Clinical analysis of 4 acute ischemic stroke children treated with endovascular thrombectomy / 中华儿科杂志

Objective: To assess the feasibility of endovascular thrombectomy (EVT) for the treatment of acute ischemic stroke (AIS) in children. Methods: Clinical data and follow-up information of 4 AIS children who received EVT in the Department of Intervention & Hemangioma at the Children's Hospital of the Capital Institute of Pediatrics from December 2020 to June 2021 were collected retrospectively. The vascular recanalization after EVT was assessed by the modified thrombolysis in cerebral infarction (mTICI) score. Efficacy outcomes were assessed with initial and postprocedural Pediatric National Institutes of Health Stroke Scale (PedNIHSS) score, and the modified Rankin scale (mRS) score at 3 and 6 months after treatment. Safety assessments included perioperative complications and intracranial hemorrhage post-treatment. Results: A total of 5 EVT treatment were performed on 4 children with AIS, of whom 3 were male. The age of onset was 4.6, 13.8, 7.8, 8.0, 8.9 years, respectively. The time from symptom onset to initiation of EVT was 19.0, 25.0, 22.0, 4.0, 16.5 hours, respectively and all patients achieved successful recanalization of the vessel after EVT (mTICI≥2b). The PedNIHSS score was 39, 14, 25, 39, 24 before treatment and decreased to 8, 1, 12, 39, 5 at discharge. All the procedures were performed with no perioperative complications. Only 1 patient with congenital heart disease had a recurrent AIS with malignant brain oedema and brain hernia. Although the occluded vessels were successfully recanalized,the symptoms were not improved and this patient died after treatment abandonment. The other 3 patients achieved good recovery at 6 months postoperatively. The mRS score of 3 patients was 3, 1, 2 at 3 months after EVT and decreased to 2, 1, 1 at 6 months. Conclusion: EVT treatment may be feasible and safe for pediatric AIS due to large vessel occlusion even when the treatment was initiated 6 hours post stroke, but children with heart disease may have a dismal prognosis.

Nature of the residue hard tissue after liposuction in lipoma and its role in lipoma recurrence / 中华整形外科杂志

<p><b>OBJECTIVE</b>To study the nature of the residue hard tissue after liposuction in lipoma and its role in lipoma recurrence.</p><p><b>METHODS</b>The residue hard tissue after liposuction was collected for histologic study, including HE-staining and immunohistochemistry with antibody of stem cell marker (CD29 and CD44). The average density and area of positive cells were analyzed statistically.</p><p><b>RESULTS</b>The residue hard tissue had a medium hardness. The center tissue was light yellow surrounding by soft, loose, irregular and cord-like tissue. The normal fat tissue is light yellow with a soft and unanimous texture. HE-staining showed abundant stromas in residue hard tissue, with lots of fibroblast-like cells locating among adipocytes. The cytoplasm was less with large and blue-staining nucleus. In normal fat tissue, the fat cells were uniform which were round or polygon. The stromas was less and the fibroblast-like cells were comparatively less. The slices were stained with antibody (CD29, CD44) of stem cell marker. The density and area of positive cells were much more in residue hard tissue than those in normal adipose tissue. Two Independence Samples T test were as follows: (t'CD29 = 9.931, P = 0.000; (t'CD44 =10.171, P = 0.000 for density; and (t'CD29 = 7.761, P = 0.000; tt'CDRR = 6.639, P = 0.000 for area. The difference was significant.</p><p><b>CONCLUSIONS</b>Abundant fibroblast-like cells that are signed by the marker of stem cells exist in residue hard tissue. Those cells are proven to be lipoma derived stem cells (LDSCs) which may play an role in lipoma recurrence after lipoma liposuction.</p>