Objective To investigate the effect of cerebral angiography on separation of craniopagus during the period of preoperation and microsurgical operation Methods There was a case of craniopagus being separated in our hospital recently Cerebral arteriography at 3 months of life, arteriography and venography through femoral vessels at 16 months were performed to analyze the twin vascular circulations of bilateral internal carotid artery, external carotid artery, vertebral artery, and venous sinus Intraoperative cerebral angiography helps to evaluate the cerebral circulations Results Preoperative cerebral angiography showed no intracranial arterial connection in the pontes of craniopagus The posterior 1/3 part of superior sagittal sinus, partial transverse sinus and torcular herophili were confluented in two children Cerebral angiography during operation was significant for monitoring the management of the part of confluent venous sinus Conclusion Cerebral angiography is the best method to investigate the vascular conditions of craniopagus The selective sinus angiography is very important in analyzing the abnormal anatomy and hemodynamics of venous sinus in the pontes Intraoperative angiography can direct the bypass shunt and reconstruction of the sinus

Objective To undertake animal experimentation and clinical study on the safety and efficacy of percutaneous transluminal angioplasty (PTA) and intraarterial papaverine (IAP) infusion for treatment of refractory symptomatic cerebral vasospasm (CVS). Methods In the experimental study, vasospasm was induced in rabbits by double injections of blood into the cisterna magna, IAP infusion was given on either the 4th day or the 7th day after occurrence of subarachnoid hemorrhage (SAH), and then neurological observation, angiography, light and electron microscopy were done. In the clinical study, since September 1996, 22 patients with refractory symptomatic CVS involving 50 vascular territories received dilation therapy by PTA and IAP within 24 hours of clinical neurological deterioration. Results In the experimental study, all the rabbits except two in the 'the 4th day' group showed angiographic dilation in all of the spastic basilar arteries, and neurological improvement; in the ' the 7th day' group angiographic dilation appeared in 4 (57. 1% ) out of 7 rabbits. After 24 hours, 1 rabbit in each group had recurrence of neurological deficits and angiographic constriction. In the clinical study after aneurysm clipping or endovascular coil embolization was done, within 72 hours of SAH all patients underwent endovascular treatment: PTA alone in 3 cases, IAP alone in 14 cases, PTA and IAP in the remaining 5 cases. All vessel segments were dilated satisfactorily after endovascular treatment. Clinical improvement was significant in 13 cases,moderate in 7, minimal or none in 2; 2 cases died on the 7th day after endovascular dilation treatment. Conclusion Endovascular dilating techniques, namely, PTA, IAP and a combination of PTA and IAP, are safe and effective for treatment of symptomatic CVS refractory to medical therapy.

Objective To Compare the use of guglielmi detachable coils(GDCs)versus microsurgical clipping for the management of acutely ruptured intracra nial aneurysm. Methods A clinical study included 82 patients with acute (90%. The technique related morbidity rate was 14.2%. In microsurgical group, 92.5% of aneurysms were completely clipped. The technique related morbidity rate was 10%. 2 cases was died. Significantly better total occlusion/embolization results were achieved in microsurgical clipping( n =40) than in GDCs ( n =35)( P 0.05). Six months follow up demonstrates that good prognosis was 95% in both groups. Conclusion In the management of acutely ruptured intracranial aneurysm, both microsurgical clipping and endovascular treatment is effective methods.

Objective To investigate the relationship of ELK-3 and epithelial-mesenchymal transition ( EMT) for ex-ploring its possible mechanism .Methods The human hepatocellular carcinoma cells ( HCC) were divided into small interference RNA transfection group and Ras-ELK-3 pathway inhibitor group .The protein level of ELK-3 target gene EGR-1 E-cadherin ,vimentin and p38 in HCC were determined by Western blot analysis .Results The protein level of ELK-3 and its target gene EGR-1 in treated human hepatocellular carcinoma cells significantly decreased as compared with the negative control group (P<0.01).The protein level of E-cadherin was significantly increased (P<0.01), while vimentin and p38 were decreased in HCC cells with ELK-3 interference (P<0.01).Conclusions ELK-3 in-terference can inhibit the epithelial-mesenchymal transition of HCC cells by down-regulating p38.

OBJECTIVETo assess the embolic effects and biocompatibility of Eudragit mixture, a new liquid embolic agent.

METHODSIn vitro, the viscosity and precipitation time of Eudragit mixtures at several concentrations were measured to study the best proportion of components of the mixture. In vivo, a branch of the right external carotid artery was embolized with Eudragit mixture in 12 rabbits, and with n-butyl cyanoacrylate in another 12 rabbits for a comparative study of the general, angiographic and histopathologic changes between the two groups.

RESULTSEudragit mixture containing 7.5 g Eudragit, 50 ml absolute ethanol and 50 ml iopromide was shown in vitro to have good properties including rapid precipitation and soft elastic sponge formation upon contact with blood; in vivo, to be nontoxic, nonadherent to the microcatheter and able to embolize the vascular lumen completely without later recanalisation.

CONCLUSIONEudragit mixture is an effective, nontoxic, safe and promising liquid embolic agent.

Animals ; Carotid Artery Thrombosis ; pathology ; physiopathology ; therapy ; Cerebral Angiography ; Chemical Precipitation ; Embolism ; therapy ; Embolization, Therapeutic ; methods ; Enbucrilate ; therapeutic use ; Male ; Polymethacrylic Acids ; chemistry ; therapeutic use ; Rabbits ; Viscosity

Objective To investigate whether embolization surgery can improve mid-to-long-term outcomes related to quality of life,anxiety and depression in patients with unruptured intracranial aneurysms(UIA).Methods This prospective study included patients diagnosed with UIA within 30 days.Patients were divided into two groups based on treatment:the embolization group and the conservative group.The assessments of quality of life,depression,and anxiety were conducted using the medical outcome study short form-36(SF-36),self-rating depression scale(SDS),and self-rating anxiety scale(SAS)at baseline,3 months,and 5 years after treatment.In the embolization group,psychological trauma was assessed using the impact of event scale-revised(IES-R)at 3 months and 5 years post-surgery.Results A total of 113 patients were involved in the analysis including 76 in the embolization group and 37 in the conservative group.Compared to the conservative group,SF-36 data showed that the embolization group had a lower physical function(80.3±16.4 vs.86.1±12.8,P=0.046)and role-physical(47.37±43.32 vs.67.57±34.29,P=0.015)scores at 3 months,but a higher mental health score(68.16±18.80 vs.61.62±14.62,P=0.048).At 5 years,all dimensions of SF-36 improved significantly compared to baseline(all P<0.05).The SDS and SAS scores in the embolization group were significantly lower at both 3 months and 5 years compared to baseline(both P<0.05).The decrease in SDS(-2.8±10.6 vs.0.5±6.5)and SAS(-2.7±11.8 vs.1.2±5.4)scores in the embolization group at 3 months was greater than in the conservative group(both P<0.05).Subgroup analysis showed that patients with depression or anxiety at baseline in the embolization group experienced a significant decrease in SDS and SAS scores at 3 months and 5 years compared to baseline(both P<0.05).Additionally,in the embolization group,the IES-R score at 3 months was 37.5±13.8,which was significantly higher than the critical threshold(P=0.005),but decreased to 33.8±13.3 at 5 years post-surgery.Conclusions Patients with unruptured intracranial aneurysms experienced long-term improvements in quality of life after embolization surgery.Embolization surgery also helped alleviate depression and anxiety.