Due to the serious shortage of donor cornea materials and the donor limit, clinical popularization of penetrating keratoplasty is severely restricted. lt is a hot spot of current research that applying tissue engineering in vitro to culture corneal endothelial cells ( CEC ) with high density, regular hexagonal shape and healthy endothelial function. ln this article, we reviewed the latest progress in the study of source of CEC seeder cells, selection of cultivating carries, type of CEC transplantation and immune mechanism that summarized the current research problems and made a prospect to the future.

Objective To investigate the efficacy of microendoscopic tubular retractor system (METRx) in the management of lumbar intervertebral disc herniation. Methods By using the METRx system with modified instruments, the lumbar discectomy was performed in 550 cases. During the operation, patients were placed in a knee-chest sitting position, and the instrumentation was utilized into the vertebral canal through the ligamenta flava. Results The patients were followed for 6~36 months (mean, 21 months). According to the Nakai criteria, the curative outcomes were “excellent” in 478 cases (86.9%), “good” in 60 cases (10.9%),“fair” in 6 cases (1.1%), and “poor” in 6 cases (1.1%). The 6 cases with “poor” results obtained “fair” results after a re-operation of lateral recess enlargement and residual nucleus removal under microendoscope. Conclusions Lumbar discectomy with the utilization of the METRx system is minimally invasive, safe and effective.

Cognitive estimation is a process in which correct answers can be reasonably estimated by relevant information,instead of be obtained in a direct manner.The cause of cognitive estimation disorder is relevant to executive function and frontal lobe damage.The assessment of cognitive estimation disorder is mainly based on texts such as CET,BCET and TKS,and clinical symptoms are also taken into consideration in this assessment.Future studies include several aspects.Firstly,more efforts should focus on improving diagnostic standard and assessment tools and expanding the related studies.Secondly,it is necessary to focus on the specific brain areas of clinical patients with cognitive estimation disorder,and to strengthen the clinical rehabilitation of cognitive functions.

Objective To investigate the effects of a training program based on virtual reality on static and dynamic balance perfor-mance in patients with Parkinson's disease (PD). Methods From June, 2014 to June, 2016, 46 patients with PD were randomly divided into control group (n=23) and experimental group (n=23). The control group received routine balance training, while the experimental group re-ceived balance training of virtual reality, for six weeks. They were assessed with Unified Parkinson's Disease Rating Scale part 3 (UP-DRS3), Berg Balance Scale (BBS), TimedUp and GoTest (TUGT) and Hamilton Depression Scale (HAMD) before and after training. The envelope area, anteroposterior standard deviation (AP-SD), mediolateral standard deviation (ML-SD) of centre of pressure (COP) were also measured with posturography. Results The scores of BBS, TUGT and HAMD improved in both groups after training (t>2.657, P<0.05), and improved more in the experimental group than in the control group (t>2.426, P<0.05). The score of UPDRS3 and the parameters of pos-turography improved in the experimental group (t>2.626, P<0.05), and improved more than that in the control group (t>2.112, P<0.05). Con-clusion Virtual reality rehabilitation is more effective than routine balance training on the static and dynamic balance function in patients with PD, and may release their depression.

Objective To evaluate the clinical efficacy and safety of Xuebijing injection in treatment of sepsis and multiple organ dysfunction syndrome ( MODS ). Methods A prospective multicenter clinical study was conducted. The patients with sepsis, severe sepsis, or MODS admitted to Department of Emergency and Critical Care Medicine of 70 hospitals across the country during 2006 to 2008 were enrolled. All of the patients received the basis treatment of conventional therapy, plus Xuebijing injection of 50-100 mL, 2-3 times a day for 5-7 days, and the dose might be increased in serious cases. The vital signs, 24-hour urine output, Glasgow coma score ( GCS ), white blood cell count ( WBC ), platelet count ( PLT ), Marshall score, gastrointestinal function score, syndrome of traditional Chinese medicine ( TCM ), blood lactate ( Lac ), blood glucose, serum creatinine ( SCr ), and total bilirubin ( TBil ) were observed before treatment, 1, 3, and 5 days after treatment, and at the end of the treatment. The results of above mentioned parameters after the treatment were compared with that before treatment in each patient. At the same time, the occurrence and the degree of adverse reactions were recorded to evaluate the safety of Xuebijing injection. Results A total of 2 574 patients were enrolled, and in 2 509 cases the treatment was completed in, with a drop of 65 cases. 704 cases were diagnosed to have sepsis, 768 with severe sepsis, and 1 037 with MODS. According to TCM, in 1 951 cases syndrome of stasis-toxin in the interior, and in 558 syndrome of excessive exuberance of heat-toxic in the interior were diagnosed. After the treatment of Xuebijing injection combined with conventional therapy, the temperature, heart rate, respiration rate, blood pressure, WBC, PLT, GCS, 24-hour urine output, blood glucose, Lac, SCr, TBil, Marshall score, gastrointestinal function score, as well as the symptoms, signs and TCM tongue condition and pulse condition, and TCM scores were significantly improved in all patients as well as the patients with sepsis, severe sepsis, or MODS ( P < 0.05 or P < 0.01 ). The effective rate of all patients and the patients with sepsis, severe sepsis, or MODS was 89.20%( 2 238/2 509 ), 92.76%( 653/704 ), 91.54%( 703/768 ), 85.05%( 882/1 037 ), respectively, and the 28-day survival rate was 93.90%( 2 356/2 509 ), 98.01%( 690/704 ), 96.35%( 740/768 ), 89.30%( 926/1 037 ), respectively. In 3 patients with MODS adverse events ( 0.12%) occurred, including 2 cases of stress ulcer and 1 case of Adams-Stokes syndrome. After clinical evaluation, the adverse events were found to be unrelated with the study medication, and Xuebijing injection was continued till the end of treatment. Conclusion Xuebijing injection combined with conventional therapy may effectively ameliorate systemic inflammatory response, protect organ function, alleviate the symptoms, improve organ functions, and elevate the clinical cure rate. Adverse events occur occasionally. Xuebijing injection is found to be safe.

Cinobufacino injection is a significant anti-tumor medicine for the treatment of various tumors in clinic, which was made from water extraction of the skin of Bufo bufo gargarizans. In present paper, HPLC-DAD-FT-ICR-MS method was used to identify the major bufadienolides in cinobufacino for the first time. Solid-phase extraction with dichloromethane and silica was used to enrich the total bufadienolides in cinobufacino. Based on the UV and high resolution MS/MS data, 33 bufadienolides were analyzed and characterized. Among them, eight compounds were identified by comparing with standard references unambiguously. This study elucidated the major bufadienolides in cinobufacino, which provided material foundation of cinobufacino and will be benefit for the further pharmacological research.
Amphibian Venoms ; chemistry ; Animals ; Bufanolides ; analysis ; chemistry ; Bufo bufo ; Chromatography, High Pressure Liquid ; Molecular Structure ; Spectrometry, Mass, Electrospray Ionization ; Tandem Mass Spectrometry

OBJECTIVETo throw a light on the possible factors which might induce resistance of vascular targeting treatment in tumors by reviewing the recent publications in the field of tumor angiogenesis and vascular targeting treatment. Data sources The data used in this review were mainly from Medline and PubMed for relevant English language articles published from 1971 to January 2008. The search terms were "angiogenesis", "vascular targeting treatment" and "endothelial progenitor cells". Study selection Articles involved in the possible influence factors during angiogenesis and vascular targeting treatment were selected, including angiogenic or anti-angiogenic mechanism, tumor vasculature, tumor cells, cancer stem cells and endothelial progenitor cells.

RESULTSAs a promising strategy vascular targeting treatment still has experimental and clinical setbacks which may term tumor vasculature's resistance to anti-angiogenesis agents. There are several possible explanations for such a resistance that might account for clinical and preclinical failures of anti-angiogenic treatment against tumor. Proangiogenic effect of hypoxia, normal tumor vasculature, escape of tumor cells and tumor vasculogenesis are included. This review reveals some clues which might be helpful to direct future research in order to remove obstacles to vascular targeting treatment.

CONCLUSIONSGenerally and undoubtedly vascular targeting treatment remains a promising strategy. But we still have to realize the existence of a challenging future. Further research is required to enhance our knowledge of vascular targeting treatment strategy before it could make a more substantial success.

Antineoplastic Agents ; pharmacology ; Blood Vessels ; drug effects ; Cell Hypoxia ; Endothelial Cells ; cytology ; Humans ; Neoplasms ; blood supply ; drug therapy ; Neoplastic Stem Cells ; drug effects ; Neovascularization, Physiologic ; drug effects ; Phenotype ; Stem Cells ; cytology

Objectives To analyze the diagnosis and management of steroid-resistant nephrotic syndrome (SRNS) accompanied with irreversible leukoencephalopathy in children. Methods The clinical, laboratory and imaging data were retrospectively analyzed in a SRNS child accompanied with irreversible leukoencephalopathy. A literature review was performed. Results After clinical diagnosis of SRNS, glucocorticoid, immunosuppressant, and hemodialysis were administrated for 10 months. During the course of treatment, the seizures, visual problems, and hypertension were repeatedly occured. The cranial MRI showed bilateral occipital parietal lobe hyperintensity and right frontotemporal lobe hyperintensity on T2-weighted imaging and bilateral occipital parietal lobe hypointensity on T2-Flair imaging, which indicated that encephalomalacia was accompanied with gliosis. Conclusions A variety of reasons may induce leukoencephalopathy in children. The accompanied irreversible leu-koencephalopathy should be strongly considered in management of SRNS.

We determined molecular characteristics of Listeria monocytogenes foodborne isolates in Hangzhou and investigated the characterization of local strains.Multi-locus sequence typing(MLST) and pulsed-field gel electrophoresis(PFGE) were applied to identify molecular types of Listeria monocytogenes isolates.Results showed that a total of 133 strains of 6 serotypes were divided into 19 MLST types including a new type ST767.ST9 and ST121 were the major ST types.There were 33 and 45 PFGE patterns characterized by AscⅠ and ApaⅠ.The molecular types of Listeria monocytogenes strains were widely distributed in Hangzhou.It is indicated that the major clusters were Lineage Ⅰ and Lineage Ⅱ which will cause listeriosis.The contamination of Listeria monocytogenes in food is serious in Hangzhou and the surveillance and management should be strengthened to prevent the food borne diseases.

Objective Although heart transplantation (HTx) has become a standard therapy for end-stage heart diseases,experience with pediatric HTx is limited in China.In this article,we will try to provide the experience with indications,complications,perioperative management,immunosuppressive therapy,and survival for pediatric HTx based on our clinical work.Method This is a retrospective chart review of the pediatric patients undergoing HTx at Department of Cardiovascular Surgery of Union Hospital from September 2008 to December 2015.We summarized the indications,surgical variables,postoperative complications,and survival for these patients.Result Twenty-three pediatric patients presented for HTx at Union Hospital of Tongji Medical College,of whom 12 were male.The age at the time of transplantation ranged from 3 months to 18years (median 14 years).Patient weight ranged from 5.2 kg to 57.0 kg (median 36.0 kg).Pretransplant diagnosis included cardiomyopathy (16 cases),complex congenital heart disease (5cases) and tumors (2 cases).All recipients received ABO compatible donor hearts.Postoperative complications occurred in 14 patients,including cardiac dysfunction,arrhythmia,pulmonary infection,renal dysfunction,and rejection.Two of them experienced cardiac failure and required extracorporeal membrane oxygenation.The immunosuppression regimen was comprised of prednisone,a calcineurin inhibitor,and mycophenolate.All patients recovered with New York Heart Association (NYHA) Class Ⅰ Ⅱ cardiac function and were discharged.Only one patient suffered sudden death 19 months after transplantation.Conclusion Orthotopic HTx is a promising therapeutic option with satisfactory survival for the pediatric population in China with end-stage heart disease.