BACKGROUND:Few cases of acute cerebral embolism were treated by mechanical thrombectomy al over the world. However, there were few cases currently treated by mechanical thrombectomy using Penumbra system. It is an unclear understanding of effects on regional cerebral blood vessels using this kind of surgery.
OBJECTIVE:To describe effects of numerical simulation on regional cerebral blood vessels of an acute cerebral embolism patient by mechanical embolectomy using Penumbra system.
METHODS:A 77-year-old woman suffering from acute cerebral embolism of left middle cerebral artery was selected. Various raw data were col ected in emergency of digital subtraction angiography, then mechanical thrombectomy using Penumbra system was carried out successful y. After these raw data were processed into dimensional numerical models of two kinds of embolectomy methods (“suction bolt method from near to far”and“suction bolt method from far to near”), and then finite element analysis was carried out.
RESULTS AND CONCLUSION:Model establishment and finite element analysis were successful y conducted. Compared with“suction bolt method from near to far”,“suction bolt method from far to near”models had smal er velocity of flow in catheter and smal er wal shear stress of thrombus (P<0.01), and had larger wal shear stress of blood vessel wal , deformation of blood vessel wal (P<0.01) and deformation of thrombus (P<0.05). Results suggested that finite element analysis of mechanical embolectomy using Penumbra system can help physicians to involve in a clear understanding of their impacts on cerebral blood vessels of patients. As a research method, it is worth to continue to explore in the future.

BACKGROUND: Anti-virus therapy is not suitable for the patients who have asymptomatic human immunodeficiency virus (HIV); otherwise, it is significant for early intervention of Chinese herbs to cure asymptomatic HIV.OBJECTIVE: To observe the interventional effects of fuzheng paidu pian on level of CD4+T lymphocytes and changes of plasma viral vector expression in early phase of asymptomatic HIV infection.DESIGN : Observational contrast study.SETTING: Institute of Acquired Immunodeficiency Syndrome (AIDS), Henan College of Traditional Chinese Medicine.PARTICIPANTS: A total of 69 asymptomatic HIV patients, who were infected by paid blood, were randomly selected from some countryside in November 2005. There were 39 males and 30 females. Their ages ranged from 30 to 61 years and the mean age was (43±8) years, and the mean course was (13±3) years. Inclusion criteria: ① coincident with diagnostic criteria of asymptomatic HIV infection published by National AIDS committee (modified in 2005); ②from 18 to 65 years old; ③ 200/mm3 ≤CD4+T lymphocyte count ＜ 600/mm3; ④ Patients did not treat with antiviral and other drugs; ⑤ All patients provided the confirmed consent. Exclusion criteria: ① severe liver and renal malfunction,combining with cardio-cerebral vascular disease and severe primary diseases of lung and hematopoietic system,mental diseases; ② primary immunodeficiency, secondary immunodeficiency induced by hormone and radiation therapy, hematologic disease; ③ pregnant or lactational women. Another 25 asymptomatic HIV patients were randomly selected.and regarded as the blank group. Inclusion and exclusion criteria were as the same as those in the treatment group.METHODS: Patients in the treatment group were treated with fuzheng paidu pian (consisting of huangqi, raw baizhu,fangfeng, baihuashe shecao, ganca o, etc.; Aolinte Pharmaceutical Factory of Henan Institute of Traditional Chinese Medicine; batch number: 050601) by using warm boiled water, 5 tablets once (eqUal to 6.6 g raw materials) for three times a day. Three months were regarded as a course and the treatment was performed four courses in total. Patients in the blank group were not treated with any drugs.MAIN OUTCOME MEASURES: ① Values of CD4+, CD8+ and CD4+/CD8+ in the treatment group before and after treatment;CD4+T lymphocyte count in the blank group after 6 months; ② Viral vector was detected by using reverse transcription polymerase chain reaction (RT-PCT) in the treatment group.RESULTS: All 69 patients in the treatment group and 25 patients in the blank group were involved in the final analysis. ①CD4+ value was decreased in the blank group after 6 months, and there was significant difference before and after 6 months based on α =0.05 level (P ＜ 0.05).However, CD4+ value was increased in the treatment group. ② Viral vector was randomly detected from 23 patients in the treatment group. As compared with before treatment, plasma viral vector was decreased in 9 patients at 6 months after treatment and in 12 patients at 1 year after treatment. The effective rate was 91.30%.CONCLUSION: Fuzheng paidu pian can improve immunological function of asymptomatic HIV patients and decrease viral vector in some cases during early interventional period.

The physical and chemical factors affecting the allergenic potency of the house bdust mite Dermatophagoides farinae extract were determined by skin test and ELISA technique in the asthmatic patients sensitive to the mite. The results showed that the allergenic potency of the extract could be reduced by heat sterilization, trypsin trea-tment and lyophization,but not lost completely,and that the potency could be increasedby supersonic treatment and repeated freeze-thaw(but less than 10 times).It was alsoshowed that the allergenic potency of the extract preserved at -20℃ was more stablethan those preserved at 4℃ or at room temperature,and that the mite extract preservedat 4℃ more than 9 years still had allergenic potency.

Objective:To explore the etiopathogenisis and pathogenesis of AIDS,provide the theoretical basis for TCM treatment based on syndrome differentiation.Methods:15 TCM experts who engaged in prevention and control of AIDS were investigated by the questionnaires,and the results were analysed.Results:In the experts' opinion,epidemic toxicity,damp-toxin,dampness pathogen and heat pathogen are the common etiopathogenisis of AIDS.Deficiency of primordial qi,yang deficiency of spleen and kidney and deficiency of both qi and yin are the common pathogenesis.The common invasion sits of pathogenic factors are in sequence of the spleen,kidney,lung,stomach and liver.Conclusion: AIDS is caused by damp-heat and epidemic toxicity,human immunodeficiency virus(HIV) has been confirmed to be the direct pathogenesis.The pathological characteristic is HIV toxicity danmaging the primordial qi.Pathological changes implicate mainly the spleen and the kidney.

Seventeen patients with femoral intertrochanteric fracture admitted to Department of Orthopedics, First Hospital of Tianjin University of Traditional Chinese Medicine between December 2005 and October 2008, including 6 males, 11 females, aged 81 to 97 years, were retrospectively analyzed. All fractures were caused by acute falling, including left side in 8 patients, right side in 9. According to Evans-Jensen classification, there were 2 cases of ⅡA, 10 of Ⅱ B, and 5 of Ⅲ. All patients underwent artificial femoral head replacement using S-ROM hip joint system (Depuy). The time of the operations, bleeding volumes and the days of hospitalization were recorded, and the complications and the motion of the hip joint were observed. All the operations were accomplished successfully, with the average surgery time of 61 minutes and the bleeding volume 435 mL. Two of them were away from bed in 3 days, 13 in 7 days and others were in 2 weeks. The average hospitalization was 19 days. The patients were followed-up for 13.7 months (ranging 4.5-36.0 months), postoperatively. No death or severe complications were found during hospitalization; 15 patients were recovered basically in doing daily as before injury; 1 patient had tow-grade fever for long period of time and been considered to get urinary system infection, but no severe complication developed. However, 1 patient died of myocardial infarction at 4.5 months post-replacement. The range of motion of the hip joints was 90°-110°. All patients became life-independent postoperatively except 3 patients hospitalized because of cerebral infarction and 2 moved assisted by the walker. The prosthetic appliance significantly reduced operation time and decreased bleeding; it is of clinical significance for elderly patients.

Objective To investigate the value of conventional ultrasound combined with contrast‐enhanced ultrasound in qualitative diagnosis of benign and malignant cervical lymph nodes (LNs) .Methods Totally 129 enlarged LNs in 112 cases were performed the 2‐dimensional ,color Doppler ultrasound ,and grey‐scale contrast‐enhanced ultrasound(CEUS)examinations .LNs were divided into the benign group and malignant group according to pathologic results .The aspect ratio ,eccentric medulla or medulla de‐fect ,echo type ,blood supply distribution ,contrast‐enhancement pattern and distribution equilibriuym of contrast agent were com‐pared between the two groups .Results The most of aspect ratio in the benign LNs group were ≥ 2 ,the cortex and medulla were uniform with symmetric increase and without microcalcification ,the blood supple was mainly the non‐blood flow type or hilar type , in contrast‐enhanced ultrasound ,the majority were the early hilar and medullar enhancement ,showing the centrifugally full filling ;the most of aspect ratio in the malignant LNs group were <2 ,medulla was eccentric or loss ,partial of LNs showed the increased parenchymal echo accompanied with cystic lesion and microcalcification ,the blood supply was mainly the peripheral and mixed types ,and the non‐hilar and medulla started enhancement pattern .The ultrasonographic parameters mentioned above were statisti‐cally different between the two groups ,in which the non‐hilar and medulla started enhancement patterns had the highest sensitivity and accuracy for diagnosing malignant LNs ,the positive predictive values of these parameters were higher ,whereas the negative predictive values were lower .Conclusion The conventional ultrasound combined with contrast‐enhanced ultrasonography has a higher practical value in qualitative diagnosis of cervical LNs ;the comprehensive judgment of multiple indicators can increase the differentiating ability for benign from malignant LNs .

Objective To observe the protective effect of sodium hyaluronate (Na-HA),and its effects on mRNA expression of peroxisome proliferators-activated receptor gamma (PPAR-γ) in cartilage of rabbit osteoarthritis (OA) model.Methods Forty eight white rabbits were divided into A,B,C groups randomly.Group A were normal controls,groups B and C were underwent unilateral anterior cruciate ligament transection (ACLT).The rabbits in group B were injected normal saline after ACLT;Group C rabbits received intra-articular 1% sodium hyaluronate (HA) injections 5 weeks after surgery,0.3 ml once a week.At week 11 after the surgery,all rabbits were sacrificed.The cartilage changes on the medial femoral condyles were graded.Cartilage sections were stained with safranin-O and HE,mRNA expression of PPAR-γ was detected by real time polymerase chain reaction (Real Time-PCR).Results Cartilage degeneration in group B was significantly more severe than in groups A and C.The grey value of Safranin-O of B group were higher than groups A and C.Expression of PPAR-γ mRNA in group B was higher than that in groups A and C.Conclusion NaHA has a protective effect on articular cartilage degeneration,and the inhibitory effect on PPAR-γ mRNA expression may be one of the therapeutic mechanism of Na-HA.

Objective To explore the respective advantages of different direction Hegu needlings by using them to treat the pain stage of scapulohumeral periarthritis (periarthritis of shoulder) and investigating their clinical therapeutic effects. Method A randomized controlled trial was carried out. Sixty patients with scapulohumeral periarthritis in the pain stage were allocated into group Ⅰ (30 cases) and group Ⅱ (30 cases). Group Ⅰ received acupuncture at points Jianyu(LI15), Jianliao(TE14) and Jianzhen(SI9) in the direction parallel to the meridian course and group Ⅱ , in the direction perpendicular to the meridian course. Treatment was given 30 min once for a total of 12 times. The simplified Mcgill Pain Questionnaire score and the Japanese Orthopaedic Association (JOA) score were recorded before and after treatment. Result There were no statistically significant differences in the pain, joint activity and joint function between the two groups before, during and after treatment. Conclusion Two different direction Hegu needlings both have a marked therapeutic effect on the pain stage of scapulohumeral periarthritis. The two have no significant difference.

Atrial Fibrillation ; therapy ; Cardiac Tamponade ; etiology ; surgery ; Catheter Ablation ; adverse effects ; Emergency Treatment ; Humans ; Male ; Middle Aged