Objective To evaluate the right ventricular (RV) systolic function in patients with systemic lupus erythematosus (SLE) by speckle tracking imaging (STI).Methods A total of 40 cases with SLE were divided into two groups,SLE (24 cases) and SLE complicated with pulmonary arterial hypertension (PAH) (16 cases).Meanwhile,35 healthy subjects were used as control group.Longitudinal peak systolic strain (PSS) of the basal,mid,apical segments of the free wall of right ventricular and interventricular septum and suben-docardial myocardium of the whole right ventricular were measured by STI respectively.Every parameter was compared.And the main factors affecting the strain of the whole right ventricule were analyzed.T test,one-way ANVOA,SNK-q,Spearman's correlation and Pearson's correlation analysis were used for statistical analysis.Results ① In SLE group,strains of the whole RV(GLS RV) [(-22±4)％] and all segments of RV wall[the basal segments of free wall (bas FW) (-27±8)％ were lower than that of the control group (-26±4)％,(-33±6)％,respectively (t=-4.815,P=0.000; t=-3.619,P=0.001)].Tricuspid valve orifice peak velocity E/A and right ventricular ejection fraction were significantly different between SLE group and control group (P＜0.05).② In terms of conventional parameters and the strain of all segments of RV wall,bas FW and GLS RV were different between the SLE group [(-30±7)％,(-23.7±3.5)％,respectively] and SLE with PAH group [(-22±6)％,(-18.4±2.3)％,respectively] (t=-3.581,P=0.001; t=-5.769,P=0.000).③ The RV anterior wall thickness of the moderate-severe subgroup was significantly higher than that of the mild group [(5.0±0.8) mm,(4.3±0.8) mm; t=-2.49,P=0.017].GLS RV[(-19±4)％,(-24±7)％;t=-3.016,P=0.015],bas FW [(-22±9)％,(-35±6)％; t=-3.125,P=0.03] and bas IVS [(-19±6)％,(-24±6)％; t=-2.272,P=0.029] were significantly lower than that of the mild group.Conclusion Right ventricular function is decreased in patients with SLE.STI can be used objectively to assess the right ventricular longitudinal systolic function.

Objective To develop transgenic mice harboring the fusion gene of mutant amyloid precursor protein and two types of fluorescent protein for the future study on Alzheimer's disease.Methods The fusion gene CFP-54 bp-YFP-C99 was introduced into mice by mieroinjection.The presence of CFP-54 bp-YFP-C99 was confirmed by PCR in the founders.Results CFP-54 bp-YFP-C99 gene was injected into pronucleus of 2202 zygotes and 1806 injected eggs were implanted into 56 foster mothers, 13 of which were pregnant.There were 13 foster mothers who borne 52 offspring and 32 of them survived.Recipient mouse pregnancy rate was 23.2% (13/56) and the integration rate was 3.9% (2/52).Conclusion CFP-54 bp-YFP-C99 transgenic mice is obtained, but the transgenic efficiency is low.

OBJECTIVETo investigate the expression and clinical significance of EphA7 protein in primary hepatocellular carcinoma.

METHODSImmunohistochemistry and Western blot were used to detect the expression of EphA7 protein in 40 cases of primary hepatocellular carcinoma, their corresponding adjacent liver tissues and 10 cases of normal liver tissues. The relations with its clinical pathological parameters were analyzed too.

RESULTSExpression of EphA7 protein was mainly located in the cytoplasm and the blood vessels of the septa, which was found in hepatocellular carcinoma tissues, their corresponding adjacent liver tissues and normal liver tissues. Western blot analysis showed that the expression level of EphA7 protein in hepatocellular carcinoma (0.58 +/- 0.26) was greater than that in corresponding adjacent liver tissues (0.40 +/- 0.22, P < 0.05) and normal liver tissues (0.32 +/- 0.16, P < 0.05). But it had no significant difference between corresponding adjacent liver tissues and normal liver tissues (P > 0.05). EphA7 protein expression was correlated with histological differentiation, tumor thrombi in portal vein, lymph node metastasis and high AFP level (P < 0.05).

CONCLUSIONSEphA7 protein expression is significantly correlated with the biological behavior of primary hepatocellular carcinoma. The high expression of EphA7 protein may play an important role in the malignancy transformation, invasion progression and metastasis of primary hepatocellular carcinoma.

Carcinoma, Hepatocellular ; metabolism ; pathology ; Humans ; Liver Neoplasms ; metabolism ; pathology ; Receptor, EphA7 ; metabolism

Autoimmune encephalitis (AE) is a novel form of encephalitis associated with antibodies to cell-surface or synaptic proteins. Epileptic seizures act as the predominant manifestation of AE which are triggered by interaction between kinds of antibodies and antigens on cell-surface or intracellular. Patients with AE-related epilepsy are insensitive to antiepileptic drugs but sensitive to immunotherapy. Early initiation of immunotherapy can significantly improve the prognosis. To date, there are few reports on the treatment plan of antiepileptic drug to the patients with AE-related epilepsy. In this review we report the most relevant data about the morbidity, pathogenesis and treatment of AE-related epilepsy with aim of providing better treatment options.

BACKGROUNDPortasystemic shunts, especially total shunts, are effective tools for reducing portal pressure and controlling variceal bleeding but lead to high risk of encephalopathy and accelerating liver failure. The purpose of this study is to evaluate the clinical effects of small-diameter expanded polytetrafluoroethylene (ePTFE) H-graft portacaval shunts in the treatment of portal hypertension.

METHODSThirty-one patients with portal hypertension were treated with ePTFE small-diameter H-graft portacaval shunts from December 1995 to April 2002. Twenty-one had externally ringed grafts and 10 had non-ringed grafts; 20 had 10 mm diameter grafts and 11 had 8 mm grafts. The left gastric artery and coronary vein were ligated in 22 patients. Additionally, 6 patients underwent pericardial devascularization, and splenectomies were performed on 30 patients.

RESULTSAn average decrease of free portal pressure (FPP) from (32.13 +/- 4.86) cmH2O before shunting to (12.55 +/- 5.57) cmH2O after shunting was observed. Portal blood flow was reduced by 1/3 compared with the levels measured before shunting. Twenty-eight patients survived after the operation, and no upper gastrointestinal rebleeding occurred in the follow-up period (40.2 months on average). We lost contact with one patient. Color Doppler ultrasonography and/or portography revealed the shunts to be patent in 28 cases and occluded in 2 (6.4%) cases. Encephalopathy developed in 4 patients (12.9%).

CONCLUSIONSmall-diameter ePTFE H-graft portacaval shunts can effectively reduce portal pressure. Moreover, the majority of the hepatopetal flow from the portal vein can be adequately maintained. The reinforced shunts may achieve a higher rate of patency. Morbidity from encephalopathy was less frequent than in patients receiving total shunts. Small-diameter H-graft portacaval shunts are also effective in preventing recurrent variceal bleeding.

Adult ; Blood Vessel Prosthesis ; Female ; Humans ; Hypertension, Portal ; surgery ; Male ; Middle Aged ; Polytetrafluoroethylene ; Portacaval Shunt, Surgical ; methods ; Treatment Outcome

INTRODUCTIONTreatment of acute lymphoblastic leukaemia (ALL) using intensive chemotherapy has resulted in high cure rates but also substantial morbidity. Infective complications represent a significant proportion of treatment-related toxicity. The objective of this study was to describe the microbiological aetiology and clinical outcome of episodes of chemotherapy-induced febrile neutropaenia in a cohort of children treated for ALL at our institution.

MATERIALS AND METHODSPatients with ALL were treated with either the HKSGALL93 or the Malaysia-Singapore (Ma-Spore) 2003 chemotherapy protocols. The records of 197 patients who completed the intensive phase of treatment, defined as the period of treatment from induction, central nervous system (CNS)-directed therapy to reinduction from June 2000 to January 2010 were retrospectively reviewed.

RESULTSThere were a total of 587 episodes of febrile neutropaenia in 197 patients, translating to an overall rate of 2.98 episodes per patient. A causative pathogen was isolated in 22.7% of episodes. An equal proportion of Gram-positive bacteria (36.4%) and Gram-negative bacteria (36.4%) were most frequently isolated followed by viral pathogens (17.4%), fungal pathogens (8.4%) and other bacteria (1.2%). Fungal organisms accounted for a higher proportion of clinically severe episodes of febrile neutropaenia requiring admission to the high-dependency or intensive care unit (23.1%). The overall mortality rate from all episodes was 1.5%.

CONCLUSIONFebrile neutropaenia continues to be of concern in ALL patients undergoing intensive chemotherapy. The majority of episodes will not have an identifiable causative organism. Gram-positive bacteria and Gram-negative bacteria were the most common causative pathogens identified. With appropriate antimicrobial therapy and supportive management, the overall risk of mortality from febrile neutropaenia is extremely low.

Candidiasis ; epidemiology ; Chemotherapy-Induced Febrile Neutropenia ; epidemiology ; microbiology ; Child ; Cohort Studies ; Escherichia coli Infections ; epidemiology ; Gram-Negative Bacterial Infections ; epidemiology ; Gram-Positive Bacterial Infections ; epidemiology ; Humans ; Influenza, Human ; epidemiology ; Klebsiella Infections ; epidemiology ; Mycoses ; epidemiology ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy ; Pseudomonas Infections ; epidemiology ; Retrospective Studies ; Singapore ; epidemiology ; Staphylococcal Infections ; epidemiology ; Virus Diseases ; epidemiology

OBJECTIVETo explore the effect of MDC1 gene silencing by RNA interference on the radiosensitivity of human esophageal carcinoma cell line ECA109.

METHODSThe vectors containing short hairpin RNA (shRNA) targeting MDC1 gene (pMDC1-shRNA) were cotransfected with pPACKH1-lentivector packaging system into 293T cells to package the lentivirus particles. Forty-eight hours after the transfection with specific or control lentiviral vectors, the stable integrants were selected using copGFP reporter gene; real-time RT-PCR and Western blotting were used to detect the expression levels of MDC1 mRNA and protein in the transfected ECA109 cells, respectively. The cell cycle distribution was measured with flow cytometry at 12, 24 and 48 h after a 5 Gy irradiation, and the radiosensitivity of esophageal carcinoma cell was evaluated by clone formation array.

RESULTSSequence analysis confirmed correct insertion of MDC1-shRNA construct into pSIH1-H1-copGFP. The percentage of G2/M phase ECA109/ MDC1 cells was lower than that of ECA109 and ECA109/negative cells. The value of D0, SF2 and Dq of ECA109/ MDC1 cells were 1.88 Gy, 0.84 and 1.20, respectively, lower than those of ECA109 cells (3.06 Gy, 0.91 and 1.59) and those of ECA109/negative cells (2.90 Gy, 0.89 and 1.47).

CONCLUSIONRNA interference can inhibit MDC1 gene expression and enhance the radiosensitivity of ECA109 cells in vitro.

Carcinoma, Squamous Cell ; genetics ; pathology ; Cell Line, Tumor ; Esophageal Neoplasms ; genetics ; pathology ; Gene Expression Regulation, Neoplastic ; Genetic Vectors ; Humans ; Nuclear Proteins ; genetics ; RNA Interference ; RNA, Small Interfering ; genetics ; Radiation Tolerance ; genetics ; Trans-Activators ; genetics ; Transfection

OBJECTIVE To explore the significance of intraoperative auditory monitoring(IAMA) in surgery of acoustic neuroma and to compare the value of auditory brainstem response(ABR) and cochlear nerve action potential(CNAP) in auditory monitoring.METHODS Retrospective analysis of 12 cases of acoustic neuroma from January 2016 to December 2016 was performed.All patients have a practical hearing(AAO-HNS,grade class a,b),the ABR waveform can be elicited,wave v differentiation,All tumors were removed via posterior sigmoid sinus approach.RESULTS ABR waveform of all patients were prolonged with different degrees of change(0.68±0.41) ms compared with the preoperative data.Amplitude of CNAP diverse in different individuals,with an average prolong compared to the data before operation(0.25±0.16) ms.In all 12 cases,8 (66.7％) patients remained usable hearing after the operation,4 cases(33.3％) failed to have a usable hearing.Among these 4 patients,3 showed disappearance of wave v,1 patient showed wave v latency prolong in the ABR,meanwhile,2 patients showed P1 dissapear,2 patients showed P1 latency prolong in CNAP.The intraoperative auditory monitoring could play a role in preventing the hearing damage in the procedure.Drilling,noise,surgical nerve stretch or thermal injury may cause the hearing damage.A 5 minutes pause could get some degree of regain,with the amplitude rise again.CONCLUSION A combination use of the ABR and CNAP monitoring has a certain significance in surgery of acoustic neuroma.ABR waveform is stable and reliable,but costs longer time;CNAP stack quickly and improve monitoring sensitivity,but waveform varies.Vibration and noise caused by drilling,nerve stretch during operation and heat damage can be monitored timely.Combined use of ABR and CNAP monitoring can enhance the auditory preservation rate during acoustic neuroma surgery.

OBJECTIVE To evaluate the application ofretrolabyrinthine approach in cerebellopontine angel(CPA) region surgeries.METHODS A total of 42 patients underwent microscopic-endoscopic cooperative surgeries for CPA lesions via retrolabytinthine approach were reviewed.They were hospitalized from January 1st 2011 to January 1st 2016 in our institution.The microscopic-endoscopic technique was applied in all surgeries.RESULTS Complete removal was obtained in all tumor resections and satisfactory symptom-relief was achieved in all microvascular decompressions and neurectomies.In cases with acoustic neuroma and cholesteatoma,useful hearing (AAO-HNS classes A,B and C) was obtained in 66.7％(6/9) patients.No facial paralysis and postoperative complications such as cerebrospinal fluid leakage occurred during follow-up.In cranial nerve rhizopathies cases,complete relief was achieved in all patients.No facial paralysis and other lower cranial nerve dysfunction occurred.CONCLUSION With the preservation of labyrinthine structures,the microscopic-endoscopic cooperative surgeries for CPA lesions via retrolabytinthine approach could increase the hearing preservation level without facial nerve injury.Retrolabyrinthine approach is a good option for cranial nerve rhizopathies and tumors smaller than 15 mm in diameter without involvement of the fundus of internal auditory canal in the CPA region.

OBJECTIVE To analyse the diagnosis of non-acoustic lesions in internal auditory canal(IAC) and cerebellopontine angle(CPA),and discuss the effects of imaging examinationon differential diagnosis.METHODS A retrospective study was carried out in 185 patients with non-acoustic lesions of IAC and CPA from January 2001 to December 2016,in which lower cranial schwannoma,facial nerve tumor,meningioma,cholesteatoma,malignant tumor,trigeminal schwannoma,cavernous hemangioma,arachnoid cyst,lipoma were diagnosed in 65,55,25,9,9,8,6,5 and 3 patients,respectively.All patients were performed surgeries,and preoperative diagnosis and surgical approach were decided according to clinical manifestation,CT and MRI findings.Postoperative diagnosis were confirmed by pathological examination.RESULTS Total removal of lesion was achieved in 185 patients [96 men and 89 women,11-77 years old,mean age (46.4±25.6) years] and mean follow-up time was (5.1 ±3.2) years.Postoperative complication was leakage of cerebrospinal (4 patients,2.2％).4 patients with malignancy were dead and 1 patient with cholesteatoma was found recurrent during the follow-up.All kinds of non-acoustic lesions in IAC and CPA had its characteristic imaging findings.Preoperative diagnostic accuracy rate was 93.5％(173/185).CONCLUSION Accurate preoperative diagnosis has great significance in developing treatment strategy for IAC and CPA lesions;Preoperative diagnosis should be achieved according to clinical manifestation,CT and MRI findings,which can significantly improve the accuracy rate of diagnosis.