Objective To discuss the clinical manifestations and the morphological features of intracranial arteriovenous malformation (AVM) in childhood. Methods During the period from Jan. 2012 to June 2013, a total of 14 AVM patients under the age of 14 years were admitted to authors’ hospital. Of the 14 patients, 11 had a history of spontaneous intracerebral hemorrhage (78.6%), 7 complained of headache (50.5% ), 5 showed signs of unilateral limb weakness (35.7% ), and 2 was accompanied with epileptic attacks (14.3% ). The clinical characteristics, the preoperative imaging features and DSA findings were retrospectively analyzed. Results DSA showed that terminal feeding branches were visualized in 9 cases and blood supply from perforating branches was seen in the remaining 5 cases. In seven cases the feeding artery was single, while in the remaining 7 cases the feeding artery was multiple, and in four of them combination blood supply from both anterior and posterior circulation was found. The lesions were situated at the lateral or convex surface of cerebral hemisphere (n = 5), lateral ventricle (n = 4), cerebral bottom (n = 3) or medial surface of cerebral hemisphere (n = 2). The lesion’s diameter was < 30 mm in 10 cases and (30 -60) mm in 4 cases. According to Spetzler- Martin grading, grade Ⅰ was seen in 4 cases, grade Ⅱ in 2 cases, grade Ⅲ in 5 cases and grade Ⅳ in 3 cases. Conclusion Although in childhood AVM lesion is small in size and lower in grading, its onset is early and the lesion is prone to bleeding. DSA findings indicate that most AVMs in childhood take the form of immature type. Nevertheless, its natural course needs to be further studied.

Objective To investigate the effects of propofol on the release of noradrenaline ( NE) from the locus coeruleus in the brain of rabbits trying to elucidate the central mechanism of the cardiovascular inhibition induced by propofol.Methods Nine healthy male New Zealand rabbits weighing 2.0-2.5 kg were used in this study. A trocar (0.8 mm in diameter) was inserted into locus coeruleus using the stereotactic technique and fixed. Four days later push-pull perfusion of the brain was performed. 37℃ artificial cerebrospinal fluid (aCSF) was infused through the trocar at 0.1 ml?min-1 . A loading dose of propofol 2 mg?kg-1 was given i.v. followed by continuous infusion at 150 ?g?kg-1?min-1 for 30 min. The experiment was concluded at 20 min after propofol infusion. The perfusate having passed through the locus coeruleus was collected before and every 10 min during and after infusion. The NE concentration of the perfusate was measured by high performance liquid chromatography. Results The NE concentration of the perfusate from locus coeruleus significantly decreased after the loading dose and during the infusion of propofol and reached its bottom level at 10 min after loading dose. The maximal decrease was 75.5% [from (15.9 ? 3.2) pg??l-1 to (3.9?0.5) pg ? ?l-1]. Conclusion Intravenous propofol decreases the NE concentration in locus coeruleus. The cardiovascular inhibition induced by propofol may partly be explained by this central mechanism.

Objective To investigate the prognosis of isolated fetal pyelectasis detected by ultrasound.Methods A total of 109 cases of isolated fetal pyelectasis (renal pelvis anteroposterior diameter ≥ 5 mm by ultrasound screening at any gestational age without structural or chromosome abnormalities) detected by prenatal ultrasound screening from March 2004 to July 2014 in Obstetrics & Gynecology Hospital of Fudan University,were delivered and followed up until neonatal period on chromosome examination,prenatal B ultrasound and outcome of neonates.Receiver operating characteristics curves were plotted and used to predict the optimal critical point of poor prognosis and the warning point of follow-up.Results Among the 109 cases,83 cases tended to have a natural recovery during pregnancy,71 of them had normal renal pelvis.Two of the neonates died,9 cases needed surgical treatment,and 98 cases had normal renal pelvis or need follow-up only.The area under the receiver operating characteristics curves was 0.860 (95％CI:0.860± 1.96 × 0.112).The optimal critical point of poor prognosis was determined at ≥ 11 mm in anteroposterior diameter with sensitivity 81.8％,and specificity 83.7％,and the warning point of prenatal follow-up was at ≥ 7 mm in anteroposterior diameter with sensitivity 100.0％ and specificity 50.0％.Conclusions The prognosis of isolated fetal pyelectasis is mostly good.The fetus with pyelectasis thicker than 7 mm should be followed-up closely during prenatal and neonatal period,and the fetus with pyelectasis thicker than 11 mm is likely to have poor prognosis in neonatal period.

0.05).The CSFP before and after opening dura mater was obviously lower than the baseline value (P0.05).The total dose of propofol in group T was smaller than in group C.CONCLUSION:Target controlled infusion of propofol is better than continuous pump injection in lowering the ICP during neurological surgery.

[ ABSTRACT] AIM: To determine the aberrant methylation status in the gene promoter regions of CDH13, RASSF1A, DLEC1, SEPT9 and RUNX3 by detecting the plasma specimens and the value of their combined detection for di-agnosis of lung cancers.METHODS:Nest methylation specific PCR ( nMSP) was used to detect the promoter methylation status of the 5 genes in the plasma from 106 normal controls, lung cancer tissues, lung benign tissues and the plasma from 106 patients with lung cancers.Multiple displacement amplification ( MDA) was used to amplify modified genomic DNA to solve the problem of insufficient of plasma DNA template.RESULTS: The positive rates of promoter methylation of CDH13, RASSF1A, DLEC1, SEPT9 and RUNX3 in the lung cancer tissues were 51.9%, 44.3%, 54.7%, 36.8%, 24.5%, respectively, and those in the plasma were 46.2%, 41.5%, 50.9%, 31.1%, 19.8%, respectively.The re-sults of the Kappa consistency check showed that the lung cancer tissues and the plasma had obviously coherence in the methylation status of the 5 gene promoter regions.Combination of DLEC1, CDH13, RASSF1A, and SEPT9 had a higher di-agnostic efficiency than the others, as their ACC value was 0.8208 and youden index was 0.6415 ( with the sensitivity of 81.13% and the specificity of 83.02%) .CONCLUSION:Combination detection of promoter methylation of lung cancer-related genes in the plasma is expected to apply to the early diagnosis of lung cancer.

Objectives:To evaluate forearm intramuscular autograft Tx vs. forearm subcutaneous ultrasound-guided homogenate injection transplantation. Methods:One hundred-ten end-stage chronic renal failure patients who after total parathyroidectomy and autologous forearm Tx from Mar 2011 to Mar 2020 were enrolled for retrospective analysis.The control group received autologous parathyroid forearm intramuscular autograft Tx, and the observation group had the anterior fascia of the flexor carpus ultrasound-guided homogenate injection Tx. We evaluated the effects of transplantation between the two groups.Results:There were no significant differences in the levels of iPTH, blood calcium, blood phosphorus, and calcium-phosphorus product between the two groups of patients 30 minutes , 1 month , and 3 months after surgery.The two-dimensional ultrasound simulated ellipse dispersion volume in the observation group is much smaller than that in the control group [(2.51±0.41) cm 3vs. (1.91±0.55) cm 3, t=6.519, <0.001] The linear regression equation of the actual volume of the three-dimensional ultrasound in the observation group and the iPTH value in the observation group after 3 months is Y1=47.728+ 122.337X, r1=0.892, P<0.05. The linear regression equation of the two-dimensional ultrasound simulated ellipse diffusion volume in the observation group and the iPTH value in the observation group at 3 months after operation was Y2=121.408+ 81.736X, r2=0.883, P<0.05. Conclusion:Compared with intramuscular Tx, the recovery levels of iPTH, calcium, phosphorus and calcium-phosphorus product after the anterior fascia of the flexor carpus ultrasound-guided homogenate parathyroid glands injection Tx are similar, but its operation is more simple and diffusion volume is smaller.

Objective Medication for pituitary adenomas is mainly targeted on the prolactin-secreting and growth-hormone types and shows poor therapeutic effects on other adenomas .Therefore, new drugs urgently need to be developed for this purpose .This study was to investigate the effects of glivec and everolimus on mouse pituitary AtT-20 cells and their molecular mechanisms in vitro. Methods Mouse pituitary AtT-20 cells were incubated with glivec or everolimus or combination of both and their inhibitory effect on the proliferation of the cells was measured by CCK-8 assay.The mRNA levels of AKT and ERK were determined by q-PCR and the ex-pressions of the phosphorylated AKT (p-AKT) and ERK (p-ERK) were detected by Western blot. Results Used alone, both glivec and everolimus inhibited the proliferation of the AtT-20 cells in a time-and dose-dependent manner , but their combination produced a mutually antagonistic effect, with combination index values of 1.13 ±0.06, 1.12 ±0.03, and 1.07 ±0.03 respectively.The two a-gents , either used alone or in combination , induced no significantly inhibitory effects on the mRNA and protein expressions of AKT and ERK ( P >0.05 ).Both glivec and everolimus up-regulated the expressions of p-AKT and p-ERK, and their combination manifested an even stronger effect (P>0.05). Conclusion Both glivec and everolimus inhibit the proliferation of AtT-20 cells when administered alone, but their combination produces an antagonistic effect .Their action mechanism might be that when targeting some signaling path-ways to inhibit cell proliferation , glivec, as well as everolimus , in-duces a feedback activation of AKT and ERK .

Objective:To establish a model of mice breast cancer of 4T1 cells in BALB/c mice and choose the best model making method.Methods:Ninety mice were divided into three groups randomly ,with 30 in each group injected by 4T1 cells suspension of 1×106 ml-1 ,1×107 ml-1 ,1×108 ml-1 respectively.Each group of mice were randomly divided into two groups which were inoculated on the chest wall and lateral abdominal wall respectively.Tumor formation time ,tumor growth rate and the 8 week survival rate in each group were compared ,and pathological character was observed by C-erbB-2 immunohistochemistry staining.Results:Tumor growth rate in cells suspension of 1×107 ml-1 was high and grow steadily.Tumor growth rate wasn′t correlative with 4T1 cells injection in different parts.The result of C-erbB-2 immunohistochemistry staining was positive.Conclusion: Injection of 4T1 cells suspension with 1 ×107 ml-1 is the best way to male tumor model in three suspension.

Objective To investigate the distribution of gut microbiota in obese patients with or without acanthosis nigricans .Methods Totally 131 obese patients and 25 healthy participants were divided into three groups:the obesity with acanthosis nigricans (AN) group (n=59), the simple obesity (OB) group (n=79), and the control (CON) group (n=25).The fresh stool samples were collected , and the clinical and biochemistry markers were measured .Pyrosequencing technology was performed based on the 16s rRNA of fecal samples to identify and analyze the distribution pattern of gut microbiota in each group .Results The AN group had signifi-cantly higher body mass index [ (37.45 ±5.12) kg/m2 vs.(33.34 ±2.54) kg/m2 vs. (20.35 ±1.68) kg/m2, P=0.045, P<0.001], insulin [32.77 (25.18) mU/L vs.20.73 (9.30) mU/L vs.8.70 (6.18) mU/L, P<0.001, P<0.001], insulin resistance [7.78 (6.87) vs.4.71 (2.88) vs.1.81 (1.40), P<0.001, P<0.001], and interleukin (IL) -6 [ (3.64 ±2.23) ng/L vs.(2.71 ±0.78) ng/L vs.(2.17 ±0.86) ng/L, P=0.040, P=0.009] levels than OB and CON groups compared with OB and CON groups , AN group had sig-nificantly decreased diversity of bacterial flora ( P=0.015 , P=0.001 ) , while no significant difference was observed in the abundance of bacterial flora .At the phylum level , the composition of flora among these three groups was similar, mainly including bacteroidetes , firmicutes, proteobacteria, and actinomycetes.Although the proportions of main bacteria flora were different , the difference was not statistically significant .At the genus level, the bacteria flora in AN and OB groups were primarily composed of Bacteroides, Megamonas, Faecalibac-terium and Escherichia-Shigella.In addition, compared to OB and CON groups , AN group had significantly lower proportion of Ruminococcus ( P=0.023 , P=0.043 , respectively ) and higher proportion of Veillonella (P=0.048, P=0.043, respectively).Furthermore, the proportion of Weissella was higher in AN and OB groups than in CON group ( P=0.045 , P=0.025 ) .Conclusion Obese patients with AN have more severe in-sulin resistance and inflammation status than those with simple obesity , and the distribution feature of gut micro-biota also differ between these two patient populations .

To investigate the clinical efficacy of distally based myocutaneous flap pedicled with nutrient vessel of cutaneous nerve of leg for the treatment of traumatic chronic osteomyelitis of lower leg. A total of 25 patients with traumatic chronic osteomyelitis of lower legs were from Department of Burn and Plastic Surgery, Beijing Jishuitan Hospital from January 2002 to June 2008. All the patients were treated with distally based myocutaneous flap pedicled with nutrient vessel of cutaneous nerve of leg after thoroughly debridement. Among them, 6 patients were treated with myocutaneous flap with nutrient vessel of saphenous nerve, and 19 patients were treated with myocutaneous flap with nutrient vessel of sural nerve. The sizes of the flaps were 5 cm×3 cm-18 cm× 12 cm, with attached muscles were 3 cm×3 cm-8 cm×5 cm. The lengths of the pedicles were 5-12 cm. All transplanted myocutaneous flaps survived well. A 6-24 months follow-up of all patients was obtained. The shape and texture of the myocutaneous flaps were good. And there was no recurrence of osteomyelitis. Results suggested that the distally based myocutaneous flap pedicled with nutrient vessel of cutaneous nerve of leg had reliable blood supply and satisfied efficacy, which was a good method for repairing traumatic chronic osteomyelitis of lower leg.