Objective To evaluate the eyeball movement examination on Parkinson' s disease (PD) and investigate their vestibular function.Methods Thirty healthy volunteers and 55 PD patients served as subjects.Thirty-one patients had bradykinesia, 23 patients had resting tremor at first visit and 1 had both.Electronystagmogram examinations were performed in all the subjects.The eyeball movment gain (G) of PD group was compared with controls and the difference between the bradykinesia group and resting tremor group was analyzed.Dissymmetry of the bilateral pursuit movement was investigated.Results The eyeball movement gains decreased in PD patients (Left G 0.79±0.10, Right G 0.78±0.11) significantly (U = 394.500, t = 3.547, P < 0.01) compared with controls (Left G 0.86±0.05, Right G 0.85±0.06).There was no difference (t = -0.100,2.005, P0.05) between the bradykinesia group (Left G 0.79± 0.14,Right G 0.74±0.14) and the resting tremor group ( Left G 0.79±0.06,Right G 0.81±0.07).The dissymmetry of the bilateral movement increased significantly (U = 755.500, P < 0.05) in PD group (1.03±0.97) than in controls (0.87±0.86).Conclusion The velocity of the eyeball movement has decreased in patients with PD.There is no difference of the pursuit gain between bradykinesia group and the resting tremor group.The bilateral vestibular function is involved dissymmetrically.

Kasabach-Merritt phenomenon (KMP) is characterized by thrombocytopenia with enlarging vascular tumour,KMP usually develops in infancy and is associated with significant morbidity and mortality,the mortality rate is reported as high as 30％.It commonly reported sites of tumor include extremities,trunk,retroperitoneum and neck.There is no consensus in treatment and various regimens have been used by different authors.This report is aim to learn the pathophysiology of the KMP and its diagnosis and treatment.

Polyethylenimine (PEI) is a kind of nanometer nonviral vector frequently applied in gene transfection. It is simple and easy to prepare and to modify and relatively safe compared to viral vectors. In recent years, PEI has been utilized in many research areas for gene delivery to stem cells in vitro or targeted gene delivery to cells in the brain. This review reveals that the cytotoxicity and low transfection efficiency of PEI requires to be improved. However brain-targeted modification indicates the promising prospect of PEI for gene therapy in cerebrovascular diseases.
Genetic Therapy ; Genetic Vectors ; Humans ; Nanostructures ; chemistry ; Polyethyleneimine ; chemistry ; Stem Cell Transplantation ; methods ; Transfection ; methods

ObjectiveTo observe the clinical efficacy of combined irbesartan and alprostadil treatment of early diabetic nephropathy (DN).Methods A total of 120 patients with early type 2 diabetes of hospitalization were randomly divided into 3 groups: irbesartan group of 40 patients (150 mg, once per day)(group irbesartan),40 patients treated with alprostadil (physiological saline and alprostadi 10 μg))(group alprostadi) ,40 patients treated with alprostadil combined irbesartan (dose same as the other two groups)(combined group).All cases were observed for 4 weeks.Comparison of serum creatinine (Cr), blood urea nitrogen(BUN) ,24 hour urinary albumin(24hUAE) changes after treatment.ResultsAfter treatment 4 weeks 24hUAE of the three groups were significantly decreased (t = 2.07, t = 2.01 and t = 3.15, Ps ＜ 0.05) .The decrease of 24hUAE in the combined treatment group ([252.69 ± 33.56]mg/24h) was better than that in the irbesartan group([268.75 ± 34.42)](t = 2.11, P ＜ 0.05)and in the alprostadil group ([267.95 ± 30.75])mg/24h (t = 1.998, P ＜ 0.05) .No significant difference were observed between the Irbesartan and alprostadil group.During treatment, several patients affected by swell, uncomfortable in the alprostadil group, but improved after treatment.No other adverse effect was observed.Conclusion Alprostadil combined with irbesartan treatment of early diabetic nephropathy is an effective way.

Objective To compare the feasibility and safety of laparoscopic versus open hepatectomy.Methods The data of 165 patients who underwent laparoscopic hepatectomy were compared with 170 patients who underwent open hepatectomy in our hospital from November 2002 to December 2010.Results Laparoscopic hepatectomy was successfully carried out in 159 patients and 6 patients were converted to open operation because of intra-operative hemorrhage.The 170 patients in the open operative group had open hepatectomy successfully carried out.The hospital stay and cost in the laparoscopic group(7.6±1.3 d,31767.4±220.1(￥))were less than the open operation group(14.6±3.3 d,35127.3±392.2(￥))(t=-12.657,P＜0.001; t=-78.859,P＜0.001).There was no significant difference in Pringle's manoeuvre time,blood loss and postoperative complications(20.6 ±8.5vs.18.6±6.5 min,t=2.108,P=0.068),(420.8±76.5 vs.395.9±96.1 ml,t=2.157,P=0.063),(0 vs.4 cases,t=2.011,P=0.156))between the 2 groups.The operative time in the laparoscopic group was significantly longer than the open group(59.6 ± 12.2 vs.42.7 ± 22.6 min)(t=6.941,P＜0.001).Conclusions Laparoscopic hepatectomy is feasible and safe.It has the advantages of having less trauma and quicker recovery for tumors which were located superficially in the left liver and in the inferior part of the right liver.The operative time was longer than open hepatectomy,but there was no significant difference between the 2 groups in Pringle's manoeuvre time,blood loss and postoperative complications.The hospital stay and total hospital cost in the open operation group were higher than the laparoscopic hepatectomy group.

AIM: To construct recombinant adenovirus vector containing brain derived neurotrophic factor, (BDNF) gene using bacterial homogenous recombination, and investigate the expression in expanded rat mesenchymal stem cells (rMSC) in vitro. METHODS: BDNF gene and proBDNF gene were subcloned into adenovirus shuttle plasmid pAdTrack-CMV containing enhanced green fluorescent protein gene (EGFP) expression cassette, forming shuttle vector of pAdTrack-BDNF, and pAdTrack-proBDNF, and co-transformed into BJ5183 bacterial cells with adenovirus backbone vector pAdEasy-1 using chemical transformation. After the recombinant adenovirus vector was obtained, the identified recombinant adenovirus plasmid DNA was digested with Pac I and transfected to 293 cells to package recombinant adenovirus particles. rMSC were infected by recombinant adenovirus and EGFP expression was detected using fluorescent microscope. Infection efficiency was assessed by flow cytometrics. Western blotting identified expression of Ad -proBDNF and Ad-BDNF in rMSC. rMSC infected with Ad -proBDNF and Ad-BDNF were induced to differentiate into neuron-like cells. rMSC infected with Ad -proBDNF and Ad-BDNF were injected into nude mice and assessd in vivo. RESULTS: We successfully constructed the recombinant adenovirus Ad -proBDNF and Ad-BDNF that expressed in expanded rMSC in vitro.CONCLUSION: Recombinant adenovirus high-effectively mediates Ad -proBDNF and Ad-BDNF expression in expanded rMSC in vitro and in vivo.

Objective To analyze the etiology and features of Pilon fractures and to explore their best operative method.Methods 92patients with pilon fracture were treated operatively and followed up between1991and 2001.According to the Ovadi a -Beals' s classification,there were 7cases of Type I fracture,12of II,30of III,26of IV,17of V.During the o peration,55patients had limited in ternal fixation with calcaneal trac-tion,18with calcaneal traction and plaster splint,10with tibial and fi bula internal fixation,9with external fixation apparatus.Results92patients were followed up for an av erage time of 53months(ranging from 4～103months).According to Mazur ' s criteria,the results of the treatm ent were rated as excellent in 42patients,good in 34,fair in 11and poor in 5.Conclusion The pilon fracture is caused by both t he force of falling from a high altitude and the force of rebounding which act in the distal end of tibia an d fibula.Limited internal fixation with calcaneal traction is a right choice of operative method to treat pilon fr actures.[

Objective To assess clinical outcomes of FasT-Fix technique in repair of meniscal injury under arthroscope. Methods A total of 36 cases (37 knees) of mensical tears were repaired with FasF-Fix technique. There were 26 males and 10 females, at mean age of 26 years (14-51 years). Eighteen meniscal tears were located in zone Ⅱ, 16 in zone Ⅲ and 3 in zone Ⅳ. The average length of the tear was 2.2 cm (1.0-3.0 cm). Results There were no any signs of early complications after sur gery. All cases were followed up For 6-26 months (mean 16 months). According to Lysholm scoring scale system ,the average score of operated knees was increased from preoperative 44.13+12.56 to postopera tive 80.24+12.67 (P<0.01). After operation, all the patients could move the knee joint at normal range, except for one case who had a limitation of 20 degree flexion, with no pain or interlocking symptom. All cases returned to original work and/or could continue sports game. Conclusion The FasT-Fix technique is a simple, safe and effective method for repair of properly selected meniscal tears.

Objective To describe and examine the clinical characteristics and spectrum of tufted angiomas (TA) in infants so as to explore the therapeutic approaches to Kasabach-Merritt phenomenon (KMP).Methods The clinical and follow-up data of 24 patients with TA were retrospectively analyzed between Jan.2009 and Mar.2013.The median age of the patients was 7.5 months(ranged from 18 days to 2 years),including l0 male and 14 female.Surgical excision and observation were chosen according to the lesion and conditions of the patients.The mean follow-up period was 3.6 years (1.2 to 5.4 years).The changes in the patients' s condition were established by evaluating platelet counts,and the size of lesion.Results Common clinical features included dusky red or violaceous infiltrating cutaneous lesion,thrombocytopenia,pain or decreased function and hyperhidrosis or hypertrichosis.The following 3 clinical patterns of TA progress were described:spontaneous complete or partial regression (n =2,8.3％),TA without complications and persistence over the years(n =9,37.5％),and TA complicated by KMP(n =13,54.2％).The average interval of development of KMP for delayed cases was 45.2 days(ranged 0 d to 4 months).Each of the 13 patients who developed KMP subsequent to initial presentation was symptomatic at the time KMP was detected(enlarged lesion,n =8;increased lesion firmness with change in cutaneous stain,n =3 ;and respiratory distress,n =2).All of 13 patients were cured by surgery.Complete surgical resections were performed on 10 cases.The thrombocyte count was back to normal within 1-3 days post operation,and hemoglobin and blood coagulation function gradually returned to normal within 1 to 2 weeks.Other 3 cases received major resection surgery.The number of platelets in the patients were unstable,but significantly higher than that of preoperational stage.The platelet count remained above 60 × 109/L.The residue lesions in 2 cases disappeared gradually after the operation and medication were given within 3-6 months.And the other case died of multiple organ failure post-operation.Conclusions Surgical intervention can be applied to TA that severely makes damage to children's appearance or looks or may be complicated with KMP or functional abnormality.A closely monitored policy seems appropriate for the early small tumor without severe complications.And it is necessary to monitor the number of the platelet regularly and find the KMP by as early as possible.TA associated with KMP is vitol to infants.And surgical therapy after clear diagnosis should be done as early as possible.The surgical therapy is a reliable management with higher curative rate,short disease period and minimal side-effect.