Objective To design a device for prevention of foot drop and explore the effects.Method A device was designed and made using elastic sock,elastic bandage and wools to prevent foot drops in 18 patients in bed for long term combined with motion functional deficit in lower limbs.Result None of the 18 patients contracted with foot drop,with limb function score of(66.11±9.89). There was statistical difference between discharge and admission(P<0.05).Conclusions The self-designed device is effective in the prevention of foot drop in the patients sleep in bed for long term combined with motion function deficits in lower limbs.It is easy and useful for the enhancement of the function of their limbs.

Objective:To summarize the clinical experiences of pediatric en-bloc kidney transplantation (EBKT) at a single center and explore the measures of improving its efficacy.Methods:Clinical data and outcomes retrospectively analyzed for 38 EBKT children between September 2014 and November 2019 from Department of Urology Affiliated Union Hospital Tongji Medical College Huazhong University of Science & Technology. The pediatric donors were aged (63.6±5.7) days with a weight of (4.1±0.2) kg. And the transplant recipients were aged (28.1±1.4) years with a weight of (48.7±4.9) kg. Serum levels of creatinine and basic profiles of both donors and recipients were recorded at Day 0/7/30/90/80/360 post-EBKT. The postoperative occurrences of such complications such as thrombosis, urine leakage, delayed graft function (DGF), proteinuria and hematoma were measured.Results:The one-year graft survival rate was 76.3%(29/38) and the recipient survival rate 100.0%(38/38). Among 29 recipients with long-term graft survival, no dialysis was required at Week 2 post-EBKT and the serum level of creatinine dropped to normal at Year 1. Thrombosis was a major post-EBKT complication with an incidence of 18.4%(7/38). The other complications included urine leakage (20.7%, 6/29), hematoma (6.9%, 2/29) and primary non-functioning kidney (2.6%, 1/38).Conclusions:As an effective way of expanding the pool of donors, pediatric EBKT is clinically feasible.

Obtective The correlation between estrus cycle and the pathological changes of liver and lung in LPS-treated mice and the possible mechanisms were investigted.Methods The pathological lesion in liver and lung、 the content of E_2、P in plasma and the content of TNF-?、EGF in plasma and ovarian supernate were examined in various times after challenge with 12.5 mg/kg LPS in estrus、metestrus and diestrus respectively and the correlation among them was assessed.Results The plasma E_2 and p levels were the lowest in diestrus.When LPS was injected in diestrus,compared with control group,the levels of P and E_2 in plasma were decreased remarkely after ip LPS 10 h(P

Organ transplantation is the most effective method to treat end-stage organ failure. As the increase of transmission risk of donor-derived diseases, the quality, safety and selection criteria of transplanted organs become more and more important. Chapter 7 of the European Union's Guide to the Quality and Safety of Organs for Transplantation (6th Edition) proposed basic requirements in terms of donor and organ quality assessment, selection criteria and procedures, which were worthy of study and practice in clinical practice.

Objective:To explore the short-term outcomes of dual kidney transplantation and summarize its safety and feasibility.Methods:From September 2018 to September 2019, a total of 7 dual kidney transplantations were performed. And retrospective analysis was performed for baseline profiles, clinical data and postoperative complications.Results:The mean age was (62.7±8.5) years for donors and (43.9±9.3) years for recipients. The Remuzzi score of 6 paired kidneys ranged from 4 to 6 points. During follow-ups, the survival rate of 7 dual kidney transplantation grafts and recipients was 100%. The median follow-up period was 16 months. Renal function of 6 recipients normalized within 1 week and delayed graft function (DGF) occurred in one case. All of them underwent unilateral kidney transplantation with an average operative duration of (5.6±1.4) hours. There was no onset of operative complications. One case of rejection was not confirmed by biopsy. Among three patients of lung infections, there was one case of severe pneumonia. In 3 cases, lateral plasma flow of transplanted kidney exceeded that of medial plasma flow.Conclusions:Dual kidney transplantation in adults is both safe and feasible so as to expand the availability of donated kidney.

Objective:To analyze the expression of glial fibrillary acidic protein (GFAP) and neuronal nuclei (NeuN) antigen in hippocampus based on the depression model of juvenile rats caused by chronic unpredictable stress (CUS), and to explore the effect of electroacupuncture vagus nerve on CUS depression model.Methods:Six juvenile SD rats were selected as the control group (without any stimulation), and the rest were divided into CUS group, pseudo stimulation group, fluoxetine group and electroacupuncture group by random number method after CUS modeling, with 6 rats in each group. Fluoxetine group was given 10 mg/kg fluoxetine intervention; control group and CUS group were given the same amount of normal saline intervention; In the electroacupuncture group, the distal vagus nerve was stimulated after ligation, while in the pseudo stimulation group, only vagus nerve was isolated without electrical stimulation. After 28 d of intervention, the five groups were subjected to Open-field Test and Sucrose Preference Test. Hippocampal neurons were detected by hematoxylin and eosin (HE) staining, and the expressions of GFAP and NeuN in hippocampal were detected by immunohistochemistry.Results:After CUS modeling and before intervention, the number of vertical and horizontal movements, sucrose consumption and sucrose preference in CUS group, pseudo stimulation group, fluoxetine group and electroacupuncture group were significantly lower than those in the control group (all P<0.01); After the intervention, the above indexes in CUS group and pseudo stimulation group were still lower than those in the control group (all P<0.01), but the above indexes in fluoxetine group and electroacupuncture group were significantly higher than those in CUS group and pseudo stimulation group (all P<0.01). HE staining showed that the arrangement of hippocampal neurons in CUS group and pseudo stimulation group were loose, and there were cell swelling and pyknosis, which was significantly improved in fluoxetine group and electroacupuncture group. Immunohistochemical results showed that compared with the control group, the expression of GFAP increased and NeuN decreased in the hippocampus of CUS group and pseudo stimulation group (all P<0.01); Compared with CUS group and pseudo stimulation group, the expression of GFAP decreased and NeuN increased in fluoxetine group and electroacupuncture group (all P<0.01). Conclusions:Electroacupuncture of vagus nerve can obviously improve the depression symptoms of juvenile rats, which is similar to fluoxetine, and may be related to regulating the expression of GFAP and Neun in hippocampus.

Objective To study the clinicopathological features, diagnosis, and differential diagnosis of atypical epithelioid hemangioendothelioma (EHE). Methods Eight cases of atypical EHEs were collected from Jiangsu Province Hospital (the First Affiliated Hospital of Nanjing Medical University) between 2010 and 2018. EnVision method and fluorescence in situ hybridization (FISH) were used to detect immunophenotype, WWTR1?CAMTA1 and TFE3 gene rearrangement, respectively. Results There were 4 males and 4 females, ranging from 42 to 59 years (median 47.5 years). The tumors located in soft tissue (3 cases), lung (3 cases), liver (1 case) and chest wall (1 case). One soft tissue EHE involved also adjacent fibula and pleural involvement was present in all three lung cases at the diagnosis. Regional lymph node metastases were present in two cases (one involving soft tissue tumor and one involving liver). Morphologically, the tumor cells were epithelioid with abundant eosinophilic cytoplasm, moderate to marked nuclear pleomorphism, irregular nuclear membrane, unevenly chromatin, and prominent nucleoli. The cells arranged in cords, small nests or solid pattern. The mitotic rate was 4.3 mitoses/2 mm2 on average (ranging 2 to 9). Tumor necrosis was seen in every case. Among all 8 cases, blister cells were found upon careful observation. Myxohyaline stroma was present in 6 cases. Immunohistochemically, tumor cells expressed CD31 (8/8), CD34 (7/8), ERG (8/8), CKpan (2/7), and CAMTA1 (4/6). None of the tested cases stained for TFE3 (0/6). WWTR1?CAMTA1 fusion gene by FISH was found in all tested 6 cases and TFE3 gene rearrangement was not detected in any. Available clinical follow?up was obtained in 7 cases and the intervals range from 6 to 55 months (average 19.6 months). Six patients had metastasis and 3 patients died of disease. One patient was alive with no evidence of disease. Conclusions Atypical EHE is a more aggressive tumor than classic EHE, with histological features including high nuclear grade, increased mitotic activity, the presence of solid growth pattern and tumor necrosis. The differential diagnoses include epithelioid angiosarcoma, carcinoma and epithelioid sarcoma.

Objective To explore the efficacy and safety of Solitaire stent arterial embolectomy in the treatment of acute cardiogenic cerebral embolism.Methods The data of 24 patients who underwent Solitaire stent arterial embolectomy,either alone or in combination with reorganization type tissue plasminogen activator (rt-PA) intravenous thrombolysis,to treat acute cardiogenic cerebral embolism in our hospital were collected.These results between October 2012 and March 2016 were compared with 21 control patients who were treated using only rtPA Ⅳ thrombolysis.The short-term efficacy,long-term clinical outcomes,complications,and mortality rate of these two groups were compared,and the clinical outcomes of these patients with posterior circulation infarction in the two groups were further assessed.Results The time between onset and rt-PA administration in the study group (median time:3.17 h) was significantly shorter than that in the control group (4.00 h,P＜0.05);rt-PA dose used in both two groups was 50 mg.NIHSS scores and Glasgow Coma scale scores at discharge,and modified Rankin scale (mRs) scores 3 and 6 months after treatment in the study group were significantly higher than those in the control group (P＜0.05).There were no significant differences in symptomatic intra-cerebral hemorrhage,high perfusion encephalopathy,incidence of hernia,or mortality between the two groups (P＞0.05).The mRS scores 3 months after treatment in patients with posterior circulation infarction (2) were significantly lower than those in the control group (3,P＜0.05).Conclusions As compared with simple venous thrombolytic therapy,Solitaire stent embolectomy can significantly improve short-term neurological function and long-term prognosis in patients with acute cardiogenic cerebral embolism,enhance their life quality,without increasing the complication incidence and mortality rate.It is safe and effective,and patients with posterior circulation infarction can also be treated by arterial embolectomy.

AIM: To explore the efficacy of bilateral lateral rectus recession in the treatment of basic intermittent exotropia. METHODS: A prospective study was conducted on 104 patients with basic intermittent strabismus admitted to our hospital from October 2022 to October 2023, patients were randomly divided into a study group of 52 cases and a control group of 52 cases using a random number ranking method. The control group received unilateral recess-resect, while the study group received bilateral lateral rectus recession, the differences in surgical success rate, postoperative strabismus, and postoperative exotropia drift were compared between two groups.RESULTS: There was no statistically significant difference between the two groups at 1 d, 1, 3, and 6 mo after surgery(all P>0.05). The strabismus in the 6 m and 33 cm eye positions at 1, 3, and 6 mo after surgery were lower than those at 1 d after surgery(all P<0.05). However, there was no statistically significant difference in the strabismus in the 6 m and 33 cm eye positions between the two groups at 1 d, 1, 3, and 6 mo after surgery(all P>0.05), and there was statistical significant difference between the two groups in exotropia drift at different postoperative time points(all P<0.05). The exotropia drift of both groups increased at 3 and 6 mo after surgery compared to 1 mo after surgery, and the exotropia drift at 6 mo after surgery was greater than that at 3 mo after surgery(all P<0.05). However, the exotropia drift of the study group at 3 and 6 mo after surgery was lower than that of the control group(all P<0.001). CONCLUSION: Bilateral lateral rectus recession for the treatment of basic-type intermittent exotropia effectively reduces the amount of postoperative exotropia drift, and it has better long-term stability.

Objective: To study the clinicopathological features, diagnosis, and differential diagnosis of atypical epithelioid hemangioendothelioma (EHE). Methods: Eight cases of atypical EHEs were collected from Jiangsu Province Hospital (the First Affiliated Hospital of Nanjing Medical University) between 2010 and 2018. EnVision method and fluorescence in situ hybridization (FISH) were used to detect immunophenotype, WWTR1-CAMTA1 and TFE3 gene rearrangement, respectively. Results: There were 4 males and 4 females, ranging from 42 to 59 years (median 47.5 years). The tumors located in soft tissue (3 cases), lung (3 cases), liver (1 case) and chest wall (1 case). One soft tissue EHE involved also adjacent fibula and pleural involvement was present in all three lung cases at the diagnosis. Regional lymph node metastases were present in two cases (one involving soft tissue tumor and one involving liver). Morphologically, the tumor cells were epithelioid with abundant eosinophilic cytoplasm, moderate to marked nuclear pleomorphism, irregular nuclear membrane, unevenly chromatin, and prominent nucleoli. The cells arranged in cords, small nests or solid pattern. The mitotic rate was 4.3 mitoses/2 mm² on average (ranging 2 to 9). Tumor necrosis was seen in every case. Among all 8 cases, blister cells were found upon careful observation. Myxohyaline stroma was present in 6 cases. Immunohistochemically, tumor cells expressed CD31 (8/8), CD34 (7/8), ERG (8/8), CKpan (2/7), and CAMTA1 (4/6). None of the tested cases stained for TFE3 (0/6). WWTR1-CAMTA1 fusion gene by FISH was found in all tested 6 cases and TFE3 gene rearrangement was not detected in any. Available clinical follow-up was obtained in 7 cases and the intervals range from 6 to 55 months (average 19.6 months). Six patients had metastasis and 3 patients died of disease. One patient was alive with no evidence of disease. Conclusions Atypical EHE is a more aggressive tumor than classic EHE, with histological features including high nuclear grade, increased mitotic activity, the presence of solid growth pattern and tumor necrosis. The differential diagnoses include epithelioid angiosarcoma, carcinoma and epithelioid sarcoma.