Adult ; Female ; Hemangioma, Cavernous ; surgery ; Humans ; Nose ; surgery ; Orbit ; surgery ; Orbital Neoplasms ; surgery

Objective To study the diagnosis and treatment of portal vein complications after orthotopic liver transplantation. Methods The clinical data of 173 patients receiving orthotopic liver transplantation in our hospital from 2002 to 2005 were retrospectively analyzed. Results The incidence of portal vein complications was 3.5% (6 cases). The incidence of portal vein stenosis was 1.2% and that of portal vein thrombosis was 2. 3%. Three cases had previously been treated for portal hypertension and three cases had had a history of portal vein thrombosis before liver transplantation. All the complicated patients recovered and were discharged after successful treatment. There was no complication related mortality. Conclusions A history of previous treatment for portal hypertension, portal vein thrombosis is a risk factor predisposing the patients to portal vein complications after orthotopic liver transplantation. Color Doppler sonography is a sensitive and specific method for monitoring the portal vein complications following orthotopic liver transplantation. The angiography of portal vein is essential for diagnosis of the complications. Thrombolysis treatment is unsatisfactory for advanced stage portal vein thrombosis. Balloon dilation and stenting are both a safe and effective management modality for simple portal vein stenosis.

Objective To investigate the prevalence of serum Anti-sperm antibodies(AsAb) in group of prepubertal boys with cryptor-chidism before and after surgery,and explore whether it may be influenced by testicular location,orchiopexy,unilateral or bilateral cryptorchi-dism and deferens and(or) epididymis abnormality.Methods Serum AsAb was examined in 50 prepubertal boys with cryptorchidism and 50 boys with oblique inguinal hernia before and 6 months after surgery.Fifty boys who were normal were served as controls.IgG and IgM AsAb were determined by the immunodotting method.Results The preoperative and post-orchiopexy serum AsAb positive rates in cryptorchid boys were significantly higher than the preoperative and post-high ligation of hernial sac ones respectively in boys with oblique inguinal hernia(Pa0.05).Conclusion Cryptorchidism may induce an autoimmune response against sperm antigen in prepuberty independent of testicular location,orchiopexy,unilateral or bilateral cryptorchidism and deferens and(or) epididymis abnormality.

Objective To explore the clinical symptoms and neuroimaging features of a patient with atypical hypomyelinating leukodystrophy with atrophy of the basal ganglia and cerebellum (H-ABC) caused by a novel TUBB4A mutation.Methods We analyzed the clinical data, imaging features and the result of genetic testing of a case diagnosed as atypical H-ABC.Results The initial symptoms were progressive spasticity, mild cerebellar ataxia and mild cognitive impairment.MRI showed regional blurring of slight high signal on T2-weight and FLAIR image in white matter of the bilateral midbrain ventral, internal capsule, posteior horn of lateral ventricle and centrum semiovale, with normal bilateral cerebellar and caudoputamen nucleus.Compared with normal subjects of the same age and gender, hypometabolism was found by 18F-FDG-PET in brainstem, cerebellar and caudoputamen nucleus in the patient.Genetic testing revealed a de novo pathogenic exome missense heterozygous mutations c.70G>A in TUBB4A, which was not reported in the human gene mutation database (HGMDpro) and was assessed to be a pathogenic mutation by pathogenic mutation prediction software.Conclusions The diversity of TUBB4A gene mutations may cause different functional and/or structural impairment in subcortical white matter, cerebellar and caudoputamen nucleus, leading to atypical symptoms and neuroimaging features.Genetic testing for pathogenic mutation in TUBB4A gene is a key for the diagnosis of H-ABC.

Objective To discuss the technical essentials of microsurgery using suboccipital muscle stratification for the treatment of complex vertebrobasilar aneurysms via far lateral approach.Methods The clinical data of 8 patients with vertebrobasilar aneurysm underwent suboccipital muscle stratification via far lateral approach at the Department of Neurosurgery,Xuanwu Hospital,Capital Medical University were analyzed retrospectively,including 5 patients with subarachnoid hemorrhage (Hunt-Hess grade Ⅱ 3 cases;grade Ⅲ 1 case;grade Ⅳ 1 case),and 3 with symptomatic dissecting aneurysm.Six patients underwent occipital artery-posterior inferior cerebellar artery and anterior inferior cerebellar artery bypass grafting,and aneurysm trapping,and the aneurysms of the other 2 cases were clipped directly in the operation.The modified Rankin scale (mRS) was used to evaluate the clinical efficacy.Results Postoperative digital subtraction angiography (DSA) revealed that all the bridge vessels were patent.The obtained length of occipital artery in the actual measurement of the operation was 12.5±1.1 cm.The distance between the anastomosis site and the skin incision in 6 cases was 50±6 mm.They were followed up for 4-21 months after procedure.The mRs score in 7 cases was 0-1.Two patients had new-onset hoarseness and recovered completely within 3 months after procedure.Another patient had postoperative cerebellar hemisphere dominant regional cerebral infarction and the mRs score was 4.None of them had poor wound healing,infection and cerebrospinal fluid leakage after procedure.Conclusion Suboccipital muscle stratification via far lateral approach can effectively obtain a longer occipital artery,reduce the occupation effect of muscle and depth of field.It is beneficial to expose lesions and operation of deep anastomosis.It is a more safe and practical technique in neurosurgery for the treatment of vertebrobasilar artery aneurysms.

The pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a serious impact on global public health and the economy. SARS-CoV-2 infiltrates host cells via its surface spike protein, which binds to angiotensin-converting enzyme 2 on the host cell membrane. As a result, small molecules targeting spike protein have emerged as a hotspot in anti-SARS-CoV-2 drug research. Activity screening is an important step in seeking small molecule drugs. Therefore, this article aims to review the biological activity evaluation methods of small molecule inhibitors targeting SARS-CoV-2 spike protein, with the goal of laying the foundation for the discovery of new anti-SARS-CoV-2 drugs.

Objective To investigate the application of computer-aided 3D reconstruction and rapid prototyping(RP) technique in the correction of prominent mandibular angle.Methods Computer tomography scanning and 3D reconstruction were performed on 15 square face patients with prominent mandibular angles,then their actual mandible models were made by RP techniques.Surgical programs were made according to the model,including partial mandibular angle osteotomy,outer mandible table sagittal splitting osteotomy,chin augmentation with autogenous mandibule bones,and so on.In 15 cases,mandibular angle partial cutting was performed in 5 cases,sagittal splitting osteotomy in 6 cases,and mandibular angle partial cutting combined with splitting osteotomy in 4 cases.The autogenous mandibule bones were transplanted for chin augmentation in 3 chin microsomia patients.All the cases were treated according to the position and range set by the RP model.Results All the mandibular models produced by RP techniques were real and complete,which could directly and precisely show the state of the mandible.The operations completed smoothly and accomplished with the expected outcomes designed before operation.In all cases,the width of lower face was efficiently reduced and the face was symmetrical after operation.The follow-up period ranged from 3 months to 1 year in 12 patients,during which their facial appearances were in good condition and the results were satisfactory.Conclusion RP techniques is helpful in precise representation of the state of mandible,which providing ideal surgical models for accurate evaluation of prominent mandibular angle,design of surgical procedures as well as surgery instruction.It can provide good assistance to facial contour plastic surgery.

Objectives To investigate the application modes of indocyanine green (ICG) angiography,digital subtraction angiography (DSA) and methylene blue angiography in the hybrid surgery of cerebral and spinal arteriovenous malformations (AVMs) and to compare the application value of different intraoperative angiographic methods.Methods From July 2013 to December 2015,55 patients treated with hybrid surgery of cerebral and spinal AVMs in Xuanwu Hospital,Capital Medical University were analyzed retrospectively,including 8 patients with cerebral AVM(Spetzler-Martin grade ≥Ⅲ) and 47 with spinal AVM.Their mean age was 33.8±15.6 years.Intraoperative DSA was performed in a hybrid operation room and methylene blue angiography was performed via the feeding artery.ICG angiography was performed in 4 cases in the initial stage as a comparison.Anatomic cure was confirmed by DSA at 3 months after surgery and the results were assessed.Results All 55 patients performed intraoperative DSA,32 underwent methylene blue angiography and 4 performed intraoperative ICG angiography.The frequency of intraoperative DSA was 3.6±1.3 times for each case.After the resection of the first lesion,the residual lesions revealed by DSA accounted for 27.3% (15/55).85.5% (47/55) patients achieved anatomic cure,in which the patients with midbrain AVM (8/8) and spinal AVM 83.0% (39/47) achieved anatomic cure.Three patients were lost to follow up at 1 year after procedure.The median modified Rankin scale (mRS) score of the cerebral AVMs was 2.0 (0.0-3.8).Compared with 3.5 (2.0-4.0) before procedure,there was significant difference (Z=-2.264,P<0.05).The Aminoff score in patients with spinal AVM after procedure was 3.5 (1.0-6.0).Compared with 4.0 (1.0-6.0) before procedure,there was no significant difference (Z=-0.262,P>0.05).The patients with function preservation (function score equal or better than pre-operation) accounted for 88.5% (46/52).Conclusions Intraoperative DSA could precisely localize the nidi and verify the complete resection.Intraoperative methylene blue angiography could selectively reveal the feeding artery supplied nidi in the operative field and identify the angioarchitecture.ICG angiography could reveal the structures of nidi on the surface of the operation area.The intraoperative methylene blue angiography could replace ICG angiography and achieve the treatment target of anatomical cure of the hybrid surgery of the cerebral and spinal cord vascular malformations.

Objective To establish an efficient HPLC method for the determination of uric acid in plasma of hyperuricemia model mice,and the evaluation of uric acid lowering effect of Lesinurad.Methods The Laballiance Series Ⅲ HPLC system was adopted with Kromasil C18 column (100 mm × 4.6 mm,5 μm).The mobile phase consisted of methanol-0.5％ acetic acid (10:90) for isocratic elution with a flow rate of 0.4 mL/min.The detection wavelength was set at 283 nm.The established HPLC method was used to detect the plasma uric acid level of mice at 0.5,1.0,and 2.0 h time points after which being ip injected with 250 and 500 mg/kg uric acid.Lesinurad of 250 and 500 mg/kg was ig given to mice,0.5 h later,mice were ip injected with 500 mg/kg uric acid to establish hyperuricemia model,and 1 h later,the established HPLC method was used to detect the plasma uric acid level of mice.Results There was a good linear relationship between peak area and the concentration of plasma uric acid in the range of 7.5-150 μg/mL (r =0.997).The specificity,repeatability,precision,stability,and recovery of the established HPLC method was in accordance with the guiding rules of biological sample determination.Compared with the endogenous serum uric acid concentration of control group mice,serum uric acid concentration of 250 mg/kg dose group was significantly increased 0.5 h after ip administration with uric acid (P ＜ 0.01),and serum uric acid concentration of 500 mg/kg dose group was significantly increased 0.5,1.0,and 2.0 h after ip administration with uric acid.Compared with model group,the concentration of uric acid in plasma decreased significantly in low dosage group administered with Lesinurad (P ＜ 0.05),while decreased more significantly in high dosage group (P ＜ 0.01).Conclusion This convenient,rapid,and accurate method can be applied to the determination of uric acid in mouse plasma and the evaluation of relative drugs,which provide an efficient analysis way for establishing hyperuricemia model and screening relative drugs.

Objective To investigate the efficacy of twice irradiating with focused ultrasound on recurrent and metastasized U14 cervical cancer implanted in the legs of mice. Methods Seventy-two mice with U14 cervical cancer cells implanted in their legs were divided into three groups randomly,with 24 rats in each group.One group received a single dose of focused ultrasound,while mice in the second group were irradiated twice and surgery resection was administered to the third group 7 or 8 days after the tumor was implanted.After 23 days post implantation of the tumor,local tumor recurrence and metastasis to the lungs and lymph nodes were evaluated. Results The inhibition rate after double irradiation was 61.70％ for local recurrence and 68.18％ for metastasis,significantly higher than in the other two groups. Conclusions Both single and double irradiation with focused ultrasound are effective for inhibiting local recurrence and metastasis,but double irradiation is more effective.