Risk factors and emergency management of intraprocedural re-rupture of ruptured intracranial aneurysms / 中华神经医学杂志

Objective To study the risk factors of intraprocedural re-rupture (IPR) of ruptured intracranial aneurysms, and the emergency management on this event and its efficacy. Methods The clinical data of 236 patients with ruptured intracranial aneurysms, admitted to our hospital from 2005 to 2009 and treated with embolization, were retrospectively analyzed; non-conditional logistic regression analysis was performed to analyze the risk factors of IPR of ruptured intracranial aneurysms. And the emergency management of IPR and its efficacy were concluded in 16 patients with IPR. Results The risk factors of IPR of ruptured intracranial aneurysms included small aneurysms with a diameter smaller than or equaling to 3.0 mm (OR=6.353, 95% CI: 1.266-31.894, P=0.025), aneurysms at distal part of Al and M1 segment of the anterior cerebral artery or middle cerebral artery (OR=35.449, 95% CI:3.053-411.642, P=0.004), atherosclerosis (OR=5.961, 95% CI: 1.215-29.260, P=0.028), mild vasospasm (OR=13.048, 95% CI: 1.220-139.574, P=0.034) and severe vasospasm (OR=14.826, 95% CI:1.871-117.488, P=0.011). Immediate reversal of heparin anticoagulation with protamine sulfate and rapid completion of coiling were performed in 16 patients (6.78%) occurred IPR. Emergent external ventricular drainage was performed in 12 patients having above Hunt-Hess grade Ⅲ:6 patients died; 1 was under persistent vegetative state and 9 fully recovered. Conclusion Small aneurysms, atherosclerosis,cerebral vasospasm and aneurysms at the distal part of Al or M1 segment may easily lead to IPR of ruptured intracranial aneurysms. Rapid completion of coiling combined with immediate reversal of heparin anticoagulation, and emergent external ventricular drainage performed in severe patients are confirmed to be the keys, which can decrease the death rate and improve the prognosis.

A modified endovascular treatment for longitudinal intracranial aneurysm / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the surgical approach and curative effect of the "interlocking basket" technique in interventional therapy for longitudinal intracranial aneurysm.</p><p><b>METHODS</b>Thirty-eight Hunt and Hess Grade I-III patients with longitudinal intracranial aneurysm underwent interventional therapy using the "interlocking basket" technique. During the operation, the aneurysm was divided into two segments based on its length and occluded with two coils. The first coil with a transverse diameter matching that of the aneurysm was deployed to form a "basket", which was densely occluded, and a portion of this coil out of the "basket" was interlocked with the second coil to form another "basket" crossing the aneurysmal neck to prevent the coils from escaping till the neck of the aneurysm was densely occluded.</p><p><b>RESULTS</b>Thirty-five aneurysms (92.1%) were completely embolized, and 3 (7.9%) were 95% embolized. No coil escaping from the aneurysm neck or other complications occurred. Twenty-five patients were discharged with a GOS score of 5 (65.8%), 7 (18.4%) with a score of 4, and 6 (15.8%) had a score of 3. In the follow-up for 3-25 months after the embolization, angiography was performed in 28 cases, and recurrence was found in 2 cases (7.14%).</p><p><b>CONCLUSION</b>The "interlocking basket" technique can increase the coil stability in longitudinal intracranial aneurysm and allows reliable block of the aneurysm neck and dense embolization of the aneurysm to improve the clinical outcomes of the patients.</p>

Clinically randomized controlled study on abdominal acupuncture for treatment of cervical spondylosis / 中国针灸

<p><b>OBJECTIVE</b>To compare clinical therapeutic effects of abdominal acupuncture and traditional acupuncture on cervical spondylosis (CS).</p><p><b>METHODS</b>Sixty-two cases of neck or nerve-root type CS were randomly divided into an observation group (n=32) treated by abdominal acupuncture at Zhongwan (CV 12), Guanyuan (CV 4) and others, and a control group (n=30) treated by traditional acupuncture at Fengchi (GB 20) and cervical Jiaji (EX-B 2), etc.. Simplified McGill Pain Questionnaire (MPQ) and clinical therapeutic effects were served as the objective indexes. Their clinical therapeutic effects were compared after the first session of treatment, at the end of therapeutic course and 3 months after the end of treatment.</p><p><b>RESULTS</b>The two groups had a same effective rate of 100.0%. All items of MPQ in these two groups after treatment and 3 months after the end of treatment significantly improved, and in the observation group the differences in the PRI feeling score before and after the first treatment, and the difference of the total PRI scores after the first treatment, at the end of therapeutic course and 3 months after the end of treatment significantly improved as compared with the control group (P < 0.05).</p><p><b>CONCLUSION</b>Abdominal acupuncture can better reduce the pain of the patient caused by CS, with transient pain-alleviating effect, but whether or not the clinical therapeutic effect of abdominal acupuncture is better than the traditional acupuncture still can not be proved.</p>

Observation on short-term therapeutic effect of Bo's abdominal acupuncture on chronic urticaria / 中国针灸

<p><b>OBJECTIVE</b>To observe short-term therapeutic effect and safety of Bo's abdominal acupuncture for treatment of chronic urticaria.</p><p><b>METHODS</b>Sixty-one cases of chronic urticaria were randomly divided into an observation group (n = 31) and a control group (n = 30). They were treated respectively with Bo's abdominal acupuncture and cetirizine. Their therapeutic effects were compared.</p><p><b>RESULTS</b>The effective rate was 80.7% in the observation group and 76.7% in the control group with no significant difference, but no adverse effect was found in the observation group, and the adverse effects such as sleepiness, headache, thirsty and so on were found in the control group.</p><p><b>CONCLUSION</b>Bo's abdominal acupuncture has a short-term therapeutic effect similar to cetirizine on chronic urticaria, and has no adverse effect of anti-histamine agents, being more safe.</p>