Background and purpose:Medulloblastoma(MB),which is a primitive neuroectodermal tumor(PNET),is the most common malignant brain tumor of childhood.The mean age at diagnosis is 6 years.Due to the tremendous improvements in techniques of radiotherapy and chemotherapy,the 5-year overall survival(OS) is increased to 70% now,compared with 20% in the 1970s.Factors which include local relapse,whether or not there has occurred metastases before resection,residual tumor and age etc.are mostly considered to have significant effects on prognosis.We studied the effects and side effects of the three dimensional conformal radiation therapy(3D-CRT) for the children with medulloblastoma,and summarized the reasons of failure of the therapy.Methods:From August 2001 to August 2007,34 children with medulloblastoma were treated in our hospital.Among all the patients(3-16 years,mean age was 9.5 years) there were 16 cases in high-risk group,and 18 cases in low-risk group.All of them underwent total or subtotal resection before radiation therapy.Patients were not given radiotherapy and chemotherapy before surgery.The interval between surgery and radiotherapy was less than 3 weeks.The 3D-CRT was done for all the patients with the same techniques:30 Gy to the whole cranialspinal axis followed by a boost of 20-25 Gy to the posterior fossa,witha median fraction dose of 180 cGy.Chemotherapy was given according to the protocol which consisted of lomustine,cisplatinum and vincristine after radiotherapy,but the patients were not given intrathecal chemotherapy.Blood counts and chemistries and renal and hepatic evaluations were performed regularly before every course.Results:5-year OS and 5-year event free survival(EFS) were 71% and 62% respectively.The mean follow-up was 36.5 months.The 5-year OS of the high risk group and low risk group were 88.9% and 50.0% respectively.There was significant difference between them(P=0.01).13 patients were failures.Of all failure patients,3 had recurrence in the region of the cribriform plate.The complete remission was 70.5%,and the partial remission was 14%.If metastases were found before surgery,the 5-year OS was 12.5%(1/8),and if the residual tumor was more than 1.5 cm3,the 5-year OS was 0%(0/5).Whether or not the metastases were found before surgery,and the presence of residual tumor,both had significant impacts on the prognosis of the children with medulloblastoma(P

By using the OEC 9600 mobile digital imaging system, 14 coronary stents were successfully implanted in all 13 cases of coronary heart disease. After the procedure,immediate satisfactory angiographic results were obtained without residual stenosis, and chest pain was relieved or disappeared in all cases. No major complications occurred except for groin hematoma in one case,these results suggest that intracoro-nary stenting is a safe and effective management for coronary heart disease.

AIM: To investigate the therapeutic effects of the marine capsules combined with composite Salvia miltiorrhiza dropping pill in treatment with patients with hepatic fibrosis related to chronic hepatitis B. METHODS: 54 patients were enrolled and randomly divided into control group and treatment group. The liver function,the marker of hepatic fibrosis and hepatitis B virus were determined before and after therapy. RESULTS: The markers in this study were significantly improved than those before treatment and those in control group (P

Objective To analysis the application value and the existing problems of sentinel lymph node biopsy in breast cancer surgery.Methods Pathological findings were retrospectively analysised in 100 female cases of breast cancer,who were diagnosed with early breast cancer and used blue dye in sentinel lymph node biopsy.Results Among 100 cases,92 cases were found SLNS,that the detected rate was 92％.Detected 217 sentinel lymph node,every case has 1 to 6 node,with the average of 2.4.Nintg-two cases were performed ALND.Among them,the SLNS negative detected 58 cases of ALN feminine,SLNS negative ALN detected positive 4 cases,30 cases of SLNS positive ALN positive detected.All of the patients did not appear allergic reaction.SLNB false positive rate of O,the false negative rate was 11.8％,sensitivity 88.3％,specific degree of 100％,the diagnostic coincidence rate was 95.7％.Conclusions Compared with the conventional axillary lymph node dissection,the sentinel lymph node biopsy has obvious advantages in early breast cancer surgery.For the cases of sentinel lymph node negative,there was no necessary to do the axillary lymph node dissection.

Objective To explore the feasibility and safety of primary coronary stenting in the patients with coronary heart disease Methods From march 1997 to august 1999, 80 cases with 90 of lesions were selected for primary coronary stenting without the predilation procedure Their efficacy and success rate were analysed Results We smoothly pushed 85 stents into the lesion in the 80 patients, the success rate of primary coronary stenting was 94% with shorter duration of the procedure and lower cost In 3 lesions the stent did not cross the lesion and was successfully retrieved in the guiding catheter, in 1 cases the stent was lost in the systemic circulation with no further complications Conclusions Primary coronary stenting without predilation was safe and feasible in selected patients

Objective To explore oligodendrocyte selective vulnerability in gray matter area and the effect of subhypothermia after transient forebrain ischemia in gerbils.Methods The gerbils model of forebrain ischemia was induced by 15 min bilateral carotid occlusion.All gerbils were divided randomly into sham operation group,ischemic reperfusion group and subhypothermia treatment group (32.5?0.5℃).Immunohistochemistry for cell specific antigens (transferrin,TF) was used to identify oligodendrocyte.Results The density of TF positive oligodendrocyte in the cortex at 1～2 days reperfusion following ischemia decreased remarkably (P

Objective To explore the relationship between reactive astrogliosis and delayed neuronal ischemic tolerance by preconditioning ischemia in gerbil hippocampal CA 1 region.Methods All gerbils were divided randomly into sham operation group,cerebral ischemia group and preconditioning ischemia group and preconditioning ischemia plus subsequent ischemia group. Transient forebrain ischemia model was induced by bilateral carotid occlution in gerbils. Immunohistochemistry for cell specific markers (glial fibrillary acidic protein(GFAP)was used to identify astrocyte.Results The numbers of GFAP positive astrocyte in hippocampal CA 1 region increased slightly at 1~7days following preconditioning ischemia, but increased significantly at 28 days after preconditioning ischemia ( P

Objective To evaluate the feasibility of catheter ablation for atrial fibrillation (AF) guided by 3 dimensional (3D) mapping combined with pulmonary vein (PV) circumferential mapping Methods 14 consecutive patients (M/F=10/4, age 52 4?12 8 y o, left atrium diameter 46 7?5 4 mm) with drug refractory paroxysmal ( n =10), permanent ( n =3) and persistent ( n =1) AF were included in this study Left atrial modification guided by 3D mapping system were performed first,and then, all PVs were isolated by circumferential mapping guided segmental ablation The endpoint of ablation included: (1) all left artial ablation lines finished; (2) all PVs were isolated and (3) non inducibility of AF was observed Results (1) Ten (71 4%) patients with paroxysmal AF reached the endpoint of the ablation completely (2) Total procedure and fluoroscopy time periods were 292?49 min and 54?9 min, respectively (3) After a mean follow up of 5 2?5 7(1-23)weeks, 7 (50%) patients with paroxysmal AF were free of AF and 3 (21 4%) patients with paroxysmal AF had significant improvement (4) No complications occurred during the procedure and the follow up period Conclusion Catheter ablation for AF guided by 3D mapping combined with PV circumferential mapping is feasible, safe and effective for patients with paroxysmal AF and left atrial enlargement

BACKGROUND:Gene therapy is the direction of spinal cord injury(SCI) therapy,the key of which is construction of targeting gene and vector. OBJECTIVE:To construct the recombinant adenovirus vector carrying human brain-derived neurotrophic factor(hBDNF) marked enhanced green fluorescent protein(EGFP). DESIGN,TIME AND SETTING:A single sample observation was completed in the First Affiliated Hospital of Fujian Medical University from September 2007 to June 2008. MATERIALS:Competent E. coli DH-5? was obtained from the American Stratagene Company. Plasmid pDC316-hBDNF,pDC316-mCMV-EGFP,pBHGlox_E1,3Cre and package system AdMax and 293 package cell strain were purchased from the Canadian Mixcrobix-Biosystems Company. METHODS:The hBDNF gene was constructed by PCR with plasmid pDC316-BDNF as template. With enzyme digestion,the hBDNF gene was inserted into the vector pDC316-mCMV-EGFP and the shuttle plasmid pDC316-hBDNF-mCMV-EGFP was constructed,which was cotransfected with the adenovirus skeleton plasmid pBHGlox_E1,3Cre into 293 cells to obtain the produced replication defective recombinant adenovirus vector Ad-hBDNF-EGFP. The recombinant adenovirus was propagated by repeat infection of 293 cells and purified by ion exchange method,then the virus particles were counted and the purity and titer were determined. MAIN OUTCOME MEASURES:①PCR identification of plasmid pDC316-hBDNF. ②Construction and identification of the shuttle plasmid pDC316-hBDNF-mCMV-EGFP. ③Packing,amplification and purification of recombinant adenovirus vector Ad-hBDNF-EGFP. ④PCR identification of the recombinant adenovirus. ⑤Titer of recombinant adenovirus. RESULTS:PCR amplification,restriction analysis and sequencing identified that both recombinant shuttle plasmid pDC316-hBDNF-mCMV-EGFP and recombinant adenovirus vector Ad-hBDNF-EGFP were correctly constructed. After amplification and purification,the virus particle count,A260/A280 and titer of recombinant adenovirus were 2.4?1011 VP/mL,2.0 and 0.8?1010 CCID50/mL,respectively. CONCLUSION:Recombinant adenovirus vector Ad-hBDNF-EGFP is successfully constructed,which laid a foundation for further study regarding gene function and therapy.

Objective To explore the feasibility to diagnose ureterolithiasis by 16-multidetector spiral computed tomography (16-MDCT) at different low doses based on body mass index (BMI).Methods A total of one hundred patients from 2009 Sep to 2010 Feb suspected of ureterolithiasis were randomly divided into 2 equal groups undergoing 16-MDCT at standard-dose (120 kV, 240 mA) or lowdose (120, 80, and 50 mA, respectively) based on the body mass index (BMI).Taking the clinical diagnosis as the standard, the sensitivity level, specificity level, and positive predictive value of these groups were compared.Results The dose length product ( DLP ) of the low-dose CT group and the average CT dose index (CTDIvol ) were 18.95 and 6.65 mGy, respectively.There was significant difference between the two groups ( t = 31.78, P ＜ 0.01 ).The sensitivity level, specificity level, and positive predictive value of the low-dose group were 97.1% , 94.0% , and 94.3% , respectively, all not significantly different from those of the standard-dose groups (97.3% , 96.0% , and 97.3% , respectively,P ＞0.05).Conclusions It is feasible to diagnose ureterolithiasis by low-dose 16-MDCT based on BMI with the obtained image quality meeting the clinical diagnostic requirements.