Objective: To compare Sunruifa electrolytically detachable coil (SEDC; developed and produced by Huanhu Medical Apparatus and Instrument, Inc., Tianjin, China) with Sapphire detachable coil (SDC; produced by Micro Therapeutics, Inc, USA) in embolization of intracranial aneurysms in clinical application. Methods: Of the 91 patients with intracranial aneurysms, 30 were treated with SEDC (SEDC group), and 61 were treated with SDC (SDC group) for the embolization of intracranial aneurysms. Both groups were treated at the same time period, by the same surgeon, and with the same type of microcatheter. The visibility of both coils, easiness of deployment through microcatheter, uncoiling, flexibility, effect of forming a basket, dense packing, and time needed for detachment were observed under the fluoroscopy during the procedures. The patients were followed up by telephone, outpatient appointment and digital subtraction angiography. Results: A total of 108 and 271 coils were used in the SEDC group and SDC group, respectively. Both kinds of coils could be clearly visible under the fluoroscopy. Friction was observed when 2 of the coils in the SEDC group and 9 in the SDC group were pushed through the microcatheter. Five coils in the SEDC group and 8 in the SDC group were stretched during the repositioning. Electrolytically detaching time of 6 coils was more than 5 minutes in the SEDC group and 10 in the SDC group. All the outcome measures in both groups were not statistically significant. The densely packed aneurysms were 25 patients in the SEDC group, and 49 in the SDC group; neck remnant in the SEDC group and SDC group was 2 and 5 patients, respectively; the loosely packed aneurysms were 3 patients in the SEDC group, and 7 in the SDC group. There was no significant difference between the two groups. Both groups were followed up for 3 to 22 months, and no rebleeding occurred. Two patients in each group were followed up with DSA, and no recurrence of aneurysm was observed. Conclusion: SEDC can replace SDC for the occlusion of intracranial aneurysms.

Objective: To observe the efficacy of craniotomy and endovascular embolization in for elderly patients with intracranial aneurysm. Methods: Seventy-four patients (aged older than 65 years) with ruptured aneurysm were selected, and they were divided into craniotomy group (n = 26) and endovascular embolization group (n = 48). Their postoperative complications and the results Glasgow outcome scale (GOS) score were evaluated at discharge. The telephone and Outpatient Department follow-up period lasted for 6 months to 4 years. Results: Ten patients presented with symptomatic vasospasm after operation in the craniotomy group; 5 patients had ventriculoperitoneal shunt because of hydrocephalus, 2 patients died because of delayed cerebral infarction, cerebral edema and herniation. Nineteen patients had better outcomes based on GOS score at discharge, 5 had poorer outcomes, and 2 died. Seventeen patients had symptomatic vasospasm in the endovascular embolization group; 5 had ventriculoperitoneal shunt because of hydrocephalus; 3 died, 2 of them die of delayed vasospastic cerebral ischemia and pulmonary infection, the other died of large cerebral infarction caused by middle cerebral artery occlusion that resulted from coil herniation. Thirty-three patients had better outcomes based on GOS score at discharge, 12 had poorer outcomes, and 3 died. There was no significant difference in GOS between the 2 groups. Conclusion: The clinical efficacy between the craniotomy and the endovascular embolization was similar. However, because of endovascular embolization is minimally; it should be the first choice in the treatment of aneurysm in older patients. In addition, the incidence of postoperative delayed vasospasm is higher in older patients with aneurysm after being treated with the 2 therapeutic approaches. Therefore, a great attention should be paid to it.

Adult ; Catheter Ablation ; methods ; Humans ; Male ; Radial Artery ; surgery ; Tachycardia, Supraventricular ; surgery

Objective To analyze the curative effects of total knee arthroplasty(TKA)for severe genu varus combined with flexion deformity.Methods The clinical data of 25 patients(36 knees),who had undergone TKA for severe genu varus combined with flexion deformity from January 2005 to October 2010,were retrospectively analyzed.There were 7 males and 18 females,aged from 55 to 80 years(average 70.5 years).The primary diseases were osteoarthritis in 22 cases and rheumatoid arthritis in 3 cases.HSS knee score was used before and after the operation to assess the efficacy of the TKA.Results All of the patients were followed up for 4 to 9 years(average 6 years).The degree of flexion deformity was reduced from (21 ±63)°to(1.1 ±2.3)°;the degree of the varus decreased from(210 ±4.8)°to(175.6 ±2.1)°;range of motion of the knee joint increased from(70.5 ±20.5)°to(115.1 ±5.3)°;knee score augmen-ted from(33.2 ±10.5)to(90.7 ±8.5);function score added from(35.5 ±14.2)to(85.6 ±10.5);there were 21 cases(8 knees)rated as excellent,2(3 knees)as good and 2(3 knees)as fair,and the excel-lent and good rate was 86%.Most of the patients had normal force line of the knee joint,but 2 patients re-mained varus deformity of 5°~10°.Conclusion Satisfying outcome can be achieved by TKA in treating severe genu varus combined with flexion deformity of the knee.

ObjectiveTo search for the optimum external masking time and tonal models for patients with tinnitus.MethodsTwenty-seven patients with cochlear tinnitus were selected respectively from three different out-patients departments and divided into three groups. Nine patients in every group were treated with different masking parameters according to factorial design which had three masking noises, i.e. narrow band noise (NBN), wide band noise (WBN), speech noise (SN),and three masking time ranges, i.e. 15,30,45 minutes. The results before and after treatment were compared and analysed with analysis of variance (ANOVA). ResultsThe treatment effect when masking for 15 minutes was worse than that for 30,45 minutes, but there was no difference between 30 and 45 minutes. The NBN had the best effect when tinnitus signal was single, the WBN was effective for tinnitus with multiple sounds. ConclusionNBN or WBN masking for 30 minutes showed better therapeutic effect.

Objective To establish a multiplex polymerase chain reaction (PCR) assay for simultaneous identification of Shigella spp., Salmonella spp. and Vibrio cholerae. Methods Based on the gene sequences of invasion plasmid antigen H (ipaH) in Shigella spp., invasion plasmid antigen B(ipaB)in Salmonella spp. and enterotoxin extracellular secretion protein (EPSM) in V. cholerae, three pairs of primer were designed. Genomic DNA was extracted by the boiling method and multiplex PCR was performed with premix Taq in an ABI 2720 thermal cycle. The PCR-amplified products were then analyzed by using agarose gel electrophoresis. Results Under the optimized conditions, the assay yielded a 606-bp product from Shigella spp., a 314-bp product from Salmonella spp., and a 482-bp product from V. cholerae, respectively. When the DNA extraction of multiple target organisms was included in the same reaction, two or three corresponding amplicons in different size were observed. Conclusions A rapid, specific and sensitive multiplex PCR system for simultaneous detection of Shigella spp., Salmonella spp. and V. cholerae has been established. The results suggest that the simultaneous amplification of several genes by multiplex PCR may provide an efficient and rapid diagnostic method for severe diarrhea.

Objective: To study the effect of breast cancer metastasis suppressor gene 1 (BRMS1) on the migration of human breast cancer cells. Methods: An eukaryotic expression vector containing BRMS1 was constructed and was transfected into human breast cancer MDA-MB-231-HM cells by using Lipofectin 2000. Expression of BRMS1 mRNA was detected by real-time PCR. The migration of the cells was assayed by Transwell test. Meanwhile, three pairs of siRNA targeting BRMS1 were designed. The most effective siRNA was screened by real-time PCR and transfected into MDA-MB-231 cells. The migration ability of the transfected cells was detected. Results: Compared with the cells transfected with empty vector, the number of MDA-MB-231-HM cells on the underlayer of transwell decreased by 51.9% after stably transfected with BRMS1. One pair of siRNA was selected which could notably down-regulated BRMS1 expression at mRNA level. After siRNA transfection, the number of MDA-MB-231 cells on the underlayer of transwell increased by 17.9%. Conclusion: BRMS1 suppresses the migration of breast cancer cells, which indicates that BRMS1 may suppress cancer distant metastasis by inhibiting migration of breast cancer cells.

Objective To analyze the vascular architecture characteristics of the complex direct cavernous arteriovenous fistula (cd-CAVF) and to discuss its treatment and the curative effect of interventional embolization. Methods The hospitalization records, imaging features and operation records of 12 patients with cd-CAVF were retrospectively analyzed. Results In the 12 patients with cd-CAVF, the lesion’s blood supply arteries included internal carotid artery (ICA,n=8), primary trigeminal artery (PTA,n=1), middle cerebral artery (MMA,n=2) and basilar artery (BA,n=1). Different degrees of “arterial steal” phenomenon could be observed in all patients. The drainage routes included the superior ophthalmic vein and the inferior petrosal sinus (n=10), and cortical vein (n=2). Interventional embolization was carried out via ICA (n=4), through both ICA and BA (n=5), through MMA (n=2), or through BA (n=1). For the embolization of the lesion the balloons were used in 8 patients, steel coils were adopted in 2 patients, and balloons together with coils were employed in 2 patients. All the patients were followed up for 3-6 months. After the treatment the clinical symptoms and signs disappeared, and the lesions were completely cured in all patients with no complications. During the follow-up period of (60.2 ±26.8) months no recurrence of CAVF was observed. Conclusion The blood supply of cd-CAVF comes directly from the rupture of the blood vessels surrounding the cavernous sinus wall, the “arterial steal” phenomenon is prone to occur, and the drainage via the superior ophthalmic vein and the inferior petrosal sinus is more often seen. Transarterial balloon embolization is very effective for the treatment of cd-CAVF, and the use of coils together with multi-artery approaches is an effective supplementary method.

Objective To investigate the effects of dexmedetomidine on hemodynamics and tra-cheal intubation facility in general anesthetized patients.Methods Forty gynecological patients of se-lective operation under general anesthesia were randomly arranged into 2 groups:group D and group C.With high flow mask oxygen inhalation(5 L/min),dexmedetomidine was intravenously pumped in-to the patients in group D at 0.6μg/kg in 10 minutes while in group C saline were given instead.Both groups were then proceeded with rapid sequence induction (RSI)immediately.The values of MAP, HR,PaO2 and PaCO2 were recorded every minute from pumping start till 15 minutes,the bucking, intubation time and glottis exposure were evaluated as well.Results No significant differences were found in intubation time or glottis exposure between these two groups.After tracheal intubation group D showed higher MAP value than group C at 14,15 minutes,and a lower HR value (P <0.05).Even no significant differences were found in values of SpO2 and PaO2 ,the group D showed less bucking than the group C (P<0.05).Conclusion Dexmedetomidine administration at 0.6μg/kg in RSI can diminish the variation in hemodynamics and facilitate the tracheal intubation by less buc-king,but no affect the oxygen reserve.

Objective To evaluate the effect of endovascular embolotherapy treatment of carotid cavernous fistulas(CCF) via superior ophthalmic vein(SOV).Methods From June 1996 to June 2006,a total of 32 patients(16 female) with complex CCF underwent endovascular embolotherapy treatment through the SOV.All of the patients visited doctor due to ocular signs and symptoms.Nine patients with direct CCF had previously undergone partial arterial balloons embolotherapy.The other 23 patients were hard mater CCF,and of which 3 had underwent NBCA,embolotherapy with line section or PVA particle.In the angiographic suite all patients underwent general anesthesia,SOV was catheterized through the eyebrow incision.Cavernous sinus was packed with free coils,detachable coils or balloons and NBCA.Results Complete embolism of the arteriovenous shunt was achieved in 81.3%(26/32).A minor residual shunt(without cortical or ocular drainage) remained in 12.5%(4/32).Only SOV was occluded in 6.2%(2/32).All patients were clinical improvement without complications.No death and permanent disability occurred.No recurrence was observed during follow-up of mean time of 3.5 years in 22 outpatients.Conclusion The operative approach to SOV is straightforward and several kind of embolic materials can be used to embolize the cavernous sinus.Endovascular occlusion of cavernous sinus through the SOV is an efficient and safe treatment in CCF.