Objective To estimate the effects of different surgical treatments of giant cell tumor of bone(GCTB) of long bone in children.Methods The effects of surgical treatment of 15 cases suffered from GCTB were observed.The tumors were rated according to the system of Enneking classification,stageⅠwas managed with a curettage combined with local adjuvant treatment and filled by allograft bone or with curettage and filled by cement of bone.StageⅡb was treated by en bloc resection followed by reconstruction with large segment bone of allograft.The follow-up was given in all patients.Results The follow-up period was 7 years(ranged 2-16 years).In all 15 children patients with GCTB,there were 13 children in stageⅠ,9 patients with curettage combined with local adjuvant treatment and allograft bone showed good bone knitting and rehabilitation without deformity and functional problem and locally recurred;4 patients with curettage and filled by cement of bone showed 2 cases locally recurred.Two children in stageⅡb treated by en bloc resection followed by reconstruction with large segment bone of allograft were perfectly incorporated without evidence of obvious immune rejection,collapse,fracture and locally recurred,but the limb-suffered was short about 2 cm.Conclusions Stage Ⅰtreated by a curettage combined with local adjuvant treatment and filled by allograft bone can get good effect,but only treated by a curettage and filled by cement of bone has 50% locally recurred.TheⅡb treated by en bloc resection followed by reconstruction with large segment bone of allograft might influence the limb growth,but without locally recurred.

Antineoplastic Agents, Phytogenic ; administration & dosage ; pharmacology ; Apoptosis ; drug effects ; Cell Line, Tumor ; Dose-Response Relationship, Drug ; Glioma ; pathology ; Humans ; Sesquiterpenes ; administration & dosage ; pharmacology ; Time Factors

Background and purpose:Tumor is a disease associated with multi-gene mutation and the abnormal expression of multi-gene expression in many steps through the process of the evolution of cell clone.A lot of oncogenes and anti-oncogenes like p27,survivin,etc.take part in the regulation of the cell cycle directly or indirectly. We studied the expression and correlation of p27 and survivin in NSCLC.Methods:The expression of p27 and survivin was detected in 60 NSCLC and 20 normal pulmonary tissues by the immohistochemical staining.Results: (1)P27 expression in NSCLC was 40.0%,significantly lower than normal pulmonary tissues(P

Objective To summarize the clinical and electroencephalography(EEG) characteristics of benign epilepsy with centro-temporal spikes (BECTS) in children.Methods The clinical manifestations,EEG findings,response to drug treatment and prognosis of 35 children with BECTS from Jul.2003 to Dec.2008 in the First Affiliated Hospital of Zhengzhou University were analyzed retrospectively.Results In the 35 cases,the age of onset was 2.5 to 14.0 years old,and the peak age of onset was 6-10 years old(62.9%).Twenty-two cases mainly presented partial seizures:hemifacial convulsions,sialorrhea,sounds,limb tonic-clonic seizures,and secondary generalized seizures.Thirteen cases were only describled generalized tonic-clonic seizures.Seizures were closely related to sleep and almost occurred shortly after falling asleep or before waking up.There were 26 cases who displayed convulsion during sleeping,including noon break.The EEG features showed numerous or single spikes on one side or both sides in the central and temporal areas under the background of normal activity in interictal period.The release frequency of abnormal wave was significantly increased after falling asleep,so the EEG monitoring during sleep could improve the positive rate of BECTS.Monotherapy with low-dose anti-epileptic drug could obtain good efficacy.Twenty-five cases stopped seizures within 3 months after therapy.Thirty-three cases hadn't get seizure since drug therapy at the age of 16 years old.So far,12 cases had been stopped medicine.Conclusions BECTS mostly begins at school-aged children,which displays partial seizures or secondary generalized seizures.The seizures are closely related to sleep.EEG monitoring during sleep which shows numerous or single spikes on the centrotemporal area has crucial diagnostic value to BECTS.There is a positive response to monotherapy with low-dose anti-epileptic drug and generally the prognosis is good.

Objective To study the dynamics changes of cerebrospinal fluid (CSF) bacterial load within 48 h after infection in a rabbit meningitis model, and provide information for diagnosis,treatment and prognosis of this disease. Methods Taking New Zealand white rabbit as the study object, meningitis model was established via cerebellar cistern puncture with different concentrations of Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) to explore the relationship between the mortality of animals and the subarachnoid inoculation dosage. The dynamics study of CSF bacterial load was conducted with proper inoculation bacterial dosage. Forty-eight rabbits were separated into four groups (12 each group): E. coli meningitis model group, E. coli meningitis + ceftriaxone treated group, S. aureus meningitis model group and S. aureus meningitis + vancomycin treated group. At 0,12, 24, 36 and 48 h of inoculation, CSF and blood samples were obtained for CSF bacterial quantitative culture, CSF leukocyte count and peripheral blood leukocyte count. Finally, the relationships between the early mortality of animals, the efficacy of antibiotics, CSF leukocyte counts and the dynamics changes of CSF bacterial load were analyzed in the bacterial meningitis rabbit model.The CSF bacterial load and the white blood cell count curve were compared by analysis of covariance (ANOVA). Correlation test was done using correlate partial analysis. Results The relationship between subarachnoid inoculation dosage and the mortality of rabbits presented S-curve correlation.The bacterial load in subarachnoid space peaked in 12-24 h after infection and then gradually decreased. Effective antibiotic therapy could significantly speed up the decline of this process. There were significantly different between E. coli meningitis model group and E. coli meningitis+ceftriaxone treated group (F= 27. 10, P<0. 01), between S. aureus meningitis model group and S. aureus meningitis + vancomycin treated group (F=5. 97, P = 0. 016). There was a positive correlation between CSF bacterial load and CSF leukocyte count in E. coli and S. aureus meningitis model groups (r=0. 89, 0.84, respectively; P = 0.046, 0.049, respectively). Conclusions In the treatment of bacterial meningitis, effective and sufficient antibiotics should be used as soon as possible to control the CSF bacterial load and reduce the mortality. The CSF leukocyte count can be used as indicator of CSF bacterial load and guide the antibiotic treatment in clinical bacterial meningitis.

Objective To evaluate shell vials of MHV,a combination of Madin-Darby canine kidney cells (MDCK),human epidermoid cancer cells (Hep-2) and African green monkey kidney cells (Vero),and conventional cell culture in detecting influenza viruses and enterovirus from fresh clinical specimens.Methods Specimens from patients with influenza-like illness and children with hand-foot-mouth disease were inoculated with both shell vials of MHV and MDCK/Vero.Then cytopathological effect (CPE) was examined daily.Influenza viruses and enteroviruses were detected by multiple reverse transcriptase-polymerase chain reaction (mRT-PCR).Results CPE of MDCK/Vero cells were stronger than the shell vials of MHV.The isolation rate of influenza virus by MHV was 24.6％ (34/138) and that by MDCK was 28.3％ (39/138),which was not significantly different (x2 =1.92,P＞0.05).That of enterovirus by MHV was 28.1％ (9/32) and that by Vero was 37.5％ (12/32),which was not significantly different (x2 =3.00.P＞0.05).Conclusions CPE in MDCK/Vero cells are easier to be observed than the shell vials of MHV.However,the shell vials of MHV are appropriate in public health emergencies,which can be used for isolation of influenza viruses and enterovirus in patients with respiratory symptoms.

AMP-Activated Protein Kinases ; metabolism ; Animals ; Male ; Mice ; Mice, Inbred C57BL ; Muscle, Skeletal ; metabolism ; Phosphorylation ; Physical Conditioning, Animal

OBJECTIVETo discuss the clinical effects of external fixator combined with limited internal fixation in the treatment of pediatric distal femur fractures.

METHODSFrom January 2008 to June 2014, 17 children of distal femur fractures were treated by external fixator combined with limited internal fixation. There were 12 males and 5 females, aged from 6 to 13 years old with an average of 10.2 years, ranged in the course of disease from 1 h to 2 d. Preoperative diagnoses were confirmed by X-ray films in all children. There were 11 patients with supracondylar fracture , and 6 patients with intercondylar comminuted fracture. According to AO/ASIF classification, 9 fractures were type A1, 5 cases were type A2,and 3 cases were type C1. The intraoperative and postoperative complications, postoperative radiological examination, lower limbs length and motion of knee joints were observed. Knee joint function was assessed by KSS score.

RESULTSAll the patients were followed up from 6 to 38 months with an average of 24.4 months. No nerve or blood vessel injury was found. One case complicated with the external fixation loosening, 2 cases with the infection of pin hole and 3 cases with the leg length discrepancy. Knee joint mobility and length measurement (compared with the contralateral), the average limited inflexion was 10 degrees (0 degrees to 20 degrees), the average limited straight was 4 degrees (0 degrees to 10), the average varus or valgus angle was 3 degrees (0 degrees to 5 degrees). KSS of the injured side was (96.4 +/- 5.0) points at final follow-up, 16 cases got excellent results and 1 good. All fractures obtained healing and no epiphyseal closed early was found.

CONCLUSIONExternal fixator combined with limited internal fixation has advantages of simple operation, reliable fixation, early functional exercise in treating pediatric distal femurs fractures.

Adolescent ; Child ; External Fixators ; Female ; Femoral Fractures ; surgery ; Femur ; injuries ; surgery ; Fracture Fixation, Internal ; Humans ; Internal Fixators ; Male

OBJECTIVETo determine the mutation responsible for the congenital fibrosis of the extraocular muscles type I(CFEOM1) in a Chinese family.

METHODSDirect sequencing of exons 20 and 21 in the KIF21A gene was performed for the proband. The mutation c.2860C to T in exon 21 was examined by allele specific-PCR (AS-PCR) analysis in other family members. Haplotype analysis was performed using four STR markers (D12S1668, D12S2194, D12S331 and D12S1048).

RESULTSA heterozygous mutation c.2860C to T in the KIF21A gene was identified in all three affected members with CFEOM1. Haplotype analysis suggested that the mutation might derive from maternal germline mosaicism.

CONCLUSIONThis Chinese family with CFEOM1 may be caused by a c.2860C to T mutation in the KIF21A gene.

Alleles ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; Child ; China ; Exons ; Female ; Fibrosis ; Haplotypes ; Humans ; Kinesin ; genetics ; Mutation ; genetics ; Oculomotor Muscles ; metabolism ; pathology ; Pedigree ; Phenotype ; Syndrome

Objective To investigate the association of cytochrome P450 2C9 (CYP2C9 * 3) (1075A ＞ C) gene polymorphisms with the susceptibility to epilepsy and the serum concentration of valproate acid (VPA).Methods DNA was extracted from peripheral blood of 245 healthy subjects and 191 patients with epilepsy.The CYP2C9 * 3 genotype was detected by sequenom mass array method.The steady-state serum concentration of VPA was determined by fluorescence polarization immunoassay.Results The frequencies of CYP2C9 * 3 alleles in patients with epilepsy and healthy subjects were 4.45％ and 2.04％,respectively,and the difference was statistically significant (P ＜ 0.05).The C allele frequency odds ratio was 2.23,C allele increased the risk of epilepsy (P ＜0.05).The steady-state VPA concentration in patients with CYP2C9 * 1/* 1 genotype and patients with CYP2C9 * 1/* 3 genotype were (55.90±21.11) and (67.75 ±21.36)μg· mL-1,respectively,and the difference was statistically significant (P ＜ 0.05).Conclusion CYP2C9 * 3 significantly increases the risk to develop epilepsy and C allele is a susceptible allele for epilepsy.CYP2C9 * 3 polymorphisms are associated with serum concentrations of VPA in epilepsy patients.