AIM:To report a case of a chronic glaucoma patient whose reduced eyesight is related to ocular ischemia.METHODS:A case report.RESULTS:A 71 year-old man presented with a decreased left eye vision for over 3 years.During the last two months,he had deteriorated blurred vision when he woke up in the morning.The loss of his lower-half peripheral vision was especially serious.The patient suffered from an episode of transient amaurosis fugax three months ago.According to transcranial Doppler ultrasound scan and cerebral computerized tomographic angiography,the patient was found that he had severe stenosis of the bilateral intracranial internal carotid artery and decreased blood flow velocity within the left ophthalmic artery.His symptoms alleviated after an internal carotid artery endarterectomy.CONCLUSION:When vision loss glaucoma cases are presented,more attention should be paid to the presence of ischemia within the ophthalmic artery except glaucoma.

[Objective] To investigate the clinical results of two-level lumbar total disc replacement with SB Charit? Ⅲ prosthesis at early metaphase and discuss the indication.[Method]From October 2000 to August 2006,22 patients who suffered degenerative disc disease from L4 to S1 underwent two level artificial lumbar disc replacement with SB Charit? Ⅲ prosthesis.There were 16 men and 6 women.The average age of the patient at surgery was 48 years(range,43 to 54 years).The duration of follow-up evaluation ranged 24 to 94 months,with an average of 59.5 months.JOA score and radiological outcomes were used to access the curative effect.[Result]The average postoperative JOA score was statistically significantly higher than preoperative JOA score(P

Thirty-five patients who underwent Scandinavian total ankle replacement (STAR) in the Union Hospital, Huazhong University of Science and Technology & First Affiliated Hospital of Nanchang University between March 1999 and November 2006 were recruited for this study. The patients averaged 50.5 years old ranging from 27 to 68 years old. STAR was performed on the left side in 20 cases and on the right side in 15 cases. Among these patients, 12 suffered from posttraumatic arthritis, 8 osteoarthritis, and 15 rheumatic arthritis. All patients complained of ankle joint pain and different degrees of swelling as well as limited motion of joint. During the operation, some complications appeared, including medial malleolus fractures 2 patients, unstable ankle joint introversion 2 patients, limited ankle joint dorsiflextion 1 pateint. Symptomatic treatments were performed in these patients. Postoperatively, injury of superficial peroneal nerve occurred in 1 patient, but this did not cause an obvious motor dysfunction, so no special treatment was given. In addition, infection of incisional wound appeared in 2 patients and late healed subsequent to another dressing. Thirty-three cases presented with primary healing of incision. Among 35 total ankle arthroplasties, 28 had detained 43.5-month follow up (range 3-80 months). The ankles were scored with Kofoed total scoring system. The average postoperative ankle score was 85.5 (range 58-95), pain degree score was 48.3 (range 35-50), joint function score was 20.7 (range 18-30), and range-of-motion score was 17.2 (range 16-20). There was significant difference in these scores as compared to preoperative scores (P < 0.01). None of prosthetic loosening and migration was found radiologically. All these indicated that standardized and normalized operative technique as well as operative tools closely matched to the prosthesis and used to prevent and treat postoperative infection, dislocation, and prosthetic loosening as well as histocompatibility between material and host are the essential conditions for enhancing the success rate of prosthetic replacement.

Aim To investigate the effect of DHA on NGF-induced neuronal differentiation of PC12 cells and explore the possible mechanism via regulating BMP pathway. Methods PC12 cells were treated with 100μg·L-1 NGF and 100 μg·L-1 NGF + 10 μmol· L-1 DHA for 3, 6 and 9 days respectively. The length and number of neurite were detected by immunofluores-cenc. DHA content was analyzed by gas chromatogra-phy in all groups. The protein expression of BMP4, BMP7 , BMPR-II and p-Smad 1/5/8 was determined by Western blot. Results The length of total primary neurite in NGF+DHA groups was obviously increased, longer than that in NGF group; DHA content in 10μmol · L-1 DHA group was higher than that in the control group;NGF+DHA groups also unregulated the protein expression of BMP4 , BMP7 , BMPR-II and p-Smad 1/5/8 . Conclusion DHA promotes NGF-in-duced neuronal differentiation in PC12 cells, which may be associated with the upregulation of BMP path-way protein.

OBJECTIVE: To investigate the clinical diagnosis, treatment and prognosis of carcinoma showing thymus-like differentiation (CASTLE) of thyroid, and to improve the understanding of CASTLE. METHOD: In 6 patients with CASTLE, we performed region VI lymph node dissection, the lesion resection of thyroid lobe and isthmus. After the operation, except one case of 68 years old patient, the rest patients were treated with radiotherapy 60 Gy in anterior cervical region after third week of operation and 5 courses of chemotherapy with cisplatin, each interval of 2 weeks. Insist on the oral Euthyrox. RESULT: All patients were alive without recurrence and metastasis. CONCLUSION The diagnosis of CASTLE depends on the histology and immunohistochemistry. Operation was the main treatment. CASTLE is a rare type of thyroid carcinoma with slow progress and good prognosis.
Carcinoma ; diagnosis ; therapy ; Humans ; Immunohistochemistry ; Neck Dissection ; Neoplasm Recurrence, Local ; Prognosis ; Thyroid Neoplasms ; diagnosis ; therapy

Objective To investigate the efficacy and safety of a novel biologies-infliximab in the treatment of patients with Crohn's disease (CD). Methods A prospective study was conducted in 10 patients with CD(8 with active refractory CD and 2 with severe lower gastrointestinal bleeding caused by CD). All patients were intravenously infused with infliximab of 5 mg/kg body weight in an induction regimen of 3 doses at week 0, 2 and 6, followed by maintenance dosing every 8 weeks beginning at week 14. The clinical and endoscopic efficacy of infliximab were evaluated by follow-up of 30 weeks. Results ① Five out of 8 patients with active CD had initial clinical response at week 2. Clinical remission was found in 4 patients at week 30, (3 of them in symptomatic remission without corticosteroids). ② Two patients with severe lower gastrointestinal bleeding caused by CD were in control of bleeding and absence of further recurrence by 30 weeks follow-up. ③ Endoscopy was performed in 6 patients at week 30 to evaluate the healing of mucosal ulceration. Four patients were evaluated for complete or almost mucosal healing. ④ Adverse events were seen in 7 out of 10 patients with infliximab treatment, among whom 2 cases had severe side effect including pneumonia in one and delayed hypersensitirity reaction in the other. Conclusion Infliximab has efficacy for the induction and maintenance of remission in part of patients with active CD. Some patients achieved mucosal healing with infliximab therapy and low incidence of serious adverse events.

ObjectiveTo compare the efficacy of step-up and top-down infliximab therapy on patients with Crohn's disease (CD).MethodsA prospective and open-label study was performed by the First Affiliated Hospital of SUN Yat-sen University during September 2007 to December 2010.Active CD patients who were refractory to steroid/immunomodulator or who were steroid-dependent were enrolled into step-up group.Active CD patients who had no steroid or immunomodulator therapy before were enrolled into top-down group. All patients were intravenously infused with infliximab of 5 mg/kg body weight in an induction regimen of 3 doses at week 0,2 and 6,followed by maintenance dosing every 8 weeks beginning at week 14.The clinical and endoscopic follow up lasted 30 weeks.Clinical symptoms and mucosal healing status under endoscopy were evaluated by follow-up at week 10 and 30.Results Forty-one CD patients were enrolled,with 24 in step-up group and 17 in top-down group. There were significant differences in disease duration (P =0.006),combination therapy (P ＜ 0.001 ) and severity of disease ( P =0.011 ) in baseline between step-up and top-down groups.At week 10 and 30 during treatment,the clinical remission rates in step-up group were 45.8％ (11/24) and 58.3％ (14/24) respectively; the mucosal healing rates in step-up group were 33.3％ (8/24) and 54.2％ (13/24) respectively; the clinical remission rates in topdown group were 70.6％ ( 12/17)and 82.4％ (14/17) respectively; and the mucosal healing rates in topdown group were 35.3％ (6/17) and 52.9％ (9/17) respectively.No significant differences in clinical remission and mucosal healing rates at both week 10 and 30 were observed between the two groups.The prevalences of adverse events in step-up and top-down group were 41.7％ (10/24) and 29.4％ (5/17)respectively ( P =0.422).ConclusionBoth step-up and top-down infliximab therapy can induce remission in more than half of CD patients,while top-down therapy might be more benefitiary to symptom and endoscopic remission.

Objective To modify the methods of operation and establishment of cerebral ischemia rat models made by thread occlusion. Method We randomly divided 120 male SD rats into a common group (n = 50), an improvement group (n = 60) and a sham-operated group (n - 10). Rats in the common and improvement groups were made into models using the common and improvement methods separately. All models were evaluated on the basis of physical sign indices and 2,3,5-triphenyltetrazolium chloride (TTC) staining. The TTC staining results were taken as gold standards. Then, we compared the achievement ratios of the two groups, and computed the sensitivity and specificity of every physical sign index based on these standards. The χ~2 or correction χ~2 test was used to compare the ratios. Results (1) The achievement ratio in the improvement group was significantly higher than that in the common group (71.67% vs. 52.00%, P = 0.034). (2) The sensitivity of evaluation for both common and improvement methods was 98.55%. However, the specificity of evaluation for the improvement method was significantly higher than that for the common method (100.00% vs. 40.00%, P =0.000). Conclusions The establishment achievement ratio and evaluation correctness of models are obviously elevated by modification of the operation and establishment methods.

Objective To assess the predictive value of thiopurine methyltransferase genotyping and enzyme activity in relation to side effects in patients with inflammatory bowel disease (IBD) who were treated with azathioprine (AZA). Methods One hundred and eleven IBD patients (26 with ulcerative colitis and 86 with Cronh's disease) with indication of AZA administration between April 2004 and Dec. 2009 were enrolled. All patients received 2 mg/kg of AZA daily. Polymerase chain reaction and high performance liquid chromatography were used to genotype the TPMT * 2, * 3A, * 3B, * 3C and to detect TPMT activity, respectively. The association of TPMT genotype and activity with side effects was analyzed in patients treated with AZA for 24 weeks or more, or in those discontinued AZA because of adverse effects. Results Adverse effects were reported in 38(33. 9%) patients, the most frequent being myelosuppression (20. 5%). The frequency of TPMT * 3C heterozygous mutation was 0. 9% (1/112). The TPMT activity was (12. 9±4. 8) U/ml RBC with unimodal distribution. One patient with TPMT * 3C heterozygous mutation developed myelosuppression at the 4th week after AZA treatment. The TPMP genotype myelosuppression patients. Conclusions TPMT genotype mutation and low enzyme activity can be used to predict myelosuppression with high specifically and low sensitivity. In patients treated with AZA, co-administration of 5-ASA results in a high frequency of myelosuppression with no effect on TPMT activity.