Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune disease of the central nervous system that is characterized by inflammatory demyelinating lesions and axonal degeneration in optic nerve and spinal cord. It has high relapse rate and high disability rate. In recent years, as the studies on mechanisms of NMOSD, related immune therapy strategies have been developed rapidly. These immunologic interventions are collectively called the disease modifying therapy, which are helpful in improving the course and outcome of the disease. In this review, the latest treatment progress in NMOSD is summarized to guide clinical choice and application of the medication.

Objective To study the effect of Chinese Herb of Yigan Granules in different dosages on bile secretion in rats.Methods The rats were randomly divided into 5 groups: blank control group,positive control group and high,mod erate,low dosages of Yigan Granules groups.The medicines were administered thr ough duodenal intubation for the rats.Then the volume of bile were gathered by common bile duct intubations in different time,and the volume of bile and the contents of bilirubin in bile were tested before and after given drugs.Results Yigan Granules increased the bile secretion in a dose-dependent manner and promote the secretion of bilirubin.Conclusion Chinese Herb of Yigan granules has a choleretic effect.

Objective To evaluate the efficacy of minimally invasive perventricular device closure of ventricular septal defect (VSD).
Methods Between September 2011 and February 2013, we collected 40 patients who underwent perventricular closure via a small lower sternal incision (minimally invasive group), aged 15.5±3.5 years (12 months to 32 years) with a body weight of 24.2±7.5 kg (10.8-58.0 kg). The mean size of VSD was 5.6±0.5 mm (2-14 mm). Another 40 patients were included as the surgical group, receiving the conventional surgical repair of VSD. The device of the minimally invasive group was released under the guidance of transesophageal echocardiography. Success rate, cardiac indicators, and clinical outcomes of the 2 groups were compared.
Results The patients in the surgical group and those in the minimally invasive group showed similar results in success rate (both 97.5%). The procedure time, intensive care unit stay, hospital stay, and postoperative recovery time in the minimally invasive group were significantly shorter than those in the surgical group (58±21 minutes versus 145±26 minutes, 2±1 days versus 8±3 days, 5±1 days versus 16±6 days, 3±1 days versus 90±20 days, all P<0.05). The minimally invasive group had a higher incidence of conduction anomalies (17.5%versus 2.5%, P<0.05). In the follow-up period of 3-12 months, there was no new residual shunt, noticeable aortic regurgitation, significant arrhythmias, or device failure except for new complications in the surgical group.
Conclusions The success rate of minimally invasive perventricular device closure of VSD under transesophageal echocardiography guidance is similar to that of conventional surgical repair, but the short-term outcomes of the minimally invasive approach is much better. Long-term follow-up is necessary to confirm the effectiveness of this technique.

ObjectiveTo evaluate the difference of the pharmacokinetic (PK) and tissue distribution properties in mice administrated with lyophilized icariin stealth solid lipid nanoparticles (Ica-SSLN) modified by polyethylene glycol and icariin control solution (Ica-Sol).Meanwhile,to establish a sensitive,specific,and stable HPLC method for the determination of Ica in mice plasma and various tissues.MethodsIca-SSLN was prepared by high temperature melt-cool solidification method.Particle size and Zeta potentials were measured by a ZetaPlus.After iv administration of Ica-SSLN and Ica-Sol at a single dose of 7.46 mg/kg,the blood and tissues including brain,liver,spleen,lung,heart,and kidney were collected at different time points.The obtained concentration from HPLC analysis was statistically treated to determine the PK model and the relevant PK parameters using DAS1.0.Tissue distribution studies of Ica-SSLN were carried out in Kunming mice after iv administration and compared to Ica-Sol.Results The characteristic data showed that the mean particle size of Ica-SSLN was (50.03 ± 0.90) nm,entrapment efficiency was (71.67 + 1.09)％,and the particles carried negative charge,Zeta potential was (-22.77 ± 1.89) mV.The concentration-time profiles of Ica in mice after iv administrated with Ica-SSLN and Ica-Sol were shown to fit a two-compartment open model.Compared with Ica-Sol,the t1/2β of Ica-SSLN was prolonged by seven times and the AUC was increased by four times.The levels of Ica concentration in the kidney tissues were significantly increased.In addition,compared with Ica-Sol,the relative target efficiency to kidney tissue was 79％ and the relative tissue exposure was 16.95.ConclusionIt demonstrates that Ica-SSLN has selective targeting to kidney tissue and the kidney targeted Ica-SSLN seems to have significant advantages and good development value.

Objective To discuss the clinical presentations and imaging features of a novel avianorigin influenza (H7N9).Methods Anteroposterior chest radiographs and serial thin-section CT images in 5 patients with H7N9 were reviewed retrospectively by two radiologists,the predominant inaging patterns of lung abnormalities and clinical data were recorded and analyzed.Results The large consolidation of the right lung with air bronchograms was the most common radiographic appearance in all patients with H7N9 at admission,and the abnormalities were more severe in the bilateral lower lobes.Both lungs developed large,scattered consolidations and ground-glass opacities with the progression of disease.The lesions in the left lung were more rapidly absorbed than those in the right lung.Conclusion Influenza H7N9 has certain chest imaging characteristics in the onset,progression and recovery of disease.

Objective To evaluate the safety and efficacy of the CT-guided percutaneous cryoablation of osteoid osteoma in children.Methods Nine children with osteoid osteoma proved by histopathology were treated with CT-guided cryoablation from January 2007 to January 2010.There were 6 boys and 3 girls.Their mean age was ( 13.0 + 1.6 ) years ( ranging from 10.0-15.0 years ).The procedures were performed under local anesthesia.Eight G bone biopsy needles for biopsy and 17 G freezing needles were used in the procedure.CT guidance was used for procedural planning,instrument guidance,and monitoring.Each cryoablation included two freezing-thawing cycles.Follow-up was performed to assess technical and clinical outcome.A visual analog scale (VAS) was used to assess severity of pain pre- and post-procedure,and mean VAS for the group was compared pre- and post-procedure with Kruskal-Wallis rank sum test.Results Biopsy and cryoablation were successfully performed in all children.No major immediate or postponed complications were observed.Significant pain relief ( P ＜ 0.01 ) was observed in all patients after procedure.The VAS of preoperation(8 points 1 case,7 points 3 cases,6 points 4 cases,5 points 1 case) compared with that of one month after operation ( 1 point 4 cases,0 point 5 cases),the difference was statistically significant( H =32.838,P ＜ 0.01 ).These patients were allowed to fully weight-bear and function without limitation 3 days after the procedure.Pain was obviously released.Pain recurrence was not observed in all patients.Moderate fever (37.8 ℃ ) was observed in a patient one day after operation and fully recovered 2 days later.Conclusion CT-guided percutaneous cryoablation is a safe and effective minimally invasive method for the treatment of osteoid osteoma in children.

Objective: To investigate the effects of Anglimingshi Capsules on preventing and treating experimental catarct. Methods: The model of D galactose induced catarct in rats was established. The effects of Anglimingshi Capsules on the catarct advance, lens opacity, lens structure, MDA and the concentrations of disoluble protein and high weight protein of treated rats were examined.Results: Anglimingshi Capsules could delay the advance of catarct, lower lens opacity and lighten the injury of lens structure by D galactose. Anglimingshi Capsules also decreased the concentration of MDA, lightened the injury of lens by lipid peroxidation and decreaseed the concentrations of disoluble protein and high weight protein. Conclusion: The test provided the foundation for application of Anglimingshi capsule.

OBJECTIVETo investigate the effects of Salvia miltiorrhiza (SM) on oxidative stress and microinflammatory state in patients undergoing continuous hemodialysis (CHD).

METHODSThirty-six patients who had received CHD for over half a year were assigned into the routine CHD group (18 cases) and the treated group treated with routine CHD plus SM (18 cases). Meanwhile, 18 healthy adults were taken as the normal control. Indexes related with oxidative stress [malondialdehyde (MDA), advanced oxidative protein products (AOPP) and superoxide dismutase (SOD)) and microinflammation C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) were detected before and after 1, 2 and 3 months of treatment.

RESULTSThe levels of AOPP, MDA, CRP, IL-6 and TNF-alpha in patients were higher and SOD was lower than those in the normal control at all the time points (P < 0.01). Compared with the baseline, the levels of AOPP and MDA in the routine CHD group significantly increased and SOD decreased after 3 months of treatment (P < 0.05), but changes of CRP, IL-6 and TNF-alpha showed no significance though there were somewhat increment (P > 0.05). The levels of AOPP and MDA were lower and SOD was higher after 1, 2 and 3 months of SM combined treatment, and CRP was lower after 3 months of treatment in the treated group than those of baselines and those at the corresponding time points in the routine CHD group (P < 0.01), but IL-6 and TNF-alpha reduced insignificantly (P > 0.05).

CONCLUSIONHemodialysis may aggravate the oxidative stress and microinflammation in patients, which could be obviously alleviated by SM.

Adult ; Aged ; C-Reactive Protein ; metabolism ; Female ; Humans ; Interleukin-6 ; blood ; Kidney Failure, Chronic ; blood ; therapy ; Male ; Malondialdehyde ; blood ; Middle Aged ; Oxidative Stress ; Phytotherapy ; Renal Dialysis ; adverse effects ; Salvia miltiorrhiza ; Superoxide Dismutase ; blood ; Tablets ; Treatment Outcome ; Tumor Necrosis Factor-alpha ; blood

Objective To study the use of a preoperative predictive scoring system established by the Beth Israel Deaconess Medical Center,Washington University School of Medicine and Hospital of the University of Pennsylvania for patients with clinically relevant postoperative pancreatic fistula (CR-POPF) after pancreaticoduodenectomy.Methods The clinical data of 394 patients who underwent pancreaticoduodenectomy at the Provincial Hospital Affiliated to Anhui Medical University from September 2007 to December 2015 were retrospectively analyzed.The four indexes including the gland texture,pathology,pancreatic duct diameter and intraoperative blood loss were calculated for the predictive score system using the logistic regression test.The factors associated with CR-POPF were analyzed.The sensitivity and specificity of the predictive scoring system were determined by the receiver operating characteristic (ROC) curve analysis.Results Of the 70 patients who were diagnosed to have postoperative pancreatic fistula (POPF),34 were CR-POPF,which included 36 with grade A,23 with grade B and 11 with grade C.Univariate analysis showed that male,preoperative serum total bilirubin level ≥ 170 mmol/L,pancreatitis or pancreatic cancer,portal vein invasion,soft pancreatic texture,main pancreatic duct diameter ≤ 3 mm,and pancreaticojejunostomy were significantly related to POPF after pancreaticoduodenectomy (P ＜ 0.05).Portal vein invasion,pancreatic texture and main pancreatic duct diameter were the risk factors of CR-POPF after pancreaticoduodenectomy (P ＜ 0.05).Multivariate analysis showed the independent risk factors associated with POPF were male,preoperative serum total bilirubin level ≥ 170 mmol/L,soft pancreatic texture and main pancreatic duct diameter ≤3 mm (P ＜ 0.05),while soft pancreatic texture and main pancreatic duct diameter ≤3 mm were the independent risk factors of CR-POPF (P ＜ 0.05).There were significant differences in the clinical relevant postoperative pancreatic fistula rates among the negligible risk,low risk,intermediate risk,and high risk patients with CR-POPF (P ＜ 0.05).The results of ROC curve analysis showed that the sensitivity and specificity of the Fistula Risk Scoring system were 76.5％ and 95.8％,respectively.The nomogram showed the area under the curve was 0.913 (95％ CI:O.858 ～ 0.968).Conclusion The preoperative predictive scoring system accurately predicted the occurrence of CR-POPF.

Objective To preliminarily evaluate the safety and efficacy of percutaneous vertebroplasty (PVP) with 131I-loaded bone cement in treating vertebral tumor in rabbit models. Methods Twelve New Zealand white rabbits with lumbar vertebral tumor, which was established by puncturing transplant of VX2 carcinoma, were randomly and equally divided into the study group and the control group with 6 rabbits in each group. PVP with injection of 131I-loaded bone cement was carried out in the rabbits of the study group, while PVP with injection of pure bone cement was employed in the rabbits of the control group. The blood cell count was determined in all the animals one day before PVP as well as on the 4th day after PVP. PET-CT examination was performed one day before PVP as well as on the 4th day after PVP to check the stand uptake value (SUV) of each vertebral tumor. SPECT was performed in all rabbits of the study group at one, 4 and 8 days after PVP respectively to estimate the distribution of 131I in the animals’ bodies. Eight days after PVP, blood cell counts, which were determined both before and after PVP, existed between the study group and the control group. SPECT that was performed after PVP indicated that 131I was mainly accumulated within PVP-treated vertebrae, and the distribution of 131I showed no obvious changes at different points of time after the procedure. Before PVP, the difference in SUV between the two groups was of no statistical significance (F = 0.765, P > 0.05). In the study group, the postoperative SUV was significantly lower than the preoperative SUV (F = 423.792, P < 0.05). Pathological examination showed that the extent of tumor cell necrosis around the bone cement in the study group was remarkably bigger than that in the control group. Conclusion In treating vertebral tumors with PVP, the use of 131I-loaded bone cement is clinically feasible, and short-term follow-up indicates that this technique is safe and effective.