Risk Factors of Complications after CT-guided Percutaneous Needle Biopsy of Lumps Near Pulmonary Hilum

The factors influencing the incidence of common complications(pneumothorax and pulmonary hemorrhage) of CT-guided percutaneous needle biopsy of lumps near pulmonary hilum were investigated. CT-guided percutaneous needle biopsy of lumps near pulmonary hilum was performed on 48 patients. The complications of pneumothorax and pneumorrhagia as well as the contributing factors were analyzed statistically. The major complications associated with CT-guided needle biopsy included pneumothorax(13 cases, 27.1%) and pulmonary hemorrhage(14 cases, 20.24%). ?2 test revealed that pneumothorax was associated with the lesion size and depth of needle penetration, and pulmonary hemorrhage with the depth of needle penetration and needle retention time with a significant P value. Pneumothorax was observed in 7 cases(17.5%) out of 40 cases with diameter of mass greater than 3 cm, and in 6 cases(60%) out of 10 cases with depth of needle penetration greater than 4 cm. Additionally, pulmonary hemorrhage was identified in 12 cases(41.4%) out of 29 cases with needle retention time longer than 15 min, and pulmonary hemorrhage in 7 cases(70%) out of 10 cases with depth of needle penetration greater than 4 cm. CT-guided percutaneous needle biopsy of lumps near pulmonary hilum is safe and effective. The key factors to prevent the complications include correct evaluation of lesion size, depth of needle penetration and the needle retention time before the operation. Key words: biopsy, CT-guided; hilum; pneumothorax; pulmonary hemorrhage     

腰椎间盘退变性疾病的研究进展及展望

腰椎间盘退变性疾病(lumbar disc degenerative disease,LDDD)是最常见的脊柱疾病之一,易造成腰椎间盘突出、腰椎滑脱、腰椎管狭窄等继发性病变.LDDD的病因复杂,发病机制及病理变化尚不明确,同时治疗效果并不十分理想.近年来,分子生物学、基因技术、生物力学的快速发展为阐明LDDD的发病机制和病理变化提供了新的方法.同时,各种新型药物和生长因子的研发应用、基因治疗、人工椎间盘置换以及组织工程技术为治疗LDDD提供了新的手段.目前,对LDDD的研究受到广泛关注.现就LDDD的研究进展及展望作一述评.     

脊髓组织工程中仿生支架材料的研究进展

由脊髓损伤(spinal cord injury,SCI)所致的截瘫是一种严重的伤残,会导致身体多个系统的功能障碍,更严重的可致命,因此脊髓损伤成为人类急需解决的医学难题之一.目前治疗SCI的主要策略有:挽救受损的神经元,减少其发生迟发性损伤和凋亡;应用神经营养因子和/或抗神经抑制因子促进受损轴突的再生;组织和细胞移植诱导轴突再生.……     

含FGL活性片段的自组装多肽支架材料修复大鼠脊髓损伤的研究

目的 建立大鼠脊髓损伤模型,将含FGL功能化多肽自组装神经支架材料(FGL-NS)植入到脊髓损伤局部,探讨FGL-NS神经支架材料修复脊髓损伤的效果和机制.方法 麻醉大鼠后,暴露胸10水平脊髓,用特制血管夹(夹力24g)钳夹1 min,建立大鼠胸髓钳夹损伤模型.设立空白组、对照组和实验组,分别于损伤后24h,暴露脊髓损伤局部,将2.5μl等渗葡萄糖溶液、1％ RADA-16和1％ FGL-NS多肽溶液注射入损伤局部.术后3d、1、3、5、7和9周分别采用Basso-Beattie-Bresnahan(BBB)评分评估大鼠脊髓损伤经治疗后运动功能恢复情况,术后9周取脊髓损伤部位组织,行半胱氨酰天冬氨酸特异性蛋白酶(Caspase)-3、神经丝蛋白-200 (NF-200)和胶质纤维酸性蛋白(GFAP)免疫组织化学染色评估损伤部位细胞凋亡、轴突再生和瘢痕形成情况.结果 成功建立大鼠胸髓钳夹损伤模型.BBB运动学评分大鼠脊髓损伤后经FGL-NS材料治疗后,BBB评分随时间逐渐升高,自伤后第5周起,显著高于RADA-16治疗组和空白组,大鼠运动功能显著改善.免疫组织化学染色结果显示,损伤后第9周,FGL-NS治疗组脊髓损伤局部可见大量NF-200阳性的神经元细胞[(35.32±3.12)个/视野],显著高于RADA-16组[(18.56±2.64)个/视野]和空白组[(14.83±1.43)个/视野],Caspase-3阳性的凋亡细胞[(22.45 ±2.74)个/视野]显著少于RADA-16组[(30.86 ±3.75)个/视野],而且损伤区GFAP染色的积分吸光度(IA)值为0.50±0.02,明显小于对照组(1.30 ±0.09)和空白组(1.60±0.11).结论 功能化多肽自组装神经支架材料FGL-NS能促进脊髓损伤大鼠的运动功能恢复,能减少脊髓损伤部位细胞凋亡,促进神经元再生,并减少胶质瘢痕形成.     

人工股骨柄真空等离子喷涂Ti基层的HA-Ti阶梯式涂层的力学性能

我们基于真空下在犬工股骨柄上等离子喷涂纯钛(Ti)后再复合羟基磷灰石(HA) -Ti阶梯式涂层,探讨该复合阶梯式涂层的力学性能和固定关节假体的可行性.     

Effect of IKVAV peptide nanofiber on proliferation,adhesion and differentiation into neurocytes of bone marrow stromal cells

This study examined the effect of IKVAV peptide nanofiber on proliferation, adhesion and differentiation into neurocytes of bone marrow stromal cells （BMSCs）. IKVAV Peptide-amphiphile was synthesized and purified. Then, hydrogen chloride was added to the diluted aqueous solutions of PA to induce spontaneous formation of nanofiber in vitro. The resultant samples was observed tmder transmission electron microscope. BMSCs were cultured with IKVAV peptide nanofiber. The effect of IKVAV nanofiber on the proliferation, adhesion and induction differentiation of BMSCs was observed by inverted microscopy, calcein-AM/PI staining, cell counting and immunofluorescence staining. The results demonstrated that IKVAV peptide-amphiphile could self-assemble to form nanofiber gel. BMSCs cultured in combination with IKVAV peptide nanofiber gel grew well and the percentage of live cells was over 90%. IKVAV peptide nanofiber gel exerted no influence on the proliferation of BMSCs and could promote the adhesion of BMSCs and raise the ra- tio of neurons when BMSCs were induced to differentiate into neurocytes. It is concluded that BMSCs could proliferate and adhere well and yield more neurons during when induced to differente into neurocytes on IKVAV peptide nanofiber gel.     

自组装IKVAV多肽纳米支架及其对背根神经节神经元细胞的作用

目的:应用自组装IKVAV多肽纳米支架与鼠背根神经节神经元细胞(DRGc)联合培养,观察其对DRGc的作用。方法:将多肽溶于0.1MNaOH溶液中,调整pH值为8.5,多肽浓度为0.01mg/μl,与等体积DMEM/F12混合触发多肽自组装为凝胶支架,透射电镜检测。采用原代分离培养方法获得DRGc单细胞悬液后分为实验组与对照组,实验组中DRGc接种于凝胶支架表面,对照组接种于多聚赖氨酸表面,倒置相差显微镜观察神经元生长情况,采用细胞计数结合免疫细胞化学染色方法,观察DRGc的存活和轴突生长情况,并行统计学分析。结果:透射电镜下显示自组装凝胶支架为编织状纳米纤维。实验组和对照组中DRGc培养1d时平均轴突长度分别为43.8±10.4μm、33.4±5.75μm;培养14d时实验组和对照组中神经元数目分别为36.50±1.78个/视野、19.70±3.71个/视野,神经元所占比例分别为(43.60±4.83)%、(26.97±4.90)%,两组间比较有显著性差异(P<0.05)。结论:自组装IKVAV多肽纳米支架能降低神经元的死亡率,并诱导轴突的发生和生长,具有支架及生物活性双重作用,可作为神经组织工程支架材料。     

SHP-1/p21/CDK6/Cyclin D1在不同放射敏感度鼻咽癌细胞中的表达

目的 建立鼻咽癌放射抗拒亚系CNE-2S,研究SHP-1/p21/CDK6/Cyclin D1通路在鼻咽癌细胞系CNE-2和CNE-2S中表达的差异,探讨鼻咽癌放射敏感度变化的分子机制.方法 通过X线大剂量低分割照射技术建立鼻咽癌放射抗拒亚系(子代,CNE-2S1),观察亲代(CNE-2)和子代细胞的形态学和生长动力学差异,检测亲代及子代细胞系放射敏感度相关参数,分析亲代及子代细胞系各自细胞周期分布,同时检测亲代与子代细胞系SHP-1/p21/CDK6/Cyclin D1通路中各因子的蛋白质表达水平.结果 通过X线大剂量低分割照射技术成功建立鼻咽癌放射抗拒亚系CNE-2S1,且CNE 2及CNE-2S1放射敏感度相关参数具有延续性.同时CNE-2S1细胞S期比例较CNE-2细胞明显增高,G1期细胞明显减少,G2-M期细胞比例变化不明显.此外SHP-1、CDK6以及CylinD1在CNE-2S1细胞中的蛋白表达水平明显上调,p21表达水平则明显下调,其与CNE-2细胞之间的差异具有统计学意义.结论 SHP-1/p21/CDK6/Cyclin D1通路可能在调控鼻咽癌放射敏感度和细胞周期分布方面发挥一定作用.     

In vivo testing of canine prosthetic femoral components with HA-Ti ladder-type coating on vacuum plasma-sprayed Ti substrate

The purpose of the present study was to observe the structure and functional change of the bone-coating-prosthesis interface in vivo and to evaluate the histocompatibility of self-made prosthetic femoral components in the body and the degree of their bonding with the surrounding bone tissues as well as their stability.Six mature beagle dogs underwent bilateral hip replacement with prosthetic femur components.Three groups were established in terms of different coating of prothesis (four joints in each group):atmosphere (A) plasma-sprayed pure titanium (Ti) prosthetic joint with hydroxyapatite (HA) coating (HA+Ti+A group);vacuum (V) plasma-sprayed pure Ti prosthetic joint with HA coating (HA+Ti+V group);vacuum plasma-sprayed pure Ti prosthetic joint with Ti-HA stepped coating (Ti+HAG+Ti+V group).The hip joints were functionally evaluated,and subjected to X-ray examination,biomechanics inspection,and histological examination.As a result,X-ray imaging revealed all prosthetic joints were in a good location and no dislocation of joint was found.Shear strength of interface was significantly higher in Ti+HAG+Ti+V group than in HA+Ti+V group (P<0.05) and HA+Ti+A group (P<0.05) at 28th week.Histological examination showed the amount of newborn bone in Ti+HAG+Ti+V group was more than in HA+Ti+V group and HA+Ti+A group after 28 weeks.It was suggested that vacuum plasma-sprayed pure Ti prosthetic joint with TI-HA stepped coating could improve the bonding capacity of bone-prosthesis,enhance the stability of prosthesis,and increase the fixion of prosthetic femoral components because of better bone growth.This new type of biological material in prosthetic femoral components holds promises for application in clinical practice.     

CT引导下经肺外通路纵隔结节/肿块粗针穿刺活检术的临床应用

目的:探讨CT引导下经肺外通路纵隔结节/肿块粗针穿刺切割式活检术的临术应用价值.方法:使用同轴定位系统及18G切割式活检装置,共计80例患者完成CT引导下经肺外通路纵隔结节/肿块穿刺活检术.分析使用该方法完成穿刺活检的纵隔结节/肿块的分布特点、病理诊断以及进针通路选择.结果:80例均穿刺成功,共检出恶性肿瘤72例、胸腺瘤5例、结核1例、慢性炎性病变2例.该方法诊断敏感度为98.6％,特异度为100％,阳性预测值为100％,阴性预测值为87.5％,假阴性率为12.5％.出现少量纵隔内积气1例(1.25％),少量纵隔内出血1例(1.25％),未见气胸及明显纵隔内出血,无致死性并发症出现.结论:CT引导下经肺外通路纵隔结节/肿块粗针穿刺切割式活检术是一项安全、高效的诊断技术.