Objective To investigate the efficacy of super selective intra-arterial infusion of verapamil for the treatment of cerebral vasospasm (CVS) after subarachnoid hemorrhage (SAH).Methods From January 2013 to February 2016,the clinical data of 15 patients with subarachnoid hemorrhage (SAH) who had CVS after intracranial aneurysm clipping (n=8) or endovascular treatment (n=7) were analyzed retrospectively.All patients received whole brain digital subtraction angiography (DSA).Microcatheter super selection to spastic arteries was used and verapamil (11.1±3.4 mg) was infused.The findings of whole brain DSA before and after treatments were compared.The blood pressure and heart rate were collected during the treatment and the findings of transcranial Doppler ultrasonography were recorded.The patients were followed up for 6 months and the Glasgow outcome scale (GCS) scores were obtained.Results (1) A total of 20 intra-arterial infusion treatments were performed in 15 cases.They were compared before and after perfusion.CVS was improved on DSA in 14 cases,there was no significant change in on cases.(2) Transcranial Doppler ultrasonography showed that the mean blood flow velocity (mBFV) of the middle cerebral artery was decreased from 181±4 cm/s before the super selective intra-arterial infusion to 126±4 cm/s within 1 hour after treatment.There was significant difference (t=42.46,P<0.01).No complications associated with the use of microcatheters were observed.(3) The right upper arm blood pressure of the patients was monitored in the process of perfusion.The systolic pressure was 138±8 mmHg at the beginning of the perfusion,it was 135±10 mmHg at the end of the perfusion,and it was 137±7 mmHg at 1 h after the perfusion.The heart rate was 83±6/min at the beginning of the operation,it was 79±8/min at the end of the operation,and it was 80±5/min at 1 h after the operation.There were no significant differences (P>0.05).(4) All patients were followed up for 6 months.The GOS score at 6 months:good recovery in 9 cases,moderate disability but could take care of themselves in 3 cases,severe disability and could not take care of themselves in 3 cases,no persistent vegetative state or death.Conclusion Super selective intra-arterial infusion of verapamil can effectively improve the treatment of aneurysmal SAH caused CVS.At the same time,it has no obvious effect on blood pressure and heart rate.

Objective To investigate the outcome of microsurgical treatment and its influencing factors in patients with aneurysmal subarachnoid hemorrhage.Methods The consecutive patients with aneurysmal subarachnoid hemorrhage treated with the early or ultra-early microsurgery were enrolled retrospectively.The Glasgow outcome scale (GOS) was used to assess the outcomes of patients at discharge.GOS 4-5 was defined as good outcome,and GOS 1-3 was defined as poor outcome.Results A total of 147 patients with aneurysmal subaraclnoid hemorrhage were enrolled.One hundred and twelve patients (76.2％) had good outcomes.There were significant differences in the proportions of preoperative Glasgow Coma Scale (GCS) scores (12.8 ± 2.8 vs.7.5 ± 3.8;t =7.525,P ＜0.001),low Hunt-Hess grade (83.0％ vs.31.4％;x2 =34.318,P ＜ 0.001),size of aneurysm (x2 =9.531,P =0.009),preoperative rebleeding (6.3％ vs.25.7％;x2 =8.506,P =0.003),preoperative brain herniation (4.5％ vs.40.0％;x2 =26.846,P ＜ 0.001),initial CT scan showing intracerebral hemorrhage (19.6％ vs.48.6％;x2 =11.449,P =0.002),and intraventricular hemorrhage (8.9％ vs.40.0％;x2 =18.846,P ＜0.001) between the good outcome group and the poor outcome group.Multivariate logistic regression analysis showed that the larger aneurysm (odds ratio [OR] 3.194,95％ confidence interval [CI] 1.458-6.999;P =0.004),older age (OR 1.054,95％ CI 1.013-1.097;P=0.010),lower preoperative GCS score (OR 0.539,95％ CI 0.410-0.724;P ＜ 0.001),and preoperative brain herniation (OR 3.633,95％ CI 1.039-12.700;P =0.043) were the independent risk factors for poor outcomes.Conclusions After active surgical treatment,most of the patients with aneurysmal subarachnoid hemorrhage have good outcomes,however,patients with older age,larger aneurysms,lower preoperative GCS scores,and preoperative brain herniation usually have poor outcomes.

Objective Toinvestigatetheimpactofthedifferentrupturepoints(sac,neck,andtop) of intraoperative aneurysm rupture (IAR)on the prognosis of patients in anterior circulation aneurysm clipping.Methods Theclinicaldataof135consecutivepatients(148aneurysms)acceptedmicrosurgical aneurysm clipping from May 2009 to March 2012 were analyzed retrospectively. The prognostic evaluation of the patients after procedure was assessed by using the Glasgow outcome scale (GOS). The different aneurysm rupture points of IAR were used as influencing factors,and the relationship between the different rupture pointsandtheprognosisofpatientswasanalyzed.Results Duringclippingof148aneurysmsin 135 patients,31 aneurysms in 30 patients had intraoperative rupture (20. 9% of the aneurysms, 22.2% of the patients). Nine rupture points occurred on the top of aneurysms,17 occurred on the sac,and 5 occurred on neck. The Glasgow outcome scale (GOS)scores 5,4,3,2 and 1 were in 17,8,2,1 and 2 patients,respectively. A total of 25 patients had good prognosis and 5 cases had poor prognosis. There were no significant differences in the impact of different rupture points of IAR on the prognosis in patients of IAR (OR,100. 00,95% confidence interval 6. 764-18. 344,P=0. 006). Of the 25 patients with aneurysm sac or top rupture,1 case had poor prognosis. Of the 5 patients with aneurysm neck rupture, 4caseshadpoorprognosis.Conclusion Inanteriorcirculationaneurysmclipping,thedifferent aneurysm rupture points may have significant impact on the prognosis of patients,the aneurysm neck rupture is a main factor for resulting in the poor prognosis of patients.

Methane is the simplest hydrocarbon, consisting of one carbon atom and four hydrogen atoms. It is abundant in marsh gas, livestock rumination, and combustible ice. Little is known about the use of methane in human disease treatment. Current research indicates that methane is useful for treating several diseases including ischemia and reperfusion injury, and inflammatory diseases. The mechanisms underlying the protective effects of methane appear primarily to involve anti-oxidation, anti-inflammation, and anti-apoptosis. In this review, we describe the beneficial effects of methane on different diseases, summarize possible mechanisms by which methane may act in these conditions, and discuss the purpose of methane production in hypoxic conditions. Then we propose several promising directions for the future research.

Objective To investigate the efficacy of microsurgery and predictors of outcome for poor -grade aneurysmal subarachnoid hemorrhage(aSAH).Methods Clinical data of 43 patients of poor -grade aSAH who per-formed microsurgery were retrospectively analyzed.There were 30 patients with Hunt -Hess grade IV and 1 3 patients with grade V.24 patients received emergency operation(within 6hours after onset),1 6 patients received ultra -early operation(within first 24hours after onset).Outcome was assessed by Glascow Outcome Scale(GOS).Results Of 43 patients who received microsurgery,favorable outcome was achieved by 1 9 cases of 43 cases (44.2%),poor outcome was achieved by 1 6 cases of 43 cases (37.2%),the overall outcome of patients with Hunt -Hess grade IV was better than that with grade V(Z =-2.486,P =0.01 6).1 8 patients with intracerebral hematoma received ultra -early or emergency operation,effective surgical intervention(GOS≥3)achieved in 1 2 patients,there was no signifi-cant difference in prognosis between the patients and the others who without intracerebral hematomas(χ2 =0.1 03,P =1 .000).Conclusion The ultra -early or emergency surgery could avoid the risk of aneurysmal re -rupture,relieve malignant intracranial hypertension as soon as possible and decrease the mortality of poor -grade aSAH patients.

Objective:To compare the clinical and prognostic characteristics of ovarian endometrioid carcinoma (OEC) patients with synchronous endometrial lesions and patients with pure OEC.Methods:A retrospective review of the medical records of patients received initial treatment and a postoperative pathological diagnosis of OEC at Peking University People′s Hospital between August 1998 and December 2017 were performed. According to the inclusion criteria, a total of 56 patients with OEC were included in the study, including 13 patients concurrent with simultaneous endometrial lesions (Group A) and 43 patients with pure OEC (Group B).Results:Patients with synchronous endometrial lesions accounted for 23% (13/56). Mean age of Group A at diagnosis was (44.9±8.3) years old, 2/13 of patients were postmenopausal, and no one had a history of hypertension, the first symptom of 5/13 people was irregular vaginal bleeding. Mean age of Group B patients at diagnosis was (52.7±10.2) years old, 53% (23/43) of patients were postmenopausal, and 28% (12/43) patients had the history of hypertension, the first symptom of 4 (9%, 4/43) people was irregular vaginal bleeding. The differences of age, menopause status, history of hypertension and initial symptoms between the two groups were statistically significant (all P<0.05). There were no significant differences in fertility history, dysmenorrhea history, age of menarche, history of endometriosis, preoperative and postoperative CA 125 level, International Federation of Gynecology and Obstetrics (FIGO) stage, tumor grade, metastatic site and platinum-based chemotherapy drug resistance between the two groups (all P>0.05). The overall 5-year survival rate of OEC patients was 91.6%, and the overall 5-year progression-free survival rate was 76.6%. Among them, the 5-year survival rate of the OEC concurrent with simultaneous endometrial lesions group was 80.2%, and the pure OEC group was 93.4%; the 5-year progression-free survival rate of the OEC concurrent with simultaneous endometrial lesions group was 74.1%, and the 5-year progression-free survival rate of the pure OEC group was 77.3%. There were no significant differences between the two groups (all P>0.05). Multivariate analysis showed that the independent factors for the prognosis of OEC patients were FIGO stage ( P=0.006) and residual lesion size ( P=0.020). Conclusions:OEC patients have a high proportion of simultaneous endometrial lesions. OEC with simultaneous endometrial lesions are younger than patients with pure OEC. Synchronous endometrial lesions do not affect the prognosis of patients with OEC.

Adult ; China ; epidemiology ; Cross-Sectional Studies ; Diabetes Mellitus ; diagnosis ; epidemiology ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Risk Factors ; Rural Population ; Sensitivity and Specificity

OBJECTIVETo summarize the experience with endovenous laser treatment(EVLT) combined with high ligation and Muller's phlebectomy for primary superficial varicose in the lower limbs.

METHODSIn 95 patients with C3-6 grade primary superficial varicose in 146 lower limbs, the extent of varicose was accurately marked, the guiding wires were manipulated precisely, and the proximal great saphenous veins (GSV) were ligated after exsanguinations. The stems of the GSV were ablated with laser with the lower limbs lift up and pressed hard along the stems, and Muller's incisions were carefully planned.

RESULTSAll the operations were completed successfully. The guiding wires entered into the deep veins through the communicating branches in 2 limbs, 1 patient experienced capillary hemorrhage from Muller's incisions, 8 had thrombotic phlebitis of the GSV, 7 sustained heat-related injury of the saphenous nerves, 1 experienced skin heat-related lesion, 2 developed hematoma in the inguinal region, 2 had pitting edema in the dorsum of the foot, 1 had fat liquefaction of the Muller incision, and 1 showed rejection of the thrum. After conservative treatment, all the patients recovered and were discharged. Part of the superficial varicose remained after the operation in 6 limbs.

CONCLUSIONIt is necessary to standardize the routine procedure of EVLT combined with high ligation and Muller's phlebectomy to reduce the complications.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Laser Therapy ; Ligation ; Lower Extremity ; blood supply ; Male ; Middle Aged ; Saphenous Vein ; surgery ; Treatment Outcome ; Varicose Veins ; surgery ; Vascular Surgical Procedures ; methods

OBJECTIVETo investigate the effects using mini-plate implant as anchorage for maxillary protraction in skeletal Class III malocclusion with retruded maxilla.

METHODSTotally 8 skeletal Class III patients aged 11 - 14 years were included in this study. There were 4 males and 4 females. The mini-plate implants were placed between the upper lateral incisors and canines on both sides in each patient. The mask was used after 1 month healing following mini-plate implant surgery. Cephalography and panoramic radiographs were taken for each patient before and after protraction. Twenty-one cephalometric measurements were used for assessment. Statistically, paired t-test was used.

RESULTSAfter protraction, SNA, ANB, Wits, NA-PA, Max-Lth, A-NP distances increased and the significant difference was founded (P < 0.01). ANS-Me, Is-FHp, Ms-FHp, A-FHp distances increased significantly, too (P < 0.05). L1-AP, OJ, AB-NP decreased and the significant difference was detected (P < 0.05). The changes of SNB, MP-SN, PP-SN, U1-PP, U1-SN, U1-AP, L1-MP and ANS-Me/N-Me ratio were not significant (P > 0.05).

CONCLUSIONSMini-plate implant was an effective and stable anchorage for promoting forward growth of maxilla following maxillary protraction.

Adolescent ; Child ; Female ; Humans ; Male ; Malocclusion, Angle Class III ; surgery ; Maxilla ; surgery ; Orthodontics, Corrective ; Osteogenesis, Distraction ; Prostheses and Implants ; Titanium

Child ; Dental Implantation, Endosseous ; Extraoral Traction Appliances ; Humans ; Male ; Malocclusion, Angle Class III ; therapy ; Maxilla ; abnormalities ; Orthodontic Anchorage Procedures ; instrumentation ; Orthodontic Appliance Design ; Orthodontics, Corrective ; instrumentation