OBJECTIVETo study the clinicopathologic features, immunohistochemical findings, diagnosis and differential diagnosis of atypical teratoid/rhabdoid tumors (AT/RT) of central nervous system in childhood.

METHODSThe clinicopathologic data, morphologic features and immunophenotypes were reviewed in 6 cases of AT/RT. EnVision method was applied. Antibodies include cytokeratin (CK), epithelial membrane antigen (EMA), vimentin, smooth muscle actin (SMA), muscle specific actin (MSA), glial fibrinary acid protein (GFAP), desmin, placental alkaline phosphatase (PLAP) and INI1.

RESULTSFive of the six cases of AT/RT occurred in infancy and early childhood. Histologically, the predominant component was rhabdoid cells. Cytoplasmic inclusions were present in all cases. Primitive neuroectodermal tumor (PNET) component was also identified in 5 of the 6 cases studied. Immunohistochemically, the tumor cells were positive for cytokeratin, epithelial membrane antigen and vimentin. The staining for INI1, desmin and PLAP was negative. Smooth muscle actin was expressed in 2 cases and glial fibrillary acidic protein in 5 cases. The proliferative index as demonstrated by Ki-67 staining was high.

CONCLUSIONSAT/RT is not a particularly uncommon malignancy in childhood. The histologic hallmark is the presence of rhabdoid cells with cytoplasmic inclusions. The tumor cells are positive for cytokeratin, epithelial membrane antigen and vimentin, and negative for INI1. Differential diagnosis includes PNET, medulloblastoma and medullomyoblastoma.

Brain Neoplasms ; metabolism ; pathology ; surgery ; Child, Preschool ; Diagnosis, Differential ; Female ; Humans ; Infant ; Keratins ; metabolism ; Male ; Medulloblastoma ; metabolism ; pathology ; Mucin-1 ; metabolism ; Neuroectodermal Tumors, Primitive ; metabolism ; pathology ; Rhabdoid Tumor ; metabolism ; pathology ; surgery ; Teratoma ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Objective To evaluate the treatment of aneurysms rupture during endovascular embolization.Methods Nine aneurysms ruptured during the embolization and were treated with endovascular embolization.The reasons of aneurysms rupture during embolization,the prevention and the first aid after aneurysms rupture were analysed.Results Seven patients recovered and 2 died.Conclusions The optimal treatment of aneurysms rupture during endovascular embolization is effective,(J Intervent Radiol,2007,16: 132-134)

OBJECTIVETo explore the clinical techniques and effects of repairing skin defects of the forefoot by free perforating flap nourished by peroneal artery.

METHODSFrom June 2007 to June 2011, 11 patients with skin and soft tissue defects of the forefoot were repaired by free peroneal artery perforating flap in emergent or subemergent. There were 10 males and 1 female with an average age of 28.6 years old ranging from 23 to 46 years old. Among them, 4 cases injured for traffic accidents, 3 for crush and 4 for machine strangulation. In all cases, the defect area of forefoot tissue varied from 2.0 cm x 4.0 cm to 4.0 cm x 8.5 cm,and the adopted area varied from 2.5 cm x 4.5 cm to 4.0 cm x 9.0 cm. The operation time was from 6 to 96 h (averaged 31.8 h). The blood vessels were anastomosed end-to-end.

RESULTSAll of the transferred free flaps survived uneventfully. Nine of them were successfully followed up from 6 to 24 months. The appearance, elasticity and functions of flaps were satisfied accompanied with slight damage of donor site although seemed bloated. The smaller donor site could be intimately seamed if necessary.

CONCLUSIONThe vessels anatomy of knee with antegrade extended peroneal artery was relative constant with a moderate thickness and simple operation, is useful to repair small or middle areas of skin defects in forefoot.

Adult ; Female ; Foot Injuries ; surgery ; Forefoot, Human ; surgery ; Free Tissue Flaps ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Soft Tissue Injuries ; surgery ; Young Adult

Objective To evaluate the effect ofendovascular embolization on intracranial aneurysms with detachable coil and detachable balloon and to emphasize the mainpoint of embolization technique.Methods 1328 patients underwent complete cerebral angiography using microcatheter under DSA imaging. 85 cases with 90 aneurysms were embolized by MDS, 825 cases with 847 aneurysms were embolized by GDC, 418 cases with 433 aneurysms were embolized by EDC. 37 of 67 giant aneurysms were embolized by detachable balloon, 18 aneurysms by GDC, 11 aneurysms by EDC, 1 by MDS. Results 1328 patients with 1370 aneurysms were cured successfully; 1 322 cases recovered clinically, 6 patients died. 1 281 aneurysms achieved 100 % occlusion, 65with 95 % occlusion, 20 with 90 % occlusion, and 4with 80 % embolization. 9 aneurysms reputured during the embolization, 5 patients had cerebral infarction, 1 patient died of intractable cerebral vasospasm for microcoil escape. 2 recurrent cases were cured by second GDC embolization. Conclusion The method of endovascular embolization to treat intracranial aneurysm is safe, reliable and effective. Those cases with giant aneurysms will have high recurrence. Patients who suffer from SAH repeatedly may have great possibility of aneurysm rupture during embolization.

Objective To observe the expression of growth factors (vascular endothelial growth factor [VEGF],stromal cell-derived factor-1 [SDF-1 ],basic fibroblast growth factor [bFGF],insulin-like growth factor [IGF-1],transforming growth factor-β [TGF-β],platelet-derived growth factor [PDGF],brain derived neurotrophic factor [BDNF],glial cell line-derived neurotrophic factor [GDNF] and nerve growth factor [NGF]) in rat ischemic brain tissues after intravenous implantation of bone marrow stromal cells (BMSCs) and/or endothelial progenitor cells (EPCs). Methods Healthy adult Wistar rats were randomly divided into 4 groups:vehicle group,BMSCs transplantation group,EPCs transplantation group and BMSCs combined with EPCs transplantation group (n=20). The rats were subjected to middle cerebral artery occlusion (MCAO),and 24 h after that,they were intravenously transplanted with either 3×106 BMSCs,EPCs,BMSCs/EPCs or 1 mL physiological saline.Seven d after transplantation,real time-PCR and Western blotting were employed to detect the expressions of VEGF,SDF-1,bFGF,IGF-1,TGF-β,PDGF-BB,BDNF,GDNF and NGF. Results The mRNA expressions of bFGF,VEGF and BNDF in the BMSCs/EPCs transplantation group were significantly higher as compared with those in the other groups (P＜0.05).BMSCs transplantation group enjoyed the highest mRNA levels of NGF,GDNF and TGF-β among all the groups, significantly higher as compared with those in the other groups (P＜0.05),followed by BMSCs/EPCs transplantation group.EPCs transplantation group enjoyed the highest mRNA levels of PDGF,IGF-1 and SDF-1,significantly higher as compared with those in the other groups (P＜ 0.05), followed by BMSCs/EPCs transplantation group. Conclusion BMSCs combined with EPCs implantation can promote the functional rehabilitation in rats after focal cerebral ischemia, which provides new way for improving the transplantation success rate.

Objective:To explore the clinical techniques and effects of repairing skin defects of the forefoot by free perfo-rating flap nourished by peroneal artery. Methods:From June 2007 to June 2011,11 patients with skin and soft tissue defects of the forefoot were repaired by free peroneal artery perforating flap in emergent or subemergent. There were 10 males and 1 fe-male with an average age of 28.6 years old ranging from 23 to 46 years old. Among them,4 cases injured for traffic accidents,3 for crush and 4 for machine strangulation. In all cases ,the defect area of forefoot tissue varied from 2.0 cm × 4.0 cm to 4.0 cm × 8.5 cm,and the adopted area varied from 2.5 cm×4.5 cm to 4.0 cm×9.0 cm. The operation time was from 6 to 96 h (averaged 31.8 h). The blood vessels were anastomosed end to end. Results:All of the transferred free flaps survived uneventfully. Nine of them were successfully followed up from 6 to 24 months. The appearance ,elasticity and functions of flaps were satisfied ac-companied with slight damage of donor site although seemed bloated. The smaller donor site could be intimately seamed if nec-essary. Conclusion:The vessels anatomy of knee with antegrade extended peroneal artery was relative constant with a moderate thickness and simple operation,is useful to repair small or middle areas of skin defects in forefoot.

Objective To observe the changes of heart rate variability (HRV),adrenomedullin (ADM) and B-type natriuretic peptide(BNP) before and after transcatheter closure in children with patent ductus arteriosus.Methods HRV spectral values (TF,VLF,LF,HF,LF/HF) were detected by 24 dynamic electrocardiogram and the concentrations of plasma ADM and BNP were measured in 55 children with patent ductus arteriosus(Group PDA,n =55) before and 3~(rd) day,3~(rd) month after transcatheter closure therapy,and in 60 normal children (Group C).Results (1) Compared with Group C,the HRV spectral values (TF,VLF,HF)were significantly lower (all P＜0.01),LF/HF and the concentrations of plasma ADM,BNP were significantly higher in patients with PDA before transcatheter closure (all P＜0.01).(2) Compared with the values before transcatheter closure values,plasma ADM were significantly reduced at 3~(rd) day and 3~(rd) month after transcatheter closure(P＜0.01),the HRV spectral values (TF,VLF,HF) were significantly increased while LF/HF and plasma BNP were significantly decreased at 3~(rd) month after transcatheter closure (P＜0.01 or P＜0.05).Conclusions HRV and plasma ADM,BNP improved significantly post tnmscatheter closure in children with patent ductus arteriosus.

OBJECTIVETo explore the implication of the dynamic changes of plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) level and Tei index of left ventricle (LV) in children with ventricular septal defect (VSD) treated by transcatheter closure.

METHODSSixty children with VSD treated by transcatheter closure with VSD occluder (Group VSD) and 30 healthy children (Group C) were included in this study. The plasma concentration of NT-proBNP, Tei index of LV and left ventricle ejection fraction (LVEF) were measured in Group C and at before, 5th minute, 4th hour, 1st month, 3rd month and 6th month after VSD closure in Group VSD.

RESULTS(1) The concentration of plasma NT-proBNP was significantly increased in children with VSD before transcatheter closure compared with Group C [(229.45 ± 57.75) ng/L vs. (99.21 ± 46.86) ng/L, P < 0.01], significantly increased at 5th minute and 24th hour after transcatheter closure [(356.27 ± 96.78) ng/L and (356.38 ± 91.95) ng/L vs. (229.45 ± 57.75) ng/L, all P < 0.01], and significantly decreased at 1st month, 3rd months and 6th months after transcatheter closure [(131.33 ± 34.79) ng/L, (96.56 ± 31.55) ng/L and (93.39 ± 29.46) ng/L vs. (229.45 ± 57.75) ng/L, P < 0.05 or P < 0.01]. (2) The Tei indexes of LV in Group VSD before transcatheter closure were significantly higher than in Group C (0.45 ± 0.05 vs. 0.33 ± 0.08, P < 0.01) and Tei index was significantly increased at 24th hour, 1st month after transcatheter closure (P < 0.01) while significantly decreased at 3rd and 6th month compared with those before transcatheter closure (0.34 ± 0.07 and 0.34 ± 0.06 vs. 0.45 ± 0.05, all P < 0.01). (3) There is a positive correlation between the changes of the plasma concentration of NT-proBNP and the change of Tei index of LV before and after transcatheter closure (r = 0.653, P < 0.05).

CONCLUSIONTei index of LV and NT-proBNP can monitor cardiac function changes in children with VSD before and after transcatheter closure.

Adolescent ; Cardiac Catheterization ; Case-Control Studies ; Child ; Child, Preschool ; Female ; Heart Septal Defects, Ventricular ; blood ; physiopathology ; therapy ; Heart Ventricles ; physiopathology ; Humans ; Male ; Natriuretic Peptide, Brain ; blood ; Peptide Fragments ; blood

OBJECTIVETo explore the relationship of pyelic separation with gestational age, body weight and sex in early newborns.

METHODSA total of 320 neonates were examined by renal ultrasound 2-7 days after birth. The neonates included 180 boys and 140 girls, with a mean gestational age of 36±3 weeks (28-42 weeks) and a mean birth weight of 2430±1000 g (900-4870 g). Correlation analysis was performed between renal pelvis anteroposterior diameter (APD) and gestational age/body weight. The newborns were grouped based on gestational age, body weight and sex and the incidence of pyelic separation was compared among the groups.

RESULTSPyelic separation was found in 100 of the 320 newborns. The incidence of pyelic separation in boys (37.8%, 70 cases) was significantly higher than in girls (22.2%, 30 cases) (P<0.05). The incidence rates of pyelic separation on the left side, right side and both sides were 59%, 13% and 29% respectively in boys, and 53%, 7% and 40% respectively in girls. There was no significant difference in the location of renal pelvis separation between boys and girls (P>0.05). There significant difference in the incidence of pyelic separation between different gestational age groups (P>0.05). APD was positively correlated with gestational age and birth weight (P<0.05). The incidence of pyelic separation was negatively correlated with birth weight in all newborns except those who were macrosomic (P<0.05).

CONCLUSIONSThe incidence of pyelic separation in early newborns is closely associated with birth weight and sex. APD is positively correlated to gestational age and birth weight. Pyelic separation often occurs more frequently on the left side or both sides than on the right side.

Birth Weight ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Kidney Pelvis ; pathology ; Male ; Ureter ; pathology

Aged ; Blood Glucose ; metabolism ; Female ; Humans ; Hyperglycemia ; epidemiology ; etiology ; Liver Transplantation ; adverse effects ; Male ; Middle Aged ; Postoperative Period ; Retrospective Studies