The brain -derived neurotrophic factor (BDNF)plays an important role in the development and function of the nervous system.BDNF controls the neuronal survival,differentiation,growth of dendrites and axons,for-mation of synapse,neuronal plasticity and the basic process of learning and memory through a variety of ways,the dys-regulation of which is probably the important molecular mechanism responsible for the onset of autism spectrum disor-der.The research advance on preclinical research and clinical research between BDNF and autism spectrum disorder is reviewed in this paper.

OBJECTIVE To improve the knowledge on the early diagnosis and treatment of the isolated fungus ball sphenoid sinusitis.METHODS A retrospe ctive study was made on10cases of isolated fungus ball sphenoid sinusitis to discuss the clinical manifestation,radiographic features and treatment with endoscopic sinus surgery.RESULTS The common symptoms in10cases were headache and/or bloody nasal discharge.Radiographic features of the disease were a soft tissue image occupying the sphenoid sinus with bones wall thickening.A soft tissue image with calcification in the sphenoid sinus was the feature of CT image.All the patients were treated by nasal endoscopic sinus surgery and cured after followed up for3to18.CONCLUSION Isolated fungus ball sphenoid sinusitis was difficult to diagnose in early stage because of its non-specif ic symptoms.The nasal endoscopy and CT scan make the early diagnosis possible.The diagnosis can be def initely confi rmed by pathological studies.Treatment with endoscopic sinus surgery is an effective method for fungus ball sphenoid sinusitis.

Objective To investigate the feasibility of measuring liver volume with Argus methoct Methods Thirty-two healthy liver transplant donor candidates underwent liver MRI on a 3.0 T MR unit.Volume interpolated body examination(VIBE)was performed after the administration of gadobenate dimeglumine.The VIBE data was transferred to the diagnostic workstation,and then multiple planar reconstruction(MPR)images were acquired.Firstly.two observers manually drawn the liver shape and calculated three volumes:the whole liver volume and right lobes volumes include middle hepatic vein (MHV)and exclude MHV,respectively.Secondly,the same data was transferred to Argus software.calculated that three volumes.Each measurement time was recorded.Actual graft volume(the right lobe)wag measured during surgery.The correlation between right lobes volume of two measurements and actual graft volume was analyzed.The time needed for Argus and that needed for manual method were compared with paired t test.Results The right lobe volumes measured by Argus,manually and surgery method were (813±187),(807 ± 181)and(713 ± 137)mm3,respectively.Argus method and manual method showed good correlation with surgery method,and the correlation coefficients were 0.897(Argus method)and 0.884(manual method),respectively.The time for manual method and Argu8 method were(44.3 ±2.7)and(12.2.±1.0)min,respectively.There was significant difference between Argus and manual methods (t=76.39,P＜0.05).Conclusion Compared with manual method,use of the Liver volumetric measurement by Argus software not only correlated well with Actual graft volume,but also saves time.Argus has potential clinical value for volumetric measurement in living liver transplant donors.

OBJECTIVETo summarize the methods and experiences in surgical treatment of hemifacial microsomia.

METHODSFifty-eight cases of hemifacial microsomia that have been treated by plastic and reconstructive surgery and followed-up in our department during last 20 years have been reviewed. Every patient's characteristic was assessed by physical examination, photography, craniofacial cephalometry before planned the method of surgery. Different surgical treatments were chosen according to the side and the structures involved in the abnormalities and the severity of hemifacial microsomia, and the cases were followed up since 3 months after the treatments. The follow-up lean of midline of the lower 1/3 face with that before treatment is compared. The degrees of patients' and surgeons' satisfactions with the treatments were evaluated respectively.

RESULTSThe average angle of lean of midline of skeletal and soft tissue of the lower 1/3 face decreased 4.2 degrees and 2.9 degrees respectively after treatment. Fifty (82.6%) cases satisfied with the outcome of the surgical treatment and surgeons satisfied with 84.5% of the outcome of all the cases.

CONCLUSIONSIndividual surgical treatment based on the side and the structures involved in the abnormalities can effectively correct facial asymmetry of hemifacial microsomia.

Adolescent ; Adult ; Child ; Child, Preschool ; Facial Asymmetry ; surgery ; Female ; Follow-Up Studies ; Humans ; Infant ; Male ; Middle Aged ; Orthopedic Procedures ; methods ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo establish the quantitative diagnostic criteria for cranio-orbito-zygomatic deformity (COZD).

METHODSComputer-assisted three-dimensional (3-D) CT measurement was performed in 30 cases with unilateral COZD. The differences of the measurement data between the affected and unaffected sides were analyzed. Then the patients were diagnosed and classified according to the affected bone, soft tissue and conjunctival sac. Based on the quantitative diagnosis, 8 patients underwent surgery to test the clinical practicability of the diagnostic criteria.

RESULTSThe quantitative diagnostic criteria for COZD could reflect the affected area and the corresponding severity of deformity. It helped to preoperative design and to predict movement of osteotomy segment and. the soft tissue volume needed for augmentation. Good postoperative results were achieved.

CONCLUSIONSThe quantitative diagnostic criteria for COZD can describe the affect area and severity of deformity in detail. It is very practical in the guidance of clinical treatment.

Adolescent ; Adult ; Bone Diseases, Developmental ; diagnostic imaging ; Child ; Diagnosis, Computer-Assisted ; standards ; Humans ; Imaging, Three-Dimensional ; Male ; Orbit ; abnormalities ; Tomography, X-Ray Computed ; methods ; Young Adult ; Zygoma ; abnormalities

BACKGROUNDDelayed puberty can result either from constitutional delay of growth and puberty (CDP) or idiopathic hypogonadotropic hypogonadism (IHH). Gonadotropin-releasing hormone (GnRH) stimulation test has been generally accepted as a current method for diagnosing delayed puberty. The objective of this research was to assess the cut-off values and the efficacy of GnRH stimulation test in the diagnosis of delayed puberty in both males and females.

METHODSA study of 91 IHH, 27 CDP patients, 6 prepubertal children, and 20 pubertal adults was undertaken. Blood samples were obtained at 0, 30, 60, and 120 min after GnRH administration and the levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) were measured. For each parameter, the sensitivities and specificities were estimated, and the receiver operating characteristic (ROC) curves were constructed.

RESULTSThe ROC curves indicated that a serum basal LH <0.6 IU/L or peak LH <9.74 IU/L resulted in moderate sensitivity (73.8% or 80.0%) and specificity (90.9% or 86.4%) in the diagnosis of HH in males. Serum basal LH <0.85 IU/L or basal FSH <2.43 IU/L resulted in moderate sensitivity (80.0% or 100.0%) and specificity (75.0% or 50.0%) in the diagnosis of HH in females.

CONCLUSIONSOur data suggest that isolated use of the gonadorelin stimulation test is almost sufficient to discriminate between HH and CDP in males, but unnecessary in females. The most useful predictor is serum basal or peak LH to differentiate these two disorders in males, but serum basal LH or FSH in females.

Adolescent ; Female ; Follicle Stimulating Hormone ; blood ; Gonadotropin-Releasing Hormone ; pharmacology ; Gonadotropins ; deficiency ; Humans ; Hypogonadism ; blood ; diagnosis ; Hypothalamus ; drug effects ; Luteinizing Hormone ; blood ; Male ; Pituitary Gland ; drug effects ; Puberty, Delayed ; blood ; diagnosis ; Sensitivity and Specificity

OBJECTIVETo discuss the application and therapeutic effect of tunable guide device in correction of prominent mandibular angle.

METHODSSince 2007, 50 cases with prominent mandible angle underwent mandible angle osteotomy with the tunable guide device. The patients were followed up for 3-6 months.

RESULTSNo severe complication happened. Local seroma occurred in one case. Improved esthetic results were achieved at both frontal and oblique view.

CONCLUSIONSThe mandibular angle osteotomy with the tunable guide device makes the procedure safe and easily performed.

Adult ; Female ; Humans ; Mandible ; abnormalities ; surgery ; Osteotomy ; instrumentation ; methods ; Young Adult

Since the worldwide introduction of sildenafil in 1998, 23 million patients with ED have been treated with the drug, and the accumulated experiences have proved its safety and efficacy. This article presents a review about the action mechanism and metabolic process of sildenafil, with a particular focus on the application of sildenafil to ED diagnosis, the curative effect of its daily use on ED, the standard treatment, combined therapy and progressive protocol with sildenafil for ED and its complications, along with such safety aspect as its effect on the sight.
Drug Therapy, Combination ; Erectile Dysfunction ; drug therapy ; Humans ; Male ; Phosphodiesterase Inhibitors ; adverse effects ; therapeutic use ; Piperazines ; adverse effects ; therapeutic use ; Purines ; adverse effects ; therapeutic use ; Sildenafil Citrate ; Sulfones ; adverse effects ; therapeutic use

OBJECTIVETo introduce the clinical experience of nipple-areolar reconstruction with the modified arrow flap.

METHODSThe arrow flaps were modified for nipple-areolar reconstruction in 12 cases. Among them, 2 cases were treated with combined thin split-thickness skin graft; 4 cases with autologous rib implant and tattoo; 6 cases with tattoo.

RESULTSAll the reconstructed nipples were survived. The reconstructed nipples lost projection 1 month after operation in 2 cases. The other 10 cases retained 50% of the nipple projection 3 months after operation. The results were maintained with satisfactory symmetry during the follow-up period of 6 months to one year.

CONCLUSIONSThe modified flap is easily performed with reasonable design and no need of donor site. The nipple projection can be maintained with good long-term effect.

Adult ; Female ; Humans ; Mammaplasty ; methods ; Middle Aged ; Nipples ; surgery ; Skin Transplantation ; Surgical Flaps

OBJECTIVETo evaluate breast reconstruction with a combined skin flap of the deep inferior epigastric perforator (DIEP) and the transverse rectus abdominis musculocutaneous (TRAM).

METHODSThe DIEP and TRAM united flap was elevated with the vessel pedicle of the deep inferior epigastric perforator on the affected side and the rectus abdominis muscle pedicle on the intact side. The reconstructive breast was shaped after the deep inferior epigastric vessels were anastomosed to the internal mammary vessels or the thoracodorsal vessels ipsilaterally.

RESULTSWe have used the DIEP and TRAM united flaps for breast reconstruction in 17 cases. All of the flaps survived, and the reconstructed breasts were well-shaped with the follow-up of 6-18 months.

CONCLUSIONSThe DIEP and TRAM united flap possesses of advantages such as rich blood supply, abundant tissue volume and easy shaping. It is especially applicable to the cases who have large chest defect and need large volume tissue.

Adult ; Epigastric Arteries ; transplantation ; Female ; Humans ; Mammaplasty ; methods ; Middle Aged ; Rectus Abdominis ; transplantation ; Skin Transplantation ; Surgical Flaps ; blood supply