简介：AbstractIntroduction:Postherpetic neuralgia (PHN) is a painful condition that occurs after herpes zoster skin lesions have subsided and that lasts for more than 1 month. PHN is usually difficult to treat.We herein present two cases of PHN comorbid with spinal metastasis of a malignant tumor. Both patients responded well to an epidural block.Case presentation:Patient 1 was a 54-year-old woman who had PHN for 35 days. Patient 2 was a 74-year-old woman who had PHN for 65 days. Both patients were treated with an epidural block and found to have spinal metastasis from a malignant tumor.Discussion:The routinely used dermatological medications for the treatment of herpes zoster and PHN have slow and unsatisfactory analgesic effects. Epidural block treatment provides a new approach for patients who cannot tolerate or do not respond to these commonly used drugs. Physicians should pay special attention to patients who have a history of a malignant tumor or are suspected to have spinal disease. Computed tomography or magnetic resonance imaging of the spine is recommended for such patients, and epidural block treatment should be performed after a spinal tumor or other lesions have been excluded.Conclusion:Epidural block treatment provides a new approach for patients of herpes zoster or PHN, but the treatment should be performed after a spinal tumor or other spinal lesions have been excluded.

简介：Type2cytokinesareusuallypredominantintumorpatientsandassociatedwithtumorprogression.Toexplorewhetherreversingoftype2predominancecouldbeapromisingstrategyintumorimmunotherapy,PBMCsof35lungcancerpatientsand19healthysubjectswerepreparedandsubjectedtobeexaminedforcytokinesecretionandgeneexpression.Tetra-Methylpyrazine(TTMP),extractedfromatraditionalChinesemedicinalherbwhichhasbeenusedinclinictoreversetheTh2statusofcancerpatientsinChina,wasaddedtoPBMCculture.DeterminedbyRT-PCR,thepositivepercentagesofmRNAexpressionoftype1cytokines(8.6%forIFN-γand11.4%forIL-2)werelowerthanthoseoftype2cytokines(71.4%forIL-4,60%forIL-6and80%forIL-10)inpatients'PBMCs.Thepotentialofgeneexpressing(measuredasrelativeintensitytotheratioofβ-actin)inthepatientsfortype1cytokineswasalsoinalowlevel(0.111forIFN-γ,0.119forIL-2)incomparisonwitharelativehighlevelfortype2cytokines(0.319forIL-4,0.303forIL-6and0.377forIL-10).Meanwhile,bothpositivepercentageandrelativeintensityofgeneexpressionwerelowerforatype1cytokine-relatedtranscriptionfactorT-bet(31.4%and0.142,respectively)thanthosefortype2cytokine-relatedGATA3(85.7%and0.378,respectively).ThebloodserumlevelsofIFN-γandIL-2inthepatientswereslightlylowerbutnotsignificantlywhencomparedwithhealthycontrol.Incontrast,thelevelsIL-4andIL-6inpatientsweresignificantlyhigherthanthoseinhealthysubjectsbyELISAanalysis.TTMPcouldenhancesupernatantconcentrationandgeneexpressionlevelsofIFN-γ,IL-2andT-bet,butreducedthoseoftype2cytokines.Theseresultsdemonstratethatthelungcancerpatientshadapredominantexpressionoftype2cytokinesandTTMPcouldreversethetype2dominantstatus,whichmightofferanalternativetherapeuticregimeforlungcancerpatients.Cellular&MolecularImmunology.2004;1(1):63-70.

简介：AbstractObjective:Second-generation antipsychotics are widely used in mental illness, but the treatment effects and side effects are affected by single nucleotide polymorphisms (SNPs) of related genes. Quetiapine and aripiprazole are two frequently used secondgeneration antipsychotic drugs. The aim of this study was to develop two different SNP detection methods for four SNP alleles associated with the pharmacokinetics of quetiapine and aripiprazole, based on high-resolution melting (HRM) and multicolor melting curve assay (MMCA) respectively.Methods:Whole genome DNA samples were obtained from 240 healthy people (107 females and 133 males) without genetic diseases. HRM methods were established using four kinds of specific primers and a saturated fluorescent dye. Each SNP allele with their own primers was detected in a single reaction. In the MMCA method, a multiplex polymerase chain reaction with 4 different-colored fluorescent probes was established to detect four SNP alleles in a single reaction. All experimental protocols were approved by the Ethics Committee of the Shanghai Children’s Medical Center, China (SCMC-201015) on November 22, 2010.Results:Two detection methods for the pharmacogenomics of quetiapine and aripiprazole, based on HRM and MMCA respectively, were established in this study. The single-target HRM method can be completed in 96 minutes, whereas the quadruplex MMCA method takes 133 minutes. It was found that the results of HRM and MMCA for the four SNP alleles had 100% coincidence with Sanger sequencing in the 240 samples.Conclusion:This study developed two methods for the detection of four pharmacogenomic SNP alleles that correlated with quetiapine and aripiprazole. Both methods are rapid, cost-saving, highly accurate and potentially facilitate rational use of second-generation antipsychotics for clinical medication.

简介：总结了52例长途转运危重患者合并呼吸衰竭使用O-two呼吸机进行救治的护理措施。主要包括转运前的准备和转运途中的护理,认为转运前做好充分的准备、途中保持患者的呼吸道通畅、严密观察呼吸机运转及患者的病情变化等措施是长途转运危重患者的安全保障。

简介：Twonewfuranfragmentisomerizedlimonoids,meliazedalidesAandB(compounds1and2),wereisolatedfromthefruitsofMeliaazedarachLinn..TheirchemicalstructureswereelucidatedonthebasisofHR-ESI-MSand1Dand2DNMRdata,whichbelongedtonimbolinin-andtrichilin-class,respectively.Compound2exhibitedweakinhibitoryeffectonNOproductioninlipopolysaccharide(LPS)-activatedRAW264.7macrophageswithIC50being37.41μmol·L^-1.

简介：ThepresentstudywasdesignedtoisolateandcharacterizetheanalgesiccompoundsofArtemisasacrorumLedeb.TheEtOAccrudeextractsfromtheaerialpartsofArtemisasacrorumLedebwereseparatedbychromatographyandthestructuresofnewcompoundswereelucidatedbasedonspectralanalyses.Analgesicactivitiesoftheisolatedcompoundswereassessedinratswithhotplatetestandpawpressureassay.TwonewflavoneC-glycosides,namedasSacrorosideAandB(Compounds1and2)wereisolatedfromtheEtOAccrudeextractoftheaerialpartsofArtemisasacrorumLedeb.Theyshowedsignificantanalgesiceffects.Inconclusion,Compounds1and2arenewnaturalproducts,whichshowsignificantanalgesiceffectsinadose-dependentmanner.

简介：Objective:Toinvestigatetheeffectoftwoantisenseoligonucleotidesoncellsurviving,bcl-2expressionandapoptosisofleukemiacells.Methods:Theexperimentalassayswereperformedwithcellculture,immunochemistryandflowcytometry.Results:Thetwoantisenseoligodeoxynucleotides,combinedwithVp16orAra-corDNR,wereabletodeclinethesurvivalrateofmyeleukemiccells,downregulatebcl-2geneexpressionandinduceapoptosisofleukemiccellssignificantly,ascomparedwithVp16orAra-corDNRalone.Conclusion:Itispossibleforthetwonewbcl-2antisensestobedevelopedintoclinicaltrialsforleukemiaandtumorwithbcl-2geneoverexpression.

简介：

简介：Intradiploicepidermoidcysts,fairlyuncommonlesionsinneurosurgicalpractice,are,asarule,benignandslow-growing.Somemayattaingreatsize.Correctradiologicalassessmentandcompleteremovalofthetumoranditscapsuleareessentialforadequatesurgicaltreatmentandgoodlong-termprognosis.Wereporttwocasesofintradiploicepidermoidcystsoftheskull,withgiantandCT-hyperdenselesionswithextraandintracranialextension,andanalyzetheclinicopathologicalandimagingfeaturesandtreatmentoftheselesionsinthelightofthemostimportantpublisheddata.

简介：AbstractObjective:Biallelic mutations in the RecQ like helicase (RECQL) 4 gene, a guardian of the genome, cause Rothmund-Thomson syndrome type II (RTS-II). Two Chinese girls with mild-phenotype RTS-II mainly restricted to their skin are herein described.Methods:Blood specimens from two families with mild-phenotype RTS-II were collected. DNA isolation, RNA isolation and complementary DNA synthesis, and next-generation sequencing using a multi-gene panel were applied to verify the underlying pathogenic variants in the causative RECQL4 gene.Results:We analyzed two patients with mild phenotypes. One patient had an unreported paternal c.2885+1G>A alteration in intervening sequence 16 and the previously reported maternal exon 14 c.2272C>T (p.R758X), both resulting in premature termination codons. The other patient carried two novel alterations, c.2886-1G>A and c.2752G>T (p.E918X). Complementary DNA sequencing showed that different splice-site mutations within the same intron could lead to completely different splicing modes.Conclusion:We identified three novel pathogenic RECQL4 variants in two patients with RTS, thus expanding the mutational spectrum of RTS-II. We also explored their pathogenic effect by transcripts analysis to address genotype-phenotype correlations.

简介：AbstractBackground:IgG4-related hypertrophic pachymeningitis is a relative newly recognized and rare manifestation of IgG4-related disease, an immune-mediated fibroinflammatory tumefactive disorder. Fewer than 80 patients have been reported in the literature, and it can mimic common neurosurgical conditions. We describe the clinical presentation of two patients that were initially considered to have a subdural collection, tuberculous meningitis, and a cervical spinal meningioma, but were eventually diagnosed with this disease.Case presentation:Two ethnic Chinese men, 86 and 62 years old, experienced a 4-week history of headache. Both patients had a history of autoimmune disease, namely glomerulonephritis and Grave's disease, respectively. Magnetic resonance brain imaging revealed diffuse dural thickening with the latter patient exhibiting homogeneous and intense gadolinium-contrast enhancement. Since the 86-year-old patient also had progressive bilateral visual loss, giant cell arteritis was suspected and a 2-week course of glucocorticoid therapy was prescribed, but his symptoms failed to improve. The 62-year-old patient also had accompanying low-grade fever and was treated empirically as having tuberculous meningitis although there were no confirmatory microbiological findings. This patient further developed right hemiparesis, and additional imaging revealed a C4/5 intradural-extramedullary contrast-enhancing lesion resembling a meningioma causing cord compression. Both patients underwent neurosurgical intervention with the former undergoing a dural biopsy and the latter having the cervical lesion resected. The final diagnosis was IgG4-related hypertrophic pachymeningitis with the hallmark histological features of lymphoplasmacytic infiltration of IgG4+ plasma cells, storiform fibrosis, and obliterative phlebitis. In addition, their serum IgG4 levels were elevated (i.e., > 135 mg/dL). Both patients received at least 6 months of glucocorticoid therapy while the latter also had azathioprine. Their symptoms improved significantly and recurrent lesions were not detected on follow-up imaging.Conclusions:A high index of suspicion for this condition is suggested when a male patient with a history of autoimmune disease and compatible radiological findings, experiences subacute headache that is disproportionate to the degree of dural involvement. Neurosurgeons should consider early meningeal biopsy to establish a definitive histological diagnosis in order for early effective immunosuppressive treatment to be initiated and to avoid unnecessary morbidity.

简介：AbstractImportance:There are a variety of musculoskeletal malformations and injuries that can occur in newborns. These can be a significant cause of perinatal death or a reason for miscarriage and can lead to long-term functional issues if not managed appropriately. There is no systematic and well-established screening program for neonatal musculoskeletal malformations and injuries in China now.Objective:To report the incidence and types of congenital musculoskeletal malformations in two hospitals in Shenzhen City, to explore and discuss the details of the screening procedure and improve future prevention and treatment.Methods:From October 2013 to May 2014, 2564 one-day-old newborns were screened by a pediatric orthopedic physical examination, in combination with ultrasonography when required, and the incidence and variety of diseases were recorded statistically.Results:Among 2564 screened newborns, the following musculoskeletal conditions were identified: congenital muscular torticollis (CMT) (seven cases, 0.27%), hip subluxation (four cases, 0.16%), hip dysplasia (47 cases, 1.83%), congenital talipes equinovarus (CTEV) (two cases, 0.08%), congenital talipes calcaneovalgus (15 cases, 0.58%), polydactyly (nine cases, 0.35%), syndactyly (one case, 0.04%), and spinal hemivertebra (one case, 0.04%). Additionally, there were five (0.19%) neonates with birth injuries.Interpretation:It is feasible to carry out neonatal screening and identification of musculoskeletal malformations and birth injuries in China. This is helpful as timely detection and early intervention for many of these conditions can avoid permanent functional impairment in these children.

简介：长期的subduralhematoma(CSDH)和蛛网状的包囊(交流)的协会是不平常的。我们报导了2个少年运动员，CSDH与在他们的每日的运动活动发生了并且考察了文学的交流联系了。他们俩通过手术被对待，与令人满意的结果。交流是在有CSDH的年轻病人的一个普通预先安排因素。intracranial流血的复杂并发症是为外科的管理的一个指示。尽管仍然在无征状的交流的治疗有争吵，有交流的病人应该避免强烈运动以便减少intracranial的发生，这是一致出血源于头损害。

简介：Antifungaldrugresistanceisasignificantclinicalproblem,andantifungalagentsthatcanevaderesistanceareurgentlyneeded.Ininfectiveniches,resistantorganismsoftenco-existedwithsensitiveones,orasubpopulationofantibiotic-susceptibleorganismsmayevolveintoresistantonesduringantibiotictreatmentandeventuallydominatethewholepopulation.Inthisstudy,weestablishedaco-cultureassayinwhichanazole-resistantCandidaalbicansstrainwasmixedwithasusceptiblestrainlabeledwithgreenfluorescentproteintomimicinvivoconditionsandscreenforantifungaldrugs.Fluconazolewasusedasapositivecontroltoverifythevalidityofthisco-cultureassay.FivenaturalmoleculesexhibitedantifungalactivityagainstbothsusceptibleandresistantC.albicans.Twoofthesecompounds,retigericacidB(RAB)andriccardinD(RD),preferentiallyinhibitedC.albicansstrainsinwhichtheeffluxpumpMDR1wasactivated.Thisselectivitywasattributedtogreaterintracellularaccumulationofthedrugsintheresistantstrains.Changesinsterolandlipidcompositionswereobservedintheresistantstrainscomparedtothesusceptiblestrain,andmightincreasecellpermeabilitytoRABandRD.Inaddition,RABandRDinterferedwiththesterolpathway,furtheraggregatingthedecreaseinergosterolinthesterolsynthesispathwayintheMDR1-activatedstrains.Ourfindingshereprovideanalternativeforcombatingresistantpathogenicfungi.

简介：Poriacocos(Schw.)Wolf,animportantmedicinalandfoodfungus,iswellknowninEastAsia.Duetogrowingmarketdemand,longcultivationperiod,andconsumptionofpinetrunkduringcultivation,developingalternativemethodsforproducingP.cocosand/oritsactivecomponentsisofinterest.Inthepresentstudy,theeffectsofdifferentculturemethodsonbiomassandaccumulationoffourtriterpenoidswereinvestigated.Theethanolextractoffermentedmycelium(EFM)wasorallyadministeredtorats.Urineoutputandconcentrationsofelectrolytes(Na~+,K~+,andCl~-)weremeasured.Ourresultsshowedthatmyceliagrewbetterundercontinuousshakingculturecondition(7.5gDW·L~(-1)),andhighertriterpenoidlevelswereaccumulatedintwo-stageculture(112mg·L-1,2.03%).Theoptimalstartingtimeofstaticculturefortriterpenoidyieldwas4~(th)daftershakingculture.SingleadministrationofmiddleandhighdoseofEFMsignificantlyincreasedurineoutput,Na~+andCl~-excretion,andNa~+/K~+ratio.Theseresultssuggestedthatethanolextractofculturedmyceliashowedsignificantdiureticactivityinratsandtwo-stagecultureofP.cocoscouldbeanalternativewaytoproducemyceliaandtriterpenoids.

简介：AbstractBackground:Extra-corporeal video telescope operating monitor system provides a necessary instrument to perform high-precision neurosurgical procedures that could substitute or supplement the traditional surgical microscope. The present study was designed to evaluate a compact high-definition two-dimensional exoscope system for assisting in surgical removal of large vestibular schwannoma (VS), as an alternative to a binocular surgical microscope.Methods:Patients with Koos grade 3 and grade 4 VS undergoing surgery were enrolled in this prospective cohort study between January 2013 and June 2018. The demographics and tumor characteristics (size, Koos grade, composition [cystic or solid mass]) were matched between the two groups of patients. The following outcome measurements were compared between the two groups: duration of surgery, volume of blood loss, extent of tumor resection, number of operating field adjustments, pre- and post-operative facial and cochlear nerve function evaluated at 3 months post-surgery, complications and surgeons’ comfortability.Results:A total of 81 patients received tumor resection through the retrosigmoid approach under either an exoscope (cases, n = 39) or a surgical microscope (control, n = 42). Patients in the two groups had comparable tumor location (P = 0.439), Koos grading (P = 0.867), and composition (P = 0.891). While no significant differences in the duration of surgery (P = 0.172), extent of tumor resection (P = 0.858), facial function (P = 0.838), and hearing ability (P = 1.000), patients operated on under an exoscope had less blood loss (P = 0.036) and a fewer field adjustments (P < 0.001). Both primary and assistant surgeons reported a high level of comfort operating under the exoscope (P = 0.001 and P < 0.001, respectively).Conclusions:The compact high-definition two-dimensional exoscope system provides a safe and efficient means to assist in removing large VSs, as compared to a surgical microscope. After the acquaintance with a visual perception through a dynamic hint and stereoscopically viewing corresponding to the motion parallax, the exoscope system provided a comfortable, high-resolution visualization without compromising operational efficiency and patient safety.

简介：二微米(铥)前列腺橘子技术(TmLRP-TT)的激光切除术是使用铥激光纤维把的一个经尿道的过程整个prostatic脑叶离开外科的囊，类似于剥一个橘子。我们最近报导了主要结果。这里，我们详细介绍这个过程。A70-W，2-m(铥)激光在连续波浪的模式被使用。我们由用verumontanum的水平做一个横向的伤口到膀胱颈加入了切口，使切除术足够地深到达外科的囊，和resected前列腺进小片，就像剥一个橘子一样。作为我们resected前列腺，片被蒸发，足够地小没被要求通过机械织物morcellator的resectoscope鞘，和使用被撤离。铥激光的优秀hemostasis保证了TmLRP-TT的安全。没有耐心的要求的输血。盐的灌溉intraoperatively被使用，并且经尿道的切除术症候群的案例都没被观察。膀胱插头阻塞清楚地在所有情况中在导管移动以后解决了。我们设计了橘子技术并且证明了它是为在良性的prostatic增生(BPH)的治疗的铥激光的使用的最合适的过程。这个过程，比标准技术花不太起作用的时间，是安全的并且联合有效的切和快速的器官的蒸发，从而在BPH的治疗显示出铥纤维激光的大优势。在1年的后续期间同样象前列腺(TURP)的经尿道的切除术安全、有效被证明了。

简介：AIMTo报告角膜的营养障碍(液晶显示器)与二个变化，R124C和A546D联系了的格子的一个phenotypic变体家谱，在导致贝它的基因(TGFBI).METHODSA详细说明了的转变生长因素，眼睛的检查为一个液晶显示器家庭的所有参加者被参加。从每个参加者的外部血白血球被提取获得DNA。TGFBI基因的所有十七exons的聚合酶链反应(PCR)被执行。产品被定序并且分析。在从proband.RESULTSGenetic分析的右眼睛的渗透的keratoplasty证明proband和所有6个影响个人两个都在codon怀有异质接合的CGC到TGC变化以后，组织学的检查被执行124并且异质接合的GCC到在codon的GAC变化546TGFBI。任何一个100个控制题目和未受影响的家庭成员都不为这二个变化是积极的。眼睛的检查显示了多重refractile在在外部角膜的中央角膜和小小粒的存款的前面的基质的像格子的暗。存款与红显示是的刚果断然被染色在自然淀粉、位于主要观察的前面、中间的stroma.CONCLUSIONWe在TGFBI基因带了二个病原的变化(R124C和A546D)的一个新奇液晶显示器家庭。phenotypic特征与与相应单个变化联系的那些显然不同。结果表明尽管明确的变化是疾病的最重要的基因原因，一些不同修饰词等位基因可以影响显型。

简介：AbstractBackground:IgG4-related hypertrophic pachymeningitis is a relative newly recognized and rare manifestation of IgG4-related disease, an immune-mediated fibroinflammatory tumefactive disorder. Fewer than 80 patients have been reported in the literature, and it can mimic common neurosurgical conditions. We describe the clinical presentation of two patients that were initially considered to have a subdural collection, tuberculous meningitis, and a cervical spinal meningioma, but were eventually diagnosed with this disease.Case presentation:Two ethnic Chinese men, 86 and 62 years old, experienced a 4-week history of headache. Both patients had a history of autoimmune disease, namely glomerulonephritis and Grave's disease, respectively. Magnetic resonance brain imaging revealed diffuse dural thickening with the latter patient exhibiting homogeneous and intense gadolinium-contrast enhancement. Since the 86-year-old patient also had progressive bilateral visual loss, giant cell arteritis was suspected and a 2-week course of glucocorticoid therapy was prescribed, but his symptoms failed to improve. The 62-year-old patient also had accompanying low-grade fever and was treated empirically as having tuberculous meningitis although there were no confirmatory microbiological findings. This patient further developed right hemiparesis, and additional imaging revealed a C4/5 intradural-extramedullary contrast-enhancing lesion resembling a meningioma causing cord compression. Both patients underwent neurosurgical intervention with the former undergoing a dural biopsy and the latter having the cervical lesion resected. The final diagnosis was IgG4-related hypertrophic pachymeningitis with the hallmark histological features of lymphoplasmacytic infiltration of IgG4+ plasma cells, storiform fibrosis, and obliterative phlebitis. In addition, their serum IgG4 levels were elevated (i.e., > 135 mg/dL). Both patients received at least 6 months of glucocorticoid therapy while the latter also had azathioprine. Their symptoms improved significantly and recurrent lesions were not detected on follow-up imaging.Conclusions:A high index of suspicion for this condition is suggested when a male patient with a history of autoimmune disease and compatible radiological findings, experiences subacute headache that is disproportionate to the degree of dural involvement. Neurosurgeons should consider early meningeal biopsy to establish a definitive histological diagnosis in order for early effective immunosuppressive treatment to be initiated and to avoid unnecessary morbidity.

简介：AbstractPurpose:Recurrent dislocation of shoulder (RDS) is a common injury in high demand professionals, like athletes and military personnel. The treatment for the patients with Bankart lesion is the arthroscopic repair. This present study compares the outcomes of two different techniques of arthroscopic Bankart repair i.e. a standard two anterior portals technique and a single anterior portal technique in patients with RDS.Methods:Patients with traumatic RDS met the inclusion criteria were managed with Bankart repair using either two anterior portals (Group A) or a single anterior portal (Group B) technique. Patients were evaluated before the intervention and at the mean follow-up of approximately two years using Rowe score, Oxford shoulder score and Tegner activity scale.Results:The mean age of the patients in Groups A (n = 34) and B (n = 37) was 29.64 years and 29.05 years respectively (p = 0.66). The dominant shoulder was involved in 27 patients in Group A and 22 patients in Group B (p = 0.069). The operative time in Group A and B was 68.52 min and 46.35 min, respectively (p < 0.001). The complications at follow-up, the mean Rowe score and Oxford score improved significantly in both groups compared with the pre-operative values. However, the final outcome scores were not significantly different between the both groups. The median Tegner's score preoperatively and at follow-up was 7 and 6, respectively in Groups A and B.Conclusions:Single anterior portal technique is an effective treatment modality, yielding a similar outcome as two anterior portals technique in the management of RDS.