Objective To investigate the flexibility of both the covered stents specially designed for use in intracranial vasculature and the delivering system in passing through the bone tube and the physiological curves of the cranial internal carotid artery(CICA)to reach the targeted area,the performance (adherence)of the covered stents in occluding vascular wall diseases and the impact on the vascular branches of the covered segment.Methods The covered stents specially designed for use in intracranial vaseulature were used to treat 13 patients with CICA diseases using endovascular techniques.There were 4 huge pseudoaneurysms,4 giant aneurysms,3 small wide-necked aneurysms,1 giant pseudoaneurysm with concurrent internal carotid cavernous fistula(CCF),and 1 CCF.Prior to the detachment of the covered stents,balloon occlusion test(BOT)of the internal carotid artery on the diseased side and whole-brain digital subtraction angiography(DSA)were performed in all the patients.Three to 16 months following procedure,DSA and clinical follow-ups were performed.Results Thirteen patients all tolerated the BOT well with the DSA demonstrating well-opened anterior and posterior communicating arteries.The covered stents and the delivering systems all successfully passed CICA to reach the targeted diseased area,with the diseased segments of the internal carotid artery including C3—C4 in 4 cases,C4—C5 in 4 and C6—C7 in 5.Immediately following the detachment of the covered stents,DSA demonstrated that 7 aneurysms were completely occluded,4 aneurysms had slight endoleak,and 1 CCF had markedly-decreased blood flow through the fistula.In the patient with concurrent pseudoaneurysm and CCF,the pseudoaneurysm disappeared and the blood flow through the fistula was markedly-reduced immediately following the stenting procedure.Apart from one patient with aneurysmal subarachnoid hemorrhage who died due to extensive vascular spasm on the 9th day following the stenting procedure,all the other 12 patients had unobstructed stented vessels on the follow-up DSA images,with 2 demonstrating slight stenosis.In the 6 patients with post-procedure endoleak,DSA showed that the endoleak in 4 patients had disappeared,one endoleak disappeared following the second stenting,and one CCF remained low-flow fistula.There was no sequela related to the occlusion of branches in the covered arterial segment.Conclusion The covered stents specially designed for use in the intracranial vasculature and the delivering system are both flexible enough to pass the tortuous CICA to reach the intracranial diseased artery,and are effective in managing CICA diseases.Further follow-up is still needed to determine the long-term effect of the covered stents,and the adherence of the covered stents needs further investigation.

Objective To summarize our experience on the food safety for residents and disaster relief workers in Li county after Wenchuan earthquake in Sichuan province.Methods A comprehensive survey was conducted to assess the current food hygiene status.According to the survey results,we had integrated the local forces and strengthened the food hygiene surveillance and quality detection focusing on the crucial procedures.Besides,effective health educations were applied to advocate the rational dietary after earthquake.Results There was no any food safety incident in the county,and the hygiene awareness of local residents has been improved.Conclusion Powerful organization,focused management and multi-collaboration are the important elements to accomplish the food safety control after earthquake.

Objective To compare metabolite ratios in the basal ganglia regions between preterm and term neonates and analyze the correlation between metabolite ratio and postmenstrual age(PMA)using 2D magnetic resonance spectroscopy(MRS)at 3.0T,so as to explore the value of MRS in evaluating neonatal brain development.Methods Normal neonates who underwent 3.0T MRS exam ination were recruited.Axial 2D MRS was performed with the point-resolved spectroscopy sequence(PRESS)(echo time/repetition time,144 ms/1 000 ms) through the basal ganglia covering three regions of interest(ROI)(i.e.bilateral lenticular nucleus,thalamus and white matter beside the anterior horn of lateral ventricle).The peak areas ratios of Cho/Cr,NAA/Cho and NAA/Cr were calculated.Metabolite ratios were compared between preterm and term neonates,and between three ROIs. Correlation between metabolite ratio and PMA was further analyzed.Results Totally 54 neonates were included(preterm/term,27/27).In all the three ROIs,preterm neonates presented significantly higher Cho/Cr(P＜0.05) and significantly lower NAA/Cho ratios(P＜0.001)than those of term neonates;higher NAA/Cr ratio was only observed in the lenticular nucleus of preterm neonates(P＜0.001).Significant differences in metabolite ratios were detected among the three ROIs in preterm group(P＜0.05).For term group,metabolite ratios differed between lenticular nucleus and white matter beside the anterior horn of the lateral ventricle(P＜0.01),while no difference between lenticular nucleus and thalamus was found(P＞0.05).Significant correlation between metabolite ratio and PMA was found in all the three ROIs except NAA/Cr ratio in the white matter beside the anterior horn of the lateral ventricle.To be specific,we found linear negative correlation of Cho/Cr ratio(r= -0.325,-0.633,-0.438) and positive correlation of NAA/Cho ratio(r = 0.604,0.773,0.483)in all the three ROIs,but negative correlations of NAA/Cr ratio(r=0.487,0.367)in lenticular nucleus and thalamus with PMA.Conclusion Our findings suggest the tempo-spatial pattern of neonatal brain metabolite development in terms of anatomic location and PMA.Besides,the multi-voxel MRS presents potentials in establishing the normal topologic and age-matched reference in neonates and thus making brain maturation assessment and detection of early abnormal metabolism.

OBJECTIVETo evaluate the efficacy and safety of video-assisted thoracoscopic (VATS) esophagectomy in the treatment of esophageal cancer.

METHODSFrom June 2004 to October 2007, video-assisted thoracoscopic esophagectomy was performed in 36 patients, including 29 men and 7 women with median age of 58.9 years old. The cancer located at upper segment in 5 cases, middle 25 cases and lower 6 cases. VATS approach was used to mobilize the intrathoracic esophagus and stomach was mobilized by open approach. Esophagogastric anastomosis was performed in the left neck.

RESULTSThe mean operative time was 250 minutes (190-330 min) and average time of VATS was 70 minutes. The mean hospital stay was 8.7 days. Mean lymph node harvest was 14.3 nodes. Post-operative complications occurred in 11 patients(30.6%), but no perioperative death occurred.

CONCLUSIONVideo-assisted thoracoscopic esophagectomy is technically feasible and safe with lower morbidity and shorter hospital stay as compared to open procedure, and may replace the open esophagectomy in selected patients.

Esophageal Neoplasms ; surgery ; Esophagectomy ; methods ; Female ; Humans ; Male ; Middle Aged ; Thoracic Surgery, Video-Assisted

OBJECTIVETo study the clinicopathologic features and immunophenotype of renal cell carcinomas, and to discuss their diagnostic value.

METHODSThe clinicopathologic features of 114 cases of renal cell carcinoma were reviewed and categorized on the basis of 2004 WHO classification. Immunohistochemical study for a panel of antibodies (including CK, CD10, vimentin, CD117, AMACR, CK7 and TFE3) was carried out. The follow-up data, if available, were also analyzed.

RESULTSThe cases were reclassified into 5 subtypes, including 77 cases (67.5%) of clear cell carcinoma (CCRCC), 11 cases (9.6%) of papillary renal cell carcinoma (PRCC), 14 cases (12.3%) of chromophobe renal cell carcinoma (chrRCC), 10 cases (8.8%) of renal carcinoma associated with Xp11.2 translocations/TFE3 gene fusions (Xp11.2RCC) and 2 cases (1.8%) of unclassified renal cell carcinoma (unRCC). Immunohistochemical study showed that the expression rates of CK, CD10 and vimentin in CCRCC were 93.5% (72/77), 93.5% (72/77) and 75.3% (58/77), respectively. On the other hand, all the 11 cases of PRCC studied were positive for AMACR. The expression rate of CD117 in chrRCC was 78.5% (11/14). In the 10 cases of Xp11.2 RCC studied, the expression rates of TFE3, AMACR, CD10 and CK were 100% (10/10), 100% (10/10), 90% (9/10) and 70% (7/10), respectively.

CONCLUSIONSThe various subtypes of renal cell carcinomas are heterogeneous in histologic appearance and demonstrate distinctive immunophenotype. The expressions of CD10, vimentin, CD117, AMACR, CK7 and TFE3 are helpful in the differential diagnosis.

Adenocarcinoma, Clear Cell ; pathology ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Basic Helix-Loop-Helix Leucine Zipper Transcription Factors ; genetics ; immunology ; metabolism ; Biomarkers, Tumor ; analysis ; genetics ; Carcinoma, Papillary ; immunology ; pathology ; Carcinoma, Renal Cell ; immunology ; metabolism ; pathology ; Female ; Gene Fusion ; Humans ; Immunophenotyping ; Kidney Neoplasms ; immunology ; metabolism ; pathology ; Male ; Middle Aged ; Neprilysin ; analysis ; Racemases and Epimerases ; analysis ; genetics ; Translocation, Genetic ; Vimentin ; analysis ; World Health Organization ; Young Adult

OBJECTIVETo evaluate the clinical value of HER2 overexpression in breast cancer and its prognostic implication in patients with lymph node negative breast carcinoma.

METHODSThe following electronic database were extracted using appropriate inclusive and exclusive standards: Cochrane library, PUBMED, Embase (1984 - 2003), OVID, CMCC and CNKI. Excel and RevMan 4.2 were used for statistical analysis.

RESULTSFifty-six articles were extracted to calculate the positive rate of HER2 overexpression. The pooled positive rate was 23.14% [19.54%, 26.73%], with positive immunohistochemistry (IHC) rate of 23.13% [19.49%, 26.77%] and positive FISH rate of 20.90% [15.54%, 26.25%]. Seven articles were used to evaluate prognostic predication of HER2 expression. It was concluded that in patients with lymph node negative breast carcinoma, HER2 overexpression (both IHC and FISH) independently predicted a poor prognosis based on disease-free survival (DFS) and overall survival (OS) with a P < 0.05. For DFS, the pooled RR was 1.38 [1.07, 1.80] with 1.16 [1.02, 1.31] for IHC and 1.98 [1.56, 2.52] for FISH. For OS, the pooled RR was 1.58 [1.16, 2.14] with 1.37 [1.14 to 1.64] for IHC and 2.33 [1.45 to 3.75] for FISH. HER2 overexpression effectively predicted DFS/OS of patients without adjuvant therapy and OS of patients with the therapy, but not for DFS, with the pooled RR of 1.46 [1.02, 2.09] and 1.11 [0.95, 1.31] for DFS, respectively and the pooled RR of 1.93 [1.44 to 2.58] and 1.25 [1.01, 1.56] for OS, respectively.

CONCLUSIONSIn patients with lymph node negative breast carcinoma, the positive rate of HER2 overexpression is 23.14%. HER2 overexpression indicates a poor prognosis and adjuvant therapy after surgery should be recommended.

Breast Neoplasms ; genetics ; metabolism ; pathology ; therapy ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Female ; Genes, erbB-2 ; Humans ; Lymph Nodes ; pathology ; Mastectomy ; Prognosis ; Receptor, ErbB-2 ; metabolism ; Survival Rate

Objective To observe the clinical efficacy and adverse drug reactions of recombinant human growth hormone on dwarfism in children with primary nephrotic syndrome.Methods Children with dwarfism in primary nephrotic syndrome were divided into control group and treatment group.Patients in control group were orally administered prednisone acetate tablets,with an initial dose of 2 mg·kg-1·d-1,at once,no more than 60 mg in a single day,and after a duration of 6 weeks of full dosage,the dosage was reduced by 2.5 mg every 2 weeks until the maintenance dose of 5-10 mg·d-1 was administered for 12 months.Patients in treatment group were injected subcutaneously with recombinant human growth hormone 0.15 U·kg-1 at 0.5 h before bedtime every night on the basis of control group for a period of 12 months.The levels of height,bone age,standard deviation fraction of height(HtSDS),insulin-like serum growth factor 1(IGF-1),insulin-like growth factor binding protein 3(IGFBP-3),and the incidence of adverse drug reactions were compared between the two groups.Results There were 63 cases in control group and 63 cases in treatment group.The height of the children in treatment group and control group after treatment were(146.48±6.76)and(138.62±4.95)cm;the HtSDS values were-1.72±0.18 and-1.97±0.20;the IGF-1 values were(158.86±18.24)and(113.14±15.88)ng·mL-1;IGFBP-3 values were(5.21±0.83)and(3.13±0.71)μg·mL-1,the differences were all statistically significant(all P＜0.05).The incidence of adverse drug reaction in treatment group and control group were 9.52％(6 cases/63 cases)and 3.17％(2 cases/63 cases),with no statistically significant difference(P＞0.05).Conclusion Recombinant human growth hormone has a definite clinical efficacy,high safety,and effective promotion of growth and development in the treatment of primary nephrotic syndrome in children with dwarfism.

Angioplasty, Balloon, Coronary ; adverse effects ; methods ; Drug-Eluting Stents ; Humans ; Paclitaxel ; therapeutic use

OBJECTIVETo explore the effects of bone mesenchymal stem cells (BMSCs) in restoring the functions of degenerative nucleus pulposus cells (dNPCs).

METHODSThe animal models of degenerative nucleus pulposus were established by means of acupuncture and aspiration. The BMSCs as well as the normal and degeneratived nucleus pulposus cells of SD rats were isolated and cultured. The BMSCs/alginate gel complex and dNPCs/alginate gel complex were used for indirect co-culture in vitro, which was set as experiment group. The NPCs and dNPCs cultured alone as positive and negative controls. The cell growth conditions were observed by light microscopy, and suitable cells were selected to combine alginate gel stents and cultured in transwell plate. Seven days later, nucleus pulposus cells of each group were recycled, and the mRNA expressions of Collagen2, SOX 9, and Aggrecan were detected by RT-PCR, and the Collagen1, 2, and Aggrecan were detected by Western blotting and immunofluorescence.

RESULTSAfter non-contact co-culture for 7 days, the mRNA levels of Collagen2, SOX 9, and Aggrecan increased apparently in BMSCs+dNPCs group, while it was significantly lower in dNPCs sample (all P<0.05). The content of Collagen2 and Aggrecan detected by Western blotting in BMSCs+dNPCs group got close to NPCs sample, but it was significantly higher than dNPCs samples (all P<0.05), while the content of Collagen1in BMSCs+dNPCs group got close to NPCs samples, but it was significantly lower than dNPCs sample (P<0.05). Immunofluorescence results showed that cytoplasm was dyed red and the color near the caryon became dark in BMSCs+dNPCs group and dNPCs group;however, the colored scope of cytoplasm and the dark colored scope surrounding the caryon in BMSCs+dNPCs group was obviously larger than dNPCs group.

CONCLUSIONUnder a 3D non-contact co-culture system, BMSCs can promote the expression of epimatrix of the dNPCs, which shows that BMSCs can restore the functions of dNPCs of intervertebral disc to certain extent.

Animals ; Bone Marrow Cells ; physiology ; Cells, Cultured ; Coculture Techniques ; Intervertebral Disc ; cytology ; pathology ; Mesenchymal Stromal Cells ; physiology ; Rats ; Rats, Sprague-Dawley

OBJECTIVE: To investigate the clinical features and outcome of neonatal acute respiratory distress syndrome (ARDS) in southwest Hubei, China. METHODS: According to the Montreux definition of neonatal ARDS, a retrospective clinical epidemiological investigation was performed on the medical data of neonates with ARDS who were admitted to Department of Neonatology/Pediatrics in 17 level 2 or level 3 hospitals in southwest Hubei from January to December, 2017. RESULTS: A total of 7 150 neonates were admitted to the 17 hospitals in southwest Hubei during 2017 and 66 (0.92%) were diagnosed with ARDS. Among the 66 neonates with ARDS, 23 (35%) had mild ARDS, 28 (42%) had moderate ARDS, and 15 (23%) had severe ARDS. The main primary diseases for neonatal ARDS were perinatal asphyxia in 23 neonates (35%), pneumonia in 18 neonates (27%), sepsis in 12 neonates (18%), and meconium aspiration syndrome in 10 neonates (15%). Among the 66 neonates with ARDS, 10 neonates (15%) were born to the mothers with an age of ≥35 years, 30 neonates (45%) suffered from intrauterine distress, 32 neonates (49%) had a 1-minute Apgar score of 0 to 7 points, 24 neonates (36%) had abnormal fetal heart monitoring results, and 21 neonates (32%) experienced meconium staining of amniotic fluid. Intraventricular hemorrhage was the most common comorbidity (12 neonates), followed by neonatal shock (9 neonates) and patent ductus arteriosus (8 neonates). All 66 neonates with ARDS were treated with mechanical ventilation in addition to the treatment for primary diseases. Among the 66 neonates with ARDS, 10 died, with a mortality rate of 15% (10/66), and 56 neonates were improved or cured, with a survival rate of 85% (56/66). CONCLUSIONS Neonatal ARDS in southwest Hubei is mostly mild or moderate. Perinatal asphyxia and infection may be the main causes of neonatal ARDS in this area. Intraventricular hemorrhage is the most common comorbidity. Neonates with ARDS tend to have a high survival rate after multimodality treatment.
China ; Female ; Humans ; Infant, Newborn ; Meconium Aspiration Syndrome ; Pregnancy ; Respiratory Distress Syndrome, Newborn ; Retrospective Studies