Hemodynamic changes in different types of intracranial aneurysms after treatment with flow diverter / 中华神经医学杂志

Objective:To analyze the hemodynamic changes of different types of unruptured intracranial aneurysms before and after flow diverter (FD) treatment with computational fluid dynamics (CFD), and lay research foundation for precision treatment and prognosis evaluation for unruptured intracranial aneurysms.Methods:Four patients with different types of unruptured intracranial aneurysms, admitted to Department of Neurosurgery, First Affiliated Hospital of Air Force Medical University from January 2022 to March 2022, were chosen. Digital subtraction angiography (DSA) data of the patients before and immediately after surgery were collected. Morphological and hemodynamic parameters of the aneurysms were calculated by 3D reconstruction, finite element simulation, and CFD methods: ostium ratio (OsR), neck ratio (NR), area ratio (ArR), volume ratio (VoR), wall shear stress (WSS), normalized wall shell stress (NWSS), blood inflow, relative inflow, aneurysm average velocity, parent artery average velocity, normalized velocity, residual flow volume (RFV), and inflow concentration index (ICI); differences of these indexes before and after treatment were compared.Results:The OsR of 6 aneurysms was 0.225, 0.267, 0.265, 0.389, 1.000, 1.000, respectively; NR was 1.220, 0.274, 1.090, 1.587, 2.809, and 4.019, respectively; ArR was 0.608 and 0.224, 0.623, 3.462, 1.225 and 1.784, respectively; and VoR was 0.386, 0.052, 0.212, 3.462, 0.422 and 1.882, respectively. The parameters of WSS, NWSS, blood inflow, relative inflow, aneurysm average velocity, parent artery average velocity, normalized velocity, RFV, and ICI decreased obviously after FD implantation.Conclusion:On the basis of 3D reconstruction combined with FD/coil virtual implantation, CFD-based hemodynamic analysis can obtain accurate parameters of different types of intracranial aneurysms before and after FD treatment.

Neglect of preschool children in urban area of Xi an under the background of multi-child policy / 中国学校卫生

Objective@#To understand the situation of neglect of preschool children in the urban area of Xi an under the background of multi child policy, so as to provide a reference for making effective prevention.@*Methods@#In Novmber 2022, according to the multi stage stratified cluster sampling principle, 2 450 parents of children aged 3-6 years were randomly selected from 7 urban areas of Xi an to participate in the questionnaire survey. A questionnaire survey was conducted using the "Neglect Evaluation Norms of 3-6 Years Old (Preschool) Children in Urban Areas of China". SPSS 18.0 software was used for statistical description, Chi square test and variance analysis.@*Results@#The total neglect rate of preschool children in the urban area of Xi an was 29.0% and the total neglect score was (37.58±8.44). There was no statistical difference in the neglect status of children in different grade groups ( χ 2/ F =1.61, 2.98, P >0.05). The neglect score of boys was higher than girls ( t =2.45, P <0.05). There was no statistical difference in the neglect rate and neglect score of boys and girls in other levels ( P >0.05); except for the significant difference in the neglect degree of medical treatment, education and safety ( t =2.01, 2.28, 2.02, P <0.05). The rate and score of neglect in multi-child families were higher than only-child families ( χ 2/ t = 13.68, -4.54, P <0.05). There were significant differences in the rate and degree of neglect of children with different birth order, which were "third and fourth-born>second-born>first-born" ( χ 2/ F = 10.84 , 2.79, P <0.05). The neglect rate and score of "single parent family" were significantly higher than that of "nuclear family" and "three-generation family" ( χ 2/ F =4.78, 2.79, P <0.05).@*Conclusion@#The neglect situation of preschool children in urban area of Xi an is still serious, especially in multi-child families. It should actively explore the risk factors and formulate effective intervention measures.

Silencing of Long Non-Coding RNA MALAT1 Promotes Apoptosis of Glioma Cells

The metastasis-associated lung adenocarcinoma transcription 1 (MALAT1) is a highly conserved long non-coding RNA (lncRNA) gene. However, little is known about the pathological role of lncRNA MALAT1 in glioma. In the present study, we explored the expression level of lncRNA MALAT1 in primary glioma tissues as well as in U87 and U251 glioma cell lines. Using qRT-PCR, we found that the expression of lncRNA MALAT1 was significantly increased in glioma tissues compared with that of paracancerous tissues. Meanwhile, the expression of MALAT1 was highly expressed in U98 and U251 cells. In order to explore the function of MALAT1, the expression of MALAT1 was greatly reduced in U87 and U251 cells transfected with siRNA specifically targeting MALAT1. Consequently, cell viability of U87 and U251 cells were drastically decreased after the knockdown of MALAT1. Concomitantly, the apoptosis rate of the two cell lines was dramatically increased. Furthermore, the expression levels of some tumor markers were reduced after the knockdown of MALAT1, such as CCND1 and MYC. In summary, the current study indicated a promoting role of MALAT1 in the development of glioma cell.

The contrast of epalrestat and mecobalamine in improving diabetic peripheral neuropathy / 中国医师杂志

Objective To compare the curative effect of Epalrestat and mecobalamine .Methods Epalrestat to treat 48 pa-tionts in DPN and mecobalamine to treat 42,measuring blood sugar ,blood pressure, blood fat and body mass index (BMI) prior and post treatment ,and measuring the MCV and SCV of nervus medianus ,nervus peronaeus connunis and nervus tibialis with EMG .Re-sults The symptom of the two sets have all been improved after the treatment ,and the effective power of Epalrestat and mecobalamine is 92.7% and 80.5% respectively.mean while there is improvement in MCV and SCV of nervus medianus ,nervus peronaeus connunis and nervus tibialis,and is more obvious in the set of Epalrestat ( P <0.01).In the whole process of the treat of the two sets ,no one appear to have adverse reactions .Conclusions Epalrestat has significant curative effect with less adverse reactions , and deserves to be spreaded in clinic.

Application of intraoperative extra strong electrical stimulation in the treatment of brachial plexus birth palsy / 中华显微外科杂志

Objective To explore clinical value of intraoperative extra strong electrical stimulation in the treatment of birth brachial plexus palsy. MethodsFrom July 2008 to September 2011,intraoperative extra strong electrical stimulation was applied in 9 cases of incomplete birth brachial plexus palsy after neurolysis.The latency and amplitude of compound muscle action potentials before and after electrical stimulation were recorded and the extent of improvement was compare.ResultsThe latency was improved in 7 cases with 8.02％ in average,amplitude in 8 cases with 185.97％ in average.The related nerve recover partial motor function in 8 cases in 2 weeks after operation.ConclusionIntraoperative extra strong electrical stimulation is a effective assistant technique to promote motor functional recovery of birth brachial plexus palsy.

The value of MRI in the diagnosis of brachial plexus birth palsy / 中华显微外科杂志

ObjectiveTo evaluate the value of MR imaging(MRI)in diagosing of obstetrical brachial plexus.MethodsBetween September 2006 to September 2011,eighteen cases (12 males and 6 females)of obstetrical brachial plexus injury had being used for investigation,aging from 2 month to 3 years, average of 10.6 month. Eight left side and 10 right side. Tassin Ⅰ was 4 cases,Tassin Ⅱ was 6 eases, Tassin Ⅲwas 5 eases, Tassin Ⅳ was 4 cases. All cases were performed to MRI test before operating and the result compare with finding during operating. ResultsFindings of MRI:pseudomeningocele was in 13 of the 18cases while 10 of the 15 patients had multiple pseudomeningoceles. Displacement of spinal cord was in 6 cases; Normal was 2 cases; thickening of nerve root was in 2 cases.ConclusionMR imaging is an effective tool for demonstrating lesions of the brachial plexus worthy of surgical exploration.

Preliminary research on the clinical classification of the brachial plexus root injury in adult / 中华显微外科杂志

Objective To explore the clinical classification of the brachial plexus root injury in adult.MethodsAll 155 cases of adult brachial plexus root injury in the First Affiliated Hospital of Sun Yat-sen University,were collected and analyzed on their characteristic,operative methods,and clinical outcome so as to find the distribution and incidence of different type of brachial plexus root injury and set up the clinical classification of adult brachial plexus root injury.ResultsBrachial plexus root injuries in adult could be classified into three types and seven subtypes.Type A is upper brachial plexus root injury,including type AⅠ (C5,C6 completely avulsion or rupture injury,with/without phrenic nerve injury),type AⅡ (C5-C7 completely injury),and type AⅢ (C5-C7 completely injury accompanied with C8,T1 incompletely injury).Type B is lower brachial plexus root injury,including type BⅠ[ C8,T1 (with/without C7)completely injury ] and type BⅡ (C8,T1,C7 completely injury,accompanied with C5、6 incompletely injury).Type C is total brachial plexus root injury,including type CⅠ(C5-T1 completely root avulsion) and type CⅡ(C7-T1 root avulsion accompanied with C5、6 root or trunkrupture).For the cases of every type,u pper brachial plexus root injury type A have 86 cases,in which type AⅠ 6 cases,type AⅡ 27 cases and type AⅢ 53 cases; lower brachial plexus root injury type B have 6 cases,in which type BⅠ 2 cases and type BⅡ 4 cases; total brachial plexus root injury type C have 63 cases,in which type CⅠ 51 cases and type CⅡ 12 cases. ConclusionExcept the upper,lower,and total three types,brachial plexus root injuries in adult could be classified further into seven subtypes.The distribution of different type of adult brachial plexus root injury is overbalance:upper type A (55.5％) is more often seen,total type C(40.6％) followed and lower type B(3.9％) is the least seen.In upper brachial plexus root injury,type AⅢ(61.6％) is more often seen,type AⅡ(31.4％) followed and type AⅠ(7％) is less seen.

Clinical research of functional reconstruction with BTA for treatment on equinovarus foot of spasitic cerebral palsy / 中华显微外科杂志

Objective To observe the clinical therapial value of functional reconstruction with Botulinum Toxin A (BTA) on spasitic cerebral palsy. Methods Thirty-two patients were treated by Achilles tendon lengthening and anterior transfer of posterior tibial tendon.According to the spasticity of triceps surae muscle,all cases were arranged by BTA injection 2 months later after operation.Results From Jan.2000 to Jan.2009,thirty-two cases with equinovarus foot of spasticitical cerebral palsy were collected,the muscle strength of ankle dorsal extensor increased from 0-2 grades to 4-5 grades,there was significant difference between preoperational muscle strength and postoperational one.There was also significant improvement to adjust yarus degrees of ankle joint.the musclar tension of triceps muscle of calf decreased from Ⅱ-Ⅳ grades to Ⅰ-Ⅱ grades. Conclusion Anterior transfer of posterior tibial tendon corresponding with Botulinum Toxin A injection not only release muscle spasticity but also improve dorsal extending strength of ankle joint.The clinical effect of these methods was reliable on cerebral palsy.

Investigation and analysis of the quality of life on brachial plexus injury patients / 中华显微外科杂志

Objective To investigate the quality of life on brachial plexus injury patients in crosssectional study method and acquire related data. To analysis the effect factors and try to study on the methods which help to improve the quality of life of these patients. To our knowledge, this is the first study that measures quality of life of the brachial plexus injury patients in China. Methods Research participants completed the Chinese version of the World Health Organization Quality of Life Assessment-Bref (WHOQOL-BREF) and the 5-items version of International Index of Erectile Dysfunction Questionnaire (IIEF-5) for male.Data were typed into computer and analyzed with SPSS version 13.0. Correlations between domain scores and hospital stay, age, and family monthly income variables were analyzed with Spearman non-parameter correlation analysis. Results Fifty-one valid questionnaires were retrieved. The average score of these patients in physical, psychological, environment domains were 11.47 ± 2.36, 12.37 ± 2.28 and 11.62 ± 2.22, respectively. They were significantly lower than the norm groups in national studies which were 15.8 ± 2.9, 14.3 ±2.5 and 13.2 ± 2.4 (P ＜ 0.01 ). The average score of IIEF-5 was ( 17.83 ± 4.65), significantly lower than the normal score of 22 (P ＜ 0.01 ). Significant correlation was found among physical domain and age(P ＜ 0.05),family monthly income (P ＜ 0.05) and IIEF-5 score(P ＜ 0.01). Psychological domain also has significant correlation with IIEF-5 score (P ＜ 0.05) and so does environment domain with family monthly income (P ＜0.05). Conclusion Brachial plexus injury patients showed a reduction in quality of life scores. Even though the physical aspect was the most affected, there is evidence that the psychological, environmental domains and erectile function remained far from the ideal conditions expected for the general population. The effect factors are complex and there still remain much work to do.

Transfer of ulnar nerve partial fascicles and brachial plexus extrinsic nerve for treatment of the brachial plexus injury / 中华显微外科杂志

Objective To evaluate the clinical effects of partial fascicle from the ulnar nerve to biceps branch of musculocutaneous nerve to treat brachial plexus injury. Methods Six cases of brachial plexus injury were involved in this group.3 cases were upper trunk injury and 3 cases were accompanied partial lower trunk injury.A partial fascicle of ulnar nerve transfered to repair biceps branch underwent in all cases,phrenic nerve or accessory nerve were transfered to repair suprascapular nerve.The mean time from injury to surgery was 2.8 months.Patients were evaluated with regard to elbow flexion and should abduction ansle,grip strengthen,morbidity of ulnar nerve function lose. Results Five cases out of six got follow up.The mean period of follow-up was 18 months(range from 9-30 months).The average reinnervation time for the biceps muscle was 3.3 months. All the patients' recovery of elbow flexion Was M_3~+-M_5; and the shoulder adduction was 90°-180°;the grip strength was not downgraded. No notable impairment of the donor site nerve function was observed in 4 cases,just 1 case with a little more fascicle been harvested had partial ulnar nerve impairments. Conclusion The use of ulnar nerve partial fascicle to biceps branch combined with phrenic nerve or accessory nerve to suprascapular nerve to reconstruct upper roots avulsion of the brachial plexus is a valid and convenient procedure.It can obtain good functional restoration in elbow flexion and shoulder adduction in a resonable time.The cases with partial lower trunk injury of brachial plexus,the partial fascicle of ulnar nerve can still be used for repair the musculocutaneous nerve.

Analytical study of human allogenic acellular peripheral nerve in standard preparation methods / 中华显微外科杂志

@#Objective To analyze five kinds of allogenic acellular peripheral nerve by different meth-ods and try to establish a standard method for preparing nerve materials. Methods Five kinds of nerve ma-terial prepared by different chemical extractions according to nowaday articles were examined by HE staining. Irmnunohistochemistry and protein ratio was studied by allogenic nerves by virtue of Kjeldahl method in order to know the efficiency of these methods in removal of SCs axons and integrality of the basilar membrane. Results Myelin sheath and cytoblast in group 2 that nerves were extracted by Triton X-100 and Sodium de-oxycholate consecutively twice were completely removed, which was well demonstrated in HE staining. Per-ineurium in red staining were arranged wave-like longitudinally, axons and myelin sheath were replaced by column-like spacing. Col I staining were positive in all groups, structure of basilar membrane became loose slightly in the first and second group, and the structure of the other groups were relatively regular. Group 1 and 2 were negative in S-100 staining. There was no difference between group 2 and group 1,3,4 and 5 in sheath removal demonstrated by TEM. Protein ratio in group 2 was the lowest in the measurement with Kjel-dahl method. Conclusion The method used in group 2 that nerves were extracted by Triton X-100 and Sodium deoxycholate consecutively twice was the best in allogenic acellular peripheral nerve preparations.

Treatment of total root avulsion of brachial plexus by contralateral C_7 nerve transfer for directly repairing C_8T_1 via prespinal route combined with functioning gracilis transplantation / 中华显微外科杂志

Objective To explore the clinical design and therapeutic effect of total root avulsion of brachial plexus by contralateral C_7 nerve transfer for directly repairing C_8T_1 via prespinal route combined with functioning gracilis transplantation. Methods Twelve cases of total roots avulsion of brachial plexus were operated at 1 month to 3 months after injury.The contralateral C_7 nerve was successfully transferred to directly repair avulsed C_8T_1 roots or lower trunk via prespinal route.At 2nd operation stage after 4 to 8 months,the functioning gracills transplantation was preformed to reconstruct the elbow flexion and fingers extension. Results Follow-ups were carried out in all 12 cases who had been discharged for 9 to 36 months after the first operation.The positive Tinel signs of ulnar or median nerves were located in the proximal arm at 3 months after 1st operation,in the elbow or proximal forarm at 6 months,and in the wrist or distal forarm at 9 months.At 12 months the positive Tinel signs were found in the plam or fingers in 9 cases.The contraction of sternocostal part of pectoralis major was found at 9 mooths in 7 cases.There were the restoration of the taction-pain sensation in the palm, finger, and medial side of forearm and the contraction of flexor carpi ulnaris and flexor digitorum(M_3)in 5 cases at 15 to 18 months after 1st operation.In 7 patients the flexion of elbow and extension of fingers and thumb restored at 9 to 12 months after the 2nd operation.Their elbow flexion was 90°-120°and M_3(Highet's method),and their finger and thumb extension M_3. Conclusion There is the possibility of the operative design and clinical application of total root avulsion of brachial plexus by contralateral C_7 nerve transfer for directly repairing C_8T_1 via prespinal route combined with functioning gracilis transplantation.There are not only the restoration of sensation and flexion of wrist and fingers,but also the restoration of elbow flexion and fingers extension.

Study in vitro of populating autogenous Schwann cells into chemical extracted allogenous nerve / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To look for an ideal substance to repair large gap of nerve defect after injury by culture of Schwann cells (Scs) and preparation of acellular allogenous nerve grafts (ANG) with chemical extraction.</p><p><b>METHODS</b>The double adhesion culture and Arab-c to prohibit the fibroblast growth were used to achieve high-purified Scs. Triton-x-100 and sodium deoxycholate were used to achieve ANG. Finally the Scs were microinjected into the acellural nerve grafts and cultured in vitro. The consequence was analysed.</p><p><b>RESULTS</b>High purified Scs and ANG were acquired, which could integrate each other well. Scs could survive and transfer to aline in vitro.</p><p><b>CONCLUSIONS</b>Populating Scs into chemical extracted ANG may be an ideal substance to repair the large gap of nerve defect after injury.</p>

Plasma endothelin in acute cerebral infarction and its change after nimodipine treatment / 中国新药与临床杂志

AIM: To explore the role of plasma endothelin (ET) in patients with acute cerebral infarction (ACI) and its change after nimodipine treatment.METHODS:Sixty-six patients with ACI were randomly divided into 2 groups according to blood pressure:hypertension ACI group 35 patients［M 20,F 15;age (65±　s　11) a］ and pure ACI group 31 patients［M 17,F 14; age (62±10) a］.Plasma ET was measured by radioimmunoassay and compared with 27 healthy individuals.Among them,42 patients（hypertension ACI group 25 patients，pure ACI group 17 patients） with ACI were given nimodipine 4 mg, iv,gtt, qd, for 2 wk and measured ET again.　RESULTS:Plasma ET in 2 groups were (144±42) ng*L-1 and (72±35) ng*L-1 respectively, and that were (94±55) ng*L-1 and (60±37) ng*L-1 respectively after treatment with nimodipine, but was still higher than that in healthy individuals (P<0.01).　CONCLUSION: The level of plasma ET was associated with blood pressure and the severity of disease. ET is closely related with ACI. Nimodipine reduces the plasma ET while nerve function default degree is effectively improved.

Experimental study on inducing bone marrow stromal cells into Schwann-liked cells in vitro by modified method / 中华显微外科杂志

Objective To search for a more efficient method to induce bone marrow stromal cells (BMSCs) into Schwann-liked cells (SLCs) in vitro. Methods On the base of the method which was used by Dezawa (it was looked as the traditional inducing method),some steps were modified,namely,to use all the reagents in half dose in the same time and two times intervally,this method was looked as the modified inducing method.After induced by the two methods,the cells morphologic characteristic,the positive ratio of immunocytochemical dye with anti-S-100 and anti-GFAP,the cells activity measured by MTT method and the DNA percentage in S period measured by flow cytometry were compared with each other respectively to evaluate the methods'effects. Results Compared with the traditional method,the cells induced by the modified method were more similar to the primary Schwann cells in morphology,more positive proportion in immunocytochemic dye with anti-S-100 and anti-GFAP,less damage in the activity and more percentage in S period. Conclusion The modified method had more advantages such as less damage on cells and more efficiency in inducing BMSCs into SLCs.