Objective To explore the clinical efficacy of evolocumab combined with bare metal stents in treating stenosis at the vertebral artery ostium and its impact on restenosis.Methods A retrospective analysis was conducted on 81 patients with ostial vertebral artery stenosis undergo-ing implantation of bare mental stents in our department from January 2022 to May 2024.Based on postoperative lipid-lowering regimens,they were divided into a statin group(51 cases,atorvas-tatin alone)and a combination group(30 cases,atorvastatin combined with evolocumab).All pa-tients were followed up for 6 months postoperatively,the changes in low-density lipoprotein cho-lesterol(LDL-C)level(△LDL-C)and total cholesterol(TC)level(△TC)as well as the rate of vascular restenosis(△restenosis rate)were compared between the two groups.Results After treatment,the combination group had significantly lower LDL-C and TC levels than the statin group(P＜0.01).The △LDL-C and △TC levels were obviously higher(1.85±1.01 mmol/L vs 1.18±0.68 mmol/L,P=0.001;1.64±0.94 mmol/L vs 1.19±0.67 mmol/L,P=0.018),and the△restenosis rate was notably lower(13.3％vs 35.3％,P=0.032)in the combination group than the statin group.Conclusion Combined evolocumab and metal bare stents demonstrates good effi-cacy in treating stenosis at the origin of the vertebral artery,and can effectively lower lipid levels and helps to reduce the occurrence of vascular restenosis.

Objective To explore the clinical efficacy of evolocumab combined with bare metal stents in treating stenosis at the vertebral artery ostium and its impact on restenosis.Methods A retrospective analysis was conducted on 81 patients with ostial vertebral artery stenosis undergo-ing implantation of bare mental stents in our department from January 2022 to May 2024.Based on postoperative lipid-lowering regimens,they were divided into a statin group(51 cases,atorvas-tatin alone)and a combination group(30 cases,atorvastatin combined with evolocumab).All pa-tients were followed up for 6 months postoperatively,the changes in low-density lipoprotein cho-lesterol(LDL-C)level(△LDL-C)and total cholesterol(TC)level(△TC)as well as the rate of vascular restenosis(△restenosis rate)were compared between the two groups.Results After treatment,the combination group had significantly lower LDL-C and TC levels than the statin group(P＜0.01).The △LDL-C and △TC levels were obviously higher(1.85±1.01 mmol/L vs 1.18±0.68 mmol/L,P=0.001;1.64±0.94 mmol/L vs 1.19±0.67 mmol/L,P=0.018),and the△restenosis rate was notably lower(13.3％vs 35.3％,P=0.032)in the combination group than the statin group.Conclusion Combined evolocumab and metal bare stents demonstrates good effi-cacy in treating stenosis at the origin of the vertebral artery,and can effectively lower lipid levels and helps to reduce the occurrence of vascular restenosis.

BACKGROUND: Aquaporin-4 may be one of the candidates for inducing the brain edema in ischemic stroke, however, it still has not been reported whether aquaporin-4 is involved in the formation of brain edema after intracerebral hemorrhage (ICH).OBJECTIVE: To observe the expression of aquaporin-4 of cerebral tissue in the pathologic course of hemorrhagic cerebral edema in rats, and investigate itsrelationship with the formation of brain edema following ICH.DESIGN: A randomized controlled experimental study.SETTING: Department of Neurology, People's Hospital of Guangxi Zhuang Autonomous Region; Research Room of Neurobiology, Chongqing University of Medical Sciences.MATERIALS: This experiment was carried out in the Research Room of Neurobiology, Chongqing University of Medical Sciences between April and October 2003. Totally 120 adult healthy male Wistar rats, weighing 250-300 g, were provided by the Experimental Animal Center of Chongqing University of Medical Sciences.METHODS: The experiment had four parts, each part (n=30) was divided into the control group (n=5) and operation group (n=25), and then the latter was subdivided into 6-hour, 1, 3, 5 and 7-day following ICH groups with 5rats in each group. In the operation group, ICH models were established by infusing collagenase into left caudate nucleus of rats unilaterally. The operative process in the control group was the same as that in the operation group except for infusing collagenase. Standards for successful model establishment: the paralytic forelimb flexed under abdomen after withdrawal,and the normal forelimb extended to the ground. ① The expression of aquaporin-4 was detected with immunohistochemistry. ② The expression of aquaporin-4 mRNA was assessed with in situ hybridizution. ③ The expression of aquaporin-4 mRNA was assessed with reverse transcription polymerase chain reaction (RT-PCR). ④ The pathological changes of hemorrhagic edema were observed under transmission electron microscope.MAIN OUTCOME MEASURES: ① expression of aquaporin-4 mRNAand protein; ② pathological changes of hemorrhagic edema.RESULTS: The model establishments were all successful in the operation group, and all the rats were involved in the analysis of results without deletion. ① Comparison of the expression of aquaporin-4 mRNA and protein among the groups. There was no significant change in the control group. As compared with the control group, there was a significant increase of the expressions of aquaporin-4 mRNA and protein in the edematous tissue at 6 hours following ICH, and then reached the peaks at 3 days, and the expression of aquaporin-4 was still significantly higher than that in the control group at one week following ICH (t=12.65, P ＜ 0.01). ② The corresponding sequential pathological changes in the edematous tissue of rats in the operation group: There was a gradual increase of intracellular edema within 1-3 days following ICH, and then the brain edema became aggravated at 3 days, an emergence of vasogenic edema and local edema tissue degeneration and necrosis were observed.CONCLUSION: The increased expression of aquaporin-4 was obviously enhanced following ICH, suggesting that aquaporin-4 may play an important role in the pathological course of hemorrhagic brain edema, and inhibition of aquaporin-4 expression may be an effective pathway to prevent and treat brain edema.

BACKGROUND:It is crucial for us to find an objective and sensitive means for the assessment ofthe severitv and development of dementia,so as to make instant diagnosis and examination of therapeutic effect on patientswith vascular dementias(VD).Event related potential endogenetic eomponent P300 is proved closely correlated with the cognitive management of examinees but not with stimulus property,thereby considered as one of the most valuable and objective index for brain superior psychological activity.OBJECTIVE:To study the role and significance of events related potential P300,providing objective basis for clinical diagnosis and therapeutic assessment for patients with VD.DESIGN:Non-randomized simultaneous controlled explorative study based on patients. SETTING:Neurological department and electromyography department in aprovincial hospital and neurological department in a medical college hospital.PARTICIPANTS:Between February 2000 and June 2001,64 patients were of VD at neurological clinic and ward ofthe Second Affiliated Hospital of Chongqing Medical College,including 38 males and 26 females with theaverage age of(66.0±4.6)years(VD group).Culturallevel:19 cases re-ceiyed over senior school education,31 cases of junior school education and14 cases of illiteracy.Meanwhile 60 inpatients without VD were enrolled(non-VD group)including 35 males and 25 females withthe average age of(68.0±3.7)years.Culturallevel:senior school or above,15 cases,junior school, 29 cases and illiteracy,16 cases.METHODS:Mental sate of both VD and non-VD groups were assessed with mini-mental state examination(MMSE),and tested with P300 potential observing the variability of latency and amplitude of P300 in patients.Both methods were compared between VD group and non-VD group, moreover relationship between P300 latency and MMSE scores was also explored.MAIN OUTCOME MEASURES:Variability of P300 latency and amplitude Relationship between P300 latency and MMSE scores.RESULTS:P300 latency was found prolonged in 74% and 7% of VD group and non-VD group respectively,with obvious significance between them,meanwhile prolonged P300 latency was proved closely correlated with the MMSE scores(r=0.609 6,P＜0.05).CONCLUSION:P300 latency can be considered as an obiective predictor for the earlier diagnosis and the assessment of therapeutic effects in patients with VD.