Arteriovenous fistula (AVF) and arteriovenous malformation (AVM) are the common intracranial vascular malformations. The experimental models of AVF and AVM include animal models, in vitro models and biomathematical models. These models could be used to investigate the pathophysiological characters of AVF and AVM, to simulate the clinical treatment, and to examine the materials for embolization therapy. This article reviewed the formation of these models, evaluated their advantages and disadvantages, and briefly introduced their applications.

Objective:To investigate the effect of DJ-1 encoded by Park7 gene on retinal ganglion cells(RGC) and visual function after optic nerve crush injury (ONC) in mice.Methods:Thirty-seven and 116 healthy male C57BL/6J mice were randomly divided into group normal, group ONC 2d, group ONC 5d, group ONC 7d and group control, group Park7, group Park7-ONC, group ONC and group green fluorescent protein (GFP)-ONC. Group ONC 2d, group ONC 5d and group ONC 7d were sacrificed on the 2nd, 5th and 7th day after the establishment of ONC model, and the follow-up experiments were carried out. The mice in group Park7 and group Park7-ONC were injected 1 μ recombinant adeno-associated virus (rAAV) with knocking down Park7 gene into vitreous cavity, and 1 μl rAAV with only GFP was injected into vitreous cavity of mice in group GFP-ONC, and virus transfection was observed 4 weeks after injection. The injury of ONC was perfomed at 23 days after vitreous injection in group ONC, group Park7-ONC and group GFP-ONC, and the samples were taken for follow-up experiment 5 days after modeling. The average density of RGC was observed by immunofluorescence staining, the latencies and amplitudes of a-wave, b-wave and photopic negative response (phNR) and the amplitude of oscillatory potential (OPs)were detected by full-field flash electroretinogram,and the visual acuity of mice was measured by optomotor response (OMR). The relative expression levels of DJ-1, Bax and B lymphoblastoma / leukemia-2 (Bcl-2) protein in the retina of mice in each group were detected by Western blot. One-way ANOVA was used to compare the data between groups, and t-test was used for pairwise comparison between groups.Results:Compared with the normal group, the relative expression of DJ-1 protein in the retina of the ONC 2 d group and ONC 5 d group increased significantly, and the difference was statistically significant ( t=16.610, 5.628, P<0.01,<0.05). Four weeks after virus transfection, strong GFP expression was seen in the RGC layer and inner plexiform layer of the retina of mice in the Park7 group. Compared with the control group, the RGC density of the retina in the ONC group decreased significantly, and the difference was statistically significant ( t=16.520, P<0.000); compared with the ONC group, the RGC density of the retina in the Park7- ONC group decreased significantly, and the difference was statistically significant ( t=6.074, P<0.01). With the increase of stimulus light intensity, the dark adaptation a wave and b wave latency of the mice in the control group gradually shortened, and the amplitude gradually increased. The stimulus light intensity was 3 cd·s/m 2. There was no statistically significant difference in the dark adaptation a wave and b wave latency and amplitude of the control group, Park7 group, Park7-ONC group, ONC group, and GFP-ONC group (Incubation period: F=0.503, 2.592; P=0.734, 0.068. Amplitude: F=0.439, 1.451; P=0.779, 0.247). Compared with the control group, the Ops and PhNR amplitudes of the ONC group mice were significantly decreased ( t=15.07, 12.80; P<0.000,<0.001). Compared with the ONC group, the Ops and PhNR amplitudes of the mice in the Park7- ONC group were significantly decreased ( t=4.042, 5.062; P<0.05,<0.01); there was no statistically significant difference in the PhNR latency of the mice in each group ( F=1.327, P=0.287). Compared with the control group, the visual acuity of the mice in the ONC group was significantly decreased, and the difference was statistically significant ( t=23.020, P<0.000); compared with the ONC group, the visual acuity of the mice in the Park7-ONC group was significantly decreased, and the difference was statistically significant ( t=3.669, P<0.05). Compared with the control group, Park7-ONC group and ONC group, the relative expression of DJ-1 protein in the mouse retina was significantly down-regulated, and the difference was statistically significant ( t=47.140, 26.920; P<0.000,<0.000). There was no significant difference between ONC group and GFP-ONC group ( t=0.739, P=0.983). Compared with the ONC group, the relative expression of Bax protein in the mouse retina of the Park7-ONC group was significantly increased, and the relative expression of Bcl-2 protein was significantly reduced. The differences were statistically significant ( t=5.960, 9.710; P<0.05,<0.05); the relative expression ratio of Bcl-2/Bax in the Park7-ONC group was significantly lower than that in the ONC group, and the difference was statistically significant ( t=13.620, P<0.01). Conclusion:The expression of DJ-1 encoded by Park7 gene is down-regulated after Park7 gene was knocked down, which aggravates the RGC damage and the decrease of retinal electrophysiological response and visual function in ONC injury mice.

Objective T_O analyze the electrophysiological features of shoulder-hand syndrome(SHS)fol- lowing stroke and investigate the relationships between peripheral nerve damage and the factors causing SHS.Meth- ods Fifty-eight stroke patients were divided into an SHS group(39 patients with shoulder-hand syndrome)and a model group(19 patients without shoulder-hand syndrome).Standard sensory and motor nerve conduction studies were performed with 58 of the patients,including sensory nerve conduction velocity(SCV),amplitude of the sensory nerve action potential(SNAP),distal motor latency(DMI)and the amplitude of the compound muscle action poten- tial(CMAP)of the median nerve.A needle electromyogram(EMG)test was performed on the abductor pollicis of the affected side with both groups.Results The needle EMG showed abnormal insertion potential,fibrillation po- tential and positive sharp waves in all 39 cases of the SHS group,which was significantly higher than in the model group.The amplitude of the sensory nerve action potential(7.77?4.34 mV)and the amplitude of the compound muscle action potential(10.13?3.15 mV)were significantly lower than those of the model group.Abnormal ampli- tude was more severe in sensory nerves than in motor nerves.Conclusion Peripheral nerve damage was found in the shoulder-hand syndrome patients,and this damage was mainly the dystrophy of axonal neuropathy.The damage severity was more in sensory nerves than in motor nerves.The study could offer an useful clue of prevention and treat- ment of shoulder-hand syndrome.

Objective To compare the diagnostic ability of triple-phase CT and multiple-phase dynamic MR for patients with suspected hepatocellular carcinoma (HCC). Methods Triple-phase CT and multiple-phase dynamic MR scan were performed in 60 patients. Fifty-nine HCC lesions were confirmed in 39 patients. MR was performed with LAVA technique, the images included masks, dual-artery phases, dual-portal phases, dual-venous phases and delayed phase. Three observers separately evaluated the CT and MR imaging, and the results were compared with alternative-free-response ROC(AFROC)curve, the area under ROC (Az) was calculated to compare the diagnostic ability. Results The mean Az value of CT for the diagnosis of HCC was 0.8120±0.0118, of MR was 0.9093±0.0072 (P>0.05). In the group of HCC less than 1 cm in the diameter, the sensitivity of CT and MR was 63.89% and 80.55%(P＝0.013). In the groups HCCs of 1-3 cm and >3 cm, the sensitivity of CT and MR appeared no significant difference (P>0.05). Of all HCCs, the sensitivity of CT was lower than MR (83.62% vs 88.70%), but the difference was not significant (P>0.05). The positive predict value (PPV) of CT was also lower than MR (93.07% vs 96.31%, P>0.05). Conclusion The diagnostic ability of multiple-phase dynamic-enhancement MR scan for HCCs is similar to that of triple-phase enhancement CT. For HCC less than 1 cm in diameter, dynamic-enhancement MR is superior to that of contrast-enhancement CT scan, while for the larger ones, the difference is not significant.

Objective To evaluate the detectability of dual-arterial phase of MRI and single-artery phase of CT scan for hepatocellular carcinoma (HCC). Methods A total of 39 patients with HCC underwent CT and MR scan, and 59 lesions of HCC were confirmed definitely. According to lesion size, the lesions were divided into 3 groups: >3 cm group (n=20), 1-3 cm group (n=27) and <1 cm group (n=12). CT was performed with 25 seconds delaying for artery phase. MR imaging was performed with liver accelerate volume acquisition (LAVA) technique, dual-artery phases included early artery phase of 17 seconds delaying and a mid-artery phase of 24 seconds delaying. The detectability of dual-artery phase of MR was compared with that of single-artery phase of CT. Results In <1 cm group, the sensitivity of CT single-artery phase images and MR dual-artery phase images in detecting HCC lesions was 50.00% (6/12) and 75.00% (9/12), respectively;the later showed a higher sensitivity (P=0.04). In groups of 1-3 cm and ＞3 cm, the sensitivity of the two technique had no statistical difference (66.67% vs 81.48% and 95.00% vs 95.00%). Conclusion For the detection of <1 cm HCC, dual-artery phase MRI has higher detectability than single artery phase enhancement CT.

Objective:To investigate the distribution and evolution of immunocytes in infantile hemangioma(IH).Methods:Fifty-two infantile hemangioma samples were investigate.The distribution of CD3+T cells,CD8+T cells and S-100+dendritic cell(DC) in IH was observed with.Results:CD3+T cell was not found among the earliest IH.In the middle proliferating stage,the number of CD3+T cells increased;But the CD8+T cells were still scare.In the late proliferating stage,there were many CD3+T cells and the number of CD8+T cells also increased.In the early involuting stage,there were still a number of CD3+ and CD8+ T cells around the microvessels.In the middle involuting and involuted stage,only a few of CD3+T cells and CD8+ T cells existed.In the early proliferating stage,there were some DC in IH.During the middle and late proliferating stage,the number of DC increased significantly.Since the early involuting stage,the DCs decreased rapidly and disappeared.Conclusion:The distribution of T cells and its subsets and DC have close relationship with the pathologic evolution of infantile hemangioma.

OBJECTIVE:To observe clinical efficacy of epinephrine combined with vasopressin and naloxone for cardiopulmonary resuscitation(CPR)and to investigate its mechanism. METHODS:64 patients with sudden cardiac and respiratory arrest were randomly divided into control group(epinephrine group),treatment group Ⅰ(epinephrine+vasopressin group)and treatment group Ⅱ(vasopressin+epinephrine+naloxone group). Spontaneous circulation,breathing recovery time,restoration of spontaneous circulation and respiration rate,24 h survival rate and discharge survival rate were observed and compared among different groups. RESULTS:As compared with control group,spontaneous circulation,breathing recovery time 24 h survival rate and discharge survival rate in treatment group Ⅰ and Ⅱwere increased significantly(P

Objective To evaluate the effect of calcipotriol on the proliferation of and cytokine secretion by melanocytes and perilesional CD8+ cytotoxic T lymphocytes (CTLs) from patients with vitiligo.Methods Melanocytes isolated from abdominal skin and CD8+ CTLs from perilesional skin of patients with vitiligo were subjected to successive culture in vitro.After several passages,the melanocytes and CD8+ CTLs were cultured alone or in combination with or without the presence of various concentrations of calcipotriol for 24 to 48 hours.MTS (3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfopheny)-2H-tetrazolium,inner salt) method was used to evaluate the proliferative activity of cells,enzyme-linked immunosorbent assay to determine the levels of interleukin (IL)-6,tumor necrosis factor (TNF)-α and interferon (IFN)-γ in the culture supematant of cells,flow cytometry to detect cell apoptosis.Some co-cultured melanocytes and CTLs were treated with calcipotriol of 10-8 mol/L and anti-IL-6 antibody of various concentrations (0,1,2,2.5,5,10 mg/L) for two days followed by enumeration of cells.The concentrations of 108 and 10-9 mol/L (calcipotriol) were chosen for relevant tests.Results There was a marked apoptosis in MCs after coculture with CD8+ CTLs.The 24-hour treatment with calcipotriol of 104 and 10-9 mol/L had no obvious effect on the proliferation of melanocytes cultured alone (both P ＞ 0.05),but accelerated the proliferation of melanocytes cocultured with CTLs (both P ＜0.05) as well as that of CD8+ CTLs cultured alone or in combination with melanocytes (all P ＜0.05).A statistical decrease was observed in IL-6,TNF-α and IFN-γlevels in the supernatant of cocultured melanocytes and CTLs compared with those in the supernatant of melanocytes and CTLs cultured alone,and calcipotriol of 10-9 mol/L intensified the decrease in supernatant IL-6 level (t =2.89,P ＜0.05),but no statistical changes were noted for the level of TNF-α or IFN-γin the supernatant of the coculture system after treatment with calcipotriol of 104 or 104 mol/L compared with that before treatment (both P ＞ 0.05).In the coculture system pretreated with calcipotriol of 10-8 mol/L,the number of CD8+ CTLs significantly decreased (t =3.15,P ＜0.05),whereas that of melanocytes significantly increased (t =3.53,P ＜0.05) after the treatment with anti-IL-6 antibody of 5 mg/L.Conclusions Perilesional CD8+ CTLs have a specific cytotoxic effect on melanocytes,and calcipotriol may inhibit the cytotoxic effect of CD8+ CTLs by suppressing the secretion of IL-6,which may partly explain the therapeutic mechanism of calcipotriol for vitiligo.

Objective To analyze the therapeutic effect of noninvasive mechanical ventilation in chronic obstructive pulmonary disease (COPD) patients with respiratory failure.Methods Sixty patients with COPD respiratory failure were randomly divided into two groups.30 cases in the conventional treatment group used conventional comprehensive therapy.30 cases in the nonfinvasive mechanical ventilation group were given noninvasive mechanical ventilation based on conventional treatment.The total effective rate,time to correct the abnormal breathing,hospitalization time were compared between the two groups.Before and after treatment,the arterial blood gas analysis indicators and heart rate,respiratory rate,probability,mortality for ventilator ventilation were compared in the two groups.Results The total effective rate of the noninvasive mechanical ventilation group was 96.67％,which was higher than 73.33％ of the conventional treatment group(x2 =6.405,P ＜ 0.05).The time to correct the abnormal breathing,hospitalization time of noninvasive mechanical ventilation group were (5.51 ± 1.41) d,(9.51 ± 2.13) d,respectively,which were shorter than (9.39 ± 2.56) d,(12.99 ± 3.57) d of the conventional treatment group (t =8.223,9.633,all P ＜ 0.05).Before treatment,the arterial blood gas analysis parameters and heart rate had no statistically significant differences between the two groups (all P ＞ 0.05).After treatment,the frequency of PaCO2,PaO2,heart rate and respiratory rate in the conventional treatment group were (60.45 ± 3.94)mmHg,(60.24 ± 4.12)mmHg,(92.58 ± 0.61)times/min,(22.45 ± 3.14)times/min,respectively,which in the noninvasive mechanical ventilation group were (52.24 ± 1.23) mmHg,(76.24 ± 5.26) mmHg,(83.92 ± 0.62) times/min,(17.26 ± 2.23) times/min,respectively,the differences between the two groups were statistically significant(t =5.133,3.734,5.166,6.360,all P ＜ 0.05).The invasive rate of invasive ventilator and mortality of noninvasive mechanical ventilation group were 3.33％ and 0.00％,respectively,which were lower than 20.00％,13.33％ of the conventional treatment group (x2 =7.214,6.247,all P ＜ 0.05).Conclusion Noninvasive mechanical ventilation is effective in treatment of patients with COPD respiratory failure,which can effectively improve the indicators of arterial blood gas and heart rate and respiratory rate,improve the prognosis of patients,improve the ventilation probability of invasive ventilator.

OBJECTIVETo investigate the ideal methods for correction of lower eyelid retraction following lower eyelid blepharoplasty.

METHODSTranscanthal canthopexy was used in 5 patients (8 eyes) with mild lower eyelid retraction. Transcanthal canthopexy combined with Hamra's lower blepharoplasty was used in 15 patients (27 eyes) with severe lower lid retraction.

RESULTS14 patients (25 eyes) were followed up for 6-12 months. Of them, 13 patients achieved satisfactory results; one patient had undercorrection of retraction.

CONCLUSIONTranscanthal canthopexy is a simple and effective method for correction of mild lower eyelid retraction following lower eyelid blepharoplasty. Transcanthal canthopexy combining Hamra's lower blepharoplasty may be an ideal choice for correction of severe lower eyelid retraction.

Adult ; Blepharoplasty ; adverse effects ; Eyelid Diseases ; etiology ; surgery ; Eyelids ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Patient Satisfaction ; Surgery, Plastic ; methods ; Treatment Outcome