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1.
Neuroscience Bulletin ; (6): 242-254, 2021.
Article in Chinese | WPRIM | ID: wpr-952017

ABSTRACT

Traumatic brain injury (TBI) triggers the activation of the endogenous coagulation mechanism, and a large amount of thrombin is released to curb uncontrollable bleeding through thrombin receptors, also known as protease-activated receptors (PARs). However, thrombin is one of the most critical factors in secondary brain injury. Thus, the PARs may be effective targets against hemorrhagic brain injury. Since the PAR1 antagonist has an increased bleeding risk in clinical practice, PAR4 blockade has been suggested as a more promising treatment. Here, we explored the expression pattern of PAR4 in the brain of mice after TBI, and explored the effect and possible mechanism of BMS-986120 (BMS), a novel selective and reversible PAR4 antagonist on secondary brain injury. Treatment with BMS protected against TBI in mice. mRNA-seq analysis, Western blot, and qRT-PCR verification in vitro showed that BMS significantly inhibited thrombin-induced inflammation in astrocytes, and suggested that the Tab2/ERK/NF-κB signaling pathway plays a key role in this process. Our findings provide reliable evidence that blocking PAR4 is a safe and effective intervention for TBI, and suggest that BMS has a potential clinical application in the management of TBI.

2.
Chinese Journal of Digestive Surgery ; (12): 757-761, 2020.
Article in Chinese | WPRIM | ID: wpr-865116

ABSTRACT

Objective:To investigate the application value of obliquus externus abdominis pedicle flap graft technique in repair of giant abdominal incisional hernia.Methods:The retrospective and descriptive study was conducted. The clinical data of 14 patients with giant abdominal incisional hernia who were admitted to Affiliated Hangzhou First People′s Hospital of Zhejiang University School of Medicine from June 2015 to June 2018 were collected. There were 5 males and 9 females, aged (67±10)years, with a range from 45 to 80 years. All the 14 patients underwent repair of abdominal wall defect and functional reconstruction with obliquus externus abdominis pedicle flap graft technique. Observation indicators: (1) surgical situations; (2) postoperative situations; (3) hernia-related quality of life; (4) follow-up. Follow-up using outpatient examination was performed at postoperative 1 and 12 months, and once a year thereafter to detect the recurrence of incisional hernia or abdominal bulging up to June 2019. Measurement data with normal distribution were represented as Mean± SD, and comparison within groups was analyzed using the paired sample t test. Measurement data with skewed distribution were described as M (range). Count data were described as absolute numbers or percentages. Results:(1) Surgical situations: all the 14 patients underwent repair of abdominal wall defect and functional reconstruction with unilateral obliquus externus abdominis pedicle flap graft technique successfully, and reinforced repair with mesh. All the meshes were standard polypropylene meshes which were placed in the retro muscular or preperitoneal space. The operation time, volume of intraoperative bleeding, mesh size of the 14 patients were (153±34)minutes, (119±59)mL, (450±156)cm 2, respectively. (2) Postoperative situations: the duration of hospital stay of the 14 patients were (14±3)days. Of the 14 patients, 1 had type Ⅲ seroma and was cured after conservative treatment. There were no complications such as ischaemia and necrosis of external oblique muscle flap, incision dehiscence, infection of operation site, intestinal obstruction or intestinal fistula observed in the 14 patients. (3) Hernia-related quality of life: the score of hernia-related quality of life of the 14 patients before operation and at postoperative 12 months were 38±8 and 77±15 respectively, showing a significant difference ( t=12.729, P<0.05). (4) Follow-up: 14 patients were followed up for 12-48 months, with a median follow-up of 16 month. During the follow-up, none of the 14 patients had recurrence of incisional hernia or abdominal wall bulging. Conclusion:Obliquus externus abdominis pedicle flap graft technique can be used for repair of giant abdominal incisional hernia, which will lead to less surgical complications and improve hernia-related quality of life of patients.

3.
Journal of Central South University(Medical Sciences) ; (12): 403-409, 2018.
Article in Chinese | WPRIM | ID: wpr-693830

ABSTRACT

Objective:To analyze the prognostic factors for survival in elderly patients with glioma.Methods:We performed a retrospective analysis of prognostic factors for elderly patients with glioma,who were treated by the same attending doctor during June 2014 and June 2016,to investigate the correlations of the age,dimension of pathology,histological grade,extent of resection,adjuvant therapy,preoperative Karnofsky Performance Scale (KPS) score,postoperative KPS score,molecular markers [isocitrate dehydrogenase-1 (IDHH-1),O6-methylguanine DNA-transferase (MGMT),epidermal growth factor receptor (EGFR),Ki-67] with the prognosis.Results:A total of 45 patients were included in the study.The median overall survival (OS) was 11 months.The median progression-free survival (PFS) was 6 months.Univariate analysis revealed that the age,gender,dimension ofpathology,histological grade and preoperative KPS score had no significant correlation with survival (P>0.05).The gross total resection,higher postoperative KPS score,adjuvant therapy,lower Ki-67 index were significantly correlated with survival.The expressions of MGMT and EGFR were significant factors for survival.High postoperative KPS score (P=0.019),adjuvant therapy (P=0.024),and the expression of MGMT (P=0.026) were independent predictors for increased median OS in a multivariate regression model.Conclusion:The extent of resection,adjuvant therapy,postoperative KPS score and molecular markers are the influential factors for survival.Larger prospective studies are needed to confirm these findings.

4.
Chinese Journal of Primary Medicine and Pharmacy ; (12): 1724-1728, 2018.
Article in Chinese | WPRIM | ID: wpr-701976

ABSTRACT

Objective To explore the clinical efficacy and safety of tetrandrine tablets and diclofenac sodium tablets in the treatment of osteoarthritis,thus to provide reference for the formulation of scientific and effective treatment.Methods From March 2015 to March 2016,Seventy patients with osteoarthritis in the People's Hospital of Yuyao were selected as study objects and divided into research group and control group according to the random number table method,with 35 cases in each group.The two groups were given glucosamine hydrochloride tablets treatment,the control group received diclofenac sodium tablets on the basis of treatment,while the research group received tetrandrine tablets on the basis of treatment of the control group,4 weeks for a course of treatment.The VAS score,joint tenderness index(TJS),joint swelling index (SJS),duration of morning stiffness,adverse reactions and clinical efficacy in the two groups were observed before and after treatment.Results The total effective rate in the study group was 97.14% (34/35),which was higher than 80.00% (28/35) in the control group,the difference was statistically significant between the two groups(x2 =23.932,P =0.001).Compared with before treatment,the VAS scores,SJS,TJS of the two groups were significantly decreased(all P < 0.01).The study group compared with the control group,decreased more significantly,VAS score (t =6.78,P < 0.05),SJS (t =5.78,P < 0.05),TJS (t =6.65,P < 0.05),and the morning stiffness time (t =6.98,P < 0.05) were significantly reduced.The incidence rate of adverse reactions of the research group 5.71% (2/35) was significantly lower than 31.43% (11/35) of the control group(x2 =19.237,P < 0.01).Conclusion Tetrandrine tablets combined with diclofenac sodium tablets in the treatment of osteoarthritis has low incidence of adverse reactions,high safety and ideal clinical effect,it can be widely used in clinical.

5.
Chinese Journal of Stomatology ; (12): 415-420, 2017.
Article in Chinese | WPRIM | ID: wpr-808967

ABSTRACT

Objective@#To provide biomechnical basis for orthodontics of centronuclear myopathy (CNM) patients, we studied the oral and maxillofacial clinical features and MRI image manifestations to explore application of MRI to objective evaluation the affected facial muscles.@*Methods@#The study consisted of 8 patients who were diagnosed as CNM (CNM group) and 20 healthy volunteers (control group). Their medical information were gathered and then we examined the ptosis situation and the facial index calculation of them. To measure the maximal hight of palate and the width of palate, patients and volunteers were made impressions. We also checked their maximum bite force with occlusion pressure tester. And they took lateral cephalometric radiographs to measure mandibular plane-Frankfort horizontal plane angle (MP-FH). At last, they were taken oral and maxillofacial region MRI to observe the affected situation of masseter muscle, medial pterygoid muscle and lateral pterygoid muscle.@*Results@#Six patients were ptosis; 6 patients had inverse V-shaped mouth; 3 patients were difficulty in swallowing; 4 patients were anterior open bites; 4 patients were mouth breathing; 7 patients liked to eat soft foods. Morphological facial index ([91.3±0.5]%), MP-FH (34.9°±2.0°) of CNM group were greater than the control group, male maximal hight of palate ([19.0±0.2] mm), female maximal hight of palate ([18.0±0.6] mm) of CNM group were greater than the control group (P<0.05). Male width of palate ([34.5±0.8] mm), female width of palate ([33.4±1.0] mm), male maximum bite force ([464.3±78.2] N), female maximum bite force ([320.7±13.8] N), maximal opening of mouth ([3.4±0.3] cm) of CNM group were less than the control group (P<0.05). And these had significant difference compared with the control group (P<0.05). In MRI examination, there were 7 patients' masseter muscles, 4 patients' medial pterygoid muscles and 6 patients' lateral pterygoid muscles to atrophy asymmetrically. These three pieces of muscular fatty infiltration were inordinately, focused on Grade 0 to 4 and the both sides were similar.@*Conclusions@#CNM patients with long and thin face, high palatine arches and low bite force together were the biomechanical basis of the maxillofacial deformities. MRI can clearly show the affected masseter muscle, medial pterygoid muscle, lateral pterygoid muscle, and can serve as an objective examination method for the evaluation of facial muscles. It can be worth of clinical popularization and application.

6.
Chinese Critical Care Medicine ; (12): 518-522, 2016.
Article in Chinese | WPRIM | ID: wpr-493325

ABSTRACT

Objective To investigate the risk factors of severe hemolysis during extracorporeal membrane oxygenation (ECMO). Methods The clinical data of adult patients undergoing ECMO after cardiac surgery admitted to Fuwai Hospital from December 2010 to October 2015 were retrospectively analyzed. Demographic characteristics, renal function, primary disease, operation data, ECMO related data and outcomes were recorded. Patients were divided into normal free hemoglobin (FHB) group (FHB ≤ 500 mg/L) and severe hemolysis group (FHB > 500 mg/L) according to the FHB level during ECMO support. The parameters before and after ECMO support were compared between the two groups. Logistic regression was used to identify the independent risk factors of severe hemolysis. Results A total of 81 patients including 19 patients with severe hemolysis was enrolled, and 62 in normal FHB group. There was no difference in cardiopulmonary bypass (CPB) time, clamping time, lactate level before ECMO, cardiopulmonary resuscitation, intra-aortic balloon pump use and central catheter insertion between two groups. The maximums of serum creatinine (SCr) and FHB levels were higher in severe hemolysis group as compared with those in normal FHB group [maximal SCr (μmol/L): 281.02±164.11 vs. 196.67±87.31, maximal FHB (mg/L): 600 (600, 700) vs. 200 (100, 300)], the incidence of clots in circuit or oxygenator, infection, and hemofiltration in severe hemolysis group was increased [26.3% (5/19) vs. 4.8% (3/62), 31.6% (6/19) vs. 12.9% (8/62), 36.8% (7/19) vs. 14.5% (9/62), all P < 0.1]. As well as outcomes including the rate of site of surgery or intubation bleeding and acute renal failure [ARF, 57.9 % (11/19) vs. 30.6% (19/62), 94.7% (18/19) vs. 41.9% (26/62)], and the survival rate was lowered [10.5% (2/19) vs. 51.6% (32/62), all P < 0.05]. As result of univariate analysis, clots in circuit or oxygenator, infection and hemofiltration were associated with severe hemolysis. It was showed by logistic regression analysis that the clots in circuit or oxygenator was a risk factor of severe hemolysis during ECMO [odds ratio (OR) = 6.262, 95% confidence interval (95%CI) = 1.244-31.515, P = 0.026]. Conclusions The clots in circuit or oxygenator were independent risk factors of severe hemolysis during ECMO. Severe hemolysis can induce the increase of the rate of bleeding in the operation site or intubation and the rate of ARF, and decrease of the survival rate.

7.
Chinese Journal of Burns ; (6): 468-470, 2015.
Article in Chinese | WPRIM | ID: wpr-327375

ABSTRACT

Extracorporeal membrane oxygenation (ECMO) is a kind of technique that uses extracorporeal circulation system to draw patients' blood into the circuit, and then oxygenate the blood when it passes along the membrane, followed by returning the blood into patients. At present, ECMO is mainly used in treating patients with respiratory failure and circulatory failure, for whom the conventional treatment such as mechanical ventilation and vasoactive drugs are invalid. ECMO can provide cardiopulmonary support for burn patients with respiratory failure or circulatory failure, and put the heart and lung at rest. The purpose of this paper is to review the application of ECMO in the treatment of severe burn.


Subject(s)
Humans , Burns , Therapeutics , Critical Care , Methods , Extracorporeal Membrane Oxygenation , Methods , Respiration, Artificial , Respiratory Insufficiency , Therapeutics , Severity of Illness Index
8.
Journal of Practical Radiology ; (12): 1003-1006,1025, 2014.
Article in Chinese | WPRIM | ID: wpr-599340

ABSTRACT

Objective To assess the efficacy and feasibility of Wingspan stents for symptomatic atherosclerotic stenosis of the bas-ilar artery.Methods Clinical data of 40 patients with symptomatic atherosclerotic stenoses in the basilar artery were analyzed retro-spectively.The operative successful rate,the degree of stenosis,perioperative complications and the results of clinical and imaging follow-up were analyzed.Results The technical success rate was 95.35%.The rate of procedure-related complications during the perioperative period (30 days)was 20.0% (eight of 40 patients).There were two patients with no permanent neurological sequelae. Ipsilateral stroke or death occurred in six patients(1 5%).Thirty-six patients(92.3%)were available for a clinical follow up.The mean follow-up period was 36.3 months (range 12-75 months).Seventeen patients (47.2%)were available for follow-up imaging with DSA or CTA.The mean imaging follow-up period was 9.4 months (range 4-41 months).Symptomatic in-stent restenosis (ISR)was documented in two (1 1.76%)of these patients.Three ischemic events occurred during the follow-up period in 12 months.The adverse event rate was 8.33% at 1 year.Conclusion Wingspan stents for symptomatic atherosclerotic stenosis of the basilar artery was an effective and feasible technique,but we should carefully grasp the operation indications.

9.
Chinese Journal of Primary Medicine and Pharmacy ; (12): 849-851, 2013.
Article in Chinese | WPRIM | ID: wpr-431950

ABSTRACT

Objective To compare the clinical effects of perforated gastroduodenal ulcer treatment by laparoscopy and traditional open repair.Methods 70 cases of patients with perforated diagnosed as gastroduodenal ulcer were selected and divided into laparoscopic group and open group by different operation type.Laparoscopy was used in laparoscopic group,while traditional open repair was used in open group.The mean time in operation,intraoperative blood loss and intraoperative and peostoperative complications were observed and recorded.Results There was no difference in operative mean time between the two groups(P > 0.05),but intraoperative blood loss was less in laparoscopic group than that in open group (P < 0.05),exhaust time and hospitalization time in laparoscopic group were shorter than that in open group(P < 0.05),and no complication was found in laparoscopic group(0.00%),while 10 cases in open group(22.73%),the rate in the former group was lower than that in the latter group(P <0.05).Conclusion Using laparoscopy to repair perforated gastroduodenal ulcer had little trauma,less pain,less complication,shorter recover time and safe.It is worthy of clinical.

10.
Chinese Journal of Postgraduates of Medicine ; (36): 1-3, 2013.
Article in Chinese | WPRIM | ID: wpr-435954

ABSTRACT

Objective To explore the efficacy of minimally invasive surgery in elderly patients with cerebral hemorrhage.Methods Clinical data of hypertensive cerebral hemorrhage patients who were older than 65 years were retrospectively analyzed,and they were divided into two groups by different surgical methods.Regular group:from March 2010 to February 2011,123 cases of conventional bone window surgery.Minimally invasive group:from March 2011 to February 2012,136 cases of minimally invasive surgery.One month after surgery,two groups of patients with the scores of Glasgow outcome scale (GOS) to determine the prognosis.Results The better prognosis rate in minimally invasive group was higher than that in regular group [39.7%(54/136) vs.29.3%(36/123)],but there was no significant difference (P >0.05).The incidence rate of death in minimally invasive group was significantly lower than that in regular group [17.6% (24/136) vs.28.5% (35/123)],and there was significant difference (P < 0.05).Conclusion For elderly patients with cerebral hemorrhage,the minimally invasive surgery can significantly improve the prognosis.

11.
Chinese Journal of Medical Education Research ; (12): 1127-1130, 2012.
Article in Chinese | WPRIM | ID: wpr-429918

ABSTRACT

Tangdu hospital of the fourth military medical university explored the aim,method,critical points and effect for organizing a neurosurgical continuous education Journal club and summarized the key factors important for its successful organization and the improvement of its short-term and long-term educational effects in order to discover a Journal club education pattern which could satisfy the demand of for neurosurgical refresher doctors.Paying attention to these factors could better satisfy the demand of for neurosurgical refresher doctors,achieve their participating aims,promote their understanding of the advancing front of the discipline and improve their literature analyzing competence and problem solving ability.The wide application of continuous education Journal club is helpful to improve the level of neurosurgical continuing education in our country.

12.
Chinese Journal of Ultrasonography ; (12): 294-297, 2011.
Article in Chinese | WPRIM | ID: wpr-416467

ABSTRACT

Objective To investigate the value of intraoperative contrast-enhanced ultrasound(CEUS) in evaluating pathological grades of cerebral gliomas. Methods Intraoperative CEUS was performed in 33 patients of cerebral gliomas of different pathological grades. Real-time blood perfusion and enhance characteristics of these tumors were observed,quantitative parameters from the automatically derived time-intensity curve (TIC) were obtained, and compared with the tumor microvessel density (MVD) by immunostaining with anti-CD34. Results The time to peak was significantly shorter and the MVD was significantly higher in the high grade cerebral gliomas compared with the low grade ones ( P <0. 05). The time to peak was negatively correlated with the MVD by immunostaining (r = -0.79, P < 0. 05). Conclusions Intraoperative CEUS could be used to observe microvascular perfusion in real-time, and could indirectly reflect the information of MVD in cerebral gliomas, which is of help to grade cerebral gliomas and guide surgical resections.

13.
Chinese Journal of Medical Education Research ; (12): 1339-1341, 2011.
Article in Chinese | WPRIM | ID: wpr-423384

ABSTRACT

Journal Club education method is widely used in resident training in foreign countries.Its function in neurosurgery clinical training is gradually focused on.This method will promote the mastery of new concept,new method and new technique by the residents,help them to form good reading habit and improve their ability to solve actual clinical problems.The application of Journal Club education method in neurosurgery clinical training in our country may have positive influence on the standardized training of clinicians and the spreading of evidenced-based medicine.

14.
Chinese Journal of Primary Medicine and Pharmacy ; (12): 2320-2321, 2010.
Article in Chinese | WPRIM | ID: wpr-386632

ABSTRACT

Objective To explore the characteristics of operation,curative effects and operative management in elderly patients of age older than 70 years with coronary heart disease receiving coronary artery bypass grafting.Methods 108 elderly patients of age older than 70 years with coronary heart disease were divided into two groups:OPCAB group(n = 76) and CCABG group (n = 32) The clinical curative effects, early postoperative mortality and complications of the two groups were compared and analyzed respectively. Results OPCAB group was better than CCABG group in these series(P < 0.05): The early postoperative mortality (5.8%, 11.2%)、 myocardial infarction (2.9%, 10.6%), respiration failure(8.7%, 17.5%), pulmonary complications: (11.8%, 31.5%) 、complication of CNS:(1.8% ,9.8%) 、acute renal failure(1.8% ,6.2%) ,the time of intubation: (9.3 ±4.5), (25.4 ±7.5) h,ICU stay(3.1 ± 1.8) ,(7.1 ±2.9) d,hospital stay(15.5 ±8.6) ,(26.4 ±8.6)d. Conclusion OPCAB could reduce operative mortality and complication, it should be the first option for the surgery of elder patients with coronary heart disease;surgical skills and correct perioperative management were the key factors to assure surgical outcome.

15.
Chinese Journal of Medical Imaging Technology ; (12): 1138-1141, 2009.
Article in Chinese | WPRIM | ID: wpr-471491

ABSTRACT

Objective To observe the diffusion characteristics and pathology changes with DTI in rabbit models with mild cerebral contusion and laceration (CCL). Methods Thirty rabbits were randomly selected and made into models of mild CCL by free fall, while other 10 rabbits were cut only in the skull as control. T2WI and DTI were performed 1, 3, 6, 12, 24, 48 and 72 h after the operation. DTI value of average diffusion coefficient (DCavg) and fractional anisotropy (FA) of mild CCL and its peripheral area were measured and compared. Histological examination was also performed. Results One hour after operation, CCL area showed high signal on T2WI, and no abnormal signal was found in the peripheral area, but both had abnormal color on DTI map. T2WI signal intensity in peripheral area of 22 rabbits (73.33%) increased gradually and had much abnormal color on T2WT map after 3 h. There was significant difference of FA and DCavg between CCL and the mirror region, the peripheral area and the mirror region (P<0.05). The value of FA decreased slightly since 12 h. More prominent tissue necrosis, edema and hemorrhage were found in CCL area than in the peripheral area with pathology examination. No abnormal manifestations of the brain were detected with both pathology and MR examination in the control rabbits. Conclusion DTI is sensitive for detecting mild CCL and can show it directly on color map, and thus may be used as a routine examination in the evaluation of mild CCL.

16.
International Journal of Cerebrovascular Diseases ; (12): 716-720, 2009.
Article in Chinese | WPRIM | ID: wpr-392483

ABSTRACT

A cerebral arteriovenous malformation is a congenital disorder characterised by an abnormal connection between the arteries and the veins in the brain. It causes intracranial bleeding, seizures, severe headache, and progressive neurological deficits. The therapeutic strategies were usually established on the basis of clinical experiences due to lack of ideal models of arteriovenous malformation in the past .In order to further increase the success rate of surgery and decrease complications, this article reviews the advances in establishment and application of animal models of cerebral arteriovenous malformation in recent years.

17.
Chinese Journal of Tissue Engineering Research ; (53): 2789-2792, 2008.
Article in Chinese | WPRIM | ID: wpr-407192

ABSTRACT

BACKGROUND:Extracorporeal membrane oxygenation(ECMO)adopts heparin-coated oxygenator as key membrane oxygenation,which is a covalent bonding of artificial material surface with mucopolysaccharide on one side of heparin.Thas artificial materials can stimulate human vascular endothelial function partly,leading to decrease production of lactic acid,increase biocompatibility of the matedals,prevent thrombogenesis and relieve inflammatory reaction after operation.OBJECTIVE:To discuss the relationship between the plasma lactic acid level and the prognosis of patients after ECMO applied with heparin-coated oxygenator.DESIGN:Self-controlled clinical study,grouping by age and survival prognosis.SETTING:Department of Cardiopuimonary Bypass,Fuwai Cardiovascular Hospital,Chinese Academy of Medical Sciences.PARTICIPANTS:Forty patients received ECMO in Fuwai Cardiovascular Hospital,Chinese Academy of Medical Sciences were selected from December 2004 to September 2006.They suffered from failing weaning of cardiopulmonary bypass postcardioctomy,cardiogenic shock based on dilated cardiomyopathy or cardiogenic shock based on coronary heart disease.All patients were divided into four groups according to age and survival prognosis:adult survival group,adult death group,infant survival group and infant death group.METHODS:All the patients received venoarterial ECMO support treatment.ECMO perfusion system consisted of centrifugal pump,water tank,heparin-coated membrane oxygenator(Jorstra Novalung,Germany)and corollary circuits (Bioline Coating,Germany,batch number:SFDA-I-20063450801).MAIN OUTCOME MEASURES:The concentrations of lactic acid were measured at the ECMO institution,6 hours later,the median time at ECMO support,6 hours before weaning off and at the time of weaning.RESULTS:①In 26 patients of adult groups,20 of them(76.9%)weaned from ECMO,16 of them(61.5%)survived and 10 of them died.In 14 patients of infant groups,7 of them weaned from ECMO(50%),5 of them(35.7%)survived and 9 of them died.②The concentrations of lactic acid in two survival groups were significantly lower than those in death groups(P<0.05 or 0.001).The concentration decreased significantly at the time points of median time,6 hours before weaning off and at the weaning time,compared with the level at the time of ECMO institution(P<0.01),indicating a decreasing concentration of lactic acid.CONCLUSION:①The concentration of lactic acid in patients after ECMO decreascs obviously.②Patients with high lactate level at the weaning time show unfavourable prognosis.

18.
International Journal of Cerebrovascular Diseases ; (12): 447-451, 2008.
Article in Chinese | WPRIM | ID: wpr-399741

ABSTRACT

Objectire:To explore and evaluate the predictors for the prognosis of acute besilar artery occlusion(BAO)and the clinical efficacy of intra-arterial thrombolysis and stenting for BAO.Methods:Intra-arterial thrombolysis was administered with recombinant tissue plasminogen activator or urokinase in 52 patients with BAO within 3 to 48 hours.Stenting was performed in patients whose partial recanalization of residual stenosis>50%after the thrombolysis.National Institutes of Health Stroke Scale(NIHSS)score was measured before the procedure,and the modifled Rankin scale(mRS)score was obtained at 3 months after the procedure.The clinical data were evaluated with the multivariable stepwise logistic regression analysis and Fisher's exact test.Results:Complete recanalization achieved in 24 patients(46.2%),partial recanalization in 16 patients(30.7%),and non-recanalization in 12 patients(23.1%).mRS scores:22 patients(42.3%)had a favorable outcome,32 survived(61.5%),and 20 died (38.5%).The prognosis of BAO was significantly correlated with the NIHSS score(P<0.01),therapeutic time window (P <0.05) and recanalization level (after the thrombolysis and stenting)(P<0.01 );the good recanalization after the intra-arterial thrombolysis was significantly correlated with the NIHSS score (P <0.01) and therapeutic time window (P <0.05).Multivariate analysis showed that the NIHSS score < 14 (P < 0.01 ) and good recanalization could independently predict the favorable prognosis of BAO.Conclusions:The NIHSS score < 14 and good recanalization were the independent predictors for good prognosis of BAO.The rapid and timely treatment of BAO with intra-arterial thrombolysis and stenting is a safe and effective measure.

19.
Chinese Journal of Tissue Engineering Research ; (53)2007.
Article in Chinese | WPRIM | ID: wpr-593059

ABSTRACT

BACKGROUND: The copper-superoxide dismutase (Cu-SOD) can not play an effective role in free radical-scavenging in the process of hypoxia or reaeration because of blood-brain barrier, whether the treating effect can be enhanced by chitosan nanoparticles is uncertain. OBJECTIVE: To observe the ability of chitosan nanoparticles loaded the Cu-SOD plasmid on free radical-scavenging in ischemia-reperfusion brain tissue. DESIGN: An observation experiment. MATERIALS: The Cu-SOD plasmid was provided by the Center Laboratory of Tangdu Hospital, Forth Military Medical University of Chinese PLA. A total of 36 rats were prepared ischemia-reperfusion models, and randomly divided into the control, physiological saline (PS) plus Cu-SOD plasmid and chitosan nanoparticles loaded the Cu-SOD plasmid groups. METHODS: The chitosan nanoparticles were prepared by cross-linking method. The Cu-SOD plasmid was absorbed to chitosan nanoparticles by electrostaficforces, mixed the 50.0 ?L nanoparticles with 10.0, 25.0, 50.0, 75.0, 100.0 ?L SOD plasmid respectively. The electrophoretic analysis was used to examine the combination condition of the chitosan nanoparticles with superoxide dismutase plasmid, and the embedding rate was calculated with ultraviolet spectrophotometer. Chitosan nanoparticles, SOD and Cu-SOD plasmid were infused into the rat after brain ischemia-reperfusion. Further more, to detect the content of malondialdehyde and superoxide dismutase in brain tissues. MAIN OUTCOME MEASURES: The combination condition of the chitosan nanoparticles with superoxide dismutase plasmid, and the activity of malondialdehyde (MDA) and SOD were measured. RESULTS: Chitosan nanoparticles and superoxide dismutase in volume ratio of 50: 75 could harvest the largest embedding rate with 100%, which had good protective effect on DNA. The contents of MDA in brain tissues of the Chitosan nanoparticles loaded the Cu-SOD plasmid group were obvious lower than that of the control (P

20.
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care ; (6)2006.
Article in Chinese | WPRIM | ID: wpr-526705

ABSTRACT

Objective: To observe the effects of tetramethylpyrazine on the content of tumor necrosis factor?(TNF?) and the activity of myeloperoxidase(MPO) after cerebral ischemia/reperfusion in rats,and to investigate its mechanism of protective effects on cerebral ischemia/reperfusion.Methods: Thirtysix male SD rats were randomly divided into shamoperated group,model group and(tetramethylpyrazine) group.The thread with embolus was(inserted) in the cerebral(middle) artery in shamoperated group,but the artery was not(embolized).The cerebral ischemia/reperfusion models of rats were established in model group and(tetramethylpyrazine) group,while in the latter group,33 mg/kg of tetramethylpyrazine was(injected)(intraperitoneally) 30 minutes before ischemia.The methods of radioimmunoassay and pectrophotometry were used respectively to detected the content of TNF? and the activity of MPO in brain tissues of rats.(Results): Compared with those in shamoperated group,the content of TNF?((0.601?0.089) ?g/L vs.(1.576?0.153) ?g/L) and the activity of MPO((0.026?0.008) U/g vs.(0.409?0.044) U/g) in brain tissues(increased) markedly in model group(both P

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