Objective To analyze the severe extracranial internal carotid artery (EICA)stenosis and occlusion caused the distribution patterns of cerebral infarction lesion and then to investigate the differences of stenosis and occlusion caused mechanisms of cerebral infarction in order to provide the basis for individual prevention and treatment strategies. Methods The clinical and imaging data of 61 patients with atherosclerotic severe EICA stenosis (70-99%) or occlusion caused acute cerebral infarction were analyzed retrospectively. They were divided into stenosis group (n =31) and occlusion group (n =30) according to the degree of stenosis. The distribution pattems of infarct lesion of both groups were compared. They were divided into good (n =31) and poor (n = 26) collateral flow compensation groups according to the middle cerebral artery (MCA) and magnetic resonance angiography (MRA) on the lesion sides of EICA.The distribution patterns of the infarct lesion in both groups were compared. Results The proportion of the patients with hypertension in the poor collateral flow compensation group was significantly higher than that in the good collateral flow compensation group (22/26 vs.18/31, P = 0. 042). The proportion of the patients with multiple cerebral infarction in the occlusion group was significantly higher than thai in the stenosis group (15/30 vs. 24/31, P =0. 026),and the proportion of the patients with single cerebral infarction was significantly lower than that in the stenosis group (15/30 vs. 7/31, P =0. 026). The proportion of the patients with large cortical infarction was significantly higher than that in the stenosis group (7/30 vs. 1/31, P=0. 026). Among the patients with single cerebral infarction, the proportion of the patients with border-zone infarct (BZI) in the occlusion group was significantly higher than that in thestenosis group (8/15 vs. 5/24, P = 0. 036), and the proportion of the patients with cortical infarct (CI) was significantly lower than that in the stenosis group (15/24 vs. 4/15, P =0. 048).The proportion of the patients with BZI in the poor collateral flow compensation group was significantly higher than that in the good collateral flow compensation group (8/15vs. 4/22, P =0. 036), and the proportion of the patients with CI was significantly lower than that in the good collateral flow compensation group (4/15 vs. 14/22, P =0. 045). The proportions of the patients with large perforating artery infarct (11/30 vs. 3/31, P=0. 016) and BZI (20/30 vs. 10/31, P =0. 010) in the occlusion group were significantly higher than those in the stenosis group, and among the patients with BZI, the proportion of the infarction involving only the patients with internal border zone was significantly higher than that in the stenosis group (15/30 vs. 6/31, P =0. 016). The proportion of the patients with BZI in the poor collateral flow compensation group was significantly higher than that in the good collateral flow compensation group (19/26 vs.9/31, P =0. 001), and among the patients with BZI, the proportion of the infarction involving only the patients with internal border zone was significantly higher than that in the good collateral flow compensation group (14/26 vs. 6/31, P =0. 011). The proportion of the patients with incomplete anterior circle of Willis in the poor collateral flow compensation group was significantly higher than that in the good collateral flow compensation group (19/26 vs. 8/31,P =0. 001).Conclusions The lesion distribution patterns of cerebral infarction caused by severe EICA stenosis and occlusion are different, and it suggests that the cerebral infarction mechanisms caused by both are different. In patients with severe EICA occlusive disease, MRA showed that the developing signal change at the lesion sides of MCA may be a potential surrogate index for identifying the state of collateral circulation, but it needs to use the research means of quantitative determination of blood perfusion to verify.

Objective To investigate the imaging characteristics of spontaneous cerebral artery dissection (CAD) causing cerebral infarction by analyzing the vascular imaging findings.Methods The neuroimaging and clinical data in patients with cerebral infarction due to spontaneous CAD were reviewed. The characteristic findings at different sites of CAD in all vascular imaging examinations were analyzed and summarized. Results A total of 43 patients (28 men, 15women; mean age, 45.1 + 12.3 years) with CAD were included in the study. Twenty-three patients with extracranial internal carotid artery dissection (ICAD), 5 with intracranial anterior circulation dissection, 7 with extracranial vertebral artery dissection (VAD), 6 with intracranial VAD, and 2 with basilar artery dissection (BAD). In patients with extracranial ICAD, occlusion (usually beginning about 1-2 cm above the bifurcation and tapering to a complete occlusion with a flame-like or mouse-tail appearance) was the common imaging findings, luminal stenosis (irregular, elongated, and tapered stenosis) and/or dissecting aneurysms were observed in partial patients, intimal flaps and double-lumen sign were found in a few patients, and vessel tortuosity of ipsilateral or bilateral ICA were observed in 6 patients. Characteristic signs of occlusion or stenosis of extracranial ICAD were observed in computed tomography angiography (CTA) or magnetic resonance angiography (MRA) in partial patients, and magnetic resonance imaging (MRI) could reveal the bright hyperintense crescent-shaped zone that represents the intramural hematoma, and resource imaging of CTA could reveal intimal flaps and double-lumen sign at the level of dissection. Occlusion (V1, V4 segment and V3 segment extending to V4 segment) was the common vascular imaging features in patients with VAD, V1 segment occlusion had a typical appearance: cut-off like or taped occlusion. MRA could reveal VA occlusion, and MRI could show the bright hyperintense of intramural hematoma at the level of VA occlusion. Concomitant dissecting aneurysms and stenosis of intracranial VA were found in 2 patients. Intracranial dissections of anterior circulation were verified mainly by digital subtraction angioraphy (DSA),if dissecting aneurysms or intimal flaps were observed, and intimal flaps were revealed by resource imaging of MRA in a patient. In patients with BAD, dissecting aneurysm was found in a patient, concomitant local stenosis in MRA and bright hyperintense of intramural hematoma on MRI were observed in another patients. Vascular imaging follow-up was performed in 7 patients, complete recanalization was found in a patient with extracranial ICA occlusion due to CAD, stenosis disappeared and dissecting aneurysm almost healed in a patient with extracranial ICAD, dissection lesions had no change in 2 patients with extracranial ICAD, dissecting aneurysm further expanded in a patient with extracranial ICAD, degree of stenosis reduced in a patient with intracranial ICAD, dissecting aneurysm healed after stenting in a patient with intracranial VAD. Conclusions Diagnosis of CAD mainly depends on vascular evaluations, and vascular imaging features of CAD, such as flame-like or taped occlusion, dissecting aneurysms,intimal flaps, irregular or/and elongated stenosis, MRI signals of intramural hematoma, doublelumen sign and so on, were the points for diagnosis of CAD. DSA was an important method for diagnosis of CAD, and MRA + MRA, or CTA and resource imaging were very valuable for diagnosis of CAD. CAD should be followed by methods of vascular imaging because the results of follow-up were very important for adjusting the treatment strategies in patients with CAD.

Infants suffering from angiostrongylus eosinophilic meningitis (AEM) is rare, while AEM can cause severe consequences.The diagnostic value of high-throughput sequencing for AEM was studied by analyzing 2 AEM children (< 2 years old) in the Department of Neurology, Shenzhen Children′s Hospital in 2019.Case 1 mainly pre-sented intermittent fever, vomiting, mental fatigue and bregma bulge.Case 2 mainly manifested intermittent fever, cough, vomiting and convulsion.Due to hypereosinophils in patients′ peripheral blood and cerebrospinal fluid (CSF), and abundant DNA sequences from a cantonensis in CSF and positive antibody test, the patients were diagnosed with AEM.The patients were treated with albendazole to deworm, and small doses of methylprednisolone to reduce inflammation.The clinical characteristics of AEM infant are not typical, and high-throughput sequencing technology can assist the diagnosis of AEM.

OBJECTIVE: To explore the clinical effects and short-term complications of using free jejunum graft (FJG) to reconstruct the defects by resections of pharyngeal, laryngeal or cervical esophageal cancers. METHOD: Fifty-eight cases of pharyngeal, laryngeal or cervical esophageal cancers were reconstructed with FJG. All cases were analyzed retrospectively. RESULT: The success rate of FJG transplantations was 91.4% (53/58). The incidence of post-operative short-term complication was 43.1% (25/58), which was not related to age or BMI. The most common complication was anastomotic leakage (18.9%), which was not related to per-operative radiation therapy. However, BMI > 25 cases had significantly higher incidence of anastomotic leakage than BMI ≤ 25 cases (P = 0.009). The second and third most common complications were respiratory system complications (10. 3%) and FJG necrosis (8. 6%). Para-operative death rate was 3.4% (2/58). Two-year overall survival rates of hypopharyngeal cancer and cervical esophageal cancer were 49% and 67% respectively. The group with no short-term complications had a slightly better survival rate than the group with short-term complications from the Kaplan-Meier curve, but there was no significant difference (P = 0.103). CONCLUSION FJG is ideal to reconstruct cervical digestive tract circumferential defects with a high success rate and a low mortality. However, the post-operative complication rate is high. Intensive observation, early detection and timely treatment of complications are crucial.
Esophageal Neoplasms ; surgery ; Humans ; Hypopharyngeal Neoplasms ; surgery ; Jejunum ; transplantation ; Laryngeal Neoplasms ; surgery ; Pharyngeal Neoplasms ; surgery ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Survival Rate

Objective To explore the effect of transplanting poly (lactic-co-glycolic acid) (PLGA) scaffolds seeded with neural stemcells (NSCs) and Schwann cells (SCs) on spinal cord injured rats and the mechanism. Methods NSCs and SCs were cultured in vitro andthen seeded into the directional PLGA scaffolds. Then PLGA-cell complexes were implanted into the spinal cord hemisected rats, whichwere divided into PLGA group, PLGA+NSCs group and PLGA+ NSC+SCs group. The rats were tested with cortical motor evoked potentials(CMEPs) and Basso-Beattle-Bresnahan (BBB) score. Then, the rats were further ipsilaterally or contralateral hemisected at T6 and testedwith CMEPs and BBB score again. Results The incidence of recovery and the amplitudes of CMEPs were the highest in PLGA+NSCs+SCs group. The rats exhibited a gradual improvement in hindlimb locomotor function in score. The BBB score was the least in the PLGAgroup in the 2nd week or later. After retransected ipsilaterally, the CMEPs disappeared again and the BBB score improved quickly. But afterretransected contralaterally, the rats were completely paraplegia. Conclusion The directional PLGA scaffolds seeded with NSCs and SCs facilitatethe recovery in spinal cord injured rats, which may associate with axonal regeneration and functional connections, but play a limitedrole.

ObjectiveTo explore the expression of N-cadherin and β-catenin mRNA in human brainstem and supratentorial gliomas. MethodsN-cadherin and β-catenin mRNA expression in 18 cases of brainstem gliomas and 18 cases of supratentorial gliomas tissues were detected with PT-PCR. Resultsβ-catenin mRNA expression was more in human brainstem gliomas than in supratentorial gliomas （t=2.255,P<0.05）, but was not significantly different of N-cadherin mRNA (P＞0.05). The expression of N-cadherin mRNA in human brainstem gliomas of grades Ⅰ～Ⅱ were less than those in human gliomas of grades Ⅲ～Ⅳ (t=2.711，P<0.05), but was not of β-catenin mRNA (P＞0.05). N-cadherin mRNA expression was positively correlated with the β-catenin mRNA expression in either brainstem gliomas or supratentorial gliomas （r=0.480，r=0.809 respectively, P<0.05）. ConclusionThe over expressions of N-cadherin and β-catenin may play an important role in the invasion and malignant progress of human brainstem gliomas.

OBJECTIVETo develop a HPCE analysis method for fingerprints of Forsythia suspensa from Hebei province, get reference fingerprint and compare the fingerprints of F. suspensa collected from different producing areas and different parts of the plant.

METHODElectrophoresis was performed on a fused silica capillary column (75 microm x 60 cm, 30 cm). The running buffer was composed of 50 mmol x L(-1) borax (adjust to pH 9.90 with 0.1 mol x L(-1) NaOH). The applied voltage was 15 kV and the temperature was 20 degrees C. The detection wavelength was 214 nm. The semblances to the crude drugs of different producing areas were compared.

RESULTThe mutual mode of HPCE fingerprints was set up with 12 common peaks. The fingerprints of F. suspensa from Hebei province had high similarity, F. suspensa from Shanxi and Henan were also of good quality. The chemical composition in different parts of the herb had big differences.

CONCLUSIONThe method is simple, quick, accurate and can be used as a new means for the quality control of F. suspensa.

Spinal cord injury (SCI) is a disabling and destructive central nervous system injury that has not yet been successfully treated at this stage. Three-dimensional (3D) bioprinting has become a promising method to produce more biologically complex microstructures, which fabricate living neural constructs with anatomically accurate complex geometries and spatial distributions of neural stem cells, and this is critical in the treatment of SCI. With the development of 3D printing technology and the deepening of research, neural tissue engineering research using different printing methods, bio-inks, and cells to repair SCI has achieved certain results. Although satisfactory results have not yet been achieved, they have provided novel ideas for the clinical treatment of SCI. Considering the potential impact of 3D bioprinting technology on neural studies, this review focuses on 3D bioprinting methods widely used in SCI neural tissue engineering, and the latest technological applications of bioprinting of nerve tissues for the repair of SCI are discussed. In addition to introducing the recent progress, this work also describes the existing limitations and highlights emerging possibilities and future prospects in this field.

BACKGROUND:The study of the lumbar spine and pelvis in patients with Lenke type 5 lordosis is limited to the coronal and sagittal planes,and the three-dimensional relationship between the scoliosis and the pelvis has not yet been clarified. OBJECTIVE:To analyze the effect of lumbar scoliosis on the pelvis in patients with Lenke type 5 lordosis and to study the correlation between the lumbar spine and the three-dimensional spatial position of the pelvis. METHODS:Imaging data of 60 patients with Lenke type 5 lordosis scoliosis admitted to the 3D Printing Reception Center of Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine from January 2019 to September 2023 were retrospectively analyzed,including Cobb angle,coronal pelvic tilt,lumbar lordosis,left and right pelvic hip width ratio(sacroiliac-anterior superior iliac spine),spinal rotation angle,pelvic tilt,sacral slope,pelvic incidence,coronal deformity angular ratio,sagittal deformity angular ratio,C7 plumb line-center sacral vertical line,apical vertebral translation,and coronal sacral inclination.The information was summarized as a database.SPSS 22.0 software was used to analyze the data related to the lumbar spine and pelvis of the patients with Lenke type 5 primary lumbar curvature adolescent idiopathic scoliosis using Spearman's correlation analysis and linear regression. RESULTS AND CONCLUSION:(1)Cobb angle was highly positively correlated with coronal deformity angular ratio,apical vertebral translation,and spinal rotation angle(r=0.91,r=0.841,r=0.736).(2)Coronal deformity angular ratio was highly positively correlated with apical vertebral translation(r=0.737),moderately positively correlated with C7 plumb line-center sacral vertical line(r=0.514),and moderately negatively correlated with sagittal deformity angular ratio(r=-0.595).(3)There was a high positive correlation between lumbar lordosis and sagittal deformity angular ratio(r=0.942)and a moderate negative correlation with coronal deformity angular ratio(r=-0.554).(4)There was a moderate positive correlation between Cobb angle with coronal pelvic tilt and coronal sacral inclination(r=0.522,r=0.534)and a moderate positive correlation between C7 plumb line-center sacral vertical line and coronal pelvic tilt(r=0.507).Apical vertebral translation with coronal pelvic tilt and coronal sacral inclination showed a moderate positive correlation(r=0.507,r=0.506).Lumbar lordosis with sacral slope and pelvic incidence showed a moderate positive correlation(r=0.512,r=0.538).Sagittal deformity angular ratio was moderately positively correlated with sacral slope and pelvic incidence(r=0.614,r=0.621).(5)Studies have found that the relative position of the lumbar spine and the pelvis is closely related in the horizontal,sagittal and coronal planes.When the lumbar spine affects scoliosis and is rotated,the relative position of the pelvis will also change to compensate,which indicates that while correcting scoliosis,the correction of the pelvis cannot be ignored.