目的比较应用计算机辅助设计与制作(CAD/CAM)转移托盘粘接托槽的实际位置和虚拟位置的差异。方法选10例舌侧矫治的患者,在其3D整合牙颌模型上进行计算机排牙和虚拟托槽定位,然后用激光快速成型技术直接输出转移托盘,用转移托盘将托槽粘...目的比较应用计算机辅助设计与制作(CAD/CAM)转移托盘粘接托槽的实际位置和虚拟位置的差异。方法选10例舌侧矫治的患者,在其3D整合牙颌模型上进行计算机排牙和虚拟托槽定位,然后用激光快速成型技术直接输出转移托盘,用转移托盘将托槽粘接到患者口内。用Bland and Altman's一致性分析比较托槽虚拟位置和口内实际位置测量值的差异。结果托槽虚拟位置和实际位置的线距测量差值从-0.26mm到0.19mm,转矩角度测量差值从-2.7°到2.5°,Bland and Altman's一致性分析显示托槽虚拟位置和实际位置的线距测量差值为0.01mm±0.21mm,转矩角度差值为0.5°±3.1°,所有测量项目的一致性分析显示无显著性差异。结论应用CAD/CAM转移托盘在临床上粘接托槽的位置有较高的准确性。展开更多
目的比较脉搏血氧计连续无创法和血气分析法检测血红蛋白（Hb）的一致性。方法对69名择期全麻肝脏部分切除术患者，在术中同时采用连续无创法和血气分析法检测Hb，共获得164对数据。采用配对t检验，Bland-Altman分析方法和多元线性回归...目的比较脉搏血氧计连续无创法和血气分析法检测血红蛋白（Hb）的一致性。方法对69名择期全麻肝脏部分切除术患者，在术中同时采用连续无创法和血气分析法检测Hb，共获得164对数据。采用配对t检验，Bland-Altman分析方法和多元线性回归分析评估2种测量方法的一致性及可能的影响因素。结果连续无创法与血气分析法分别测得Hb（s／dL）为-12．7±1．9 vs 11．6±1.9（P〈0．05）；Bland—Altman方法分析2种测量方法的偏倚值为（1．1±2．8）g／dL；95％一致性界限为（-1．7～3．9）g／dL；多元线性回归分析提示使偏倚值发生明显变化（P〈0．05）的变量包括有创Hb浓度（tHb）、平均动脉压（MAP）和灌注指数（PI）。结论Masimo Radical-7脉搏血氧计倾向于高估Hb，其准确性易受外界因素的影响；但术中维持稳定的血流动力学能够保持其检测误差的稳定，因而在肝脏部分切除术中对指导输血仍具有一定的参考意义。展开更多
Hepatocellular carcinoma(HCC)is the most common primary cancer of the liver and has an overall five-year survival rate of less than twenty percent.For patients with unresectable disease,evolving liver-directed locoreg...Hepatocellular carcinoma(HCC)is the most common primary cancer of the liver and has an overall five-year survival rate of less than twenty percent.For patients with unresectable disease,evolving liver-directed locoregional therapies provide efficacious treatment across the spectrum of disease stages and via a variety of catheter-directed and percutaneous techniques.Goals of locoregional therapies in HCC may include curative intent in early-stage disease,bridging or downstaging to surgical resection or transplantation for early or intermediate-stage disease,and local disease control and palliation in advanced-stage disease.This review explores the outcomes of chemoembolization,bland embolization,radioembolization,and percutaneous ablative therapies.Attention is also given to prognostic factors related to each of the respective techniques,as well as future directions of locoregional therapies for HCC.展开更多
BACKGROUND At the diagnosis of hepatocellular carcinoma(HCC),more than 90%of HCC patients present cirrhosis,a clinical condition often associated to malnutrition.Sarcopenia is an indirect marker of malnutrition assess...BACKGROUND At the diagnosis of hepatocellular carcinoma(HCC),more than 90%of HCC patients present cirrhosis,a clinical condition often associated to malnutrition.Sarcopenia is an indirect marker of malnutrition assessable on computed tomography(CT).AIM To evaluate the prognostic value of sarcopenia in patients with HCC treated by trans-arterial(chemo)-embolization.METHODS Patients with HCC treated by a first session of trans-arterial(chemo)embolization and an available CT scan before treatment were included.Sarcopenia was assessed using skeletal muscle index at baseline and at the first radiological assessment.Radiological response was recorded after the first session of treatment using mRECIST.RESULTS Of 225 patients treated by trans-arterial bland embolization(n=71)or trans-arterial chemoembolization(n=154)for HCC between 2007 and 2013,Barcelona Clinic of Liver Cancer stage was A,B,and C in 27.5%,55%,and 16.8%of cases,respectively.Sarcopenia was present in 57.7%of the patients.Patients with sarcopenia presented a higher rate of progressive disease(19%vs 8%,P=0.0236),a shorter progression-free survival(8.3 vs 13.2 mo,P=0.0035),and a shorter median overall survival(19.4 mo vs 35.5 mo,P=0.0149)compared with non-sarcopenic patients.Finally,patients whose sarcopenia appeared after first transarterial treatment had the worst prognosis(P=0.0004).CONCLUSION Sarcopenia is associated with tumor progression and poor survival outcomes after trans-arterial(chemo)-embolization for HCC.展开更多
文摘目的比较应用计算机辅助设计与制作(CAD/CAM)转移托盘粘接托槽的实际位置和虚拟位置的差异。方法选10例舌侧矫治的患者,在其3D整合牙颌模型上进行计算机排牙和虚拟托槽定位,然后用激光快速成型技术直接输出转移托盘,用转移托盘将托槽粘接到患者口内。用Bland and Altman's一致性分析比较托槽虚拟位置和口内实际位置测量值的差异。结果托槽虚拟位置和实际位置的线距测量差值从-0.26mm到0.19mm,转矩角度测量差值从-2.7°到2.5°,Bland and Altman's一致性分析显示托槽虚拟位置和实际位置的线距测量差值为0.01mm±0.21mm,转矩角度差值为0.5°±3.1°,所有测量项目的一致性分析显示无显著性差异。结论应用CAD/CAM转移托盘在临床上粘接托槽的位置有较高的准确性。
文摘目的比较脉搏血氧计连续无创法和血气分析法检测血红蛋白（Hb）的一致性。方法对69名择期全麻肝脏部分切除术患者，在术中同时采用连续无创法和血气分析法检测Hb，共获得164对数据。采用配对t检验，Bland-Altman分析方法和多元线性回归分析评估2种测量方法的一致性及可能的影响因素。结果连续无创法与血气分析法分别测得Hb（s／dL）为-12．7±1．9 vs 11．6±1.9（P〈0．05）；Bland—Altman方法分析2种测量方法的偏倚值为（1．1±2．8）g／dL；95％一致性界限为（-1．7～3．9）g／dL；多元线性回归分析提示使偏倚值发生明显变化（P〈0．05）的变量包括有创Hb浓度（tHb）、平均动脉压（MAP）和灌注指数（PI）。结论Masimo Radical-7脉搏血氧计倾向于高估Hb，其准确性易受外界因素的影响；但术中维持稳定的血流动力学能够保持其检测误差的稳定，因而在肝脏部分切除术中对指导输血仍具有一定的参考意义。
文摘Hepatocellular carcinoma(HCC)is the most common primary cancer of the liver and has an overall five-year survival rate of less than twenty percent.For patients with unresectable disease,evolving liver-directed locoregional therapies provide efficacious treatment across the spectrum of disease stages and via a variety of catheter-directed and percutaneous techniques.Goals of locoregional therapies in HCC may include curative intent in early-stage disease,bridging or downstaging to surgical resection or transplantation for early or intermediate-stage disease,and local disease control and palliation in advanced-stage disease.This review explores the outcomes of chemoembolization,bland embolization,radioembolization,and percutaneous ablative therapies.Attention is also given to prognostic factors related to each of the respective techniques,as well as future directions of locoregional therapies for HCC.
基金The study was conducted according to the guidelines of the Declaration of Helsinki.Study ethics was approved by the independent French ethic committee CERIM(Comitéd’éthique de la recherche en imagerie médicale)(approval date May 252020,No.CRM-2004-084).
文摘BACKGROUND At the diagnosis of hepatocellular carcinoma(HCC),more than 90%of HCC patients present cirrhosis,a clinical condition often associated to malnutrition.Sarcopenia is an indirect marker of malnutrition assessable on computed tomography(CT).AIM To evaluate the prognostic value of sarcopenia in patients with HCC treated by trans-arterial(chemo)-embolization.METHODS Patients with HCC treated by a first session of trans-arterial(chemo)embolization and an available CT scan before treatment were included.Sarcopenia was assessed using skeletal muscle index at baseline and at the first radiological assessment.Radiological response was recorded after the first session of treatment using mRECIST.RESULTS Of 225 patients treated by trans-arterial bland embolization(n=71)or trans-arterial chemoembolization(n=154)for HCC between 2007 and 2013,Barcelona Clinic of Liver Cancer stage was A,B,and C in 27.5%,55%,and 16.8%of cases,respectively.Sarcopenia was present in 57.7%of the patients.Patients with sarcopenia presented a higher rate of progressive disease(19%vs 8%,P=0.0236),a shorter progression-free survival(8.3 vs 13.2 mo,P=0.0035),and a shorter median overall survival(19.4 mo vs 35.5 mo,P=0.0149)compared with non-sarcopenic patients.Finally,patients whose sarcopenia appeared after first transarterial treatment had the worst prognosis(P=0.0004).CONCLUSION Sarcopenia is associated with tumor progression and poor survival outcomes after trans-arterial(chemo)-embolization for HCC.
