超声引导经胸穿刺活检周围型肺病变的影响因素及临床价值

目的探讨超声引导经胸穿刺活检周围型肺病变的影响因素、穿刺技巧及安全性。方法回顾性分析177例可疑周围型肺病变患者行超声引导经胸穿刺活检的病理结果,分析患者年龄、性别、穿刺体位、穿刺部位、病灶大小、穿刺角度、穿刺针数及穿刺针型号对穿刺有效率的影响。结果病理做出明确诊断患者153例,穿刺无效24例,穿刺有效率为86.44%。病灶大小>50mm及26~50mm的患者穿刺有效率高于病灶大小<26mm(P<0.05),患者穿刺时体位采取坐位、平卧位者的穿刺有效率高于侧卧位(P<0.05),穿刺针型号16G穿刺有效率高于18G(P<0.05)。患者性别、穿刺部位、穿刺角度及穿刺针数比较,差异无统计学意义(P>0.05)。177例患者穿刺术后并发症总发病率为5.65%(10/177),其中气胸3例(1.69%)、胸膜反应5例(2.82%)、咳血痰2例(1.13%)。结论病灶大小、穿刺时患者体位是影响超声引导经胸穿刺活检有效率的主要因素,应规范各项操作,为周围型肺病变的临床诊疗提供可靠的依据。

In vivo observation of cerebral microcirculation after experimental subarachnoid hemorrhage in mice

Acute brain injury caused by subarachnoid hemorrhage is the major cause of poor prognosis. The pathology of subarachnoid hemorrhage likely involves major morphological changes in the microcirculation. However, previous studies primarily used fixed tissue or delayed injury models. Therefore, in the present study, we used in vivo imaging to observe the dynamic changes in cerebral microcirculation after subarachnoid hemorrhage. Subarachnoid hemorrhage was induced by perforation of the bifurcation of the middle cerebral and anterior cerebral arteries in male C57/BL6 mice. The diameter of pial arterioles and venules was measured by in vivo fluorescence microscopy at different time points within 180 minutes after subarachnoid hemorrhage. Cerebral blood flow was examined and leukocyte adhesion/albumin extravasation was determined at different time points before and after subarachnoid hemorrhage. Cerebral pial microcirculation was abnormal and cerebral blood flow was reduced after subarachnoid hemorrhage. Acute vasoconstriction occurred predominantly in the arterioles instead of the venules. A progressive increase in the number of adherent leukocytes in venules and substantial albumin extravasation were observed between 10 and 180 minutes after subarachnoid hemorrhage. These results show that major changes in microcirculation occur in the early stage of subarachnoid hemorrhage. Our findings may promote the development of novel therapeutic strategies for the early treatment of subarachnoid hemorrhage.

Potential aquatic environmental risks of trifloxystrobin:Enhancement of virus susceptibility in zebrafish through initiation of autophagy

Chronic pollution in aquatic ecosystems can lead to many adverse effects,including a greater susceptibility to pathogens among resident biota.Trifloxystrobin(TFS)is a strobilurin fungicide widely used in Asia to control soybean rust.However,it has the potential to enter aquatic ecosystems,where it may impair fish resistance to viral infections.To explore the potential environmental risks of TFS,we characterized the antiviral capacities of fish chronically exposed to TFS and subsequently infected with spring viraemia of carp virus(SVCV).Although TFS exhibited no significant cytotoxicity at the tested environmental concentrations during viral challenge,SVCV replication increased significantly in a time-dependent manner within epithelioma papulosum cyprini(EPC)cells and zebrafish exposed to 25μg/L TFS.Results showed that the highest viral load was more than 100-fold that of the controls.Intracellular biochemical assays indicated that autophagy was induced by TFS,and associated changes included an increase in autophagosomes,conversion of LC3-II,accumulation of Beclin-1,and degradation of P62 in EPC cells and zebrafish.In addition,TFS markedly decreased the expression and phosphorylation of mTOR,indicating that activation of TFS may be associated with the mTORmediated autophagy pathway.This study provides new insights into the mechanism of the immunosuppressive effects of TFS on non-target aquatic hosts and suggests that the existence of TFS in aquatic environments may contribute to outbreaks of viral diseases.