Objective To study the clinical efficacy of treatment of atrophic scars of facial hemangioma after isotopes radiotherapy with micro-plasma.Methods A total of 52 patients with atrophic scars were selected under micro-plasma treatment for 4 times,one time every six weeks.And their efficacies were evaluated by compared with single standard of that before and after the treatment.Results By means of rate of clinical index,the total effective rate of atrophic scars was 82.7％.The degree of improvement was as follows:cured in 53.8％,marked effective in 28.9％,effective in 17.3％ and no case ineffective.The total effective rate of hyperpigmentation was 90.3％,including cured in 59.6％,marked effective in 30.8％,effective in 9.6％ and no ineffective cases.Conclusions Micro-plasma is an effective therapy for atrophic scars of facial hemangioma after isotopes radiotherapy,which can significantly improve the depression degree of scars,eliminate the hyperpigmentation and improve the color of scars,but it only has adverse reactions of wound pain and postoperative wound erythema.

Objective To observe the clinical efficacies of acupoint injection versus acupoint application in treating patients with chronic bronchitis due to lung-qi deficiency in remission stage.Method Totally 163 patients with chronic bronchitis were randomized into group A of 78 cases and group B of 85 cases. Group A was intervened by acupoint application, while the control group was by acupoint injection. The syndrome score of traditional Chinese medicine (TCM) was evaluated before and after treatment, the attack frequency of cold, quality of life, and pulmonary function were observed in the 6-month follow-up.Result The TCM syndrome scores were significantly changed after treatment in both groups (P<0.05). There was no significant inter-group difference in comparing the attack frequency of cold in the 6-month follow-up (P>0.05). The scores of quality of life (FS1, FS2, FS3, FS4 and TMS) in group A were significantly changed after treatment (P<0.05). The FS1 score in group B was remarkably changed after treatment (P<0.05). The parameters of pulmonary function (FEV1.0%, V50, V25, FVC, FEV1.0) were significantly changed after treatment in both groups (P<0.05).Conclusion Acupoint application and acupoint injection both can significantly improve the symptoms, quality of life, and pulmonary function in chronic bronchitis.

Objective To evaluate the feasibility,efficacy and complication of early middle cerebral artery(MCA) mechanical recanalization(MER) for treatment of acute ischemic stroke.Methods Seven cases undergone MER of MCA for the treatment of acute cerebral infarct were retrospectively reviewed and analyzed,including the etiology,mechanism,Qureshi grading scale,location and size of infarcts,NIHSS score of pre and post procedure,endovascular technique and complications.Referring to the literature,the indications of MCA recanalization were further identified.Results A total of 7 cases with mean age of 48 yrs were reviewed,which included 3 cases of atherosclerotic thrombosis and 4 embolic cases with pre NIHSS score ranging from 3 to 22.Mechanical recanalization succeeded in 6 cases,but 2 cases of cardiogenic embolism died of intrac ranial hemorrhage postoperatively.Favorable clinical outcomes were achieved in 4 cases whereas 1 deteriorated.Overall complications seemed to be consistent with literatures reviewed.Conclusions Early MER of MCA may benefit to a certain subset of acute ischemia stroke patients,however,embolic cases,elder patients and those with severe neurologic deficits are often accompanied by higher complications and unfavorable outcome.

Objective To evaluate the technical feasibility,safety and treatment effect of endovascular revascularization of symptomatic sub-acute and chronic intracranial vertebrobasilar artery occlusion.Methods Twenty-one consecutive patients with symptomatic sub-acute and chronic intracranial vertebrobasilar occlusion underwent endovascular revascularization.Perioperative complications and recurrent events during the follow-up period were recorded. The modified Rankin scale ( mRS ) scores and blood stream thrombolysis in myocardial infarction (TIMI) scores for all patients preoperatively,postoperatively and at follow-up were evaluated.The results were analyzed using Wilcoxon rank sum test and Fisher exact test.Results All 21 patients but 1 (95.2％,20/21 ) obtained successful recanalization. After the procedure,9 patients showed improvements,10 were stable,and 2 worse. The decline of median mRS scores,which was 4 preoperatively [ inter-quartile range ( IR ) 2.5-5.0 ] and 4 ( IR 1.0-5.0 ) on discharge from the hospital respectively,showed significant statistical difference (Z =2.810,P ＜ 0.01 ).Three ( 14.3％ ) patients suffered periprocedural complications,namely basal arterial dissection,intra-stent thrombosis and postoperatively acute occlusion in each one.There was no death,stoke or recurrent transient ischemic attack (TIA) occurring 30 days after the procedure. During the 7 months after operation,which was the mean clinical follow-up duration,TIA and recurrent stoke occurred in one patient respectively,and two patients died of systemic complications. The median mRS scores were 2.0 (IR 1.0-4.0 )in all 21 patients and 1 ( IR 1.0-4.0) in the surviving subjects.Conclusions Endovascular revascularization for the recanalization of symptomatic sub-acute and chronic vertebrobasilar artery occlusion is technically feasible,and helps to prevent ischemic events and improve disability recovery. However,its exact effect needs further verification by future random controlled studies.

BACKGROUND: Exogenous neural stem cells (NSCs) can repair nerve and promote recovery of neurofunction following cerebral hemorrhage.OBJECTIVE: To observe the growth and development of NSCs in vitro, to evaluate the survival, migration and differentiation of transplanted NSCs surrounding hematoma and the possible recovery function of NSCs, and to investigate the repairing effect of NSCs on damaged neurofunction in cerebral hemorrhage model rats.DESIGN: Completely randomized grouping design and controlled animal study,SETTING: Department of Neurosurgery, Huashan Hospital, Fudan University.MATERIALS: Eighteen adult healthy male SD rats weighing 280-320 g were provided by Shanghai Animal Center of Chinese Science Academy. BrdU was provided by Neomarkers Company; rat-anti-glial fibrillary acidic protein (GFAP) and rabbit-anti-microtubule-associated protein-2 (MAP-2) by Chemicon Company.METHODS: This study was performed at the Laboratory of Anatomy and Histology & Embryology, Shanghai Medical College,Fudan University from February to December 2006. The NSCs was isolated, cultured, and evaluated from hippocampus of day E14fetal SD rats. Eighteen rats were randomly divided into control group, PBS group and NSC transplantation group. Cerebralhemorrhage rat models were established via injection of autoiogous arterial blood in caudate nucleus. Thirty minutes after model establishment, 5 μ L NSC suspension with the concentration of 2×1011 L-1 was transplanted at four points surrounding hematoma cavity in the NSC transplantation group. Transplantation of PBS and NSCs was the same as autoblood transplantation. Thirty minutes after model establishment, injuries at the four points were performed, and nothing was injected in the control group.MAIN OUTCOME MEASURES: Neurofunction was evaluated with forward limb scale and turning scale just soon after transplantation and at 1, 3, 5, 14, and 28 days after transplantation. Brain was colleted by anesthesia 28 days after model establishment.Differentiation of transplanted NSCs was detected through testing GFAP, MAP-2, and BrdU by using immunohistochemistry.RESULTS: ①Neurofunction scores: There was no significant difference 5 days after model establishment (P＞0.05). However, the scores were significantly improved in the NSC transplantation group 14-28 days after model establishment (P＜0.05).②lmmunofluorescent double labeling: Apoptosis ceils around hemotoma in the NSC transplantation group were less than those in the PBS group. BrdU and MAP-2 or GFAP-positive ceils were observed in cerebral tissue sections, and this suggested that NSCs could survive, migrate and differentiate in host brain and differentiate into neurons or astrocytes.CONCLUSION: NSC Transplantation contributes to the recovery of neurofunction in cerebral hemorrhage rats through differentiation into neurons or astrocytes.

Objective To evaluate the mid-and long-term follow-up outcome of revascularization and stenting of nonacute intracranial vertebrobasilar artery occlusion. Methods Consecutive data of 27 patients who suffered from nonacute intracranial vertebrobasilar artery occlusion beyond 24 hours and underwent endovascular revascularization, were retrospectively collected and analyzed. Complications and recurrent ischemic events during the follow-up period were recorded. The modified Rankin scale(mRS) scores were used and compared between pre-and postoperation. Results All 27 patients except one(96.3%) obtained successful recanalization. After the procedure, 13 patients showed improvement, 11 were stable, and 3 worse. The decline of median mRS scores, which was 4(interquarter range-IR, 2-5) preoperatively and 3(IR, 1-5) on discharge. Five patients suffered from procedural complications and three of them resulted in aggravation. Nineteen patients received imaging follow-up during the median 10 months, 6 restenosis occurred and 3 of them were symptomatic. During median 55 months clinical follow-up after operation, 2 ipsilateral stroke and 2 ipsilateral transient ischemic attack occurred. The mRS scores decreased significantly in the first one year after procedure. Conclusions Revascularization and stenting of nonacute intracranial vertebrobasilar artery occlusion can prevent recurrent ipsilateral ischemic event and improve disability recovery in the first one year.

Objective To evaluate the technical feasibility,safety and mid-term effect of endovascular revascularization of nonacute intracranial vertebrobasilar artery occlusion.Methods Consecutive data of patients who suffered from nonacute intracranial vertebrobasilar artery occlusion beyond 24 hours and underwent endovascular revascularization,were retrospectively collected and analyzed.Complications and recurrent events during the follow-up period were recorded.The modified Rankin scale (mRS) scores were used to compare the symptoms before and after the procedure.Results All 27 patients but 1 (96.3％) obtained successful recanalization.After the procedure,13 patients showed improvements,11 were stable,and 3 worse.The decline of median mRS scores,which was 4 [interquarter range(IR),2-5) preoperatively and 3 (IR,1-5) on discharge,showed significant statistical difference (Z =3.116,P =0.002).Five patients had procedural complications,namely 2 dissection,1 in-stent thrombosis during the operation,1 thrombus disruption and translocation during the operation and 1 acute reocclusion after operation.During the follow-up period with the median of 21 months,3 death,1 stroke and 2 transient ischemic attack occurred.The latest median mRS scores were 1 (IR,0-3).The ratio of patients with mRS ≤ 2 increased from 25.9％ (7/27) before operation to 63.0％ (17/27) at the follow up.Seventeen patients received imaging follow-up during the 9 months,with restenosis in 6 and symptom in 3 of them.Subgroup analyses revealed better functional recovery (lower mRS) both in patients with vertebral artery occlusion (Z =2.111,P =0.035) and those with basilar artery occlusion (Z =2.333,P =0.020).Conclusions Endovascular revascularization for the nonacute intracranial vertebrobasilar artery occlusion beyond 24 hours is technically feasible,and improves disability recovery.However,the rates of procedural complication and restenosis are high.

Objective To retrospectively evaluate the cerebrovascular complications from stenting for symptomatic intracranial stenosis and to detect the factors associated with complications.Methods Medical records of Wingspan stenting were reviewed for 306 cases with symptomatic intracranial stenosis from July 2007 to February 2012,including transient ischemic attack,ischemic stroke,death and intracranial hemorrhage as clinical in-hospital complications.The location of lesions included middle cerebral artery level M1 (114 lesions),intracranial portion of the internal carotid artery (50 lesions),vertebral artery 4(75 lesions),venebro-basilar artery (14 lesions),basilar artery (76 lesions).Complications were evaluated and analyzed to find out whether they were associated with patient-or stenosis-related risk factors using x2test.Results The technical success rate was 99％ (303/306).Cerebrovascular complications rate was 6.9％ (21/303),with 1.6％ (14/303) of disabling stroke events and 0.7％ (2/303) of deaths.Hemorrhagic events were consisted of procedure-related events (3 cases),hyperperfusion (3 cases),ischemic events of perforator stroke (8 cases),transient ischemic attack (3 cases),embolization (2 cases),thrombosis in stent (2 cases).Hemorrhagic events were associated with significantly higher morbidity and mortality rates(x2 =2.908,P ＜ 0.05) and occurred more frequently after treatment of middle cerebral artery stenosis than other lesions(x2 =1.168,P ＜ 0.05).Perforating branches were detected to be affected mainly in the basilar artery than other locations (x2 =4.263,P ＜ 0.05).Conclusion The complication rates in the study are preliminary consistent with the previously published data.Hemorrhagic events are prone to occur in the treatment of middle cerebral artery stenosis,while perforating branches are affected mainly in the basilar artery.

Chemotherapy is one of the traditional tumors treatment solutions.Chemotherapy has the feature of tissue non-specificity,which can cause side effects on normal cells while inhibiting tumor cell growth.Magnetic targeting drug delivery system (MTDDS) employs biocompatible and stable magnetic nanoparticles (MNP) as drug carries to transport and accumulate anticancer drugs to the specific tumor tissues under the guidance of external magnetic field.This technology not only improves the efficiency of drug delivery and antitumor activity,but also reduces the drug dosage and side effects.The properties of drug-loaded MNPs and the applied external magnetic field are the main factors that affecting the MNPs targeting to the tumor tissues.The effectiveness of the targeted delivery of the drug-loaded magnetic nanoparticles mainly depends on the form and strength of the magnetic field at the target site.That is,whether there is sufficient strength to attract and retain NMPs,and to promote antitumor drug release at the tumor region.In this paper,the research progress of static magnetic field targeting drug delivery system in tumor diagnosis and therapy was summarized,which can provide some basic information for the relative scientific researches.

Objective To investigate the outcome between endoscopically assisted and routine anterior transposition of the ulnar nerve for treatment of cubital tunnel syndrome.Methods From Februray 2008 to June 2010, forty-four patients with cubital tunnel syndrome were treated with routine anterior subcutaneous transposition (routine group,28 cases) and endoscopically assisted anterior subcutaneous transposition (endoscope group,16 cases).The operate time,drug administration,scar and postoperative hospital stay were compared.The patients were followed 1-12 month postoperatively,postoperative time back to work and function of ulner nerve were recorded.Results The results of endoscope group were as follows: operative time was (67.20 ± 19.69)min; postoperative scar length was (1.5％ ± 0.58) cm; rate of administration of anodyne was 6.3％; postoperative hospital stay was (2.4％ ± 1.42) days; postoperative time back to work,(14.6 ± 4.69)days; the results of open surgery group were as follows:operative time (62.8％ ± 11.06) min; postoperative scar length was (8.7％ ± 1.42) cm; rate of administration of anodyne was 42.8％; postoperative hospital stay was (5.7％ ± 2.53) days; postoperative time back to work was (29.40 ± 8.75) days; all differences of the results were significant between two groups (P ＜ 0.05).According to function of ulner nerve scoring system,one year postoperatively, excellent or good results were 82.14％ in routine group and 81.25％ in endoscope group,no significant difference between two groups (P ＞ 0.05). Conclusion Compared with routine anterior transposition of the ulnar nerve,endoscopically assisted anterior transposition has the following advantages: smaller incision and less tissue damage,less postoperative pain and sooner returning to work.And similar outcome was achieved from the two group.