Microsurgery for ruptured intracranial dural arteriovenous fistula: a retrospective case series of 8 patients / 国际脑血管病杂志

Objective:To investigate the emergency surgical effect of ruptured intracranial dural arteriovenous fistula (DAVF).Methods:Patients with ruptured intracranial DAVF underwent microsurgery in the Department of Neurosurgery, Nanping First Hospital Affiliated to Fujian Medical University from May 2013 to July 2022 were retrospectively included. The clinical, imaging and follow-up data were collected, and the clinical characteristics, selection of surgical methods and treatment effects of patients were summarized.Results:A total of 8 patients with DAVF were enrolled. Their age ranged from 11 to 60 years (average, 48 years). There were 7 males and 1 female. All 8 patients suffered from intracranial hemorrhage, manifested as headache and vomiting in 2 cases, simple conscious disturbance in 2 cases, conscious disturbance with cerebral hernia in 3 cases, and conscious disturbance with limb paralysis in 1 case. The fistula was located in the anterior fossa in 4 cases (including 2 cases with aneurysms), the middle fossa in 2 cases (including 1 case with moyamoya disease), the transverse sinus in 1 case, and the anterior 1/3 area of the sagittal sinus in 1 case. Cognard classification: 7 patients were type Ⅲ and 1 was type Ⅳ. After admission, all patients underwent emergency craniotomy and microsurgery to remove hematoma. Among them, 4 patients underwent decompressive craniectomy at the same time, 1 patient with moyamoya disease underwent dural turnover and temporalis muscle application at the same time, and 2 patients with aneurysms at the same location were clipped at the same time. Postoperative re-examination of head CT showed that the hematoma was cleared satisfactorily and the midline was no shift in all 8 patients. CT angiography (CTA) showed that the fistula disappeared within 2 weeks. Seven patients were followed up within 1-12 months after operation. CTA or digital subtraction angiography showed no recurrence of DAVF. Two patients with aneurysms did not have residual or recurrent aneurysms. All patients had no new neurological symptoms, and the Glasgow Outcome Scale score in 2 patients increased by 1 compared with that at discharge.Conclusion:Emergency microsurgery is an effective method for the treatment of ruptured intracranial DAVF, especially for patients with special parts or complicated hematoma, cerebral hernia, and other vascular diseases.

Involvement of dynorphin A in the inhibition of morphine physical dependence by N-nitro-L-arginine in rats / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the involvement of immunoreactive-dynorphin A in the inhibitory effect of N-nitro-L-arginine on the morphine physical dependence in rats.</p><p><b>METHODS</b>The rats were rendered dependent on morphine by subcutaneous administration of morphine solution three times daily in a manner of dose increment of 5 mg.kg(-1) for 6 days. The degree of morphine physical dependence was monitored by scoring the abstinence syndromes precipitated by 5 mg.kg(-1) naloxone of the rats. The expression levels of immunoreactive dynorphin A in tissues were determined using a radioimmunoassay.</p><p><b>RESULTS</b>Intraperitoneal injection of 5 mg.kg(-1) N-nitro-L-arginine suppresses most of the withdrawal symptoms of morphine dependent rats. N-nitro-L-arginine can elevate the expression of immunoreactive dynorphin.</p><p><b>CONCLUSIONS</b>Chronic N-nitro-L-arginine administration can inhibit the development of morphine physical dependence in a manner of dose-dependence, which is significantly related to its role of regulating the endogeneous dynorphin system.</p>

ANTIINFLAMMATORY ACTIVITY OF BUFEXAMAC ON TOPICAL SKIN INFLAMMATION MODEL INDUCED BY FORMALDEHYDE / 中国药理学通报

The paper reported the topical skin antiinflammatory activity of bufexamac on inflammation model induced by formaldehyde in mice. Comparing with the blank cream, the effect of 0.5% bufexamac cre-am on inflammation had no statistically difference, but all those of 1% bufexamac cream at 1 and 2 h after treatment, of 2 % and 5 % bufexamac cream at 1, 2 and 4h after treatment, showed significantly difference. The antiinflammatory activity was enhanced with the increase of bufexamac concentration in cream. The antiinflammatory activity of 2 % bufexamac cream was close to the effects of 1 % indomethacin cream and 0.05 % clobetasol Cream.Furthermore, our study showed that steroid antiinflammatory agents and nonsteroid antiinflammatory agents were all active against erythema and edema produced by formaldehyde in mice. Formaldehyde and mice are cheap and easy to obtain in our country. It is of some value to use the animal model for screening the topical skin antiinflammatory agents.