Objective To explore the posibility of removing the jugular tubercle precisely and design a new far-lateral supraeondylar keyhole approach based on keyhole idea.Methods Eight cadaveric heads fixed by 10% formalin and perfused intracranial vessels with colored silicone were used in this study.Before the operation,navigation data of these cadaveric heads were established and circumscriptions of jugular tuber- cle were outlined in the navigation system in order to aid drilling it in operation.A 7cm longitudinal“S”shaped skin incision as we reported was performed.After inverting suboccipital muscles and exposing the far lateral of the occipital bone,occipital condyle,jugular tubercle,hemilamina of C_1,vertebral artery and pos- terolateral portion of foramen magnum,a 3cm retro-condylar bone window was made.Under the microscope, anatomic structures were observed and important structures were measured after jugular tubercle removal assis- ted by neuro-navigation.Results The 7cm longitudinal“S”shaped skin incision with its superior border 2cm behind the middle point of mastoid and inferior margin at the level of C_2 can fully meet the needs of the far-lateral supracondylar keyhole approach;jugular tubercle can be drilled satisfactorily with the help of neuro- navigation;inferior segment of basilar artery[long(15.65?1.34)mm]and anterior inferior cerebellar artery [long(20.36?4.18)mm] can be exposed.Conchlsion Owing to the area of middle clivus is increasingly exposed after removal of jugular tubercle,it is feasible to perform the far-lateral supracondylar keyhole ap- proach on the operations of vertebral-basilar artery aneurysm,anterior inferior cerebellar artery aneurysm and tumor located inferior and middle clivi or jugular foramen.

Objective To investigate the effect of rosiglitazone (ROS),a peroxisome poliferator- activated receptor (PPAR)?ligand,combined with all-trans retinoic acid (ATRA) on anti-angiogenesis of transplanted gastric cancer in nude mice,and to explore the mechanism of anti-angiogenesis prelimina- rily.Methods The model of xenograft tumor in nude mice were established by inoculating human gastric cancer cells line MGC803 (lower differentiated) into the back of nude mice subcutaneously.The cancer- bearing nude mice were divided randomly into 5 groups:group 1 (n=6) with no treatment;ROS treat- ment (group 2,n=6),ROS combined ATRA treatment including:low dose treatment (group 3,n= 6),moderate dose treatment (group 4,n=6) and high dose treatment (group 5,n=6).After treated for forty days,the volume change of tumor and tumor inhibition rates were observed.The expression of CD34,vascular endothelial growth factor (VEGF) in grafts were detected by immunohistochemical and calculated the difference of MVD.The mRNA expression levels of VEGF,HIF-l?were detected by RT- PCR assay accordingly.Results①The volume of tumor was significantly decreased in ROS treatment group compared with group 1 (P＜0.01).The tumor inhibition rates of group 2 were similar to group 3 (P＞0.05).With the increasing of the dose of ROS the tumor inhibition rates were increased.They were dose-dependent in specified dose-range.②ROS could inhibit angiogenesis of xenograft tumor and depress expression of mRNA of VEGF and HIF-l?.When ROS combined with ATRA,the increasing of dose of ROS,inhibiting angiogenesis of tumor and depressing expression of mRNA of VEGF and HIF-l?were found (P＜0.05).Conclusion ROS (25 mg?kg?2 d~(-1)) can inhibit the growth of tumor,and ROS combined with ATRA can further inhibit the growth of tumor,which may be through the path of PTEN by inhibiting the angiogenesis of tumor

Objective To explore the clinical application of keyhole craniotomy microsurgery in neurosurgery. Methods Corresponding keyhole approach operation was employed in 13 cases of sellar region tumor, 6 cases of meningoma, 5 cases of hypertensive cerebral hemorrhage, 2 cases of glioma of corpus callosum, 2 cases of acoustic neuroma, 1 case of metastatic cerebral tumor, 1 case of epidural hematoma and 1 case of C 2 intravertebral tumor. Results Among the 25 cases, total resection was accomplished in 19 cases and subtotal resection, 6 cases. Lesions were all thoroughly cleared away in 5 cases of cerebral hemorrhage and 1 case of epidural hematoma. One case of acoustic neuroma died of re-bleeding in the lesion on the 3rd postoperative day. Subcutaneous dropsy took place in 2 cases and transient diabetes insipidus occurred in 3 cases. Conclusions Keyhole craniotomy microsurgery has the advantages of minimal exposure, micro-invasion, fewer complications and faster recovery.

Abstract: Objective　To analyze the impact of the flood disaster on the distribution of Oncomelania snails in 2020 in Wuhu City, to provide scientific basis for formulating the "14th Five-Year Plan" for schistosomiasis control and precise prevention and control measures in Wuhu City. Methods　Systematic sampling combined with environmental spot check was used to investigate the distribution of snails in the historical snail's environment, existing snail's environment and suspected snail's environment in Wuhu City. The collected snails were crushed and examined by microscope to understand the death and life of snails and the infection of Schistosoma japonicum, and the density of live snails and other indicators were counted. Results　The historical area of snails was 14 475.24 hm2 in Wuhu City, and the existing area of snails was 4 588.72 hm2, including 4 210.32 hm2 for lake type and 378.40 hm2 for hill type snails. The average occurrence rate of live snails was 14.59%, and the average density of live snails was 0.50 snails/0.1 m2 in Wuhu City. There were 2 745 snail breeding environments, of which 491 were lake type and 2 254 are hill type, accounting for 17.89% and 82.11% respectively. The existing snail area was mainly distributed in the beaches and ditches, accounting for 92.51% and 6.29% of the existing snail area respectively. Some snails were distributed in ponds, paddy fields and other environments. Among all the historical snail habitats, the majority were class Ⅱ and class Ⅲ environments (which still have the basic conditions for snail breeding at present), with a total of 1 739 sites (blocks), accounting for 63.35% of the total environment. No schistosomiasis infected snails have been found, and the newly discovered and recovered snails cover an area of 268.21 hm2 in Wuhu City. Conclusions　The distribution of snails is extensive in Wuhu City, and snails are mostly distributed in beaches, which are vulnerable to the impact of flood disasters. The spread of Oncomelania snails is found in 30 marshlands in 3 counties in this survey. It is necessary to continue to strengthen snail monitoring after disasters, and take class Ⅱ and class Ⅲ environments as key areas for snail monitoring, so as to find, identify and evaluate the risk of schistosomiasis transmission as soon as possible, to avoid or reduce the impact of flood disasters on the process of schistosomiasis control, and promote the process of schistosomiasis elimination.

Adenoma, Sweat Gland ; pathology ; Humans ; Male ; Middle Aged ; Nose Neoplasms ; pathology

BACKGROUND:A series of studies have demonstrated that ventral mesencephalic dopamine precursors may differentiate into considerable dopaminergic neurons (DNs) available for cell transplantation for Parkinson's disease.However,the detailed molecular characteristics of these cells remain undear.OBJECTIVE:To observe the expression of main marker genes of DNs cultured in vitro.DESIGN,TIME AND SETTING:This observation experiment was performed at the Brain Tumor Laboratory in the Second Affiliated Hospital of Soochow University and Shanghai Biochip Company from December 2005 to December 2008.MATERIALS:Inbred pregnant Wistar rats (F+36) weighing 300 g approximately were used for in vitro culture of mesencephalic cells.METHODS:Ventral mesencephalic cells from inbred pregnant Wistar rats were cultured with basic fibroblast growth factor,and were induced to differentiate in vitro with L-Ascorbic acid-2-phosphate sesquimagnesium salt.Total RNA were extracted before and 4,7 days after the induction.Affymetrix microarrays were utilized to detect the expression changes of main marker genes of DNs.MAIN OUTCOME MEASURES:Morphologic changes of differentiated ventral mesencephalic precursors;Expression of DN-ralated common marker genes before and after the induced differentiation.RESULTS:Rat ventral mesencephalic precursors differentiated into numerous tyrosine hydroxylase-positive cells,which expressed multiple marker genes of DNs,such as AHD2,calcium binding protein 1 (Cab1),DDC,DAT,Drd2,Girk2,VMAT-2,with variously degrees and with different tendencies.Among those genes,only Cab1 was significantly up-regulated and only Girk2 was significantiy down-regulated.CONCLUSION:Rat ventral mesencephalic precursors can be induced to differentiate into plenty of tyrosine hydroxylase-positive DNs,mainly originating in A10 regions.

Objective To evaluate the efficacy of Qingfei-Jiedu decoction in the treatment of Acne. Methods A total of 93 female patients with acne were randomly divided into 3 groups according to random number table, 31 in each group. The observation group took the oral Qingfei-Jiedu decoction, and the Chinese medicine control group took the oral tanshinone capsule, and the western medicine control group took the oral acetic acid ring propyl alcohol progesterone. All 3 groups were treated for 4 weeks. The levels of serum dihydro (DHT), IL-6 and IL-8 were measured by ELISA. The changes of the lesions before and after treatment were observed and the adverse events were recorded during the treatment. The clinical effect was evaluated. Results After treatment, the serum DHT (56.94 ± 15.74 pg/ml vs. 74.48 ± 18.53 pg/ml, t=2.089), IL-6 (22.84 ± 11.77 pg/ml vs. 30.37 ± 14.50 pg/ml, t=2.135), IL-8 (22.64 ± 7.38 pg/ml vs. 29.54 ± 9.65 pg/ml, t=2.057) in the observation group were significantly lower than those in the Chinese medicine control group (P<0.05). After treatment, the disappearance rate of skin lesions (65.4% ± 15.0% vs. 44.7% ± 12.9%, 42.7% ± 13.6%, F=6.862) and comprehensive syndrome effective rate (57.2% ± 12.6% vs. 46.3% ± 12.8%, 44.8% ± 11.7%, F=5.322) in the observation group were significantly higher than those in the other two control groups (P<0.05). The observation group and the traditional Chinese medicine control group did not have adverse events, but the western medicine control group showed one case nausea. Conclusions The Qingfei-Jiedu decoction can reduce the level of serum DHT, IL-6 and IL-8 in female patients with acne vulgaris, and improve the skin lesion disappearance rates and comprehensive syndrome rates.

Objective To explore the value of echocardiography in percutaneous left atrial appendage (LAA)closure for stroke prevention in patients with nonvalvular atrial fibrillation during procedure and for short-term follow-up.Methods Twenty patients were enrolled to undergo percutaneous LAA closure with the LAmbre device.Rheumatic valvular diseases were excluded by transthoracic echocardiography (TTE) and transesophageal echocardiography(TEE)before the closure procedure.TEE was performed during the procedure for the trans-septal puncture and the release of the closure device.Combined TEE with angiographic measurements,guidance for the optimal device size was provided.The closure effect and procedure-related complications were observed immediately by TEE and also evaluated by TTE at 1-day and 1-month follow-up.Results All patients underwent LAA occlusion successfully.TEE color Doppler evaluation have shown nine patients with complete closure immediately,one with a ≤ 1 mm residual LAA leak,and ten with a 1 -3 mm jet.There were no other complications during the procedure.One day after the closure,small pericardial effusions were observed for three patients while two of the three were free of the pericardial effusion at the 1-month follow-up.During the short-term follow-up,no damage was found at any anatomical structures near LAA due to the closure process,and there was no significant difference of cardiac function before and after the procedure.Conclusions With the guidance of TEE,the successful rate of percutaneous LAA closure procedure was preferable and the occurrence rate of compliance was acceptable. And TTE played an important role in patients'short-term follow-up.

This article surveyed the protocols and informed consent forms of 15 paediatric clinical trials which had been reviewed by the hospital′s institutional research board from 2008 to 2013 .This survey reevaluated and made suggestions on the protocols and informed consent forms, focusing on the risk level, protocol design back-ground, risk minimization measures, the required elements as well as the language expressions of informed consent forms and finding out the shortage of informed consent and give appropriate advices.

Objective To discuss the clinical efficacy of surgery for chronic subdural hematoma assisted by rigid neuroendoscope and its surgical techniques. Methods Clinical data of 161 patients with chronic subdural hematoma from August 2009 to December 2015 was analyzed retrospectively. 74 of them experienced surgeries assisted by rigid neuroendoscope (endoscope group) and other 87 cases were operated without neuroendoscope (routine group) during the same period. Results Although there were significant difference in operative duration between the two groups, complications, ratio of total removal of hematoma after surgery, postoperative inpatient duration and recurrent rate of hematoma were more advantageous in endoscope group. The operative duration of endoscope group with (112.68 ± 34.86) min was longer than that of routine group with (74.11 ± 28.23) min (t = 7.75, P = 0.000), while the postoperative inpatient duration of endoscope group with (8.23 ± 2.01) d was shorter than that of another group with (10.79 ± 5.02) d (t = -4.12, P = 0.000). There were no surgical associated complications in endoscope group, but 1 patient in routine group experienced intracerebral hematoma of frontal lobe and associated aphemia. Total removal of hematoma was confirmed in endoscope group with 98.65% (73/74), which was higher than that in routine group with 86.21% (75/78) (χ2 = 8.34, P = 0.004). Hematoma recurrence was found in 16 cases of routine group (18.39%), but more superiority in endoscope group with 1.35% (χ2 = 12.29, P = 0.000). Outpatient follow-up was carried out in all patients from 6 to 38 months with an average duration of 30.06 months. In 17 cases with recurrent hematoma during follow-up, 15 of them were cured by a second surgery, and another 2 patients were cured by atorvastatin. Conclusion As a simple, safe and effective technique, the application of rigid neuroendoscope during surgery for chronic subdural hematoma is more advantage than routine surgery. A self-made suction with adjustable soft curved tip is suitable for such procedure.