Objective To discuss the clinical value of partial splenic embolization in the treatment of schistosomial hypersplenism. Methods Peripheral partial splenic embolization using gelatin sponge (gelfoam) was performed in 17 cases of schistosomial hypersplenism. Results The amount of devascularized parenchyma was 50%~75% (mean, 59%). Postoperative follow-up was conducted for 6~29 months (mean, 16.9 months) in all the 17 cases. The leucocyte count was elevated significantly on the latest follow-up (5.74?1.31?109/L), as compared with the preoperative value (2.19?0.73?109/L) (t=11.86,P=0.000). The platelet count was significantly higher on the latest follow-up (106.18?30.92 ?109/L) than before the embolization (31.29?14.09?109/L) (t=8.28,P=0.000). No severe complications were seen. Conclusions Partial splenic embolization in the treatment of schistosomial hypersplenism is safe and effective, but its long-term effects remain a question to be answered through further research.

Objective To evaluate the clinical application of partial splenic embolization in the treatment o hypersplenism caused by schistosomiasis. Methods Twenty four patients with hypersplenism caused by schistosomiasis were treated with peripheral partly splenic embolization with gelf.oam. The counts of white blood cell(WBC) and platelet (PLT) were compared between pre-and post-splenic embolization. Results The extent of splenic embolization were 50% - 75%(mean 59.24%) with post-therapeutic follow-up of 6 months ~ 2 years, showing significant increase of WBC count with preoperative, peak and the latest follow-up counts as (2.15?0.67)?109/L, (12.36?3.24)?109/L and (5.65?1.38)?109/L respectively(t = 11.08, P

Objective To explore the efficacy of calmodulin antagonist berbamine(BBM)on multidrug resistance(MDR)reversal and its mechanism. Methods Human breast cancer cell line MCF7 and its adriamycin-resistant counterpart MCF7/ADR were used in the study.The cells were cultured with ADR and different concentration of BBM. MTT assay was used to analyze the effect of BBM on cell growth inhibition.According to the MTT assay,the 50% inhibitory concentration(IC 50 ),the multiples of drug resistance and increased sensitivity of ADR were calculated.The concentration of intracellular ADR and expression level of P-glycoprotein(P-gp)were detected by flowcytometry(FCM).The mRNA expression level of mdr1 gene was detected by semi-quantitative reverse transcriptase polymerase chain reaction(RT-PCR)with ?-actin as internal reference. Results The IC 50 of ADR in MCF7 and MCF7/ADR cells were(0.98?0.06)?mol/L and(101.20?5.72)?mol/L,respectively.The resistant multiple of MCF/ADR cells to ADR was 103 folds higher than that of MCF7 cells.BBM increased the chemo-sensitivity of ADR in MCF7/ADR cells with dose-dependent relationship,i.e.when 5*!?mol/L ,10*!?mol/L and 20*!?mol/L BBM was added into the culture the chemo-sensitivity of ADR was increased to 2.76,5.88,and 28.26 folds(P

ObjectiveTo investigate the delineation of gross tumor volume (GTV) in locally advanced nasopharyngeal carcinoma (LANC) according to imageological changes before and after induction chemotherapy (IC) in order to decrease high dose area and protect normal tissue better.MethodsBetween Mar 2010 to Jan 2011,11 patients with LANC were enrolled and treated with TPF regimen followed by intensity-modulated radiotherapy (IMRT) with concurrent chemotherapy,target volumes were delineated based on fused CT imaging before and after IC following project determination.Tumor target volumes after and before IC were respectively delineated according to imaging tumor residues and were overlaid by CTVnx in order to ensure radical doses for the imaging tumor volume before IC,the resulting differences of tumor target volumes of IC before and after were measured and analyzed by paired t-test.ResultsBefore and after IC,the average volumes of GTVnx were respectively 44.72 cm3 and 28.87 ( t =3.89,P =0.003 ),the average volumes of GTVnd were respectively 32.76 cm3 and 19.82 cm3 ( t =2.47,P =0.033 ),the volumes of maximum dose area in brainstem and spinal cord as well as eyeball decreased ( t =2.93-4.59,all P ＜0.05).ConclusionsLANC treated by 3 cycle TPF regimen followed by IMRT with concurrent chemotherapy showes significant shrinkage of tumor volume.The volume of high dose region which caused by normally recovered tissues were decreased by re-delineation of target volume in brainstem and spinal cord as well as eyeball of CT images after IC.

Objective To describe the clinical features, differential diagnosis and therapeutic method of Madras motor neuron disease (MMND) to improve the understanding of MMND. Methods We retrospectively summarized the clinical data of 3 MMND patients. and conducted the related literature review to compare the similarities and differences on clinical features between our cases and foreign MMND patients. Results Patients in the present study were adult-on?set without definite family history. The main manifestations were multiple lower cranial nerve palsies along with weakness and wasting of proximal limbs. Bifacial palsy and dysarthria were most presented in patients, while definite hearing im?pairment was rarely seen. Two patients had fasciculation and atrophy in tongue and one presented with dysphagia. Weak?ness and atrophy were more frequently presented in upper extremities than in lower limbs. All patients had signs of upper motor neuron damage. The level of creatine kinase (CK) moderately increased in one case. Electromyography (EMG) de?tected a widespread neuronal damage in all patients. MMND should be differentiated from Amyotrophic Lateral Sclerosis, Kennedy Disease and Brown–Vialetto–van Laere Syndrome. Intravenous immunoglobulin therapy showed effective in some cases to some extent. Compare to foreign MMND patients, bifacial weakness at onset was more frequently presented in our patients, but hearing impairment was absent. Conclusion The clinical features of MMND include weakness and at?rophy of limbs, involvement of facial and bulbar muscles, pyramidal dysfunction and hearing impairment. Some clinical manifestations of our patients are different from foreign MMND patient.

Objective To analyze the clinical features of 35 cases of Kennedy's disease and the correlation be?tween clinical features and CAG repeat size to strengthen the understanding of KD and to avoid misdiagnosis and delayed diagnosis.Methods Clinical data, including clinical signs and symptoms ,serum lipid, serum sex hormone level, electro?myography, the number of CAGs and (amyotrophic lateral sclerosis muscular atrophy,ALS) rating scale were collected from 35 patients genetically diagnosed of Kennedy disease and proceed system analysis. Results Patients with KD were adult onset with the average age of (40.77 ± 8.57) years and the average confirmed course were (8.32 ± 4.17) years. Forty-two point nine percent of the patients had family history. Clinical features included medulla oblongata and spinal muscular atrophy and weakness, limbs tremor, perioral muscles twitch and endocrine function and metabolic disorders in some cases. Creatine kinase, triglyceride, low density lipoprotein, follicle estrogen and prolactin were significantly in?creased compared to healthy adults (P:0.000,0.018,0.000,0.000,0.003). The number of CAG repeat was negatively correlated with the onset age (r=-0.549, P=0.001) but not associated with the illness severity (ALS rating scale) (r=0.001, P=0.998). ALS score was negatively correlated with course of disease(r=-0.540, P=0.001).Conclusions Chinese KD pa? tients share similar clinical phenotypes with those of other races but exhibit slightly different clinical characteristics. The length of the CAG repeat influences age at onset but not the severity of disease. Severity of disease is related to the course of disease.

Objective:To explore the clinical characteristics and prognostic risk factors of accidental injuries in pediatric intensive care unit(PICU).Methods:The children with accidental injuries admitted to the PICU at Shanghai Children′s Hospital from January 2017 to December 2019 were analyzed retrospectively.The patients were divided into survival group and death group according to outcome.We collected the patients′ clinical data and laboratory indexes, and analyzed the differences between two groups.Multivariate Logistic regression was used to screen the risk factors of death and receiver-operating characteristic(ROC)curve was used to determine the threshold.Results:(1)A total of 253 children were included, accounting for 5.2% of PICU hospitalization during the same period.There were 137 males(54.2%)and 116 females(45.8%), with an average age of 45(19, 96)months.The top three causes of accidental injuries were fall injury in 82 cases(32.4%), traffic accident in 70 cases(27.7%)and foreign body in 39 cases(15.4%). There were 22 cases of deaths, with a fatality rate of 8.7%.(2)The mean arterial pressure at admission in the death group was lower than that in the survival group( P<0.05), and the total length of stay was longer( P<0.001). There were significant differences in Glasgow coma scale, Pediatric Risk of Mortality Scoring Ⅲ(PRISM Ⅲ)between the two groups( P<0.001). In the death group, and the blood lactic acid(LA) significantly increased( P<0.001), hemoglobin and fibrinogen were lower than those in the survival group, the activated partial thromboplastin time and prothrombin time(PT)were significantly prolonged( P<0.001). (3)Multivariate Logistic regression analysis showed that PRISM Ⅲ score, LA and PT were independent risk factors for the death of accidental injuries.The area under curve(AUC)of PRISM Ⅲ score was 0.987(95% CI 0.976-0.999, P<0.001)and the cut-off value was 11 with a sensitivity of 100% and a specificity of 95.7%.The AUC of LA was 0.886(95% CI 0.810-0.961, P<0.001)and the cut-off value was 3.1 mmol/L with a sensitivity of 85.7% and a specificity of 77.3%.The AUC of PT was 0.835(95% CI 0.730-0.941, P<0.001)and the cut-off value was 13.9 s with a sensitivity of 86.6% and a specificity of 72.7%. Conclusion:The main accidental injuries in PICU of our hospital in the past three years are falling injuries, traffic accidents and foreign body injuries.PRISM Ⅲ score, LA and PT at admission are independent risk factors for predicting death.

Phyllanthus emblica L.is related to traditional tibetan medicine,containing diversified pharmacological and physiological functions,such as anti-tumor effects,anti-inflammatory effects,anti-oxidation funtions,slow down in glycemia and blood pressure and the prevention of cardio-cerebral vascular diseases,etc.In this study,the research progress on the anti-tumor efficacy of monomer compounds and the extraction of Phyllanthus emblica L.were reviewed,providing references for the anti-tumor studies of Phyllanthus emblica L.

Objective:To investigate the effect of astaxanthin on the refractive status and pathological morphology of the guinea pig myopia models induced by concave lens,and to elucidate the improvement effect of astaxanthin on the refractive status of myopia.Methods:A total of 48 healthy guinea pigs were randomly divided into blank control group (n=12) and model group (n=36);the guinea pig myopia models (right eyes) were established with far vision optical method (left eyes were used as control).The guinea pig models were divided into model control group,high of astaxanthin (50 ig · kg-1) group and low dose of astaxanthin (25 ig · kg 1) group.After 2 and 4 weeks treatment,the diopters and the lengths of optic axis of both eyes of each guinea pig in various groups were tested,and at 4 weeks the right eyes of the pigs were removed and the pathomorphology was observed by HE staining.Results:The diopters of the model eyes in model group were lower than those of left eyes used as control (P＜0.05) and those of right eyes in blank control group after 2 and 4 weeks (P＜0.05 or P＜0.01).The length of optic axis of the model eye in model group was increased compared with left eye used as controls and blank control group after 2 weeks (P＜0.05) and especially at 4 weeks (P＜0.01).Compared with model group,the axial oculi and diopters of the guinea pigs in astaxanthin groups were increased (P＜0.05);the pathohistological changes were improved,the collagen fracture was obviously decreased,and the collagen fibers were orderly arranged.Conclusion:Astaxanthin can recover the length of optic axis,diopter and histomorphology of sclera of guinea pig myopia models in some extents.

Objective:To observe and analyze the changes of macular retinal thickness and related factors in children with occult myopia.Methods:A prospective longitudinal control study. From February 2021 to February 2022, 120 eyes of 60 children who first visited Department of Ophthalmology of The Affiliated Hospital of Chengde Medical College without any corresponding myopia correction treatment were included in the study. There were 32 males (64 eyes) and 28 females (56 eyes), with the age of 4-6 years. Visual acuity, medical optometry, corneal topography, spectral-domain optical coherence tomography (OCT) and axial length (AL) were measured at the first visit and 3, 6, 9 and 12 months. The children were divided into occult myopia group with 60 eyes of 30 cases and control group with 60 eyes of 30 cases according to visual acuity, equivalent spherical refraction (SE), AL and corneal curvature (CC). The macular fovea retinal thickness was measured by spectral-domain OCT enhanced deep imaging technique. According to the treatment and study of diabetic retinopathy, the retina within the 6 mm of the macular center was divided into three concentric circles with the macular fovea as the center, the central fovea of 1 mm, the inner ring of 1-3 mm and the outer ring of 3-6 mm. In the inner ring and outer ring, the retina was divided into 4 areas, upper and lower, left and right, with a total of 9 regions. The four regions of the inner ring and the outer ring were superior, inferior, nasal and temporal, respectively. The differences of AL, CC, SE, macular retinal thickness and the changes of related factors with time were compared between the occult myopia group and the control group. SE, AL, CC and retinal thickness in different macular regions of the two groups were compared by repeated measurement analysis of variance. In pairwise comparison, the minimum significant difference t test was used in different measurement time points, and the independent sample t test was used between groups at the same measurement time points. Results:At first diagnosis and after diagnosis, there were significant differences in SE ( F=783.710), AL ( F=742.192), macular fovea ( F=330.292), inferior and temporal ( F=158.250, 108.292) side of the outer ring retinal thickness in occult myopia group ( P <0.01). In the control group, there were significant differences in the retinal thickness of SE ( F=1 793.976), AL ( F=457.362), macular fovea ( F=31.029), inferior and temporal ( F=7.405, 77.245) side of the outer ring retinal thickness ( P<0.01). In both groups, with the prolongation of the time after the first diagnosis, the SE gradually increased, the AL gradually lengthened, and the thickness of the macular fovea, inferior and temporal side of the outer ring retinal thickness gradually thinned. Independent sample t test was performed on the data with differences between groups at the same time, and the results showed that at 3, 6, 9 and 12 months after first diagnosis, there were significant differences in SE, AL and CC between the occult myopia group and the control group ( t=-4.801,-11.532, 16.276, -17.145), AL ( t=24.203, 26.353, 27.057, 25.552); CC ( t=-23.362, -25.382, -25.890, -24.350; P<0.01). There were significant differences in macular fovea, inferior and temporal side of the outer ring retinal thickness at 6, 9 and 12 months, macular fovea ( t=-2.596, -2.542, -2.941; P<0.05), outer ring temporal ( t =-2.285, -2.610, -2.506; P<0.05). Conclusion:The SE and AL of the occult myopia group and the control group increase with time, and the former increase more rapidly than the latter; the macular fovea, inferior and temporal side of the outer ring retinal become thinner, and the former become thinner than the latter.