BACKGROUND:In order to avoid distal arterial embolism fol owing mechanical thrombectomy, micro-bal oon catheter temporary isolation is applied to prevent thrombus shedding.
OBJECTIVE:To investigate the safety and feasibility of adopting the micro-bal oon catheter technique in treatment of the hyperacute cerebral infarction. The micro-bal oon catheter technique can temporarily block the artery blood flow and isolate the embolism location fol owing mechanical thrombectomy and aspiration combined with thrombolysis.
METHODS:Ten beagle dogs were included in this study. Under general anesthesia, the micro-bal oon catheter was delivered to the dominant vertebral artery through the femoral artery in al the dogs and it was fil ed and temporarily blocked the blood flow. Then the autologous thrombus was injected through the micro-catheter into proximal vertebral artery to make a thrombosis model. Al the dogs were equal y divided into two groups according to the embolectomy method:control group (receiving pure stent embolectomy, n=5) and experimental group (n=5). The experiment group was disrupted and aspirated thrombus combined with the drug thrombolysis after temporarily blocking out the blood flow and isolating the target artery by micro-bal oon catheter technique. After treatment, two groups underwent digital subtraction angiography to review the vertebral artery recanalization after different embolectomy methods. The hemodynamic status was evaluated through the thrombolysis in cerebral ischemia grade. Al the dogs were scanned with magnetic resonance diffusion weighted imaging before modeling and at 12 hours after the thrombectomy. The animals were kil ed to perform pathological examination after magnetic resonance diffusion weighted imaging (12 hours after the thrombectomy). The vessel recanalization rates and complications were calculated in the two groups.
RESULTS AND CONCLUSION:The thromboembolism model was successful y established in the dominant vertebral artery of al the 10 beagle dogs. In the control group, the vertebral arteries were completely successful recanalized in two dogs and were partly recanalized in three dogs, while the vertebral-basilar and intracranial arteries in one dog showed multiple smal punctate fil ing defects with poor intracranial arterial development and contrast agent reflux. At 12 hours after embolectomy, the magnetic resonance diffusion weighted imaging showed slightly high signal intensity at the left temporoparietal lobe and the pathologic examination suggested thrombosis in the cerebral artery lumen of the left temporal lobe. In the experimental group, the vertebral arteries in five dogs were completely recanalized without infarction. The revascularization rate in the experimental group was significantly higher than that in the control group (P<0.05). Experimental findings indicate that, the application of disruption and aspiration thrombus combined with the drug thrombolysis after temporarily blocking the blood flow and isolating the target artery by micro-bal oon catheter technique in treatment of hyperacute cerebral infarction, can effectively prevent the smal embolus exfoliating, which can cause distal embolization. Thus, the micro-bal oon catheter technique is a safe, effective and relatively inexpensive interventional embolectomy.

BACKGROUND:It is difficult to perform superselective catheterization of the internal carotid artery in dogs because of the large bending and spiral shape of the interal carotid artery before entering into the skul. At present, the dog models of cerebral infarction established by injecting autologous blood clots and gelatin spongevia the internal carotid artery are far from the perspective of pathological mechanism of human patients with cerebral infarction. Aortography can visualize the structure of cerebral vessels and is likely to provide a new condition for the establishment of dog models of acute cerebral infarction. OBJECTIVE:To explore the feasibility of establishing cerebral infarction models in beagle dogs by superselective catheterizationvia the vertebral basilar artery. METHODS: Five beagle dogs were divided into thrombus group (n=3) and control group (n=2). The beagle dogs in the thrombus group were subjected to digital subtraction angiography of the aortic arch, bilateral common carotid arteries and vertebral arteries in addition to femoral arterial catheterization. The 2.7F micro-catheter was inserted into the convergence zone of the left posterior communicating artery and the internal carotid artery through the vertebrobasilar artery. An autologous blood clot was injected into the convergence zone. The dogs in the control group were injected with appropriate amount of contrast medium. RESULTS AND CONCLUSIONS:Through angiography of the left and right common carotid artery of five dogs, thick external carotid arteries (10/10) and their branches were clearly displayed, however, only five (5/10) internal carotid arteries were dimly present. A spiral vascular loop formed in the internal carotid artery with a smal-sized diameter. Through antiography of the left and right vertebral arteries (10/10) angiography, vertebral basilar artery, the circle of “Wilis”, bilateral posterior cerebral arteries, bilateral middle cerebral arteries and bilateral anterior cerebral arteries were clearly displayed, al these contribute to insertion of microcatheter into the convergence zone of the left posterior communicating artery and the internal carotid artery through the vertebrobasilar artery. High signal intensity of the left temporal lobe was shown on 3-hour and 6-hour diffusion weighted images.The results demonstrate that the beagle dog models of acute cerebral infarction can be successfuly established by injecting autologous blood clots into the left middle cerebral artery through a microcathter insertedvia the vertebrobasilar artery, which provides a new method of precisely occluding the middle cerebral artery of beagle dogs by catheterization.

OBJECTIVE:To ensure drug use safety and lower drug-induced risks.METHODS:Based on risk management theory and USA-EU drug risk management system,we analyzed the contents of drug risk management,the relationship between drug safety and drug risk,and the classification of drug-risk factors etc.And some suggestions were put forward.RESULT & CONCLUSION:The introduction of drug-risk management system can help facilitate the normalization and standardization of drug safety control,maximize drug benefit and minimize drug risk.

Objective:To investigate the efficacy of microsurgical treatment in cavernous sinus tumors.Methods:The clinical data of 87 patients with cavernous sinus tumor treated by microsurgery from January, 2010 to August, 2019 were analysed retrospectively. The surgical approaches and microsurgical skills for common tumors in Cavernous Sinus region were discussed. The follow-up included outpatient and telephone follow-ups, and the follow-up results were evaluated by KPS score.Results:Among the 87 cases, 57 were totally resected (65.5%), 14 were subtotal resected (16.1%) and 16 were major resected (18.4%). Hospitalisation ranged from 14 to 98 days, with an average of 29 days. Postoperative complications occurred in 30 cases with cranial nerve injury, 2 brain stem injury, 4 postoperative bleeding, 5 cerebrospinal fluid leakage, 4 infection, 1 Pituitary damage and 1 death. Prognosis and follow-up analysis showed 68 cases with KPS>60 and 66 with KPS>80 at 1 month after surgery; 74 with KPS>70 and 72 with KPS>80 at 3 months after surgery; 78 with KPS>80 by 12 months after surgery. During the follow-up period of 6-120 months, 3 cases died. Recurrence: 6 of incomplete resection of meningioma, were in 1-6 years after the surgery, 4 of incomplete resection of schwannoma in 1-8 years, 2 of pituitary adenoma respectively in 13 and 16 months after the surgery. There was no recurrence after reoperation. Two cases of chondrosarcoma, 3 of chordoma and 3 of germinoma were treated with radiotherapy, and during the follow-up, there was no progress of the focus. No tumor progression or recurrence was found in other cases during follow-up.Conclusion:Surgery of cavernous sinus tumor is difficult due to frequent postoperative complications. Reasonable preoperative plan, surgical approach and precise microsurgical techniques are the keys in reduction of postoperative complications and in the improvement of prognosis.

The first hand documents, the process and achievements of Mr. CHENG' s study in Japan in the 1930s were investigated in order to provide basic information to explore the original academic thoughts of Mr. CHENG and the Chengjiang Acupuncture School. It was concluded that the experiences of Mr. CHENG's study in Japan had significant influence on enriching and developing his academic thoughts. It has not only enhanced his confidence in therapeutic effect of moxibustion and revival of Chinese acupuncture, but also established the foundation for the reform of needles and expansion of the domain of Chinese acupuncture and its development after returning home.
Acupuncture ; education ; history ; Acupuncture Therapy ; history ; China ; History, 19th Century ; History, 20th Century ; Humans ; Japan ; Male

Taxus suspension cell culture has the potential to provide a sustainable source of anticancer drug paclitaxel (Taxol) and other taxoids. In the cell culture of Taxus chinensis, Taxuyunnanine C (Tc) is the primary taxoid. To design a rational strategy for redirecting the precursor fluxes from other taxoids into paclitaxel production, we employed Real-time Quantitative PCR (RQ-PCR) to understand the dynamic profiling of key biosynthetic pathway genes of palcitaxel and taxoids during the culture process. Six genes (TASY, TDAT, T5alphaH, TalphaH, T10betaH and T14betaH) were quantified under the process condition of double elicitation by 2,3-dihydroxylpropanyl jasmonate (DHPJA) (100 micromol/L on day 7 and day 12), and sucrose feeding (20 g/L) on day 7. This process treatment led to a high accumulation of Tc at (554.46 +/- 21.28) mg/L 8 days after the first elicitation. Then 9 days after the second elicitation, Tc production was as high as (997.72 +/- 1.51) mg/L. The early pathway genes TASY and TDAT were significantly up-regulated by 182-fold and 98-fold, respectively for the first DHPJA elicitation and by 208-fold and 131-fold, respectively for the second elicitation. The induction occurred after each elicitation lasted for about 24 h before their abundances decreased. Things are somewhat different in the case of the other four genes T5alphaH, TalphaH, T10betaH and T14betaH. For gene TalphaH, it was highly up-regulated by 3061-fold for the first DHPJA elicitation and by 1016-fold for the second elicitation. For the other three genes T5alphaH, T10betaH, T14betaH, they were up-regulated by 13-fold, 38-fold and 20-fold, respectively for the first DHPJA elicitation and by 7-fold, 16-fold and 6-fold, respectively for the second elicitation. The RQ-PCR results showed that there is tight correlation between gene expression and Tc accumulation. Gene expression was in accordance with Tc yield. Elicitation could improve expression of six genes. While along with culture course, high expression of the genes weakened. Elicitation for the second time would promote high expression of the genes again.
Cell Culture Techniques ; Culture Media ; Cyclopentanes ; pharmacology ; Gene Expression Regulation, Plant ; Oxylipins ; pharmacology ; Plant Growth Regulators ; pharmacology ; Sucrose ; pharmacology ; Taxoids ; metabolism ; Taxus ; genetics ; metabolism ; Transcriptome

Objective To investigate the efficacy and influence factors of uterine artery embolization (UAE)in treatment of intractable postpartum hemorrhage (PPH).Methods 126 patients with intractable PPH were treated by UAE in our hospital.We analyzed the influence factors of failed UAE treatments according to the amount of bleeding,the stability of hemodynamics,with disseminated intravascular coagulation(DIC)or not and active extravasation detected in angiography.Results In 126 intractable PPH patients,13 cases (10.3%) failed to stop bleeding after UAE and the other 113 cases (89.7%)successfully got hemostasis.Logistic regression analysis showed that DIC was a significant factor in failed UAE group (P=0.033,OR 0.107,95%CI 0.014-0.835).Conclusion UAE is an effective method of treating intractable PPH.DIC may be the main cause of the failure of UAE in treatment of intractable PPH.

Plexiform neurofibromas (pNF) is significant hallmark of type Ⅰ neurofibromatosis, posing substantial negative impacts on patients’ quality of life and daily functionality. Surgical intervention remains the primary modality of treatment. However, the surgery is fraught with challenges due to the rich vascularization, intricate neural involvement, and ill-defined borders of the tumors. The risk of recurrence and complications further complicates the surgical approach. Through extensive literature review and integrative analysis, this article summarizes the current surgical treatment options and adjunctive techniques available for pNF management. Preoperative radiological assessments, vascular embolization, intraoperative neural monitoring, and fluorescence navigation are among the ancillary techniques that can effectively mitigate surgical risks. The timing of surgery should be guided by specific indications and contraindications, while the surgical plan must be individualized based on the patient’s unique presentation, sometimes necessitating a multidisciplinary approach. Overall, a comprehensive assessment of the patient’s condition and the implementation of multifaceted adjunctive measures are imperative for maximizing tumor resection while minimizing the risks of recurrence and complications.

Plexiform neurofibromas (pNF) is significant hallmark of type Ⅰ neurofibromatosis, posing substantial negative impacts on patients’ quality of life and daily functionality. Surgical intervention remains the primary modality of treatment. However, the surgery is fraught with challenges due to the rich vascularization, intricate neural involvement, and ill-defined borders of the tumors. The risk of recurrence and complications further complicates the surgical approach. Through extensive literature review and integrative analysis, this article summarizes the current surgical treatment options and adjunctive techniques available for pNF management. Preoperative radiological assessments, vascular embolization, intraoperative neural monitoring, and fluorescence navigation are among the ancillary techniques that can effectively mitigate surgical risks. The timing of surgery should be guided by specific indications and contraindications, while the surgical plan must be individualized based on the patient’s unique presentation, sometimes necessitating a multidisciplinary approach. Overall, a comprehensive assessment of the patient’s condition and the implementation of multifaceted adjunctive measures are imperative for maximizing tumor resection while minimizing the risks of recurrence and complications.

The recent emergence of targeted therapies for neurofibromatosis type 1 (NF1) brings a new dawn for these patients and contributes to an increase in the number of patients seeking medical treatment, which was a great unmet medical need in the past. It puts forward higher requirement for the clinical standard diagnosis and treatment of NF1. As a rare autosomal dominant genetic disorder, the clinical manifestations of NF1 are various and could involve multiple organs and systems, which requires Multi-Disciplinary Treatment (MDT). However, as NF1 is a relatively rare disease and has insufficient attention in the past, current understanding for NF1 is still limited. Standardized multi-disciplinary consultation has not been established nationwide. Furthermore, due to the lack of unified patient registration, evaluation and follow-up system, it is difficult to conduct large-scale clinical cohort studies based on Chinese population. This article reviewed current challenges in the diagnosis, management, and research on NF1 in China. Meanwhile, we proposed several suggestions to improve the diagnosis and treatment abilities based on our long-term experience on NF1, to establish a high-quality Chinese NF1 diagnosis, management, and research system in the future.