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Objective To evaluate the feasibility, safety and clinical efficacy of endovascular angioplasty for symptomatic, non-acute occlusion of the large intracranial artery under the guidance of highresolution magnetic resonance imaging (HR-MRI). Methods A total of 31 patients with symptomatic and subacute or chronic occlusion of the large intracranial artery in the Department of Interventional Therapy, First Affiliated Hospital of Dalian Medical University from June 2017 to December 2019 was analyzed retrospectively. The location of luminal and plaque at the occlusion segment were evaluated by HR-MRI to determine the characteristic of the occlusion (thrombosis or substantial occlusion of the wall), and obtain the relationship between the plaque distribution of intracranial artery and the opening location of perforating artery. According to the evaluation results, 26 patients were screened for recanalization with angioplasty. The success rate of surgical technique, perioperative complications, and the outcomes of postoperative clinical and imaging follow-up were evaluated. The modified Rankin scale (mRS) was used to assess the patient's prognosis. Results Of the 26 patients undergoing surgery, 22 cases were successful in recanalizing the occlusion vessel; 4 cases were failed to open due to the guidewire was difficult to pass through the occlusion segment, of which one case was occluded at the C6 segment of the internal carotid artery, two cases were occluded at the segment of the intracranial vertebral artery, and one case was occluded at the basilar artery. There were 2 cases with complications during the operation, both of which were asymptomatic peripheral embolism, and there were no complications of bleeding and death during the perioperative period. The median follow-up time in 22 successful patients was 12 (3, 21) months. There were no deaths or losses to follow-up. The median mRS score was 1 (1,3). There were no recurrent stroke or transient ischemic attacks. Two cases of asymptomatic in-stent restenosis occurred without adverse reactions and adverse consequences. Four failed patients had a median follow-up time of 11 (3, 18) months. There were no deaths or losses to follow-up. The median mRS score was 2(2, 3). There were 1 case of recurrent stroke and 2 cases of transient ischemic attacks, respectively. Conclusions For patients with symptomatic occlusion of the large intracranial artery in non-acute stage, It is safe and feasible with angioplasty for selected patients guided by HR-MRI to evaluate the occlusion length, pathological nature and latent space of the occlusion segment, and combined with other clinical conditions, which can improve the short-term outcomes of patients' ischemic symptoms and reduce the rate of recurrent stroke. However, the long-term efficacy needs to be confirmed with long-term follow-up.
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Objective To systematically evaluate the incidences of complications of high frequency oscillatory ventilation ( HFOV) and conventional mechanical ventilation ( CMV ) in premature infants. Method Randomized controlled trials of HFOV and CMV in premature infants published in databases including PubMed, Embase, Cochrane Library, CNKI Database, Wanfang Database, Weipu Chinese Sci－Tech Periodical Database were searched.The retrieval time was from the establishment of the databases to January 2018.The quality of the literature were evaluated , and Stata 15.0 statistical software was used for meta－analysis.Result A total of 18 articles and 3 888 premature infants were included in the study , including 1 910 in the HFOV group and 1 978 in the CMV group.No significant differences were found in the incidences of in－hospital mortality, air leakage syndromes , retinopathy of prematurity (ROP),≥grade 3 intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), necrotizing enterocolitis (NEC) and patent ductus arteriosus ( PDA) requiring medication or surgery ( P ＞0.05 ).The incidences of bronchopulmonary dysplasia (BPD) (RR ＝0.90,95%CI 0.83 ～0.98),≥grade 2 ROP (RR ＝0.78, 95%CI 0.63～0.96) and pulmonary hemorrhage (RR＝0.63, 95%CI 0.47～0.85) in HFOV group was significantly lower than the CMV group (P＜0.05).In the subgroup analysis, the results of the researches in 1980s, 1990s, 2000s, and 2010s showed that no significant differences existed in in－hospital mortality between the HFOV group and the CMV group on ventilator pressure control mode and volume control mode (P＞0.05).Conclusion Current evidences suggested that comparing with CMV , the application of HFOV in preterm infants might reduce the incidences of BPD ,≥grade 2 ROP and pulmonary hemorrhage.
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Objective To develop a rapid ,convenient ,sensitive and specific method for the detection of marine Vbrio vulnificus by using loop‐mediated isothermal amplification(LAMP) technique ,and evaluate the specificity and sensitivity of this method . Methods According to marine Vibrio vulnificus cytolysin(vvhA) gene sequence published by GenBank ,a set of LAMP primers were designed .LAMP and polymerase chain reaction(PCR) amplification were carried out in 47 strains of bacteria(including 20 strains of Vibrio) and specificities of LAMP and PCR were compared .Serial ten‐fold dilutions of an overnight Vibrio vulnificus M06 culture were prepared in sterile saline solution ,and compared the sensitivity of LAMP with that of PCR after extracting DNA tem‐plates .A recombinant plasmid containing fragment of vvhA gene was constructed and set as a standard positive control of LAMP assay .Results False‐positive results occurred in the conventional PCR ,while in the LAMP assay positive amplifications were only seen in strains of Vibrio vulnificus and no false‐positive or false‐negative results were generated among 47 strains of bacteria ,which indicated that primers had high specificity .Additionally ,the results of electrophoresis were consistent with those after adding the calcein .The detection limit of LAMP was 4 × 10 CFU each reaction for detecting vvhA gene in pure culture ,which was 10‐fold more sensitive than that of conventional PCR(4 × 102 CFU each reaction) .It indicated that LAMP assay had good sensitivity .Repeated the test twice ,the detection results of LAMP and PCR were both stable .Conclusion An LAMP detection method for marine Vibrio vulnificus has been developed ,which is highly specific ,sensitive ,convenient and suitable for rapid field detection and point‐of‐care testing .
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Objective To explore the efficacy and safety of the treatment of Xuezhikang and fluvastatin in elderly angina patients with mildly abnormal liver function .Methods 84 cases of ALT in 40-80u/L very elderly patients with coronary heart disease were randomly selected and divided into the two groups , the Xuezhikang group received Xuezhikang (0.6g,bid,orally),the fluvastatin group received fluvastatin (40mg,1time/night,oral),the total course was 12weeks,the TC,TG,LDL-C,HDL -C were measured before and after treatment ,liver function was measured once 2 -4times.If ALT was 3 times higher than before , Xuezhikang was instead of statins , if ALT was 5 times higher than before ,both of the two drags were withdrawaled .Results The TC,LDL,TG,HDL-C and ALT of the two groups were no significant difference before treatment (P >0.05),the TC,LDL,TG were decreased after treatment in the both group .There was no case of increased of ALT to three times in Xuezhikang group ,however ,ALT of 6 patients were increased more than three times in fluvastatin group ,four weeks after exchange of Xuezhikang ,the ALT were not continued to rise .Conclusion Both the two medicine can significantly lowered the cholesterol in very elderly patients with angina ,but the Xuezhikang were more safety in the patient with mild increased of liver function .