Objective To investigate the expression changes of Ire1α and caspase-12 in rats with spinal cord ischemia-reperfusion injury.Methods Fifty-five adult SD rats(250-300 g)were randomly divided into control group(re=5)and operation group(n=50).The spinal cord ischemia-reperfusion models were established and the neuronal apoptosis was detected by terminal deoxynucleotidyl transferasemediated dUTP nick end labeling(TUNEL).The expressions of Ire1α and caspase-12 in spinal cord tissue were detected by immunohistochemistry,immunofluorescence and Western blot analysis at 1,4,8,16and 24 hours after ischemia-reperfusion.Results TUNEL staining showed that the number of apoptotic cells was gradually elevated with time.The expressions of Ire 1α and caspase-12 were increased at 1 hour after reperfusion,and peaked at 16 hours,but began to decline at 24 hours after reperfusion.The number of neurons with positive expressions of Irelaand caspase-12 was significantly higher than that of control group(P＜0.05).Conclusion Ire 1α and caspase-12 synergistically participate in the neuronal apoptosis induced by the endoplasmic reticulum stress.

Objective To valuate the feasibility and safety of double stents-assisted coil embolization in the treatment of intracranial blood blister-like aneurysms.Methods The clinical data of 10 patients with BBAs who treated by double stents-assisted coil embolization were retrospectively reviewed.The clinical angiographic findings and follow-up restdts were analyzed and evaluated.Results The stent implantation were successfully performed in parent artery of 10 patients.There were 4 patients were performed with solo stents only because tumor was too small.5 patients were treated with double stents-assisted partial coil embolization.1 patient was treated with double stents-assisted totall coil embolization.The modified Rankin Scale score at the time of discharge in the alive patientswas 1 point in 5 patients,2 points in 2 patients,and 3 points in 1 patient,two patients died due to postoperative bleeding.The modified Rankin Scale score at 6-24 months after the treatment was 0 points in 5 patients,1 point in 2 patients,and 2 points in 1 patient,no rebteeding occurred.All patients received imaging follow-up to make sure the aneurysm imaging disappeared in 3 cases,3 cases of aneurysm development smaller,2 cases of imaging had no obvious change.Conclusion Double stents-assisted coil embolization is one of feasible methods for the treatment of BBAs.This method has high security,can reduce the fatality rate of BBAs.It is possible that new type low porosity stents may further reduce the risk of rebleeding and reoccurrence.

Objective To summarize the clinical characteristics and therapeutic effect of congenital vascular rings in in-fants. Methods The clinical data of 54 children with vascular rings were retrospectively analyzed from August 2011 to June 2017 at our center for surgical treatment. Age 2 days to 11 months,the median age was 1 months;weight 1. 4 - 9. 4 kg,the average weight of(4. 52 ± 1. 89)kg. The type of vascular ring includes 21 cases of double aortic arch,right aortic arch with left aortic duct / ligament with or without vagal left subclavian artery in 14 cases,9 cases of pulmonary artery suture,left aortic arch with right aortic duct / ligament with or without 5 cases of oblique right subclavian artery,3 cases of nameless arterial com-pression syndrome,2 cases of other vascular rings. All cases underwent echocardiography,chest radiography,and CT scan of the heart,and 42 cases were examined before operation or intraoperative bronchoscopy. 39 cases(72％)had tracheal stenosis. Results Twenty-six patients underwent extracorporeal circulation underwent vascular anteroposterior surgery with an average extracorporeal circulation time of( 160 ± 61)min and 28 patients underwent extracorporeal circulation. Postoperative mechani-cal ventilation 1 to 22 days,the median number of days 2 days;hospitalization time 7 to 62 days,the median of 19 days,hos-pital death in 2 cases(3. 7％). Discharge patients were followed up for 2 to 74 months,respiratory symptoms to varying degrees to ease or disappear,discharged in 3 cases. Conclusion Airway stenosis is a serious complication of the vascular ring. CT is the best way to determine the vascular ring. To avoid serious airway complications,the vascular ring should be operated as soon as possible,and the airway stenosis and intracardiac malformation Children suggested concurrent treatment,this can improve the survival rate of surgery and improve the prognosis of children.

Objective To study the expression of thyroid hormone receptor binding protein 4(TRIP4)and DNA damage inducing transcription factor 4(DDIT4)in glioma tissue and their relationship with clinical pathological characteristics and prognosis.Methods 94 glioma patients admitted to the First Hospital of Hebei Medical University from February 2018 to February 2019 were selected as the research subjects.The expression of TRIP4,DDIT4 proteins in tissues were detected by immunohistochemistry.The relationship between the expression of TRIP4,DDIT4 proteins in glioma tissues and clinical pathological characteristics were compared.The differences in survival prognosis of glioma patients with different levels of TRIP4,DDIT4 protein expression were analyzed by Kaplan-Meier survival curve.Univariate and multivariate COX regression analysis was conducted to analyze the factors affecting the survival prognosis of glioma patients.Results The positive rates of TRIP4(68.09%),DDIT4(65.96%)proteins in glioma tissues were higher than those in adjacent tissues(13.83%,10.64%),with statistically significant differences(χ2=57.212,60.866,all P<0.05).There was a significant positive correlation between TRIP4 and DDIT4 protein expression in glioma tissues(r=0.722,P<0.05).The positive rates of TRIP4(83.64%vs 46.15%,80.00%vs 51.28%)and DDIT4(80.00%vs 46.15%,76.36%vs 51.28%)proteins in glioma tissues with tumor diameter≥3cm,WHO grade Ⅲ were significantly higher than those in tissues with tumor diameter＜3cm,WHO grade Ⅰ～Ⅱ(χ2=6.393～14.754,P<0.05).The 3-year overall survival rates of the TRIP4 positive and negative expression groups were 37.50%(24/64)and 66.67%(20/30),respectively.The 3-year cumulative survival of the TRIP4 positive expression group was significantly lower than that in the TRIP4 negative expression group(Log-rank χ2=5.949,P=0.015).The 3-year overall survival rate of DDIT4 positive and negative expression group was 37.10%(23/62)and 70.00%(21/30),respectively.The 3-year cumulative survival of the DDIT4 positive expression group was significantly lower than that in the DDIT4 negative expression group(Log-rank χ2=7.642,P=0.006).Tumor diameter≥3cm(HR=1.614,P=0.000),WHO grade Ⅲ(HR=1.790,P=0.000),positive TRIP4(HR=1.665,P=0.000)and positive DDIT4(HR=1.476,P=0.000)were independent risk factors affecting the survival prognosis of glioma patients.Conclusion The expression of TRIP4 and DDIT4 protein in glioma tissue was increased.Both of them were related to tumor diameter and WHO grade,and are potential tumor markers for survival prognosis of glioma.