Relationship between post?operative residual patellar J sign and the laxity of reconstructed medial patellofemoral liga?ment in recurrent patellar instability adult patients / 中华骨科杂志

Objective To discover the relationship between the post?operative positive residual patellar J sign and the laxity of reconstructed medial patellofemoral ligament (MPFL) after MPFL reconstruction combined with tibial tubercle osteotomy (TTO). Methods A total of 39 consecutive recurrent patellar dislocation (RPD) adult patients who were performed MPFL recon?struction and TTO with more than 2 follow?up time were analyzed retrospectively in the present study. The patellar tracking of all the patients was evaluated and was classified into positive patellar J sign group and negative J sign control group during knee ac?tive flexion and extension at final follow up. The computed tomography (CT) examination was performed in all patients at 0°exten?sion of the knee. The patellar laxity index measured by patellar glide test (PGT) and the radiographic parameters (tibial tuberosity?trochlear groove distance, bisect offset index, patella trochlear?groove distance, patella lateral tilt angle, femoral anteversion angle, tibial external angle and knee rotational angle) calculated by CT scans slices as well as the pre?/post?operative knee functional scores including International Knee Documentation Committee (IKDC) score, Kujala score, and Lysholm score were compared be?tween the positive group and negative group at final follow up. Results The average follow?up duration was 26.3±6.7 months (range 24-31) and all the patients did not suffer from the RPD during the follow?up. Ten (26%, 10/39) patients performed positive J sign, and the remaining 29 (74%, 29/39) performed negatively. The two groups were compatible with no significant difference in age, gender, injury side, follow?up duration and preoperative knee function scores (P＞0.05). At the final follow up, the patellar laxity index in the positive J sign group was 34.9%±6.9%, while that in the negative group was 24.6%±8.6%. There was signifi?cantly difference in the patellar laxity index between two groups (t=-3.413, P=0.002). The bisect offset index in the positive group was 102.9%±12.4%, while that in the negative group was 76.0%±18.4%. There was significantly difference in the bisect offset in?dex between two groups (t=-4.268, P=0.000). The patella trochlear?groove distance in the positive group was 2.2±3.7 mm, while that in the negative group was-7.6±5.8 mm. There was significantly difference in the patella trochlear?groove distance between two groups (t=-4.233, P=0.000). The two groups were compatible with no significant difference in tibial tuberosity?trochlear groove distance, patella lateral tilt angle, femoral anteversion angle, tibial external angle and knee rotational angle (P＞0.05). The IKDC, Kujala, and Lysholm in the positive group were 86.4±6.5, 85.3±1.1, 91.5±7.9 respectively with significantly differences compared with preoperative scores 53.3±2.4, 73.2±9.7, 76.7±6.6 (t=-10.163, P=0.000; t=-1.274, P=0.023; t=-8.533, P=0.018). The IKDC, Kujala, and Lysholm in the negative group were 87.3±8.6, 84.3±4.7, 93.1±4.3 respectively with significantly differences compared with preoperative scores 49.1±4.6, 71.4±6.5, 79.5±7.0 (t=-14.381, P=0.000; t=-0.068, P=0.037; t=-6.902, P=0.013). There were no significant difference in the postoperative knee function scores between the two groups (P＞0.05). Conclusion RPD patients can recover the patellar instability from the surgical technique of MPFL reconstruction and TTO and none of them suffer from the RPD during the follow?up. However, the morbidity of post?operative positive residual patellar J sign was 26%. The positive J sign might increase the laxity of patella.

Study Progress of TCM Syndrome and Neuroplasticity Mechanism of Parkinson's Disease with Depression / 世界科学技术-中医药现代化

Parkinson's disease with depression belongs to the category of "tremor syndrome" and "depression syndrome" of Traditional Chinese Medicine. Its syndrome characteristics and distribution are different from simple tremor syndrome and depression syndrome. Its neuroplastic mechanism involves dopamine, serotonin, norepinephrine and brain-derived neurotrophic factor. Parkinson's disease and depression have common neuro-biological mechanisms. Therefore, Chinese medicine treatment of Parkinson's disease with depression may have a dual regulation effect.

Incidence of concomitant anterolateral ligament MRI abnormality on patients with high-grade pivot-shift phenomenon / 中华骨科杂志

Objective To investigate the incidence of concomitant anterolateral ligament (ALL) abnormality by magnetic resonance imaging (MRI) on patients with high-grade pivot-shift after anterior cruciate ligament (ACL) injuries.Methods From January 2016 to June 2016,one hundred and sixty-four consecutive patients with acute ACL injury were retrospectively reviewed.All patients underwent comprehensive pre-operative physical examinations and MRI scans.Sixty-eight patients with acute ACL injury who showed high-grade (grade Ⅱ and Ⅲ) pivot-shift phenomenon were enrolled in the high-grade pivot-shift group.They were matched in a 1:1 fashion to another 68 ACL-injured participants who showed low-grade (grade 0 and Ⅰ) pivot-shift phenomenon during the same study period.The grade of ALL injury was divided into grade Ⅰ (sprain),grade Ⅱ (partial tear) and grade Ⅲ (complete tear),and they were further compared between the high-grade pivot-shift group and the low-grade pivot-shift group on the coronal view of their T2WI MRI scans.Results The mean age of the patients in all groups was 29.3 years old.There were 43 male and 25 female patients in each group.There were no significant differences in terms of the time from injury to surgery,the body mass index and the KT-1000 side-to-side difference.Overall,there were 105 patients (77.2％,105/136) showed abnormal signal of the anterolateral ligament on MRI scans.The incidence of concomitant ALL injury in the high-grade pivot-shift group (94.1％,64/68) was significantly higher than that in the low-grade pivot-shift group (60.3％,41/68,x2=10.786,P=0.013).Specifically,there were 15,19 and 30 patients who showed grade Ⅰ,Ⅱ and Ⅲ ALL abnormality in high-grade pivot-shift group.However,there were only 29,8 and 4 patients who showed grade Ⅰ,Ⅱ and Ⅲ ALL abnormality in low-grade pivot-shift group.The incidence of patients who showed grade Ⅱ/Ⅲ MRI evidence of concomitant ALL injury was 76.6％ (49/64) in the high-grade pivot-shift group,which was also significantly higher than that in the low-grade pivot-shift group (29.3％,12/41,x2=18.452,P=0.009).Conclusion In the present study,77.2％ of the patients who showed high-grade pivot-shift demonstrated combined ALL injury on the MRI scan.In addition,patients in the high-grade pivot-shift group showed significantly higher incidence of combined ALL MRI abnormality compared with those in the low-grade pivot-shift group.The high-grade pivot-shift phenomenon might be caused by combined ACL and ALL injury.

Clinical useness of multimodal techniques in microsurgical resection of cerebral arteriovenous malformation / 中华外科杂志

Objective@#To explore the clinical useness of intraoperative functional neuronavigation and fluorescent indocyanine green(ICG) angiography as well as electrophysiological evaluation during microsurgical resection of cerebral arteriovenous malformations (AVM).@*Methods@#A series of 42 consecutive cases with AVM underwent microsurgery by intraoperative functional neuronavigation at Department of Neurosurgery of People′s Liberation Army General Hospital from January 2009 to February 2015 were retrospectively analyzed. Of the 42 patients, 29 were males and 13 were females aging from 4 to 62 years (mean age 32.6 years). Preoperative assessment included functional magnetic resonance imaging and diffusion tensor imaging to identify the relationship between lesions and eloquent areas. The results of images were integrated into three-dimensional datasets to achieve intraoperative microscopic-based functional neuronavigation during AVM resection. Operations involved in motor areas and corticospinal tract were performed under continuous electrophysiological monitoring. ICG angiography was performed at pre-dissection, post-clipping of the feeders, and post-resection of the nidus. FLOW 800 software presented a color map and ICG intensity-time curve to demostrate the vascular architecture. Postoperative digital subtraction angiography was re-examined routinely to evaluate the extent of resection. Clinical outcomes were evaluated with the modified Rankin Scale.@*Results@#All patients underwent surgery under intraoperative navigation. Of the 42 patients, total resection was achieved in 36 cases (85.7%, 36/42) including 14 cases of AVM in eloquent areas. A total of 40 ICG angiographies were successfully performed among 11 patients. Average number of ICG injections per operation was 3.6 (ranging from 3 to 6). Feeders were visualized in 10 patients and drainers were visualized in 9 cases. The post-surgical follow-up period varied from 3 months to 70 months (mean 22.5 months). 83.8% of the patients returned to normal work and life during the followed-up period.@*Conclusion@#Combining intraoperative neuronavigation and electrophysiological monitoring, as well as fluorescent ICG angiography contribute to microsurgical resection of cerebral AVM effectively in selecting suitable patients, further avoiding neurologic compromise as well.

Knee J-Sign in Recurrent Patella Dislocation: Incidence, Classification and Radiographic Characteristics / 中国运动医学杂志

Purpose To determine the incidence,degree and radiographic characteristics of knee Jsign in recurrent patella dislocation patients.Method It was a retrospective review of a consecutive series of 59 recurrent patella dislocation patients.The knee J-sign was classified into negative (-),positive one degree(mild,l+)and positive two degree(gross,2+)based on the severity of patellar lateral translation at the extreme extension of knees with quadriceps contracted actively.The computed tomography(CT)examination at 0° extension of the knee was performed to quantify the degree of patellar lateral translation and tilt,with three CT parameters measured and calculated in axial slices:patella bisect offset index (BOI),patella trochlear-groove (PTG) distance and patella lateral tilt (PLT) angle.Results In all the 59 patients,72.9％(43/59)showed positive J-sign,27.1％(16/59)of positive one degree(1+) and 45.8％(27/59)of positive two degree(2+).All the three CT parameters increased with the severity of Jsign(P＜0.05).Conclusion Among 59 recurrent patella dislocation patients,we have found 72.9％ of positive knee J-sign.The severity of J-sign has a positive correlation with the degree of patellar lateral translation and tilt.

Static Anterior Tibial Translation after Anterior Cruciate Ligament Injury: Incidence and Clinical Characteristics / 中国运动医学杂志

Objective To explore the incidence and clinical characteristics of the anterior tibial translation(ATT) after anterior cruciate ligament injury.Methods One hundred and fifty-three patients with the anterior cruciate ligament injury underwent standard magnetic resonance imaging scans with full knee extension.Based on the relative location between the lateral tibial plateau and the lateral femoral condyle,all the patients were divided into an ATT positive group and an ATT negative group.Moreover,the posterior tibial slope angle(PTSA),the continuity of anterolateral ligament(ALL),and the integrity of posterior horn of the lateral meniscus of all the patients were detected so as to find the risking factors for ATT.Results Among the 153 patients,46 patients were finally confirmed to have ATT.Moreover,the average PTSA of the ATT positive group was significantly larger than that of the ATT negative group.However,there were no significant differences between the two groups in the continuity of ALL and the integrity of posterior horn of lateral meniscus.Conclusion In this study,the incidence of ATT was 30.1％,which may be correlated to the increased PTSA.

Quantification of Patellar Maltracking Combined with J-Sign Using Computed Tomography / 中国运动医学杂志

Objective To quantify the patellar mal-tracking combined with J-sign using the computed tomography (CT).Method Fifty-three adult patients diagnosed as recurrent patellar dislocation (RPD) were chosen.According to their patellar tracking during knee active flexion and extension,they were divided into group A(with positive J-sign) and group B(with negative J-sign).The CT examinations were performed in all patients at 0°extension of the knee and the patella bisect offset index (BOI),patella troehlear-groove distance (PTG) and patella lateral tilt (PLT) were measured in the axial position and compared.The receiver operating characteristic analysis (ROC) curve was used to analyse the accuracy and stability of the three J-sign parameters.Results In all the 53 patients,thirty-seven(69.8％) knees were of positive J-sign,while the rest 16 were of negative J-sign.The mean values of CT parameters BOI,PTG and PLT in group A were significantly larger than those of group B.Moreover,the area under the curve for BOI,PTG and PLT were 0.906,0.883 and 0.833 respectively.The sensitivity and specificity of BOI were 83.3％ and 87.5％,while the predicting cut-off value was 97.5％.Conclusion In all the 53 recurrent patella instability patients,the morbidity of patella proximal mal-trackingis 69.8％.The CT parameter BOI can be used to quantify the J-Sign into positive and negative groups.

The Effect of Hinge Direction on Posterior Tibial Slope in Medial Open-wedge High Tibial Osteotomy: A Study Based on Three-dimensional Computed Tomography Modelling / 中国运动医学杂志

Objective To explore factors affecting posterior tibial slope changes after the medial openwedge high tibial osteotomy.Methods The open-wedge high tibial osteotomy was simulated and performed on the three-dimensional proximal tibia model reconstructed based on the computed tomography (CT) scanning,and the roles of hinge axis direction and correction of genu varum in postoperative posterior tibial slope changes were analyzed separately.Results Hinge axis pointing anterolaterally was significantly associated with the increase of postoperative posterior tibial slope with regard to the axis along the anterior-posterior direction.Meanwhile,the correction of the genu varum at a larger angle was also a crucial factor for the increase of postoperative posterior tibial slopes.Conclusion Postoperative posterior tibial slope changes after open-wedge high tibial osteotomy is closely associated with the hinge axis direction and correcting angle of the genu varum.

Tibial Tubercle Proximalization for the Treatment of Severe Habitual Dislocation of Patella: A Retrospective Study / 中国运动医学杂志

Objective To evaluate the clinical outcome of tibial tubercle proximalization in the treatment of patients with severe habitual dislocation of patella (HDP).Methods Among 51 HDP patients treated surgically in our hospital between April 2010 and 2014,28 were eligible for retrospective evaluation.All patients underwent tibial tubercle proximalization and lateral structure release.Additional surgeries included medial patellofemoral ligament (MPFL)reconstruction and tibial tubercle medialization.Radiological and subjective evaluations were performed at 4th and 8th weeks after the operation,as well as 1 year and every year afterwards.Results Twenty-eight patients,with an average age of (27.2 ± 9.4)(ranging from 18 to 39)were followed up for a minimum of 2 years,the mean follow-up period being (26.4 ± 5.8)months (ranging from 24 to 36).It was found 17.2％ (5/29) patients of quadriceps weakness,6.9％ (2/29)of patellofemoral pain and 6.9％ (2/29)of stiffness.No redislocation was reported.Significant improvement was observed in all subjective evaluation scores.Conclusions For patients with severe HDP,tibial tubercle proximalization can achieve satisfactory results.

Surgical management of proximal anterior cerebral artery (A1) aneurysms / 南方医科大学学报

<p><b>OBJECTIVE</b>To review our experience in surgical management of proximal anterior cerebral artery (A1) aneurysms in 23 patients.</p><p><b>METHODS</b>Between January, 2004 and December, 2014, 23 patients (1.6%) with A1 aneurysms diagnosed by CTA or DSA were treated surgically. The "3H" therapy was adopted for postoperative prevention of cerebrovascular spasm. All the patients were followed up and examined with cerebrovascular CTA at 6, 12, 48 and 60 months after the operation with their Glasgow Outcome Scale score recorded.</p><p><b>RESULTS</b>The patients consisted of 15 men and 8 women with an age range of 16 to 72 years (mean 51.3 years). The average diameter of the aneurysms was 5.8 mm, ranging from 3.2 to 9.7 mm. Twenty-two saccular aneurysms were found in these patients; 21 patients presented with SAH and two had vascular malformation. All the A1 aneurysms were managed through the pterional approach, and the mean postoperative Glasgow Outcome Scale score was 4.8.</p><p><b>CONCLUSION</b>Thorough analysis of the angiographic data is essential for the diagnosis and treatment of A1 aneurysms. Preservation of the perforators and prevention of aneurysm rupture are critical during the surgery. Full exposure of the Sylvian fissure and temporary occlusion of the parent artery ensures safe and effective dissection of A1 aneurysms.</p>

Clinical Study on the Real-time Analgesic Effect of Acupuncture at Sanyinjiao (SP6)Versus Multiple Points for Primary Dysmenorrhea / 上海针灸杂志

ObjectiveTo compare the real-time analgesic effects between two different groups of acupoints in treating primary dysmenorrhea, for providing objective evidences for optimizing the treatment protocol for primary dysmenorrhea.MethodSixty eligible patients with primary dysmenorrhea were randomized into 3 groups: group A received acupuncture at Sanyinjiao (SP6), group B received acupuncture at Sanyinjiao and Guanyuan (CV4), and group C as a blank control group, 20 cases in each group. Visual Analogue Scale (VAS) was observed prior to the acupuncture treatment, after the insertion of the needles, and after removal of the needles in the three groups.ResultThe VAS scores changed significantly in group A and B after intervention (P0.05).Conclusion Acupuncture at Sanyinjiao alone and acupuncture at Sanyinjiao and Guanyuan both can produce analgesic effect at the attackof primary dysmenorrhea. However, for optimizing the treatment protocol, selecting Sanyinjiao alone will be enough.

The herbal-partitioned moxibustion for primary dysmenorrhea and it's impact on reproductive endocrinal function of patients / 中国针灸

<p><b>OBJECTIVE</b>To explore the efficacy and the reproductive endocrinal mechanism of herbal-partitioned moxibustion in the treatment of primary dysmenorrhea.</p><p><b>METHODS</b>One hundred and seventy-one cases of primary dysmenorrhea were randomized into an herbal-partitioned moxibustion group (group A), an starch-partitioned moxibustion group (group B) and an acupuncture group (group C), 57 cases in each one. In the group A, moxibustion isolated with herbal medicine was applied to Shenque (CV 8). In the group B, moxibustion isolated with starch was used at Shenque (CV 8). In the group C, acupuncture was given at Sanyinjiao (SP 6). The changes of estradiol (E2), progesterone (P) and prostaglandin levels (PGF2alpha) were observed before and after treatment, and the therapeutic effects were compared among the 3 groups.</p><p><b>RESULTS</b>The therapeutic effect in the group A was better than those in the other two groups [compared the cured rate: 89.8% (44/49) vs 60.0% (30/50), 60.4% (32/53), both P < 0.05]. In the group A, E2 level [(110.99 +/- 12.90) pg/mL vs (83.94 +/- 8.91) pg/mL, P < 0.05] and PGF2alpha level [(24.58 +/- 3.01) pg/mL vs (14.34 +/- 1.48) pg/mL, P < 0.01] were decreased and P level was increased [(4.65 +/- 0.68) ng/mL vs (6.68 +/- 0.95) pg/mL, P < 0.05]. In the group B and C, PGF2alpha level were reduced. Concerning to the regulating of E2 and PGF2alpha levels, the results in the group A were better than those in the group B and C [(-30.16 +/- 10.20) pg/mL vs (10.79 +/- 15.01) pg/mL, (22.81 +/- 12.22) pg/mL; (-13.10 +/- 2.40) pg/mL vs (-6.52 +/- 1.88) pg/mL, (-3.14 +/- 1.19) pg/mL, (see text) P < 0.05]. Concerning to the regulation of P level, the results in the group A and B were better than that in the group C (all P < 0.05).</p><p><b>CONCLUSION</b>The herbal-partitioned moxibustion achieves the significant efficacy on primary dysmenorrhea, which could be related to regulating the reproductive endocrinal level. It decreases E2 and PGF2alpha levels and increases P level.</p>

The surgery of giant symptomatic cavernous sinus aneurysms / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the management and outcomes in patients with giant symptomatic cavernous sinus aneurysms who underwent aneurysms trapping with bypass, proximal carotid occlusion and aneurysms trapping.</p><p><b>METHODS</b>Twenty-three patients with giant symptomatic cavernous sinus aneurysms underwent surgery between February 2007 and March 2013, 3 cases were male and 20 cases were female patients, the age of the patients ranged between 24 and 68 years, mean age was 54.7 years. The pre-operative digital subtraction angiography (DSA) and ballon occlusion test (BOT) were performed to confirm the diagnosis and identify hemodynamic reserve with carotid occlusion, and the aneurysms trapping with bypass, aneurysms trapping and proximal occlusion of the internal carotid artery were performed according to BOT results. During the surgery, the neurophysiological monitoring and the intraoperative CT perfusion were used. The follow-up by DSA or CT angiography were made.</p><p><b>RESULTS</b>Seventeen patients underwent aneurysms trapping with bypass, 1 underwent aneurysms trapping and 5 underwent proximal occlusion of the internal carotid artery. After surgery, symptom improved in 4 cases, did not change in 10 cases, and new neural function deficit developed in 9 cases. The follow-up period were 3 months to 75 months. Two patients were lost. The Glasgow Outcome Scale of last follow-up were 5 in 19 patients, 3 in 1 patient and 1 in 1 patient.</p><p><b>CONCLUSIONS</b>The aneurysms trapping with bypass and proximal occlusion of the internal carotid artery are effective and reliable procedure for treatment of giant symptomatic cavernous sinus aneurysms in selected patients after evaluation of the pre-operative BOT, intra-operative neurophysiological monitoring and the intraoperative CT perfusion.</p>

Individualized surgical treatment of complex middle cerebral artery aneurysms / 中华外科杂志

<p><b>OBJECTIVE</b>To summarize individualized surgical treatment strategies for complex middle cerebral artery (MCA) aneurysms.</p><p><b>METHODS</b>Twenty patients with complex MCA aneurysms treated by microsurgery in Chinese People's Liberation Army General Hospital between December 2009 and November 2012 were retrospectively analyzed. There were 12 male and 8 female patients, with a mean age of 43 years (range: 14-58 years). Giant aneurysms (size > 2.5 cm) were found in 6 cases, wide-neck aneurysms in 7 cases and serpentine ones in 3 patients. Important perforators were involved in aneurysm neck in 2 cases. Important branches originated from aneurysms in 6 patients. Two patients harbored recurrent aneurysms after coiling. Individualized surgical strategies were planned according to preoperative imaging. A frontotemporal approach was routinely used. Intraoperative somatosensory evoked potential monitoring, indocyanine green videoangiography and microvascular Doppler ultrasonography were regularly used. A postoperative digital subtraction angiography (DSA) or computed tomography angiography (CTA) was performed to verify the efficacy of treatment and patency of bypass vessels.</p><p><b>RESULTS</b>Of the 20 cases, 7 aneurysms were clipped with clipping and reconstruction of parent artery with multiple clips, 3 M1 segment aneurysms were proximally occluded with extra-intracranial high-flow revascularization, 2 aneurysms were treated with aneurysmectomy with superficial temporal artery to middle cerebral artery low-flow revascularization, 1 aneurysm was treated with aneurysmectomy with superficial temporal artery to middle cerebral artery low-flow revascularization and branch side-to-side anastomosis, 2 aneurysms were treated with aneurysmectomy and re-anastomosis of parent artery, 1 aneurysm was treated with aneurysmectomy and re-anastomosis of parent artery and reinplantation of lenticulostriate artery, 3 bilateral MCA aneurysms were clipped by unilateral approach, and 1 was trapped. Nineteen patients were favorable with Glasgow Outcome Scale score 4-5 at discharge, and 1 patient died of cardiac infarction one week after surgery. The mean clinical follow-up was 20 months (range: 6-39 months). During follow-up, no bleeding occurred. DSA or CTA confirmed absence of aneurysm in 14 cases and residual neck in 2 patients. The other 3 patients were lost to follow-up.</p><p><b>CONCLUSIONS</b>Individualized, multi-modality surgical treatment strategies are effective and safe solution for treatment of complex MCA aneurysms. Revascularization remains imperative surgical technique.</p>

Effects of vagus nerve stimulation on neuroprotective mechanism of cerebral ischemia in rats / 中国脑血管病杂志

Objectives To investigate the neuroprotective mechanism of vagus nerve stimulation ( VNS) by stimulating the vagus nerve in ischemic cerebral tissue in a rat model of transient focal cerebral ischemia. Methods Twenty-six adult male Sprague-Dawley ( SD ) rats were randomly divided into sham operation group (n=6),model group (n=10),and VNS-treated group (n=10) . The model of rat transient focal cerebral ischemia was induced by the intraluminal suture method. At 30 min after modeling,the right side neck VNS in the VNS-treated group was stimulated ( stimulus intensity 0. 5 mA, interval 0. 5 ms, frequency 20 Hz),once every 5 min within 1 h,and once for 30 s. The model group repeated the steps of the VNS-treated group,but did not stimulate. The sham operation group repeated the experimental steps,but it neither embolized the vessels nor stimulated nerves. The changes of cerebral blood flow were monitored with a laser Doppler flowmeter. The rats were sacrificed after 24 h. The expressions of interleukin 6(IL-6) and caspase-3 in brain tissue were determined by immunohistochemistry staining. The neuronal apoptosis was observed by the in situ end-labelling technique. Results ( 1 ) Compared with the sham operation group, the number of positive cells of IL-6,caspase-3,and the numbers of neuronal apoptosis in the model group were significantly increased (20. 7 ± 5. 0 cells/HP vs. 2. 3 ± 1. 0 cells/HP,44. 5 ± 9. 5 cells/HP vs. 0,30. 9 ± 9. 0 cells/HP vs.0).Thereweresignificantdifferences(P0. 05). Conclusion The neuroprotective mechanism of VNS for cerebral ischemia may be associated with the inhibition of neuronal apoptosis and decreasing inflammatory response. It may not be associated with the changes of cortical cerebral blood flow.

Surgical management of intracranial mirror aneurysms / 中华外科杂志

<p><b>OBJECTIVE</b>To study the clinical characteristics and treatment strategies of mirror aneurysms.</p><p><b>METHODS</b>Nineteen patients with 20 pairs of mirror aneurysms from November 2007 to November 2012 were retrospectively analysed. Among the 19 patients, 13 were female and 6 were male, mean age was 56 years (ranged 32-75 years). Distribution of the lesions included 11 bilateral posterior communicating artery aneurysms (one with a pair of anterior choroidal artery aneurysm), 4 bilateral middle cerebral artery aneurysms, 3 bilateral paraclinoidal aneurysms, and 1 bilateral pericallosal-callosomarginal artery aneurysm. Surgical strategies were selected according to location of hemorrhage, Hunt-Hess grade, location and size of aneurysm, etc.</p><p><b>RESULTS</b>Four mirror aneurysms were clipped at one stage, 3 mirror aneurysms were clipped at two stages, 2 were treated with combination of clipping and coiling and remaining 10 were clipped unilaterally. At discharge, 15 out of 19 patients had a Glasgow Outcome Scale score of 5, 4 patients had a score of 4. The mean clinical follow-up was 18.6 months (range 3-50 months). Two patients had oculomotor nerve palsy postoperatively. At 3-month follow-up, 1 improved and 1 unchanged. In 10 patients with unilateral clipping, contralateral aneurysms were unruptured, small ( < 5 mm) and regular. No remnant or recurrence of aneurysm were found in other 9 patients whose bilateral aneurysms had been treated.</p><p><b>CONCLUSIONS</b>The mirror aneurysms are rare kinds of multiple aneurysms. The aneurysm responsible for hemorrhage should be treated with first priority. The contralateral unruptured aneurysm could be observed, clipped or coiled in one stage, or treated in two separate stages.</p>

Pharmacophore modeling of dual angiotensin II and endothelin A receptor antagonists / 药学学报

Three-dimensional pharmacophore models were generated for AT1 and ET(A) receptors based on highly selective AT1 and ET(A) antagonists using the program Catalyst/HipHop. Both the best pharmacophore model for selective AT1 antagonists (Hypo-AT(1)-7) and ETA antagonists (Hypo-ET(A)-1) were obtained through a careful validation process. All five features contained in Hypo-AT(1)-7 and Hypo-ET(A)-1 (hydrogen-bond acceptor (A), hydrophobic aliphatic (Z), negative ionizable (N), ring aromatic (R), and hydrophobic aromatic (Y)) seem to be essential for antagonists in terms of binding activity. Dual AT1 and ET(A) receptor antagonists (DARAs) can map to both Hypo-AT(1)-7 and Hypo-ET(A)-1, separately. Comparison of Hypo-AT(1)-7 and Hypo-ET(A)-1, not only AT1 and ET(A) antagonist pharmacophore models consist of essential features necessary for compounds to be highly active and selective toward their corresponding receptor, but also have something in common. The results in this study will act as a valuable tool for designing and researching structural relationship of novel dual AT1 and ET(A) receptor antagonists.