目的：運用多層螺旋CT（MSCT）后處理技術顯示周圍性肺癌與支氣管關系，分析其影像表現及診斷價值。方法：采用MSCT對77例周圍性肺癌行層厚為0.5 mm的容積靶掃描，通過多平面或曲面重建（MPR或CMRP）以及表面遮蓋（SSD）法顯示支氣管與周圍腫塊的關系,CT影像表現與手術、病理對照。結果：（1）全部3～7級支氣管均全程、較完整顯示。42例腺癌中與支氣管有關系者為39例（92.9％），20例鱗癌中為15例（75.0％）。（2）腫瘤—支氣管關系可分為4型：Ⅰ型，支氣管被腫塊截斷；Ⅱ型，支氣管進入腫塊內后被截斷；Ⅲ型，支氣管在腫塊內保持通暢；Ⅳ型，支氣管緊貼腫塊邊緣走行，形態正常或受壓移位。（3）發生率：Ⅰ型為48.1％（37/77），其中鱗癌略多于腺癌；Ⅱ型為13.0%（10/77），其中鱗癌略多于腺癌；Ⅲ型為16.9％（13/77），僅見腺癌；Ⅳ型為15.6％（12/77），腺癌略多于鱗癌。（4）與第四級支氣管相關的腫塊，鱗癌多于腺癌；與第六級支氣管相關的腫塊，腺癌多于鱗癌。結論：采用MSCT超薄層靶掃描后行MPR、CMPR和SSD重建，能準確顯示腫塊與支氣管關系，并反映一定的病理改變關系，對良惡性鑒別或長期預后等相關性研究有著重要意義。
Objective To find a kind of simple and effective method for purifying and label ing stromal vascular fraction cells (SVFs) so as to provide a theoretical basis for cl inical application of SVFs. Methods The subcutaneous adi pose tissue were harvested form volunteers. The adi pose tissue was digested with 0.065%, 0.125%, and 0.185% type I collagenase,respectively. SVFs were harvested after digestion and counted. After trypan blue staining, the rate of viable cells was observed. SVFs was labeled by 1, 1’-dioctadecyl-3, 3, 3’, 3’-2-tetramethy-lindocyanine perchlorate (DiI). The fluorescent label ing and growth was observed under an inverted fluorescence microscope. MTT assay was used to detect cell proliferation. Results The number of SVFs was (138.68 ± 11.64) × 104, (183.80 ± 10.16) × 104, and (293.07 ± 8.31) × 104 in 0.065% group, 0.125% group, and 0.185% group, respectively, showing significant differences among 3 groups (P lt; 0.01). The rates of viable cells were 91% ± 2%, 90% ± 2%, and 81% ± 2% in 0.065% group, 0.125% group, and 0.185% group, respectively, and it was significantly higher in 0.065% group and 0.125% group than in 0.185% group (P lt; 0.01), but no significant difference was found between 0.065% group and 0.125% group (P=0.881). Inverted fluorescence microscope showed that the cell membranes could be labeled by DiI with intact cell membrane, abundant cytoplasm, and good shape, but nucleus could not labeled. SVFs labeled by DiI could be cultured successfully and maintained a normal form. MTT assay showed that similar curves of the cell growth were observed before and after DiI labeled to SVFs. Conclusion The optimal collagenase concentration for purifying SVFs is 0.125%. DiI is a kind of ideal fluorescent dye for SVFs.
Objective To review the research progress of growth factor sustained-release microspheres in fat transplantation. Methods The recently published 1iterature at home and abroad related the growth factor sustained-release microspheres in fat transplantation was reviewed and analyzed. Results The sustained-release microsphere carrier materials include natural polymer materials and synthetic polymer materials.The sustained-release complexes of different microsphere materials with different growth factors can promote the vascularization of transplanted fat in a timely manner, improve the survival rate of grafts, and reduce the incidence of complications such as liquefaction, calcification, and necrosis. Conclusion The growth factor sustained-release microspheres have the characteristics of persistence and controllability, which is a research hotspot in the field of fat transplantation and has broad application prospects.
ObjectivesTo systematically review the diagnostic value of GerdQ questionnaire for diagnosing the gastro-oesophageal reflux disease (GERD).MethodsPubMed, Web of Science, EBMR, CNKI, CBM, VIP and WanFang Data databases were searched to collect studies on the diagnostic value the GerdQ questionnaire in diagnosing the GERD from inception to January 1st 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed by using Meta-Disc 1.4 software. We used the Stata 12.0 software to assess the publication bias with funnel plots.ResultsA total of 20 studies were enrolled, including 7 978 patients. Among them, 4 848 patients were confirmed with GERD. The results of meta-analysis showed that: a) The pooled sensitivity, specificity, +LR, ?LR, and DOR were 0.79 (95%CI 0.78 to 0.81), 0.66 (95%CI 0.65 to 0.68), 2.28 (95%CI 1.77 to 2.94), 0.37 (95%CI 0.27 to 0.52) and 6.34 (95%CI 3.59, 11.19), SROC(AUC) was 0.789 3, and Q* was 0.726 6. b) When the cut-off was 7, the diagnostic accuracy of GerdQ questionnaire for the GERD was the highest, and that of 9 was the second. c) The diagnostic accuracy of GerdQ questionnaire was higher when it was used in China.ConclusionsGerdQ questionnaire has a moderate accuracy for the diagnosis of GERD, which can be a useful complementary tool for diagnosing GERD, and can be popularized in clinical settings. Due to limitation of quantity and quality of included studies, the above conclusions requires verification by more high quality studies.
Objective To observe the relationship of serum levels of homocysteine (HCY) and chemokine C-C motifligand 2 (CCL2) with cognitive impairment in COPD patients with different degrees of emphysema. Methods Sixty-twoCOPD patients identified according to emphysema phenotype classification and admitted from January 2016 to March 2017 were recruited in the study. There were 37 cases in emphysema 1-2 grade and 25 cases in emphysema 3-4 grade. Simultaneous 30 healthy subjects undergoing physical examination were recruited as control. Montreal cognitive assessment (MoCA) scale investigation and serum HCY and CCL2 test were completed. Relationship analysis was conducted on serum HCY, CCL2 levels with cognitive impairment in the COPD patients with different degrees of emphysema. Results Compared with the 1-2 grade subgroup, the PaO2 was lower, PaCO2 was higher, the plasma HCY and CCL2 levels increased in the 3-4 grade subgroup with significant differences (all P<0.05). MoCA total score and subscores were relatively low in the COPD group with emphysema than the control group (except visuospatial ability scores in the 1-2 grade subgroup). MoCA scores were statistically lower in the 3-4 grade subgroup than those in the 1-2 grade subgroup (allP<0.05). Correlation analysis showed that HCY and CLL2 levels were negatively correlated with MoCA scores and subscores (P<0.01), and HCY and CLL2 were positively correlated (bothP<0.01). The area under the receiver operating characteristic curve of HCY and CLL2 for evaluating cognitive impairment was 0.79 and 0.97, respectively. Conclusion In patients with different degrees of emphysema phenotype, serum HCY and CCL2 levels are increased in different degree, and the degree of emphysema is closely related with cognitive dysfunction.