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Objective· To compare the impacts on clinical efficiency and safety between 0.014 inch Synchro microwire and Transend microwire used during mechanical thrombectomy for acute ischemic stroke (AIS) caused by large artery occlusion.Methods· Forty-six patients undergoing mechanical thrombectomy with stent retrievers between October 2012 and January 2016 were included,who were classified into Synchro group (21cases) and Transend group (25 cases).The clinical outcome,procedure time,and safety were analyzed and compared between two groups.Results· The recanalization rates were similar between two groups (P=0.600),but time from puncture to vascular recanalization of Synchro group was much shorter than that of Transend goup (48.88 min vs 82.33 min,P=0.001).The rates of functional independence (modified Rankin scale score ≤ 2) were similar between two groups (P=1.000).There was no significant difference of the rates of post-procedure subarachnoid hemorrhage (PSAH) between two groups (P=1.000).However,there were two cases that had fatal subarachnoid hemorrhage with intracranial hematoma in Transend group,while there was only one case of mild subarachnoid hemorrhage who recovered well in Synchro group.Conclusion· Compared with Transend microwire,Synchro microwire can significantly shorten the procedure time of mechanical thrombectomy,and the risk of fatal subarachnoid hemorrhage is rather small.
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After more than3 years of pilot (since 2010), standardized training of resident physicians in Shanghai has made great progress, however, it still needs to be improved. Cerebral and spinal vascular diseases are main types of neurological diseases and they seriously influence people's life and health. Interventional neuroradiology plays an important role in the diagnosis and treatment of cerebral and spinal vascular diseases. However, in the current residency training system in Shanghai or other provinces of China, the training of interventional neuroradiology is not included. In this paper, the authors analyzed the important role of interventional neuroradiology in diagnosis and treatment of cerebral and spinal vascular disorders and discussed the feasibility, method, and time arrangement of including interventional neuroradiology curriculum into the schedule of neurology standardizedresidency training and hoped to provide reference for the relevant departments to formulate a future policy.
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Objective To review the clinical and laboratory features of tuberculous meningitis (TBM). Methods The clinical and laboratory data from 246 cases of TBM in Tuberculosis Treatment Center of Integrated Chinese and Western Medicine Hospital of Zhejiang Province from January 1,1999 to December 31,2005 were collected and analyzed with SPSS 15.0 software. Results In 246 TBM patients,203(82.5%)was of basilar meningitis, 170(69. 1%)complicated with pulmonary tuberculosis. Fever,nausea, vomiting and headache were common symptoms in TBM patients. PPD skin tests were positive in 155(63.0%)patients, but only 12(4.9%)were acid-fast bacillus smear-positive in cerebrospinal fluid (CSF). CSF test showed that the white blood cells[(320 - 880)× 106/L], protein(0. 95 - 13.8 g/L)were increased, while glucose(1.53 - 3.2 mmol/L)and chloride content(90 - 111 mmol/L)were decreased. Adenosine deaminase ≥8 U/L was observed in 230(93.5%)patients, and 185(75.2%)patients were tuberculosis antibody positive. Eighty-one(32. 9%)patients showed nodular or annular shadows in cranial CT. After comprehensive therapy, 242(98.4%)patients recovered or improved and no sequela was observed, while 4(1.6%)patients died. Conclusion Early diagnosis of TBM should be based on clinical manifestations, changes of cerebrospinal fluid, imaging examination and PPD test.
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Objective To evaluate the relationship between stenosis of intra- or extra-cranial cerebral large artery and capsular warning syndrome(CWS). Methods Eleven consecutive CWS patients hospitalized during period of time from November 2008 to December 2009 were retrospectively analyzed.Result In these 11 patients with CWS, 5 patients had motor symptoms only, 4 patients had pure sensory symptoms, and 2 patients had sensorimotor symptoms. Ten patients underwent cervical contrast-enhanced MRA and intracranial MRA examination. The results showed no sign of arterial stenosis. Seven CWS patients eventually had strokes, 1 progressed to stroke despite receiving the therapy of antiplatelet and anticoagulation. All stroke lesions were located in the capsula interna. All the CWS patients had vascular risks: 7 were smoker, 8 had hypertension, 1 had diabetes mellitus, and 5 had hyperlipidemia. One patient had a history of previous stroke; no patient had a history of ischemic heart disease or atrial fibrillation. At follow-up(10. 2 ±3.4)mouths, the average modified Rankin scale score for all patients was 0. 73 ± 1.20.Conclusion CWS was not associated with stenosis of the intra and extra-cranial large cerebral arteries.CWS may be associated with small-vessel single-penetrator disease.
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Objective To establish a method for the in-vitro culture of astrocytes from cerebral cortex of neonatal rats.Methods Astrocytes were isolated from cerebral cortex of the neonatal SD rats aged 24 hours,and then were cultured in the high-glucose DMEM medium with 10% fetal bovine serum added.The morphological features of astrocytes were examined under inverted microscope.The growth of the third generation of astrocytes was observed with counting plate method and methyl thiazolyl tetrazolium (MTT) assay.Results The astrocytes from cerebral cortex of neonatal rats grew well,the astrocytes showed typical morphological features,and no other kinds of cells was found.Conclusion A simple and practical in-vitro culture method for rats astrocytes is established.
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Objective To determinted whether GM1 had a protective effect on injury induced by serum-deprivation and the possible mechanism in PC12 cells. Methods The viability of PC12 cells was quantified by MTT after serum-deprivation.The number of apoptotic cells and necrotic cells were determined by Hoechst 33258/PI staining.And the change of PKC protein expression on PC12 cells' membrane and cytosols was detected by Western blotting. Results 1.The viability of PC12 cells decreased after serum-deprivation and the serum-deprivation for 24 hours was chosen as an injury model in this research.Most of the PC12 cells presented apoptosis 24 hours after serum-deprivation.In addition,the PC12 cells' cytosols PKC protein decreased,while the PC12 cells' membrane PKC protein increased significantly,and this result suggested PKC's translocation to membrane and its activation.2.The viability of PC12 cells preincubated with GM1 in high concentrations(10,1,0.1?mol/L) increased significantly and GM1 protected PC12 cells from apoptosis after serum-deprived injury.GM1 reduced the damage of serum-deprivation on PC12 cells and inhibited PKC protein translocation after injury.3.The repair function of GM1 was effective to neuronal resume after serum-deprived injury.Conclusion Neuroprotective effects of GM1 on serum-deprived injury may be partly mediated through the regulation of PKC pathways and it is helpful for the recovery after injury.