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Objective@#To observe the effect of monopolar radiofrequency(RF) and fractional CO2 laser on the filler hyaluronic acid (HA) injected subcutaneously in rats.@*Methods@#Five circular areas with a diameter of 2 cm at the dorsum of each rat were prepared for different treatment randomly: (1)HA injection group(HA). (2)HA injection+ fractional CO2 laser treatment group(HA+ CO2). (3)HA injection+ radiofrequency treatment group(HA+ RF). (4)0.9%NaCl+ fractional CO2 laser treatment group(NaCl+ CO2). (5)0.9%NaCl+ radiofrequency treatment group(NaCl+ RF). The volume of HA in group 1, 3, 4 were determined via MRI with reconstruction of Mimics Research X 17.0 before or 1, 3, 6, 12 months after photoelectric treatment. The rates of absorption of each time point and duration were calculated.@*Results@#The mass of HA could be even recognized 12 months after treatment macroscopicly. Inflamatory cell infiltration and fibring were observed around HA in HA, HA+ RF, HA+ CO2 group within 1 month. The fibrous capsule formed around HA, which was enhanced by RF and CO2 laser therapy since 3 months post therapy. There was no significant difference of volume of HA among the three groups before photoelectric treatment. There was significant difference of HA volume on 12 months post treatment, HA(311.90±52.59) μl, HA+ RF(404.80±64.29) μl, HA+ CO2(357.60±59.10) μl(P<0.01). The volume of HA received RF treatment degraded more slowly. The rate of HA absorption during 3-6 months post treatment was significantly lower than that of 6-12 months post treatment(P<0.05).@*Conclusions@#Fractional CO2 laser and radiofrequency do not increase the degradation of HA. On the contrary, they may prolong the duration of HA injected subcutaneously in rat.
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Objective To investigate the clinical effect of endovascular interventional treatment of intracranial peripheral aneurysms. Methods From January 2013 to December 2016,the clinical data of 31 patients with intracranial peripheral aneurysm admitted to the Department of Neurosurgery,Anhui Provincial Hospital were analyzed retrospectively.Among them,12 patients had saccular aneurysms,10 had narrow-neck aneurysms,and 2 lacked clear aneurysm necks;19 patients had fusiform aneurysms,they all lacked clear aneurysm necks.Ten patients with narrow-neck saccular aneurysm were treated with coil embolization, of the 2 lacked clear neck saccular aneurysms,1 was treated with stent-assisted coil embolization,1 was treated with coil occlusion of the aneurysm and parent artery;4 patients with fusiform aneurysm were treated with coil occlusion of the aneurysms and parent arteries,11 with fusiform aneurysm were treated with Onyx glue occlusion of the aneurysms and parent arteries,and 4 with fusiform aneurysm were treated with coils in combination with Onyx glue occlusion of the aneurysms and parent arteries.They were followed up for 6 to 36 months after procedure. Results All patients were successfully treated with endovascular intervention,no rebleeding cases were found.Immediate postoperative angiography showed that 11 patients with saccular aneurysm were totally occluded.The aneurysms and parent arteries in 1 patient with saccular aneurysm and 19 with fusiform aneurysm were totally occluded.The aneurysms and parent arteries of 8 patients were occluded with Onyx glue,cranial CT revealed different degrees of cerebral infarction (6 patients without new neurological deficits,2 new neurologic deficits).CT revealed cerebral infarction in 1 patient treated with coils in combination with Onyx glue for occlusion of the aneurysm and parent artery(no new neurologic deficit),other patients did not have cerebral infarction and new neurologic deficits.DSA follow-up revealed aneurysm neck recurrence in 1 patient with saccular aneurysm,no obvious aneurysm recurrence was observed in all other patients. Conclusions Endovascular treatment of intracranial peripheral aneurysms is safe and effective.Choose what specific intervention therapy base on the aneurysm morphology,location, tortuous degree of the parent artery,and the importance of the blood supply area.
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This paper reviewed and summarized experiences of Shanghai Hospital Development Center in the design and implementation of infrastructure planning for municipal public hospitals in Shanghai.The capital construction of more than 10 years has effectively upgraded infrastructure of such hospitals,enforced the people-oriented awareness,expanded the service ability and service capacity, further balanced the layout of quality medical resources,and significantly improved the sustainability of development.Furthermore, ever increasing government investment keeps business performance and service capability of such hospitals on the rise.
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Objective To explore the expression of heat shock protein (HSP) 90α in outside of different metastatic hepatocellular carcinoma (HCC) cell lines and its role in the cells migration and invasion.Methods The expression of HSP90α was detected by Western blot analysis in conditioned media of MHCC97L and MHCC97H with low and high metastatic HCC cell lines.A small molecule cell-impermeant HSP90 inhibitor DMAG-N-oxide was used to inhibit extracellular HSP90α.Changes of the cells migratory and invasive capability were assessed by in vitro motility and invasion assay.The endogenous matrix metalloproteinase 2 (MMP-2) was demonstrated by Zymography.The expression of extracellular co-chaperone HSP70 and MMP-2 were tested by Western blots and the association between HSP90α,HSP70 and MMP-2 was analyzed by immunoprecipitation.The effects of HSP70 knockdown by siRNA,with or without MMP-2 inhibitor Batimastat,on the level of active MMP-2 and cell migration and invasion were also evaluated.Results HSP90α can express both inside and outside of different metastatic HCC cell lines,and the level of expression was consistent with metastasis potentials.After MHCC97-H cells were treated with a special HSP90α inhibitor DMAG-N-oxide for 24 h,the average migratory cell numbers (28.11 ±3.56) had a significantly reduction,compared with those without treatment group (80.12±4.16) and empty control group (82.24±4.12),respectively (P ＜ 0.01).In vitro invasion assay showed the average invaded cell numbers in treatment group (36.54±4.12) were more fewer than without treatment group (95.12±3.48) and empty control group (101.1 1±3.36),respectively (P =0.017),and accompanying with decreasing of the extracellular MMP-2 activity.HSP70 and MMP-2 could express outside of MHCC97-H cells and interact with HSP90α.Small molecular interfere RNA (siRNA) dramatically inhibited HSP70 expression and reduced the interaction HSP90α with MMP-2 and MMP-2 activity outside MHCC97-H cells,and also suppressed MHCC97-H cells migration and invasion.In addition,combining MMP-2 inhibitor had additive inhibition effects.Conclusion Extracellular HSP90α and HSP70 form chaperone complex to assist in MMP-2 activation and increases HCC cells migration and invasion,which maybe a novel therapeutic target against metastatic HCC.
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Complex intracranial aneurysms refer to huge aneurysm, wide-necked aneurysm, fusiform aneurysm, microaneurysm, dissecting aneurysm and pseudoaneurysm.Endovascular interventional therapy is one of the safe and effective methods for intracranial aneurysms. However, the treatment is still limited by the morphology and is challenged by the recurrence for most of the complex intracranial aneurysms. The article reviews the treatment progress of complex intracranial aneurysms.
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Revascularization technique is a favorable approach to solve the insufficient compensation of cerebral blood flow for intractable intracranial aneurysms that needed to occlude parent arteries.With the development microsurgical technique and the improving of patency rate of vasotransplantation,the efficacy of revascularization for the treatment of intractable intracranial aneurysms is also improving constantly.
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OBJECTIVE: To explore the significance of the combination of factor analysis and systematic cluster analysis in classification of traditional Chinese medical syndromes in patients with posthepatitic cirrhosis, and to provide a scientific basis for the criterion of the classification. METHODS: We designed a clinical questionnaire according to the clinical characteristics and the demands of traditional Chinese medical information collection for patients with posthepatitic cirrhosis. By means of clinical epidemiological research, with the four diagnosis methods for clinical information collection of traditional Chinese medicine, symptoms, physical signs, tongue conditions and pulse conditions in 310 patients with posthepatitic cirrhosis were collected, and the characteristics of traditional Chinese medical syndromes in these patients were explored with statistical methods, such as factor analysis, varimax and systematic cluster analysis. RESULTS: Analyzed by factor analysis and systematic cluster analysis with SPSS 11.0, the traditional Chinese medical syndromes in 287 of the 310 cases (92.58%) of posthepatitic cirrhosis could be classified. The syndromes could be divided into 7 categories, which were internal accumulation of damp-heat (55 cases), insufficiency of the spleen with overabundance of dampness (74 cases), accumulation of blood stasis plus deficiency of liver-yin and kidney-yin (73 cases), accumulation of blood stasis plus deficiency of both blood and qi (40 cases), deficiency of both blood and qi (16 cases), deficiency of yin and blood heat (6 cases) and stagnation of the liver-qi and deficiency of the spleen (23 cases). The traditional Chinese medical syndromes in the other 23 cases could not be classified. CONCLUSIONS: The clinical information collected with the four diagnostic methods of traditional Chinese medicine can be classified into different categories with the factor analysis and systematic cluster analysis. The factor analysis and systematic cluster analysis can reveal the characteristics and regularity of traditional Chinese medical syndromes in patients with posthepatitic cirrhosis in a way, and have value in researching the syndromes of traditional Chinese medicine.
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OBJECTIVE: To explore the characteristics of traditional Chinese medical syndrome (TCM syndrome) of hepatocirrhosis. METHODS: Clinical information from the four diagnosis methods of traditional Chinese medicine (TCM) and related laboratorial indexes were systematically collected from 223 hepatocirrhosis cases, and the multi-statistical methods including systematic cluster analysis, principal component analysis, stepwise discrimination and variance analysis were made with the software SAS 6.11. RESULTS: Multi-analysis showed that there were 3 categories of syndrome characteristics. Type 1 (134 cases): damp heat, blood stasis, deficiency of liver and spleen Qi; Type 2 (62 cases): deficiency of both Qi and Yin with severe deficiency of Qi, heat with severe dampness, blood stasis; Type 3 (27 cases): deficiency of both Qi and Yin with severe deficiency of Yin, stasis and heat or dampness. Analysis of the changes of the related laboratorial indexes among the three types of syndrome showed that Type 1 mainly manifested asthenia syndrome with sthenia syndrome, and its indexes of AST, ALT, GGT levels were markedly higher than those of Type 2 and Type 3, both of which mainly showed sthenia syndrome with asthenia syndrome, and that Type 3 was in active inflammation, deficiency of both Qi and Yin (deficiency of Yin > deficiency of Qi), and its FN, Alb, FV, FVII, PLT, PCT levels were obviously reduced. CONCLUSION: The multi-statistical methods can reveal the characteristics and regularity of TCM syndrome of hepatocirrhosis, and the 3 categories of syndrome characteristics basically conform to clinical manifestations. The result of TCM syndrome distribution and laboratorial indexes infer that damp heat is the pathological basis of hepatocirrhosis, and the degree of liver function disorder and liver damage may be the pathological basis of deficiency of Yin of both liver and kidney.
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Objective To evaluate endovascular embolization with Onyx in treating brain arteriovenous malformations(AVM) located in the centre-encephalic region.Methods Eighteen patients with AVM in the brain centre-encephalic region were treated with embolization by using Onyx.According to Drake criteria of the AVM type,small type was seen in 10,medium type in 6 and large type in 2 cases.By using Onyx as embolization material,a total of 24 endovascular procedures were carried out.Results After treatment,complete obliteration was obtained in 12 cases(66.7%),disability(symptoms worsened) resulted in 2 cases(11.2%) and no death occurred.In the medium type group and the small type group complete obliteration was seen in 3(50%) and 9(90%) cases respectively,the difference between the two groups was significant(P 2 cm and the patients with the feeding artery