Self-assessment of COVID-19 vaccination efficacy using a simple POCT for SARS-CoV-2 S1 protein antibody IgG-IgM

BackgroundMore than ten novel COVID-19 vaccines have been approved with protections against SARS-CoV-2 infections ranges between 52-95%. It is of great interest to the vaccinees who have received the COVID-19 vaccines, vaccine developers and authorities to identify the non-responders in a timely manner so intervention can take place by either giving additional boosts of the same vaccine or switching to a different vaccine to improve the protection against the SARS-CoV-2 infections. A robust correlation was seen between binding antibody titer and efficacy (p=0.93) in the clinic studies of 7 COVID-19 vaccines, so it is of urgency to develop a simple POCT for vaccinees to self-assess their immune response at home. MethodsUsing CHO cell-expressed full length SARS-CoV2 S1 protein as coating antigen on colloidal gold particles, a SARS-CoV-2 S1 IgG-IgM antibody lateral flow test kit (POCT) was developed. The test was validated with negative human sera collected prior to the COVID-19 outbreaks, and blood samples from human subjects prior, during, and post-immunization of COVID-19 vaccines. ResultsThe specificity of the POCT was 99.0%, as examined against 947 normal human sera and 20 whole blood samples collected pre-immunization. The limit of detection was 50 IU/mL of pseudovirus neutralizing titer (PVNT) using human anti-SARS-2 neutralizing standards from convalescent sera. The sensitivity of POCT for SARS-CoV-2 S1 protein antibody IgG-IgM was compared with SARS-CoV-2 RBD antibody ELISA and determined to be 100% using 23 blood samples from vaccinated human subjects and 10 samples from non-vaccinated ones. Whole blood samples were collected from 119 human subjects (ages between 22-61 years) prior to, during, and post-vaccination of five different COVID-19 vaccines. Among them, 115 people tested positive for SARS-CoV-2 S1 antibodies (showing positive at least once) and 4 people tested negative (tested negative at least twice on different days), demonstrating 96.64% of seroconversion after full-vaccination. 92.3% (36/39) of the human subjects who were younger than 45 achieved seroconversion within 2 weeks while only 57.1% (4/7) of subjects older than 45 tested positive for S1 antibodies, suggesting that younger people develop protection much faster than older ones. Even though the S1 antibody level in 88% of human subjects vaccinated with inactivated virus dropped below 50 IU/mL two months later, one boost could quickly raise the S1 antibody titer above 50 IU/mL of PVNT, indicates that the initial vaccination was successful and immunization memory was developed. ConclusionUsing the lateral flow tests of SARS-CoV2 S1 IgG+IgM, vaccinated human subjects can easily self-assess the efficacy of their vaccination at home. The vaccine developer could quickly identify those non-responders and give them an additional boost to improve the efficacy of their vaccines. Vaccinees who failed in response could switch to different types of COVID-19 vaccines since there are more than 10 COVID-19 vaccines approved using three different platform technologies. HighlightsO_LIMore than ten novel COVID-19 vaccines have been approved with protections against SARS-CoV-2 infections ranges between 52-95%. It is of great interest to the vaccinees who have received the COVID-19 vaccines, vaccine developers and authorities to identify the non-responders in a timely manner. C_LIO_LIA highly specific and very simple lateral flow test kit for measurement of SARS-CoV-2 S1IgG+IgM antibodies post-immunization of COVID-19 vaccine using peripheral blood was developed as a home-test assay with a limit of detection (LOD) at 50 IU/mL of pseudovirus neutralizing titer (PVNT). C_LIO_LIAfter full vaccinations with COVID-19 vaccines, 96.6% of the volunteers successfully achieved the seroconversion of SARS-CoV-2 S1 IgG+IgM antibody. C_LIO_LI92.3% (36/39) of the human subjects who were younger than 45 achieved seroconversion within 2 weeks while only 57.1% (4/7) of subjects older than 45 tested positive for S1 antibodies, suggesting that younger people develop protection much faster than older ones. C_LIO_LIEven though the S1 antibody level in 88% of human subjects vaccinated with inactivated virus dropped below the detection 2-6 months later, one boost could quickly raise the S1 antibody titer above 50 IU/mL of PVNT, indicating that the initial vaccination was successful and immunization memory was developed. C_LI

Improvement and Optimization of Quality Standard for Qiangli Pipa Distillate Formula / 中国药师

Objective: To improve the quality standard for Qiangli Pipa distillate formula. Methods: The chemical reactions for i-dentification in the old standard were deleted. TLC methods were established to identify Papaveris pericarpium, Eriobotryae folium and Platycodonis radix. The contents of morphine and codeine phosphate from Papaveris pericarpium were determined by HPLC. The chro-matographic conditions for morphine content determination were as follows: an Inertsil ODS-3 chromatographic column (250 mm × 4. 6 mm, 5 μ m ) was used, the mobile phase was acetonitrile-the mixture of 0. 01 mol·L-1sodium heptane sulfonate and 0. 02 mol ·L-1potassium dihydrogen phosphate with equal amount (10% phosphoric acid was used to adjust pH to 2. 8) ( 13: 87 ), the detec-tion wavelength was 220 nm ,the column temperature was 30 ℃, and the flow rate was 1. 0 ml·min-1. The chromatographic condi-tions for codeine phosphate content determination were as follows : an Inertsil ODS-3 chromatographic column (250 mm×4. 6 mm, 5 μ m ) was used, the mobile phase was acetonitrile-the mixture of 0. 01 mol·L-1sodium heptane sulfonate and 0. 02 mol·L-1s potas-sium dihydrogen phosphate with equal amount (10% phosphoric acid was used to adjust pH to 2. 8) ( 15: 85 ), the detection wave-length was 220 nm, the column temperature was 30 ℃, and the flow rate was 1. 0 ml·min-1. Results: TLC had obvious characteris-tics with clear and well-separated spots. Morphine showed a good linear relationship within the range of 3. 14-62. 8 μg·ml-1( r=1. 000 0) with the average recovery of 96. 69% (RSD=2. 41% , n=9). Codeine phosphate showed a good linear relationship within the range of 3. 52-87. 94 μg·ml-1(r=1. 000 0) with the average recovery of 95. 68% (RSD=2. 64% , n=9). Conclusion: The quality standard for Qiangli Pipa distillate formula is improved. The methods are easy-operated and accurate with good specificity, which are suitable for the quality control of Qiangli Pipa distillate formula.

Qualitative and quantitative study of Shengui anti-pruritic mixture / 国际中医中药杂志

Objective To study the qualitative and quantitative standard of Shengui anti-pruritic mixture. Mehtods Sophorae Flavescentis Radix, Cnidii Fructus, Polygoni Multiflori Radix, Astragali Radix, Paeoniae Radix Alba and Glycyrrhizae Radix Et Rhizoma were identified by TLC.The contents of matrine and ferulic acid were determined by HPLC. Results The TLC showed the obvious characteristics with the spots clear and well-separated with no interference by negative control. Matrine showed a good linear relationship at 0.062 5- 2.500 0 μg (r=0.999 9) with a good meeting of adding sample recovery test. Ferulic acid showed a good linear relationship at 0.021 0-0.840 0 μg (r=0.999 9) with a good meeting of adding sample recovery test. Conclusions The method is easy-operated and accurate which showed a good specificity for the quality control of Shengui anti-pruritic mixture.

Shorter Telomere Length Is Associated with Increased Breast Cancer Risk in a Chinese Han Population: A Case-Control Analysis / 한국유방암학회지

PURPOSE: The aim of this study was to investigate the association of telomere length with breast cancer risk. We simultaneously explored the association between telomerase reverse transcriptase gene polymorphisms and telomere length. METHODS: We used real-time quantitative polymerase chain reaction to measure relative telomere length (RTL) in genomic DNA extracted from peripheral blood from 183 breast cancer cases and 191 healthy controls. Genotyping was performed using the Sequenom MassARRAY platform. RESULTS: Our results show that breast cancer patients had significantly shorter RTLs than control subjects (p 40 years (OR, 2.41; 95% CI, 1.31–4.43; p=0.005), body mass index ≤24 kg/m2 (OR, 2.81; 95% CI, 1.55–5.10; p=0.001), and postmenopausal women (OR, 3.94; 95% CI, 1.63–9.51; p=0.002), respectively. In addition, individuals with the AA genotype of rs2853677 have longer telomeres than those of breast cancer patients with the AG genotype (p=0.011). CONCLUSION: Our results suggest that shorter RTL was associated with an increased risk of breast cancer. An association was found between the AA genotype of rs2853677 and longer RTLs in the case group. Functional studies are warranted to validate this association and further investigate our findings.

Impaired Na⁺−K⁺-ATPase signaling in renal proximal tubule contributes to hyperuricemia-induced renal tubular injury

Hyperuricemia contributes to renal inflammation. We aimed to investigate the role of Na⁺–K⁺–ATPase (NKA) in hyperuricemia-induced renal tubular injury. Human primary proximal tubular epithelial cells (PTECs) were incubated with uric acid (UA) at increasing doses or for increasing lengths of time. PTECs were then stimulated by pre-incubation with an NKA α1 expression vector or small interfering RNA before UA (100 μg ml⁻¹, 48 h) stimulation. Hyperuricemic rats were induced by gastric oxonic acid and treated with febuxostat (Feb). ATP levels, the activity of NKA and expression of its α1 subunit, Src, NOD-like receptor pyrin domain-containing protein 3 (NLRP3) and interleukin 1β (IL-1β) were measured both in vitro and in vivo. Beginning at concentrations of 100 μg ml−1, UA started to dose-dependently reduce NKA activity. UA at a concentration of 100 μg ml⁻¹ time-dependently affected the NKA activity, with the maximal increased NKA activity at 24 h, but the activity started to decrease after 48 h. This inhibitory effect of UA on NKA activity at 48 h was in addition to a decrease in NKA α1 expression in the cell membrane, but an increase in lysosomes. This process also involved the subsequent activation of Src kinase and NLRP3, promoting IL-1β processing. In hyperuricemic rats, renal cortex NKA activity and its α1 expression were upregulated at the 7th week and both decreased at the 10th week, accompanied with increased renal cortex expression of Src, NLRP3 and IL-1β. The UA levels were reduced and renal tubular injuries in hyperuricemic rats were alleviated in the Feb group. Our data suggested that the impairment of NKA and its consequent regulation of Src, NLRP3 and IL-1β in the renal proximal tubule contributed to hyperuricemia-induced renal tubular injury.

Changes of the peripheral blood cells in children with high-risk neuroblastoma after chemotherapy and factors related to severe infection / 上海交通大学学报（医学版）

Objective · To investigate the changes of neutrophils and lymphocytes during chemotherapy courses in children with high-risk neuroblastoma, as well as severe infection rate and its relationship with combination chemotherapy regimens in order to provide guidance to prevent infection in these children. Methods · A total of 45 cases of children with high-risk neuroblastoma, who were hospitalized in Xinhua Hospital from July 2012 to September 2015 were recruited. Reactions after chemotherapy and the results of routine blood tests on every 5 days during the whole chemotherapy circles were recorded. Follow-up visits were carried out to learn the infection occurrence. Results · The counts of neutrophils and lymphocytes dropped to the minimum at the 10th day or so during chemotherapy, then rised near the 15th day. Infections were negatively correlated with the numbers of neutrophils (r =-0.245) and lymphocytes (r=-0.227) at the 10th day. Persistent lymphopenia occured after the forth course of chemotherapy. Rate of grade Ⅳ bone marrow suppression after chemotherapy was 90%, and severe infection rate was 15.5%. There were significant differences in the rates of grade Ⅲ bone marrow suppression (P=0.008), grade Ⅳ bone marrow suppression (P=0.001) and severe infection (P=0.010) among the 3 combination chemotherapy regimens used in high-risk neuroblastoma children. Conclusion · Children with high-risk neuroblastoma had obviously high rates of bone marrow suppression and severe infection after chemotherapy, especially after cyclophosphamide+doxorubicin+vincristine regimens. More attention should be paid to this group of children and preventive measures were worthy of taking into account.

Establishment and Evaluation of Fingerprint Identification Pattern for Epimedium Pieces / 中国药师

Objective:To establish a comprehensive quality evaluation pattern for epimedium pieces to provide reference for the quality control. Methods:The overall quality of Epimedium brevicornu Maxim was evaluated through the establishment of a fingerprint identification mode to perform the bifunctional feedback to the fingerprint peaks. The chromatographic separation was carried out on an Agilent ZORBAX Eclipse XDB-C18 (150 mm × 4. 6 mm,5 μm) column with the mobile phase of acetonitrile and water with gradient e-lution. The flow rate was 1. 0 ml·min1 , and the column temperature was maintained at 30℃. Results:The HPLC fingerprint of Epi-medium brevicornu Maxim decoction pieces containing 16 common peaks was obtained. The marketed Epimedium brevicornu Maxim de-coction pieces were divided into two categories and the quality between them showed significant differences. Conclusion:The similarity of 11 batches of epimedium herbs used to establish the fingerprints shows notable different, and the different habitats and sampling time exhibit significant influence on the overall quality. The fingerprint pattern can effectively reflect the overall trend of quality of Chinese herbal pieces, which is suitable for comprehensive quality evaluation of traditional Chinese medicines with multiple components and their relative preparations.

Determination of Six Main Flavonoids in Herba Epimedii by Self Contrast with Correction Factor / 中国药师

Objective:To determine the content of six main flavonoids in herba epimedii by self contrast with correction factor. Methods:HPLC was carried out with reversed-phase technique on an Agilent ZORBAX Eclipse XDB-C18 (150 mm × 4. 6 mm, 5 μm) column with the mobile phase consisting of acetonitrile-water with gradient elution. The detection wavelength was 268nm and the col-umn temperature was 30℃. The correction factor was established through the increase value of chromatographic peak area for the self internal standard. The relative retention time and spectrum reference method were used to determine the position of impurities. Re-sults:The relative retention time of epimedin A1 , epimedin A, epimedin B, epimedin C and baohuoside I was 0. 750,0. 810,0. 865, 0. 939 and 1. 651, respectively. The correction factor of them was 0. 998 6, 0. 998 7, 0. 998 8, 0. 989 4 and 0. 985 6, respectively. Conclusion:The self contrast with correction factor can be use to quantitatively determine the components with the same kind of chem-istry environment. The method is simple, efficient and accurate in the quantitative analysis of multi components in Chinese medicines.

Role of miR-17 in human glioma U87 cells invasion by regulating MMP-2 expression / 军事医学

Objective To identify the role of microRNA-17(miR-17)in human glioma U87 cells invasion which may regulate expression of matriv metalloproteinase(MMP)-2.Methods U87 cells were cultured in vitro,while changes in cellular morphology were observed by phase contrast microscope.The miR-17 which might regulate the expression of MMP-2 was predicted by bioinformatics and identified using dual luciferase report system.Expressions of miR-17 and MMP-2 were determined using real-time PCR and Western blot after transfection of miR-17 mimics.The invasion of U87 cells was detected in vitro by Transwell chamber.Results Expression of MMP-2 was positive by immunofluorescence cytochemistry. Using dual luciferase reporter system,miR-17 could inhibit the expression of MMP-2 by binding to its mRNA 3′UTR. Results of real-time PCR and Western blot showed that over-expression of miR-17 down-regulated expression of MMP-2. The invasion of U87 cells was suppressed by over-expression of miR-17.Conclusion MiR-17 may negatively regulate expression of MMP-2 in human glioma U87 cells and inhibit cell invasion.

Real-time fluorescence polymerase chain reaction for detecting Legionella in sputum specimens of patients with pulmonary infection / 国际检验医学杂志

Objective To establish a real‐time fluorescent polymerase chain reaction and detect 16S rRNA gene of Legionella strains isolated from sputum specimens of patients with pulmonary infection by using this method .Methods 16s rRNA gene of Le‐gionella was used to design primers and probes .The reaction system and reaction conditions were optimized and the specificity ,sen‐sitivity and repeatability of this method were verified by detecting Legionella pneumophila ,non‐Legionella pneumophila and other bacteria .A total of 557 sputum specimens of patients with pulmonary infection were detected ,and PCR‐digestion identification method was carried out as control .Otherwise ,sequences of 16S rRNA were verified in patients with positive detection results .Re‐sults The results showed that all reference strains of Legionella were positive ,while all of other bacteria were negative ,and the sensitivity was 102 CFU/mL .Among sputum specimens collected from 577 cases of patients with pulmonary infection ,the positive rate of Legionella detected by using real‐time fluorescent PCR and PCR‐digestion identification method was 23 .1% and 19 .9% re‐spectively ,while the positive rate was 17 .2% by verifying the sequences of 16s rRNA .There were no statistically significant differ‐ences of positive rate among the three methods(P>0 .05) .Conclusion The real‐time fluorescent PCR is fast and convenient in de‐tection of Legionella strains isolated from sputum specimens of patients ,which could be an assisted method for clinically diagnosing Legionella infection .

Continuous observation of changes in renal function after radical nephrectomy / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate continuous change in renal function by various clinical factors after radical nephrectomy (RN).</p><p><b>METHODS</b>Patients after RN from January 2007 to December 2011 in the First Affiliated Hospital to Soochow University were enrolled, 356 cases continuously enrolled throughout the follow-up process, because of lost, missing data and other material reasons, 185 cases meet the requirements, eventually, including 121 male and 64 female patients, aged from 30 to 88 years (average age: (58 ± 12) years). There were 34 diabetes mellitus, 82 hypertension patients. Open surgery for 132 cases, laparoscopic surgery for 53 cases. Continuous checked serum creatinine at 3, 6, 9, 12, 24, 36, 48, 60, 72 months after RN and calculated to estimated glomerular filtration rate (eGFR) by Modification of Diet in Renal Disease equation.Linear mixed models were carried out to analyze postoperative continuous change in eGFR in multivariate regression analysis postoperative risk factors for changes in renal function.</p><p><b>RESULTS</b>Overall, there was a subsequent restoration of renal function over the follow-up period. The slope (β) for the relationship between the eGFR and the time since RN was 0.099 (95%CI:0.07-0.13, P < 0.01) indicating that each month after RN was associated with an increase in eGFR of 0.099 ml×min(-1)×(1.73 m(2))(-1)×month(-1). The slope (β) was different between the group with clinical factor and its reference group, but the difference in the next three groups with statistically significant after multivariate regression analysis:diabetic and non-diabetic mellitus patients with a slope (β) of -0.02 and 0.12 (P < 0.01) .Hypertension and non-hypertensive patients with a slope (β) of 0.08 and 0.11 (P < 0.05). Age ≤ 50 years, > 50-65 years and > 65 years patients with a slope (β) of 0.15,0.09 and 0.05 (P < 0.05), respectively. There were 13 new-onset of chronic kidney disease (CKD) after RN, including 9 patients with CKD III and 4 patients with CKD IV.</p><p><b>CONCLUSIONS</b>Renal function recover continuously during the follow-up period after RN. Preoperative predictors of an increase in eGFR after RN are young age, no diabetes mellitus, no hypertension.</p>

Clinical characteristics of severe pneumonia in children and the significance of neutrophil elastase detection / 实用医学杂志

Objective To study the clinical characteristics of severe pneumonia in children , to explore the significance of neutrophil elastase detection. Methods Patients were divided to severe pneumonia group and non-severe pneumonia group Fever, cough, lung wet rale duration and image changes were statistically analyzed. The percentage of abnormal lymphocyte in peripheral blood was counted by Wright's dyeing method. The neutrophil elastase expression in peripheral blood was determinated by enzyme-linked immunosorbent analysis. Results In severe pneumonia group,atelectasis occurred in 5 cases,8 cases complicated with heart failure, 8 cases complicated with respiratory failure and 4 cases were complicated with toxic encephalopathy. In severe pneumonia group , fever time was 13.5±5.1 days, cough time was 15.1±3.2 days, the time of lung wet rale duration was 12.2±2.3 days, which were significantly longer than that of non-severe pneumonia group (t = 2.346,2.457,2.346,P < 0.05);In severe pneumonia group , pathogens included streptococcus pneumoniae , respiratory syncytial virus and adenovirus , etc.In severe pneumonia group,the percentage of abnormal lymphocyte in peripheral blood smear increased with virus infection (8.1±1.2)%. In 12 cases of severe pneumonia,the expressions of neutrophil elastase were 127.6± 12.5 ng/ml, more than that of non-severe pneumonia group (75.4 ± 6.4 ng/ml,t=3.047, P<0.05). Conclusion Severe pneumonia is a serious diseases impacting children health. Detection of neutrophil elastase shows a markedly clinical value to judge the severity of pneumonia.

Percutaneous microballoon compression for trigeminal neuralgia using Dyna-CT.

Percutaneous microballoon compression (PMC) is a well-established technique for treatment of trigeminal neuralgia (TN). However, direct puncture of the foramen ovale (FO) is sometimes difficult and there have been well-reported complications from cannulating the FO. We describe our experiences in using Dyna-CT for cannulating the FO and determining balloon position and volume. Dyna-CT was used to perform image reconstruction in 21 cases. The optimal working projection was generated and further fluoroscopic data were used to determine the needle's relationship to the foramen during puncture. Furthermore, the balloon position and three-dimensional shape were verified by Dyna-CT during balloon compression. The balloon volume and puncture angle were further calculated. Patients' prognosis was further discussed. Dyna-CT allowed quick, safe, and easy cannulation of the FO. It provided three-dimensional images which were more elaborate than the classic 'pear-shaped' images for determining correct positioning in 21 cases. The volume of the flattened balloon ranged from 568.2 mm(3) to 891.4 mm(3) with an average of 775.9 mm(3). The angle of introducing the cannula ranged from 15.17°-35.48° rotation to the midline with an average of 26.24° and 38.47°-51.89° angulation to the Reid line with an average of 46.09°. All the patients were pain free after PMC. Four patients had resolvable masseter weakness and fine touch loss. There was no recurrence of TN during follow-up. Dyna-CT demonstrated three advantages in assisting PMC. Firstly, the FO can be better visualized irrespective of the patient's position. Secondly, needle correction or insertion can be performed much more easily because of the direct fluoroscopic control. Thirdly, the needle position, balloon position, balloon configuration and the volume of the inflated balloon are more reliably determined. The use of dyna-CT provided an assisted method to PMC with a low incidence of complications and good prognosis.

High-performance liquid chromatographic analysis of felotaxel, a novel anti-cancer drug, in rat plasma and in human plasma and urine.

A high-performance liquid chromatographic method was developed for the determination of a new derivative of docetaxel, felotaxel, in rat plasma and human plasma and urine. The separation of felotaxel was performed on a Dikma C18 column with 0.2% formic acid and acetonitrile (50:50) as the mobile phase. The flow rate was 0.8 mL/min and the column effluent was monitored by an ultraviolet detector set at 275 nm. The method was validated and found to be linear in the range of 5-1,000 ng/mL. The lower limit of quantification was 5 ng/mL based on 100 µL of plasma. The variations for intra-day and inter-day precision were less than 6.9%, and the accuracy values were between 87.3 and 107.4%. The extraction recoveries were more than 80.5%. These data confirm that the developed method has satisfactory sensitivity, accuracy and precision for the quantification of felotaxel in rat plasma and in human plasma and urine. The method was successfully applied to a pharmacokinetics study of felotaxel after intravenous doses of 5 mg/kg in rats.

Microsurgery techniques for insular glioma / 中南大学学报(医学版)

OBJECTIVE@#To explore the microsurgical techniques for insular glioma without damaging its surrounding normal structures.@*METHODS@#We retrospectively analyzed 54 patients with insular gliomas who underwent microsurgical operation by trans-syvian fissure approach between May, 2003 and August, 2008 in Xiangya Hospital. We discussed the techniques in the operation and summarized how to protect the key blood vessels, distinguish and protect the surrounding normal structures.@*RESULTS@#There were 36 complete removals,14 secondary complete removals, and 4 partial removals.Six patients had complications after the craniotomy who had temporal speech disorder (aphasia mostly began to recover about 10 days after the craniotomy),4 patients had opposite side paralysis worsening (3 recovered normally and 1 improved after 6 months),4 had light paralysis, and another 3 had paralysis and speech disorder.@*CONCLUSION@#The microsurgery by means of trans-syvian fissure approach can well expose the anatomical relation between tumor and its surrounding structures,so that we can remove the tumor and protect the surrounding normal tissues as much as we can.

The management of cerebrospinal fluid leakage after transsphenoidal surgical removal of pituitary adenomas / 中国医师进修杂志

Objective To evaluate the incidence and the causes of the intra-and postoperative cerebrospinal fluid(CSF)leakage during transsphenoidal surgical removal of pituitary adenomas,and discuss the sella closure methods.Method During the period from January 1998 to May 2008,118 patients underwent 134 transsphenoidal operations for pituitary adenomas.Two different methods to close the sella were used.The first one consisted packing the sella turcica and sphenoidal sinus with autologous fat and restoring the defect of sella turcica with autologous bone.In the second method,tht regenerated oxidized cellulose and collagen sponge with human fibrin were used to cover the seUa membrane defect and the dural defect,followed by packing the seHa with autologous fat.Proportions of each type of pituitary adenomas were analyzed.The frequency of the intra-and postoperative CSF leakage were evaluated in different type tumors and different operations.Data had been studied by statistical analysis.Results The incidence rate of intraoperative CSF leakage(26.5%,9/34)Was obviously increased in patients with growth homone adenoma compared with other type of adenoma(13.0%,13/100).Patients with invasive adenoma had an increased incidence rate of intraoperative CSF leakage(21.1%,8/38)compared with noninvasive adenoma(14.6%,14/96)(P＜0.05).When the descent of the sella turcica membrane Was visualized with tumor being totally removed,the incidence rate of intraoperative CSF leakage increased(18.7%,20/107)compared with when membrane descent was not seen with tumor remaining(7.4%,2/27)(P＜0.05).There were 3 cases postoperative CSF leakage happened in all 12 cases which adopted the first method. By the second method,there was no postoperative CSF leakage,and the number of postoperative complications was significantly smaller than the first method (10.0% and 33.3%,respectively). Conclusions The technique of covering the sella membrane and dural defects with oxidized cellulose and collagen sponge with human fibrin in the presence of intraoperative CSF leakage appears to be the most reliable,as no postoperative CSF leakage after applying this technique has been observed.

Transplantation of olfactory ensheathing cells for the treatment of obsolete spinal injury in 48 cases / 中国组织工程研究

BACKGROUND: Changing the local environment of spinal injury promotes the repair and regeneration of injured nerve and recovery of partial nervous function of spinal cord. Transplantation of olfactory ensheathing cells can improve the local internal environment of injured spinal cord.OBJECTIVE: To probe into the effect and safety of transplantation of olfactory ensheathing cells on functional repair of spinal cord and nerve in patients with obsolete spinal injury DESIGN: Self-control experiment.SETTING: Wards of the Department of Surgery, Taian Rongjun Hospital of Shandong Province.PARTICIPANTS: Totally 48 patients admitted for obsolete spinal injury in the Department of Surgery, Taian Rongjun Hospital, between June 2004 and July 2005 were recruited. There were 39 males and 9 females, aged 7 to 59 years with the mean of 36 years.METHODS: ①Cell culture: Olfactory bulb of aborted fetus was digested into single olfactory ensheathing cells, which were then cultured and puri fied for 1 to 2 weeks, and finally made into single cell suspension. ②Operation and cell transplantation: Under general anesthesia, the purified single cell suspension (about 0.05-0.20 mL) of olfactory ensheathing cells was injected into the corresponding spinal injury site through multiple points with home-made syringe of 0.45 mm in diameter. Stitches were taken out at postoperative 10 to 14 days. ③Evaluation of spinal function: Injury Scoring Standard made by American Spinal Injury Association (ASIA) was used for scoring, comparison and statistical analysis at postoperative 1 day and 2 weeks to 2 months. ④Spinal function of 48 patients was observed or followed up through telephone at postoperative 3 weeks to 1 year.MAIN OUTCOME MEASURES: Changes of postoperative sensory function of the patients. Changes of postoperative motor function of the patients. Changes of postoperative automatic nervous system of the patients.RESULTS: ①All the 48 patients had improvement in spinal function, and continued improved tendency was found in the observation and follow-up through telephone at postoperative 3 weeks to 1 year. ②Scoring by ASIA for sensory function was higher after operation than before operation (touch sensation: 56.9, 51.2, P ＜ 0.01; pain sensation: 55.2, 48.3, P ＜ 0.01). Sensory function was improved obviously at the lower shift of sensory level,generally more than 2 segments. ③Scoring by ASIA for motor function was higher after operation than before operation (44.8, 40.7, P ＜ 0.01), but the improvement was slow. ④Scoring by ASIA for automatic nervous system was higher after operation than before operation (18.0, 14.5, P ＜ 0.01); diaphoresis, increased enterokinesia and other automatic nervous system improved earliest.CONCLUSION: Transplantation of olfactory ensheathing cells promotes the spinal and neurofunctional recovery of patients with malignant spinal injury, and the therapeutic method is safe.