ObjectiveTo investigate the clinical value and pathological basis of peritumoral hyperenhanced rim (PHR) of renal cell carcinomas (RCCs) on CEUS.MethodsCEUS images of 53 patients with 54 renal tumors (27 RCCs,27 renal angiomyolipomas) were analyzed,and the detection and distribution of PHR were evaluated.HE staining and immunohistochemistry of CD34 were performed in tissue surrounding RCCs (TSR) to observe distribution of psuedocapsule,large vessels,and microvasculars among TSR with different modes of PHR.ResultsPHR was found only in RCCs.PHR distribution between RCCs and angiomyolipomas was statistically different (P＜0.05).Using PHR to diagnose RCC,the sensitivity,specificity,positive predictive value,negative predictive value,false positive and false negative was 44.44％ (12/27),100％ (27/27),100％ (12/12),64.29％ (27/42),0 (0/27) and 35.71％ (15/42),respectively.Pseudocapsule distribution between RCCs with PHR and RCCs without PHR was not statistically different (P＞ 0.05).There were rich large blood vessels in TSR with PHR in washin and both phases,and few or thimbleful large vessels were found in TSR without PHR in washout phase.Cancer tissue near the boundary (CTNB) of TSR had the highest microvessel density (MVD).MVD differences in different TSR with PHR were statistically different between washin and washout phases,washin and both phases,both phases with PHR and without PHR (P＜0.05),but no statistical difference was found between washout and both phases (P＞0.05).ConclusionPHR is a highly specific complementary indicator in diagnosing RCC,and it is correlated with rich blood vessels in TSR and (or) a higher MVD value in CTNB.

Objective:To evaluate the immunogenicity of recombinant factor H binding protein(fHBP) by detecting serum antibody titer and serum bactericidal antibody test (SBA).Methods:fHBP sequence was selected and synthesized, connected to plasmid pET43.1a, transformed to Escherichia coli BL21(DE3), and expressed two recombinant fHBP proteins, included two subfamilies, fHBPA and fHBPB. After purification, the recombinant fHBP proteins were immunized to rabbits and mice. The immune antiserum titer and the bactericidal titer to epidemic strains of meningococcal bacteria group B were measured by ELISA and SBA respectively. Results:The antiserum titer of fHBP immunized rabbits was greater than 2.0×10 6, and that of immunized mice was not less than 1.0×10 6. fHBP immunized rabbit serum had bactericidal titer more than 1∶128 to 41 strains A subfamily and 20 strains B subfamily in the SBA against 69 endemic strains, and there was no cross-protection between the subfamily bacteria. The bactericidal titers of mouse serum immunized fHBPA to strains A subfamily such as Nm210902 Nm211009、Nm450522 were 1∶1 024, 1∶608、1∶861, to Nm510703、Nm311304、Nm431002 were 1∶234、1∶861、1∶430 respectively, and mouse serum immunized fHBP B to strains B subfamily Nm311302、Nm311304、Nm431002 were 1∶876、1∶274、1∶1858, all of three strains were positive in bactericidal titers. Conclusions:the titer of fHBP antiserum was higher than 1.0×10 6, the bactericidal titer was no less than 1∶128 to 61 epidemic strains, and it has a 94.2% protective effect on 69 meningococcal epidemic strains group B.

?AlM:To study the relationship between blood lead level and abnormal eye blinking in children.
? METHODS: The patients with chief complaint of frequent eye blinking, whose diagnosis of abnormal eye blinking, were randomized to experimental group. The patients in this group carried out vision and the slit-lamp examination, detected corneal fluorescein staining and tear break-up time, and improved the level of blood lead and trace elements examination. The patients in control group with chief complaint of health physical examination in our hospital, excepted of blood lead level, the other body check results were normal and were divided into boys group and girls group according to the gender. The changes of the experimental group and control group in blood lead level were compared.
?RESULTS: Totally 371 cases ( male:295 cases; female:76 cases) with mean age was 6. 56±2. 41 years and 6. 08±2. 82 years respectively were in experimental groupe. ln control group, there were 300 cases ( male: 186 cases;female:114 cases) with mean age was 6. 99±3. 01 years and 6. 56±2. 80 years respectively. The average of blood lead level of boys in experimental group was 63. 82 ±24. 56μg/L and 53. 98±15. 42μg/L in control group. The average of blood lead level in experimental group was higher than that in control group. The difference between of the two group was statistically significant (χ2=16. 96, P<0. 01 ). The average of blood lead level of girls in experimental group was 56. 96±16. 69μg/L and 48. 18±12. 35μg/L in control group. There was no difference between of the two group (χ2=5. 77, P=0. 56). ln control group, the average of blood lead level with <3 years, 3~6 years and >6 years children were 48. 73±11. 67μg/L, 51. 39 ± 14. 87μg/L, 52. 98 ± 14. 45μg/L respectively. ln expirement group, the results were 56. 57±17. 89μg/L, 59. 92±18. 46μg/L and 67. 00±32. 55μg/L in <3, 3~6 and >6 children, respectively. There was no significant difference with <3 years (χ2=3. 54, P=0. 17). The difference with 3~6 years and >6 years children were statistically significant (χ2 = 9. 62, P = 0. 008 ) and (χ2 = 19. 22, P = 0. 000 ) respectively. The blood lead level were divided into three grades: <50μg/L, 50 ~100μg/L, >100μg/L, and relative risk (RR) were 0. 65, 1. 22, and 10. 11 respectively.
?CONCLUSlON: Blood lead level of experimental group is higher than that of control group. The relationship between blood lead level and abnormal eye blinking in children is positive correlation.

BACKGROUND:Monoaxial pedicle screws are not conducive to the instal ation during percutaneous pedicle screw technique, but it has better mechanical conductivity and stability than polyaxial pedicle screws. How to select and use these two kinds of screws in the clinic to exert their advantages and to further elevate efficacy has become a subject worthy of reflection. OBJECTIVE:To compare the clinical efficacy of percutaneous pedicle screw placement for thoracolumbar fracture using monoaxial and polyaxial pedicle screws at different placement selections. METHODS:A total of 46 cases of thoracolumbar fracture without neurological symptoms underwent minimal y invasive percutaneous pedicle screw fixation. 25 patients (monoaxial screw group) were treated with monoaxial pedicle screws and the other 21 ones (polyaxial screw group) with polyaxial pedicle screws. Kyphotic angle, correction rate, correction loss rate and height of injury vertebrae were compared before and after fixation in both groups. The therapeutic effects of monoaxial and polyaxial percutaneous pedicle screw fixation in the treatment of thoracolumbar fractures were evaluated. RESULTS AND CONCLUSION:(1) Fixation time, blood loss, complication and hospital stay were not significantly different in both groups (P>0.05). (2) Kyphotic angle and height of the fractured vertebra body were significantly different between the two groups (P<0.05). (3) The restoration of anterior height of injured vertebrae, kyphotic angle and correction rate were better in the monoaxial screw group than in the polyaxial screw group after treatment (P<0.05). The correction loss rate was significantly better in the monoaxial screw group than in the polyaxial screw group during last fol ow-up (P<0.05). However, there was no significant difference in the posterior height of injured vertebraeafter fixation (P>0.05). (4) These findings indicate that compared with the polyaxial percutaneous pedicle screw fixation, the monoaxial pedicle screw may be preferable in percutaneous pedicle screw fixation for thoracolumbar fractures, has more satisfactory fracture distraction reduction, and has less postoperative correction loss rate.

Objective To evaluate the clinical results of self-designed double-pivot extracorporeal reduction device in internal fixation with percutaneous pedicle screws for thoracolumbar fractures.Methods From January 2014 to May 2015,a total of 41 patients with thoracolumbar fracture without neurological symptoms underwent minimally invasive fixation with percutaneous pedicle screws.Of them,22 were treated with our self-designed double-pivot extracorporeal reduction device and the other 20 with common single-pivot extracorporeal reduction device.The 2 groups were compared in terms of pre-and postoperative kyphotic angles,correction rates and anterior,middle and posterior heights of injured vertebrae to evaluate the therapeutic effects of the self-designed double-pivot extracorporeal reduction device.Results The patients were followed up for 6 to 18 months (average,12.3 months).No iatrogenic impairment of nerve root,postoperative infection,or implant failure happened.Compared with preoperation,significant improvements were observed in all the patients regarding cobb's angle,anterior,middle and posterior heights of the fractured vertebral body (P ＜ 0.05).Compared with the single-pivot group,the double-pivot group were significantly superior in the kyphotic angle,correction rate,and anterior and middle heights of the injured vertebrae(P ＜ 0.05),but there was no significant difference between the 2 groups in the recovery of posterior height of the fractured vertebral body (P ＞ 0.05).Conclusion Compared with the single-pivot reduction device,the self-designed double-pivot reduction device may be preferable in percutaneous pedicle screw fixation for thoracolumbar fractures.

Background Whether ocular anterior and posterior chamber exist a blood-aqueous barrier is in controversy.Conventional method can not offer a good evidence because it is unable to detect the aqueous component in the posterior chamber.Objective This study was to investigate the distribution of Gadolinium-diethylene triamine pentaacetic acids(Gd-DTPA)after peripheral iridectomy with magnetic resonance imaging(MRI)in rabbit.Methods Monocular peripheral iridectomy was performed on the right eyes in 8 clean New Zealand white rabbits and the fellow eyes were as controls.0.2 ml/kg(0.5 mol/L)Gd-DTPA,a tracer of MRI,was injected into ear vein in vivo to scan the eyes with MRI for the observation of the permeability and distribution.The signal enhanced ratio of interest region associated with time were analyzed.Results The signal in ciliary body of both eyes showed an immediately sharp enhancement within 10 minutes following the injection of Gd-DTPA with a peak intensity at 30-40 minutes,and then the intensity was gradually weaken over time.The signal was stronger in the operative eyes than that in the fellow eyes.The signal in the posterior chamber was gradually increased after operation,however,that in posterior chamber of the control eyes was lower.The interest regions of Gd-DTPA were ciliary,anterior chamber and posterior chamber,and the enhanced signal intensities were consisted in the posterior chamber after operation.However,the increase of the signal was not seen in the posterior chamber in the control eyes.Conclusions The pathway of plasma protein entering into the anterior chamber is very different from that of aqueous secretion.There exists a barrier between the anterior and posterior chamber which might be an integral part of the blood-ocular barrier.

OBJECTIVETo observe the preventive effect different compatibilities of Ramulus Cinnamomi (RC) and peony in Guizhi Decoction (GD) on diabetic cardiac autonomic neuropathy (DCAN).

METHODSTotally 60 male rats were randomly divided into 5 groups, i.e., the blank control DM group, the model group, the methycobal group, the 1:1 (RC/peony) Guishao group, the 2:1 Guishao group, and the 1:2 Guishao group, 10 in each group. Rats were pretreated with corresponding drugs for 1 week, and then induced diabetes by intraperitoneal injection of STZ. Drugs were administrated by gastrogavage for 4 more weeks after STZ-injection. Enzyme-linked immunosorbent assay (ELISA) was employed to detect levels of tyrosine hydroxylase (TH), choline acetyltransferase (CHAT), nerve growth factor. (NGF), and ciliary neurotrophic factor (CNTF) in myocardial homogenates.

RESULTSAfter 4-week modeling, body weight (BW) was obviously lower, but blood glucose (BG) was higher in STZ rats than in rats of the blank control DM group. There was no statistical difference in BW or BG among the 5 groups (P >0.05). Compared with the blank control group, TH, TH/CHAT, and NGF in left ventricle and ventricular septum increased, CHAT and CNTF increased in the model group (P < 0.05, P < 0.01). Compared with the model group, TH and TH/CHAT in left ventricle decreased (P < 0.05, P < 0.01), CNTF in left ventricle increased (P < 0.05), CHAT in left ventricle and ventricular septum increased (P < 0.05, P < 0.01) in the methycobal group. TH and TH/CHAT in left ventricle and ventricular septum decreased, CNTF in left ventricle and ventricular septum increased (P < 0.05, P < 0.01), CHAT in left ventricle and ventricular septum increased (P < 0.01), NGF in ventricular septum decreased (P < 0.01) in the 1:1 Guishao group. TH/CHAT in left ventricle decreased (P < 0.01), CHAT and CNTF in left ventricle and ventricular septum increased (P < 0.05, P < 0.01) in the 1:2 Guishao group. Compared with the methycobal group, CHAT in left ventricle decreased, TH and TH/CHAT in left ventricle increased in the 2:1 Guishao group (P < 0.05, P < 0.01). TH and TH/CHAT in ventricular septum decreased (P < 0.05), CHAT and CNTF in left ventricle and ventricular septum increased (P < 0.05, P < 0.01) in the 1:1 Guishao group. Compared with the 1:2 Guishao group and the 2:1 Guishao group, CHAT in left ventricle increased, TH/CHAT in left ventricle decreased, TH and TH/CHAT in ventricular septum decreased, CHAT in ventricular septum increased, CNTF in left ventricle and ventricular septum also increased in the 1:1 Guishao group (all P < 0.01).

CONCLUSIONSSTZ model rats had autonomic neural injury, manifested as lowered vagal nerve activity and hyperactive sympathetic nerves. GD could effectively suppress hyperactive cardiac sympathetic nerves and protect the vagus. Besides, GD (1:1) showed the optimal effect in regulating the balance of cardiac autonomic nerves and could be used in early prevention of DCAN.

Animals ; Blood Glucose ; Choline O-Acetyltransferase ; Diabetic Neuropathies ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Heart ; Heart Ventricles ; Male ; Myocardium ; Nerve Growth Factor ; Paeonia ; Rats ; Tyrosine 3-Monooxygenase

Animals ; History, 20th Century ; Hong Kong ; epidemiology ; Humans ; Influenza A Virus, H3N2 Subtype ; classification ; genetics ; isolation & purification ; Influenza, Human ; epidemiology ; history ; virology ; Molecular Sequence Data ; Phylogeny

Objective To explore the application of event-related potentials (ERP) by positive, negative, and neutral face expression images in the evaluation of mood disorders in brain traumatic patients.Methods ERP was tested by face expression images in 24 patients mainly with anxiety and depression symptoms (depression group) and 19 patients mainly with hostile and suspicion symptoms (hostile group), respectively.The findings were compared with those of the control group.Results There were no significant differences, between the depression group and the hostile group, on latencies and amplitudes of late positive potential (LPP) induced by the three types of face expression images, except the amplitude induced by negative face expression image.Compared with the control group, the latencies were extended and the amplitudes were lower in both depression and hostile groups.Within each group, the difference of latencies induced by the three images was not significant.The amplitudes induced by negative face expression image was higher than those induced by positive and neutral face expression images, with significant differences in the hostile group and the control group (P＜0.05) but not in the depression group.Conclusion Changes in latencies and amplitudes of LPP could be an objective indicator in the evaluation of mood disorders of brain traumatic patients.The LPP induced by negative face expression images could be more meaningful for patients mainly with anxiety and depression symptoms.

BACKGROUNDCatheter-directed thrombolysis (CDT) has been a mainstay in treating deep venous thrombosis (DVT). However, the optimal dosage of a thrombolytic agent is still controversial. The goal of this study was to evaluate the safety and efficacy of low dosage urokinase with CDT for DVT.

METHODSA retrospective analysis was performed using data from a total of 427 patients with DVT treated with CDT in our single center between July 2009 and December 2012. Early efficacy of thrombolysis was assessed with a thrombus score based on daily venography. The therapeutic safety was evaluated by adverse events. A venography or duplex ultrasound was performed to assess the outcome at 6 months, 1 year and 2 years postoperatively.

RESULTSThe mean total dose of 3.34 (standard deviation [SD] 1.38) million units of urokinase was administered during a mean of 5.18 (SD 2.28) days. Prior to discharge, Grade III (complete lysis) was achieved in 154 (36%) patients; Grade II (50-99% lysis) in 222 (52%); and Grade I (50% lysis) in 51 (12%). The major complications included one intracranial hemorrhage, one hematochezia, five gross hematuria, and one pulmonary embolism. Moreover, no death occurred in the study.

CONCLUSIONSTreatment of low-dose catheter-directed thrombosis is an efficacious and safe therapeutic approach in patients with DVT offering good long-term outcomes and minimal complications.

Adolescent ; Adult ; Aged ; Drug Administration Schedule ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Urokinase-Type Plasminogen Activator ; administration & dosage ; adverse effects ; therapeutic use ; Venous Thrombosis ; drug therapy ; Young Adult