【摘要】 目的 探討椎管內囊腫的手術治療療效。 方法 2006年5月-2009年12月對30例患者的臨床表現、影像學和治療情況進行回顧性分析。 結果 30例均行手術治療，3例為椎管內單側硬膜下髓外囊腫，3例為腦脊膜囊腫，12例為髓外硬脊膜下囊腫，9例為神經根袖套部囊腫（Tarlov囊腫），3例為脊管內腸源性囊腫。術后21例癥狀消失；9例好轉，其中3例術后發生腦脊液漏，傷口二次縫合未成功，后經內引流后切口愈合。 結論 椎管內囊腫的臨床表現及體征復雜，不典型，與椎管內腫瘤及椎間盤突出癥的臨床表現和體征相似；對癥狀及體征明顯者宜施行手術治療，手術治療效果較滿意。【Abstract】 Objective To evaluate the therapeutic effect of the surgery on intraspinal cyst. Methods A total of 30 patients from May 2006 to December 2009 were collected, and the clinical manifestations, results of examinations and therapeutic effects were retrospectively analyzed. Results All the patients underwent the surgery, inluding 3 with unilateral intraspinal subdural extramedullary cyst, 3 with meningeal cyst, 12 with subdural extramedullary cyst, 3 with nerve-root oversleeve cyst (Tarlov cyst), and 3 with intra-spinal-canal enterogenous cyst. Afterh the surgery, the symptoms disappeared in 21 patients, alleviated in 9 including 3 with postoperative cerebrospinal-fluid leakage whose wound was not sutured successfully for the second time and healed up after drainage. Conclusions The clinical manifestations of intraspinal cyst are complicated and untypical, which is similar to that of intraspinal tumor and slipped disc. The surgeries should be performed on the patients with obvious symptoms and the therapeutic effect is good.
Objective
To verify tissue factor (TF)-bearing microparticle (TF-MP) could be released from Kupffer cells (KCs) stimulated by lipopolysaccharide (LPS) and TF controlled by Toll-like receptor 4 (TLR4) could induce acute pancreatitis.
Methods
After the acute pancreatitis model completed, the wild type C57/BL6 mouse (WT group) and the TLR4-/- mouse (TLR4-/- group) received intraperitioneal injections of 10 mg/kg LPS. The degree of pathological lesion and the TF expression were detected in the pancreas tissue. The TF and TLR4 protein and mRNA expressions in the KCs were detected at 6, 12, and 24 h after the last injection of LPS. The survival rates were campared in these estabilshed acute pancreatitis model mice. The TF and TLR4 protein and mRNA expressions in the KCs stimulated with LPS (300 μg/L) were also detected at 0, 15, 30, 60, and 120 min. The TF and TF-MP levels were detected in the supernatants of the KCs at these time point.
Results
The injury of the pancreas in the TLR4-/- group was slighter than that in the WT group. The TF proteins in the liver and pancreas tissues of the TLR4-/- group were significantly lower than those of the WT group (P<0.05). The survival rate of the TLR4-/- group was significantly higher than that of the WT group under the situation of the acute pancreatitis (P<0.05). The TLR4 and TF protien and mRNA expressions of the KCs were significantly decreased in the TLR4-/- group as compared with the WT group at 30, 60, and 120 min (P<0.05). The levels of TF and TF-MP in the supernatant of the TLR4-/- group were significantly lower than those of the WT group at 30, 60, and 120 min (P<0.05).
Conclusion
Acute pancretitis can be induced by TF and TF-MP expressions in KCs which could be regulated by TLR4 pathway.
