Dual antiplatelet therapy in stent-assisted coil embolization of unruptured intracranial aneurysms: a comparison of ticagrelor and clopidogrel / 国际脑血管病杂志

Objective:To compare the safety and efficacy of ticagrelor and clopidogrel in dual antiplatelet therapy for stent-assisted embolization of unruptured intracranial aneurysms.Methods:Patients with unruptured intracranial aneurysms received stent-assisted embolization in the Department of Neurosurgery, Linyi People's Hospital from January 2021 to June 2022 were retrospectively included. According to the preprocedural dual antiplatelet therapy scheme, they were divided into aspirin+clopidogrel group (clopidogrel group) and aspirin+ticagrelor group (ticagrelor group). The incidence of ischemic and bleeding events was compared between the clopidogrel group and the ticagrelor group at 3 months after procedure. Multivariate logistic regression model was used to analyze independent risk factors for postprocedural ischemic and bleeding events. Results:A total of 195 patients were included. Their age was 58.15±10.11 years and 75 were males (38.5%). There was no statistically significant difference in the incidence of bleeding events (12.8% vs. 5.9%) and ischemic events (14.9% vs. 18.8%) at 3 months after procedure between the ticagrelor group ( n=94) and the clopidogrel group ( n=101). Multivariate logistic regression analysis showed that smoking (odds ratio [ OR] 6.085; 95% confidence interval [ CI] 1.589-13.012; P=0.019], hypertension ( OR 4.547, 95% CI 1.589-13.012; P=0.005), aneurysm at the branch vessel ( OR 3.089, 95% CI 1.122-8.504; P=0.029), and the use of flow diverter ( OR 3.111, 95% CI 1.062-9.110; P=0.038) were the independent risk factors for postprocedural ischemic events. Triglycerides might be an independent risk factor for postprocedural bleeding events ( OR 1.435, 95% CI 0.989-2.082; P=0.057), but did not reach statistical significance. Conclusions:In dual antiplatelet therapy for stent-assisted embolization of unruptured intracranial aneurysms, ticagrelor and clopidogrel have the same safety and efficacy.

Efficacy and safety of Tubridge flow diverter in the treatment of unruptured intracranial aneurysms / 国际脑血管病杂志

Objective:To investigate the efficacy and safety of Tubridge flow diverter (TFD) in the treatment of unruptured intracranial aneurysms (UIAs).Methods:The clinical data of patients with UIAs treated with TFD in the Department of Neurosurgery, Linyi People's Hospital from July 2021 to July 2023 were retrospectively analyzed. The modified Rankin Scale (mRS) was used to evaluate functional outcomes during postoperative follow-up. Digital subtraction angiography (DSA) follow-up was performed at least 3 months after procedure, and the occlusion degree of the aneurysm was assessed with the O'Kelly-Marotta (OKM) grading system.Results:A total of 52 patients (71 aneurysms) were included and 54 TFDs were successfully implanted. Forty-one patients (78.8%) were treated with TFD alone, while 11 (21.2%) were treated with TFD combined with coil embolization. One patient experienced in-stent thrombosis during the procedure, and the symptoms disappeared after medical treatment. Postoperative hemorrhage and ischemic complications occurred in each 2 cases, respectively. No patient died during the follow-up period. DSA follow-up was performed on a total of 45 aneurysms in 34 patients. The followed-up time was 8.3±3.1 months (range, 3-15 months), including 2 OKM grade A (4.4%), 11 grade B (24.4%), 1 grade C (2.2%), and 31 grade D (68.9%). At the last follow-up, 51 patients had good outcomes (mRS score 0-2), and 1 patient had poor outcome (mRS score 4).Conclusion:TFD for UIAs has a high complete occlusion rate and a low complication rate.

Diagnosis and treatment of a gastric cancer patient with hemorrhage and new cerebral infarc-tion / 中华消化外科杂志

Gastric cancer with hemorrhage and cerebral infarction is a serious complica-tion with poor prognosis in clinic. Although the incidence rate is extremely low, the fatality and disability rates are very high. In addition, the opposition in treatment between the two complica-tions increases the difficulty of clinical diagnosis and treatment. The authors report the diagnosis and treatment of a gastric cancer patient with hemorrhage and new cerebral infarction, in order to to provide reference for related treatments.

Related risk factors for progressive occlusion of intracranial aneurysms treated with low-profile visualized intraluminal support device stent in mid-term follow up / 中华神经医学杂志

Objective To analyze the angiographic results of intracranial aneurysms without complete embolization immediately after low-profile visualized intraluminal support device (LVIS) stent at mid-term follow up,and explore the risk factors for healing of partial occluded aneurysms.Methods One hundred and sixty-one patients with intracranial aneurysms treated by LVIS stent embolization in our hospital from December 2014 to December 2018 were selected;193 aneurysms in total,including 93 un-ruptured aneurysms and 100 ruptured aneurysms,were noted.DSA was performed immediately after operation to evaluate the degrees of aneurysm embolization according to Raymond grading criteria.The embolization degrees of aneurysms were compared at 8 months after surgery and immediately after surgery,and the healing of aneurysms (Raymond grading 1) was calculated.Univariate Logistic regression analysis and multivariate Logistic regression analysis (forward maximum likelihood ratio method) were used to screen the risk factors for healing of incomplete aneurysm embolization.Results The embolization degrees immediately after surgery were as follows:78 were with Raymond grading 1,54 with Raymond grading 2,and 61 with Raymond grading 3;complete aneurysm embolization were noted in 78 aneurysms (40.41％) and incomplete aneurysm embolization were noted in 115 (59.59％).Follow up (8 months after surgery) results indicated that,of the 193 aneurysms,171 were with Raymond grading 1,10 with Raymond grading 2,and 12 with Raymond grading 3;there were 171 aneurysms (88.60％) having complete aneurysm embolization and 22 (11.40％) having incomplete aneurysm embolization.In the aneurysms having incomplete aneurysm embolization immediately after surgery,the healing rate was 81.74％ (94/115).Univariate Logistic regression analysis showed that hypertension,diabetes mellitus,posterior circulation aneurysm,dissecting aneurysm,body-neck ratio and embolization degrees immediately after surgery were risk factors for healing of aneurysms (P＜0.05).Multivariate Logistic regression analysis revealed that posterior circulation aneurysm and diabetes mellitus were independent risk factors for healing of aneurysms (P＜0.05).The area under the curve of receiver operating characteristic curve of the regression model was 0.755,indicating that the prediction efficiency of the regression model was moderate.Conclusion Treatment of intracranial aneurysms with LVIS stent is effective,and the complete occlusion rate is high,even in the aneurysms with incomplete embolization immediately after surgery;aneurysms located in the posterior circulation and associated with diabetes can affect the treatment of aneurysms.

Research on the clinical value of tumor deactivation after radiofrequency ablation of liver cancer assessed by MDCT / 中国医学装备

Objective:To explore the clinical value of tumor deactivation after radiofrequency ablation of liver cancer assessed by MDCT.Methods: By CT perfusion combined with CT angiography and CT enhanced scan in 91 cases of liver cancer patients before and after radiofrequency ablation treatment, the change of tumor size, density change, scope of coagulation necrosis area and comparison sensitivity, specificity and accuracy of two methods diagnosis of recurrent or residual tumor were observed.Results:In the diagnosis of tumor recurrence or residual degree of sensitivity, specificity and accuracy CTP combine CTA were 100%, 95.3%, 96.2%, conventional enhanced CT were 33.3%, 88.4% and 78.8%. The diagnosis of recurrence or residual tumor after radiofrequency sensitivity and accuracy CTP combine CTA is higher than conventional enhancement CT, The difference was statistically significant(x2=6.912, x2=7.121;P<0.05). Both no statistical difference between specificity(x2=0.615,P<0.05).Conclusion: CTP combination CTA can accurately determine the tumor after radiofrequency ablation for inactivated and degree, and superior to the conventional enhanced CT, is an effective evaluation method of radiofrequency ablation with a high clinical value.

Isolation of glioma stem cells from human glioma cell lines U87 with serum deprivation method / 中国组织工程研究

BACKGROUND: Cell cycle has proved that about 90% stem cells were in resting state in the G0 phase; therefore, serum deprivation method which did not contain any growth factors and related nutrition additive was beneficial for separating glioma stem cells.OBJECTIVE: To explore the method of serum deprivation to culture glioma cell lines U87, and to isolate and identify the cancer stem cells which are in the U87 cell lines. METHODS: U87 cells were cultured in the medium containing both DMEM and L-glutamine for six days; cancer stem cells would be screened out; then the medium was changed for the neural stem cell culturing medium. The formation of tumor spheres and their differentiation characteristics were observed when they were inoculated onto serum-containing medium. The immunofluorescence staining of cells was employed to identify the surviving cells cultured in serum deprivation medium, tumor spheres and differentiated cells. RESULTS AND CONCLUSION: The serum deprivation method was used to select tumor stem cells successfully which expressed CD133 and could form tumor spheres. The tumor spheres had an ability of multi-differentiations, and the daughter cells expressed glial fibrillary acidic protein and neuron specific enolase. The U87 cell lines exist glioma stem cells which have the capacities of self-renewal and multi-differentiation.

Effect of Hemiplegic Gymnastics on Motor Function and Activities of Daily Living of Stroke Patients / 中国康复理论与实践

@#Objective To observe effect of hemiplegic gymnastics on motor function and activities of daily living(ADL)of stroke patients.Methods 60 stroke patients were randomly divided into the rehabilitation group and hemiplegic gymnastics group with 30 cases in each group.All patients of two groups received conventional physical therapy and occupational therapy training,using neural technology for development.The course was eight weeks.At same time the patients of the gymnastics group also received hemiplegic gymnastics treatment.Before and after treatment,all patients of the two groups were assessed with Fugl-Meyer Assessment(FMA)for motor function and Modified Barthel Index(MBI)for ADL respectively.The changes of FMA and MBI scores of patients in two groups were compared.Results Before treatment,there was no significant difference in FMA and MBI scores between two groups(P>0.05);after treatment,the FMA and MBI scores of the patients in the gymnastics group were superior to that of the rehabilitation group(P<0.01).Conclusion Hemiplegic gymnastics combined with conventional rehabilitation training can improve motor function and ADL of stroke patients.

EVALUATION OF NUTRITIVE VALUE OF N-ALKANE GROWN YEAST / 营养学报

1.The nutrient content of yeast (Condida Y-17) grown on n-alkane studied in this experiment was comparable to that of the same type of yeast produced in other countries. Its content of lead, arsenic, mercury and benzo (a) pyrene were within the limit proposed by the Protein-Calorie Advisory Group of the United Nations System. The Content of its residual n-alkanes and total aromatic hydrocarbons were within or a little over that limit. It is a good supplementary protein feed.2.The corrected PER values were, yeast grown on n-alkane 1.18; deli pid and denucleic acid yeast grown on n-alkane 1.16; brewer's yeast 1.52; full fat soybean meal 1.81. The PER of yeast grown on n-alkane was significantly lower than those of other samples. When 0.3% DL-methionine was added to the diet, the corrected PER values increased: n-alkane grown yeast 2.32; delipid and denucleic acid n-alkane grown yeast 2.49; brewer's yeast 2.35; full fat soybean meal 2.28. The corrected PER value of casein used for correction was 2.43, it was standardized with ANRC reference protein (PER = 2.50).3.Yeast grown on n-alkane with and without removal of lipids and nucleic acid was fed to groups of rats at a dietary level of 25% and 35% respectively for 1 year. A stock diet group and a brewer's yeast diet group were used as control. In the first 3 months the weight gain and feed consumption of the rats fed n-alkanc grown yeast diet were lower than those of the two control groups. The male rats were more sensitive to the change of diet. In the later 9 months the difference of weight gain among different groups were not significant. The concentration of haemoglobin, red cell counts, white cell counts, GPTase activity, serum cholesterol levels and serum urea levels determined at the beginning and the end of the experiment were all in the normal ranges. The concentrations of n-alkanes and odd-chain fatty acids in the adipose tissue of the n-alkane grown yeast group were higher than those of the two control groups, and the difference was highly significant. The concentrations of total aromatic hydrocarbons and benzo(a) pyrene in the muscle of different groups of rats were 0.4-0.6 ppm and 0.4 ppb respectively. No detrimental effect was observed in pathological examination.4.When 5% fish meal or 3.5% casein was added to the 25% n-alkane grown yeast diet, the weight gain and feed consumption of weanling rats were improved significantly, though it was still inferior to those fed with stock diet.5.Strongly growth depressive effect was noted as the level of n-alkane grown yeast was increased to 20% in the diet. This depressive effect was neither due to the toxicity of the residual n-alkanes and aromatic hydrocarbons, nor due to the deficiencies of potassium and selenium in the diet. It might be the result of nutrient or nutrients imbalance of the diet. The appropriate amount of yeast grown on n-alkane used in mixed feed should not be more than 15%.