0.05).Thirty-four cases of newly diagnosed children with CR rate was 88.2% (30 cases).Which the expression of PRAME gene,WT1 gene were both positive and negative groups of children with CR rates were 62.5% and 100.0%,there was no significant difference between the 2 groups(P

Objective To analyze the efficacy and safety of different chemotherapy regimens for treatment of progressive patients with small cell lung cancer (SCLC) brain metastasis after radiotherapy. Methods 96 SCLC brain metastasis patients with progressive intracranial lesions after radiotherapy were divided into four groups: carmustine group (Group A, 28 cases), temozolomide group (Group B, 19 cases), topotecan group (Group C, 24 cases) and no chemotherapy group (Group D, 25 cases). Results In terms of brain metastases, there were no complete response cases in the whole groups. The rates of partial remission (PR), stable disease (SD) and progression of disease (PD) in Group A were 17.8%(5/28), 53.6%(15/28) and 28.6 % (8/28), respectively, the response rate (RR) of intracranial lesions was 17.9 % (5/28), and disease control (CR+PR+SD) rate was 71.4%(20/28). The rates of PR, SD and PD in Group B were 15.8%(3/19), 63.2 % (12/19) and 21.1 % (4/19), respectively, the RR of intracranial lesions was 15.8 % (3/19), and disease control rate was 78.9 % (15/19). The rates of PR, SD and PD in Group D were 8.3 % (2/24), 54.2 %(13/24) and 37.5 % (9/24), respectively, the RR rate of intracranial lesions was 8.3 % (2/24), and disease control rate was 62.5 % (15/24). In Group D, there was no response case, and 20 patients with PD (80.0 %) were found. The median progression-free survivals (PFSs) were (3.64 ±0.43) months, (4.68 ±0.49) months,(3.58 ±0.50) months, (2.60 ±0.31) months in Group A, B, C and D, respectively, and the median overall survivals (OSs) were (18.80±1.74) months, (18.76±1.85) months, (19.10±1.64) months and (9.64±0.84) months, respectively. The median OS of Group A, B or C was longer than that of Group D (P=0.002). The differences of grade Ⅲ-Ⅳhematologic toxicities among the four subgroups were not statistically different. Patients in Group B had better tolerance to nausea and vomit. In Group D, the central nervous system symptoms such as fatigue and headache occurred frequently. Conclusions The response rate and OS of SCLC brain metastasis patients with progressive intracranial lesions after radiotherapy are improved after chemotherapy, however, PFS is not significantly prolonged. The efficacies of carmustine, temozolomide and topotecan are similar in short and long term, besides, temozolomide shows less adverse events and a higher disease control rate. The application of chemotherapy that could penetrate the blood-brain barrier can improve the efficacy on SCLC brain metastasis patients with progressive intracranial lesions after radiotherapy with well tolerance.

0.05). The main toxicity reactions were myelosuppression,gastrointestinal reactions,peripheral neurotoxicity and most of the patients can suffer that. CONCLUSION:Docetaxel combined with oxaliplatin and capecitabine have good effect on advanced gastric cancer and are less toxic. It can be the main treatment way to cure advanced gastric cancer.

Objective To observe the morphological characteristics of congenital optic disc pit with maculopathy, the natural de-velopment, and changes after laser photocoagulation. Design Retrospective case series. Participants Twelve cases with congenital optic disc pit. Methods Records of 12 patients with congenital optic disc pit with maculopathy were reviewed. Clinical examination includes optical coherence tomography (OCT), color fundus photography, and fluorescein angiography (FA). The data was analyzed with the exist-ing theory of pathogenesis of the disease. Main Outcome Measures Visual acuity and morphology of macupopathy. Results All the patients were noted to have serous maculopathy associated with optic disc pit. Serous detachment of neuro-retina was found in two pa-tients, schisis of neuro-retina in two patients, and both serous detachment and schisis of nearo-retina were observed in other patients. Two patients were associated with choroidal coloboma. Four patients were treated with laser photocoagulation, in which 3 patients had vision improved. Conclusions Schisis and detachment of neuro-retina are the important morphologic changes of congenital optic disc pit with maculopthy. Proper understanding of the relationship between the development of the disease and these changes will be helpful to study its pathogenesis. Patients may benefit in part from laser photocoagulation. (Ophthalmol CHN, 2009, 18: 233-236)

Humans ; Myocardium ; Stem Cell Transplantation ; Stem Cells ; Tissue Engineering

Objective To investigate the clinical significance of retinal binding protein (RBP) and Cystatin C in blood and urine in patients with chronic kidney disease (CKD).Methods One hundred and twenty-one patients with CKD in Nephrology Laboratory of The People's Hospital of Xinjiang Uygur Autonomous Region from Aug.2012 to Jan.2013 were served as the case group.Sixty healthy check-up people were considered as control group.Enzyme linked immunosorbent assay was used to detect RBP and Cystatin C in urine,and the immune turbidimetry testing was applied to detect RBP and Cystatin C in blood.The receiveroperating characteristic (ROC) curve and area under curve (AUC) were applied to evaluate the sensibility and diagnostic value of indexes in CKD.Results The positive rate of RBP,Cystatin C in urine and blood were 89.6％,92.6％,52.5％,59.5％ respectively of 12 patients in case group,higher than those in control group (all value were 0,P ＜0.001).ROC curve showed that the sensitivity of urine RBP and Cystatin C were higher than that in blood of case group.AUC of RBP,Cystatin C level in urine and blood were 0.915,0.974,.655,and 0.623 respectively.And 95％ confidence interval were 0.877-0.954,0.956-0.992,0.575-0.736,0.543-0.702 respectively,and the differences are statistically significant (P ＜ 0.001).Conclusion The sensitivity of urine cystatin C and RBP are significantly higher than that in blood,which might be served as a diagnostic marker of CKD and can provide important basis for clinical diagnosis.

Objective To explore changes of brain function among patients with partial epilepsy in resting state by using the blood oxygenation level dependent functional magnetic resonance imaging (fMRI) techniques.Methods fMRI scanning was performed in resting state among 60 patients with partial epilepsy and 60 gender,age and educational levels matched normal controls.The functional connectivity analysis was applied to calculate the default mode network ( DMN ) functional connectivity in resting-state fMRI.SPM5 was used to analyze differences in functional connectivity between the two groups( P ＜0.001,cluster ＞50).Results Left precuneus and adjacent posterior cingulate cortex ( Pcu/PCC),angular gyrus,and cingulate gyrus were involved in the DMN of epileptic patients.By contrast,the DMN of controls included left Pcu/PCC,right angular gyrus,bilateral medial frontal lobe and temporal lobe.Compared with normal controls,patients with partial epilepsy showed a significantly decrease in functional connectivity of DMN region such as left inferior parietal lobule,supramarginal gyrus,parahippocampa gyrus and superior temporal gyrus,and bilateral uncus,while no regions were found increased functional connectivity in patients group.Conclusions Patients with partial epilepsy show abnormal changes in functional connectivity of DMN in resting state by fMR],which may associate with the potential pathophysiological mechanisms of epilepsy.The findings demonstrate that the resting-state fMRI might detect the extensive changes of brain function in partial epilepsy with negative results of conventional MRI,suggestive of fMRI as an effective and non-invasive method to explore brain function in epilepsy.

Objective To evaluate the CT and MRI findings and their diagnostic value of central nervous system complications of leukemia (CNSCL). Methods The CT and MRI findings of 18 adult patients with CNSCL proved by clinical features or pathology were retrospectively analyzed. Among 18 cases,7 were acute lymphocytic leukemia, 10 acute non-lymphocytic leukemia and 1 chronic myelomonocytic leukemia. Eleven cases underwent plain CT scan with one of them also receiving contrast-enhanced CT scan enhancement, 16 cases underwent plain MR scan with 11 of them receiving contrast-enhanced MR scan.Results Intracranial lesions in 14 cases: (1)intracranial hemorrhage was found in 7 cases, including intracerebral hematoma in 4 cases, micro-haemorrhage in 2 cases, and intracerebral hematoma accompanying by multiple intracerebral micro-haemorrhage foci in 1 case. All cases with intracerebral hematoma showed multiple lesions, which demonstrated high-density on CT images, and low or mixed signal on T1 WI, high- or intermediate signal with low-signal rim on T2 WI and ring enhancement or no evident enhancement. Microhaemorrhage manifested as multiple mini-mottling and strip hypointense foci on susceptibility weighted imaging, on which the detection rate of micro-haemorrhage foci was much higher than that on CT and other sequences of MRI. Among the 7 cases, one also had cerebral infarction and one subarachnoid hemorrhage.(2) Intracranial mass was found in 5 cases, among which two appeared as masses under or bestride cranium in the left frontal region with hypointensity on T1 WI, mixed signal on T2WI, strong homogeneous enhancement and dural tail sign;one showed a mass in saddle area, with high density on CT, slightly low signal on T1WI, high signal on T2WI and heterogeneous enhancement; one case displayed a mass near lateral ventricle with iso-intensity on T1 WI and T2WI and strong homogeneous enhancement; and one case manifested as cystic mass in the left fronto-apical lobe, with thick wall and ring enhancement (3)Obstructive hydrocephalus was found in 1 case, manifesting dilation of ventricles above the aquaeductus mesencephali. (4) Meningopathy was found in 1 case, manifesting diffuse thickening of meninges with strong homogeneous enhancement on MRI. Pathological changes of spinal canal was found in 4 cases among which two showed para-spinal mass involving vertebral canal and causing bone destruction of adjacent ribs; one case showed fusiform mass posterior to vertebral canal with high and intermediate signal on T1 WI and low and iso-signal on T2WI without enhancement; one showed zonale leison in thoracic cord with high signal on T2WI and fluid attenuated inversion recovery. Conclusion The radiologic manifestations of adult CNSCL are various and the role of CT and MRI for the diagnosis of CNSCL may complement each other. SWI is suggested as routine examination for patients of leukemia, in whom intracerebral lesions were suspected in order to find micro-haemorrhage as early as possible and reduce the risk of intracerebral hematoma occurrence.

Objective To determine the incidence and risk factors of iatrogenic retinal breaks in eyes undergoing pars plana vit- rectomy for idiopathic macular pucker.Design Retrospective case series.Participant 88 consecutive vitrectomies performed on eyes with idiopathic macular pucker.Method Consecutive vitrectomies performed on eyes with idiopathic macular pucker at Beijing Tongren Eye Center between 2002 and 2006 were retrospectively reviewed.Cases with iatrogenic retinal breaks were recorded and analyzed. Main Outcome Measure Number and location of retinal breaks,and anatomic outcome after surgical managements.Result A total of 88 consecutive vitrectomies were included in the study.Of the 88 eyes,8 eyes had 14 iatrogenic retinal breaks detected,with an aver- age incidence of 9.1%.Peripheral retinal breaks(8.0%)were more common than posterior retinal breaks(1.1%).All peripheral retinal breaks occurred around the selerotomy sites(100%)and the quadrant of predominant hand was involved most commonly(62%).Most of the breaks(88%)were detected during the surgery.All eyes with iatrogenic retinal breaks obtained anatomic retinal reattachment (100%).Conclusion Despite improvements in instrumentation and surgical techniques,iatrogenic retinal break continues to be an im- portant complication of pars plana vitrectomy in eyes with idiopathic macular pucker.This complication tends to occur more commonly at peripheral retina and is mainly selerotomy-related.

AI M:Our purpose wastoinduce MSCs differentiatinginto endothelial cells (EC)invitroandto providetheseed cells for study of cardiovascular tissue -engineering.METHODS :MSCs were separated by gradient centrifugation on Percoll(density 1 073 g/L) fromhuman bone marrow(HBM) ,and incubated for purification and amplification in DMEM(lowglucose)with 10 %fetal bovine serum(FBS) .Then,the MSCs were incubated for orientation differentiated into ECin DMEM(high glu-cose) with20 %FBS,VEGF(10?g/L) ,bFGF(5?g/L) ,L-glutamine (2 mmol/L) ,penicillin (1?105U/L) and streptomycin(100 mg/L) for about 14 -21 days andtheir phenotypic characteristics were analyzed byflowcytometry.Afterwards ,the differenti-ating cells were evaluated by histology andimmunohistochemistry.RESULTS :The quantity of MSCs was increasedfrom5?0?105inthe primary culture to 8?0?1012,or toincrease to 1?6?107times after 15 generations of incubation.The purity of MSCs wasabove 95 %and 98 %homogeneous at passages 2 and 3 ,respectively.About 80 %-90 %of the differentiating cellsfrom MSCs af-ter 14 -21 days were positively stainedfor Ⅷfactor (vWF) related antigen by immunohistochemistry assay,and Weible -paladecorpuscle was also observed bytransmission electron microscopyinthe cytoplasm.CONCLUSION:MSCs from HBMhave the ca-pability of differentiationinto ECsin vitro,which may be a potential source of seed cellsforfabrication of tissue -engineering heartvalve ,particularlyin children with congenital heart disease .