Objective To evaluate the hemodynamics change of brain before and after vertebrobasilar angioplasty and stenting in the patients with intracal stenosis.Methods All the indexes were compared among thirty-eight patients with intracal arterial stenosis,including mean peak flow velocity,systolic peak flow velocity,and resistance index of hemodynamics ; Cerebral blood volume ( CBV),cerebral blood flow (CBF)and middle time to peak(MTT) before and after the operation.Results After vertebro-basilar angioplasty and stenting in the 38 patients,the Vs of PCA were significantly lower in the affected side [ (226 ±27)cm/s vs (135 ± 18)cm/s; t =21.74,P ＜0.01 ].Significant difference was found between pro-and post stenting of rMTT and rCBF in the blood territories of stenotic cerebrovascular ( t =3.987,P =0.001 )and( t =-2.027,P =0.029),There was no significant difference between pro-and post stenting of rCBV in the blood territories of stenotic cerebrovascular ( t =-0.901,P =0.329).Conclusions Transcranial Doppler and CT perfusion can be used to evaluate hemodynamic changes before and after pereutaneous transluminal angioplasty and stenting.

Objective To investigate the influence of different interventional treatment timing on the prognosis of patients with intracranial aneurysms. Methods One hundred and thirty-eight patients with ruptured intracranial aneurysms were divided into group A (Ⅰ- Ⅲ grade) with 109 cases and group B ( Ⅳ- Ⅴ grade) with 29 cases according to Hunt-Hess grade when admitted. All patients received interventional treatment, the operation period was divided into early, middle and late stage according to the different time from disease time to operation, then compared the good rate, cerebral vasospasm and hydrocephalus incidence of patients underwent surgery at different period. Results The good rate at different period in group A were respectively 69.7% (23/33),58.8% (10/17) and 61.0% (36/59),which and the cerebral vasospasm and hydrocephalus incidence of patients underwent surgery at different period in group A had no significant difference(P > 0.05). The good rate of patients received surgical treatment at early stage in group B was 46.2%(6/13), which was significantly superior to late stage (0), the difference was statistically significant (P < 0.05), while the cerebral vasospasm and hydrocephalus incidence of patients underwent surgery at different period in group B had no significant difference(P> 0.05). Conclusion The prognosis of patients with Hunt-Hess grade Ⅰ - Ⅲ grade undergoing interventional treatment at early, middle and late stage can be satisfactory, while grade Ⅳ - Ⅴ grade patients should receive interventional treatment at early stage.

Objective To assess the safety and efficiency of Angioseal device in patients undergoing percutaneous femoral artery puncture in brain angiograph or interventional therapy. Methods A prospective trial was carried out in 128 patients undergoing brain angiograph and interventional therapy,in which 93undergoing brain angiography and 35 interventionsl therapy. All patients were divided into pure compression group by manual compression (83 cases) and vascular blocking group by Angioseal device (45 cases)according to different hemostatic measures. Results In angiography, hemostasis time of vascular blocking group and pure compression group was (1.8 ±0.8) min and(20.2 ±9.4) min (P＜0.01 ),ambulation time was (3.8 ± 0.8) h and (19.4 ± 2.2) h (P ＜ 0.01). In interventional therapy,hemostasis time of vascular blocking group and pure compression group was (2.0 ± 1.1) min and (24.5 ± 10.3) min (P ＜ 0.01), ambulation time was (4.3 ± 1.5) h and (24.3 ± 3.2) h (P＜ 0.01). Pure compression group had higher complication rate (such as bleeding,hematoma,skin ulceration and blister) than vascular blocking group (P＜0.01).Conclusion Angioseal closure device is safe, efficient and easy to use.

ObjectiveTo study the clinical effect of YL-1 type hematoma puncture needle in the treatment of basal ganglion region cerebral hemorrhage.MethodsSixty-two patients with hypertensive basal ganglion region cerebral hemorrhage were treated by YL-1 type hematoma puncture needle from January 2007 to May 2011 (minimally invasive punctural evacuation group),of which,60 patients were treated by conservative treatment(conservative treatment group) as control,compared two groups of neural function defect score,hematoma clearance rate on admission,after 3 weeks treatment,and quality of life after 6 months.ResultsNeural function defect score on admission of minimally invasive punctural evacuation group was (23.6 ± 18.4) scores,while (23.4 ± 17.8) scores in conservative treatment group,the difference was not statistically significant(P ＞ 0.05).After 3 weeks' treatment,neural function defect score and hematoma clearance rate of minimally invasive punctural evacuation group was superior to conservative treatment group [ (14.6 ± 12.4) scores vs.(20.1 ± 18.4) scores,(92.3 ± 5.4)％ vs.(79.5 ± 13.8)％ ] (P ＜0.05 ).After 6 months' treatment,the good rate of quality of life in minimally invasive punctural evacuation group was 81.7％(49/60),which was significantly increased compared with that of conservative treatment group [67.2％ (39/58)] (P ＜ 0.05).ConclusionsThe minimally invasive punctural evacuation in the treatment of basal ganglion region cerebral hemorrhage has small invasion,better prognosis,effective and fast decompression of intracranial hematoma,reducing disability rates,improvement of the quality of life,which could be a beneficial complement for traditional therapies.

Objective To investigate the dynamical changes of Rho kinase in the cerebrospinal fluid (CSF) and its relationship with cerebral vascular spasm CVS. Methods CSF were collected on the ist, 3rd, 7th, 10th and 14th day after subarachnoid hemorrhage. The expression of Rho-kinase mRNA in CSF was determined by RT-PCR. The expression of endothelin-1 in CSF was determined by radioimmuno-assay. TCD was used to measure the velocity of the cerebral artery. Results The levels of ET-1 and Rho-kinase mRNA in CSF were re-markably increased on the 3rd day, and reached at the peak on the 7th day after subarachnoid hemorrhage, which were significantly higher than those without CVS. Conclusion There is a positive correlation between the level of Rho-kinase mRNA and ET-1 in CSF. Rho-kinase may participate in the development of CVS.

We investigated the effects of IFN-γ on Chlamydia psittaci (Cps) infection.HeLa cells were treated with different concentrations of recombinant human IFN-γ (5 ng/mL,25 ng/mL,50 ng/mL) after infecting with C.psittaci 6BC,then the number and morphology of C.psittaci inclusion bodies were examined after 48 hours.C57BL/6J mice were intranasally infected with 2 × 106 IFUs C.psittaci 6BC,and intraperitoneally administrated with 10 μg recombinant murine interferon-γ 24 hours prior or post infection,then body weight,activity and survival rate were recorded.The histopathology of mice livers and lungs was analyzed by HE staining on day 5 or day10 post infection.And the chlamydial inclusion bodies were titrated in the lung homogenates of mice sacrificed on day 5 after infection.The inclusion body numbers of recombinant human IFN-γ treated groups (by 5ng/mL,25ng/mL,50ng/mL) were significantly less than that in the control group (23.8±5.1)× 106,(10± 3.58) × 106,(8.0±2.22) × 106,(43.3±11.05)× 106,respectively).And the morphology of inclusion bodies in IFN-γ treated HeLa cells was irregular and much smaller.We also found that IFN-γ could significantly improve the survival rate,reduce acute clinical manifestations and pathological injurery of lung and liver in C.psittaci respiratory tract infected mice model.So we summarized that IFN-γ can mediate strong immunological protection during acute C.psittaci early infection.

Objective To discuss the MRI findings of common complications following hip arthroplasty and their association with operative and pathological findings to improve the early diagnosis and etiological differential diagnosis for common complications following hip arthroplasty. Methods Forty-six patients with hip arthroplasty complication were included in this study. We observed prosthesis location, signal changes between prosthesis and bone, and periprosthesis signal changes, signal changes of articular capsule, adjacent soft tissue and bone on MR images. Diagnostic value of MRI in detecting hip arthroplasty complication was evaluated with operative and pathological findings as reference standard. Results Complications following hip arthroplasty included aseptic loosening (n=26), osteolysis (n=12), infection (n=12), heterotopic ossification (n=4), pseudoneoplasm (n=4) and periarthroplasty fracture (n=1). The MRI finding suggestive of aseptic loosening in 24 cases was a smooth intermediate signal intensity layer along the interface. Osteolysis is seen as soft tissue signal intensity material replacing normal high signal intensity fatty marrow in 12 cases. Bone marrow edema, bone destruction, fluid collection, estracapsular collections, periprosthetic muscle edema, and sinus were predictors of infection. On MRI, mature heterotopic ossification had the appearance of cancellous bone in 5 cases. Pseudoneoplasm represents fluid signal intensity with intermediate signal intensity pseudocapsule in 5 cases. Periprosthetic fracture included hypointesense fracture lines, periosteal reaction, and periprosthetic muscle edema in one patient. Conclusion MRI is useful in detecting osseous and soft-tissue abnormalities in patients with hip implants.

Objective To evaluate the value of captopril challenge test (CCT) in the diagnosis of primary aldosteronism (PA).Methods A total of 674 patients [(45.0±13.7) years, men 341, women 333] admitted to Peking Union Medical College Hospital from 2000 to 2015 were analyzed.Among them, 222 subjects were with essential hypertension (EH), 28 were with pheochromocytoma (PHEO), 246 were with idiopathic hyperaldosteronism (IHA) and 178 were with aldosterone producing adenoma (APA).All patients received CCT.24 h urine sodium was measured in partial patients.Plasma renin activity (PRA), aldosterone (ALD) were detected.Results Compared with EH [PRA: before 0.5(0.2,0.9) μg·L-1·h-1, after 0.8(0.4,1.5) μg·L-1·h-1;ALD: before (393±122) pmol/L, after (360±97) pmol/L] and PHEO [PRA: before 0.3(0.1,0.9) μg·L-1·h-1, after 0.4(0.1,1.6) μg·L-1·h-1;ALD: before (396±108) pmol/L, after (374±114) pmol/L], lower levels of PRA and higher levels of ALD before and after CCT were observed in PA patients [PRA: before 0.1 (0.1,0.2) μg·L-1·h-1, after 0.1 (0.1,0.2) μg·L-1·h-1;ALD: before (468±216) pmol/L;after (457±199) pmol/L].After CCT, the suppression rate of ALD [2.8% (-8.8%,15.4%) vs 6.6% (-4.3%, 17.6%)] and increasing rate of PRA [0(0,50%) vs 50%(0, 200%)] in PA patients were lower than those in EH patients.The ALD/PRA ratio (ARR) were higher in PA than that in EH or PHEO patients.In the EH subjects, ALD levels of seated posture were higher than those of recumbent posture both before and after receiving captopril, but with no changes in ARR after CCT.No significant differences in ALD and ARR (before and after receiving captopril) were observed between seated and recumbent position in the PA group.The ARR after CCT tended to decrease in EH subjects with elevated urine-sodium compared with those with normal urine-sodium.No changes could be viewed in ALD and PRA levels between normal urine-sodium and elevated urine-sodium groups among APA, IHA and EH patients either before or after CCT.Among patients with APA, the ALD levels before CCT and the ARR after CCT were lower in the patients with AngiotensionⅡ(AngⅡ) reactive than those without.A ROC curve analysis suggested that the optimal cutoff value was 46.2 (ALD unit:ng/dl;PRA unit:μg·L-1·h-1) for ARR after challenge in diagnosing PA, with the sensitivity of 88.7% and specificity of 84.8%.Conclusions ARR after 25 mg captopril had high sensitivity and specificity in diagnosis of PA with the cutoff of 46.2.Seated CCT could replace recumbent CCT as a more confirmatory test.The PRA increasing rate should be taken into consideration when diagnosis of PA.

Objective To evaluate the efficacy and safety of a new drug,human urinary kallidinogenase,against acute brain infarction.Method A 15-center,randomized,double-blinded and 3:1 placebo-controlled study was carried out.Acute brain infarction within 48 hours of onset in the territory of the middle cerebral artery were indicated as subjects;kallidinogenase or placebo which was dissolved in 50 ml saline,was slowly injected intraveousely within 30 minutes daily for 3 weeks.The European Stroke Scale and Barthel Index were used to evaluate the neurological deficit and the activities of daily living(ADL),followed by a follow-up at the end of the third month.Results 446 patients were enrolled,who completed ITT analysis,including 330 in kallidinogenase group and 116 in placebo group,meanwhile 421 proceeded with PP analysis(311 and 110 respectively).There were no significant differences of the baseline data between the 2 groups.At the end of treatment,the ESS scores increased by 55.1%?33.0% and 44.7%?32.8% respectively in kallidinogenase group(KG)and placebo group(PG,P=0.0022),the difference being significant.PP analysis had similar results.As for ADL,follow-up 90 days after the treatment showed 374 cases followed,280 in KG and 94 in PG;1 died in PG,while none in KG.In KG,the cases whose BI≥50 were significantly more than those in PG(P=0.0228).Adverse events possibly or definitely attributable to the drug were observed in 27 cases(7.74%),mostly were mild,such as palpitation,flush,dizziness, nausea etc,without special management needed.Only 2 died which was confirmed not correlated to kallidinogenase,and another 2 cases of sudden blood pressure drop were observed.The blood pressure drop, quickly restoring soon after the withdrawal of kallidinogenase and use of hemopiesic drugs,was considered to be caused by the combination use of anti-hypertensive drug ACEI and quick infusion speed.Conclusion Kallidinogenase is efficacious for acute brain infarction in improving the neurological deficits,which is safe in clinical use.

An actinomycetes which produced soluble blue pigment was isolated from the soil sample in Nanjing,China.Based on its cell chemical characteristics and 16S rDNA sequence we found that its cell wall contained L-diaminopimelic acid and glycine,the whole cell hydrolysates contained glucose and ribose,whole cell contained fatty acid from C14 to C17 with 12-methyltetradecanoic(anteiso-15) and 14-methylpentadentadecanoic acid(iso-16) as the major components.The results shown that,it belongs to the genus Streptomyces.Phylogenetic tree of 16S rDNA sequences indicated that all strains were clustered into 9 branches.All strains that could produce blue pigment were clustered into 2 branches,they were S.coelicolor、S.cyaneus.The isolate closely related to Streptomyces indigocolor with a similarity of 99.4% fell into S.cyaneus branch.