Since the 1960s,endovascular coil embolization has gradually become another treatment for intracranial aneurysms in addition to craniotomy clipping surgery,and in recent years,it has become the preferred method for many neurologists.However,the complexity of intracranial vascular anatomy and the diversity of intracranial aneurysm make the coil embolization alone unable to meet the needs of all intracranial aneurysms.And then some novel materials and techniques emerged,such as coated coils,balloon-assisted embolization,stent-assisted embolization,and covered stents.The principle of covered stents for the treatment of intracranial aneurysms is to place a kind of stents with bio-physical barriers into the parent arteries,while maintaining the patency of the parent artery,thus isolating aneurysms,leading to thrombogenesis inside and finally curing the lesions while maintaining the patency of parent arteries.It has huge advantage in the treatment of wide-necked,huge,dissecting and pseudo aneurysms without important adjacent branch vessels.This article reviews the application situation and the prospects of development of covered stents in the treatment of intracranial aneurysms.

Objective To explore the effect of home-based rehabilitation on cerebral palsy.Methods 60 children with cerebral palsy were assigned to hospital-based rehabilitation group and hospital-home-based rehabilitation group and treated for 1 year.Every child was evaluated before and after the treatment with Bayley Scales of Infant Development(BSID).The Mental Development Index(MDI) and Physical Development Index(PDI) were compared between these two groups.Results After one year,the MDI and PDI improved in both groups(P<0.05),while those of the hospital-home-based rehabilitation group was better than of the hospital-based rehabilitation group(P<0.05).Conclusion Home-based rehabilitation plays an important role in the rehabilitation of cerebral palsy children.

Objective To investigate the physical and mechanical properties of home-made bone cement mixed with different antibiotics.Methods The specimens of bone cement each of 40g were divid-ed in to6groups depending on mixed antibiotics,groupⅠmixed with1g gentamicin,groupⅡwith2g gen tam icin,groupⅢwith1g cephradine,groupⅣwith1.5g cefuroxine,groupⅤwith1g ceftriaxone and groupⅥwith out any antibiotics served as control.The dough time,compressing depth,compressive strength,bending strength and bending elastic modulus were measured respectively,elution examination of antibiotics from bone ce ment was performed by chromatography.Results The dough time and compress-ing depth of the groups were better than that of ISO5833standard,and there was no significant difference a-mong the groups.The com pressive strength and bending strength of the groupⅡwere lower than that ISO5833standard,but there was no significant difference among the groups by analysis of variance.The bending elastic modulus of the groupⅡwas lower than the control group and other groups(P

Objective To preliminarily investigate curative effect of hepatic arterial perfusion of p53 gene in the therapy of advanced hepatocellular carcinoma.Methods Tirty cases of advanced hepatocellular carcinoma were divided into experimental group and control group,p53 gene was perfused into target artery confirmed by angiography.In experimental group,10~(12)Vp of p53 gene and 20 mg OPT were employed every week as a course for 21 days and 1 to 4 courses time the cases of the study.In control group,only 20 mg OPT was used.Results The survival period was 14 to 405 days in experimental group and 18 to 167 days in control group.There was a significant difference between the two groups(P＜0.05). Conclusion p53 gene is efficacious in the therapy of advanced hepatocellular carcinoma.(J Intervent Radiol,2007,16:127-129)

Objective To compare the quadriceps strength and short-term outcome in patients who had undergone primary total knee arthroplasty (TKA) with minimally invasive (MIS) or conventional surgical technique.Methods Sixty-eight knees undergoing TKA were evaluated and they were randomly divided into two groups.One group included 34 knees which were undergone conventional approach,and the other group included 34 knees undergone MIS approach.The age,BMI,quadriceps strength,extension lag,American Knee Society Score (KSS),Western Ontario and McMaster Universities (WOMAC) osteoarthritis index and visual analogue scale (VAS) of pain of all patients were evaluated at the day before surgery and the 1st,2nd,3rd,6th,and 12th months after surgery.Results At the 1st,2nd,3rd,6th,and 12th months after surgery,the quadriceps strength in MIS group was 0.59±0.12,0.74±0.18,0.86±0.16,1.02±0.17,1.05±0.04 N·m/kg respectively,while in conventional group was 0.46± 0.56,0.56±0.12,0.70±0.16,0.94±0.19,1.04±0.03 N· m/kg respectively.The extension lag in MIS group was 13.11°±6.56°,8.53°± 5.12°,4.79°±3.62°,1.53°±2.64°,1.62°±1.76° respectively,while in conventional group was 22.47°±8.41°,16.23°±6.26°,10.58°± 4.4°,2.58°±2.85°,1.62°±1.76° respectively.There were significantly differences in the two groups.Meanwhile,compared with conventional patients,MIS patients demonstrated significantly higher KSS scores at the 1st and 2nd months postoperatively.WOMAC scores were significantly lower in MIS group than in conventional group at the 1st month after surgery.During the first postoperative week,MIS technique significantly decreased VAS scores,showing significance.On the other hand,no significant difference was observed with respect to deep infection incidence and radiological outcome between two groups.Conclusion MIS TKA offers a significant improvement in extensor muscle strength over conventional surgery.These results suggest that the MIS approach results in better outcomes with regard to maintaining extensor strength than the conventional surgical approach.

Aged ; Anesthesia, General ; Dentures ; Esophagoscopes ; Esophagus ; surgery ; Foreign Bodies ; Humans ; Male

Background In patients with syphilis,one of the common manifestations is uveitis.However,the lack of understanding on syphilic posterior uveitis may result in misdiagnosis and delayed treatment.Objective This study was to assess ocular clinical features,treatment and prognosis in patients who had latent syphilis and presented with posterior uveitis as the initial symptom.Methods A serial cases-observational study was designed.Twelve patients(19 eyes)who were diagnosed as syphilis from September 2011 to January 2013 were retrospectively analyzed.All patients were characterized by initial posterior uveitis before the final diagnosis.The clinical manifestation,management and prognosis were evaluated and analyzed.All patients were informed of this study and consented with the use of their data for this retrospective study.Results The patients presented with initial clinical signs of acute or chronic posterior uveitis and lacked systemic syphilis symptom.Bilateral posterior uveitis were found in 7 patients and unilateral in 5 patients.The dust-like and grey-white opacification in vitreous was seen by threemirror contact lens in all the patients.Mild hyperemia of the optical disc was found in 10 eyes with the unclear peripapillary boundary.Yellow-white lesions were observed in retinas of 7 eyes and retinal punctuate hemorrhage was in 1 eye.Fundus fluorescein angiography demonstrated fluorescine staining or hyperfluorescence of optic disc in all of the 19 eyes,and fluorescein leakage from vein in 18 eyes,retinal pigment epithelium dye pooling in 6 eyes and cystoid macular edema in 11 eyes.Rapid plasma reagin (RPR) test and treponema pallidum hemagglutination assay (TPHA) were performed and presented positive results in all patients.The visual acuity improved in 19 eyes and partly elevated in 2 eyes following a standard therapy for neurosyphilis was used,including penicillin and/or small doses of glucocorticoid.Conclusions The serological examination for syphilis should be considered for patients with unexplained uveitis.Early diagnosis and prompt treatment are important for the improvement of prognosis in syphilitic posterior uveitis.

Increasing the production and secretion of endogenous opioid peptide by immune cell can significantly induce myocardial protective effects against ischemia-reperfusion injury. Gene therapy is promising to increase endogenous enkephalin (ENK). However, classical viral and plasmid vectors for gene delivery are hampered by immunogenicity, gene recombination, oncogene activation, the production of antibacterial antibody and changes in physiological gene expression. Minimalistic immunologically defined gene expression (MIDGE) can overcome all the deficients of viral and plasmid vectors. The exon of rat's preproenkephalin (PPENK) gene was amplified by PCR and the fragments were cloned into pEGFP-N1 plasmids. The recombined plasmids were digested with enzymes to obtain a linear vector contained promoter, preproenkephalin gene, RNA stable sequences and oligodesoxy nucleotides (ODNs) added to both ends of the gene vector to protect gene vector from exonuclease degradation. A nuclear localization sequence (NLS) was attached to an ODN to ensure the effective transport to the nucleus and transgene expression. Flow cytometry, laser confocal microscopy and Western blotting demonstrated that PPENK-MIDGE-NLS can transfect leukocyte of rat in vivo, increase the expression of proenkephalin (PENK) in tissue, and the transfection efficiency depends on gene vector's dosage. These results indicate that PPENK-MIDGE-NLS could be an innovative method to protect and treatment of myocardial ischemia-reperfusion injury.
Animals ; Cloning, Molecular ; Enkephalins ; genetics ; Gene Expression ; Genetic Therapy ; Genetic Vectors ; Leukocytes ; Plasmids ; Promoter Regions, Genetic ; Protein Precursors ; genetics ; Rats ; Transfection ; Transgenes

Objective To study the clinicopathologic features,immunophenotype,diagnosis and differential diagnosis,prognosis and treatment of solid papillary carcinoma(SPC)of breast.Methods A retrospective study was performed to analyse the clinicalpathologic features and immunophenotype of 52 case of SPC,with or without invasion. The cytokeratins(CK),myoepithelial markers,neuroendocrine markers,proliferation marker Ki -67,estrogen receptor (ER),progesterone receptor(PR),HER2,ect were detected by immunohistochemical staining,and HER2 was detected by FISH.All patients were followed up.Results All the patients were females with a mean age of (66.76 ±10.19)years. The incidence of SPC among all the breast cancers in this department was 0.99%.The presenting symptoms was a painless mass with or without nipple discharge in the central of breast.All of them accepted surgical resection,13 cases were administrated with chemotherapy after surgery,6 cases were radiotherapy.Metastasis was observed four in 34 cases who had undergone axillar lymph node dissection.General observation tumor was substantive and nodular lesions,may be accompanied by cyst formation,microscopy tumor for swelling,substantive nodules within only fine fiber vascular axis,and lacked obvious nipples and screen structure.The cells were lack of atypia,adhesive in cells nest,35 patients were accompanied with mucus secretion.Immunohistochemical study show that the tumor cells experssed CK8 /18,ER and PR,but not basal cell cytokertin CK5 /6 and 34βE12.Positivity for CK5 /6,34βE12 and P63 were 5.78%, 9.62% and 7.69% in the myoepithelial layers of axis of papillary,and were 21.15%,38.46% and 19.23% in cell nests and tumor peripheral myoepithelial,respectively.Positivity for CgA,Syn,NSE,CD56 were 82.69%,88.46%, 94.23% and 90.38%,respectively.The staining of HER2 oncoprotein was most negative,and 23 cases of FISH detection were all negative.The average positive index of Ki -67 was 4.28%.47 cases received follow -up of patients(90.38%),only 1 case death,1 case recurrence the rest were no tumor recurrence or metastasis,disease -free survival.Conclusion SPC of breast,a rare pathologic type,usually occurs in old females.The diagnosis depends on pathological characteristics and its unique immune phenotypic characteristics,is closely associated with mucinous carcinoma and neuroendocrine carcinoma,and the treatment is given priority tosurgery with a relatively inert biological behaviour.

Objective To evaluate the efficacy of pulmonary thromboendarterectomy (PTE) in treatment of chronic thromboembolic pulmonary hypertension (CTEPH) using 99Tcm-macroaggregated albumin (99 Tcm-MAA) pulmonary perfusion tomography.Methods Sixteen patients with CTEPH underwent 99Tcm-MAA pulmonary perfusion tomography before and 6-12 months after PTE.The perfusion defects and improvement both in pulmonary lobe and segment were observed pre-and post-PTE.Percentage of perfusion defect scores (PPDs％) were calculated and the change of systolic pulmonary artery pressure (SPAP) measured by echocardiography was also recorded.Results The postoperative SPAP was significantly lower than that before surgery ([36.56±8.47] mmHg vs [90.52±14.55] mmHg,t=14.14,P＜0.001).Before PTE,perfusion abnormalities were identified in 86 (86/96,89.58％) pulmonary lobes of 16 patients.In all of the 86 abnormal lobes,21 (21/86,24.42％) became normal,and the remaining 65 (65/86,75.58％) were improved after PTE.Perfusion defects were confirmed in 230 (230/304,75.66％) pulmonary segments of 16 patients before surgery.In all of the 230 abnormal segments,73 (73/230,31.74％) became normal,74 (74/230,32.17％) were improved and 83 (83/230,36.09％) remained unchanged after PTE.The mean PPDs％ decreased from (56.79±14.54)％ pre PTE to (28.20±15.24)％ at 6 12 months after PTE.The PPDs％ was positively correlated with homochronous SPAP (r=0.68,P＜0.001).Conclusion PTE can significantly reduce SPAP and improve the pulmonary perfusion in CTEPH patients.Pulmonary perfusion imaging can evaluate the curative effect of PTE.