Preoperative diffusion-weighted imaging value of rectal cancer: preoperative T staging and correlations with histological T stage.

PURPOSE: To assess the ability of diffusion-weighted imaging (DWI) for evaluating T stage and correlation with histological T stage of rectal cancer. METHOD: The diagnostic accuracy, sensitivity, and specificity of T2WI and DWI combined with T2WI for T stage were evaluated. Mean tumor apparent diffusion coefficient (ADC) was compared with histological T stage. RESULT: There were no significant differences in the diagnostic accuracy, sensitivity, and specificity no matter what kind of T stage was concerned. The difference between ADC values and histological T stage were significantly different. CONCLUSION: DWI was useful for evaluating T stage of rectal cancer. The ADC may predict the histological grade.

Enzymatic hydrolysis optimization of Paphia undulata and lymphocyte proliferation activity of the isolated peptide fractions.

BACKGROUND: The immune system is important in preventing and controlling various infectious diseases. Immunoactive peptides derived from food proteins could exert immunomodulatory activity without side effects. Paphia undulata with high-protein is suitable for the production of immunoactive peptides. The objective of this study was to optimize the hydrolysis parameters to maximize the immune activity of hydrolysates from Paphia undulata. RESULTS: Hydrolysis parameters, including temperature, time and the ratio of alkaline protease to Paphia undulata meat (E/S), were optimized by response surface methodology with a central composite design. The optimum conditions were obtained as follows: temperature, 51 °C; time, 3.14 h; E/S, 4,321 U g(-1) (Paphia undulata meat). Furthermore, hydrolysates obtained under the optimum conditions were fractionated by ultrafiltration and gel filtration on a Sephadex G-25 column. After two-step isolation, the isolated fractions (P2 and P3) including the peptides Pro-His-Thr-Cys, Val-Gly-Try-Thr, Glu-Phe, Leu-Phe, and Glu-Gly-Ala-Lys, Trp-Ile or Trp-Leu, respectively, could significantly enhance lymphocyte proliferation ability. CONCLUSION: These results showed that response surface methodology and two-step separation were efficient for recovery of low-molecular-weight peptides with high spleen lymphocyte proliferation activity, and the isolated fractions of Paphia undulata hydrolysates are potential ingredients for development of functional foods.

[Application value of computed tomography dacryocystography in children lacrimal diseases].

OBJECTIVE: To explore the application value of computed tomography (CT) dacryocystography in children lacrimal diseases. METHODS: Retrospective case series. The results of CT dacryocystography in 300 children (395 eyes) with lacrimal diseases from October 2009 to October 2011 in Beijing Children Hospital were analyzed retrospectively. RESULTS: Among 240 children (326 eyes) with congenital nasolacrimal duct obstruction, the sites of obstruction were in the common canaliculus or upper position in 6 eyes (1.8%), in the lacrimal sac in 38 eyes (11.7%), at the borderline between lacrimal sac and nasolacrimal duct in 213 eyes (65.3%) and at the terminal of nasolacrimal duct in 69 eyes (21.2%). CT dacryocystography could display the obstruction position of lacrimal duct in congenital nasolacrimal duct obstruction. In unilateral congenital nasolacrimal duct obstruction, CT dacryocystography indicated that nasolacrimal canal in affected side were much larger than that in normal side. It could show the destruction of lacrimal soft tissue and the fossa of lacrimal sac in traumatic lacrimal duct obstruction. CT dacryocystography was also the main subsidiary method for the diagnosis of congenital dacryocystocele, congenital nasolacrimal canal agenesis and lacrimal sac diverticula. CONCLUSIONS: CT dacryocystography can provide important aspects for the diagnosis and treatment of children lacrimal diseases. Therefore, it can be used as an important image examination method in children with lacrimal diseases.

[Visual function of seven children with malignant osteopetrosis after hematopoietic stem cell transplantation].

OBJECTIVE: To detect long-term ocular alteration of children with malignant osteopetrosis after hematopoietic stem cell transplantation. METHODS: Children diagnosed as osteopetrosis from 5 months to 31 months underwent hematopoietic stem cell transplantation. Computed tomography of optic canal, FVEP, ERG and fundus examination were applied to assess the visual function. RESULTS: Bone marrow transplantation was successful. Peripheral blood test, splenohepatomegalia and osteosclerosis improved gradually. The mean optic canal diameters of right eyes before transplantation was (1.7 ± 0.4)mm. The mean optic canal diameters of right eyes was (3.2 ± 0.7)mm after transplantation. The mean optic canal diameters of left eyes before transplantation was (1.9 ± 0.5)mm . The mean optic canal diameters of left eyes was (3.1 ± 0.8)mm after transplantation. The difference between above two groups was statistically significant(t = -5.204, -4.211;P < 0.05). P2 latency period of FVEP prolonged in 7 cases before transplantation. Mean P2 latency period of FVEP decreased 21.13 ms in 5 cases after transplantation. Mean P2 latency period of FVEP prolonged 22.25 ms in 2 cases after transplantation. Under light adaptation and dark adaptation, ERG amplitude depressed obviously in 2 cases. Two cases with optic nerve atrophy did not change after transplantation. CONCLUSIONS: Hematopoietic stem cell transplantation is an effective way to deal with malignant osteopetrosis. Successful transplantation has been shown to arrest visual deterioration in some cases.

[Congenital dacryocystocele: presentation and treatment].

OBJECTIVE: To report the presentation, complications, and treatment strategies for infants with congenital dacryocystocele. METHOD: We performed a retrospective chart review of all patients presenting with dacryocystoceles to Beijing Children's Hospital between 2007 and 2011. RESULTS: Thirty-one patients (33 eyes) were identified, presenting at a median age of 10 days of life. Twenty-four (72.72%) patients presented with cellulitis or dacryocystitis and required systemic antibiotics. Two (6.45%) patients presented with respiratory compromise. Resolution occurred with conservative treatment for 6 eyes, but 27 (81.82%) required surgical intervention. All 27 eyes received probing, and 20 (74.07%) were successful. The other 7 eyes required marsupialization of an intranasal cyst. CONCLUSIONS: Although congenital dacryocystoceles may resolve with conservative measures, many become infected and require systemic antibiotic treatment, and most require surgical intervention. Referral in the early neonatal period can aid in timely intervention before complications such as infection occur.

Aggressive osteoblastoma of the temporal bone: a case report and review of the literature.

Osteoblastoma can take place in any part of the skeleton. Its occurrence in the calvarium is extremely rare. The aggressive form of osteoblastoma is a rare variant. To our knowledge, this is the second case of aggressive osteoblastoma arising in the temporal bone. We report an 18-year-old patient with aggressive osteoblastoma involving the left temporal bone. Computed tomography of temporal bone showed an osteolytic lesion with granular mineralization and mottled ossified density. Permanent histopathologic sections and immunohistochemical stains revealed an aggressive osteoblastoma.

[Correlation of lipocalin-2 and its receptor expressions with preeclampsia].

OBJECTIVE: To research the correlation of the expressions of lipocalin-2 (LCN-2) and its receptor (NGALR) in serum and placenta with preeclampsia. METHODS: From Dec.2010 to Apr.2011, 64 women with preeclampsia who delivered in Affiliated Hospital of Qingdao University Medical College were recruited in the study, including 26 women with moderate preeclampsia (MPE group) and 38 women with severe preeclampsia (SPE group). Twenty-five healthy pregnant women were taken as control group. LCN-2 and NGALR mRNA and protein expression in placenta were measured by reverse transcription-PCR (RT-PCR) and western blot, respectively. RESULTS: (1) The serum levels of LCN-2 in MPE group and SPE group [(58 ± 20), (90 ± 18) µg/L] were significantly higher than that in control group [(19 ± 6) µg/L, P < 0.01]; the serum LCN-2 level in SPE group was significantly higher than that in MPE group (P < 0.01). (2) LCN-2 mRNA expression in placenta in MPE group and SPE group (0.55 ± 0.14, 0.61 ± 0.14) were both significantly higher than that in control group (0.28 ± 0.16, P < 0.01); LCN-2 protein expression in placenta of MPE group and SPE group (2.2 ± 0.4, 2.4 ± 0.5) were also significantly higher than that in control group (1.4 ± 0.4, P < 0.01), no significant difference was found between MPE group and SPE group (P > 0.05). (3) No significant difference was found in the expressions of NGALR mRNA in placenta among MPE group, SPE group and control group (0.46 ± 0.11, 0.46 ± 0.14, 0.45 ± 0.15, P > 0.05). (4) NGALR protein expressions in MPE group, SPE group and control group were 2.7 ± 0.8, 3.0 ± 0.9, and 2.7 ± 0.9, and there were no significant difference among these three groups (P > 0.05). (5) In preeclampsia, serum LCN-2 level significant associated with 24 hours total urinary protein and uric acid (r = 0.565, 0.476, P < 0.01). LCN-2 serum level were not associated with systolic pressure and diastolic pressure (P > 0.05); there were no association with the expressions LCN-2 mRNA and protein in placenta (P > 0.05). CONCLUSIONS: Serum LCN-2 level is closely related to the progress of preeclampsia. Increasing expression of LCN-2 in placenta may be a compensatory response to preeclampsia.

[Factors affected therapeutic results in treatment of children congenital nasolacrimal duct obstruction by Ritleng lacrimal intubation].

OBJECTIVE: To evaluate the efficacy of the Ritleng lacrimal intubation system in the treatment of congenital nasolacrimal duct obstruction (CNLDO) after failed probing and to analyze the effect of various factors that affected the recovery rate. METHODS: Retrospective noncomparative case series. The outcome of 616 cases (eyes) of silicone intubation with the Ritleng lacrimal intubation system, performed between Feb. 2008 and Oct. 2009 on 546 children with CNLDO (aged from 3 to 156 months with an average at 11 months) from Beijing Children's Hospital, was retrospectively reviewed. The follow-up period varied from 4 to 17 months (average 11 months). The effects of age, treatment history, and the type of obstruction on the recovery rate were evaluated and the complications such as epistaxis, lacrimal duct edema or silicone tube prolapse were recorded. The statistics analysis included Pearson correlation coefficient and independent-samples t-test. RESULTS: The overall recovery rate was 88% (544/616 cases). In the five sub-groups based on the age, 6 - 12 month, 12 - 24 month, 24 - 36 month, 36 - 48 month and older than 48 month age, the recovery rate was 96% (94/98); 94% (244/260); 87% (104/119); 77% (58/75) and 69% (44/64), respectively (R = -0.98, P = 0.003). According to the times of previous probing, there were three groups, once, twice, and more than twice, the recovery rate was 95% (291/304); 89% (163/184) and 70% (90/128), respectively (R = -0.99, P = 0.050). In the simple membranous obstruction group and the complex obstruction group, the recovery rate was 92% (343/374) and 83% (201/242), respectively (P = 0.000). Complications included laceration of lachrymal point (8 eyes, 1%) and false passage formation (14 eyes, 2%). The silicone tube prolapsed in 18 eyes (3%). CONCLUSIONS: The Ritleng lacrimal intubation system is an easy, effective and non-traumatic procedure for the treatment of CNLDO children after failed probing. Age of the patients, times of previous probing and type of obstruction influence the recovery rate.

[Balloon dacryocystoplasty in the treatment of congenital nasolacrimal duct obstruction after previous unsuccessful surgery].

OBJECTIVE: To introduce the procedure of balloon dacryocystoplasty and to evaluate its effectiveness and complications as the treatment of congenital nasolacrimal duct obstruction after a previous unsuccessful surgery. METHODS: Prospective case series. Balloon dacryocystoplasty was performed under general anesthesia in 50 eyes of 31 children with congenital nasolacrimal duct obstruction following previous unsuccessful surgery in Beijing Children's Hospital between May 2008 and October 2009. A probe was introduced through the punctum into the inferior meatus of the nasal cavity. A deflated balloon catheter was introduced anterogradely and the balloon was inflated several times to perform the dilation of the nasolacrimal duct. Treatment success was defined as absence of epiphora and mucous discharge, negative results of fluorescein dye disappearance test (FDDT) and the unobstructed irrigation of the lacrimal system during the follow-up period of 4 - 17 months after tube removal. RESULTS: Successful operation was reported in 44 of 50 eyes (88.0%; 95% confidence interval 85.5% - 96.9%). Forty of 50 eyes were FDDT 0 - 1(80.0%). Major complications included epistaxis (10 eyes, 20.0%) and lacrimal duct laceration (2 eyes, 4.0%). CONCLUSION: Balloon dacryocystoplasty is a safe, simple and effective procedure for congenital nasolacrimal duct obstruction following previous unsuccessful surgery without disturbing the anatomy of normal lacrimal drainage system.

[Accessory extraocular muscle-a case report and review].

OBJECTIVE: Explored the causation of a case of incomitant vertical strabismus accompanied with elevation deficit and globe retraction by surgery. METHODS: Case report. Orbital imaging study of MRI was used to discover the anatomic feature of extraocular muscle. By released the restrictive structure to treat strabismus. Histopathologic inspection was used to confirm the origin of the abnormal structure. RESULTS: Abnormal extraocular muscle that located within the cone formed by the four recti muscles was the causation of strabismus. It arose at the annulus of Zinn, passing forwards between the inferior rectus muscle and lateral rectus muscle, and insert directly on the sclera. After Released it from eyeball and recession of inferior rectus muscle the strabismus was improved. Elevation deficit was not improved. Histopathologic inspection confirmed that the structure was muscular in origin. CONCLUSION: The abnormal structure that found by MRI was the cause of elevation deficit and globe retraction. Its histopathologic inspection confirmed the muscular origin. The abnormal structure was an accessory extraocular muscle. For incomitant vertical strabismus accompanied with elevation deficit and globe retraction anomalous orbital structures maybe the causation. Orbital imaging studies should be done to explore the origin of disease.

[Effects of land use/cover change on runoff sediment discharge in typical watershed in Loess gullied-hilly region of China].

By using the measurement technique of dynamic hydrological process and the estimation method of landscape ecology, this paper studied the effects of 1986-2004 land use/cover change (LUCC) on the runoff sediment discharge in the Luoyugou watershed in Tianshui of Gansu Province in third sub-region of Loess Plateau. The results showed that the LUCC in Luoyugou watershed had significant effects on the annual sediment yield. In 1995-2004, the sediment discharge was reduced by approximately 63.0%, compared with that in 1986-1994, and the reduction effect was more significant with increasing annual precipitation. The effects of LUCC on sediment discharge demonstrated seasonal fluctuation characteristic. Relative to that in 1986-1994, the reduction effect of sediment discharge in 1995-2004 was more concentrated in the period from May to October, and, the more the monthly precipitation, the more the reduction of monthly average sediment discharge in 1995-2004 than in 1986-1994. The analysis on precipitation and flood peak discharge frequency indicated that under the same frequency distribution of precipitation intensity, the average sediment concentration in any recurrence period in Luoyugou watershed was smaller in 1995-2004 than in 1986-1994.

[Lacrimal intubation with the Ritleng system in congenital nasolacrimal duct obstruction in children].

OBJECTIVE: To evaluate the efficacy and complication of the Ritleng lacrimal intubation system in the treatment of congenital nasolacrimal duct obstruction. METHODS: In this retrospective cases series, 148 patients (187 eyes) with congenital nasolacrimal duct obstruction between 2006 and 2007 from Beijing Children's Hospital, whose age ranged from 5 to 40 months (average 13 months), underwent silicone intubation with the Ritleng lacrimal intubation system, who received unsuccessful probing procedure previously. The therapeutic effect including dacryorrhea disappearance and lacrimal passages excretory function regaining was observed and the complications such as epistaxis, lacrimal duct edema or silicone tube prolapse were recorded. The follow-up period was from 4 to 17 months (average 11 months). RESULTS: Dacryorrhea disappeared in 157 eyes (84.0%) within 1 - 3 days after the surgery. The tubes were left in the place for 3 or 6 months. All the 187 eyes were successfully taken out of tubes. As follow-up, the overall successful rate was 95.2% (178/187). Seven eyes (3.7%) relief from symptoms and two eyes (1.1%) were ineffective. 46 cases (52 eyes), whose ages were about 5 months, regained normal lacrimal passages excretory function within 1 month after surgery. Complication included epistaxis (9 eyes) and lacrimal duct edema (9 eyes). The silicone tube prolapsed in eight eyes (4.3%). CONCLUSIONS: The Ritleng lacrimal intubation system is an easy, effective and nontraumatizing procedure for the treatment of congenital nasolacrimal duct obstruction. The lacrimal intubation procedure offers an early and active treatment for congenital nasolacrimal duct obstruct patients.

p38 mitogen-activated protein kinase plays a critical role in the control of energy metabolism and development of cardiovascular diseases.

p38 mitogen-activated protein kinase (p38) is a member of MAP kinase family. Its wide-spectrum roles in the control of energy metabolism have been indicated in numerous studies. p38 participates in the energy metabolism in all major tissues/organs involved in the control of energy metabolism, including adipose tissue, skeletal muscles, islet cells, and liver. In white adipose tissue, p38 plays an important role in adipose differentiation and glucose uptake although it is still inconclusive whether this role of p38 is stimulatory or inhibitory. The stimulatory role of p38 in transcription of the uncoupling protein 1 (UCP1) gene in brown adipose tissue is relatively clear. A fundamental role for p38 in the differentiation of skeletal muscles and mitochondrial biogenesis in skeletal muscles is rather definitive although the role of p38 in glucose uptake of skeletal muscles remains controversial. In islet cells, p38 appears to be involved in beta-cell apoptosis. p38 has been indicated in the control of preproinsulin gene transcription, but remains controversial. However, it seems clear that p38 does not play a significant role in insulin secretion. In the liver, p38 plays a central role in hepatic glucose and lipid metabolism. Activation of p38 participates in the processes to increase blood glucose levels through reducing glycogen synthesis and increasing hepatic gluconeogenesis. p38 appears to prevent fat storage by inhibiting hepatic lipogenesis and promoting fatty acid oxidation in the liver. Additionally, p38 may play a critical role in cholesterol metabolism by regulating expression of the LDLR gene and bile metabolism. p38 does not only participate in various physiological and pathophysiological processes in cardiomyocytes, but also is heavily involved in the development of atherosclerotic lessions through its influences on monocytes/macrophages, vascular endothelial cells, and vascular smooth muscle cells.