Objective This study is to explore the infratentoriat-supracerebellar keyhole approach for microsurgical treatment of pineal region tumors and to evaluate its curative efficacy and safety.Methods According to hi-fi quality MRI images,individual operation schemes were designed.Microsurgical infratentori- al-supracerebellar keyhole approach was used to resect lesions in 7 consecutive patients with prone postition.A 2.0 cm?2.5 cm surgical bone window was performed with its superior margin reaching to the inferior margin of the transverse sinus and confluence sinus.Results Among the 7 pineal region tumors,there were 2 ger- minomas,2 pineocytomas,1 pineoblastoma,1 glioma and 1 chlesteatoma.All cases were re-examined with MRI after operation and it was found that 6 lesions were totally removed and 1 was subtotally removed.The outcome of the treatment was satisfying.There was no infection,bleeding or death after surgery.The follow-up result in the near future was good.Conclusion The infratentorial-supracerebellar keyhole approach for the excision of pineal region tumors was proved to be a satisfactory means with a total removal rate,an excellent curative effect and small surgical trauma.

OBJECTIVETo investigate whether mammalian target of rapamycin (mTOR) kinase was abnormally activated in maldeveloped balloon cells and dysmorphic neurons of focal cortical dysplasia (FCD) with refractory epilepsy.

METHODSA total of 12 archival cases of FCD typeIIwith medically intractable epilepsy treated between 2008 and 2010 were retrieved. Perilesional brain tissue was used as control specimens (n = 8). The expression of phosphorylated p-AKT (Ser473), p-mTOR (Ser2448) and p-P70S6K (Thr389) was investigated by imunocytochemistry.

RESULTSThe expression of p-AKT (Ser473), p-mTOR (Ser2448) and p-P70S6K (Thr389) was found in meldeveloped balloon cells and dysmorphic neurons of FCD. A weak stain in a small amount of pyramid neurons was also found in the control group.

CONCLUSIONAbnormal activation of mTOR in maldeveloped balloon cells and dysmorphic neurons of FCD may be a key molecular mechanism underlying the histological changes and repeated seizures.

Adolescent ; Adult ; Brain Diseases ; metabolism ; pathology ; Child, Preschool ; Epilepsy ; metabolism ; pathology ; Female ; Glial Fibrillary Acidic Protein ; metabolism ; Humans ; Immunohistochemistry ; Male ; Malformations of Cortical Development ; metabolism ; pathology ; Malformations of Cortical Development, Group I ; Nestin ; metabolism ; Neurons ; metabolism ; Phosphorylation ; Proto-Oncogene Proteins c-akt ; metabolism ; Ribosomal Protein S6 Kinases, 70-kDa ; metabolism ; TOR Serine-Threonine Kinases ; metabolism ; Young Adult

Objective To test the reliability and validity of International Physical Activity Questionnaires (long self-administrated format)( IPAQ), Chinese version on women of 12-44 years old, in Chengdu city. Methods Clustered sampling was used, according to the age distribution of investigated population. One community, one university and two middle schools (including one high school and one junior high school) in Chengdu were selected. The reliability study was conducted in a 28-day period.Participants were contacted three times within 28 days (on the 1st , the 8th and the 28th day respectively).In the validity study, participants completed the same questionnaire and Bouchard physical activity diary(PA diary) each day for seven days between visit 1 and visit 2 before comparing the IPAQ's result with Bouchard physical activity diary's for validity study. Pearson or Spearman' correlation coefficients were calculated for validity and interclass correlation coefficients for reliability according to date distribution.Results (1)One hundred and eighty six participants were recruited for the reliability study. All of them completed the first questionnaire with 143(76.88%) and 172 (92.50%) finished the second and third questionnaires. One hundred and fifty eight participants were recruited in the validity study. Qualified questionnaire accounted for 90.59 % (143). (2) Results from the test-retest reliability of the Chinese version of long self-administrated format (IPAQ) showed: the ICC after one week ranged from 0.7373 to 0.972(mean:0.870) which were higher than those interval's reliability [ ICC= 0.472-0.948 for three weeks interval (mean:0.721), and 0.473-0.925 for four weeks interval (mean:0.696)]. The ICCs of three weeks interval and four weeks interval were not significantly different. ICCs for vigorous physical activity and leisure time physical activity were the best. (3)The validity for different intensity, total physical activity and sitting time showed the correlation coefficients between IPAQ and PA diary ranged from 0.445 to 0.696, with correlation for vigorous physical activity the best (r=0.696). Conclusion IPAQ-C seemed a reliable and validated measure of physical activity for 12-44 year-old women in Chengdu city.

Adult ; COVID-19/diagnosis* ; Humans ; Intracranial Thrombosis/virology* ; Male ; Severity of Illness Index ; Venous Thrombosis/virology*

Background:Pioglitazone may be beneficial in the treatment of psoriasis.However,based on the effectiveness and safety considerations,it has not been widely used.To fully evaluate the strength of evidence supporting psoriasis treatment with pioglitazone,we conducted a meta-analysis of existing published studies.Methods:PubMed,Ovid,Cochrane Library,Google Scholar,and Web of Science databases were systematically searched before February 2019.Randomized controlled trials (RCTs) of pioglitazone administration compared with placebo,administered to patients with psoriasis for at least 10 weeks,and published in English were included.Quality of the included RCTs was identified by the modified Jadad scale.The quality of evidence for each outcome was evaluated using the GRADEpro Guideline Development Tool online software.Primary outcomes were proportion of patents showing psoriasis area and severity index (PASI) score improvement (＞75％) and the mean percent change in PASI score from baseline to the end of treatment.Dichotomous data were analyzed using odds ratios (ORs) corresponding to the 95％ confidence interval (CI),whereas continuous variables,expressed as mean and standard deviation,were analyzed using the mean differences (MD) with the 95％ CI.Results:Six RCTs were analyzed.Meta-analysis showed that pioglitazone reduced the PASI scores in patients with psoriasis compared with the control group when administered at 30 mg per day (P ＜ 0.001,MD =-3.82,95％ CI =-5.70,-1.93) and at 15 mg per day (P =0.04,MD =-3.53,95％ CI =-6.86,-0.20).The PASI-75 of the pioglitazone group was significantly higher than that of the control group at 30 mg per day (P ＜ 0.001,OR =8.30,95％ CI =3.99,17.27) and at 15 mg per day (P =0.03,OR =2.96,95％ CI =1.08,8.06).No statistically significant differences in total adverse events were observed between the groups.There were no significant differences in common adverse reactions such as weight gain and elevated liver enzymes between the two pioglitazone groups.Conclusions:Use of pioglitazone in the current treatment of psoriasis is beneficial.The therapeutic effect of the daily 30 mg dose may be greater than that of the 15 mg dose per day with no significant change in the frequency of adverse reactions.

Objective To observe Th-1 drift induced in vitro by high immunogenic glioblastoma multiforme (GBM) U251 cell vaccine with high expression of membrane-enriched heat shock protein 70 (Hsp70) and major histocompatibility complex class Ⅰ (MHC-Ⅰ) molecules. Methods The high expression of MHC-Ⅰ and Hsp70 in U251 cells were induced by 500 U/ml IFN-γ for 48 h, heat shock at 43 ℃ for 2 h, or their combination. The cells were then inactivated by the mitomycin C (MMC) to prepare the cell vaccine. Peripheral blood mononuclear cells (PBMCs) from healthy donators were incubated with GBM U251 cell vaccines as the effector cells. Flow cytometry was applied to analyze the changes of CD4<'+> and CD8<'+>T lymphocytes in the PBMCs. The secretion of IFN-γ and IL-2 of the effector cells, after assaulting the target cells, was evaluated by ELISA. Results The percentages of CD4<'+> and CD8<'+> T lymphocytes of the PBMCs incubated with the U251 cell vaccine increased significantly as compared to that stimulated by the membrane-enriched MHC class Ⅰ or Hsp 70 molecule U251 cell vaccines (P<0.05), and so was the secretion of IFN-γ and IL-2 (P<0.05). Conclusions Th-1 drift stimulated by GBM U251 cell vaccine with high immunogenicity, high expression of Hsp 70 and membrane-enriched MHC class Ⅰ molecules plays an important role in antitumor mechanism in vitro.

BACKGROUNDGlioma-induced edema is considered as one of the most pathological characteristics of glioma and a significant source of morbidity and mortality. New strategies are needed for the treatment of peritumoral edema in glioma. Endostatin has been proven to be beneficial as an anti-angiogenic agent in experimental gliomas, but the effects are unclear. This study aimed to investigate the effects of endostatin on C6 glioma-induced edema.

METHODSTumorigenic mice were established by subcutaneous injection of three glioma cell lines, C6-null cells and stable transfected-C6 cells overexpressing mock vector (C6-mock cells) and endostatin (C6-endo cells). Endostatin expression in xenograft C6 glioma was determined by immunostaining and Western blotting. Glioma-induced edema and tumor vessel permeability were assayed. The effect of endostatin on vascular enodothelial growth factor (VEGF) expression in vivo was analyzed by quantitative polymerase chain reaction (Q-PCR) and enzyme-linked immunosorbent assay (ELISA). The number of vesiculo-vascuolar organelles (VVOs) formed in tumor endothelia was calculated using electron microscopy. Data were analyzed by using one-way analysis of variance (ANOVA) followed by Dunnett's post hoc test for multiple comparisons to the control groups.

RESULTSOverexpression of endostatin (C6-endo cells) significantly suppressed tumor growth and reduced tumor edema and vessel permeability. ELISA analysis showed that the level of VEGF protein was markedly decreased in tumor from C6-endo cells compared with tumor from C6-null cells and C6-mock cells. Similar results were obtained by Q-PCR. Furthermore, the number of VVOs observed in tumor from C6-endo mice was significantly reduced compared with tumor from C6-null cells or C6-mock cells.

CONCLUSIONSOur data provide primary evidence that endostatin reduces glioma-induced edema and vascular permeability. Using endostatin may be an effective strategy for treating glioma edema.

Animals ; Cell Line, Tumor ; Edema ; drug therapy ; etiology ; Endostatins ; therapeutic use ; Enzyme-Linked Immunosorbent Assay ; Glioma ; drug therapy ; physiopathology ; Male ; Mice ; Mice, Inbred BALB C ; Polymerase Chain Reaction ; Rats ; Xenograft Model Antitumor Assays

OBJECTIVETo investigate the clinical significance of resection of the pancreatic capsule and anterior layer of transverse mesocolon in radical gastrectomy.

METHODSBetween January 2007 and July 2008, a total of 213 gastric cancer patients enrolled in the study. These patients were randomly assigned into two groups: 105 in group R and 108 in group N. Only in group R were the pancreatic capsule and anterior layer of transverse mesocolon resected during radical gastrectomy. The pancreatic capsule and anterior layer of transverse mesocolon were histologically analyzed for metastasis. The data including blood loss during operations, number of dissected lymph nodes and postoperative complications were analyzed in both groups.

RESULTSThere were no significant differences between the two groups in blood loss during operation and postoperative complications, but the differences in operation time and number of dissected lymph nodes between the two groups were significant. Metastases to the pancreatic capsule and/or anterior layer of transverse mesocolon were diagnosed in nine (8.6%) patients of group R. The metastases to the pancreatic capsule and/or anterior layer of transverse mesocolon were found to be associated with tumor invasion depth, anterior or posterior gastric wall, clinical staging and perigastric lymph node metastasis extent (P<0.05), but not with age, gender, tumor location, size, Borrmann type and pathological classification (P>0.05).

CONCLUSIONSResection of pancreatic capsule and anterior layer of transverse mesocolon in group R does not increase postoperative complications in comparison with group N. The resection is beneficial to the patients with advanced gastric cancer staging relatively late because of potential metastasis to pancreatic capsule and anterior layer of transverse mesocolon.

Adult ; Aged ; Aged, 80 and over ; Colon, Transverse ; Female ; Gastrectomy ; methods ; Humans ; Male ; Mesocolon ; surgery ; Middle Aged ; Pancreas ; surgery ; Stomach Neoplasms ; surgery

OBJECTIVETo summarize the clinical experience on the arterial switch operation for complex congenital heart disease in recent 3 years in our hospital.

METHODSSixty-one patients with complex congenital heart disease received by arterial switch operation from Jan 2000 to May 2003. There were 26 patients with transposition of the great arteries and intact ventricular septum (TGA-IVS), 19 patients with transposition of the great arteries and ventricular septal defect (TGA-VSD) and 16 patients with double outlet of right ventricle with subpulmonary ventricular septum defect (Taussig-Bing).

RESULTSThere were 2 death among TGA-IVS cases, 4 deaths among TGA-VSD cases and 4 deaths among Taussig-Bing cases. The total operative mortality was 16%. All patients were followed up 3 months to 3 years. In all patients, the cyanosis disappeared and the physical activities increased obviously. One patients with Taussig-Bing keep moderate mitral valve reflux unchanged, 2 patients with TGA had pulmonary and aortic supra-valve stenosis with 40 mmHg pressure gradient. One patient with subpulmonary stenosis and residual VSD was re-operated 3 months later. All survivor had good heart function.

CONCLUSIONSThe effect of arterial switch operation on the treatment of TGA was well accepted in this study. The procedure used in treatment on Taussig-Bing can prevent pulmonary obstruction and avoid the complication of left ventricular outflow tract obstruction caused by intraventricular repair.

Aorta ; surgery ; Cardiovascular Surgical Procedures ; methods ; Double Outlet Right Ventricle ; complications ; surgery ; Female ; Follow-Up Studies ; Heart Septal Defects, Ventricular ; complications ; surgery ; Humans ; Infant ; Infant, Newborn ; Male ; Pulmonary Artery ; surgery ; Retrospective Studies ; Transposition of Great Vessels ; complications ; surgery

OBJECTIVETo investigate the correlation of age and sex hormones to the total volume (TV) and transition zone volume

METHODSEighty-two men were divided into two groups with the age of 60 as the dividing line. Prostatic TV (TZV and TZV were measured with transrectal ultrasound (TRUS) and the concentrations of total testosterone (T), free testosterone (fT) and estradiol (E2) were measured with radioimmunoassay. Exponential curve regression and one-factor analysis of variance (ANOVA) were used for statistical analysis.

RESULTSAge was significantly correlated with TV, TZV and the TZV/TV ratio, P < 0.01. There was a significant positive correlation between the concentrations of fT and TZV, a negative correlation between those of E2 and TZV (P < 0.01), but no correlation between those of T and TZV (P > 0.05).

CONCLUSIONThe significant acceleration of the TZV of the prostate after the age of 60 is related to sex hormones.

Adult ; Aged ; Aged, 80 and over ; Aging ; physiology ; Analysis of Variance ; Estradiol ; blood ; Humans ; Male ; Middle Aged ; Prostate ; diagnostic imaging ; Regression Analysis ; Testosterone ; blood ; Ultrasonography