年,通过常规体表心电图测得完全起搏时QRS波时限分为四组:A组为QRS≤120ms(21例);B组为120ms180ms(26例),行心脏彩色多普勒检查获取左房内径(LAD)、收缩末期左室内径(LVESD)、舒张末期左室内径(LVEDD)、室间隔厚度(IVST)、左室后壁厚度(LVPWT)及LVEF,同时检测患者的血清氨基末端脑肭肽前体(NT-proBNP),分析起搏QRS波时限与以上各指标的关系。结果:D组患者LAD、LVEDD、LVESD、IVST及IVPWT较其他三组明显增大,同时LVEF显著下降,NT-proBNP明显升高,有统计学意义(P<0.05)。同时发现随起搏QRS时限的不断增宽,不同组别的LVEF是依次降低(中位值分别为66.5%、60.3%、52.7%和45.8%),而血清NT-proBNP水平是依次增大(中位值分别为143.7 pg/ml、261.8 pg/ml、599.4 pg/m和971.2 pg/ml)。直线相关性分析示起搏QRS波时限与LAD(r=0.141,P<0.05)、LVEDd(r=0.678,P<0.05)、LVEDs(r=0.439,P<0.05)、IVST(r=0.165,P<0.05)及LVPWT(r=0.189,P<0.05)有显著线性关系,呈正相关。起搏QRS波时限与LVEF负相关(r=-0.684,P<0.05),起搏QRS波时限与NT-proBNP的对数正相关(r=0.368,P=0.029)。结论:对于右室间隔部起搏的双腔起搏患者,起搏QRS波时限是一个可初步判断心脏结构和功能的指标,其起搏QRS波时限延长可能会恶化患者的心脏结构及功能,可结合NT-proBNP进行动态观察,对起搏器植入患者的心功能恶化和心衰的预防有一定的临床实用价值。     

Colonization pattern in the pine shoot beetle, Tomicus piniperda: Effects of host declination, structure and presence of conspecifics

A survey of 100 Scots pine trees (Pinus sylvestris) showed that those windthrown with a declination > 50° from vertical were preferentially colonized by the larger pine shoot beetle, Tomicus piniperda (L.) (Coleoptera: Scolytidae). A factorial experiment was done with logs of 0°, 45° and 90° declination, and different diameters and spacing to test hypotheses, involving olfactory, visual and tactile mechanisms. In the experiment, the attack rates depended strongly on log diameter with a preference being shown for larger diameter logs having a rough bark structure. In contrast to the field survey, experimental declination did not increase attack densities. The spacing between neighbouring attack sites in the bark was regular rather than random, which could be due both to spacing between conspecifics and regularities in bark structure. The contrary data from survey and experiment is explained by release of odours from wind damaged trees, and host odour and bark roughness stimuli are suggested to operate in different steps in the behavioural sequence of host location and colonization.

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Résumé L'observation de 100 individus de Pinus sylvestris a montré que les arbres inclinés de plus de 50° par le vent sont colonisés de préférence par T. piniperda L., Scolytidae. Des expériences avec des branches de différents diamètres, plus ou moins espacées et inclinées de 0°, 45° et 90°, ont permis d'examiner les influences de l'olfaction, de la vision et du tact. Les attaques ont montré une préférence marquée pour les diamètres les plus grands et pour la structure la plus rugueuse. Contrairement aux observations dans la nature, l'inclinaison n'a pas augmenté les attaques.L'analyse sur l'écorce de la distance entre les points d'attaque montre une tendance à une distribution régulière plutôt qu'au hasard, tenant compte de la régularité structurale de l'écorce.Les résultats contradictoires entre les expériences et les observations peuvent s'expliquer par l'abondante émission d'odeurs par les arbres endommagés par le vent, paramètre non contrôlé dans les observations. Les stimuli dus à la rugosité et à l'odeur de l'arbre devraient opérer à différentes étapes de la découverte et de la colonisation de l'hôte.

     

Progesterone administration reduces the behavioural and physiological responses of ewes to abrupt weaning of lambs

Abrupt weaning, a usual management in sheep productive systems, may provoke behavioural and physiological responses indicative of stress in ewes and lambs. Progesterone (P4) has anxiolytic and sedative effects through the union of its metabolites that contain 3α-hydroxyl group to the γ-aminobutyricacid_A receptor. Our first aim was to determine whether P4 administration reduces the behavioural and physiological responses of ewes to abrupt weaning of lambs. A complementary aim was to determine whether P4 treatment affects the milk yield and composition of ewes, and the BW of their lambs. In experiment 1, seven ewes received P4 treatment for 32 days (group E1-P4), and eight ewes remained as an untreated control group (group E1-C). BW of the lambs was recorded during P4 treatment. Lambs were weaned at 59 days (Day 0 = weaning). The main behaviours of the ewes before and after weaning were recorded using 10 min scan sampling. The ewes’ serum total protein, albumin and globulin concentrations were measured before and after weaning of the lambs. In experiment 2, milk yield and composition were determined in two different groups of six ewes treated with P4 (group E2-P4) for 16 days and in five untreated controls (group E2-C). The BW of lambs increased with time (P = 0.001) in both groups and did not differ. The percentage of observations in which the ewes were seen pacing on Day 0 was greater in the E1-C group than in the E1-P4 group (P = 0.0007). Similarly, the percentage of observations in which the ewes were recorded vocalizing on Day 0 was greater in the E1-C group than in the E1-P4 group (P = 0.04). The percentage of observations in which E1-C ewes were recorded lying did not change from Days 0 to 1; however, it increased in E1-P4 ewes. Total serum protein concentration did not change in E1-P4 ewes from Days 0 to 3, although a decrease was seen in E1-C ewes (P = 0.04). Serum globulin concentration was greater in E1-P4 ewes on Day 3 than in E1-C ewes (P = 0.0008). In experiment 2, there were no differences between E2-P4 and E2-C ewes in terms of milk yield, protein, fat and lactose content. Progesterone administration reduced the behavioural and physiological responses of ewes to abrupt weaning of lambs, and this effect was not mediated by changes in milk yield and composition, or by lambs’ BW.     

重组人血管内皮抑制素(恩度)联合肝动脉栓塞化疗术(TACE)治疗中晚期肝癌的临床疗效评价

目的:探讨重组人血管内皮抑制素(恩度)联合肝动脉栓塞化疗术(TACE)治疗中晚期肝癌的临床疗效,为中晚期肝癌的临床治疗提供参考依据。方法:选择我院2012年6月至2013年7月收治的中晚期肝癌患者82例,根据治疗方法随机分为观察组(43例)和对照组(39例),对照组给予TACE治疗;观察组在给予TACE治疗的基础上,联合恩度治疗。治疗结束后,观察和评价两组患者的临床疗效和不良反应的发生情况。结果:治疗后,观察组的有效率为46.51%(20/43),显著高于对照组30.77%(12/39)(P0.05);观察组的AFP水平为(412.58±10.66)μg/m L,明显低于对照组(445.27±11.39)μg/m L(P0.05);两组并发症的发生率比较,差异无统计学意义(P0.05)。结论:恩度联合TACE治疗可以有效提高中晚期肝癌的临床疗效,且不增加不良反应。     

中国肝细胞癌患者TACE术后死亡原因分析(英文)

目的:通过探讨中国肝细胞癌患者肝动脉化疗栓塞术(TACE)术后并发症及死亡原因,来提高临床治疗效果,并积累治疗经验。方法:通过联合检索CBM及CNKI上从1994年1月到2008年9月的关于中国肝细胞癌患者行TACE术后出现并发症的相关文章,分析总结肝细胞癌患者TACE术后死亡的原因及特点。结果:中国肝细胞癌患者TACE术后并发症较为危重,致死率较高,死亡原因有84%是肝功能衰竭、上消化道出血及肝癌破裂出血,且死亡病例发生在术后1月内的占78.7%,因此大多是早期死亡。结论:中国肝细胞患者TACE术后死亡原因主要是肝功能衰竭、上消化道出血及肝癌破裂出血,且术后死亡常为早期死亡,因此TACE术后严重并发症可直接影响患者的预后情况,我们需要提高对TACE术选择时机的重视程度,规范介入治疗手段和流程,尽量避免和减少严重并发症的发生。     

Behavioral and adrenocortical responses to environmental changes in leopard cats (Felis bengalensis)

Indicators of environmental adequacy relevant to the well-being of small felids are developed by examining, in 4 captive leopard cats, interrelationships between behavioral and adrenocortical responses to changes in housing conditions. Singly housed cats were moved from their barren home cage (Cage 1, baseline) sequentially to 2 new, barren housing situations (Cages 2 and 3; ≈ 10 weeks/cage). Urinary cortisol concentrations, stereotypic pacing, and hiding frequencies were transiently increased for 1 week after translocation to Cage 2. After translocation to Cage 3, cortisol concentrations and hiding also were increased for the first week. However, conditions in Cage 3 were determined to be aversive to the cats, as evidenced by cortisol concentrations that remained chronically elevated for the entire 10-week period. Exploratory behavior was suppressed during this period. When Cage 3 was enriched with a complex of branches and hiding places, urinary cortisol concentrations and stereotypic pacing decreased, and exploration increased. Concealment locations that camouflage were more often used for lying down when urinary cortisol was elevated. These results suggest that reduced exploratory behavior is an indicator of chronic exposure to aversive environmental conditions. Stereotypic pacing may not necessarily increase when adrenocortical activity increases. The results also suggest that enrichment facilitates coping with aversive stimulation by providing behavioral options to confined felids. To promote the welfare of small felids, appropriate camouflaged hiding places should be provided and enrichment programs developed to stimulate exploratory behavior. © 1993 Wiley-Liss, Inc.