ABSTRACT
The curative efficacy of percutaneous transluminal angioplasty and stenting (PTAS) in the treatment of patients with ischemia cerebrovascular disease caused by artery stenosis was explored. The clinical data of 111 patients with ischemia cerebrovascular disease receiving PTAS in Guangdong Province General Hospital from Aug. 2007 to Nov. 2009 were retrospectively analyzed. In total 132 stents were implanted in the 111 patients. The mortality and rate of neural and non-neural complications were assessed perioperatively. Outcomes [including the frequency of transient ischemic attack (TIA), stroke, or death from vascular diseases) were assessed after operation. NIHSS rating was performed in all cases before and at first week, 6th month and 12th month after the operation. The PTAS success rate was 100%. The degree of stenosis was reduced after PTAS. The total complication rate during perioperative period was 15.3% (the rate of neural complications was 3.6%). Sixty-seven patients were followed up. Three patients (4.48%) developed cerebrovascular events within 1 month, containing one case of TIA, one case of ipsilateral mild stroke and one case of contralateral mild stroke. No severe stroke or death was observed. During a follow-up period of 12 months 7 patients had cerebrovascular events (10.44%), including 2 cases of ipsilateral TIA (2.99%), 2 cases of ipsilateral mild stroke and 2 cases of contralateral mild stroke (2.99%), one case of severe stroke (1.49%). In 13 patients receiving DSA re-examination one year after PTAS, 2 patients (15.38%) had in-stent restenosis. NIHSS scores were obviously decreased during a follow-up period as compared with those pre-operation (P<0.05). It was concluded that PTAS could significantly alleviate the neural function deficit of the patients with ischemia cerebrovascular disease. The success rate of PTAS was high, and the rate of complications was lower and the clinical outcomes were satisfactory. PTAS is a safe and effective therapeutic method, though the long-term outcomes need further study.
ABSTRACT
Adipose tissue is a readily available source of adult stem cells with multipotent properties suitable for tissue engineering and regenerative medical applications. Peptide hydrogel is a novel biomaterial which provides three-dimensional microenvironments for a variety of cells for tissue grafting. In this study, adipose-derived stem cells (ADSCs) were isolated from rats, seeded into the peptide hydrogel polymer scaffolds and cultured in Neurobasal (NB) media supplemented with B27, basic fibroblast growth factor (bFGF) and epidermal growth factor (EGF). Ten days after the culture, some cells were expanded into clonal populations in which the expression of both Nestin and Brdu was detected but only Brdu expression was detected in the cells that were not expanded into clonal populations. Our results suggested that ADSCs in peptide hydrogel polymer scaffolds can be induced to differentiate into cells capable of expressing the neuron-associated markers, self-renewal and self-propagation.
ABSTRACT
Objective To explore whether there is enough clinical evidence to confirm that hyperbaric oxygen (HBO) does more good than other treatments in treating patients with diabetic peripheral neuropathy. Methods Published clinical trials on hyperbaric oxygen treatment for diabetic peripheral neuropathy were collected through electronic searches of PubMed, the Cochrane Central Register of Controlled Trials, EMbase, Science Citation Index Expanded, the China Biological Medicine Database (CBM-disc), the Chinese National Knowledge Infrastructure (CNKI) and the VIP Database for Chinese Technical Periodicals (from the date of establishment of the databases to July 2010). The bibliographies of the retrieved articles were also checked. Results A total of 7 trials involving 446 patients with diabetic peripheral neuropathy were included. All studies reported positive results regarding the effects,but the quality of the studies was generally poor. The main problem was that most trials were reported as randomized and controlled, but with no description of the methods of randomization, concealment and blinding. Conclusions HBO in the treatment of diabetic peripheral neuropathy is promising based on present evidence. However at present,definite conclusions cannot be drawn about whether hyperbaric oxygen treatment is superior to the alternatives for patients with diabetic peripheral neuropathy. Higher quality randomized and controlled trials are required.
ABSTRACT
Objective To study improvement of neural function by stereotaxic transplantation of adipose-derived stem cells (ADSC) into lateral cerebral ventricle after intracerebral hemorrhage in rats and its mechanism. Methods ADSC were cultured and proliferated in vitro, which had been marked with Brdu for 48 h before transplantation. The rat caudate nucleus hemorrhage (ICH) models were divided into 2 groups. ADSC were stereotaxically transplanted into the right lateral ventricles in ADSC group, and equal volume of saline was transplanted into control group. The score of neurological behavior were evaluated at modeling and 1, 3, 7, 14, 28 days after transplantation respectively.Double-staining immunofluorescence technique was used to detect Brdu-positive cells and the differentiation of neurons and astrocytes. In accordance with the instructions of TUNEL kit, cell apoptosis, and the expression of VEGF and angiogenesis were assayed. Results In vitro ADSC expressed undergo osteogenic and adipogenic differentiation. Compared with the control group, ADSC group had better motor function at 3, 7, and 14 days (P＜0. 05). Double-staining immunofluorescence showed mostly grafted Brdu-reactive ADSC had migrated to the hematoma zone, and some survivedand expressed Neun of Gfap. TUNEL analysis revealed that, 3 days after transplantation, the number of apoptotic cells in ADSC group was significantly less than in the control group (P＜0. 05). Three days after transplantation, VEGF expression levels in ADSC group were significantly higher than in the control group (P＜0. 05). Conclusion ADSC stereotaxially transplanted into the lateral ventricle can survive and differentiate into neuron-like cells. ADSC transplantation may reduce apoptosis and secret VEGF to promote the angiogenesis, and improve neural functional in intracerebral hemorrhage rats.
ABSTRACT
Objective To evaluate the effectiveness of constraint-induced movement therapy (CIMT),modified CIMT and forced use in the treatment of the upper limbs of adults after stroke. Methods Published ac-counts of trials of these techniques were located through electronic searches of the following databases: PubMed,EBSCO, Ovid, the Cochrane Central Register of Controlled Trails, EMbase, Science Citation Index (Expanded),HighWire Press, CBMDisc, CCTR, CNKI and VIP from the date of establishment of the databases to September 2009. The bibliographies of the articles thus retrieved were also checked. Results A total of 12 trials involving 648 patients were discovered. Meta-analysis showed that CIMT has been shown to increase movement efficiency, reduce normalized movement time, increase use of the more affected arm, improve the quality of use of the more affected arm and reduce the impact of the affected arm. C1MT showed no significant effect in improving independence in daily life compared with traditional rehabilitation. Conclusions To some extent, (modified) CIMT promotes arm rehabilita-tion after stroke effectively. However, these studies were small and their quality was poor. They had different follow-up points, assessed with different rating scales, and the course of stroke in the studies was also different. So more high-quality and large-scale randomized controlled trials are needed.