Imaging and prognostic analysis in different molecular subtypes medulloblastoma / 临床儿科杂志

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.

A quantitative study on evaluation of child diffuse axonal injury severity by using MR diffusion tensor imaging / 重庆医学

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.

Study on the establishment of rat model of different degree of diffuse axonal injury / 重庆医学

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 .

Clinical characteristics of hospitalized severe acute respiratory illnesses (SARI) in children and risk factors analysis of severe illness: results from SARI patients under 15-year-old of sentinel surveillance in 10 cities, China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate clinical and epidemiological characteristics of hospitalized severe acute respiratory illnesses (SARI) patients under 15 years old registered by sentinel hospitals at 10 cities and risk factors analysis of severe illness.</p><p><b>METHODS</b>The objects of this study were 2 937 SARI patients under 15 years old registered by sentinel surveillance in internal wards, pediatrics wards and intensive care units (ICU) of 10 sentinel hospitals in 10 cities during the period from December 2009 to June 2014. We also collected case report form (CRF) of them and their throat swabs for influenza testing. The inclusion criteria was hospitalized patients who were admitted by surveillance departments, registered by SARI surveillance system, under 15 years old, meeting SARI case definition and with complete CRF. Rank-sum test was used to compare the difference of age, the duration including from onset to admission, hospital stay and from onset to discharging/death between mild illness and severe illness. Chi-square test was used to compare the difference of demographic characteristics, influenza psoitive rate, vaccination rate of influenza, chronic medical conditions and clinical characteristics between mild illness and severe illness. Logistic regression was used to analysis risk factors associated with severe illness by two stratifications from SARI surveillance protocol (< 2 years old and ≥ 2 years old).</p><p><b>RESULTS</b>Among 2 937 SARI patients under 15 years old, 97.7% (2 872/2 937) was mild illnesses, and 2.3% (65/2 937) was severe illnesses. 78.8% (2 315/2 937) was under 5 years old. The median ages of severe illness and mild illness were 0.4 and 2.0 years old (U = -6.23, P < 0.001). The proportions of severe illness and mild illness with at least one chronic medical condition were 32.3% (21/65) and 8.4% (240/2 872) (χ² = 45.03, P < 0.001). The positive rate of influenza virus was 6.5% (190/2 937), which was 6.5% (186/2 858) for mild illness and 6.2% (4/65) for severe illness (χ² = 0.08, P = 0.961). The proportion of seasonal influenza vaccination was 1.5% (42/2 853), which was 1.5% (42/2 788) for mild illness and higher than that for severe illness (0) (χ² = 6.09, P = 0.048). For under 2 years old patients, age < 11 months and with at least one chronic medical condition were risk factors for severe SARI illness, and the risk for SARI patients who was 12-23 months and without medical condition was 14.71 (5.35-40.44) and 5.61 (2.96-10.63). For ≥ 2 years old patients, age, with at least one chronic medical condition and seasonal influenza vaccination history have no association with severe illness, OR (95% CI) was 0.92 (0.80-1.05), 0.67 (0.09-5.05) and 0.85 (0.31-2.35), respectively.</p><p><b>CONCLUSION</b>Most of SARI patients registered by 10 urban sentinel hospitals were patients under 5 years old. Age < 11 months and with at least chronic medical conditions were possible risk factors of severe illness of SARI patients.</p>

Clinical characteristics of hospitalized cases of severe acute respiratory infection with laboratory-confirmed influenza and the risk factors analysis of influenza infection for children under 15 years old in ten provinces in China during 2009-2014 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To identify clinical characteristics of hospitalized laboratory-confirmed influenza cases of children under 15 years old, and their risk factors of influenza infection.</p><p><b>METHODS</b>Analyzing the reports of hospitalized laboratory-confirmed influenza cases of children under 15 years old who were detected by the sentinel surveillance systems in 10 provinces from December 2009 to June 2014. Such data as their demographic, medical history, clinical symptoms and signs, treatment and outcome were collected using questionnaires, with their clinical characteristics and their risk factors of influenza infection described.</p><p><b>RESULTS</b>Of the 2 937 severe acute respiratory infection inpatients, 190 (6.5%) were laboratory-confirmed influenza cases. 123 (64.7%) of such confirmed cases were male, and 139 (73.2%) were children under 5 years old, with age median of 3.0 years (IQR: 1.0-5.0 years). 20 (10.5%) of them had at least one chronic medical condition, mostly chronic cardiovascular disease (3.2%), immunosuppressive disease (3.2%), and cancer/tumor (2.6%). Most common clinical symptoms of the cases were fever (92.6%) and cough (88.8%), of which abnormal pulmonary auscultation (51.1%) and abnormal chest X-ray performance (36.1%) were the most common clinical signs. 29 cases (15.8%) had complications, of which pneumonia (15.3%) was most common. 16 cases (8.6%) used antiviral drugs, and 4 cases (2.2%) were admitted into ICU. Risk factor analysis suggested that age < 6 months (OR = 0.406, 95% CI: 0.203-0.815) was a protective factor against influenza infection; and age 5-9 years old (OR = 2.535, 95% CI: 1.059-6.066) was a risk factor for influenza infection.</p><p><b>CONCLUSION</b>Hospitalized laboratory-confirmed influenza cases were found mostly in children under 5 years old. Risk exposure for influenza infection varied among age groups.</p>

Management of obstructive hydrocephalus before posterior fossa tumor resection in children / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the management of obstructive hydrocephalus caused by posterior fossa tumors before tumor resection in children.</p><p><b>METHODS</b>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.</p><p><b>RESULTS</b>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.</p><p><b>CONCLUSION</b>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.</p>

Improvement of teaching methods of minimally invasive neurosurgery / 中华医学教育探索杂志

Minimally invasive neurosurgery techniques developing by leaps and bounds in the past few years,which is to be a great challenge for the clinical teaching of neurosurgery.Based on their own actual,neurosurgery department of the Children's hospital of Chongqing medical university enriched the teaching contents,improved teaching methods and trained microsurgical techniques for doctors at various levels,meanwhile,it strengthened participants'sterile awareness,set good team spirit,developed individualized assessment standards and achieved good results.

Treatment of acute traumatic subdural hematomas in infants / 中华创伤杂志

Objective To investigate the clinical features of acute traumatic subdural hematomas (SDH) in infants and discuss the treatment methods. Methods The clinical features of 48 infants under three years old with acute traumatic SDH admitted from 2002 to 2008 were retrospectively analyzed.Results There were 31 infants under one year old (65%). The most popular injury cause was accidental fall in 37 patients (77%). Of all patients, 12 patients (25%) had disturbance of consciousness,eight ( 17% ) had convulsion and eight ( 17% ) were combined with skull fractures. The treatment methods included craniotomy and evacuation of the blood clot in 18 patients ( including 13 patients underwent instant operation after admission ), burr hole craniotomy and external drainage of the chronic subdural hematoma in seven and conservative management in 23 with small subdural hematomas. All patients obtained good outcome except that two patients had motor dysfunction and one death. Conclusions The incidence of acute traumatic SDH in infants is high, especially in infants under one year old. It is easy to be disregarded at early stage and may deteriorate to chronic subdural hematoma or hydropsy. Early diagnosis and active surgical treatment may attain sound prognosis.

Isolation methods and biological characteristics of bone marrow mesenchymal stem cells / 中国组织工程研究

BACKGROUND:Bone marrow mesenchymal stem cells(BMSCs)have the properties involving high proliferation capability,widely distribution,functional tissue repair after injury,as well as immune modulation,by which bring us extensive therapeutic possibilities.There are plenty of methods for isolation of BMSCs,yet,BMSCs exhibit discrepancies in varied growth stage and culture conditions.Up to now,there has been no agreement about the identification methods for cultured BMSCs.OBJECTIVE:To review the isolation methods and biological characteristics of BMSCs,and to compare the differential expression of BMSCs between in serum and serum-free medium,prior to and after proliferation,as well as before and after induction.METHODS:A computer-based online search was performed using key words of "bone marrow mesenchymal stem cells,isolation,culture,induce,marker,and characterization" to find documents published in the database of CNKI (http://dlib.cnki.net/kns50/)or Pubmed(http://www.ncbi.nlm.nih.gov/PubMed)from January 2003 to June 2009.The languages were limited Chinese and English.A total of 237 literatures were searched by the computer.RESULTS AND CONCLUSION:The positive rates of CD44 and CD34 of BMSCs isolated by the whole bone marrow culture were smaller than that of the density gradient centrifugation.However,BMSCs isolated by the whole bone marrow culture were superior to those isolated by the density gradient centrifugation in cell viability,proliferation rate,confluence time,as well as generation time.Other methods for BMSCs isolation had drawbacks of large cost and high requirement of experimental equipments.Following conditions were used to identify BMSCs:cell adherence,cell surface molecule labeling,strong self-proliferation ability,as well as potentials multi-directional differentiation.BMSCs exhibit differential expression between in serum and serum-free medium,prior to and after proliferation,as well as before and after induction.

The protective effect of ginkgetin in impairment to testicular toxicity by cyclophosphamide / 重庆医科大学学报

Objective:To investigate the protective effect of ginkgetin from oxidative stress on immature testis induced by cyclophosphamide(CP) metabolite acrolein(ACR) in vitro.Methods:The sertoli cells were isolated from 7-days old SD rats' testes,culture and passage to F2 generations.Experiment groups were divided into: 1)Ginkgetin incubated for 12 hours and then treat with ACR 2) Ginkgetin and ACR add to cells at the same time 3) Ginkgetin and ACR were incubated for 12 hours,then add to cells.Control group include: 1) Vitamin E were incubated cells for 12 hours,then add ACR respectively 2) Added ACR only as the negative control group 3) Not add any factors as the positive control group.3 h later the viability of sertoli cell were determined by MTT.Protein concentration was determinate by Coomassie Brilliant Blue.Malondialdehyde(MDA),hydroxyl radical(OH ?),total antioxidant capacity(T-ACO),Superoxide dismutase(SOD) and glutathione reductase(GR) activity were tested.Results:1) Ginkgetin(add before ACR) can significantly raise the viability of the cells(P