Objective To investigate the therapeutic effect of trans-TrkC gene neural stem cells (NSCs)on the recovery of neural function after spinal cord injury.Methods Sixty SD rats were ran- domly divided into six groups:normal control group(A),hemisection group(B),NSCs transplantation grnup(C),NSCs transplantation with the regional application of NT-3 group(D),trans-TrkC gene NSCs transplantation group(E)and trans-TrkC genc NSCs transplantation with the regional application of NT- 3 group(F),10 rats in each group.Nine days after the set up of animal models,cell transplantation into the injured spinal cord was performed.The BBB locomotor score was calculated,and MEP(motor evoked potential)and SEP(somatesensory evoked potential)were pedormed two months after cell transplanta- tion.Results Two months after cell transplantation,the BBB locomotor score was partly recovered, and the MEP and SEP(somatosensory evoked potential)results were also markedly improved in Group F, which indicated the restoration of the upward and downward nerve conduction function of the injured spinal cord.But it seemed that the restoration of the downward nerve conduction was better than that of the up- want,and the extent of the improvement of MEP and SEP results was larger than that of motion function recovery.The onset latency,peak to peak amplitude of MEP and SEP,and the BBB score of Group F re- stored the best compared with the other groups,and the differences were statistically significant(P

Objective To report the development of clinical symptoms in a Chinese family with autosomal dominant progressive external ophthalmoplegia(adPEO).Methods Electromyologram and muscle biopsy were performed in the proband and 4 family members with the disease.Results The proband was a 57 year-old woman,who developed bilateral ptosis after the age of 30,external ophthalmoplegia after the age of 35 years old,weakness of extremities at the age of 37 years old and bulb palsy with palmus at the age of 47 years old.In the family there were 20 male and female members from five generations.All of them complained about bilateral ptosis between 26—33 years old,external ophthalmoplegia(12/15)and weakness of all extremities(14/15)between 35—45,facial and masticatory weakness(9/9)as well as dysphagia(8/9)between 44—60,accompanied with heart lesions(4/7)after 50 years old.Some patients died due to cardiac impairment.Electromyologram showed myopathic abnormalities in the examined patients. The main myopathological changes were ragged red fibers,cytochrome c oxidase negative fibers and ragged blue fibers in succinate dehydrogenase staining.Conclusions The adPEO started from extra-ocular muscles to limbs,finally facial and bulbar muscles.Heart lesions were presented in late stage and lead to death in some members.The developing process of symptoms suggested that we should pay more attention to cardiac manifestations in this disease.

Objective To analysis the clinical manifestations of mtDNA A3243G mutation in adulthood.Methods The clinical features were investigated in 36 cases (28 patients from 5 families with the mutation and 8 sporadic cases),in whom mtDNA A3243G mutation was confirmed genetically in 23 cases (15 cases from 5 mutation families and 8 sporadic cases).Cranium radiology was performed in 14 cases.Muscal biopsies were performed in l0 cases.Results Among 28 cases in the 5 family,there were 9 cases (32.1%) with stroke like episodes,17 cases (60.7%) with diabetic mellitus and 16 cases (57.1%) with deafness.Such symptoms usually combined with each other and rarely existed alone. Cardiomyopathy and renal failure were uncommon.In the 23 cases with mtDNA A3243G mutation,14 cases (61.0%) had mitochondria] myopathy,encephalopathy,lactic acidosis,and stroke-like episodes (MELAS),mostly presenting cognitive abnormalities,dysarthria or aphasia and headache,3 cases (13.0%) were asymptomatic carriers,2 cases (8.7%) had autonomic dysfunction,2 cases (8.7%) had diabetic mellitus with or without nerve deafness,1 case (4.3%) had diabetic mellitus with infertilitas and cardiomyopathy,respectively.Cranial radiological images revealed the changes more commonly in the temporal and occipital lobes and less frequently in the frontal lobes.Ragged red fibers were confirmed in 9 of 10 cases with muscle biopsies.The proportion of mutant mtDNA A3243C was not significantly different between MEALS (28.75%?13.69%) and non-MELAS (25.08%?11.54%).Conclusions mtDNA A3243G mutation mainly results in the lesions in the central nerve system,pancreatic island and acoustic nerve in adulthood.Heart and kidney are less frequently involved.Cognitive abnormalities,aphasia and headache are the major symptoms of adult MELAS.Families have with more than 1 patient with diabetic mellitus and deafness,indicating that the mutation is other than MELAS mutation.We should pay more attention to the non-MELAS symptoms in the families with mtDNA A3243G mutation.

OBJECTIVETo explore an effective method for further improving the surgical results of treatment of olfactory groove meningiomas.

METHODSSixty seven cases of olfactory groove meningiomas were treated by microneurosurgery, among which fifty seven were de novo cases, eight were recurrent tumors and the other two re-recurrent cases. Modified Derome approach was used in 12 cases, bilateral subfrontal approach in 28 cases, modified pterional approach in 21 cases and unilateral subfrontal approach in six cases. Tumors were resected microsurgically with radical removal of invaded dura, bone, and paranasal sinus mucosa. Reconstruction was performed in patients with skull base defect.

RESULTSSimpson grade I removal was accomplished in 59 cases, grade II in seven cases and grade IV in one case. Among 57 patients with de novo tumor, Simpson I resection was accomplished in 54 cases. Postoperative rhinorrhea and intracranial infection occurred in one case and was cured after temporal lumbar CSF drainage and antibiotic therapy. Two patients (2.9%) died within one month after operation, i.e.one aged patient of heart failure and the other of severe hypothalamus complication. Forty seven patients (72.3%) were followed up from one to ten years with an average of five years and four months. With the exception of two cases died, among the alive 45 patients, there were only three patients with tumor recurrence, which had undergone Simpson II or IV tumor resection. No recurrence was found in cases with Simpson I tumor removal. Previous blurred vision was not improved in three patients, hemiparalysis in two patients, and the other patients recovered well, resuming previous jobs or being able to take care themselves.

CONCLUSIONSTotal tumor removal (Simpson I) should be the surgical goal for treatment of olfactory groove meningiomas, especially for de novo cases. An appropriate approach is fundamental in the effort to remove an OGM totally. Appropriate anterior skull base reconstruction with vascularized material is important and mandatory.

Adult ; Aged ; Cerebrospinal Fluid Rhinorrhea ; etiology ; Dura Mater ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Meningeal Neoplasms ; diagnosis ; pathology ; surgery ; Meningioma ; diagnosis ; pathology ; surgery ; Microsurgery ; adverse effects ; methods ; Middle Aged ; Neoplasm Recurrence, Local ; Paranasal Sinuses ; pathology ; surgery ; Reconstructive Surgical Procedures ; Skull Base ; pathology ; surgery

OBJECTIVETo describe the characteristics of magnetic resonance (MR) signals generated by lipiodol and to assess the influence on MR imaging of hepatoma nodule.

METHODSPure lipiodol and lipiodol emulsions mixed with 76% urografin in different ratio were imaged by both CT and MR; quantitative T(1) and T(2) measurements of lipiodol were performed. Fourty-one SD rats with transplanted walker-256 sarcoma in liver were randomly divided into six groups: 0.4-0.6 ml lipiodol emulsion was infused via hepatic artery in experimental groups by means of laparotomy under celiac anesthesia. The changes in MRI signal of hepatoma nodule were observed.

RESULTIn vitro, iodized oil demonstrated high signal on T(1)-weighted images when performed at 37 degree, but all could be suppressed by the fat saturation sequence, and showed very low signal on T(2)-weighted images. The characteristic of MR signal with ultra fluid lipiodol was different from that of iodized oil (P<0.01), showing short T(1) and long T(2) signal; the high signal on T(1)-weighted images was only partially suppressed by the fat saturation sequence. With descending ratio of lipiodol in emulsion, the signal behavior was gradually similar to urografin (r -0.958, P<0.01). When rats were transarterially infused with emulsion, the intensity of the signal on MRI was nearly the same as that in the control rats, but when lipiodol was injected out of the hepatic artery and accumulated in lymphadenopathy, it demonstrated a signal similar to fat; the high intensity signal was maintained on T(1)-weighted images and T(2)-weighted images.

CONCLUSIONThere are little changes in MR signal intensity when the lipiodol is accumulated in the tumor nodules. MR behavior of lipiodol is determined by its deposit area.

Animals ; Chemoembolization, Therapeutic ; Iodized Oil ; chemistry ; metabolism ; Liver Neoplasms ; pathology ; therapy ; Magnetic Resonance Imaging ; Male ; Rats ; Rats, Sprague-Dawley ; Tomography, X-Ray Computed

OBJECTIVE: To describe the imaging features of pelvic solitary plasmacytoma and to correlate them with the pathologic grade. MATERIALS AND METHODS: A retrospective study was performed on the imaging features of 10 patients with a histological diagnosis of pelvic solitary plasmacytoma. The imaging studies were assessed for bone expansion, cortical destruction, signal intensity/density of soft tissue mass and enhancement manifestations, which were then correlated to the pathologic grade. RESULTS: The imaging features of pelvic solitary plasmacytoma revealed 3 different types: multilocular type (n = 5), unilocular type (n = 2) and complete osteolytic destruction type (n = 3) on computed tomography and MRI. Pathologically, the tumors were classified into low, intermediate and high grades. Features such as multilocular change, perilesional osteosclerosis, slight expansion, local bone cortex disruptions and masses inside bone destruction, often suggest a low-grade solitary plasmacytoma; complete osteolytic destruction, huge soft tissue mass, and osseous defects imply a higher pathologic grade. CONCLUSION: Pelvic solitary plasmacytoma has various imaging manifestations, while a slight expansile osteolytic feature with multilocular change or homogeneous enhancement highly suggests its diagnosis. The distinctive imaging features of pelvic solitary plasmacytoma are well correlated to the pathologic grade.
Adult ; Aged ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Grading ; Pelvic Neoplasms/*pathology/radiography ; Plasmacytoma/*pathology/radiography ; Retrospective Studies ; Tomography, X-Ray Computed

BACKGROUNDEverolimus, a derivative of sirolimus, is a potent immunosuppressant that has important anti-proliferative properties. In the present study, we demonstrated the inhibiting neointimal hyperplasia in injured carotid arteries in rats by using two different doses of everolimus administrated via the oral route for a long time.

METHODSA rat model of carotid artery injury was established by balloon inflation. Eighty rats were randomly divided into the sham-operated group (n = 20), injury group (n = 20), low dosage of everolimus group (n = 20), and high dosage of everolimus group (n = 20). The low dose of everolimus (1.5 mg/kg) was given one day before injuring the carotid artery by balloon, followed by 0.75 mg/kg per day for 28 days via intragastric gavage. High dose everolimus (2.5 mg/kg) was given one day before injuring the carotid artery by balloon, followed by 1 mg/kg per day for 28 days. Expression of eukaryotic translation initiation factor 4E (eIF-4E) and phosphorylation of ribosomal protein S6 kinase 1 (P70S6K) were determined by reverse transcription-polymerase chain reaction and Western blotting analysis.

RESULTSIn the injured carotid artery, neointimal hyperplasia was normally observed four weeks after injury. Everolimus inhibited neointimal hyperplasia after balloon injury in a dose dependent manner. At the same time, the study demonstrated that everolimus reduced the expression of P-P70S6K, eIF-4E, transforming growth factor (TGF)-β1 and of proliferating cell nuclear antigen (PCNA).

CONCLUSIONSEverolimus significantly inhibited neointimal hyperplasia of the injured carotid artery. The effect depended on dosage and was associated with the reduction of phosphorylation of P70S6K and the eIF-4E expression level.

Animals ; Carotid Arteries ; drug effects ; Carotid Artery Injuries ; drug therapy ; Carrier Proteins ; metabolism ; Everolimus ; Male ; Neointima ; drug therapy ; Phosphoproteins ; metabolism ; Phosphorylation ; drug effects ; Rats ; Rats, Sprague-Dawley ; Ribosomal Protein S6 Kinases, 70-kDa ; metabolism ; Sirolimus ; analogs & derivatives ; therapeutic use

PURPOSE: The International Study Group on Pancreatic Fistula's definition of postoperative pancreatic fistula (POPF) has recently been updated. This study aimed to identify risk factors for POPF in patients having pancreaticoduodenectomy (PD) and to generate a nomogram to predict POPF. METHODS: Data on 298 patients who underwent PD from March 2012 to October 2017 was retrospectively reviewed and POPF statuses were redefined. A nomogram was constructed using data from 220 patients and validated using the remaining 78 patients. Independent risk factors for POPF were identified using univariate and multivariate analyses. A predictive nomogram was established based on the independent risk factors and was compared with existing models. RESULTS: Texture of the pancreas, size of the main pancreatic duct, portal vein invasion, and definitive pathology were the identified risk factors. The nomogram had a C-index of 0.793 and was internally validated. The nomogram performed better (C-index of 0.816) than the other most cited models (C-indexes of 0.728 and 0.735) in the validation cohort. In addition, the nomogram can assign patients into low- (less than 10%), intermediate- (10% to 30%), and high-risk (equal or higher than 30%) groups to facilitate personalized management. CONCLUSION The nomogram accurately predicted POPF in patients having PD.

OBJECTIVETo explore the risk factors for Guillain-Barre syndrome.

METHODSCase-control study design was used in 51 cases of Guillain-Barre syndrome, and 51 matched controls. All of the 51 cases in this study had been examined by electrophysiology. Serum IgG antibodies specific for C. jejuni were determined in all the subjects by ELISA. Each case and control were interviewed using an ad hoc questionnaire, including his/her demographic information, onset of the illness, their personal hygiene and so on.

RESULTSThe study showed that Guillain-Barre syndrome was associated with a few factors, such as polio vaccine immunization before onset of illness (OR=7.27), no hand washing after defecation and before meals (OR=6.15). Infection of C. jejuni was strongly associated with the illness (OR=9.5, P<0.001).

CONCLUSIONIt is suggested that occurrence of Guillain-Barre syndrome may correlate to infection of C. jejuni and poor personal hygiene in children.

Adolescent ; Campylobacter Infections ; complications ; Campylobacter jejuni ; pathogenicity ; Case-Control Studies ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Guillain-Barre Syndrome ; epidemiology ; etiology ; microbiology ; Hand Disinfection ; Humans ; Immunoglobulin G ; analysis ; Infant ; Male ; Poliovirus Vaccines ; adverse effects ; Risk Factors

Purpose To study the clinicopathologic features of ganglioglioma. Methods The clinicopathologic data of the cases pathologically diagnosed as ganglioglioma that underwent resection of epileptic focus were retrospectively analyzed. Results In the 19 cases studied, the mean onset age was 9.1 years, and the duration of disease was 9.3 years. MRI images showed abnormal signals. The majority of the site was temporal lobe (14/19, 73.7％). The tumors showed heterogeneity and often accompanied by focal cortical dysplasias (13/19, 68.4％). Immunohistochemical staining showed CD34 positive in 18 cases, Nestin positive in 16 cases, and BRAF-V600E positive in 6 case. The positive expression rate of CD34 and Nestin did not have significant differences. Conclusion The diagnosis of ganglioglioma relies on pathological observations combined with clinical features and neuroradiological examinations. Differential diagnosis should be done from other tumors or cortical dysplasia. Immunohistochemical staining of CD34 and Nestin can help diagnosis.