Objective To investigate the expression and distribution of Kv1.6 in rat hippocampus after status epilepticus (SE) induced by lithium and pilocarpine to explore the relationship between Kv1.6 and epileptogenesis.Methods Forty-eight healthy male Sprague-Dawley rats were randomly divided into experiment group and control group.The rats in each group were randomly assigned into 6-hour,1-day,2-day and 3-day subgroups (n =6).Electroencephalography (EEG) of rats in both groups were recorded to show the electrical activity of the rat brains.Nissel staining was performed to investigate the pathological changes,and immunohistochemistry and Western blotting were applied to analyze the expression and distribution of Kv1.6.Results (1) The EEG of rats in control group showed α wave with uniform amplitude,while the EEG in rats subjected to pilocarpine injection showed slow waves and spike waves with irregular amplitude and rhythm.Sustained spike waves were observed during SE.(2) Nissl staining showed that 6 hours after SE,the neural morphology of hippocampi in experiment group was as the same to that in control group.There was no change in neuronal morphology and numbers.However,1 day after SE,the structure of hippocampi was discrete and the number of neurons was decreased.Two and 3 days after SE,the number of neurons in hippocampi decreased further.Swelling and deformation of neurons were seen.Nissl bodies emerged,decreased or even disappeared.(3) There was no statistically significant difference in the expression of Kv1.6 in CA3 and CA1 areas between experiment group and control group 6 hours after SE (all P＞0.05).One day,2 days and 3 days post SE,the expression of Kv1.6 in CA3 area (0.117 ±0.040,0.135 ±0.029,0.112 ±0.050) decreased obviously compared to control group (0.192±0.054,0.201 ± 0.062,0.184 ±0.042;t---3.861,3.745,5.579,all P ＜0.05);and the expression of Kv1.6 in CA1 area (0.114 ± 0.02,0.082 ± 0.031,0.106 ± 0.043) decreased significantly compared to control group (0.165±0.036,0.187 ±0.025,0.172 ±0.052;t=3.221,6.360,3.645,all P＜0.05).The expression of Kv1.6 did not show statistically significant difference in DG area between experiment group and control group at all time points examined (P ＞ 0.05).The Western blotting showed the same trend.Conclusion The decreased expression of Kv1.6 may play a role in the epileptogenesis.

Objective To observe the clinical effect of acupuncture plus ginger-partitioned moxibustion in treating diarrhea-predominant irritable bowel syndrome (D-IBS). Method Ninety D-IBS patients were randomized into an acupuncture-moxibustion group (acupuncture plus ginger-partitioned moxibustion), an acupuncture group, and a Western medication group (Pinaverium bromide), 30 patients in each group. The clinical effect, symptom score, and quality of life in the 3 groups were observed. Result The general clinical effect of the acupuncture-moxibustion group was significantly higher than that of the acupuncture group and Western-medication group (P＜0.05), but there was no significant difference in comparing the total effective rate between the acupuncture group and acupuncture-moxibustion group (P>0.05). After treatment, the Western medication group showed marked decreases in abdominal pain, abdominal distension and discomfort, defecation property, and defecation frequency (P＜0.01);the acupuncture group showed significant decreases in abdominal pain, abdominal distension and discomfort, mucous stool, and appetite (P＜0.05, P＜0.01); the acupuncture-moxibustion group had significant decreases in abdominal pain, abdominal distension and discomfort, defecation property, defecation frequency, mucous stool, and appetite (P＜0.01). The quality of life score changed significantly in all groups after treatment (P＜0.05, P＜0.01);the changes of quality of life score in the acupuncture group and acupuncture-moxibustion group were both significantly higher than that in the Western-medication group (P＜0.01);the change of quality of life score in the acupuncture-moxibustion group was significantly higher than that in the acupuncture group (P＜0.01). Conclusion Acupuncture plus ginger-partitioned moxibustion and acupuncture alone both can produce a higher therapeutic efficacy than Pinaverium bromide in treating D-IBS; acupuncture plus ginger-partitioned moxibustion is superior to acupuncture alone.

Objective To investigate the treatment effects and toxicities of extended-field intensity modulated radiation therapy (EF-IMRT) and intra-cavitary brachytherapy combined with chemotherapy for stage Ⅰ b1-Ⅳa cervical cancer with positive para-aortic lymph nodes.Methods A total of 46 stage Ⅰ b1-Ⅳa cervical cancer patients with positive para-aortic lymph nodes treated at Fudan University Shanghai Cancer Center between 2009 and 2011 were reviewed.Neoadjuvant,concomitant and adjuvant chemotherapy with paclitaxel and carboplatin were administrated for one cycle before radiation therapy,two cycles during radiation therapy or three cycles after radiation therapy.All patients received EF-IMRT and intra-cavitary brachytherapy.The positive lymph nodes received an additional boost dose.Results All patients received EF-IMRT to 50.4 Gy (1.8 Gy per fraction).Twenty-six patients was treated with boost dose of 6.0-8.0 Gy in 2.0 Gy per fraction to positive para-aortic lymph nodes.Thirty-seven patients received a positive paraaortic lymph nodes boost or(and) parametrial boost.All patient also received a high-dose-rate intra-cavitary brachytherapy at the point A dose of 20.0-30.0 Gy in 5.0 Gy per fraction.Total chemotherapy cycles were 189,and the average patient received 4.1 courses.Two cases (4％,2/46) experienced grade Ⅲ gastrointestinal toxicities,no patients suffered grade Ⅳ gastrointestinal toxicities.Fifteen cases (33％,15/46) experienced grade Ⅲ hematological toxicities,and 3 (7％,3/46) experienced grade Ⅳ hematological toxicities.Late grade Ⅲ-Ⅳ toxicity was seen in 3 cases (7％,3/46).The 3 year progressionfree survival rate was 46.2％,and the 3 years overall survival rate was 61.2％.Conclusion EF-IMRT and intra-cavitary brachytherapy combined with chemotherapy is safe and effective for stage Ⅰ b1-Ⅳa cervical cancer with positive para-aortic lymph nodes.

Background and purpose:More than 70 percent of ovarian cancer patients were diagnosed in the advanced stage. Currently the 5-year disease free survival (DFS) of stageⅢC-Ⅳovarian cancer patients wsa about 10 percent after first line chemotherapy. This study aimed to improve the 5-year DFS by three-step chemotherapy according to the mechanisms of ovarian cancer biological characteristics, cytodynamics and pharmacology. Methods:In arm A, the patients received three-step chemotherapy after primary debulking surgery, step one with paclitaxel plus carboplatin (TC regimen), every 3 weeks for 6 to 8 cycles;step two with etoposide plus cyclophosphamide, every 4 weeks for 6 cycles;step three wit carboplatin plus cyclophosphamide every eight weeks for six cycles. In control arm B, we retrospectively analysed 51 cases withⅢC-Ⅳstage ovarian cancer, who had completely response after standard chemotherapy with six to eight cycles of TC after primary surgery during 2007. We compared the 5-year DFS between the two arms. Results:The 5-year DFS of 15 cases in arm A was 80%(12/15), which was signiifcantly higher than that of arm B (5.9%, 3/51, P<0.01). Conclusion: The three-step chemotherapy after optimal debulking surgery in stageⅢC-Ⅳ can improve the 5-year DFS. This regimen is high efficacy, mild side-effect witn low cost, which deserves further exploration.

Objective To explore the correlation between time-intensity curve (TIC) parameters of CEUS and microvessel density (MVD) of inverted papilloma of bladder (IPB) and bladder urothelial carcinoma (BUC).Methods Clinical and CEUS characteristics of 30 patients with IPB and 50 patients with BUC confirmed by pathology were retrospectively analyzed.CEUS TIC parameters included rise time (RT),mean transit time (MTT),peak intensiy (PI),time from peak to one half (TPH),wash in slope (WIS),time to peak (TP),semi-descending slope (DS) were acquired by QLab software and statistical analysis was carried out.The MVD of the resectioned tissue specimens were quantified via immunohistochemistry for CD34 and the correlation with CEUS TIC parameters was investigated.Results In CEUS quantitative parameters,PI,TPH,TP and DS had statistical significance in IPB and BUC (all P＜＜0.05).MVD of BUC was obviously higher than that of IPB (P＜0.05);TPH and DS both correlated with MVD (rs =0.74,-0.81,both P＜0.05).Conclu sion CEUS characteristics has certain clinical value in identification of IPB and BUC.TIC parameters of CEUS can reflect the MVD of IPB and BUC.

Objective To investigate the effect of smoking status after vascular construction on the long term prognosis in the patients with coronary heart disease(CHD).Methods Totally 893 patients with CHD were divided into 3 groups according to the smoking status before and after vascular construction,non-smoking group(n=458),quiting smoking group(n=287) and smoking group(n=148).The occurrence situation of major adverse cardiovascular and cerebrovascular events(MACCE) during follow-up period were recorded in detail.The postoperative cumulative survival rate was described by using Kaplan-Meier survival analysis.The effect of smoking status on the all-cause death and MACCE was compared.The Cox stepwise regression analysis was used to analyze the all-cause death and the influence factors of MACCE.Results The average follow up time was about 27 months,the postoperative smoking rate was significantly lower than the preoperative multivariable smoking rate(16.57 ％ vs.48.71％),the patients in the smoking group were younger (P＜0.01);the patients in the non-smoking group were mainly female (P＜0.01),the body mass index (BMI) was smaller(P＜0.01).The all-cause death in the smoking group was higher (1.53％ vs.1.05％ vs.6.76％,P=0.002) and the occurrence rate of MACCE was higher (4.37％ vs.5.23％ vs.15.54％,P=0.001).The Cox multivariable stepwise regression analysis showed that postoperative persistent smoking was an important risk factor leading to the all-cause death[HR=2.753,95％CI(1.695-4.473),P＜0.01] and MACCE[HR=1.552,95％CI(1.049-1.754),P=0.001].Conclusion Persistent smoking is an independent risk factor leading to all-cause death and MACCE occurrence in CHD patients after vascular construction.

Objective:To define the expression levels of MDM2 gene in nasopharyngeal carcinoma (NPC)and its relationship with p53 protein expression and EB virus latent infection. Method :MDM2 gene expression atmRNA and protein levels,p53 protein and EB virus DNA were detected by nonradioactive in situ hybridization(ISH) ,immunohistochemistry(IHC) and polymerase chain reaction (PCR) separately in 46 cases of NPC tissuesand 12 cases of chronic inflammation of nasopharyngeal epithelium (CINE). Result: Fourteen cases of NPCshowed MDM2 mRNA and protein overexpression, 38 cases were p53 protein positive,and 43 cases were EBV-DNA positive. Neither MDM2 nor p53 protein was expressed in any case of CINE. MDM2 expression was signifi-cantly related to p53 protein expression ( P ＜0. 05), but not to EB virus latent infection in NPC. Conclusion:MDM2 gene may play an important role in the pathogenesis of NPC through interacting with p53 protein.

OBJECTIVE: To study surgical techniques and clinical applications of the intranasal endoscopic combined middle meatus and expand prelacrimal recess-maxillary ainus approach for orbital fracture treatment. METHOD: A retrospective clinical analysis of 3 patients whose admitted for orbital floor fractures or medial wall fractures operated by the intranasal endoscopic middle meatus with expand prelacrimal recess-maxillary ainus approach surgical treatment was studied, and the treatment effects and the postoperative complications were analyzed. RESULT: All patients had been followed up for 6 to 12 months. All cases of diplopia symptom were disappeared, enophthalmos were totally corrected, no cases of complication were found. CONCLUSION Endonasal endoscopic combined middle meatus and expand prelacrimal recess-maxillary ainus approach for orbital fracture treatment have great and clear view. This approach with less tissue damage and high therapeutic effect makes the cost lower than other methods and complications will be decreased as well, it has a great advantage in the orbital fracture treatment.
Diplopia ; etiology ; therapy ; Endoscopy ; Enophthalmos ; etiology ; therapy ; Humans ; Maxillary Sinus ; surgery ; Nose ; Ophthalmologic Surgical Procedures ; methods ; Orbital Fractures ; complications ; surgery ; Postoperative Complications ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies

OBJECTIVE: To evaluate the imaging characteristics of B-cell non-Hodgkin lymphoma of skull base. METHOD: Two patients with B-cell non-Hodgkin lymphoma of skull base in our hospital were reported, meanwhile the imaging characteristics were summarized and analyzed with the related literature. RESULT: The imaging feature of B-cell non-Hodgkin lymphoma of skull base was equal or low signal on MR T2-weighted and not obviously enhanced. The width of the soft tissue invaded in intracalvarium appeared much bigger than the width of bone destruction, and the lesion infiltrated along the dural surface. CONCLUSION Characteristic imaging appearance of B-cell non-Hodgkin lymphoma of skull base have the significance in diagnosis and differential diagnosis.
Adult ; Child, Preschool ; Humans ; Lymphoma, B-Cell ; diagnostic imaging ; pathology ; Lymphoma, Non-Hodgkin ; diagnostic imaging ; pathology ; Magnetic Resonance Imaging ; Male ; Skull Base Neoplasms ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed

OBJECTIVE: To explore the methods and feasibility of the transnasal endoscopic reconstruction of the nasal-skull base defect to manage the cerebrospinal fluid leaks using intranasal autologous grafts. METHOD: Ninety six nasal-skull base defect patients with cerebrospinal fluid leaks were managed under endoscope with intranasal autologous materials. The repair materials and methods for the management of the cerebrospinal fluid leaks were tailored based on the different location and size of nasal-skull base defect. Eighteen cases with nasal-skull base defects less than 0.5 cm in diameter were repaired by an overlay technique using free mucoperiosteal graft from the middle turbinate. Thirty five patients with defects in the ethmoid roof and ethmoid plate ranging in size from 0.5 to 1.0 cm in diameter were repaired by an overlay technique using a pedicled middle turbinate flaps. Twelve cases with defects in the sellar clivus ranging in size from 0.5 to 1.0 cm in diameter were repaired by an overlay technique using a pedicled septal mucoperiosteal grafts. Nineteen cases with a diameter of 1.0 to 1.5 cm defects were repaired using free septal cartilage and mucoperiosteal grafts. Seven cases with defects in the ethmoid roof and ethmoid plate ranging from 1.5 to 2.5 cm in diameter were repaired using a pedicled middle turbinate and ethmoid plate flaps. Five sellar clival defect cases ranging from 1.5 to 2.5 cm in diameter were repaired using ethmoid plate and pedicled septal mucoperiosteal flaps. RESULT: Six months to 6 years' follow up indicated that two patient developed postoperative cerebrospinal fluid leaks one year and two years after operation, respectively. One was successfully managed by conservative treatment. The other was successfully repaired by second surgery. Three patients developed transient postoperative cerebrospinal fluid leak that was spontaneous recovered without special treatment. No other new postoperative cerebrospinal fluid leaks occurred. CONCLUSION We concluded that transnasal endoscopic reconstruction of the nasal-skull base defect is a highly effective method for managing the cerebrospinal fluid leak with the advantage of easily obtaining the intranasal autologous materials. The autologous materials should be varied based on different size and location of the skull base defects.
Adolescent ; Adult ; Cerebrospinal Fluid Rhinorrhea ; surgery ; Child ; Child, Preschool ; Endoscopy ; Ethmoid Bone ; transplantation ; Female ; Humans ; Male ; Microsurgery ; Middle Aged ; Skull Base ; surgery ; Turbinates ; transplantation ; Young Adult