scholarly journals Effect of Radiofrequency Ablation with Interventional Therapy of Hepatic Artery on the Recurrence of Primary Liver Cancer and the Analysis of Influencing Factors

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Sishuo Zhang ◽  
Ge Zhao ◽  
Honglin Dong

Background. The probability of liver cancer recurring in patients after surgery is a serious threat to liver cancer patients. Radiofrequency ablation is widely employed in liver cancer cases. We explored the therapeutic effects and influencing factors of radiofrequency ablation combined with hepatic artery intervention in patients with recurrence of primary liver cancer surgery. Methods. 90 patients with primary liver cancer postoperative recurrence admitted to our hospital from January 2014 to February 2017 were selected as the research objects. The patients were randomly divided into the control group (n = 45) and combined treatment group (n = 45). The combined treatment group received radiofrequency ablation combined with hepatic artery interventional therapy, and the control group received hepatic artery interventional therapy. The short-term efficacy, AFP levels before and after treatment, and long-term survival results of the two groups were compared. Single-factor and multifactor analyses of the clinical information of the combined treatment group were carried out to find out the factors affecting the therapeutic effect of radiofrequency ablation combined with hepatic artery intervention on patients with recurrence of primary liver cancer. Results. The total effective rate of short-term curative effect of the combined treatment group was higher than the control group, and there was a statistically significant difference existing ( P  < 0.05). After treatment, two groups of patients’ AFP levels were greatly lower than before treatment, the AFP levels of the combined treatment group were significantly lower than the control group, and there was a statistically significant difference ( P  < 0.05). The survival rates of patients in the combined treatment group at the sixth month, the first year, and the second year after treatment were significantly higher than those of the control group, and there was a statistically significant difference ( P  < 0.05). The univariate results showed that, in the combined treatment group, there were statistically significant differences between the effective group and the ineffective group in tumor diameter, intact capsule, liver cirrhosis, intrahepatic spread, and tumor adjacent to large blood vessels ( P  < 0.05). The outcomes of multivariate analysis indicated that tumor diameter ≥ 3 cm, incomplete capsule, intrahepatic spread, and tumor adjacent to large blood vessels were risk factors for ineffective recurrence of patients with primary liver cancer after radiofrequency ablation combined with hepatic artery intervention ( P  < 0.05). Discussion. Tumor diameter ≥ 3 cm, incomplete capsule, intrahepatic spread, and tumor adjacent to large blood vessels are risk factors for the ineffectiveness of radiofrequency ablation combined with hepatic artery interventional therapy for patients with recurrence of primary liver cancer. It is necessary to increase the range of radiofrequency treatment, increase the temperature of the radiofrequency needle, and strengthen postoperative follow-up interventions based on the specific conditions of the patient's tumor.

2017 ◽  
Vol 1 (3) ◽  
Author(s):  
Yongbo Wang

Objective: To investigate the effects of radiofrequency ablation assisted partial hepatectomy in the treatment of primary liver cancer. Methods: A total of 60 patients with primary liver cancer treated in our hospital from March 2013 to October 2015 were selected as study subjects and were divided into the control group and the study group by the random number table method, 30 cases in each group. The control group were treated with partial hepatectomy. On the basis, the study group were treated with radiofrequency ablation. The operation associated indexes (operation time, the average wound bleeding volume, postoperative length of hospital stay), preoperative and postoperative liver function indexes [alanine aminotransferase (ALT), total bilirubin (TBIL), aspartate aminotransferase (AST)], the incidence of complications and recurrence rates in the two groups were observed. Results: The operation time and postoperative length of hospital stay of the study group were significantly shorter than those of the control group, and the average bleeding volume was significantly less than that of the control group (P < 0.05). There was no significant difference in ALT, TBiL and AST between the two groups before operation(P>0.05). After operation, ALT, TBiL and AST in the two groups were significantly lower than those before operation, and the changes in the study group were greater than those in the control group (P < 0.05). The incidence of postoperative complications and the recurrence rate in 1 year after operation were significantly  lower than those in the control group (P < 0.05). Conclusion: Radiofrequency ablation has obvious positive effect in patients with primary liver cancer undergoing partial hepatectomy. It has advantages of little bleeding, short rehabilitation time, protecting liver function, few postoperative complications and low recurrence rate.


2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Antonios E. Spiliotis ◽  
Gereon Gäbelein ◽  
Sebastian Holländer ◽  
Philipp-Robert Scherber ◽  
Matthias Glanemann ◽  
...  

Abstract Background Guidelines have reported that although microwave ablation (MWA) has potential advantages over radiofrequency ablation (RFA), superiority in efficacy and safety remain unclear. Aim of the study is to compare MWA with RFA in the treatment of liver cancer. Methods Meta-analysis was conducted according to the PRISMA guidelines for studies published from 2010 onwards. A random-effects model was used for the meta-analyses. Complete ablation (CA), local tumor progression (LTP), intrahepatic distant recurrence (IDR), and complications were analyzed. Results Four randomized trials and 11 observational studies with a total of 2,169 patients met the inclusion criteria. Although overall analysis showed no significant difference in LTP between MWA and RFA, subgroup analysis including randomized trials for patients with hepatocellular cancer (HCC) demonstrated statistically decreased rates of LTP in favor of MWA (OR, 0.40; 95% CI, 0.18–0.92; p = 0.03). No significant differences were found between the two procedures in CA, IDR, complications, and tumor diameter less or larger than 3 cm. Conclusions MWA showed promising results and demonstrated better oncological outcomes in terms of LTP compared to RFA in patients with HCC. MWA can be utilized as the ablation method of choice in patients with HCC.


2019 ◽  
Vol 18 ◽  
pp. 153473541984317 ◽  
Author(s):  
Hongde Zhen ◽  
Xiang Qian ◽  
Xiaoxuan Fu ◽  
Zhuo Chen ◽  
Aiqin Zhang ◽  
...  

Background: Shaoyao Ruangan mixture (SRM) has been applied clinically for more than 20 years in Zhejiang Cancer Hospital to treat patients with primary liver cancer (PLC). Intestinal microecology plays an important role in the emergence of liver diseases. This study aimed to reveal connections among SRM, intestinal microbiota and PLC, and the potential targets of SRM for liver cancer. Methods: We established a control group, a PLC model group, and a treatment group of mice to analyze the inhibitory effect of SRM on PLC and its intestinal flora target. We also evaluated drug efficacy of SRM and analyzed specific changes in intestinal flora by 16S rDNA sequencing of stools. As the serum interleukin (IL)-10 level could be an independent prognostic factor for unresectable liver cancer, we detected IL-10 levels and analyzed their association with the abundance of specific bacteria. Results: Liver tumors in the treatment group were smaller and fewer than those in the model group ( P = .046). The abundance of Bacteroides was significantly higher in the model group than that in the control group, while SRM significantly reduced the increasing abundance of Bacteroides in mice with PLC. We found that the IL-10 level was positively correlated with the abundance of Bacteroides. Conclusion: SRM can effectively inhibit the progression of PLC and increase Bacteroides abundance. In view of the association between Bacteroides and liver cancer and the significant positive correlation between Bacteroides and IL-10 levels, Bacteroides may be the target intestinal flora of SRM to inhibit PLC.


2020 ◽  
Vol 20 (12) ◽  
pp. 7283-7288
Author(s):  
Xinhong Wang ◽  
Min Li ◽  
Jing Wang ◽  
Yihong Cao

This study aimed at investigating the clinical effect and safety of albumin binding paclitaxel (Nab-P) for the first-line treatment of advanced primary liver cancer. Clinical data of 23 patients with primary liver cancer, who were treated in the first-line tumor treatment Department in the PLA General Hospital from May 2014 to December 2015, were analyzed retrospectively. The patients were divided into an observation group and a control group, according to their treatment plan. The patients in the observation group (12) received Nab-P treatment (5 cases of Nab-P combined with tegeor, 5 cases of Nab-P combined with capecitabine, and 2 cases of Nab-P single drug), and the patients in the control group (11) received gemcitabine combined with oxaliplatin. Each treatment cycle lasted for 21 days, and the treatment effect was evaluated once every two cycles, while the adverse reactions were assessed after every cycle. The survival rates of the different groups were compared using the chi-square test or the Fisher’s exact test, the Kaplan Meier survival curve, and the log rank test. Results from all patients were used to evaluate treatment efficacy and adverse reactions. In the observation group, there were 2 cases of partial remission, 7 cases of disease stability, and 3 cases of disease progress; in the control group, there were 2 cases of partial remission, 5 cases of disease stability, and 4 cases of disease progress. There was no significant difference in disease control rate between the two groups (75% vs. 64%, χ2 = 0.350, P > 0.05). There was no significant difference in the median progression free survival time between the two groups (5.1 (2.7–6.7) months versus 4.3 (2.5–54) months, χ2 =0.647, P > 0.05). No serious side effects were observed in any of the two groups. Among the observed side effects were some PLT toxicity and increased AST (Aspartate transaminase) incidence, which showed a statistically significant difference between the two groups (χ2 = 5.490, P = 0.036 for PLT; χ2 = 6.135, P = 0.027 for AST). The new Nab-P-based drug regimen has a good effect against primary liver cancer, and the side effects are tolerable. However, the sample size used in this study was small and further clinical studies using larger samples are required to verify the results.


2011 ◽  
Vol 39 (10) ◽  
pp. 1431-1439 ◽  
Author(s):  
Selcuk Karaman

The effects of audience response systems (ARS) on students' academic success and their perceptions of ARS were examined in this study. Participants, comprising 44 undergraduate students, were randomly assigned to a control or treatment group. The course design was the same for both groups and the instructor prepared the multiple-choice questions in advance; students in the control group responded to these questions verbally whereas the treatment group used ARS. Two paper-based examinations were used to measure the learning of concepts and skills that were taught. Students' perceptions of ARS were collected via a questionnaire. Results showed that ARS usage has a significant learning achievement effect in the first 4 weeks but not at the end of the second 4 weeks. There was no significant difference in retention between either group. Students perceived the ARS tool positively, finding it very enjoyable and useful.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kyoungwon Baik ◽  
Seon Myeong Kim ◽  
Jin Ho Jung ◽  
Yang Hyun Lee ◽  
Seok Jong Chung ◽  
...  

AbstractWe investigated the efficacy of donepezil for mild cognitive impairment in Parkinson’s disease (PD-MCI). This was a prospective, non-randomized, open-label, two-arm study. Eighty PD-MCI patients were assigned to either a treatment or control group. The treatment group received donepezil for 48 weeks. The primary outcome measures were the Korean version of Mini-Mental State Exam and Montreal Cognitive Assessment scores. Secondary outcome measures were the Clinical Dementia Rating, Unified Parkinson’s Disease Rating Scale part III, Clinical Global Impression scores. Progression of dementia was assessed at 48-week. Comprehensive neuropsychological tests and electroencephalography (EEG) were performed at baseline and after 48 weeks. The spectral power ratio of the theta to beta2 band (TB2R) in the electroencephalogram was analyzed. There was no significant difference in the primary and secondary outcome measures between the two groups. However, the treatment group showed a significant decrease in TB2R at bilateral frontotemporoparietal channels compared to the control group. Although we could not demonstrate improvements in the cognitive functions, donepezil treatment had a modulatory effect on the EEG in PD-MCI patients. EEG might be a sensitive biomarker for detecting changes in PD-MCI after donepezil treatment.


Author(s):  
Muhammad Kashif ◽  
Nosheen Manzoor ◽  
Rimsha Safdar ◽  
Hafsa Khan ◽  
Maryam Farooq ◽  
...  

BACKGROUND: Cervicogenic headache (CGH) is a common condition that results in significant disability. To treat this dysfunction, Mulligan described sustained natural apophyseal gliders (SNAGs) as a manual therapy approach. However, only inconclusive short-term evidence exists for treating CGH with SNAGs. OBJECTIVE: The present study aims to investigate the effect of SNAGs in the treatment of CGH. METHODS: Fourty female patients ranging from 20 to 40 years with CGH were randomly assigned to two groups: 20 in a treatment group and 20 in a control group. SNAGs were applied to the treatment group while the control group received placebo treatment. Both groups received their respective treatment for 20 minutes, alternately three times per week, for a total of 12 times in four weeks. The outcome measures were the Neck Disability Index (NDI) and the Visual Analogue Scale (VAS). Participants were assessed at baseline and at the end of each week. The data was analyzed using SPSS version 20. Independent t-testing was used to reveal changes between groups. One-way ANOVA was used to determine changes within groups. The level of significance was P< 0.05. RESULTS: Twenty participants (100%) in the treatment group and 17 (85%) in the control group had a history of headache aggravation with active movements or passive head positioning. There was no significant difference at baseline (p> 0.05), indicating that both groups were homogeneous at the time of recruitment. The p value (p< 0.05) showed a significant difference in pain and level of disability at three and four weeks (p< 0.05) in patients treated with SNAGs. However, the cervical range of motion (ROM) showed a statistically significant improvement in flexion and extension in the treatment group (p< 0.05) while there was no significant improvement in side flexion and rotation ROM in both groups (p> 0.05). CONCLUSION: This study found that SNAGs were effective in reducing pain and neck disability and improved ROM in females with CGH.


Author(s):  
Changying Yi ◽  
Jie Zhang ◽  
Meili Fan

<B>Objective:</B> Functional fecal incontinence in children (FFIC), also known as functional fecal disorder in children, is a type of childhood diseases characterized by excretory dysfunction. In the study, we observed the clinical effect of Changqiang acupoint injection on functional fecal incontinence in children (FFIC) by randomized controlled clinical trials. <BR><B>Materials and methods:</B> 140 children with functional fecal incontinence who met the screening criteria were respectively assigned into the treatment group (100 cases) and the control group (40 cases) according to the completely randomized controlled design. In the treatment group, Chuankezhi injection was administrated at the Changqiang acupoint once a week for three weeks (one course of treatment). In contrast, the subjects in the control group was instructed to receive sphincter exercise and defecation training, followed by an assessment on the therapeutic efficacy after one course of treatment. <BR><B>Results:</B> The overall response rate of the two groups was 93.00% (93/100) and 57.50% (23/40), respectively, with a statistically significant difference (P<0.01). The treatment group showed a performance superior to the control group based on the Cleveland Clinic Florida Fecal Incontinence Score System (CCF-FI)—dry stool incontinence, liquid incontinence, gas incontinence, lifestyle change, necessity of using pads or antidiarrheals, the ability to delay defecation, and the total score. The inter-group comparison revealed a statistically significant difference (P<0.01). <BR><B>Conclusion:</B>Changqiang acupoint injection has significant curative effect on FFIC as demonstrated by significant relief in the symptoms associated with fecal incontinence, and thus is considered as a useful approach to be widely applied in clinical practice.


2018 ◽  
Vol 38 (3) ◽  
pp. 164-172
Author(s):  
Khilyatul Baroroh ◽  
Suradi Suradi ◽  
Ade Rima

Background: Amplification of inflammation in acute exacerbation of chronic obstructive pulmonary disease (COPD) increases inflammatory mediators and oxidative stress in the airways, pulmonary and systemic circulation that are characterized by increased plasma level of IL-6 and MDA, resulting in worsening of clinical symptoms. Xanthones in mangosteen pericarp have anti-inflammatory and antioxidant effects, potentially as an adjuntive therapy in acute exacerbations of COPD. Methods: The aim of this study was to determine the effect of mangosteen pericarp extract to clinical improvements, plasma level of IL-6 and MDA of acute exacerbation COPD patients. A clinical trial of experimental with pretest and posttest was conducted on 34 acute exacerbation of COPD patients in Dr. Moewardi Hospital Surakarta and Dr. Ario Wirawan Lung Hospital Salatiga from April until May 2016. The sample was taken by consecutive sampling. Subjects were divided by randomized double blind technique into the treatment group (n=17) received mangosteen pericarp extract 2x1100mg/day and control group (n = 17) received placebo. Clinical improvements were measured in CAT score and length of stay. CAT score, plasma level of IL-6 and MDA were measured on admission and at discharge. Length of stay based on the number of days of care in hospitals. Results: There was significant difference (p=0,011) towards decreased of IL-6 plasma level between treatment group (-2,17 ± 3,46 pg/ mL) and control group (+1,67 ± 6,81 pg/mL). There were no significant difference towards decreased of length of stay (p=0,34) between treatment group (4,12 ± 1,54 days) and control group (5,24 ± 2,49 days), towards decreased of CAT score (p=0,252) between treatment group (-19,18 ± 3,96) and control group (-18,24 ± 2,75), and towards decreased of MDA plasma level (p=0,986) between treatment group (+0,03 ± 0,36μmol/L) and control group (+0,35 ± 1,58). Conclusions: The addition of mangosteen pericarp extract 2x1100mg/day during hospitalization was significantly lowered plasma levels of IL-6, but were not significant in lowering the CAT score, shortening the length of stay, and reducing the increase in plasma level of MDA.


The utilization of teaching aids is crucial in enhancing students’ mathematical process skills. However, teachers give less accentuation on this aspect of usage which leads to students’ low competence in mathematical process skills. The purpose of this study was to determine the effectiveness of a developed teaching aids, in particular, a Smart Kit in enhancing mathematical process skills and achievement among selected primary school students in Hulu Kinta, Perak. The experimental method was used in this study. Cluster sampling was used to select the samples. The samples were divided into two groups, the control and treatment groups which each consisted of 36 respondents. The treatment group was engaged with the developed Smart Kit while the students in the control group followed the conventional method of teaching and learning. Measurement and Geometry topics at primary school level were selected and students’ mathematical process skills were assessed based on Malaysia Assessment and Curriculum Standard Documents. The findings revealed that there was a significant difference in problem solving, reasoning and connecting skills between the control group and the treatment group. Furthermore, the mathematical achievement of the treatment group was higher than the control group. In conclusion, the utilization of the developed Smart Kit enhanced students’ problem solving, reasoning and connecting skills, and improved mathematical achievement. In implicative insinuation, the use of the developed Smart Kit can help teachers and students in teaching and learning processes specifically on the topics of Measurement and Geometry.


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