Angioplasty, Balloon, Coronary ; Coronary Artery Disease ; therapy ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; therapy ; Stents ; Vascular Malformations ; therapy

OBJECTIVE: To evaluate the applicative value of multimodal navigation combined with intraoperative magnetic resonance imaging system in the treatment of complex lesions of middle skull base. METHOD: Nineteen consecutive patients undergoing complex lesions resection using multimodal microscopic navigation combined with iMRI were included. Preoperative radiological images were imported into navigation planning system, based on which approach and microsurgical window were designed. Transcranial approach and extracranial approach(include trans-oral-nasal-sphenoidal approach and transsphenoidal approach) were performed in our series. After presumptively total resection were finished, intraoperative magnetic resonance (iMRI)were performed, followed by navigation images updating, and continuing resection if necessary. RESULT: iMRI scan were performed from 1 time to 2 times. In 5 cases with residual seen on iMRI scan, continued resection were carried on in 2 of them. There was no iMRI-associated complications. CONCLUSION Microscopic-based neuronavigation, in combination with intraoperative magnetic resonance, could provide objective basis for resection, and improve the safety level of tumor resection.
Adult ; Aged ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Microsurgery ; methods ; Middle Aged ; Neurosurgical Procedures ; Skull Base ; surgery

Descending nociceptive modulation from the supraspinal structures plays an important role in cancer-induced bone pain (CIBP). Rostral ventromedial medulla (RVM) is a critical component of descending nociceptive facilitation circuitry, but so far the mechanisms are poorly known. In this study, we investigated the role of RVM glial activation in the descending nociceptive facilitation circuitry in a CIBP rat model. CIBP rats showed significant activation of microglia and astrocytes, and also up-regulation of phosphorylated p38 mitogen-activated protein kinase (p38 MAPK) and pro-inflammatory mediators released by glial cells (IL-1β, IL-6, TNF-α and brain-derived neurotrophic factor) in the RVM. Stereotaxic microinjection of the glial inhibitors (minocycline and fluorocitrate) into CIBP rats' RVM could reverse the glial activation and significantly attenuate mechanical allodynia in a time-dependent manner. RVM microinjection of p38 MAPK inhibitor (SB203580) abolished the activation of microglia, reversed the associated up-regulation of pro-inflammatory mediators and significantly attenuated mechanical allodynia. Taken together, these results suggest that RVM glial activation is involved in the pathogenesis of CIBP. RVM microglial p38 MAPK signaling pathway is activated and leads to the release of downstream pro-inflammatory mediators, which contribute to the descending facilitation of CIBP.

Adult ; China ; epidemiology ; GB virus C ; classification ; Hepatitis, Viral, Human ; epidemiology ; virology ; Homosexuality, Male ; Humans ; Male

Objective To understand the capacity of Plasmodium detection and helminth detection and the mastery degree of basic knowledge of parasitic diseases. Methods Three professionals from each city were selected as contestants. The content of the competition contained three parts. The first part included making blood slides and Giemsa staining of Plasmodium,and identifi-cation of species and number with microscopy,the second part included making stool slides with Kato-Katz technique and identifi-cation of common helminth eggs with microscopy,and the third part was basic knowledge of parasitic diseases. Results Totally 51 contestants took part in the competition. The average score of the test of making blood slides was 14.8±3.3,and the passing rate was 82.4%. The average score of the identification of species and number of Plasmodium with microscopy was 19.2 ± 9.3,and the passing rate was 29.4%. The average score of the test of making stool slides was 9.3±0.7,and the passing rate was 100%. The aver-age score of the identification of common helminth eggs with microscopy was 28.0±2.6,and the passing rate was 100%. The aver-age score of basic knowledge of parasitic diseases was 76.3±11.9,and the passing rate was 88.2%. The average score of the test of making blood slides in the female was higher than that in the male(15.7vs.13.5,P<0.05),and the average score of the test of making blood slides in the intermediate title contestants was higher than that in the junior title contestants(16.1vs.14.1,P <0.05). The average score of the basic knowledge of parasitic diseases in the contestants from cities was higher than that in the con-testants from towns(83.2vs.72.6,P<0.05),and the average score of basic knowledge of parasitic diseases in the contestants from high economic level cities was higher than that in the contestants from low economic level cities(82.4vs.71.5,P<0.01). Conclu-sions For professionals in Shandong Province,the capacity of helminth detection was strong and the basic knowledge of parasitic diseases was mastered well,while the capacity of Plasmodium detection was weak.

Objective To understand the infection status of intestinal parasites and related knowledge and behavior factors of the residents in north-west Shandong Province,so as to provide the evidence for taking targeted preventive measures. Meth-ods Eighteen villages were randomly selected as survey spots by the stratified multi-stage sample method. The Kato-Katz tech-nique was used to detect intestinal parasite eggs among the residents and the cellophane tape anus test was used to detect Entero-bius vermicularis eggs among 3-12 years old children. Questionnaires were applied to investigate related knowledge and behavior factors about the intestinal parasite infections in the residents. Results Totally 6 366 residents were detected for intestinal para-sites and the infection rate was 0.28%(18 cases). Totally 895 children were detected for E. vermicularis and the infection rate was 5.70%(51 cases). Totally 2 915 residents were investigated by questionnaires and the awareness rate of knowledge about preventing parasitic diseases was 26.72%. The formation rates of washing hands before meal and after WC,washing fruit and vegetable before eating,never drinking unboiled water were 55.42%,42.87%,43.54%and 83.04%respectively. The aware-ness rate of knowledge about preventing parasitic diseases of 3-12 years old children was 12.24%;and the formation rates of washing hands before meal and after WC were 47.04%and 30.44%respectively. Conclusions The total infection rate of intesti-nal parasites is low but the E. vermicularis infection rate is high among children in north-west Shandong Province. The awareness rate of knowledge about preventing parasitic diseases and the formation rates of healthy behaviors are all low. Therefore ,the tar-geted health education should be taken to increase the awareness rate and guide the residents to develop their healthy behaviors.

Objective To observe the diagnostic value of non-invasive 128-slice computed tomography coronary angiography(CTA)in comparison with invasive coronary angiography.Methods 128-slice CTA and invasive coronary angiography were performed in 78 unselected consecutive patients(63 patients with suspected coronary artery disease and 15 patients with previous coronary stenting,56 males,mean age 61±10 years)and ＞50% reduction of minimal lumen diameter was defined as significant coronary stenosis.Results Fifty-eight out of 879 segments(7%)from CTA were not assessable because of irreguldr rhythm,vessel calcification or tachycardia.Compared with invasive coronary angiography,segmentbased analysis from the 821 segments showed the sensitivity by CTA was 87%,specificity 97%,PPV 83% and NPV 97%.Four out of 22 stents implanted in 15 patients were not assessable by CTA because of poor image quality.Compared with invasive coronary angiography,the sensitivity of diagnosing in-stent restenosis by CTA was 100%,specificity 77%,PPV 63% and NPV 100% for the remaining 18 stents-Conclusions One hundred and twenty-eight-slice CTA has a high accuracy for detecting coronary artery disease and instent restenosis after coronary stenting and could be considered as a valuable noninvasive technique for screening coronary artery disease in suspected patients.

Objective To evaluate the role of mitochondrial ATP sensitive potassium ( mito-KATP ) channel in dexmedetomidine-induced inhibition of subarachnoid hemorrhage ( SAH )-caused programmed cell death ( PCD) in cardiomyocytes of rats. Methods On hundred and twenty clean-grade healthy male Sprague-Dawley rats, aged 9-10 weeks, weighing 350-400 g, were divided into 5 groups ( n=24 each) using a random number table method: sham operation group ( group Sham ) , SAH group, SAH plus dexmedetomidine group ( group SD) , 5-HD plus SAH and dexmedetomidine group ( group HSD) and 5-HD plus SAH group ( group HS) . The rats were subjected to SAH by intracranial vascular puncture after being anesthetized with pentobarbital sodium. Dexmedetomidine 5 μg∕kg was infused for 10 min via the jugular vein starting from the time point after intracranial vascular puncture, followed by a continuous infusion of 5μg·kg-1 ·h-1 for 1 h in SD and HSD groups. 5-HD 30 mg∕kg was intraperitoneally injected at 1 h before intracranial vascular puncture in HSD and HS groups. Blood samples were collected from the abdominal aor-ta at 24 h after intracranial vascular puncture for determination of serum cardiac troponin I ( cTnI) concen-trations. The animals were then sacrificed, and myocardial specimens were collected for determination of PCD rate ( by TUNEL) , reactive oxygen species ( ROS) activity ( by DCFH-DA assay) , and expression of cleaved caspase-3, cleaved caspase-1 and interleukin-1beta ( IL-1β) ( by Western blot) . Results Com-pared with group Sham, the serum concentrations of cTnI, PCD rate and ROS activity were significantly in-creased, and the expression of cleaved caspase-3, cleaved caspase-1 and IL-1βwas up-regulated in SAH, SD, HSD and HS groups ( P<0. 05) . Compared with group SAH, the serum concentrations of cTnI, PCD rate and ROS activity were significantly decreased, and the expression of cleaved caspase-3, cleaved caspase-1 and IL-1βwas down-regulated in group SD, and the serum concentrations of cTnI, PCD rate and ROS activity were significantly increased, and the expression of cleaved caspase-3, cleaved caspase-1 and IL-1βwas up-regulated in group HS ( P<0. 05) . Compared with group SD, the serum concentrations of cT-nI, PCD rate and ROS activity were significantly increased, and the expression of cleaved caspase-3, cleaved caspase-1 and IL-1β was up-regulated in group HSD ( P<0. 05) . Compared with group HSD, the serum concentrations of cTnI, PCD rate and ROS activity were significantly increased, and the expression of cleaved caspase-3, cleaved caspase-1 and IL-1βwas up-regulated in group HS ( P<0. 05) . Conclusion mito-KATP channel is involved in dexmedetomidine-induced inhibition of PCD in cardiomyocytes of rats with SAH.

Objective To evaluate the role of Toll-like receptor 4 (TLR4) signaling pathway in sevoflurane anesthesia-induced cognitive dysfunction in aged rats.Methods Twenty-seven SPF healthy male Sprague-Dawley rats,aged 20 months,weighing 550-750 g,were divided into 3 groups (n =9 each) using a random number table:control group (C group),sevoflurane anesthesia group (S group) and TLR4 antagonist plus sevoflurane anesthesia group (TS group).TLR4 monoclonal antibody 30 μl was injected into the lateral cerebral ventricle in group TS,and the equal volume of serum containing no antibody was injected into the lateral cerebral ventricle in C and S groups.At 10 min after completion of injection,S and TS groups inhaled the mixture of 4％ sevoflurane and 30％ oxygen for 6 h,and group C only inhaled the mixture of air and oxygen.Morris water maze test was performed at 24 h after the end of sevoflurane anesthesia.The animals were sacrificed after completion of Morris water maze test,brains were removed and hippocampi were isolated for determination of nerve cell apoptosis (using TUNEL) and expression of activated caspase-3 (using immunofluorescent staining).Nerve cell apoptosis rate was calculated.The expression of high-mobility group box 1 protein (HMGB1) mRNA in hippocampi was measured by Northern blot assay at 6 h after the end of sevoflurane anesthesia.The expression of amyloid precursor protein (APP) and amyloid beta protein (Aβ) in hippocampi was assessed by Western blot at 24 h after the end of sevoflurane anesthesia.Results Compared with C group,the escape latency was significantly prolonged,nerve cell apoptosis rate was increased,the expression of activated caspase-3,HMGB1 mRNA,APP and Aβ was up-regulated in group S,and nerve cell apoptosis rate was increased,the expression of activated caspase-3,HMGB1 mRNA,APP and Aβ was up-regulated (P＜0.05),and no significant change was found in the escape latency in group TS (P＞0.05).Compared with S group,the escape latency was significantly shortened,nerve cell apoptosis rate was decreased,and the expression of activated caspase-3,HMGB1 mRNA,APP and Aβ was down-regulated in group TS (P＜0.05).Conclusion Activation of TLR4 signaling pathway is involved in the mechanism of sevoflurane anesthesia-induced cognitive dysfunction in aged rats.

Objective To explore the effect of erythropoietin (EPO) attenuating apoptosis in old rat hippocampal neuronal cells exposed to sevoflurane and the role of toll like receptor 4.Methods Twenty months old SD rats,male,550-750 g,in accordance with the random number table,were divided into 3 groups (n =9):control group (group C),sevoflurane treatment (group S),and sevoflurane plus EPO treatment (group ES).The rats in group S and ES were subjected to inhale 4％ sevoflurane for 6 h,but the rats in group C were inhaled air-oxygen only.The rats in group ES were injected with EPO into caudal vein at 24 h,48 h,and 72 h after sevoflurane exposure.The cognitive ability was assessed by Morris water maze test;the effects of hippocampal apoptosis were assessed by TUNEL assays;the expressions of TLR4 mRNA was measured by RT-PCR assay;mitochondrial membrane potential (MMP) was assessed by JC-1 fluorescence;the expressions of APP and Aβ were assessed by western blot.Results Compared with group C,there were significant increases of escape latency period,neuronal apoptosis,TLR4 mRNA,and APP and Aβ expression,but a decrease of MMP in group S (P＜0.05).Compared with group S,there were significant decreases of escape latency period,neuronal apoptosis,TLR4 mRNA,and APP and Aβ expression,but a increase of MMP in group ES (P＜0.05).Conclusion The attenuation of rat hippocampal neuronal apoptosis induced by EPO could be associated with inhibition of TLR4,improvement of MMP,as well as inhibition of APP and Aβ activity.