Objective To evaluated the safety and complications of endovasdcular stenting for symptomatic carotid stenosis with surgical high risk.Methods A series of 11 vessels in 9 patients at surgical high risk were treated by endovascular stenting. The complications during the procedures and postoperative periods were analyzed within one to five months. Results All of the operations were successfully performed without any serious complications. During the follow up period (averaging 6 months), there were no complications of TIAs, stokes and restenoses.Conclusions The study suggests that endovascular stenting may be safe and effective for patients at surgical high risk, but further more study is needed.

Objective To assess the clinical effect and methods of posterior decompress and fixation for upper-middle thoracic fracture and dislocation. Methods Between September 2002 and September 2007,21 patients suffered from upper-middle thoracic fracture and dislocation were treated with posterior approach, which comprising 5 patients with compressed fracture,4 patients with burst fracture, 12 patients with fracture and dislocation. There were 12 cases companied by complete paraplegia, and 9 cases companied by incomplete paraplegia. All cases adapted to pedicle screw fixation system after decompression and reduction. Reduction or removal of fragments was done through posterior-lateral of the spinal canal for patients with fragments migrated into the spinal canal. The operation time,blood loss volume,preand postoperative transverse displacement degree and angle of the injured vertebra were recorded. The neurological function was assessed by Frankel criteria. Results The patients was followed up for (2.5 ± 0.5 ) years. The Frankel score increased from ( 1.0 ± 0.1 ) scores preoperatively to ( 1.3 ± 0.1 ) scores postoperatively. The incomplete paraplegia patients' score increased from (2.2 ± 0.2) scores preoperatively to (3.1± 0.2) scores postoperatively. The height of injured vertebral body, the interangle of vertebral body and spondylolistheses after operation increased comparing with those before operation(P ＜ 0.05 ). No implant loosening or breakage was found. Conclusions Severe spinal cord injury occurs in upper-middle thoracic fracture and dislocation.Unstable fracture should be treated with internal fixation and fusion in time. Decompression ought to be done in patients who suffering from incomplete paraplegia. Early operation takes advantages of immediate stability and a good improvement of the neurologic function.

OBJECTIVE:To determine 5-Fu concentration in serum,peritoneal fluid and tissue by HPLC in patients undergoing rectal cancer operation and receiving regional chemotherapy.METHODS:20 patients who undergoing rectal cancer operation and receiving regional chemotherapy were administered with drugs,whose blood samples were taken from portal veins,peripheral veins,peritoneal fluid and tissues around tumor at 2,5,10,20,30 and 60min,respectively after administration for the determination of 5-FU by HPLC.RESULTS:Peak concentrations in all samples appeared 2 minutes after administration,but lowered gradually thereafter.The drug level in peritoneal fluid was the highest,but was the lowest in the tissue,and that in the portal vein was higher than in peripheral veins.CONCLUSION:For patients who undergoing rectal cancer operation,regional chemotherapy could maintain 5-FU concentration at a higher level in portal vein,peritoneal fluid and tissue around cancer,which has significance in the prevention of metastasis to the local sites and liver after rectal cancer operation.

AIM: To explore the effects of hydrogen sulfide (H_2S) on proliferation of vascular smooth muscle cells (VSMC) stimulated by endothelin (ET-1, 10 -7 mol/L ) and mitrogen-activated protein kinase (MAPK) activity in VSMCs. METHODS: Cultured VSMCs were divided into six groups: (1) control group, (2) serum group, (3) endothelin group, (4) NaHS groups, (5) serum+NaHS group, and (6) endothelin+NaHS group. VSMC proliferation was measured by [ 3H]-TdR incorporation and MAPK activity in VSMC was determined by radioactivity assay. RESULTS: ET-1 increased VSMC [ 3H]-TdR incorporation by 2.39 times ( P

Objective To investigate the value of quantitative assessment of hepatic fibrosis and indocyanine green measurement in predicting hepatic functional reserve in rats with liver cirrhosis.Methods Female Wister rats were divided into normal control and cirrhotic group,and cirrhotic models were established.Quantitative assessment of hepatic fibrosis was done by use of computer-assisted digital image analysis,and R15ICG was measured.Results Differences of R15ICG and quantitative assessment of hepatic fibrosis between the two groups at 8 and 10 weers after hepatic fibrosis model was established were statistically significant(P

Objective To evaluate the clinical results of uncemented fully porous-coated long femoral stems in treating Vancouver type B2 periprosthetic femoral fracture following hip arthroplasty.Methods A retrospective analysis was made on 12 patients (12 hips) with Vancouver type B2 periprosthetic femoral fracture treated using the uncemented fully porous-coated long femoral stem prosthesis combined with cerclage fixation with steal-wire or titanium cable devices from February 2006 to January 2013.There were 5 males and 7 females,aged average 69.8 years (range,62 to 79 years).The status of primary arthroplasty was uncemented bipolar hemiarthroplasty in 2 patients and total hip arthroplasty in 10 patients (2 cement and 8 cementless femoral stems).At the final follow-up,Harris hip score for clinical evaluation,Beals and Tower's criteria for radiological evaluation,and complications were recorded.Results There were no intra-operative complications such as femoral perforation and femoral fracture.All patients were followed up for mean 38 months (range,24-72 months).At the last followup,mean Harris hip score was 87.2 points (range,50 to 100 points).All fractures healed at average 16 weeks (range,12-28 weeks).All the 12 hips showed prosthesis stability despite there was one femoral stem subsidence of 3 mm.One patient slipped and sustained another periprosthetic fracture (Vancouver type B1) at postoperative 4 months and was treated successfully with locking plate and cables.According to the Beals and Tower's criteria,there were 10 excellent,1 good and 1 poor results.Final follow-up revealed no complications of deep vein thrombosis,dislocation and prosthesis loosening.Conclusion Uncemented fully porous-coated long femoral stems provide good primary stability that promotes fracture healing and offers a reasonable treatment of Vancouver B2 femoral periprosthetic fracture.

The 3T road map proposed by Dougherty and Conway views translational research as a continuous process that moves from basic research through clinical (T1),postclinical (T2),and practice-based research and ultimately to health policies,outcomes,and impacts (T3).It can be used as a fundamental framework for evaluating and measuring translational research.The citation networks between publications may reveal translational interfaces,translational path,and translational lag in a specific research field,which can help researchers understand the critical content and road maps during their translational research,and thus accelerate translational medicine during T1,T2,and T3 phases of translational research.Based on the citation networks,we built a two-dimensional model for measuring the process of translational research.

Objective To assess the feasibility and clinical value of high-resolution magnetic resonance imaging (HRMRI) in patients with symptomatic severe intracranial stenosis (SSIS).Methods HRMRl wasperformed with a 3.0 T MR scanner on 5 patients with symptomatic middle cerebral(n=3) or basilar (n=2) arterial stenosis of≥70% confirmed bv DSA.Image diagnosis Was made on the basis of HRMRI findings of vessel wall at the stenotic segment by 2 neuroradiologists blinded t0 patient's status.Results Three of the five patients were diagnosed to have advanced intracranial atherosclerosis based on the presence of a complex eccentric atherosclerotic plaque containing a large lipid-rich necrotic core with a heterogeneous post-contrast enhancement and with signs of ruptured fibrous cap.Two other patients were likely to suffer from non-atherosclerotic lesion.HRMRI revealed an iso-signal septum in the arterial lumen attaching to the slighfly thickened arterial wall that was iso-signal with a homogeneous post-contrast enhancement in one patient and an obviously concentrically thickened arterial wall with hypo-intense signal on T1 WI and slightly high signal on T2 WI and PDWI and without any post-contrast enhancement in the remaining patient.Conclusions In vivo HRMRI in patients with SSIS is technically feasible.It provides detailed information of intracranial arterial wall at the stenotic segment.

Objective To investigate short-term hemodynamic changes in selected patients with middle cerebral artery(MCA) stenting by transcranial Doppler sonography(TCD).Methods Stenting was given to 29 cases (31 MCAs) of patients with moderate and severe MCA stenosis if they had recurred symptoms during the standard antiplatelet therapy.TCD was applied to assess the hemodynamic changes in the stenosis segment and stenotic distal segment before stenting, 1 h and 3 d after stenting. Results Angiography showed that the rate of post-procedure residual stenoses of MCA were less than 20%.Compared with the pre-stentinng peak systolic velocity [PSV, (273±77)cm/s], the post-stenting PSV significantly decreased,which was (162±38) cm/s (P＜0.01) at 1 hour and (168±45)cm/s ( P＜0.01)at 3 days, respectively.Three cases (3 MCA) experienced recurrent stenosis-like spectra at stenosis segments 3 d after stenting and brain CT showed that 2 out of 3 cases suffered intracranial hemorrhage,which was potentially induced by hyperperfusion; PSV doubled in the stenotic distal segment in at least 28.6% patients.There was no statistic difference between pre- and post-stenting in the contralateral MCA (P＞0.05).Conclusions Stenting can dramatically improve the hemodynamic compromise of stenosis segments and their distal segments in selected patients with symptomatic MCA stenosis, however, potential hyperperfusion risk might he taken into consideration after MCA stenting.

Objective To evaluate the relevant causes of neurologic complications following liver transplantation.Methods 155 adult patients (131 males, 24 females) who received liver transplantation for the first time at Tongji Hospital between January 2005 and September 2009 were identified.Case notes were reviewed and demographic data, details of the liver disease, neurologic complications, MELD score and discharge information were recorded.Results Neurologic complications occurred following 36 transplants (23.2 %), The complications included mental symptoms in 15 cases (41.7 %), disorder of consciousness and action in 9 cases (25 %), and coma in 12 cases (33.3 %).Twelve percent patients with liver cancer experienced a neurologic complication, which was lower than for other transplant indications, like acute and chronic hepatic failure because of HBV infection (33.3 %, P＜0.01), inborn/metabolic disease (40 %, P＜0.05), and HCV Infection (25 %, P = 0.36).Patients who experienced a neurologic problem had significantly higher MELD score (for non-cancer patients:22.93 ± 8.21; for cancer patients:17 ± 5.4) than the other Patients (for non-cancer patients:18.33 + 8.47, P＜0.05; for cancer patients:13 ±3.4, P＜0.01).The rate of infection (36.1 %) and mortality (30.5 %) were significantly higher in patients with neurologic complications (P＜0.01).The levels of ALT, TBil, ALB, PT and the concentrations of serum sodium and chlorine had no impact on neurologic complications.Conclusion Neurologic complications are common in liver transplant recipients.These complications are related to primary disease and liver function before the operation, and increase the rate of infection and mortality.