Application of reperfusion-expanding-thrombectomy-stenting technique in carotid tandem lesions / 中华神经科杂志

Objective:To analyze the feasibility and clinical efficacy of reperfusion-expanding-thrombectomy-stenting (RETS) technique in the endovascular treatment of acute carotid artery tandem lesion.Methods:The general clinical data of 88 patients with carotid artery tandem lesion who received emergency endovascular treatment from January 2018 to December 2020 in Department of Neurology, Linyi People′s Hospital were reviewed, the Modified Rankin Scale (mRS) was used as the evaluation standard for the prognosis of patients at 90 days after endovascular treatment, and the clinical data were analyzed, including the recanalization (modified thrombolysis in cerebral infarction ≥2b), perioperative complications and 90-day prognosis, and good prognosis was defined as a mRS score of 0-2.Results:A total of 88 patients with tandem carotid artery disease were included,48 of whom were treated with RETS technique, 40 were treated with anterograde approach. Compared with antegrade recanalization, RETS technique had significant differences in the time from puncture to recanalization [(72.06±17.29) min vs (98.88±26.09) min, t=-5.56, P<0.001] and the primary recanalization rate [35/48(73.0%) vs 21/40(52.5%),χ2=3.93 ,P=0.047], with statistically significant difference. There was no significant difference in clinical prognosis and surgical complications between the two methods (all P>0.05). Conclusions:RETS technique can shorten the operation time and increase the primary recanalization rate. RETS technique is safe and feasible for the treatment of carotid tandem lesions.

Clinical and radiologic features of posterior reversible encephalopathy syndrome associated with preeclampsia-eclampsia / 中华神经科杂志

Objective To investigate the clinical and radiologic features of posterior reversible encephalopathy syndrome (PRES) associated with preeclampsia-eclampsia.Methods Twenty-one cases of PRES associated with preeclampsia-eclampsia were retrospectively studied on some aspects of clinical and radiologic features.Results The most common clinical presentations were seizures( 18 cases ),headache (16 cases),altered mentation (15 cases) and vision change (12 cases). Vasogenic edema lesions distributed in the parietal or occipital lobe (20 cases),the frontal lobes (14 cases),temporal lobes ( 11 cases), and basal ganglia (11 cases). The splenium involvement occurred in 4 cases,cerebellar hemispheres and brain stem involvement was prcscnted in 3 cases and 1 case separately. Three major patterns of PRES included dominant parietal-occipital (7 cases),the holohemispheric watershed (7 cases),and superior frontal sulcal (6 cases).Partial and asymmetric expression of PRES only occurred in 1 case.Conclusions The clinical features of PRES associated with preeclampsia-eclampsia are typical.Except the parietal or occipital lobe,involvement of the frontal lobe,temporal lobe and basal ganglia is common,followed by the occasional presence of the splenium,cerebellar hemispheres and brain stem.Three primary PRES patterns are noted,occasional with partial and asymmetric expression of PRES. Awareness of these typical and variable characteristics is important to recognize the PRES ncurotoxicity morc accurately when PRES present.

Study on in vivo antioxidant effect of TPD in Rosmarinus officinalis / 中草药

Object To investigate the in vivo antioxidant effect of the extract from Rosmarinus officinalis L. and its active substances. Methods The contents of MDA, the activites of SOD and GSH Px in serum, heart, liver, brain and skeleton muscle were determined in oxidative stress mouse model caused by exercise. Results It was found that in serum, liver, heart and skeleton muscle except the brain, the contents of MDA were decreased and the activities of SOD and GSH Px were increased by 250 mg/kg and 500 mg/kg of total phenolic diterpenes (TPD) extract taken. Conclusion The results showed that R. officinalis has prominent antioxidant effect in exercise mice and the active constituents may be phenolic diterpenes.

The rapid prediction of GVHD by three-dimensional structure differences of HLA / 中国输血杂志

Objective Trying to predict the degree of GVHD after partly matched hematopoietic stem cell transplantation. Methods Analysis of the relationship between three-dimensional structure differences of donor-patient unmatched HLA and the GVHD levels after hematopoietic stem cell transplantation. Results GVHD levels were related to donor-patient unmatched HLA structure differences. The HLA structure differences forⅠ - Ⅱ degree GVHD were much smaller than that for Ⅲ - Ⅳ degree GVHD. Conclusion Prediction of GVHD by HLA structure differences is simple, rapid, specific and could help select proper conditioning regimens before transplantation and the proper immune suppressive agents after transplantation.

THE APPLICATION OF MOLECULAR MODELING OF HLA ANTIGENS IN UNMATCHED STEM CELL TRANSPLANTATION FOR GVHD PREDICTION / 解放军医学杂志

To explore the pathogenic mechanism of GVHD, attempting to forecast the degree of GVHD after stem cell transplantation, and to enhance the therapeutic effectiveness of clinical transplantation. The conventional microlymphocytotoxicity and sequencing methods were used in typing the HLA. The degrees of GVHD were estimated by molecular modeling of HLA antigens and veryfied the estimation by comparing the clinical results with anticipated degrees. In 8 recipients, three were transplanted with half matched stem cells. Among these 3 pationts, two developed IV degree GVHD, and one developed II degree GVHD. In the other 3 patients, cells of two unmatched HLA antigens were transplanted, and among them one developed I degree GVHD, and two developed II degree GVHD. In two patients who were transplanted with cells of one unmatched HLA antigens, I and II degrees GVHD developed respectively. Second, the correlationship analysis showed that degrees of GVHD had positive correlation with the RMSD (relative mean square deviation) between different HLA antigens. These results indicated that the degrees of GVHD after stem cell transplantation were related with the difference of three dimensional structures of unmatched stem cell HLA antigens; molecular modeling might be used to predict the prognosis of clinical stem cell transplantation.