Objective To retrospectively analysis our experience of embolization of ruptured intracranial aneurysms during the period of cerebral vasospasm (CVS). Methods Thirty-seven patients with ruptured intracranial aneurysms were embolized with electrolytic detachable coils during the period of CVS (days 4 to 14). Group A included the 14 patients with angiographic CVS and group B included 23 patients without angiographic CVS. All except 2 patients were transferred to our department during the CVS period. Results Twelve patients in group A were successfully received the aneurysms embolization and treatment of the CVS with intraarterial papaverine injection and balloon angioplasty. The Glasgow Outcome Scales (GOS) in 3 months were good recovery in 7 patients, moderate disability in 2, severe disability in 1 and dead in 2. Two patients failed the embolization because the microcatheters can't pass the spasmatic parent arteries. All the aneurysms in group B were successfully embolized. The GOS were good recovery in 18 patients, moderate disability in 2, severe disability in 2 and dead in 1. There was no intraprocedural aneurysmal rupture but with 2 thromboembolic events. No rebleeding occurred during the mean 11 months follow-up.Conclusions The so-called “the period of CVS” isn't always associated with CVS in angiograpy. Embolization of ruptured intracranial aneurysms during the period of pure CVS doesn't carry an increased risk. Both the aneurysms and CVS can be treated during the single procedure. It can reduce the rebleeding rate in hospital and improved the prognosis of the patients with CVS.

Objective The Neuroform stent is the first self-expandable intracranial stent designed for the treatment of wide-necked intracranial aneurysms. We report the results of our preliminary experience in combination of this stent and detachable coils to treat patients with wide-necked intracranial aneurysms. Methods From August 2003 to August 2004, 22 patients with 24 wide-necked intracranial aneurysms were treated with combination of Neuroform stents and detachable coils. There are 19 acutely ruptured aneurysms and 5 unruptured aneurysms. Results Twenty-three aneurysms were successfully treated by combination of stents and detachable coils. In one patients with multiple aneurysms, an unruptured small wide-necked aneurysm was successfully treated with the stent deployment but failed coiling. All stents were deployed successfully. Mild stent displacement was found in one patient. Intraaneurysmal contrast media stagnation was not seen immediately after the stents deployment. Total (100%) obliteration of the aneurysm was achieved in 18 aneurysms, and subtotal (more than 90%) obliteration was achieved in 5 aneurysms. All the parent arteries were patency after treatment. In 2 aneurysms, some small coil loops were herniated into the parent artery from the stent struts but did not affect the blood flow within parent artery. No symptomatic brain ischemia was found in perioperative period. Seventeen patients were received a mean of 3 months follow-up and control angiography. No recurrence was found in 16 patients. Recanalization was found in one patient, he received a second embolization and the aneurysm was totally oberliterazation.Conclusions The Neuroform stent is a very safe and effective intracranial stent for treatment of wide-necked intracranial aneurysm. It is very suitable for wide-necked intracranial aneurysm with severely tortuous parent artery. Due to lack of significant radial strength of the stent, the stent can be shifted by a microguidewire or microcatheter when performed superselective catheterization. Because the big struts of this stent, the change of intraaneurysmal hemodynamics after stent deployment was notevident as coronary stent. So dense packing the aneurysm is advocated. Care must be taken when packing the detachable coils after the stent deployment. The administration of dual anti-platelet drug to prevent stent-related thromboembolic complications in the perioperative period is important. Although a good angiographic result is achieved, long-term angiographic follow-up is still necessary.

Objective To investigates the gene expression of telomerase by real-time quantitative telomeric-repeat amplification protocol assay (RTQ-TRAP) in the peripheral blood mononuclear cells (PBMC) of colorectal carcinoma patients and the relationship between the telomerase gene expression in PBMC and clinicopathological features. Methods Peripheral blood samptes were collected from 71 colorectal carcinoma patients, 20 benign colorectal disease patients and 25 normal controls. The telomerase gene expression in PBMC was measured by RTQ-TRAP, and serum CEA in colorectal carcinoma patients was measured by chemiluminescence immunoassay. Results The gene expression of telomerase in PBMC was positive in 50 out of 71 cancer patients (70. 4% ) , 1 out of benign patients (5. 0% ), respectively. The difference of the telomerase gene expression of PBMC in benign colorectal diseases and cancer patients was significant (χ2 = 24. 521, P < 0. 001 ). There was no significant association between the expression of telomerase and patient's gender, age, Dukes stage, and tumor site. The positive rate of CEA in colorectal carcinoma patients was not significantly higher than positive rate of telomerase gene expression(χ2 = 2. 286,P = 0. 125). Conclusions The RTQ-TRAP method is highly accurate and sensitive in measuring telomerase gene expression. The detection of telomerase gene expression in PBMC of colorectal carcinoma patients is a simple and useful molecular marker for the diagnosis of colorectal carcinoma.

Objective To optimize the parameters of the low-frequency/low-energy ultrasound combined with micro-bubbles in inducing early apoptosis of DU145 cells (an androgen-independent prostatic cancer cells). Methods In our study, the impact of ultrasonic power, micro-bubbles/cell suspension volume rate and irradiation time were investigated. Three levels of each factor were deifned as ultrasonic power (60, 80, 100 mW), micro-bubbles/cell suspension volume rate (10%, 20%, 30%), irradiation time (30, 60, 90 s). According to the three-factor three-level orthogonal design, nine experiments were carried out. The early apoptosis was detected by lfow cytometry. A new experiment was designed with the optimized parameters. Another group without ultrasound irradiation was designed as the control group. Flow cytometry and transmission electron microscope (TEM) were used to detect the early apoptosis. Results In descending order, the inlfuence of these factors on the cell early apoptosis were:ultrasonic power>micro-bubbles/cell suspension volume rate>irradiation time. Moreover, the inlfuence of each factor level were:80 mW>60 mW>100 mW in ultrasonic power, 20%>30%>10%in micro-bubbles/cell suspension volume rate, 60 s>90 s >30 s in irradiation time. The early apoptosis rate of experiment group was 10.41%, while the control group was 0.94%. TEM showed apoptotic cells in the experiment group. Conclusions The optimized parameter of low-frequency/low-energy ultrasound with micro-bubbles in inducing early apoptosis of DU145 cells are ultrasonic power of 80 mW, micro-bubbles/cell suspension volume rate of 20%, and irradiation time of 60 s. With the optimized parameters, the early apoptosis rate of the experiment group has signiifcant higher than the control group.

Objective To investigate the feasibility of low-frequency ultrasound combined with microbubbles improving transfection of enhanced green lfuorescent protein plasmid (pEGFP) to subcutaneously transplanted prostate cancer in nude mice, and to optimize the parameters of intensity. Methods The model of nude mice of subcutaneously transplanted prostate cancer were built. Then they were divided into 2 groups including low-frequency ultrasound group and low-frequency ultrasound combined with microbubbles group, each group with 15 mice. Then 250μl of mixture of saline and pEGFP (50μg) were co-injected in low-frequency ultrasound group and 250μl of mixture of SonVue and pEGFP (50μg) were co-injected in low-frequency ultrasound combined with microbubbles group through tail vein. According to intensity, they were divided into 3 subgroups respectively, including group 1 W/cm2, group 2 W/cm2 and group 3 W/cm2, each group with 5 mice. Ultrasound was applied at 80 kHz input frequency with 50%duty cycle for 10 minutes after pEGFP injection. The tumors were collected on the third day after treatment. The expression of pEGFP in tumor was examined by laser scanning confocal microscope (ISCM) and the average lfuorescence intensity were estimated. At the same time, routine pathological examination was performed. The mean lfuorescence intensity of low frequency ultrasound group and low frequency ultrasound combined with microbubble group were compared with one-way ANOVA and those of any two groups were compared by SNQ-q test. Results TThe mean lfuorescent light in low-frequency ultrasound combined with microbubbles group were 23.75±2.54, 30.25±1.67 and 59.60±2.03, which were obviously stronger than those of low-frequency ultrasound treatment group (14.04±1.35, 14.66±0.98 and 14.32±1.20), the difference was statistically signiifcant (the value of q were 18.26, 14.12 and 13.88, P<0.05). The rate of gene transfection increased along with the enhancement of the ultrasound intensity (the value of q were 15.33, 17.81 and 13.79, P<0.05). Histology analyses performed by HE staining showed that there was no damage to the tumor tissues in all groups, tumor tissues were intact and without infection. Conclusions Low-frequency ultrasound combination with microbubbles can significantly enhance pEGFP transfecting into subcutaneously transplanted prostate cancer in nude mice. In certain range, improving the ultrasound intensity can increase the rate of gene transfection.

Objective To investigate the effect of 20 kHz low-intensity ultrasound combined with microbubbles on autophagy of both PC3 cells and DU145 cells. Methods Ultrasound with a frequency of 20 kHz and intensity of 80 mW in continuous wave mode was used. Both PC3 cells and DU145 cells were divided into four groups, including control group (A), microbubbles group (B), ultrasound group (C) and ultrasound combined with microbubbles group (D). Twenty-four hours after treatment, the acid vesicular organelles were detected by acridine orange lfuorescence staining, and transmission electron microscopy (TEM) was used to observe autophagosomes. Results Acridine orange lfuorescence staining showed formation of acid vesicular organelles (AVOs) in the cytoplasm with normal nucleus in both PC3 cells and DU145 cells in group D, while in group A cells were basically normal. Lots of autophagosomes with double-membrane structure were detected by transmission electron microscope in group D. Conclusions Low-frequency and low-intensity ultrasound combined with microbubbles can induced autophagy in both PC3 cells and DU145 cells.

Objective To investigate the effect of hypertension on the large artery elasticity index (C1),the small artery elasticity index (C2) and the medial structure of the ascending aorta as well as the relationship between artery elasticity and the medial structure of the ascending aorta.Methods Sixty patients with CHD receiving coronary artery bypass graft surgery at our hospital were divided into two groups:30 patients in the hypertension group and 30 patients in the non-hypertension group.C1 and C2 were measured using the CVProfilor DO-2020 system.Sections of tissues taken from the anterior wall of the ascending aorta during the surgery were subjected to Masson's trichrome staining for the detection of vascular smooth muscle and collagen fibers and Weigert's resorcin-fuchsin staining for the detection of elastic fibers.The relative areas of vascular smooth muscle fibers,collagen fibers and elastic fibers of the ascending aorta were measured by a computer image analysis system under the light microscope.The linear correlations of C1 and C2 with the medial structure of the ascending aorta were analyzed.Results C1 in the non hypertension group was higher than that in thehypertensiongroup[11.9±1.8 (ml/mmHg×10) w 13.1±2.5 (ml/mmHg×10),t 2.22,P ＜0.05].In the media of the ascending aorta,the relative content of collagen fibers was higher,while the relative content of elastic fibers was lower in the hypertension group than in the non-hypertension group [(46.0±3.8)％ w (42.2±3.0)％,(17.5±3.5)％ vs.(19.3 2.7)％,respectively,t=4.24 and 2.20,P＜0.01 or 0.05].C1 was positively correlated with the relative content of elastic fibers but negatively correlated with the relative content of collagen fibers in both groups (r=0.52 and 0.39,respectively,P＜0.05 or 0.01).Conclusions The main pathogenic basis of hypertension-induced decline in arterial elasticity in CHD patients is increased collagen fibers and reduced elastic fibers with disorganization of the two types of components.C1 may accurately reflect the effect of hypertension on medial collagen fibers and elastic fibers in the ascending aorta.

Objective Autologous hematopoietic stem cell transplantation (Auto-HSCT) has been widely used in hematological malignancies.To mobilize and harvest sufficient number of peripheral CD_(34)~+ cells is one of key issues for auto-HSCT. Peripheral CD_(34)~+ cell numeration has been used as an indicator for apheresis while we mostly rely on the peripheral WBC or MNC count. In this study, we try to evaluate the association of peripheral CD_(34)~+ count to the CD_(34)~+ cells number in the apheresis product and to find out a potential threshold. Methods From Jan 2007 to Dec 2009, a total of 57 apherosis for auto-HSCT were analysed. All patients were mobilized by cyclophophamide (CTX) plus G-CSF(5-10μg/kg) regimen. The apheresis were performed with COBE SPECTRA VERSION 6 and CD_(34)~+ count of both peripheral and apheresis products were analysed by flow cytometry. Results The median number of MNC in apheresis products was 4.6(0.3-10.5)×10~8/kg with median CD_(34)~+ cells at 2.4(0.16-34.9)×10~6/kg. The peripheral CD_(34)~+ count was the only parameter associated with the MNC and CD_(34)~+ cell numbers in the apheresis products while the WBC number was irrelevant to the results of apheresis. Our data showed that when the peripheral CD_(34)~+ count reach 15/μl, the efficacy of a single apheresis significantly improved with 81 % and 60 % reached 1 and 2×10~6 CD_(34)~+ cells/kg respectively and the total number of MNC and CD_(34)~+ cells were significantly superior to apheresis with peripheral CD_(34)~+ cells <15/μl, thus indicated that CD_(34)~+ ≥15 /μl can be used as the threshold for apheresis. Furthermore, the ROC analysis demonstrated that CD_(34)~+ cells ≥25(26.5-28.6) /μl is the best indicator level for a successful single apheresis. Conclusion Our study clearly showed that peripheral CD_(34)~+ cell count is a key indicator of apherosis. CD_(34)~+ cells at 15/μl can be used as the threshold to start apheresis in the clinical setting.

Objective To investigate the incidence of white matter lesions(WML) in acute ischemic stroke ,and to analyze its the risk factors .Methods Totally 248 cases of acute ischemic stroke patients were selected ,patients′general information were in‐vestigated ,the WML severity with Fazekas rating scale were evaluated and patients were divided into severe group and no severe group according to the results ,the differences of general information between two groups were compared ,the severe WML was set as dependent variable ,the risk factors were ananlzed by multiariable Logistic regression analysis .Results There were 106 cases se‐vere WML patients among 248 cases acute ischemic stroke ,the incidence was 42 .74% ;single factor analysis found that the age in severe group was significantly higher than non severe group ,the incidence of hypertension ,diabetes in severe group was significantly higher than non severe group ,the difference was statistical significance (P<0 .05);multiariable Logistic regression analysis showed that age (OR=4 .116 ,95% CI:1 .816-6 .454 ,P=0 .000) ,hypertension (OR=1 .462 ,95% CI:0 .842-1 .946 ,P=0 .026) and dia‐betes (OR=1 .157 ,95% CI:0 .698-1 .673 ,P=0 .038)were the independent risk factors of severe WML in acute ischemic stroke . Conclusion The incidence of severe WML in acute ischemic stroke patients is high ,we need to targeted prevention measures on ol‐der age ,hypertension ,diabetes mellitus patients to reduce severe WM L occurred .

Objective To evaluate double microcatheter technique for detachable coil treatment of wide-necked intracranial aneurysms. Methods Routine endovascular coil occlusion was not achieved in 6 cases of wide-necked intracranial aneurysms. A second femoral arterial sheath was inserted on the opposite side . A second microcatheter was positioned within the aneurysm. The detachable coils were introduced via double microcatheter simultaneously or successively till the aneurysm were compactly embolized. The coils were detached after satisfactorily positioned. Results Total 6 cases of wide-necked aneurysms were successfully embolized with detachable coil. Aneurysmal sacs were 100% embolized in 2 cases, over 90% in 4 cases. 1 case suffered moderate disablement as a result of complication of. Angiographic follow-up in 5 cases revealed no recurrent or rerupture.Conclusions The double microcathter technique may be an optional method during embolization of some complicated wide-necked aneurysms.