Objective To study the short-term outcome and safety of radiofrequency ablation (RFA) combined with recombinant human endostatin (endostar) for non-small cell lung cancer (NSCLC) patients. Methods Between December 2013 and December 2014, 80 consecutive patients (50 males, 30 females) with biopsy-proved NSCLC were divided into two groups: a RFA combined treatment group (RFA combined with endostar, 60 patients, 38 males, 22 females, mean age at 67.77±10.43 years) and a RFA alone group (20 patients, 12 males, 8 females, mean age at 67.35±9.82 years). The RFA combined treatment group was divided into three groups according to vascular normalization window of endostar and 20 patients in each group: a combined treatment group 1 (transfusion of endostar after RFA), a combined treatment group 2 (transfusion of endostar for 1 to 3 d before RFA) and a combined treatment group 3 (transfusion of endostar for 4 to 7 d before RFA). The CT scan of the chest was followed up after the treatment, local recurrence and safety was observed. Results There was a statistical difference in local recurrence time among groups (χ2 = 11.05, P = 0.011). The effect of the combined treatment group is better than that of the radiofrequency ablation therapy alone group. And in the recombinant human endostatin of tumor vascular normalization time best combination therapy was observed in the near future effect compared with the radiofrequency ablation therapy alone. In this study common complications were associated with radiofrequency ablation. No recombinant human endostatin related complication was found. There was no satistical difference in safety between the combined treatment group and the radiofrequency ablation therapy group (χ2= 0.889, P > 0.05). Conclusion RFA combined with endostar is safe and effective for non-small cell lung cancer.
Abstract： Objectives To determine the atrial expression of the collagen Ⅰ, collagen Ⅲ and the transforming growth factorbeta 1 (TGF-β1) in patients with rheumatic heart disease (RHD) and permanent atrial fibrillation(PAF) and to investigate the relationship between the extent of atrial fibrosis and the effectiveness of radiofrequency maze procedure in patients with RHD and PAF. Methods A total of 40 patients with RHD and PAF (≥6 months) who underwent a radiofrequency maze procedure with concomitant valvular surgery were collected for the experimental group. We acquired 100 mg of the left auricle tissue in each patient and followed up these patients after 3, 6 months of [CM(158mm]surgery. Then we assigned these patients to nonAF group and persistent AF group according to the results of the 6month followup. Another 10 patients with RHD and sinus rhythm(SR) who underwent valvular surgery alone were assigned to SR group and their left auricle tissue was also obtained. In order to determine the extent of atrial fibrosis, we observed the amount of collagen volume fraction Ⅰ，Ⅲ(CVF-Ⅰ,CVF-Ⅲ) by semiquantitative analysis with picrosirius red staining method. Using the β actin protein as the endogenous reference gene, we detected the expressions of TGF-β1 mRNA by semiquantitative reverse transcriptionpolymerase chain reaction(RT-PCR) technique. Results Each group has the same clinical baseline. At 6month follow-up, 28 among the 40 patients were categorized into the nonAF group and 12 into the AF group. (1) Patients in the nonAF group and the AF group had higher mRNA expressions of TGF-β1, CVF-Ⅰ and CVF-Ⅰ/CVF-Ⅲ compared with the SR group (F=6.487, P=0.003; F=3.711, P=0.032; F=3.697, P=0.032). The AF group had higher mRNA expressions of TGF-β1, CVF-Ⅰ and CVF-Ⅰ/CVF-Ⅲ than the nonAF group (t=4.372, P=0.043; t=4.603, P=0.038; t=4.776, P=0.035). But the CVFⅢ had no significant differences among the three groups (P＞0.05). (2) The patients whose left atrial function recovered after Maze procedure had lower mRNA expression than those patients whose left atrial function did not recover in the nonAF group (t=5.570, P=0.027). (3) The TGF-β1 mRNA expression has a positive correlation with both the contents of CVF-Ⅰ and left atrial diameter (r=0.786, Plt;0.05; r=0.858, Plt;0.05). Multiple logistic regression analysis revealed that the mRNA expression levels of TGF-β1, CVF-Ⅰ and left atrial diameter were independently associated with the postoperative persistence of atrial fibrillation. Conclusion The extent of atrial fibrosis in patients with RHD and PAF may be related to the sinus rhythm restoration and maintenance after AF surgical radiofrequency ablation and the resumption of atrial function.
ObjectiveTo observe the changes of peripheral blood lymphocyte subsets of patients with primary hepatocellular carcinoma (PHCC) treated with radiofrequency ablation (RFA). MethodsThe data of 70 cases of hospitalized patients with PHCC that voluntary accepted RFA diagnosed by clinical and pathological in our hospital between July 2011 and December 2014 were collected. According to the numbers of HCC lesions, 70 cases were divided into single focus group (n=41) and multifocal group (n=29). The changes of their immune parameters before and after RFA were analyzed. Results①The ratioes of peripheral blood CD3+/CD19-, CD3+/CD4+, CD4+/CD8+, and NK cells on 7 days and 14 days after RFA treatment of 70 cases were significantly higher than those on 1 day before RFA treatment (P < 0.05). The ratio of CD3+/CD8+ T cells reduced from 1 day before RFA treatment to 14 days after RFA treatment, but the difference was no statistically significant (P > 0.05).②The changing trend of peripheral blood lymphocyte subsets before and after RFA treatment in single focus group and multifocal group were similar to the above.③Compared with single focus group, the ratioes of peripheral blood CD3+/CD19-, CD3+/CD4+, CD4+/CD8+, and NK cells before and after RFA treatment in multifocal group were lower, and the ratio of CD3+/CD8+ T cells was higher, but the difference were not statistically significant (P > 0.05). ConclusionRFA can not only destroy small PHCC foci, but also to significantly improve immune function and enhance the anti-tumor effect.
ObjectiveTo systematically evaluate the efficacy and safety of radiofrequency ablation versus amiodarone in the treatment of atrial fibrillation, so as to provide reference for the chosen of clinical treatment options. MethodsWe searched PubMed, The Cochrane Library (Issue 10, 2014), CNKI, VIP and WanFang data from inception to October 2014 to collect randomized controlled trials (RCTs) comparing radiofrequency ablation versus amiodarone for atrial fibrillation. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. ResultsA total of 4 RCTs involving 511 atrial fibrillation patients were included. The results of meta-analysis showed that:compared with amiodarone, radiofrequency ablation could reduce the risk of atrial fibrillation recurrence (RR=0.35, 95%CI 0.22 to 0.55, P<0.000 01). There was no significant difference in all-cause mortality (RR=0.97, 95%CI 0.17 to 5.61, P=0.97) between both groups. The incidence of adverse events in the radiofrequency ablation group was 7.7%, and was lower than 12.7% of the amiodarone group, but there was no significant difference between the two groups. ConclusionCurrent evidence shows that, compared with amiodarona, radiofrequency ablation is related to lower recurrence rate and higher efficacy, but there is no difference in the safety between the two interventions. However, due to the limited quality and quantity of included studies, higher quality studies are needed to verify the above conclusion.
ObjectiveTo investigate heart rhythm outcomes of radiofrequency ablation (RFA)of atrial fibrillation (AF)during mitral valve replacement (MVR)for patients with rheumatic heart disease (RHD), and explore clinical results of radiofrequency catheter ablation (RFCA)for postoperative atrial tachycardia (AT). MethodsEleven RHD patients who developed AT after RFA of AF during MVR were enrolled in this study. There were 4 males and 7 females with their age of 49±8 years. Electroanatomic mapping of the left or right atrium was conducted with three-dimensional electroana-tomic mapping system during continuous AT. RFCA was performed at the key areas of AT. ResultsFor MVR, operation time was 149±18 minutes, postoperative hospital stay was 9.5±2.9 days, and length of ICU stay was 1.8±0.4 days. During electroanatomic mapping, 17 ATs were recorded in 11 patients. Six ATs (35%)of 5 patients originated from the right atrium and 11 ATs (65%)of 6 patients originated from the left atrium (LA). Among them, AT of 2 patients was related to the mitral valve ring. Immediate success of RFCA was obtained in 91% (10/11). After a mean follow-up of 17±4 months, 2 patients whose AT originated from LA had AT recurrence. ConclusionsMajority of postoperative ATs originate from LA, and majority of ATs are not mitral-dependent. RFCA is an effective and safe procedure for AT in patients after RFA of AF during MVR.
The treatment of liver cancer is still a challenge in the world, and it is mainly refers to hepatocellular carcinoma (HCC). There are many factors affecting the overall survival rate of HCC; the recurrence of HCC is the main risk factor affecting the survival of patients, hence, it is urgent to explore the clinical treatment of recurrent HCC to obtain long-term survival of the patients. Up to now, surgical treatment is a radical treatment for HCC. Similarly, liver resection and liver transplantation are still the main therapy methods for recurrent HCC. In addition, radiofrequency ablation and transcatheter arterial chemoembolization and other local treatments still play an irresistible role. Therefore, emphasizing the postoperative follow-up of patients, diagnosing recurrent HCC in early stage, paying attention to the risk factors of HCC recurrence and selecting a suitable treatment plan for individuals are critical ways to prolong the survival of patients.
Objective To investigate the impact of injection of acetic acid hypertonic saline solution (AHS) in dog liver during radiofrequency ablation (RFA) on its destructive zone. Methods RFAs were performed in dog livers by using LDRF-120S mutiple probe ablation system combining 50% acetic acid 5% hypertonic saline solution injection. Thirty healthy adult hybrid dogs were randomly divided into 5 groups (n=6). Group A: RFA was performed immediately after injection of 2 ml AHS; Group B: RFA was performed 5 min after injection of 2 ml AHS; Group C: RFA was performed immediately after injection of 4 ml AHS; Group D: RFA was performed 5 min after injection of 4 ml AHS; Group E: RFA was performed immediately after injection of 6 ml AHS. Results There were no significant differences in the mean initial impedance within 5 groups. The mean ablation times were different significantly among 5 groups (F=83.831, P＜0.001). The mean ablation time was different significantly between any two groups by LSD-t analysis (P＜0.001). The mean coagulation diameters were different significantly among 5 groups （F=53.488, P＜0.001）. The mean coagulation diameter of group E was the largest among 5 groups. Besides mean coagulation diameter was no significant difference between group D and E (Pgt;0.05), the mean coagulation diameter was different significantly between any two groups by LSD-t analysis (P＜0.001). Obviously thrombus were shown in coagulation necrosis zone and nearly normal tissue with gordon amp; sweet. AHS spillage from the injection site occurred in group E. Four dogs died in group E within 14 d but no dog died in the other groups. Conclusion RFA is performed 5 min after injection of 4 ml AHS in dog liver produces the ideal ablation destructive zone.
ObjectiveTo understand the latest progress of transcatheter arterial chemoembolization (TACE)-based combination therapies for unresectable liver metastasis from colorectal carcinoma, and to explore the safe and effective combination therapies in order to controlling the rapid progress of disease and improving the quality of life of patients. MethodsThe literatures about TACE-based combination therapies of liver metastasis from colorectal carcinoma and the latest advance in researches of this field at home and abroad were collected, and the application of combination therapies, the advantages and features of the combined treatments were reviewed. ResultsTACE was a safe and effective therapeutic modality in treating primary liver cancer or secondary liver cancer.Compared with a single treatment, TACE-based combination therapies had distinct advantages to patients with liver metastasis from colorectal carcinoma not only improved the quality of life but also prolonged the survival time.With the emerging of various kinds of new drugs and the rapid development of a variety of interventional treatments, it could bring long-term survival benifit for patients with liver metastasis from colorectal carcinoma. ConclusionsDoctors should pay attention to the combined treatments of patients with liver metastasis from colorectal carcinoma, improve the knowledge of personalized medication about advanced tumors and actively promote more usage of combination therapies.
ObjectiveTo explore the safety and feasibility of contrast enhanced intraoperative ultrasonographyguided percutaneous radiofrequency ablation with artificial hydrothorax to hepatocellular carcinoma in the hepatic dome. MethodsThe clinical data of nine patients with hepatocellular carcinoma in the hepatic dome underwent ultrasonographyguided percutaneous radiofrequnecy ablation with artificial hydrothorax from January 2008 to June 2009 at Department of Hepatobiliopancreatic Surgery of West China Hospital were retrospectively analyzed. The perioperative results and recurrence of tumor were also analyzed. ResultsAll of nine patients with twelve tumors received successfully radiofrequency ablation with artificial hydrothorax of (2 444±464) ml (2 000-3 000 ml). The ablation time was 12-24 min (median 12 min), with an average of (15±5) min for each tumor. No hemothorax, pneumothorax, and death occurred during operation. One patient had ascites of 2 000 ml after ablation due to hypoalbuminenia, and ascites disappeared by infusion of abumin on 4 d after operation. The total volume of pleural drainage was 250-1 420 ml, with an average of (717±372) ml for each patient, and the drainage tube was withdrawn on 3-5 d after operation. The followup time was 7-23 months (mean 15 months). Tumor recurrence was found in three patients on 5, 6, and 7 months after operation, respectively. Of them, two patients were in stable disease stage after interventional and conservative therapy, respectively, and one case recurred at six months after operation and died of hypertensive heart disease and hepatic function deterioration at sixteen months after operation. The rest patients survived and no recurrence and metastasis was observed during the follow-up period.ConclusionThe technique of percutaneous radiofrequency ablation with artificial hydrothorax increases the feasibility of the minimal invasive treatment for hepatoma, which can be applied to hepatocellular carcinoma in the hepatic dome with high safety and clinical application value.
ObjectiveTo evaluate the effect and experience of monopolar or bipolar radiofrequency ablation for organic heart disease with atrial fibrillation under the open heart surgery. MethodsWe retrospectively analyzed the clinical data of 305 patients with organic heart disease such as atrial fibrillation underwent the open heart surgery in Changle People's Hospital and Shanghai Renji Hospital between December 2004 year and December 2013 year. There were 188 male and 117 female patients at age of 38 to 81 years. The patients were divided into three groups according to monopolar or bipolar radiofrequency ablation used. There were 128 patients in a monopolar group, 165 patients in a bipolar group, and 12 patients in a combined group with monopolar radiofrequency ablation plus bipolar radiofrequency ablation. ResultTwo patients died after operation. There were 249 patients (81.6%) with sinus rhythm after operation. Sinus rhythm was restored 78.9% in the monopolar group compared with 83.6% in the bipolar group with a statistical difference (P>0.05). We followed up the patients for 3 to 85 (38.2±15.4) months after operation. There were no statistical differences in sinus rhythm rates after following-up 0.5 year (80.5% vs. 83.9%, P>0.05), 1 year (78.4% vs. 83.3%, P>0.05), 2 years (76.5% vs. 81.1%, P>0.05), and 5 years(73.8% vs. 77.1%, P>0.05). ConclusionMonopolar or bipolar radiofrequency ablation for atrial fibrillation with open heart surgery is an effective method, especially in long-term effect. There was no significant difference between the monopolar group and the bipolar group in effect. Bipolar radiofrequency ablation can reduce the ablation time.