Objective To summary indications and treatment results of operation and endovascular interventional therapy for intracranial aneurysms. Methods From 1992 to 2003 , 345 cases of intracranial aneurysms were reviewed .We putted attention to condition of patients and the size, shape and site of aneurysms particulary. Angiography was requested in all patients at different times. Results 236 patients undergo clipping operation . 31 patients appeared operation complications. 6 patients with postoperative hemorrhage recepted surgical operation again.9 cases died.3 patients were reoperated because of aneurysm clips translatory. 103 cases were embolized by microcoil.4 cases suffered transient aphasia after embolization, recovered after medical treatment. 1 patients died because of cerebral vessel spasm. 6 patients recepted medical treatment. Conclusions Operation is suitable for very small,gaint aneurysms which locate anterior circulation and indovascular interventional therapy for small, middle, big aneurysms. The result needs further long term follow-up study.

Objective To study the effects of treating intracranial hypertension(ICP) with different dosage Mannitol alone or combined with Furosemide.Methods 60 patients with high ICP after all kinds of operations on cranium and brain were divided into 4 groups according to the dosage of Mannitol alone or combined with Furosemide: 0.5 g/kg Mannitol(group A),1.0 g/kg Mannitol(group B),0.5 g/kg Mannitol and 20 mg Furosemide(group C),1.0 g/kg Mannitol and 20 mg Furosemide(group D).The effective power,rebound ratio,average effective time,average amplitude of decreasing ICP,plasma osmolarity and renal function were evaluated by monitoring intracranial pressure.Results In response of the effective power,rebound ratio of ICP and average effective time,groups C and D were more noticeable than groups A and B(all(P

Objective To study the preventive effect of recombinant streptokinase (r-SK) on cerebral vasospasm (CVS) after subarachnoid hemorrhage(SAH).Methods Rabbit models of SAH were made by double blood injection into cisterna magna. A tube was inserted into lateral ventricle after 24 h. In group treating one, 1.25 mg r-SK were injected into lateral ventricle, and the tube was opened for drainage after closed 6 h, and then 6 h later, injection, closed pipe and drainage were recycled for another 2 times. In the group SAH , 1 ml normal saline (NS) was injected into lateral ventricle, and then the way was the same as group treating one. In group treating two, 3.75 mg r-SK were injected for once. 6 h, 12 h ,1 d, 3 d, 5 d and 7 d later, 1 ml CSF was drained from the lateral ventricle in groups SAH , treating one and treating two ,respectively. The level of OxyHb in CSF was detected, angiograms of basilar artery(BA) were performed before and after 7 d of SAH,calculation the rate of calibre and histological examinations were also performed. Results (1)The level of OxyHb in CSF of group SAH was increased gradually while decreased in groups treating one and treating two. Compared with group SAH, the levels of OxyHb were significant lower in groups treating one and treating two at 1～7 d after administration(P

Objective: To compare the effect of urapidil at different doses on blood pressure and prognosis of patients with acute ischemic stroke (AIS) so as to provide data evidence for its clinical use.Methods: Totally 62 patients with AIS were divided into 3 groups in a prospective study: 20 cases in high dosage group, 21 cases in middle dosage group and 21 cases in low dosage group.All the patients were treated with urapidil and urokinase, and the initial dose of urapidil was 25 mg, 15 mg and 5 mg, respectively.Systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the patients before and after the treatment were observed, and the US national institutes of health stroke scale (NIHSS), modified Rankin scale (mRS) and activity of daily living scale (ADL) were also evaluated in the follow-ups.Results: The time of blood pressure up to standard in the middle dosage group and low dosage group was longer than that in the high dosage group.At the same time, the time of blood pressure up to standard in the low dosage group was longer than that in the middle dosage group, and the difference had statistical significance (P＜0.05).After the treatment, SBP and DBP at T1 in all the groups were notable lower than those at T0,and those at T2 and T3 were lower than those at T1, and the differences had statistical significance (P＜0.05).After the treatment, the SBP and DBP levels in the high dosage group were lower than those in the middle dosage group and low dosage group, and those in the middle dosage group were lower than those in the low dosage group, and the differences had statistical significance (P＜0.05).The NIHSS, mRS and ADL scores of the middle dosage group were lower than those of the low dosage and the high dosage group (P＜0.05), and there was no significant difference between the latter two groups (P＞0.05).Conclusion: With the initial dose of 15 mg, urapidil can ensure good prognosis on the premise of effective decompression.

Objective To evaluate the clinical factors of recurrent intracranial aneurysm with endovascular embolization.Methods DSA was performed in 70 cases with 74 intracranial aneurysms after endovascular embolized treatment,of them,8 cases(9 aneurysms)were detected having recurrent.The geometry form of aneurysms,embilized method,material of endovascular embolization and DSA images pre-and post-embolized were analysed.Results In all recurrent intracranial aneurysms,five located at posterior communicating artery,two at anterior communicating artery and two at the first crotch of right middle cerebral artery.Four were wide-necked aneurysms,five were irregular aneurysms in form.Before recurrence,three aneurysms were embolized completely,six were proportion occlusion.Conclusion Aneurysms localized at the branching region of artery,being wide-neck,large,irregular form and residual neck are facility factors for intracranial aneurysm recurrence after endovascular embolization.

The association of serum nesfatin-1 levels with insulin resistance and pancreatic β-cell function in gestational diabetes mellitus was investigated.Oral glucose tolerance test(OGTT) was performed in ninety pregnant women from 24,to 28 gestational weeks.They were divided into three groups according to OGTT:45 nomal controls,27 gestational diabetes mellitus with fasting plasma glucose (FPG) of 5.1 mmol/L to 7.0 mmol/L (GDM1),18 gestational diabetes mellitus with FPG more than 7.0 mmol/L (GDM2).Serum nesfatin-1 levels were significantly higher in patients with GDM1 and GDM2 than in controls (P＜0.01),and in GDM2 group it was also higher than GDM1 group(P＜0.05).Fasting serum nesfatin-1 was positively correlated with FPG,30 min plasma glucose,1 h plasma glucose,2 h plasma glucose,homeostasis model assessment for insulin resistance,and PGAUC,but negatively correlated with homeostasis model assessment for β-cell function.Furthermore,multiple stepwise regression analysis showed that FPG was the independent influencing factor of serum nesfatin-1 level.Nesfatin-1 was positively correlated with insulin resistance,while negatively correlated with pancreatic β-cell function.Nesfatin-1 may play a role in the pathogenesis of gestational diabetes mellitus.

Objective:To enhance the capabilities of individual monitoring technology services for external exposure.Methods:The intercomparison results of the national individual monitoring for external exposure during 2015-2019 were presented, together with a summary and analysis provided of the main existing problems.Results:By 2019, 382 of individual monitoring technology service uints, from 30 provinces, autonomous regions or municipalities, participated in the individual monitoring intercomparisons results, involving disease control and prevention centers, occupational prevention and control institutions, research institutes, universities, nuclear industry, medical institutions, and companies. Except for slightly low in 2017, the pass rate in the other four years was above 90%. The excellence rate increased with the years.Conclusions:The capabilities of individual monitoring service units can meet the concerned requirements and provide standardized monitoring report for the period of 2015 to 2019, but with some being unqualified. These service units should carefully analyze and identify the reasons for the failure, standardize the quality control of laboratory, and improve the level of measurement and the ability of data analysis.

BACKGROUND:Phytohemagglutinin (PHA) can stimulate the peripheral blood mononuclear cells (PBMCs) into cellcycle, and cause their immune activation, which is a common immune proliferation model. However, the role of non-PBMC ingredient of peripheral blood is unclear, as wel as the expression of endothelial cells related cytokines. OBJECTIVE:To study the effect of whole blood culture and PBMCs alone culture with PHA on the PBMC proliferation and apoptosis, expression of inflammatory cytokine and endothelial cellsecreted cytokine markers. METHODS:Morphological changes of PBMCs separated from normal karyotype human peripheral blood individual y cultured with or without PHA were observed. The PBMCs were col ected by whole blood culture or PBMC separated culture. mRNA was extracted for the fluorescence quantitative RT-PCR, which was applied to detect the cellproliferation, apoptosis, and expression of inflammatory cytokine and endothelial cellsecreted cytokines. The statistic analysis was used for the significance explication. RESULTS AND CONCLUSION:PBMCs alone cultured ere different from those undergoing whole blood culture. The PHA could up-regulate the gene expression of Ki67, proliferating cellnuclear antigen, Caspase 3, interferon-γ, tumor necrosis factor-βand interleukin-6, but down-regulate Protein C. This indicted that PHA could promote the proliferation and apoptosis of PBMCs and up-regulate the expression of inflammatory cytokines, but down-regulate the expression of endothelial cells secreted coagulation cytokines.

Objective To investigate the clinical efficacy and value of percutaneous transluminal angioplasty (PTA) in treating arteriosclerosis obliterans (ASO) of lower extremity that shows no visualization of its vascular outflow tract. Methods A total of 19 patients with ASO of lower extremities showing no outflow tract visualization were included in this study. The patients included 11 males and 8 females with a median age of 66 years (48-79 years. The main clinical symptom was rest pain of the leg in all patients; 10 cases had different degrees of foot ulcer and gangrene. Preoperative multi-slice CT angiography and DSA examination were performed in all patents. After PTA, the patients were followed up for 12 months, the changes of the clinical symptoms and signs were recorded. The claudication distance, toe skin temperature, ankle-brachial index (ABI), toe-brachial index (TBI), and CT angiography or color Doppler examination were separately performed before and one, 3, 6 and 12 months after PTA. Results In the 19 patients (38 diseased limbs in total), ASO with no visualization of vascular outflow tract was detected in 54 arteries, 3%), posterior tibial artery (n=18, 33.3%), peroneal artery (n=9, 16.7%) and popliteal artery (n=2, 3.7%). The technical success rate of limb PTA was 89.5%, while the technical success rate of single artery PTA was 85.2%. After PTA, the skin temperature of all the diseased limbs that had been successfully treated was obviously improved, the pain was significantly relieved or disappeared. One, 3, 6 and 12 months after PTA, the claudication distance, toe skin temperature, ABI and TBI were strikingly improved when compared with those determined before PTA (P<0.05). Twelve months after PTA the vascular restenosis rate was 39.5% (15/38), the limb vascular patency rate was 55.3% (21/38), and the limb salvage rate was 81.6%(31/38). Conclusion For the treatment of lower extremities arterial obliterans with obstructed outflow tract, PTA is safe and effective in short-term period. Although its long-term restenosis rate is higher, this technique can effectively control the progress of the disease, relieve the clinical symptoms, and help improve the limb salvage rate of ischemic limbs.

Objective To analyze the expression of purinergic receptor P2X ligand-gated ion channel 7 (P2X7R) on different cells and peripheral blood mononuclear cell (PBMC) and to investigate its correlation with inflammatory cytokines in patients with SLE.Methods Flow cytometry was used to detect surface expression of P2X7R on lymphocytes,CD4+ cells,and CD19+ cell in 29 SLE patients and 28 healthy human controls to compare the difference between the SLE patients and the controls in P2X7R expression.Enzyme linked immunosorbent assay (ELISA) was performed to detect P2X7R-related serum cytokines interleukin (IL)-1β,IL-6,tumor necrosis factor (TNF)-α level.T test,Wilcoxon rank sum test,Spearman's correlation analysis were used for statitical analysis.Results ① SLE patients had significantly higher expression of P2X7R on CD4+,CD8+ lymphocytes compared to controls [CD4+ cells∶ 2.21(3.55) vs 0.89(1.15),Z=-1.527,P=0.015； CD19+ cells∶ 11.53(20.01) vs 6.66 (6.27),Z=-2.091,P=0.037]； ② The levels of three cytokines in patients with SLE were significantly higher than those in control.The positive relationship between P2X7R expression in lymphocytes with the serum IL-6 level was found in SLE patients (r=0.449,P=0.015)；③ Patients with arthritis showed significantly higher expression of P2X7R on lym-phocytes compared to patients without arthritis (Z=-2.772,P=0.006).The expression of P2X7R on lymphocytes and CD19+ cell was significantly positively correlated with the SLEDAI score.Positive correlation with anti-β2GP Ⅰ in lymphocyteswas also found.Conclusion P2X7R may mediate the release of inflammatory cytokines involved in the pathogenesis of SLE,and may participate the development of arthritis,lupus nephritis and NPSLE in SLE patients.