Clinical features and prognosis of patients with acute ST-segment elevation myocardial infarction comorbid with diabetes mellitus / 中国介入心脏病学杂志

Objective To investigate the clinical features of patients with acute ST-segment elevation myocardial infarction (STEMI) comorbid with diabetes mellitus (DM) and to analyze the prognosis within 12 months after primary percutaneous coronary intervention (pre-PCI). Methods A total of 375 STEMI patients were divided into the diabetes group (n=140) and the normal blood glucose group(n=235) according to whether they met the diagnostic criteria of DH. The clinical data,characteristics of coronary artery lesions,type of stent implant,rate of coronary slow flow or no-reflow after pre-PCI, and the prognosis within 12 months after PCI of the two groups were investigated.Results Patient in the diabetes group presented with higher mean age ,higher comorbid rates of hypertension , hyperlipidemia and heart function of Killip class Ш and above than patients in the normal blood glucose group (all P<0.05). patients in the diabetes group had higher rates of slow reflow /no-reflow after PCI(12.9% vs.5.5%,P=0.013),higher percentages of 3-ressel disease(40.7% vs. 28.9%,P=0.019)and lef t main lesions(13.6% vs. 7.2%,P=0.044). The in-hospital mortality rates(6.4% vs.1.7%,P=0.020),revascularization rates within 12 months(7.9% vs.0.9%,P=0.001)and incidence of heart failure(7.9% vs. 2.6%,P=0.017)were all higher in the diabetes group. Conclusions STEMI patients comorbid with DM were relatively older, had higher comorbidities of hypertension,hyperlipidemia, three-vessel disease, left main coronary lesions and higher mortality during hospitalization. No significant increase in cardiac death and recurrent myocardial infarction were deserved during the follow-up period. These patients may benefit more from early intervention.

Establishment of a Wistar rat model bearing brain glioma C6 cells and its experimental application / 南方医科大学学报

<p><b>OBJECTIVE</b>To establish a rat model bearing brain glioma and investigate the optimal conditions for its experimental application.</p><p><b>METHODS</b>C6 cells were implanted into the unilateral brain hemisphere of 20 Wistar rats. The growth behaviors of the brain tumor and behavioral changes of the rats were observed at different time points after the implantation.</p><p><b>RESULTS</b>On day 3 after the implantation, only a slight increase of signal intensity was observed on T2-weighted images. By day 5, the tumor became visible in 15/18 of the rats in at least two sections. By day 11, 16/18 of the rats showed space-occupying effect in the brain, and by day 14, the tumor occupied over 1/2 of the hemisphere in 14/18 of the rats. By day 20, 14/18 of the rats showed a tumor mass occupying over 2/3 of the hemisphere, and some tumor cells had migrated into the contralateral hemisphere.</p><p><b>CONCLUSION</b>In this model of brain glioma, the optimal time widow for experiment is between 14 and 18 days after the cell implantation. The cell density and viability for implantation and the site of implantation may also affect the experimental time widow.</p>

Value of interictal 18F-FDG-PET in localization of epileptogenic focus of temporal lobe epilepsy / 中华神经医学杂志

Objective To introduce the technique of interictal 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) examination and explore the value of 18F-FDG-PET in the localization of epileptogenic focus of temporal lobe epilepsy (TLE) confirmed by surgical result.Methods Clinical data were retrospectively analyzed in 82 TLE patients having received interictal 18F-FDG-PET preoperative evaluation and got EngleⅠ grade epileptic surgical outcome, and the sensitivity and specialty of interictal 18F-FDG-PET were compared with those of MRI and scalp video-EEG. Results Epileptogenic foci showed hypometabolism on 18F-FDG-PET, and the hypometabolism zones were localized in ipsilateral temporal lobe in 68 cases,beyond ipsilateral temporal lobe in 9 cases; the other 5 had no hypometabolism zone. Accuracy rate of localization of epileptogenic foci by interictal 18F-FDG-PET was 82.9% (68/82), significantly higher than that by MRI or EEG(P＜0.05).77.4%(41/53)epileptogenic foci where MRI showed negative and 75%(15/20)where EEG with imbedded electrode was applied were precisely localized by 18F-FDG-PET. The accuracy was higher in the cases with positive pathological result than in the ones with negative result. Conclusions Interictal 18F-FDG-PET possesses excellent sensitivity and specialty in preopemtive assessment for TLE, and is of good value in the localization of epileptogenic focus where MRI shows negative or invasive electrophysiologic monitoring is needed.Rational application may raise the accuracy rate.

Curative effect of EEG localization and microsurgery for intractable epilepsy / 中华神经医学杂志

Objective To explore the epileptogenic focus locating methods before and during operation and the curative effect of surgical treatment on the basis of localization. Methods Epileptogenic foci in 621 cases of intractable epilepsy were localized according to clinical manifestations and imaging findings by routine EEG (REEG), ambulatory EEG (AEEG) or video-EEG (VEEG).Different types of operations were performed based on the categories of epilepsy, the preoperatively localized foci and electrocorticogram (ECoG) monitoring results during operations. Results The follow-up ranging 0.5-4 years revealed, according to the criteria of International Antiepileptic Association,that 340 cases(54%)were completely recovered(no postoperative seizure),223 cases(36%)were improved obviously (seizure frequency was decreased by more than 75%), 37 cases (6%) were improved a little(seizure frequency was decreased by 50%-75%)and 21(3%)were not improved(seizure frequency was decreased by less than 50%): the effective rdte was 97%.No case worsened.Conclusions Preoperative integrated localization by EEG principally and intraoperative ECoG monitoring can effectively confirm the site and size of epileptogenic foci to instruct the operation and prevent complications so that the satisfactory treatment efficacy can be achieved.

Localization and distribution of magnetic chemotherapeutic drugs with magnetic targeting in rat brain / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Magnetic targeting therapy may be a new method for the treatment of malignent tumors. The purpose of this study was to investigate the localization and distribution of ferrofluid microsphere of human serum albumin methotrexate (FM-HSA-MTX) carriers in the brain and to explore the magnetic targeting chemotherapy for malignant brain tumor.</p><p><b>METHODS</b>Ninety SD rats were divided into three groups: targeting group, non-magnetic targeting group, and control group. Synthesized FM-HSA-MTX carriers (MTX 25 mg/kg) were injected into the systemic circulation via the caudal vein (magnetic targeting group, n = 30). A 0.6 T magnetic field was placed around the right hemisphere. The non-magnetic targeting group (n = 30) was administered with FM-HSA-MTX without external magnetic field, meanwhile the control group (n = 30) was treated with MTX and a magnetic field. Random serial sacrifices (n = 10) were conducted at 15, 30 and 45 minutes after drug administration. Bilateral hemispheres were collected respectively, and analyzed for total MTX content.</p><p><b>RESULTS</b>MTX content in the right hemisphere of the magnetic targeting group was significantly higher than that in the other two groups at 15, 30 and 45 minutes after drug administration (P < 0.05) No difference was seen between the non-targeting group and control group. In the magnetic targeting group, MTX returned to the peak level [(0.564 +/- 0.018) mg/g, q15-45 = 32.252, P < 0.05] 45 minutes after the injection but it deceased in the other two groups [non-magnetic targeting group: (0.060 +/- 0.015) mg/g, q15-45 = 9.245, P < 0.05, control group: (0.074 +/- 0.045) mg/g, q15-45 = 6.299, P < 0.05]. In the magnetic targeting group, the concentration of MTX in the right hemisphere was significantly higher than that in the left hemisphere (t45min = 21.135, P = 0.000) but no difference was observed between bilateral hemispheres in the other two groups (non-magnetic targeting group: t45min = 0.434, P = 0.670; control group: t45min = 0.533, P = 0.600).</p><p><b>CONCLUSION</b>In the presence of the external magnetic field, FM-HSA-MTX can distribute successfully in the targeting areas of the brain.</p>

Clinical study on operative effect of traumatic cerebral herniation with bilateral mydriasis / 中华创伤杂志

Objective To explore the surgical effect to traumatic tentorial herniation with bilater- al mydriasis.Methods The patients were divided into three groups,ie,epidural hematoma group,a- cute diffuse brain swelling group and cerebral contusion and/or subdural hematoma group,to perform clinical outcome analysis.Half year after operation,the neurological outcome was scored according to the Glasgow Outcome Scale.Results Of all,there were three cases with good recovery,10 with moderate disability,nine with severe disability and 10 with vegetative survival but 35 deaths.The outcome was the best in epidural hemotoma group but the poorest in acute diffuse brain swelling group.Conclusions The operative effect of traumatic cerebral herniation with bilateral mydriasis is related with the type of orig- inal injury that is important for selection of operation.Patients with cerebral herniation caused by epidural hematoma should receive immediate operation that will induce better outcome.The operation is not vital for those with cerebral herniation caused by acute diffuse brain swelling.Emergent surgery can save lives of some patients with cerebral contusion and/or subdural hematoma.Rapid diagnosis,correct operation and perioperative treatment may ensure the success of surgery.