Objective:To investigate the correlation between asymmetrically prominent cortical veins (APCV) on susceptibility-weighted imaging (SWI) and early neurological deterioration (END) in patients with acute ischemic stroke.Methods:From October 2016 to September 2018, patients with acute ischemic stroke admitted to the Department of Neurology, Donghua Hospital Affiliated to Sun Yat-sen University were enrolled retrospectively. They completed MRI within 3 d of onset. APCV was evaluated using SWI. END was defined as the National Institutes of Health Stroke Scale (NHISS) score at any time point within 7 d after the onset increased by ≥2 or the motor function item score increased by ≥1 from baseline. Multivariate logistic regression analysis was used to determine the independent correlation between APCV and END. Results:A total of 133 patients with acute ischemic stroke were enrolled, including 40 females and 93 males, with a median age of 57.3 years (interquartile range: 47.5-67.5 years). Baseline NIHSS score was 5.9±5.0. Fifty-one (38.3%) patients had APCV, and 38 (28.6%) had END. The proportions of APCV, ipsilateral large vessel stenosis, and patients receiving anticoagulation after admission were significantly different between the END group and the non-END group ( P<0.05). Multivariate logistic regression analysis showed that after adjusting for age and gender, APCV was an independent risk factor for END in patients with acute ischemic stroke (odds ratio 6.907, 95% confidence interval 2.798-17.052; P<0.001). Conclusions:APCV on SWI was an independent risk factor for END in patients with acute ischemic stroke.

Objective To investigate the preventive effect and mechanisms of Naoshuantong capsule in stroke induced by artificial cold wave in hypertensive rats.Methods A total of 130 SD rats were randomly divided into a sham operation group (n =30),a model control group (n =50) and a Naoshuantong treatment group (n=50;intragastric administration of Naoshuantong,0.5 g/kg,2/d for 7 days).Renovascular hypertensive rats model were established by two-kidney,two clip method.At 13th week after operation,rats were exposed to artificial cold wave for 3 days (12 h light of 22 ℃ and 12 h dark of 4 ℃,3 cycles).The brain tissue samples were extracted at the end of the experiment.Differential protein proteomic techniques were used for the identification,functional classification and preliminary analysis of the differentially expressed protein spots,and Western blot was used for the validation of some key proteins.Results There was no occurrence of stroke in the sham operation group,and the incidence of stroke in the model control group (36.00％,18/50) was significantly higher than that in the Naoshuantong treatment group (18.00％,9 / 50;x2 =4.110,P =0.043).With the two-dimensional gel electrophoresis analysis,6 different proteins were identified from 14 protein spots.Among them,the up-regulated superoxide dismutase 2 (SOD2) and the down-regulated B-cell lymphoma 10 (Bcl-10) were found to be at the central location of protein interactions,which has been verified by Western blot.Conclusion Naoshuantong can reduce the occurrence of stroke induced by artificial cold wave in renovascular hypertensive rats.SOD2 up-regulating and Bcl-10 downregulating may be involved in the mechanisms of of Naoshuantong in the prevention of cold wave-induced stroke in hypertensive rats.

Epidemiological studies and clinical observations have indicated that cold temperature can trigger the occurrence of stroke in individuals at high risk.However,the underlying mechanisms are still unknown.Matrix metalloproteinase-9 (MMP-9) has been found to be associated with the formation,progression and rapture of atherosclerotic plaques and cerebral aneurysms,which is the pathological basis of stroke.Cold temperature activates renin-angiotensin system (RAS) in circulation and tissue.Angiotensin Ⅱ has been implicated in the inducing MMP-9 expression and activation.An increase of MMP-9 may facilitate destabilization and rupture of atherosclerotic plaques or cerebral aneurysms,resulting in the occurrence of stroke.

ObjectiveTo verify the reliability of the mouse model of cerebral cortical microinfarct induced by two-photon microscopy and to explore its pathological changes.MethodsSeventeen male C57BL/6J mice were randomly divided into a microinfarct group (n=11) or a sham operation group (n=6).A thinned cranial window of 3 mm diameter was performed over the cerebral cortex with a high-speed micro-drill until the small blood vessels were clearly observed under a dissecting microscope.Then, a permanent single cortical penetrating arteriole occlusion was induced with a gradually enhanced ultrashort laser irradiation through the thinned cranial window with two-photon microscopy.At 7 days after modeling, the cerebral microinfarct volume was measured with HE staining, and the neuron loss, activation of glial cells and deposition of 3-nitrotyrosine were assessed using immunohistochemistry.ResultsThe target vessels of cerebral cortex in 8 (72.7%) mice were occluded and the microinfarcts formed in the microinfarct group, and the average microinfarct volume was 317.23±20.29 μm3.There were remarkable neuron loss and microglia infiltration in the infarcted core, a large number of reactive astrocytes surrounding the infarcted lesion, and massive deposition of 3-nitrotyrosine in the peri-infarct area.No infarcts were observed in the sham operation group.The deposition of 3-nitrotyrosine in the sham operation group was significantly less than that in the microinfarct group (8.00±1.48 vs.98.38±9.10;t=23.962, P<0.001).Conclusions The mouse model of cerebral cortical microinfarct induced by two-photon microscopy is reliable, and its histopathologic changes are consistent with the pathologic features of cerebral microinfarct.

Objective To investigate the correlation between the measurement methods of carotidcerebral pulse wave velocity (ccPWV) and the traditional method of brachial-ankle pulse wave velocity (baPWV).Methods A total of 136 healthy volunteers were divided into a youth group (20-39 years),a middleaged group (40-59 years),and an elderly group (more than 60 years) according to their ages.While detecting baPWV,transcranial Doppler ultrasound was used to simultaneously monitor the ipsilateral common carotid artery and the terminal segment of internal carotid artery.The time differences of the beating points of their cardiac cycles and the distanceses of the skin surfaces between the 2 probes were measured and ccPWV was calculated.Results The systolic blood pressure,pulse pressure and mean arterial pressure in the elderly group were signifificantly higher than those in the middle-aged group and the young group.The ccPWVs in the youth,middle-aged and elderly groups were 418 ± 52 cm/s,489 ±54 cm/s,and 599 ± 58 cm/s,respectively.The elderly group was significantly faster than the middle-aged group (t =7.308,P ＜0.001),and the middle-aged group was significantly faster than the youth group (t=6.758,P＜0.001).A Pearson correlation analysis showed that ccPWV was significantly positively associated with the age (r=0.847,P＜0.001) and baPWV (r =0.548,P ＜0.001).The multiple linear regression analysis showed that ccPWV was significantly positively associated with the age and diastolic blood pressure (partial correlation coefficients were 0.742 and 0.293respectively,P ＜0.001 and ＜0.010 respectively).Conchlusions ccPWV is a new measurement method for cerebrovascular stiffneas,and it has a good correlation with the traditional measurement method.

Objective Evaluation of cerebral blood flow in patients with transient ischemic attack (TIA) using cerebral CT perfusion imaging.Methods CT perfusion scan was performed on a consecutive series of 20 patients with clinical definite TIA.Following their initial CT scan at acute stage of TIA, patients underwent two repeat CT perfusion scanning of region of interest at acute stage and one month after symptom remission.Results Mild to moderate decrease in regional cerebral blood flow (rCBF) and unchanged or mildly decrease in regional cerebral blood volume (rCBV) were observed at acute stage in the majority cases.Normal cerebral perfusion was found in 12 cases and mild to moderate decrease of rCBF in 8 cases one month after TIA.During the one-year follow-up period, all of 12 cases with normal cerebral perfusion did not have recurrence while among 8 cases with mild to moderate decrease of rCBF at initial scan, 6 cases had recurrent TIA or cerebral infarction and 2 cases did not have recurrence.Patients with more severe cerebral perfusion defects usually had a shorter interval time between two attacks.Conclusions Intensive intervention should be performed on patients with severe and long lasting decrease of cerebral perfusion.

OBJECTIVE: To explore the feasibility of cervical approach for goiter in posterior mediastinum. METHOD: According to the mechanism that goiter filed into posterior mediastinum and the dissection of thyroid gland and mediastinum, we designed the following surgery principles (1) From top to bottom. (2) Find out recurrent nerve at the place where it enters larynx, then dissect recurrent nerve as long as possible and protect it carefully, meanwhile, search thyroid vessels along recurrent nerve. (3) To avoid and uncontrollable serious hemorrhage in the operation, all normal and aberrant blood vessels must be ligated cautiously, and avoid pulling great vessels in the thoracic part. (4) Separating tumor of hemorrhage under surgical capsule. Bluntly, it can avoid damage important structure in most occasions. (5) If the tumor of hemorrhage was difficult to be separated from the surrounding structure, ask thoracic surgeon for cooperation. RESULT: Two operations case were operated under the above guideline successfully, and the operations were performed with satisfactory effect, minimal invasion, rapid recovery and low medical cost. CONCLUSION Cervical approach for goiter in mediastinum posterior is an ideal method of surgery, but it has following operative indication. (1) imaging date indicate that tumor of posterior septum is not connected to the surrounding structure. (2) It is not accompanied with superior vena cava syndrome. (3) The size of large thyroid tumor of posterior septum could be decreased by taking out the center part of tumor, and it is suitable for liquidized center tissue especially, then take out the tumor from neck. If it is hard to be taken out, you can ask thoracic surgeon for help.
Contraindications ; Female ; Goiter ; surgery ; Humans ; Mediastinum ; surgery ; Middle Aged ; Neck ; surgery ; Orthopedic Procedures ; methods ; Thyroid Neoplasms ; surgery

OBJECTIVETo evaluate the clinical effect, CT image changes and side-effects of percutaneous microwave coagulation therapy for lung cancer.

METHODSCT-guided percutaneous puncture was performed using a needle mono-pole microwave antenna with 65W, 2 450 MHz microwave delivered in 60 seconds to 20 peripheral lung cancer patients, including 8 suffering from primary lung cancer and 12 metastatic lung cancer (totally 28 lesions).

RESULTSSixteen patients were alive after having been followed-up for 3 approximately 24 months. All patients showed nodules decreased in size. Diminution of over 50% was observed in 13 nodules and 3, completely disappeared. The overall response rate was 57.1%. Ellipsoid shadow 3.5 cm x 2.5 cm across was observed by CT in lesions immediately after coagulation. Gasification within the coagulated area was observed in a week with a high density in the peripheral region. Consolidation was observed in 3 months and the lesion disappeared 1 year later. Complete tumor necrosis was proved by biopsy. No side-effects or complications were observed.

CONCLUSIONPercutaneous microwave coagulation therapy is a new safe treatment for lung cancer, giving marked effect but minimum trauma.

Follow-Up Studies ; Humans ; Lung Neoplasms ; complications ; diagnostic imaging ; pathology ; therapy ; Microwaves ; adverse effects ; therapeutic use ; Survival ; Time Factors ; Tomography, X-Ray Computed ; methods ; Treatment Outcome

ObjectiveTo explore the effects of the serum of traditional Chinese medicine Nao Yi An on glutamate induced cell death in cultured hippocampal neurons of rat and the underlying mechanisms. MethodsHippocampal neurons were cultured. The excitatory amino acid induced toxicity on cultured neurons was investigated. The viability of injured neurons was determined with the measurement of Lactate dehydrogenase (LDH) activity. Mitogen activated protein kinase (MAPK) were determined by immunoprecipitation /kinase assays /western blot detection.ResultsThe serum of Nao Yi-An raised cell viability. The serum of Nao Yi-An upregulated the expression of extracellular regulated protein kinases(ERK) and downregulated the expression of c-Jun N terminal kinase/stress activited protein kinase(JNK) in cultured neurons. The serum of Nao Yi-An induced upregulation of ERK and its anti death action were prevented with the specific ERKs inhibitor PD98059. Conclusions Activation of ERK signaling together with inhibition of JNK signaling by Chinese medicine Nao Yi-An appears to be an important mechanism for its survival effects on cultured hippocampal neurons.

Objective 　To search the relative factors of cerebral damage, rebleeding, delayed cerebral ischaemia(DCI) and hydrocephalus after subarachnoid haemorrhage (SAH) by CT scans and clinical findings in acute phase. Methods　To analyse the relationship between cerebral damage after SAH and clinical findings: CT scans resulte, age, sex, blood pressure, hyponatraemia, therapeutic methods. Results　Cerebral damage were related to the pattern of distritution of SAH on brain CT and hyponatraemia. The high attack rate of rebleeding and DCI is related to presence of blood in the surface of brain, collection of blood in the ventricle, saccula aneurysms or cerebral arteriovenous malformation (AVM) (P＜0.01). Conclusions　To forecast of cerebral damage after SAH by study of CT scans showing and clinical findings have clincal significance. According to these findings, we may take some therapeutics to prevent the cerebral damage after SAH.