Efficacy of drug coated balloon vs. plain old balloon on the treatment of femoropopliteal artery in-stent restenosis / 中华普通外科杂志

Objective:To compare the clinical efficacy of drug coated balloon (DCB) vs. plain old balloon (POB) on in-stent restenosis (ISR) of femoropopliteal artery occlusive disease of the lower limb. Methods:The clinical data of 91 ISR patients admitted at Shanxi Bethune Hospital from Jul 2016 to Dec 2017 were retrospectively analyzed. The primary patency rates were compared.Results:There were 43 patients treated with drug coated balloons and 48 patients treated with plain old balloons. The surgical procedure was successful in all cases, and the symptoms of lower limb ischemia were significantly improved after surgical procedure. The primary patency rate of patients who were treated by drug coated balloons was significantly higher than by plain old balloons at 12 months after surgery (83.7% vs. 62.5%, P<0.05). Conclusion:The use of drug coated balloons could acquire more satisfactory short-term clinical efficacy for ISR patients of femoropopliteal artery occlusive disease.

Comparison on therapeutic effect of stent implantation and drug treatment for young cerebral infarction combined with middle cerebral artery stenosis / 中国介入影像与治疗学

Objective: To compare the effect of stent implantation and drug treatment for young cerebral infarction combined with middle cerebral artery stenosis. Methods: A total of 71 young cerebral infarction patients (aged 30-44 years) with severe stenosis of middle cerebral artery (stenosis rate >70%) were enrolled and divided into drug group (n=39, received conventional oral medication) and stent group (n=32, underwent stent implantation). The therapeutic effects and follow-up outcomes during 24 months were compared between 2 groups. Results: The success rate of stent group was 100%, and 32 stents were implanted. Significant differences were found between the scores at enrollment and those at 3, 6, 12 and 24 months of modified Rankin scale (mRS) and National Institutes of Health Stroke Scale (NIHSS) within both the two groups during the follow-up (all P0.05). Within 24 months' follow-up, the incidence of end-point event was 20. 51% (8/39), the stroke recurrence rate was 20.51% (8/39), and the disability rate of recurrence stroke (mRS score ≥ 2 points) was 20. 51% (8/39) in drug group, while in stent group was 6.25% (2/32), 3.13% (1/32) and 3.13% (1/32), respectively. There was no statistically significant difference of the incidence of endpoint events between 2 groups (P=0.17), while the recurrence rate of stroke (P=0.04) and the disability rate of recurrent stroke (P=0.04) in stent group were both lower than those in drug group. Conclusion: Compared with drug therapy, stent implantation can reduce stroke recurrence rate and disability rate of in young cerebral infarction with middle cerebral artery stenosis.

Cerebral venous sinus thrombosis: Endovascular treatment with different aproaches and anticoagulant therapy / 中国介入影像与治疗学

Objective: To compare the efficacy of multi-channel endovascular treatments and anticoagulant therapy in treatment of cerebral venous sinus thrombosis (CVST). Methods Data of 88 CVST patients were analyzed retrospectively, including 47 patients treated with multi-channel endovascular treatments (experimental group) and 41 patients treated with anticoagulation therapy (control group). Clinical follow-up was carried out for 6 months, and the efficacies were compared between the two groups. Results At the discharge, 3-month and 6-month follow-up points, modified Rankin scale (mRS) score and National Institute of Health stroke scale (NIHSS) score of the experimental group were 1 (1,2) and 1.43±0.50, 1 (0,2) and 1.04±0.33, 1 (0,1) and 0.87±0.28, lower than that of control group (2 [1,2] and 2.20±0.62, 2 [1,2] and 1.59±0.49, 1 [0,2] and 1.37±0.37, all P<0.05). Conclusion: Compared with traditional anticoagulant therapy, multi-channel endovascular treatments have better efficacies, which can reduce the disability rate and improve the quality of life of CVST patients.

Clinical analysis of submaximal balloon dilatation combined with Enterprise stent in treatment of complex symptomatic intracranial atherosclerotic stenosis / 中华神经医学杂志

Objective To observe the safety and efficacy of submaximal balloon dilation combined with Enterprise stent in the treatment of complex symptomatic intracranial atherosclerotic stenosis (ICAS).Methods Clinical data of 70 patients with complicated symptomatic ICAS treated in our hospital from February 2015 to September 2018 were retrospectively analyzed, and any stroke (cerebral infarction or transient ischemic attack [TIA] or cerebral hemorrhage), or death within 30 days were observed, as well as the recurrence of ischemic events and stent restenosis in the vascular supply area after 30 d of follow-up.Results Among the 70 patients, the success rate of operation was 100％; the preoperative stenosis rate was (81.4±10.2)％ and the postoperative stenosis rate was (18.3±6.4)％, with significant difference (P<0.05). Perioperative complications occurred in 4 patients (5.7％): two were subacute thrombosis in stent two d after operation; one had cerebral hemorrhage 10 h after operation, and one had perforator artery occlusion leading to pontine infarction. Nine patients (14.5％) had restenosis in stent during the follow-up period; symptomatic restenosis occurred in 3 (4.8％).Conclusion It is safe and effective to treat complex symptomatic ICAS with submaximal balloon dilatation combined with Enterprise stent, which can obviously decrease the incidences of postoperative complications and recent in-stent restenosis.

Clinical follow-up observation on treatment of middle cerebral artery stenosis with stents for stroke in young patients / 中国介入影像与治疗学

Objective: To investigate the clinical value of stent treatment for middle cerebral artery (MCA) stenosis in young stroke patients. Methods: Clinical and follow-up data of 37 young stroke patients with MCA stenosis treated with stents were retrospectively analyzed. Results: The technical success rate of cerebral vascular stenting was 100%. And the residual stenosis rate was (6.60±0.71)%. The median follow-up period was 34 months. The incidence of endpoint events (such as recurrent stroke, transient ischemic attack and death) was 8.11% (3/37), and the disability rate of endpoint events was 2.70% (1/37). Conclusion: Cerebrovascular stents are effective in treatment of MCA stenosis for young patients with stroke. The risk of recurrent stroke and the disability rate is low.

Effect of recombined human epidermal growth factor combined with alprostadil on Wnt/β-catenin signal pathway in rats with diabetic ulcer / 中国糖尿病杂志

Objective To explore the effect of recombined Human epidermal growth factor (rhEG) combined with alprostadilon Wnt/β-Catenin signal pathway in rats with diabetic ulcer. Methods Rats with diabetic ulcer were randomly divided into four groups :control group ,rhEG group ,epidermal group and combined treatment group. Ulcer skin was smeared by normalsaline in control group ,and by rhEG in rhEG group. Epidermal was administered from caudal vein in epidermal group.Combined treatment group was treated by rhEG and epidermal at the same time. The healing status were observed. The proteinand mRNA expression of Wnt-1 ,β-Catenin and GSK-3β were measured 14 days after treatment. Results The healing rates in combined treatment group were (9.76 ± 2.37 )% ,(35.74 ± 3.65 )% ,(51.37 ± 4.16)% and (84.42 ± 5.35 )% respectivelyin 6th , 10th and 14th day after treatment , which were significantly higher than in rhEG group and epidermal group (P<0.05). The mRNA levels of Wnt-1 ,β-Catenin and GSK-3βin combined treatment group were (1.42 ± 0.19) ,(1.56 ± 0.21) and (0.95 ± 0.15) after treatment for 14 days ,which were significantly higher than in rhEG group and epidermal group (P<0.05). Protein levels of Wnt-1 ,β-Catenin and GSK-3βin combined treatment group were (1.17 ± 0.16) , (1.38 ± 0.18 ) and (0.81 ± 0.13 ) after treatment for 14 days ,which were significantly higher than in rhEG group and epidermal group ( P < 0.05 ). Conclusion rhEG combined with epidermal can significantly accelerate the healing of diabetic ulcer ,and can regulatethe Wnt/β-Catenin signal pathway by increasing the expression of Wnt-1 ,β-Catenin and GSK-3β.

Efficacy of systemic anticoagulation combined with endovascular interventional therapy for cerebral venous sinus thrombosis / 中国脑血管病杂志

Objective To investigate the efficacy of treatment of intracranial venous sinus thrombosis using systemic anticoagulation combined with endovascular intervention.Methods From May 2014 to January 2017,the clinical data of 52 patients with cerebral venous sinus thrombosis diagnosed with DSA and treated with micro catheter thrombolysis at the Department of Neurology,the Second Hospital of Hebei Medical University were analyzed retrospective.The microcatheters were indwelled for 3-14 d.The dosage of urokinase ranged from 10-20 thousand U/h,13 patients were also treated with balloon dilatation,and 1 was also treated with stent-assisted treatment.The results of imaging data and 6-month telephone follow-up were analyzed.The prognosis was evaluated with the modified Rankin scale (mRS) and National Institutes of Health Stroke Scale (NIHSS).Results In 52 patients admitted to hospital,the whole brain DSA showed sagittal sinus thrombosis in 34 cases,transverse-sigmoid sinus transitional zone thrombosis in 31 cases,inferior sagittal sinus thrombosis in 2 cases,straight sinus thrombosis in 3 cases,and cortical vein thrombosis in 14 cases.Angiography before discharge showed complete patency of the venous sinus in 9 cases,most patency in 42 cases,partial patency in 1 cases,the symptoms were relieved,and neurological function scores were improved at discharge in 48 cases.There were no obvious changes in 3 cases,and 1 case aggravated.The mRS and NIHSS scores before and after treatment were compared.The difference was statistically significant (Z =5.45 and 3.03 respectively,all P ＜ 0.05).Forty-eight patients were followed up for 6 months by telephone,no symptoms related to venous sinus thrombosis were found.Three patients died,and 1 died of traumatic intracranial hemorrhage.Conclusions Endovascular intervention is an effective and safe treatment for intracranial venous sinus thrombosis.It can be used as an alternative treatment scheme of internal medicine for patients of ineffective anticoagulation.

BMP9 effectively induces osteogenic differentiation of immortalized calvarial mesen-chymal progenitor cells / 军事医学

Objective To investigate the effect of adenovirus-bone morphogenic protein 9 ( Ad-BMP9 ) on osteogenic differentiation of immortalized calvarial mesenchymal progenitor cells ( iCALs ) .Methods iCALs were infected with adenoviral vectors encoding BMP-9 or green fluorescent protein ( GFP) and the early osteogenic differentiation was assessed by detecting alkaline phosphatase (ALP) activity after being cultured for 3, 5 and 7 days.14 days after infection, alizarin red S staining was performed to study the formation of osteogenic calcium nodules .The expression of osteogenic marker genes Runx2 and OCN was assessed by quantitative real-time ( RT )-PCR and Western blotting .Results Significant increases in ALP activity and in the expressions of Runx 2 and OCN were detected in BMP-9 treated iCALs compared with GFP-treated cells(P<0.05).Meanwhile, alizarin red S staining showed that more mineralized nodules were found in the BMP-9 induced group .Conclusion BMP-9 can promote the osteogenic differentiation of iCALs .