Hirayama disease is benign and self-limited,characterized by atrophy of unilateral upper extremity.Misdiagnosis was common due to the restriction of diagnostic techniques in the past.In recent years,Hirayama disease is familiar to us because of the rapid development of electromyography and imageological examinations.X-ray and CT scan play an important role in evaluations on cervical curvature,segmental stability,degeneration of facet joints and posterior longitudinal ligament.Loss of attachment in neutral cervical MRI and anterior shift of dura mater in flexion cervical MRI are the most important signs.This review summarizes the imageological examinations and characteristic signs of Hirayama disease in detail,together with a brief introduction to clinical manifestations and electromyography features.

Virus infection can cause a variety of host immune response to prevent the spreading of virus.Innate immunity is the first line of defense to resist to virus infection in host.After the virus enters,the macrophage phagocytoses and process of virus antigen.On the other hand,it activates the innate antiviral immune response.The expression of interferon after EV71 infection may be associated with cell specific response.Most studies have shown that EV71 can inhibit the expression of interferon to achieve immune escape.Then antigen presenting cells present antigens to T/B lymphocytes,once specific T/B lymphocytes are activated by antigen,they will be activated,proliferated,diferentiated to immunologic effector cells,which secrete antibodies,cytokines,cell toxicity of medium,ultimately,develop immunological effect.Both humoral immunity and cellular immunity are activated in EV71 infection,and play an important role in mediating protection effect.Cellular immunity may be associated with the clinical outcome of EV71 infection.The EV71-specific neutralizing antibody generated by the humoral immunity plays a key role in protective immunity,but the antibody response level is not correlated with disease severity.In addition,virus infection can induce cell apoptosis to prevent the virus proliferation and the spreading of progeny virus.

Neoadjuvant chemoradiotherapy (nCRT)and subsequent radical resection have become the standard care of locally advanced rectal cancer (LARC).However,conventional radical surgery is associated with high intra-and postoperative morbidities,and a temporary or permanent stoma in some cases,impaired sexual and urinary function,and it eventually impair the quality of life.Rectum-preserving surgery is a novel concept in the era of nCRT,which will maximally benefit patients through the minimized injuries.This strategy has been increasingly utilized in LARC following nCRT.Nevertheless,it lacks high-level evidence of evidence-based medicine,and the long-term oncological safety remains to be determined by larger,multicenter,randomized clinical trials.The crucial aspect of rectum-preserving surgery is to accurately evaluate the status of primary tumor and metastatic lymph nodes,and thus to selective patients who could benefit from this strategy most.

The surgical management and the nutritional support in patients with AHNP were reported.We consider that the necrosis of the pancreas complicated with infection should be operated and that parenterally nutritional support could be helpful to patients with AHNP.

Objective To observe the effect of Tongqiaohuoxue decoction on cognitive impairment in rats with traumatic brain injury and explore the mechanisms. Methods 70 Sprague-Dawley rats were randomized into normal group (n=10), sham operated group (n=20), untreated group (n=20) and treatment group (n=20). Controlled cortical impact device was utilized to establish traumatic brain injury model. The treatment group received Tongqiaohuoxue decoction 5 ml/d, and other groups received distilled water. The cognitive function of rats was evaluated with Morris water maze 1, 2, 3, 4 weeks post operation. And the rats were sampled to test the expression of brain-derived neu-rotrophic factor (BDNF) and synaptophysin (Syn) I in hippocampus through immunohistochemistry. Results The escape latency was longer in the untreated group than in the normal group in all the time points (P<0.05), and was longer in the treatment group than in the normal group 1 and 2 weeks after injury (P<0.05), with no significant difference 3 and 4 weeks after injury (P>0.05). And it was shorter in the treat-ment group than in the untreated group 3 and 4 weeks after injury (P<0.05). The percentage of swimming time was lower in the untreated group than in the normal group in all the time points (P<0.05), and was lower in the treatment group than in the normal group 1, 2, and 3 weeks after injury (P<0.05), with no significant difference 4 weeks after injury (P>0.05). And it was higher in the treatment group than in the untreated group weeks after injury (P<0.05). The BDNF expression was lower in the untreated group than in the normal group 1 and 2 weeks after injury (P<0.05), with no significant difference 3 and 4 weeks after injury (P>0.05). It was higher in the treatment group than in the normal group 4 weeks after injury (P<0.01), and was higher in the treatment group than in the untreated group 2, 3 and 4 weeks after in-jury (P<0.05). The Syn I expression was lower in the untreated group than in the normal group in all the time points (P<0.001), and was low-er in the treatment group than in the normal group 1, 2 and 3 weeks after treatment (P<0.01). And it was higher in the treatment group than in the untreated group 3 and 4 weeks after injury (P<0.01). Conclusion Tongqiaohuoxue decoction could improve the cognitive function in rats with traumatic brain injury. The change in expression of BDNF and Syn I might be associated with the improvements.

This study focused on prevention and treatment of acute and chronic asthma by oligonucleotides containing unmethylated CpG motifs (CpG-ODNs). Acute and chronic asthma models of mice were made by sensitizing and inhaling ovalbumin (OVA); The number of white blood cells (WBC) and eosnophils (EOS) in bronchoalveolar lavage fluid (BALF) was counted and the concentration of cytokines and vascular endothelial growth factor (VEGF) was examined in BALF by ELISA kit. After that, TLR-9 mRNA was detected in mice spleen cells by reverse transcription polymerase chain reaction (RT-PCR) and TLR-9 protein was determined in mice lung tissues by Western blotting. Compared with acute asthma models of mice, WBC in BALF decreased obviously in the groups of Bordetella pertussis, CpG-ODNs and seq A to seq I which were administrated by both of intragastric (ig) and intraperitoneal (ip) injection group, EOS decreased obviously in Bordetella pertussis, CpG+ and seq A to seq D ig groups, and in all ip administrating groups, although it was not effective in the groups of seq E to seq I. In chronic asthma models of mice, IFN-gamma increased ((1) control: 176.45 +/- 23.46 pg x mL(-1); (2) model: 174.11 +/- 22.71 pg x mL(-1); (3) CpG+ ip: 220.56 +/- 15.42 pg x mL(-1); (4) seq A ip: 225.23 +/- 21.60 pg x mL(-1)) and IL-4 decreased obviously (1) control: 66.91 +/- 5.81 pg x mL(-1); (2) model: 81.02 +/- 11.24 pg x mL(-1); (3) CpG+ ip: 63.99 +/- 6.09 pg x mL(-1); (4) seq A ip: 62.75 +/- 10.03 pg x mL(-1)) in the BALF of CpG+ and seq A ip group, although VEGF was not changed in this research. And also, TLR-9 mRNA in spleen cells (TLR-9/GAPDH: (1) control: 0.62 +/- 0.13; (2) model: 0.66 +/- 0.17; (3) CpG+ ip: 1.46 +/- 0.26; (4) seq A ip: 1.42 +/- 0.34) and TLR-9 protein in lung tissues (TLR-9/beta-actin: (1) control: 0.63 +/- 0.16; (2) model: 0.61 +/- 0.07; (3) CpG+ ip: 1.15 +/- 0.25; (4) seq A ip: 1.03 +/- 0.29) both increased in ip groups, but the change was not significant in ig group. The study confirms that CpG-ODNs and seq A could inhibit airway inflammation remarkably, this mechanism might be related with regulating Th1/Th2 balance and controlling the expression of TLR-9.

OBJECTIVE: Epileptic attack can cause neuronal damage and increase the risk of potential seizure. Analysis of the possible mechanism of neuronal damage following epileptic seizure may provide evidences for implementing preventive measures against brain damage due to epileptic seizures.DATA SOURCES: A computer-based search of the related publications in PubMed database between June 1995 and June 2004 with different combinations of the key words of "epilepsy", "neuron damage", "necrosis"and "apoptosis", limiting the results to the language of English.STUDY SELECTION: The retrieved articles were examined at first to select reports of experimental study on human and animals related to epilepsy and the subsequent neuronal damages, and their full-text publications were obtained with the other unrelated articles excluded.DATA EXTRACTION: Eighteen articles documenting randomized controlled experiment immediately related to neuronal damage after epilepsy seizure, 4 reporting non-randomized controlled experiments related to central neuronal excitatory toxic damage, and 3 concerning neuronal damage were collected for this review.DATA SYNTHESIS: In the 14 randomized controlled experiments, chemical or electric methods were used to induce epilepsy in the animal models in which the ultrastructural changes of the neurons and cell organelles were observed and the expression of apoptosis-related factors determined.In the 4 non-randomized controlled experiments, central neuronal ischemic and hypoxic models were adopted for observing the expression of various apoptotic factors in the neurons due to different damages with the assistance of electron microscope, to provide direct evidences for the mechanism of central neuronal excitatory toxic damage. The other three related literatures introduced the pathways of neuronal damages and the expression of the related factors.CONCLUSION: Neuronal death after epileptic seizure is correlated with the severity of the damage and mitochondrial functional status, and the mitochondria constitute the control center for neuronal survival. The release of cytochrome C and the activation of caspases are the final common pathway of neuronal damage.

Humans ; Monitoring, Intraoperative ; methods ; trends ; Perioperative Care ; methods ; trends

Objective To explore the management of gliomas in pregnant women.Methods We retrospectively analyzed the clinical data in 11 pregnant women with gliomas treated at Xuanwu Hospital of Capital Medical University between January 1989 and December 2012.Results All the patients were first diagnosed with gliomas during pregnancy,including two cases during early pregnancy,four cases during midpregnancy,and five cases during late pregnancy.The main clinical manifestations were dizziness,headache,nausea and vomiting due to intracranial hypertension,accompanied by epilepsy and blurred vision,hearing and speech disorder and other neurological dysfunctions.Among the 11 patients,one received no obstetric treatment,five underwent cesarean section,three had metaphase induced labor,one had induced abortion,and one had spontaneous abortion.Five neonates appeared normal without malformation:four survived,and one with severe asphyxia died.Ten patients underwent neurosurgery,four of them were diagnosed with low-grade gliomas and six were diagnosed with high-grade glioma by pathology.Seven patients received craniotomy after termination of pregnancy,two underwent craniotomy before termination of pregnancy,and one received emergency craniotomy immediately after admission without obstetric treatment because of her critical conditions.Of the ten patients treated with craniotomy,one died after a coma for 50 days,one was lost to follow-up,six received radiotherapy plus chemotherapy,one received chemotherapy alone,and one received neither radiotherapy nor chemotherapy.Among the 11 patients,one patient who underwent cesarean section without craniotomy was lost to follow-up,one patient with low-grade glioma died 50 days after operation,one treated with craniotomy was lost to follow-up,and eight were followed up for four months to three years,among which four survived and four with high-grade glioma died within one year after operation.Conclusion The overall prognosis of glioma patients during pregnancy is poor.It is important to take into account the tumor status of the pregnant women,gestational age,fetal maturity and patient's desire for tocolysis,and weigh the pros and cons,and timely terminate pregnancy and perform neurosurgery.

Objective To explore the relationship between diabetic retinopathy (DR) and intima-media thickness in newly diagnosed type 2 diabetic patients. Methods A total of 1236 diabetic subjects who were diagnosed within 1 year, including 218 older patients, were enrolled in the study. Intima-media thickness of the right common carotid artery and femoral artery were determined using B mode ultrasonography. All subjects were ophthalmologically examined. Results The intima-media thickness values of the carotid artery and femoral artery[(0.83 ± 0.11)mm, (0. 80 ±0.11)mm] in elderly DR group were higher than those [(0. 78±0.12)mm, (0.75±0.13)mm] in elderly non-DR group(P＜0.05). The prevalences of DR in IMT≥0.8 mm group[20.6%: carotid artery, 18.6%: femoral artery] were higher than those in IMT＜ 0.8mm group [13.0%: carotid artery, 13.6%: femoral artery] (P＜0. 05). Logistic regression analysis also showed DR was associated with IMT. Conclusions DR is associated with IMT in newly diagnosed type 2 diabetic patients, and early changes of retinopathy are associated with increased IMT.