Objective To outline the classification of spinal tuberculosis based on MRI findings (Southern Medical University classification,SMU classification) and explore its use in the diagnosis,surgical protocols.Methods The MRI data from 230 cases with spinal tuberculosis were analyzed retrospectively.Our classification system was based on clinical and radiological criteria (abscess formation,disc degeneration,vertebral collapse,kyphosis,sagittal index,instability and neurological problems).The surgical strategies were made according with this classification.Results Two hundred and thirty cases with spinal tuberculosis were classified into the 5 types.There were signal change type (type Ⅰ) in 28 cases,abscess formation type (type Ⅱ) in 39,vertebral collapse type (type Ⅲ) in 78,canal compression type (type Ⅳ) in 46 and kyphosis type (type Ⅴ) in 39 respectively.In type I lesion,25 patients had been followed up.Twenty patients were treated medically.Recurrence of tuberculosis was found in 2 cases.Surgical meticulous debridements were done in 5 cases without recurrence.In type Ⅱa lesion,6 patients were treated medically.The other 6 patients underwent surgical meticulous debridement with recurrence occurred in one patient.There was no difference between medical and surgical treatment regarding outcomes in patients with type Ⅰ and Ⅱa lesion.In type Ⅱb-Ⅴ,surgical treatments were carried out according to the pathological changes.There was no difference between medical and surgical treatment regarding outcomes in the patients with type Ⅱb-Ⅴ.Conclusion The SMU classification helps in differentiating the various manifestations of spinal tuberculosis and appears to correlate with the surgical treatment of spinal tuberculosis.We believe that this new classification system can be used as a practical guide in the treatment of spinal tuberculosis.

Objective To investigate the risk factors of symptomatic cerebral vasospasm (SCVS) after craniocerebral trauma. Method The clinical data of 308 patients with craniocerehral trauma were analyzed by single factor analysis and Logistic regression analysis. Resnlts SCVS occurred in 94 patients (30.52%). The risk factors were subarachnoid hemorrhage (SAH), Glasgow coma scale, blood glucose, emergency operation,smoking and age. Conclusions Various factors are related to the development of SCVS after craniocerebral trauma. Prophylactic treatments should be given in early stage for the patients with risk factors.

Objective To investigate the expression of CyelinD1 protein in nephroblastoma.Methods The tissue microarray were made in 28 cases of nephroblastoma and 19 cases of renal tissue adjacent to tumor.The expression of CyclinD1 and p53 proteins were detected by immunohistochemistry.Results The positive rate of the expression of CyclinD1 and p53 protein was significantly different between nephroblastoma and renal tissue adjacent to tumor (P < 0.05).The positive rate of the expression of CyclinD1 and p53 protein was significantly different in different degree of differentiation of nephroblastoma (P < 0.05).The expression of CyclinD1 and p53 protein was positively correlated (P < 0.05).Conclusions The CyclinD1 and p53 might be used as the marks for estimating the degree of differentiation of nephroblastoma.The over-expression of CyclinD1 and the mutation of p53 might play the vital role in nephroblastoma.

ObjectiveTo investigate the clinical application of tacrulimus (TAC, FK506) in children with primary nephrotic syndrome (NS). MethodsSixty-five primary NS children received routine or decreased-dosage glucocorticosteroid according to clinical NS types after hospitalization. At the same time, TAC was given orally with the dosage of 0.1 to 0.15 mg/kg, once every 12 hours, for 6 to 24 months. And the serum concentration of TAC was monitored during the course. ResultsAfter the treatment of TAC for 1 to 2 months, 65 patients were recovered with gradually reduced urinary protein, rapidly increased serum albumin, and improvement of cholesterol and triglycerides. Total remission rate was 83.1% and onset time was 7 to 54 days. Twelve cases experienced recurrence. Increased CD4, as well as 3/3 or 3/1 TAC genotype, indicated higher remission rate. Various pathological types had different remission rates or ratio, which were as follows: minimal change nephropathy (96.4%), mesangial proliferative glomendonephritis (90.0%), membranous nephropathy (2/3), membranous proliferative glomerulonephritis (3/5), focal segmental glomerulosclerosis (4/9). The patients would recover in the course of treatment under the conditions of TAC initial dose as 0.1 to 0.15 mg /kg per 12 hours and controlled serum concentration as 5 to 10 g/L. During the treatment, 12 cases appeared gastrointestinal symptoms, mainly as anorexia, nausea and vomiting, 1 abdominal pain, 2 headache, 1 tremor, 1 paresthesia, 3 insomnia, 4 transient increased Scr, 8 slightly increased NAG, 6 increased C3 and α-2 macroglobulin. The symptoms disappeared within one week or after stopping TAC. ConclusionsTAC is effective in primary NS children, even with abnormal liver function or tuberculosis infection. TAC can also be a substitute to cyclosporine A.

Objectives: The aim of the study was to evaluate the therapeutic effects of 6-mercaptopurine in the treatment of refractory childhood nephrotic syndrome (NS). Methods: According to the varieties of NS, 6-mercaptopurine (2 mg/kg body weight daily) combined with corticosteroid or 6-mercaptopurine (2 mg/kg body weight daily) alone after tapering of steroids were given to 28 consecutive children with primary NS in our hospital. Results: One month after the use of 6-mercaptopurine, proteinuria was decreased. The duration of improvement was 9～28 days, with mean duration of 17 days. Over-all effective rate was 85.7%. Among different varieties of NS, the best therapeutic effect was noted in steroid-dependent children; the better therapeutic effect in steroid-resistant children; and good therapeutic effect in frequently relapsing children. The effective rates were 100%, 84.6%, 81.8% respectively. All the pathological varieties of 28 children were confirmed by renal biopsy. The better therapeutic effects were noted in slight mesangial proliferative glomerulonephritis (MsPGN) and minimal change nephrotic syndrome (MCNS). The less therapeutic effect was noted in membranoproliferative glomerulonephritis (MPGN). Their therapeutic effective rates were 92.9%, 80%, 66.7% respectively. Unfortunately, drug-induced aplastic anemia was seen in 2 cases. Slight gastrointestinal reactions were present in 6 cases. There were no side reaction on the gonad. Conclusions: The great difference in the therapeutic effects is related to the different pathologic varieties of NS. With regard to the treatment of refractory NS in children, the pathological varieties should be confirmed by renal biopsy as soon as possible. Based on the renal biopsy, 6-mercaptopurine can be considered in the treatment of MsPGN and MCNS. As a result, relapses could be reduced; the duration of remission could be prolonged, and the side reactions from steroid treatment could be avoided. The use of 6-mercaptopurine for the treatment of refractory NS is one of the effective therapy.

Biopsy ; Child, Preschool ; Female ; Glomerulonephritis ; pathology ; Humans ; Infant ; Kidney ; pathology ; physiopathology ; Kidney Function Tests ; Male

BACKGROUND: Previous animal studies demonstrated that bone marrow mesenchymal stem cells could differentiate into nerve cells under a certain condition; however, the clinical application for treating nervous system disease has been less reported. OBJECTIVE: To observe a short-term effect of autologous bone marrow mesenchymal stem cell transplantation on treating cerebral hemorrhage.METHODS: A total of 32 patients with cerebral hemorrhage who were selected from the Department of Neurosurgery, Liaocheng Brain Hospital between November 2007 and January 2009 were considered as a treatment group. According to general data and the amount of hematoma, they were treated by drilling drainage or hematoma evacuation. Drainage tubes were detained into hematoma cavity, and 3.5 mL autologous bone marrow mesenchymal stem cell suspension was injected through drainage tube. A total of 40 additional patients who did not treated with stem cell transplantation were considered as a control group. Neurologic impairment (NIHSS) and activities of daily living (Barthel index) were performed before and 6 months after transplantation; meanwhile, the brain MRI, serum biochemical and tumor marker were evaluated to detect security of stem cell transplantation. RESULTS AND CONCLUSION: The NIHSS score and Barthel index in the treatment group were similar to those in the control group before transplantation. Compared with control group, NIHSS scores were significantly decreased in the treatment group (P < 0.01), but Barthel index was significantly increased 6 months after transplantation (P < 0.01). Compared with before transplantation, NIHSS score were significantly decreased (P < 0.01), but Barthel index was significantly increased in the treatment group 6 months after transplantation (P < 0.01). Two patients in the treatment group had febrile, which was recovered after treatment. The following-up 6 months after transplantation demonstrated that brain MRI and biochemical indicators were normal except an increasing of CA-153 caused by lung cancer in one patient. The autologous bone marrow mesenchymal stem cell transplantation for treatment of cerebral hemorrhage is safe and effective in a short-term period; however the long-term effect still needs to be further studied.

Objective To investigate the recent efficacy and safety of autologous bone marrow stem cells transplantation in treatment of early spinal cord injury. Methods 51 cases of early spinal cord injury admitted to Liaocheng People Hospital from 2007.11 to 2009.8 were enrolled in this study. In transplantation group, 24 patients were treated by subarachnoid space injection with autologous bone marrow stem cell transplantation. The patients who were not transplanted in the same period of hospitalization were selected as control group. Motor and sensory function ( AISA score) was assessed at 1, 3, 6 months before and after transplantation in two groups patients. And blood routine, clotting mechanisms, biochemical items andtunor markers were determined in followed up. Results After one month of transplantation, two groups ofpatients had recovered in motor and sensory function to some degree. After three months of transplantation,there was significant different between transplantation group and control group in sensory function recovery (P < 0. 05 ). After 6 months of transplantation, there were significant different between transplant group and control group in motor and sensory function recovery (P<0.05). Blood examination results did not show markedly abnormal in followed -up patientsConclusion The safety and recent effect of autologous bone marrow stem cells transplantation in treatment of early spinal cord injury were satisfied, but the long - term effect was still unclear.

Objective To evaluate the effect of Jostent coronary stent-graft in endovascular treatment of traumatic carotid cavernous fistula. Methods Eight patients with traumatic carotid-cavernous fistula were treated by Jostent coronary steat graft from June 2001 to May 2007. Results The stent graft was successfully implanted in the target artery in all patients. The fistula in all patients was removed and the parent arteries kept unblocked. The clinical outcome was favorable, with no operation-related complications occurred. The ang4ogram showed normal patency of the parent arteries, without recanalization of the fistula six months after the stent graft implantation in six patients. Conclusions Stent graft is a useful tool for endovascular treatment of carotid cavernous fistula in selected patients. Further research is needed to optimize the stent graft for further use in cerebrovascular system.

OBJECTIVE To analyze the risk factors,clinical characteristics and prevention countermeasures of(nosocomial) fungal infection in patients with acute leukemia.METHODS To adopt investigation way to review and analyze the clinical data of nosocomial fungal infection in 39 cases from 178 acute leukemia inpatients.RESULTS The(nosocomial) fungal infection rate was 21.91%.The nosocomial fungal infection rate in elderly group was(higher) than that of younger group,and in granulocytosis group(≥0.5?10~9/L) was higher than that of