Acute Disease ; Adolescent ; Adult ; Electromyography ; Female ; Humans ; Male ; Middle Aged ; Nervous System Diseases ; chemically induced ; diagnosis ; Organophosphate Poisoning ; Pesticides ; poisoning

Group A β-hemolytic streptococcus (GAS),namely Streptococcus pyogenes,is one of the most im-portant human pathogen.GAS can cause skin and mucous membrane superficial infectious diseases,life -threatening invasive disease,toxin -mediated diseases and immune -related diseases.Antibiotic is an effective mean to control GAS infection.The β-lactam antibiotics remain the first -choice treatment for GAS infection and the macrolides are often recommended as a replacement therapy for β-lactam antibiotics allergic patients or a means to blocking GAS exotoxin product.But with the widespread use of macrolides autibiotics,macrolide -resistant GAS spread in the world. This paper will elaborate the situation of macrolide -resistant clones.

Objective To investigate the relationships among cerebellar mutism (CM), relapsed medulloblastoma (MB) and the primary tumor location.MethodsA retrospective analysis was conducted in 114 children over 3 years old with MB from November 2011 to April 2015.ResultsThe median onset age was 84.7 months (36.4 to 184.7 months) in 114 children with MB (77 boys and 37 girls), of whom there were 48 cases of recurrence. There were twenty two cases of CM and the overall incidence of CM was 19.3% (22/114). The incidence of CM was 19.7% (13/66) in non-recurrent cases and 18.8% (9/48) in recur-rent cases, and there was no signiifcant difference between two groups (P=0.899). The incidence of CM was 17.6% (9/51) in cas-es with primary tumor in the fourth ventricle, 7.1% (1/14) in cases with primary tumor in the cerebellar vermis, 21.4% (3/14) in cases with primary tumor in both fourth ventricle and cerebellar vermis, 45.5% (5/11) in cases with primary tumor in fourth ven-tricle and other parts of the brain, and 50.0% (4/8) in cases with primary tumor in cerebellar vermis and other parts of the brain. No CM incidence was observed in cases with primary tumor in central nerve system except for the fourth ventricle and cerebellar vermis. The incidence of CM between the cases with fourth ventricle/cerebellar vermis involvement and those without fourth ventricle/ cerebellar vermis involvement had signiifcant difference (P=0.039). ConclusionsThere is no relationship between CM and relapsed MB. Children with MB whose primary tumor is located in the fourth ventricle and/or the cerebellar vermis is susceptible to CM.

Objective To investigate the clinical characteristics of children with medulloblastoma (MB). Methods The correlations amongst MB histopathological subtype,age at diagnosis,gender,primary tumor locations, relapsed tumor and relapsed tumor locations were analyzed retrospectively in 83 children who were diagnosed as MB by histopathology subtypes from February 2012 to April 2015 in Beijing Shijitan Hospital Affiliated to Capital Medical Uni-versity.The data was conducted by using SPSS 22.0 statistical software.Results Among the 83 cases (53 boys and 30 girls),there were 14 patients younger than 3 years old (9 boys and 5 girls)and 69 patients (44 boys and 25 girls)ol-der than 3 years old,including 28 relapsed (19 boys and 9 girls)and 55 non -relapsed cases (34 boys and 21 girls). The median age was 80.2 (13.1 -184.7)months at diagnosis.Of these 83 cases,48.2% (40 /83 cases)was classic medulloblastoma (CMB)(2 cases less than 3 years old),24.1 % (20 /83 cases)was desmoplastic /nodular medullo-blastoma (DMB)(6 cases less than 3 years old),12.1 % (10 /83 cases)was large cell/anaplastic medulloblastoma (LC /AMB)(1 case less than 3 years old),3.6% (3 /83 cases)was extensive nodular medulloblastoma (MBEN)(1 case less than 3 years old),and 12.1 % (10 /83 cases)(3 cases less than 3 years old)was mixed subtype.The rela-tionships between age at diagnosis and histopathological subtype,gender and primary tumor location were all statistically significant (χ2 =0.014,0.013,all P <0.05).Conclusions The incidence of boys with MB is higher than girls.CMB is the main histopathologic subtype in children over 3 years old.The primary tumor location involving the cerebellar vermis or cerebellar vermis and the fourth ventricle is higher in girls with MB.The primary tumor location involving the fourth ventricle,the fourth ventricle and other parts of the central nervous system,Cerebellar vermis and other parts of the central nervous system or other parts of the central nervous system is higher in boys with MB.

Objective To investigate the executive function of children with different sports training. Methods Forty children with Ping-Pong training (Ping-Pong group) and 41 children with swimming training (swimming group), aged 6-9 years, completed GO/NOGO task. Behavioral data (reaction time and accuracy) and event related potential component N2 were collected and analyzed. Results The reaction time was significantly faster and accuracy significantly lower of GO task and NOGO task in swimming group than in Ping-Pong group (P<0.05 and P<0.01). There were significant differences in the amplitude of NOGO-N2 on site CPz between swimming group and Ping-Pong group[(-11.36±9.4) μV vs (-7.55±7.99) μV, P<0.05]. Conclusion The inhibitory function of children with Ping-Pong training is stronger than those with swimming training.

Objective To investigate clinical efficacy of Easy First strategy in laparoscopic pancreaticoduodenectomy (PD) for borderline resectable pancreatic cancer.Methods The clinical data of 9 patients with borderline resectable pancreatic cancer who were admitted to the Sir Run Run Shaw Hospital of Zhejiang University (8 patients) and Zhejiang Provincial People's Hospital (1 patient) from June 2013 to March 2015 were retrospectively analyzed.Nine patients underwent laparoscopic pancreaticoduodenectomy based on the Easy First strategy (to sequentially dissect and amputate jejunum,stomach,hepatoduodenal ligament,common bile duct,main portal vein,head of pancreas,second segment and third segment of the duodenum,uncinate process and neck of pancreas).The operation time,volume of intraoperative blood loss,postoperative pathological examination,complications and duration of hospital stay were recorded.Patients were followed up once every 3 months by outpatient examination and telephone interview up to June 2015.Results Of 9 patients,4 received totally laparoscopic PD (2 received partial resection and repair of portal venous wall),1 received laparoscopic assisted resection and digestive tract reconstruction,and 4 received laparoscopic transection of jejunum,bile tract and stomach and conversion to open surgery for resection and digestive tract reconstruction (1 with severe adhesion between tumor and portal vein,3 with bleeding due to dissection of neck and unciform process of pancreas).The operation time and volume of intraoperative blood loss in all patients and in 4 patients with totally laparoscopic PD were (404 ± 49) minutes and (456 ± 348) mL,(395 ± 61) minutes and (188 ± 25) mL,respectively.Of 9 patients,5 with postoperative complications were cured without perioperative death,including 2 with Grade B pancreatic fistula,1 with biliary leakage,1 receiving reoperation due to gastric stump bleeding at postoperative day 7 and 1 with abdominal infection.The extubation time of right drainage tube and left drainage tube was (9 ± 5) days and (11 ± 4) days,respectively.The duration of hospital stay was (24 ± 10)days.All patients were diagnosed as with pancreatic cancer by pathological examinations with the tumor diameter of (3.2 ± 0.8) cm.The number of harvested lymph nodes in all patients and in 4 patients with totally laparoscopic PD were 16.8 (range,6.0-25.0) and 19.8 (range,15.0-25.0).All the patients were followed up for mean time of 12 months (range,4-24 months),including 1 death at postoperative month 3,1 with tumor survival of 20 months and others with tumor-free survival.The postoperative survival time of 4 patients was more than 18 months at the end of follow-up.Conclusion Easy First strategy in laparoscopic PD is safe,feasible and practical for borderline resectable pancreatic cancer.

OBJECTIVETo study the feasibility of intraoperative radiotherapy (IORT) in primary liver cancer.

METHODSBased on the target of dose curves, the dose-volume histogram (DVH) and cost of radiation equipment and radiation therapy, IORT was compared with protonbeam therapy (PBT) and 3DCRT in 16 patients with primary liver cancer using the therapy plan system (TPS).

RESULTSIORT had significantly better performance than 3DCRT to allow a target region surrounded by 90% of the dose lines. IORT was similar to protonbeam therapy in terms of target region surroundings and absorbed dose in the normal organs, but the cost of IORT was significantly lower.

CONCLUSIONThe TPS of IORT is better than 3DCRT and similar to protonbeam therapy in the treatment of primary liver cancer with similar cost to 3DCRT. IORT can effectively protect the neighboring sensitive organs and improve the absorbed dose in the tumors and the local control rate.

Aged ; Feasibility Studies ; Female ; Humans ; Intraoperative Care ; Liver Neoplasms ; radiotherapy ; surgery ; Male ; Middle Aged ; Radiotherapy ; methods ; Radiotherapy Dosage ; Radiotherapy, Adjuvant ; methods

OBJECTIVETo study the effects of short hairpin RNA (shRNA) mediated gene silencing of β-catenin on the biological characteristics of esophageal carcinoma cells, and to provide theoretical and experimental evidence for the gene therapy of esophageal carcinoma through target inhibition of β-catenin gene.

METHODSSingle strand DNA was synthesized according to the hairpin RNA sequence, and then subcloned into eukaryotic expression vector pGenesil-3 to construct a shRNA-expression pDNAs driven by human U6 promoter of β-catenin (pGen-3-CTNNB1). One additional construct of random siRNA (pGen-3-con) without homologous to any human genes was constructed in a similar fashion as control.Positive clones were identified and verified by restriction cleavage and DNA sequencing analyses. pGen-3-CTNNB1 and pGen-3-con were then transfected into esophageal carcinoma cell line Eca-109 with liposome, respectively. Positive colonies were selected with G418. Expression of β-catenin protein and mRNA in the transfected and nontransfected Eca-109 cells were examined by Western blotting, immunofluorescence and RT-PCR, respectively. Xenograft tumor model was used to compare the tumorigenesis of three different cells.Expressions of β-catenin in all tumor tissues were examined by immunohistochemistry staining. The invasive abilities of three different cells were examined with transwell invasion filter and Matrigel.

RESULTSβ-catenin expression levels were found markedly decreased in Eca-109 cells transfected with pGen-3-CTNNB1. In vivo, transfection with β-catenin shRNA greatly impeded the tumor growth, pGen-3-con (1.18 ± 0.13) g, Eca-109 (1.38 ± 0.21) g, pGen-3-CTNNB1 (0.42 ± 0.09) g, P < 0.05. Immunohistochemistry staining showed a significantly decreased expression of β-catenin in β-catenin shRNA transfected cells than in random shRNA transfected and nontransfected cells (P < 0.05). The infiltration abilities of esophageal carcinoma cells were significantly suppressed, pGen-3-con (81 ± 5)/HPF, Eca-109 (77 ± 6)/HPF, pGen-3-CTNNB1 (41 ± 4)/HPF, P < 0.01; along with significantly decreased migration abilities, pGen-3-con (73 ± 5)/HPF, Eca-109 (69 ± 5)/HPF, pGen-3-CTNNB1 (38 ± 4)/HPF (P < 0.05).

CONCLUSIONSThere are abnormal expression of β-catenin and activation of Wnt signaling pathway in human esophageal carcinoma cell line Eca-109. RNA interference targeting β-catenin gene suppresses the growth of xenograft tumorigenesis in nude mouse and the invasiveness and metastatic capability of esophageal carcinoma cells.

Animals ; Carcinoma, Squamous Cell ; genetics ; metabolism ; pathology ; Cell Line, Tumor ; Cell Movement ; Esophageal Neoplasms ; genetics ; metabolism ; pathology ; Female ; Gene Silencing ; Genetic Vectors ; Humans ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neoplasm Invasiveness ; Neoplasm Transplantation ; Plasmids ; RNA, Messenger ; metabolism ; RNA, Small Interfering ; genetics ; Random Allocation ; Signal Transduction ; Transfection ; Tumor Burden ; Wnt Proteins ; metabolism ; beta Catenin ; genetics ; metabolism ; physiology

OBJECTIVETo study the feasibility and effect of Blunt esophageal denudation without thoracotomy in the treatment of cervical esophageal carcinoma with laryngeal function preservation.

METHODSThe data of 28 patients with cervical esophageal carcinoma, collected from Aug. 1997 to Nov. 2005, were investigated retrospectively.

RESULTSAll the 28 patients were diagnosed as cervical esophageal squamous cell carcinoma. Among them, 12 patients underwent surgery (surgery group), while the other 16 patients underwent surgery plus radiation therapy preoperatively or postoperatively (multimodality therapy group). No uncontrolled intraoperative and postoperative hemorrhage and tracheal tear occurred. The incidence of complications was 21.4% (6/28), including cervical anastomotic leakage in 2 patients and recurrent laryngeal nerve injury in 4 patients. The overall 5-year survival rate was 50.3%. The 5-year survival rate was 25.7% in surgery group and 66.1% in multimodality therapy group, and the difference between two groups was statistically significant (chi(2)=4.07; P=0.0438).

CONCLUSIONSBlunt esophageal denudation without thoracotomy in the treatment of cervical esophageal carcinoma with larynx function preservation is possible. Combined with radiotherapy preoperatively or postoperatively, the survival time in patients with cervical esophageal carcinoma is able to be prolonged.

Adult ; Aged ; Aged, 80 and over ; Esophageal Neoplasms ; surgery ; Esophagectomy ; methods ; Esophagoplasty ; Feasibility Studies ; Female ; Humans ; Male ; Middle Aged ; Neck ; Retrospective Studies

Objective: To investigate the clinical features and diagnostic bases of childhood leukoencephalopathy with cerebral calcifications and cysts (LCC). Methods: The clinical data involving manifestations and laboratory examinations of 4 children with LCC admitted to Beijing Children's Hospital Affiliated to Capital Medical University from 2012 to 2017 were retrospectively summarized. Each patient had a follow-up visit ranging from 4 months to 5 years and 9 months after initial examination. Results: Patients consisted of 2 males and 2 females, whose age of onset was respectively 2 years and 9 months, 6 years and 2 months, 7 years and 10 months, and 5 years and 1 month. The main clinical symptoms of these cases included headache, dizziness, partial seizure and claudication, and two of these cases had insidious onset. Cerebral calcifications and cysts with leukoencephalopathy were detected by neuroimaging in all patients. In addition, multifocal microhemorrhages and calcifications were observed by magnetic susceptibility-weighted imaging (SWI) series in 3 patients. Brain biopsy performed on 1 case disclosed a neuronal reduction in the cerebral cortex, loosening of focal white matter, multifocal lymphocyte infiltration, fresh hemorrhages, and gliosis, as well as angiomatous changes of blood vessels with hyalinized thicken-wall, stenotic or occlusive lumina and calcification deposits. The compound heterozygous mutations of n.*10G>A and n.82A>G in SNORD118 were identified in 1 case by target-capture next-generation sequencing. Sanger sequencing verified that the variant n.*10G>A was a novel mutation and it was of paternal-origin, while the variant n.82A>G was of maternal-origin, which had already been reported to be pathogenic to LCC. Follow-up study had shown continued partial seizure in 1 case and remissive claudication in another, while the remaining 2 cases had a relatively favorable outcome without obvious neurological symptoms at present time. Conclusions The clinical manifestations of LCC are nonspecific, and the onset of the disease tends to be insidious. The triad neuroimaging findings of cerebral calcifications, cysts and leukoencephalopathy are essential to the diagnosis of the disease, and the signals of microhemorrhages revealed by SWI series provide another eloquent reference for the diagnosis. As biopsy is invasive and usually unavailable in the early stage, gene assessment, instead of pathological data, should be the gold standard in the diagnosis of LCC.