As an effective therapeutic approach for acute ischemic stroke,endovascular interventional therapy has received increasing attention.However,a large number of revascularization clinical trials have shown that its mortality rate and the incidence of complications are higher than intravenous thrombolysis.This article reviews the perioperative complications of endovascular interventional therapy of acute ischemic stroke and thek treatment.

Endovascular interventional therapy can signifantly improve the clinical outcomes in patients with acute ischemic stroke.It has become the important therapeutic means and research focus for acute ischemic stroke.However,there are many factors affecting its efficacy.This article reviews the factors affecting the treatment effect of endovascular interventional therapy of acute ischemic stroke.

Fanconi anemia (FA) is an rare autosomal recessive inherited disease which manifests progressive marrow failure, congenital bone malformation, high risk to cancers and so on. Chromatin of FA cells display auto-instability and high hypersensitivity to interstrand DNA cross-links such as mitomycin C. As normally FA develop into acute myeloid leukemia easily, it has been regarded as pre-leukemia state. Till now 11 FA genes have been found and play a role in sustaining stability of gene groups through the same mechanism. As an active connecting protein, FANCF protein play an important part in correct FA complex formation. Which makes FANCD2 single ubiquitin. Ubiquitin FANCD2 induces chromatin and BRCA1 interact, and repair injured DNA. FA gene defect makes gene group instable and increases the risk of chromatin collapse, which finally leads to acute myeloid leukemia and myelodysplastic syndrome.

As teaching overseas students have its particularity,we made efforts to investigate laboratory teaching of pathology.Beneficial progresses on language,teaching preparation and teaching skills were made to improve our work.In the practice,we gained some enlightenments and experiences.

Objective To investigate the factors and rate of the forming of the collateral feeding arteries from inferior phrenic artery(IPA) in hepatocellular carinoma(HCC).Methods IPA was demonstrated on angiographs in 137 patients with HCC during transcatheter arterial chemoembolization(TACE),TACE was performed through diaphragmatic inferior artery(DIA) super setectively.Results Of 137 cases,21 cases underwent TACE through DIA(15.3%),of them 2 cases were recurrent after surgical operation(9.5%),3 cases had the tumor receive blood supply from IPA at first TACE(14.3%) and 16 cases were occured after TACE tow and more times(76.2%).Conclusion Collateral branches originated from IPA are important feeding arteries in HCC,TACE of IPA can be performed with a high success rate without major complications.

ObjectiveTo discuss the diagnosis and treatment of spontaneous carotid artery dissection (SCAD).Methods Clinical diagnosis and treatment data of 9 patients with SCAD were analyzed retrospectively.ResultsVascular ultrasound showed stenoses or occlusions of carotid artery.Angiography showed “flame-shaped ” sign in totally occluded proximal section and free intimal flap in stenoses section.One patient with total occlusion of bilateral internal carotid artery and 6 patients with total occlusion of unilateral internal carotid artery were treated with antiplatelet therapy.Two patients with incomplete occlusion of the carotid were operated with stent implantation in carotid arteries,and the clinical effect of both operations was satisfactory.ConclusionAngiography remains the gold standard in diagnosing SCAD,and stent implantation is an effective treatment of this disease.

Objective To study the correlation between N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac diastolic and systolic function. Methods 60 New Zealand male rabbits were randomly assigned to two groups. The abdominal aorta 1 cm just above right renal artery were constricted in operated group. The clinical manifestation of heart failure was observed, and cardiac structure and function were investigated with echocardiography. Concentration of serum NT-proBNP was determined regularly. Results The concentration of NT-proBNP was correlated with Sm（r=－0.635,P=0.000）, Em（r=－0.693,P=0.000）, E/Em（r=0.688,P=0.000）, E/Vp（r=0.707, P=0.000）, and EF（r=－0.395,P=0.001）. Conclusion Concentration of serum NT-proBNP could prognose the diastolic and long axis systolic function of left ventricle.

Objective To establish an animal model of heart failure with preserved ejection fraction(EF)resulting from hypertension.Methods35 male New-Zealand rabbits were randomly assigned to 2 groups:constriction was performed at the abdominal aorta 1 cm just above right renal artery in operated group(n=25),and the sham-operated animals were taken as control group(n=10).The clinical manifestations of heart failure were followed up carefully.Systolic and diastolic function,and systemic hemodynamics were investigated with echocardiography and left ventricle catheter.ResultsIn operated group,marked ventricular hypertrophy was observed 2 weeks after operation.4 weeks after operation,the clinical manifestations of heart failure presented,and IVRT and LVEDP increased,and-dp/dt max decreased.Tissue doppler image indicated that e/a ratio of annulus of mitral valve decreased(P<0.05).However,EF and +dp/dt max were preserved.ConclusionThe operated animals presented the clinical manifestation of heart failure,and diastolic function of left ventricle injured,however,ejection fraction was preserved,which corresponded with the character of heart failure with preserved ejection fraction resulting from hypertension.

ObjectiveTo study the changes of cellular immunity caused by intravenous infusion of allogenic rhesus mesenchymal stem cells (MSCs).MethodsMSCs were isolated and cultured.Then the immunomodulatory effects after MSCs infusion were evaluated by means of peripheral blood counts,mixed lymphocyte reaction (MLR) and analysis of lymphocytic subgroup. ResultsMSCs of rehsus were successfully cultivated. No acute toxicities or GVHD were observed in recipients. No obvious changes of peripheral blood counts were present. Recipients A2, A3, A4 were administered with MSC by 4.0 ×105/kg, 1.0 ×106/kg, 2.0×106/kg respectively and relative reaction (RR) of MLR decreased 14 days post MSCs infusion: from 46±2.6 ％to 40.4±1.73 ％ (F =10.19, P =0.023), from (40.9±2.3) ％ to (33±2.1) ％ (F =2.593, P =0.013), from 48.3±2.0 ％ to 39±1.0 ％ (F =28.431, P =0.003) respectively. The decrease degree (ARR) was positively related to the amount of MSCs(F =27.413, P =0.038). RR was restored within 30 days post MSCs infusion. After MSCs infusion, CD3+ CD3+CD4+ and CD3+CD8+ T-lymphocytes decreased in recipient A4, who was administered with the largest number of MSCs, and restored within 30 days. ConclusionMSCs infusion without any other treatment could temporarily inhibit immunity of T lymphocytes in MLR and the immunity inhibition was positively related to the amount of MSCs.The specific immunological characteristics of MSCs were demonstrated with extensive prospect in clinical research.

Objective To establish a rapid,accurate and specific method to detect the common mycobacteria based on multiplex real-time PCR.Methods The dual priming oligonucleotide ( DPO)primers and TaqMan probes labeled with FAM,ROX,HEX or JOE fluoresceins at 5' end and eclipse at 3' end respectively were designed to detect the 16S rRNA of mycobacteria.Both specificity and sensitivity were estimated on multiplex real-time PCR detecting genome DNA from 4 mycobacterial model species.Sixty eight early morning sputum specimens collected from hospitalized patients in the Red Cross Hospital of Hangzhou were detected by multiplex real-time PCR,bacterial culture and smear microscopy simultaneously.The positive rates were analyzed by chi-square.Results Mycobacteria including Mycobacterium tuberculosis and three common non-tuberculosis mycobacteria spp.were identified by multiplex real-time PCR accurately and specifically,with the limited load at 101 cfu/ml.In 68 sputum specimens,31 were positive (positive rate 45.6％ ) by this method,which was significant higher than that by smear microscopy ( positive rate 14.7％,x2 =15.4,P ＜0.05 ).The positive cases were identified as 28 Mycobacterium tuberculosis,1 Mycobacterium avium and 2 Mycobacterium intracellulare in agreement with the culture results.One case,which is detected by culture,but not by PCR,was identified as Mycobacterium chelonae by sequencing.Conclusion The multiplex real-time PCR characterizing as sensitive,specific and time-saving for Mycobacterium tuberculosis and common non-tuberculosis mycobacteria could be chosen as the rapid laboratory test of mycobacterial infection.