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Guidelines for diagnosis and management of aneurysmal subarachnoid hemorrhage: top issues and prospective
ZHANG Jian-min
Journal of ZheJiang University(Medical Science), 2015, 44(4): 357-360.   https://doi.org/10.3785/j.issn.1008-9292.2015.07.01
Abstract( 149 )   HTML (   PDF(663KB)( 714 )

Objective: Aneurysmal subarachnoid hemorrhage (aSAH) is a kind of hemorrhagic stroke with high mortality and morbidity. Although the preoperative diagnosis, surgical clipping, endovascular treatment, and intensive care have progressed in recent years, the overall prognosis of aSAH patients remains poor. In 2011, the Neurocritical Care Society organized an international, multidisciplinary consensus conference addressed the critical care management of SAH. In 2012, the American Stroke Association (AHA) updated the guidelines of diagnosis and treatment of aSAH published in 2009. In 2013, European Stroke Organization established the guideline for management of intracranial aneurysms and SAH. In 2014, the Korean Society of Interventional Neuroradiology (KSIN) published clinical practice guideline for the management of ruptured and unruptured aneurysms. The guideline for diagnosis and management of aSAH for Chinese patients has been drafted in this year. Thus, the diagnosis and management of aSAH is a hot topic in neurosurgery. This editorial summarizes the above mentioned guidelines and focuses on the progress and update of these guidelines. In this article we discuss the advantage and disadvantage of those imaging techniques, the pros and cons of surgical clipping and endovascular treatment.

Prevention and treatment of drug-related stroke
WANG Yong-jie, ZHANG Jian-min
Journal of ZheJiang University(Medical Science), 2015, 44(4): 361-365.   https://doi.org/10.3785/j.issn.1008-9292.2015.07.02
Abstract( 114 )   HTML (   PDF(605KB)( 249 )

Stroke classified into ischemic and hemorrhagic subtypes, is among the most devastating diseases for human being. Certain drugs could increase the blood viscosity, thereby increasing the potential risk of ischemia. Anti-platelet and anti-coagulation drugs, as the treatment of first choice, increase the risk of intracranial hemorrhage and death. Here, we are the first to propose the concept of drug-related stroke, and discuss the treatment strategy for patients who are complicated with intracranial hemorrhage or plan to receive neurosurgical operation during either anti-platelet or anti-coagulation medication. We hope to arouse the attention for drug related stroke among the clinicians and offer recommendation for clinical intervention.

Pterional keyhole approach in surgical treatment of ruptured anterior circulation intracranial aneurysm: a report of 313 cases
YAN Wei, MOU Chao-hui, WU Sheng, LING Chen-han, WU Qun, HONG Yuan, CHEN Sheng, CAI Feng, ZHANG Jian-min, CHEN Gao
Journal of ZheJiang University(Medical Science), 2015, 44(4): 366-370.   https://doi.org/10.3785/j.issn.1008-9292.2015.07.03
Abstract( 104 )   HTML (   PDF(981KB)( 224 )

Objective: To review the surgical modality with pterional keyhole approach in treatment of anterior circulation aneurysm. Methods: Three hundred and thirteen patients with ruptured anterior circulation intracranial aneurysm treated surgically with pterional keyhole approach between January 2009 and June 2014 in Department of Neurosurgery, the Second Affiliated Hospital of Zhejiang University School of Medicine, were included in the analysis. Complete occlusion rate of aneurysms and incidence of major complications including delayed cerebral ischemia and chronic hydrocephalus were documented. Surgical outcomes at 6-month follow up were assessed by modified Rankin Scale. Results: Totally 348 aneurysms were treated with pterional keyhole approach, 326 aneurysms were completely clipped, 16 aneurysms were partly clipped, and 6 aneurysms were wrapped with gauze material. Among 313 patients, 15 patients (4.79%) suffered from delayed cerebral ischemia, and 10 patients (3.19%) suffered from hydrocephalus. At the 6-month follow up, the rate of good outcome was 66.77% (209/313). Conclusions: The pterional keyhole approach can be used to clip most of anterior circulation aneurysms, and it seems to have advantages over the traditional approaches with lower incidence of complications and similar outcomes.

Brainstem cavernous malformation and its surgical treatment
WANG Zhen, WANG Lin, ZHU Xiang-dong, Wu Qun, SHI Lu-feng, WANG Yong-jie, ZHANG Jian-min
Journal of ZheJiang University(Medical Science), 2015, 44(4): 371-375.   https://doi.org/10.3785/j.issn.1008-9292.2015.07.04
Abstract( 142 )   HTML (   PDF(1128KB)( 234 )

Objective: To analyze the clinical characteristics and surgery approach for patients with brainstem cavernous malformation (BSCM). Methods: The clinical data of 23 BSCM patients (5 cases at midbrain, 16 cases at pons, and 2 cases at medulla) treated in the Second Affiliated Hospital Zhejiang University School of Medicine from July 2003 to June 2014 were retrospectively reviewed. The medical history, radiological findings, operation records, postoperative course and follow-up results were analyzed. Results: Suboccipital approach, retrosigmoid approach, subtentorial supracerebella approach, Poppen approach, pterional approach, Kawase approach, interhemispheric transcallosal third ventrical approach were applied for the surgery of BSCM patients. Among them, Kawase approach and interhemispheric transcallosal third ventrical approach were firstly reported in treatment of BSCM. Total resection was achieved in 22 cases. Neurological function was improved in 15 cases, unchanged in 7 cases and deteriorated in 1 case. Fifteen cases were followed up for a mean period of 3.5 years and signs of recurrence was found. Conclusion: Proper selection of surgical approach is important to assure total resection of the lesions, to protect surrounding normal vital structures and to avoid post-surgical complications.

Evacuation of spontaneous supratentorial intracerebral hematoma with double targets-single channel and multiaxial stereotaxis
CHEN Peng, CHEN Ting, ZHANG Yang, GAO Lian-sheng, FU Wei-ming, ZHANG Jian-min, LIU Feng-qiang
Journal of ZheJiang University(Medical Science), 2015, 44(4): 376-382.   https://doi.org/10.3785/j.issn.1008-9292.2015.07.05
Abstract( 123 )   HTML (   PDF(3738KB)( 202 )

Objective: To evaluate the efficacy and safety of evacuation of spontaneous supratentorial hemorrhage with double targets-single channel and multiaxial stereotaxis. Methods: Thirty-four patients with supratentorial intracerebral hemorrhage, who underwent hematoma evacuation with the method of double targets-single channel between January 2014 and November 2014 in the Second Affiliated Hospital, Zhejiang University School of Medicine, were included in the study. We classified the hematoma into four types based on the principle of double targets-single channel calculation method (DTSC). And the appropriate stereotactic surgery path and operation opportunity were designed individually according to the hematoma volume and mass effect. Twenty-seven patients with supratentorial hemorrhage who underwent hematoma evacuation with the method of single targets-single channel between January 2013 and November 2014 were selected as single target group. Results: Volumes of initial hematoma in DTSC and single target groups were(38.6±19.2)mL and(40.1±18.1)mL, respectively. Initial Glasgow Coma Scale were 9.6±3.2 (3~15) and 9.1±2.9(3~13) (all P >0.05). Residual volume of hematoma and clearance ratio were (11.1±4.2) mL and(73.1±5.4)% in DTSC group and (18.5±5.3) mL and(55.1±5.1)% in single target group by CT scan 24 h after operation(all P <0.05). There was no significant difference in Glasgow Outcome Scale between two groups in one-month follow-up. Average length of postoperative stay of two groups were(12.6±9.8)d and (14.2±7.1)d, respectively.Conclusion: Evacuation of spontaneous supratentorial intracerebral hematoma with DTSC and multi-axial stereotaxis can increase clearance ratio remarkably and decrease average length of stay.

Surgical treatment of anterior circulation aneurysms via lateral supraorbital approach
QIN Bin, YING Guang-yu, HU Hua, CHEN Gao, ZHANG Jian-min, WANG Lin
Journal of ZheJiang University(Medical Science), 2015, 44(4): 383-388.   https://doi.org/10.3785/j.issn.1008-9292.2015.07.06
Abstract( 100 )   HTML (   PDF(1306KB)( 228 )

Objective: To evaluate the efficacy of the surgery with lateral supraorbital approach for clipping anterior circulation aneurysms. Methods: The clinical data of 99 patients with anterior circulation aneurysms who underwent a clipping via lateral supraorbital approach from October 2012 to September 2014 and 75 patients, who underwent a clipping via pterional approach from January 2010 to December 2011 in the second Affiliated Hospital, Zhejiang University School of Medicine were reviewed. The operative duration, prognosis, residual rate and rupture rate during surgery were compared between two groups. Results: The patients by lateral supraorbital approach had a shorter operative duration, namely 37~61 min less than that in the patients by pterional approach. No difference were found in residual rate and rupture rate between two groups. The Glasgow Outcome Scale (GOS) at 3 months after surgery showed no significant difference between two groups. Conclusion: The lateral supraorbital approach can be used safely and effectively with shorter operative duration and less tissue damage for treatment of patients with anterior circulation aneurysms.

Comparison clinical efficacy of 3% hypertonic saline solution with 20% mannitol in treatment of intracranial hypertension in patients with aneurysmal subarachnoid hemorrhage
HUANG Xue-cai, YANG Ling-ling
Journal of ZheJiang University(Medical Science), 2015, 44(4): 389-395.   https://doi.org/10.3785/j.issn.1008-9292.2015.07.07
Abstract( 137 )   HTML (   PDF(749KB)( 303 )

Objective: To compare the efficacy of 3% hypertonic saline solution with 20% mannitol in treatment of intracranial hypertension in patients with aneurysmal subarachnoid hemorrhage. Methods: An alternating treatment protocol was used to compare the efficacy of 160 mL 3% hypertonic saline solution (HSS) with 150 mL 20% mannitol for episodes of increased intracranial pressure (ICP) in patients with aneurysmal subarachnoid hemorrhage. The dependent variables were the extent and duration of reduction of increased ICP after each event. Results: Both 3% HSS and 20% mannitol rapidly decreased the ICP in patients with aneurysmal subarachnoid hemorrhage (P <0.01). No difference between two medications in the extent of duration of ICP and reduction of action (P >0.05). Conclusion: 3% HSS should be considered as the first-line osmotic drug in treatment of intracranial hypertension in patients with aneurysmal subarachnoid hemorrhage.

A3-A3 side-to-side anastomosis combined with endovascular intervention in recurrent complex anterior artery aneurysm: a case report and literature review
CHEN Xian-yi, WANG Lin, FANG Bing, YU Jun
Journal of ZheJiang University(Medical Science), 2015, 44(4): 396-399.   https://doi.org/10.3785/j.issn.1008-9292.2015.07.08
Abstract( 92 )   HTML (   PDF(863KB)( 267 )

A 28-year-old female patient was admitted to the Second Affiliated Hospital, Zhejiang University School of Medicine, with sudden headache and vomiting for 1 day. CT scan conducted at emergency revealed subarachnoid hemorrhage, whereas digital subtraction angiography demonstrated a wide-neck aneurysm located at A1 segment of the left anterior cerebral artery. The aneurysm was totally coiled using stent assistance, which, however, was recanalized at 3 month follow-up. This patient was then subjected to aneurysm and parent artery occlusion after bypass of the bilateral A3 segments, who recovered well and discharged without ischemic complications.

Effects of miRNA-21 on paclitaxel-resistance in human breast cancer cells
ZHAO Zun-lan, CAI Ying, WANG Yang-yang, XIA Chun-lei, LI Cong-xin, CHEN Su-lian, YANG Qing-ling, CHEN Chang-jie
Journal of ZheJiang University(Medical Science), 2015, 44(4): 400-409.   https://doi.org/10.3785/j.issn.1008-9292.2015.07.09
Abstract( 128 )   HTML (   PDF(1876KB)( 373 )

Objective: To investigate the effects of miR-21 on paclitaxel-resistance in human breast cancer MCF-7/PR and SKBR-3/PR cells. Methods: Paclitaxel-resistant human breast cancer cell lines MCF-7/PR and SKBR-3/PR were established by stepwise selection in increasing concentration of paclitaxel. Cellular morphology, mRNA and protein level of MDR1, BCRP and MRP1 in MCF-7/PR and SKBR-3/PR cells were determined. The expression of Bax, Bcl-2 and miR-21 in parental and paclitaxel-resistant cells was detected by RT-PCR and Western blotting. The synthetic miR-21 inhibitor or miR-21 mimic were transfected into MCF-7/PR, SKBR-3/PR and MCF-7, SKBR-3 cells with Lipofectamine 2000. The miR-21 levels were determined by RT-PCR, and P-gp, Bcl-2 and Bax protein levels were examined by Western blotting. MTT assay was used to measure the cell viability, and flow cytometry was performed to analyze the cell cycle and apoptosis. Results: The levels of MDR1, BCRP, MRP1, Bcl-2/Bax and miR-21 in MCF-7/PR and SKBR-3/PR cells were significantly higher than those in MCF-7 and SKBR-3 cells. The protein levels of P-gp, Bcl-2 were up-regulated, and Bax was down-regulated compared with parental cells. MiR-21 was significantly down-regulated after miR-21 inhibitor was transfected; and the levels of MDR1, BCRP, MRP1 and Bcl-2/Bax (P <0.05) were also down-regulated. MiR-21 inhibitors significantly suppressed G0/G1 transition of the cell cycle, and induced cell apoptosis in MCF-7/PR and SKBR-3/PR cells. MTT results showed that miR-21 inhibitors induced sensitivity of MCF-7/PR and SKBR-3/PR cells to paclitaxel. And miR-21 mimic can increase the expression of MDR1, Bcl-2/Bax and change cell morphology from parental cells to resistant cells. Results: The established MCF-7/PR and SKBR-3/PR breast cancer cells show typical multidrug resistance characteristics, which can be used as the model for drug resistance study. Down-regulated miR-21 expression in MCF-7/PR and SKBR-3/PR breast cancer cells can enhance cell sensitivity to paclitaxel.

Risk factors of progressive brain contusion and relationship with outcome
WANG Ke, ZHAO Dong-qing, ZHANG Jian-jun, LI Yu-jian, ZHANG Hai-dong, SHEN Zhang-feng, HU Bin, WU Hai-bin
Journal of ZheJiang University(Medical Science), 2015, 44(4): 410-416.   https://doi.org/10.3785/j.issn.1008-9292.2015.07.10
Abstract( 104 )   HTML (   PDF(974KB)( 234 )

Objective: To investigate the risk factors of progressive brain contusion and to evaluate their impact on patients' outcome. Methods: One hundred and thirty two patients with traumatic brain contusion were enrolled in the study, including 70 cases with progressive contusion and 62 cases with non-progressive contusion. The risk factors were investigated with univariate and multivariate Logistic regression analysis. Results: The univariate analysis showed that Glasgow Coma Score (GCS) at admission, contusion volume at the first brain CT scans, midline shift, combined with skull fracture, subarachnoid hemorrhage, epidural hematoma, subdural hematoma, location of brain contusion, D-dimer levels, combined with type 2 diabetes were associated with progressive brain contusion. Multivariate Logistic regression analysis showed that GCS at admission, contusion volume at the first CT scans, combined with subarachnoid hemorrhage, combined with type 2 diabetes were the independent risk factors for disease progression. The outcome in the progressive group was more aggravated than that in non-progressive group (P = 0.001). Conclusion: Patients with disturbance of consciousness, the larger contusion volume, combined with subarachnoid hemorrhage and diabetes are at risk for progressive brain contusion and unfavorable outcome.

Distribution of HCV genotypes in Chinese Han population with chronic hepatitis C
MAO Xiao-rong, ZHANG Li-ting, JIANG Ni, XIAO Ping, PENG Xue-bin, ZHANG You-cheng
Journal of ZheJiang University(Medical Science), 2015, 44(4): 417-422.   https://doi.org/10.3785/j.issn.1008-9292.2015.07.11
Abstract( 109 )   HTML (   PDF(686KB)( 178 )

Objective: To investigate the distribution of HCV genotypes in Chinese Han population with chronic hepatitis C (CHC). Methods: This randomized multicenter study included 1 014 CHC patients from 28 hospitals in different regions of China. SPSS 20.0 was applied to analyze the relationship among region, HCV genotype, gender and the replication level of HCV-RNA. Results: HCV 1 genotype (56.80%) was the most common genotype. The majority of CHC patients were of genotype 1, 2, 3, 6 in the order of frequency, except those in southwestern, southern and central China. HCV 1, 2, 3, 6 genotypes were most common among male patients in southern China; among female patients in northern China; among male patients in northern and northwestern China and among male patients in northwestern China, respectively (all P <0.05). There was no statistical significance between different genders in other regions. The high viral load was more common than the low viral load among HCV 1, 2, 3, 6 genotype-infected patients. Conclusion: There are different distributions of HCV genotypes among the different regions. In addition, HCV genotypes are correlated with gender and HCV-RNA load.

Preparation of rabbit monoclonal antibody against cGMP and development of competitive ELISA for cGMP
TAN Xing-mei, HU Hai-feng, CHEN Shu-qing
Journal of ZheJiang University(Medical Science), 2015, 44(4): 423-428.   https://doi.org/10.3785/j.issn.1008-9292.2015.07.12
Abstract( 255 )   HTML (   PDF(685KB)( 313 )

Objective: To prepare rabbit monoclonal antibody (RabMab) against guanosine 3', 5'-cyclic monophosphate (cGMP) and to develop a competitive ELISA for the detection of cGMP. Methods: New Zealand white rabbits were immunized with synthesized cGMP-keyhole limpet hemoeyanin (cGMP-KLH) to prepared a RabMAb with monoclonal antibody technique of Epitomics. A competitive ELISA kit was produced with cGMP RabMAb. The specificity, the precision and the recoveries of the method were determined. Results: The RabMAb with high sensitivity towards cGMP were prepared with an antibody timer of 3.1 ng/mL and 50% inhibitive concentration (IC50) of 12.57 ng/mL. The cGMP RabMAb had 33% cross-reactivity to inosine 3', 5'-cyclic monophosphate (cIMP) and little or no cross-reactivity to other compounds. A competitive ELISA was developed for detection of cGMP. The range of detection was 0~120 ng/mL with a minimal limit of 1.95 ng/mL. The recovery of assay was 89%~103%. The inter-assay and intra-assay coefficient variations were below 11.68% and 13.85%, respectively. Conclusion: The RabMab against cGMP with high affinity and high specificity has been generated successfully, and a competitive ELISA for detection of cGMP has been developed with the prepared cGMP RabMAb.

Simultaneous quantitative analysis of different ceramide species in cells by high-performance liquid chromatography-tandem mass spectrometry
QIU Li-ping, SUN Wen-jun
Journal of ZheJiang University(Medical Science), 2015, 44(4): 429-434.   https://doi.org/10.3785/j.issn.1008-9292.2015.07.13
Abstract( 117 )   HTML (   PDF(744KB)( 315 )

Objective: To establish a high-performance liquid chromatography-tandem mass spectrometry (HPLC-ESI-MS) method for simultaneous quantitative analysis of different ceramide species in cells. Methods: The analysis was performed on an Agilent 1290 HPLC system with a ZORBAX Eclipse XDB-C8 (150.0 mm×2.1 mm, 3.5 μL) column and a temperature of 35 ℃. Methanol with 1 mmol/L ammonium formate and 0.2% formic acid was used as mobile phase A and 100% methanol was used as mobile phase B. And the ceramides were separated by gradient elution at a flow rate of 0.3 mL/min. Electrospray ionization (ESI) with multiple reaction monitoring (MRM) was used in the analysis. Results: Four ceramide species all had a good linear response in the determination ranges (R2 ≥0.9987). The average recoveries (n = 9) were 99.1%,99.9%,100.5% and 98.2% with RSDs of 5.6%, 5.1%, 4.7% and 5.5%, respectively. In addition, the levels of ceramides in FL cells were relatively stable, while the C24-ceramide had the highest level. Conclusion: The HPLC-ESI-MS method for simultaneous analysis of ceramides has high accuracy, reproducibility and linearity, which may be used for quantification of ceramide species in cells.

The value of narrow-band imaging with magnifying endoscopy in diagnosis of early gastric cancer: a meta-analysis
HUANG Wei, WANG Lei, DU Jing, YANG Jian-min
Journal of ZheJiang University(Medical Science), 2015, 44(4): 435-442.   https://doi.org/10.3785/j.issn.1008-9292.2015.07.14
Abstract( 97 )   HTML (   PDF(806KB)( 320 )

Objective: To assess the diagnostic value of narrow-band imaging with magnifying endoscopy (NBI-ME) for early gastric cancer (EGC). Methods: We searched PubMed, Embase, Web of Science and the Cochrane Library for literature of NBI-ME in diagnosis of EGC, and then performed meta-analysis. Results: A total of 12 articles involving 2 278 samples from 2 048 patients were included. The overall sensitivity of NBI-ME for diagnosis of EGC was 0.84 [95% CI: 0.80~0.87], specificity was 0.96 (95% CI: 0.95~0.97),and area under the symmetric receiver operator characteristic curve (AUC) was 0.9592. The AUC value of the NBI-ME plus conventional white light endoscopy (C-WLE) subgroup (0.9706) was higher than that of NBI-ME alone (0.8162). The incremental yield of NBI-ME plus C-WLE over C-WLE was significant (IY = 9.4%, P = 0.011), while NBI-ME alone over C-WLE was not significant (IY = 0.8%, P = 0.498). Conclusions: The results show that NBI-ME plus C-WLE is an effective and preferable method for diagnosis of EGC; however, NBI-ME alone is not superior to C-WLE.

Epidemiology, diagnosis and treatment of Middle East respiratory syndrome
ZHANG Yu, CHEN Shao-hua
Journal of ZheJiang University(Medical Science), 2015, 44(4): 443-450.   https://doi.org/10.3785/j.issn.1008-9292.2015.07.15
Abstract( 118 )   HTML (   PDF(1052KB)( 280 )

Middle East respiratory syndrome (MERS) has raised global public health concerns. The recent outbreak of MERS coronavirus (MERS-CoV) infection has led to 1 338 laboratory-confirmed cases in 26 countries worldwide as reported till 19 June, 2015. MERS-CoV may be considered a zoonotic virus that has crossed the species barrier to humans, but the pathogenesis and the routes of transmission are not completely understood. Most MERS-CoV cases reported thus far have a history of residence in or travel to the Middle East. Human-to-human transmission though was observed on some occasions in Korea, it is documented as non-sustainable event. The envelope spike glycoprotein on the surface of MERS-CoV which mediates receptor binding, membrane fusion and viral entry is thought to be involved in the mechanism of MERS-CoV.No specific and effective treatment for MERS-CoV is currently recommended, although supportive treatment has played an important role. Prophylactic strategies are necessary to prevent MERS-CoV infection.

Progress on perioperative monitoring of cerebral blood flow autoregulation
ZHENG Yue-ying, PAN Cai-fei, ZHU Sheng-mei
Journal of ZheJiang University(Medical Science), 2015, 44(4): 451-457.   https://doi.org/10.3785/j.issn.1008-9292.2015.07.16
Abstract( 118 )   HTML (   PDF(747KB)( 213 )

Cerebral blood flow autoregulation is physiologically protective mechanism to maintain the stability of cerebral blood flow. Once autoregulation is impaired, the cerebral blood flow fluctuates with blood pressure, leading to the risk of brain ischemia or cerebral hyperemia. Multiple research results indicate that cerebral blood flow can be monitored indirectly and continuously with transcranial Doppler, near infrared spectroscopy or ICP. The correlation coefficient calculated by the surrogate for cerebral blood flow and blood pressure is used to judge cerebral blood flow autoregulation. When the correlation coefficient is close to 1, cerebral blood flow will be passively fluctuated by blood pressure, indicating autoregulation is impaired. When the coefficient is less than 0, cerebral blood flow will not be changed with blood pressure, indicating autoregulaiton is intact. The status of autoregualtion is closely associated with mortality or poor neurological outcomes in patients with cardiac surgery underwent cardiopulmonary bypass, liver transplantation patients or patients with deep trendelenburg position for long time or beach chair position. Continuous monitoring of cerebral blood flow autoregulation can identify the lower or the upper limit of autoregulation, and provide information to individualize the perioperative management of blood pressure.

Advances in measles virus for cancer therapy
ZHOU Duo, ZHAO Zheng-yan
Journal of ZheJiang University(Medical Science), 2015, 44(4): 458-464.   https://doi.org/10.3785/j.issn.1008-9292.2015.07.17
Abstract( 100 )   HTML (   PDF(759KB)( 287 )

Oncolytic virotherapy is a novel cancer therapy. Vaccine-attenuated strains of measles virus(MV)is an ideal candidate for oncolytic virotherapy which has an excellent safety record. Vaccine-attenuated MV uses CD46 and Nectin-4 molecule as major entry receptors into cells. Vaccine-attenuated MV can selectively infect and kill a wide variety of cancer cells in vitro and in vivo. With the development of molecular cloning, scientists have successfully rescued cDNA of vaccine-attenuated MV and increased its oncolytic efficiency with molecular engineering techniques. Phase I clinical trials of virotherapy for ovarian cancer and multiple myeloma with vaccine-attenuated MV are underway. The preliminary results indicate the promising antitumor potential of vaccine-attenuated MV.

Asteatotic dermatitis: etiology and pathogenesis
ZHOU Li-juan, LYU Zhong-fa
Journal of ZheJiang University(Medical Science), 2015, 44(4): 465-470.   https://doi.org/10.3785/j.issn.1008-9292.2015.07.18
Abstract( 127 )   HTML (   PDF(730KB)( 247 )

Asteatotic dermatitis (AsD) is a common skin disease characterized by dry skin, itching, erythema, peeling and other skin lesions. It results from the damage in cutaneous barrier related to age, seasonal climate and bathing habits, and presents dysfunction of sebaceous, sweat glands and the increase of transepidermal water loss. The pathogenesis of AsD is not clear. Previous studies mainly focused on the relationship between skin barrier damage and bathing habits, age or gender. Recently, more studies focus on its relationship with other systematic diseases and drugs. This paper reviews etiology and pathogenesis of AsD to provide new ideas for the diagnosis and treatment of AsD.

18 articles