Objective To explore surgical techniques and curative effects of microsurgical treatment for tumors in upper cervical spinal canal.Methods A total of 81 cases of tumors in upper cervical spinal canal had received microneurosurgery from January 1990 to December 2005.The operation was conducted through a posteromedial approach.A total tumor resection was performed in 73 cases of neurofibroma or neurilemmoma,3 cases of spinal meningioma,and 3 cases of ependymoma.A subtotal tumor resection was conducted in 2 cases of astrocytoma.Results A complete recovery was achieved in 75 cases,an improvement of symptoms was achieved in 4 cases,and no improvement in 2.No death was encountered.Follow-up observations were carried out in 52 cases for 3 months ～ 3 years(8.5?1.5 months).MRI examinations 3 months after operation in 15 cases found no residual or recurrent tumor.X-ray radiography under anteroposterior,lateral,and open-mouth view 6 months after operation in 32 cases showed no spinal deformation and good vertebral stability.Recurrence of intramedullary tumor was seen in 3 cases. Conclusions As long as tumors in upper cervical spinal canal are diagnosed,a microsurgical treatment should be given as early as possible.Appropriate selection of surgical approach,skillful microsurgical techniques in accordance with pathological types of lesions,and principles of minimal invasion are critical for the operation safety.

Objective To explore the surgical techniques of keyhole approach craniotomy in the treatment of hypertensive intracerebral hemorrhage in old patients. Methods CT-guided keyhole approach craniotomy was performed to treat 50 old patients with hypertensive hematomas from January 2000 to August 2003. Results CT scans within 12 postoperative hours showed over 90% hematomas were removed. The activity of daily living (ADL) classification results 6 months after the surgery were: grade Ⅰin 10 cases (20.0%), grade Ⅱ in 21 cases (42.0%), grade Ⅲ in 9 cases (18%), grade Ⅳ in 3 cases (6.0%), grade Ⅴ in 2 cases (4.0%), and grade Ⅵ in 5 cases (10.0%). Conclusions Senility is by no means a contraindication for surgery in the treatment of hypertensive hematomas and keyhole approach minimally invasive craniotomy can give a satisfactory effect.

Objective To investigate the long-term effects of microendoscopic discectomy for lumbar intervertebral disc herniation. Methods A retrospective analysis was made on 218 cases of lumbar intervertebral disc protrusion treated by microendoscopic discectomy. The Japanese Orthopedic Association (JOA) scoring system for lumbar myelopathy was used to evaluate surgical outcomes for each patient. Results All the patients were followed for more than 3 years postoperatively. Excellent outcomes were achieved in 121 cases, good in 80 cases, fair in 16, and poor in 1, the rate of excellent or good outcomes being 92.2% (201/218) . Conclusions Microendoscopic discectomy for lumbar intervertebral disc herniation has definitive long-term effects. Skillful surgical performance and proper postoperative rehabilitation training are crucial to good surgical outcomes.

Objective To investigate the PCR-based evaluation of prednisolone-induced relapse of asymptomatic Toxoplasma gondii infection and the therapeutic efficacy of azithromycin.Methods A total of 36 of female ICR mice,about 20 g,were randomly divided into 6 groups:contrast group (C),prednisolone group (P),infection group(I),infection plus prednisolone group (IP),infection plus azithromycin group(IA),infection plus prednisolone and azithromycin group (IPA).The infection group (I),infection plus prednisolone group(IP),infection plus azithromycin group(IA),infection plus prednisolone and azithromycin group (IPA)were challenged at week 0 with 10 cysts of Toxoplasma gondii Prugniaud strain per injection intraperitoneally.The prcdnisolone group (P),infection plus prednisolone group (IP) infection plus prednisolone and azithromycin group (IPA)were injectied with prednisolone 1 mg into hind medial subcutaneous every day from the 6th week to 7th week.The infection plus azithromycin group(IA),infection plus prednisolone and azithromycin group (IPA) were injectied with azithromycin 250 mg/kg intraperitoneally every day from the 6th week to 7th week.The serum samples were collected and DNAs extracted at week 0,1,2,3,4,5,6 and 7 for amplification of Toxoplasma gondii of specific B1 gene by PCR.All the mice were sacrificed 7 weeks after the challenge to calculate the number of cysts in brain tissues.Results Compared with the primer of AF146527 gene,the primer of B1 gene was more sensitive and specific.The method of PCR could amplify the productions of specific B1 gene Toxoplasma gondii 5 weeks before the challenge,while it could not amplified 5 weeks after the challenge.All the mice of the IP group were dead 2 weeks after the injection of prednisolone (week 7),and the only two mice of the IPA group were dead at the same time (P <0.05),respectively.Compared with the I group,IA group and IPZ group,the number of cysts in brain tissues of the IP group significantly increased (P <0.01).Conclusions B1 as target gene is more suitable for diagnosis of Toxoplasma gondii infection by PCR.Prednisolone could induce the relapse of asymptomatic Toxoplasma gondii infection of mice and the mice are finally dead.Azithromycin is effective but it can not completely cure the Toxoplasma gondii infection.

Objective To express human cytotoxic T lymphocyte associated antigen-4 (CTLA4) extracelluar domain in Bacmid-baculovirus expression system. Methods The cDNA of human CTLA4 extracelluar domain was isolated from plasmid pUC19-CTLA4Ig by PCR.The specific cDNA was subcloned into plasmid pFastBacl. The insertion was confirmed by DNA sequencing, and then transposed into Hz8 Bacmid in DH10B. The recombinant Bacmid was used to transform Hz insect cells. The supernatant and cellular lysate were analyzed by using SDS-PAGE. Results A specific protein in the cellular lysate of Hz insect cells containing human CTLA4 extracelluar domain with MW38 x 103 was found. Conclusion Human CTLA4 extracellular domain is expressed in the Bacmid-baculovirus expression system.

Background and purpose:The prognosis of high grade gliomas remains poor, and multidisciplinary treatment strategy has been much investigated recently. This study was to explore the efficacy of Temozolomide as first-line treatment combined with radiotherapy and followed by adjuvant chemotherapy for the treatment of newly diagnosed high grade gliomas. Methods:18 patients who had been pathologically proven to be high grade gliomas were enrolled into the study. The patients received 40 Gy/20fractions for the whole brain and followed by 20Gy/10fractions as a boost to tumor bed. All of the patients were given daily oral temozolomide 75mg/ m2 during radiotherapy. 4 weeks after radiotherapy, all of the patients received 6 cycles of Temozolomide, each cycle lasted 5 days with 28 days interval between each cycles. 150 mg/m2 of temozolomide was given for the first cycle for five days,followd by 200 mg/m2 of drug for the rest of the cycles if no significant drug related toxicities were observed. Results:Median follow-up was 12.5 months, 11 cases had either recurrence or progression, 5 of them died from the disease. The median time for disease progression-free survival was 9.8 months (95% CI, 6.1~9.8months), the median time for overall survival was 14 months (95% CI, 8.5 ~ 19.5months), 1-year overall survival rate was 55.6% ,6-month progression-free survival rate was 81.8%. there were no severe temozolomide related toxicities. Conclusion: Concurrent temozolomide with radiotherapy and followed by 6 cycles of temozolomide in the treatment of high grade gliomas had better clinical efficacy, the patients tolerated the strategy well and no severe toxicities were observed.

Objective To study the probability of applying mesenchymal stem cells isolated from human umbilical cord blood (hUCB MSCs) to repair mouse skin wound in vivo. Methods hUCB MSCs isolated from full term delivery human umbilical cord blood were cultured and amplified in vitro.hUCB MSCs at passage 9 were labeled with BrdU (5-bromodeoxy-uridine) and grafted on the full-thickness skin loss wound created on the back of the severe combined immunodeficiency (SCID) mouse (treatment group), when a PBS control group was set. The wound healing rate was surveyed and compared at days 7 and 14 postoperatively. Meanwhile, the wound was biopsied at days 7, 14 and 28 after operation,and the expressions of BrdU antibody and K19 antibody were checked pathologically and immunohistochemically by HE staining, respectively. Results The wound in treatment group was healed more rapidly than that in control group (P ＜ 0.01 ). The pathological check of the biopsy sample showed that the epidermis was thicker, with more epidermal ridges in the treatment group, compared with control group.It was found that some BrdU positive cells were distributed successively on the hair follicle, the stratum basal and the spinosum layers, a few of which even expressed K19. Conclusion hUCB MSCs can be differentiated into skin tissue and cells and is possible to repair skin wound.

Objective To find the different plasma-associated proteins of rheumatoid arthritis (RA) by using two-dimensional gel electrophoresis for understanding the pathogenesis of RA. Methods The total protein from either RA patients or normal ones was prepared by means of immobilized pH gradient based on two-dimensional gel electrophoresis. After silver staining, gel-image analysis was performed by using PDQuest. The differentially expressed proteins were identified by matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF-MS). Results 2-DE patterns of plasma from controls and RA patients were presented. The results showed that average number of protein spots was 592 and 563 respectively, and the corresponding average matching rate was 89% and 87% respectively. Gel-image analysis revealed that there were 24 differential protein spots. A total of 15 differential protein spots were successfully identified by MALDI-TOF-MS, of which 6 proteins were up-regulated as compared with control. Conclusion The differentially expressed proteins can be observed in plasma from RA and controls, which can be used to elucidate the pathogenesis of RA for further study.

Objective To study the current status of catheter - related thrombosis(CRT)in Chinese children through a retrospective analysis of the inpatients in the Department of Medicine,Beijing Children's Hospital Affiliated to Capital Medical University. Methods The clinical data of the inpatients with CRT from November 2010 to November 2013 were collected retrospectively,and the causes,clinical symptoms,diagnosis,treatment and prognosis were ana-lyzed. Results There were 42 cases of children with CRT in Beijing Children's Hospital Affiliated to Capital Medical University. Among the cases,the male to female ratio was 1. 0:0. 5;the median age of onset was 88(2 - 186)months with ﹤ 1 year old counted for 16. 7%(7 / 42 cases)and 13 - 14 years old counted for 11. 9%(5 / 42 cases);the distri-bution differences between the male and the female age were not significant(P = 0. 826). The median time from cathe-terization to CRT onset was 9(1 - 81)days,0 - 10 days after catheterization was the peak of onset(52. 5% ,21 / 40 ca-ses)followed by 10 - 20 days(35. 0% ,14 / 40 cases). The protopathy was usually hematologic tumor,kidney disease or deep fungal infection. Slightly more cases developed CRT on the right side(57. 1% ,24 / 42 cases)than on the left side (38. 1% ,18 / 42 cases). All cases were diagnosed by using B - ultrasound,of whom 28. 6%(12 / 42 cases)were symp-tom - free. After being diagnosed,7. 1%(3 / 42 cases)were treated with conservative methods such as immobilization of the affected limbs and hot compress;7. 1%(3 / 42 cases)had catheter removed;anticoagulant and/ or thrombolytics after catheter removal used in 33. 3% patients(14 / 42 cases). After 1 week,22 cases were reviewed,of whom 54. 5%(12 / 22 cases)had thrombosis reduced(all with intervention),thrombosis growing in 22. 7% patients(5 / 22 cases), and thrombosis did not change in 22. 7% patients(5 / 22 cases). Three cases needed re - catheterization after catheter removal,and all of 3 cases had CRT recurrences(100% ). Conclusions CRT is more common among infants and senior children. CRT usually develops within 20 days after catheterization. Children with hematologic tumor,kidney disease or deep fungal infection are more likely to have CRT. Routine ultrasound test should be conducted to monitor CRT in catheterized children. Once CRT is diagnosed,patients need to be treated with anticoagulants and/ or thrombo-lytics. Catheter should also be removed if necessary. Recatheterization can result in CRT recurrence.

U1 trastuctrural changes of myocardium and lungs from 6 cases died of cranioce-rebral penerating gunshot wound 2 hours after injury is reportcd.In all cases theelectron microscopy of the myocardial and lung tissue samples showed the similar ultrastructural morphological changes of the cells and interstitial tissues.The mostpr-ominent ultrastructural changes of myocardium were disorderly arrangement of the Zband.focal dissociation of the myofibrills,mitochondrial swelling with decreasing ofmatrix density and disruption of cristae,and interstial edema.The changes of theung tissue were increasing of width of alveolar septa with decreasing of the electron density.Aggregation of neutrophils in the capillaries of alveolar septa and some alveolar space was observed.The significance and the pathogenesis of the mainpathological changes were discussed.It is suggested that the pulmonary interstitialedema was neurogenic.The pulmonary edema may be manifested as interstitial edemaor intra-lveolar edema depending upon the time elapsed after the gunshot injury.