背景急性胰腺炎(acute pancreatitis,AP)是常见的急腹症,不同类型预后不同.AP的免疫应答和失衡免疫与其严重程度有关,炎症因子和相关免疫细胞在AP发病机制中至关重要,因而寻找炎症细胞和新炎症免疫因子对精准治疗AP具有重要意义.目的探...背景急性胰腺炎(acute pancreatitis,AP)是常见的急腹症,不同类型预后不同.AP的免疫应答和失衡免疫与其严重程度有关,炎症因子和相关免疫细胞在AP发病机制中至关重要,因而寻找炎症细胞和新炎症免疫因子对精准治疗AP具有重要意义.目的探讨AP患者外周血CD14^+CD16^+单核细胞表达B7-H2的临床意义.方法A P患者63例[轻度A P(m i l dA P,M A P)25例、中度AP(moderately severe AP,MSAP)20例、重度AP(severe AP,SAP)18例],对照组为健康体检者20例,采用流式细胞仪检测CD14^+CD16^+细胞亚群上B7-H2表达情况,评价其与胰腺炎严重程度关联性及临床意义.结果AP患者发病24hCD14^+CD16^+细胞B7-H2出现异常高表达,显著高于健康对照组(t=11.10,P<0.001);A P各组B 7-H 2在C D 14^+C D 16^+细胞膜上表达明显高于CD14^+C D16^-细胞膜上表达(P<0.01);SAP组CD14^+C D 16^+和CD14^+C D 16^-细胞B7-H2表达(373.30±89.72和78.62±13.05)最高,M S A P组(279.55±76.95/44.92±12.44)其次,均高于M A P组(181.15±35.75/23.32±4.28),各组两两比较差异有显著性(P<0.01);MAP组、MSAP组发病24 h、48 h、72hCD14^+CD16^+和CD14^+CD16^-单核细胞膜B7-H2动态表达差异无显著性(P>0.05),然而,SAP组无论C D14^+C D16^+还是CD14^+C D16^-细胞膜B7-H2表达24h、48h、72h均呈明显上升趋势,差异有显著性(P<0.05).结论CD14^+CD16^+和CD14^+CD16^-单核细胞膜B7-H2在AP患者体内高表达,与AP严重程度密切相关,且SAP呈动态升高变化;同时B7-H2在AP患者CD14^+CD16^+单核细胞膜表达较CD14^+CD16^-单核细胞明显升高,为进一步认识AP免疫应答和失衡提供了新的线索,为AP精准靶向治疗提供参考.展开更多
AIM To evaluate a 3 D-printed coplanar template for iodine-125 seed implantation therapy in patients with pancreatic cancer. METHODS A retrospective analysis of our database was performed, and a total of 25 patients w...AIM To evaluate a 3 D-printed coplanar template for iodine-125 seed implantation therapy in patients with pancreatic cancer. METHODS A retrospective analysis of our database was performed, and a total of 25 patients with pancreatic cancer who underwent iodine-125 seed implantation between January 2014 and November 2017 were analyzed. Of these, 12 implantations were assisted by a 3 D-printed coplanar template(group A), and 13 implantations performed freehand were selected as a control group(group B). A 3 D coplanar template was designed and printed according to a preoperative CT scan and treatment planning system. The iodine-125 seeds were then implanted using the template as a guide. Dosimetric verification was performed after implantation. Pre-and postoperative D90, V100, and V150 were calculated. The success rate of iodine-125 seed implantation, dosimetric parameters, and complications were analyzed and compared between the two groups.RESULTS Iodine-125 seed implantation was successfully performed in both groups. In group A, the median pre-and postoperative D90 values were 155.32 ± 8.05 Gy and 154.82 ± 16.43 Gy, respectively; the difference between these values was minimal and not statistically significant(P > 0.05). Postoperative V100 and V150 were 91.05% ± 4.06% and 64.54% ± 13.40%, respectively, which met the treatment requirement. A better dosimetric parameter was observed in group A than in group B, and the difference was statistically significant(V100: 91.05% ± 4.06% vs 72.91% ± 13.78%, P < 0.05). No major procedure-related complications were observed in either group. For group A, mild hemorrhage was observed in 1 patient with a peritoneal local hematoma due to mesenteric vein damage from the iodine-125 seed implantation needle. The hematoma resolved spontaneously without treatment. Postoperative blood amylase levels remained within the normal range for all patients.CONCLUSION A 3 D-printed coplanar template appears to be a safe and effective iodine-125 seed implantation guidance tool to improve implantation accuracy and optimize dosimetric distribution.展开更多
AIM To assess the feasibility and effectiveness of a novel application of percutaneous intraductal radiofrequency (RF) for the treatment of biliary stent obstruction. METHODS We specifically report a retrospective stu...AIM To assess the feasibility and effectiveness of a novel application of percutaneous intraductal radiofrequency (RF) for the treatment of biliary stent obstruction. METHODS We specifically report a retrospective study presenting the results of percutaneous intraductal RF in patients with biliary stent occlusion. A total of 43 cases involving biliary stent obstruction were treated by placing an EndoHPB catheter and percutaneous intraductal RF was performed to clean stents. The stent patency was evaluated by cholangiography and follow-up by contrast enhanced computed tomography or ultrasound after the removal of the drainage catheter. RESULTS Following the procedures, of the 43 patients, 40 survived and 3 died with a median survival of 80.5 (range: 30-243) d. One patient was lost to followup. One patient had the stent patent at the time of last follow-up. Two patients with stent blockage at 35 d and 44 d after procedure underwent percutaneous transhepatic drain insertion only. The levels of bilirubin before and after the procedure were 128 +/- 65 mu mol/L and 63 +/- 29 mu mol/L, respectively. There were no related complications (haemorrhage, bile duct perforation, bile leak or pancreatitis) and all patients' stent patency was confirmed by cholangiography after the procedure, with a median patency time of 107 (range: 12-180) d. CONCLUSION This preliminary clinical study demonstrated that percutaneous intraductal RF is safe and effective for the treatment of biliary stent obstruction, increasing the duration of stent patency, although randomized controlled trials are needed to confirm the effectiveness of this approach.展开更多
Ju et al first parcellated in detail the bed nuclei of stria terminalis according to its cyto-and chemoarchitecture.They found that the oval nucleus(OV)was rich in neurotensin(NT)-and corticotropin-releasing factor(CR...Ju et al first parcellated in detail the bed nuclei of stria terminalis according to its cyto-and chemoarchitecture.They found that the oval nucleus(OV)was rich in neurotensin(NT)-and corticotropin-releasing factor(CRF)like immunoreactivities.Using indirect immunohistochemical technique it has been shown in the present study that both neuropeptides show quite similar distribution pattern in OV of the Sprague-Dawley rat(180-250 g).展开更多
文摘背景急性胰腺炎(acute pancreatitis,AP)是常见的急腹症,不同类型预后不同.AP的免疫应答和失衡免疫与其严重程度有关,炎症因子和相关免疫细胞在AP发病机制中至关重要,因而寻找炎症细胞和新炎症免疫因子对精准治疗AP具有重要意义.目的探讨AP患者外周血CD14^+CD16^+单核细胞表达B7-H2的临床意义.方法A P患者63例[轻度A P(m i l dA P,M A P)25例、中度AP(moderately severe AP,MSAP)20例、重度AP(severe AP,SAP)18例],对照组为健康体检者20例,采用流式细胞仪检测CD14^+CD16^+细胞亚群上B7-H2表达情况,评价其与胰腺炎严重程度关联性及临床意义.结果AP患者发病24hCD14^+CD16^+细胞B7-H2出现异常高表达,显著高于健康对照组(t=11.10,P<0.001);A P各组B 7-H 2在C D 14^+C D 16^+细胞膜上表达明显高于CD14^+C D16^-细胞膜上表达(P<0.01);SAP组CD14^+C D 16^+和CD14^+C D 16^-细胞B7-H2表达(373.30±89.72和78.62±13.05)最高,M S A P组(279.55±76.95/44.92±12.44)其次,均高于M A P组(181.15±35.75/23.32±4.28),各组两两比较差异有显著性(P<0.01);MAP组、MSAP组发病24 h、48 h、72hCD14^+CD16^+和CD14^+CD16^-单核细胞膜B7-H2动态表达差异无显著性(P>0.05),然而,SAP组无论C D14^+C D16^+还是CD14^+C D16^-细胞膜B7-H2表达24h、48h、72h均呈明显上升趋势,差异有显著性(P<0.05).结论CD14^+CD16^+和CD14^+CD16^-单核细胞膜B7-H2在AP患者体内高表达,与AP严重程度密切相关,且SAP呈动态升高变化;同时B7-H2在AP患者CD14^+CD16^+单核细胞膜表达较CD14^+CD16^-单核细胞明显升高,为进一步认识AP免疫应答和失衡提供了新的线索,为AP精准靶向治疗提供参考.
基金Supported by the National Natural Science Foundation of China,No.81771949 and No.81471808the Project of Medical Key Specialty of Shanghai Municipality,No.ZK2015A22the Science and Technology Commission of Shanghai Municipality,No.18411968600
文摘AIM To evaluate a 3 D-printed coplanar template for iodine-125 seed implantation therapy in patients with pancreatic cancer. METHODS A retrospective analysis of our database was performed, and a total of 25 patients with pancreatic cancer who underwent iodine-125 seed implantation between January 2014 and November 2017 were analyzed. Of these, 12 implantations were assisted by a 3 D-printed coplanar template(group A), and 13 implantations performed freehand were selected as a control group(group B). A 3 D coplanar template was designed and printed according to a preoperative CT scan and treatment planning system. The iodine-125 seeds were then implanted using the template as a guide. Dosimetric verification was performed after implantation. Pre-and postoperative D90, V100, and V150 were calculated. The success rate of iodine-125 seed implantation, dosimetric parameters, and complications were analyzed and compared between the two groups.RESULTS Iodine-125 seed implantation was successfully performed in both groups. In group A, the median pre-and postoperative D90 values were 155.32 ± 8.05 Gy and 154.82 ± 16.43 Gy, respectively; the difference between these values was minimal and not statistically significant(P > 0.05). Postoperative V100 and V150 were 91.05% ± 4.06% and 64.54% ± 13.40%, respectively, which met the treatment requirement. A better dosimetric parameter was observed in group A than in group B, and the difference was statistically significant(V100: 91.05% ± 4.06% vs 72.91% ± 13.78%, P < 0.05). No major procedure-related complications were observed in either group. For group A, mild hemorrhage was observed in 1 patient with a peritoneal local hematoma due to mesenteric vein damage from the iodine-125 seed implantation needle. The hematoma resolved spontaneously without treatment. Postoperative blood amylase levels remained within the normal range for all patients.CONCLUSION A 3 D-printed coplanar template appears to be a safe and effective iodine-125 seed implantation guidance tool to improve implantation accuracy and optimize dosimetric distribution.
基金Supported by the Youth Foundation of the Shanghai Public Health Bureau,No.20134Y195the Project of Medical Key Specialty of Shanghai Municipality,No.ZK2015A22
文摘AIM To assess the feasibility and effectiveness of a novel application of percutaneous intraductal radiofrequency (RF) for the treatment of biliary stent obstruction. METHODS We specifically report a retrospective study presenting the results of percutaneous intraductal RF in patients with biliary stent occlusion. A total of 43 cases involving biliary stent obstruction were treated by placing an EndoHPB catheter and percutaneous intraductal RF was performed to clean stents. The stent patency was evaluated by cholangiography and follow-up by contrast enhanced computed tomography or ultrasound after the removal of the drainage catheter. RESULTS Following the procedures, of the 43 patients, 40 survived and 3 died with a median survival of 80.5 (range: 30-243) d. One patient was lost to followup. One patient had the stent patent at the time of last follow-up. Two patients with stent blockage at 35 d and 44 d after procedure underwent percutaneous transhepatic drain insertion only. The levels of bilirubin before and after the procedure were 128 +/- 65 mu mol/L and 63 +/- 29 mu mol/L, respectively. There were no related complications (haemorrhage, bile duct perforation, bile leak or pancreatitis) and all patients' stent patency was confirmed by cholangiography after the procedure, with a median patency time of 107 (range: 12-180) d. CONCLUSION This preliminary clinical study demonstrated that percutaneous intraductal RF is safe and effective for the treatment of biliary stent obstruction, increasing the duration of stent patency, although randomized controlled trials are needed to confirm the effectiveness of this approach.
文摘Ju et al first parcellated in detail the bed nuclei of stria terminalis according to its cyto-and chemoarchitecture.They found that the oval nucleus(OV)was rich in neurotensin(NT)-and corticotropin-releasing factor(CRF)like immunoreactivities.Using indirect immunohistochemical technique it has been shown in the present study that both neuropeptides show quite similar distribution pattern in OV of the Sprague-Dawley rat(180-250 g).
