The protective effect of astrocyte inhibitor fluorocitrate on subarachnoid hemorrhage in rats / 西安交通大学学报(医学版)

Objective To study the effects of fluorocitrate (FC),astrocytic metabolic inhibitor,on early brain injury after subarachnoid hemorrhage (SAH)in rats so as to explore the mechanism of early brain injury mediated by astrocyte after SAH.Methods Thirty six SD male rats were randomly divided into sham group,SAH 3 d group and SAH 3 d+FC group,with 12 rats in each group.The model of SAH was established by an endovascular perforation technique. FC was injected into the lateral ventricle. Three days after SAH, the expressions of GFAP,Iba-1 and TNF-α were detected using immunohistochemistry in all rats.The expression and phosphorylation of NF-κB in the nucleus were detected by Western blot.The expressions of TNF-α,IL-1βand IL-6 were detected by ELISA.Cell apoptosis was detected by TUNEL.Results Neuronal swelling,nuclear anomalies, disorganization of micrangium,abnormality of endothelial cells appeared in SAH 3 d group,but not in sham group. The expressions of NSE,GFAP and Iba-1 were significantly increased in SAH 3 d group compared with those in sham group (all P＜0.05).The number of apoptotic cells was increased.The expression and phosphorylation of NF-κB were significantly increased.The expressions of TNF-α,IL-1β and IL-6 were significantly increased.However, neuronal injuries were alleviated by injecting FC.The expressions of NSE,GFAP and Iba-1 in SAH 3 d+FC group were inhibited.The number of apoptotic cells in SAH 3 d+FC group was decreased compared with that in SAH 3 d group.The expression and phosphorylation of NF-κB were decreased by FC.The expressions of TNF-α,IL-1β and IL-6 were significantly decreased by FC (P＜0.05).Conclusion Astrocytes may play an important role in early brain injury after SAH,underlying the mechanism that they released TNF-α,IL-1βand IL-6 and activate microglia by activating NF-κB signal.The inhibition of excess activation of astrocytes may plays a protective role in early brain injury after SAH.

The early diagnosis and therapy of aneurismal subarachnoid hemorrhage / 中华外科杂志

<p><b>OBJECTIVE</b>To discuss the early diagnostic methods and therapeutic principles of aneurysmal subarachnoid hemorrhage (SAH), and evaluate the therapeutic efficacy objectively.</p><p><b>METHODS</b>Using neuro-imaging examinations combined with case history and clinical symptoms to make the early diagnosis of 96 case with aneurysmal SAH, and Guglielmi detachable microcoil (GDC) was utilized for early intracapsular embolization in the ruptured aneurysms. Efficient symptomatic treatment was done early after operation.</p><p><b>RESULTS</b>All of 96 cases were early diagnosed and successfully embolized; Among them, the aneurysmal lumen was 100% occluded in 83 cases, 95% in 8 cases, 90% in 5 cases. There were 3 cases complicating with aneurysms rupture during operation, 5 cases with cerebral vasospasm. One case was affected by microcoil terminal escape after operation, 3 recurrent cases were all cured with secondary GDC embolization. There were 9 complications associated with embolization techniques and 13 cases (13.5%) occurring permanent sequelae associated with SAH. According to the Glasgow prognosis score, 77 patients got grade I, 7 grade II, 6 grade III, 3 grade IV, and 3 grade V. The mortality rate was 3.1%.</p><p><b>CONCLUSIONS</b>To make early etiological diagnosis of the SAH patients, using GDC to embolize the aneurysms, and earlier efficient symptomatic treatment are important methods to improve the curative rate and reduce the mortality rate.</p>

The early etiological diagnosis and endovascular embolization therapy of Hunt-Hess Ⅳ—Ⅴ grade subarachnoid hemorrhage / 中华放射学杂志

Objective To explore the methods of early etiological diagnosis and principles of endovascular embolization in Hunt-Hess Ⅳ—Ⅴ grade subarachnoid hemorrhage(SAH),and to evaluate the therapeutic efficacy.Methods Thirty-one patients underwent imaging examinations such as CT and DSA to make the early diagnosis of SAH.Meanwhile,Guglielmi detachable microcoil(GDC)was used to applying aneurysmal intracapsular embolization in the ruptured aneurysms,and efficient symptomatic treatment was adopted early postoperatively.The results were tested by ?~2 test.Results All 31 cases were diagnosed early and operated successfully.Among them,the aneurysm lumen was 100% occluded in 26 cases,95% occluded in 3 cases;90% occluded in 2 cases.There were 5 cases complicating with cerebral vasospasm.One case recurrent was cured with secondary complementary GDC embolization.Nine cases(29.0%)had permanent sequelae associated with SAH.According to the Glasgow prognosis score, the therapeutic efficacy was as following:6 patients were in grade Ⅰ,9 in grade Ⅱ,4 in grade m,2 in grade Ⅳ,and 10 in grade Ⅴ;10 patients died,and the morality rate was 32.3%.None of them exhibited re-bleeding with follow-up period of 3 to 68 months postoperatively.Morality rates were significantly different between the group with aneurysmal diameter of 11—25 mm and the group of 5—10 mm(?~2=6.60,P

Clinical study:endovascular embolization of intracranial aneurysm with coils / 中华放射学杂志

Objective To summarize the technique and managements of complications in endovascular embolization on intracranial aneurysm with Guglielmi detachable coils(GDC),and to evaluate the effect of the treatment.Methods One hundred and thirty six cases with Aneurizym were treated using GDC to embolize the aneurismal sac via femoral artery approach.Results One hundred and thirty six aneurysms were cured.Of them 132 cases recovered clinically,4 patients died.The mortality was 2.9%. The sac of 123 aneurysms were embolizied at 100%,8 cases with 95% embolization,5 with 90% embolization.3 aneurysms reptured during the embolization,cerebral vasospasm happened in 7 eases. microcoil escaped in 2 case.Three recurring cases were cured after second GDC embolization.The technique-related complications occured in 13 cases.No re-bleeding occurred during the 6 to 54-month follow-up.Conclusion Endovascular embolization of intracranial aneurysm with coils is a safe and effective treatment for intracranial aneurysm.Advances in Techniques and treating the complications correctly would decrease the complications and improve future outcomes.