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 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.

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 investigate early and differential diagnosis of Alzheimer disease and vascular dementia (VD)using FDG-PET scan. Methods Clinical data was collected from AD,VD and normal control(NC). 18F-2-fluo-ro-deoxy-D-glucose(18F-FDG)PET scan was conducted to detect the cerebral FDG metabolism. The average standard uptake value (SUV) of cerebral regions was expressed as semiquantitative index relative to ipsilateral cerebellum. Re-sults There were no differences in age and the mean total scores of the mini mental status examination (MMSE) between patients with VD and those with AD.The AD group showed that the SUV was significantly decreased in the right frontal, parietal,temporal lobe,hippocampus,temporo-parietal junction,and bilateral posterior cingulate cortex compared to the VD and in the bilateral posterior cingulate cortex,temporo-parietal junction,frontal and temporal lobe comparing to the NC(P≤0.01). SUV was significantly increased in the right parietal,posterior cingulate cortex and hippocampus whereas was significantly decreased in the left frontal lobe,temporo-parietal junction and thalamus in the VD compared with NC group(P≤0.01). Conclusion AD patients have typical features of 18F-FDG PET which may be helpful for the diagnosis of AD in the early stage.

Broth microdilution method was hired to measure the minimum inhibitory concentrations (MICs) of luteolin against Trueperella pyogenes,Escherichia coli,Salmonella and Streptococcus in order to evaluate the antimicrobial activity of luteolin in vitro.Meanwhile,the bacteria growth curves in medium containing sub-inhibitory concentration of luteolin were measured in this test.The results indicated that Tureperella pyogenes was the most sensitive to luteolin with a MIC of 0.078 g/L than that of these strains;and Salmonella was also sensitive to luteolin (MIC:1.25 g/L).However,The inhibitory effect of luteolin on Escherichia coli and Streptococcus is relatively weak,and shared the same MIC with 2.5 g/L.Luteolin showed inhibitory effects on the growth curves of all the strains in this test at sub-inhibitory concentration,and the inhibitory effects on the growth curves increased with the concentration of luteolin(P＜0.05).