Diagnosis and therapeutic strategies for small bowel vascular lesions

Small bowel vascular lesions, including angioectasia (AE), Dieulafoy’s lesion (DL) and arteriovenous malformation (AVM), are the most common causes of obscure gastrointestinal bleeding. Since AE are considered to be venous lesions, they usually manifest as a chronic, well-compensated condition. Subsequent to video capsule endoscopy, deep enteroscopy can be applied to control active bleeding or to improve anemia necessitating blood transfusion. Despite the initial treatment efficacy of argon plasma coagulation (APC), many patients experience re-bleeding, probably because of recurrent or missed AEs. Pharmacological treatments can be considered for patients who have not responded well to other types of treatment or in whom endoscopy is contraindicated. Meanwhile, a conservative approach with iron supplementation remains an option for patients with mild anemia. DL and AVM are considered to be arterial lesions;therefore, these lesions frequently cause acute life-threatening hemorrhage. Mechanical hemostasis using endoclips is recommended to treat DLs, considering the high re-bleeding rate after primary APC cauterization. Meanwhile, most small bowel AVMs are large and susceptible to re-bleeding therefore, they usually require surgical resection. To achieve optimal diagnostic and therapeutic approaches for each type of small bowel lesion, the differences in their epidemiology, pathology and clinical presentation must be understood.     

鼻内镜加低温等离子射频治疗伴鼻中隔偏曲的变应性鼻炎临床观察

目的探讨鼻内镜下鼻中隔矫正术加低温等离子射频治疗伴鼻中隔偏曲的变应性鼻炎的疗效。方法 168例伴鼻中隔偏曲的变应性鼻炎患者随机分成A,B,C三组。A组40例,鼻内镜下单纯鼻中隔矫正术治疗;B组49例,采用鼻内镜下低温等离子射频治疗;C组79例,应用鼻内镜下鼻中隔矫正术联合低温等离子射频治疗。结果术后1年A,B,C组显效率分别为77.5%,57.1%,79.7%。A,C组的显效率差异无统计学意义（P〉0.05）,但高于B组（P〈0.05）;术后2年A,B,C组显效率分别为55%,40.8%,75.9%。C组显效率则高于A、B组（P〈0.05）。结论鼻内镜下手术联合低温等离子射频治疗伴鼻中隔偏曲的变应性鼻炎有较好的远期疗效。     

离子色谱法同时测定血清和尿中草酸及枸橼酸含量研究

目的:建立简便快速梯度淋洗离子色谱法直接同时测定血清和尿中草酸及枸橼酸含量。方法:选用IonpacAS18阴离子分析柱,0~50 mmol/L KOH淋洗液,流速为1.0 ml/min,电导检测器。样品经过高速离心用0.25μm微孔滤膜过滤稀释后直接进样。结果:本法相关性好(r0.9994),精密度高(RSD%5.0),样品加标平均回收率为87.8%~101%,最低检出量0.008~0.012μg/ml。结论:该法操作简单、快速、准确、灵敏,适用于大批样分析。     

人类胃癌裸鼠淋巴结转移模型的建立

 目的　研究胃癌淋巴结转移动物模型的建立方法。方法　人类胃癌低分化细胞系SGC-7901体外培养、传代并扩增后，收集细胞行皮下种植成瘤，鼠间传代至第6代，以皮下肿瘤组织块原位种植于裸鼠胃壁建立动物模型。种植后第9周处死裸鼠，观察原位种植瘤生长、淋巴结转移及其他脏器转移情况，测定荷瘤裸鼠血清癌胚抗原（CEA）值。结果　原位移植瘤种植成功率100 ％，胃周淋巴结转移率93.3 ％，移植瘤可发生局部浸润及远处脏器转移，荷瘤裸鼠CEA值明显高于正常裸鼠（P＜0.01）。结论　应用SGC-7901细胞系可成功建立胃癌的淋巴结转移动物模型。     

Improved circulating microparticle analysis in acid-citrate dextrose (ACD) anticoagulant tube

Introduction

Recently extracellular vesicles (exosomes, microparticles also referred to as microvesicles and apoptotic bodies) have attracted substantial interest as potential biomarkers and therapeutic vehicles. However, analysis of microparticles in biological fluids is confounded by many factors such as the activation of cells in the blood collection tube that leads to in vitro vesiculation. In this study we aimed at identifying an anticoagulant that prevents in vitro vesiculation in blood plasma samples.

Materials and Methods

We compared the levels of platelet microparticles and non-platelet-derived microparticles in platelet-free plasma samples of healthy donors. Platelet-free plasma samples were isolated using different anticoagulant tubes, and were analyzed by flow cytometry and Zymuphen assay. The extent of in vitro vesiculation was compared in citrate and acid-citrate-dextrose (ACD) tubes.

Results

Agitation and storage of blood samples at 37 °C for 1 hour induced a strong release of both platelet microparticles and non-platelet-derived microparticles. Strikingly, in vitro vesiculation related to blood sample handling and storage was prevented in samples in ACD tubes. Importantly, microparticle levels elevated in vivo remained detectable in ACD tubes.

Conclusions

We propose the general use of the ACD tube instead of other conventional anticoagulant tubes for the assessment of plasma microparticles since it gives a more realistic picture of the in vivo levels of circulating microparticles and does not interfere with downstream protein or RNA analyses.