肝素联合VEGF预处理对人工血管内皮细胞生长及贴附率的影响

目的联合应用肝素及血管内皮细胞生长因子(VEGF)预处理以提高人工血管移植物内皮细胞(EC)生长及贴附率.方法联合应用肝素及血管内皮细胞生长因子预处理人工血管移植物,比较各组EC生长曲线和贴附率.结果肝素在体外与VEGF联合应用,可显著增加EC在人工血管内壁的贴附率,并对EC的增殖有一定的持续影响.结论肝素与VEGF联用,能促进EC在人工血管的增殖和贴附率.     

Treatment of malignant dysphagia with nitinol stents

Self-expanding nitinol stents were used in 22 patients for palliative treatment of malignant esophagogastric strictures. All patients but 5 were men (age range 47–75 years). The strictures were caused by squamous cell carcinoma (n = 12), adenocarcinoma (n = 8), and recurrent anastomotic carcinoma (n = 2). No technical failure or procedural complications occurred. After the procedure, the severity of dysphagia decreased at least one grade in all patients. Tumor ingrowth into the stent was seen in 7 patients of 22 (32%). Four of these patients were treated with additional stents, and in 3 patients, due to refusal, only balloon dilations were performed, which caused temporary relief. Tumor ingrowth into the stent was noted from 10 days to 7 months (mean 3 months). This seems to be a disadvantage of nitinol stents. At the end of the study 10 patients had died dead with a mean survival of 3 months (range 1 week to 6 months) and 12 patients were still alive with a mean follow-up of 4 months (range 1–8 months). It is concluded that nitinol stents provide satisfactory palliation in patients with malignant dysphagia with neglectable procedural morbidity and mortality rates.     

Electrical properties of implant encapsulation tissue

The purpose of this study was to determine the electrical properties of the encapsulation tissue that surrounds electrodes chronically implanted in the body. Two four-electrode arrays, fabricated from either epoxy or silicone rubber, were implanted in each of six adult cats for 82 to 156 days.In vivo measurements of tissue resistivity using the four-electrode technique indicated that formation of the encapsulation tissue resulted in a significant increase in the resistivity of the tissue around the arrays.In vitro measurements of tissue impedance using a four-electrode cell indicated that the resistivity of the encapsulation tissue was a function of the tissue morphology. The tight layers of fibroblasts and collagen that formed around the silicone rubber arrays had a resistivity of 627±108 Ω-cm (mean ± SD; n=6), which was independent of frequency from 10 Hz to 100 kHz, and was significantly larger than the resistivity of the epoxy encapsulation tissue at all frequencies between 20 Hz and 100 kHz. The combination of macrophages, foreign body giant cells, loose collagen, and fibroblasts that formed around the epoxy arrays had a frequency-dependent resistivity that decreased from 454±123 Ω-cm (n=5) to 193±98 Ω-cm between 10 Hz and 1 kHz, and was independent of frequency between 1 kHz and 100 kHz, with a mean value of 195 ±88 Ω-cm. The results indicate that the resistivity of the encapsulation tissue is sufficient to alter the shape and magnitude of the electric field generated by chronically implanted electrodes.     

Charcot-Marie-Tooth disease: molecular characterization of patients from Central and Southern Italy

The syndrome of peroneal muscular atrophy, or Charcot-Marie-Tooth (CMT), disease represents the most common inherited peripheral neuropathy, with a prevalence of about 1 per 2500. The disease is usually transmitted in an autosomal dominant fashion, although it can display all the mendelian patterns of inheritance. The chromosome 17-linked form (CMT1a) appears to be the most common form of the disease in all the ethnic groups studied so far, Italians included, and is due to a tandem duplication in 17p11.2. In order to study the distribution of CMT types and to establish a genotype-phenotype correlation in patients from Central and Southern Italy, we collected 19 CMT pedigrees diagnosed in the years 1992–1993. Simple tandem repeats (STR) polymorphism analysis with the marker RM11-GT and Southern blotting with the probes pVAW409R3 and pVAW412 were performed, demonstrating a high prevalence (about 60%) or 17p duplication in the families studied. No clinical or electrophysiological differences were noted between CMT1 patients with or without 17p duplication, respectively. Two families affected by CMT2 showed no evidence of rearrangement at the D17S122 locus. These data are consistent with the hypothesis of a different molecular basis for CMT2.     

胸腰段后髓动脉的起源及其临床意义

目的:为选择性脊髓血管造影和椎管内显微外科提供解剖学资料。方法:采用尸体标本30例,于节段性动脉内逐一注入红色乳胶,在完整脊髓上解剖观察。结果:每例脊髓胸腰段的后髓动脉数目5～13支,平均8.4支。后髓动脉起始情况分3型10亚型,其中后髓动脉与前髓动脉由同一肋间后动脉发出仅34支(13.5％)。胸下部及腰部后髓动脉呈典型“发卡”样折曲。后髓动脉平均外径0.37±0.12mm。约1/3标本在T_(11)～L_3间有1支后髓动脉较粗(>0.5mm),它是脊髓后下部血供的主要来源。结论:多数后髓动脉单独起始,较大的后髓动脉应引起注意。     

The Effects of Hyperfiltration on Serum Sickness Glomerulonephritis in Rats

The effects of hyperfiltration induced due to unilateral nephrectomy on immunologically induced glomerular injuries were studied. Glomerulonephritis was induced in rats by sensitizing them with egg albumin as an antigen. Unilateral nephrectomy did not affect the removal rate of the antigen from the glomeruli in the rats, but accelerated the rate of the glomerular injuries after cessation of the immunologically induced glomerular inflammation. The histopathological features were characterized by sciero-adhesive lesions with aneurysmal dilatation and hyalinosis of the glomerular capillaries. The parietal epithelial cells extended from the Bowman's capsule with matrices to cover the denuded basement membrane and formed adhesions. The neighboring capillaries collapsed, and the sclero-adhesive lesions progressed. These findings indicate that hyperfiltration at the capillary level did not accelerate the recovery from glomerulonephritis, but induced glomerular sclerosis with adhesions and deteriorated the trivial glomerular injuries to produce similar focal segmental lesions.     

3D-printed prostheses for large bone defect reconstruction following bone tumor surgery北大核心

BACKGROUND: Tumor segment resection is one of the standard methods for the treatment of bone tumors. However, the reconstruction of bone defects atumor resection faces many challenges. A growing number of researchers are focusing on 3D-printed prostheses for bone defect repair and reconstruction following bone tumor surgery. OBJECTIVE: To explore the feasibility of 3D-printed prostheses in the reconstruction of large bone defect following bone tumor surgery and to evaluate the postoperative outcomes. METHODS: Retrospective analysis of clinical data of 24 patients [19 males and 5 females, age 23.8 (6-61) years] who underwent bone tumor resection and 3D-printed prosthesis implantation in the Department of Bone Oncology, the First Affiliated Hospital of Xinjiang Medical University from December 2020 to September 2021 was conducted. There were 7 cases with distal femur tumor, 5 with pelvis tumor, 4 with proximal tibia tumor, 3 with middle femur tumor, 1 with distal tibia tumor, 1 with proximal humerus tumor, 1 with middle humerus tumor, 1 with scapula tumor, 1 with ulna tumor, and 22 cases with primary tumors (13 osteosarcoma, 4 Ewing sarcoma, 2 giant cell tumor of bone, 1 chondroblastoma, 1 chondrosarcoma, and 1 osteoblastoma), 2 metastatic carcinoma. Preoperative and postoperative imaging data were recorded and neoadjuvant chemotherapy was administered in 17 cases before surgery. The Musculoskeletal Tumour Society score was used to assess limb function before surgery and 6 months after surgery, and pain was assessed by the Visual Analog Scale, as well as the complications were recorded. RESULTS AND CONCLUSION: (1) All patients undergoing resection of the tumor segment and 3D-printed prosthesis implantation for the reconstruction of the bone defect were followed for 6-49 months, and the results showed that the length of osteotomy was (18.2 ± 7.3) cm and an average intraoperative bleeding volume was 740 (100-3 000) mL. (2) Two patients died of systemic metastasis, the remaining 22 had no pulmonary metastasis or recurrence during the follow-up period, and 1 patient developed aseptic loosening of the prosthesis at 25 months postoperatively. (3) The Musculoskeletal Tumour Society scores were significantly increased, while Visual Analog Scale scores were significantly decreased (P < 0.05) at 6 months postoperatively. (4) The Musculoskeletal Tumor Society score was rated excellent in all 22 patients at the final follow-up. (5) These results suggest that 3D-printed prosthesis is suitable for the reconstruction of large bone defects caused by bone tumor resection. Patients have good postoperative function and few complications. However, further investigations are needed to explore long-term follow-up results. © 2023, Publishing House of Chinese Journal of Tissue Engineering Research. All rights reserved.     

Extensive somatosensory innervation in infants with obstetric brachial palsy

In the pre-operative screening of infants with obstetric brachial palsy (OBP), the results of routine electromyography are often overly optimistic when compared to the peri-operative findings. This prompted us to include investigation of the sensory innervation of these infants using the N20 (the first cortical response to a peripheral stimulation) of the somatosensory evoked potentials (SSEP). Three to seven months after birth, SSEP were recorded at the skull after stimulation of the thumb and middle finger in infants with obstetric rupture of the upper trunk or avulsion of roots C5, C6, or C7, and in whom no clinical improvement of motor function was observed in the biceps brachii and deltoid muscles. In most infants, a normal N20 could be evoked, indicating the existence of peripheral sensory pathways. From the thumb, these sensory pathways would necessarily bypass the upper trunk and dorsal roots of spinal nerves C5 and C6, and from the middle finger bypass the middle trunk and dorsal root C7, before extending into the dorsal column and projecting toward the thalamus and cerebral cortex. These data suggest that in infancy the segmental sensory innervation of the hand is more diverse than is described in most textbooks.     

Ultrastructural Changes Suggestive of Focal Segmental Glomerulosclerosis in Atypical Minimal Change Nephrotic Syndrome

In an attempt to recognize early stages of focal segmental glomerulosclerosis (FSGS) in patients with a clinical course suggesting a diagnosis other than minimal change disease (MCD) and normal histology, or minor, nondiagnostic changes on light microscopy (LM), we used a protocol for systematic and extensive electron microscopy (EM) examination of kidney biopsies obtained from such patients. By this method ultrastructural pathology was found in 8 patients. These changes were localized, involving only portions of single glomerular segments. The findings included mild to moderate increase of the mesangial matrix, focal wrinkling of the capillary basement membrane, and early obliteration of the normal architecture of individual capillary loops, as well as electron-dense deposits in a mesangial and subendothelial distribution. Of these 8 patients, 2 are at present in remission without therapy (in 1, following therapy with cyclophosphamide); 3 are in remission on steroid therapy; 1 developed massive proteinuria during pregnancy, after a spontaneous remission lasting almost 2 years; 1 patient advanced to terminal renal failure 3 1/2 years after biopsy; and 1 died of sepsis 1 month after biopsy. We believe that the ultrastructural changes found may represent early or mild FSGS and that the protocol described can add valuable information in clinically worrisome patients in whom renal histology appears normal.     

三维节段脊柱内固定系统在脊柱矫形术中的应用

目的评价三维节段脊柱内固定系统在不同脊柱畸形中的应用效果.方法应用三维节段脊柱内固定系统CD、TSRH等治疗脊柱畸形26例,其中特发性侧凸19例,先天性侧凸2例,后凸畸形5例,均以后路矫形自体骨植骨融合.结果所有病例经6～27个月随访,平均10.4个月.侧凸冠状面畸形平均矫正率为61.4%;矢状面后凸术后平均32.5°;旋转畸形平均矫正Ⅰ度,顶椎最大偏距平均矫正率为65.1%;后凸畸形平均矫正率为59.2%.所有病例无脱钩、断棍、感染、骨折以及脊髓神经损伤.结论三维节段脊柱内固定系统不仅可以完成畸形的三维矫正,而且矫正可靠,稳定性高,术后可不用石膏固定.