Takayasu arteritis (TA) is a devastating vasculitis of the aorta and its major branches,coronary and pulmonary arteries.The clinical manifestations in children are less specific than in adnlts:the disease in children presents with fever,arthralgias,vomiting,weight loss and hypertension.Conventional angiography,which is recognized as the golden standard in evaluating vascular lesions in TA,combined with computer tomography angiography (CTA),magnetic resonance angiography (MRA),ultrasonography,could not only provide important information for early diagnosis,but also detect disease activity.New immunosuppressive agents and biological therapies,such as TNF-a blocking agents,have been verified to be effective although corticosteroids and conventional immunosuppressive agents are still basic treatment.

Objective To study the expression and its significance of bcl-2 associated death (bad) gene in human optic nerves from traumatic atrophic eyeballs. Methods The optic nerves from 8 normal human donor eyes and 31 traumatic atrophic eyes were studied by immunohistochemistry technique. Results Bad protein was positively expressed in the normal optic nerve myelin sheath and residual myelin portions of optic nerve tissues from traumatic atrophic eyes. The expression of bad protein in the residual portions of myelin sheath was stained significantly stronger than that in normal optic nerves (P0 05). Conclusion Bad might possess the function of promoting the optic nerve atrophy processes in traumatic atrophic eyes.

Objective:We probe more direct operation pathways in sphenoidal sinus and saddle area, and take proper measures for correlated diseases which surpass scope of sphenoidal sinus by combining image data, which could prevent serious complication.Method:Under nasal endoscope, the operation approaches we adopted included trans-anterior ethmoid sinus-posterior ethmoid sinus-sphenoidal sinus pathway, trans-meatus nasi superior-posterior ethmoid sinus-sphenoidal sinus pathway, trans nasal septum-sphenoidal sinus pathway and trans-natural opening of sphenoid sinus anterior into sphenoid sinus pathway by taking upper edge of posterior naris as a consistent surgical landmark. Forty-six cases who had sphenoidal sinus mass with bone erosion recieved surgical treatment.Result:Twenty-one cases with cyst and pus cyst of sphenoidal sinus had been healed by trans-meatus nasi superior pathway;1 case with hematoma and organization in sphenoidal sinus had been cleared by trans-meatus nasi superior pathway;3 cases had hematoma and organization in sphenoidal sinus and pseudoaneurysm in internal carotid artery,one of them suffered fatal hemorrhage in surgical exploration, and cured by endovascular embolization, the other two only underwent nasal endoscopic examination,the diagnosis was established by DSA and they received interventional therapy;4 cases with papilloma in sphenoidal sinus had been treated by trans-natural opening of sphenoid sinus approach,and 3 cases were cured,1 case had only partial mass resection as the papilloma offended the outer wall of sphenoidal sinus diffusely;2 cases with cholesteatoma of sphenoid sinus have been removed completely by trans-meatus nasi superior approach;1 case with encephalomeningocele of sphenoidal sinus underwent sphenoidotomy by trans-natural opening of anterior of sphenoidal sinus, and intraoperative puncture showed characteristic cerebrospinal fluid,the exposed meninges were then repaird surgically;1 case with mycosis of sphenoidal sinus had been cured by thorough clearing of the leision in sphenoidal sinus combined with antifungal therapy;3 cases with malignancy of sphenoidal sinus had received major mass resection of sphenoidal sinus by trans-anterior ethmoid sinus-posterior ethmoid sinus approach, and followed with radio therapy and chemotheraphy;5 cases with NPC in-volving sphenoidal sinus had been treated by radio therapy and chemotherapy after pathological examinacation;5 cases with post-operative cerebrospinal rhinorrhea and granulation hyperplasia of sphenoidal sinus had been repaired successfully by trans-meatus nasi superior approach or tans-nasal septum approach.Conclusion:There are various surgical pathways to deal with sphenoidal sinus and correlated diseases under nasal endoscope.The operation will be direct, safe and minimal invasive if we choose the pathway properly. Thin slice CT scan and 3D reconstruction of sella, and DSA or angiography of brain before operation is one of effective means to prevent surgical complications for leisions beyond scope of sphenoidal sinus.

BACKGROUND:In recent years, endoplasmic reticulum stress-caused apoptosis plays a crucial role in ischemia impairment and has become the hotspot of studies addressing myocardial ischemia/reperfusion (I/R) injury. The lower limb ischemic preconditioning (LIP) has the obvious protective effect on the immature myocardium, but until now, no study reports whether LIP effects on endoplasmic reticulum stress apoptosis in immature myocardial cells. OBJECTIVE:To investigate the effect of LIP on endoplasmic reticulum stress and apoptosis.
METHODS:Langendorff-perfused isolated rabbit hearts were used in this study. Twenty-four immature rabbits were randomized into three groups. Control group:Isolated rabbit heart was only perfused with Krebs-Henseleit for 180 minutes. I/R group:Isolated rabbit heart was perfused 20 minutes, and then ischemia for 60 minutes fol owed by reperfusion 100 minutes. LIP group:Limbs were repeatedly obstructed 5 minutes and relaxed 5 minutes for three times, to establish Langendorff models, and then repeated the method of ischemia/reperfusion in I/R group. The myocardial apoptosis was assayed with TUNEL method. The expression of glucose-regulated protein 78, Bcl-2, Bax and Fas was detected with western blot analysis.
RESULTS AND CONCLUSION:Compared with I/R group, apoptosis rate was significantly lower, the expression of Bcl-2 was significantly higher, and the expression of glucose-regulated protein 78, Bax and Fas was significantly lower in LIP group. This study demonstrated that LIP regulates myocardial cellapoptosis through reducing the expression of endopasmic reticulum stress GRP78, Bax and Fas and increasing the expression of Bcl-2.

Objective To investigate the effect of electro-acupunctare at zusanli on acute lung injury in a rat model of sepsis after scald.Methods Fifty SPF male Sprague-Dawley rats,weighing 200-250 g,aged 2-3 months,were randomly divided into 5 groups (n =10 each) using a random number table:control group (group C),sepsis after scald group (group SS),electro-acupuncture at zusanli group (group E),electric stimulation of non-acupoint group (group NE) and electro-acupuncture at zusanli + α-bungarotoxin (α-BGT,a selective α7 nicotinic acetylcholine receptor antagonist) group (group α-BGT).The rats were subjected to a third degree scald covering 20％ total body surface (TBS) and muramyl dipeptide (MDP) 5 mg/kg was injected into the femoral vein immediately after scald to induce sepsis.Electro-stimulation (3 V,2 ms,3 Hz) of bilateral zusanli was performed for 12 min starting from the time point immediately after MDP injection and every 8 h for 2 consecutive days in group E.In group NE,electro-stimulation was performed at the points 5 mm lateral to the bilateral acupoints of Zusanli and the method was similar to those previously described in group E.In group α-BGT,α-BGT 1.0 μg/kg (in 1 ml of normal saline) was injected into the femoral vein before electro-stimulation of zusanli.At 48 h after treatment,arterial blood samples were obtained for determination of serum tumor necrosis factor-alpha (TNF-α) and high mobility group box-1 (HMGB1) protein levels (by ELISA) and lung specimens were removed for microscopic examination and for determination of the expression of Nod like receptor 2 (NLR2) mRNA (by RT-PCR) and receptor interacting protein 2 (RIP2) in the lung tissues (by Western blot).Results Compared with group C,the expression of NLR2 mRNA and RIP2 was significantly up-regulated,and the serum TNF-α and HMGB1 levels were increased in SS,NE and α-BGT groups (P ＜ 0.05),and no significant change was found in the parameters mentioned above in group E (P ＞ 0.05).Compared with group SS,the expression of NLR2 mRNA and RIP2 was down-regulated,and the serum TNF-α and HMGB1 levels were decreased in group E (P ＜ 0.05),and no significant change was found in the parameters mentioned above in NE and α-BGT groups (P ＞ 0.05).Compared with group E,the expression of NLR2 mRNA and RIP2 was significantly up-regulated,and the serum TNF-α and HMGB1 levels were increased in NE and α-BGT groups (P ＜ 0.05).The pathological changes of lung tissues were significantly reduced in group E as compared with group SS.Conclusion Electro-acupunctare at Zusanli can reduce acute lung injury in a rat model of sepsis after scald and inhibition of NLR2/RIP2 signaling pathway and activation of cholinergic anti-inflammatory pathway in lung tissues may be involved in the mechanism.

To study the correlation between traditional Chinese medicine (TCM) syndrome type and the ultrasound imaging changes in patients with limb lymphedema, and to provide evidence for TCM syndrome differentiation.

Objective To analyze the CT signs and the clinical relevant factors of degenerative osteoarthritis of athnto-odontoid joint.Methods The CT signs and the clinical information of 214 patients received CT scans of skull from June 2011 to April 2012 were analyzed retrospectively.Results One hundred and twenty patients were diagnosed with degenerative osteoarthritis of atlanto-odontoid joint,while 67 of them having subaxial degenerative osteoarthritis at the same time.Forty-three patients had a history of chronic cervical and occipital pain.95.83％ (115/120) patients showed osteophytes in CT scans,while 44.17％ (53/1 20) showed calcification around dens and 24.17％ (29/120) showed joint space obliteration.The incidence rate increased with age.Seventy-seven patients [64.17％(77/120)] appeared cervical and occipital pain.Conclusions Degenerative osteoarthritis of atlanto-odontoid joint shows hyperostosis,osteophytes at the edge of joint,joint space obliteration and calcification around dens in the CT scans.The incidence rate is increased with age and correlated with cervical and occipital pain.

Objective To establish the pharmacodynamic model of sevoflurane with bispectral index (BIS) as the effective index in pediatric patients.Methods Thirteen ASA physical status Ⅰ or Ⅱ pediatric patients,aged 4-9 yr,weighing 12-39 kg,undergoing non-cardiac surgery,were selected in the study.The pediatric patients sequentially inhaled 1％,5 ％ and 1％ sevoflurane via a face mask and each concentration was inhaled for 15 min.BIS value,HR,BP and SpO2 were automatically recorded every 10 s.Based on nonlinear mixed effect modeling,the population pharmacodynamic model of sevoflurane was established using NONMEM software.The effect of age on the pharmacodynamic parameters was evaluated using a stepwise forward addition then backward elimination modeling approach.The standard for model improvement was defined as a decrease in the value of the objective function by more than 3.84.Results Twelve pediatric patients,aged 4.0-8.5 yr,weighing 12.8-38.0 kg,with body height of 92-135 cm,were enrolled in this study and the data which were enrolled comprised 2964 effective concentration-time-BIS points.The model was not improved significantly with any covariates (age,body height,and body weight) introduced (P ＞ 0.05).The estimated parameters of the final pharmacodynamic model of sevoflurane were as follows:ke0 =O.516/min ; EC50 (BIS50) =2.11％ ; γ =2.46 ; E0 =74.6 ; EMAx =11.2.Conclusion The pharmacodynamic model of sevoflurane is successfully established with BIS as the effective index in pediatric patients,and the analysis for each parameter of the model indicates that the sensitivity to sevoflurane is lower,but the blood-brain equilibration time of the drug is shorter and the onset and recovery are faster in children than in adults.

This study was designed to determine the effects of the recombinant adeno-associated virus vector containing sense CD151 gene (rAAV-CD151) and antisense CD151 gene (rAAV-antiCD151) on the migration of Tca8113 cell. Functional fragment of CD151 gene was amplified by RT-PCR, and inserted into the vector pAAV in the sense direction and antisense direction, respectively. The rAAV-CD151 and rAAV-antiCD151 were produced and the titers were determined by dot blot. The CD151, at protein level, was detected by Western blot. The Transwell chamber was used to detect the effects of the rAAV-CD151 and rAAV-antiCD151 on the tumor cell migration. The titers of the rAAV-CD151 and rAAV-antiCD151 were 2 x 10(11) pfu/ml and 1.0 x 10(11) pfu/ml, respectively. The expression of CD151 was increased by 108% in the cells transfected with rAAV-CD151 and decreased by 79% in the cells transfected with rAAV-antiCD151, as compared with non-transfected cells, respectively. The number of the migrating cells was significantly increased in the cells transfected with rAAV-CD151 (93.56 +/- 11.59) and decreased in the cells transfected with rAAV-antiCD151 (24.00 +/- 4.36) as compared with non-transfected and rAAV-GFP transfected cells (53.00 +/- 6.56 and 46.00 +/- 7.00, P<0.05). It is an important molecular mechanism of the tumor metastasis that the overexpression of CD151 promotes the migration of the tumor cells. The rAAV-antiCD151 is a novel tool, which can reduce the expression of CD151 and inhibit the migration of the tumor cells, and brings us a new approach of anti-sene gene therapy targeted at CD151 in human carcinoma.
Antigens, CD/immunology ; Antigens, CD/*pharmacology ; Carcinoma, Squamous Cell/pathology ; Cell Movement ; DNA, Antisense/*pharmacology ; Dependovirus/*genetics ; Genetic Vectors ; Recombinant Proteins/biosynthesis ; Recombinant Proteins/genetics ; Tongue Neoplasms/*pathology ; Transfection ; Tumor Cells, Cultured

BACKGROUND: Studies have shown that the combined use of sufentanil and neural stem cell (NSC) transplantation can increase the number of newborn nerve fibers.OBJECTIVE: To investigate the effect of sufentanil on the hind limb function of rats with spinal cord injury after neural stem cell transplantation.METHODS: (1) Eighty adult female Sprague-Dawley rats were used to build spine cord injury model according to the modified Allen's method and divided into model group, sufentanil group, NSCs transplantation group and sufentanil combined with NSCs transplantation group (combined group). Extra 20 adult female Sprague-Dawley rats were not conducted any treatment as normal control group. (2) After 6 days of modeling, the model rats were subjected to subarachnoid injection of 10 μL of NSC culture medium and intraperitoneal injection of 100 μL of saline in the model group; subarachnoid injection of 10 μL of NSC culture medium and intraperitoneal injection of 100 μL of sufentanil (150 μg/kg) in the sufentanil group; subarachnoid injection of 10 μL of 1×1010/L NSCs suspension and intraperitoneal injection of 100 μL of saline in the NSCs transplantation group; and subarachnoid injection of 10 μL of 1×1010/L NSCs suspension and intraperitoneal injection of 100 μL of sufentanil (150 μg/kg) in the combined group. (3) After 72 hours of modeling, the AQP4 and MMP9 gene expression levels were detected by RT-PCR, and the cell apoptosis changes around the spine cord injury area were determined with TUNEL staining method. (4) The motor functions of rats were tested by Basso, Beattie and Bresnahan score and inclined plane test after 1, 3 days and 1, 2, 3 and 4 weeks of modeling. (5) After 4 weeks of modeling, the histopatholgical changes in the area of spine cord injury were observed by hematoxylin-eosin staining method. The survival changes of NSCs labeled by CM-Dil were determined by fluorescence microscope. The regenerations and distributions of spinal nerve fibers were observed by fluorescein gold retrograde tagging.RESULTS AND CONCLUSION: (1) After 72 hours of modeling, the AQP4 and MMP9 gene expression levels as well as the cell apoptotic rate in the combined group were significantly lower than those in the model, sufentanil and NSCs transplantation groups (P < 0.05). (2) After 2 weeks of modeling, the combined treatment significantly improved the hind limb motor functions of rats compared with the sufentanil and NSCs transplantation groups (P < 0.05), and the recovery of motor function was better in the sufentanil and NSCs transplantation groups than in the model group (P < 0.05). (3) After 4 weeks of modeling, the results of hematoxylin-eosin staining manifested that the spinal cord tissues lost and the magnified syringomyelias occurred in the model group. The syringomyelias in the sufentanil and NSCs transplantation groups were significantly smaller than that in the model group, and the syringomyelias almost disappeared in the combined group. (4) The number of positive cells was the most in the combined group, more in the NSCs transplantation group, but there were no positive cells labeled by CM-Dil in the sufentanil and negative control groups. (5) The number of positive neural fibers in the combined group was the highest followed by the sufentanil and NSCs transplantation groups, and the number of positive neural fibers in negative control group was the lowest. To conclude, sufentanil can improve the recovery of hind limb motor function by reducing the AQP4 and MMP9 expression levels in the injury area, promoting the survival of transplanted NSCs, and decreasing the local NSCs apoptosis after spinal cord injury.