Objective To explore the early diagnosis of germinoma originating from the basal ganglia (BG) and thalamus during juveniles. Methods Retrospective analysis was done with the clinical cases of germinomas in BG and thalamus from 2000 to 2009. The symptoms, signs, neuroimaging,cerebrospinal fluid (CSF) findings were analyzed and related literature were reviewed. Results Eight patents were collected. The main symptoms were hemiplegia, associated with aphasia and/or impaired cognition. Brain CT showed high density and calcification. Abnormal T1 and T2 signal were found in brain MRI frequently associated with ipsilateral hemisphere atrophy. MRS showed increased choline and decreased N-acetylaspartate level. Elevated CSF human chorionic gonadotrophin level were found in two of them.Conclusions Germinoma in BG and thalamus predominates in a boy. The neuroimaging features are very informative for early diagnosis.

with pyramidat tract and/or peripheral nerve symptoms.

Objective To improve the recognition of early diagnosis and pathogenesis of non-traumatic rhabdomyolysis and prevent the occurrence of rhabdomyolysis.Methods Seven cases of non-traumatic rhabdomyolysis were collected,whose clinical data and related review were analyzed.Results The clinical features included weakness of limbs,myalgias,myoglobinuria,and an elevated serum creatine kinase.pathogenesis of non-traumatic rhabdomyolysis include drug in three cases,diabetic ketoacidosis in one case and metabolic myopathy in one case.Conclusion Multiple diseases can cause non-traumatic rhabdomyolysis.The early diagnosis and investigation of causes of non-traumatic rhabdomyolysis are important.

BACKGROUND:Medical glue as a biological hemostatic material shows a good diffusivity in body fluids and blood, and has a rapid polymerization reaction, which plays an ideal hemostatic effect and promotes wound healing. OBJECTIVE:To investigate the clinical value of medical glue as a hemostatic material in the open wound of the frontal plane in children. METHODS:Totaly 1 218 children with open wounds of the frontal plane treated with medical glue were enroled as observation group, and another 600 children with open wounds of the frontal plane treated with silk sutures as control group. Wound healing time, postoperative wound bleeding, suture reaction, pigmentation and scar hyperplasia were compared between the two groups. RESULTS AND CONCLUSION:Compared with the control group, the operative time, blood loss and wound healing time were al less in the observation group (P < 0.05), and the effective bleeding rate was higher in theobservation group (P < 0.05). Stage I wound healing occurred in 1 215 cases of the observation group, and 586 cases of the control group. At the end of 12-month folow-up, healed scar formed with no knot scar and needle scar, the skin color was similar and cosmetic results were good in the observation group; in the control group, there were more obvious scars, visible knot and needle scars, and erythema, induration and hypertrophic scars were found around the most wounds. The medical glue for open wounds of the frontal plane in children has good biocompatibility and cosmetic results, which is safe and convenient in clinical use.

Objective To explore a set of suitable content and methods of evaluation for nursing students' humanistic quality. Methods Using dynamic evaluation theory, from three aspects of the evaluational main body, evaluation content and evaluation way, we assessed 261 nursing students' humanistic quality of the five-year undergraduate. Results Based on students' four consecutive years of assessment,results showed that the students' spirit had obviously changed, the students' comprehensive achievements had obviously promoted, the students' employment was obviously higher than other professionals and the students' degree of satisfaction from employing unit had increased yearly. Conclusions Dynamic evaluation can evaluate the best development of students, to strengthen nursing students' humanities education, to improve level of nursing students' humanities education, it is feasible in humanities education of higher nursing profession.

Objective To explore the clinical and radiological features of bilateral thalamus venous infarction.Methods The cases definitely diagnosed as thalamus venous infarction were collected and the corresponding clinical and radiological data were retrospectively analyzed.Results Four cases confirmed as thalamus venous infarction by digital substraction angiography (DSA) were collected.Bilateral thalamus lesions were detected in all cases by brain MRI scans which mainly presented as thalamus edema with high T1 and T2 signals with partial enhancement.Mild hemorrage was also shown in one case.Acute or subacute onset with clinical manifestations of headache,hypomnesia and hypersomnia were reported in all cases.The neurological examination showed conscious disturbance,memory impairment and positive Babinski sign.The venous thrombi were formed mainly in the transverse and the straight sinuses in 3 cases with the deep cerebral venous involved in 2 cases.All patients were improved after the anticoagulation therapy.Dural arteriovenous fistula was found in the other case drained by the Rosenthal's vein,and the symptoms were ameliorated after the embolotherapy.Conclusions As the thalamus is drained by the thalamostriate vein and the lateral thalamic vein towards the internal cerebral vein with the caudate portion drained particularly by the Rosenthal's vein,venous thrombosis or fistula drainage into these veins would probably disturb the normal drainage of the thalamus and result in further edema and infarction.Thus,the venous infarction should be taken into consideration whenever bilateral thalamus lesions are encountered in clinical practice and DSA is necessary to confirm the diagnosis.

Objective To investigate the sedative effect of propofol combined with different doses of midazolam in patients undergoing long-time microsurgeries.Methods Forty ASA(American Society of Anesthesiologists)Ⅰ～Ⅱ patients were randomly divided into 4 groups.Normal saline(NS) 2 mL was administered in groupⅠ,while midazolam 0.01,0.02 and 0.04 mg/kg was administered in groupⅡ,Ⅲ,Ⅳ respectively.one min later,propofol was infused at a rate of 5～10 mg/kg?h combined with midazolam based on the abovementioned dosage per hour for groupⅡ,Ⅲ,Ⅳ respectively.Taking auditory evoked potential index(AAI) as a parameter,after it decreased to 40,the infusion rate of propofol was adjusted to keep AAI at the level of 30～45,and maintained the level by infusing propofol and midazolam for 5 hours.The dosage of propofol required for induction and maintenance was recorded.The emergence time and whether patients had awareness during the operation were recorded after the infusion stopped.Results At the target sedative level of AAI 30～45,the Observer's Assessment of alertness/sedation(OAA/S) score of all patients in the four groups reached 0～1.The induction period was obviously shortened and the propofol dosage was dramatically reduced in group Ⅱ～Ⅳ as compared with groupⅠ.At the stage of maintenance of sedation,the dosages of propofol in both groupⅠandⅡ were larger than those in group Ⅲ and Ⅳ.The emergence time in group Ⅳ was dramatically longer than the other groups(P

It had been proved by many evidences that several heat shock proteins (HSPs) expression is up-regulated in tissue-derived primary lung cancer, and HSPs may play important roles in development, in resistant to drugs and in prognosis of lung cancer. However, there have not still systemic research on which HSPs,especially HSP70 can be or not thought as a new biological target in the therapy to lung cancer. In order to address the expression and roles of heat shock protein 70 (HSP70) in lung adenocarcinoma, immunoblotting was performed to detect the expression of HSP70 in tissue specimens from lung adenocarcinoma which were diagnosed unambiguously by branch fibromicroscopy and were excised. It showed that in the normal lung tissues, the expression of HSP70 was less then that in cancer tissues. After down-regulation of HSP70 protein by HSP70 anti-sense oligonucleotides in A549 cell line, MTT assay showed that the proliferation of A549 cells was inhibited remarkably after the treatment with HSP70 antisense oligonucleotides and Act D. There had significant differential in HSP70 antisense treatment group followed by Act D treatment and Act D treatment group. Results of Hoechst33258 staining revealed that HSP70 antisense oligonucleotides could promote Act D-mediated apoptosis in A549 cells with a higher percentage of apoptotic cells (26.91?3.73)% than that of Act D-treated group (16.83?3.41)% (P

Objective To clone and express the Tp0453 antigen immuno-dominant epitope fragment of Treponema pallidum (Tp) in Escherichia coli,in an effort to develop serological tests with increased specificity for the diagnosis of syphilis.Methods The gene encoding Tp0453 recombinant outer membrane protein fragment was amplified by polymerase chain reaction (PCR),and inserted into expression vector pQE30 after T-A cloning,then confirmed by restriction map.The constructed recombinant plasmid pQE30-Tp0453 was transformed to E.coli M15 for expression induced by isopropyl β-D-1-thiogalactopyranoside.The expressed product was identified by Western blot,and purified by Ni2+-NTA agarose column chromatography.A double antigen sandwich enzymelinked immunosorbent assays (ELISA) was established by using the recombinant Tp0453 protein to test sera from 48 patients with positive Treponema pallidum particle agglutination test (TPPA),and 40 negative sera as control.Results The PCR amplicon of the target gene was about 490 bp.The recombinant plasmid pQE30-Tp0453 was correctly constructed and successfully expressed in E.coli M15.The expressed product,with a relative molecular of about 21 000,existed in a form of inclusion body,accounting for about 18％ of total somatic protein,and reached a purity of more than 95％ after purification.Western blot showed specific reaction of the expressed protein with Tp positive serum.The ELISA tests with the 88 clinical samples yielded a sensitivity of 97.9％ (47/48),and specificity of 100.0 ％ (40/40).The consistency of results between the ELISA test and the TPPA test was 98.9 ％ (87/88).Conclusion The expressed Tp0453 fragment has showed good immunoreactivity with serum from patients with syphilis,providing the foundation of further development of serological diagnostic kit with increased specificity for the diagnosis of TP infection.