Efficacy of dual stent-assisted coil embolization in ruptured vertebral artery dissecting aneurysms / 中华神经医学杂志

Objective:To evaluate the safety and efficacy of dual stent-assisted coil embolization in intracranial ruptured vertebral artery dissecting aneurysms (VADAs).Methods:Seventeen patients with intracranial ruptured VADAs (17 aneurysms), treated with dual stent-assisted coil embolization in our hospital from September 2015 to March 2020, were recruited. DSA was performed immediately after surgery to evaluate the embolization degrees of VADAs. At the end of follow-up, modified Rankin scale (mRS) was used to evaluate the prognoses of these patients, and DSA was used to determine the healing status of aneurysms.Results:The postoperative immediate DSA showed that total occlusion was achieved in 6 patients (35.3%), subtotal occlusion in 8 (47.1%) and partial occlusion in 3 (17.6%). Two patients died during the perioperative period and 2 patients presented symptoms of cranial nerve palsy after surgery. Fifteen patients were followed up for 5-24 months, 14 were with good prognosis, and one was with poor prognosis. Eleven patients underwent DSA follow-up, which showed that 8 aneurysms healed completely, 2 aneurysms were stable, and 1 aneurysm recurred.Conclusion:Dual stent-assisted coil embolization may be an effective and safe treatment method for intracranial ruptured VADAs.

Practical experience of virtual acupuncture and moxibustion teaching system in the operation teaching course of / 中国针灸

Started from the needs of clinical teaching and practice of acupuncture and moxibustion, based on the acupuncture education and assessment model, the virtual acupuncture teaching system was developed with the help of virtual reality (VR) technology, and applied to the course teaching of meridian and acupoint and needling and moxibustion method of . Compared with conventional teaching, this system can effectively improve practical operation test scores of students, meanwhile, it has higher interest, interactivity and helpfulness for knowledge learning, and improve independent learning ability, learning effect and memory depth, so student's satisfaction is higher.

Debridement, internal fixation, and reconstruction with titanium mesh for the surgical treatment of lumbar tuberculosis via a posterior-only approach in adults / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the clinical effects, indications and key techniques of debridement, internal fixation, and reconstruction with titanium mesh in lumbar tuberculosis via a posterior-only approach in adults.</p><p><b>METHODS</b>The clinical data of 26 patients with monosegment lumbar tuberculosis treated with surgery from March 2012 to March 2014 was retrospectively analyzed. Among them, 15 cases were male and 11 cases were female, and patients' age ranged from 21 to 68 years old (average, 44.7 years old). All patients suffered from back pain and/or pain with radiation to the legs. The clinical efficacy was evaluated based on the complications, erythrocyte sedimentation rate (ESR), imaging examination, and back and leg pain score of visual analogue scale (VAS).</p><p><b>RESULTS</b>All operations were successful in 26 patients with an average operation time of (2.4±0.8) h (range from 2 to 4 h), with an average blood loss of (320±86) ml(range from 200 to 700 ml) .VAS was decreased from (5.7±1.4) points preoperatively to (1.6±0.5) points 2 weeks postoperatively (<0.01); and ESR was decreased from (42.8±10.4)mm/h preoperatively to (12.1±5.6)mm/h 3 months after surgery (<0.01). All the patients were followed up for 24 to 48 months with an average of(28.3±5.8) months. One patients suffered from the recurrence of TB and sinus tract formation at 2 months after surgery, and was cured by stronger anti-tuberculosis drugs, local debridement with drainage, and sinus tract healed at 3 months after operation. All intervertebral bone graft obtained fusion within 1 year after operation and no local recurrence of TB was found at final follow-up.</p><p><b>CONCLUSIONS</b>Debridement, internal fixation, and reconstruction with titanium mesh via a posterior-only approach is a effective and safe method for the treatment of monosegment lumbar tuberculosis, especially for the patients with secondary spinal stenosis.</p>

Migration of Adipose-derived Mesenchymal Stem Cells Stably Expressing Chondroitinase ABC In vitro / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Several studies have revealed that adipose-derived mesenchymal stem cells (ADSCs) can be used as seed cells for the treatment of spinal cord injury (SCI). Chondroitinase ABC (ChABC) decomposes chondroitin sulfate proteoglycans in the glial scar that forms following SCI, allowing stem cells to penetrate through the scar and promote recovery of nerve function. This study aimed to establish ADSCs that stably express ChABC (ChABC-ADSCs) and evaluate the migratory capability of ChABC-ADSCs in vitro.</p><p><b>METHODS</b>ADSCs were obtained from Sprague-Dawley rats using secondary collagenase digestion. Their phenotypes were characterized using flow cytometry detection of cell surface antigens and their stem cell properties were confirmed by induction of differentiation. After successful culture, ADSCs were transfected with lentiviral vectors and ChABC-ADSCs were obtained. Proliferation curves of ChABC-ADSCs were determined using the Cell Counting Kit-8 method, ChABC expression was verified using Western blotting, and the migration of ChABC-ADSCs was analyzed using the transwell assay.</p><p><b>RESULTS</b>Secondary collagenase digestion increased the isolation efficiency of primary ADSCs. Following transfection using lentiviral vectors, the proliferation of ChABC-ADSCs was reduced in comparison with control ADSCs at 48 h (P < 0.05). And the level of ChABC expression in the ChABC-ADSC group was significantly higher than that of the ADSC group (P < 0.05). Moreover, ChABC-ADSC migration in matrigel was significantly enhanced in comparison with the control (P < 0.05).</p><p><b>CONCLUSIONS</b>Secondary collagenase digestion can be used to effectively isolate ADSCs. ChABC-ADSCs constructed using lentiviral vector transfection stably express ChABC, and ChABC expression significantly enhances the migratory capacity of ADSCs.</p>

Clinical characteristics of pediatric intracranial arachnoid cysts: an analysis of 488 cases / 中华神经医学杂志

Objective To summarize the clinical features of pediatric intracranial arachnoid cysts (IACs).Methods Retrospective analysis of clinical data of 488 patients with pediatric IACs,admitted to our hospital from January 2003 to September 2013,was performed; 342 males and 146 females (M∶F=2.34∶1,mean age=[5.61±3.25] years) were chosen.Results A total of 221 patients (45.29％) were discovered accidentally,while 267 patients (54.71％) existed clinical chief complaints,including123 (46.07％) can be found being responsible for.Atotalof364 patients (74.59％) were simple IACs,and 124 patients (25.41％) were combined with other congenital diseases.IACs located at the middle cranial fossa (n=355,72.75％),the posterior fossa (n=82,16.80％),the anterior cranial fossa (n=20,4.10％),the cerebralconvexity (n=12,2.46％),the suprasellarcistern (n=7,1.43％),the intracerebral ventricle (n=5,1.02％),the quadrigeminal cistern (n=5,1.02％),and the inter hemispheres (n=2,0.41％).Four hundred and forty-nine patients (92.01％) were single cyst,and 39 (7.99％) were multiple cysts.In aspect of the tension effects based on imaging,127 patients (26.02％) were positive,and 361 (73.98％) were negative.All 76 patients (15.57％) accepted surgical operation,and 412 (84.43％) adopted the conservative treatment.After 3-72 months follow-up (mean 32.43±8.92 months),the symptoms relieved and the volume of cysts reduced in operation cases in different degrees; while 407 patients (98.78％) were stable,3 (0.73％) worsened on clinical symptoms,and 2 (0.49％) were improved.Conclusions The clinical complaints of IACs in children are complex,but only part could be determined the responsibility relations between the clinical complaints and IACs.Some IACs could be accompanied with other congenital diseases.In the natural history of IACs,most cysts maintain the stable volume,and only a few ofIACs need operation intervention.

Surgical intervention strategies for pediatric intracranial arachnoid cysts / 中华神经医学杂志

Objective To investigate the operation strategy of pediatric intracranial arachnoid cysts (IACs).Methods Surgical intervention was performed in 76 patients with pediatric IACs,admitted to our hospital from January 2003 to October 2013; cyst-peritoneal shunt was chosen in 40 patients and fistulation in 36 (including microscopic fistulation in 31 and endoscopic fistulation in 5).According to the changes of cyst volume and the relief of symptoms,the efficacy was evaluated,and the complications after operation,including the recent complications (within 2 months of operation) and long-term complications (longer than 2 months of surgery),were observed.Results The efficiency of cysts-peritoneal shunt was 80％ (32/40); the rate of recent complication for patients performed cysts-peritoneal shunt was approximately 17.5％ (7/40),including 3 of CSF leakage,3 of intracranial infection and 1 of wound infection; the rate of long-term complications was approximately 22.5％ (9/40),including 3 of shunt-dependency,2 of intracranial infection,2 of obstruction of the catheter,1 of off the catheter and 1 of skin channel infections.Meanwhile,the efficiency of fistulation was approximately 91.67％ (33/36); the rate of recent complication was approximately 8.33％ (3/36),including 1 of intracranial infection,2 of subdural hematoma; the rate of long-term complications was 0.Significant difference was noted in the surgical efficiency (x2=1.126,P=0.289) and the rate of recent complication (x2=0.707,P=0.401) between cyst-peritoneal shunt and fistulation; however,the rate of long-term complications in patients after cyst-peritoneal shunt insertion was significantly higher than that in patients after fistulation (x2=7.159,P=0.008).Conclusion Fistulation might be the preferred method for pediatric IACs,and shunt should be avoided.

Strong halo-femoral traction with wide posterior spinal release and three dimensional spinal correction for the treatment of severe adolescent idiopathic scoliosis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Many investigators advocate anterior release combined with halo-femoral traction and posterior fusion when treating stiff thoracic curves in patient with adolescent idiopathic scoliosis (AIS). But the anterior operations often induce severe complications. Some surgeons choose posterior-only surgery with halo-femoral traction, posterior wide release and correction. But to the best of our knowledge, there are only rare prospective studies on these posterior-only surgeries for AIS patients who have a rigid curve more than 80° and flexibility less than 35%.</p><p><b>METHODS</b>Sixty-four AIS patients were recruited from September 2006 to June 2009. All patients had rigid curves and underwent spinal correction. They were randomly divided into group A (combined anteroposterior surgery) and group B (posterior-only surgery). Images and scoliosis research society-22 questionnaire (SRS-22) scores were performed pre- and post-operation and during follow-up visits. The operation time, blood loss, hospital days, and hospital charges were compared between the two groups.</p><p><b>RESULTS</b>These patients were followed for an average of 37.5 months (range, 24 - 65 months). No serious complications were observed. There were no significant differences between the two groups in gender, age, preoperative radiographic data, or preoperative SRS-22 score. The average operation time, blood loss, hospital days and hospital charges in group B were less than those in group A. The SRS-22 score in group B was better than in group A at post-operation and at final follow-up.</p><p><b>CONCLUSIONS</b>In AIS with a rigid curve more than 80° and flexibility less than 35%, strong halo-femoral traction with wide posterior spinal release and three dimensional spinal correction can provide better SRS-22 scores, comparable curve correction, shorter operation time, less blood loss, shorter hospital stays and lower charges when compared to combined anterior and posterior surgery.</p>

Weekly regimen of paclitaxel liposome combined with cisplatin and 5-fluorouracil continuous infusion in the treatment of advanced gastric carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and toxicity of paclitaxel with low-dose cisplatin and 5-fluorouracil continuous infusion in the treatment of advanced gastric carcinoma.</p><p><b>METHODS</b>The patients were treated with paclitaxel liposome 60 mg/m(2) i.v. gtt on d1, 8, 15, DDP 15 mg×m(-2)×d(-1) by i.v. gtt on d1-5, 5-Fu 500 mg×m(-2)×d(-1) by civ for 120 h, administered every 21 days.</p><p><b>RESULTS</b>Out of the whole group, 3 cases achieved CR, 29 cases achieved PR with an ORR of 54.2% and median TTP of 7.1 months. Out of 40 cases in the primary treatment, 3 cases achieved CR, 22 cases achieved PR with an ORR of 62.5% and median TTP of 7.6 months. Out of 20 evaluable retreated cases, no case achieved CR, 7 cases achieved PR with an ORR of 36.8% and median TTP 6.3 months. The main toxicities were hematological toxicities, nausea and vomiting of grade I-II.</p><p><b>CONCLUSION</b>The combination regimen of paclitaxel, low-dose cisplatin and 5-fluorouracil is effective and well tolerated for patients with advanced gastric carcinoma, especially for primary treatment cases. It is worthy of further study.</p>

Apoptosis of breast cancer cell line MCF-7 cells induced by gemcitabine and radiation / 中南大学学报(医学版)

OBJECTIVE@#To investigate the apoptosis of human breast cell line MCF-7 cells induced by gemcitabine and radiation.@*METHODS@#The MTT method was applied to study the growth inhibition of MCF-7 treated with gemcitabine, radiation, gemcitabine and radiation. The apoptosis index (AI) was analyzed by flow cytometry. The morphology of the MCF-7 cells apoptosis was observed by transmission electron microscopy.@*RESULTS@#When MCF-7 cells were treated with gemcitabine at different concentrations for 24 h, the cell growth inhibition rate was increased in a concentration-dependent manner. The apoptotic indexes (AI) of MCF-7 of four groups by flow cytometry revealed. The AI of (R+D) group was significantly different from those of the radiation group and the gemcitabine group (P<0.05). Condensed chromation, nuclear fragmentation and apoptotic body of MCF-7 cells were found by transmission electron microscope.@*CONCLUSION@#The apoptosis of human breast cancer cell line, MCF-7 cells, could be induced by gemcitabine. Gemcitabine can significantly enhance the radiation-induced apoptosis of MCF-7 cells.

Clavicular hook plate in the treatment of dislocation of acromioclavicular joint and fracture of distal clavicle / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the curative effects of AO clavicular hook plate in the treatment of dislocation of acromioclavicular joint and fracture of distal clavicle.@*METHODS@#We retrospectively analyzed the clinical data of 39 patients with acromioclavicular joint dislocation or distal clavicle fractures treated with clavicular hook plate: 16 suffered from dislocation of acromioclaviculr joint, 18 suffered from far end collarbone fractures, and 5 patients had both symptoms.@*RESULTS@#The 39 patients were followed up for 12 months averagely. All patients got good reduction and fixation. The acromioclavicular joint subluxation, breakage, and loosening of the clavicular hook plate were not observed. The acromioclavicular joint recovered quickly.@*CONCLUSION@#AO clavicular hook plate is a good choice for acromioclavicular joint dislocation and distal clavicular fracture.