Objective To investigate the possible role and mechanism of the neurotoxic effect of dexamethasone on adult rats after having focal cerebral ischemia. Methods The rat model of focal cerebral ischemia was established by permanent middle cerebral artery occlusion (MCAO) One hour after ishemia,the experimental groups were treated with dexamethasone (5 mg/kg) while the control groups were treated with saline TUNEL staining and In-suit RT-PCR were used to show the changes of apoptosis and the expression of Fas mRNA at ipsilateral cerebral hemisphere. Results TUNEL positive cells were present in a time from 48 h to 72 h, localizing at peripheral ischemic area The expression of Fas mRNA at peripheral ischemic area in control groups began at 12 h, peaked at 24 h, and decreased to a lower level at 48 h and 72 h, and returned to the baseline at 120 h Treatment with dexamethasone after ischemia made apoptosis present at 24 h and the number of TUNEL positive cells at 48 h exceeded that in the control group at 48 h ( P

Objective To study the expression of TGF ? 1 protein and the changes of microglia of adult rats' brain treated with dexamethasone following permanent focal cerebral ischemia as to elucidating the neurotoxic effect of dexamethasone. Methods The adult rat's models of permanent focal cerebral ischemia were established by permanent middle cerebral artery occlusion.One hour after ischemia experimental groups were treated with dexamethasone (0.5 mg?kg -1?d -1) where as the control groups were treated with saline. The size of infarct was detected by Q570 image analysis system. Immunohistochemistry and picture analyses were performed to observe the expression of TGF ? 1 protein. The microglia was demonstrated by histochemical staining with isolectin-B4.? Result Dexamethasone treatment after ischemia increases the infarct volume significantly. The expression of TGF ? 1 and the changes of microglia were mainly located at the border zone of the infarct. The accumulation of the isolectin-positive microglia began at 12 h,peaked at 2d, decreased at 5 d. The densities of microglia in the groups treated with dexamethasone after ischemia decreased significantly at 12 h,24 h and 3 d as compared with the control groups, and disappeared at 5 d.The expression time-course of TGF ? 1 protein was two-phase. The first peak of expression was at 6 h; the second was from 24 h to 72h. The significant decrease in expression of TGF? 1 protein in rats treated with dexamethasone was observed at 6 h,24 h and 72h compared with that of control group. Conclusion The exceeding inhibition of the response of microglia and the two-phase expression of TGF ? 1 protein at the border zone of infarct may play a role in the neurotoxic effect of dexamethasone on cerebral ischemia.

To explore the clinical characteristics and imaging features of miliary tuberculomas in central nervous system (CNS).A total of 5 cases diagnosed with tuberculosis in CNS first diagnosed by neurologists in Navy General Hospital of PLA were enrolled in the study.All clinical and imaging data were collected and analyzed retrospectively.The main initial symptoms were fever and headache (4/5).Multiple diffused miliary lesions were shown by brain MRI,with maximum diameter ranged from 1-4 mm and ringshape or nodular enhancement after gadolinium injection.As mycobacterium tuberculosis could seldomly be found in serum and cerebrospinal fluid,contrast MRI remains the effective method for detecting miliary tuberculomas in CNS.

10.3969/j.issn.2095-4344.2013.25.011

BACKGROUND: Tumor recurrence in liver transplant recipients greatly affects prognosis of liver transplantation with hepatocellular carcinoma (HCC). How to prevent tumor recurrence has aroused increasing attention. Arsenious acid chemotherapy is considered effective on treating moderate or advanced liver cancer, but its utilization following liver transplantation remains few. OBJECTIVE: To explore the role of arsenious acid on tumor recurrence in liver transplant patients with primary HCC extending Milan criteria. RESULTS AND CONCLUSION: All patients were routinely followed up for 3-32 months. Thirty recipients were presented with tumor recurrence, 16 in the chemotherapy group and 14 in the non-chemotherapy group. Tumor recurred in lung, liver graft and bones in most cases. The total recurrence rate was similar in these two groups, but chemotherapy could delay recurrence after transplantation (P=0.026). There was no significance in 6-month, 1-year survival rate between two groups, but the 2-year survival in the chemotherapy group was higher (P=0.037); 6-month tumor-free survival rates in the two groups had no significance, 1-year and 2-year tumor-free in the chemotherapy group were significantly higher than those in the non-chemotherapy group (P=0.030, 0.023). Intravenous arsenious acid chemotherapy can delay tumor recurrence and prolong survival in liver transplant patients with HCC extending Milan criteria.

Objective To explore the mediating effect of perceived social support on the relationship between perfectionism and depression. Methods 454 college students completed Almost Perfectionism Scale Revised Chinese Revised, Perceived Social Support Scale and Beck Depression Inventory. SPSS 12.0 was used for Spearman Correlation Analysis and Lisrel 8. 70 was used for Structural Equation Model Analysis. Results The model(M1) fit indexes of perceived social supports partial mediating effect on the relationship between discrepancy and depression were χ2/df = 2.15, RMSEA = 0.049, SRMR = 0.068, NNFI = 0.97, CFI = 0.98, IFI = 0.98, PNF1 =0.74, ECVI =0. 35. The model( M3) fit indexes of the relationship among high standard, discrepancy, perceived social support and depression were χ2/df = 1.77, RMSEA = 0.040, SRMR = 0.059, NNFI = 0.98, CFI = 0.98, IFI = 0.98, PNFI = 0.76, ECVI = 0.48. The two models were proved well. Conclusions Perceived social support partially mediates the relationship between the negative component of perfectionism and depression; The positive component of perfectionism moderates the relationship between the negative component of perfectionism and depression; Considering the effect of the positive component of perfectionism, perceived social support still partially mediates the relationship between the negative component of perfectionism and depression; To change the perceived social support of level may help perfectionistic individuals to decrease their depressive level.

Objective To analyze the clinical,imaging and pathological features of cortical vein thrombosis (CoVT). Methods Ten patients with CoVT (4 patients with CoVT alone and 6 patients with CoVT and venous sinus thrombosis)treated at Navy General Hospital from January 2006 to Jun 2013 were collected retrospectively.Its etiology,imaging,and pathological features of brain tissue in 3 patients were analyzed. Results Of the 10 patients with CoVT,3 were female and 7 were male.Their mean age was 31 ± 15 years old.(1)Brain CT scan and MRI showed hemorrhagic cerebral infarction,and contrast-enhanced MRI showed scattered heterogeneous enhancement within lesions. DSA could find CoVT at different parts.(2)3 patients underwent brain biopsy because they were initially diagnosed as brain tumor. Pathological examination showed glial cell,endothelial proliferation and phagocytic reaction.Scattered spotty bleeding was observed,and significant expansion of small veins,A few of them had blood stasis and thrombosis. Conclusion CoVT is one kind of intracranial venous thrombosis. It is more common occurred in young and middle aged adults,and most of them were venous sinus thrombosis.It is caused by retrograde thrombosis and spread to cortical veins.CoVT is easily to be misdiagnosed as brain tumor.Combination of clinical and imaging findings is needed for accurate diagnosis.

Objective To analyze the clinical,imaging and pathological features of cortical vein thrombosis (CoVT).Methods Three cases of cortical vein thrombosis were diagnosed in our hospital from February 2010 to October 2012.We reviewed and summarized their clinical manifestation,radiological feature and pathological characteristics.Results All patients were young with acute onset.The main clinical manifestations included headache,epilepsy or limbs weakness.Two cases had intracranial hypertension.One case had decreased activity of protein S.One had increased plasma homocysteine.Brain computed tomography scan showed hypodensity lesion with some hyperdensity inside.Cranial routine magnetic resonance imaging showed long signal in T1-weighed image and T2-weighed image,with occasional short T1 signal inside.Contrast-enhanced magnetic resonance imaging revealed heterogeneous enhancement.All of 3 cases underwent brain biopsy because of the suspected diagnosis of brain tumor.Brain pathology showed the local necrosis and hemorrhage,dilated small vein with congestion or thrombosis.Neuronal degeneration,hyperplasia of gliocyte,hyperplasia of endotheliocyte in small blood vessels with reaction of histiocytes was also displayed.Duration from initial visit to final diagnosis was from 14 days to 2 months.Conclusions CoVT has various clinical and radiological manifestations and it is easy to misdiagnose as brain tumor.Careful analysis of clinical and imaging data could improve its diagnostic accuracy.Brain biopsy would also be helpful for diagnosis.

OBJECTIVE: To study the effect and outcome of Boari bladder flap plasty surgery for the treatment of kidney-sparing strategy for patients with middle and lower ureteral carcinoma. METHODS: Database at the department of urology in the Second Xiangya Hospital from 2002-2007 was screened and all cases of primary solitary lower ureteral carcinoma treated with Boari bladder flap plasty surgery or radical nephroureterectomy were collected. We performed a retrospective review of the clinical data including sex, age, smoking history, tumor site, size, stage, grade, bladder recurrence, renal function et al and evaluated survival rate. The Cox proportional hazards regression model was build to analyze the correlation between each variable and survival time. RESULTS: Thirty nine patients in total were enrolled, including 16 cases underwent Boari bladder flap plasty surgery and 23 cases underwent radical nephroureterectomy. The median follow-up time was 53 months (range 10-84 months). During the follow-up time, 18 patients died, including 6 patients treated with Boari bladder flap plasty surgery and 12 patients treated with radical nephroureterectomy. The estimated bladder recurrence-free survival rate and cancer-specific survival rate at 5 years were 63% vs 59% and 73.8% vs 73.5%, respectively (P>0.05). The survival rate at 5 years and the overall survival rate were 61% vs 57 % and 64.8% vs 58.1% respectively in the 2 groups (P>0.05). There was no significant difference in renal function before surgery between the two groups [creatinine clearance 57 (32-104 ) mL/ min vs 55 (30-102) mL/ min, P>0.05]. Patients underwent Boari bladder flap plasty showed better renal function than patients underwent radical nephroureterectomy [creatinine clearance 55 (35-102) mL/ min vs 43 (30-89) mL/min, P<0.05]. In multivariate Cox regression analysis, the tumor size, pT stage, tumor cell grade and the estimated glomerular filtration rate level were independent factors that affected the overall survival rate of the patients (P<0.05). The tumor size, pT stage and tumor cell grade were positively correlated to the survival time, and the estimated glomerular filtration rate was negatively correlated to the survival time. CONCLUSION Boari bladder flap plasty surgery could be used to treat lower ureteral carcinoma. Compared with radical nephroureterectomy, Boari bladder flap plasty surgery has equal survival rate and shows superior postoperative renal function.
Carcinoma ; surgery ; Humans ; Kidney ; Neoplasm Recurrence, Local ; Nephrectomy ; Postoperative Period ; Proportional Hazards Models ; Retrospective Studies ; Surgical Flaps ; Survival Rate ; Ureter ; pathology ; Ureteral Neoplasms ; surgery ; Urinary Bladder ; surgery ; Urologic Surgical Procedures ; methods

OBJECTIVE: To review the technical details of retroperitoneoscopic ureterolithotomy and evaluate the clinical effect. METHODS: Between June 2004 and December 2008, 69 patients (55 males and 14 females) with upper ureteral calculus received retroperitoneal laparoseopic ureterolithotomy (40 left sides and 29 right sides). The stone size ranged from 1.5 to 3.1 cm [(2.2±0.6) cm]. RESULTS: All the patients underwent retroperitoneoscopic ureterolithotomy. The operation time was 40-295 (63.1±19.8) min,and the blood loss was 30-150 (57.2±23.0) mL.The hospital stay was 5-8 (6.7±1.3) d. During the followup, there was neither ureteral stricture nor recurrent calculus. CONCLUSION Retroperitoneoscopic ureterolithotomy is safe, effective and minimally invasive, which may replace the conventional open surgery.
Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Laparoscopy ; methods ; Male ; Middle Aged ; Retroperitoneal Space ; Ureter ; surgery ; Ureteral Calculi ; surgery ; Urologic Surgical Procedures ; methods ; Young Adult