Objective To explore a new surgical method for hypertensive cerebral hemorrhage and its efficacy.Methods A total of 12 patients with hypertensive cerebral hemorrhage in the fundus node at a super early stage(≤6 h)were enrolled in this study.Microsurgery trough the lateral fissure and insula via pterional keyhole approach was employed to treat the patients.Results All but one of the patients survived after the operation.One patient received a second operation because of hemorrhage for twice,one patient developed intracerebral infection.The survivors were followed up for 3 to 6 months.According to GOS scoring system,7 of them achieved excellent outcomes,3 were good,and 1 was moderate.Conclusion Microsurgery trough the lateral fissure and insula via pterional keyhole approach is effective for hypertensive cerebral hemorrhage.

To observe the expression of CD40/CD40L on peripheral blood mononuclear cells (PBMC) in patients with condyloma acuminatum (CA), flow cytometry was employed to examine the expression of CD40 and CD40L on PMBC in 36 patients with CA and 20 healthy controls. Our results showed that mean level of CD40 expression in CA patients was significantly lower than that in the controls (6.58% +/- 2.74% vs 14.81% +/- 6.12%, t = 5.703, P < 0.05); the average level of CD40L in CA patients was also significantly lower than that in the controls (0.73% +/- 0.54% vs 2.67% +/- 2.43%, t = 3.532, P < 0.05). Our results suggest that the reduced costimulatory interaction of CD40 and CD40L in CA patients may be one of the important factors responsible for the low cellular immunity.

Objective To research the angiographic manifestations of rabbit implanted VX_2 liver carcinoma.Methods 34 New Zealand big white rabbit were implanted VX_2 tumor pieces under orthophoria into liver left middle segment.Angiography of coeliac artery-hepatic artery catheterization via right femoral artery was performed at the third week after inoculation.Results The tumor blood vessel and tumor stain in 6 rabbit could be not showed clearly by digital cinematography mode but which could be showed in 28 rabbit by digital subtraction mode.The tumor angiographic signs included:dilating growth of tumor,the feeding arteria surrounding the tumor surface were resemblance to the clenched fist,embraced globosity and wreath in form;many slender vessels from feeding arteria appeared as small bud form,root form and filose form pushed forward to the center from the surface of tumor.The tumor vascular density in periphery was higher than that in center and formed circular or oval tumor stain which more denser at periphery than center.The tumor node stain was complete with definite margin when tumor size was large or equal to 1 cm in diameter,and the tumor stain appeared as clump with indefinit margin.Conclusion There are abundant vascularity for rabbit implanted liver VX_2 tumor,and more abundant at periphery part than center part, coeliac artery catheterization angiography can show the typical manifestations of tumor clearly.

Objective To research the angiographic anatomy of celiac artery in rabbit.Methods 36 New Zealand big white rabbitswere included in this study,the angiography of celiac artery and hepatic artery via right femoral artery was performed,and the branchand diameter of celiac artery system were analysed.Results 66.7% of the celiac arterial opening localized at the level of T_(12) vertebral body low edge,gastrohepatic arterial truncus could been divided into three types : type Ⅰ(47.22%),tree-like branch;type Ⅱ(38.88%),trifurcate branch and type Ⅲ(13.90%),dichotomy branch.The length of proper hepatic artery was from 22.70 to 33.00 mm(26.64 mm?2.28 mm),the inner diameter of proper hepatic artery,left hepatic artery and right hepatic arteria was 0.60~1.20 mm(0.90 mm?0.16 mm),0.60~1.10 mm(0.72 mm?0.09 mm) and 0.50~1.00 mm(0.67 mm?0.09 mm) respectively.The segmental artery of liver could be displaied clearly by proper hepatic artery angiography.Conclusion To realize the angiographic anatomy of rabbit celiac artery would provide a useful help for transhepatic arterial interventional treatment of the liver VX_2 tumor model of rabbit.

Objective To research tumor cell apoptosis induced by Lp-THAE of rabbit VX2 liver implanted tumor.Methods 27 New Zealand white rabbits implanted with VX2 tumor at left middle lobe of the liver divided into three groups:Group A(n = 9) Lp-THAE:treated through transhepatic artery catheterization;Group B(n = 9) THAI and Group C(n = 9) as control.The rabbits were executed at second to fifth day after treatment.HE dye microscopy was taken for counting the typical apoptosis cells and calculating apoptosis index(ApI).FITC-AnnexinV/PI assay was used for measuring apoptosis by flow cytometry.Results The ApI of tumor central area and marginal area were(17.769 ? 2.417)%,(4.129 ? 1.172)%,P

Objective To study the expression of Gli1 protein and vascular endothelial growth factor (VEGF)-C in papillary thyroid carcinoma and their relationship with cervical lymph node metastasis.Methods The expression of Gli1 protein and VEGF-C were investigated by immunohistochemical EnVision method in 67 cases of papillary thyroid carcinoma and 32 cases of nodular goiter pathological specimen tissues.Nascent microvascular and micro-lymphatic of all pathological speimen tissues were examined by immunohistochemical monoclonal antibody CD34 and D2-40 staining assay respectively,and the microvascular density (MVD) and micro-lymphatic vessel density (MLVD) were calculated.The relationship between the positive expression of Gli1 protein and MVD,between the positive expression of VEGF-C and MLVD,and their relationship with cervical lymph node metastasis were analyzed.Results The positive rates of Gli1 protein,VEGF-C and MVD,MLVD were significantly higher in papillary thyroid carcinoma than those in nodular goiter [67.16％(45/67) vs.43.75％(14/32),70.15％(47/67) vs.31.25％(10/32),23.14 ± 2.06 vs.2.14 ± 0.31,13.36 ± 1.32 vs.3.53 ± 0.65,P ＜ 0.05].The positive expression of Gli1 protein was related to the patient' s age and the tumor size (P ＜ 0.05),while the positive expression of VEGF-C was not related to the patient' s age and the tumor size (P ＞ 0.05).The positive expression of Gli1 protein and VEGFC were significantly higher in TNM stage Ⅲ-Ⅳ of papillary thyroid carcinoma than those in TNM stage Ⅰ-Ⅱ (P ＜ 0.01) and also was significantly higher with cervical lymph node metastasis than without cervical lymph node metastasis (P ＜ 0.01).MVD and MLVD were significantly higher with cervical lymph node metastasis than without cervical lymph node metastasis (P ＜ 0.05).The positive expression of Gli1 protein was positively correlated with MVD (r =0.784,P＜ 0.01),the positive expression of VEGF-C was positively correlated with MLVD (r =0.529,P ＜ 0.01),the positive expression of Gli 1 protein was positively correlated with the positive expression of VEGF-C (r =0.586,P ＜0.01).Conclusions Gli1 protein which may participate in the formation of nascent microvascular is abnormally activated by the Hedgehog signaling pathway to express,VEGF-C which may be participate in the formation of nascent micro-lymphatic is mediated and started by the MAPK signaling pathways to express.Expressions of Gli1 protein is positively correlated with expressions of VEGF-C,therefore the Hedgehog signaling pathway may be associated with the MAPK signal pathway.Suppressing nascent microvascular and micro-lymphatic may become new target to blockingup papillary thyroid carcinoma cervical lymph node metastasis.

Objective To investigate the risk factors of central lymph node metastasis and significance of prophylactic central lymph node dissection for clinical N0 (cN0) patients with papillary thyroid carcinoma (PTC).Methods The clinical data of 315 patients with cN0 PTC in Department of General surgery,the Second Affiliated Hospital of Dalian Medical University from Jan.2012 to Jan.2014 were analyzed retrospectively.Results (Iumor size,infiltration of thyroid capsule,and tumor number were associated with central lymph node metastasis in patients with cN0 PTC(P＜0.05),and the high risk factors of central lymph node metastasis were infiltration of thyroid capsule and multiple lesions (P＜0.05);()The overall complication rate was 3.17％ (10/315),the rate of transient recurrent laryngeal nerve paralysis was 0.63％ (2/315),and the rate of transient hypoparathyroidism was 2.54％ (8/315).All patients with complications recovered after treatment.No patient developed permanent recurrent laryngeal nerve paralysis or hypoparathyroidism;()The follow-up time was 6 to 30 months,and 2 cases were lost.No patient developed local tumor recurrence,distant metastasis,or death.Conclusions The high risk factors of central lymph node metastasis in patients with cN0 PTC were infiltration of thyroid capsule and multiple lesions.No patient developed local tumor recurrence,distant metastasis,or death.It is preferable and necessary to perform prophylactic central lymph node dissection in patients with cN0 PTC.

Objective To evaluate the hematological toxicity of craniospinal irradiation,and determine the short-term clinical efficacy and prognostic factors in medulloblastoma.Methods Eightseven patients who underwent craniospinal irradiation were retrospectively analyzed with respect to the changes in hematology during craniospinal irradiation.The effect of sex,age,tumor location,interval between surgery and radiation,interval time during radiation and radiation sequence on survival were also studied.Results The 1,2,3-year overall survival (OS) and progress-free survival (PFS) rate were 95.0％,92.4％,84.9％ and 93.7％,89.8％,80.8％,respectively.The incidence of 2-3 grade leucopenia was 90.8％,while the incidence of 1-2 grade thrombocytopenia was 70.1％,and the incidence of 3 grade thrombocytopenia was 1.1％.The incidence of 1-2 grade hemoglobin reduction was 16.1％.No patient had grade 3-4 hemoglobin reduction.Kaplan-Meier analysis shows that more favorable prognoses in terms of 3-year PFS were evident for 0-1 grade thrombocytopenia compared with 2-4 grade thrombocytopenia (x2 =3.936,P ＜ 0.05).And 3-year PFS and 3-year OS were evident for 0 grade hemoglobin reduction compared with 1-4 grade hemoglobin reduction (x2 =10.269,9.336,P ＜ 0.05).The 3-year PFS between interval time during radiation ＜ 3 days and ≥ 3 days was 84.6％ and 68.6％ (x2 =4.413,P ＜ 0.05).Conclusions Hematological toxicity during craniospinal irradiation and the interval time during radiation were prognostic factors.

Objective To evaluate the prognostic factors and treatment results of intracranial ependymomas (EPs).Methods Thirty-one intracranial EPs patients who received postoperative radiotherapy in Beijing Shijitan Hospital between January 2009 and June 2012 were analyzed retrospectively.Twenty-two males and 9 females had an average age of 18 years (range 3-60 years).Seventeen patients received gross total resection (GTR) while fourteen received subtotal resection (STR).Median total radiation dose was 53.9 Gy (48.6-60 Gy).The three-year and five-year progress-free survival (PFS) and overall survival (OS) were estimated with the Kaplan-Meier method.Univariate analysis was performed using eight clinical and dosimetric factors by Log-Rank testing.Cox proportional hazards model was used to identify the independent prognostic factors correlated to EPs.Results The median time of follow-up was 51 months.At the endpoint of the follow-up period,7 patients experienced tumor recurrence:5 had a local recurrence (LR) and 2 had both LR and distant recurrence.Six patients died,4 of which had cases of pediatric infratentorial anaplastic EPs.The three and five-year progress-free survival (PFS) were 80.6％ and 75.9％.Overall survival (OS) at three-year and five-year were 83.9％ and 76.2％,respectively.Univariate analysis showed a more favorable prognoses in terms of three-year PFS,five-year PFS and OS for GTR compared to STR (x2 =4.685,6.311,4.238,P ＜ 0.05).Besides,a more favourable univariate outcome in terms of five-year PFS was evident in patients when the total radiotherapy dose was ＞ 55 Gy compared to ≤55 Gy (x2 =4.210,P ＜ 0.05),and no severe radiotherapy complications occurred.Conclusions Surgery is the major treatment method,while adjuvant radiotherapy is important for subtotal resection and anaplastic EPs patients.Surgical resection and radiotherapy dose were relevant to prognosis.

AIM:To observe the myogenic effect of bone marrow-derived mesenchymal stem cell(MSC)transplantation after chemical-induction and stress-induction on denervated skeletal muscle atrophy in vivo. METHODS:The experiment was performed at the Animal Experimental Center and Central Laboratory in Xinhua Hospital affiliated to Shanghai Jiao Tong University from April to October 2007.SD rats were provided by B&K Universal Group Limited.The experimental procedure was consistent with animal ethical standard.The MSCs from male SD rat femurs and tibia were isolated by density gradient centrifugation.The third passage of MSCs after chemical-induction and stress-induction was labeled with DAPI before transplantation.Thirty-six 8-week-old SD rats were randomly divided into control group and experimental group(n=18).The animal model of denervated gastrocnemius muscles were made by cutting the left sciatic nerve and creating nerve defect about 1 cm. MSCs were percutaneously transplanted to medial and lateral gastrocnemius of the experimental group rats,while low carbohydrates DMEM culture solution without MSCs and fetal bovine serum were transplanted to gastrocnemius of the control group.Bilateral gastrocnemius muscles of each rat from the two groups were weighed 4,8 and 12 weeks postoperatively after examining the motor unit potential and fibrillation potential.The gastrocnemius muscles underwent HE staining and image analysis to measure cross-section area of muscle fiber.The amount of protein was detected by BCA method. RESULTS:Muscular atrophy was observed 2 weeks after denervation.The motor unit waveshape of gastrocnemius became single; time limit became long;voltage became low,and the fibrillation potential norientation wave was increased.Differences were observed between two groups 4 weeks and 8 weeks,but no differences were observed after 12 weeks.Cells with fluorescence were observed in transplantation sites of the experimental group,but not in the control group.The wet weight remnant rate,cross-sectional area of fiber remnant rate and muscle amount protein content remnant rate in rates transplanted with MSCs were significantly lower than those in the control group 4 and 8 weeks after surgery(P