ObjectiveTo investigate the growth characteristics of pancreatic cancer cells in the twodimensional culture system (monolayer) and threedimensional culture system (type Ⅰ collagen and extracellular matrix gel). MethodsThree pancreatic cancer cell lines (SW1990, PCT, and ASPC1) were cultured in monolayer, type Ⅰ collagen, and extracellular matrix gel, respectively. The growth patterns were observed, growth curves were detected by CCK8 test, and the cell cycle distributions were analyzed by propidium iodide staining. Results In the twodimensional culture system, cells grew in monolayer. In the type Ⅰ collagen and the ECM gel threedimensional culture system, cells formed multicellular spheroids (MCS), of which the growth rates were slower than those of the cells in monolayer. The proportions of S phase of SW1990, PCT, and ASPC1 cells in twodimensional culture system were significantly more than those in the type Ⅰ collagen on 4 d and 8 d 〔(29.6±3.0)% vs. (18.2±5.1)%, (33.6±2.1)% vs. (14.5±3.2)%, (33.1±1.8)% vs. (24.7±2.6)%; Plt;0.05〕, while the difference of proportion of three cell lines in G2/M phase was not different between twodimensional culture system and type Ⅰ collagen (Pgt;0.05). The proportions of G0/G1 phase of SW1990 and PCT cells cultured in the type Ⅰ collagen on 4 d and 8 d and ASPC1 cells cultured in the type Ⅰ collagen on 4 d were significant more than those cultured in twodimensional culture system (Plt;0.05). The proportions of S phase of ASPC1 cells and SW1990 cells cultured in the type Ⅰ collagen on 4 d were significant more than those cultured in the type Ⅰ collagen on 8 d (Plt;0.05). ConclusionsThe characteristics of pancreatic cancer cells in twodimensional and threedimensional culture systems are different. MCS culture system can better mimic the in vivo growth environment of cells in tumors.
目的 总结腔内修复术治疗主动脉夹层的经验。方法 选择2011年7月至2013年1月期间我院住院的胸主动脉夹层患者15例，术前均采用CTA评估，全部行腔内修复术。结果 15例患者采用腔内修复手术全部成功，手术时间95～165min，（120±26） min；失血量30～160mL，（68±34） mL。10例采用经股动脉入路，5例采用经股动脉及肱动脉入路。13例单一破口者各植入支架1枚，手术全部成功。15例患者未发生截瘫，无一椎基底动脉缺血症状，无下肢缺血改变，无伤口感染及腹股沟区淋巴瘘。2例存在Ⅱ型内漏，未经处理自行闭合。随访胸腹主动脉CTA扫描显示覆膜支架均未移位，未发现植入支架后并发近端夹层者。结论 腔内修复术治疗主动脉夹层是一种有效的治疗方法，具有安全性高、术后并发症少、治疗效果好等优点。
ObjectiveTo study the prevention and treatment of restenosis after the stent placement in the latest progress. MethodsThere were four methods including drug-eluting stents, intracavitary illuminate, drug therapy, and mesenchymal stem cells, which prevented or treatment restenosis after stent placement. ResultsAll the four methods could reduce the postoperative restenosis rate after interventional treatment. Many experimental study of prevention and treatment of restenosis had obvious effect, but clinical curative effect was not very satisfactory, because of a series of problems such as safety, animal models, experiment method, and so on. ConclusionThe multiple factors and links caused restenosis should be considered fully, and interrupting the links or factors as far as possible could control the occurrence or development effectively.
ObjectiveTo study the clinical role of spleen/remnant liver volume ratio in evaluating liver reserve function after surgical treatment for liver cancer. MethodsTo calculate the ratio of spleen volume/remnant liver volume after tumor excision with imaging method and immersion method; to analyze the relationships between spleen/remnant liver volume ratio and liver function score after operation as well as hospital stay. ResultsLiver function ChildPugh score was related mainly with spleen/remnant liver volume ratio (t=7.831, P=0.000), which was proved by multiple regression analysis. The median hospital stay of the group with spleen/remnant liver ratio ≤0.9 was 14 d （12-16 d）, which was less than that (22 d, 15-29 d) of the other group with the ratio gt;0.9 (P=0.000). ConclusionsSpleen/remnant liver volume ratio can predict effectively recovery ability of patients after operation for liver cancer， and assess correctly the reserve function of liver. When the ratio is less than or equal 0.9, the operation is safe.
目的 探讨输入袢空肠结扎术在胆肠和胰肠吻合中的效果。 方法 我院2006年2月至2008年3月期间共收治43例需行胆肠及胰肠吻合的患者，分别行输入袢结扎的间置空肠吻合术（观察组，n=25）和经典的Roux-en-Y吻合术（对照组，n=18），观察2组患者手术时间、住院时间、肠功能恢复时间、返流性胆管炎、胆管积气及并发症发生情况。 结果 与经典的Roux-en-Y吻合术相比，输入袢结扎的间置空肠吻合术患者消化道重建时间、术后住院时间及肠功能恢复时间明显缩短,返流性胆管炎及胆管积气发生例数均显著减少，差异有统计学意义(Plt;0.05)。对照组2例患者出现切口感染； 观察组1例切口感染，1例肺部感染，均经对症治疗后痊愈。 结论 输入袢结扎的间置空肠吻合术操作简单、术后恢复快、并发症少，在上腹部消化道重建中有一定的应用价值。
目的探讨全腹腔镜下肝切除的可行性、安全性及手术技巧。 方法回顾性分析2010年7月至2013年3月期间我院行全腹腔镜下肝切除20例病例（腹腔镜组），其中肝海绵状血管瘤10例，原发性肝细胞癌6例，肝内胆管结石4例。与同期25例开腹肝切除手术（开腹组）进行比较。 结果2组患者一般临床资料比较差异无统计学意义（P＞0.05），具有可比性。腹腔镜组术后有1例出现胆汁漏（＜100 mL/d），经通畅引流7 d后停止，未发现腹腔积液后拔除引流管，顺利恢复；术后1～2 d逐步恢复饮食，5～7 d出院，原发性肝细胞癌患者病理检查切缘未发现残余病灶。腹腔镜组术后切口疼痛持续时间明显短于开腹组〔（1.67±0.52）d比（3.39±0.63）d，t=2.266，P=0.035〕。无一例切口出现感染及脂肪液化。腹腔镜组和开腹组的手术时间比较差异无统计学意义〔（110.29±25.11）min比（100.95±24.32）min，t=0.731，P=0.415〕，腹腔镜组的术中出血量明显少于开腹组〔（345.11±45.21）mL比（506.72±58.32）mL，t=25.10，P＜0.001〕，住院时间也明显短于开腹组〔（3.57±1.52）d比（6.39±3.63）d，w=15.00，P=0.005〕。 结论全腹腔镜下肝切除（特别是肝脏边缘及左外叶病灶）是安全、可行的，较开腹手术其具有微创、住院时间短、术中出血量少、手术并发症少等优点。
【摘要】 目的 比较胫骨平台骨折术后辅助与不辅助持续被动运动（continuous passive motion，CPM）的临床疗效。 方法 对2008年6月-2009年6月86例行手术治疗的闭合性、无合并损伤的胫骨平台骨折患者进行回顾性分析。根据是否辅助CPM分为CPM组27例和非CPM组（对照组）59例。对两组患者的伤口愈合情况，膝关节屈曲、伸直角度，以及膝关节功能恢复情况进行比较。 结果 两组伤口甲级愈合率差异无统计学意义（P=0.566）。在术后2周和6周，CPM组患者的膝关节屈曲角度明显大于对照组（Plt;0.001），但在术后3个月和12个月，两组的差异无统计学意义（P=0.219，P=0.512）。在术后2、6周，3、12个月，CPM组和对照组患者的膝关节伸直角度差异无统计学意义。在术后12个月的Rasmussen膝关节功能评分方面，CPM组和对照组的差异无统计学意义。 结论 胫骨平台骨折术后辅助CPM能早期提升膝关节屈曲角度，但并不能提高远期的膝关节活动度和最终的膝关节功能。【Abstract】 Objective To compare the therapeutic effect of continuous passive motion (CPM) treatment after tibial plateau fractures operation. Methods From June 2008 to June 2009, 86 patients were treated due to closed tibial plateau fractures without combined injuries. The patients were treated with (27 patients, CPM group) and without (59 patients, control group) CPM. The wound healing rates, range of motion and the knee function were compared between the two groups. Results There was no significant difference between the two groups in wound healing rates (P=0.566). Two and six weeks after the operation, there were significant differences between the two groups in flexion degree (Plt;0.001); three and 12 months after the operation, there were no significant differences between the two groups (P=0.219, P=0.512). At the 2nd and 6th week, 3rd and 12th month postoperatively, there were no significant differences between the groups in extension degree. Twelve months after the operation, there were no significant differences between the groups in functional recovery of the knee. Conclusion CPM in the post-operative treatment of tibial plateau fractures is effective increasing knee flexion in the early stage, but is not effective increasing range of motion or knee function in a long term.
Objective To investigate the effects of long time different negative pressures on osteogenic diffe-rentiation of rabbit bone mesenchymal stem cells (BMSCs). Methods The rabbit BMSCs were isolated and cultured by density gradient centrifugation. Flow cytometry was used to analyze expression of surface markers. The third passage cells cultured under condition of osteogenic induction and under different negative pressure of 0 mm Hg (control group), 75 mm Hg (low negative pressure group), and 150 mm Hg (high negative pressure group) (1 mm Hg=0.133 kPa), and the negative pressure time was 30 min/h. Cell growth was observed under phase contrast microscopy, and the growth curve was drawn; alkaline phosphatase (ALP) activity was detected by ELISA after induced for 3, 7, and 14 days. The mRNA and protein expressions of collagen type I (COL-I) and osteocalcin (OC) in BMSCs were analyzed by real-time fluorescence quantitative PCR and Western blot. Results The cultured cells were identified as BMSCs by flow cytometry. The third passage BMSCs exhibited typical long shuttle and irregular shape. Cell proliferation was inhibited with the increase of negative pressure. After induced for 4 days, the cell number of high negative pressure group was significantly less than that in control group and low negative pressure group (P<0.05), but there was no significant difference between the low negative pressure group and the control group (P>0.05); at 5-7 days, the cell number showed significant difference between 3 groups (P<0.05). The greater the negative pressure was, the greater the inhibition of cell proliferation was. There was no significant difference in ALP activity between groups at 3 days after induction (P>0.05); the ALP activity showed significant difference (P<0.05) between the high negative pressure group and the control group at 7 days after induction; and significant difference was found in the ALP activity between 3 groups at 14 days after induction (P<0.05). The greater the negative pressure was, the higher the ALP activity was. Real-time fluorescence quantitative PCR and Western blot detection showed that the mRNA and protein expressions of COL-I and OC protein were significantly higher in low negative pressure group and high negative pressure group than control group (P<0.05), and in the high negative pressure group than the low negative pressure group (P<0.05). Conclusion With the increase of the negative pressure, the osteogenic differentiation ability of BMSCs increases gradually, but the cell proliferation is inhibited.