Correlation of fluid-attenuated inversion recovery sequence vascular hyperintensity in magnetic resonance with collateral circulation and short-term clinical prognosis in acute ischemic stroke.

Background: Accurately assessing the prognosis of patient with large-scale cerebral infarction caused by acute middle cerebral artery (MCA) occlusion in the early stages of onset can help clinicians to actively and effectively intervene, thus reducing mortality and disability rates. This study set out to investigate the predictive value of fluid-attenuated inversion recovery vascular hyperintensity (FVH) on collateral circulation and clinical prognosis. Methods: The clinical data of 70 patients admitted to The First People's Hospital of Lianyungang from January 2018 to December 2021 with acute cerebral infarction due to occlusion of the proximal end of the M1 segment in the MCA were retrospectively collected. All patients had their first onset of disease and did not receive thrombolytic therapy at the time of onset. Subsequently, they underwent endovascular thrombectomy for treatment. The FVH and collateral vessel scores were derived according to patients' fluid-attenuated in version recovery (FLAIR) sequence and time-of-flight magnetic resonance angiography images. Based on the 90-day Modified Rankin Scale (mRS), patients were allocated to a good prognosis group (mRS ≤2) and a poor prognosis group (mRS =3-6). The correlation between the FVH and collateral vessel scores was assessed using the Spearman rank correlation test. Pearson correlation coefficient analysis was used to assess the correlation between FVH and the 90-day mRS together with the infarct size. Univariate analysis, multivariate binary logistic regression analysis, and receiver operating characteristic (ROC) curve analysis were adopted to identify those factors potentially. associated with the prognosis of patients with acute ischemic stroke (AIS). Results: Out of 70 patients with acute unilateral MCA occlusion (MCAO) who met the inclusion criteria, 62 showed positive FVH sign. These 62 patients were divided into a good prognosis group (n=32) and a poor prognosis group (n=30) based on the mRS score 90 days after discharge. The Spearman rank correlation test indicated that FVH was positively correlated with collateral vessel grade (Spearman rho =0.865; P<0.001); meanwhile, Pearson correlation coefficient analysis indicated that FVH score had moderate negative correlation with 90-day mRS score (r=-0.605; P<0.001). The results of multivariate binary logistic regression analysis indicated that collateral vessel grade and FVH score may be associated with the prognosis of patients with AIS, and the area under the curve (AUC) of FVH score was larger than collateral vessel grade (AUC =0.738). Conclusions: There was a positive correlation between FVH score and collateral vessel grade, and FVH score could indicate collateral circulation. FVH score was negatively correlated with 90-day mRS score and infarct volume and thus can predict clinical prognosis.

Role of MiR-20a-3p in Axonal Repair in Rats with Spinal Cord Injury / 中国康复理论与实践

@#Objective:To study the molecular biology mechanisms of Wistar rats after spinal cord injury, and find out key microRNAs. Methods:A total of 15 Wistar rats were divided into control group (<italic>n</italic> = 3) and spinal cord injury group (<italic>n</italic> = 12). The latter group was divided into four hours, three days, seven days and 14 days subgroups, with three rats in each subgroup. Microarray 3.0 was used to investigate microRNA expression profiles of Wistar rats with spinal cord injury. Bioinformatics was used to predict microRNAs playing key regulatory roles, and to predict target genes. Reverse transcription real-time quantitative polymerase chain reaction (RT-qPCR) was applied to detect the expression of miR-20a-3p. Western blotting was employed to detect the signal transducer and activator of transcription (STAT) 3 level. The correlation between target protein and microRNA expression trend in each group was analyzed. The key microRNA was inhibited in the neurons. The relationship between target protein expression and axon growth was observed with immunofluorescence. Results:In the rats with spinal cord injury, totally 658 microRNAs had changed at least once. In all the altered microRNAs, miR-20a-3p was upregulated obviously. It predicted that the target gene of miR-20a-3p was STAT3 via application of bioinformatics analysis. The expression trend of STAT 3 and miR-20a-3p in spinal cord was opposite. After the inhibition of miR-20a-3p, the expression of STAT3 in neurons was unregulated and axonal growth was extended. Conclusion:The upregulation of miR-20a-3p leads to downregulation of STAT3, and miR-20a-3p is one of the key targets in the treatment of spinal cord injury.

Effect of Zhenwu Tang on regulating of "AVP-V2R-AQP2" pathway in NRK-52E cells / 中国中药杂志

This study was aimed to investigate the effect and mechanism of Zhenwu Tang on AVP-V2R-AQP2 pathway in NRK-52E cells . Forty eight male SD rats were randomly divided into eight groups with 6 animals in each group. Distilled water or 22.68 g·kg⁻¹·d⁻¹ Zhenwu Tang(calculated by raw drug dosage meter) was given by gavage. Blood samples were collected by cardiac puncture， and the medicated serum was centrifuged from the blood by 3 000 r·min⁻¹. NRK-52E cells were treated with different medicated serum or dDAVP. The condition of cell proliferation was detected by RTCA. The distribution of V2R and AQP2 in cells were detected by immunofluorescence. The expression of V2R， PKA and AQP2 were detected by Western blot and AQP2 mRNA level was detected by real-time PCR. Results showed that the level of AQP2 mRNA(<0.01) and protein expression of V2R， PKA and AQP2(<0.05， <0.01， <0.05) of Z7d group which was treated with Zhenwu Tang medicated serum for 24 h were significantly higher than that of normal rat serum group. And the expression level of V2R， p-AQP2 and AQP2(<0.01， <0.05， <0.01) of Z7d+dDAVP group were significantly increased comparing to normal rat serum group. The results indicate that the applying of Zhenwu Tang medicated serum could increase the expression level of V2R， PKA and AQP2 which exist in AVP-V2R-AQP2 pathway in NRK-52E， and there is synergistic effect between Zhenwu Tang medicated serum and dDAVP. So the pathway of AVP-V2R-AQP2 may be one of the mechanism for which Zhenwu Tang regulate balance of water transportation.

Advance in Riluzole for Spinal Cord Injury (review) / 中国康复理论与实践

Spinal cord injury (SCI) is a disabling disease usually caused by trauma. The treatment and nursing of SCI patients has brought great economic burden to the society. This article introduced the mechanism of riluzole in treating spinal cord in-jury, including blocking Na+channels, reducing glutamate-mediated excitotoxicity, promoting the expression of neuro-trophic factors, and alleviating cellular oxidative stress damage and apoptosis, and the research progress on clinical trials of riluzole.

Research Related to Neural Protection of Hypoxic and Hyperoxic Preconditioning after Spinal Cord Injury (review) / 中国康复理论与实践

Repeated acute intermittent hypoxia promotes the expression of growth factors and neurotrophic factors, as well as the key molecules for neural protection and plasticity. Hypoxic preconditioning may improve the survival rate of transplant-ed stem cells and protect the neural function. Meanwhile, acute intermittent hypoxia can be an approach to improve re-spiratory function after spinal cord injury. Hyperbaric oxygen may improve the neural tolerance to hypoxia and isch-emia, to protect the structure of cells and tissues, and promote the neuranagenesis. It is important to study the role of hy-poxic and hyperoxic preconditioning in spinal cord injury.

Diffusion Tensor Imaging Study on Cervical Spinal Cord Injury without Radiographic Abnormality / 中国康复理论与实践

@#Objective To apply MR diffusion tensor imaging (DTI) to quantitatively analyze cervical spinal cord injury without radiographic abnormality (CSCIWORA). Methods 15 patients with CSCIWORA and 20 healthy controls were scanned with MRI of conventional scans and DTI. The fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were measured. Results FA and ADC of the patients were (0.475±0.109) and (1.438±0.252)×10-3 mm2/s, respectively. Whereas, they were (0.604±0.096) and (1.371±0.280)×10-3 mm2/s in the controls. Compared with the controls, the FA was less (P<0.05) in the patients, but the ADC was not significantly different (P=0.267). The fiber tracking (FT) showed the abnormality of white matter fiber tracts of cervical spinal cord in the patients. Conclusion DTI can detect the CSCIWORA, and FT can directly display the injuries of white matter fiber tracts of cervical spinal cord, which provide more information to evaluate the clinical severity of CSCIWORA.

Combined common femoral artery endarterectomy with superficial femoral artery stenting plus Shuxuening Injection infusion for chronic lower extremity ischemia: 3-year results / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the efficacy and safety of combined common femoral artery (CFA) endarterectomy with superficial femoral artery (SFA) stenting plus Shuxuening Injection infusion in patients with complex multifocal arterial steno-obstructive lesions of the lower extremities.</p><p><b>METHODS</b>From March 2006 to March 2011, 104 lower limbs in 96 patients with multilevel peripheral arterial steno-occlusive disease, involving SFA as well as CFA and deep femoral artery (DFA) orifice, were treated by combined surgical with endovascular therapy, such as SFA stenting as an adjunct to CFA endarterectomy and patch angioplasty with the great saphenous vein. Before the end of the operation, 20 mL of Shuxuening Injection was infused through the catheter located in the treated artery. Technical and hemodynamic success, as well as primary and primary-assisted patency, was determined according to the Society for Vascular Surgery Guidelines. During follow-up, clinical status assessment, ankle-brachial index (ABI) test, and duplex Doppler ultrasound were administered every 6 months, and computed tomography angiography or magnetic resonance angiography was performed at 12, 24, and 36 months after discharge.</p><p><b>RESULTS</b>All patients underwent successful combined CFA endarterectomy with SFA stenting treatment. The average ABI after the combination treatment increased from pretreatment of 0.32±0.21 to 0.82±0.24 (P<0.01). No perioperative death and major limb amputations occurred. The mean duration of follow-up for 104 limbs from 96 patients was 1,180 days (range, 196-2,064 days). During follow-up, 5 patients died due to myocardial infarction, cerebral infarction, or pneumonia, and 5 patients were lost to follow-up. There were 21 cases (21.4%) of restenosis, with 15 that occurred in-stent and 6 near the distal end of the stent. A total of 18 (18.3%) reinterventions were performed, including 6 balloon angioplasty, 8 restenting procedures, 2 bypass surgeries, and 2 major limb amputations. The primary patency rates were 92.2%, 76.8%, and 61.3% at 12, 24, and 36 months, respectively, while the primary-assisted patency rates were 94.4%, 83.2%, and 75.6% at 12, 24, and 36 months, respectively.</p><p><b>CONCLUSION</b>The combined CFA endarterectomy with SFA stenting plus Shuxuening Injection infusion appears to offer a safe, less invasive, and effective treatment option to patients with chronic lower extremity ischemia due to complex multifocal peripheral artery disease.</p>

Relationship between computational fluid dynamics simulation and acoustic rhinometry and rhinomanometry in nasal cavity / 上海第二医科大学学报

Objective To reconstruct a computational fluid dynamics (CFD) model of human nasal cavity, and make comparison analysis with acoustic rhinometry and rhinomanometry. Methods One healthy volunteer was performed CT scanning of nasal cavity, three dimensional CFD model was established by Simplant 10.0 and Gambit 2.3.16, and Fluent 6.3.2 was employed to simulate the airflow of nasal cavity. Acoustic rhinometer was used to assess the area of nasal cavity, rhinomanometry was adopted to measure the airflow and intranasal pressure drop during inspiration, and the results were compared with those obtained from CFD model. Results Cross section area of nasal cavity obtained from CFD model matches well with that measured by acoustic rhinometer within 30 mm distance from nostril, while the latter was larger than the former beyond 50 mm distance from nostril. The trend of intranasal pressure drop at different airflows measured by CFD model was the same as that measured by rhinomanometry, while the transnasal pressure obtained by CFD model was lower than that recorded by rhinomanometry. Conclusion CFD model can accurately simulate the shape of nasal cavity and measure the parameters of intranasal airflow, which helps to understand the airflow characteristics of nasal cavity.

Clinical analysis of endarterectomy to the stenosis and occlusion of carotid artery / 中华外科杂志

<p><b>OBJECTIVE</b>To sum up the experience of carotid endarterectomy (CEA).</p><p><b>METHODS</b>From January 1999 to July 2003, 59 patients were treated by CEA. There were 40 males and 19 females, and their age ranged from 56 to 79 years with an average of 71.8 years. The stenotic degree of internal carotid artery were over 80% in all cases. The left lesions were in 35 cases, and the right in 19, and the bilateral in 5. Patching were in 5, bypass with a great saphenous vein in 2.</p><p><b>RESULTS</b>Fifty-five cases were excellent. Two patient died, one was caused by hyperperfusion syndrome, the another was due to the acute cardiac infarction at 31 days after operation. The complications included 5 hematosis and 1 hoarseness.</p><p><b>CONCLUSION</b>CEA is still the best method in treating the stenosis and occlusion of carotid artery.</p>

Supracricoid Partial Larynegectomy for Laryngeal Cancer / 上海第二医科大学学报

Objective To assess the effectiveness of supracricoid partial laryngectomy in the treatment of laryngeal cancer. Methods This study infiuded 22 patients operated on from 1993 to 2000 using this surgical procedure. 22 were males with mean age of 63 years (ranging from 43 to 74 years). 21 were glottic cancers (3 T1aNoMo, 4 T1bNoMo, 11 T2NoMo, 3 T3NoMo) and 1 supraglottic cancer (T2N1Mo) according to the 1997 UICC system. Supracrieoid partial laryngectomy was performed, with the epiglottis preserved and reconstructed with cricohyoidoepiglottopexy (CHEP). Results The overall 3-year and S-year survival rates were 88.24％ and 70％, respectively. All patients were decannulated. The average time for decannulation was 25 days (ranging from 14 to 60 days). Speech was good in all cases. Conclusion CHEP not only excises the neoplasms completely and safely but also preserves the laryngeal physiologic function well.