术前TAGM联合弹簧圈门静脉栓塞根治肝门胆管癌1例报告

正右侧侵犯为主的肝门胆管癌根治术多需要联合右半肝切除,可能会导致术后肝衰竭。近年来,计划性肝切除的策略备受关注,采用门静脉栓塞(portal vein embolization,PVE)的介入技术能诱导未来残余肝(future liver remnant,FLR)术前增生、降低肝衰风险~([1-3])。使用三丙烯酸酯明胶微球(tris-acryl gelatin microspheres,TAGM)作为末梢栓塞剂,联合近侧弹簧圈的PVE在国内鲜有报道。笔者单位1例尝试采用此技术治疗1例。报告如下。     

罹患重度牙周病变磨牙采取微创拔牙和微翻瓣位点保存术后种植修复效果观察（附1例3年随访报告）

种植治疗因其临床长期效果稳定,逐渐成为牙列缺损或缺失后的常规修复方法,而充足的骨量和良好的软组织条件对种植治疗方案的实施至关重要。罹患重度牙周病变的磨牙不但在拔牙之前已经存在牙槽骨吸收,而且在拔牙窝愈合过程中所发生的不同程度牙槽骨吸收均会增加种植治疗的难度。文章完整展示了1例磨牙牙周-牙髓联合病变病例从病情分析、采取微创拔牙和微翻瓣技术在拔牙窝实施位点保存创造良好硬组织条件、按照标准化流程完成种植修复到追踪观察3年的具体实施过程,为评价此类病例微创拔牙和微翻瓣位点保存术后种植修复的长期效果提供了依据。     

严重联合免疫缺陷高危儿羊膜腔穿刺产前诊断7例临床分析

探讨羊膜腔穿刺结合基因序列和染色体核型分析在严重联合免疫缺陷（SCID）高危儿产前诊断中的意义。方法　2008—2010年重庆医科大学附属儿童医院基因诊断明确的7例SCID患儿,其中6例X连锁SCID、1例Omenn综合征。追问病史,建立7个SCID家系图谱,确诊20个异常基因携带者。对其中7个携带异常基因的高危孕妇于孕18～20周经羊膜腔穿刺抽取羊水,部分羊水经离心后,提取羊水细胞DNA,经PCR扩增IL-2RG或RAG1基因,扩增PCR产物进行双向序列重复测定。此外对羊水中胎儿脱落细胞进行培养,采用原位制片、G带染色技术进行染色体核型分析。产后采集高危儿外周血重新进行基因分析,并进行免疫功能评估。结果　全部病例穿刺均成功,羊水细胞培养成功率100%。基因和染色体核型分析结果显示,3例为正常男性胎儿,2例为正常女性胎儿,2例为男性缺陷胎儿。2例男性缺陷胎儿均为IL-2RG基因突变。除2例缺陷胎儿行人工流产术外,5例SCID高危儿均顺利出生,产后基因分析结果均正常,与产前结果相同。随访免疫功能均正常。结论　羊膜腔穿刺结合基因和染色体核型分析在SCID的产前诊断中是一项成熟有效的操作技术。     

RNA versus DNA (NucliSENS EasyQ HIV-1 v1.2 versus Amplicor HIV-1 DNA test v1.5) for early diagnosis of HIV-1 infection in infants in Senegal

The objective of this study was to compare the performance of the NucliSENS EasyQ HIV-1 v1.2 platform (bioMérieux, France) to the Amplicor HIV-1 DNA test v1.5 (Roche Molecular Systems, Switzerland) in detecting HIV-1 infection in infants using venipuncture-derived whole blood in tubes and dried blood spots. A total of 149 dried blood spots and 43 EDTA-anticoagulated peripheral blood samples were collected throughout Dakar and other areas in Senegal from infants and children aged 3 weeks to 24 months who were born to HIV-1-infected mothers. Samples were tested using the NucliSENS and Amplicor technologies. The NucliSENS and Amplicor results were 100% concordant using either EDTA-anticoagulated peripheral blood or dried blood spots. Compared to Amplicor, the sensitivity and specificity of the NucliSENS test were 100%. The NucliSENS EasyQ HIV-1 RNA assay performed as well as the Amplicor HIV-1 DNA test in detecting HIV-1 infection in infants. In addition, this platform can give an indication of the viral load baseline. The NucliSENS EasyQ platform is a good alternative for early infant diagnosis of HIV-1 infection.     

Age-related progression of tau pathology in brains of baboons

Recently, cytoskeletal changes associated with abnormally phosphorylated tau protein were demonstrated in neurons and glial cells of two aged baboons (Papio). The present study examines the effects of age on the development of tau pathology in baboons. Brains of 50 baboons ranging in age from 1 to 30 years were categorized into four age groups: Group I: 1–10 years [n = 9], group II: 11–20 years [n = 13], group III: 21–25 years [n = 17], group IV: 26–30 years [n = 11]). Whole hemisphere sections (100 μm) were examined using phosphorylation-dependent anti-tau antibodies. Cytoskeletal changes were completely absent in animals of group I. In group II four animals (31%) exhibited cytoskeletal changes which were rated as mild or moderate. In group III abnormal tau was found in 12 brains (71%) ranging in severity from mild to severe. Finally, in group IV 10 out of 11 animals (91%) exhibited some degree of tau pathology which was rated as severe in 4 animals (36%). A statistically significant relationship was found between advancing age and progression of tau pathology in baboons. In conclusion, the present findings underline the value of the baboon as a potential nonhuman primate model for age-related tau pathology afflicting the human brain.     

大鼠股骨缺损模型中BBP增强BMP-2的骨诱导作用*

目的验证在大鼠节段性骨缺损模型中骨形态发生蛋白结合肽（BMP Binding Peptide,BBP）对于重组人骨形态发生蛋白-2（recombinent human bone morphogenetic protein-2,rhBMP-2）骨诱导作用的影响。方法 70只缺损大鼠分别分成7组,每组不同剂量的rhBMP-2＋/-1000 gBBP,4w和8w后分别摄片,动物8w后处死,股骨样本分别手工评估,采用uCT测量骨容积,随后分别采用组织学和生物力学分析。结果高剂量（10 g）rhBMP-2组术后8w可见骨愈合,骨缺损处骨完全覆盖和桥接,但低剂量（5 g和2 g）rhBMP-2组术后8w骨愈合欠佳。与单独应用rhBMP-2相比,使用低剂量的rhBMP-2复合一定量的BBP可以取得更满意的骨形成量。BBP增强rhBMP-2的骨形成活性发生于4~8w时,而在术后早期并无明显作用。单纯应用BBP仅可见骨缺损处局部的钙化,未见骨愈合。结论 BBP能显著增强rhBMP-2的骨形成活性,这种增强作用需要一定时间来产生效果;其活性发生于术后4~8w时,在术后早期并无明显作用。而且BBP本身并没有骨诱导潜力,仅仅能增强rhBMP-2的骨形成活性。BBP起到缓释作用,与rhBMP-2紧密结合后,让rhBMP-2缓慢而持久的释放。