经皮微通道显微手术切除腰椎椎管内肿瘤的疗效

目的探讨经皮微通道显微镜下手术切除腰椎椎管内肿瘤的效果。方法回顾性分析2017年1月至2020年2月经皮微通道显微镜下手术治疗的37例腰椎椎管内肿瘤的临床资料。结果术后病理检查显示,神经鞘瘤20例,脊膜瘤4例,先天性囊肿6例,神经根囊肿5例,肠源性囊肿2例。术后症状均明显改善,未出现切口感染、神经根损伤、硬脊膜损伤、脑脊液漏、脊柱稳定性下降等并发症。术后1周复查腰椎MRI示椎管内肿瘤完全切除;术后6个月,复查MRI未见肿瘤复发。术后1周、3个月及6个月,疼痛视觉模拟量表评分、日本骨科协会评分、Oswestry功能障碍指数均明显改善（P<0.05）。结论经皮微通道显微镜下手术切除腰椎椎管内肿瘤,手术创伤小,具有良好的临床疗效。     

Effect of substrate thermal resistance on space-domain microchannel fluorescent melting curve analysis

In recent years, Fluorescent Melting Curve Analysis (FMCA) has become an almost ubiquitous feature of commercial quantitative PCR (qPCR) thermal cyclers. Here a micro-fluidic device is presented capable of performing FMCA within a microchannel. The device consists of modular thermally conductive blocks which can sandwich a microfluidic substrate. Opposing ends of the blocks are held at differing temperatures and a linear thermal gradient is generated along the microfluidic channel. Fluorescent measurements taken from a sample as it passes along the micro-fluidic channel permits fluorescent melting curves to be generated. In this study we measure DNA melting temperature from two plasmid fragments. The effects of flow velocity and ramp-rate are investigated, and measured melting curves are compared to those acquired from a commercially available PCR thermocycler.     

微通道和标准通道在经皮肾取石术中的应用效果观察

目的比较微通道和标准通道在经皮肾取石术中的应用效果。方法选择衡水市第四人民医院于2011年11月至2012年10月收治的85例肾结石患者作为研究对象,按照不同手术方案分为两组:采用微通道经皮肾取石术治疗的40例为对照组,采用标准通道经皮肾取石术治疗的45例为观察组,比较两种手术方案的临床应用效果。结果观察组一期清除率显著高于对照组(93.3%vs 77.5%),观察组的手术时间显著少于对照组,组间比较差异均有统计学意义(P<0.05),但两组的术中出血量、住院时间比较,差异无统计学意义(P>0.05);观察组术后发热的发生率显著低于对照组(2.2%vs 20.0%),组间比较差异有统计学意义(P<0.05)。结论标准通道在经皮肾取石术中的应用效果更佳,具有更高的结石清除率,手术时间更短,安全性好,应作为首选的手术方案。     

A cell culturing system that integrates the cell loading function on a single platform and evaluation of the pulsatile pumping effect on cells

In this paper, we present a novel microfluidic system with pulsatile cell storing, cell-delivering and cell culturing functions on a single PDMS platform. For this purpose, we have integrated two reservoirs, a pulsatile pumping system containing two soft check valves, which were fabricated by in situ photopolymerization, six switch valves, and three cell culture chambers all developed through a simple and rapid fabrication process. The sample volume delivered per stroke was 120 nl and the transported volume was linearly related to the pumping frequency. We have investigated the effect of the pulsatile pneumatic micropumping on the cells during transport. For this purpose, we pumped two types of cell suspensions, one containing human breast adenocarcinoma cells (MCF-7) and the other mesenchymal stem cells (hMSCs) derived from bone marrow. The effect of pulsatile pumping on both cell types was examined by short and long-term culture experiments. Our results showed that the characteristics of both cells were maintained; they were not damaged by the pumping system. Evaluations were carried out by morphological inspection, viability assay and immunophenotyping analysis. The delivered MCF-7 cells and hMSCs spread and proliferated onto the gelatin coated cell culture chamber. This total micro cell culture system can be applied to cell-based high throughput screening and for co-culture of different cells with different volume.     

微通道经皮肾镜治疗输尿管上段结石与输尿管硬镜碎石效果比较

目的 比较微通道经皮肾镜取石术(MPCNL)与经尿道输尿管镜碎石取石术(URL)治疗输尿管上段结石的临床效果及安全性.方法 选取汉中市中心医院2014年5月-2016年1月收治的178例输尿管上段结石作为研究对象,其中行MPCNL治疗96例,行URL治疗82例,比较两组手术时间、术中出血量、住院时间、住院费用、中转开放手术、结石清除率以及并发症发生率.结果 MPCNL组手术时间、术中出血量、住院时间、住院费用均显著高于URL组(P＜0.01);MPCNL组术后3d、术后1个月的结石清除率均显著高于同期URL组(P＜0.01);MPCNL组并发症发生率显著高于URL组(P＜0.05);两组中转开放手术发生率比较差异无统计学意义(P＞0.05).结论 MPCNL与URL均是输尿管上段结石有效的微创治疗手段,对结石位置偏低、直径偏小的患者可考虑首选URL;对于嵌顿性输尿管上段结石以及结石位置较高的患者,MPCNL更为适用.     

标准通道与微通道经皮肾镜取石术治疗肾结石的疗效对比

目的：探讨经皮肾镜取石术治疗肾结石的标准通道和微通道治疗的临床效果和不同点。方法：选取2008年11月-2011年7月本院科室收治的肾结石患者100例,随机分为普通组和对比组,各50例,普通组实施标准通道经皮肾镜取石（SPCNL）,对比组实施微通道经皮肾镜取石（MPCNL）;对比两组的手术时间、术中出血量、结石清除率以及手术并发症。结果：SPCNL相比MPCNL的手术时间更短、术中出血量更少,差异有统计学意义（P<0.05）;普通组和对比组在一次结石和单发结石上的清除率两者相近,比较差异无统计学意义（P>0.05）;在鹿角结石和多发结石中,对比组的结石清除率明显低于普通组,比较差异有统计学意义（P<0.05）;普通组和对比组分别出现了术后出血等不良并发症,但是两组发生率对比差异无统计学意义（P>0.05）。结论：SPCNL和MPCNL治疗肾结石效果较好,但两者各有优劣,应依据实际情况选择合适方式。     

Microfluidic fatty acid rearrangement in silkworm pupae oil with magnetically responsive lipase under continuous-flow condition

Silkworm pupae-derived structured lipids are expected to promote the absorption of unsaturated fatty acids, however, low efficiency of bioprocess and low reusability of biocatalyst limit the corresponding biocatalysis technology. Thus, a novel strategy combining magnetic response immobilized lipase and continuous-flow microchannel reactor was proposed to modify silkworm pupae oil. The lipase from Aspergillus niger was immobilized on the surface of chitosan cross-linked magnetic nanoparticles, with increased esterification activity from 151.51 to 418.10 U/g due to the hydrophobic microenvironment. In the microchannel, the enzyme activity could be increased to 2371.3 U/g because of the strengthening effect of the microfluidic field. Furthermore, the employment of chitosan cross-linked magnetic nanoparticles leads to good reusability, and the remaining activity could stay above 90% after 13 cycles. Moreover, the immobilized lipase could be removed and loaded easily due to the employment of magnetically responsive nanoparticles. In addition, 2 min was required to rearrange the unsaturated fatty acids, increasing the relative content of sn-1.3 unsaturated fatty acids from 59.91% to 74.8% and sn-2 palmitic acid from 2.69% to 18.88%, which indicated the improved nutritional value of modified silkworm pupae oil. Therefore, the combination of microfluidic field and hydrophobic microenvironment formed by the chitosan layer on the surface of the nanoparticles effectively strengthens the biocatalysis in a solvent-free system, while the developed strategy provides a convenient biocatalysis strategy for the quality improvement of edible insect oil.     

微通道经皮肾镜联合输尿管软镜与输尿管软镜钬激光碎石术治疗复杂肾结石疗效及对肾功能的影响

目的比较微通道经皮肾镜取石术(mPCNL)联合输尿管软镜钬激光碎石术(FURL)与单纯FURL治疗复杂肾结石(CRC)的疗效及对肾功能的影响。方法采用回顾性研究方法,将2019年1月至2021年5月苏州大学附属第一医院收治的96例CRC患者纳入本次研究,根据治疗方式不同将其分为A组(n=48)和B组(n=48)。A组选择FURL治疗,B组选择mPCNL联合FURL治疗。比较两组患者围手术期相关指标、碎石成功率、手术前后肾功能及血清白细胞介素-6(IL-6)、C反应蛋白(CRP)水平以及并发症发生情况。结果B组手术时间、术后住院时间为(136.2±12.8)min、(8.6±1.9)d,明显长于A组[(113.8±11.6)min、(5.8±1.5)d],术中出血量为(67.7±10.8)mL,多于A组[(26.9±9.5)mL],差异均有统计学意义(P<0.05)。B组一次碎石成功率为100.0%,显著高于A组的83.3%,差异有统计学意义(P<0.05)。B组术后的肌酐和尿素氮分别(78.95±9.12)μmol/L、(7.01±1.13)mmol/L,A组分别为(77.34±8.91)μmol/L、(6.69±1.10)mmol/L,两组术后肌酐和尿素氮水平比较,差异均无统计学意义(P>0.05)。B组术后血清IL-6、CRP水平分别为(16.82±1.71)ng/L、(22.72±3.55)mg/L,A组为(17.54±1.44)ng/L、(23.67±4.01)mg/L,两组术后血清IL-6、CRP水平比较,差异均无统计学意义(P>0.05)。B组并发症发生率为6.25%,与A组的10.42%相比,差异无统计学意义(P>0.05)。结论CRC患者选取mPCNL联合FURL治疗效果良好,安全性较高,可提高一次碎石成功率,对肾功能的影响较小。     

硕通镜钬激光碎石术与微通道经皮肾镜碎石术治疗输尿管上段结石(<2cm)疗效及应激反应指标变化的比较

目的比较硕通镜钬激光碎石术与微通道经皮肾镜碎石术(MPCNL)治疗输尿管上段结石(<2cm)的疗效及对应激反应指标的影响。方法选取2019年7月至2021年7月桂林医学院第二附属医院收治的202例输尿管上段结石患者作为研究对象,分为硕通镜组与微通道组,各101例。硕通镜组予以硕通镜钬激光碎石术治疗,微通道组予以MPCNL治疗。比较两组的手术相关指标(手术时间、术中出血量和住院时间)、手术后结石清除率和并发症发生情况,以及手术前后两组的肾功能指标[血尿素氮(BUN)和血肌酐(Cr)]、应激反应指标[去甲肾上腺素(NE)和肾上腺素(E)]。结果与微通道组比较,硕通镜组手术时间和住院时间更短,术中出血量更少,差异具有统计学意义(P<0.05);手术后第1天和第30天,硕通镜组结石清除率均高于微通道组,差异具有统计学意义(P<0.05);手术后,两组BUN水平均低于手术前,Cr水平均高于手术前,且硕通镜组BUN水平低于微通道组,Cr水平高于微通道组,差异具有统计学意义(P<0.05);手术后,两组NE和E水平均低于手术前,且硕通镜组NE和E水平低于微通道组,差异具有统计学意义(P<0.05);手术后,硕通镜组总并发症发生率为2.97%,低于微通道组的14.85%,差异具有统计学意义(P<0.05)。结论相比采用MPCNL治疗输尿管上段结石(<2cm),采用硕通镜钬激光碎石术治疗的手术时间和住院时间更短,术中出血量更少,结石清除率更高,可以更有效地改善患者肾功能,减少应激反应和并发症。     

微通道经皮肾镜取石术大出血原因分析及对策

目的探讨微通道经皮肾镜取石术并发大出血的原因及防治对策.方法对2003年1月至2008年12月昆明医学院第二附属医院泌肾外科收治的7例微通道经皮肾镜取石术后大出血患者的临床资料进行回顾性分析.结果肾血管造影显示患者叶间动脉损伤1例,假性动脉瘤4例,肾动静脉瘘1例,真性动脉瘤1例,均行超选择性肾动脉栓塞成功治疗大出血,无切肾病例.结论充分的术前准备,规范的手术操作,及时有效的治疗是防治微通道经皮肾镜取石术大出血的重要保障.