To evaluate the efficacy of treating severe and chronic vertebral compressive fractures in the elderly with percutaneous vertebroplasty.Sixteen patients who suffered from severe back pain and whose daily living was badly affected were retrospectively reviewed. The average age was 72.5 years, the average disease history was 19 months, and the average compressive rate of the affected vertebral bodies was 74.1%.Nineteen affected compressive vertebral bodies in 16 cases were treated with percutaneous vertebroplasty. All the procedures were successful without any complication. After 3.5-7 ml of cement was injected into the lesions, complete relief was achieved in 3 cases, remarkable relief was achieved in 11 cases, and improvement was observed in 2 cases. The scores of 6-point Behavioral Rating Scale and Activity of Daily Living (ADL) declined significantly after the treatment (P < 0.001).Percutaneous vertebroplasty can significantly improve the symptoms and quality of life in the elderly patients with severe and chronic vertebral compressive fractures.
Objective
To investigate the safety and effectiveness of rescue stenting after failure of mechanical thrombectomy in patients with acute ischemic stroke (AIS) caused by large vessel occlusion (LVO).
Methods
From December 2015 to December 2017, patients with AIS caused by LVO and treated with Solitaire AB stent thrombectomy in the Fifth Central Hospital of Tianjin were enrolled retrospectively. CT scans were performed within 24 h after surgery. Symptomatic intracraninal hemorrhage (sICH) was defined as CT confirmed intracranial hemorrhage and the National Institutes of Health Stroke Scale score increased ≥4. Clinical outcomes were assessed using the modified Rankin Scale at 90 d after onset, and 0 to 2 was defined as good outcome. According to whether to receive rescue stenting or not, the patients were divided into 2 groups. The clinical outcomes and incidence of sICH were compared between the 2 groups.
Results
A total of 39 patients were enrolled. Among them, 29 (74.3%) were successfully recanalized by mechanical thrombectomy and 10 (25.6%) performed stenting after failure of mechanical thrombectomy. Four (40.0%) in the stenting group and 11 (37.9%) the non-stenting group had good outcomes respectively at 90 d. There was no significant difference (P=1.000). Two patients (20.0%) and 1 patient (3.4%) developed sICH within 24 h after operation in the stenting group and the non-stenting group respectively. There was also no significant difference (P=0.156).
Conclusions
Rescue stenting can be used as a safe and effective remedy for patients with failure of mechanical thrombectomy.
Key words:
Stroke; Brain Ischemia; Thrombectomy; Stents; Treatment Outcome
Objective To study the clinical effects and safety of the treatment in acute cerebral artery occlusion with superselective intracranial arterial thromblysis by rt-PA,mechanical fragmentation by microcatheter and microguid wire and (or) solitairAB sent thrombectomy.Methods 42 patients of acute cerebral artery occlusion were treated by superselective intracranial arterial thrombolysis,mechanical fragmengation and (or) solitairAB sent thrombectomy from October 2010 to March 2012 and the data were retrospectively reviewed.Results Occluded arteries of 42 patients were dredged totally or partialy,the recanalization rate or partial recanalization rate of blocked blood vessel was 100％,including 37 cases with total recanalization (88％).After operation one case suffered from cerebral hemorrhage of basal ganglia,one subarachnoid hemorrhage,and one died of ardent fever after 8 days.9 cases (21％) remained functional impairments to some extents after medical therapy.The ranks of NIHSS between preoperation and 1 week after operation were discrepant obviously.Conclusions Superselective intracrainal arterial thrombolysis by rt-PA and papaverine,mechanical fragmentation by microcagheter and micoguide wire and (or) solitairAB sent thrombectomy in patients of acute cerebral artery occlusion is a safe and an effective therapy within the right time.
Key words:
Mechanical fragmentation ; Sent thrombectomy; Cerebrovascular occlusion ; Arterial thrombolysis
Abstract Background: Bone marrow mesenchymal stem cells (BMSCs) are widely used in many fields such as wound repair, gene delivery, and microenvironment improvement. In some cases, BMSC transplantation requires long-term anesthesia. However, the effects of anesthetics on the characteristics of BMSCs are poorly understood. Methods: In this study, we examined the effect of sevoflurane, a gas anesthetic drug most commonly used in children, on the proliferation, differentiation, and homing potential of BMSCs. Results: Short-term (6 h) sevoflurane exposure had almost no effect on the proliferation, differentiation, and homing of BMSCs. However, long-term (24 h) sevoflurane exposure inhibited the proliferation of BMSCs, accelerated their differentiation into nerve cells, and inhibited their homing potential to damaged vascular endothelial cells and intact glioma cells. Conclusion: Short-term anesthesia with sevoflurane as the main inducer is safe and harmless to BMSCs, but long-term sevoflurane exposure may reduce their repair potential. Therefore, because of the high proportion of BMSCs in children, the application of long-term anesthesia with sevoflurane should be cautious, or more suitable anesthetic drugs are needed.
Objective: To investigate the malignant phenotype of human glioma cells by microRNA-7 (miR-7) silencing epidermal growth factor receptor (EGFR)/ phosphatidylinositol kinase-3 (PI3K) pathway. Methods: The human U251 glioma cells were transfected with pri-miR-7. The expression of miR-7 was analyzed by real-time fluorogenic quantitative-PCR (RFQ-PCR). The expressions of epidermal growth factor receptor (EGFR), PI3K and AKT2 proteins were detected by immunocytochemistry and Western blotting. The cell growth curves were drawn, and the cell cycle distribution induced by miR-7 was determined by flow cytometry (FCM). The cell migration ability and tumorigenicity were detected by Transwell chamber assay and soft agar colony assay, respectively. Results: The result of RFQ-PCR showed that the expression level of miR-7 was up-regulated in human glioma cells transfected with pri-miR-7. The expression levels of EGFR, PI3K and AKT2 proteins were down-regulated in glioma U251 cells transfected with pri-miR-7 (P＜0.05). The cell proliferation rate was slowed down, and the proportion of S phase cells was reduced. The abilities of cell migration and soft agar colony formation of U251 cells transfected with pri-miR-7 were significantly reduced (P＜0.05). Conclusion: MiR-7 transfection can effectively silence the expressions of key members of EGFR/PI3K pathway and reverse the malignant phenotype of U251 cells，and which is expected to become a new choice of glioma gene therapy. DOI:10.3781/j.issn.1000-7431.2011.11.005
Objective To analyze and compare the change of hemodynamics between pre and post operation of EDAS on patients of moyamoya disease with the way of computational fluid mechanics.Methods We analyzed the hemodynamicses of 29 hemorrhagic and 64 ischemic patients of moyamoya disease with the way of computational fluid dynamics,and compared the pressure and blood flow between pre and post operation of EDAS on patients of moyamoya disease.Results Calculated with the software of computational fluid dynamic,the pressure of the terminal of internal carotid artery decreased (2295.60 ±758.09)Pa post operation on hemorrhagic moyamoya disease.There waa significant difference(P ＜0.01)inthe pressure and blood flow between pre and post operation.Conclusion The operation of EDAS can effectively improve the blood flow and decrease the pressure of terminal of internal carotid artery.
Key words:
Moyamoya disease; Hemodynamic; Cerebral hemorrhage; Cerebral infarction; EDAS
DL-3-n-butylphthalide (NBP) is a drug for treating acute ischemic stroke and may play a neuroprotective role by acting on multiple active targets. The efficacy of NBP in patients with acute ischemic stroke receiving reperfusion therapy remains unknown. To assess the efficacy and safety of NBP in patients with acute ischemic stroke receiving reperfusion therapy of intravenous thrombolysis and/or endovascular treatment. This multicenter, double-blind, placebo-controlled, parallel randomized clinical trial was conducted in 59 centers in China with 90-day follow-up. Of 1236 patients with acute ischemic stroke, 1216 patients 18 years and older diagnosed with acute ischemic stroke with a National Institutes of Health Stroke Scale score ranging from 4 to 25 who could start the trial drug within 6 hours from symptom onset and received either intravenous recombinant tissue plasminogen activator (rt-PA) or endovascular treatment or intravenous rt-PA bridging to endovascular treatment were enrolled, after excluding 20 patients who declined to participate or did not meet eligibility criteria. Data were collected from July 1, 2018, to May 22, 2022. Within 6 hours after symptom onset, patients were randomized to receive NBP or placebo in a 1:1 ratio. The primary efficacy outcome was the proportion of patients with a favorable outcome based on 90-day modified Rankin Scale score (a global stroke disability scale ranging from 0 [no symptoms or completely recovered] to 6 [death]) thresholds of 0 to 2 points, depending on baseline stroke severity. Of 1216 enrolled patients, 827 (68.0%) were men, and the median (IQR) age was 66 (56-72) years. A total of 607 were randomly assigned to the butylphthalide group and 609 to the placebo group. A favorable functional outcome at 90 days occurred in 344 patients (56.7%) in the butylphthalide group and 268 patients (44.0%) in the placebo group (odds ratio, 1.70; 95% CI, 1.35-2.14; P < .001). Serious adverse events within 90 days occurred in 61 patients (10.1%) in the butylphthalide group and 73 patients (12.0%) in the placebo group. Among patients with acute ischemic stroke receiving intravenous thrombolysis and/or endovascular treatment, NBP was associated with a higher proportion of patients achieving a favorable functional outcome at 90 days compared with placebo. ClinicalTrials.gov Identifier: NCT03539445.
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