1.Carotid angioplasty and stenting for carotid stenosis in high-risk symptomatic NASCET-ineligible patients
Qiang HAO ; Shenmao LI ; Liqan JIAO ; Zhongrong MIAO ; Fengshui ZHU ; Feng LING
International Journal of Cerebrovascular Diseases 2010;18(5):331-337
Objective To investigate the efficacy and safety of carotid angioplasty and stenting for carotid stenosis in high-risk symptomatic NASCET-ineligible patients. Methods Twenty patients with symptomatic carotid stenosis at high risk ineligible for NASCET were treated with carotid angioplasty and stenting,12 of them were men,and 8 wre women,the patients ranged in age from 62 to76 years (mean age,69 years). Eleven patients had transient ischemic attack and 9 had cerebral infarction. Digital subtraction angiography showed that the degree of carotid stenosis in all patients was > 70% (NASCET criteria). Among them,9 patients had unilateral carotid artery severe stenosis (2 had restenosis after endarterectomy),6 had bilateral carotid artery severe stenosis,5 had unilateral carotid artery occlusion with contralateral severe sentoses (1 had undergone cervical radiotherapy for nasopharyngeal carcinoma). The embolic protection devices,predilation,and self-expandable stents were used in all patients. Results The success rate of the procedure was 100%. The residual stenosis rate was < 30%. The different levels of a transient decline in heart rates and blood pressure occurred in all the patients during the procedure. One patient was complicated with microembolic embolism. No ischemic stroke occurred in the remaining patients in the periprocedure. The postoperative examination with carotid ultrasound showed that the stenoses were improved significantly. No ipsilateral ischemic stroke and coronary ischemic events were observed at 1 and 3 months follow-up after the procedures. Conclusions Carotid artery stenting is less invasive,and the perioperative complications are fewer,The treatment of symptomatic carotid stenosis with high surgical risks is safe and effective.
2.The application value of the modified hypotonic method of intestinal system contrast ultrasonography in elder patients with small intestinal diseases
Nanping ZENG ; Ling ZENG ; Helin ZHANG ; Fei YI ; Limin XIAO ; Zhongrong ZHU ; Yanhong WU
Chongqing Medicine 2013;(32):3878-3880
Objective To explore the application value of the modified hypotonic method of intestinal system contrast ultra-sonography in elder patients with small intestinal diseases .Methods Group A were 28 patients with small intestine disease and 8 patients who was found abdominal mass suspected source of intestinal tumors by routine abdominal ultrasound inspection .We con-trast the mannitol intestinal system contrast ultrasound with modified hypotonic method of intestinal system ultrasound contrast , and compare with gastrointestinal ,gastrointestinal barium meal contrast ,then contrast the results of pathology .Group B were 37 patients ,with definite diagnosis with duodenal ulcers ,polyps ,the descending part of the diverticulum ,who respectively treated with drinking water method and modified hypotonic method of intestinal system ultrasound contrast ,then carry the two methods into comparison .Results The nidus detection increase from 9 to 12 in group A ;the nidus detection increase from 13 to 33 in group B . The modified hypotonic method of intestinal system contrast ultrasonography ,which eliminate intestinal gas more obvious and relax the intestinal lumen more sufficient than conventional contrast ,can improve the nidus detection rate .Conclusion The modified hy-potonic method of intestinal system contrast ultrasonography could be as a routine inspection method for elder small intestinal dis-ease paitents .
3.Inhibitory effect of tetramethylpyrazine on ultraviolet A-induced senescence and matrix metalloproteinase-1 and-3 mRNA expressions in human dermal fibroblasts
Minling ZHAO ; Zhongrong LIU ; Hulin CHEN ; Yingjie ZHU ; Miaomiao YAN ; Xiuzhen FAN
Chinese Journal of Dermatology 2015;48(10):700-704
Objective To explore the inhibitory effect of tetramethylpyrazine (TMP) on ultraviolet A-induced senescence as well as matrix metalloproteinase-1 (MMP-1) and-3 (MMP-3) mRNA expressions in human dermal fibroblasts (HDFs).Methods HDFs were isolated from the prepuce by enzymatic digestion, and subjected to primary culture.Cultured HDFs were randomly divided into several groups: control group cultured in high-glucose DMEM medium and receiving no treatment, three TMP groups treated with 20, 50 and 100 mg/L TMP respectively, UVA group receiving UVA radiation alone, UVA + TMP groups pretreated with 20, 50 and 100 mg/L TMP respectively for different durations followed by UVA radiation.UVA radiation was given once daily for 5 consecutive days.The 55th passage HDFs served as the P55 group (senescence control group).Subsequently, CCK-8 assay was performed to evaluate the proliferative activity of HDFs in vitro, optical microscopy to observe the morphologic changes of HDFs after UVA radiation, β-galactosidase staining to estimate the senescence in HDFs, and real-time fluorescence-based quantitative PCR to quantify the mRNA expressions of MMP-1 and MMP-3 in HDFs.Statistical analysis was carried out by one-way analysis of variance (ANOVA) followed by least significant difference (LSD)-t test or Dunnett's T3 test.Results Compared with the control group, the proliferation of HDFs was significantly but transiently inhibited in vitro after the treatment with 100 mg/L TMP for 48 hours (P < 0.05), but showed no significant changes after the treatment with 20 or 50 mg/L TMP for 24, 48 or 72 hours or after the treatment with 100 mg/L TMP for 24 or 72 hours (all P < 0.05).The pretreatments with TMP of 20, 50 and 100 mg/L for 24, 48 and 72 hours all promoted the proliferation of HDFs to a certain degree in the UVA + TMP groups compared with the UVA group, with significant differences in cellular proliferative activity among the UVA group, UVA + TMP groups and control group at 24, 48 and 72 hours (F =17.451,15.231, 23.535, all P < 0.01).Compared with the UVA group, the proliferative activity of HDFs was significantly increased in UVA + 100-mg/L TMP group at 24, 48, 72 hours, UVA + 50-mg/L TMP group at 24 and 72 hours and UVA + 20-mg/L TMP group at 72 hours.After repetitive UVA radiation, HDFs in the UVA group experienced an increase in cell volume, granule acount, and β-galactosidase expression, which was similar to the changes in the P55 group, while the pretreatments with 20, 50 and 100 mg/L TMP for 24 hours suppressed these UVA-induced changes in HDFs.The percentage of β-galactosidase-positive HDFs was 68.417% ± 1.181% in the UVA group, 58.167% ± 5.620% in the UVA + 20-mg/L TMP group, 45.167% ± 5.502% in the UVA + 50-mg/L TMP group, 43.000% ± 2.000% in the UVA + 100-mg/L TMP group, 33.667% ± 5.865% in the control group, and 76.000% ± 6.557% in the P55 group, with significant differences among these groups (F =45.918, P < 0.01).Furthermore, the UVA group significantly differed from the UVA + TMP groups and control group in the percentage of β-galactosidase-positive HDFs and mRNA expressions of MMP-1 and MMP-3 (all P < 0.05).Conclusion TMP can protect HDFs against senescence induced by repetitive UVA radiation, and down-regulate the mRNA expressions of MMP-1 and MMP-3 during senescence.
4.Endovascular mechanical recanalization of subclavian artery total occlusion
Li QI ; Liqun JIAO ; Shenmao LI ; Zhongrong MIAO ; Fengshui ZHU ; Feng LING
Journal of Interventional Radiology 2010;19(2):138-141
Objective To discuss the skills and effects of several endovascular mechanical techniques for the recanalization of subclavian artery total occlusion. Methods Endovascular mechanical recanalization of subclavian artery total occlusion was performed in 32 patients with symptomatic subclavian artery total occlusion. The re-open rate and the therapeutic results were observed and analyzed. Results Several endovascular mechanical techniques, including percutaneous transluminal angioplasty, were employed in treating 32 patients with subclavian artery total occlusion. After the procedure, the ischemic 8ymptoms of posterior circulation and/or upper extremity were markedly relieved. Conclusion It is safe and feasible using appropriate endovascular mechanical technique for re-canalizing the occluded subclavian artery.
5.Complications of stent-assisted angioplasty of carotid artery stenosis:an analysis of 23 cases
Huaiqian QU ; Zhongrong MIAO ; Shenmao LI ; Fengshui ZHU ; Yanni LEI ; Feng LING
Chinese Journal of General Surgery 2001;0(08):-
Objective To evaluate the mechanism,prevention and prognosis of complications after stent angioplasty in the treatment of carotic artery stenosis. Methods[WT5”BZ] From 1997 to 2003,312 cases of carotid artery stenosis were treated by transluminal stent-assistant angioplasty. Results Procedure-related complication developed in 23 cases including 19 cases of transient mild complications such as transient arrhythmia and hypotension in 10 cases (3.2%) during deploying stent or balloon dilation,transient cerebral ischemia symptoms in 6 cases after balloon dilation,hypotension in 3 cases after the procedure. Severe complications occurred in 4 cases after the procedure,including embolus detachment,stent migration,carotic artery occlusion and fatal cerebral hemorrhage. Conclusion Although stent-assistant angioplasty are effective for treatment of carotid artery stenosis,severe complications could develop.
6.Effect of erosion on strength of dental infiltrated Al2O3 ceramics.
Fang XIONG ; Haiyang A YU ; Yunmao LIAO ; Zhimin ZHU ; Zhongrong ZHOU ; Minhao ZHU
Journal of Biomedical Engineering 2005;22(6):1189-1199
The objective of the research is to investigate the elements of routine sandblast technique on the evolution of bending strength of dental infiltrated Al2O3 ceramics and the underlying erosion mechanism. The plane specimens of an infiltrated ceramic were manufactured, polished and then tested under the modified pen-like sandblasting apparatus (90 degrees erosive angle and 10 mm sandblasting distance), with different grit sizes, working pressure and disposing time. Half of samples were selected randomly and sintered subsequently with Vitadur alpha veneering porcelain. Before and after sintering, the three-point-bending strengths was measured, and the surfaces of dental porcelain were observed with SEM and LCSM. The bending strength of ceramics decreased significantly after sandblast as compared with that of empty control group. After the procedure of sintering the veneering porcelain, the descending evolution of bending strength slowed down. Under the present manufacturing conditions, grit size effect is prominent among those correlative elements of sand grit size, working pressure and disposing time. And fatigue cracking characterizes the mechanism of erosion of dental infiltrated Al2O3 ceramics.
Aluminum Oxide
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chemistry
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Dental Materials
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chemistry
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Dental Stress Analysis
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Humans
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Materials Testing
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Metal Ceramic Alloys
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chemistry
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Shear Strength
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Stress, Mechanical
7.Experience with transluminal stent-assisted angioplasty for intracranial vascular diseases.
Zhongrong MIU ; Feng LING ; Shenmao LI ; Fengshui ZHU ; Moli WANG ; Hongqi ZHANG ; Yang HUA ; Qingbin SONG
Chinese Journal of Surgery 2002;40(12):886-889
OBJECTIVETo assess the value of stent-assistant angioplasty for intracranial vascular diseases.
METHODSThirteen patients with intracranial vascular diseases were treated consecutively by stent-assistant angioplasty for different purposes. Of these patients 7 had symptomatic intracranial artery stenosis, 3 intracranial wide-neck aneurysms, 2 intracranial pseudoaneurysms, and 1 bilateral transverse sinus stenosis. Clinical procedures and technical data of the patients were retrospectively analyzed.
RESULTSIn the 7 patients, the degree of intracranial artery stenosis reduced from 83% to 5%. Three months after the operation they exhibited good patency of stented lesions. Intracranial wide neck aneurysms (with 2 pseudoaneurysms) were successfully embolized with GDC in 5 patients. The patients with bilateral transverse sinus stenosis were implanted a self-expanded stent in the right transverse sinus. One patient failed because of the tortuous configuration of the left jugular bulb, but the patient's symptoms were improved quickly after the procedure.
CONCLUSIONStent-assistant angioplasty is a useful technique for selected intracranial vascular diseases, and it needs further investigation.
Adult ; Angioplasty, Balloon ; methods ; Cerebrovascular Disorders ; therapy ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Stents ; Treatment Outcome
8.Multiple modality endovascular treatment for intracranial venous thrombosis
Xunming JI ; Feng LING ; Jianping JIA ; Shenmao LI ; Zhongrong MIAO ; Fengshui ZHU ; Yingying SU ; Baoquan MIN ; Xiangbo WANG ; Hongqi ZHANG ; Peng ZHANG ; Xinglong ZHI ; Qingbin SONG ; Xiaohong QIN ; Xiangmei LIU ; Hong ZHANG
Chinese Journal of Radiology 2001;0(01):-
Objective To review the experience of multiple modality endovascular treatment for intracranial venous thrombosis, and to evaluate the efficacy and risk of endovascular thrombolysis for intracranial venous thrombosis.Methods From October, 2000 to October, 2001, 12 patients with intracranial venous thrombosis confirmed by CT, MRI, MRV, and/or DSA were treated with multiple modality endovascular thrombolysis including intravenous thrombolysis, mechanical thrombus maceration, intraarterial thrombolysis, and stenting.After thrombolysis, treatment aimed at the primary diseases was continued and warfarin was used for 6 months.The patients were followed-up for 17-29 months, averaged 23 months.Results Of the twelve patients, all underwent transvenous thrombolysis, ten underwent combined transvenous thrombolysis and clot maceration, seven underwent transvenous infusion of urokinase combined with transarterial infusion of urokinase.Two underwent transvenous infusion of urokinase combined with transarterial infusion of urokinase.The thrombolysis duration was from one to three days.The infusion dose of urokinase was 800 000 to 2 900 000 IU, the averaging dosage of urokinase was less than 1 000 000 IU per day.All patients achieved from recanalization of sinuses as confirmed on postprocedural angiography, MRI, and MRV studies prior to hospital discharge.At discharge, all the patients improved neurologically, and GCS improved from averaged 12 of pre-operation to 14 of post-operation.During the averaging 23 months follow-up, no patient recurred. Conclusion Combined multiple modality endovascular treatment is an effective and safe procedure for potentially catastrophic intracranial venous thrombosis.
9.Correlation of memory impairment and cerebral perfusion in patients with vertebral-basilar artery stenosis
Yiming DENG ; Meifang ZHU ; Feng GAO ; Xuan SUN ; Lian LIU ; Shujie ZHOU ; Weibin GU ; Binbin SUI ; Mi SHEN ; Chunxue WANG ; Zhongrong MIAO
Chinese Journal of Behavioral Medicine and Brain Science 2018;27(4):322-326
Objective To evaluate the correlation between cerebral blood flow perfusion and memory impairment in patients with severe stenosis of vertebral basilar artery (VBA).Methods 62 cases of patients with VBA stenosis diagnosed by digital subtraction angiography(DSA) in Beijing Tiantan Hospital from September 2016 to March 2017 were enrolled.Mental State Examination (MMSE),Clinical Memory Scale (CMS) test and CT perfusion(CTP) was performed.All patients were divided into memory normal group(n=24,including 1 excellent case,6 above normal cases,and 14 normal cases) and memory impairment group(n =38,including 18 below normal cases,12 periphery cases,8 impaired cases) according to CMS.The ratios of side-to-side period were compared between bilateral mesial temporal lobe and anterior circulation area.The relative time to peak (rTTP),relative mean transit time(rMTY),relative cerebral blood flow(rCBF) and relative cerebral blood volume (rCBV) were calculate.Results The incidence of CTP decompensation in the medial temporal lobe was higher than that in the patients with memory impairment(P<0.05).The difference of rTTP and rMTT value between the two groups in the bilateral medial temporal lobes was statistically significant (rTFP:(1.131 ±0.037),(1.437±0.139),t=10.520,P< 0.05);rMTT:(1.081 ±0.059),(1.281 ±0.174),t=5.423,P<0.05).Conclusion The patients with VBA severe stenosis are more likely to get memory impairment due to cerebral hypoperfusion.
10.Endovascular versus Medical Management of Acute Basilar Artery Occlusion: A Systematic Review and Meta-Analysis of the Randomized Controlled Trials
Mohamad ABDALKADER ; Stephanos FINITSIS ; Chuanhui LI ; Wei HU ; Xinfeng LIU ; Xunming JI ; Xiaochuan HUO ; Fana ALEMSEGED ; Zhongming QIU ; Daniel STRBIAN ; Volker PUETZ ; James E. SIEGLER ; Shadi YAGHI ; Kaiz ASIF ; Piers KLEIN ; Yuyou ZHU ; Bruce C.V. CAMPBELL ; Hui-Sheng CHEN ; Simon NAGEL ; Georgios TSIVGOULIS ; Zhongrong MIAO ; Raul G. NOGUEIRA ; Tudor G. JOVIN ; Wouter J. SCHONEWILLE ; Thanh N. NGUYEN ;
Journal of Stroke 2023;25(1):81-91
Background:
and Purpose The optimal management of patients with acute basilar artery occlusion (BAO) is uncertain. We aimed to evaluate the safety and efficacy of endovascular thrombectomy (EVT) compared to medical management (MM) for acute BAO through a meta-analysis of randomized controlled trials (RCTs).
Methods:
We performed a systematic review and meta-analysis of RCTs of patients with acute BAO. We analyzed the pooled effect of EVT compared to MM on the primary outcome (modified Rankin Scale [mRS] of 0–3 at 3 months), secondary outcome (mRS 0–2 at 3 months), symptomatic intracranial hemorrhage (sICH), and 3-month mortality rates. For each study, effect sizes were computed as odds ratios (ORs) with random effects and Mantel-Haenszel weighting.
Results:
Four RCTs met inclusion criteria including 988 patients. There were higher odds of mRS of 0-3 at 90 days in the EVT versus MM group (45.1% vs. 29.1%, OR 1.99, 95% confidence interval [CI] 1.04–3.80; P=0.04). Patients receiving EVT had a higher sICH compared to MM (5.4% vs. 0.8%, OR 7.89, 95% CI 4.10–15.19; P<0.01). Mortality was lower in the EVT group (35.5% vs. 45.1%, OR 0.64, 95% CI 0.42–0.99; P=0.05). In an analysis of two trials with BAO patients and National Institutes of Health Stroke Scale (NIHSS) <10, there was no difference in 90-day outcomes between EVT versus MM.
Conclusion
In this systematic review and meta-analysis, EVT was associated with favorable outcome and decreased mortality in patients with BAO up to 24 hours from stroke symptoms compared to MM. The treatment effect in BAO patients with NIHSS <10 was less certain. Further studies are of interest to evaluate the efficacy of EVT in basilar occlusion patients with milder symptoms.