Objective To discuss the operative methods,clinical effect and safety of endovascular stenting in treatment of upra-arch extra intracranial artery stenosis.Methods Symptomatic carotid artery stenosis ＞ 50％,or no symptomatic stenosis ＞ 75％ with upra-arch extra intracranial artery stenosis patients were treated by endovascular stenting,of all patients,85 cases with carotid artery stenosis,37 cases with vertebral artery stenosis,6 cases with subclavian artery stenosis.Results One hundred and twenty-eight patients were treated with 130 vessel,used 131 stents,59 patients used vascular protection,the achievement rate of stent implantation was 100.00％.The degree of stenosis were significantly improved,the degree of stenosis from (87.65 ± 8.70)％ to (14.28 ± 4.87)％.Twenty-six patients appeared transient decline in blood pressure and heart rate,31 patients appeared persistent hypotension and decrease in heart rate.One patient (no using of vascular protection) appeared obhteration in ipsilateral middle cerebral artery,the artery was recanalization after thrombolysis treatment.The rest of 127 patients did not appear intraoperative vascular embolization complications.Eighteen patients appeared perioperative perfusion in transition,1 case happened cerebral hemorrhage (＜ 10 ml).Postoperative symptoms were improved significantly.Followed up for 6-36 months,84 patients had not restenosis in stent,1 patient had symptomless restenosis (＜ 50％).In 37 patients with vertebral artery stenosis,3 patients again appeared ischemia symptoms in postoperative 1 year,digital subtraction angiography (DSA) showed restenosis in stent,the patient was again given endovascular stenting,the symptoms disappeared.Conclusion As long as the correct choice of indications and perioperative treatment properly,the endovascular stenting in treatment of upra-arch extra intracranial artery stenosis has good clinical effect and high security.

[Objective]To study the stability function of Luschka Joint(LJ) of lower cervical spine.[Method]C_(3、4) and C_(5、6) as a funtional spinal unit(FSU) were taken from 16 fresh adult cadavers and randomly divided into experimental group,its LJ was cut out and in control group,LJ was maintained.The FSU of C_(3、4) and C_(5、6)was loaded and tested on the AG-10 AT automatic electronic versatile machine in normal,flexion ≤10? and extension ≤7.5? positions.Data of sigattal horizontal displacement(SHD),rotational angulation(RA) and coronary laterral displacement(CLD) were collected,counted and 3-dimesionally analyzed by computer.[Result]The SHD,RA and CLD of FSU experimental group were significantly different with that of control group(P

Objective To investigate the disease menu of acupuncture and moxibustion therapy grade classification considerations of herpes zoster, and to provide a routine analysis flowsheet to other diseases’ classification. Methods Being subject to the control group for classification and based on the five point classification of evidence-based medicine for evaluation, the internalized documents were evaluated according to the sequence from high level to low. If the conclusion supported by the higher level documents, other lower level documents’ results were given up. Results Acupuncture is effective and safe to herpes zoster, comparing with the international accepted curative drugs such as aciclovir tablet and so on, it is much more effective to relieve pain and make it quickly absorbed and cured. Conclusions Herpes Zostor drugs is the first grade disease menu of acupuncture and moxibustion therapy.

Clinical ophthalmic surgery is a special branch of general surgery,the microsurgery of ophthalmology has properties of high-precision,high-risk and longer learning curve.The ophthalmology department of Tongji University Hospital has explored a set of step-by-step and efficacious postgraduate student education method,including theoretical basis,in vitro stimulation and in vivo practice.The intervention of quality control and incentive mechanism were also included.

Objective:To investigate the correlation between CHA 2DS 2-VASC score and the recurrence risk of paroxysmal atrial fibrillation after radiofrequency ablation. Methods:It was a retrospective cohort study. A total of 150 patients who underwent radiofrequency ablation for paroxysmal atrial fibrillation in Xingtai People′s Hospital from January 2017 to January 2021 were consecutively included in the study. According to the preoperative CHA 2DS 2-VASC score, patients were divided into high score group (≥3 points, n=90) and low score group (<3 points, n=60). Baseline clinical data was collected. All patients underwent circumferential pulmonary vein isolation, and those with atrial flutter before ablation also underwent tricuspid isthmus isolation. Holter and electrocardiogram examinations were performed at 3, 6 months and 1 year after ablation to evaluate whether there was recurrence of atrial fibrillation. Univariate and multivariate Cox regression was used to analyze the risk factors for recurrence of atrial fibrillation after radiofrequency ablation. Results:Among 150 patients 90 were males and 60 were females with a mean age of (64.0±3.6) years. There were no significant differences in age, sex, and proportion of hypertension, diabetes, chronic heart failure and stroke or transient ischemic attack (TIA), medication of antiarrhythmic and anticoagulant drugs between the two groups (all P>0.05). The longest duration of atrial fibrillation in the high score group was significantly longer than that in the low score group (26.0±6.1) hours vs. (10.0±2.1) hours, P<0.05). There were no patients with cardiac tamponade, atrial esophageal fistula and severe vascular puncture complications in the two groups. During the follow-up period, the recurrence rate in the high score group was significantly higher than that in the low score group (16.7% (15/90) vs. 8.3% (5/60), P<0.05). Multivariate Cox regression analysis showed that CHA 2DS 2-VASC score≥3 was an independent risk factor for atrial fibrillation recurrence in patients with paroxysmal atrial fibrillation after radiofrequency ablation ( HR=3.84, 95% CI: 1.87-7.89, P=0.02). Conclusion:CHA 2DS 2-VASC score≥3 is an independent risk factor for atrial fibrillation recurrence in patients with paroxysmal atrial fibrillation after radiofrequency ablation.

Objective To investigate the influence of necroptosis pathways in microglia activation and inflammatory factor levels in cerebral ischemia/reperfusion (I/R) injury in rats and their significances.Methods A modified suture method was used to establish the models of middle cerebral artery I/R in rats.(1) SD rats according to the random number table were divided into cerebral I/R 6 h group,cerebral I/R 12 h group,cerebral I/R 24 h group,and cerebral I/R 72 h group (n=6);the expression of ionized calcium binding adaptor molecule-1 (iba-1) was detected by immunohistochemical staining,and time points enjoyed obvious iba-1 expression were selected according to the experimental results.(2) SD rats were randomly divided into sham operation group,cerebral I/R group,80 nmol necrostatin-1 (Nec-1) intervention group and 160 nmol Nec-1 intervention group (n=6),and the Nec-1 intervention was given 2 h after ischemia;Longa method was used to evaluate the neurological function scores and TTC method was used to detect the infarct volume;and the appropriate dosages of Nec-1 were selected according to these results.(3) SD rats were randomly divided into sham operation group,cerebral I/R group,solvent group and Nec-1 intervention group (n=6),and Nec-1 or DMSO intervention was given 2 h after ischemia.HE staining was used to observe the survival and proliferation ofmicroglias around the infarction tissues;immunohistochemical staining was used to detect the iba-1 expression surrounding the infarction tissues;immunohistochemistry and Western blotting were employed to observe the cytokine tumor necrosis factor (TNF)-α and interleukin (IL)-1β and glia-derived neurotrophic factor (GDNF) expressions.Results (1) The iba-1 expression at cerebral I/R 24 h group was significantly increased as compared with that in other groups (P＜0.05).(2) As compared with those in the cerebral I/R group,the neurological function scores and infarct volume were significantly decreased in the 80 nmol Nec-1 intervention group and 160 nmol Nec-1 intervention group (P＜0.05);more obvious changes were noted in the 160 nmol Nec-1 intervention group as compared with those in the 80 nmol Nec-1 intervention group,with significant difference (P＜0.05).(3) HE staining showed peri-infarct tissue inflammatory cell infiltration,reduced neuron number,cell body shrinkage and nuclear pyknosis in the cerebral I/R group,while these changes were less obvious in the Nec-1 intervention group;as compared with cerebral I/R group,the Nec-1 intervention group had significantly decreased expressions of iba-1,TNF-α,IL-1 β and GDNF (P＜0.05).Conclusion Necroptosis pathway involves in the activation ofmicroglias after I/R injury in rat brains;Nec-1 inhibits the activation of microglia,and reduces the neuronal damage by regulating inflammatory cytokines.

Objective To provide new ideas for promoting wound healing by digging and sorting out the medication rules in ancient classics and modern literatures. Methods The prescriptions for promoting wound healing recorded in literatures were collected to establish the database. The data mining technology was used for the analysis. Results 75 prescriptions and 203 traditional Chinese medicines were recorded in the ancient TCM literatures for promoting wound healing. The core medicines included frankincense, liquorice, angelica sinensis, angelica dahuricae, cortex phellodendri, myrrh, etc. They mainly belong to the class of clearing-heat drugs, promoting-circulation drugs, reinforcing drugs, relieving drugs, detoxification and tissue granulation drugs. Cluster analysis and association rule analysis were conducted for 16 core drugs. 4 cluster combinations ,15 groups of drug pairs and drug group association rules were obtained. Conclusion The prescription rules for wound healing mainly included clearing heat, promoting circulation, reinforcing, relieving, detoxification, and promoting tissue granulation. TCM wound treatment should be based on syndrome differentiation for fever, blood stasis, deficiency, anabrosis, exterior syndrome and poisoning.

The aim of this study was to construct a recombinant adenovirus expressing extracellular domain gene of human epidermal growth factor receptor variant Ⅲ (EGFRvIII ECD), and to prepare single domain antibody targeting EGFRvIII ECD by immunizing camels and constructing phage display antibody library. Total RNA was extracted from human prostate cancer cell line PC-3 cells and reversely transcribed into cDNA. EGFRvIII ECD gene was amplified using cDNA as template, and ligated into pAdTrack-CMV plasmid vector and transformed into E. coli BJ5183 competent cells containing pAdEasy-1 plasmid for homologous recombination. The recombinant adenovirus expressing EGFRvIII ECD was obtained through transfecting the plasmid into HEK293A cells. The recombinant adenovirus was used to immunize Bactrian camel to construct EGFRvIII ECD specific single domain antibody library. The single domain antibody was obtained by screening the library with EGFRvIII protein and the antibody was expressed, purified and identified. The results showed that recombinant adenovirus expressing EGFRvIII ECD was obtained. The capacity of EGFRvIII specific phage single domain antibody library was 1.4×10⁹. After three rounds of enrichment and screening, thirty-one positive clones binding to EGFRvIII ECD were obtained by phage-ELISA, and the recombinant single domain antibody E14 with highest OD₄₅₀ value was expressed and purified. The recombinant E14 antibody can react with EGFRvIII ECD with high affinity in ELISA assessment. The results indicated that the EGFRvIII specific single domain antibody library with high capacity and diversity was constructed and the single domain antibody with binding activity to EGFRvIII was obtained by screening the library. This study may facilitate the diagnosis and treatment of EGFRvIII targeted malignant tumors in the future.
Adenoviridae/genetics* ; DNA, Complementary ; ErbB Receptors ; Escherichia coli/genetics* ; Genetic Vectors/genetics* ; Humans ; RNA ; Recombinant Proteins/metabolism* ; Single-Domain Antibodies