BACKGROUND:Patients with Parkinson disease (PD) are always supplied exogenous dopamine so as to balance a disproportion of neurotransmitter.However,a long-term administration may easily cause drug resistance;therefore,it is not able to solve nerve injuries at all.A lot of researches suggest that ganglioside can promote neural axon growth,improve neurotrophy,and resist cellular toxicity mediated by glutamic acid (GA).OBJECTIVE:To probe into the duration and effect of oraL administration of ganglioside on improving clinical symptoms of PD patients.DESIGN:Retrospective case analysis.SETTING:Department of Internal Medicine.Shanghai Electric Power Hospital;Departments of Neurosurgery and Internal Medicine,the First Affiliated Hospital of Kunming Medical College.PARTICIPANTS:A total of 6 344 PD patients were selected from Heilongjiang,Hebei,Shandong,Henan, Beijing,Jiangsu,Gansu,Qinghai.Guizhou,Fujian,Hunan,Shanxi, Hubei,Sichuan,Chongqing,Jiangxi, Shanghai and Yunnan from January 2001 to January 2005.All patients met the diagnostic and typing criteria of PD in Practical Neurology.They orally took≥10 mg/d ganglioside for more than 1 month,and all of them were provided the consent.METHODS:Patients who were treated with oral ganglioside accepted neural functional rehabilitation. Every oral solution of ganglioside contained 0.25 g/L ganglioside [including monosialoteterahexosyl ganglioside 1 (21%),diplo-sialoteterahexosyl ganglioside 1a(40%),diplo-sialoteterahexosyl ganglioside 1 b(16%),and tri-sialoteterahexosyl ganglioside 1b(19%)],and patients fastingly took two ampoules in every morning and 2 in every evening before sleeping, or took 4 ampoules in every evening before sleeping. Every 3 months was regarded as a course, and patients were always treated for two or three courses;especially,patients having a long-term duration were treated for above 4 courses.Regular follow-up was performed during the administration to observe the improvements of PD patients on the aspects of chatter, myotone, bradypraxia,posture irregularity, etc. Effective evaluation: Iilness improvements of PD patients who orally took ganglioside were observed within 3,6,9 months and 1 year.Excellent effective: Chatter and myotone disappeared after gradually stopping administration of dopamine preparation;improvement: Symptoms mentioned above were relieved after gradually reducing administration of dopamine preparation (effect=apparent effect+improvement);inefficacy:Symptoms mentioned above were not changed.MAIN OUTCOME MEASURES:Effect at various time Points of administration.RESULTS:Among 5 937 patients who met the inclusion criteria,all of them were involved in the final analysis without any loss.① Improvement of clinical symptoms at various time points of administration:There were 669 PD patients with the effective improvements within 1-3 months.941 within 4-6 months and 1713 within 7-12 months.The total effective rate was 56%.② Therapeutic effective rate of PD patients at various administrating times:The therapeutic effective rates of patients who received administration from 1 to 3 months,from 4 to 6 months and from 7 to 12 months were 30%,57%and 84%respectively.The rate was higher of patients administrated from 4 to 6 months than.of those from 1 co 3 months(P<0.05),and also higher of those from 7 to 12 months than of those from 4 tp 6 months and from 1 to 3 months (P<0.05,P<0.01).CONCLUSION:Ganglioside can effectively improve clinical symptoms,such as chatter,myotone,bradypraxia,posture irregularity,etc.In addition,it has a better effect during a long-term administration.

OBJECTIVE:To investigate effectiveness and safety of rh-endostatin in the treatment of keloid.METHODS:Sixty-four keloid patients in Nanchong Central Hospital during Jan.2015-Jan:2016 were divided into observation group and control group by random number table,with 32 cases in each group.Both group received fractional CO2 laser treatment.After surgery,control group was given antioxidant drug and antibiotics routinely.Observation group was additionally given Rh-endostatin injection 0.1-0.2 mg/cm2 via keloid body,once a month,for twice,on the basis of control group.Clinical efficacy,symptom score after laser treatment and 2 months after laser treatment,wound healing time,wound pigmentation area and keloid area before and after treatment,the occurrence of ADR were compared between 2 groups.RESULTS:There was no statistical significance in total re sponse rate (93.75％ vs.87.50％) and the incidence of ADR (15.63％ vs.12.50％) between observation group and control group (P＞0.05).There was no statistical significance in symptom score of control group between after laser treatment and after 2 months of treatment (P＞0.05).The erythema,edema and pigmentation scores of observation group were significantly lower than before treatment and control group,with statistical significance (P＜0.05);there was no statistical significance in skin itching and burning sensation score between 2 groups (P＞0.05).The wound incrustation time,decrustation time and wound healing time of observation group were significantly shorter than those of control group,with statistical significance (P＜0.05).Pigmentation area and keloid area of 2 groups were significantly smaller than before,and the observation group was significantly smaller than the control group,with statistical significance (P＜0.05).CONCLUSIONS:Rh-endostatin can alleviate erythema,edema,pigmenta tion and other symptoms effectively,shorten healing time,and inhibit pigmentation and keloid regeneration effectively with good safety.

Objective To evaluate the feasibility and effectiveness of bladder-preserving local resection combined with intra-artery chemotherapy for patients with T1G3 bladder cancer.Methods Thirty five cases with T1G3 bladder cancer were analyzed retrospectively. Patients were all treated by bladder-preserving local resection combined with intra-artery chemotherapy. Results Thirty five cases were followed up. The time of follow-up ranged from 7 to 116 months,and mean time was(66.0±18.3)months.The 5 year recurrence and bladder-preserving rate were 48.6 ％(17/35)and 68.6 ％(24/35),respectively.The overall and tumor specific survival at 5 years was 77.1％ (27/35)and 82.9 ％ (29/35).The effect of bladder-preserving local resection plus intra-artery chemotherapy was satisfactory. Moreover, intra-artery chemotherapy had no obvious side effects.Conclusion Bladder-preserving local resection combined with intra-artery chemotherapy not only can retain normal bladder function, decrease in the recurrence, but also does not reduce the survival rate. It is an effective treatment for some patients with T1G3 bladder cancer instead of cystectomy over-treatment.

Objective To investigate whether the percutaneous ethanol injection (PEI)under sedation and analgesia can in-crease the energy deposition and curative efficiency of the high intensity focused ultrsound(HIFU)in treating unresectable middle and advanced stages of primary liver cancer.Methods Thirty-six cases of clinically diagnosed unresectable middle and advanced sta-ges of primary liver cancer were randomly divided into the PEI+ HIFU group(combination group,n = 23)and the simple HIFU group (HIFU group,n=13);10mL of the mixture of 99.7% ethanol and iodized oil (9:1)was given by intratumoral injection at 30 min before ablation in the PEI+HIFU group,while 0.9% physiological saline 10mL was replaced in the simple HIFU group.The ablation energy efficiency factor(EEF)and irradiation time were compared between the two groups.Results The ablation EEF in the PEI+HIFU group and the simple HIFU group were (13.82+4.26)J/mm3 and (25.63+6.31)J/mm3 respectively,the PEI+HIFU group was significantly lower than the simple HIFU group (P <0.05);the irradiation time were (1 468.28+253.21)s and (2 352.56+463.34)s respectively;which in the PEI+ HIFU group was significantly shortened (P <0.05).Conclusion PEI can enhance the HIFU ablation energy deposition and improve the efficiency of HIFU for treating unresectable primary liver cancer.

Objective To discuss the different clinical features and prognosis of single cerebral venous thrombosis (CVT) and multiple CVT. Methods The site and the number of vein and thrombosed sinuses of 136 patients with CVT were summarized. The patients were divided into 2 groups according to the numbers of thrombosed sinuses. The clinical features and outcome of the patients with single CVT were analyzed in comparison with those with multiple CVT by univariate analysis. Results In 44 patients (32.4%), only 1 cerebral sinus was involved. In 92 patients (67.6%), 2 or more cerebral veins and sinuses were involved (2 sinuses in 45, 3 sinuses in 35, 4 sinuses in 9, 5 sinuses in 3). The lateral sinus and the sigmoid sinus were the most frequent thrombosed sinuses which were found in 86.8% of patients; the followings were superior sagittal sinus (58.1%), straight sinus (18.4%) , deep venous system (7.4%), and cortical veins (2.9%). Mean ages were significantly older but the short-term prognosis was better in the group of patients with single CVT in comparison with those in the group of patients with multiple CVT. The patients with multiple CVT also presented more serious intracranial hypertension, more frequent parenchymal lesions and systematic thrombotic events than those with single CVT (P＜0.05). Conclusion In most CVT patients, 2 or more veins and sinuses are involved and thromboses most commonly implicate the lateral sinus and the superior sagittal sinus. Patients with multiple CVT usually present higher intracranial pressure, more serious clinical course, worse outcome and higher incidence of systematic venous thrombotic events in comparison with patients with single CVT. And the multiple sinus thrombosis is more likely to cause venous infarctions and intracranial hemorrhage than the single one.

OBJECTIVETo construct a replication-incompetent recombinant adenovirus mediating short hairpin RNA (shRNA)-induced tissue factor gene silencing in the islet.

METHODSFour pairs of complementary oligonucleotides were designed and synthesized to create double-stranded oligonucleotides (ds oligo). The ds oligos were cloned into Pentr/U6 vector to construct the shuttle plasmid pENTR/U6-shRNA, which was transduced into human islets via liposome after sequence verification. The plasmid with the best silencing effect was identified by real-time RT-PCR, followed by homologous recombination with the adenovirus backbone plasmid. The functional clone was transfected into 293A cells to amplify the adenovirus, whose silencing effect against TF expression was tested using real-time RT-PCR and Western blotting.

RESULTSThe pENTR/U6-shRNA shuttle plasmid was constructed and verified by sequencing. The recombinant adenovirus-mediated shRNA against TF was constructed, and real-time RT-PCR and Western blotting demonstrated that the strongest silencing effect of the adenovirus against TF occurred on the 4th day following islet transfection.

CONCLUSIONReplication-incompetent recombinant adenovirus-mediated shRNA against TF has been successfully constructed, which has good silencing effect against TF expression in human islet in vitro.

Adenoviridae ; genetics ; physiology ; Base Sequence ; Cell Line ; DNA, Recombinant ; genetics ; Gene Expression ; Genetic Engineering ; methods ; Humans ; Inverted Repeat Sequences ; Islets of Langerhans ; metabolism ; Plasmids ; genetics ; RNA Interference ; RNA, Small Interfering ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Thromboplastin ; deficiency ; genetics ; Viral Load ; Virus Replication

OBJECTIVETo investigate the clinical therapeutic results of allograft tendon for anatomical reconstruction of medial patellofemoral ligament (MPFL) for the treatment of patellar dislocations.

METHODSFrom September 2008 to June 2013, 16 patients with patellar dislocation underwent MPFL reconstructions. There were 2 males and 14 females, aged 11 to 27 years old (16 years old on average). Patellar dislocations occurred in 11 left and 5 right knees. The disease course ranged from 3 to 10 years. The frequency of dislocation ranged from 9 to 33 times (19 times on average). Affected knee joints showed patellar instability; the range of action for patella obviously increased. The X-ray films showed patellar dislocation. The preoperative Q angle was (36 ± 9)°, and the congruence angle was (63 ± 18)°. Reconstruction was performed via allograft tendon. Allograft tendon was fixed through the superomedial pole of the patella, and the other end was fixed at the natural MPFL insertion site near the medial femoral condyle with an interference screw in a bone tunnel. All the patients were evaluated postoperatively; Kujala patellofemoral scores, objective knee function, complications, and reoperations were assessed.

RESULTSPrimary healing was achieved in all cases. No infection or necrosis and absorption of grafts was observed. All the patients were followed up for an average of 16.4 months (ranged, 10 to 24 months) postoperatively. At the latest follow-up, all the patients had no pain, swelling and patellar instability; neither patella redislocation nor fracture occurred. The X-ray films showed good position of tunnel 6 months after operation, and the congruence angle was (5 ± 9)°, showing statistically significant difference when compared with preoperation (P < 0.05). The postoperative Q angle was (17 ± 8)°, the Kujala knee function score improved significantly from 45.20 ± 9.20 to 89.30 ± 6.40 at the latest follow-up, showing statistically significant difference (P < 0.05).

CONCLUSIONMPFL reconstruction improves clinical symptoms. Anatomical MPFL reconstruction is effective for patellar dislocation, and it offers good recovery of the premorbid patella mechanics. The interference screw provides firm fixation. Allograft can avoid the graft harvest site morbidity, but it increases the cost of the surgery.

Adolescent ; Adult ; Allografts ; Child ; Female ; Humans ; Ligaments, Articular ; surgery ; Male ; Patellar Dislocation ; surgery ; Patellofemoral Joint ; surgery ; Reconstructive Surgical Procedures ; methods ; Tendons ; transplantation

Neuro signal has many more advantages than myoelectricity in providing information for prosthesis control, and can be an ideal source for developing new prosthesis. In this work, by implanting intrafascicular electrode clinically in the amputee's upper extremity, collective signals from fascicules of three main nerves (radial nerve, ulnar nerve and medium nerve) were successfully detected with sufficient fidelity and without infection. Initial analysis of features under different actions was performed and movement recognition of detected samples was attempted. Singular value decomposition features (SVD) extracted from wavelet coefficients were used as inputs for neural network classifier to predict amputee's movement intentions. The whole training rate was up to 80.94% and the test rate was 56.87% without over-training. This result gives inspiring prospect that collective signals from fascicules of the three main nerves are feasible sources for controlling prosthesis. Ways for improving accuracy in developing prosthesis controlled by neuro signals are discussed in the end.
Amputation ; Amputees ; Artificial Limbs ; Electrodes ; Humans ; Movement ; physiology ; Muscles ; innervation ; physiology ; Neurons ; physiology

OBJECTIVETo assess the diagnostic value of tumor markers in the cerebrospinal fluid (CSF) for meningeal carcinomatosis (MC).

METHODSTwenty-one MC patients (including 13 adenocarcinoma and 8 non-adenocarcinoma patients), 72 patients with tuberculous meningitis (TBM) and 23 with primary intracerebral tumors (PIT) were enrolled in this study. Blood and CSF tumor markers including CEA, CA125, CA15-3, CA19-9, CA72-4, CYFRA21-1, AFP and NSE were measured by Roche E170 electrochemiluminescence analyzer and sandwich assay.

RESULTSCSF tumor markers CEA, CA125, CA199 and CYFRA21-1 and the serum tumor markers CEA, CA125, CA153, CA199 and AFP were significantly higher in MC group than in the other two groups. CSF CEA and CA15-3 were significantly higher in adenocarcinoma MC than in non-adenocarcinoma MC patients, but no significant differences were found in the serum tumor markers between the two groups (P>0.05). CSF tumor markers including CEA, CA125, CA15-3, CA72-4 and CYFRA21-1 were positively correlated to the serum tumor markers (P<0.05). CA199 was positively correlated to the disease course (P<0.05), and age was not correlated to any of the indexes (P>0.05).

CONCLUSIONDetection of the tumor markers in the CSF, especially CEA, CA125, CA19-9 and CYFRA21-1, may help in the early diagnosis of MC. CEA and CA15-3 can serve as indicators for differential diagnosis of adenocarcinoma and non-adenocarcinoma.

Adenocarcinoma ; cerebrospinal fluid ; diagnosis ; Adult ; Aged ; Antigens, Neoplasm ; cerebrospinal fluid ; Biomarkers, Tumor ; cerebrospinal fluid ; CA-125 Antigen ; cerebrospinal fluid ; CA-19-9 Antigen ; cerebrospinal fluid ; Carcinoembryonic Antigen ; cerebrospinal fluid ; Female ; Humans ; Keratin-19 ; cerebrospinal fluid ; Male ; Membrane Proteins ; cerebrospinal fluid ; Meningeal Neoplasms ; cerebrospinal fluid ; diagnosis ; Middle Aged ; Young Adult

OBJECTIVETo study the value of combined measurement of intestinal fatty acid-binding protein (I-FABP) and fecal calprotectin (FC) in the diagnosis of necrotizing enterocolitis (NEC) in full-term neonates.

METHODSA total of 36 full-term neonates with NEC (case group) and 39 neonates without digestive system diseases (control group) were enrolled as study subjects. ELISA was used to measure the serum I-FABP level and fecal FC level, and the clinical value of I-FABP combined with FC in the diagnosis of NEC was evaluated.

RESULTSThe case group had significantly higher I-FABP and FC levels than the control group (P<0.05). In the case group, serum I-FABP level was positively correlated with fecal FC level (r=0.71, P<0.05). In the diagnosis of NEC, I-FABP alone, FC alone, and I-FABP/FC combination had sensitivities of 83.3%, 81.5%, and 79.5%, specificities of 72.5%, 75.8%, and 86.3%, and areas under the ROC curve (AUCs) of 0.82, 0.81, and 0.88. The combined measurement showed significantly higher specificity and AUC than single measurement (P<0.05).

CONCLUSIONSChildren with NEC have significant increases in I-FABP and FC levels, and there is a correlation between them. Combined measurement of I-FABP and FC can increase the specificity of the diagnosis of NEC.

Enterocolitis, Necrotizing ; diagnosis ; Fatty Acid-Binding Proteins ; blood ; Feces ; chemistry ; Female ; Humans ; Infant, Newborn ; Leukocyte L1 Antigen Complex ; analysis ; Male