Objective To compare the efficacy and safety of vitrectomy combined with internal limiting membrane flap and vitrectomy combined with internal limiting membrane peeling for the treatment of idiopathic macular hole with different sizes.Methods A total of 127 consective patients (127 eyes)were divided into two groups according to the size of the hole diameter of the smallest split points by less than or equal to 500 μm (small diameter macular hole group) and more than 500 μm (huge diameter macular hole group).According to different surgical methods the patients were divided into non ILM flap coverage group (peeling 1 group and peeling 2 group) and ILM flap cover group (covering 1 group and covering 2 group).All the patients underwent vitrectomy combined with internal limiting membrane peeling or vitrectomy combined with limiting membrane flap.Preoperative and postoperative best correct visual acuity,closure ratio of macular hole and postoperative major complications were observed and followed up.Results The postoperative best correct visual acuity improved in all the groups,there was no significance difference between small diameter macular hole group and huge diameter macuiar hole group (t =0.112 2,0.750 8;all P ＞0.05).The closure ratio of peeling 1 group and covering 2 group at postoperative 6 months were all 100％,there was no statistical difference (P ＞ 0.05),which in peeling 2 group and covering 2 group were 84.85％ and 100.00％,there was statistical difference (x2 =13.292,P ＜ 0.05).There was no statistical difference in preoperative defect diameter of the inner and outer junction between peeling 2 group and covering 2 groups (P ＞0.05),there was also no statistical difference between peeling 2 group and covering 2 groups at postoperative 1 months (P ＞ 0.05),but there were statistical differences at postoperative 3 months,6 months and 12 months (all P ＜ 0.05),the covering 2 group were less than the peeling 2 group.Conclusion ILM flap coverage helps to heal macular holes greater than 500 μm diameter,and has no extra effect on healing of diameter less than 500 μm.

OBJECTIVEThere are small smount of literatures on the study of the anterior surgical approaches to the upper thoracic spine (UTS). Moreover, there are many differences among the results of these studies. This study is to investigate the exposure ranges of different anterior surgical approaches to the UTS for making the preoperative plan by means of CT images analysis.

METHODSFrom October to December in 2008, 120 CT images of normal chests were chosen. These subjects (58 males, 62 females) ranged in age from 16 to 75 years (mean 40.3 +/- 12.3 years). By using the X-ray positioning images of these CT images,following indexes were studied: the location of the superior margin of the left brachiocephalic vein on the sagittal plane, the confluence of the bilateral brachiocephalic veins, and the vertebrae level of the tracheal bifurcation. The caudal access of E1 (the interval between the tracheo esophageal sheath and the bilateral carotid sheath), E2 (the interval between the right brachiocephalic vein and the brachiocephalic artery), and E3 (the interval between the ascending aorta and superior caval vein) were respectively defined as the above mentioned three points.

RESULTSAmong the 120 studies, 105 T2 vertebral bodies could be exposed through E1 (87.5%), 82 T3 vertebral bodies could be exposed through E2 (68.3%), and 89 T4 vertebral bodies could be exposed through E3 (74.2%).

CONCLUSIONThe exposure ranges of three different anterior surgical approaches to the upper thoracic spine are different. Proper surgical approaches could be selected according to the chest CT images of the patients.

Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Surgical Procedures, Operative ; methods ; Thoracic Vertebrae ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed ; methods ; Young Adult

Chronic myeloid leukemia (CML) is a malignant clonal disease derived from hematopoietic stem cells. CML stem cells were thought to be the root which could lead disease development and ultimately rapid change. However, a stable animal model for studying the characteristics of CML stem cells is currently lacking. This study was aimed to establish a transplanted human CML nude-mice model to further explore the biological behavior of CML stem cells in vivo, and to enrich CML stem cells in nude mice by series transplantation. The 4 - 6 weeks old BALB/c nude mice pretreated by splenectomy (S), cytoxan intraperitoneal injection (C) and sublethal irradiation (I) were transplanted intravenously with (5 - 7) × 10(7) of bone marrow mononuclear cells from CML patients in chronic phase. Alternatively, 4 - 6 weeks old BALB/c nude mice pretreated by lethal irradiation were transplanted intravenously with 5 × 10(6) homologous bone marrow cells of BALB/c nude mice together with (5 - 7) × 10(7) of bone marrow mononuclear cells from CML patients in chronic phase simultaneously. The leukemic cells engrafted and infiltrated in organs and bone marrow of the mice were tracked by reverse transcription-polymerase chain reaction (RT-PCR), plastic-embedded biopsy and flow cytometry. The results of these two methods were compared. The results showed that human CML cells engrafted and infiltrating into the bone marrow of two nude mice pretreated with SCI could be detected. In spite of the low successful rate, results suggested the feasibility of this method by using BALB/c nude mice as a human CML animal model. In contrast, in nude mice pretreated by the lethal dose irradiation, CML cells in the bone marrow could not be found. It is concluded that human bone marrow CML cells can results in leukemia in nude mice pretreated by SCI. Thus this study provides a new strategy for establishment of CML animal models which deserves further elaboration.
Animals ; Disease Models, Animal ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Male ; Mice ; Mice, Nude ; Mice, SCID ; Neoplasm Transplantation ; Neoplastic Stem Cells ; Transplantation, Heterologous

OBJECTIVETo establish the three-dimensional (3D) visible models of the anatomical structures of the anterior approach to the upper thoracic spine (UTS) for anatomic study and preoperative planning of the UTS.

METHODSSectional images from the superior margin of the first thoracic vertebral body to the inferior margin of the fifth thoracic vertebral body were acquired through the Chinese Visible Human Female (VCHF) database which was collected by the Third Military Medical University. These images were imported into Photoshop CS, cut automatically and converted into a JPEG format. Surface and volume reconstruction were performed by 3D Doctor 3.5 and Amira 4.0 software programs on an ordinary personal computer respectively.

RESULTSThe surface reconstruction model could be rotated at any angle and observed from any direction. And the reconstructed structures of the anterior approach to the UTS could be displayed individually or as a composite with any other selected structure. The volume reconstruction displayed abundant internal details of the reconstructed images in transverse, coronal, sagittal, and random oblique sections.

CONCLUSIONThree-dimensional visible models of the anatomical structures of the anterior approach to the UTS based on the sectional images of VCHF can clearly display the morphology, spatial orientation and adjacent relationship of every structure. These models are very helpful to the anatomy study and preoperative planning of this complex anatomic region.

Female ; Humans ; Imaging, Three-Dimensional ; methods ; Thoracic Vertebrae ; anatomy & histology

OBJECTIVETo explore the effects of anti-CD44 monoclonal antibody-IM7 on the in vitro adhesion and migration of chronic myeloid leukemia stem cell (CML-LSC) and its mechanism.

METHODSCD34(+)CD38(-)CD123(+) leukemic stem cells (LSC) from 20 newly-diagnosed chronic myeloid leukemia (CML) patients BM cells and CD34(+)CD38(-) hematopoietic stem cells (HSC) from 20 full-term newborn cord blood cells were isolated with EasySep(TM) magnet beads. The CD44 expression of the LSC and HSC was detected by flow cytometry (FCM), and the adhesion and migration ability of the LSC and HSC pre- and post-incubated with IM7 in vitro by MTT assay and transendothelial migration assay, respectively.

RESULTS(1) After incubated with IM7, the LSC and HSC CD44 expression rates were (86.60 ± 2.10)% vs. (25.40 ± 1.70)% (P < 0.05), respectively. (2) The adhesive ability of the LSC to endothelial cells was decreased markedly after incubated with IM7, the OD value (A(570)) changing from pre-incubation of (0.62 ± 0.11) to post-incubation of (0.34 ± 0.07), while there was little change of A(570) in the HSC group. (3) The migration ability of the LSC group was inhibited evidently after incubated with IM7, the inhibition rate being 46% ∼ 63%, while little change of that in HSC group was detected. (4) The adhesive ability of the LSC group to marrow stromal cells was decreased markedly after incubated with IM7, while little change was found in that of HSC group.

CONCLUSIONThe anti-CD44 monoclonal antibody-IM7 can effectively inhibit the adhesion and migration abilities of the LSC in vitro, which might provide a theoretical evidence for targeting therapy.

Antibodies, Monoclonal ; pharmacology ; Antigens, CD34 ; metabolism ; Bone Marrow ; drug effects ; Flow Cytometry ; Hematopoietic Stem Cells ; drug effects ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; metabolism

Adult ; Blood Donors ; China ; epidemiology ; Female ; Genotype ; HIV Infections ; complications ; epidemiology ; virology ; Hepacivirus ; genetics ; Hepatitis C ; complications ; epidemiology ; virology ; Humans ; Male ; Middle Aged

Aged ; Anti-Inflammatory Agents ; therapeutic use ; Cyclophosphamide ; therapeutic use ; Female ; Humans ; Immunosuppressive Agents ; therapeutic use ; Methylprednisolone ; therapeutic use ; POEMS Syndrome ; complications ; diagnosis ; drug therapy ; pathology ; Plasma Cells ; pathology ; gamma-Globulins ; therapeutic use

Objective: : To evaluate the safety and efficacy of an overlapped stenting-assisted coiling technique in treating vertebral artery dissecting aneurysm (VADA) via Low-profile Visualized Intraluminal Support (LVIS) stent-within-Neuroform EZ stent. Methods: : From January 2017 to June 2019, 18 consecutive patients with VADAs (ruptured : unruptured=5 : 13) were treated with the overlapping stents assisted-coiling technique in our center. The overlapping manner was a Neuroform EZ stent being deployed first, followed by LVIS stents placement using the ‘shelf’ technique. The patients’ clinical characteristics, technical feasibility and safety, and immediate and follow-up angiographic results were retrospectively reviewed. Results: : Seventeen (94.4%) procedures were technically successful with an exact deployment of the stents and patent parent or perforator arteries. The immediate angiographies after procedure confirmed Raymond class I, II, and III occlusion of VADAs were in 12 (66.7%), two (11.1%), and four cases (22.2%), respectively. Post-procedural complications developed in one patient (5.6%) with minor brainstem infarctions, which resulted from an in-stent thrombosis during the procedure. Angiographic follow-up at 5.7 months (range 3 to 9 months) demonstrated Raymond class I and II occlusion were in all cases (100%). The modified Rankin Scale scores at 21.3 months (range 15 to 42 months) 0–2 in 17 cases (94.4%) and three in one case (5.6%). Conclusion : Overlapping stents via LVIS stent-within-Neuroform EZ stent combined with coiling is safe and effective for patients with VADA in the midterm results.

Based on the deletion information of high virulent PRRSV genome, 3 oligonucleotide primer were designed and synthesized. Specific and sensitive reverse transcription-PCR (RT-PCR) assays were de-veloped for the detection of high virulent PRRSV. The sensitivity and specificity of RT-PCR assays were evaluated, the results showing that the detection limit of the assay was found to be 0.265 pg of tissue total RNA, and the protocol have no cross-reaction with classical swine fever virus, porcine circovirus type 2,pseudorabies virus, streptococcus, haemophilus parasuis and Escherichia coli. Then 36 cell cultures, two PRRSV live vaccine strains and 184 clinical specimens from 52 farms were tested. Five PRRSV field iso-lates were the high virulent PRRSV; two PRRSV live vaccine strains from normal PRRSV, and 123 speci-mens from 42 farmer were positive (only 1 specimen was normal PRRSV). This RT-PCR method proved to be accurate differential diagnosis of the high virulent PRRSV and normal PRRSV with the characteristics of rapidity, sensitivity and specificity, and has a strong clinical relevance.

Autophagy, an evolutionarily conserved process by which components of the cell are degraded in lysosomes, may facilitate survival of cancer cells under stress conditions. 8-Azaguanine (8-AG), an inhibitor of purine nucleotide biosynthesis, shows antineoplastic activity in multiple tumor cells. However, chemoresistance has restricted its development as an anticancer agent, and the mechanism of 8-AG resistance is not fully understood. We report here that 8-AG induces a protective autophagy to eliminate its cytotoxicity, and inhibition of autophagy increases cellular sensitivity of cancer cells to 8-AG treatment. Using HepG2 or SMMC-7721 hepatic cancer cell lines, we found that 8-AG inhibited cell viability and induced intrinsic apoptosis, accompanied by the up-regulation of the pro-apoptotic protein BimS, one of Bim (also known as BCL-2-like protein 11, BCL2L11) isoforms. Furthermore, 8-AG treatment enhanced the autophagy flux by promoting the dephosphorylation and activation of Unc-51-like autophagy activating kinase 1 (ULK1) via Akt/mTORC1 (mammalian target of rapamycin complex 1) signaling inhibition. Depletion of autophagy-related gene 7 (ATG7) markedly enhanced the level of BimS, and promoted cell death in response to 8-AG. 8-AG in combination with autophagy inhibitor chloroquine (CQ) or bafilomycin A1 (Baf A1) promoted the 8-AG-induced apoptosis in hepatic cancer cells. Altogether, these findings suggest that autophagy promotes chemoresistance of cancer cells for 8-AG, and blocking autophagy increases cellular sensitivity of cancer cells to 8-AG treatment.