BACKGROUND: With development of modern medical sciences, the out comes after meningioma surgery cannot be fully assessed using morbidity,livability and mortality merely. Quality of life (QOL) is a health-related multivariable index, which provides integrated inf ormation associated with physiological,sychological and social adaptation status of the patients to doctors. Assessment of the QOL in meningioma patients may be one of a relatively good method for guiding surgery and reducing reoccurrence of tuOBJECTIVE: To evaluate the QOL in meningioma patients and then to provide relevant data for assessing the outcomes of meningioma surgery comprehensively.DESIGN: It was a single-sample investigation. SETTING: Neurosurgery Department, Second People's Hospital of Wuxi City of Nanjing Medical University.PARTICIPANTS: Totally 147 patients underwent meningioma surgery in the Neurosurgery Department of the Second Affiliated Hospital of Wuxi City affiliated to Nanjing Medical University between January 1995 to January 2001 were selected, 61 males and 86 females, with a male/female ratio of 2:3 and an age ranging from 5-77 years old, in average of 43 years old, and the median was 43 years old.METHODS: Based on World Health Organization Quality of Life 100item questionnaire (WHOQOL-100) and Karnofsky Performance Scale (KPS), we designed a questionnaire on QOL in patients with meningioma.Outcomes of the transverse investigation on 147 meningioma patients were compared with healthy controls. Surgery-related QOL curve was used for identifying the threshold satisfactory point of QOL. In addition, with selfcontrol, influence of surgery on QOL was assessed.MAIN OUTCOME MEASURES: Relationship between QOL and clinical histories, radiological analysis, operation grading, histological properties and reoccurrence were investigated.RESULTS: All of the 147 patients entered the statistical analysis. ①In patient with meningioma, Cronbach's coefficient was 0.9521 and the correlated coefficient was 0.8685, which suggested that QOL questionnaire for patients with meningioma had a good reliability and validity. ②QOL ≥70 represented that the patient was satisfied with the QOL. ③In patients underwent surgical treatment, their physiological functions, self-help and self-care except for psychological functions were significantly improved (P ＜ 0.001 ).CONCLUSION: Surgical treatment enables patients to get a satisfied QOL. QOL questionnaire for patients with meningioma is helpful to provide relevant data for meningioma operation.

Objective To evaluate multi-slice spiral CT venography (MSCTV) and digital subtraction venography (DSV) in diagnosing iliac vein compression syndrome (IVCS) and secondary thrombosis. Methods The imaging materials, including MSCTV and DSV performed before and after the thrombolysis therapy, of 38 patients with clinically-suspected IVCS were collected. The inner diameters of the compressed iliac veins were measured on MSCTV images and the compression ratio was calculated. Usingχ2 test, the detection rates of IVCS by MSCTV and DSV were compared. Results Of 38 patients, IVCS was detected by MSCTV in 29, by pretreatment DSV in 20 and by post-treatment DSV in 29. The difference in the detection rate of IVCS between MSCTV and pre-treatment DSV was statistically significant (χ2=4.65, 0.010.05). Conclusion For the diagnosis of IVCS, MSCTV is superior to pre-treatment DSV in the diagnostic accuracy of iliac vein compression syndrome. Therefore, MSCTV should be used as the preferred method of examination.(J Intervent Radiol, 2015, 24:301-305)

Purpose To explore the value of 128-slice dual source CT (DSCT) three-dimensional post-processing techniques in the diagnosis of acute aortic dissection (AAD). Materials and Methods All image data of 116 patients with AAD who underwent conventional and enhanced DSCT scan by dual-energy scanning technology were retrospectively analyzed, and the multi-planar reconstruction (MPR), volume rendering (VR) and maximum intensity projection (MIP) were conducted in the workstation. Taking digital subtraction angiography (DSA) as the diagnostic gold standard, we analyzed the imaging manifestation of the original and 3D-reconstruction images and evaluated the specificity and the sensitivity of diagnostic accuracy and the image quality. Results The diagnostic accuracy of conventional scan was 37.1%(43/116). The display rates of MPR for initial break, intimal flap and true and false lumen were 93.1%, 100.0%and 100.0%, respectively. The display rates of VR and MIP for the initial break were 33.62%and 6.90%, respectively, which was both lower than that of MPR. The display rate of MIP for the true and false lumen was 23.28%. The overall display capability of MPR was significantly better than that of VR and MIP (P<0.01), and the display capability of VR was better than that of MIP (P<0.01). The sensitivity and specificity of enhanced DSCT in the diagnosis of AAD were both 100.0%. Conclusion DSCT has a fast and reliable diagnostic value on AAD. Conventional CT signs should be highly valued in the evaluation of chest or abdominal pain; and a thin layer of MPR and VR should be chosen in the three-dimensional reconstruction;whilst MIP reconstruction may be unnecessary for AAD.

Pancreatic cancer is a commonly malignant gastrointestinal tumor with an significantly increasing incidence.Those patients without nonspecific symptoms at early stage had mostly lost the opportunity of surgical therapy when pancreatic cancer was detected at advanced stage,and its prognosis is poor.Therefore,it is rather important to improve the early diagnosis of pancreatic cancer.In recent years,proteomics is developing rapidly.Proteomics technologies have been widely used in clinical research.Using proteomics technology screening pancreatic cancer tumor markers becomes the research focus,thus we try to find a kind of or a group of pancreatic tumor markers,so as to improve the diagnosis of pancreatic cancer.

Objective To investigate the clinical characteristics, operation time and methods for patients with central brain herniation caused by bifrontal contusions. Methods A retrospective study was performed on the medical records of patients with central brain herniation caused by bifrontal contusions admitted from January 2000 to December 2006. There were 45 males and 18 females, at age range of 20-72 years (average 43 years). The majority of the patients were victims of falls and traffic accidents. There were 29 patients treated with immediate operation and 34 with emergency operation. All the operations involved simultaneous bilateral craniectomy for decompression, including 17 patients treated with bilateral decompressive craniectomy and 46 with unilateral decompressive craniectomy. Results The prognosis was favorable in 19 patients with GOS score of 5 or 4 points, severely disabled in seven with GOS score of 3 points, vegetative in four with GOS score of 4 points and the worst in seven with GOS score of 1 point. Of all, 19 patients suffered severe mental disorders especially personality change and disturbance of intelligence. Seven patients were complicated by epilepsy and three by hydrocephalus. Conclusions Based on early clinical manifestations of central brain herniation combined with imaging manifestations, bilateral balance decompression craniectomy can reduce the mortality and morbidity and improve the cure rate of patients with central herniation caused by bifrontal brain contusions.

ObjectiveA comparative proteomic method was used to analyse serum proteins between pancreatic cancer patients and control group,and to find a new protential specific marker.MethodsComparative analysis on the pancreatic peripheral blood protein profiling from 40 pancreatic cancer patients,10 chronic pancreatitis patients,10 benign tumor patients and 40 cancer-free controls was carried out by 2D differential gel electrophoresis,and differentially expressed proteins were identified by matrix-assisted laser desorption/ionization time of flight mass spectrometry.ResultsTwo differentially expressed proteins:transthyretin and apolipoprotein E were identified.Those proteins were highly expressed in pancreatic carcinoma group compared with normal control group,chronic pancreatitis group and benign tumor group.Conclusion2D differential gel electrophoresis and matrix-assisted laser desorption/ionization time of flight mass spectrometry technology in screening specific serum biomarkers of pancreatic cancer has a well repeatability and stability.The identified protein transthyretin in this study may be as specific serum biomarkers of pancreatic carcinoma.

Objectives To explore the route of ESBL producing bacteria in neonatal faeces, and to investigate the gene and drug resistance of ESBL producing bacteria in intestinal tract of neonates. Methods Fecal samples of healthy newborns and their mothers were collected, and bacterial cultures were carried out using selective ESBL medium. The positive strains were identified by Time-of-flight mass spectrometry. ESBL genotyping and resistance gene detection were performed by whole genome sequencing technique. Results In 146 neonatal fecal specimens, the positive rate of ESBL producing bacteria was 8.90％,and the positive rate in the first time stool was 3.23％. Seventy-two hours after birth, the positive rate of fecal ESBL producing bacteria was 13.10％. Among the 13 ESBL producing strains, there were 9 strains of CTX type, 3 strains of TEM type and 1 strain of SHV type. Nine strains of CTX include five types such as CTX-M-24, CTX-M-18, CTX-M-27, CTX-M-42 and CTX-M-15. The positive rate of ESBL producing bacteria was 21.6％ in 167 mothers' fecal specimens. The ESBL genotype included 24 strains of CTX type, 6 strains of TEM type, 4 strains of SHV type and 2 strains of QnrS type. Twenty-four strains of CTX include CTX-M-24, CTX-M-14, CTX-M-18, CTX-M-27, CTX-M-42 and CTX-M-15. There were 2 or 3 ESBL genotypes in 12 maternal and neonatal specimens. It was detected to have 6 types of resistance gene such as aadA5, strA, strB, sul1, sul2 and dfrA17 in 49 strains of ESBL producing bacteria in maternal and neonatal strains. Resistance genes were exactly the same in the neonates as in mothers who were detected to have ESBL producing bacteria. A variety of resistance genes were detected in feces in 7 neonates and 23 mothers. Conclusions The neonates in hospital may be detected to have ESBL produing bacteria in the intestinal tract at the same time as their mothers or separately. However, there are many ways for neonates to have ESBL producing bacteria in intestinal tract. There are many genotypes and resistance genes of ESBL producing bacteria.

Objective To investigate the effects of alpha lipoic acid on patients with diabetic retinopathy (DR),explore the possible mechanisms,and provide experimental evidence for the treatment of DR with lipoic acid.Methods Totally 75 DR patients were randomly divided into control group and treatment group.Patients in control group received the standard hypoglycemic treatment,antihypertensive therapy,and other comprehensive treatment.Patients from the treatment group were treated with alpha lipoic acid 600 mg + 250 ml 0.9％ sodium chloride injection additionally,avoiding light intravenous therapy,for a total of 4 weeks.Before and after treatment,fundus fluorescein angiography and visual inspection were detected in two groups.In addition,serum level of asymmetric dimethylarginine (ADMA) were detected with high performance liquid chromatography,serum lipid peroxidation product malondialdehyde (MDA) content and superoxide dismutase (SOD) activity were detected to reflect the in vivo oxidative stress before and after treatment in two groups.Results Compared to the control group,visual acuity was improved significantly (P ＜ 0.05),and total efficiency of ocular lesions-improved was increased significantly (84.21％ vs 40.54％,x2 =15.28,P ＜ 0.01).Serum levels of endogenous inhibitor of nitric oxide synthase ADMA [(0.32 ±0.13) μmol/L vs (0.51 ± 0.26) μmol/L,P ＜ 0.05] and MDA [(3.22 ± 0.90) nmol/L vs (5.13 ± 0.42) nmol/ml,P ＜ 0.05] were significantly decreased,while SOD levels [(72.68 ± 1.31) U/ml vs (53.16 ± 1.54) U/ml,P ＜0.05] were significantly increased in DR patients after alpha lipoic acid treatment.Conclusions Alpha lipoic acid had some therapeutic effects for DR patients,which mainly lied in the improvement of visual acuity and eye disease,might be related to the decrease of oxidative stress and serum level of endogenous nitric oxide synthase (NOS) inhibitor ADMA.

ObjectiveTo explore the expression of CD3+ CD8+ human leukocyte antigen (HLA)-A2+T lymphocytes with specificity to the different hepatitis B virus (HBV) peptides in the peripheral blood mononuclear cells (PBMC)from the patients with hepatitis B associated hepatocellular carcinoma (HCC).MethodsThe HLA-A2+ PBMC from four patients with hepatitis B associated HCC were incubated with five HBV/HLA-A2 pentamers respectively,which were HBV sAg (FLLTRILTI),HBV sAg (GLSPTVWLSV),HBV sAg (WLSLLVPFV),HBV core (FLPSDFFPSV),and HBV pol (FLLSLGIHL),as well as anti-CD3-pacific blue and anti-CD8-fluorescein isothiocyanate (FITC).Then,HBV/HLA-A2-CD3-CD8 positive cells were detected by flow cytometry. The monoclonal HBV/HLA-A2-CD3-CD8+ cells were acquired by fluorescenceactivated cell sorter,and cultured and identified by flow cytometry.The anti-HBV specific T lymphocytes were then cultured with HepG2 (HLA-A2+ ) cells and the release of interferon γ (IFN-γ)were determined by enzyme-linked immunosorbent assay (ELISA),Res(a)ltsThe percentage of antiHBV T lymphoeytes with specificity to GLSPTVWLSV in total CD8+ T lymphoeytes from four patients with hepatitis B associated HCC was 1.44％±0.04％,which was higher than those to other four HBV antigen peptides (0.68％±0.08％ of FLLTRILTI,1.06％±0.09％ of FLPSDFFPSV,0.56％ ±0.04％ of FLLSLGIHL,and 0.46％ ±0.08％ of WLSLLVPFV) (t=0.001,P＜0.05).The two lines of monoclonal cell with specificity to GLSPTVWLSV both exhibited high level of IFN-γ expression after incubated with hepatic carcinoma cell line HepG2 (HLA-A2+)with HBV GLSPTVWLSV peptide.ConclusionsCD3+ CD8+ HLA-A2+ cells with specificity to the different HBV peptides exist in PBMC of patients with hepatitis B associated HCC.The expression level depends on HBV antigen peptide sequences and genomic sites.

ObjectiveTo explore the expression of N-cadherin and β-catenin mRNA in human brainstem and supratentorial gliomas. MethodsN-cadherin and β-catenin mRNA expression in 18 cases of brainstem gliomas and 18 cases of supratentorial gliomas tissues were detected with PT-PCR. Resultsβ-catenin mRNA expression was more in human brainstem gliomas than in supratentorial gliomas （t=2.255,P<0.05）, but was not significantly different of N-cadherin mRNA (P＞0.05). The expression of N-cadherin mRNA in human brainstem gliomas of grades Ⅰ～Ⅱ were less than those in human gliomas of grades Ⅲ～Ⅳ (t=2.711，P<0.05), but was not of β-catenin mRNA (P＞0.05). N-cadherin mRNA expression was positively correlated with the β-catenin mRNA expression in either brainstem gliomas or supratentorial gliomas （r=0.480，r=0.809 respectively, P<0.05）. ConclusionThe over expressions of N-cadherin and β-catenin may play an important role in the invasion and malignant progress of human brainstem gliomas.