Objective To investigate the classification of cerebral arteriovenous malformation (AVM) associated with hemodynamics correlative aneurysms and its efficiency treated by endovascular treatment.Methods The clinical data of 17 patients of AVM associated with hemodynamics correlative aneurysms undergoing endovascular treatment were analyzed retrospectively.Results Eleven cases of aneurysms with great divergence between the aneurysm and arteriovenous malformation were embolized,6 cases of aneurysms without a great divergence between the aneurysm and arteriovenous malformation,1 case of aneurysm was treated with stent,other 5 cases of aneurysms were not treated.Eleven cases of arteriovenous malformations were embolized completely,4 cases were embolized 71％-90％ and 2 cases were embolized 50％-70％.Six cases with residual were given radiotherapy.Follow-up 3 months to 3 years,there were no cases of cerebral hemorrhage or death.Unhandled 5 cases of aneurysm and 1 case of stent implantation with the follow-up by using digital subtraction angiography,laneurysm with a stent was closed.Three aneurysms were disappeared and 2 aneurysms were reduced significantly among the 5 cases of aneurysms without treatment.One case of aneurysm occlusion in patients with stent implantation.Conclusions Classification based on a great divergence artery or not between the aneurysm and arteriovenous malformation is more instructive for clinical treatmen of cerebral arteriovenous malformation associated with hemodynamics correlative aneurysm.If it has not a great divergence artery between aneurysm and arteriovenous malformation,arteriovenous malformation after a thorough treatment,aneurysms need not be treated.The endovascular treatment for cerebral arteriovenous malformation associated with hemodynamics correlative aneurysms has a good efficiency and can be treated as a priority.

BACKGROUND:Some scholars have prepared zein/chitosan composite membrane based on blending methods, and preliminary evaluation ofitsphysical and chemical properties showsthat chitosan partly improvesthe mechanical properties and hydrophilic properties of zein. Therefore, zein/chitosan composite membrane presumably has good cytocompati bility, which is beneficial to osteogenic differentiation of bone marrow mesenchymal stem cels.
OBJECTIVE:To explore the effect of zein/chitosan composite membrane on the differentiation of bone marrow mesenchymal stem cels into osteoblasts and its feasibility asabone tissue-engineered material.
METHODS:With 60% acetic acid as solvent, zein/chitosan composite membrane was prepared by blending and casting method. The structure and physicochemical properties of the composite membrane were investigated by Fourier transform infrared spectroscopy, tensile testing, water absorption testing and scanning electron microscopy. And the cytocompatibility of the membrane was evaluated byin vitrocel cufture. Besides,bone marrow mesenchymal stem celsfrom Sprague-Dawley ratwere isolatedvia adherence screening method, andthe effects of thecompositemembrane on theosteogenic differentiation ofthese celswere observedby scanning electron microscopy, fluorescent labeling and alkaline phosphatase assay.
RESULTS AND CONCLUSION:The tensile strength, water absorption and hydrophilicity of the films were improved with the chitosan increased; chitosan could promote cel proliferation indicating the good cytocompatibility of the composite films. Moreover, osteogenic induction occurredin bone marrow mesenchymal stem cels cultured on the compositem embrane, and with an increase of chitosan, the induction was promoted. In conclusion, zein/chitosan composite membrane can be applied widely in the field of bone tissue engineering.

Objective To observe the effect of JLP deficiency on the progression of renal interstitial fibrosis in mice model of unilateral ureteral obstruction (UUO),and to investigate the role and underlying mechanism of JLP in the development of renal fibrosis in obstructive nephropathy.Methods jlp Wild type (jlp+/+) and jlp deficient (jlp-/-) mice were divided into four groups:jlp+/+-and jlp-/--sham-operated groups(jlp-/--sham group and jlp+/+-sham group),jlp+/+-and jlp-/--unilateral ureteral obstruction (UUO)-operated groups (jlp/--UUO group and jlp+/+-UUO group).Mice were sacrificed at 7 days and 14 days after the operation respectively to evaluate the fibrosis by Masson staining.The expression of JLP in jlp +/+ renal tissue was assayed by immunohistochemistry staining,immunofluorescence and Western blotting.Immunohistochemical staining was used to detect the expression of α-smooth muscle actin (α-SMA),collagen Ⅰ (COL-Ⅰ),collagen Ⅲ (COL-Ⅲ) and transforming growth factor-β1 (TGF-β1) in sham and UUO groups.Besides,the α-SMA,COL-Ⅰ,COL-Ⅲ,TGF-β1,p-Smad2 and p-Smad3 protein levels were also analyzed by Western blotting in four groups.Results The expression of JLP was mainly demonstrated in the renal tubules of mice.A large amount of collagen deposition was observed in the renal interstitial area in jlp-/--UUO group compared to jlp+/+-UUO group.Similarly,the expression of α-SMA,COL-Ⅰ,COL-Ⅲ and TGF-β1 was significantly increased in the kidney cortices in jlp-/--UUO-operated groups.Meanwhile,Western blotting showed that the expression of α-SMA,COL-Ⅰ,COL-Ⅲ,and TGF-β1 protein was obviously higher in jlp-/--UUO group.Moreover,the expression of p-Smad2 and p-Smad3 protein was markedly higher in jlp-/--UUO group.Conclusion Scaffolding protein JLP is critical in preventing renal fibrosis through the inhibition of TGF-β1 expression and myo-fibroblast production.

Objective:To evaluate the safety and effectiveness of one-stage intravascular interventional treatment for intracranial multiple aneurysms.Methods:From January 1, 2010 to January 1, 2018, the data of patients with multiple intracranial aneurysm undergoing one-stage endovascular embolization in the Department of Nerurosurgery, Puning People's Hospital, Guangdong Province were analyzed retrospectively. The clinical and angiographic findings at discharge and follow-up were evaluated.Results:A total of 16 patients with multiple intracranial aneurysms received one-stage endovascular treatment were enrolled. Among them, 10 were females and 6 were males; their age was 49.5±17.2 years; 5 patients were subarachnoid hemorrhage caused by rupture of intracranial aneurysms, three of them were classified as grade Ⅰ and two were classified as grade Ⅱ by the World Federation of Neurosurgical Societies (WFNS). There are a total of 35 aneurysms, 13 patients had 2 intracranial aneurysms, and 3 had 3 intracranial aneurysms. There were 3 posterior circulation aneurysms and 32 anterior circulation aneurysms; the mean diameter of the aneurysms was 6.9±3.3 mm. Fifteen aneurysms were only treated with coil embolization, and 20 aneurysms were treated with stent-assisted coil embolization. No treatment-related complications occurred. Thirteen patients were followed up for a total of 17.7±6.4 months (range, 6-28 months). The modified Rankin Scale score of 12 patients was 0 and 1 was 6 (died of rebleeding). The imaging follow-up data of 23 aneurysms in 10 patients were obtained. They were followed up for 10.2±3.3 months (range, 6-15 months), 20 aneurysms did not recur and 3 (3/23, 13.0%) recurred.Conclusions:One-stage endovascular embolization is a safe and effective treatment for multiple intracranial aneurysms, and its long-term outcome should be further evaluated.