PurposeTo explore and compare subtracted and unsubtracted volume rendering process on DSA apparatus in the diagnosis and treatment of intracranial aneurysms, and to provide a better reconstruction in clinic.Materials and Methods Twenty-seven patients with subarachnoid hemorrhage (SAH) underwent rotational cerebral angiography and 19 cases with embolization treatment underwent rotational cerebral angiography follow-up. 3D volume unsubtracted reconstruction and subtracted reconstructions were used respectively. Two sets of 3D volume reconstruction images were observed and analyzed by two neuroradiologists to compare the detection rate, image quality and post-embolization follow up.Results Thirty-three intracranial aneurysms were identiifed in 27 cases with SAH underwent three-dimensional digital angiography (3D-DA). False positives were found in 2 cases. 3D-DSA detected 33 intracranial aneurysms with no false positive case. There was no statistical signiifcance in intracranial aneurysms detection rate (χ2=1.943,P>0.05). There was no statistical significance in image quality of two reconstruction methods (Z=-1.445,P>0.05). In 19 cases with embolization treatment underwent the follow-up of rotational cerebral angiography, 3D-DA detected 3 cases with aneurysm remnants, while 3D-DSA detected 10. There was statistical signiifcance between 3D-DA and 3D-DSA when detecting aneurysm remnant (χ2=5.729,P<0.05).Conclusion Aneurysms can be well detected with better image quality by 3D-DSA and 3D-DA in the diagnosis and treatment of intracranial aneurysms. 3D-DSA can display more information on tiny vessels, and is better in detecting aneurysm remnants.

Background Researches demonstrated that CpG ODN,a immunostimulatory sequences,has preventing and treating effect on allergic conjunctivitis caused by protein allergen.However,its effect on allergic conjunctivitis caused by fungal allergen is unclear. Objective This study aimed to investigate into whether the Th1-Th2 switching immunostimulatory CpG ODN could reverse the response in the murine allergic conjunctivitis model caused by aspergillus fumigatus. Methods A mixture of spores and hyphae of aspergillus fumigatus strain was used to induce allergic conjunctivitis in male BALB/C mice aged 6-8 weeks.This experiment was designed into preventive or therapeutical treatment program.Under both settings,allergic conjunctivitis of the animals were treated with CpG ODN,nonstimulatory GpC ODN or PBS.After the last challenge with the allergen,the clinical symptoms of the animals were scored based on the criteria of Magone.The animals were sacrificed and the histopathological examination of conjunctiva was performed.Expression of TLR4 mRNA in conjunctiva was analyzed by real-time PCR assay.The responsiveness and populations of lymphocytes in spleen and draining lymph nodes were analyzed by flow cytometry.The use complied with the Standard of Association for Research in Vision and Ophthalmology. Results In the prevention mode.CpG ODN decreased subconjunctival infiltration compared with GpC ODN and PBS groups with the average neutrophil count index(21.25 ±11.59/section,30.75 ±11.44 section and 69.00±9.90/section,respectively).Expression of TLR4 mRNA was up-regulated significantly by CpG ODN.The clinical scores for CpG ODN group were insignificantly lower than those in GpC ODN group and PBS group(P＞0.05).In the therapeutic mode,compared with GpC ODN and PBS groups,the allergic symptom score in CpG ODN group manifested significantly lower(t=4.000.t=2.750,P＜0.01)and showed fewer cellular infiltration(t=4.870,t=3.829,P＜0.01)and higher expression of TLR4 mRNA(P＜0.01).In cultured splenic and draining lymph node cells,increased percentages of CD4+ CD25+ and CD4+ CD25+ CD69+ in CpG ODN group were observed compared with control groups(|P＜0.05). Conclusion CpG ODN can relieve aspergillus fumigatus-induced allergic conjunctivitis via either subconjunctival injection or topical application by upregulating expression of TLR4 and activating Treg lymphocytes.

Introduction:The 2010 targets of the China Hepatitis B Prevention Programme were a prevalence of hepatitis B surface antigen (HBsAg) less than 1.0% for children less than five years old and less than 6.0% for the total population. This survey assessed the prevalence of Hepatitis B infection in Lianyungang, Jiangsu province, China in 2009–2010.Methods:Multistage sampling was used with 2372 subjects among 17 selected villages. Blood specimen collection and testing by enzyme-linked immunosorbnet assay (ELISA) were completed using the following markers for hepatitis infection: HBsAg and antibody to HBsAg (anti-HBs); hepatitis B e antigen (HBeAg) and antibody to HBeAg (anti-HBe); and hepatitis B core antibody (total anti-HBc). The data were analysed with Epi Info, version 3.3.2.Results:The prevalence of HBsAg was 2.4% (95% Confidence Interval [CI]: 1.8–3.0; Adjusted Prevalence [AP] 2.9%); anti-HBs prevalence was 51.1% (95% CI: 49.1–53.1; AP 49.2%) and total anti-HBc prevalence was 41.7% (95% CI: 39.8–43.7; AP 45.5%). The prevalence of HBsAg and total anti-HBc positivity increased from young to older age groups, yet the prevalence of anti-HBs positivity decreased from young to older age groups (P< 0.001 for all). There was no difference in the prevalences of HBsAg and anti-HBs among females and males (P= 0.108 and 0.089), but females had a higher prevalence than males for total anti-HBc positivity (P< 0.001). Discussion: This survey showed that in 2010 the prevalence of HBsAg among children aged less than five years was lower than the national target of 1.0% and that the prevalence of HBsAg for the total population was lower than the national target of 6.0%.

OBJECTIVETo establish a real-time reverse transcription-polymerase chain reaction (RT-PCR) for quantitative detection of E2A-PBX1 fusion gene mRNA in acute lymphoblastic leukemia (ALL) children and to explore its clinical significance in minimal residual disease monitoring and prognosis evaluation.

METHODSReal-time RT-PCR was used to quantitatively detect the mRNA expression of E2A-PBX1 gene in 11 newly diagnosed ALL patients at diagnosis (11 cases), complete remission (11 cases) and periods of relapse (3 cases). Ten children with normal bone marrow cell morphology and without hematopathy or tumor diseases were used as the control group.

RESULTSThe median expression levels of E2A-PBX1 fusion gene in the ALL group at diagnosis and the relapse group were significantly higher than in the control and complete remission groups (P<0.01). Compared with E2A-PBX1 negative patients on day 33 during induction of remission, the recurrence rate increased and disease free survival rate at 3 year decreased significantly in E2A-PBX1 positive patients decreased (P<0.05).

CONCLUSIONSMeasurement of E2A-PBX1 levels by real-time RT-PCR is useful for monitoing minimal residual disease, prediction of relapse and individual treatment. The expression level of E2A-PBX1 gene on day 33 during induction of remission can be used for prognosis evaluation.

Adolescent ; Child ; Child, Preschool ; Female ; Homeodomain Proteins ; genetics ; Humans ; Male ; Neoplasm, Residual ; diagnosis ; Oncogene Proteins, Fusion ; genetics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; diagnosis ; genetics ; Prognosis ; Real-Time Polymerase Chain Reaction ; methods

BACKGROUNDNumerous studies have shown that reducing the level of tumor necrosis factor-alpha (TNFα) through the use of anti-TNF antibodies or soluble TNF receptor is a safe and efficacious treatment to inflammatory diseases such as rheumatoid arthritis. Therefore, novel approaches to achieve this outcome are desired. The aim of this study was to investigate the characterization of a small molecule inhibitor, Y316, which blocks TNF mRNA upregulation and TNF production by lipopolysaccharides (LPS) stimulated monocytes.

METHODSPeripheral blood mononuclear cells (PBMC) from healthy volunteers were plated in 24-well plates and stimulated with LPS (1 µg/ml), phorbol-12-myristate-13-acetate (PMA) (100 ng/ml), zymosan (10 µg/ml) and Tsst (100 ng/ml). Supernatants were collected after 4-hour culture at 37°C, and quantitative determination of TNFα, interleukin-1β (IL-1β), IL-6, IL-8, IL-10 and IL-2 production in the supernatants was performed by colorimetric enzyme-linked immunosorbent assay (ELISA). Total RNA of PBMC was isolated and cytokine mRNA quantitation was performed by using a RNA level measuring kit (R & D Systems). PBMC were pretreated with Y316 (10 µmol/L, 1 µmol/L, 0.1 µmol/L, 0.01 µol/L and 0.001 µmol/L) or dimethyl sulfoxide at 37°C for 10 minutes, and then stimulated with LPS or PMA, protein concentrations of p44.42, IKBα, P38 and Jun NH2-terminal kinase were determined by Western blotting. Cyclic adenosine-3',5'-monophosphate (cAMP) of PBMC was measured by enzyme immunoassay kit (Amersham Pharmacia Biotech).

RESULTSY316 blocked TNF production and inhibited the upregulation of TNF mRNA levels in response to LPS, and also prevented the production of IL-1 and IL-6. In contrast, Y316 augmented the production of IL-10 in LPS-stimulated monocytes. Y316 failed to prevent the production of IL-2 and TNF in antigen-stimulated T cells, suggesting that its effects may be cell-type specific. Y316 prevented the phosphorylation and activation of the MAPK, ERK, and therefore appeared to mediate its effects on TNF by acting at an early point in the signaling cascade induced in response to LPS. There was no effect of Y316 on cAMP levels either alone or in the presence of LPS.

CONCLUSIONSY316 appears to be a small molecule inhibiting TNF production, which may act via a novel mechanism. Identification of the target of Y316 may lead to the development of alternative strategies for achieving selective cytokine inhibition.

Anti-Inflammatory Agents ; pharmacology ; Extracellular Signal-Regulated MAP Kinases ; metabolism ; Humans ; Interleukin-1 ; antagonists & inhibitors ; biosynthesis ; Interleukin-6 ; antagonists & inhibitors ; biosynthesis ; Lipopolysaccharides ; pharmacology ; Monocytes ; drug effects ; immunology ; Phosphorylation ; Tumor Necrosis Factor-alpha ; antagonists & inhibitors ; biosynthesis

OBJECTIVETo assess the outcome of childhood hepatoblastoma after a combination therapy of resection and chemotherapy.

METHODSThe clinical data of 14 children with hepatoblastoma was retrospectively reviewed. Their long-term survival was followed-up.

RESULTSTwelve cases received surgery and planned chemotherapy. The follow-up duration averaged 18 months (range 1.5-74 months). Nine survived free of events, 1 died, 1 survived with multiple lung metastases, and 1 with increased alpha-fetoprotein (AFP) content but without residual tumor.

CONCLUSIONSSurgery assisted with chemotherapy can improve the outcome of hepatoblastoma.

Chemoembolization, Therapeutic ; Child ; Child, Preschool ; Combined Modality Therapy ; Female ; Hepatoblastoma ; blood ; therapy ; Humans ; Infant ; Lung Neoplasms ; blood ; therapy ; Male ; Retrospective Studies ; Treatment Outcome ; alpha-Fetoproteins ; analysis

database until 2015-01, and all randomized controlled trials (RCT) upon (RVS) pacing and (RVA) pacing in Chinese population were enrolled. According to Cochrane Handbook 5.0.2 quality evaluation criteria, the publications were selected by 2 independent researchers and Meta-analysis was conducted with RevMan5.0 software.
Results: A total of 16 RCT articles including 1199 patients were enrolled in this study. The research was divided into 2 groups: RVS group,n=602 and RVA group,n=597. Meta-analysis indicated that the following indexes in RVS group were better than those in RVA group: the differences between post-and pre-operation for the combination value in LVEF (MD=1.90, 95% CI 0.75-3.05,P=0.001), stroke volume (MD=7.08, 95% CI 2.39-11.76,P=0.003), QRS wave width (MD=29.13, 95% CI 5.71-52.54,P=0.01), LVESV (MD=2.04, 95% CI -4.22 to 8.31,P<0.00001), LVEDV (MD=2.64, 95% CI 1.80-3.49, P<0.00001), BNP (MD=68.00, 95% CI 57.57-78.43,P<0.00001), inter ventricular septum and left ventricular posterior wall motion delay time (SPWMD) (MD=22.68, 95% CI 16.91-28.45,P<0.00001), E/A (MD=0.49, 95% CI 0.41-0.57, P<0.00001), LRVPEI (MD=14.06, 95% CI 12.36-15.75,P<0.00001), resistance of electrode (MD=-67.02, 95% CI -119.96 to -14.08,P=0.01) and pacing threshold (MD=0.09, 95% CI 0.00-0.18,P=0.04). The time of operation in RVS group was longer than that in RVA group, (MD=-11.76, 95% CI -14.69 to -8.82,P<0.00001). The differences between post- and pre-operation in LVEDD, Tei index and X-ray exposure time were similar between 2 groups,P>0.05.
Conclusion: RVS is a relatively feasible pacing method in Chinese population.

Objective:To provide experimental evidences for choosing murine models in the pathogenesis research of thymic impairment induced by viral infection,we compared the impacts of polycytidylic acid(Poly(I:C)) and dexamethasone(DEX) on the thymic morphology and thymic output function,and explored the implication of RLR signaling pathway.Methods: 24 male C57BL/6 mice were randomly assigned into three groups and treated with Poly(I:C),DEX,or saline respectively.Thereafter,their thymic morphology,pathological changes,thymic index,and thymic pathology were examined.Their contents of T-cell receptor excision circles (TRECs) and proportions of the naive CD4+T cell in the peripheral blood were determined to evaluate their thymic output function.The expression levels of thymic RLR/MAVS/IFN-α/β signaling pathway and IL-1β were also measured.Results: Both Poly (I:C) and DEX treatment caused thymic atrophy in appearance and structural destruction under the microscope inspection,and DEX treatment did much more severe damage,especially to the thymic cortex.TRECs decreased significantly in both groups.The proportions of na?ve/memory CD4+T cell subsets remained stable,though total CD4+T cell decreased in DEX group,while the proportion of na?ve CD4+T cell in Poly (I:C) group increased significantly.The expression of RIG-Ⅰ,MDA5,LGP2,and IFN-α/β were up-regulated in DEX group, while it remained unchanged in Poly (I:C) group.Conclusion:Both Poly (I:C) and DEX induced thymic atrophy and the impaired thymic output function.Nevertheless,the expression of RLR-IFN signaling pathway up-regulated more significantly in DEX group instead of in Poly (I:C) group.These results implied the existence of different pathological manifestations and mechanisms underlying the impaired thymic function in different animal models,as well as impact on na?ve/memory CD4+T cell proportions.Our research provides references for choosing animal models in the basic research and drug development for viral infection induced thymic atrophy based on the RLR signaling pathway.

·AIM: To investigate the relationship between the thickness of choroid and the development of idiopathic macular epiretinal membrane (IMEM). ·METHODS: A retrospective analysis on 48 cases (48 eyes) of idiopathic macular epiretinal membrane patients (the IMEM group) was taken in our hospital from January 2014 to December 2016, and 50 right eyes in 50 healthy persons with physical examination were selected the control group, comparison on subfoveal choroidal thickness (SFCT) levels of sicked eyes, normal eyes in IMEM group and the control group were made, postoperative SFCT level change of sicked eyes in IMEM patients and normal eyes were investigated via follow-up, and analysis on correlation between postoperative choroidal thickness and the best corrected visual acuity was taken. ·RESULTS: The SFCT of sicked eyes in IMEM group 362.22±40.75μm was significantly lower than that of the contralateral eyes (410.56 ± 38.45μ m) and the right eyes of the control group (420.73±39.63μ m), and data of the contralateral eyes was lower than right eyes of the control group, distinct difference was shown between groups(P<0.05). The IMEM group's SFCT of sicked eyes and normal eyes at postoperative 1wk had no significant difference with that before operation (P>0.05), and at postoperative 1mo,SFCT of sicked eyes and normal eyes evidently increased, showing sharp difference compared with that before operation (P<0. 05). After that, the SFCT value stabilized, but there was no obvious difference between the sicked eyes and healthy eyes at postoperatively 1mo (P>0.05). The numbers of patients whose postoperative BCVA &ge; 0. 5 with different preoperative SFCT values had statistically significant differences (P<0.05), and those with BCVA &ge;0.5 of SFCT values> 380μ m were significantly higher than those with <320μ m and 320μ m-380μ m groups. Fisher exact probability analysis showed that the differences were significant. Pearson analysis showed that there was a positive correlation between the postoperative choroid thickness and the best corrected visual acuity of IMEM group (r=0.629,P<0.05). · CONCLUSION: Choroidal thinning may be an important cause of IMEM, and preoperative choroidal thickness also has an influential effect on postoperative visual recovery.

Objective To investigate the 3.0T high-field intraoperative MR imaging applications in surgical resection of gliomas.Methods One hundred and fifty-two patients with brain gliomas, admitted to our hospital from January 2011 to December 2013, were enrolled in our study;tumor resection was performed in 85 patients under the guidance of a simple neural navigation (control group) and 67 patients under intra-operative MRI neuronavigation (iMRI group).A retrospective analysis was performed on the clinical data of the patients;tumor resection rate, surgical time and prognosis of the patients were analyzed and compared between the two groups.Results All the 152 patients were successfully performed tumor resection.Longer surgical time was needed in patients of iMRI group than that in the control group, with significant difference (P＜0.05).In the iMRI group, total resection was achieved in 60 patients, subtotal resection in 4, greatly partial resection in two, and partial resection in one;in the control group, total resection was achieved in 61 patients, subtotal resection in 8, greatly partial resection in 9, and partial resection in 7;the resection rate in the iMRI group was significantly higher than that in the control group (P＜0.05).The good prognosis rate in the iMRI group (94.0％) was significantly higher than that in the control group (72.9％, P＜0.05).No MRI-related adverse events or infected patients were noted.Conclusion 3.0T high-field intraoperative MRI technology helps intra-operative brain shift in real-time to correct the error, pinpoint glioma imaging edge to maximize clinical glioma resection, retain neurological areas and improve prognosis of the patients.