Objective To assess the technical feasibility and efficacy of the combined application of a flexible,self-expanding neurovascular stent(Neuroform)and Gugliebni detachable coils(GDC)in the management of wide-necked intracranial aneurysms in humans.Methods Sixty-five wide-necked aneurysms which underwent 65 endovascular procedures were performed by using intracranial stent and GDC.There was a total of 30 aneurysms at basilar artery including 16 at the basilar tip,9 at the basilar trunk and 5 at the beginning of the basilar artery.And there were 30 aneurysms located at the posterior communicating artery, and 5 aneurysms located at the vertebral artery.The Neuroform stents were deployed to cover the neck of aneurysms.Another microcatheter was introduced into the aneurysm sac through the stent interstices and then detachable coils were released to embolize the aneurysms.Results The combined procedures were successful in all of the 65 patients with wide-necked aneurysms.The stent could pass smoothly through the intracranial artery and got released.Complete occlusion was achieved in 60 patients and incomplete occlusion in 5 patients.In-stent thrombosis occurred in 2 patients.All patients recovered well.Forty-two patients had followe-up angiography at 3 to 6 months after the procedure.Among them,no filling was found for the 39 aneurysms which were densely packed,and 3 aneurysms had neck remnant.Conclusion The implantation of Neuroform stent as a complimentary device to GDC coiling is easy and safe for embolization of wide-necked intracranial aneurysms.It has great advantage for treatment of wide-necked intracranial aneurysms.

Objective To explore whether dynamic contrast-enhanced MRA (DCE MRA) can provide an effective assessment of renal vascular in living donors before transplantation.Methods Thirty five healthy living renal donor candidates were scanned on MR system before transplantation.After injection of Gd-DTPA 1 ml in vein, a test-bolus scan was used to get the time delay of Gd-DTPA reaching renal artery.Then, a 3D T1-weighted fast low-angle shot sequence (3D FLASH) was performed in the coronal plane.The 3D FLASH scan would repeat four times with an inter-phase of 10 seconds.Thus, the imaging of the renal arterial, venous and collecting systems were got.Two radiologists observed renal arteries and veins on original imaging and MIP reconstructed imaging.The quality of MR angiography was evaluated on a fivepoint scale and the vascular anatomy or variations of the arterial and venous systems were recorded, using intraoperative findings as a standard of reference.Results The quality for all MRA was good or very good for the most of living renal donors.Among 70 renals, several variations of vascular were found, including 5 left accessory artery, 9 right accessory artery, 3 left proximal arterial branch and 6 right proximal arterial branch.Among 70 renal veins, 1 right accessory veins and 2 left varieocele were observed.One small accessory artery of right kidney was missed with DCE MRA, but identified by operation.Conclusion DCE MRA was noninvasive tool for evaluation of the renal vasculature and variations with high accuracy.It would be a good modality in preoperative evaluation of living renal donors.

Objective To investigate the feasibility of measuring liver volume with Argus methoct Methods Thirty-two healthy liver transplant donor candidates underwent liver MRI on a 3.0 T MR unit.Volume interpolated body examination(VIBE)was performed after the administration of gadobenate dimeglumine.The VIBE data was transferred to the diagnostic workstation,and then multiple planar reconstruction(MPR)images were acquired.Firstly.two observers manually drawn the liver shape and calculated three volumes:the whole liver volume and right lobes volumes include middle hepatic vein (MHV)and exclude MHV,respectively.Secondly,the same data was transferred to Argus software.calculated that three volumes.Each measurement time was recorded.Actual graft volume(the right lobe)wag measured during surgery.The correlation between right lobes volume of two measurements and actual graft volume was analyzed.The time needed for Argus and that needed for manual method were compared with paired t test.Results The right lobe volumes measured by Argus,manually and surgery method were (813±187),(807 ± 181)and(713 ± 137)mm3,respectively.Argus method and manual method showed good correlation with surgery method,and the correlation coefficients were 0.897(Argus method)and 0.884(manual method),respectively.The time for manual method and Argu8 method were(44.3 ±2.7)and(12.2.±1.0)min,respectively.There was significant difference between Argus and manual methods (t=76.39,P＜0.05).Conclusion Compared with manual method,use of the Liver volumetric measurement by Argus software not only correlated well with Actual graft volume,but also saves time.Argus has potential clinical value for volumetric measurement in living liver transplant donors.

Objective To evaluate the diagnostic values of microRNAs (miRNAs) as plasma biomarkers for early diagnosis of non-small cell lung cancer (NSCLC). Methods The levels of 10 miRNAs in plasma of 59 patients with early stage (stage Ⅰ-ⅢA) NSCLC (lung cancer group) and 59 benign lesions (control group) were detected by real-time quantitative polymerase chain reaction (RT-PCR). The levels of serum cytokeratins antigen 21-1 (CYFRA21-1), carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC) and other tumor markers were detected by electrochemiluminescence immunoassay (ECLIA), chemiluminescence immunoassay (CLIA) and immunoradiometric assay (IRMA). The early diagnostic value of miRNAs and other markers were evaluated by receiver-operating-characteristic (ROC) curve analysis. The sensitivity, specificity and area under the curve were calculated for the cut-off value. Results Plasma CYFRA21-1, miR-486 and miR-210 levels were significantly different in lung cancer group and control group (CYFRA21-1: 8.896±3.681 vs. 5.892±2.028, P= 0.020; miR-486:2.778±0.778 vs. 1.746±0.892, P< 0.001;miR-210: 4.836 ±1.374 vs. 2.829 ±1.503, P< 0.001). Area under ROC curve of CYFRA 21-1, miR-486 and miR-210 was 0.624 (sensitivity: 0.576, specificity: 0.797), 0.848 (sensitivity: 0.831, specificity: 0.780) and 0.751 (sensitivity: 0.746, specificity: 0.746), respectively. MiR-486, miR-210 combined with CYFRA21-1 had the highest diagnostic efficiency, and the area under the curve was 0.924 (sensitivity: 0.847, specificity:0.811), miR-486 combined with miR-210 had the highest diagnostic efficiency, and the area under the curve was 0.892 (sensitivity: 0.831, specificity: 0.780). Conclusions MiR-486 and miR-210 could be potential biomarkers for diagnosis of NSCLC. Plasma miRNAs combined with tumor markers can improve the diagnostic efficacy of early stage NSCLC.

Objective To investigate the expression of apoptotic protease cysteinyl aspartate specific proteinase (caspase-3) in cortex neurons of rats with sepsis.Methods Models of rats with sepsis were established by the cecal ligation and puncture (CLP).Totally 70 cases of 30-day-old male Wistar rats were randomly divided into CLP group (n =50) and control group (n =20).In CLP group,CLP was performed in the rats.Neurobehavioral score was measured in 5 rats at 6,12,24 and 48 h after CLP surgery,respectively.Then,they were killed and their brains were removed.The immunohistochemical staining and Western blot were used to detect the apoptotic protein caspase-3 expression in cortex of rats.Control group did not undergo CLP,and the other treatment was the same as CLP group.Results Neurobehavioral scores at 12,24 and 48 h after CLP surgery were significantly lower than that in the control group(t =3.651,3.773,7.155,all P ＜ 0.05),and the scores were gradually decreased,overall situation of rats was getting worse along with the time.Caspase-3 protein expressed only in trace amounts in rat cerebral cortex in the control group by immunofluorescence analysis,however,its expression was significantly increased at 12 h after CLP surgery.Western blot test showed that caspase-3 protein expression in rat cerebral cortex at 6,12 and 24 h after CLP surgery was significantly higher than those in control group (all P ＜ 0.05).Its expression began to increase at 6 h after CLP surgery,and reached the peak at 12 h,then decreased at 48 h.Conclusion The neurobehavioral scores decreases and the expression of apeptosis protease caspase-3 increases in cortex of rats with sepsis brain injury.

OBJECTIVEThe aim of the present study was to prepare uniform-sized silybin loaded poly (lactic-co-glycolic acid) (PLGA) microspheres in study of silybin with stainless steel membrane.

METHODSilybin PLGA microspheres were prepared by stainless steel membrane emulsification. The preparation conditions were optimized by single-factor test and orthogonal experiment, and evaluating the mean diameters, the particle size distribution, drug loading, entrapment efficiency and morphology of microsphere.

RESULTPrepared microspheres were round and surface was smooth. The mean diameter was (4.961 +/- 0.56) microm. The span was (1.75 +/- 0.18). The entrapment efficiency was (54.997 +/- 4.05)% and the average drug loading was (23.6 +/- 1.70)%.

CONCLUSIONThe stainless steel membrane emulsification can be used to prepare the silybin PLGA microspheres. The mean diameters of the silybin PLGA microspheres can be controlled in certain level. Stainless steel membrane emulsification has great potentiality exploitation and utilization.

Drug Compounding ; methods ; Emulsions ; chemistry ; Lactic Acid ; chemistry ; Microspheres ; Particle Size ; Polyglycolic Acid ; chemistry ; Silymarin ; chemistry ; Stainless Steel ; chemistry

To investigate the structure disruption of BSA (1mg/ml, dissolved in PBS) induced by ultrasonication and the French press. The BSA solution was passed through the French press and received ultrasound irradiation, and then detected by HPLC(High-performance liquid chromatography),DLS(Dynamic Light Scattering),CD(Circular Dichroism)and nondenaturing SDS-PAGE. Detection results showed that BSA was polymerized after ultrasound irradiation and the polymerization can be reduced by adding mannitol (free radical scavenger). This means that the free radical play an important role in this process. However, the BSA passing through the French press for several times wasn’t polymerized, and the secondary structure was somewhat destroyed. These results suggested that ultrasound irradiation and French press destroy the molecular structure in different manners, so that the suitable cell lyses methods should be selected according to the characteristics of the protein.

To investigate the value of MRI for the diagnosis of achilles tendon closed rupture. 1.5T Maestro Class MRI scanner was used for the conventional scanning of 15 patients confirmed with achilles tendon closed ruptures by operation, and then the findings by imaging were compared with those by operation. The 15 patients proved with achilles tendon closed rupture, including 4 cases of incomplete rupture and 11 cases of complete rupture. MRI could display clearly the changes in morphology and signal of incomplete or complete closed ruptures of Achilles tendon, and the results were consistent with those by operation. MRI can make an accurate display of the lo-cation and extent of achilles tendon rupture.

12E7 Antigen ; Aged ; Antigens, CD ; metabolism ; Carcinoma, Transitional Cell ; pathology ; Carcinosarcoma ; pathology ; Cell Adhesion Molecules ; metabolism ; Cystectomy ; methods ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Male ; Nephrectomy ; Osteosarcoma ; metabolism ; pathology ; surgery ; Ureter ; surgery ; Ureteral Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Objective The aim of the present study was to evaluate the clinical application of 2 μm thulium laser in pulmonary nodules resection under VATS.Methods 61 patients,undergoing thoracoscopic resection of pulmonary nodules in thoracic department of Xuanwu Hospital,were identified between January and December of 2016.Of those,30 underwent 2μm thulium laser dissection and 31 were treated with standard technique by using staplers.In terms of clinical characteristics,including gender,age and smoking history,there is no significant difference between the laser group and the stapler group,but the lesion size was slightly larger in the stapler group compared with the laser group.The lesions of the two groups were almost evenly distributed on the five lobes.Results All the procedures were performed successfully under VATS.The intraoperative evaluation of air leaks demonstrated that less than or equal to 2 grade air leaks were observed in 28 cases in the laser group and in 30 cases in the stapler group.Grade 3 air leaks requiring a rescue treatment were observed in 2 cases in the laser group and in 1 case in the stapler group.There were no significant differences in the postoperative hospital stay and total hospital stay between two groups.Chest tube duration was lower in the laser group compared with the stapler group even if it was not statistically significant (2.71 vs 3.55 days).Hospitalization costs was significantly lower for the laser group.Conclusion The use of 2um thulium laser to prevent intra-and postoperative air leaks and bleeding is effective and makes patients recover quickly,which allows a minimally invasive,accurate and safe application during thoracoscopic resection of pulmonary nodules.