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Objective:To investigate the clinical characteristics of choledocholithiasis com-bined with periampullary diverticulum and influencing factor for difficult cannulation of endoscopic retrograde cholangiopancreatography (ERCP).Methods:The retrospective case-control study was conducted. The clinical data of 1 920 patients who underwent ERCP for choledocholithiasis in 15 medical centers, including the First Hospital of Lanzhou University, et al, from July 2015 to December 2017 were collected. There were 915 males and 1 005 females, aged (63±16)years. Of 1 920 patients, there were 228 cases with periampullary diverticulum and 1 692 cases without periampullary diverticulum. Observation indicators: (1) clinical characteristics of patients with choledocholithiasis; (2) intraoperative and postoperative situations of patients undergoing ERCP for choledocholithiasis; (3) influencing factor analysis for difficult cannulation in patients undergoing ERCP for choledocholithiasis. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M(range) or M( Q1, Q3), and com-parison between groups was conducted using the Wilcoxon rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test or Fisher exact probability. The Logistic regression model was used for univariate and multivariate analyses. Results:(1) Clinical characteristics of patients with choledocholithiasis. Age, body mass index, cases with complications as chronic obstructive pulmonary disease, diameter of common bile duct, cases with diameter of common bile duct as <8 mm, 8?12 mm, >12 mm, diameter of stone, cases with number of stones as single and multiple were (69±12)years, (23.3±3.0)kg/m 2, 16, (14±4)mm, 11, 95, 122, (12±4)mm, 89, 139 in patients with choledocholithiasis combined with periampullary diverticulum, versus (62±16)years, (23.8±2.8)kg/m 2, 67, (12±4)mm, 159, 892, 641, (10±4)mm, 817, 875 in patients with choledocholithiasis not combined with periampullary diver-ticulum, showing significant differences in the above indicators between the two groups ( t=?7.55, 2.45, χ2=4.54, t=?4.92, Z=4.66, t=?7.31, χ2=6.90, P<0.05). (2) Intraoperative and postoperative situations of patients undergoing ERCP for choledocholithiasis. The balloon expansion diameter, cases with intraoperative bleeding, cases with hemorrhage management of submucosal injection, hemostatic clip, spray hemostasis, electrocoagulation hemostasis and other treatment, cases with endoscopic plastic stent placement, cases with endoscopic nasal bile duct drainage, cases with mechanical lithotripsy, cases with stone complete clearing, cases with difficult cannulation, cases with delayed intubation, cases undergoing >5 times of cannulation attempts, cannulation time, X-ray exposure time, operation time were 10.0(range, 8.5?12.0)mm, 56, 6, 5, 43, 1, 1, 52, 177, 67, 201, 74, 38, 74, (7.4±3.1)minutes, (6±3)minutes, (46±19)minutes in patients with choledocholithiasis combined with periampullary diverticulum, versus 9.0(range, 8.0?11.0)mm, 243, 35, 14, 109, 73, 12, 230, 1 457, 167, 1 565, 395, 171, 395, (6.6±2.9)minutes, (6±5)minutes, (41±17)minutes in patients with choledocholithiasis not combined with periampullary diverticulum, showing significant differences in the above indicators between the two groups ( Z=6.31, χ2=15.90, 26.02, 13.61, 11.40, 71.51, 5.12, 9.04, 8.92, 9.04, t=?3.89, 2.67, ?3.61, P<0.05). (3) Influencing factor analysis for difficult cannulation in patients undergoing ERCP for choledocholithiasis. Results of multivariate analysis showed total bilirubin >30 umol/L, number of stones >1, combined with periampullary diverticulum were indepen-dent risk factors for difficult cannulation in patients with periampullary diverticulum who underwent ERCP for choledocholithiasis ( odds ratio=1.31, 1.48, 1.44, 95% confidence interval as 1.06?1.61, 1.20?1.84, 1.06?1.95, P<0.05). Results of further analysis showed that, of 1 920 patients undergoing ERCP for choledocholithiasis, the incidence of postoperative pancreatitis was 17.271%(81/469) and 8.132%(118/1 451) in the 469 cases with difficult cannulation and 1 451 cases without difficult cannula-tion, respectively, showing a significant difference between them ( χ2=31.86, P<0.05). In the 1 692 patients with choledocholithiasis not combined with periampullary diverticulum, the incidence of postopera-tive pancreatitis was 17.722%(70/395) and 8.250%(107/1 297) in 395 cases with difficult cannula-tion and 1 297 cases without difficult cannulation, respectively, showing a significant difference between them ( χ2=29.00, P<0.05). In the 228 patients with choledocholithiasis combined with peri-ampullary diverticulum, the incidence of postoperative pancreatitis was 14.865%(11/74) and 7.143%(11/154) in 74 cases with difficult cannulation and 154 cases without difficult cannulation, respectively, showing no significant difference between them ( χ2=3.42, P>0.05). Conclusions:Compared with patients with choledocholithiasis not combined with periampullary divertioulum, periampullary divertioulum often occurs in choledocholithiasis patients of elderly and low body mass index. The proportion of chronic obstructive pulmonary disease is high in choledocholithiasis patients with periampullary diverticulum, and the diameter of stone is large, the number of stone is more in these patients. Combined with periampullary diverticulum will increase the difficult of cannulation and the ratio of patient with mechanical lithotripsy, and reduce the ratio of patient with stone complete clearing without increasing postoperative complications of choledocholithiasis patients undergoing ERCP. Total bilirubin >30 μmol/L, number of stones >1, combined with periampullary diverticulum are independent risk factors for difficult cannulation in patients of periampullary diverticulum who underwent ERCP for choledocholithiasis.
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In the process of radical resection of abdominal malignant tumors, large blood vessels are often invaded, which not only increases the difficulty of operation, but also directly affects the curative effect and prognosis. As the concept of expanded radical surgery combined with vascular resection and reconstruction and related techniques have been gradually recognized, surgeons have begun to use autologous, allogeneic or artificial vessels to repair the defective blood vessels during surgery, so as to achieve the effect of radical surgery. However, due to the short comings of these materials, scholars have been looking for better alternatives. In view of the fact that the mesothelial cells of the peritoneum and the endothelial cells of the blood vessels have many similarities in embryology, histology and physiology, and peritoneum is also easier to obtain than autologous, allogeneic or artificial vessels. To make the autologous peritoneum into a patch for repairing the defective blood vessels is feasible in theoretical and technical. In this paper, we review the current research progress of autologous peritoneal patch to repair blood vessels of defect.
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Medication-related osteonecrosis of the jaw (MRONJ) is a serious side effect of bone-modifying agents and inhibits angiogenesis agents. Although the pathogenesis of MRONJ is not entirely clear, multiple factors may be involved in specific microenvironments. The TGF-β1 signalling pathway may have a key role in the development of MRONJ. According to the clinical stage, multiple variables should be considered when selecting the most appropriate treatment. Therefore, the prevention and management of treatment of MRONJ should be conducted in patient-centred multidisciplinary team collaborative networks with oncologists, dentists and dental specialists. This would comprise a closed responsibility treatment loop with all benefits directed to the patient. Thus, in the present review, we aimed to summarise the pathogenesis, risk factors, imaging features, clinical staging, therapeutic methods, prevention and treatment strategies associated with MRONJ, which may provide a reference that can inform preventive strategies and improve the quality of life for patients in the future.
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Humanos , Osteonecrosis de los Maxilares Asociada a Difosfonatos/prevención & control , Conservadores de la Densidad Ósea/efectos adversos , Calidad de Vida , Factores de RiesgoRESUMEN
Purpose@#Combining targeted agents with adjuvant chemotherapy prolongs survival in human epidermal growth factor receptor 2 (HER2)-positive breast cancer patients, but also increases the risk of adverse effects. The updated results of 3 randomized controlled trials (RCTs) were reported in 2019. Given the lack of adequate head-to-head pairwise assessment for anti-HER2 agents, network meta-analysis facilitates obtaining more precise inference for evidence-based therapy. @*Methods@#RCTs comparing at least 2 anti-HER2 regimens in an adjuvant setting for HER2-positive early-stage breast cancer (EBC) were included. Hazard ratios for overall survival (OS) and disease free survival (DFS), with respective 95% confidence intervals were pooled for assessment of efficacy. A Bayesian statistical model was used, and odds ratios (ORs) for adverse events (AEs) were used to pool effect sizes. @*Results@#We demonstrated that 1-year trastuzumab plus chemotherapy had increased efficacy compared to shorter or longer treatment duration. The OR of cardiac events gradually increased from 6 months to 1 and 2-year trastuzumab arms, relative to chemotherapy only.Compared to trastuzumab plus chemotherapy, dual HER2-targeting therapies increased DFS, especially for hormone receptor negative patients. Dual anti-HER2 blockade regimens revealed an increased probability of gastrointestinal reactions. As a second agent, pertuzumab showed significantly higher DFS and OS. @*Conclusion@#We conclude that 1-year adjuvant trastuzumab should remain as the standard treatment for HER2-positive EBC patients, as it has greater efficacy and a manageable proportion of AEs. Clinical efficacy can be increased for hormone receptor-negative tumors by including a second HER2-targeted agent to the treatment regimen. For hormone receptorpositive cases with basal disease, it is acceptable to reduce the risk of cardiotoxicity by shortening the duration of trastuzumab.
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Objective@#To investigate the accuracy of parents′ self-assessment of dental caries status of their children and to explore the relevant factors affecting accuracy.@*Methods@#A total of 329 children in kindergarten of Science and Technology Research Institute of China Petroleum Corporation and their parents were recruited by convenience sampling method. The parents assessed their children's dental caries status and completed a questionnaire, and then children were examined by the dentists. The difference between parents and dentists′ the assessment of children's dental caries status and relevant influencing factors were analyzed.@*Results@#51.06%(168/329) of the parents did not agree with the doctor's diagnosis in the assessment of children's caries. The rate of parents' missed diagnosis was 94.12%. Logistic regression analysis showed that 'children brush teeth everyday' (OR value was 2.919), 'parents can help children brush their teeth' (OR value was 2.670), 'parents can check results after children brushing their teeth '(OR value was 4.508), and 'children received the treatment of dental caries' (OR value was 1.768) were significant influencing factors of parents' assessment accuracy (P<0.01).@*Conclusions@#The accuracy of parents' assessment of children′s dental caries status is low, and it is related to many factors. Attention should be paid to the implementation of oral heath behavior during oral health education, and parents' capacity of assessing children caries should be improved.
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Objective:To investigate the accuracy of parents′ self-assessment of dental caries status of their children and to explore the relevant factors affecting accuracy.Methods:A total of 329 children in kindergarten of Science and Technology Research Institute of China Petroleum Corporation and their parents were recruited by convenience sampling method. The parents assessed their children's dental caries status and completed a questionnaire, and then children were examined by the dentists. The difference between parents and dentists′ the assessment of children's dental caries status and relevant influencing factors were analyzed.Results:51.06%(168/329) of the parents did not agree with the doctor's diagnosis in the assessment of children's caries. The rate of parents' missed diagnosis was 94.12%. Logistic regression analysis showed that 'children brush teeth everyday' ( OR value was 2.919), 'parents can help children brush their teeth' ( OR value was 2.670), 'parents can check results after children brushing their teeth '( OR value was 4.508), and 'children received the treatment of dental caries' ( OR value was 1.768) were significant influencing factors of parents' assessment accuracy ( P<0.01). Conclusions:The accuracy of parents' assessment of children′s dental caries status is low, and it is related to many factors. Attention should be paid to the implementation of oral heath behavior during oral health education, and parents' capacity of assessing children caries should be improved.
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Purpose@#Combining targeted agents with adjuvant chemotherapy prolongs survival in human epidermal growth factor receptor 2 (HER2)-positive breast cancer patients, but also increases the risk of adverse effects. The updated results of 3 randomized controlled trials (RCTs) were reported in 2019. Given the lack of adequate head-to-head pairwise assessment for anti-HER2 agents, network meta-analysis facilitates obtaining more precise inference for evidence-based therapy. @*Methods@#RCTs comparing at least 2 anti-HER2 regimens in an adjuvant setting for HER2-positive early-stage breast cancer (EBC) were included. Hazard ratios for overall survival (OS) and disease free survival (DFS), with respective 95% confidence intervals were pooled for assessment of efficacy. A Bayesian statistical model was used, and odds ratios (ORs) for adverse events (AEs) were used to pool effect sizes. @*Results@#We demonstrated that 1-year trastuzumab plus chemotherapy had increased efficacy compared to shorter or longer treatment duration. The OR of cardiac events gradually increased from 6 months to 1 and 2-year trastuzumab arms, relative to chemotherapy only.Compared to trastuzumab plus chemotherapy, dual HER2-targeting therapies increased DFS, especially for hormone receptor negative patients. Dual anti-HER2 blockade regimens revealed an increased probability of gastrointestinal reactions. As a second agent, pertuzumab showed significantly higher DFS and OS. @*Conclusion@#We conclude that 1-year adjuvant trastuzumab should remain as the standard treatment for HER2-positive EBC patients, as it has greater efficacy and a manageable proportion of AEs. Clinical efficacy can be increased for hormone receptor-negative tumors by including a second HER2-targeted agent to the treatment regimen. For hormone receptorpositive cases with basal disease, it is acceptable to reduce the risk of cardiotoxicity by shortening the duration of trastuzumab.
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Objective@#To explore peptidomic changes of peptides in saliva and gingival crevicular fluid (GCF) before and after treatment of gingivitis.@*Methods@#From January 2017 to September 2017, seventeen participants at the age of 24-62 (6 males and 11 females) at Department of Preventive Dentistry, Peking University School and Hospital of Stomatology with gingivitis were recruited in the present study. Their clinical parameters were measured and recorded. Saliva and GCF samples were collected from each of the participants at the baseline and 7 days after ultrasonic supragingival scaling, respectively. Matrix-assisted laser desorption-ionization time-of-flight mass spectrometry (MALDI-TOF MS) was employed to detect the changes of peptidomic profiles, while ano-liquid chromatography-electrospray ionization-tandem mass spectrometry (nano-LC/ESI-MS/MS) was performed to identify the possible proteins from which the peptides might derive.@*Results@#Initially, four peptide peaks [mass-to-charge ratio (m/z) values: 1 030.6, 1 043.4, 1 053.4 and 1 064.6] were screened out exhibiting a decreasing trend after treatment (P<0.05). Besides, five peptide peaks from gingival crevicular fluid (P<0.05) exhibited differential expression, among which 1 055.5 and 1 168.3 demonstrating a decrease after treatment, while 3 363.7, 3 480.9 and 3 489.5 increased overtime. Certain positive correlations were detected between some peptides and clinical parameters. Principle component analysis using the above mentioned peptide peaks showed a distinct distribution before and after treatment and peptides from GCF showed a slightly better capacity to discriminate patients before and after treatment. The peptides with m/z values of 1 055.5 in GCF and 1 064.6 in saliva were identified to be segments of serum albumin and complement C3, respectively.@*Conclusions@#Several differentially expressed peptides were detected in saliva and GCF by MALDI-TOF MS, exhibiting the potentiality to act as biomarkers in gingivitis patients.
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Large Hiatal Hernia(LHH)is a special type of hiatal hernia,usually defined as more than 1/3 of stomach mi-gration with or without other organs or diameter of esophageal hiatus more than 5 cm.Operation is the only therapeutic method. With the development of laparoscopic surgery, laparoscopic repair of large hiatal hernia(LRLHH)is the standard technique for repair of large hiatal hernias.However LRLHH still is a kind of complexity, difficulty, high risk and recurrence to some extent. Moreover, there is still no consensus amongst surgeons about what is the optimal technique for LRLHH .Currently, controver-sies and advancement of LRLHH mainly concentrated on completely dissection and reduction of the sac from the mediastinum , suture cruroplasty with or without mesh, deal with short esophagus and gastroesophageal reflux.Modified LRLHH achieves completely dissection hiatal hernia sac , which is more convenient and more helpful for suture cruroplasty and reduce the ten-sion.The use of mesh effectively reduces the anatomical recurrence rate and may lead to complications such as esophageal ero-sion or extensive fibrosis with troublesome dysphagia .LRLHH with mesh or without mesh should be individualized .Optimal technique for LRLHH needs continual improvement and high-quality randomized controlled trials to obtain the most effective and safe mesh in the long term.In this paper, the controversy and progress of laparoscopic huge esophageal hiatal hernia repair will be summarized.
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Objective To investigate the safety and effectiveness of mesh and non-mesh techniques in laparoscopic repair of large hiatal hernias (LRLHH).Methods A retrospective clinical controlled study of mesh and non-mesh techniques in LRLHH form January 2006 to August 2014 was performed.Results A total of 83 and 36 patients were recruited to mesh and non-mesh group respectively.There were no significant differences in operation time,operation bleeding volume,hospitalization time or complications between the two groups.Main symptoms were significantly improved during the postoperative long-term follow-up in both groups.The improvement of dysphagia in mesh group showed no significant difference [22.9％ (19/83) VS 12.0％ (10/83),P=0.066],however,non-mesh group showed significant difference [30.6％ (11/36) VS 5.6％ (2/36),P=0.006].Rate of dysphagia alleviation in non-mesh group was significantly higher than that in mesh group [25.0％ (9/36) VS 10.8％ (9/83),P =0.048].Mesh-related complications of esophageal erosions occurred in 5 patients (6.0％) in mesh group,including esophageal stenosis in 3 patients,esophageal-cardiac stricture in 1 patient.Recurrent hernia occurred in 1 patient (1.2％) in mesh group and 3 patients (8.3％) in non-mesh group (P =0.082).Conclusion LRLHH with mesh should be individualized.The use of mesh in LRLHH reduces the recurrence rate,but may lead to some complications.
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<p><b>OBJECTIVE</b>To evaluate the accuracy of MRI for estimating residual tumor size after neoadjuvant chemotherapy (NAC) with three-dimensional (3D) reconstruction technique.</p><p><b>METHODS</b>This was a prospective study. The data of 61 patients with pathologically proven solitary invasive ductal carcinoma (IIA-IIIC) who had received 6 to 8 cycles of NAC from July 2010 to August 2013 was analyzed. All the patients were female, aging from 31 to 70 years with a median of 49 years. Breast specimen after surgery was prepared with part-mount sub-serial section, and residual tumors were microscopically outlined, scanned and registered by Photoshop software. The 3D model of pathological and MRI residual tumors was reconstructed with 3D-DOCTOR software. The longest diameter, maximum cross-section area and volume of the residual tumors determined using 3D MRI were compared with 3D pathological findings, and the associations between MRI and pathology were analyzed by Spearman rank correlation and Bland-Altman analysis.</p><p><b>RESULTS</b>The longest diameter, maximum cross-section area and volume of the residual tumors after NAC measured by MRI and pathology was highly correlated (r=0.942, 0.941, 0.903, all P=0.00). MRI appears to underestimate pathology in the longest diameter, maximum cross-section area, but slightly overestimate in volume, and two methods had a good consistence (MD=0.3 cm, 95% CI: -1.43 to 1.9 cm; MD=1.39 cm², 95% CI: -9.55 to 12.34 cm²; MD=-0.433 cm³, 95% CI: -7.065 to 6.199 cm³).</p><p><b>CONCLUSION</b>3D MRI reconstruction after NAC could accurately detects the residual tumors after neoadjuvant chemotherapy, and contribute to select patients who received breast conserving therapy after NAC with tumor downstaging.</p>
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Adulto , Anciano , Femenino , Humanos , Persona de Mediana Edad , Protocolos de Quimioterapia Combinada Antineoplásica , Neoplasias de la Mama , Diagnóstico , Quimioterapia , Imagenología Tridimensional , Imagen por Resonancia Magnética , Terapia Neoadyuvante , Neoplasia Residual , Diagnóstico , Estudios Prospectivos , Tomografía Computarizada por Rayos XRESUMEN
Objective To investigate the safety and efficacy of technical modification for laparoscopic repair of giant hiatal hernias.Methods A total of 49 patients with giant hiatal hernia underwent modified laparoscopic repair by dissecting sac, closing hiatal, mesh placement and fundoplication from June 2010 to May 2014.The operation time, hospitalization time, postoperative complications, upper gastrointestinal imaging and improvement of postoperative symptoms were observed.Results The average operation time was (103.6 ±31.7) min(88-173min).The average length of post operation hospitalization was (4.2 ± 1.8) d (range,3-12d).Postoperative complication occurred in 4 patients,including pleural effusion (1 patient),respiratory failure (1 patient), difficulty in swallowing (2 patients)with complication occurrence rate being 8.2％ (4/49).No conversion or death occurred.The average time of follow-up was (28.3 ± 12.7) months (6-50 months) in 49 cases.During the follow-up, main symptoms were relieved and no recurrence was found by barium swallow.Conclusion Technical modification for laparoscopic repair of giant hiatal hernias is safe and effective.
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Objective To explore the clinical variables associated with the shrinkage modes of primary breast tumor in women after neoadj uvant chemotherapy (NAC ), and to develop a nomogram for predicting non-concentric shrinkage mode(NCSM).Methods Sixty-one women with pathologically proven solitary invasive ductal carcinoma (ⅡA-ⅢC)were recruited. Breast specimen was prepared with PMSS, and residual tumors were microscopically outlined,scanned and registered by Photoshop CS 5 software.The 3D model of residual tumors was reconstructed with 3D-DOCTOR 4.0 software to evaluate the shrinkage mode.17 factors such as age and body mass index and menopausal status were chosen as independent variables,and the clinic-pathologic shrinkage mode was considered as dependent variable. A Logistic regression model was used to construct the nomogram. Results Primary tumor stage,lymph node down-staging, PR and mammographic malignant calcification before NAC were independent predictors of clinic-pathologic shrinkage mode (β:1.538,OR:4.656,95%CI:1.414-15.328,P=0.011;β:1.555,OR:4.735, 95%CI:1.082-20.722,P=0.039;β:-1.707, OR:0.181, 95%CI:0.044-0.741,P = 0.017;β:- 1.405, OR:3.808, 95% CI:0.06 - 0.998,P = 0.048, respectively ). The nomogram predicting the risk of NCSM showed a good concordance index(0.869),and its conformity of mean absolute error was 0.039. Conclusion Based on the clinicopathological findings of primary breast tumor, a nomogram to predict shrinkage modes after NAC in breast carcinoma patients is constructed.The statistical tool is helpful for individually selecting the patients who can be treated with BCT after NAC.
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Objective To establish a optimal method and threshold of 3-deoxy-3-fluorothymidine (FLT) PET-CT in delineating the biological target length of gross tumor in esophageal carcinoma, and to compare FLT PET-CT with other imaging modalities including esophagoseopy, esophagography, CT and flu-orodeoxyglucose (FDG) PET-CT. Methods Twenty-four patients with esophageal squamous cell carcinoma treated with radical surgery were enrolled. Before surgery, all the patients underwent FLT PET-CT, esepha-goscopy and esophagography. Twenty-two patients also received FDG PET-CT scan. Gross tumor volumes (GTV) were delineated using seven different threshold of FLT PET-CT: visual interpretation, standardized uptake value (SUV) 1.3, SUV 1.4, SUV 1.5, 20% of maximum standard uptake value (SUV_(max)), 25% SUV_(max), and 30% SUV_(max). Three different thresholds of FDG PET-CT were used, including visual interpre-tation, SUV 2.5, and 40% SUV_(max). The length of tumors on FLT PET-CT scan were measured and recorded as L_(FLTvis), L_(FLT1.3), L_(FLT1.4), L_(FLT1.5), L_(FLT20%), L_(FLT25%), and L_(FLT30%), respectively. The length of tumors on FDG PET-CT scan were recorded as L_(FDGvis), L_(FDG2.5), and L_(FDG40%), respectively. The length of tumors on CT, esophagography and esophagoscopy were recorded as L_(CT), L_(X-ray) and L_(Scopy). All of these results were com-pared with the length of gross tumor in the reseeted specimen measured by pathological examination (L_(Path)), Results The L_(Path) was (4.90±2.14) cm. The Length of tumors delineated by different methods, being from short to long, were L_(FDG40%), L_(Scopy), L_(X-ray),L_(FLT1.5),L_(CT),L_(FLT30%),L_(FLTvis),L_(FLT1.4),L_(FLT25%), L_(FDG2.5),L_(FDGvis),L_(FLT1.3),L_(FLT20%). The mean values were (3.85±1.52), (4.46±2.23), (4.63± 2.37), (4.64±2.38),(4.69± 1.85),(4.75±2.19) ,(4.85±2.33),(4.87±2.35),(5.05±2.20), (5.08± 2.19) ,(5.10±2.22), (5.21±2.40) and (5.53±2.17) cm,respectively. The correlation coefficients were 0.91,0.93,0.88, 0.95, 0.90, 0.81,0.96, 0.96, 0.80, 0.99, 0.99, 0.95 and 0. 79 , respective-ly. All the P values were 0. 000. L_(FLT1.4) of FLT PET-CT and L_(FDG2.5) of FDG PET-CT were found more ap-proximate to L_(Path). There was no significant difference between L_(FLT1.4) and L_(FDG2.5) (1= 1.23, P = 0.232), and the correlation coefficient was 0.96 (P = 0. 000). Conclusions Thresholds of SUV 1.4 on FLT PET-CT and SUV 2.5 on FDG PET-CT could optimally estimate the tumor length measured by pathological examina-tion, and could be objective and simple methods for semiquantitative analysis.
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Rotating wall vessel (RWV) was used for the ex-vivo expansion of umbilical cord blood stem cells to meet the requirement of clinical application in the aspect of quantity and quality of the stem cells. The mononuclear cells (MNCs) from umbilical cord blood were cultured in T-flasks for 24 h, and then inoculated in RWV to culture for 200 h. The nucleated-cell numbers, pH and osmolality of the culture medium were determined every 24 h. The CD34+ cells content was measured and CFU-GM culture was carried out at 144 h and 197 h. Nucleated cells (NC) and CD34+ cells had a 435.5 +/- 87.6 fold expansion and a 32.7 +/- 15.6 fold expansion respectively in 197 h, and CFU-GM (colony-forming unit-granulocyte/macrophage) cells had a 21.7 +/- 4.9 fold expansion. In the whole course of culture, the pH and osmolality of the medium in the RWV were kept in the optimal hematopoietic stem cells' expansion conditions. pH was kept from 7.2 to 7.4, and the osmolality was kept from 290 mmol/kg to 310 mmol/kg. Owing to its structural particularity, the RWV could ensure cells to grow in the suspension state, could simulate the micro-environment of umbilical cord blood, and thus could make the hematopoietic stem cells expand largely in the RWV in short time.
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Humanos , Antígenos CD34 , Metabolismo , Reactores Biológicos , Técnicas de Cultivo de Célula , Métodos , Proliferación Celular , Células Cultivadas , Medios de Cultivo , Citocinas , Farmacología , Sangre Fetal , Biología Celular , Células Madre Hematopoyéticas , Biología Celular , FisiologíaRESUMEN
When the size of a neurosphere cultured in vitro reaches a certain critical value, a necrotic core will appear inside the neurosphere because of the limitation of oxygen or other nutrients transport from medium to the cells in the neurasphere. Large necrotic core will greatly reduce the expansion of NSCs. The cellular automaton (CA) model is applied in this article to model the growth of NSCs in sphere state. The appearance and enlargement of the necrotic core in a neurosphere is calculated by coupling the CA model with the nutrient diffusion analysis in bioreactors. The calculation results indicate that the culture conditions, such as seeding density, the concentration of nutrients in medium and the mass transfer coefficient between a neurosphere and medium, have some effects on the appearance of the necrotic core. However, the necrotic core mainly depends on the inner diffusion. It will certainly appear if the size of the neurosphere is large enough even the outside mass transfer is in a good condition in bioreactors. Additionally, the appearance of the necrotic core resulting from the shortage of oxygen is earlier than that caused by the limitation of glucose. And the growth of the necrotic core is very fast after its appearance, and the whole neurosphere may become necrotic. The model developed with cellular automaton and mass transfer is a good qualitative representation of NSCs growth in bioreactors.