Objective To explore the microsurgical treatment of the fourth ventricular tumors. Methods A total of 29 cases of the fourth ventricular tumors were given microsurgical treatment from January 2000 to June 2003 in this hospital. In 5 cases the tumor was located close to the cortex with the superior vermis involvement and the microsurgical operation was performed through the cerebellar vermis. The remaining 24 cases underwent microsurgical resection of tumor through the cerebellomedullary fissure approach. Results A total resection was achieved in 23 cases, and a subtotal resection in 6 cases. Postoperative complications included 2 cases of hemorrhage of the upper digestive tract, 1 case of mutism, 1 case of hematoma of the fourth ventricular, 1 case of epidural hematoma remote from surgical site, and 1 case of irregular breath. Follow-up surveys in 19 cases for 3~12 months (mean, 5.5 months) revealed no tumor recurrence. Conclusions Preoperative proper differentiating characters of tumors, clarifying the position of tumors' basal part, selecting appropriate surgical approach, and understanding microanatomy of the fourth ventricular are the key to successfully complete the procedure.

ObjectiveTo investigate the diagnosis and treatment of hepatic venous outflow obstruction(HVOO) after pediatric liver transplantation.MethodsFrom Jan.2000 to Dec.2009,48 children received liver transplantation in the Department of Liver Transplantation,First Central Hospital,Tianjin.There were 3 patients who developed HVOO (2 received liver transplantation in our center,while the third from another centre).The HVOO was diagnosed by color Doppler ultrasound (CDUS),computed tomography (CT),and angiography of inferior vena cava (IVC).The patients received balloon dilation and/or stent placement and followed-up with regular monitoring.ResultsIn our center,the incidence rate of HVOO was 4.17％ (2/48).The time of onset was 2 months to 1 year postoperatively.The pressure gradient between the hepatic vein and the right atrium was from 6 to 30mmHg.After treatment,the venous pressure gradient decreased from 4 to 10mmHg.Resolution of clinical symptoms was achieved in these patients.HVOO relapsed in two patients who received balloon angioplasty only.The clinical symptoms were relieved after repeated balloon dilation in one and stent placement in the other.There were no further complications after these procedures.All patients were alive at a follow-up from 2 months to 9 years.ConclusionThe incidence of HVOO after pediatric liver transplantation was not high,but HVOO led to serious consequences.Balloon dilation and/or stent implantation were safe and efficacious treatments for HVOO after pediatric liver transplantation.

Objective To explore the surgical treatment strategies,advantages and surgical indications of pontine cavernous malformations (CMs) through transtelovelar approach.Methods This study included 12 patients with pontine CMs,admitted to our hospital from January 2009 to December 2014.The clinical data of these patients were retrospective study.Results All patients received microsurgical treatment to remove the pontine CMs located in the back of pons through transtelovelar approach.The total resection was achieved in all 12 patients.Follow up was performed for 4 to 36 months,no death case was noted.Postoperative complications of worsening original symptom were noted in one patient and new neurological symptoms in one.Conclusions The transtelovelar approach can provide adequate exposure to remove the brainstem CMs located in the back of pons.Long-term follow up indicates satisfactory efficacy and prognosis of microsurgical treatment.

Equine interferon-gamma (eIFN-gamma) expressed both in E. coli and baculovirus were evaluated for antiviral activity against recombinant Vesicular Stomatits Virus expressing green fluorescence protein (rVSV-GFP) in EFK-78 cells. The assays were conducted in 96-well plate. Virus infectivity was measured by quantifying GFP-positive cells, instead of quantifying the CPE reduction. Prior to infection of EFK-78 cells with rVSV-GFP, the cells were incubated with eIFN-gamma. The GFP expression in the EFK-78 cells dramatically decreased in the cells treated with eIFN-gamma in a dose-dependent manner, comparing with the mock-treated cells. The titers of antiviral activity were 1 x 10(3) AU/mL and 1 x 10(5) AU/mL of eIFN-gamma expressed from E. coli and baculovirus, respectively. The antiviral activities of the recombinant eIFN-gamma were highly efficient and specific, as it was blocked by mAbs against eIFN-gamma.
Animals ; Antibodies, Monoclonal ; immunology ; Antiviral Agents ; metabolism ; pharmacology ; Baculoviridae ; genetics ; metabolism ; Escherichia coli ; genetics ; metabolism ; Green Fluorescent Proteins ; metabolism ; Horses ; Interferon-gamma ; biosynthesis ; genetics ; pharmacology ; Recombinant Proteins ; Vesicular stomatitis Indiana virus ; drug effects ; metabolism

Objective To summarize the clinical experience in pediatric split liver transplantation (SLT) recipients.Methods A retrospective analysis was conducted on 38 cases of pediatric recipients using split donors during February 2007 to December 2015.The ex situ splitting technique was used for 22 grafts and in situ splitting technique was used for the rest 16 grafts.The survival rate of patients,recovery of liver function,re-transplantation rate,incidence of vascular complications and biliary complications were Observed,and the causes of death were analyzed.Results The median follow-up time of all the patients was 30.65 months (0.1-96.6 months).The 1-and 3-year cumulative survival rate was 81.6％ and 76.3％ respectively.The re-transplantation rate was 13.16％,the incidence of vessel complications was 31.58％,and biliary complication rate was 31.58％.There were 9 deaths,including 5 deaths which were related to surgical complications.Conclusion SLT can expand the resource of 1iver donors for pediatric recipients.Comparing to ex situ split liver grafts,in situ split liver grafts can reduce morbidity and mortality of children after liver transplantation.

Objective To investigate the influence of type 2 diabetes mellitus(T2DM)on cognitive function and the effective connectivity with in the default mode network(DMN)in the brain.Methods A total of 93 hospitalized patients diagnosed with T2DM were enrolled in this study as T2DM group from The First Affiliated Hospital of Guangzhou University of Chinese Medicine during September 2021 to December 2022.Simultaneously,108 healthy individuals were recruited from the community as normal control(NC)group.The cognitive functions were evaluated in the two groups.A random dynamic causal modeling approach was employed to analyze the effective connectivity within DMN in both groups.Additionally,Pearson correlation analysis was performed to examine the association between differential connectivity,clinical indicators,and cognitive scores in both groups.Results In comparison to the NC group,T2DM individuals exhibited statistically significant reductions in scores in the auditory verbal learning test(AVLT)for immediate recall and the digit symbol substitution test(DSST)(P＜0.05).Additionally,they displayed a notable decrease in effective connectivity from the left lateral parietal cortex(LLPC)to the posterior cingulate cortex(PCC),as well as from the LLPC to the right lateral parietal cortex(RLPC)within the DMN(P＜0.05).Pearson correlation analysis unveiled a negative association between HbA1c levels and the strength of effective connectivity from LLPC to PCC.Conversely,a positive correlation was observed between AVLT(immediate)scores and the strength of effective connectivity from LLPC to PCC and LLPC to RLPC.Additionally,DSST scores displayed a positive correlation with the strength of effective connectivity from LLPC to PCC(P＜0.05).Conclusion Patients with T2DM display compromised effective connectivity from LLPC to PCC and LLPC to RLPC within the DMN network,and this alteration may associated with cognitive impairment.

Objective:To investigate the efficacy and clinical experiences of fluorescein angiography assisted occlusion via lateral-orbital keyhole approach in internal carotid bifurcation aneurysms. Methods:The clinical data of 16 patients with internal carotid artery bifurcation aneurysms admitted to our hospital from January 2016 to December 2020 were retrospectively analyzed. All patients accepted fluorescein angiography assisted occlusion via lateral-orbital keyhole approach. The patients were followed up at one, 3, and 6 months after surgery by medical imaging. The therapeutic efficacy of these patients was assessed by Glasgow outcome scale (GOS). Results:All aneurysms in these 16 patients were clipped at one-stage operation. Intraoperative fluorescein angiography and FLOW 800 showed that the aneurysms were completely clipped without residual, and the blood flow of the parent artery and perforating arteries was unobstructed. Six months after surgery, 14 patients recovered well (GOS scores of 5), and 3 developed limb hemiplegia (GOS scores of 4).Conclusion:Intraoperative fluorescein angiography assisted occlusion via lateral-orbital keyhole approach is safe and effective in internal carotid bifurcation aneurysms.

Objective:To understand the 10-year risk of ischemic cardiovascular disease (ICVD) in hypertensive patients in communities in Shenzhen, and to provide baseline data for the comprehensive implementation of community-based hypertension health management measures based on ICVD risk assessment.Methods:From July 2017 to June 2018, 200 community health service centers in 10 districts of Shenzhen were selected by multi-stage random sampling to investigate hypertensive patients in communities aged≥35. After the patients who met the inclusion criteria signed the informed consent form, the demographic characteristics, physical examination, and laboratory tests were conducted. The absolute risk of ICVD in 10 years was evaluated by using the ICVD risk assessment module from the Shenzhen community health service information system. According to the China 10-year risk for ICVD score tables, recommended by the Chinese cardiovascular disease prevention guidelines, the risk grade of ICVD was estimated and analyzed. In addition, the relative risk was used to eliminate the influence of gender and age, and the single sample t-test was used for comparisons with the larger population. Results:30 015 hypertensive patients from communities were investigated, including 16 165 (53.86%) males and 13 850 (46.14%) females, aged 35-102 years, with a median age of 59.0. 6 405 (21.34%), 5 771 (19.23%) and 17 839 (59.43%) were at high, medium and low risk of ICVD, respectively. The absolute risk was 3.77%, 95% CI (3.72%-3.82%). The risk grades of ICVD in 10 years was different as per gender, age, marital status, population type， smoking, family history of hypertension, history of diabetes mellitus, systolic blood pressure, body mass index, and total cholesterol level, P values were all<0.001. The risk grades of ICVD in males, married patients, floating populations, having a total cholesterol <5.20 mmol/L, non-smokers, non-diabetics, and having a family history of hypertension were lower than that of other characteristics, and increased with age, systolic blood pressure, and body mass index. Further analysis of 15 652 patients aged 35-59 years old showed that the 10-year risk of ICVD in patients with hypertension in communities was slightly higher than that of the larger population, and the relative risk was 1.27, 95% CI (1.25-1.28), t=37.648, P<0.001. In males, relative risk was 0.94, 95% CI (0.93-0.95), t= 9.906, P<0.001, and there were no significant trend changes among age groups. In females, relative risk was 2.05, 95% CI (2.01-2.09), t=72.207, P<0.001, and increased with age. Conclusion:The 10-year risk of ICVD in hypertensive patients is often at a high level in Shenzhen, so it is necessary to carry out the risk assessment of ICVD in the community. The effect of community hypertension health management on reducing the risk of ICVD may vary between genders. The risk of ICVD in male patients is lower than that of males in the larger population, but in female patients it is still much higher.

OBJECTIVETo investigate the number of dissected lymph nodes and the incidence of injury to parathyroid glands during surgery for papillary thyroid carcinoma (DTC) in young patients.

METHODSThis study collected clinicopathological data of 51 young patients with PTC. Of the 51 patients, 18 patients were classified into carbon nanoparticles group (CNP group) and 33 patients into traditional surgical group (TS group). The number of dissected lymph nodes and the incidence of injury to parathyroid glands were analyzed using Wilcoxon rank sum test and chi-square test.

RESULTSThere were 16 males and 35 females, with a male/female ratio of 1: 2.19. The age ranged from 14 to 29 (25 ± 3.9) years. There was no statistically significant difference in age, gender, T-classification, TNM stage and surgical procedures between two groups (P > 0.05). The total number of dissected lymph nodes in CNP group was higher than that in TS group (Z = -2.258, P < 0.05) . However, significant difference in the total number of metastatic lymph nodes between the two groups was not found (Z = -0.396, P > 0.05). In level VI, the detected lymph node number of group CNP was higher than that of TS group (Z = -2.461, P < 0.05) but there was no significant difference in the detected number of metastatic lymph nodes (Z = -1.396, P > 0.05) . The rates of injury to parathyroid gland were 5.5% in CNP group and 18.2% in TS group, respectively (χ(2) = 1.568, P > 0.05).

CONCLUSIONCarbon nanoparticles could be an effective lymph nodes tracer applying to PTC operation in young patients.

Carbon ; Carcinoma ; therapy ; Carcinoma, Papillary ; Female ; Humans ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis ; Male ; Nanoparticles ; Nanotubes, Carbon ; Parathyroid Glands ; Thyroid Neoplasms ; therapy

Microneedles can penetrate the skin barrier to deliver drugs without touching the nociceptive nerves， to effectively increase the efficiency of transdermal drug delivery and improve patient compliance. Exosomes have multiple physiological functions and good biocompatibility， and are natural nanoscale drug carriers. This paper reviews the pathways and advantages of exosomes combined with microneedles for the treatment of diseases， and describes the current research status of exosome microneedle drug delivery system in various diseases. Exosome microneedles can be divided into two categories： （1） exosomes as therapeutic agents， their unique physiological origin can effectively avoid the toxicity and immunogenicity of conventional drugs and other problems； combined with microneedles directly in the specific medication site can greatly improve the metabolic consumption of oral drug delivery and patient compliance of injection drug delivery. （2） Exosomes as drug carriers， their natural vesicle structure and endogenous characteristics can protect the metabolism of foreign drugs in the body and enhance the targeting； combined with microneedles can effectively solve the problem of transdermal delivery of drugs with high efficacy but poor stability. Exosome microneedle drug delivery system is still in the laboratory stage， but it has shown great development prospects in repairing spinal cord injury， promoting diabetic ulcer wound healing， germinating， intervening myocardial infraction， relieving chronic pain and other diseases.