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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.
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Objective To investigate the influence of Buyanghuanwu (BYHW) Decoction on cerebral infarct volume and pathological changes after cerebral ischemia and reperfusion. Methods The model of focal cerebral ischemia and reperfusion was made by thread embolism method. Healthy male SD rats were divided randomly into sham-operated group, model group and BYHW Decoction group. Infarct volume was detected by triphenyltetrazolium chloride (TTC) staining and pathological changes were observed microscopically in HE stained sections. Results In BYHW Decoction group, infarct volume was significantly smaller than that in model group (P
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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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Objective To study the causes and protection of intracranial aneurysms uncompletely embolized with micro-coils. Methods 47 cases of intracranial aneurysms were treated with micro-coils to embolize the aneurysaml sac via femoral artery approach to endovascular embolization.The aneurysms were located on AcoA in 19,on MCA in 7,on PcoA in 16 and on ICA in 5,2 aneurysms were foundin each of 2 cases. Results The uncompletely occuluded in 12 of them,aneurysms were completely occluded in 35,9 aneurysms wereoccluded to 95%,2 aneurysms were occluded to 90%,1 neurysms were occluded to 80%. Conclusion The wide neck intracranialaneurysms,hugeness intracranial aneurysms and ophidian,irregular intracranial aneurysms are of high rate of uncompletely occluded.Usingbasket-technique,remodel technique,vein rebuild technique and nibble subdivision endovascular embolization can decrease the rate ofuncompletely embolize intracranial aneurysm.
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Objective To investigate the protective effects of astragaloside Ⅳ on blood-brain barrier(BBB) and influence on expression of ZO-1 protein after cerebral ischemia and reperfusion in rats.Methods 72 SD rats were randomly divided into:sham operation group,model group and two astragaloside Ⅳ therapy groups [group A(10 mg/kg,group B(20 mg/kg)].Method of Evans blue leakage and water content in the brain tissue were used to investigate the permeability of the BBB,and method of immunohistochemistry combined with image analysis was used to measure the expression of ZO-1 protein in microvessels.Results Compared with those in the model group,Evans blue leakage and water content were less and the number of ZO-1 possitive vessels was increased in the two astragaloside Ⅳ therapy groups.There were statistical differences between therapy groups and model group(all P
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Objective To study neuroprotective machanisms of Mannitol combined with Nimodipine in treatment of ischemic reperfusion injury in rats. Methods Seventy-two SD rats were randomly divided into six groups (Group A:sham-operated group;Group B:model group;Group C:low-dose Mannitol group;Group D:high-dose Mannitol group;Group E:Nimotop group;Group F:Mannitol combined with Nimotop group). Both nitrate reductase and TUNEL methods were respectively used to measure NO content and apoptotic neurons in the brains.Results NO content and apoptotic neurons were higher in group B than those in group A (P0.05). NO content and apoptotic neurons were lower in group F than in group C,D and E (all P
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Objective To investigate the safety and efficacy of carotid angioplasty and stenting(CAS)for the treatment of carotid stenosis with filter cerebral protection devices(CPD).Methods The filter CPD was used in treating carotid artery stenosis by angioplasty and stenting in 19 cases.Cerebral thromboembolic events were noted and the filter devices were observed.All patients were followed-up for short-term.Results The placement of filter CPD and CAS were successfully administered in all patients.Tissue debris could be found in 8 out of 19 with naked eyes in the CPD.There was no death or symptomatic cerebral thromboembolic events during theropy procedure.Short-term follow-up showed excellent results.Conclusion CAS under the filter CPD is a safe and effective method in treating carotid stenosis.The effect of long-term follow-up needs to be further observed and the materials need to be further improved.