Objective: Cholangiocarcinoma (CCA) presents a therapeutic challenge due to its aggressiveness and poor survival rates. This study introduces an approach using tissue inhibitor of metalloproteinase 2 (TIMP2)-enriched bone marrow mesenchymal stem cell-derived exosomes (BMSC-Exo) encapsulated in chitosan hydrogels (CS), intending to provide novel insight into the CCA treatment. Methods: BMSC-Exo was characterized by using TEM, nanoparticle tracking analysis, and western blotting. Role of TIMP2 in CCA was explored using bioinformatics analysis. Therapeutic efficacy and mechanisms of BMSCExo/CS in CCA were assessed through cell viability tests and colony formation assays. Angiogenic and Wnt/ beta-catenin signaling pathways-related key factors were detected through RT-qPCR or western blotting. Results: BMSC-Exo displayed typical cup-shaped morphology and was positive for exosomal markers CD9 and TSG101, but negative for endoplasmic reticulum marker Calnexin, with a diameter of 124.6 nm. BMSC-Exo combined with CS showed synergistic anti-proliferative effects in CCA cells. High-expression TIMP2 samples indicated a better prognosis of CCA patients, and BMSC-Exo/CS increased the TIMP2 expression in CCA cells. Mechanistically, BMSC-Exo/CS TIMP2 overexpression inhibited key factors related to angiogenesis (VEGFA and VEGFR2) and Wnt/beta-catenin pathway (beta-catenin and c-Myc), thereby reducing CCA cell viability. Notably, these inhibitory effects were reversed by a Wnt signaling agonist (BML-284). Conclusion: The study validates the therapeutic potential of BMSC-Exo/CS TIMP2 in CCA treatment. This innovative approach targets angiogenesis and Wnt/beta-catenin signaling, providing a new avenue for more effective and comprehensive CCA therapies.
肺癌是最常见的肿瘤之一,而云南省肺癌的发病率位居全国首位.许多患者确诊时已为晚期肺癌,采用多手段联合治疗,包括化学治疗、放射治疗、靶向治疗、免疫治疗以及局部治疗(消融、冷冻、125I等).放射性125I粒子植入治疗作为晚期肺癌局部治疗手段之一,有其独特的优势,其放射半径小,特异性照射靶向病灶,而对周围正常组织损伤小,并且临床效果较好.研究表明上皮-间质样表型转化(epithelial-mesenchymal transformation,EMT)与肺腺癌的生长、侵袭、转移密切相关.对放射性125I粒子在肺腺癌EMT及临床治疗中的作用进行论述.
完全植入式静脉输液港（totally implantable venous access ports，TIVAP）是临床常用的用于化疗的深静脉置管装置，具有留置时间长、感染机率低、美观度高、维护周期间隔长、并发症少等优点。TIVAP植入过程中要求导管尖端位于上腔静脉下1/3与右心房交界处。永存左上腔静脉（persistent left superior vena cava，PLSVC）是最为常见的一种体静脉回流畸形，发生率占所有先天性心脏病患者的3.0%~10.0%[1]。本科室自2018年9月至2021年12月共行TIVAP植入术1 037例，仅出现1例PLSVC，术后静脉港正常使用，现将病例要点报告如下。
目的 对比胆道125I粒子支架与金属裸支架治疗Bismuth Corlette Ⅲ型胆管癌合并梗阻性黄疸疗效.方法 回顾性收集自2010年1月至2018年6月期间于云南省肿瘤医院微创介入科进行治疗的所有由Bismuth Corlette Ⅲ型胆管癌引起的恶性胆道梗阻患者共51例,其中125I粒子支架植入组(观察组)25例,金属裸支架植入组(对照组)26例,比较2组术前术后肝功能、并发症发生率、患者支架通畅时间及生存期.结果 125I粒子支架植入组(观察组)与金属裸支架植入组(对照组)患者术后1月肝功能及黄疸程度均明显改善;观察组较对照组术后并发症发生率并未增加;观察组的平均支架通畅时间为(369.20±231.64)d,中位支架通畅时间为310.05 d,对照组的平均支架通畅时间为(194.57±118.09)d,中位支架通畅时间为142.52 d,观察组患者支架通畅时间明显长于对照组(P＜0.05);观察组平均生存期为(334.24±193.38)d,中位生存期为385.21 d,对照组平均生存期为(251.23±182.51)d,中位生存期为274.43 d,观察组患者生存期明显长于对照组(P＜0.05).结论 胆道125I粒子支架较金属裸支架在不增加术后并发症的基础上可显著降低支架再狭窄率,延长支架的通畅时间,提高患者生存期.
目的 对比经桡动脉途径(TRA)和股动脉途径(TFA)对肺鳞癌患者行支气管动脉介入的可行性.方法 选取122例肺鳞癌患者,采取经左侧桡动脉入路行支气管动脉介入治疗58例(行BAI患者47例,行BAE患者5例,行BACE患者6例),经股动脉入路行支气管动脉介入治疗64例(行BAI患者51例,行BAE患者10例,行BACE患者3例).结果 2种入路均成功实施经支气管动脉介入治疗,术后无明显并发症.经左侧桡动脉入路手术时间少于经股动脉入路.结论 经桡动脉途径(TRA)行支气管动脉介入治疗是安全、快速和可行的,为肺部肿瘤介入提供更多可选择的介入路径.
