Objective To evaluate the adaption,effectiveness,dose,complication of the treatment for cranio pharygiomas with gamma knife surgery.Methods Gamma knife surgery was performed in 41 patients.Patients with mixed solid and cystic tumors were treated with stereotaxic aspiration while six cases were treated with divergence surgery prior to gamma knife therapy.The central dose ranges from 17.1 ～40 Gy(29.6Gy in average).The patients were treated at 30%～50% equal dose curve with 6 ～14Gy of tumormargin dose(9.5Gy in average).The exposure dose of the optic nerve and optic tract is less than 10Gy.Results Of twenty-nine patients who were followed up from 6 to 100 months,sixteen had disappeared or decreased tumor,six had unchanged,two was performed craniotomy one year or three years after gamma knife surgery,and the remaining five were dead one year to three years.The tumor control rate was 75.9%(22/29).Conclusion The treatment of stereotaxic radiation with single and high dose is sensitive to most of the solid craniopharyngioma,and the treatment of stereotaxic resection combined with gamma knife surgery may be feasible for the recurrent mixed solid and cystic craniopharyngioma.

OBJECTIVE： To confirm the efficacy and safety of latanoprost in treating glaucoma.METHODS： In a double blind， randomized control clinical trial， we compared the efficacy and adverse drug reactions of once daily topically applied 0.005％ latanoprost with those of twice daily 0.5％ timolol for 12 weeks in patients with open angle glaucoma or ocular hypertension.RESULTS： The study included 46 patients（22 pts.randomized to latanoprost treatment， 24 pts.to timolol） ， 46 patients remained at the end of the study.Comparing with baseline diurnal intraocular pressure（IOP） ， the IOP reduction（mean±standard deviation） achieved with latanoprost（7.86±2.39） mmHg， （31.1％， P<0.001），and timolol（6.24±2.58）mmHg （24.9%，P<0.001），the difference between the two groups（1.62mmHg） being significant（P<0.01）. Two patients treated with latanoprost had foreign body sensation. No other ocular and systemic adverse reactions related to the two drugs were found. CONCLUSION: The results of this study demonstrated that 0.005% latanoprost applied once daily is well tolerated and more effective in reducing IOP than 0.5% timolol applied twice daily. Thus, latanoprost has the potential for becoming one of the ideal antiglaucoma drugs.

OBJECTIVETo study the safety of Hydrophilic polyacrylamide gel (HPAG) through an animal experiment.

METHODSAfter HPAG was injected underneath the skin of SD rats, tissue specimens were taken for general and histological examinations. The cytotoxicity was evaluated by agar coverage and MTT method.

RESULTSIt was determined that the cytotoxicity was over level-two. The toxicity to kidney was obvious. The local histological reaction was slight and a thin fibrous membrane was formed around HPAG, which became stiff gradually. The shape and location of the injected HPAG was not stable. The HPAG could not be drawn out completely.

CONCLUSIONHPAG has obvious cytotoxicity and is not a suitable material as soft tissue implant for the bad shape and texture.

Acrylic Resins ; toxicity ; Animals ; Cell Survival ; drug effects ; Kidney ; drug effects ; pathology ; Rats ; Rats, Sprague-Dawley

AIM:To explore the feasibility of inducing mouse embryonic stem cells into neural stem cells in vitro. METHODS: Embryonic body induced by retinoic acid and retinal m?ller cells were selected in neural stem cell-defined medium for 7 days, and the morphological changes were observed. The selected cells were stained immunocytochemically with anti-nestin, anti-BrdU antibodies, and their ability of expansion and differentiation were analyzed. RESULTS:Large amounts of neurospheres were derived from embryonic body in the selected medium on the 7th day, which could be passaged and differentiated, stained positive with nestin and BrdU, and expressed nestin, glutaminase and Brn-3 genes. CONCLUSION:Neural stem cells could be derived from embryonic body induced by RA and m?ller cells in the selected medium, which would offer an alternative to treat neuropathy such as glaucoma and retinal degeneration in the future.

Objective To evaluate the clinical efficacy of standardized house dust mite allergen specific immunotherapy (SIT) for rhinitis and asthma in children. Methods Forty-two children with allergic rhinitis and asthma who received a standardized house dust mite allergen SIT in our hospital were enrolled in our study. The result of allergen skin prick test, serum specific IgE levels (sIgE) of house dust mite and dust mite,pulmonary function and symptom scores were analysed before and at one year after treatment in all children. Results Skin indexes of house dust mite and dust mite, symptom score were significantly decreased at one year after treatment,but the levels of house dust mite and dust mite sIgE,lung function test (FVC,FEVt,MEF25-75) showed no significant differences. Conclusion Children with allergic rhinitis and asthma have significant improvements in their skin sensitivity and clinical symptoms by given SIT for one year,but the impact of SIT on airway inflammation needs further observation.

Objective To assess the efficacy of stone fragmentation and clearance of this new intracorporeal ultrasound lithotripter (CQS-01) compared with currently available ultrasound units (EMS-Ⅲ/Ⅳ).Methods Twenty phantom stones composed of dental gypsum were randomly divided into four groups,and CQS-01 ultrasound lithotripter (70％ power and 70％ duty factor),EMS-Ⅲ ultrasound lithotripter (70％ power and 70％ duty factor),EMS-Ⅳ ultrasound lithotripter (type A,70％ power and 70％ duty factor) and EMS-Ⅳ ultrasound lithotripter (type B,70％ power and 100％ duty factor) were used to fragment and removepbantom stones.The mean stone breakdown time and fragment removal time and stone fragmental sizes for the standard ultrasound devices were compared to determine the completeness and efficiency of stone fragmentation and removal.Results The average time for stone breakdown was 7.4 ± 1.9 s,9.4 ± 1.6 s,82.2 ± 12.6 s and 51.4 ± 18.7 s,respectively.There was no significant difference between CQS-01 and EMS-Ⅲ (P ＞ 0.05),but there was significant difference between CQS-01 and EMS-Ⅳ (A or B) (P ＜ 0.001).The average time for stone clearance using the ultrasound devices was 387.8 ± 68.0 s,41 1.6 ± 57.6 s,568.0 ± 119.1 s and 383.6 ± 75.6 s,respectively.In addition,the average size of the largest fragments removed was the same among the groups (＜ 3 mm).Conclusion The ultrasound capabilities in a newly developed lithotriter (CQS-01) exhibited the same ability to fragment and clear phantom stones compared with standard ultrasound devices.

Objective To summarize 500 cases of surgical experience in restoration of adult congenital heart disease ( ACHD) treatment and early postoperative.Methods During January 2012 to December 2014 in Fuwai Hospital, 500 cases of ACHD treated by operation were chosen to collect the clinical data .We divided the groups according to whether the case was a complex malformation and whether the case had an ICU retention time is more than the 5 days.Results The average age was 35, the average weight was 59 kg.The operation average cardiopulmonary bypass(CPB) time was 102min.The average ICU treatment time was 2 days, the average duration of mechanical ventilation was 23 hours, 3 early deaths occurred.The complex malformation group had younger age and less weight than the simple malformation group , the complex malformation group had longer time of cardiopulmonary bypass time, aortic cross clamping time, mechanical ventilation time and ICU treatment time, had higher rate of complication and blood transfusion peri-operative period than the simple malformation group.(P<0.05) The group of ICU retention time less than 5 days had higher rate of the male proportion, had younger age and less weigh, had longer time of cardiopulmonary bypass time , mechanical ventilation time and ICU treatment time , had higher rate of complication and blood transfusion peri-operative period than the control group(P <0.01).Conclusion Although ACHD patients have long medical history and complicated pathological and physiological changes , when they get proper surgical operation and periopera-tive treatment, they should obtain satisfied effect.Professional medical team or organization service for the ACHD patient is very important and urgent to build.

Objective To observe the application effect of extended Gamma 3 intramedullary nail close reduction in treatment of the subtrochanteric comminuted fracture. Methods A total of 80 cases of patients with subtrochanteric comminuted fracture treated in our hospital from January 2010 to December 2013 were selected as the research objects, and recieved closed reduction treatment, and they were randomly divided into the treatment group (n=46), which were given the treatment of extended Gamma 3 intramedullary nail, and the control group (n=34), which were given the treatment of dynamic hip screws. During the 12 months of postoperation follow up, the surgical results, fracture healing time, functional recovery and complications of the patients in two groups were compared. Results The operation time of two groups was (57.34±11.52) minutes vs (67.25±18.38) minutes, the amount of bleeding during operation was (145.78± 28.57) mL vs (264.55±25.26) mL, the time of hospitalization was (14.20±2.63) days vs (18.65±3.00) days and the time of fracture healing was (10.38 ±2.46) weeks vs (14.21 ±2.24)weeks. The differences were significant (P<0.05). In addi-tion, after one year of follow-up, the excellent rates of function recovery in two groups were 91.30%and 82.35%. There were no significant differences between them ( P>0 . 05 ) . The incidence of complications of the patients in the two groups were 2.17%and 17.65%. The differences were significant (P<0.05). Conclusion The subtrochanteric comminut-ed fracture is treated by closed reduction and application of extended Gamma 3 intramedullary nail, the functional re-covery of the patients is good and the complications are fewer. This method is worth the clinical promotion.

BACKGROUND:Studies have shown that atorvastatin can up-regulate the expression of heme oxygenase-1 and enhance the anti-inflammation and anti-oxidative damage ability of cells.However,whether atorvastatin can regulate macrophage polarization,inhibit inflammation and reduce cholesterol accumulation by inducing heme oxygenase-1 expression remains unclear. OBJECTIVE:To investigate the effect of atorvastatin on polarization,inflammation and cholesterol content of oxidized low-density lipoprotein stimulated RAW264.7 macrophages by inducing heme oxygenase-1 expression and its related mechanism. METHODS:Firstly,RAW264.7 cells were randomly divided into six groups and incubated with different concentrations of atorvastatin for 24 hours.The expression of heme oxygenase-1 protein and cell activity were detected to explore the optimal dose of atorvastatin for subsequent studies.RAW264.7 cells were randomly divided into control group,atorvastatin group and heme oxygenase-1 inhibition group.Cells were preincubated with pure medium,atorvastatin 20 μmol/L and atorvastatin 20 μmol/L + zinc protoporphyrin IX 10 μmol/L for 24 hours,and then oxidized low-density lipoprotein 50 mg/L was added for 48 hours.The polarization of macrophages was detected by flow cytometry.The secretion of inflammatory factors such as transforming growth factor β,interleukin 10,interleukin 1β,and tumor necrosis factor α was detected by ELISA.The expression levels of heme oxygenase-1,LC3II,LC3I,P62,PPARγ and ABCA1 were detected by western blot assay.The intracellular cholesterol content was measured with the oxidose method and the accumulation degree of intracellular lipid droplets was evaluated by oil red O staining. RESULTS AND CONCLUSION:(1)Atorvastatin could induce the expression of heme oxygenase-1 protein in macrophages in a dose-dependent manner.(2)Oxidized low-density lipoprotein could induce macrophages to polarize towards M1,secrete proinflammatory factors,and increase the accumulation of intracellular cholesterol.(3)Compared with the control group,the heme oxygenase-1 protein expression of macrophages was increased after atorvastatin intervention,and the cells turned to M2-type polarization and mainly secreted anti-inflammatory factors such as transforming growth factor-β and interleukin-10.PPARγ,ABCA1,LC3II/I and other signal molecules reflecting cholesterol efflux and autophagy increased,and the contents of intracellular cholesterol and lipid droplets decreased significantly(P<0.05).(4)The heme oxygenase-1 inhibition group treated with zinc protoporphyrin IX significantly reversed the above changes in the atorvastatin group.(5)The results have shown that atorvastatin may promote the polarization of macrophages stimulated by oxidized low-density lipoprotein to M2 type and inhibit inflammation by up-regulating the expression of heme oxygenase-1 and by up-regulating PPARγ/ABCA1 signaling pathway and enhancing autophagy.Atorvastatin can increase the outflow of intracellular cholesterol and reduce the accumulation of intracellular lipids.

Objective To explore application of our self-designed U-shaped transdermal surgical navigator based on three-dimensional reverse design in cannulated screwing for femoral neck fracture Methods A retrospective study was done of 5 patients with femoral neck fracture who had been treated from August 2016 to March 2017.They were 3 men and 2 women,aged from 33 to 60 years (average,46.5 years).Thin layer CT scanning was conducted on the patients' affected hip (at the left side in 2 cases and at the right side in 3).Based on their CT data,3D design software and 3D printing technique were used to manufacture the U-shaped transdermal surgical navigator and a real-sized model of the fracture.Operations were simulated using the U-shaped transdermal surgical navigator on the fracture model to determine the angle,depth and location of the screwing.Fixation of the fracture with cannulated screws was conducted after confirmation of satisfactory surgical parameters.The postoperative X-ray films of the patients were reviewed.Evaluations were conducted of the screw position,operating time,volume of operative bleeding,and number of intraoperative X-ray shots.Results The screw positions in the 5 patients were consistent with their preoperative design.Four patients had only one shot of fluoroscopy and one patient 3 shots.Their operating time ranged from 15 to 30 minutes,averaging 22.5 minutes;their bleeding ranged from 5 to 10 mL,averaging 7.5 mL.The 5 patients were followed up for an average of 4.5 months (from 3 to 6 months).By the Harris scoring at their final follow-ups,one was excellent,3 good and one fair.No complications like pain,functional impairment of the joint,or collapse or necrosis of the femoral head occurred during the follow-up.Conclusions Our self-designed U-shaped transdermal surgical navigator based on three-dimensional reverse design can significandy improve the accuracy and safety of the cannulated screwing for femoral neck fractures.The operation is minimally invasive,reducing operating time and intraoperative blood loss.