Moyamoya disease is a cerebrovascular disease w hich is characterized by progressive cerebrovascular stenosis and occlusion. The direct and indirect revascularizations modalities are the preferred methods for the treatment of moyamoya disease now . This article review s the surgical modalities of moyamoya disease.

Objective To evaluate treatment outcomes and quality of life (QOL) in glioma patients treated with postoperative intensity-modulated radiotherapy (IMRT), and to explore the possible clinical factors of affecting QOL. Methods From 2007 to 2009, 37 patients with low or high grade glioma were analyzed retrospectively. All patients were operated by tumor resection below microscopy. IMRT began at 2-4 week postoperstion with 2.0 Gy/fractior, 5 fractions/week and to shrink portal and to add dose to 50-60 Gy/25-30 fractions after 40-50 Gy. The gross tumor volume (GTV) was defined as preoperation T2WI MRI high sign area and postoperation tumor cavity for low grade glioma, and with preoperation T1WI MRI enhanced abnormity area and postoperation tumor cavity for high grade glioma. The clinical target volume ( CTV ) was defined as GTV with a margin of 1.5 cm for low grade glioma and a margin of 2.5 cm for high grade ghoma, the planning target volume (PTV) with CTV plus 0.4 cm margin for setup errors according to the European Organization for Research and Treatment of Cancer ( EORTC ).The treatment outcomes and QOL were assessed. Results The half-year and one-year survival rates for all the patients were 100% and 79.2%, respectively. The median progression-free survival time was 10 months. The main side-responses after postoperative IMRT were fatigue and mild memory decline or cognitive disabilities, which were radiation dose-dependent. Conclusions Postoperative IMRT is an effective and safe modality of therapy for glioma patients.

Aim To study the chemical constituents of Cypripedium tibeticum. Methods Compounds were isolated by repeated silica gel chromatography and purified on Sephadex LH-20 and structures were determined by spectral analysis. Results Cypritibetquinones A and B were isolated from the ethyl acetate residue and their structures were determined as 7-hydroxy-2-methoxy-1, 4-phenanthraquinone ( 1 ) and 7-hydroxy-2,10-dimethoxy-1,4-phenanthraquinone ( 2 ), respectively, by extensive spectral analyses. Conclusion Cypritibetquinones A and B are two new phenanthraquinones.

BACKGROUND:Pedicle screw implantation is a common method to repair many kinds of diseases of the lower cervical spine. Three-dimensional (3D) reconstruction visualization system can be used in order to improve the accuracy of the implant and improve the prognosis.
OBJECTIVE:To investigate the effect of 3D reconstruction visualization system on the accuracy of cervical pedicle screw implantation.
METHODS: The clinical data of 89 patients with cervical spine dislocation, who underwent cervical pedicle screw implantation, were analyzed retrospectively. Patients were divided into control group (46 cases) and observation group (43 cases) according to the navigation method. Patients in the control group underwent C arm X ray two dimensional navigation. Patients in the observation group underwent three-dimensional reconstruction visualization system navigation. Intraoperative placement time was observed, and the accuracy of screw placement was assessed in both groups. The cases were folowed up for 12 months, and the adverse events were recorded and compared.
RESULTS AND CONCLUSION: (1) Intraoperative implantation time was shorter in the observation group than in the control group, but no significant difference was found (P> 0.05). (2) Accuracy rate: There were no three types of nail cases in the observation group, and the accuracy rate was 93% (40/43). In the control group, two cases affected three types of nailing, and the accuracy rate was 81% (37/46). The accuracy rate was significantly higher in the observation group than in the control group (P < 0.05). (3) Postoperative folow-up: None suffered from nerve tissue injury to vertebral artery, blood vessel and spinal cord. The screws of the two groups were in stable condition, without screw breakage or loosening. (4) Results suggested that in lower cervical pedicle nail implantation, 3D reconstruction navigation system can effectively improve the accuracy of screw placement, and does not increase nailing time or lead to adverse events. It is a safe and effective navigation mode.

Objective To investigate pulmonary infect flora distribution characteristics of stroke patients with tracheotomy in Intensive care unit (ICU) and analyze the risk factors.Methods A total of 792 cases of ICU stroke patients was selected,including 426 cases of tracheotomy patients,and 366 cases of non-tracheotomy patients.The incidence of lung infections was compared.Bacteriological examination was used for tracheotomy bacteriological studies for lung infected stroke patients with tracheotomy.Bacteria infection's characteristics was observed.The risk factors were analyzed.Results (1) The tracheotomy patient 's lung infection rate was 23.00％,higher than 9.56％ of the non-tracheotomy patients,the difference was statistically significant (X2 =19.125,P ＜0.05);(2) For lung infection-occurred patients with tracheotomy of ICU,gram-negative bacteria infection rate was 63.97％,significantly higher than 19.85％ of gram-positive bacteria and 16.18％ of fungi,the difference was statistically significant (x2 =18.255,17.042,P ＜ 0.01);(3) Lung infection rate of ICU stroke tracheotomy patients with unconscious,dysphagia,hospitalization time ＞ 14 d,blood glucose levels ≥≥7.8 mmol/L,and based diseases was significantly higher than that of patients with conscious,non-dysphagia,hospitalization time ≤＜14 d,blood sugar level ＜7.8 mmol/L,and no based diseases (P ＜ 0.05);(4) Consciousness,dysphagia,hospitalization,blood sugar levels,and the underlying disease were the independent risk factors of lung infection in ICU stroke tracheotomy patients (OR1 =11.528,OR2 =8.046,OR3 =15.174,OR4 =7.795,ORs =10.784,P ＜0.05).Conclusions Gram-negative bacteria is the main reason for pulmonary infections in ICU stroke tracheotomypatients patients with stroke.State of consciousness,invasive treatment,hospitalization,blood sugar levels,and the underlying disease are the independent risk factors.

Communicable Disease Control ; Communicable Diseases ; Disease Notification ; Humans ; Population Surveillance ; methods

Objective To investigate the effect of N-myc downstream regulated gene 2 (NDRG2) on the apoptosis of bladder cancer cells by regulating the signal transducer and activator of transcription 3(STAT3) signaling pathway.Methods The expression level of NDRG2 in human bladder cancer cell BIU-87 and immortalized cell SV-HUC-1 was detected by Western blot.NDRG2 over expression vector and empty vector control (pcDNA3.1),siRNA-NDRG2,siRNA control were transfected into BIU-87 cells.After transfected 48 h,the expression level of NDRG2,Cleaved caspase 3,STAT3,p-STAT3,JAK2,p-JAK2 were detected by Western blot,the cell proliferation and apoptosis were measured by MTT and flow cytometry.After adding inhibitor AG490 of 45 μmol/L in cultured BIU-87 cells,MTT assay was used to detect cell proliferation and flow cytometry was used to detect the cell apoptosis,Western blot to detect the expression level of Cleaved caspase 3,STAT3,p-STAT3,JAK2,p-JAK2.Results The expression level of NDRG2 in bladder cancer cells was higher than that in bladder epithelial cells.The cell survival rate of pcDNA3.1/NDRG2 group was lower than that of pcDNA3.1 group,the difference was statistically significant (P ＜ 0.01).The cell survival rate of siRNA-NDRG2 group was higher than that of siRNA control group (P＜ 0.01).The apoptosis rate of pcDNA3.1/NDRG2 group was higher than that of pcDNA3.1 group (P ＜ 0.01).The apoptosis rate of NDRG2 siRNA group was lower than that of siRNA control group (P ＜ 0.01).The level of p-STAT3 and p-JAK2 in pcDNA3.1/NDRG2 group was lower than that in pcDNA3.1 group (P＜ 0.01).The survival rate and apoptosis rate of BIU-87 cells cultured with AG490 were in agreement with the trend of pcDNA3.1/NDRG2 after transfection.Conclusions NDRG2 could promote the apoptosis of bladder cancer cells,and its mechanism may be related to STAT3 signaling pathway.

OBJECTIVE: To investigate the relationship between obstructive sleep apnea hypopnea syndrome (OSAHS) and adenoid size as well as tonsil size in Children. METHOD: A total of 545 patients, 338 OSAHS patients (treated group) diagnosed by PSG and 207 patients with vocal cord nodules but symptoms of upper airway obstruction (control group), were enrolled from inpatient and outpatient between June, 2008 and October, 2010. The oropharynx and electron-nasopharyngolaryngoscopy examination records of the two groups were retrospectively analyzed. The patients in the treated group were also divided into mild group, moderate group and severe group according to obstructive apnea index (OAI) or AHI. SPSS 17.0 was used for statistical analysis. RESULT: In the treated group, 89.7% had grade III-V adenoid and 68.4% had grade III-IV tonsil, compared with 30.9% (adenoid) and 13.5% (tonsil) in the control group. The significant differences were found (all P < 0.01). The comparison between patients with different grades of adenoidal size and tonsil size in the treated group had indicated that patients with grade IV adenoid or grade IV tonsil have a higher risk of OSAHS than patients with grade III adenoid or grade III tonsil. In the treated group, the ratio of patients with different severity of adenoid or tonsil had increased with the severity of OSAHS (P < 0.01). This retrospective study had also found that most of the grading results from Electron-nasopharyngolaryngoscopy examination were consistent with that from oropharynx examination. 13 (37.1%) of 35 patients with grade I or II tonsil diagnosed by Oropharynx examination were considered as grade III by Electron-nasopharyngolaryngoscopy examination. CONCLUSION Adenoidal hypertrophy and tonsil hypertrophy are the risk factors for OSAHS in children. The risk of OSAHS and the severity of OSAHS are positively associated with the severity of adenoid and tonsil. The electron-nasopharyngolaryngoscopy examination is an important examination method for diagnosing OSAHS in children, as well as determination of tonsil size.
Adenoids ; pathology ; Adolescent ; Child ; Endoscopy ; methods ; Female ; Humans ; Hypertrophy ; complications ; pathology ; Laryngoscopy ; methods ; Male ; Organ Size ; Palatine Tonsil ; pathology ; Retrospective Studies ; Risk Factors ; Sleep Apnea, Obstructive ; classification ; etiology

Objective To study methods and effect of granule bone grafting into the vertebral pedicle pyramid under endoscope for treatment of thoracolumbar fractures. Methods There were 26 cases (7 males and 19 females; age range of 32 79 years, average 51.2 years) with thoracolumbar fractures. The fractures included 8 cases (30.8%) of thoracolumbar compression burst fractures with no compression of the spinal cord by broken bone fragments and 18 (69.2%) compression fractures due to senile osteoporosis. Posterior to a preliminary reduction of the lumbar region on the operating table, all cases underwent vaginal vertebral pedicle reduction under endoscope and autogenous or hererogeneous granule bone graft in order to restore the height of the fractured vertebra pyramid. The patients kept in bed for two months postoperatively; meanwhile, the excise for the back muscle was performed. Results The mean follow up period was 3 18 months. Twenty one cases (80.8%) got excellent therapeutic result, four (15.4%) moderate and one (3.8%) poor. (1) The vertebral height recovered average 29%, with mean height loss of 5% through six month follow up. (2) The posterior convex cobb angle of the spine recovered for 10? 20? (mean 13.8?). (3) No lumbago or nerve compression symptoms were found in 21 cases. Conclusions Granule bone graft into vertebra pyramid under endoscope in the treatment of thoracolumbar fractures is a minimally invasive procedure that can enhance the bone capacity of the vertebra, alleviate pain, restore the height of the fractured vertebra pyramid and accelerate bone healing.

Objective To investigate the effects of the interaction between human hepatoma cells and hepatic stellate cells on their growth state,and study its role of interaction on the progression of hepatocellular carcinoma.Methods Human hepatoma cell line HepG2 and hepatic stellate cell line hepatic stallate cells (HSC)-T6 were used and the methods including methyl thiazolyl tetrazolium (MTT) assay,flow cytometry (FCM) analysis,immunohistochemistry,and electron microscopy were employed in this experiment.The effects of conditioned medium (CM) of HepG2 on the activation and proliferation of HSC were explored.The effects of activated HSC CM on HepG2 proliferation were investigated.The uhrastructural changes of the two co-cultured cells were observed.Results MTT assay result showed that HepG2/HSC CM could promote HSC/HepG2 proliferation.FCM result demonstrated that HepG2/HSC CM could influence the cell cycle distribution in HSC/HepG2.Immunohistochemistry exhibited that after the treatment of HepG2/HSC CM,the expression ofα-smooth muscle actin (α-SMA) in HSC and proliferating cell nuclear antigen (PCNA) in HepG2 were increased.When HepG2 and HSC were co-cultured,the ultrastructure of HSC displayed an activated feature.Conclusions HepG2 cells can induce the activation and proliferation of HSC,and the activated HSC can also stimulate the proliferation of HepG2.Interaction between hepatoma cells and hepatic stellate cells may play an important role in the progression of hepatocellular carcinoma.