[Concomitant unruptured intracranial aneurysms and ischemic cerebrovascular diseases: a surgical experience of 31 cases].

Objective: To summarize the clinic experience of preventing cerebral ischemic events during perioperative period in patients which concomitant unruptured intracranial aneurysms and ischemic cerebrovascular diseases. Methods: The clinical materials of 31 consecutive patients with concomitant unruptured intracranial aneurysms and ischemic cerebrovascular diseases from April 2010 to April 2014 were retrospectively reviewed.A total of 35 aneurysms were detected, and all of them were unruptured aneurysms.Among them, 17 cases were located on the ipsilateral side of artery stenosis or occlusion, and 18 cases were detected in the contralateral side. Minimal invasive surgical approaches such as small pterional approach and lateral sub-frontal approach were adopted.The better management of perioperative blood pressure was performed. Intraoperative electroencephalogram and somatosensory evoked potential monitoring, indocyanine green video angiography and/or microvascular Doppler ultrasonography were regularly used to guarantee the safety of the surgery. The follow-up by digital subtraction angiography or computed tomography angiography were made. Results: All of 35 aneurysms were clipped. Major infarction occurred in one patient with posterior communicating artery aneurysm concomitant with common cervical carotid artery stenosis.Large bone flap was resected and dural-matter were got enlarged to tolerate the edema period.Paralysis and aphasia accompanied at discharge.Minor infarction in posterior limb of internal capsule occurred in one patient.Twenty-nine patients were favorable with Glasgow Outcome Scale (GOS) score 5 at discharge, one patient with minor neurological defect (GOS 4), and one patient with severe neurological defect (GOS 3). The follow-up period was 6 to 40 months.Four patients were lost.The modified Rankin scale (MRS) of last follow-up were 0-1 in 25 patients, 2 in one patient and 3 in one patient.Third months after operation, 3 cases were performed carotid artery stenosis, 1 patients were performed carotid endarterectomy. Conclusion: Reinforcing the management of perioperative blood pressure, adjusting the perioperative blood coagulation function, and combine application of intraoperative monitoring technology can effectively prevent the occurrence of cerebral ischemia.

Screening for preeclampsia pathogenesis related genes.

OBJECTIVES: Preeclampsia is a complication of pregnancy that severely threatens the health of the mother and infant, yet the mechanism of pathogenesis remains unclear. In this article, gene array technology was applied to identify the genes related to the pathogenesis of preeclampsia, and to explore the regulatory effect of epigenetic modification by on these genes. PATIENTS AND METHODS: Placental tissue of preeclampsia patients was collected, and DNA methylation arrays and gene expression microarrays were used to identify the genes. The effect of methylation on the regulation of genes related to the pathogenesis of preeclampsia was also investigated. RESULTS: The expression levels of more than ten genes were found to be significantly altered in the placental tissue of patients with preeclampsia as measured by gene expression microarray. This study also identified more than ten genes with notable changes in expression level as well as methylation level. The gene expression of CUEDC1 and DHX34 were verified in this study and the findings were consistent with previous reports. CONCLUSIONS: Our research indicates that the occurrence of preeclampsia is correlates closely with differences in the expression of specific genes, which may be regulated through methylation.

Topical tolerability of salmon calcitonin assessed by mucociliary transport velocity investigation.

The topical tolerability of an intranasal salmon calcitonin spray preparation, of the excipients alone and of sodium taurocholate has been studied by assessment of the mucociliary transport velocity (MTV) on the frog's palate. The rate of mucus transport was investigated in 3 groups of animals (Rana esculenta; 6 frogs per group) in basal conditions and after a challenge with a salmon calcitonin intranasal spray preparation, with the excipients and with sodium taurocholate, respectively. The salmon calcitonin intranasal spray preparation and the excipients did not affect the mucociliary transport velocity on the frog's palate. On the contrary, sodium taurocholate produced severe impairments in the mucociliary transport velocity and histological lesions of the epithelial layer of the frog's palate. The comparison among the mean values of the mucociliary transport velocity before and after treatments showed a significant difference between controls and sodium taurocholate groups (p less than 0.05) as well as among the groups treated with sodium taurocholate versus salmon calcitonin and versus the excipients alone of the calcitonin preparation (p less than 0.05). These findings provide evidence that the salmon calcitonin intranasal spray preparation tested in the present ex vivo model does not affect the mucociliary transport velocity in the frog's palate, while this is markedly affected by sodium taurocholate. The use of sodium taurocholate as a promoter of absorption in intranasal preparations should thus be reconsidered.

[Clinical observations on the combined operation of penetrating keratoplasty, extracapsular cataract extraction and IOL implantation].

26 cases of cataract complicated with corneal leukoma were performed penetrating keratoplasty in combination with extracapsular extraction and IOL implantation. In a follow-up of 6-31 months, the corneal grafts were transparent in 16 eyes(62%), semi-transparent in 7 eyes(27%), and opaque in 3 eyes (11%). Useful vision was restored to 18 eyes (69%). The combined operation is believed to be the best choice in treatment for such cases.