杜仲醇提取物可促进根尖周炎模型大鼠骨组织的愈合

文题释义：杜仲：杜仲是中国传统的中药药材，其具有增加机体免疫性、强身健骨的疗效，研究表明杜仲可以促进成骨细胞的增殖并且可以促进骨组织的愈合。近年来对于杜仲的研究主要集中于其有效成分的提取及分析。 杜仲醇：是杜仲的主要有效成分之一，可以增强关节炎大鼠骨组织的强度，并且具有降血压以及促进伤口愈合的能力。 背景：目前关于杜仲的研究主要集中于其治疗骨关节炎能增强骨组织的愈合能力，但是关于杜仲对根尖周炎骨破坏的修复作用尚未见报道。 目的：探讨杜仲醇提取物对根尖周炎大鼠组织蛋白酶K的影响。 方法：选取24只SD大鼠随机分为根尖周炎组20只及对照组4只，根尖周炎组于右侧下颌第一磨牙开髓后建立根尖周炎模型，对照组不做任何处理。饲养4周后，取根尖周炎组及对照组各4只拍摄MICRO-CT，计算根尖周炎骨破坏量，确认大鼠根尖周炎动物模型构建成功。饲养第5周，将剩余16只根尖周炎大鼠随机分为杜仲醇提取物组及生理盐水组，每组8只，每天灌胃杜仲醇提取物5 mL/kg或等量生理盐水。灌胃4周后，每组取4只大鼠拍摄MICRO-CT，分析杜仲醇提取物对根尖周骨组织的修复能力，另外取4只大鼠采用免疫组化染色观察右下颌第一磨牙牙槽骨组织蛋白酶K的表达。 结果与结论：①MICRO-CT结果显示，对照组骨吸收体积为(0.223±0.009) mm³，根尖周炎组骨吸收体积为(0.945±0.037) mm³，两组骨吸收量比较差异有显著性意义(P=0.00)，说明大鼠根尖周炎模型构建成功；②灌胃4周后，MICRO-CT结果显示杜仲醇提取物组骨吸收体积较灌胃前减小，差异有显著性意义(P < 0.05)；③灌胃4周后，免疫组化结果显示杜仲醇提取物根尖周炎骨破坏标志因子组织蛋白酶K的表达较灌胃前降低，差异有显著性意义(P < 0.05)；④结果表明，杜仲醇提取物可以抑制骨破坏标志因子组织蛋白酶K的表达，并且可以促进大鼠根尖周炎骨组织的愈合。 ORCID: 0000-0001-5450-7016(吴大雷) 中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程     

中晚期儿童肾透明细胞肉瘤10例的诊治及预后分析

目的探讨中晚期儿童肾透明细胞肉瘤(CCSK)的临床特点、诊治经过及预后特点。方法收集2014年1月至2017年12月在首都医科大学附属北京同仁医院儿科住院治疗的10例中晚期CCSK患儿的临床资料,对其临床特征、诊疗经过及预后情况等进行回顾性分析。结果1.临床特点:10例CCSK病例中男6例,女4例;中位发病年龄为32个月;7例为左侧CCSK,3例为右侧CCSK。初次诊断时Ⅲ期9例,Ⅳ期1例;其中4例初次诊断时误诊为肾脏其他肿瘤(40%,4/10例)。5例Ⅲ期病例治疗及随访过程中出现肿瘤复发及转移,主要远处转移部位为肺、骨、肝脏及脑。2.治疗及预后:10例中给予手术联合放疗及化疗者7例,未规范化治疗放弃者3例。中位随访时间33.5个月,7例存活,3例死亡,3年总生存率为65.6%。Ⅲ期患儿3年总生存率为74.1%,Ⅳ期患儿3年总生存率为0,Ⅲ期与Ⅳ期预后比较差异有统计学意义(χ^2=9,P=0.003)。5例复发病例中仅1例完全缓解,2例部分缓解,1例进展,1例死亡;3例无复发病例均完全缓解,且均为给予手术、化疗及放疗规范化治疗者。结论儿童CCSK初诊误诊率高,Ⅲ期病例治疗及随访过程中复发及远处转移风险高;Ⅲ期病例积极给予手术、化疗及放疗的规范化治疗,预后良好,而发生复发及远处转移者死亡率高。     

A Stable Q Compensated Reverse Time Migration Method Based on Excitation Amplitude Imaging Condition

The stability and efficiency, especially the stability, are generally concerned issues in Q compensated reverse time migration (Q-RTM). The instability occurs because of the exponentially boosted high frequency ambient noise during the forward or backward seismic wavefield propagation. The regularization and low-pass filtering methods are two effective strategies to control the instability of the wave propagation in Q-RTM. However, the regularization parameters are determined experimentally, and the wavefield cannot be recovered accurately. The low-pass filtering method cannot balance the selection of cutoff frequency for varying Q values, and may damage the effective signals, especially when the signal-to-noise ratio (SNR) of the seismic data is low, the Q-RTM will be a highly unstable process. In order to achieve the purpose of stability, the selection of cutoff frequency will be small enough, which can cause great damage to the effective high frequency signals. In this paper, we present a stable Q-RTM algorithm based on the excitation amplitude imaging condition, which can compensate both the amplitude attenuation and phase dispersion. Unlike the existing Q-RTM algorithms enlarging the amplitude, the exponentially attenuated seismic wavefield will be used during both the forward and backward wavefield propagation of Q-RTM. Therefore, the new Q-RTM algorithm is relative stable, even for the low SNR seismic data. In order to show the accuracy and stability of our stable Q-RTM algorithm clearly, an example based on Graben model will be illustrated. Then, a realistic BP gas chimney model further demonstrates that the proposed method enjoys good stability and anti-noise performance compared with the traditional Q-RTM with amplitude amplification. Compare the Q-RTM images of these two models to the reference images obtained by the acoustic RTM with acoustic seismic data, the new Q-RTM results match the reference images quite well. The proposed method is also tested using a field seismic data, the result shows the effectiveness of our proposed method.     

胃-食管预制机器人胸内手工分层吻合——一种胃-食管胸内吻合的新策略

目的报告胃-食管预制机器人胸内手工分层吻合（PRILA）的技术特点。 方法术前活检确诊为食管癌并愿意接受机器人辅助微创食管切除术（RAMIE）的患者为本研究纳入对象。胃食管吻合前预处理措施主要包括以下四方面：以胸骨角为标志在体外完成管状胃的预制；吻合前采用冷造口的方法在胃前壁造口；采取保护性胃包裹及传动法拖曳管状胃进入胸腔的方式；采用腔内阻断的方法夹闭食管近端，以减少吻合时食管端出血。术后每半年随访一次以追踪患者转归。 结果2018年9月至2019年7月，12名食管癌患者采用PRILA术式顺利完成了肿瘤切除及消化道重建，均未发生中转开胸。所有患者取得R0切除，术后均未发生吻合口瘘。术后住院时间平均9.9天，出院时所有患者可耐受半流质饮食，术后随访1年均未发生肿瘤复发或转移。 结论胃-食管PRILA在食管癌的外科治疗中安全可行。该术式通过对食管及管状胃的预处理，为术者提供了一个清晰的术野，保证了手术的流畅性和分层吻合的精确性。该方法为胸外科医师应对胃-食管胸内吻合的挑战提供了一条新策略。     

医疗器械口咽通气道产品注册的常见问题及改进建议

近年来,医疗器械口咽通气道产品的注册数量日益增加,针对该产品的相关咨询也逐渐增多。但该产品暂无相关的注册技术审查指导原则,以致该产品的注册申报资料经常出现一些共性问题。现根据医疗器械口咽通气道产品相关法规和标准,对日常工作中遇到的常见问题进行归纳,分析该产品注册申报中的技术审评要求及共性问题,并给出对策或建议。     

Mesenchymal stem cell therapy alleviates the neuroinflammation associated with acquired brain injury

Ischemic stroke and traumatic brain injury (TBI) comprise two particularly prevalent and costly examples of acquired brain injury (ABI). Following stroke or TBI, primary cell death and secondary cell death closely model disease progression and worsen outcomes. Mounting evidence indicates that long‐term neuroinflammation extensively exacerbates the secondary deterioration of brain structure and function. Due to their immunomodulatory and regenerative properties, mesenchymal stem cell transplants have emerged as a promising approach to treating this facet of stroke and TBI pathology. In this review, we summarize the classification of cell death in ABI and discuss the prominent role of inflammation. We then consider the efficacy of bone marrow–derived mesenchymal stem/stromal cell (BM‐MSC) transplantation as a therapy for these injuries. Finally, we examine recent laboratory and clinical studies utilizing transplanted BM‐MSCs as antiinflammatory and neurorestorative treatments for stroke and TBI. Clinical trials of BM‐MSC transplants for stroke and TBI support their promising protective and regenerative properties. Future research is needed to allow for better comparison among trials and to elaborate on the emerging area of cell‐based combination treatments.