ABSTRACT
OBJECTIVE: To discuss the clinical efficacy and safety of balloon-expandable stent in the treatment of symptomatic atherosclerotic cerebral artery stenosis in the middle cerebral artery(MCA), and to assess the appropriate methods of postoperative follow-up auxiliary examination. METHODS: A total of 67 patients with symptomatic atherosclerotic cerebral artery stenosis in the MCA were treated with balloon-expandable stent. The clinical data and follow-up data were collected and then analyzed retrospectively.RESULTS: the success rate of the surgical treatment with balloon-expandable stent was 98.51%(66/67). The incidence of symptomatic perioperative complications was 4.48%(3/67). All patients received clinical follow-up, and the auxiliary examination methods of the internal condition lesion of the stent included transcranial Doppler(TCD) or digital subtraction angiography(DSA). The incidence of in-stent restenosis or occlusion was 8.96%(6/67), and the consistency rate of stent restenosis or occlusion between TCD and DSA was75.00%, and the incidence of symptomatic in-stent restenosis or occlusion was 2.99%(2/67). It was found that there were two patients with recurrent stroke in cerebrovascular stent related region but without in-stent restenosis, and within 1 year of follow-up, the incidence of symptomatic stroke in stent-associated areas after operation was 10.44%(7/67). CONCLUSION: The treatment with balloonexpandable stent for symptomatic MCA stenosis has good clinical effect. The incidence of perioperative complications is low and the incidence of stroke in stent-associated areas after operation is low. TCD is an effective way of follow-up after the arterial stenting in the brain, which can play a role in the early detection of the in-stent restenosis, and its consistency with DSA is high.
ABSTRACT
To construct knockout vectors containing ampicillin resistant gene and partial sequence of hyaluronidase gene(Hyl)so that Hyl can be knock out by transforming the plasmid into Streptococcus zoopidemics mutans.First,partial sequence of Hyl(Hyl-1)was cloned into the vector of pMD19-T by using DNA of Streptococcus zoopidemics as template,and then a knockout vector pMD19T-SA was constructed,in which Hyl-1 gene was disrupted by inserting ampicillin resistant gene(Amp)from reverse PCR.As expected,the vector was proved to be consisted of Hyl-1-Amp-Hyl-1-pMD19-T.Thereafter,DNA fragment of Hyl-1-Amp-Hyl-1 was subcloned into pBR322 vector,the resulting construct was then checked by PCR and restriction analysis for the proper configuration of the knockout vector pBR322-SA.Both of the knockout vectors were used to transform Streptococcus zoopidemics and one recombinant was obtained in result.From results of PCR and Hyl activity assay,it was indicated that in the recombinant the Hyl gene was disrupted completely.