Objective To evaluate the clinical effect and value of CT-guided percutaneous microwave abla-tion therapy for lung cancer. Methods From October 2014 to December 2016, the clinical data of 60 patients with peripheral lung cancer were analyzed, and they were randomly divided into the chemotherapy group and the micro-wave ablation group, 30 cases in each group. The chemotherapy group was given GP chemotherapy, and the micro-wave ablation group was given CT-guided percutaneous microwave ablation therapy. Their clinical efficacy was com-pared. Results Karnofsky score showed no significant difference between the two groups before treatment ( P >0. 05). After treatment, the total effective rate was obviously higher in the microwave ablation group (60. 0％) than in the chemotherapy group (33. 3％) (P<0. 05). 1 and 3 months after treatment, Karnofsky score was significantly higher in the microwave ablation group than in the chemotherapy group ( P<0. 05 ) . The incidence of adverse reac-tions was 16. 7％ in the microwave ablation, significantly lower than 40％ in the chemotherapy group ( P<0. 05 ) . Conclusion Compared with chemotherapy alone, the use of CT-guided percutaneous microwave ablation has better curative effect, less invasive effect and higher safety.

Objective To explore the clinical efficacy of transcatheter arterial chemoembolization (TACE) combined with three-dimensional conformal radiation therapy (3D-CRT) in the treatment of patients with massive primary liver cancer (PLC). Methods From January 2009 to January 2015,147 unresectable massive PLC(tumor size≥10 cm) patients in our hospital were divided into TACE plus 3D-CRT group (n=63) and TACE group(n=84) according to different treatment methods. Curative effects in the two groups were compared,and the adverse reaction during treatment period were recorded. Results The effective rate was 65.1% in the TACE plus 3D-CRT group,significantly higher than 40.5% in the TACE group (P<0.05);The 6-month,1-year and 2-year survival rates were 84.1%,55.6% and 27.0%,respectively,in the TACE plus 3D-CRT group,and 59.5% (P<0.05),38.1% (P<0.05) and 19.1% (P>0.05),respectively,in the TACE group;The adverse reactions in the two groups were not significantly different. Conclusion TACE combined with 3D-CRT therapy for unresectable massive PLC has good clinical efficacy.

Objective To explore the influencing factors and long-term efficacy of transcatheter arterial chemoemboliza-tion( TACE) combined with microwave ablation therapy ( MWA) for advanced liver cancer.Methods 90 patients with advanced primary liver cancer who underwent TACE combined with MWA were followed up ,1~5 years survival rates were analyzed.7 fac-tors affecting long-term curative effects of TACE combined with MWA were studied by single factor variance analysis ,the statisti-cal difference was screened and analyzed by logistic regression analysis ,the independent influencing factors were examined.Re-sults Of 88 patients,there had 82 cases of death,accounting for 93.18% in follow-uPcases.1-,2-,3-,4-,5-year survival rates were 73.86%,45.45%,32.95%,25%,13.63%.Single factor variance analysis showed that clinical grading ,Child-Pugh grad-ing,tumor diameter,portal vein tumor thrombus and targeted drug therapy were factors affecting 3-year survival rate of liver cancer patients treated with TACE combined with MWA ,these 5 factors were studied by logistic regression analysis ,the results showed that clinical grading ,tumor diameter ,portal vein tumor thrombus and targeted drug therapy independent influence factor for 3-year survival rate of liver cancer patients treated with TACE combined with MWA.Conclusion Targeted drug therapy is independent protective factor for liver cancer patients treated with TACE combined with MWA ,clinical grading,tumor diameter,portal vein tumor thrombus are independent risk factors.

Objective To investigate the feature of diffusion-and perfusion-weighted imaging(DWI and PWI) and its relation to neurological deficit in acute focal cerebral ischemia rabbits.Methods A total of 30 adult male New Zealand rabbits were selected,and the acute focal cerebral ischemia models in middle cerebral artery were prepared.All rabbits were assessed of neurological deficit severity by Purdy score 6 h after successful modeling.After that,they underwent DWI and PWI with MRI,and the DWI high signal volume and the hypoperfusion volume of cerebral blood flow(CBF) on the PWI were calculated separately.Finally,the correlation was analyzed between the volume of abnormal signal region and the Purdy score.Results The hypoperfusion volume of CBF was 91.89 ± 51.31 mm3 and the DWI high signal volume was 70.90 ± 43.77 mm3.The former was larger than the later in all the rabbits,and the CBF-DWI mismatch volume was 21.99 ± 16.29 mm3.There was a significant positive correlation between both the CBF hypoperfusion volume and the DWI high signal volume and the neurological deficit score,while the CBF-DWI mismatch volume did not correlate with the Purdy score.Conclusions The CBF hypoperfusion volume and the DWI high signal volume can reflect the extent of the neurological deficit in the rabbits with acute focal cerebral ischemia.

目的了解先天性肝外门腔静脉分流（Abernethy畸形）的临床特点。方法回顾分析1例Abernethy畸形并下消化道出血患者的临床资料，并进行文献复习。结果本例患者男性，20岁。反复间歇性便血20年。重度贫血貌，外周血WBC 2.0×109/L，RBC 2.6×1012/L，HB41g/L，PLT 125×109/L；粪红色软便，OB（+++），血液（++）；经电子胃镜、电子结肠镜、腹部血管彩超、腹部CT血管重建和磁共振成像检查诊断，行结直肠周围血管离断和直肠下段曲张静脉缝扎术，术后恢复良好，随访2年，生活质量好。结论 Abernethy畸形分为Ⅰ型和Ⅱ型，Ⅱ型患者肝外门静脉广泛扩张并导致门腔静脉分流，以下消化道出血为主要临床表现。

1 临床资料 患者男性,79岁,因慢性肾功能不全在外院血液透析治疗2年半,治疗效果尚好;其初始治疗经过是先行右颈内静脉插管,随后已分别进行左、右前臂内瘘手术.近期患者因内瘘闭塞临时行股静脉插管透析,现要求建立长期血管通路收住.体温36.8℃,脉搏80次/min,血压140/80 mmHg.营养一般,神志清晰,查体配合,面部及四肢无肿胀,心肺听诊正常,腹部平坦无压痛,右股静脉置管在位、无渗出,双上肢可见陈旧性手术瘢痕,双上肢动静脉内瘘听诊无血管杂音.

Objective To investigate the therapeutic effects of bone marrow stem cells for the treatment of decompensated liver cirrhosis. Methods The clinical data of 28 patients with decompensated liver cirrhosis who were admitted to the No. 105 Hospital of PLA from July 2009 to March 2010 were retrospectively analyzed. Bone mesenchymal stem cells (BMSCs) were separated and purified from the bone marrow cells of the patients in vitro,and then they were transplanted into the liver of the patients through proper hepatic artery. The clinical symptoms and physical signs of the patients were monitored, and the biochemical indexes of the liver were measured at the 2nd, 4th, 8th and 12th weeks after operation. All data were analyzed using the analysis of variance, LSD test or Dunnett's test. Results The appetite and physical strength of 26 patients were apparently improved one week after operation. The ascites of 23 patients were reduced at the end of the 4th week. At the end of the 12th week,the level of alanine aminotransferase was decreased from (99 ± 36)U/L to (48 ± 26 )U/L, aspartate aminotransferase was decreased from (86 ±36)U/L to (46 ±22)U/L, total bilirubin was decreased from (38 ± 16)μmol/L to (18 ± 13)μmol/L, albumin was increased from (29 ± 4)g/L to (35 ± 5 )g/L, and the prothrombin time was decreased from ( 19 ±4)s to ( 13±4) s. There were significant differences in the biochemical indexes of the liver after operation when compared to those before operation ( F =267. 35, 143. 52, 218. 74, 125. 57, 331.25, P <0.05). No fever, rash or allergic reaction was detected. Hematoma was detected in the incision site of the posterior superior iliac spine in one patient, and it disappeared one week later; one patient had discomfort in the liver area during the process of the BMSCs transplantation, and the discomfort disappeared at the end of the process; one patient died of hemorrhage of the upper gastrointestinal tract at the end of the 3rd month after operation. Conclusion The short term outcome of the autologous BMSCs transplantation for the treatment of decompensated liver cirrhosis is satisfactory, while its long term effect needs to be further investigated.

材料与方法1.临床资料:本组男性32例,女性9例,年龄36-68岁,平均年龄54岁.全部患者均经过临床检查,AFP检测,B超,CT检查综合确诊.其中原发性肝癌34例,肝转移癌6例,肝癌术后复发1例.

目的:评价经门-体侧支循环介入性治疗6例胃底静脉曲张临床运用的可行性.方法:采用Seldinger技术经皮穿刺股静脉插管至门-体侧支分流道,用球囊导管阻塞分流道并经其缓慢注入鱼肝油酸钠栓塞胃底曲张静脉,术后1、3、6、12个月分别行胃镜和增强CT检查进行评估.结果:6例治疗后胃底静脉曲张几乎完全消失.结论:经门-体侧支介入性治疗胃底静脉曲张,创伤小,可重复治疗 ,是安全可行的技术,对消除胃底静脉曲张有良好效果.

患者男，64岁。持续胸闷、呼吸困难、咳嗽1年，间断咯血2个月。查体：胸骨左缘第2前肋间可闻及连续机械样杂音伴震颤。X线胸片示：左肺门影增大，肺动脉段明显突出。超声心动图诊断为肺动脉瘤。 血管造影：常规经股静脉—右心室选择性肺动脉造影，表现为主肺动脉呈瘤样扩张，与左肺动脉交界处有约4.8cm×5.0cm对比剂均匀充盈之膨胀病灶；左肺动脉分支减少，未见肺静脉显影(图1)。当肺静脉显影充盈时，肺动脉病灶内仍可见对比剂滞留(图2)，动脉期主动脉充盈，未见异常分流和血管显影(图3)。DSA诊断为肺动脉瘤。

患者　男，57岁。乙肝病史10年，肝区疼痛、肝功能持续异常6个月。B超及CT检查诊断为原发性肝癌。住院施行介入治疗。