33例肝占位性病变MRI误诊的分析

我院１９８８年以来４０００余例腹部ＭＲＩ中，发现肝占位性病变误诊３３例。所用机型为美国Ｄｉｓｏｎｉｃｓ公司０．５Ｔ超导ＭＲＩ，自旋回波序列（ＳＥ序列）、常规Ｔ１加权（Ｔ１ＷＩ）、质子加权（ＰＤＷＩ）、Ｔ２加权（Ｔ２ＷＩ），覆盖全肝。其中，ＰＨＣ误诊为ＭＨＣ５例、ＭＨＣ误诊为ＰＨＣ６例、ＰＨＣ误为ＨＨＥ５例、ＭＨＣ误诊为ＨＨＥ２例、ＨＨＥ误诊为ＰＨＣ６例、肝硬化结节误诊为ＰＨＣ２例、炎性假瘤误诊为ＰＨＣ３例、肝结核误诊为ＰＨＣ１例、ＨＣＹ误诊为ＨＨＥ３例。本文从病变的影像学特征和扫描技术方面详细探讨了误诊的原因和鉴别诊断要点。     

Placental tissue stem cells and their role in neonatal diseases

Neonatal diseases such as hypoxic ischemic encephalopathy, diseases of prematurity and congenital disorders carry increased morbidity and mortality. Despite technological advancements, their incidence remains largely unabated. Stem cell (SC) interventions are novel therapies in the neonatal world. In pre-clinical models of neonatal diseases, SC applications have shown encouraging results. SC sources vary, with the bone marrow being the most utilized. However, the ability to harvest bone marrow SCs from neonates is limited. Placental-tissue derived SCs (PTSCs), provide an alternative and highly attractive source. Human placentas, the cornerstone of fetal survival, are abundant with such cells. Comparing to adult pools, PTSCs exhibit increased potency, decreased immunogenicity and stronger anti-inflammatory effects. Several types of PTSCs have been identified, with mesenchymal stem cells being the most utilized population. This review will focus on PTSCs and their pre-clinical and clinical applications in neonatology.     

生物医用材料现状和发展趋势

本文综述了生物医用材料产业的现状，总结了生物医用材料发展历程，指出了生物医用材料的发展方向。第三代生物医用材料应兼具生物活性和降解两种性能，在植人体内后可促进机体的再生能力．从而达到治疗效果。以生物医用材料为支架的组织工程可复制“组织”和“器官”，为再生医学的崛起开辟了道路，也为生物医用材料的发展提出了更高的要求，并且拓展了更大的发展空间。     

肝硬化再生结节和退变结节的MRI表现：初步研究结果

目的研究肝硬化再生结节和退变结节的MRI表现.资料与方法前瞻性地研究26例肝硬化再生结节和退变结节的MRI表现,其中合并肝癌8例.26例中有12例行CT平扫,6例行CT增强扫描;26例均行MRI平扫,18例行Gd-DTPA增强MRI,10例行超顺磁性氧化铁(菲立磁)增强MVI.临床实验室检查中,除8例合并有肝癌的患者甲胎蛋白显著增高外,其余18例甲胎蛋白均正常.结果26例中12例结节灶直径＜1 cm，8例在1～3 cm，6例＞3 cm.MRI表现：12例直径＜1 cm的结节灶在T1WI呈等信号，T2WI呈低信号，Gd-DTPA和菲立磁增强与正常肝实质呈同步强化，在CT上呈高密度改变.结节灶直径1～3 cm的8例中,5例结节在T1WI呈高信号,T2WI呈低信号,强化同前;另3例在T1WI呈低信号的结节,在T2WI呈高信号,其强化与正常肝实质不同步,在菲立磁增强扫描中呈高信号;CT平扫均呈等密度.6例直径＞3 cm的结节中2例在T1WI、T2WI均呈等高信号,菲立磁增强扫描呈高信号,Gd-DTPA增强MRI示巨大结节较周围邻近正常肝组织信号高;4例在T1WI呈高信号,在T2WI呈低信号，菲立磁增强扫描呈低信号,Gd-DTPA增强扫描巨大结节无强化，较周围邻近正常肝组织信号低,有时可见血管经过巨大结节表面.CT显示6例呈等或稍高密度.在MRI上可见1例“结中结”征.结论肝硬化再生结节在MRI上能较好地与肝细胞癌鉴别,但较难与退变结节鉴别.退变结节在T2WI不呈高信号,而肝细胞癌呈高信号,以此可作区别.此外,良性退变结节菲立磁增强T2WI呈低信号.     

中药汤剂联合原位再生复原技术治疗大面积烧伤后期残余创面的疗效观察

目的对比观察中药汤剂联合皮肤原位再生复原技术治疗大面积烧伤后期残余刨面的临床疗效。方法将2011年1月-2012年12月收治的65例大面积烧伤后期残余创面患者随机分为两组,治疗组(33例)患者在口服中药汤剂的同时,创面采用湿润烧伤膏和创疡贴包扎换药治疗,根据分泌物的多少,每日换药1~2次;对照组(32例)患者单纯应用1%的磺胺嘧啶银霜药纱包扎换药治疗,每日1次。对比观察两组患者的创面治愈率、有效率及安全性。结果治疗组患者的有效率为90.9%,对照组患者的有效率为68.7%,两组对比,P0.05,差异具有统计学意义;两组患者在治疗过程中均未发生不良反应,安全性无统计学差异。结论中药汤剂联合皮肤原位再生复原技术治疗大面积烧伤后期残余创面安全、有效,可提高创面治愈率,值得临床推广应用。     

应用DCE-MSCT扫描鉴别诊断小肝癌及肝硬化再生结节的可行性研究

目的 分析应用动态增强一多层螺旋CT(DCE-MSCT)扫描鉴别诊断小肝癌及肝硬化再生结节的可行性.方法 选取本院2017年5月至2018年11月收治的27例小肝癌和30例肝硬化再生结节患者作为研究对象,分析小肝癌与肝硬化再生结节大小、形态、密度及CT动态增强分型等征象,比较两者不同扫描时相的CT值.结果 小肝癌平扫期...     

Vitrification preserves murine and human donor cells for generation of tissue-engineered intestine

Background

Short bowel syndrome causes significant morbidity and mortality. Tissue-engineered intestine may serve as a viable replacement. Tissue-engineered small intestine (TESI) has previously been generated in the mouse model from donor cells that were harvested and immediately reimplanted; however, this technique may prove impossible in children who are critically ill, hemodynamically unstable, or septic. We hypothesized that organoid units (OU), multicellular clusters containing epithelium and mesenchyme, could be cryopreserved for delayed production of TESI.

Methods

OU were isolated from <3 wk-old mouse or human ileum. OU were then cryopreserved by either standard snap freezing or vitrification. In the snap freezing protocol, OU were suspended in cryoprotectant and transferred directly to −80°C for storage. The vitrification protocol began with a stepwise increase in cryoprotectant concentration followed by liquid supercooling of the OU solution to −13°C and nucleation with a metal rod to induce vitrification. Samples were then cooled to −80°C at a controlled rate of −1°C/min and subsequently plunged into liquid nitrogen for long-term storage. OU from both groups were maintained in cryostorage for at least 72 h and thawed in a 37°C water bath. Cryoprotectant was removed with serial sucrose dilutions and OU were assessed by Trypan blue assay for post-cryopreservation viability. Via techniques previously described by our laboratory, the thawed murine or human OU were either cultured in vitro or implanted on a scaffold into the omentum of a syngeneic or irradiated Nonobese Diabetic/Severe Combined Immunodeficiency, gamma chain deficient adult mouse. The resultant TESI was analyzed by histology and immunofluorescence.

Results

After cryopreservation, the viability of murine OU was significantly higher in the vitrification group (93 ± 2%, mean ± standard error of the mean) compared with standard freezing (56 ± 6%) (P < 0.001, unpaired t-test, n = 25). Human OU demonstrated similar viability after vitrification (89 ± 2%). In vitro culture of thawed OU produced expanding epithelial spheres supported by a layer of mesenchyme. TESI was successfully generated from the preserved OU. Hematoxylin and eosin staining demonstrated a mucosa composed of a simple columnar epithelium whereas immunofluorescence staining confirmed the presence of both progenitor and differentiated epithelial cells. Furthermore, beta-2-microglobulin confirmed that the human TESI epithelium originated from human cells.

Conclusions

We demonstrated improved multicellular viability after vitrification over conventional cryopreservation techniques and the first successful vitrification of murine and human OU with subsequent TESI generation. Clinical application of this method may allow for delayed autologous implantation of TESI for children in extremis.