Cov txheej txheem ntawm pob txha pob txha Puncture Thiab Biopsy nyob rau hauv Tsis yog -Human Primates: Tsom ntsoov rau Biopsy Koob Daim Ntawv Thov

Tsis yog -tib neeg primates (NHPs) yog cov tsiaj sim tseem ceeb rau kev tshawb fawb hematology preclinical, stem cell tshuaj txhim kho, kev tshawb nrhiav kev tiv thaiv kab mob thiab kev tshawb fawb tshuaj txhais lus. High-zoo, qis- paug thiab ua tiav cov pob txha pob txha cov qauv yog qhov chaw thiab lub hauv paus ntawm cov ntaub ntawv kev sim txhim khu kev qha. Cov pob txha pob txha puncture thiab core biopsy yog cov ntsiab lus tseem ceeb tshaj plaws hauv vivo pob txha pob txha sampling cov txheej txheem rau tsis yog - tib neeg primates. Different from ordinary venous blood collection, this technology relies on professional hard hollow biopsy needles to penetrate the cortical bone of long bones and flat bones, and obtain qualified bone marrow fluid and intact bone marrow core tissues from the medullary cavity. Kev ua haujlwm tag nrho yog nyob ntawm qhov kev ua tau zoo, cov qauv sib txuam thiab cov qauv siv ntawm cov pob txha pob txha biopsy koob. Ua ke nrog kev paub txog kev sim tsiaj txhu thiab cov ntaub ntawv kev paub dhau los, kab lus no tau piav qhia tag nrho - cov txheej txheem kev ua haujlwm tshwj xeeb ntawm NHP cov pob txha pob txha puncture thiab biopsy, tsom mus rau cov yam ntxwv xaiv, qhov zoo ntawm daim ntawv thov thiab cov qauv kev ua haujlwm tseem ceeb ntawm cov koob txhaj tshuaj biopsy, los muab cov txheej txheem kev qhia rau cov kws tshawb fawb sim.

Lub hauv paus ntsiab lus ntawm cov pob txha pob txha puncture thiab biopsy nyob rau hauv tsis yog - tib neeg primates yog raws li classical canine pob txha sampling system (Crow et al., 2009). Cov ntsiab lus tseem ceeb yog siv cov koob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob. Raws li cov yam ntxwv anatomical ntawm NHPs, cov chaw kuaj pom tau muab faib ua forelimb thiab hindlimb thaj chaw. Lub hindlimb qhov tseem ceeb sampling qhov chaw muaj xws li iliac crest thiab femoral trochanteric fossa (Wolf & White, 2012), uas haum rau feem ntau nruab nrab thiab loj -sized primate qauv; lub forelimb lwm qhov chaw yog lub humeral ntau dua tubercle, nrog ntiav anatomical txoj hauj lwm thiab yooj yim ua hauj lwm, haum rau ntxiv sampling thiab rov sampling thwmsim. Cov chaw kuaj mob sib txawv muaj qhov sib txawv ntawm cov pob txha tuab, kab noj hniav medullary kab noj hniav thiab cov ntaub so ntswg mos, uas yuav tsum tau ua kom zoo sib xws nrog cov kev qhia tshwj xeeb ntawm cov pob txha pob txha siv cov koob txhaj tshuaj kom paub meej cov qauv zoo thiab cov qauv zoo.

Raws li kev ua haujlwm ntawm pob txha, NHP pob txha pob txha puncture thiab biopsy yuav ua rau cov ntaub so ntswg stimulation thiab mob teb. Txhawm rau kom muaj kev noj qab haus huv rau tsiaj thiab kev sim ua haujlwm ruaj khov, tag nrho cov kev ua haujlwm sampling yuav tsum tau ua raws li tus qauv tshuaj loog. Cov kws tshawb fawb tuaj yeem xaiv cov tshuaj loog lossis tshuaj loog hauv zos raws li lub voj voog ntawm kev sim, piv txwv zaus thiab tus tsiaj lub xeev, thiaj li ua tiav kev ua haujlwm txaus thiab kev ua haujlwm tom qab analgesia. Tsis tas li ntawd, tag nrho cov txheej txheem yuav tsum nruj me ntsis raws li cov kev sim ua kom tsis muaj menyuam, suav nrog kev shaving ua ntej thiab kev npaj ntawm daim tawv nqaij ntawm qhov chaw kuaj, multi-txheej txheem tshuaj tua kab mob nrog povidone- iodine thiab cawv, sterile phuam nteg, thiab hnav hnab looj tes tsis muaj menyuam thiab cov cuab yeej phais mob, kom tsis txhob muaj kev mob tshwm sim tom qab kis kab mob thiab lwm yam kab mob hauv zos. kev sim.

Kev faib tawm, kev xaiv thiab kev ua tau zoo ntawm cov pob txha pob txha tshwj xeeb Biopsy koob

Cov pob txha pob txha biopsy koob yog cov cuab yeej tseem ceeb ntawm NHP cov pob txha pob txha sampling, uas txiav txim siab qhov ua tau zoo ntawm ib qho - lub sij hawm puncture, specimen integrity thiab peripheral blood contamination degree. Tam sim no, muaj ntau yam kev lag luam paub tab ntawm cov pob txha pob txha tshwj xeeb rau cov tsiaj sim, suav nrog Rosenthal, Klima, Illinois sternal / iliac koob thiab Jamshidi koob. Txhua tus qauv muaj qhov sib txawv tsim hauv rab koob ntev, ntsuas txoj kab uas hla, cov qauv hauv cov tub ntxhais thiab tuav tuav, yoog rau cov tsiaj sib txawv ntawm lub cev, cov yam ntxwv ntawm pob txha anatomical thiab cov hom phiaj kev sim.

Ntawm txhua hom koob, lub14G Jamshidi pob txha pob txha biopsy koobyog tus qauv kub rau NHP pob txha pob txha core biopsy, uas yog cov lus pom zoo tshaj plaws rau kev sim ua haujlwm. Hom kab mob biopsy no siv cov qauv zoo nruj hollow, nrog kev sib txuam hauv nruab nrab cov khoom stylet. Lub cev rab koob muaj nruab nrab hardness thiab toughness, uas tuaj yeem nkag mus rau cov pob txha cortical ntawm primates yam tsis muaj dabtsi yog khoov lossis swb. Lub kauv txiav ntug ntawm rab koob tuaj yeem ruaj khov thiab cuam tshuam cov pob txha pob txha ua tiav cov ntaub so ntswg, kom tsis txhob muaj cov khoom tawg thiab cov ntaub so ntswg extrusion puas tsuaj los ntawm cov koob tsis zoo. Piv nrog rau nyias - ntsuas koob aspiration, 14G Jamshidi biopsy koob muaj qhov loj hauv kab noj hniav txoj kab uas hla, uas tuaj yeem tau txais txaus- ntim cov qauv ntawm cov tub ntxhais thaum ua kom muaj kev nyab xeeb, ua tau raws li kev kuaj pom morphological, cov ntaub so ntswg ntu thiab kev sim ntsuas ntsuas qhov xav tau ntawm core biopsy. Muab piv nrog cov koob tuab tuab, nws tuaj yeem txo cov pob txha raug mob ntau dhau thiab los ntshav ua haujlwm, ntsuas cov qauv zoo thiab siv tsiaj rov siv dua.

Txhua qhov tshwj xeeb ntawm cov pob txha pob txha biopsy koob yog tsim los nrog qhov sib txuam hauv nruab nrab stylet, uas yog ib qho tseem ceeb ntawm cov qauv sib txawv ntawm cov koob txhaj tshuaj zoo tib yam. Lub stylet tuaj yeem thaiv cov kab noj hniav ntawm lub cev rab koob thaum lub sij hawm puncture, tiv thaiv cov tawv nqaij mos thiab cov pob txha cov pob txha los ntawm kev nkag mus rau hauv rab koob kab noj hniav los thaiv cov raj xa dej, thiab xyuas kom meej qhov kev vam meej ntawm qhov kev xav tsis zoo tom ntej thiab cov ntaub so ntswg txiav. Hauv kev sim rov ua piv txwv, cov kws tshawb fawb yuav tsum xaiv cov koob tshwj xeeb raws li tsiaj lub cev qhov hnyav thiab pob txha loj: luv thiab zoo - ntsuas cov koob txhaj tshuaj rau cov tsiaj me (lub cev hnyav dua 5kg), thiab cov pa 14G nruab nrab- ntev Jamshidi koob rau cov neeg nruab nrab thiab loj, paub txog qhov sib txuam ntawm cov khoom siv thiab kev sim.

Cov Kev Tiv Thaiv Ua Ntej Tseem Ceeb rau Kev Siv Tshuaj Biopsy

Txhawm rau zam cov qauv coagulation, hemolysis thiab kev sib kis, thiab txhim kho tus nqi tsim nyog ntawm cov qauv kev sim, cov qauv ua ntej thiab kev ua haujlwm tshwj xeeb rau cov koob tshuaj biopsy yuav tsum tau ua ua ntej kuaj. Ua ntej,Heparin anticoagulation pretreatment ntawm koob thiab koob txhaj tshuajyog yuav tsum tau. Ua ntej siv, rho tawm ib qho me me ntawm cov tshuaj heparin los yaug cov phab ntsa sab hauv ntawm lub koob txhaj tshuaj thiab cov koob txhaj tshuaj sib luag, thiab tso tawm cov kua uas seem, tsim cov txheej txheem heparin anticoagulant txheej rau sab hauv phab ntsa ntawm koob kab noj hniav. Qhov kev ua haujlwm no tuaj yeem tiv thaiv kev coagulation sai ntawm cov pob txha cov kua dej tom qab kuaj, zam qhov ua tsis tiav ntawm kev npaj smear thiab kuaj pom ntawm tes los ntawm cov qauv coagulation, thiab yog qhov tseem ceeb pretreatment kauj ruam rau siab - zoo pob txha pob txha kom tau.

Thib ob, rau lub sijhawm ntev - rov ua piv txwv cov tsiaj sim,rotational xaiv ntawm qhov chaw punctureyuav tsum tau txais kev pom zoo kom tsis txhob rov ua dua ntawm ib qhov chaw, uas tuaj yeem ua rau cov pob txha cortical hyperplasia, cov ntaub so ntswg hauv zos adhesion thiab nce puncture resistance, uas ua rau cov qauv tsis ua hauj lwm thiab cov tsiaj raug mob. Nyob rau hauv cov nqe lus ntawm analgesia scheme, lub zos analgesic txhaj rau hauv daim tawv nqaij thiab sib sib zog nqus cov ntaub so ntswg ntawm qhov chaw puncture yog superior rau yooj yim kev siv tshuaj loog, uas yuav pab tau zoo txo ​​qhov mob tom qab phais mob thiab tsis xis nyob, txo cov tsiaj kev nyuaj siab teb, thiab pab txhawb postoperative rov qab thiab tom qab thwmsim.

Nyob rau hauv cov nqe lus ntawm sampling ntim tswj, txwv los ntawm lub koob kab noj hniav muaj peev xwm ntawm lub biopsy koob thiab lub physiological cov ntshav ntim ntawm cov tsiaj sim, cov sampling ntim ntawm ib tug puncture site yuav tsum tsis txhob ntau tshaj 2mL. Kev rho tawm ntau dhau yuav ua rau muaj ntshav peripheral loj dilution, txo qhov kev faib ua feem ntawm cov hlwb nucleated thiab cov pob txha pob txha pob txha hauv cov qauv, cuam tshuam nrog cov txiaj ntsig kev sim, thiab cuam tshuam rau qhov tseeb ntawm hematological Performance index tsom xam thiab cov ntaub so ntswg morphological soj ntsuam.

Txheej Txheem Kev Ua Haujlwm rau Iliac Crest Puncture (Core Biopsy Needle Operation)

Iliac crest yog qhov chaw kuaj pom zoo tshaj plaws thiab nyiam tshaj plaws rau qhov tsis yog - tib neeg primate pob txha pob txha biopsy, nrog cov pob txha cortical tuab, nplua nuj medullary kab noj hniav hematopoietic cov ntaub so ntswg thiab ob peb lub cev tseem ceeb uas nyob ib sab, muaj kev nyab xeeb siab thiab ua tau zoo sampling. Tom qab tus tsiaj muaj tshuaj loog tag lawm, muab tso rau hauv ib qho yooj yim txoj hauj lwm, fold ob sab ceg ceg nyob rau hauv lub plab mog nqa lub duav pob txha thiab tag nrho nthuav cov iliac crest sampling cheeb tsam. Feem ntau cov tsis yog - tib neeg primates muaj cov plaub hau nyob rau hauv thaj tsam iliac crest, uas tsuas yog xav tau yooj yim shaving thiab npaj daim tawv nqaij. Daim tawv nqaij yog tshuaj tua kab mob sib txuas nrog povidone-iodine thiab cawv, thiab muab ib daim phuam uas tsis muaj menyuam tso rau cais thaj chaw phais thiab xyuas kom tsis muaj menyuam.

Tom qab paub meej tias iliac crest ciam teb los ntawm palpation, ua ib qho me me ntawm daim tawv nqaij incision nrog ib tug sterile phais hniav nyob rau sab anterior ntawm lub iliac crest kom txo tau cov kev sib txhuam tsis kam ntawm lub biopsy koob thaum nkag. Teem lub 14G Jamshidi biopsy koob nrog qhov txiav, maj mam nce mus rau sab nraub qaum ntawm lub iliac crest, ua kom lub koob lub cev perpendicular mus rau lub dav hlau iliac crest txhua lub sijhawm, thiab siv tas li thiab ruaj khov downward siab thaum tig lub koob lub cev clockwise. Lub koob ntsug ntxig lub cev yog tus yuam sij rau kev ua tiav kev kuaj ntshav, uas tuaj yeem xyuas kom meej tias rab koob yog nkag mus rau hauv lub medullary kab noj hniav, zam kev nkag mus rau oblique ua rau cov pob txha cortical splitting thiab cov ntaub so ntswg uas nyob ib sab, thiab ua kom qhov kev txiav thiab kev ua piv txwv ntawm cov kab noj hniav.

Thaum rab koob lub cev nkag mus rau hauv cov pob txha cortical, tus neeg teb xov tooj yuav pom tseeb tias qhov txo qis ntawm kev nkag mus rau hauv lub cev, thiab rab koob biopsy tuaj yeem ruaj khov rau hauv cov pob txha cov ntaub so ntswg yam tsis tau co, qhia tias rab koob taub tau ntse nkag mus rau hauv cov kab noj hniav medullary. Lub sijhawm no, rub tawm lub hauv paus stylet kom tiav, txuas 10mL sterile syringe mus rau tus Tsov tus tw ntawm rab koob biopsy, thiab siv lub zog tsis zoo los ntawm rub lub piston. Cov pob txha primate tshiab yog xim liab thiab foamy, nrog cov viscosity siab dua cov ntshav peripheral, thiab muaj cov teeb me me - cov ntaub so ntswg trabecular, uas yog cov pob txha pob txha tsim nyog.

Yog tias tsis muaj cov kua dej hauv pob txha rho tawm, tsis txhob rub tawm lub koob lub cev dig muag. Tig lub koob tshuaj biopsy 90℃-180℃los kho qhov txiav thiab kuaj ntau yam ntawm rab koob; yog tias tseem siv tsis tau, rov ntxig cov stylet, kho qhov tob ntawm rab koob lub cev rau pem hauv ntej lossis rov qab, thiab siv lub siab tsis zoo dua. Rau kev soj ntsuam kuaj cov qauv, cov qauv ntim ntawm ib qhov chaw yog tswj nyob rau hauv 1mL los xyuas kom meej cov qauv purity; Yog tias qhov ntim loj ntawm cov pob txha pob txha yuav tsum tau ua rau kev sim, ntau qhov chaw sib tsoo yuav tsum raug xaiv rau kev kuaj es tsis txhob muab rho tawm ntau dhau ntawm ib qhov chaw. Tom qab kuaj xyuas, rub tawm cov koob tshuaj biopsy sai sai, siv ncaj qha compression hemostasis rau ntawm qhov chaw puncture rau lub sijhawm ntev, thiab suture daim tawv nqaij nrog ib txoj hlua suture yog tias cov ntshav tshwm sim.

Puncture thiab Biopsy Kev Ua Haujlwm ntawm Femoral Trochanteric Fossa thiab Humeral Proximal End

Lub femoral trochanteric fossa yog qhov zoo tshaj plaws ntxiv qhov chaw kuaj rau me me uas tsis yog - tib neeg primates (lub cev hnyav<5kg). The local bone structure is shallow, and the medullary cavity is concentrated, which is convenient for the positioning and penetration of fine-gauge biopsy needles. However, the proximal thigh muscle layer of large primates is thick, resulting in large puncture resistance and difficult operation. The core operation principle is consistent with iliac crest biopsy: place the animal in lateral position, hold the proximal thigh with the palm, locate the trochanteric fossa at the inner and distal side of the femoral greater trochanter by thumb palpation, insert the biopsy needle toward the femoral shaft to penetrate into the medullary cavity, and complete negative pressure aspiration and specimen collection according to the standard needle operation procedure.

Lub proximal humerus yog lwm qhov chaw ua piv txwv zoo. Txoj kab uas hla ntawm cov pob txha humeral ntev yog loj dua, thiab cov kab noj hniav medullary yog dav dua thiab ntiav, ua rau lub cev nqaij daim tawv qhov chaw ntawm qhov tseeb dua thiab kev ua haujlwm yooj yim dua. Muab tus tsiaj tso rau hauv txoj hauj lwm sab nraud, tuav lub forelimb proximal, palpate lub intertubercular sulcus ntawm lub humeral ntau dua thiab tsawg dua tubercles, ntxig rau lub biopsy koob mus rau lub humeral ncej nkag mus rau hauv lub medullary kab noj hniav. Qhov chaw no muaj qhov yuav tsum tau tsawg rau koob lub cev precision, tsis tshua muaj puncture tsis ua hauj lwm tus nqi, thiab yog haum rau ceev sampling thiab batch tsiaj thwmsim.

Ntev pob txha Perfusion Method thiab Core Biopsy koob hauv - Daim ntawv thov tob

Sib txawv ntawm cov pa ib zaug - koob puncture, txoj kev siv cov pob txha ntev (Kushida li al., 2000) yog siab -purity pob txha pob txha sampling thev naus laus zis tsim nyog rau siab - kev sim siab, uas yuav tsum muaj kev sib koom tes siv ob lub pob txha pob txha siv koob. Kev ua haujlwm yuav tsum tau ntxig cov koob txhaj tshuaj sib luag rau hauv lub medullary kab noj hniav ntawm ob qho kawg ntawm cov pob txha ntev raws li txoj cai, txhaj tshuaj tsis huv ib txwm saline maj mam los ntawm ib rab koob biopsy, thiab sau cov pob txha pob txha- uas muaj perfusate rau hauv lub thawv kaw tsis muaj menyuam los ntawm lub raj txuas txuas nrog rau lwm lub koob. Qhov no dual - koob kev sib koom tes sampling hom ua tau zoo zam cov ntshav peripheral paug nyob rau hauv cov pa puncture, thiab cov pob txha pob txha cov qauv tau muaj siab purity, uas yog haum rau qia cell sib cais, nyob rau hauv vitro kab lis kev cai thiab siab -precision omics nrhiav kom tau thwmsim.

Kev ua haujlwm sib txawv ntawm pob txha pob txha aspiration thiab Core Biopsy Raws li Biopsy Needles

Cov pob txha pob txha aspiration thiab core biopsy qhia tib qhov chaw piv txwv thiab cov khoom siv koob tshuaj biopsy, tab sis cov kev ua haujlwm tom qab koob txhaj tshuaj yog qhov sib txawv kiag li, uas txiav txim siab txog ob hom kev sim: kua pob txha pob txha thiab cov pob txha pob txha pob txha. Hauvpob txha pob txha aspiration, tom qab lub koob tshuaj biopsy tau kho nyob rau hauv lub medullary kab noj hniav, rub tawm cov stylet thiab txuas ib tug syringe siv tsis zoo siab los extract kua pob txha pob txha kua, uas yog siv rau kev suav cell, smear morphology thiab txaus cytometry nrhiav kom tau.

Hauvpob txha pob txha core biopsytsom rau cov ntaub so ntswg, tom qab rub tawm cov stylet, Jamshidi biopsy koob yog ntxiv 1-2cm mus rau hauv lub medullary kab noj hniav los ntawm ruaj khov thiab qeeb rotation. Lub kauv txiav ntug ntawm rab koob tuaj yeem qhwv cov pob txha pob txha hauv cov ntaub so ntswg. Tom qab ntawd loosen lub koob lub cev los ntawm rotating thiab viav vias, me ntsis retract thiab reinsert kom cais cov hauv qab ntawm cov ntaub so ntswg ntawm cov pob txha trabecula. Tom qab paub meej tias cov ntaub so ntswg yog sib cais tag nrho, rub tawm lub biopsy koob integrally los ntawm rotary traction. Thaum kawg, thawb cov pob txha pob txha pob txha cores tawm ntawm lub koob kab noj hniav nrog ib txoj kab pusher, thiab kho nws nrog 10% formalin rau cov ntaub so ntswg thiab tshuaj xyuas kab mob.

Xaus

Daim ntawv thov txheej txheem ntawm cov pob txha pob txha biopsy koob yog lub hauv paus tseem ceeb rau kev ua tiav ntawm tsis yog - tib neeg primate pob txha pob txha puncture thiab biopsy thwmsim. 14G Jamshidi biopsy koob, nrog nws cov qauv tsim kho kom zoo thiab kev ua haujlwm ruaj khov, yog cov khoom siv zoo tshaj plaws rau NHP core biopsy. Cov kws tshawb fawb yuav tsum xaiv cov koob tshwj xeeb raws li cov tsiaj lub cev thiab cov hom phiaj kev sim, nruj me ntsis siv cov tshuaj heparin pretreatment, kev ua haujlwm tsis muaj menyuam thiab qhov chaw sib hloov raws tu qauv, thiab paub txog cov txheej txheem kev ua haujlwm sib txawv ntawm kev xav thiab kev kuaj ntshav. Kev xaiv rab koob thiab kev ua haujlwm tau zoo tuaj yeem txhim kho cov qauv purity thiab kev ncaj ncees, txo cov tsiaj raug mob thiab kev sim ua yuam kev, thiab muab kev pabcuam zoo rau kev tshawb fawb txog kev kho mob hematology thiab kev txhais lus tshuaj raws li tsis yog - tib neeg cov qauv primate.