Objective To determine the safety and efficacy of intra-arterial recombinant tissue plasminogen activator (r-tPA) for the treatment of acute cerebral infarction (ACI) in patients under the guidance of computed tomography perfusion-based selection within a 6-9 hour window.Methods Sixtythree ACI patients selected by using computed tomography perfusion imaging (CTPI) identifying thresholds for salvageable penumbra were randomly (random number) assigned to the group treated with intra-arterial thrombolysis with r-tPA (group A,n =30) or to the group managed with conventional anti-platelet aggregation agent (group B,n =33) within a 6-9 hour window.The National Institutes of Health Stroke Scale (NIHSS) and the modified Rankin Scale score (mRS) and Barthel Index (BI) were used for evaluating therapeutic efficacy.Global brain digital subtraction angiography (DSA) was done pre-and posttreatment to observe the recanalization of occluded vessels in the group A.All patients were monitored with CT scan within 24 hours to determine the cerebral hemorrhage,an unexpected complication of thrombolysis.Results Compared with pre-treatment,there were significant differences in NIHSS 24 hours after treatment in the group A and 7 days after treatment in both groups (P ＜ 0.01).However,there were no significant differences in NIHSS 24 hours after treatment in the group B.More improvements in NIHSS at 24 hours and 7 days after treatment were observed in the group A than those in group B (P ＜ 0.01),and more patients with favorable outcomes identified by mRS and BI in the group A than those in the group B (P =0.017 and P =0.016,respectively).In addition,twenty patients were showed successful recanalization in the group A and there were 2 cases of cerebral hemorrhage occurred in the group A,and there was no significant difference in the incidence of cerebral hemorrhage within 24 hours between the two groups (P ＞ 0.05).Conclusions Intra-arterial thrombolysis with r-tPA for treatment of acute cerebral infarction was safe and effective within a 6-9 hour window under the guidance of CTPI.

AIM:To observe the effect of arsenic trioxide (ATO) on bleomycin-induced pulmonary fibrosis in rats. METHODS:Pulmonary fibrosis was induced in Sprague-Dawley (SD) rats by intratracheal instillation of bleomycin (BLM). The rats in ATO treatment group,steroid treatment group and model group were intraperitoneally injected with ATO,dexamethasone or normal saline (NS),respectively,while the control rats received NS both intratracheally and intraperitoneally. The effects of ATO were evaluated by analyzing the median survival time,hydroxyproline level in the lung,semiquantitative grading of alveolitis and pulmonary fibrosis,and quantitative analysis of the collagen in lung tissue (Masson's trichrome staining). Apoptosis index (AI) of the lung was detected by using the terminal transferase dUTP-digoxygenin nick endlabeling (TUNEL) method. The results of immunohistochemical staining for some cytokines were quantitatively analyzed. RESULTS:ATO (1) prolonged the median survival time of rats with BLM-induced pulmonary fibrosis at some extent; (2) attenuated the alveolitis and pulmonary fibrosis,reduced hydroxyproline level and collagen deposition in the lung tissue; (3) increased the AI of lung tissue at a certain phase; and decreased the levels of transforming growth factor-?1(TGF-?1) and tissue inhibitor of metalloproteinase-1 (TIMP-1),increased the content of in-terferon-? (IFN-?),but did not influence the concentration of matrix metalloproteinase-9 (MMP-9) significantly. CONCLUSION:ATO might attenuate BLM-induced pulmonary fibrosis in rats via increasing the AI in the lung tissue.

Objective To explore the Efficacy and safety of intravenous thrombolysis with different doses of rt-PA in the treatment of acute anterior circulation cerebral infarction with atrial fibrillation.Methods Retrospective analysis of 61 cases of patients with anterior circulation of cerebral infarction with atrial fibrillation from October 2009 to October 2014 in the First Affiliated Hospital of Xiamen University, the incidence within 4.5 hours of intravenous thrombolysis,and divided into two groups by rt-PA usage,19 cases in adequate group,received 0.9 mg/kg rt-PA intravenous thrombolytic therapy,42 cases in low dose group, received 0.6 mg/kg rt-PA intravenous thrombolysis.Before and after thrombolysis 1,7 and 30 days,NIHSS score was measured, the indexes of coagulation were observed at before thrombolysis and 1,7 days after thrombolysis,,CT scans were performed at 1, 7, and 14 days after thrombolysis,and Rankin (MRS) scores were compared at 90 days after thrombolysis.Results NIHSS 1,7,30 days scores of 2 groups were significantly decreased after thrombolysis(P<0.05),there was no statistically significant at at each time point after thrombolysis.Plasma prothrombin time increased significantly at 1 day and 7 days after thrombolysis,fibrinogen was significantly lower,compared with the low dose group, the difference was significant (P<0.05).There was no significant difference between the two groups in clinical outcome and mortality.The rate of mucosal bleeding in low dose group was lower than that in adequate group (P<0.05).Conclusion Low-dose rt-PA group intravenous thrombolysis with anterior circulation of atrial fibrillation is more safe,can reduce the risk of bleeding, reduce neurological deficits and improve the quality of life of patients.