Child ; Child, Preschool ; Humans ; Infant ; Smith-Lemli-Opitz Syndrome

Objective To investigate the feasibility and complications of the transcranial approach for resection of tumors that involve the anterior skull base, orbit and paranasal sinuses. Methods Nine cases of tumors involving the anterior skull base, orbit and paranasal sinuses, which were resected by transcranial approach alone in our hospital from July 2000 to April 2001, were retrospectively analyzed. All patients had the lesion of the anterior skull base and orbit, and 5 cases had additional paranasal sinuses involvement. Results The tumors in all patients were removed completely. Complications occurred in three cases, including one case of cerebrospinal fluid leaking and two cases of blepharoptosis. One died of tumor recurrence one year after operation. Eight were tumor-free survival during the follow-up period of 20～29 months. Conclusion The transcranial approach can completely remove the tumors widely invading the anterior skull base, orbit and paranasal sinuses. Separation of the periosteum of the orbital roof can cause blepharoptosis, which leads to failure of cosmetics. Extending approach must be avoided if it is possible. The reconstruction of the skull base with pedicle pericranial flap may be the key factor to reduce complications.

Objective To evaluate the prognosis and influencing factors of unprotected left main coronary artery lesion intervention with drug-eluting stents.Methods Forty-five patients with unprotected left main coronary artery disease were treated with percutaneous coronary intervention (PCI).According to whether the lesions involving the distal left main bifurcation,the patients were divided into two 2 groups:nonbifurcation lesion group (26 cases) with opening or body disease,bifurcation lesion group (19 cases) with involving the distal left main or anterior descending artery,circumflex openings.Fifteen patients were guided by intravascular ultrasound (IVUS) during PCI,and 13 patients were reviewed by coronary angiography at (9.5 ±6.3) months after PCI.Results All the 45 patients were successful.There were 42 patients successfully finished the follow-up study for the average of 8-48 (19.9 ± 10.2) months,non-bifurcation lesion group was 24 cases,bifurcation lesion group was 18 cases.The incidence of recurrent angina pectoris during the follow-up period in bifurcation lesion group was significantly higher than that in non-bifurcation lesion group [6/18 vs.12.5％ (3/24)],there was statistical difference (P ＜ 0.05),but there was no statistical difference in the incidence of major adverse cardiac events (MACE) between 2 groups [3/18 vs.12.5％ (3/24),P ＞ 0.05].Single-variable analysis results showed that MACE in IVUS guided during PCI was less than that in non-IVUS guided during PCI [1/15 vs.18.5％(5/27)],there was statistical difference (P ＜0.05).In 13 patients who reviewed by coronary angiography,4 patients were found in-stents restenosis,all in bifurcation lesion group,the rate of restenosis in double stents was 3/6,in simple stents was 1/4.Conclusions PCI with drug-eluting stents is safe and feasible for the treatment of selective left main coronary artery lesion,it could bring the better short and long-term outcomes.IVUS guided PCI could significantly reduce MACE.

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Objective To explore the expressions of lectin-like oxidized low-density lipoprotein receptor-1(LOX-1)and apoptosis related genes caspase-3,Bax and bcl-2 in placenta,and their associations with the pathogenesis of preeclampsia.Methods Thirty preeclampsia patients(preeclampsia group),hospitalized in Department of Obstetrics,Shengiing Hospital of China Medical University from June 2005 to December 2006,were selected as the subject group,and 40 normal pregnant women as control group.The expressions of LOX-1 and apoptosis related genes caspase-3.Bax and bel-2 in different gestational weeks'placenta tissues were examined using immunohistochemistry.RT-PCR and western-blot.Results (1)Immunohistochemical detection in preeclampsia group:at 20 w+1-24 w,24 w+1-28 w,28 w+1-32 w.32w+1-36 w+1-36 w+1-40 w,respectively,the results of LOX-1 were 20.1±1.8,25.6±1.3,32.8±1.6,34.3 ±1.5,39.9±1.2;in the control group they respectively were 11.2±0.6,18.5±1.6,26.1±1.8,28.3 4-1.6,32.3±1.6;the difierence was significant(P<0.05).In preeclampsia group,the results of easpase-3 were 12.3±0.9,16.3±0.9,24.4 4-0.8,28.3±0.5,36.3±1.1.and in the control group they respectively were 8.5±1.0,12.3±1.1,17.4±1.2,20.4±stronger than those in normal pregnant women at different gestational weeks(P<0.05).However,the expression tendency of bcl-2 mRNA and proten was converse to the expression tendency of Bax.Conclusion The expressions of LOX-1,caspase-3,and Bax are upregulated in placentas of preeclampsia patients,while bcl-2 iS downregulated,both of which are associated with the pathogenesis of preeclampsia.

Objective To explore the role and mechanism of protein disulfide isomerase A3 (PDIA3) in abnormal colonic mucosa immune response of irritable bowel syndrome (IBS) rats with visceral hypersensitivity.Methods A total of 48 SD rats were divided into blank control group (n=12),empty virus group (IBS-1) (n=12),PDIA3 silencing group (IBS-2) (n=12) and model control group(IBS-3) (n=12).The expression of CD103 in ileocecus colonic tissues was detected by immunohistochemistry.Dendritic cells (D C) of mesenteric lymph node were isolated by flow cytometry.CD4+/CD8+ T cells of spleen were separated by immune-magnetic beads sorting technique.DC and CD4+/CD8+ T cells were co-cultured.The proliferation ability of lymphocytes promoted by DC was measured by methyl thiazolyl tetrazolium (MTT).The secretion levels of interlcukin (IL) 4 and IL-9 of CD4+/CD8+ T cells stimulated by DC were determined by enzyme linked immunosorbent assay (ELISA) method.Independent sample t-test was performed for statistical analysis.Results The cell number of CD103 positive DC of rats colon of blank control group,IBS-3 group was 6.25±1.14 and 10.83± 1.03(t=10.07,P＜0.05);that of IBS-2 group was 7.42 ± 0.90,and compared with that of IBS-3 group,the difference was statistically significant (t=-9.25,P ＜ 0.05).The MTT value of CD4+ T cells proliferation stimulated by DC of blank control group and IBm3 group was 0.54±0.01 and 0.60±0.01 (t=3.373,P＜0.05);that of IBS-2 group was 0.53±0.01,and compared with that of IBS-3 group,the difference was statistically significant (t =-3.139,P ＜ 0.05).The MTT value of CD8+ T cells proliferation stimulated by DC was 0.52±0.01 and 0.59±0.00(t=3.539,P＜0.01);that of IBS-2 group was 0.54±0.01,and compared with that of IBS-3 group,the difference was statistically significant (t=-3.183,P＜0.05).The level of IL-4 secreted by CD4+T cells promoted by DC of blank control group and IBS-3 group was 10.24±0.09 and 16.61±1.00 (t=3.222,P＜0.05);that of IBS-2 group was 11.75±0.54,and compared with that of IBS-3 group,the difference was statistically significant (t=-3.539,P＜0.01).The level of IL-9 secreted by CD4+T cells stimulated by DC of blank control group and IBS-3 group was 15.86±10.19 and 43.51±11.32 (t=4.529,P＜0.05);that of IBS-2 group was 29.05±2.09,and compared with that of IBS-3 group,the difference was statistically significant (t=-6.841,P＜0.01).The level of IL-4 secreted by CD8+T cells promoted by DC of blank control group and IBS-3 group was 7.35±0.12 and 13.91±0.57 (t=19.557,P＜0.01);that of IBS-2 group was 8.63± 0.24,and compared with that of IBS-3 group,the difference was statistically significant (t =-14.782,P＜0.01).The level of IL-9 secreted by CD8+T cells stimulated by DC of blank control group and IBS-3 group was 29.12±5.14 and 60.70±11.02 (t=4.122,P＜0.05);that of IBS-2 group was 37.17±2.65,and compared with that of IBS-3 group,the difference was statistically significant (t=-3.255,P＜ 0.05).Conclusions Protein disulfide isomerase A3 may mediate the process of DC activating T lymphocyte levels of related cytokines,cause abnormal immune response of colonic mucosa and promote the genesis of IBS visceral hypersensitivity.

Objective To investigate the feasibility of fast track surgery (FTS) application in arthroscopic reconstruction of anterior cruciate ligament.Methods A total of 80 cases of anterior cruciate ligament(ACL) tear patients were randomized into two groups.While the experimental group (n =42) was treated with the conception of FTS, and the control group(n =38) was treated with the traditional methods.The postoperative pain, knee Lysholm score, quality of life score (SF-36), knee joint activity (EUROPEP), and postoperative infection were compared between the two groups.Result The VAS score of post-operation pain (VAS) 1 h(1.80±1.13) ,6 h(1.91±0.98), 12 h(1.73±0.95) ,24 h(1.68±0.65) ,48 h(1.69±0.90) ,the time stay in hospital (7 ± 1), total cast (205 600 ± 7 600) yuan, were significantly decreased compared to the traditional therapy group(VAS : (7.00± 1.56), (7.41±0.93), (6.82±1.12), (6.65±0.76), (6.34±0.88) ,P ＜0.05 or P＜0.01;(12± 1) d, P =0.021;(28 600±5 400) yuan, P =0.042).Recovery time of ROM of experimental group was significant lower than control group (P ＜ 0.05).But the comparison of patients, satisfaction of post-operation in two groups was inverse(P=0.007).The Lycholm scores of post-operation of FTS group were remarkably higher than the control group and the scores of prior treatment(85.1 ± 14.2) vs (73.6 ±12.3);P＜ 0.05).Conclusion The new methods of FTS can apparently accelerates recovery after ACL reconstruction,reduces complications, shorten time stay in hospital, cut down the total cost, and improve the experience and the satisfaction of patients.It was safety and feasible.

Objective To investigate the effect of microbubble-enhanced non-focused ultrasound on liver uhrastructure during the treatment of hepatic trauma.Methods The model of hepatic trauma was established in 18 healthy New Zealand rabbits.The subjects were divided into trauma group,ultrasound group and ultrasound-microbubble group according to the random number table,with 6 rabbits each.Thicker region of the left hepatic lobe was treated by custom-made non-focused ultrasound for 5 min.Peak intensity (PI) was used to evaluate the blood reperfusion of the target region after treatment.Liver specimens were performed transmission electron microscope examination immediately and 24 h after treatment to analyze ultrastructure changes.Results PI ratio in ultrasound-microbubble group (15.1 ± 2.6) was significantly lower than that in trauma group (23.1 ± 1.1) and ultrasound group (23.4 ± 1.3) (P ＜ 0.05).But the difference between trauma and ultrasound groups was insignificant (P ＞ 0.05).Compared with trauma and ultrasound groups immediately after treatment,hepatic cells in ultrasoundmicrobubble group had obvious edema,sinusoids thinned,organelles arranged in disorder,mitochondrial edema was present,endothelia cells of interlobular hepatic artery,interlobular vein and bile canaliculi in the portal area damaged,and microvilli of bile canaliculi disappeared.Hepatic cells showed morphology of apoptosis 24 h after treatment.Conclusion Microbubble-enhanced non-focused ultrasound can be used to make rapid hemostasis by decreasing the blood perfusion,but it causes certain damage to the ultrastructure of hepatic cells and may induce apoptosis in the radiation zone and neighboring cells.

OBJECTIVE To investigate the accumulated effect and the mechanism of repeated sc administration of acrylamide (AM) on learning and memory after 28 d,and the effect of AM on the amplitude of population spike(PS) potential after a single sc administration of AM. METHODS Female Wistar rats were sc adminstered with AM 10, 20 and 40 mg · kg-1 once a day for 28 d, and weighted every week. The ability of study and memory was evaluated, The morris water maze was used from 22nd to 28th day,followed by step down test on the 29th and 30th day. The escape latent period and the number of errors in those two days were recorded. Rats from normal control group and AM 40 mg·kg-1 group were taken to have their N-methyl-D-aspartate receptor (NR) and calmodulin-dependent protein kinaseⅡ (CaMKⅡ) protein levels detected by Western blotting. Additionally, some other female Wistar rats were sc administered with a single dose of AM 40 mg · kg-1 ,before the changes in PS potential amplitude induced by high frequency stimulation were recorded by long-term potential (LTP). RESULTS Compared with normal control group, the relative body mass gain was significantly decreased in AM exposure groups(P<0.01). Additionally, the escape latency period was significantly increased in AM 20 and 40 mg·kg-1 groups compared with normal control group, while the crossing frequency was not significantly different betmeen these four groups. Compared with the first day of step down test, the number of errors was significantly decreased(P<0.01) and the escape latency period was significantly extended(P<0.01) in normal control group on the 2nd day. However, the number of errors and the escape latency period did not significantly change in the AM groups between the two days. The results of Western blotting showed that the protein expressions and phosphorylation of NR2A and NR2B, as well as the phosphorylation of CaMKⅡ in AM 40 mg · kg-1 group were significantly increased compared with normal control group. LTP result showed that AM 40 mg·kg-1 significantly inhibited the amplitude of PS potential after a single percutaneous administration. CONCLUSION AM can inhibit the PS amplitude by inhibiting the release of glutamate, increasing the expressions and activities of NR,and inhibiting PS potential, thus affecting the hippocampal synaptic plasticity, and the function of learning and memory.

9).Renal pathology revealed 3 patients with class Ⅳ, 1 patient with class Ⅱ. Image results showed diffuse pulmonary infiltration lesions. Bronchial lavage fluid was hemorrhage. Three patients recovered after treatment with corticosteroid and intravenous cyclophosphamide therapy. Conclusions Diffuse alveolar hemorrhage is rare serious complications of lupus nephritis. Aggressive immunosuppressive therapy should be started early for a favorable outcome.