Acute ischemic stroke is characterized by high morbidity, high disability and high mortality. The effectiveness and safety of endovascular therapy in the treatment of acute ischemic stroke have been recognized, but there are few studies on perioperative blood pressure control, and the best blood pressure control management strategy has not yet reached a consensus. This article reviews the blood pressure management during the perioperative period of endovascular treatment.

Objective To study the clinical and pathological features of hepatic steatosis in patients with chronic hepatitis B (CHB)based on a matched case-control study.Methods Cross-sectional study was carried out on CHB patients who received liver biopsy in the Department of Infectious Diseases, Shunde First People′s Hospital from January 2006 to December 2014.Clinical data of the patients were collected.A total of 216 matched pairs were created according to gender and age.The clinical and pathological feathers of both groups were compared and analyzed. Quantitative data with normal distribution were compared by t test and those with abnormal distribution were compared by nonparametric rank sum test of two- or multi-independent samples. Categorical data were compared by χ2 test. Results In matched pairs,rates of overweight/obesity were 84.2% in fatty liver group and 18.5 % in non-fatty liver group (χ2 =189.30,P =0.001 ),patients with high cholesterol in the two groups were 30.6% and 13.4%,respectively (χ2 =18.47,P =0.001 ),high triglycerides were 27.3% and 9.7%, respectively (χ2 =22.15 ,P =0.001),high low-density lipoprotein were 16.7% and 5 .6%,respectively (χ2 =13.50,P =0.001),high uric acid were 31 .0% and 15 .3%,respectively (χ2 =15 .04,P =0.001 ) and rates of alcohol history were 38.9% and 25 .9%,respectively (χ2 =8.08,P =0.001).The differences of hepatitis B virus (HBV)DNA and status of hepatitis B e antigen between the two groups were not statistically significant (both P >0.05 ).Compared to fatty liver group,rates of hepatic inflammation activity degree ≥ 3 (54.6% vs 37.5 %,χ2 = 12.75 ,P <0.01 )and fibrosis staging ≥ 3 (53.2% vs 41 .7%,χ2 =5 .80,P =0.016)in non-fatty liver group were both significantly higher.Conclusions CHB patients with overweight/obesity,high cholesterol,high triglycerides,high low-density lipoprotein,high uric acid and drinking history are more likely to develop hepatic steatosis.The inflammatory grade and fibrosis stage in non-fatty liver group are more serious than those in fatty liver group.

Objective To investigate the effects of xuanzhi analgesic tablets on plasma levels of 6-keto-prostaglandin Flα(6-K-PGFlα) and thromboxane B2(TXB2) in rats with acute blood stasis. Methods Sixty SD rats were divided into six groups randomly, namely normal control, model control, positive control, xuanzhi analgesic tablets at 1. 36, 2. 72, and 5. 44 g·kg-1 groups. The rat model of blood stasis syndrome was caused by subcutaneous injection of adrenaline incorporated with ice-bathing. The effects of xuanzhi analgesic tablet on 6-K-PGFlαand TXB2 were observed. Results Compared with the normal control,plasma level of 6-K-PGFlα was significantly reduced(P<0. 01) and that of TXB2 in the model control was evidently increased(P<0. 01). Three dosages of xuanzhi analgesic tablets significantly raised 6-K-PGFlαlevel(P<0. 05)and lowered TXB2 level (P<0. 05). Conclusion Xuanzhi analgesic tablets significantly adjust plasma levels of 6-K-PGFlαand TXB2in rats with acute blood stasis. Xuanzhi analgesic tablets can coreect the imbalance between PGI2 and TXA2 through increasing 6-K-PGFlαand desearing TXB2 levels.

Objective To investigate the effect of FK506 on the expression of axon guidance cue slit-2 after spinal cord injury(SCI)in rats.Methods A total of 75 adult Sprague-Dawley rats were randomly divided into three groups,ie,sham operation group,SCI group and FK506 treatment group.The SCI model was made by using the modified Allen's technique.Then,the rats were sacrificed and the spinal cord was removed at different time points(at days 1,3,7,14 and 28)for detection of the expression of slit-2 by means of reverse transcription polymerase chain reaction(RT-PCR)and immunohistochemistry.Results The expression of slit-2 changed with time.The expression of slit-2 could be detected at day 1 after SCI,reached the highest at day 7 and then decreased gradually,with higher expression level in the injury group compared with treatment group(P ＜ 0.05).Conclusion Following spinal cord injury,administration of FK506 can up-regulate the expression of slit-2 and may exert important effect on the guidance of the axon regeneration.

We report the treatment process of a patient with acute vertebral artery occlusion complicated by top of the basilar artery syndrome after arterial thrombolysis.The top branches of vertebral artery and basilar artery were patent after the mechanical and drug thrombolysis again. The prognosis of the patient was good. The modified Rankin scale score was 1. It suggested that in addition to the arterial local thrombolysis was effective to the lesions themselves, it also had good efficacy for the newly developed embolic complications during the process of thrombolysis.

Objective To examine the clinical effect and learning curve of endoscopic thyroidectomy via chest-areolar approach in the treatment of benign thyroid nodules. Methods From January 2012 to May 2016,49 patients underwent endoscopic thyroidectomies via chest-areolar approach in Xuanwu Hospital ,Capital medical university. The clinical characteristics ,prognosis and operation time were retrospectively analyzed. The patients were divided into 9 groups according to the surgical sequence ,and the learning curves were analyzed by using moving average method. Results 49 endoscopic thyroidectomies via chest-areolar approach were performed successfully. The average size of the nodules was(2.80 ± 0.62)cm. 10 patients underwent bilateral thyroidectomy and 39 underwent unilateral thyroidectomy. The average operation time was(157.49 ± 21.23)min. 2 cases received re-operation due to postoperative pathology of malignancy. There were no postoperative recurrent laryngeal nerve injuries. 11 patients suffered from asymptomatic hypocalcemia with parathyroid hormone in the normal range. All of the patients were satisfied with the cosmetic results. The learning curves indicated that 35 endoscopic thyroidectomies were needed to be performed in the early study stage. Conclusions For surgeons with experience of conventional thyroidectomies,endoscopic thyroidectomy via chest-areolar approach is feasible and safe for selected patients. There is a significant learning curve in the application of endoscopic thyroidectomy. In the early study stage of endo-scopic thyroidectomy,35 cases are basically required for beginning surgeons to practice the surgical operation.

Aim To establish insulin resistance cell model on HepG2 cells (human embryonic liver tumor cells )and investigate the effect of berberine hydro-chloride on insulin-resistant HepG2 (IR-HepG2 ) cells.Methods ① IR model was induced by respec-tively using 10 -9 ,10 -8 ,10 -7 ,10 -6 ,10 -5 ,10 -4 mol ·L-1 insulin with 25 mmol · L-1 glucose in HepG2 cells.② HepG2 cells were incubated with 2-NBDG (fluorescent labeled glucose)in a series of concentra-tion:50,100,200,400,600,800 μmol·L-1 and a series of incubation time:20,40,60,80,100 min, to select the optimum concentration of insulin and the optimum incubation concentration and time of 2-NBDG in HepG2 cells.The success of the model was deter-mined by detecting the consumption of glucose in the cell supernatant and the uptake of glucose in HepG2 cells.③To study the effect of berberine hydrochloride on improving insulin resistance on the cell level,met-formin and berberine hydrochloride were used in the IR cells.Results Six concentrations of insulin induced the IR model in different degrees.Although 10 -4, 10 -5 mol·L-1 insulin was significant,a large amount of cells died.10 -6 mol·L-1 insulin was effective and had high survival rate of HepG2 cells,which had sta-tistical significance compared with the normal group. When the incubation concentration of 2-NBDG was more than 100 mol·L-1 ,the fluorescence intensity of the cells was significantly different from the normal group.When the incubation time of 2-NBDG was more than 20 min,fluorescence intensity was significantly different from the normal group.When the incubation time of 2-NBDG was more than 100 min,the fluores-cence quenching phenomenon was obvious in the cells. Berberine hydrochloride and metformin significantly in-creased the glucose consumption and glucose uptake in cell supernatant, which had statistical significance compared with the model group.Conclusions Using 10 -6 mol · L-1 insulin induced IR model in HepG2 cells,the optimum incubation concentration and incu-bation time of 2-NBDG is 200 μmol·L-1 and 80 min, respectively.Berberine hydrochloride and metformin have obvious effect on improving IR in HepG2 cells.

Adult ; Diabetes Mellitus, Type 2 ; diagnosis ; Diagnosis, Differential ; Female ; Humans ; Insulin Resistance ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Yang Deficiency ; diagnosis ; Yin Deficiency ; diagnosis

AIM: To explore the therapeutic strategies of heat-clearing and detoxifying (HCDT) and Yin-invigorating and fluid-supplementing (YIFS), the method of Chinese medicine, on the high density lipoprotein (HDL) and alkaline phosphatase (ALP) molecules, which are associated with endotoxin-degradation. METHODS: The animal model of endotoxemia was established by the injection of E. Coli lipopolysaccharides through rabbits ear vein. The endotoxemic rabbits were treated respectively with two representative herbal preparations of therapeutic principles against febrile diseases: HCDT or YIFS preparations. The serum levels of interleukin-1 (IL-1), tumor necrosis factor ? (TNF-?) and HDL, the ALP activity, the expression of ALP mRNA in liver and kidney tissues were observed. RESULTS: The serum levels of IL-1 and TNF-? in HCDT group were significantly decreased, while the serum ALP activity and the expression of ALP mRNA in liver and kidney tissues were obviously increased, as compared with those in model group. Meanwhile, the serum levels of IL-1 and TNF-? in YIFS group were significantly reduced, and its plasma HDL level was elevated. CONCLUSIONS: Both the herbal preparations, HCDT and YIFS, have the scavenging effects on the overproduction of inflammatory cytokines such as IL-1 and TNF-? induced by endotoxin, but their effects on the endotoxin-degrading molecules might be different. HCDT principally increases ALP activity and enhances ALP expression in liver and kidney tissues, while YIFS might preferably facilitate the elevation of plasma HDL level.

AIM: The aim of this study was to investigate the possibility of establishing a chronic atrial fibrillation model with long-term rapid atrial stimulation ( 1 000 bpm), which was performed in rabbits in vivo. METHODS: 20 rabbits were randomly divided into 2 groups: 1) control group (n=10): pacemaker was implanted but no pacing; 2) experimental group (n=10): a left intercostal thoracotomy was performed and the pericardium was opened to expose the heart and a steel-wire pacing electrode was fixed on the epicardium of the left atria in 10 rabbits. Then the rapid pulse generator was implanted subcutaneously in the left abdominal region and rapid atrial pacing ( 1 000 beats/min) was initiated and continued for 30 days. Electrocardiogram (ECG) was monitored and recorded on day 1, 3, 5, 7, 14, 21 and 30. The atrial effective refractory period (AERP) was measured before pacing and at the time of fibrillation. RESULTS: On day 14, atrial fibrillation was developed in 8 rabbits (80%) and sustained at least till to day 30 (P