Objective To discuss the effect of interleukin-17A(IL-17A)and transforming growth factor-β1(TGF-β1)on the benign tracheal stenosis after tracheal injury in experimental dogs.Methods The trachea stenosis model of healthy Beagle dogs was established by burning the middle part of trachea with electric snare under bronchoscopy guidance.A total of 21 dogs were divided into normal group(n=3,receiving normal feeding),molding group(n=12,after airway modeling every 3 dogs were sacrificed each week for 4 weeks),IL-17A suppression group(n=3,receiving Secukinumab after airway modeling),and IL-17A inhibitor+TGF-β1 inhibitor group(n=3,receiving Secukinumab and SB43154 after airway modeling).Bronchoscopy and CT scan were performed once a week,and the stenosis degree was calculated.RT-qPCR,immunohistochemistry,and HE staining of the obtained tracheal tissues were performed.Results Within 1-4 weeks after molding,in module-making dogs the degree of stenosis of the injured trachea gradually increased,and the expressions of ECM-related proteins,TGF-β1 and IL-17A were up-regulated.After treatment with IL-17A inhibitors,the inflammatory infiltration and granulation tissue hyperplasia were reduced and the early tracheal stenosis was improved(P＜0.05).The combination use of IL-17A inhibitor and TGF-β1 inhibitor had a better remission effect(P＜0.05).Conclusion IL-17A and TGF-β1 may synergistically affect the formation of tracheal stenosis.

Objective:To investigate the preoperative evaluation and treatment methods of non-firearm penetrating brain injury (PBI) in children.Methods:A retrospective analysis was performed. The clinical data of 18 children with non-firearm PBI admitted to our hospital from January 2012 to December 2020 were collected.Results:CT angiography was performed in 10 patients and MRI in 8 patients before treatment. CT angiography indicated that the intracranial large vessels were not injured by the foreign bodies. The foreign bodies of 7 patients were removed by craniotomy and the foreign bodies of 3 patients were removed directly under general anesthesia; the foreign bodies of 8 patients were removed directly outside the hospital without anesthesia. Cerebrospinal fluid leakage was noted in 4 patients and intracranial infection in 7 patients after surgery; no foreign body residue or intracranial hemorrhage after surgery was noted. After 3-69 months of follow-up, 3 patients had visual decline, one had limited eye movement, and one had olfactory decline.Conclusion:CT angiography is a safe and effective evaluation method for children with non-firearm PBI, and direct extraction of foreign body under general anesthesia is a feasible surgical method when CT angiography shows that the blood vessels are not hurted by the foreign bodies.

Objective To detect molecular subtypes of medulloblastoma, and its correlation with prognosis. Methods Surgically treated 32 cases of primary medulloblastoma from 2010-2013 were collected, the molecular subtypes were determined by immunohistochemical detection of GAB1 and YAP1 protein in the sample. Clinical characteristics, imaging features and survival condition of different molecular subtypes were analyzed. Results Molecular typing of the 32 cases (21 males and 11 females) shows 4 (12.5%) cases of SHH, 7 (21.9%) cases of WNT and 21 (65.6%) cases of non-SHH. There was no significant correlation of molecular subtypes with age, gender and pathological classification. Three-year progression free survival rate in SHH, WNT and non-SHH/WNT subtypes were 75%, 57.1% and 38.1%, respectively. Three-year progression free survival rate was significantly higher in patients under 3 years old group than that in patients over 3 years old group in non SHH/WNT (P=0.047). Conclusions The prognosis of SHH was better than WNT, WNT was better than non-SHH/WNT type, prognosis in patients under 3 years old group of non-SHH/WNT was better than that in patients over 3 years old group.

Objective To compare the value of fractional anisotropy(FA)of MR diffusion tensor imaging(DTI) and Glasgow coma scale(GCS) at admission for judging the injury severity and prognosis of diffuse axonal injury (DAI). Methods Thirty-four patients with DAI adopted the GCS score to evaluate the conscious disturbance levels at admission and conducted the DTI examination within 2 weeks. Twenty-three individuals undergoing healthy physical examination conducted the DTI examination. The FA values of visuality lesion area in various sites,healthy side symmetric site and cerebral midline site were measured. The reduction degree of mean FA value at midline site and visuality lesions were measured. The correlation between GCS score,mean FA value reduction degree in visuality lesions and mean FA value at cerebral midline site with consciousness disorder time and recovery degree in half a year after injury was analyzed. Results The reduction degree of mean FA value at cerebral midline site was significantly correlated with consciousness disorder time and recovery degree in half a year after injury(r= 0. 519,P=0. 002; r= 0. 669, P=0. 000) ;the mean FA value reduction degree in visuality lesions and GCS score had low or weak correlation with consciousness dis order time and recovery degree in half a year after injury(r=0. 285,P=0. 103;r=0. 487,P=0. 003;r= -0. 241,P=0. 169;r=-0. 229,P=0. 192). The correlation between mean FA reduction degree in cerebral midline site and mean FA value reduction degree in visuality lesions with the recovery degree in a half years after injury was higher than that in GCS score. Conclusion DTI is a sensitive sequence for diagnosing DAI and has much more value for judging the injury degree and prognosis than the GCS score generally adopted by clinic.

Objective To establish the different degrees of rat diffuse axonal injury (DAI) model by using a self‐made DAI device .Methods A total of 70 healthy adult clean SD rats were selected and randomly divided into the normal control group (n=10) and DAI group (n=60) ,then the DAI group was randomly subdivided into the group A ,B ,and C ,20 cases in each group .The rat head injury model was prepared by using the self‐made experimental device ,which made the rat head to simultaneously produce instant oversized linear and angular accelerations ,different degrees of rat DAI model ,including mild DAI(group A) ,moderate DAI (group B) and severe DAI(group C) ,were induced by different rotation back and forth ,accelerated movement times under the con‐stant air pressure .The pathological and behavior effect evaluation was performed .Results With the injury degree aggravating ,the time interval of nerve physiological reflex recovery and awakening time in the acute DAI groups were increased (P<0 .05) .The nerve function score after 7 d in the DAI groups was decreased (P<0 .05);the death rates within 14 d after injury in the group A , B and C were 5 .0% ,25 .0% and 50 .0% respectively .With the injury degree aggravating ,the DAI pathological characteristics were more significant .Conclusion This device could effectively establish different injury degrees of DAI animal model .

The basic theory of high power green laser equipment for prostate hyperplasia therapy and the components of the system developed are introduced. Considering the requirements of the clinical therapy, the working process of the high power green laser apparatus are designed and the laser with stable output at 120 W is achieved. The controlling hardware and application software are developed, and the safety step is designed. The high power green laser apparatus manufactured with characteristics of stable output, multifunctional and friendly interface provides a choices of prostate hyperplasia therapy for using nationalization instrument.
Humans ; Laser Therapy ; Lasers ; Male ; Patient Safety ; Prostatic Hyperplasia ; therapy ; Software

The basic theory of high power green laser equipment for prostate hyperplasia therapy and the components of the system developed are introduced. Considering the requirements of the clinical therapy, the working process of the high power green laser apparatus are designed and the laser with stable output at 120 W is achieved. The controling hardware and application software are developed, and the safety step is designed. The high power green laser apparatus manufactured with characteristics of stable output, multifunctional and friendly interface provides a choices of prostate hyperplasia therapy for using nationalization instrument.

OBJECTIVETo explore the management of obstructive hydrocephalus caused by posterior fossa tumors before tumor resection in children.

METHODSThe clinical data were reviewed of 162 pediatric patients of posterior fossa tumors with obstructive hydrocephalus undergoing surgical tumor removal between January 2008 and June 2012. Ninety children received preoperative Ommaya external drainage (group A) and 72 underwent preoperative ventriculo-peritoneal shunting (V-Ps) (group B). The therapeutic effects were evaluated and compared between the two groups.

RESULTSPostoperative complications found in a total of 67 cases including infection (27), shunt blockage (19), subdural hematoma or effusion (16), ventricle fissure syndrome (5), and tumor hernia (4). Significant differences were found in the incidences of shunt blockage (P=0.047) and subdural hematoma or effusion (P=0.039) but not in the incidences of intracranial infection (P=0.478) or tumor hernia (P=0.462) between the two groups.

CONCLUSIONOmmaya reservoir can produce good results through simple surgical procedures for treatment of acute hydrocephalus in children with posterior fossa tumors and is associated less trauma and complications.

Adolescent ; Astrocytoma ; complications ; surgery ; Brain Diseases ; etiology ; Child ; Child, Preschool ; Drainage ; adverse effects ; methods ; Female ; Hematoma, Subdural ; etiology ; Humans ; Hydrocephalus ; etiology ; surgery ; Infant ; Infection ; etiology ; Infratentorial Neoplasms ; complications ; surgery ; Male ; Medulloblastoma ; complications ; surgery ; Preoperative Period ; Retrospective Studies ; Ventriculoperitoneal Shunt ; adverse effects

Objective To explore the clinical characteristics of posttraumatic cerebral massive infarction in children. Methods 68 cases were reviewed. Results There were 43 cases complicated with subarachnoid hemorrhage, 37 with brain contusion, 48 with fracture of skull,and the hematoma was subdural in 29 cases, epidural in 16 cases, and intracerebral in 14 cases. Other complications included fracture of limbs (24/68), thoracic or abdominal injury (15/68), and hemorrhagic shock (30/68). The infarction were found mostly in the first 7 d (range 2 h~13 d), and 32 cases within 4~7 d after the trauma. The outcome when discharged (according to the Glasgow outcome scale) was good recovery in 32 cases, moderate disability in 15 cases, severe disability in 9 cases, vegetative state in 4 cases, and 8 cases died. Conclusion The feature of the posttraumatic cerebral massive infarction in children is usually concealed by primary injury. CT and MRI are the bases for diagnosis.The outcome may be better than in the adults when early diagnosis and intervention has been produced.

Objective To explore the management of obstructive hydrocephalus caused by posterior fossa tumors before tumor resection in children. Methods The clinical data were reviewed of 162 pediatric patients of posterior fossa tumors with obstructive hydrocephalus undergoing surgical tumor removal between January 2008 and June 2012. Ninety children received preoperative Ommaya external drainage (group A) and 72 underwent preoperative ventriculo-peritoneal shunting (V-Ps) (group B). The therapeutic effects were evaluated and compared between the two groups. Results Postoperative complications found in a total of 67 cases including infection (27), shunt blockage (19), subdural hematoma or effusion (16), ventricle fissure syndrome (5), and tumor hernia (4). Significant differences were found in the incidences of shunt blockage (P=0.047) and subdural hematoma or effusion (P=0.039) but not in the incidences of intracranial infection (P=0.478) or tumor hernia (P=0.462) between the two groups. Conclusion Ommaya reservoir can produce good results through simple surgical procedures for treatment of acute hydrocephalus in children with posterior fossa tumors and is associated less trauma and complications.