Objective To explore how to improve the sensitivity and specificity of CT cisternography (CTC) examination.Methods The clinical data of 20 cases of CTC in detecting cerebrospinal fluid rhinorrhea were analyzed,and the influence of continuous dripping of fluid and the filling time of subarachnoid space upon the image quality were observed.Results Nineteen cases of active cerebrospinal fluid rhinorrhea were found with CTC,and the fistula sites were determined by CTC.Eighteen cases received operation which confirmed the fistula sites.One case was found with no active fistula site.According to the image of ethmoid sinus leaks results,7 cases had better image quality in 9 cases whose subarachnoid space filling time was longer than or equal to 10 min.One case had better image quality in 6 cases whose subarachnoid space filling time was shorter than 10 min.There was significant difference (P =0.0406).Conclusion To raise the positive rate of CTC,the position of active fistula should be maintained and keep the time between the injection and scan longer than or equal to 10 min,which help to get better image quality.

ObjectiveTo evaluate the safety and efficacy of biological meshes (human aceUular dermal matrix mesh) in single-stage repair of infected or contaminated abdominal abdominal wall defects and abdominal hernias. MethodsSeventeen patients with abdominal wall defects or abdominal hernias were enrolled. The wounds of all these patients were infected or contaminated due to the existence of enterocutaneous fistula or stoma, wound infection and synchronous colonic resection. The diagnosis included enterocutaeneous fistula 8 cases, incisional hernia 6 cases, incarcerated inguinal hernia 1 case and cylindrical abdominoperineal resection for rectal cancer for 2 cases. The sizes of abdominal defects ranged from 3 cm × 2 cm to 6 cm × 17 cm, and all the cases were repaired with human acellular dermal matrix mesh(RENOV(R)). Most of the patients were repaired with intraperitoneal onlay mesh technique( IPOM, for 12 cases), and other methods included Lichtenstein operation for 1 case, inlay repair for 2 cases and sublay for 2 cases. Results All the 17 patients recovered uneventfully. For 12 patients, the wounds were sutured at operation and only one case of delayed healing occurred due to fat liquefaction. For the other 5 patients, the wounds were left open and healed after vacuum assisted closure (VAC) therapy or wet- to- dry dressing changes. On follow up for 8.3 ±4.5 months ( 1 to 15 months), no occurrence of incisional hernia or recurrence was found. laxity of abdominal wall occurred in one case. A patient complained intermittent pain of the site of suture for mesh fixing two months after operation and the pain resolved spontaneously one month later. ConclusionsThe biological mesh, acellular dermal matrix mesh, could be used in single- stage repair of infected or contaminated abdominal wall defects safely and effectively, although the long-term outcome still needs further evaluation.

Objective To investigate the effects of mannan-binding lectin(MBL) on TNF-α production induced by peptidoglycan (PGN) and its mechanism in human THP-1/CD14 monocytes.Methods The THP-1/CD14 cells were stimulated for 24 h with PGN at the indicated ratios after pretreated with human natural MBL at concentrations ranging from 1 to 20 mg/L for 2 h.The content of TNF-α and IL-6 in culture supernatants were detected by ELISA,and the levels of TNF-α and IL-6 mRNA expressions in these cells were determined by RT-PCR.FACS was used to investigate the interaction of MBL with THP-1/CD14 cells and the impact of MBL on PGN binding to THP-1/CD14 cells.Western blot was used to detect PGN-induced NF-κB translocation in THP-1/CD14 cells.Results ELISA showed that secretion of TNF-α and IL-6 from THP-1/CD14 cells could be induced by PGN ;The productions of TNF-α and IL-6 by THP-1/CD14 cells induced with PGN were profoundly inhibited by MBL at higher concentrations (10-20 mg/L) but not MBL at lower concentrations (1 mg/L).RT-PCR analysis also indicated that the mRNA expressions of TNF-α and IL-6 in THP-1/CD14 cells were decreased by MBL at higher concentration,compared to the corresponding THP-1/CD14 cells stimulated with PGN only.FACS showed that the binding of MBL to THP-1/CD14 cells was evident in a Ca2+-dependent manner.PGN could competitively inhibit the binding of MBL to THP-1/CD14 cells.MBL could competitively inhibit the binding of PGN to THP-1/CD14 cells by binding to THP-1/CD14 cells directly.Similarly,MBL at higher concentration (20 mg/L) decreased the NF-κB translocation in THP-1/CD14 cells.Conclusion MBL may inhibit TNF-α and IL-6 production induced by PGN in THP-1/CD14 cells through NF-κB signaling pathways,suggesting that MBL can play some roles in the regulation of PGN-induced inflammatory response.

Objective To obtain methamphetamine concentration profiles in saliva and urine samples of drug addicts and to screen the colloidal gold strip. Methods Methamphetamine concentration in saliva and urine samples of drug addicts was determined by liquid chromatography tandem mass spectrometry. The initial screening was obtained by colloidal gold strip test. The results were compared and analyzed. Results using the method of protein and fluid MRM scan method to detect direct precipitation, saliva is linear in the range of 1~100ng/mL, the linear correlation coefficient is 0.9987, the detection limit is 0.1ng/mL, the limit of quantification was 1ng/mL, the urine is linear in the range of 1~100ng/mL, the linear correlation coefficient is 0.9943, the detection limit is 0.5ng/mL, the limit of quantification was 1ng/mL. Saliva and urine samples diluted, the concentration in the linear range. Saliva and urine samples of four types of methamphetamine colloidal gold reagent strip were screened directly, and the results were judged visually. Conclusion the detection rate of colloidal gold strip is about 79%, the detection rate of saliva is about 81%, and the detection rate can be increased to more than 93% by using two reagent strips. Combined with the initial screening results and the instrument confirmation concentration, it can be found that the gray zone setting and sensitivity setting have certain influence on the detection rate, and it is suggested to improve the sensitivity to meet the needs of screening.

Objective To explore the effect and complications of ventricle peritoneal shunt n pediatric hydrocephalus. Methods The clinical data was analysed in 30 cases of pediatric hydrocephalus. Results A total of 27 cases (90%) of pediatric hydrocephalus were found reduction of ventricle. 3 cases were found no obvious reduction of ventricle. Post-operative complications in 3 cases (10%), subcutaneous liquid collection in 2 cases (6.67%), diverter pump in 1 case (3.33%). No patients were found infection. Conclusion Strict sterilizing procedures andhigh quality and attention-to-detail is the key to reduce postoperative complications and improve surgical outcomes.

Objective To investigate the application value of CT perfusion (CTP) imaging for the revascularization treatment in adult patients with Moyamoya disease.Methods Adult patients with Moyamoya disease underwent revascularization in the Department of Neurosurgery,Wuhan No.1 Hospital from July 2009 to December 2016 were analyzed retrospectively.CTP and clinical evaluation were performed before and after 3-6 months of procedure.The modified Rankin Scale (mRS) was used to assess the functional outcomes.Results A total of 20 patients were enrolled in the study,including 9 females and 11 males,aged 29 to 73 years,with an average of 53.5 years.The initial symptom was ischemic stroke in 10 patients,transient isehemic attack in 7 patients,and hemorrhagic stroke in 3 patients.All patients underwent superficial temporal artery-middle cerebral artery bypass grafting plus encephalomyo-synangiosis under general anesthesia.All patients have different degrees of improvement in cerebral blood flow after procedure,and the CTP parameters were significantly improved compared with those before procedure (all P ＜0.05).The clinical symptoms were significantly improved in 3 cases (15％) and recovered in 13 cases (65％) at 6 months after procedure.The proportion of the mRS score 0-2 was significantly higher than that before procedure (90.0％ [18/20] 对 50.0％ [10/20];x2 =7.619,P =0.006).Conclusion CTP can evaluate the cerebral perfusion status in various vascular areas through hemodynamic parameters in early stage,which can effectively guide the operation mode of Moyamoya disease,and evaluate the changes of cerebral perfusion status after procedure as a means of follow-up of the disease.

Objective To study the Homer1a protein expression and its relationship with neurological deficit and neuronal apoptosis in craniocerebral trauma patients. Methods Forty-two craniocerebral trauma patients, admitted to our hospital from May 2012 to March 2016, were selected as craniocerebral trauma group; 50 healthy subjects accepted physical examination at the same period in our hospital were selected as normal control group (n=50). Immediately after admission, serum contents of Homer1a protein and nerve function damage indices (neurospecific estrogenase [NSE]), fatty acid binding protein [FABP], insulin-like growth factor [IGF-1], and S100B protein) were measured by enzyme linked immunosorbent assay (ELISA). Serum apoptotic indices (soluble apoptotic factor [(sFas)], sFas ligand [sFasL], and cell lymphoma-2 [Bcl-2]) were detected by radioimmunoassay. Results Immediately after admission, serum content of Homer1a protein content in craniocerebral trauma group ([113.27±12.19] pg/mL) was significantly higher than that in normal control group ([53.93±4.06] pg/mL, P<0.05); the median serum Homer1a protein level was 115.302 pg/mL, and according to this level, the patients from the craniocerebral trauma group were further divided into high Homer1a group and low Homer1a group. Serum NSE, FABP, S100B, sFas and sFasL levels in the high Homer1a group, low Homer1a group and normal control group were decreased in sequence, and IGF-1 and Bcl-2 levels increased in sequence, with significant differences (P<0.05). Conclusion Expression of Homer1a protein is increased in patients with traumatic brain injury, and its content is directly related to nerve injury and neuron apoptosis.

The p21 activated kinase 4 (PAK4) is serine/threonine protein kinase that is critical for cancer progression. Guided by X-ray crystallography and structure-based optimization, we report a novel subseries of C-3-substituted 6-ethynyl-1H-indole derivatives that display high potential and specificity towards group II PAKs. Among these inhibitors, compound 55 exhibited excellent inhibitory activity and kinase selectivity, displayed superior anti-migratory and anti-invasive properties against the lung cancer cell line A549 and the melanoma cell line B16. Compound 55 exhibited potent in vivo antitumor metastatic efficacy, with over 80% and 90% inhibition of lung metastasis in A549 or B16-BL6 lung metastasis models, respectively. Further mechanistic studies demonstrated that compound 55 mitigated TGF-β1-induced epithelial-mesenchymal transition (EMT).