Objective To assess the clinical features,diagnosis,therapy and the prognosis of vertebral artery dissection presented as ischemie cerebral vascular disease.Methods Clinical and routine laboratory examinations were performed in all the 6 patients,who underwent brain DSA,MRI,MRA and cervical vascular duplex ultrasound examinations.They fulfilled at least 1 of 2 imaging criteria used to diagnose vertebral dissection.Results There was sudden neck pain or occipital headache in 4 of the 6 eases.Vertigo and (or) dizziness were the main onset symptoms for all the subjects.Two cases presented Wallenberg syndrome; Three had recent trauma to the neck.DSA showed occlusion or stenosis of the vertebral artery.MRI showed an crescent-shaped intramural hematoma.Cervical vascular duplex ultrasound revealed normal intima-media thickness and no carotid atheroscleretic plaque,and displayed significant stenosis or occlusion of the involved vertebral artery.The dissections were found in the extracranial segment of the vertebral artery in 5 cases.The follow up period for all patients was approximately 26 months.The anticoagulant therapy was administered to all subjects for a period ranging from 9 to 53 months.The modified Rankin Scale (mRS)improved significantly as compared to baselines in all except for one ease,the mRS were4,4,4,2,2,2 vs 4,3,2,1,0,1 (Z=-2.07,P=0.038).Conclusions Vertebral artery dissection has unique clinical features.Neuroimnging is useful in confirming the diagnosis.The occlusive lesion of the involved vertebral artery is reversible under long-term anticoagulant treatment.The prognosis is relatively positive.

Objective To evaluate the clinical parameter, diagnosis and operative mode of parathyroid tumor. Methods The clinical symptoms, examination methods and the mode of operation in 15 operated patients with parathyroid tumor from May 1979 to October 2001 were retrospectively analyzed. Results 15 patients with parathyroid tumors, including 10 adenomas, 3 carcinoma and 2 cysts, all revealed the symptom of hyperparathyroidism except 2 cases of cyst. The accuracy of B-US and CT in preoperative diagnosis on location was 86 7% and 91 7% respectively, and their accuracy in preoperative diagnosis on quality was 26 7% and 75 0% respectively. All patients were treated by surgery. Among them, 12 patients were cured, 1 died, and 2 relapsed. Conclusion If a patient has the symptoms of bone pain, nephrolith and the mass in neck, we should consider whether he suffers from parathyroid tumor. B-US is the first choice in preoperative diagnosis on tumor location, and CT was the good examination method for tumor location also. The diagnosis on tumor quality dependeds on pathological examination mostly. Surgery remains to be the most important. The only unilateral exploration for the benign parathyroid tumor is performed and the operative range of parathyroid carcinoma should include both the mass and thyroid.

Objective: To explore the protective effect of minocycline on hepatic ischemia-reperfusion injury (IRI) in rats and the underlying mechanisms. Methods: A total of 54 male Sprague-Dawley rats were randomly divided into 3 groups: the sham-operated group (control group), the ischemic–reperfusion (IR group), and the minocycline preconditioning group (n=18 per group). The rats in the minocycline preconditioning group were given minocycline (45 mg/kg) by gastric irrigation at 36 h before operation and then were subsequently administered with minocycline (22.5 mg/kg) at every 12 h. hTe rats were sacriifcedat 2, 6, 24 h after reperfusion. The serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) were measured. HE staining of liver tissues was performed to detect the histological changes, and the degree of liver IRI according to Suzuki score were calculated. hTe levels of malondialdehyde (MDA) and myeloperoxidase (MPO) were determined by spectrophotometer; the mRNA expression of tumor necrosis factor-α (TNF-α) and interleukin-1 beta (IL-1β) in the liver were measured by real-time PCR; Dickkopf-1 (DKK-1) and beta-catenin (β-catenin) protein expression in the liver were detected by Western blot. Results: Atfer 2, 6, 24 h reperfusion, compared with the IR group, the liver function (ALT, AST and LDH) in the minocycline group was signiifcantly improved (allP<0.05); the Suzuki’s scores and the levels of hepatic TNF-α and IL-1β mRNA were signiifcantly decreased (allP<0. 05); the MDA and MPO levels the liver were decreased (bothP<0.05); the protein expression of hepatic DKK-1 was decreased (P<0.05), while the protein expression of β-catenin was increased (P<0.05). Conclusion: Minocycline can alleviate the ischemic-reperfusion injury mainly through reducing oxidative stress and inhibiting the release of pro-inlfammatory cytokines depends on the activation of the Wnt/β-catenin signaling pathway in the liver.

0.05).Anastomotic inflammatory reaction occurred in 2 patients(3.2%) in BAR group and 13 patients(20.0%) in manual group.The difference was statistically significant(P

Langerhans cell histiocytosis (LCH) is a rare histiocytic disorder. Here, we report a rare case of multi-system LCH in a 20-month-old children presenting nasal congestion, fever, abnormal liver function, anemia, and skin damage. The radiograph computed tomography showed an osteolytic lesion in the lateral skull base with tumor extension. Pathological biopsy was performed, and the histopathologic diagnosis was LCH. A general review of LCH, including clinical manifestations, diagnosis, treatment, and prgognosis, is presented.
Histiocytosis, Langerhans-Cell ; diagnosis ; Humans ; Infant ; Rare Diseases

ObjectiveTo investigate the surgical procedures of orthotopic small bowel transplantation (SBT) model in mice to study the function and rejection of SBT.MethodsWe established a mouse SBT allograft model as follows: the donor portal vein was anastomosed end by side with the recipient inferior vena cava; the donor superior mesenteric artery with aorta patch was anastomosed end by side with recipient abdominal aorta.After an appropriate length of the recipient's small bowel was removed,the donor's small bowel and the recipient's small bowel were end-to-end anastomosed discontinuously.The mice were fasted for 4 d after the operation,free access to water and subcutaneously injection of 2 mL of 5％ glucose saline twice daily.Operation success was regarded as survival for more than 5 d.There is no antibiotic and immunosuppressor.ResultsA total of 30 transplantations were done,the 5 d survival rate was 60％ ( 18/30),and 12 died within 5 d.Among the dead recipients,5 died of arterial anastomotic stenosis and anastomotic thrombosis,2 of hemorrhagic shock caused by anastomotic bleeding,and the other 5 of intra-abdominal infection caused by postoperative intestinal fistula.The donors' operative time was (40 ± 4.5 ) min,warm ischemia time was about 0.5 min,donor preparation time was about 3 min,and cold preservation time was (30 ±7.5) min.The recipients' operative time was (95 ±8.0) min,among which,the abdominal aorta and inferior vena cava clamping time was ( 38 ± 3.5 ) min,the venous anastomotic time was (10 ±2.0) min and the arterial anastomotic time was (15 ± 3.0) min.The mean intraoperative blood loss of the surviving recipient mice was about 0.2 mL.ConclusionHigh quality vascular anastomosis,and rehydration of donors and recipients are crucial factors for improving the success rate of SBT.

ObjectiveTo investigate the expression of T helper (Th) 17 cells and the related interleukin 17 (IL-17) in acute renal allograft rejection in mice and its significance.Methods We established a mouse renal allograft model,in which mice were randomly divided into a renal isograft group and an acute renal allograft rejection group.Three and 7 d after the transplantation,the serum interferon (IFN)-γand IL-17 levels in the mice were determined by enzyme-linked immunosorbent assay,the percentage of Th1 and Th17 cells in the total kidney-infiltrating lymphocytes was investigated by flow cytometry,and the transplanted kidney species were given routine pathological examination after fixation with 10％ formalin.ResultsCompared with the isograft group,the allograft mice showed a significantly higher content of IL-17 (P ＜0.05 ) but not IFN-γ in the serum 3 d after transplantation,and showed significantly higher serum IL-17 and IFN-γcontents 7 d after transplantation (P ＜ 0.05 ).Also,compared with the isograft group,the allograft mice exhibited significantly higher percentage of Th1 and Th17 cells on both day 3 and day 7 ( P ＜ 0.05 ).In the allograft group,the contents of serum IFN-γand IL-17 and the percentage of Th1 and Th17 cells were significantly higher on day 7 than on day 3 (P ＜ 0.05 ).Routine pathological examination indicated that,as time passed,the allograft mice showed gradually stronger rejection responses.ConclusionTh17 cells might play an important role in the development of acute renal allograft rejection,and IL-17 can be used as an early indicator of acute rejection.

Objective To observe changes in mean platelet volume ( MPV) and investigate its possibility as a predictor and influence in patients with pulmonary artery hypertension associated with secundum atrial septal defect (ASD-PAH) . Methods 627 patients who suffered from secundum ASD were included in the study from the First Affiliated Hospital of Xinjiang Medical University Heart Center between January 2010 and March 2014. Patients were divided into two groups based on whether they had PAH or not (PAH group, n = 420 and non-PAH group, n = 207) . We also included 690 healthy people as a control group who received routine body check up at the same time. Examinations including complete blood count, serum biochemistry and ECG were done. Right heart catheterization examination was performed in patients who suffered from secundum ASD. Results The MPV was significantly higher in secundum ASD patients than in the control group [ (9. 4 ± 1. 6) fl vs. (8. 9 ± 1. 5) fl, P ﹤ 0. 001] . No significant difference was observed in MPV between PAH group and non-PAH group (P = 0. 268) . In univariate and multivariate logistic regression analysis, age ( OR 1. 401, 95% CI 1. 087 to 1. 806, P = 0. 009), RV diameter (OR 1. 101, 95% CI 1. 026 - 1. 181, P = 0. 008) and ASD defect diameter (OR 1. 064, 95% CI 1. 013 - 1. 118, P = 0. 013) were associated with ASD-PAH. Conclusions Our study demonstrated that age, RV diameter and ASD defect diameter were associated with ASD-PAH. Platelet activation exists in ASD-PAH, but this may not be the precipitating cause that contribute to the pathogenesis of ASD-PAH. MPV at admission does not predict the risk of PAH in patients with secundum ASD.

Objective To investigate the effects of tegaserod on visceral sensitivity and explore the regulating mechanism.Methods Forty-two male Spragre-Dawley rats,which were induced colonic inflammation by intraluminal administration of trinitrobenzenesulfonic acid(TNBS),were randomly divided into eight groups.In the three colorectal distention(CRD) treated groups(n=6),abdominal contractions were recorded after 3,7 and 14 days of intra-gastric administration of tegaserod 2mg/kg d.In the three CRD control groups(n=4),abdominal contractions were recorded after 3,7 and 14 days of intra-gastric injection of saline 2.0mL/d.In immunohistochemistry(IH) treated group(n=6) and IH control group(n=6),samples of colon were removed and processed for SP and CGRP immunohistochemistry after 7 days of intra-gastric administration of tegaserod and saline,respectively.Results Abdominal contractions induced by colonic distention decreased significantly at 1.2mL and 1.6mL distention volume after 3 days of tegaserod administration(P

Currently,surgical treatments in tennis elbow include open,arthroscopic and percutaneous procedures.Open surgery,having definite curative effects,is commonly used.There are different surgical methods based on different hypotheses about the pathogenesis of tennis elbow,such as detachment of common extensor origin,resection of annular ligament,denervation surgery and resection of microvascular nerve bundle.There is a huge difference in open surgery of tennis elbow between China and abroad.Debriding or releasing extensor carpi radialis brevis and common extensor tendon are mostly used abroad though it remains controversial whether we should release or debride with tendon,as well as whether it is better to decorticate on lateral epicondyle or not.In China,tennis elbow is treated with resection of microvascular nerve bundle except for debridement and release of tendon.As for evaluation criteria,the following methods,grip strength,grading system and visual analogue scale have been used in researches.However,cure rate and response rate are valuation criteria for resection of microvascular nerve bundle in China.The evaluation criteria are different among various surgical methods,even in the methods,especially for grading system.Each research has unique standards to define excellent,good,fair and poor outcomes.Complications of tennis elbow open surgery are rare,while subcutaneous hematoma is the common complication.