Objective:To evaluate the efficacy and safety of intrasaccular flow disruptor in wide-necked intracranial aneurysms.Methods:One hundred and seventeen patients with wide-necked intracranial aneurysms treated with intrasaccular flow disruptor were collected from Department of Neurointervention (First Affiliated Hospital of Zhengzhou University), Department of Neurosurgery (Beijing Tiantan Hospital, Capital Medical University), Department of Cerebrovascular Surgery, Neurosurgery Center (Zhujiang Hospital, Southern Medical University), and Department of Neurosurgery (First Affiliated Hospital of Harbin Medical University) from August 2022 to March 2024. Raymond-Roy Occlusion Classification (RROC) was employed to evaluate aneurysm embolization immediately after procedure; cranial CT or MRI within 48 hours of embolization were performed to identify any new intracranial hemorrhage, subarachnoid hemorrhage, or new symptomatic cerebral infarction related to the intracranial aneurysms. Modified Rankin Scale (mRS) was used to assess the neurological function at discharge. Imaging follow-up and outpatient follow-up were performed at 6 months after embolization to evaluate the aneurysm occlusion degree and complications.Results:A total of 117 intrasaccular flow disruptors were implanted in 117 patients, with a technical success rate of 100%; 115 patients (98.3%) enjoyed successful one-time release of their disruptors, and 2 patients (1.7%) required retrieval and redirection of the disruptors before second successful attempt. Flow disruptor plus stent was performed in 13 patients (11.1%). Immediately after procedure, RROC grading I was noted in 3 patients, grading II in 51 patients and grading III in 63 patients. Cranial CT or MRI within 48 hours of embolization indicated no new intracranial hemorrhage, subarachnoid hemorrhage, or symptomatic cerebral infarction related to the intracranial aneurysms. All patients had mRS score of 0 at discharge. Eighty-three patients completed a 6-month follow-up (RROC grading I in 41 patients, grading II in 33 patients and grading III in 9 patients), without ischemic or hemorrhagic adverse events.Conclusion:The results of this study preliminarily suggest that intrasaccular flow disruptor is effective and safe in wide-necked intracranial aneurysms.

Objective:To evaluate the efficacy and safety of Neuroform Atlas stent-assisted coil embolization in patients with middle cerebral artery bifurcation aneurysms.Methods:A retrospective analysis was performed; the clinical data of 46 patients with middle cerebral artery bifurcation aneurysms accepted Neuroform Atlas stent-assisted coil embolization in First Affiliated Hospital of Zhengzhou University, Beijing Tiantan Hospital Affiliated to Capital Medical University, First Affiliated Hospital of Harbin Medical University, Zhujiang Hospital of Southern Medical University and First Affiliated Hospital of Chongqing Medical University from January 2022 to March 2024 were collected. There were 28 ruptured aneurysms (60.87%) and 18 unruptured aneurysms (39.13%). Follow-up was performed for more than 3 months; Raymond-Roy grading was used to evaluate the aneurysm embolization immediately after embolization and during follow-up; perioperative hemorrhagic or ischemic complications were recorded; modified Rankin Scale (mRS) was used to evaluate the prognosis of the patients at discharge and during follow-up (mRS score≤2: good prognosis, and mRS score>2: poor prognosis).Results:Coil embolization was successful in all 46 patients. DSA immediately after embolization showed that 41 patients (89.13%) had completely occluded aneurysms (Raymond-Roy grading I), 2 patients (4.35%) had residual aneurysm neck (Raymond-Roy grading Ⅱ) and 3 patients (6.52%) had partially occluded aneurysms (Raymond-Roy grading Ⅲ). Perioperative complications occurred in 5 patients, including 2 with postoperative cerebral infarction, 1 with hydrocephalus, 1 with postoperative pneumonia leading to respiratory failure, and 1 with stent thrombosis during embolization. Both at discharge and 3 months after embolization, 43 patients (93.48%) had good prognosis and 3 patients (6.52%) had poor prognosis. No obvious ischemic complications (such as stent restenosis) or hemorrhagic complications (such as re-rupture of the aneurysms) were found in all patients. Thirty patients (65.22%) had imaging follow-up for 6-12 months: 26 (86.67%) had Raymond-Roy grading I, 3 (10.00%) had Raymond-Roy grading II, and 1 (3.33%) had Raymond-Roy grading III.Conclusion:Neuroform Atlas stent-assisted coil embolization has good short-term efficacy and high safety in middle cerebral artery bifurcation aneurysms, but long-term follow-up observation is still needed to verify its efficacy.

Objective:To evaluate the efficacy and safety of intrasaccular flow disruptor in wide-necked intracranial aneurysms.Methods:One hundred and seventeen patients with wide-necked intracranial aneurysms treated with intrasaccular flow disruptor were collected from Department of Neurointervention (First Affiliated Hospital of Zhengzhou University), Department of Neurosurgery (Beijing Tiantan Hospital, Capital Medical University), Department of Cerebrovascular Surgery, Neurosurgery Center (Zhujiang Hospital, Southern Medical University), and Department of Neurosurgery (First Affiliated Hospital of Harbin Medical University) from August 2022 to March 2024. Raymond-Roy Occlusion Classification (RROC) was employed to evaluate aneurysm embolization immediately after procedure; cranial CT or MRI within 48 hours of embolization were performed to identify any new intracranial hemorrhage, subarachnoid hemorrhage, or new symptomatic cerebral infarction related to the intracranial aneurysms. Modified Rankin Scale (mRS) was used to assess the neurological function at discharge. Imaging follow-up and outpatient follow-up were performed at 6 months after embolization to evaluate the aneurysm occlusion degree and complications.Results:A total of 117 intrasaccular flow disruptors were implanted in 117 patients, with a technical success rate of 100%; 115 patients (98.3%) enjoyed successful one-time release of their disruptors, and 2 patients (1.7%) required retrieval and redirection of the disruptors before second successful attempt. Flow disruptor plus stent was performed in 13 patients (11.1%). Immediately after procedure, RROC grading I was noted in 3 patients, grading II in 51 patients and grading III in 63 patients. Cranial CT or MRI within 48 hours of embolization indicated no new intracranial hemorrhage, subarachnoid hemorrhage, or symptomatic cerebral infarction related to the intracranial aneurysms. All patients had mRS score of 0 at discharge. Eighty-three patients completed a 6-month follow-up (RROC grading I in 41 patients, grading II in 33 patients and grading III in 9 patients), without ischemic or hemorrhagic adverse events.Conclusion:The results of this study preliminarily suggest that intrasaccular flow disruptor is effective and safe in wide-necked intracranial aneurysms.

Objective:To evaluate the efficacy and safety of Neuroform Atlas stent-assisted coil embolization in patients with middle cerebral artery bifurcation aneurysms.Methods:A retrospective analysis was performed; the clinical data of 46 patients with middle cerebral artery bifurcation aneurysms accepted Neuroform Atlas stent-assisted coil embolization in First Affiliated Hospital of Zhengzhou University, Beijing Tiantan Hospital Affiliated to Capital Medical University, First Affiliated Hospital of Harbin Medical University, Zhujiang Hospital of Southern Medical University and First Affiliated Hospital of Chongqing Medical University from January 2022 to March 2024 were collected. There were 28 ruptured aneurysms (60.87%) and 18 unruptured aneurysms (39.13%). Follow-up was performed for more than 3 months; Raymond-Roy grading was used to evaluate the aneurysm embolization immediately after embolization and during follow-up; perioperative hemorrhagic or ischemic complications were recorded; modified Rankin Scale (mRS) was used to evaluate the prognosis of the patients at discharge and during follow-up (mRS score≤2: good prognosis, and mRS score>2: poor prognosis).Results:Coil embolization was successful in all 46 patients. DSA immediately after embolization showed that 41 patients (89.13%) had completely occluded aneurysms (Raymond-Roy grading I), 2 patients (4.35%) had residual aneurysm neck (Raymond-Roy grading Ⅱ) and 3 patients (6.52%) had partially occluded aneurysms (Raymond-Roy grading Ⅲ). Perioperative complications occurred in 5 patients, including 2 with postoperative cerebral infarction, 1 with hydrocephalus, 1 with postoperative pneumonia leading to respiratory failure, and 1 with stent thrombosis during embolization. Both at discharge and 3 months after embolization, 43 patients (93.48%) had good prognosis and 3 patients (6.52%) had poor prognosis. No obvious ischemic complications (such as stent restenosis) or hemorrhagic complications (such as re-rupture of the aneurysms) were found in all patients. Thirty patients (65.22%) had imaging follow-up for 6-12 months: 26 (86.67%) had Raymond-Roy grading I, 3 (10.00%) had Raymond-Roy grading II, and 1 (3.33%) had Raymond-Roy grading III.Conclusion:Neuroform Atlas stent-assisted coil embolization has good short-term efficacy and high safety in middle cerebral artery bifurcation aneurysms, but long-term follow-up observation is still needed to verify its efficacy.

Objective:To evaluate the risk factors of hypoalbuminemia (serum albumin <35 g/L) in the maintenance hemodialysis (MHD) patients.Methods:From January 2011 to December 2018, 915 patients (≥18 years) who underwent MHD programs from 12 hospitals in south China were enrolled in a retrospective analysis. Univariate and multivariate Logistic regression analysis was applied to evaluate the risk factors of hypoalbuminemia in the MHD patients.Results:The MHD patients had poor albumin level in general, with hypoalbuminemia accounting for about 20.55% (188/915). Compared with the patients with normal albumin level, the patients with hypoalbuminemia had older age (61.46 years vs. 55.85 years, P<0.01), the greater incidence of diabetes [29.79%(56/188) vs. 19.39%(141/727), P = 0.002] and the lower application in high flux dialysis [42.55%(80/188) vs. 57.36%(417/727), P<0.01], while the gender, duration of dialysis, dialysis frequencies and the incidence of hepatitis showed no significant difference between 2 groups. In linear correlation analysis, albumin and hemoglobin level were positively correlated ( r = 0.213, P<0.01). In Spearmen correlation analysis, albumin was negatively correlated with age, hypersensitive C reactive protein (hsCRP), alkaline phosphatase, and diabetes ( r = -0.232, -0.176, -0.153 and -0.132; P<0.01); and it was positively correlated with the Kt/V and the application in high flux dialysis ( r = 0.151 and 0.124, P<0.01). The multivariate Logistic regression analysis showed that age, diabetes, alkaline phosphatase and hsCRP were the independent risk factors of hypoalbuminemia, while the application of high flux dialysis and hemoglobin were the independent protection factors. Conclusions:The patients undergoing a MHD program have poor albumin level. Diabetes is the independent risk factor of hypoalbuminemia of MHD patients, and the practice of high flux dialysis may reduce the hypoalbuminemia.

Pigment epithelium-derived factor (PEDF) is an antiangiogenic factor which is effective in tumour inhibition in a variety of tumours and has not yet been studied in bladder tumour before. In this study the expression of PEDF, interleukin-1α (IL-1α) and -8 (IL-8) in bladder tumours was investigated. Immunohistochemistry was performed on 64 bladder tumour and 23 normal uroepithelium samples. Expression change of the factors was compared with clinicopathological parameters. Correlations between PEDF, IL-1α and IL-8 were analyzed. None of the factors was in relation to gender, tumour occurrence, and size or onset pattern. PEDF (P=0.014) and IL-1α (P=0.049) expression was down-regulated with grade progression. PEDF expression was lower in normal uroepithelium than in papillary urothelial neoplasm of low malignant potential (PUNLMP) (P=0.000) and carcinoma (P=0.009) whilst IL-1α (P=0.000 and P=0.000 respectively) and IL-8 (P=0.000 and P=0.023 respectively) expression was higher in the same grouping. PEDF expression had a negative correlation with IL-8 in PUNLMP (P=0.049, r=-0.578) as well as in tumour grouping (P=0.033, r=-0.276). Deranged expressional change of PEDF, IL-1α and IL-8 could be in relation to loss of differentiation from normal uroepithelium to papillary lesion and eventually to carcinoma.

Pigment epithelium-derived factor (PEDF) is an antiangiogenic factor which is effective in tumour inhibition in a variety of tumours and has not yet been studied in bladder tumour before.In this study the expression of PEDF,interleukin-1 α (IL-1α) and -8 (IL-8) in bladder tumours was investigated.Immunohistochemistry was performed on 64 bladder tumour and 23 normal uroepithelium samples.Expression change of the factors was compared with clinicopathological parameters.Correlations between PEDF,IL-1α and IL-8 were analyzed.None of the factors was in relation to gender,tumour occurrence,and size or onset pattem.PEDF (P=0.014) and IL-1α (P=0.049) expression was down-regulated with grade progression.PEDF expression was lower in normal uroepithelium than in papillary urothelial neoplasm of low malignant potential (PUNLMP) (P=0.000) and carcinoma (P=0.009) whilst IL-1α (P=0.000 and P=0.000 respectively) and IL-8 (P=0.000 and P=0.023 respectively) expression was higher in the same grouping.PEDF expression had a negative correlation with IL-8 in PUNLMP (P=0.049,r=-0.578) as well as in tumour grouping (P=0.033,r=-0.276).Deranged expressional change of PEDF,IL-1 α and IL-8 could be in relation to loss of differentiation from normal uroepithelium to papillary lesion and eventually to carcinoma.

Objective To evaluate the efficacy and safety of holmium laser lithotripsy for the treatment of urinary calculi.Methods A total of 1216 cases of urinary calculi underwent ureteropyeloscopic and cyctocopic holmium laser lithotripsy.There were 1 006 cases of ureteral stones(302 cases of upper ureteral stones,364 cases of middle ureteral stones,and 340 cases of lower ureteral stones) and 210 cases of bladder stones.Results In 1 case of upper ureteral stones,failure to access the ureteral orifice due to enlarged prostate was encountered,and extracorporeal shock wave lithotripsy(ESWL) was employed.In 1006 cases of ureteral stones,the rate of successful fragmentation on single session was 95.5%(961/1 006),with 89.4%(270/302),96.4%(351/364),and 100%(340/340) for upper,middle,and lower ureteral stones,respectively.Ureteral perforation was encountered during lithotripsy in 6 cases.In 210 cases of bladder stones,the rate of successful fragmentation on one session was 100%(210/210).No bleeding or bladder perforation was observed during lithotripsy.Follow-up checkups for 0.5~40 months(mean,18.6 months) in 881 cases of ureteral stones showed that the stone-free rates were 91.1%(224/246),98.5%(318/323),and 100%(312/312) for upper,middle,and lower ureteral stones,respectively.The overall stone-free rate for all levels of ureteral stones achieved 96.9%((854/881)).Ureteral stenosis was found in 6 cases.Follow-up checkups for 0.5~31 months(mean,12.4 months) in 187 cases of bladder stones revealed a stone-free rate of 98.4%(184/187). Conclusions Holmium laser lithotripsy is a highly effective,minimally invasive,and safe therapy for urinary calculi.It is indicated as the first choice of treatment for patients with ureteral stones and bladder stones.

OBJECTIVETo determine the feasibility of single dose intravesical epirubicin in the prevention of recurrent superficial bladder carcinoma.

METHODSWe compared the effect of intravesical epirubicin or mitomycin C on tumor recurrence and disease free interval and their side effects after treatment of superficial bladder tumor. 47 postoperative patients with stages Ta to T1 primary superficial bladder carcinoma of grades 1 or 2 were randomized into groups A: single 80 mg epirubicin; B: 40 mg consecutive epirubicin; C: 40 mg consecutive mitomycin C. Patients were followed up for clinical, analytical, and cystoscopic evaluations every 3 months.

RESULTSThe disease free intervals of the three groups were found no significant differences (F = 3.25, P > 0.05). The recurrence rate was 6.25% (1/16), 13.3% (2/15), 12.5% (2/16) (chi(2) = 0.496, P > 0.05) in groups A, B, and C at 1 year, and 33.3% (5/15), 26.7% (4/15), 25% (4/16) (chi(2) = 0.290, P > 0.05) at 3 years after operation, respectively. Side effects of group A (13.3%) were lower than those of group B (46.7%) or C (43.8%) (chi(2) = 14.56, P < 0.01).

CONCLUSIONSSingle dose of epirubicin given intravesically immediately after tumor resection is effective in preventing tumor recurrence.

Aged ; Antibiotics, Antineoplastic ; adverse effects ; therapeutic use ; Epirubicin ; adverse effects ; therapeutic use ; Feasibility Studies ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; prevention & control ; Urinary Bladder Neoplasms ; prevention & control

ObjectiveTo investigate effects of exhaustive swimming on erythrocyte membrane composition. MethodThe components of rat erythrocyte membrane like sialic acid,phospholipid cholesterol ,ratio of cholesterol/phospholipid , -SH and MDA were measured afterexhaustive swimming. ResultThe components of erythrocyte membrane such as sialic acid,phospholipid and-SH decreased significantly while MDA,cholesterol/phospholipid ratio increased after exhaustive swimming,no significant change of cholesterol content was ob-served. ConclusionIt suggested that exhaustive swimming caused significant changes in composition of erythrocyte membrane impairing thedeformability and normal function of erythrocyte.