Thrombolytic therapy for ischemic stroke has received wide attention. Now the thrombolytic therapy mainly includes intervenous thrombolysis, intra-arterial thrombolysis, combination of intravenous and intra-arterial thrombolysis, and mechanical thrombolysis. The review mainly presents the recent progress in this field.

BACKGROUNDMediastinoscopy has experienced a renaissance due to the introduction of neoadjuvant treatment protocols and recognition of the limitations of noninvasive mediastinal staging of lung cancer by CT and PET. The aim of this study is to determine the value of video-mediastinoscopy in mediastinal staging of lung cancer.

METHODSA total of 60 patients who underwent video-mediastinoscopy for known or suspected lung cancer were retrospectively reviewed. There were 52 cervical mediastinoscopies, 2 parasternal mediastinoscopies and 6 combined procedures. All the patients were found to have enlarged mediastinal lymph nodes on radiographic examination of the chest (more than 1.0cm on its shortest axis).

RESULTSOf the 60 patients, 42 patients were found with N2 or N3 disease on video-mediastinoscopy and then were confirmed pathologically. The other 18 mediastinoscopy-negative patients underwent thoracotomy for pulmonary resection and mediastinal lymph node dissection in the same operative session, in which thoracotomy-proven N0 was found in 17 patients, and N2 in 1 patient (false-negative result by video-mediastinoscopy). The sensitivity, specificity, and accuracy of video-mediastinoscopy for mediastinal staging of lung cancer were 97.7%, 100% and 98.3%, respectively. In the entire group of 60 patients, there was 1 complication (1.7%) , and no perioperative death.

CONCLUSIONSVideo-mediastinoscopy is a highly effective and safe procedure. It can be used routinely in mediastinal staging of lung cancer.

Background Zero spherical aberration intraocular lenses(IOL)is designed to prevent the addition of positive spherical aberration after surgery.Research indicated that some positive spherical aberration can provide better depth distance of focus and pseudoaccommodation.Objective The present study was to compare the visual function and wavefront aberrations in pseudophakic eyes with zero spherical aberration IOL and spherical IOL.Methods A prespective case-controlled study was designed.Eighty eyes of 52 patients with age-related cataract were enrolled and divided into two matched groups based on random number table method.The regular phacoemulsification was performed on the eyes,and a zero spherical aberration IOL(Akreos AO)was implanted in the test group and a spherical IOL was used in the control group(Akreos Adapt IOL).The corrected distance visual acuity(CDVA),contrast sensitivity,depth of focus and wavefront aberrations were recorded and compared at 3 months after cataract surgery between these two groups.The trail was approved by the Ethic Committee of Eye Hospital of Wenzhou Medical College,and written informed consent was obtained from each patient prior to the program.Results The clinical demography from the two groups was matched(P ＞ 0.05).There were no significant difference in the CDVA (LogM AR)(-0.03 ±0.08 versus-0.02+0.10)(t =-0.50,P =0.61)and in depth of focus(3.48± 1.07 DS versus 3.20±0.77 DS)(t =1.15,P=0.25)between the zero spherical aberration IOL group and the spherical IOL group.The contrast sensitivities under the mesopic condition at 12.0 c/d and mesopic with glare at 3.0,6.0,18.0 c/d were 12.42 ± 13.16,42.58 ±24.96,30.19± 25.64 and 3.03 ± 5.49 in the zero spherical aberration IOL group,and those in the spherical IOL group were 5.59 ± 8.11,28.74 ± 18.69,17.07 ± 19.35 and 0.22 ± 1.15 without significant differences between these two groups(P＜0.05).Under the 5.0 mm pupil analyzing zone,the spherical aberration in zero spherical aberration IOL group was(0.13 ±0.07)μm,showing a significant reduction in comparison with spherical IOL group(0.21 + 0.07 μm)(P ＜ 0.05).No evidently differences were found in total high-order aberration,coma aberration and trefoil aberration(P＞0.05),but the sphere aberration was considerably lower in the zero spherical aberration IOL group compared with spherical IOL group(t=-4.19,P＝0.00).Conclusions The visual quality of the eyes implanted zero spherical aberration IOL is significantly better than ones implanted with spherical IOL.

Objective To study the effect of glucocorticoid receptor(GCR) on the treatment of patients with nephrotic syndrome(NS) and to observe the accommodation effect of herbal gynostemmae,acanthopanax senticosus harns on GCR levels.Methods The patients were divided into 3 groups: the healthy control group,treatment group Ⅰ(GC only) and treatment group Ⅱ(combination with herbal gynostemmae,acanthopanax senticosus harns and GC),radioligand binding assay was used to measure the GCR levels of each group.At the same time,the urine protein ratio within 24 hours was observed in each group.Results Compared with healthy control group,the GCR levels of treatment group Ⅰ and Ⅱ were both reduced,but after 4 weeks of treatment in the treatment group Ⅱ,not only GCR level recovered but also the urine protein were decreased faster than treatment group Ⅰ.Conclusions Herbal gynostemmae,acanthopanax senticosus harns can accommodate the GCR levels of children with NS.They can also eliminate urine protein and cure NS ideally.

Objective To analyse the difference between stage Ⅰ pure bronchioloalveolar carcinoma (BAC) and stage Ⅰ adenocarcinoma of the lung among operative cases.Methods We use the Lobectomy Cases Registration and Statistics System database (2006-2011) to compare the epidemiology,clinical presentation,image characteristics,surgical outcomes,recurrence and overall survival between BAC and adenocarcinoma groups.All the patients received lobectomy procedure in the department of thoracic surgery of Peking University People' s Hospital.Results Excluding those cases with both BAC and adenocarcinoma aspects,337 patients were enrolled.Thirty-nine patients were stage Ⅰ pure BAC and 298 patients were stage Ⅰadenocarcinoma.BAC has its proper clinical spectrum,occurring more frequently in women (69.2％ vs.52.0％,P =0.042)and in younger patients (57.4 vs.61.8,P =0.014).BAC also seems to be less dependent on tobacco exposure (12.8％ vs.29.9％,P =0.026).The percentage of ground-glass opacity (GGO) in CT scan of BAC patients was much more than that registered in adenocarcinoma patients (35.9％ vs.9.7％,P ＜0.001).And the tumor size of BAC group was smaller than that of the adenocarcinoma group (1.4 cm vs.2.3 cm,P ＜0.001).The operation method,time,blood loss and complications were similar between the two groups.Kaplan-Meier survival curves showed that both 3-year disease-free survival (DFS) and overall survival (OS) were significantly higher in patients affected by BAC (100％ vs.76.1％,P =0.030 and 100％ vs.86.1％,P =0.041).Conclusion BAC presents specificity in its epidemical,clinical,radiological and evolutionary aspects.Stage Ⅰ pure BAC patients have better prognosis following video-assisted thoracoscopic lobectomy and system lymph node dissection than the similar stage adenocarcinoma patients.

Bronchitis ; diagnosis ; Diagnostic Errors ; Humans ; Infant ; Male

Adenocarcinoma, Mucinous ; pathology ; Breast Neoplasms ; pathology ; Carcinoma, Ductal, Breast ; pathology ; Carcinoma, Renal Cell ; pathology ; Carcinoma, Squamous Cell ; pathology ; Cystadenocarcinoma, Mucinous ; pathology ; Cystadenoma, Mucinous ; pathology ; Female ; Giant Cells ; pathology ; Humans ; Osteoclasts ; pathology ; Ovarian Neoplasms ; pathology ; Pancreatic Neoplasms ; pathology ; Thyroid Carcinoma, Anaplastic ; Thyroid Neoplasms ; pathology ; Tongue Neoplasms ; pathology ; Urologic Neoplasms ; pathology

Objective To construct a cell line with long time secreting endostatin. Methods Human endostatin cDNA containing interleukin-2 (IL-2) secreting peptide was cloned into eukaryotic expression plasmid pSNA2.0 to construct recombinant plasmid pSNA2.0/Endostatin. The plasmid pSNA2.0/Endostatin was transfected into HEK293 cells by cationic liposome. The positive cell clones were selected by G418 and named hED/293. The expression of endostatin protein was analyzed by Western-blot. Results Endostatin could be determined in the supernatant of hED/293 cells. Conclusion The recombinant eukaryotic expression vector is correctly constructed. The human endostatin protein can be expressed and secreted.

Objective To establish the model of glioma by hypodermic of C6 cells line into the nude mice and observe the growth characteristics. Methods The C6 gliocyte suspension was injected into the left subaxillary hypoderma of nude mice. The diameter and the volume of the tumor were measured and calculated, and the volume-time growth curve was plotted. The cells of tumor were observed under the HE and glial fibrillary acidic protein (GFAP) immono-histochemistry staining. Results The tumor appeared in inoculation area 7 d after injection, and presented nearly exponential development after about 20 d. The survival time of the nude mice is 22～48 d. The tumors were with sharp border, affluent blood vessel, and a great number of GFAP-positive cells. Conclusion The model of glioma can be well induced by hypodermic of the cultured C6 gliocyte into nude mouse.

Objective To analyze the utility of MRI with multiple contrast and dynamic contrast weightings enhancement(DCE) in evaluation of vulnerable atherosclerotic plaques. Methods Forty male New Zealand white rabbits were fed with hypercholesterolemic diet,and right iliac arteries including the common and external iliac arteries were examined by multiple contrast and DCE MRI at intervals 6 to 20 weeks after balloon denudation.For multiple contrast weightings scanning,T1-,T1-/T2WI with fat suppression,proton density weighted and double invention recovery were used.Meanwhile,post DCE T1-with fat suppression images were obtained in 1,5,15 and 25 min after a bolus injection of Gd-DTPA contrast agent.Then a comparative analysis of plaque morphology and components to images was performed. Results There were 34(42.5%) vulnerable plaques and 46(57.5%) stable plaques amomg the 80 atherosclerotic lesions located at the right common or external iliac arteries.The accuracy,sensitivity and specificity of MRI with multiple contrast weightings and DCE for the detection of vulnerable plaques were 87.5%,94.1% and 82.6%,respectively,significantly higher than those only with multiple contrast weightings,which were 73.8%,82.3% and 67.4%,respectively(P