Background Basic fibroblast growth factor(bFGF)secreted by cornea after injury is important to cytothesis,collagen fibers reconstruction and axons recovery.However,the local bFGF is not enough for the reparation process.Objective This study aimed to observe the findings of corneal collagen and nerve recovery under the confocal microscopy through focusing(CMTF) in the eyes with intervene of exogenous recombinant bFGF(rbFGF) after excimer laser in situ keratomileusis(LASIK).Methods LASIK rabbit models were binocularly created in 34 clean New Zealand white rabbits.The tobramycin combined with dexamethasone were dropped after operation for 10 days in bilateral eyes.rbFGF was topically administered in the right eyes of rabbits from 1 day through 3 months after LASIK,and lubricant was used in the left eyes at the same way.The corneal collagen and nerve recovery,keratocyte and endothelial cell counting were observed with CMTF at the 1st week,2nd week,2nd month,3rd month and 5th month after LASIK.Results Total 19 rabbits were meted the request of LASIK models.The keratocyte densities in anterior stroma of both groups reached the lowest level at the 2nd week and the highest level at the 3rd month.Otherwise,haze changed on the contrary.No statistically significant differences were found in anterior stroma keratocyte densities,haze grade,grey value between rbFGF group and lubricant group at various time points after operation(P＞0.05).The nerve cord densities of both groups were increased gradually,and those under the epithelial basement membrane were more dominant.The nerve density of the anterior stroma of rbFGF group was significant higher than the lubricant one in the 2nd group(P=0.038).The considerably elevated the subepithelial nerve density value was also seen in rbFGF group compared with lubricant at 5 months after operation(Z=-2.060,P=0.039).No any corneal neovascularization occurred in both groups through experiment duration.The positive correlation was found between grey value with haze grade in rbFGF group(b=22.687,F=37.975,P=0.000) and lubricant group(b=20.410,F=18.516,P=0.000).However,haze grade was not significant correlated with stromal keratocyte density(rbFGF group:b=0.001,F=0.164,P=0.668;lubricant group:b=-0.002,F=1.896,P=0.178).Conclusion Exogenous bFGF can improve the recovery of corneal nerve and regeneration of keratocyte after LASIK.No evidence of bFGF promoting corneal neovascularization is found in this experiment.

OBJECTIVEWernicke's encephalopathy (WE) is an acute neuropsychiatric syndrome resulting from thiamine deficiency, which is associated with significant morbidity and mortality. The disorder is still greatly underdiagnosed in children because of either a relatively non-specific clinical presentation in some cases or unrecognized clinical setting. The aim of this literature review was to provide knowledge of pediatric WE in an effort to assist in early diagnosis, thereby reducing the morbidity and mortality.

METHODSThe clinical manifestations, characteristic magnetic resonance imaging (MRI), diagnosis and treatment of one case and the other 35 cases reported in the last decade in children were summarized.

RESULTSThirty-six cases (22 boys and 14 girls, 2-month to 16-year-old) were analyzed. All the other 35 cases except for our case had underlying diseases: improper feeding in 25/35 cases, long-time vomiting in 5/35 cases, immunosuppressive therapy in 4/35 cases, long-time total parenteral nutrition without multivitamin preparations supplementation in 3/35 cases and anorexia nervosa in 1/35 case. The classic triad (mental-status changes, nystagmus and ophthalmoplegia, and ataxia) was seen in 6/36 cases. The other clinical manifestations included consciousness disturbance in 24/36 cases, infection in 22/36 cases, pathological reflex and muscular tension changes in 18/36 cases, convulsion in 17/36 cases, developmental delay in 4/36 cases and failure to thrive in 2/36 cases. Cerebrospinal fluid examination was performed in 31/36 cases, and a slightly raised protein concentration was seen in 7/31 cases. The cerebrospinal fluid lactate levels were detected in 4/36 cases (all increased), serum lactic acid levels in 7/36 cases (6/7 cases increased), serum pyruvate in 4/36 cases (all increased), thiamine pyrophosphate effect (TPPE) in 9/36 cases (all increased), and serum thiamine in 2/36 cases (increased in 1/2 cases). The brain computed tomography (CT) scan was conducted in 20/36 cases and 16/20 cases showed abnormal hypodensity in bilateral basal ganglia, one case revealed diffuse cortical atrophy. The brain MR scan was conducted in 13/36 cases and all the 13 cases revealed symmetrical abnormal signal in bilateral mamillary body and basal ganglia, and 7/13 cases showed abnormal signals in the tegmentum of midbrain, cerebral aqueduct and white matter around the third and fourth ventricles. The diagnosis of WE was confirmed by MR in 12 cases, triad combined with MR in 3 cases, autopsy in 1 case among the 13 cases who underwent MR scan. The diagnosis of WE was confirmed by the TPPE and/or lactate levels in 9/11 cases. The initial thiamine was given by intravenous or intramuscular infusion in 33/36 cases, unknown method in 1 case, orally in 1 case and no thiamine was used in 1 case. The dosage of thiamine was 100 mg daily in 29/35 cases, unknown in 3/35 cases, 50 mg daily in 2/35 cases, 600 mg daily in 1/35 case. 34/35 patients' clinical symptoms improved during 24 hours to 1 week after initial treatment, and 1 case died due to no response to thiamine. Nineteen patients were followed up for 2-2.5 months and 17 cases recovered completely.

CONCLUSIONWernicke's encephalopathy can be difficult to diagnose because of a relatively non-specific clinical presentation. The characteristic MRI findings and the dramatic response of neurological signs to parenteral thiamine will assist early clinical diagnosis. Early and timely thiamine supplementation could reverse the clinical features and improve the prognosis in most cases.

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Sepsis ; complications ; Wernicke Encephalopathy ; complications ; diagnosis

BACKGROUNDbevacizumab is a humanized recombinant vascular endothelial growth factor (VEGF) monoclonal antibody, which specifically binds to VEGF and inhibits tumor cell growth, proliferation and metastasis. We aimed to investigate the safety and pharmacokinetics of bevacizumab in Chinese patients with advanced cancer.

METHODSThirty-nine Chinese patients with metastatic or relapsed cancers who failed prior therapy were enrolled in this phase I study of bevacizumab. Bevacizumab was infused by a calculated pump at doses from 5 mg/kg to 15 mg/kg in 90 minutes. Patients underwent serial pharmacokinetic evaluations. Patients that received at least one infusion of bevacizumab were included in the safety study.

RESULTSThirty-five patients finished all 5 infusions following protocol. One patient withdrew after 3 infusions due to grade 3 proteinuria. Common adverse events possibly related to the study drug were proteinuria (17/39, 43.6%), hypertension (13/39, 33.3%), gingival bleeding (7/39, 17.9%), epistaxis (6/39, 15.4%), pharyngeal inflammation (6/39, 15.4%), fatigue (6/39, 15.4%) and stomatitis (4/39, 10.3%). Bevacizumab pharmacokinetics was linear within the range of 5 mg/kg q2w--10 mg/kg q2w and 15 mg/kg q3w. CL (clearance), Vd (volume of distribution at elimination) and Vss (volume of distribution at steady state) were similar after single and multiple doses at 5, 10 and 15 mg/kg.

CONCLUSIONSBevacizumab is well tolerated in Chinese patients. No unexpected adverse events were observed. There is no racial difference in the pharmacokinetics.

Adult ; Aged ; Angiogenesis Inhibitors ; adverse effects ; pharmacokinetics ; therapeutic use ; Antibodies, Monoclonal ; adverse effects ; pharmacokinetics ; therapeutic use ; Antibodies, Monoclonal, Humanized ; Asian Continental Ancestry Group ; Bevacizumab ; Female ; Humans ; Male ; Middle Aged ; Neoplasms ; drug therapy

OBJECTIVETo analyze sex chromosome mosaicisms in early cleavage-stage human embryos and blastocysts with poor embryo quality score based on the numbers of pronucleus(PN) zygotes using X,Y dual color fluorescence in situ hybridization (FISH), and to discuss the possible mechanisms.

METHODSFresh or frozen-thawed early cleavage-stage human embryos and blastocysts with poor embryo quality score not suitable for embryo transfer were studied with dual color FISH.

RESULTSDouble signal rate of 2PN among early cleavage-stage embryos was 66.67%, which was significantly higher than 1PN and 3PN embryos. Single signal rate of 1PN early cleavage-stage embryos was 90.41%, which was significantly higher than 2PN and 3PN ones. Three signal rate of 3PN early cleavage-stage embryos was 28.00%, which was significantly higher than 1PN and 2PN ones. Double signal rate of 3PN ones was 46.00%, which was significantly higher than 1PN ones. The polyploid rate of frozen-thawed early cleavage-stage embryos was 23.53%, which was slightly higher than that of fresh embryos, but with no statistical significance. The mosaicism rate of 24 blastocysts was 100.00% and the double signal dominant (≥ 50%) rate was 62.50%, which was significantly higher than the rate of early cleavage-stage embryos.

CONCLUSIONUsing 2PN as the criterion for embryo quality score cannot guarantee the selection of normal fertilized embryo for transplantation. Frozen-thawed embryos may harbor more polyploid cells. To avoid the selection of embryos with abnormal chromosomes, combinations of pre-implantation genetic diagnosis (PGD) and prenatal diagnosis are necessary. Meanwhile, blastocysts with poor quality scores may provide an important source for embryo stem cells.

Blastocyst ; metabolism ; Cleavage Stage, Ovum ; metabolism ; Fertilization in Vitro ; Humans ; In Situ Hybridization, Fluorescence ; Mosaicism ; embryology ; Sex Chromosomes

Objective To study the clinical manifestations, radiological features, andpostoperative outcomes of patients with subependymal giant cell astrocytoma (SEGA). Methods Aretrospective analysis of the clinical presentations, imaging examinations, pathological features,treatments and follow-up results was conducted in 6 SEGA cases treated in our department from 2000 to2007. Results The most common clinical maifestations of SEGA included increased intracranialpressure and impaired visual acuity. CT scan of the tumors displayed isodensity or slightly increaseddensity with well defined border. Calcification was seen in some of the tumors. On T1-weighted magneticresonance images, the tumor masses presented with isointense or mixed signals, while on T2-weightedimages, the tumors exhibited isointense or hyperintense signals. The solid part of the tumor showedheterogeneous enhancement in contrast-enhanced imaging. No operative death occurred in these casesafter total removal of the tumors through a transcallosal approach (4 cases) or a frontal transcorticalapproach (2 cases). No postoperative tumor recurrence was found in the follow-up for 10 months to 8years. Conclusion The diagnosis of SGCA should be considered for the presence of tuberous sclerosisin the subependymal lesion adjacent to the foramen of Monro in cases presenting hydrocephalus orprogressive tumor growth. Surgical resection of the tumor should be performed as early as possible.SGCA is a benign tumor with good prognosis after a total resection. Regular follow-up examinationshould be undertaken to monitor the subependymal nodules for prevention of tumor recurrence.

OBJECTIVE: Using the CT three-dimensional reconstruction to measure the activity degree of atlanto-occipital joint and the atlantoaxial joint in different directions and its coupling movement in healthy volunteers, and three dimensional motion range of the maximum rotation position of the upper cervical spine of cervical spondylosis patients, and to analyze the differences, verifing the reliability of the method at the meantime. METHODS: From January 2014 to June 2015, 20 healthy adult subjects(healthy adult group), and 26 patients with cervieal spondylosis(cervical spondylosis group) were selected. In healthy adult group, there were 11 males and 9 females, aged from 22 to 26 years old with an average of (24.0±1.2) years, and in cervical spondylosis group, there were 24 males and 2 females, aged from 36 to 72 years old with an average of (52.8±8.6) years. Healthy adults underwent CT examination in neutral position, maximum right rotation, maximum right lateral bending, maximum flexion and extention, and cervical spondylosis patients underwent CT examination in neutral position, maximum right rotation. Then the software Mimics was used to reconstruct occiput (Oc), atlas(C1) and axial(C2) vertebral three-dimensional image. Three virtual non-collinear markers were positioned on prominent structures of foramen magnum, C1 and C2. The 3D spatial coordinates of these virtual anatomical markers entail the definition of an anatomical local coordinate system which represent the position and orientation of the bones. Segmental motions were calculated using Eulerian angle in three major planes, and the difference between cervical spondylosis group and healthy adult group were compared. Due to the inaccuracy in anatomical landmark idenrification, two groups were measured 3 times, and the reliability of the experimental metnod was verified by the intra-group correlation (intra-group ICC) and the inter-group correlation coefficient(inter-group ICC). RESULTS: Reliability verification results:the intra-group ICC and inter-group ICC results were all above 0.90, and the measurement method had high reliability. Three-dimensional activity of the upper cervical spine in healthy adults:the atlanto-occipital joint had(-6.8±1.5)° coupled left lateral bending and (8.9±2.0)° coupled extension in the maximum right rotation position, and the motion of atlanto-occipital joint had low activity[maximum was(5.3±2.6)°] in the remaining 3 positions; the rotation of atlanto-axial joint was(37.9±5.1)°, accounting for 52.34% of the total cervical spine activity[(72.4±5.0)°] in the maximum right rotation position, and rotational motion was still prominent in the remaining three positions. The relative translations of the upper cervical spine in all direction were small. The average axial rotation angle [(62.0±3.4)] ° of the total cervical spine in cervical spondylosis group was significantly lower than that in the healthy adult group, but the mean axial rotation angles of the atlanto-occipital and the atlantoaxial joint were not significantly different from those of the healthy adults(>0.05). CONCLUSIONS The three-dimensional CT reconstruction method has high reliability, which can be applied to measure the movement of spine. The upper cervical spine contributed the most to the direction of rotation, and the movement in all directions are accompanied by coupled motion in the other direction. There was no significant difference in the rotation of the upper cervical spine between cervical spondylosis patients and normal subjects.
Adult ; Aged ; Atlanto-Axial Joint ; Biomechanical Phenomena ; Cervical Vertebrae ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Range of Motion, Articular ; Reproducibility of Results ; Rotation ; Spine ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo explore the effect of bone morphogenetic protein (BMP) to activate mesenchymal stem cells of skeletal muscle for rescuing bone marrow failure.

METHODSThe study was performed on lethal rat acute aplastic anemia model induced by combined 5-fluorouracil (5-FU) and busulfan. The rh-BMP-2 was implanted into the thigh muscle of the rats at 3 days before aplastic anemia was induced. In the control group the rats were implanted with agar into the thigh muscle. The blood picture, pathologic changes and the mortality in two groups were observed. At the same time, rh-BMP-2 were implanted into the thigh muscle of normal Kun-min mice for dynamic control observation of the implantation local morphological changes, colony forming units-spleen (CFU-S) and stem cell growth factor (SCF) expression of the stroma cells of ectopic ossicles induced by BMP.

RESULTSAt 7 days after BMP implantation in the mice the mesenchymal cells around BMP in muscle proliferated, and appeared in bone marrow to form an ectopic ossicles. The SCF expression of stroma cells in ectopic ossicles were higher than that of self-bone marrow. 56.3% of BMP-treated aplastic rats were survived over 3 months and its hematopoiesis was completely reconstituted and the histo-morphological picture of the spleen and bone marrow were recovered to normal. But in the control group only one of 23 rats was survived, the remainder died of hematopoietic failure.

CONCLUSIONSBMP-implantation into the skeletal muscle could rescue the bone marrow hematopoietic failure. The mechanism might be related to the BMP activated auto-mesenchymal cells of skeletal muscles to direct hematopoietic cell differentiation. In our hands it might create a new pathway for utilization of auto-muscle derived mesenchymal cells to reconstitute hematopoiesis.

Anemia, Aplastic ; chemically induced ; pathology ; therapy ; Animals ; Bone Morphogenetic Proteins ; therapeutic use ; Busulfan ; Cell Differentiation ; Female ; Fluorouracil ; Hematopoiesis ; Hematopoietic Stem Cells ; cytology ; Implants, Experimental ; Male ; Mice ; Muscle, Skeletal ; surgery ; Rats ; Rats, Wistar ; Recombinant Proteins ; therapeutic use ; Stem Cells ; cytology

OBJECTIVESTo discuss the possible cause of intracranial hemorrhage and treatment after carotid artery stenting (CAS) in patients with carotid artery stenosis.

METHODSFrom January 2003 to August 2009, 403 patients with carotid artery stenosis that were performed CAS, intracranial hemorrhage occurred in 5 cases after the procedure. We analyzed the feature of these cases and perioperative management retrospectively to summarize the possible cause of intracranial hemorrhage and preventive measure.

RESULTSCerebral hemorrhage were found 30 min after CAS in 2 cases, 5 days in 2 cases and 3 days in 1 case. One patient was treated conservatively whose hemorrhage was about 2 ml, one was performed draining of ventricle and the other three cases were all performed craniotomy to remove the hematoma and to depress. The position of hemorrhage were all in the side of carotid artery stenosis, and in 2 cases of them the hemorrhage were at the region of previous cerebral infarction. One patient was cured conservatively, the one who was performed draining of ventricle died. Among the other three cases performed craniotomy, one recovered with light neurological deficit and two died of multiple organ failure.

CONCLUSIONIntracranial hemorrhage is the most serious complication of CAS of carotid artery, and general measure should be taken to prevent it from occurring.

Aged ; Aged, 80 and over ; Carotid Stenosis ; surgery ; Female ; Humans ; Intracranial Hemorrhages ; etiology ; prevention & control ; Intraoperative Complications ; etiology ; prevention & control ; Male ; Middle Aged ; Retrospective Studies ; Stents

OBJECTIVETo explore a simply, effective dynamical method to correct late facial palsy.

METHODSThe method of suspending of M. temporalis, temporal fascia was reformed below: (1) To prolong flap of M. temporalis, temporal fascia by parietal periosteum. (2) To elevate the reversal level of compound flap. (3) To fill depressed temporal area by silica gel piece.

RESULTSThe compound flap is united structurally and long enough to transfer. Temporal defect is recontoured. And zygomatic area is no longer protruded.

CONCLUSIONSThe reformative method resists defect of the old one and obtains a dynamical result.

Adult ; Facial Paralysis ; surgery ; Fascia ; transplantation ; Female ; Humans ; Male ; Skull ; transplantation ; Surgical Flaps ; Temporal Muscle ; transplantation ; Young Adult

OBJECTIVETo discuss the efficiency and safety of carotid angioplasty stenting (CAS) in patients with contralateral carotid artery occlusion.

METHODSFrom January 2001 to January 2010, 56 carotid artery stenosis patients with contralateral carotid artery occlusion were performed CAS and the feature and results of these cases were analyzed retrospectively. All the cases were confirmed to be carotid artery stenosis with contralateral carotid artery occlusion by digital subtraction angiography (DSA). The diameter stenosis rate was 72% ± 15%. CAS were performed with distal protection device in 56 cases.

RESULTSThe technique success rate of CAS were 100% in all the 56 patients with contralateral carotid artery occlusion and post-procedure stenosis rate descended to 13% ± 8%, and the symptoms of cerebral ischemia were all improved. Only 1 case occurred remote hemorrhage in the position of previous cerebral infarction in the side of CAS after the procedure, and recovered with light neurological deficit after the craniotomy to remove the hematoma. No ischemic complications or death occurred. During the following up of 6 months to 3 years, no cerebral ischemic symptoms reoccurred. The rechecking results of color Doppler of 47 cases and DSA of 2 cases showed no restenosis in-stent.

CONCLUSIONSCAS is safe and effective for the patients with contralateral carotid artery occlusion. Critical election of the case, operation of skilled doctors and scrupulous post procedure general management can decrease the rate of complication.

Adult ; Aged ; Aged, 80 and over ; Angioplasty, Balloon ; methods ; Carotid Artery, Internal ; surgery ; Carotid Stenosis ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Stents ; Treatment Outcome