Does glioblastoma cyst fluid promote sciatic nerve regeneration?

Glioblastoma cyst fluid contains growth factors and extracellular matrix proteins which are known as neurotrophic and neurite-promoting agents. Therefore, we hypothesized that glioblastoma cyst fluid can promote the regeneration of injured peripheral nerves. To validate this hypothesis, we transected rat sciatic nerve, performed epineural anastomosis, and wrapped the injured sciatic nerve with glioblastoma cyst fluid- or saline-soaked gelatin sponges. Neurological function and histomorphological examinations showed that compared with the rats receiving local saline treatment, those receiving local glioblastoma cyst fluid treatment had better sciatic nerve function, fewer scars, greater axon area, counts and diameter as well as fiber diameter. These findings suggest that glioblastoma cyst fluid can promote the regeneration of injured sciatic nerve and has the potential for future clinical application in patients with peripheral nerve injury.

Cerebrospinal fluid otorrhea caused by porencephalic cyst: A rare case report and literature review

Objective Poreneephalic cyst presenting with otologie involvement is uncommon. Only a few eases have been reported. We report a rare case of cerebrospinal fluid （CSF） otorrhea caused by a massive porencephalic cyst encompassing the left temporal and occipital lobes. The CSF leak was repaired successfully using a transmastoid approach with facia, abdomen fat and fibrin glue to seal the osseous defects in the sinodural angle. A review of the literature concerning porencephalic cyst and CSF otorrhea is also presented.

Cystic pancreatic lesions,the endless dilemma

Cystic pancreatic lesions involve a wide variety of pathological entities that include neoplastic and non-neoplastic lesions.The proper diagnosis,differentiation,and staging of these cystic lesions are considered a crucial issue in planning further management.There are great challenges for their diagnostic models.In our time,new emerging methods for this diagnosis have been discovered.Endoscopic ultrasonography-guided fine-needle aspiration cytology with chemical and molecular analysis of cyst fluid and EUS-guided fine needlebased confocal laser endomicroscopy,through the needle microforceps biopsy,and single-operator cho-langioscopy/pancreatoscopy are promising methods that have been used in the diagnosis of cystic pancreatic lesions.Hereby we discuss the diagnosis of cystic pancreatic lesions and the benefits of various diagnostic models.

Molecular analysis of pancreatic cystic neoplasm in routine clinical practice

BACKGROUND Cystic pancreatic lesions consist of a wide variety of lesions that are becoming increasingly diagnosed with the growing use of imaging techniques.Of these,mucinous cysts are especially relevant due to their risk of malignancy.However,morphological findings are often suboptimal for their differentiation.Endoscopic ultrasound fine-needle aspiration(EUS-FNA)with molecular analysis has been suggested to improve the diagnosis of pancreatic cysts.AIM To determine the impact of molecular analysis on the detection of mucinous cysts and malignancy.METHODS An 18-month prospective observational study of consecutive patients with pancreatic cystic lesions and an indication for EUS-FNA following European clinical practice guidelines was conducted.These cysts included those>15 mm with unclear diagnosis,and a change in follow-up or with concerning features in which results might change clinical management.EUS-FNA with cytological,biochemical and glucose and molecular analyses with next-generation sequencing were performed in 36 pancreatic cysts.The cysts were classified as mucinous and non-mucinous by the combination of morphological,cytological and biochemical analyses when surgery was not performed.Malignancy was defined as cytology positive for malignancy,high-grade dysplasia or invasive carcinoma on surgical specimen,clinical or morphological progression,metastasis or death related to neoplastic complications during the 6-mo follow-up period.Next-generation sequencing results were compared for cyst type and malignancy.RESULTS Of the 36 lesions included,28(82.4%)were classified as mucinous and 6(17.6%)as non-mucinous.Furthermore,5(13.9%)lesions were classified as malignant.The amount of deoxyribonucleic acid obtained was sufficient for molecular analysis in 25(69.4%)pancreatic cysts.The amount of intracystic deoxyribonucleic acid was not statistically related to the cyst fluid volume obtained from the lesions.Analysis of KRAS and/or GNAS showed 83.33%[95%confidence interval(CI):63.34-100]sensitivity,60%(95%CI:7.06-100)specificity,88.24%(95%CI:69.98-100)positive predictive value and 50%(95%CI:1.66-98.34)negative predictive value(P=0.086)for the diagnosis of mucinous cystic lesions.Mutations in KRAS and GNAS were found in 2/5(40%)of the lesions classified as non-mucinous,thus recategorizing those lesions as mucinous neoplasms,which would have led to a modification of the follow-up plan in 8%of the cysts in which molecular analysis was successfully performed.All 4(100%)malignant cysts in which molecular analysis could be performed had mutations in KRAS and/or GNAS,although they were not related to malignancy(P>0.05).None of the other mutations analyzed could detect mucinous or malignant cysts with statistical significance(P>0.05).CONCLUSION Molecular analysis can improve the classification of pancreatic cysts as mucinous or non-mucinous.Mutations were not able to detect malignant lesions.

Endoscopic ultrasound-through-the-needle biopsy in pancreatic cystic lesions: A large single center experience

BACKGROUND Establishing a diagnosis of pancreatic cystic lesions(PCLs)preoperatively still remains challenging.Recently,endoscopic ultrasound(EUS)-through-the-needle biopsy(EUS-TTNB)using microforceps in PCLs has been made available.AIM To assess the efficacy and safety of EUS-TTNB in the diagnosis of PCLs.METHODS We retrospectively collected data of patients with PCLs who underwent both EUS-fine-needle aspiration(FNA)for cytology and EUS-TTNB at our institution since 2016.EUS-FNA for cytology was followed by EUS-TTNB in the same session.Evaluation of the cyst location,primary diagnosis,adverse events,and comparison between the cytologic fluid analyses and histopathology was performed.Technical success of EUS-TTNB was defined as visible tissue present after biopsy.Clinical success was defined as the presence of a specimen adequate to make a histologic or cytologic diagnosis.RESULTS A total of 56 patients(mean age 66.9±11.7,53.6%females)with PCLs were enrolled over the study period.The mean cyst size was 28.8 mm(12-85 mm).The EUS-TTNB procedure was technically successful in all patients(100%).The clinical success rate using EUS-TTNB was much higher than standard EUS-FNA,respectively 80.4%(45/56)vs 25%(14/56).Adverse events occurred in 2 patients(3.6%)who developed mild pancreatitis that resolved with medical therapy.Using TTNB specimens,23 of 32 cases(71.9%)with intraductal papillary mucinous neoplasm were further differentiated into gastric type(19 patients)and pancreaticobiliary type(4 patients)based on immunochemical staining.CONCLUSION EUS-TTNB for PCLs was technically feasible and had a favorable safety profile.Furthermore,the diagnostic yield for PCLs was much higher with EUS-TTNB than standard EUS-FNA cytology and fluid carcinoembryonic antigen.EUSTTNB should be considered as an adjunct to EUS-FNA and cytologic analysis in the diagnosis and management of PCLs.

Potential Use of Ultrasonic Cavitation Threshold to Non-Invasively Differentiate Cystic Masses

Objectives: To demonstrate in vitro that changes in ultrasound cavitation threshold might be used for non-invasively distinguishing high viscosity mucinous fluid from low viscosity serous fluid in cystic masses, based on the facts that cavitation threshold increases with increasing viscosity and that cavitation microbubbles are observable with diagnostic ultrasound. Methods: An in vitro model of a cyst was designed using dilutions of ultrasonic gel, and the cavitation threshold of this model was determined using focused and unfocused ultrasound for bubble initiation and clinical ultrasound b-scan for detection. Results: Viscosities of dilutions between 0% and 30% gel were had viscosities measuring between 1.05 ± 0.08 cP and 6600 ± 875 cP. Inertial cavitation in the latter was determined to require an order of magnitude greater intensity, at 1 MHz and 100% duty cycle, than the former (>2.2 W/cm2 vs. <0.19 W/cm2) using unfocused ultrasound. A four-fold increase in the peak negative pressure was required to initiate significant bubble activity using 1.1 MHz and 50% duty cycle focused ultrasound in the 6600 cP fluid compared with the 1 cP fluid. Based on these results, it was estimated that a threshold could be defined that would result in no bubbles in 99.9% of mucinous cysts and just 22% of serous cysts. The remaining 78% of patients presenting with serous cysts would be positively identified by detection of bubbles, and would be spared an unnecessary biopsy. Conclusions: The cavitation threshold may be used non-invasively to distinguish between high viscosity and low viscosity fluids in cysts and reduce biopsies on serous cysts.

Novel and supplementary management of pancreatic fluid collections:Endoscopic ultrasound-guided drainage

AIM To compare efficacy and safety of endoscopic ultrasound (EUS)-guided and surgical drainage in pancreatic fluid collection management.METHODS Data were obtained retrospectively from January 2012 to December 2016.Patients with pancreatic fluid collection were performed EUS-guided or surgical procedure.Main outcome measures including clinical efficiency,complication,duration of procedures,hospital stay and cost were analyzed.RESULTS Thirty-six patients were enrolled into the study,including 14 in endoscopic group while 22 in the surgical group.Twelve (86%) patients were treated successfully by endoscopic approach while 21 (95%) patients benefited through surgical procedure.Endoscopic treatment had higher recurrence and complication rates than surgery,resulting in more re-interventions.Meanwhile,duration of procedure,hospital stay and cost were significantly lower in endoscopic group.CONCLUSION Both approaches were effective and safe.EUS-guided approach should be the first-line treatment in mild and simple cases,while surgical approach should be considered as priority in severe and complex cases.

神经内镜下经鼻蝶入路治疗Rathke’s囊肿

目的研究神经内镜技术治疗Rathke’s囊肿(Rathke’scleft cysts,RCC)的有效性。方法回顾性分析34例RCC病例资料,均采用神经内镜技术治疗,对比手术前后病人头疼、视力障碍、内分泌障碍等症状的改善,以及术后脑脊液漏的发生与囊肿复发情况等。结果33例采用内镜下囊肿开窗或囊壁部分切除术,1例囊壁全切除。术前有头疼症状21例(61.8%),术后1周~12个月头疼症状改善9例。术前视力下降9例(26.5%),术后改善2例。术前垂体功能异常21例(61.8%),术后恢复正常7例。1例囊壁全切除病人,术后持续性脑脊液漏,保守治疗1个月后行二次手术修补。复发2例(5.9%),1例随访未手术,1例2年后囊肿萎缩消失。无手术相关死亡。结论神经内镜技术可用于治疗出现头疼、视力下降、激素水平改变的RCC病人。

自发性脑脊液鼻漏误诊误治临床探讨

目的分析自发性脑脊液鼻漏误诊误治的原因,总结避免误诊误治的措施。方法回顾性分析2008年12月至2023年8月被误诊的11例自发性脑脊液鼻漏患者的临床资料。结果8例流清水样涕、鼻腔黏膜色泽苍白或淡红,被误诊为过敏性鼻炎。1例左侧鼻腔流水、中鼻道半透明荔枝肉状肿物,副鼻窦CT示“左上颌窦、筛窦炎,左中鼻道软组织密度影”,被误诊为左慢性鼻窦炎伴鼻息肉。1例上呼吸道感染后,头部不适,流清水样涕,被误诊为急性鼻炎。1例睡觉时鼻腔有液体流向喉部,鼻窦CT示“右侧上颌窦卵圆形肿物、边界清晰,考虑囊肿”,被误诊为右上颌窦囊肿。11例患者经对症治疗后症状无缓解,进一步行影像学及鼻流出液葡萄糖定量检查后确诊为自发性脑脊液鼻漏。误诊时间10~60(24.09±13.5)d。11例均行经鼻内镜脑脊液鼻漏修补术后痊愈。结论自发性脑脊液鼻漏起病隐匿、临床少见、多为单侧发病、鼻流出液多呈持续性且清亮无色,可因体位改变、咳嗽、喷嚏、便秘等致颅内压增加而加重。完善鼻窦CT和磁共振成像,可为该病的诊断提供证据,确诊需要鼻流出液葡萄糖定量检查。

斑点金免疫渗滤法在检测囊虫抗体中的应用

目的 将斑点金免疫渗滤法用于检测囊虫抗体 ,以制备囊虫病诊断试剂盒。方法 经透析的猪囊尾蚴囊液作为检验抗原 ,对 71份囊虫病患者、90份正常人和 2 0份其他病患者血清进行了斑点金免疫渗滤法检测并与酶联免疫吸附法比较。结果 斑点金免疫渗滤法的敏感性为 90 .1% (6 4 / 71) ,特异性为 95 .6 % (86 / 90 ) ,其他病患者血清反应中仅 1例脑肿瘤患者血清阳性 ,其余为阴性。斑点金免疫渗滤法和酶联免疫吸附法的符合率为94 .4 % (15 2 / 16 1)。

细粒棘球蚴病诊断抗原研究进展

细粒棘球蚴病严重危害人畜健康,给畜牧业造成巨大经济损失。该病的早期诊断有很重要的意义。囊液抗原、原头节抗原和囊壁抗原等天然抗原是用于该病诊断的主要抗原,但存在敏感性差、特异性弱等缺点。近年来,人们合成了AgB、Ag5、EpC1、EgTPx等重组抗原,将其用于诊断,并获得了较高的敏感性和特异性。论文将用于诊断的天然抗原和重组抗原进行了综述。

双向电泳及免疫印记法对囊尾蚴囊液抗原的分析、纯化及鉴定

目的 通过分析、纯化囊液抗原 ,筛选高免疫反应性和高特异性抗原组分 ,用于囊虫病免疫诊断。 方法 用分辨率极高的双向电泳法对囊液抗原进行分离、纯化 ,并通过免疫印记 ,用囊虫病人血清、包虫病人血清和其它异源血清筛选特异性抗原组分 ,为建立新一代免疫学诊断方法奠定基础。 结果 得到了等电点为 9 4,分子量为14KD和 16 6KD两组抗原组分 ,特异性达 10 0 % ,并且仅被急性感染的囊虫病人血清识别 ,而不被囊虫完全钙化病人血清识别。 结论 得到了高免疫反应性和高特异性的蛋白纯品 。

包虫病诊断抗原的纯化及诊断效价

[目的]建立一种简便快速、适合基层的包虫病诊断方法。[方法]采用简便的一步层析方法从包囊液内纯化具有诊断价值的脂蛋白抗原,应用酶联免疫吸附试验(ELISA)和诊断试纸法(Dipstick法),对血清进行检测,评价其效果。[结果]ELISA检测包虫病人血清48份,阳性45份,检出率93.7％,和10份羊多房棘球蚴血清中的1份起交叉反应,而和羊细颈囊尾蚴、弓形虫、血吸虫血清不起反应。用Dipstick方法检测24份包虫病人血清,19份阳性,检出率79.2％,和其它寄生虫血清无交叉反应。[结论]本试验为包虫病诊断试剂盒的研制奠定了基础。

泡球蚴囊液对大鼠肝星状细胞MAPK信号通路5个相关基因的影响

目的探讨泡球蚴囊液对大鼠肝星状细胞丝裂原活化蛋白激酶(mitogen-activated protein kinase,MAPK)信号通路5个相关基因的影响。方法采用大鼠肝星状细胞株HSC-T6与不同蛋白浓度的泡球蚴囊液(0.01、0.025、0.05、0.1、0.2、0.4、0.9、1.7、3.4、6.8和13.5 mg/ml)共培养24 h后收集细胞,同时收集对照组(未加泡球蚴囊液干预)细胞,显微镜下观察HSC-T6细胞的形态变化。利用荧光实时定量PCR检测大鼠肝星状细胞的细胞外调节蛋白激酶(ERK)、c-Jun氨基末端激酶(JNK)和丝裂原活化蛋白激酶(p38)的表达情况。结果蛋白浓度为13.5 mg/ml泡球蚴囊液与HSC-T6细胞共培养24 h后,大部分细胞发生固缩,呈脱落前兆。6.8 mg/ml囊液组部分细胞固缩,呈脱落前兆;而部分HSC-T6细胞收缩,呈长梭形,细胞生长出许多细长的伪足,是正常状态的2倍以上。3.4 mg/ml囊液组部分细胞呈收缩的长梭形,生长出许多细长的伪足,但大部分细胞仍呈现为贴壁的胞体较大的不规则多边形,且伸出较短的伪足与其他细胞连接成片状。<1.7 mg/ml囊液组与对照组细胞形态上无差异。实时荧光定量PCR检测显示,泡球蚴囊液浓度>0.4 mg/ml时,ERK1/2、JNK1/2和p38 m RNA水平显著增加;囊液浓度为6.8 mg/ml时,ERK1/2、JNK1/2和p38 m RNA较对照组高表达(P<0.05)。结论浓度为6.8 mg/ml的泡球蚴囊液可显著影响大鼠肝星状细胞ERK1/2、JNK1/2和p38 m RNA水平。

常染色体显性遗传多囊肾病的治疗研究进展

常染色体显性遗传多囊肾病是一种较常见的单基因遗传病,病变以双肾多发性进行性充液囊泡为主要特征。囊泡损伤肾组织,引起肾功能改变,最终导致肾衰竭。除透析和肾移植治疗终末期肾衰竭,尚无有效疗法延缓多囊肾病程进展。抑制囊泡液体分泌,抗囊泡上皮细胞生长和减轻继发病变是治疗该病的主要策略。

子宫内膜异位症血清和囊液CA125的测定及临床意义

目的探讨CA125与子宫内膜异位症(EM)的关系。方法分别测定卵巢子宫内膜异位囊肿(巧囊)和非子宫内膜异位症的卵巢良性囊肿患者血清及囊液CA125水平。结果巧囊组囊液CA125高于血清CA125水平(P<0.01);巧囊组血清和囊液CA125均高于对照组(P<0.01);且分别与病情程度成正相关(r=0.8564,r=0.8118,P<0.01);血清CA125与痛经严重程度呈正相关(r=0.5545,P<0.01);而囊液CA125水平与痛经严重程度无明显相关性(P>0.05)。结论CA125与子宫内膜异位症的发生、发展及预后有关;血清和囊液CA125随着病情程度增加而升高,血清CA125与痛经程度呈正相关,测定CA125有助于EM的诊断及病情、预后的判断。

猪囊尾蚴囊液抗原制备及ELISA检测条件的优化

本试验采用SephadexG-200层析技术纯化猪囊尾蚴(Cysticercus cellulosae)的囊液粗抗原。共获得两种(CF_1、CF_2)层析抗原,以酶联免疫吸附试验(ELISA)判定抗原的最适包被浓度以及抗体的最适稀释倍数,各阶段最适反应条件,结果证明CF_1具有特异性强、敏感性高、稳定性好、重复性强的特点可以作为免疫诊断囊尾蚴病猪IgG。

泡球蚴囊液对原代培养大鼠肝细胞增殖影响的初步研究

目的探讨泡球蚴囊液对体外原代培养大鼠肝脏细胞增殖的影响。方法以Wistar大鼠作肝细胞供者,采用胶原酶肝脏原位灌流消化法分离肝细胞。取1×106肝细胞接种于Ⅰ型胶原铺底35mm培养皿,无血清培养20h后以泡球蚴囊液置换培养液培养24h和48h,期间在荧光倒置显微镜下观察肝细胞形态变化,流式细胞仪测定细胞周期;另取1×105肝细胞接种于Ⅰ型胶原铺底96孔培养板,同上培养,MTT法检测泡球蚴囊液对大鼠肝脏细胞毒性作用。结果与泡球蚴囊液共培养后肝细胞贴壁生长良好,MTT法测定肝细胞存活率为77.5%～100%。培养24h后肝细胞增殖指数(PI)泡球蚴囊液处理组为(49.35±4.00)%,对照组为(82.00±6.00)%;培养48h后两组肝细胞增殖指数(PI)分别为(27.61±6.00)%和(67.00±10.00)%,差异均有显著性(P<0.05)。结论泡球蚴囊液对体外培养大鼠肝细胞无毒害作用,但对肝细胞的增殖有一定的抑制作用。

棘球蚴囊液对小鼠脾细胞IL-17及Smad2表达的影响

目的:观察细粒棘球蚴囊液对体外培养BALB/c小鼠脾细胞白介素(IL)-17和Smad2基因表达的影响。方法:制备小鼠脾细胞悬液,接种于48孔培养板中进行培养,以不加任何干预为对照组,囊液处理组为实验组。定时取样提取总RNA,经反转录成cDNA后用实时荧光定量PCR(qRT-PCR)检测IL-17和Smad2基因的表达。结果:小鼠脾细胞IL-17表达在囊液处理6h和12h后升高(1.000±0.207 VS 3.672±0.746和1.000±0.154 VS 5.525±0.843),差异有统计学意义(P<0.05);小鼠脾细胞Smad2表达在培养1h后升高(1.000±0.077 VS 2.069±0.098)在12h后降低(1.000±0.110 VS 0.247±0.011),差异有统计学意义(P<0.05);协同分析发现IL-17基因与Smad2基因的表达变化呈现负相关(P<0.01),相关系数r=-1。结论:细粒棘球蚴囊液对小鼠脾细胞IL-17和Smad2基因的表达具有上调作用,推测其可能与宿主抗棘球蚴感染的机制有关。

棘球蚴感染绵羊并诱发休克期间特异性IgG、IgE抗体对特异性抗原的识别

目的 探讨细粒棘球蚴(E.g.)囊液粗制抗原和B抗原(EgB)识别绵羊感染E.g.后及诱发过敏性休克期间特异性IgG和IgE抗体的特异性反应,并对抗原特性及分子量进行描述。 方法 制备E.g.囊液粗制抗原及EgB,应用免疫印迹技术检测经剖杀证实感染E.g.并诱发过敏性休克的20只绵羊血清特异性IgG和IgE抗体对两种抗原的抗体反应性,并对抗原特性和分子量进行描述。 结果 特异性IgE抗体与耐热、低分子量的EgB(8、12和16 kDa)抗原未见明显的反应条带,而与E.g.囊液粗制抗原在43 kDa处可见明显的反应条带。IgG抗体与E.g.囊液粗制抗原未见明显的反应条带,但与EgB抗原反应后在31、43和66.2 kDa处可见较为明显的反应条带。 结论 EgB可能不是特异性IgE抗体的特异性抗原,而是IgG抗体的特异性抗原。E.g.粗制囊液抗原中含有特异性IgE抗体的特异性抗原组分,其分子量大于43 kDa,可能是导致棘球蚴病患者过敏性休克的主要致敏原。