Objective To assess the value of multislice spiral computed tomography (MSCT) in diagnosing pulmonary hypertension.Methods One hundred and forty-two patients on hemodialysis were divided into the group with pulmonary artery hypertension and the group without pulmonary artery hypertension.The diagnosis of pulmonary artery hypertension (pulmonary artery systolic pressure,PASP ＞ 35 mmHg) was according to the guideline from the American Society of Echocardiography.All patients were received the check of MSCT and the diameters of the main pulmonary artery,ascending aorta and descending aorta were recorded.PASP and left ventricular ejection fraction were assessed by echocardiography.High sensitivity C-reactive protein and rumor necrosis factor were measured by automatic analyzer and enzyme linked immunosorbent assay.Results There were significant differences between the two groups in systolic blood pressure,hemoglobin,serum albumin,high sensitivity C-reactive protein and TNF-α (P ＜ 0.05); There were significant differences between the two groups in diameters of the maim pulmonary artery,ratio of the diameter of the main pulmonary artery to the diameter of ascending aorta and ratio of the diameter of the main pulmonary artery to the diameter of descending aorta (P ＜ 0.05).In different heart function groups,there were significant differences in diameters of the main pulmonary artery,ratio of the diameter of the main pulmonary artery to the diameter of ascending aorta,and ratio of the diameter of the main pulmonary artery to the diameter of descending aorta,and left ventricular ejection fraction (P ＜ 0.05).Ratio of the diameter of the maim pulmonary artery to the diameter of ascending aorta was positively related to PASP (r=48.77,P ＜ 0.01),and left ventricular ejection fraction was negatively related to PASP (r=-0.40,P ＜ 0.01).In multivariate linear regression,TNF-α,ratio of the diameter of the maim pulmonary artery to the diameter of ascending aorta and ejection fraction were independent factors of PASP (P ＜ 0.01).Conclusions MSCT measurements play an important role in diagnosis of pulmonary hypertension and in evaluation of clinical prognosis in patients on hemodialysis.

BACKGROUND:Current research data have shown that patients with epilepsy are often accompanied by complications such as cognitive impairment. Recent studies have demonstrated that melatonin has an inhibitory effect on epilepsy, but its underlying mechanism is unknown. OBJECTIVE: To investigate the effects of melatonin on the cognitive function and GluR2 expression in the hippocampus of rat models of epilepsy, and further study the mechanism of melatonin against epilepsy. METHODS: Rat models of chronic epilepsy were established by intraperitoneal injection of lithium chloride-pilocarpine, and intraperitonealy injected with sufficient amount of physiological saline and melatonin respectively. Control group was set for observation. RESULTS AND CONCLUSION:At 4 and 6 weeks after modeling, the GluR2 expression level in the hippocampus of rats in the epilepsy + melatonin group was significantly higher than that in the epilepsy group (P < 0.05); the GluR2 expression level in the synaptic membrane of hippocampal CA1 region of rats in the control and epilepsy + melatonin groups was significantly higher than that in the epilepsy group (P < 0.05). At 4 days after modeling, compared with epilepsy group and epilepsy + physiological saline group, the escape latency, operation time, active avoidance latency, passive avoidance latency of rats in the epilepsy + melatonin group were significantly decreased (P< 0.05), the correct rate and active avoidance number were significantly increased (P < 0.05). These results demonstrate that melatonin can improve the cognitive function of rat models of epilepsy by up-regulating the expression of GluR2 in the synaptic membrane of hippocampal CA1 region.

Objective To evaluate the clinical efficacy of endovascular embolization with detachable balloon, based on the characteristics of traumatic carotid-cavernous fistulae (TCCF), in treating TCCF. Methods The clinical data of 188 patients with TCCF, who had received endovascular embolization with detachable balloon via femoral artery access, were retrospectively analyzed. The risk factors for recurrence were statistically analyzed. Results Of the total 188 patients, complete cure after the first balloon embolization was obtained in 160, certain improvement of clinical symptoms was achieved in 22, and balloon embolization failed in 6, for whom other surgical options had to be carried out. Complications occurred in three patients. Recurrence was seen in 23 patients within the period from one day to 5 years after the treatment, and the recurrent lesion was successfully cured in all patients. Univariate analysis and chi square test or correction chi square test indicated that factors affecting postoperative recurrence were the use of multiple balloons for embolization and the presence of residual fistula after operation (P<0.05), while patient’s sex, age, duration of disease showed no statistically significant correlation with the recurrence (P>0.05). Multivariate logistic regression analysis revealed that the independent factors affecting recurrence included the number of used balloon≥2 (OR=7.80, 95%CI:2.28-26.73,P=0.001) and postoperative residual fistula that was observed immediately after the embolization (OR=10.46, 95%CI:2.99-36.50,P=0.000). Conclusion For the treatment of TCCF, transcatheter embolization with detachable balloon is minimally-invasive, safe and reliable with fewer complications, therefore, this technique should be regarded as the therapy of first choice. The use of multiple balloons and the presence of residual fistula observed immediately after the embolization procedure are the risk factors for recurrence. Other possible risk factors are still to be furtherstudied.

One hundred and forty-two patients on maintenance hemodialysis were enrolled in the study.According to the guideline of American Society of Echocardiography 97 patients (68.3％) were classified as pulmonary artery hypertension [PAH,pulmonary artery systolic pressure (PASP) ＞ 35 mmHg (1 mmHg =0.133 kPa)] and 45 patients (31.7％) as non-PAH (PASP ≤ 35 mmHg).High sensitivity Creactive protein (hs-CRP) and tumor necrosis factor-α (TNF-α) were measured by automatic analyzer and enzyme linked immunosorbent assay (ELISA),respectively.There were significant differences in CRP and TNF-α levels between PAH and non-PAH patients (P ＜ 0.05).Multivariate linear regression showed that TNF-α and interdialytic weight gain were positively correlated with PAH and left ventricular ejection fraction was negatively correlated with PAH (P ＜ 0.01).In the multivariate Cox proportional hazards models,PAH and TNF-α level were independently associated with higher risk for all-cause death (HR =1.06,95％ CI:1.03-1.09 and HR =1.31,95％ CI:1.17-1.46,respectively).In Kaplan-Meier survival analysis,the risk of all-cause mortality increased in parallel with PASP.The risk of death in patients with PASP ＞45 mmHg was higher than that in patients with PASP ≤45 mmHg (log-rank test:x2 =6.58,P =0.010),the risk was 2.82-fold (HR =2.82,95％ CI:1.38-5.77,P =0.004).

Objective To explore the safety and efficacy of the Wingspan stenting of basilar artery atherosclerosis stenosis though the analysis of single center massive clinical data. Methods Ninety one consecutive patients received Wingspan stenting because of basilar artery stenosis in our center from July 2007 to April 2013. The patients were classified into three groups:early term (n=30), middle term (n=30), and late term (n=31) according to the operation time in our center. The basic clinical data and the factors which may affect the ischemic events were retrospectively analysed, t test and Chi?Square test were used to analyze the factors related to the periprocedural ischemic complications. Results All of patients were stented successfully and the technical success rate was 100%(91/91). The mean stenosis was reduced from (82.2 ± 5.8)% to (15.9 ± 5.7)%; strokes or death happened in 13 cases within 30 days, including perforator stroke in 8 patients(8.8%, 8/91), thrombosis in 4 patients(4.4%, 4/91), subarachnoid hemo rrhage in 1 patient(1.1%, 1/91), 2 patients with disabling or fatal strokes. Lesions involving in the middle segment of basal artery (P=0.049), long?segment disease (P=0.002), severe stenosis (P=0.001) may be a risk factor affecting perioperative ischemic stroke, and the surgeons' surgical technique was not risk factors for ischemic complications (P=1.000). Seventy seven patients (84.6%, 77/91) had the clinical follow?up and the mean follow?up period was (31.3±15.1) months. Four patients suffered from posterior circulation strokes during the clinical follow?up , one of them (1.3%, 1/77) had disabling stroke, another 3 patients (3.9%, 3/77) suffered from TIA. The 2?year accumulate probability of stroke (any stroke or death within 30 days and stroke in the territory of the qualifying artery beyond 30 days)was 16%(95%CI, 8.2%to 23.8%). Forty six patients had the imaging follow?up and the mean follow?up period was(9.5±8.3)months, 6 patients(13.0%,6/46) had in?stent restenosis (ISR) and 2/6 patient had the symptomatic ISR. Conclusions The stroke or death rate of symptomatic basilar atherosclerosis Wingspan stenting within 30 days is high, but the disabling or fatal stroke rate is low. The middle segment of basilar artery involved, the long stenosis, the severe atherosclerosis may be the factors related to the periprocedural ischemic strokes. The incidence of disabling or fatal strokes was low following Wingspan stenting.

Objective To explore the feasibility and safety of using 6 F guiding catheter to perform the carotid artery stenting (CAS) via transradial approach (TRA). Methods A retrospective analysis of 28 cases with carotid atherosclerotic stenosis who were using 6 F guiding catheter to perform the CAS via TRA, and the preoperative assessment confirmed that some of whom were difficult to operate via femoral artery, or couldn't tolerate the lying in bed after the operation, and the others were failure to perform via femoral artery. The atherosclerotic carotid stenosis lesion of 9 cases were located in the left internal carotid artery (ICA), and the other 19 cases were in the right ICA. All the patients were performed via the right radial artery approach, a 6 F guiding catheter was used to super-select the target vessel, implanted the distal protection device, then underwent balloon angioplasty and stent implantation. We observed and recorded that whether the guiding catheters were in the right places, the success rate of stent implantation, the incidence of radial artery spasm and the puncture site bleeding. The postoperative pulse and occlusion of radial artery, and the occurrence of cardio-cerebrovascular complications during perioperative period were also observed. The fluoroscopy time of surgery ray were also recorded, and compared with corresponding 30 cases who were performed CAS via the tranfemoral approach (TFA) by t test. Results The guiding catheters were in the right places and stenting success of all the 28 cases. There was no significant difference in the fluoroscopy time between TRA and TFA group [(8.6 ± 1.4) min vs. (9.0 ± 2.1) min,t=-0.717,P=0.477)]. Two cases appeared radial artery spasm after puncture, and 1 case experienced puncture site bleeding at 8 h after the operation. After examined the radial artery by color doppler ultrasound at 1 week after the operation, we found that blood flow of 27 cases were patency, but another 1 was slowed down, which was restored at 3 months follow up. None of the cases occurred cerebrovascular events in the present research. Conclusion Transradial approach for CAS using 6 F guiding catheter is safe and technically feasible.

Objective To discuss the perioperative complications of self-expanding Wingspan stent angioplasty for symptomatic basilar atherosclerotic stenosis.Methods A total of 91 consecutive patients with severe basilar atherosclerotic stenosis, who were admitted to the Interventional Radiology Department of Zhengzhou University People’s Hospital during the period from July 2007 to April 2013 to receive Wingspan stent angioplasty, were included in this study.The clinical data were retrospectively analyzed.Based on the operator’s experience, 30 patients who received treatment in the early stage of the period were defined as group A, 30 patients who received treatment in the middle stage of the period were defined as group B, and 31 patients who received treatment in the recent stage of the period were defined as group C.The incidence of perioperative complications, the risk factors and the prevention measures were analyzed.Results Wingspan stent angioplasty was successfully accomplished in all patients.The mean basilar atherosclerotic stenosis ratio was reduced from preoperative (82.2±5.8)%to postoperative (15.9±5.7)%.During the perioperative period of 30 days, strokes occurred in 13 patients (14.3%, 13/91), including perforating branch strokes in 8 patients (8.8%, 8/91); thrombosis occurred in 4 patients (4.4%, 4/91) and subarachnoid hemorrhage in 1 patient (1.1%, 1/91).Lethal and disabling stroke was seen in 2 patients (2.2%, 2/91), resulting in death (n=1) and severe disability (n=1).No other non-stroke-related complications occurred.Statistical analysis indicated that the incidence of ischemic strokes bore a parallel correlation with the following factors: involvement of the middle segment of basilar artery (P=0.049), the longer affected arterial segment (P=0.002) and severe degree of stenosis(P=0.001); while the incidence of ischemic strokes showed no definite correlation with the operator’s experience (P=1.000).Conclusion In treating symptomatic severe basilar atherosclerotic stenosis, self-expanding Wingspan stent angioplasty carries a relatively higher incidence of perioperative complications.Patients with the middle segment stenosis of basilar artery and severe longer segmental stenosis are more prone to develop complications, but the incidence of lethal and disabling stroke is rather lower.

Objective: To study the effect of flavonoids from seed residues of Hippophae rhamnoides L.( FSH) and Hippophae rhamnoides L. oil(HRO)on serum lipid in female rats with obesity. Methods Female aged rats with obesity were given FSH and HRO by oral administration for 6 w. Serum triglyceride(TG) and cholesterol(TC) were determined every 2 w. The serum free fatty acid (FFA), high-density lipoprotein cholesterol (HDL-C),body weight and Lee’s index were measured after 6 w. Results: Serum TG and FFA level decreased significantly in rats given FSH. At the same time, FSH could inhibit the increase in body weight and Lee’s index. HRO could regulate the lipid metabolism and decrease serum TG level significantly in female aged rats with obesity. Conclusion: Both FSH and HRO can improve lipid metabolism in female aged rats with obesity.

Objective To discuss the application value,safety and feasibility of indwelling guidewire technique in performing mechanical thrombectomy for acute cerebral artery occlusion.Methods The clinical data of 15 patients with acute ischemic stroke,who were treated with mechanical thromnectomy at authors' hospital during the period from December 2015 to February 2016,were retrospectively analyzed.The diseases included middle cerebral artery occlusion (n=6),internal carotid artery and middle cerebral artery occlusion (n=5) and vertebral basilar artery occlusion (n=4).Indwelling guide-wire technique was adopted to quickly and accurately determine the vascular occlusion characteristics,then,endovascular mechanical thrombectomy was carried out.Results By using indwelling guide-wire technique,the occlusive features of the diseased arteries were successfully and precisely determined.Immediate recanalization of the occluded artery was obtained in 13 patients (87％).The blood flow classification score after thrombolysis in cerebral infarction (TICI) reached 3 points in 10 patients and 2b points in 5 patients.In 2 patients,the vascular recanalization procedure failed because the thrombus load was large,the length of occluded segment was long,and the effect of mechanical thromnectomy was poor.According to American National Institutes of Health Stroke Scale (NIHSS),the evaluation score was improved from preoperative (19.2±7.0) to postoperative (6.3±3.6),the difference was statistically significant (P＜0.05).Three months after the treatment,the score measured by modified Rankin scale(mRS) was ≤2 points in 10 patients.Conclusion Mechanical thrombectomy is safe and effective for the treatment of acute cerebral artery occlusion.The indwelling guide-wire technique can safely,conveniently,quickly and accurately determine the characteristics of the occluded blood vessels,which is very helpful in assisting surgical manipulation,reducing procedure-related complications,and improving vascular recanalization rate.(J Intervent Radiol,2017,26:202-205)

Objective To evaluate the incidence,potential hazards and effective countermeasure for perforator stroke (PS) resulting from stent angioplasty of symptomatic intracranial artery stenosis.Methods Peri-operation PS complications of 258 patients receiving Gateway balloon-Wingspan stenting for severe symptomatic intracranial stenosis were analyzed.The incidence,clinical course,and prognosis of PS resulting from stenting were recorded.Special attention was given to the anatomical features,clinical manifestation and video materials of patients with PS.x2 test was used for statistics.Results Two hundred and fifty-five patients received stent angioplasty successfully and 7 patients had PS ( incidence rate 2.7％ ).The patients with basilar artery stenosis had a higher incidence of PS resulting from intracranial stenting (6.1％,4/66) than patients with middle cerebral artery stenosis (2.5％,3/118) (x2 =2.320,P =0.025 ).The potential hazards for PS included preoperative perforator stroke adjacent to the stenotic segment and prominent dissection during operation.Six patients presented symptoms after awake from general anaesthesia and one had symptoms 3 hours after stenting.One deteriorated gradually and the others reached the maximum deficit almost at once.At the follow-up of 3 months,3 patients were disabled and scored one,two,two by mRS respectively.Conclusion The incidence of PS resulting from intracranial stenting was low and the prognosis was not disastrous.Stenosis at basilar artery and preoperative perforator stroke adjacent to the stenotic segment were potential risk factors for PS complication.Proper maneuver of angioplasty may decrease the incidence of PS and improve the prognosis.