Objective To investigate the effectiveness and safety of carotid stenting for progressive cerebral watershed infarction (PCWI) patients with ipsilateral internal carotid stenosis or occlusion during the progressive stage. Methods The clinical data of 23 PCWI patients with ipsilateral internal carotid stenosis or occlusion treated with carotid stenting during the progressive stage were analyzed retrospectively. Among them, 18 were severe internal carotid artery stenosis, and 5 were carotid artery occlusion. Carotid artery stenting were performed in patients with severe internal carotid artery stenosis. The first-stage angioplasty and second-stage stenting were performed in patients with internal carotid artery occlusion. The National Institutes of Health Stroke Scale (NIHSS) score and the modified Rankin scale (mRS) were used to evaluate preoperative and postoperative neurologic deficits. Results Twenty-two of 23 patients were stented successfuly, the Thrombolysis In Myocardial Infarction (TIMI) flow grade was 3, and the technical success rate was 95. 7% . None of the patients demonstrated hyperperfusion in the ipsilateral hemisphere. At day 30 postprocedure, the NHISS scores were significantly improved compared with before procedure (4. 41 ± 1. 88 vs. 10. 00 ± 1. 47; t = 11. 234, P < 0. 001). The preprocedural TIMI flow grade was 3 in 12 patients (52. 2% ). Proportion of patients with TIMI flow grade 3 after procedure was significantly increased compared with before procedure (95. 7% vs. 52. 2% ; χ2 = 11. 274, P = 0. 002). The proportion of patients with mRS scores 0-2 at day 90 after procedure was significantly increased compared with before procedure (69. 6% vs. 0% ; χ2 = 24. 533, P < 0. 001). Conclusions Carotid stenting during the progressive stage is safe and it may improve the prognosis in PCWI patients with ipsilateral internal carotid stenosis or occlusion.

Objective To evaluate the safety and efficacy of early carotid artery stenting in treating cerebral watershed infarction patients with carotid artery stenosis. Methods A total of 33 patients with acute cerebral watershed infarction complicated by carotid artery stenosis received carotid artery stenting within one week after the onset of the disease. The clinical safety and efficacy were evaluated. Results The carotid artery stenting was successfully accomplished in all 33 patients with a success rate of 100%. After the procedure, different degree of bradycardia and hypotension was seen in 23 patients, which restored to normal after prompt medication with atropine, dopamine, etc. During the procedure, one patients developed cerebral embolism due to dislodgment of emboli, resulting in contralateral hemiparalysis, and the contralateral limb muscle strength returned to preoperative status after proper treatment. After the treatment, no ipsilateral hemisphere excessive perfusion or cerebral hemorrhage occurred. Thirty days after the treatment, NHISS scores of the patients were obviously improved, which were significantly different from those determined before the treatment (P<0.05). Conclusion For the treatment of acute cerebral watershed infarction, early carotid artery stenting to relieve carotid artery stenosis is quite safe and it may improve the prognosis as well.

Objective To synthesize a new kind of acid-sensitive doxorubicin prodrug nanoparticles and to evaluate its anti-brain glioma effect and efficiency through blood-brain barrier (BBB). Methods The prodrug acid-sensitive poly-ethylene glycol (PEG)-doxorubicin (PEG-DOX) copolymer was synthesized by Schiff base reaction, and PEG-DOX pro-drug nanoparticles (PEG-DOX NPs) were prepared by self-assembling. The character of PEG-DOX copolymer was detected by dynamic light scattering (DLS) instrument and 1H NMR. The morphology of PEG-DOX NPs was observed by transmission electron microscopy (TEM). The character of drug release was detected by UV mothed. The cellular uptake efficiency of glio-ma cells to PEG-DOX NPs was observed by inverted fluorescence microscope. The anti-brain glioma effects of PEG-DOX NPs and Free DOX were studied by MTT mothed. PS80-PEG-DOX NPs were gained by the modification of PEG-DOX NPs with Tween 80. Nine BALB/c mice were separated into Free DOX, PEG-DOX NPs and PS80-PEG-DOX NPs groups by ran-dom drawing lots. The mean fluorescence intensity of brain and main organs were observed by in vivo imaging system. Re-sults The copolymer of PEG-DOX can self-assemble into nanoparticles with the diameter of 100 nm. PEG-DOX NPs can quickly release DOX in acid environment. Although PEG-DOX NPs had slow cancer cell uptake than Free DOX, it had lon-ger accumulation. MTT results showed that PEG-DOX NPs had concentration dependent anti-brain glioma effect. Indepen-dent samples t-test indicated that the efficiency through BBB was significantly higher in PS80-PEG-DOX NPs group than that of Free DOX group and PEG-DOX NPs group. Conclusion PEG-DOX NPs show well anti-brain glioma effect in vi-tro, and can across BBB with high efficiency after modification, which make it possible for a potential therapeutic prodrug for brain glioma.

Purpose To investigate the clinical value of gated myocardial perfusion imaging (GMPI) quantitative analysis technique in evaluating left ventricular remodeling and its effects on left ventricular function in patients with myocardial infarction (MI). Materials and Methods Seventy-six cases of MI patients were retrospectively analyzed, including pure left anterior descending artery (LAD) disease in 21 cases , left circumlfex artery (LCX) or right coronary branch (RCA) disease in 23 patients and multivessel disease in 32 cases. Seventy-four healthy people were additionally selected as control group. GMPI was performed on all subjects. Reconstruction images were automatically analyzed by using cardiac software QGS 2009 to obtain left ventricular remodeling index, including diastolic sphericity index (SIED) and end-systolic sphericity index (SIES). Cardiac function parameters were also obtained, including left ventricular end-diastolic volume (EDV), end-systolic volume (ESV), left ventricular ejection fraction (LVEF), and peak iflling rate (PFR). Differences of the left ventricular remodeling index and cardiac function parameters between the MI group and the control group were compared to analyze the relationship between left ventricular remodeling after myocardial infarction and coronary artery lesions. Results SIED, SIES and EDV, ESV in MI group were signiifcantly higher than those in the normal group (P<0.01). The cardiac function parameters of LVEF and PFR were significantly lower than those of the normal group (P<0.01). SIED and SIES in the group of LAD lesions and multi-vessel disease were signiifcantly higher than those in the LCX/RCA lesion group (P<0.05). The left ventricular remodeling was occurred more often in LAD lesion group and multi-vessel disease group than in the LCX/RCA lesion group (χ2=6.502 and 10.166, P<0.05). There was no significant difference between the LAD lesions group and multi-vessel disease group (χ2=0.105, P>0.05). Linear regression analysis showed that LVEF and PFR in group of left ventricular remodeling was signiifcantly lower with the increase of SIED (F=43.231 and 15.642, P<0.01). SIED and SIES analysis resulted in high correlation for both intra-observer and inter-observer (r=0.881-0.926, P<0.01). Conclusion Left ventricular remodeling after myocardial infarction can be accurately evaluated by GMPI. Patients with myocardial infarction due to LAD or multi-vessel coronary artery diseases may have left ventricular remodeling easier and more severe. Left ventricular remodeling will seriously affect the myocardial contraction and diastolic function, resulting in the entire left ventricular dysfunction.

Objective To compare the biodistribution difference of peptide nanofibers, which were self-assembled by peptide composed of L-or D-amino acids, respectively, and provide the guidance for the in vivo applications of peptide nanofibers. Methods The Nap-GFFYGRGD (L-peptide) and Nap-GDFDFDYGRGD (D-peptide, F and Y were D-configura-tion) were synthesized with solid phase peptide synthesis (SPPS). The structure of the two peptides was identified by nuclear magnetic resonance spectroscopy (1H NMR) and high-resolution mass spectrometry (HR-MS). The two peptides could self-assemble into nanofibers during the cooling process after being boiled. The morphology of the nanofibers was observed with transmission electron microscope (TEM). The peptides were radiolabeled with iodine-125 and self-assembled into nanofi-bers, which were then administered into BALB/c mice via tail vein. The blood samples were collected and then mice were sacrificed at 1, 3, 6 and 12 hours. The main organs (heart, liver, spleen, lung, kidney, stomach, large intestine, small intes-tine, muscle and brain) were isolated and weighed. The radioactivity of organs was detected with a gamma counter. Results The two peptides could self-assemble into nanofibers with diameter of 10-20 nanometers. There were no significant differ-ences in the diameter and morphology between two naofibers. There was significant difference in the biodistribution between two nanofibers. The blood concentration of D-fiber was (8.17±0.32)%ID/g at one hour after injection and then cleared rapid-ly from the blood. The blood concentration of L-fiber was (5.96±0.30)%ID/g at one hour after injection and maintained at a stable level for six hours. The L-fiber was mainly distributed in stomach while the D-fiber was mainly accumulated in liver. Conclusion The configuration of amino acids (D/L) could affect the biodistribution of peptide nanofibers dramatically, which may provide the guidance for the medical applications of peptide nanofibers.

Objective:To evaluate the protection of small bowel and bladder by Contoura carbon fiber belly board in patients with rectal cancer undergoing postoperative radiotherapy and the position deviation during radiotherapy. Methods: This study enrolled 45 consecutive patients with rectal cancer who had undergone prior surgery. Twenty patients who applied the belly board were defined as group A, and the other 25 patients were defined as group B. All the patients received threE-dimensional conformal radiation therapy(3D-CRT), and the prescriptive radiation dosage of 95% of planning target volume (PTV) was 50 Gy/25 times. Patients in group A underwent two sets of CT scans as follows: group A1, prone alone; group A2, prone with the use of the belly board. The radiation dosage and radiated volume in PTV, small bowel, and bladder were observed by dosE-volume histograms. Ten patients were selected randomly from group A and group B, respectively. Their position deviation during radiotherapy was measured by double exposure field verification system. The acute radiation reactions of all patients were observed and recorded during radiotherapy. Results: No significant difference was found in the total PTV and total volume of small bowel and bladder and mean irradiation dosage to PTV between groups A1 and A2. The mean irradiation dosage to the small bowel and bladder, the volume of small bowel irradiated at 10%-100% dose levels, and the volume of bladder irradiated at 30%-100% dose levels, were significantly decreased in group A2. The difference was significant. Compared with group B, the right-left and superior-inferior position deviations were significantly reduced in group A. The difference was significant (P<0.05). The anterior-posterior position deviation was also reduced, but the difference was not significant (P=0.705). The incidence of grade 3 or more adverse reactions were 15% (3/20) in group A and no patient broke off or stopped treatment; the incidence of grade 3 or more adverse reactions was 24% (6/25) in group B, and two patients broke off the treatment because of severe adverse reaction. One patient terminated the treatment. Conclusions: The Contoura carbon fiber belly board can reduce the irradiation dosage and volume of small bowel and bladder in patients with rectal cancer undergoing postoperative radiotherapy. The position deviation has better reproducibility and the acute radiation reactions are tolerable. It is worthy of application in clinic.

Intracranial atherosclerotic stenosis (ICAS) is one of the most common causes of ischemic stroke worldwide. A variety of factors are associated with the occurrence and development of ICAS, including gender, age, persistent inflammatory state, hypertension, hyperlipidemia and diabetes. Early identification and appropriate management of risk factors for ICAS are of great significance for actively preventing and treating ICAS and reducing the risk of ischemic stroke occurrence and recurrence.

Intracranial atherosclerotic stenosis (ICAS) is the main cause of ischemic stroke. Endovascular therapy (EVT) is a method of treating symptomatic ICAS, and in-stent restenosis (ISR) is an important factor affecting the efficacy of EVT. This article summarizes the influencing factors of ISR in patients with ICAS receiving EVT treatment.

Posterior circulation ischemic stroke is a kind of cerebral infarction which occurs in the blood supply area of vertebrobasilar artery. Its etiology is complex. The common causes include thromboembolism, large artery atherosclerosis, and small arterial disease. The treatment options for posterior circulation ischemic stroke include drug therapy, intravenous thrombolysis and endovascular therapy. However, the application of endovascular therapy in patients with posterior circulation ischemic stroke is still in the exploratory stage, and there is not enough evidence of randomized controlled trials.

Intracranial atherosclerotic stenosis (ICAS) is the most common cause of ischemic stroke in Asians, and the middle cerebral artery (MCA) is its most common site. MCA stenosis can be divided into symptomatic or asymptomatic. The current endovascular treatment is mainly aimed at symptomatic stenosis. Early drug therapy can alleviate the clinical symptoms of patients and change its natural course to some extent. This article reviews the treatment of symptomatic MCA stenosis from two aspects: drug therapy and endovascular therapy.