Objective To explore the diagnosis,treatment and pathology of malignant brain tumor in children.Methods The clinical data of 61 children with malignant brain tumor were reviewed,including their age distribution,diagnosis,operation route(according to the position of the brain tumors),chemotherapy [using bischloro-nitrosourea(BCNU),teniposide(VM-26) and temozolomide]and radiotherapy (part and whole brain irradiation,three diamensions conformal therapy,gamma knife and X-kinfe).Results Of 61 cases,which including 37 boys and 24 girls whose mean age was 11.3 years,24 cases were supratentorial tumors and 37 cases were infratentorial.Forty-five tumors received total or subtotal recession,10 cases with major recession,and 6 cases with partial recession.After operation,39 cases (63.9%) received radiotherapy,and 29 cases (47.5%) with chemotherapy.Follow-up of 49 cases were achieved,in which 22 cases died and 27 cases survived.Conclusions Surgical removal is still the chief treatment for malignant brain tumor in children.The exairesis profect should be formulated according to the specificity of each case.Radiotherapy methods should be related to post-operational images(CT or MRI).And it was different from the brain tumors in adult.It is good to prolong survival duration for some chosen cases with optimal chemotherapy.

Objective To evaluate the clinical value of real-time 3 dimensional echocardiography (RT-3DE) for measurement of right ventricular function in the repaired tetralogy of Fallot (TOF) compared to cine magnetic resonance imaging (c-MRI).Methods Thirty-seven randomly selected patients with repaired TOF from Jan.2000 to Jun.2007 in Children's Hospital,Fudan University underwent both RT-3DE and c-MRI for the data of right ventricular enddiastolic volume (RVEDV),right ventricular end-systolic volume (RVESV),right ventricular ejection fraction (RVEF),which were compared to evaluate the reproducibility and correlation of two ways on right ventricular function.Results All the patients completed both RT-3DE and c-MRI on the same day.The correlation for RVEDV,RVESV,RVEF measured by 2 methods was high (r =0.933,0.943,0.911,P =0.000,0.000,0.105),and it showed that consistency existed in RVEF,as difference was only (1.2 ± 4.5) ％.Comparison with c-MRI,RVEDV and RVESV measured by RT-3DE was underestimated,in which difference was (-17.4 ± 16.9) mL,(-9.3 ± 10.5) mL.Conclusions RVEF with RT-3DE can be assessed with acceptable accuracy,but it is not so good for RVEDV and RVESV.Further study needs to be performed to make sure the value of RT-3DE on the assessment of right ventricular function in repaired TOF.

Objective To study the feasibility of using gooseneck snare combined with 0.035 inch loach guidewire for subintimal angioplasty in iliac artery occlusion , and to discuss its clinical indications. Methods During the period from October 2011 to May 2013, 3 cases with unilateral complete iliac artery occlusion were admitted to authors’ hospital. As the guidewire inserted from the healthy side could not returned into the true lumen once it entered into the subintimal space of the iliac artery , the puncture at the diseased side was carried out and the guidewire was pushed into the artery , but the catheter and the guidewire could not converge or anastomose in the subintimal site , gooseneck snare had to be used to grab the guidewire in subintimal site as to establish a path and completed the angioplasty. Results Successful and safe balloon dilatation and stent implantation were accomplished in all the 3 patients , and the patients complained of no special discomfort. Conclusion In performing the subintimal angioplasty for patients with iliac artery occlusion, the use of gooseneck snare combined with retrograde insertion of guidewire should be considered when it occurs that the guidewire can not return into the true lumen after it enters into the subintimal space. Nevertheless, gentle manipulation is first important in order to avoid the possible rupture of vessels.

Objective To observe the effects of early intravenous administration of Astragalus on brain inju-ry in neonates with severe asphyxia. Methods According to hospital serial number, 80 neonates with severe as-phyxia were divided into conventional treatment group (control group) (n=40), which was on the basis of symp-tomatic support treatment for the use of cerebrolysin and citicoline treatment; Astragalus injection treatment group (n=40), which, apart from the conventional treatment, Astragalus injection was given as soon as possible (within six hours after birth). The incidence of convulsions or frequent seizures convulsions and the mortality in two groups, the clinical degree of hypoxic ischemic encephalopathy (HIE) and the behavior nerve score determination were ob-served and compared. Results The incidence of convulsions or frequent seizures convulsions was significantly lower in the Astragalus treatment group than in the control group (45.00% vs 67.50%, χ24.501,P<0.05). The per-centage of the behavior nerve score determination in 7 d-8d and 12 d-14d after birth was obviously lower in the for-mer group than the latter one (48.57% vs 74.19%, χ2 4.642,P<0.05; 31.42% vs 58.06%, χ24.601, P<0.05). The mortality was not significant different between the two groups (12.50 % vs 22.50%, χ22.000, P>0.05). Conclusion For severe asphyxia neonates, on the basis of the symptomatic support treatment, the use of Astragalus injection, as soon as possible, can significantly reduce the hypoxic ischemic brain injury.

ObjectiveTo evaluate the feasibility of a three-dimensional (3 D) operation planning system for precise hepatectomy in patients with giant hcpatocellular carcinoma (HCC).MethodsThe clinical data of 34 patients with giant HCC who received precise hepatectomy at the First Affiliated Hospital of Sun Yat-sen University from May 2009 to May 2011 were retrospectively analyzed.Preoperative evaluation was done based on the computed tomography data,and the resection margin and the volume of resectcd liver were calculated using simulation.The predicted resected liver volume and resection margins were compared with the results of the actual operations.All data were analyzed using the t test,and the correlation between predicted and the actual values was analyzed by calculating Pearson correlation coefficients.Results Hepatic and tumor tissues and the hepatic vessels were reconstructed three-dimensionally using the 3D preoperative simulation software.The volume of simulated resected liver and the length of resection margin were ( 2112 ± 1550 ) ml and ( 12 ± 6) mm,respectively,while the volume of actual resected liver and the length of resection margin were (2031 ± 1411 )ml and ( 12 ± 6)mm,respectively.The predicted and the actual values were statistically correlated ( r =0.961,0.923,P ＜ 0.05 ).There was no significant difference between the predicted and the actual values ( t =1.549,1.143,P ＞ 0.05 ).All patients received precise hepatectomy,and no hepatic failure or death was observed. Conclusion The 3D operation planning system can accurately evaluate the condition of the liver and simulate hepatectomy,and could contribute to safer and more curative precise hepatectomy in patients with giant HCC.

Objective To establish a specific fluorescence quantitative method for determining the mRNA expression of Toll-like receptor3(TLR3)in peripheral blood mononuclear cells(PBMCs).Methods Using the Beacon Designer 2.1 software,specific primers and Taqman-MGB probe were designed.The plasmid pMD18-T-TLR3 was constructed as calibrator and the amplified fragment was obtained by reverse- transcript-PCR(RT-PCR).RNA quantification based on cycle threshold values(Ct)was used to establish the standard curve.According to which,the TLR3 mRNA levels in 30 normal individuals,20 patients with primary biliary cirrhosis(PBC)and 20 ones with chronic liver cirrhosis induced by HBV were calculated automatically by software after the fluorescence of PCR product was detected continuously during amplification.Results The linear detection range of the assay for TLR3 gene and ?-actin was 10~2-10~8(r= -0.9974)and 10~3～10~8(r=-0.9984),respectively.The coefficient of variation of both intra-and inter- assay reproducibility for high concentration sample were 6.7% and 8.7%,respectively,and those for low concentration sample were 12.3% and 14.0%.The TLR3 mRNA expression level ranges from 3.46?10~2- 4.51?10~3 copies/?g RNA,4.92?10~2-1.42?10~4 copies/?g RNA and 2.58?10~2-7.17?10~3 copies/?g RNA for 30 healthy individuals,20 PBC patients and 20 ones with chronic liver cirrhosis induced by HBV, respectively.Conclusion We have successfully set up a FQ-RT-PCR method for detecting TLR3 mRNA, which may be used as an excellent tool for the clinic and basic study on the expression of TLR3 gene.

OBJECTIVE:To study the econamics effect of risperidone and quetiapine in treating of schizophrenia.METH ODS:64schizophrenia patients were randomly divided into risperidone group(34cases)and quetiapine group(30cases).The effects were evaluated based on the reduction of scores determined by brief psychiatric rating scale(BPRS);the adverse effects were evaluated by treatment emergent symptom scale(TESS).And then the cost-effectiveness analysis was carried through.RESULTS:The per capita costs for risperidone and quetiapine were3598.85yuan and3778.63yuan respectively;the re-duction of BPRS scores were(36.09?15.52)and(25.03?14.45)respectvely;the respective cost-effect ratio was99.72yuan and150.96yuan;the increment of the cost-effect ratio for the quetiapine group was-16.25compared with the risperidone group.CONCLUSION:Risperidone is more economical than quetiapine in the treatment of schizophrenia.

OBJECTIVE:To analyze the cost-effectiveness of3kinds of Chinese patent drugs in the treatment of insomnia outpatients.METHODS:78outpatients with insomnia were randomly divided into group A,group B and group C,and they were treated with shumian capsule,sweet dream capsule and compound semen ziziphi spinosae capsule,respectively,then,cost-effectiveness analysis was carried out with pharmacoeconomics.RESULTS:The per capita costs(C)for group A,B and C were288.20yuan,163.08yuan and139.22yuan respectively,the reduction in PSQI scores(E 1 )were5.15,8.88and11.84respectively,the effective rates(E 2 )were26%,46%,and64%respectively;The average cost-effect ratios C/E 1 were55.96,18.36,and11.76respectively;C/E 2 were11.08,3.55,and2.18respectively;The increment of the cost-effect ratios?C/?E 1 for group A and B were—22.27and—8.06respectively;?C/?E 2 were—3.92,—1.33respectively,as compared with group C.CONCLUSION:Compound semen ziziphi spinosae capsule is more economical in3drugs in treating insomnia outpatients.

AIM: To investigate the effect of IL-4, CD40L on RANTES production in murine renal tubular epithelial cells (TEC). METHODS: TEC were obtained from mouse, expression of RANTES and CD40 on TEC were measured. RESULTS: (1) Activation of TEC with IL-4 resulted in significant increase in CD40 expression (P

Objective To use hemin as a catalyst in the formation of disulfide bonds in the synthesis of linaclotide. Methods The linaclotide peptide was synthesized by the standard 9-fluorenylmethyl(Fmoc)solid-phase synthetic strategy. Wang resin and Trt-protected cysteine were used in the synthesis. Hemin was used in random oxidation of line linaclotide. The result was compared with those of air,dimethyl sulfoxide(DMSO),and I2 oxidation systems. Results and Conclusion Hemin is a highly effective catalyst for disulfide bond formation in linaclotide synthesis. It overcomes some disadvantages in oxidation reactions with conventional oxidative re-agents,and supplies a convenient way for the synthesis of peptide with concentrated disulfide bonds.