Liuzijue qigong for stroke survivors with dysarthria / 中华物理医学与康复杂志

Objective:To document any improvement in the breathing control of stroke survivors with dysarthria after practicing Liuzijue qigong.Methods:A total of 157 stroke survivors with dysarthria and abnormal respiration control were randomly divided into an observation group and a control group. Both groups were given traditional breathing training and basic articulation training (including articulatory organ training and speech training). The observation group also received training in Liuzijue qigong. It requires inhaling through the nose and exhaling through the mouth while producing the speech sounds xu, he, hu, si, chui and xi. The training lasted two weeks. Both groups were then evaluated using the modified Frenchay dysarthria assessment. Maximum phonation time, maximum counting ability and volume were also recorded as secondary indexes.Results:After the 2-week intervention, significant improvement was observed in the average scores on all of the indexes, with all of the observation group′s average scores except for volume significantly better than those of the control group. The average volume scores were significantly improved, but not significantly different.Conclusion:Supplementing basic articulation training with Liuzijue qigong can improve respiratory function and the speaking ability of stroke survivors with dysarthria. It is worthy of wider clinical application.

Delayed spontaneous rupture of cavernous segment of the internal carotid artery following dual ophthalmic segment aneurysms treatment with pipeline embolization device: A case report.

RATIONALE: The incidence of double aneurysms on the ophthalmic segment of the internal carotid artery (ICA) is very rare. Nevertheless, delayed rupture of a parent artery instead of the aneurysmal sac following pipeline embolization device (PLED) is unusual. PATIENT CONCERNS: We present a 72-year-old female who was admitted at our facility with gradual onset of nonspecific visual changes. DIAGNOSIS: Conventional angiography revealed 2 aneurysms located at the ophthalmic segment of the left ICA. INTERVENTIONS: Both aneurysms were successfully treated with PLED. OUTCOMES: Two months after discharge, the patient was rushed into the emergency with bilateral conjunctival congestion. Computed tomography revealed intracranial hemorrhage at left temporal lobe while digital subtraction angiography established a left direct carotid cavernous fistula. We utilized stent (Solitaire 6*30) assisted coils to occlude the fistula. The patient is well and go about her normal duties. LESSIONS: Manipulation of the tortuous parent artery resulted in a focal traumatic weakness in the artery and subsequently a delay tear. We are of the view that, endovascular surgeons should be on the lookout for this complication following flow deviation treatment modalities.

Concomitant occurrence of clinoid and cavernous segment aneurysms complicated with carotid cavernous fistula: A case report.

RATIONALE: Dual aneurysms arising from the internal cerotic artery (ICA) is a very rare occurrence. Clinoid segment aneurysms (CSAs) are often seen at the carotid dural rings while cavernous carotid aneurysms (CCAs) are often a direct communication between the ICA and the cavernous sinus (CS). We present a case of complex concomitant occurrence of a CSA and a CCA complicated with delay aneurysmal rupture (DAR) resulting in carotid cavernous fistula (CCF) after our initial treatment of the patient with pipeline embolization devices (PLEDs) PATIENT CONCERNS:: We present a 64-year old female who we admitted at our institution due to one-year history of double vision. Neurological examinations were unremarkable. DIAGNOSIS: Magnetic resonance imaging (MRI) and computer tomography (CT)-scan revealed dual aneurysms on the ICA. Digital subtracting angiogram (DSA) confirmed a small CSA and a large CCA on the right ICA. INTERVENTIONS: We treated both aneurysms with PLED and subsequently observed DAR of CCA as a complication. OUTCOMES: We successfully occluded the fistula with ONYX (ev3, Irvine, CA) via the trans-venous approach. LESIONS: PLED was the best endovascular treatment option though DAR was inevitable. Although the trans-arterial approach may be the gold standard for the managing of CCF, the complex nature of our case made us opt for trans-venous approach. The trans-venous route is very appropriate for fistulas with complex parent arteries.

Traumatic Arteriovenous Fistula Between Extracranial Middle Meningeal Artery and Petrosal Vein.

BACKGROUND: The incidence of traumatic arteriovenous fistula (TAVF) between the middle meningeal artery (MMA) and the petrosal vein (PV) is rare. Although TAVF has been reported involving the MMA several sinus and veins, this is the first incidence of a fistula involving the extracranial MMA and PV. CASE DESCRIPTION: We present a 47-year-old male with sudden onset of weakness of his right limb and speech difficulty a few hours before admission to our facility. He had a 6-month history of mild traumatic head injury. Initial computed tomography revealed midbrain hemorrhage while digital subtraction angiography revealed a TAVF of the left MMA. Enhanced magnetic resonance imaging, however, revealed communication between the MMA and PV. We treated the patient with coil embolization via the transarterial route. CONCLUSIONS: This is the first incidence of a fistula connecting the extracranial MMA and PV. We managed the patient with only coil embolization without any further neurologic deficits.

Progress toward the clinical application of Rhodiolae Crenulatae Radix et Rhizoma / 国际中医中药杂志

Rhodiolae Crenulatae Radix et Rhizoma is a precious traditional Chinese medicine and has extensive pharmacological effects, such as anti-hypoxic, anti-fatigue, anti-aging, anti-inflammatory, anti-tumor, lowing blood sugar, heart and brain protection. It has been applied to the treatment of cardiovascular diseases, nervous diseases, respiratory diseases, endocrine diseases, fracture problems, emotional stress, and skin diseases. The present review summarized the literature about its clinical use, which would provide a reference for further utilization.

Surgical treatment of adult patients with anomalous left coronary artery from the pulmonary artery / 中华胸心血管外科杂志

Objective To review the experience of the surgical treatment of adult patients with anomalous left coronary artery from the pulmonary artery(ALCAPA).Methods A retrospective,single institution review was conducted on nineteen adult patients with ALCAPA surgical treatment from February 2006 to October 2012.Of these patients,five were males and fourteen were females.The age was(35.3 ± 11.7) years.The weight was (61.2 ± 9.4) kg.Most patients showed some evidence of myocardial infarction or ischemia with either abnormal Q waves (4) or ST-T abnormality (13).Twelve patients with coronary angiography and four patients with coronary CT scan showed good coronary collateralization.The preoperative UCG showed the mean left ventricular ejection fraction(LVEF) was 0.60 ± 0.07,and the mean left ventricular end-diastolic dimension(LVEDD) was(52.4 ± 4.4) mm.Severe mitral regurgitation(MR) was seen in two patients,moderate in three patients and mild in four patients.The operative procedures included Takeuchi operation in seven patients,ligation of left coronary artery concomitant with coronary artery bypass graft in two patients,coronary artery re-implantation in ten patients.Of the ten patients with coronary artery re-implantation,two patients underwent mitral valve repair.Results There was no operative mortality.The mean cardiopulmonary bypass time was (144.5 ± 66.9) min and cross-clamp time was (96.4 ± 38.8) min,respectively.The mean mechanical ventilation time was(12.9 ± 3.7) h and intensive care unit time was(39.2 ± 12.5) h,respectively.The mean postoperative LVEF was 0.62 ± 0.04.No significant reduction in LVEDD (45.8 ± 5.5) mm,P ＞ 0.05.Mild and trivial MR were observed in one and four patients,respectively.Sixteen patients(84.2％) completed the follow up with a mean time of 19.2 months.All the patients survived with New York Heart Association class Ⅰ or Ⅱ.During the follow up period,no patient required reoperation or readmission.At the latest echocardiography,the mean LVEF of 0.63 ± 0.05 and mean LVEDD of(49.2 ± 4.6) mm did not significantly improved compared with the data preoperatively or postoperatively.Mild MR was detected in six patients,trivial in three patients during the follow-up period.Conclusion The adult patients with ALCAPA have a dormant disease process.Surgical treatment has been recommended at the time of diagnosis and the coronary re-implantation could be the first choice.As for the concomitant MR,the guideline for the adult MR should be followed.

Omentopexy Decreasing the Susceptibility of Ventricular Arrhythmia in Experimental Rats With Chronic Myocardial Infarction / 中国循环杂志

Objective: To conifrm the omentopexy decreasing the susceptibility of ventricular arrhythmia in experimental rats with chronic myocardial infarction (MI) by nerve remodeling. Methods: The MI model of SD rats was established by left coronary artery ligation. 3 weeks later, the qualiifed animals were randomized into 3 groups for the 2nd operation. ① Sham operation group, the rats received the 2nd operation without ligation, ② Isolated MI group, the rats received the 2nd operation without omentopexy, ③ Omentopexy group, the rats received the 2nd operation with omentopexy. n=20 in each group. 4 weeks after the 2nd operation, the electrophysiological characteristics were assessed by relevant techniques, the new and sympathetic nerves in MI border zone were examined by immunohistochemistry, the protein expressions of connexin43 and nerve growth factor (NGF) were measured by western blot analysis and the cardiac endothelin-1 (ET-1) level was evaluated by ELISA. Results: Compared with Isolated MI group, Omentopexy group showed decreased susceptibility of arrhythmia (3.5 ± 1.2) vs (0.9 ± 0.2), improved electrical transduction (1.5 ± 0.2) mV vs (3.4 ± 0.3) mV and decreased capture threshold (5.5 ± 0.3) mV vs (2.2 ± 0.2) mV, all P Conclusion: Omentopexy may decrease the susceptibility of ventricular arrhythmia after MI in experimental rats, which might be related to the cardiac nerve remodeling.

Effect of Omentopexy Combining Autologous Atrial Tissue Patch Cardiomyoplasty for Treating the Chronic Myocardial Infarction in Experimental Rats / 中国循环杂志

Objective: To explore the effect of omentopexy combining autologous atrial tissue patch cardiomyoplasty for treating the chronic myocardial infarction (MI) in experimental rats. Methods:The MI model of SD rats was established by left coronary artery ligation. 3 weeks later, the qualiifed animals were randomized into 4 groups for the 2nd operation. ① Control group, the rats only received re-thoracotomy, ② Atrial appendage group, the autologous atrial tissue patch was harvested from left atrial appendage of rats and transplanted to infarcted zone, ③ Omentum group, the omentum of rats was transplanted to infarcted zone through diaphragm and ④ Combination group, the left atrial appendage tissue and omentum were transplanted to infarcted zone together. 4 weeks after the 2nd operation, the cardiac function was evaluated by echocardiography, the size and scar thickness of the infarction were examined by Masson staining, the survival of transplanted atrial tissue and angiogenesis were measured by immunohistochemistry, the protein expressions of VEGF, MMPs and TIMP-3 were examined by Western blot analysis, and the activities of MMPs were identiifed by gelatin zymography. Results:4 week after the 2nd operation, transplanted left atrial appendage tissue only survived in Combination group. The areas of infarction were similar among different groups, P>0.05. Compared with Control group, Combination group had the increased scar thickness (329 ± 33)μm vs (391±31)μm, improved LVEF (47.5 ± 4.5)%vs (57.9 ± 5.8)%, improved LVFS (20.7 ± 2.0)%vs (25.2 ± 3.6)%, all P Conclusion:Omentopexy could improve the angiogenesis and support the survival of transplanted autologous atrial tissue patch, therefore improve the cardiac function in experimental rats with chronic MI.

Congenital Pial Arteriovenous Fistula in the Temporal Region Draining into Cavernous Sinus: A Case Report

This report concerns a 4-month-old infant with progressive prominent and redness of his left eye since birth. This report concerns a 4-month-old infant with progressive prominent redness of his left eye since birth. Angiography revealed a congenital pial arteriovenous fistula between the temporal branch of the left posterior cerebral artery and left cavernous sinus through the sphenoparietal sinus, a condition not reported in the literature. The fistula was successfully occluded with two micro-coils by vertebrobasilar approach.

Experimental study on animal with automatic drug injection based on predictive control for vascular interventional therapy / 生物医学工程学杂志

This paper focuses on the animal experiment of automatic drug delivery based on predictive control for vascular interventional therapy. Improvement of drug delivery system based on predictive control used in simulated experiments was put forward after the presence of time varying parameters and the characteristics of individual differences of animal had been studied. The adaptability of time varying parameters and fault tolerance of the system were also enhanced. Different injection methods were tested on animals. It is proved that higher target blood concentration can be reached while injecting during diastolic than that while injecting during systolic or injecting at a constant speed within the whole cardiac cycle. The results also showed that the improved drug injection system based on predictive control which synchronizes with the cardiac cycle could be applied to clinical trials.

Covered stents in neural interventional therapy / 中国组织工程研究

BACKGROUND: With the development of neural interventional therapy, the application of covered stents in neural intervention is becoming a topic of general interest.OBJECTIVE: To introduce the structure of stent-graft, and to summary the application of covered stents in clinical treatment of the neural interventional therapy and the shortage of covered stents.RETRIEVAL STRATEGY:The relevant articled were searched for in Pubmed database by researcher of this article with the key words of "stent graft, covered stents, cerebrovascular disease" in English, and with the key words of "covered stent, cerebrovascular disease" in Chinese in VIP database. 223 English and 196 Chinese articles were selected and reviewed primarily. Inclusive criteria: Articles having a close relation with the application of covered stents in neural intervention, especially in cerebrovascular disease, and the latest articles or articles published in authority journals in the same field were chosen. Exclusive criteria: articles with repetitive studies were excluded.LITERATURE EVALUATION: 223 English and 196 Chinese articles were primarily checked by reading titles and abstracts. Among the 31 collected articles, 4 are reviews, 3 are experimental studies and others are clinical studies.DATA SYNTHESIS: Covered stents show special advantages in neural interventional therapy and become a hot spot in present study. There are individual case reports or small group case reports on the application of covered stents in hemorrhagic cerebrovascular disease. It is reported that the covered stent effectively occludes aneurysm, dissecting aneurysm and arteriovenous fistula, keeps patency of the parent artery. The covered stent isolates ulcerated plaque via physical barriers, avoids the abscission of embolus, which can further reduce the development of embolism in percutaneous carotid artery stenting. After releasing covered stents, polytetrafluoroethylene makes the disepiment smooth. Its good biocompatibility reduces thrombosis, and then decreases the incidence of restenosis. Covered stents in vessel for cerebrovascular disease have achieved good effects, but there are some problems in clinic as follows. ①The main shortage of covered stents is to occlude small branch vessels. ②Thrombosis and restenosis occur after covered stenting. ③Covered stents increase the volume of the stent, reduce the compliance and flexibility of the stents, and increase the pushing difficulty and vascular injury. ④Covered stents cannot be used in vessels of less than 4 mm.CONCLUSION: Covered stents for intracranial ischemic and hemorrhagic diseases shows significant outcomes, but there are disadvantages. With the clarification of the related theories and the improvement of new material technology, there will be a brighter future of the application of covered stents for treatment of cerebrovascular diseases.