ABSTRACT
Objective To evaluate the clinical application value of CT guided percutaneous lung biopsy in patients with negative fiberoptic bronchoscopy. Methods The clinical data of 51 patients with central type lung lesions were retrospectively analyzed and all patients had a negative result of fiberoptic bronchoscopy. Then they underwent the CT guided percutaneous lung biopsy. The number of paracentesis, complication and pathology were recorded. The patients were divided into 3 groups according to the tumor size:2.5-4.5 cm group, 4.6-6.5 cm group and>6.5 cm or tumor reaching the segmental bronchus group. Results The tumor diameter of 51 patients was 2.5-10.8 cm, average 4.9 cm. The number of paracentesis was 86 times, and 43 cases (84.3%) obtained definite pathological diagnosis: small cell carcinoma of lung in 14 cases, lung squamous cell carcinoma in 11 cases, adenocarcinoma in 6 cases, neuroendocrine carcinoma in 1 case, adenosquamous carcinoma in 4 cases, sclerosing hemangioma in 2 cases, tuberculosis in 2 cases, inflammatory pseudotumor in 2 cases, and large cell carcinoma in 1 case. The incidence of complication was 47.1%(24/51), among which the total slight pneumothorax occurred in 10 cases, intraoperative and postoperative hemoptysis, sputum with blood in 6 cases, greater amounts pneumothorax in 5 cases (3 cases underwent the closed drainage of pleural cavity), puncture path errhysis in 2 cases, thoracic cavity hemorrhage and thoracic wall haematoma in 1 case. No patient died. The 2.5-4.5 cm group had 22 cases, 4.6-6.5 cm group had 17 cases and >6.5 cm or tumor reaching the segmental bronchus group had 12 cases, and there was no statistical difference in the rate of definite pathological diagnosis among 3 groups:81.8%(18/22), 14/17 and 11/12, P>0.05;and there was statistical difference in the incidence of complication among 3 group:63.6% (14/22), 7/17 and 2/12, P<0.05. Conclusions The preferred examination of central type lung lesions patients is fiberoptic bronchoscopy, but because of diversity of disease, the CT guided percutaneous lung biopsy in the patients with negative fiberoptic bronchoscopy is feasible, safe, with high positive rate of biopsy and lower risk.
ABSTRACT
Aim To investigate the curative effect of rAAV-PR39-ADM,which co-expressed the gene of an-tibacterial peptide (PR39 ) and adrenomedullin (ADM),in a rat cerebral ischemia/reperfusion (I/R) injury.Methods In vitro,Matrigel angiogenesis as-say was made with human umbilical vein endothelial cells.In vivo,the cerebral I/R model was established by the occlusion of the cerebral artery for 2h and then reperfused for 24 h.SD rats were randomly divided in-to sham group,I/R+normal saline group,I/R+null virus (AAV ) group, and IR +rAAV-PR39-ADM group.rAAV-PR39-ADM,saline and null virus were administered through the femoral vein after 24 h of the reperfusion in I/R group.MRI,neurological deficit score,TTC and HE staining were measured respective-ly 1 ,2,3 and 4 weeks after the injection in order to e-valuate the therapeutic efficacy.Results In vitro, rAAV-PR39-ADM group had significant angiogenic effect compared with sham group and null virus group. In vivo,successful I/R model was verified by the ima-ges of MRI.Compared with sham group,the nerve function defect score and the cerebral infarction size in each time nodes were significantly raised in I/R groups (P<0.01).There was no significant difference in in-farct size and nerve function defect score between I/R+normal saline group and I/R +null virus (AAV ) group,and obviously,the IR +rAAV-PR39-ADM group lowered these indexes compared with the other two groups.HE staining showed that the number of neurons,new capillaries vessels of I/R +PR39-ADM group were significantly more than those in group I/R and group I/R +null virus.Conclusion The treat-ment of rAAV-PR39-ADM promotes vascular forma-tion,neuron protection and reduces the infarct size in the model of cerebral ischemia/reperfusion.