1.The Clinical Analysis of Microsurgical Treatment for Anterior Communicating Artery Aneurysm Via Pterional Approach
Ming LI ; Hualin YU ; Peng BAI
Journal of Kunming Medical University 2016;37(11):116-120
Objective To summarize treatment experiences of microsurgical clipping for anterior communicating artery aneurysm via pterional approach.Methods Clinical data of 82 cases undergoing microsurgical clipping for anterior communicating artery aneurysm via pterional approach in the first affiliated hospital of Kunming Medical University from October 2008 to December 2014 were collected and retrospectively analyzed.The patients were divided into different groups by Hunt-Hess illness grading scale,with 11 cases for level 0,7 cases for level Ⅰ,30 cases for level Ⅱ,25 cases for level Ⅲ,8 cases for level Ⅳ,and 1 cases for level Ⅴ.Twenty-one patients underwent operation at early stage of SAH (<3d),15 at late stage of SAH (4d~2W),and 35 at prolonged stage of SAH (>2W).The prognosis of patients was evaluated according to GOS classification criteria at discharge.Results A total of 85 ACoAA were found in 82 patients and all of them were clipped and,at the same time,3 aneurysms were resected and 11 thrombuses were punctured,cut and removed.In the operation,15 (17.6%) aneurysms ruptured again and temporary blocking happened for 73 times,with the shortest blocking time of 2 rmin,the longest of 40 rmin,and the average of 9.26min.According to GOS score,good recovery rate was 79.3% (65/82),moderate disability rate was 12.2% (10/82),severe disability rate was 3.7% (3/82),vegetative state rate was 0%,and death rate was 4.9% (4/82).Good recovery rates for the operations at early,late and prolonged stage of SAH were 85.7%,73.3% and 82.3% respectively and for level 0 to level Ⅴ were 90.9%,85.6%,86.7% and 84.0%,25.0% and 0.0% respectively.Results of DSA or CTA re-examination upon 55 patients followed-up at discharge or three months after discharge showed that tumor pedicle were clipped and aneurysm disappeared.Fifty cases were followed up from four months to seven years after the operation,with one case of aneurysm recurrence.Another thirty-two cases were lost to follow-up.ConclusiornS Microsurgical techniques and microdissection are keys to successful operation.Pterional approach can guarantee successful clipping of aneurysms with different directions,locations and sizes.It is also an easy,effective and reliable approach with less postoperative complications.Operation for anterior communicating artery aneurysm should be performed as early as possible.
2.A comparison of clinical outcome of radiofrequency modification and augmentation reconstruction in the treatment for partial anterior cruciate ligament tears
Bin LI ; Peng SHEN ; Lunhao BAI
Clinical Medicine of China 2016;32(9):786-790
Objective To compare the outcomes between radiofrequency modification and augmentation reconstruction in the treatment for partial anterior cruciate ligament( ACL) tears. Methods Fifty?four patients with partial ACL tears were divided into radiofrequency modification group( n=16) and augmentation reconstruc?tion group( n=38) according to different treatment methods. Minimum follow?up was 2 years. Patients were eval?uated just after the injury and at the latest follow?up with several parameters, including the international knee documentation committee( IKDC) score,Lysholm knee score,Tegner activity rating,range of motion ( ROM) and the kneelax arthrometer. Results The kneelax was (4. 4±0. 9) mm of preoperative, (5. 0±1. 5) mm of post?operative in radiofrequency modification group,the difference was no signifiacnt( t=1. 372,P=0. 183);in aug?mentation reconstruction group was (4. 7±0. 8) mm and (1. 7±1. 0) mm respectively,the knee stability was in?crease significantly postoperative;knee stability was significantly improved in the augmentation reconstruction group compared with the radiofrequency modification group( t=9. 228,P=0. 000) . In radiofrequency modifica?tion group,ROM,Lysholm score and Tegner score were improved significantly between the results pre?and post?operatively((105. 4±22. 5)° vs. (123. 5±11. 4)°,t=59. 189,P=0. 000;65(51,90)) points vs. 86(59,100) points,Z=3. 852,P=0. 000;3(1,5) points vs. 6(1,9) points,Z=4. 637,P=0. 000). In augmentation recon? struction group, ROM,Lysholm score and Tegner score were improved significantly between the results pre?and post?operatively((99. 4±21. 9)° vs. (125. 3±10. 9)°,t=6. 527,P=0. 000;(65(51,89) points vs. (85 (59, 100) points,Z=4. 427,P=0. 000;3(1,5) points vs. 6(1,9) points,Z=3. 961,P=0. 000). Conclusion Augmentation reconstruction technique is more beneficial to the knee stability than radiofrequency modification in the treatment for the partial ACL tears.
3.Clinical observation on catgut implantation at acupoint combined sodium valproate in treatment of cerebrovascular epilepsy
Dongmei LI ; Liping WANG ; Peng BAI
International Journal of Traditional Chinese Medicine 2014;(5):422-425
Objective To observe the effect of catgut implantation at acupoint on treating cerebrovascular epilepsy and discuss the therapeutic mechanism. Methods 58 patients were divided into an observation group and a control group. The control group was treated with sodium valproate, and the observation group was treated with catgut implantation at acupoint on the basis of the control group.Epilepsy scoring, sodium valproate adverse reactions, the change of blood concentrations of sodium valproate and curative effect evaluation and so on were observed before and after the treatment. Results The basic control and excellent rate in the observation group were 16.7%and 73.3%, better than the control group of 10.7%and 53.6% respectively. The epilepsy scoring and sodium valproate adverse reactions after treatment in the observation group were superior to the control group [observation group is(5.05±1.5),(5.09±1.53),control group is(6.40±1.74),(10.85±1.91),P<0.05]. The number of patients with blood concentrations of sodium valproate in range 50-100 mg/L after treatment was increased in the observation group(Z=2.07, P=0.038). Conclusion Catgut implantation at acupoint combined sodium valproate was more effective than sodium valproate in treating cerebrovascular epilepsy, which can obviously alleviate the adverse reaction of drugs and increase blood concentrations of sodium valproate.
4.Application of contrast ultrasound in diagnosis of orbital neoplasms
Gang, BAI ; Li, WU ; Peng, LI ; Liao, CHEN ; Wenwei, CHEN
Chinese Journal of Experimental Ophthalmology 2015;33(11):1028-1032
Background Orbital tumor has complex histological types and it is difficult for clinical differential diagnosis.Therefore, it is badly in need of a new diagnostic technology to distinguish its benign and malignancy.Objective This study aimed to analyze and compare the characteristics of contrast ultrasound image between benign and malignant orbital neoplasms and evaluate the diagnostic value of contrast ultrasound to orbital tumor.Methods The clinical data of 24 patients with malignant orbital neoplasms and 51 patients with benign orbital neoplasms were retrospectively analyzed in Taihe Hospital of Hubei University of Medicine from September 2010 to September 2013.Contrast ultrasound examination was carried out on all the patients using MyLab Twice color ultrasonic device under the informed consent.SonoVue solution of 2.0 ml was intravenously injected and then the state and dynamic graphs of orbital tumors were collected.According to the classification of enhanced levels and patterns,the imaging features of orbital neoplasms were evaluated, and time-intensity curve (TIC) and dynamic vascular pattern (DVP) curve were obtained with SonoLiver software.The general ultrasonic signs and contrast ultrasonic characteristics between benign and malignant neoplasms were compared.Results Hyper-enhanced lesions were found in 62.5% (15/24) and 27.5% (14/51) ,and iso-intensity lesions were found in 20.8% (5/24) and 49.0%(25/51) in the malignant orbital neoplasm patients and benign ones, respectively, with a significant difference in enhanced types between them (x2 =26.40,P<0.01).Based on the enhanced mode, heterogeneity enhancement lesions were found in 75.0% (18/24) and 25.5% (13/51), and hemogeneity enhancement lesions were seen in 25.0%(6/24) and 47.1% (24/51) in the malignant orbital neoplasm patients and benign ones, respectively, showing a significant differnee between them (x2 =30.40, P < 0.01).The 58.3% patients showed rapid rising and sharp descending TIC curves,and 75.0% patients showed the biphasic wave DVP curves in the malignant lesions;while in the benign lesions,the TIC curves of 78.7% patients were quick lift and slow dessend, and the DVP curves of 74.5 %patients appeared to be positive phasic wave.These curve features were significantly different between the malignant lesions and benign ones (TIC:Z=-3.130,P=0.002;DVP:Z =-4.730,P =0.000).Conclusions Contrastultrasound examination shows that different tissue-derived orbital neoplasms have varied enhanced modes and types.Contrast-ultrasound examination is helpful for the differential diagnosis of orbital neoplasms.
5.Expression and clinical significance of p21-activated kinase 1 in colorectal carcinoma
Weijie LI ; Yuanman REN ; Wenqi BAI ; Wengang PENG
Cancer Research and Clinic 2010;22(7):466-468
Objective To investigate the expression of p21-activated kinase 1 (PAK1) protein in patients with colorectal carcinoma and evaluate its clinicopathological significance. Methods The expression of PAK1 was detected by the immunohistochemical method (SABC) in 50 cases of colorectal carcinoma and pericancerous normal specimens, and the relationship between the expression of PAK1 protein and clinicopathological parameters was analyzed. Results The positive rate of PAK1 in colorectal carcinoma was significantly higher than that in normal pulmonary tissues (58 % vs 22 %, P <0.01), and the expression of PAK1 protein was significantly correlated to lymph node metastasis (χ2 =8.872, P =0.003) and degree of differentiation (χ2 =6.344, P =0.042), but not to tumor location, size, age and sex (P >0.05). The positive staining of PAK1 protein was mainly located in the cytoplasm of tumor cells. Conclusion Overexpression of PAK1 is closely related with tumor biological behavior and it may play important role in the development of colorectal carcinoma.
6.Simultaneous determination of 18 organophosphorous and carbamate pesticides in human plasma by UPLC-MS/ MS
Peng LI ; Zexin BAI ; Qiujin XIAHOU ; Fei GUO ; Wenji BI
Chinese Journal of Forensic Medicine 2017;32(1):51-54
Objective To develop a method for determination of 18 organophosphorous and carbamate pesticides in human plasma by UPLC-MS/MS. Methods Following deproteinization by acetonitrile, an aliquot of the biological sample was injected into a C18 column(1.7μm 2.1×50mm) using 5mmol/L Ammonium acetate-methanol as the mobile phase with the flow rate of 0.3mL/min, the injection volume was 10μL. Electro spray ionization(ESI) Indicators source was applied and operated in positive ion mode, and multiple reaction monitoring(MRM) mode was used to quantify. Results The limits of detection(LODs) in human plasma ranged from 0.1 to 40ng/mL, and the limits of quantitation(LOQs) ranged from 0.5 to 50ng/mL. An excellent linearity was observed for these LOQs up to 50ng/mL. The average extraction recoveries were with in 64.3%~111.9%, relative standard deviation(RSD) is 3.9%~10.3%. Conclusion This method is specific, sensitive and accurate, and can be used to detect pesticides in forensic.
7.MicroRNA profiling on oxidative stress induced apoptosis of human lens epithelium
Ling, BAI ; Peng, LI ; Ling, CHEN ; Ling, HE ; Feng, WANG
International Eye Science 2014;(10):1770-1772
AIM: To identify the changes in microRNA ( miRNA ) profile of human lens epithelium ( HLE) induced by H2 O2 and the role of miRNA in oxidative stress induced apoptosis.
METHODS: HLE cell line HLE - B3 was treated by 100μmol/L H2 O2 for 24h and the total RNA were isolated by Trizol reagent. miRNA profile was generated by miRCURYTM LNA microRNA Array. The target genes of differentially expressed miRNAs were predicted by bioinformatics software.
RESULTS:Twenty-eight miRNAs showed significantly differential expression after H2 O2 treatment, 18 miRNAs upregulated and 10 miRNAs downregulated. The differentially expressed miRNAs may involve in apoptosis of lens epithetium and development of cataract through targeting BCL2L2 and MIP.
CONCLUSION: H2 O2 can induce dramatically changes in miRNA profile of HLE, which may play a pivotal role in the pathogenesis and development of cataract.
8.Different Effects of Simvastatin on the Expression of Lectin-like Oxidized Low-Density Lipoprotein Receptor-1 (LOX-1) Induced by Oxidized Low-Density Lipoprotein (ox-LDL) or Glucose
Yang PENG ; Xue BAI ; Yi ZHANG ; Hui LI ; Yanmin YANG
Tianjin Medical Journal 2013;(11):1059-1062
Objective To investigate the effects of simvastatin on the expression of lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) induced by oxidized low-density lipoprotein (ox-LDL) or Glucose in U937 macrophages, and explore the role of NF-κB in modulating of LOX-1 expression. Methods U937 macrophages were treated with PMA to induce differentiation, which were co-cultured with 50 mg/L ox-LDL or/and 25 mmol/L glucose. Pyrrolidine dithiocarbamate (PDTC) and simvastatin (1 μmol/L or 10 μmol/L) were used to treat cells. The expression of LOX-1 protein and NF-κB ac- tivity were detected by enzyme-linked immunosorbent assay technology. The expression of LOX-1 mRNA was measured by RT-PCR. Results The expression of LOX-1 was up regulated by ox-LDL, glucose and combination of both. The inhibitor of NF-κB PDTC suppressed this up-regulation. Simvastatin suppressed the expression of LOX-1 induced by ox-LDL, and showed a significant effect in the higher concentration. There was no significant effect of simvastatin on the expression of LOX-1 induced by glucose. The variation of NF-κB activity was similar to that of LOX-1 expression. Conclusion Simvas- tatin suppressed the expression of LOX-1 induced by ox-LDL, while no significant effect on the expression of LOX-1 in- duced by glucose. The expression and regulation of LOX-1 were related with NF-κB pathway.
9.The effect of lipoic acid on SP-A and SP-B during acute paraquat poisoning
Shoupeng LI ; Jiyuan HAN ; Peng SUN ; Guoyan WU ; Xiangyan BAI
Chinese Journal of Emergency Medicine 2013;22(11):1213-1218
Objective To observe the changes in concentrations of pulmonary surfactant SP-A/B in lung tissue during acute lung injury (ALI) /acute respiratory distress syndrome (ARDS) induced by acute paraquat poisoning (PQP) after the treatment with metabolic antioxidant,lipoic acid,and to explore the potential involvement of TNF-α in ALI/ARDS as well as to discuss the assumed protective mechanisms of lipoic acid against acute lung injury.Methods Sixty-six male Sprage-Dawley rats were randomly (random number) divided into 3 groups,namely control group (NS,n =6),paraquat poisoning group (PQ,n =30),paraquat + lipoic acid treatment group (LA,n =30).Then both group PQ and group LA were further divided separately into five subgroups,namely 3,6,12,24 and 48 h subgroups (n =6 in each subgroup).After rats sacrificed,the lung tissues were selected,and after HE staining,histological changes were observed under light microscope.Histopathological changes were inflammation and fibrosis in models successfully established.The lung tissues were also taken for tests of SOD and MDA levels.Specimens of whole blood 0.8 mL without anticoagulant were taken from tail vein of rats for determining the TNF-α level.The expressions of SP-A mRNA and SP-B mRNA were measured with RT-PCR from total RNA of the lung tissue.Results ① HE staining showed that the histopathological changes were milder in LA group than that in PQ group.② There were significant differences in MDA and SOD levels between different intervals both in intergroups and intragroup except the groups of 3 hours (P < 0.01).③ Likewise,the significant differences in the levels of TNF-α were also present between three groups and between different intervals (P<0.01).④ The significant differences in SP-A mRNA and SP-B mRNA amplification ratio existed between three groups at the same interval (P < 0.01),but those differences between different intervals in group PQ were of statistical significance (P < 0.05).And those differences between diffirent intervals in group LA were statistically significant (P <0.01).Conclusions Lipoic acid in acute paraquat poisoning could lessen lung tissue damage,which might be directly dominated by the levels of tumor necrosis factor,and in turn indirectly affect the content of pulmonary surfactant,thereby reducing pulmonary edema and improving lung compliance,then protecting the lung tissues.
10.Comparison of clinical characteristics of new onset ulcerative colitis in the elderly versus the youth and middle-aged patients
Ping ZHAO ; Chuanfeng LI ; Yumin LYU ; Fang GU ; Peng BAI
Chinese Journal of Geriatrics 2014;33(5):503-506
Objective To analyze the differences in the clinical characteristics,endoscopy,pathology and therapy between the patients with new onset ulcerative colitis(UC) in the elderly versus youth and middle-aged patients.Methods A review analysis was carried out in the 178 hospitalized patients with UC in Third Hospital of Peking University from 1994 to 2010.The patients were divided into two groups according to the age of onset:UC onset at age of 60 years and older were enrolled in elderly group; UC onset at age less than sixty years were enrolled in youth and middle-aged group.The data of clinical manifestation,endoscopy,pathology,laboratory test,the severity of disease classification and therapy were analyzed and compared between the two groups.Results The elderly group consisted of 21 men and 6 women.The youth and middle-aged group consisted of 83 men and 68 women.The ratio of male was higher in elderly group than in youth and middle-aged group (77.8% vs.55.0%,P<0.05).No significant difference in the clinical type of UC was observed (P>0.05).The ratio of abdominal pain in elderly group was lower than in youth and middle-aged group (44.4% vs.78.8%,P<0.05).There were no significant differences in other symptoms,laboratory test and the severity of disease between the two groups (all P>0.05).The ratio of Grade Ⅰ and Ⅱwas much higher in the elderly than in youth-middle-aged group(70.4% vs.39.9%,P<0.05),but the ratio of Grade Ⅲ and Ⅳ was much lower in the elderly than in youth-middle group(29.6% vs.60.1%,P<0.05).No significant differences between the two groups were found in the extent of disease,pathological characteristics and therapy (all P>0.05).Conclusions Compared with the youth and middle-aged patients with onset UC,the ratio of male patients was higher,the ratio of abdominal pain was lower,and the severity of endoscopic manifestation was less in the elderly patients with onset UC.