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Objectives: To introduce a more effective surgical technique for the repair of spontaneous incurable cerebrospinal fluid (CSF) leakage (CSF otorrhea)., Methods: The cases of five Chinese patients with Mondini dysplasia and CSF leakage were reviewed. All patients presented with rhinorrhea or otorrhea from childhood and recurrent meningitis attacks. CSF leakage was repaired surgically using the translabyrinthine approach., Results: Facial paralysis occurred in the first two patients, but was cured 2 months later. The other three patients recovered well and had no facial paralysis or complication. CSF leakage did not recur in any patient after follow-up periods of 0.5-3 years., Conclusion: Mondini dysplasia with CSF leakage is rare. Adequate diagnosis and treatment are required to avoid life-threatening complications, such as meningitis. We recommend the translabyrinthine approach as an alternative surgical technique that reduces recurrence., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

Aim: To confirm the hypothesis that polymorphisms of the uncoupling protein 3 (UCP3) gene are associated with the occurrence of nonalcoholic fatty liver disease (NAFLD)., Methods: A total of 250 NAFLD patients (147 males and 103 females) and 200 healthy individuals who served as controls (control, 109 males and 91 females), aged between 6 and 16 years were enrolled in this study. The four non-synonymous single nucleotide polymorphisms (SNPs) in the UCP3 gene polymorphisms of rs1726745, rs3781907, rs11235972 and rs1800849, were genotyped using MassArray. Body mass index (BMI), waist and hip circumference, blood pressure (BP), fasting blood glucose (FBG), insulin and lipid profiles were measured and B-ultrasound examination was performed in all subjects., Results: NAFLD patients showed risk factors for metabolic syndrome: elevated BMI, waist-to-hip ratio, BP, FBG, homeostasis model assessment-estimated insulin resistance, total triglyceride, total cholesterol and low-density lipoprotein-cholesterol, while decreased high-density lipoprotein-cholesterol level compared with the control group. The GG genotype distributions of rs11235972 in the NAFLD group differed significantly from that in the control group. We found that waist circumference between CC (58.76 ± 6.45 cm) and CT+TT (57.00 ± 5.59 cm), and hip circumference between CC (71.28 ± 7.84 cm) and CT+TT genotypes (69.06 ± 7.75 cm) were significantly different with and without rs1800849 variation (P < 0.05)., Conclusion: A higher prevalence of rs11235972 GG genotype was observed in the NAFLD group compared with the control group. No differences were observed for the other SNPs. However, there was a significant difference in body height in addition to waist and hip circumference between the CC (mutant type group) and CT+TT group with and without rs1800849 variation.

Using scanning tunneling microscopy, the coordination self-assembly of a series of peripheral bromo-phenyl and pyridyl substituted porphyrins with Fe was studied on an Au(111) surface. The porphyrins functionalized with two trans-pyridyl groups afford extended hexagonal frameworks and the porphyrins functionalized with three pyridyl groups generate discrete rosette and extended chiral kagome framework structures. The self-assembly of the porphyrin derivatives in which phenyl groups are substituted by bromo-phenyl results in coordination networks exhibiting identical structures to that of the parent compounds. These structures contain nanocavities decorated with Br, which provide potential for covalent functionalization.

Intermolecular benzylic methylene functionalization of exo-cyclic enol ethers has been achieved using imines as reagents and potassium tert-butoxide as the catalyst. Depending on the solvent used, the reaction proceeds by two pathways. In THF, an addition/elimination reaction of exo-cyclic enol ethers with imines provides dihydroisobenzofuran derivatives in good yield. In DMSO, an addition/ring-opening/cyclization cascade reaction occurs with unexpected cleavage of C-O and C-C bonds, affording isoquinolin-1(2H)-one products in high yield under ambient reaction conditions.

On-surface polymerization represents a novel bottom-up approach for producing macromolecular structures. To date, however, most of the structures formed using this method exhibit a broad size distribution and are disorderly adsorbed on the surface. Here we demonstrate a strategy of using metal-directed template to control the on-surface polymerization process. We chose a bifunctional compound which contains pyridyl and bromine end groups as the precursor. Linear template afforded by pyridyl-Cu-pyridyl coordination effectively promoted Ullmann coupling of the monomers on a Au(111) surface. Taking advantage of efficient topochemical enhancement owing to the conformation flexibility of the Cu-pyridyl bonds, macromolecular porphyrin structures that exhibit a narrow size distribution were synthesized. We used scanning tunneling microscopy and kinetic Monte Carlo simulation to gain insights into the metal-directed polymerization at the single molecule level. The results reveal that the polymerization process profited from the rich chemistry of Cu which catalyzed the C-C bond formation, controlled the size of the macromolecular products, and organized the macromolecules in a highly ordered manner on the surface.

Conclusions: The diagnosis of occult otogenic cerebrospinal fluid (CSF) leakage is challenging and it can easily be misdiagnosed. Some characteristics of clinical presentation can supply important clues and confirmed diagnosis should be obtained according to these clues and suitable imaging studies before meningitis develops. Different surgical techniques should be adopted to treat the CSF leakage according to different leakage etiologies, and good results can be obtained., Objective: The aim of the study was to evaluate the diagnosis and surgical treatment of occult otogenic CSF leakage, including the characteristics of clinical presentation, imaging studies, and operation methods in order to decrease the rate of misdiagnosis and obtain a good curative effect., Methods: We performed a retrospective review of 11 cases of CSF leakage that were all misdiagnosed and accompanied by meningitis, operated in our department from 2007 to 2012 after a mean follow-up of 3 years. In this context, the characteristics of clinical presentation, imaging studies, and management of CSF leakage were studied., Results: The CSF leakage had arisen traumatically (n = 9) or congenitally (n = 2). The medical history and special clinical presentation such as repeated otorrhea or rhinorrhea, fever, headache, and unilateral deafness can supply important diagnostic clues. Imaging studies including high-resolution noncontrast CT (HRCT), CT cisternography, and magnetic resonance imaging (MRI) are very important diagnostic methods. The surgical repairs were performed via a transmastoid approach (n = 8), packing the vestibule (n = 1) or a translabyrithine approach (n = 2). Recurrent leakage did not occur.

We use cryogenic scanning tunneling microscopy and spectroscopy and density-functional theory calculations to inspect the modulation of electronic states of aromatic molecules. The molecules are self-assembled on a Cu(111) surface forming molecular networks in which the molecules are in different contact configurations, including laterally coupled to different numbers of coordination bonds and vertically adsorbed at different heights above the substrate. We quantitatively analyze the molecular states and find that a delocalized empty molecular state is modulated by these multiple contacts in a cooperative manner: its energy is down shifted by ∼ 0.16 eV for each additional lateral contact and by ∼ 0.1 eV as the vertical molecule-surface distance is reduced by 0.1 Å in the physisorption regime. We also report that in a molecule-metal-molecule system the bridging metal can mediate the electronic states of the two molecules.

Multi-strand metallo-supramolecular polymers are self-assembled by pyridyl-functionalized porphyrin derivatives on a Au(111) surface through pyridyl-Cu-pyridyl coordination. Single-molecule-resolved characterization by scanning tunneling microscopy reveals a novel chain-growth polymerization mechanism for multi-strand supramolecular polymers. Furthermore, by varying the growth temperature and adding specific molecular modulators, both the length and the width of the polymers can be controlled.

The ruthenium hydride complex RuH(2)(CO)(PPh(3))(3) was found to be an effective catalyst for the cycloaddition reactions of terminal alkynes and azides. In the presence of RuH(2)(CO)(PPh(3))(3), various azides reacted with a range of terminal alkynes to produce 1,4-disubstituted 1,2,3-triazoles with 100% selectivity and moderate to excellent yields.

Objective: To investigate the positive rate of hepatitis B surface antibody (HBsAb) in children., Methods: Blood samples from 3022 children who received a physical examination in outpatient departments from 2009 to 2011 were subjected to serological test using ELISA to measure the positive rate of HBsAb., Results: The positive rate of HBsAb decreased with age (P<0.01). There was no significant difference in the positive rate of HBsAb between boys and girls (P>0.05), however the positive rate of HBsAb in boys aged one year and over was lower than in girls of the same age (P<0.01). The positive rate of HBsAb in boys aged between 3 and 4 years was higher than in girls of the same age (P<0.01). The positive rate of HBsAb decreased with age in boys, and was lower in those aged two years and over than in those aged one year and over (P<0.01). The positive rate of HBsAb also decreased with age in girls, with significant differences between different age groups (P<0.01)., Conclusions: The positive rate of HBsAb decreases with age in children, so younger children have a higher risk of infection with hepatitis B virus. Serological monitoring of hepatitis B needs to be enhanced.

Background: Carbon dioxide (CO2) laser soldering is an alternative technique for tissue bonding. Basic fibroblast growth factor (bFGF) and transforming growth factor β(1) (TGFβ(1)) are two key factors for wound healing. This study was performed to demonstrate the efficacy of CO2 laser soldering for dural reconstruction and the effect of bFGF and TGFβ(1) on healing., Methods: In Part I, 10 minipigs were randomized into two equal groups. Dural defects were reconstructed by conventional fibrin glue bonding (group I(a)) or CO2 laser soldering (group I(b)). The reconstructed dura was subjected to burst pressure (BP) measurement and immunohistochemical staining after 1 week. In Part II, 36 minipigs were randomized into three equal groups. Dural reconstruction was achieved by CO2 laser soldering. Exogenous bFGF (group II(b)) or TGFβ(1) (group II(c)) was administered while group II(a) served as a control group. The specimens were subjected to BP measurement after 1, 2, 3, and 4 weeks, respectively., Results: In Part I, the dura specimens displayed positive staining of only bFGF in group I(a) and of both bFGF and TGFβ(1) in group I(b). Group I(b) showed higher BP than group I(a) ((98.00 ± 21.41) mmHg vs. (70.80 ± 15.09) mmHg, respectively; P < 0.05). In Part II, BP of group II(c) was significantly higher than that of group II(a) (P < 0.01). The BP of group II(a) trended toward stabilization after 3 weeks of growth, while that of groups II(b) and II(c) trended toward stabilization after 2 weeks of growth., Conclusions: CO2 laser soldering is a reliable technique for dural reconstruction. The superior healing of dural reconstruction by CO2 laser soldering may be related to higher expression of bFGF and TGFβ(1), and CO2 lasers may stimulate their secretion. Exogenous bFGF or TGFβ(1) may improve healing by shortening the wound healing time, and exogenous TGFβ(1) may improve the tensile strength.

Objective: Obstructive sleep apnea-hypopnea syndrome (OSAHS) may cause serious morbidities, such as systemic hypertension, diabetes, and cor pulmonale. However, currently no many reports on study of OSAHS in children are available. This study aimed to explore the effects of OSAHS on children's multiple systems., Method: A total of 89 cases of children who came to the Sleep Treatment Center in the authors' hospital from March 2009 to December 2010 with snoring were tested with overnight polysomnography (PSG). They were classified into mild OSAHS group (n = 59, mean age of 5.71, SD = 2.46) and moderate to severe group (n = 30, mean age of 5.30, SD = 2.73) based on the PSG results, and 100 healthy children were selected as the control group (n = 100, mean age of 6 years, SD = 2.98). Data including height, weight, body mass index and blood pressure, peripheral blood routine, blood lipids, glucose and insulin, electrocardiogram and echocardiography were collected. Patients' adenoid face and abnormal occlusion were also recorded. Comparisons of the data were made among those groups., Result: Mild OSAHS and moderate to severe group had significantly higher prevalence of adenoid face (23.7%, 26.7%), and abnormal occlusion (74.6%, 60.0%) than that in control group (0, 40%) (P < 0.05). There were no significant differences in terms of BMI between the OSAHS group and the control group, but the weight (kg) and height (cm) in the mild OSAHS group (23.3 ± 10.1, 114.9 ± 16.2) and moderate to severe group (21.9 ± 8.4, 110.8 ± 13.3) were lower than those of the control group (31.8 ± 10.1, 136.1 ± 15.1) (all P < 0.05). Compared with the control group, the level of HDL-C (mmol/L)and insulin (mU/L) in moderate and severe group decreased [(1.20 ± 0.30) vs. (1.40 ± 0.27), 2.79 (0.84 - 16.16) vs. 4.92 (0.76 - 16.80), P < 0.05], while the LDL-C (mmol/L) increased [(2.61 ± 0.75) vs. (2.32 ± 0.62), P < 0.05]. The red blood cell counts (× 10(12)/L) and the blood platelet counts (× 10(9)/L) in the mild OSAHS (4.93 ± 0.37, 292.92 ± 75.64) and moderate and severe OSAHS group (5.23 ± 0.22, 292.50 ± 63.05) were significantly higher in contrast to the control group (4.70 ± 0.31, 255.60 ± 69.12) (all P < 0.05), systolic blood pressure (mmHg) in mild group (98.54 ± 10.44) and moderate to severe group (99.13 ± 19.13) was significantly higher compared to control group (87.88 ± 11.37), and the heart rate (beats/min) in moderate to severe group (94.43 ± 10.64) was higher than those in control group (87.12 ± 16.20) (all P < 0.05). The mild OSAHS and moderate and severe OSAHS group had decreased right ventricular internal diameter [(14.24 ± 1.64) mm, (13.17 ± 2.07) mm ], increased main pulmonary artery diameter [(17.05 ± 3.33) mm, (16.33 ± 3.14) mm] and the thickness of right ventricular wall [(3.43 ± 0.26) mm, (3.57 ± 0.20) mm] compared to control group [ (16.10 ± 2.96) mm, (14.11 ± 2.52) mm, (3.32 ± 0.25) mm] (all P < 0.05)., Conclusion: OSAHS in children may be associated with craniofacial malformations, and may contribute to slow growth and development, elevated blood viscosity and blood pressure, metabolic abnormalities, and change cardiac structure.

Background: Intracranial infection is a common postoperative complication of neurosurgery. This study aimed to identify risk factors of postoperative intracranial infection in patients with cerebrospinal fluid rhinorrhea and to suggest proposals for the prevention., Methods: A total of 167 patients (113 males and 54 males, average age of 34.4 years) with cerebrospinal fluid rhinorrhea operated on by the senior author were retrospectively reviewed. The data collected included etiology, previous history, clinical manifestation, site of bone defect, operative approach, and postoperative complications. Risk factor(s) for postoperative infection were analyzed using the stepwise multiple Logistic regression., Results: Eighteen (10.8%) patients were infected post-operatively. The independent risk factors for infection were the site of defect (RR = 0.508, 95%CI 0.306 - 0.843, P = 0.009) and historical meningitis (RR = 0.290, 95%CI 0.094 - 0.893, P = 0.031). Patients with multiple defects and saddle floor defects had a higher infection rate. The germiculture was positive in 11 patients, and vancomycin was sensitive to all the pathogenesis. Nine infected patients needed lumbar drainage. Ten patients had hyponatremia, and hydrocephalus occurred in two patients with serious trauma., Conclusions: To prevent the infection, we should pay closer attention to the high-risk patients pre-operation. During the operation, the methods those can improve wound healing, such as using blood-supply materials, reliable fixation, and eliminating dead space are all helpful. Conducting lumbar drainage and choosing effective prophylactic antibiotics in the early postoperative stage for the high-risk patients are methods of postoperative management.

The coordination assembly of 1,3,5-trispyridylbenzene with Cu on a Au(111) surface has been investigated by scanning tunneling microscopy under ultrahigh vacuum conditions. An open two-dimensional (2D) metal-organic network of honeycomb structure is formed as the 2D network covers partial surface. Upon the 2D network coverage of the entire surface, further increment of molecular density on the surface results in a multistep nonreversible structural transformation in the self-assembly. The new phases consist of metal-organic networks of pentagonal, rhombic, zigzag, and eventually triangular structures. In addition to the structural change, the coordination configuration also undergoes a change from the two-fold Cu-pyridyl binding in the honeycomb, pentagonal, rhombic and zigzag structures to the three-fold Cu-pyridyl coordination in the triangular structure. As the increment of molecular packing density on the surface builds up intrinsic in-plane compression pressure in the 2D space, the transformation of the structure, as well as the coordination binding mode, is attributed to the in-plane compression pressure. The quantitative structural analysis of the various phases upon molecular density increment allows us to construct a phase diagram of network structures as a function of the in-plane compression.

We investigated the thermodynamic processes of two-dimensional (2D) metallo-supramolecular self-assembly at molecular resolution using scanning tunneling microscopy and variable-temperature low-energy electron diffraction. On a Au(111) substrate, tripyridyl ligands coordinated with Cu in a twofold Cu-pyridyl binding mode or with Fe in a threefold Fe-pyridyl binding mode, forming a 2D open network structure in each case. The network structures exhibited remarkable thermal stability (600 K for the Cu-coordinated network and 680 K for the Fe-coordinated network). The Fe-pyridyl binding was selected thermodynamically as well as kinetically in self-assembly involving both modes. The selectivity can be effectively suppressed in a specifically designed self-assembly route.

The direct addition of various beta-dicarbonyl compounds to a series of secondary alcohols and alkenes has been achieved using 1 mol % perchloric acid (HClO(4)) as the catalyst. The HClO(4)-catalyzed reactions could be conveniently conducted in commercial solvent and gave moderate to excellent yields. Moreover, the silica gel-supported HClO(4) could also catalyze the heterogeneous addition for a series of substrates with similar or even higher yields in comparison with the homogeneous ones. The supported catalyst could be readily recovered and reused for four runs. Furthermore, the mechanism of the HClO(4)-catalyzed addition of the beta-diketone to alcohol was investigated, and an S(N)1 mechanism was proved unambiguously for the first time through a series of experiments. The discrimination of catalytic abilities among different Brønsted acids was also rationalized by DFT calculations.

The new ruthenium complex [Ru(N(3)P)(OAc)][BPh(4)] (4), in which N(3)P is the N,P mixed tetradentate ligand N,N-bis[(pyridin-2-yl)methyl]-[2-(diphenylphosphino)phenyl]methanamine was synthesized. The complex was found to be catalytically active for the endo cycloisomerization of alkynols. The catalytic reactions can be used to synthesize five-, six-, and seven-membered endo-cyclic enol ethers in good to excellent yields. A catalytic cycle involving a vinylidene intermediate was proposed for the catalytic reactions. Treatment of complex 4 with PhC[triple bond]CH and H(2)O gave the alkyl complex [Ru(CH(2)Ph)(CO)(N(3)P)][BPh(4)] (30), which supports the assumption that the catalytic reactions involve addition of a hydroxyl group to the C=C bond of vinylidene ligands.

Superexchange coupling in poly-p-phenylene molecular wires was probed using scanning tunneling microscopy/spectroscopy at cryogenic temperatures. The coupling strength was characterized by measuring the energy splitting between the molecular states constructed by symmetric and antisymmetric dimerization of molecular fragments' orbitals. The results confirm the theoretically predicted exponential decay behavior of the superexchange coupling on a single-molecule level. A decay constant of 0.10 +/- 0.02 A(-1) was obtained. Owing to the high spatial resolution of scanning tunneling microscopy, the molecules' internal states (e.g., molecular conformation) as well as external states (e.g., interaction with foreign atoms or molecules) were elucidated with atomic precision at the mean time of characterizing the superexchange coupling. This method provides a new approach to quantify how intramolecular charge transfer is influenced by molecular conformation and interaction with the surroundings.

Objective: Obese children and adolescents are often complicated with the abnormalities of lipid and glucose metabolism, which are often associated with adulthood hypertension, diabetes and cardiovascular disease. In this study, the blood lipids, blood pressure and carotid arterial intima-media thickness (IMT) in obese children and adolescents were measured to investigate the relationship between the dyslipidemia and early vascular lesions., Method: A total of 580 obese children and adolescents aged from 7 to 17 years of age were enrolled from 3 hospitals from Jan. 2008 to Sept. 2009. They were divided into 2 groups according to their blood lipoid levels. Ortholiposis group included 100 males and 52 females with a mean age of 10.47 years and a mean body mass index (BMI) of 28.28 kg/m(2). Dyslipidemia group included 305 males and 123 females with a mean age of 10.83 years and a mean BMI of 27.60 kg/m(2). Physical examination, and measurement of blood lipid, glucose and liver enzyme were taken. Carotid IMT was measured for 285 subjects., Result: (1) Hypertension was found in 12.5% (19/152) and 20.1% (86/428) patients in ortholiposis and dyslipidemia groups, respectively, with a significant difference (χ(2) = 4.362, P = 0.037). The OR was 1.760 with 95% confidence interval of 1.030 - 3.008. Higher prevalence of hypertension was found in patients with dyslipidemia. (2) The left, right and mean common carotid IMTs of dyslipidemia group were higher than those of ortholiposis group without significant difference (all P > 0.05). The left, right and mean internal carotid IMTs in dyslipidemia group were (0.66 ± 0.15) mm, (0.65 ± 0.15) mm and (0.65 ± 0.15) mm, respectively while these in ortholiposis group were (0.62 ± 0.13) mm, (0.60 ± 0.13) mm and (0.61 ± 0.12) mm, respectively (P < 0.05 for all). (3) Bivariate correlation analysis showed that systolic blood pressure was positively correlated with age, BMI, BMI Z score, waist circumference, hip circumference, uric acid, alanine transaminase, triglyceride, fasting insulin and insulin resistance index (P < 0.05 for all). Moreover, mean carotid and internal carotid IMTs were positively correlated with age, BMI, waist circumference, hip circumference, and triglyceride (all P < 0.05). Multiple linear regression analysis showed that hip circumference and insulin resistance index were independent determinants of systolic pressure. Waist circumference was independent determinant of mean common and internal carotid IMT and triglyceride was independent determinants of mean internal carotid IMT., Conclusion: (1) Vascular lesions, including hypertension and thicker tunica intima are common in obese children and adolescents. (2) Vascular lesions are closely related with dyslipidemia, and waist circumference and hypertriglyceridemia are the risk factors.

Background: Surgical management of skull base tumors is still challenging today due to its sophisticated operation procedure. Surgeons who specialize in skull base surgery are making endeavor to promote the outcome of patients with skull base tumor. A reliable skull base reconstruction after tumor resection is of paramount importance in avoiding life-threatening complications, such as cerebrospinal fluid leakage and intracranial infection. This study aimed at investigating the indication, operation approach and operation technique of anterior and middle skull base reconstruction., Methods: A retrospective analysis was carried out on 44 patients who underwent anterior and middle skull base reconstruction in the Department of Neurosurgery at Beijing Tiantan Hospital between March 2005 and March 2008. Different surgical approaches were selected according to the different regions involved by the tumor. Microsurgery was carried out for tumor resection and combined endoscopic surgery was performed in some cases. According to the different locations and sizes of various defects after tumor resection, an individualized skull base soft tissue reconstruction was carried out for each case with artificial materials, pedicled flaps, free autologous tissue, and free vascularized muscle flaps, separately. A skull base bone reconstruction was carried out in some cases simultaneously., Results: Soft tissue reconstruction was performed in all 44 cases with a fascia lata repair in 9 cases, a free vascularized muscle flap in 1 case, a pedicled muscle flap in 14 cases, and a pedicled periosteal flap in 20 cases. Skull base bone reconstruction was performed on 10 cases simultaneously. The materials for bone reconstruction included titanium mesh, free autogenous bone, and a Medpor implant. The result of skull base reconstruction was satisfactory in all patients. Postoperative early-stage complications occurred in 10 cases with full recovery after conventional treatment., Conclusions: The specific characteristics of skull base defects in various regions require different reconstruction materials and methods. The individualized reconstruction based on different skull base defects can achieve satisfactory results.

Objective: To observe the changes of tongue and pulse parameters in lung cancer patients after combined treatment with integrated traditional Chinese and Western medicine, and to probe into the application of the tongue and pulse parameters in evaluation of integrated traditional Chinese and Western medicine therapy on lung cancer patients., Methods: Electropulsograms and tongue pictures of 50 lung cancer patients were examined by TP-I digital electropulsography. The tongue and pulse parameters of the patients, including the indexes of moistness and dryness, thinness and thickness, fissure, swollenness and emaciation, greasiness and likeness of curd, and power spectral ratios (PSRs) 1, 2, 3, 4 and cepstrum spectral ratios (CSRs) 1, 2, 3, 4, were observed after 1-month and 2-month treatment with Yifei Kangliu Oral Liquid (a compound traditional Chinese herbal medicine) plus chemotherapy, respectively. The above parameters of the lung cancer patients were compared before and after the treatment., Results: PSR1 increased, while PSR2 decreased significantly after 1-month and 2-month treatment as compared with before treatment (P < 0.05). PSR1 decreased, while PSR2 increased after 2-month treatment as compared with after 1-month treatment (P < 0.05). PSR4 after 1-month treatment was lower than before treatment (P < 0.05). The tongue parameters including the indexes of moistness and dryness, and greasiness and likeness of curd increased significantly after 1-month and 2-month treatment as compared with before treatment (P < 0.05). The index of thinness and thickness decreased, while the index of fissure increased significantly after 1-month treatment as compared with before treatment (P < 0.05)., Conclusion: Tongue and pulse parameters can be regarded as one of reference indexes in evaluation of integrated traditional Chinese and Western medicine therapy on lung cancer patients.

Objective: To investigate the management experience with transnasal endoscopic technique for meningoencephalocele., Methods: Nine patients with endonasal encephalomeningocele were managed by transnasal endoscopic surgery, and the skull base defect was repaired by fascia., Results: Eight cases were successfully managed at the time of the first operation, and no relapse case was found during 1 to 4 years follow-up. Only one case of a two years old child relapsed with cerebrospinal fluid rhinorrhea one month after operation. During the second operation, titanium mesh uncovering was found, and replacement of titanium mesh by fascia via skull base defect was done, without relapse one and half years after the second operation. Another case of a one year old child got a fever one day after operation, but no white blood cell was found in the cerebrospinal fluid, and the temperature recovered to normal after release cerebrospinal fluid management. There were no complications of cranial infection, hemorrhage, edema and water retention in brain to be found in all cases., Conclusions: It is not only minimally invasive, safety and efficiency of transnasal endoscopic technique for meningoencephalocele, but also had a clear operating view for better recolonization of the position of leak and the structure of operating field, therefore, transnasal endoscopic technique is the first choice for the management of endonasal encephalomeningocele. The accurate localization of leak and selection of the appropriate repairing materials are the key point for the successful operation.

The perchlorate salt of the dicationic bipy-ruthenium complex cis-[Ru(6,6'-Cl2bipy)2(H2O)2]2+ effectively catalyzes addition of beta-diketones to secondary alcohols and styrenes to yield the alpha-alkylated beta-diketones. In a catalytic addition reaction of acetylacetone to 1-phenylethanol, the kappa2-acetylacetonate complex [Ru(6,6'-Cl2bipy)2(kappa2-acac)]ClO4 was isolated after the catalysis; this complex is readily synthesized by reacting cis-[Ru(6,6'-Cl2bipy)2(H2O)2](ClO4)2 with acetylacetone. [Ru(6,6'-Cl2bipy)2(kappa2-acac)]ClO4 is unreactive toward 1-phenylethanol in the presence of HClO4; it also fails to catalyze the addition of acetylacetone to 1-phenylethanol. On the basis of these observations, it is proposed and confirmed by independent experiments that the catalytic addition of beta-diketones to the secondary alcohols is in fact catalyzed by the Brønsted acid HClO4, which is generated by the reaction of cis-[Ru(6,6'-Cl2bipy)2(H2O)2](ClO4)2 with the beta-diketone.

Objective: To study the correlation of multislice spiral CT features and vascular endothelial growth factor (VEGF) expressions and microvessel density (MVD) in renal cell carcinoma (RCC)., Methods: Fourth-seven patients with pathologically confirmed RCC were examined by multislice spiral CT, and VEGF expressions and MVD of the RCC and the adjacent normal tissues were determined by immunohistochemistry with specific monoclonal antibodies., Results: VEGF expression and MVD in the RCC and adjacent normal tissues increased with the pathological grades of RCC (P<0.05), VEGF expression was found to significantly correlate with MVD (r=0.67, P<0.01). The positive expression of VEGF and MVD were associated with the findings by multislice spiral CT scan of tumor size, intratumor necrosis, cystic degeneration, intensity signal, lymph node metastases, invasion of the renal vein or inferior vena cava, and invasion of the adjacent organs or distant metastases (P<0.01)., Conclusion: Multislice spiral CT findings can be indicative of the histopathology of RCC, and some CT findings are closely correlated with MVD and VEGF expressions in RCC, which may help evaluate the biological behavior and malignancy of the tumor and predict tumor invasion and metastasis.

Total DNA was extracted from T. vaginalis with Chelex-100 method and used as templates for PCR. The ferredoxin gene was directionally cloned into plasmid pMD-18T vector and subcloned into eukaryotic expression vector pcDNA3. 1 (+). The transformants were screened and identified by PCR and restriction analysis. The size of amplified ferredoxin gene was 306bp and the DNA sequence of cloned gene was same with that published.

Objective: To construct a recombinant plasmid containing ferredoxin gene of Trichomonas vaginalis., Methods: Total DNA was extracted from Trichomonas vaginalis with Chelex-100 method and used as templates for PCR. Primers were designed based on the published sequence of the ferredoxin gene and used to amplify the Trichomonas vaginalis gene using PCR method. The ferredoxin gene obtained by PCR technique was directionally cloned into plasmid pMD-18T simple vector. The constructed recombinant plasmid was transferred into E. coli JM109. The transformants were screened and identified by PCR and restriction analysis. The DNA sequence of the gene was determined by Sanger's method., Results: The size of amplified ferredoxin gene was 306bp. The correct recombinant plasmid was isolated and confirmed by PCR and restriction analysis. The DNA sequence of cloned gene was the same as the published sequence., Conclusion: The ferredoxin gene was successfully amplified and cloned into plasmid pMD-18T simple vector. The cloned ferredoxin gene could be used to produce recombinant protein and for study of its function.

Objective: To summarize and analyze the application of neuroendoscopic techniques in neurosurgery, and to discuss the role and significance of neuroendoscopic techniques in the diagnosis and treatment of neurosurgical diseases., Methods: We treated 1300 patients with different neurosurgical diseases by performing endoscopic neurosurgery (EN) and endoscopy-assisted microneurosurgery (EAM). Among 1300 paitents, 522 were treated with pure endoscopic neurosurgery, 260 with endoscopy-assisted microneurosurgery, 79 with endoscope-controlled bur hole trephination neurosurgery, 434 with endoscope transsphenoidial surgery, and 5 with other techniques through which an endoscope was used in conjunction with stereotactic guidance., Results: Totally 362 hydrocephalus patients were treated using EN. Among them, 190 were treated by third ventriculostomy, 30 by V-P shunt, and 142 patients with complicated hydrocephalus and unsymmetry hydrocephalus by endoscopy-controlled pathologic septum fenestration, septum pellucidum fenestration, and treatment of inventricula inflammation. Clinical symptomatic improvement was achieved in 341 of 362 patients (94.2%). Also 160 intracranial cyst patients were treated using EN for resection and partial resection. Eighty-two patients were performed through cyst-ventricula fenestration. Clinical symptomatic improvement was achieved in 76 of 82 patients (92.7%). Seventy patients treated with endoscopy-controlled bur hole neurosurgery and 8 cases with endoscopy-assisted microneurosurgery got better recovery after operation. Among 260 patients with brain tumors, 252 patients were operated with EAM (190 patients with epidermoid cyst), 8 patients with EN (all brain tumors with diameters < 2.5 cm in inventricular). Clinical symptomatic improvement was achieved in 228 of 260 patients (87.7%). Among 49 patients with inventricular and cistern cyst, 40 patients who were treated by EN and 9 patients by endoscopy-controlled bur hole neurosurgery were resected and their clinical symptoms were improved after operation. Among 434 patients with sellar region lesions, 387 patients with pituitary adenomas, 19 patients with repair for CSF leaks, 9 patients with chordoma, and 19 patients with other neurosurgical diseases were performed with endoscopy-controlled transsphenoidial surgery. Clinical symptoms in 88.9% (386/434) of these patients were improved. Another 5 patients were treated with endoscopy combined with navigation and stereotatic guidance with good results. The complications related to operation were found in only 2% of all the patients including hemorrhage, infection, and damage of important structure., Conclusions: Clinical application of neuroendoscopic techniques can decrease the damage caused by pure open surgery operation. It is possible to resect lesions at the utmost and protect normal tissue from lesions for using EN and EAM or endoscopy-controlled microneurosurgery (ECM). It is also helpful to enhance surgical quality and, reduce the complications.

A highly efficient heterogeneous asymmetric transfer hydrogenation of ketones in water was developed for the first time, which exhibited excellent enantioselectivities, distinct acceleration effect and remarkably high recyclabilities., (Copyright 2004 The Royal Society of Chemistry)

[reaction: see text] Chiral Ru-TsDPEN [N-(p-toluenesulfonyl)-1,2-diphenylethylenediamine]-derived catalysts were first successfully immobilized onto amorphous silica gel and mesoporous silicas of MCM-41 and SBA-15 by an easily accessible approach. The catalyst immobilized on silica gel demonstrated remarkably high catalytic activities and excellent enantioselectivities (up to >99% ee) for the heterogeneous asymmetric transfer hydrogenation of various ketones. Particularly, the catalyst could be readily recovered and reused in multiple consecutive catalytic runs (up to 10 uses) with the completely maintained enantioselectivity.

Henoch-Schönlein purpura (HSP) is a systemic vasculitis with manifestations usually involving the skin, gastrointestinal tract, kidney and joints. Epididymitis is rarely seen as a complication of HSP. It is easily misdiagnosed as testicular torsion, causing the patient to undergo unnecessary surgery, because the patient may have complained of severe scrotal pain and swelling. We report a 5-year-old boy who was suffering from HSP associated with acute scrotal pain and swelling of the left testicle. No gastrointestinal signs were noted but severe joint pain, swelling and palpable skin lesions in the lower limbs and the buttocks were found. Prednisolone was prescribed and the boy recovered without surgical intervention.

Pyomyositis is a primary infection of skeletal muscle. We report the case of a previously healthy six-year-old who suffered from pyomyositis in the right lower back. He presented with lower back pain and low-grade fever for one week. After a series of laboratory and imaging studies, the diagnosis of right multifidus muscle pyomyositis with abscess formation was made. The patient recovered rapidly after incision and drainage therapy, accompanied by antibiotic treatment. Methicillin-resistant Staphylococcus aureus was cultured from the abscess discharge. It was strongly suspected that herbal medicines and common cold medication the patient had been prescribed before admission to our hospital produced a masking effect that delayed the diagnosis.

Rabbits were immunized with the Fab fragment of a murine monoclonal antibody (McAb) PD4 against human gastric cancer to produce anti-PD4-idiotypic antibody (alpha PD4-Ab2). The alpha PD4-Ab2 could not only competitively inhibit binding of McAb PD4 to gastric cancer cell MGC803, but also induce delayed-type hypersensitivity (DTH) to MGC803 in mice. Spleen cells of mice immunized with alpha PD4-Ab2 were fused with myeloma cell SP2/0 to form hybridoma secreting Ab3 which could be bound to target cell MGC803. McAb C7-Ab3, one of the Ab3, could selectively react with a 40 kD tumor-associated antigen located on MGC803 cell membrane, as well as McAb PD4. The results indicate that alpha PD4-Ab2 possesses determinants (internal image antigen) similar to those on MGC803, and could mimic human gastric cancer-associated antigen.

Mouse and rat fibroblasts were transfected with total DNA from human gastrocarcinoma cell line BGC-823. It was shown by hybridization assay that the genome of one of the rat secondary foci contains transforming genes from the human gastrocarcinoma cell line, which are homologous to the protooncogene c-Ha-ras in the normal cells. The genomic library of the rat secondary foci was constructed, using lambda phage EMBL3 as the vector. The transforming gene Ha-ras of the human gastrocarcinoma cell was thus cloned by screening the library with the probes of human Alu repeat sequence and c-Ha-ras. The nucleotide sequences of the first and second exons were analysed by M13-dideoxy method. The result shows that the nucleotide sequence of the transforming gene is the same as that of the normal protooncogene except one nucleotide difference in the first exon.

The rat fibroblast cell line Rat 1 was transfected with total DNA of a gastrocarcinoma cell line, BGC-823. The transforming gene was cloned from the genomic library of the secondary transformants using in situ hybridization with a probe of the human Alu repeat sequence. This cloned gene is homologous to the protooncogene c-Ha-ras. The activation lesion of the transforming gene was identified by sequence analysis as a single nucleotide substitution of thymine for guanine in the 12th codon. This results in the substitution of valine for glycine at the 12th amino acid of the Mr 21,000 protein.

DNAs of three cell lines of human gastrocarcinoma (MGC-803, BGC-823 and PACM-82) and two fresh solid tumors of human stomach cancer were used to transfect NIH3T3 and Rat-1 cells. The transformed cells were selected with high concentration of glucose and low concentration of serum, or with medium containing Geneticin (G418) after co-transfection of pSVneo and DNAs of stomach cancer cell line or primary transformants. From the second round transfection, we had obtained transformants which could grow with high colony forming efficiency in soft agarose and were tumorigenic in nude mice. The southern blot analysis showed that the cellular DNA of the transformants contained human Alu repeat sequence and the transformed gene from stomach cancer cell line (BGC-823) and was homologous to proto-oncogene c-Ha-ras. The transforming gene is able to induce neoplastic transformation of NIH3T3 and Rat-1 cells.