Objective To evaluate the clinical value of optic nerve sheath diameter(ONSD)measured on thin-slice CT scan in the diagnosis and prognostic assessment of cerebral venous sinus thrombosis(CVST).Methods The clinical data of patients with CVST,who were admitted to the First Affiliated Hospital of Nanjing Medical University of China to receive treatment from January 1,2016 to December 31,2022,were retrospectively analyzed.The difference in ONSD was compared between CVST patients and normal population,the postoperative changes in ONSD was analyzed.Results A total of 49 patients with CVST(CVST group)and 49 normal persons having no brain disorders(control group)were enrolled in this study.In CVST group,the preoperative ONSD was(5.33±0.50)mm,which was significantly higher than(4.40±0.40)mm in control group(P＜0.001),the postoperative ONSD remarkably decreased to(4.98±0.59)mm(P＜0.01).The difference value between postoperative ONSD and preoperative ONSD in the patients receiving pure anticoagulation treatment was not statistically significant different from that in the patients receiving endovascular treatment[(-0.43±0.22)mm vs.(-0.40±0.42)mm,P=0.84].The preoperative ONSD in the patients having intracranial hemorrhage and in the patients having no intracranial hemorrhage was(5.26±0.51)mm and(5.41±0.49)mm respectively(P=0.31),and the difference value between postoperative ONSD and preoperative ONSD was(-0.39±0.40)mm and(-0.45±0.25)mm respectively(P=0.66).At the three-month follow-up visit,the difference in ONSD between the patients having a good prognosis(mRS score being 0-2 points)and the patients having a poor prognosis was not statistically significant(P＞0.05).Conclusion ONSD that is measured on plain head CT scan can be used as a response indicator of elevated intracranial pressure in CVST patients,which can be used to monitor the changes in intracranial pressure before and after treatment,but its value in assessing the curative efficacy of different therapeutic methods needs to be further explored.

Objective:To compare the clinical efficacies of endovascular treatments in patients with acute basilar artery occlusion (ABAO) caused by large-artery atherosclerosis (LAA) and cardioembolism (CE).Methods:From March 2018 to February 2021, 104 patients with ABAO accepted endovascular treatments in Department of Neurology and Department of Interventional Radiology, Xuyi County People's Hospital of Huaian City were enrolled; these patients were classified into either a LAA group or a CE group according to Trial of ORG 10172 in Acute Stroke Treatment classification (TOAST). The differences in general data, procedure information, and clinical efficacies were compared between the 2 groups. Univariate and multivariate Logistic regression analyses were used to identify the influencing factors for poor prognosis.Results:In these 104 patients, 51 patients (49.0%) were into the LAA group and 53 patients (51.0%) into the CE group. Ninety-six patients (92.3%) acquired successful revascularization, and 35 patients (33.7%) had good prognosis (modified Rankin scale scores of 0-2) 90 d after surgery. LAA group had significantly lower percentage of patients with atrial fibrillation, significantly lower baseline National Institutes of Health Stroke Scale scores, statistically higher percentages of patients with lower and middle basilar artery occlusion and patients accepted rescued stenting, and statistically longer procedure time ( P<0.05). There were no significant differences between the two groups in terms of successful recanalization percentage, symptomatic intracranial hemorrhage incidence, and prognosis 90 d after surgery ( P>0.05). Age ( OR=0.935, 95%CI: 0.891-0.981, P=0.006) and semiquantitative scores of basilar artery based on computed tomography angiography ( OR=1.520, 95%CI: 1.180-1.959, P=0.001) were independent influencing factors for poor prognosis. TOAST etiology (LAA/CE) was not an independent influencing factors for poor prognosis ( OR=1.175, 95%CI: 0.461-2.933, P=0.736). Conclusion:There are differences in risk factors, vascular occlusion sites, endovascular treatment, and procedure time between patients with ABAO caused by LAA and CE; however, no obvious difference in clinical outcomes is noted, and there was no obvious correlation between stroke etiology and prognoses.

Adipose-derived mesenchymal stem cells (ASCs) are pluripotent adult mesenchymal stem cells that are expected to be ideal seed cells for bone tissue engineering(BTE) due to their biosecurity, abundance, and easy access. However, in comparison with bone marrow mesenchymal stem cells, ASCs possess a relatively limited osteogenic capacity and often require further induction. Advances on strategies for promoting osteogenic differentiation of ASCs are reviewed from following aspects: optimization of scaffolds, addition of bioactive factors or drugs, non-coding RNA regulation, and physical stimulation, so as to provide references for the use of ASCs in BTE.

Adipose-derived mesenchymal stem cells (ASCs) are pluripotent adult mesenchymal stem cells that are expected to be ideal seed cells for bone tissue engineering(BTE) due to their biosecurity, abundance, and easy access. However, in comparison with bone marrow mesenchymal stem cells, ASCs possess a relatively limited osteogenic capacity and often require further induction. Advances on strategies for promoting osteogenic differentiation of ASCs are reviewed from following aspects: optimization of scaffolds, addition of bioactive factors or drugs, non-coding RNA regulation, and physical stimulation, so as to provide references for the use of ASCs in BTE.

Objective:To investigate the effect of ultrapulse fractional carbon dioxide laser (UFCL) microporous transdermal triamcinolone acetonide acetate (TAA) in the treatment of early hypertrophic scar.Methods:Ninety patients with early hypertrophic scar in Luoyang Central Hospital Affiliated to Zhengzhou University from March 2016 to March 2019 were included and randomly divided into study group ( n=30), control group A ( n=30) and control group B ( n=30). The control group A was treated with UFCL, the control group B was treated with TAA, and the study group was treated with UFCL combined with TAA. All three groups were treated for 6 months. The effectiveness of the three groups before and 6 months after treatment was compared, the status of hypertrophic scar was evaluated by Vancouver Scar Scale (VSS), the pain degree before and after treatment was evaluated by Visual Analogue Scale (VAS), and the patients’ satisfaction with the treatment was also evaluated. Results:(1) The study group and the control group were effective in the treatment of early hypertrophic scar, and the effective rate of the study group was higher than that of the control group A and the control group B [93.3%(28/30) vs. 70.0%(21/30) and 66.7%(20/30); all P<0.05]. (2) There was no significant difference in the scores of color, thickness, softness and vascular distribution among the three groups before treatment ( P>0.05). After 6 months of treatment, the scores of the three groups were lower than those before treatment ( P<0.05). The scores of study group were lower than those of control group A and control group B respectively( P<0.05). (3) There was no significant difference in VAS scores among the three groups before treatment ( P>0.05). The VAS scores of the three groups after treatment were lower than those before treatment, and the VAS scores in study group were lower than those in control group A and control group B( P<0.05). (4) After 6 months of treatment, the satisfaction rate of study group was higher than that of control group A and control group B ( P<0.05). Conclusions:UFCL microporous transdermal TAA can effectively treat early hypertrophic scar, reduce the VSS score and VAS score of hypertrophic scar, significantly improve the state of scar hyperplasia, and improve the satisfaction rate of patients, which can be widely used in clinic.

Objective:To investigate the effect of ultrapulse fractional carbon dioxide laser (UFCL) microporous transdermal triamcinolone acetonide acetate (TAA) in the treatment of early hypertrophic scar.Methods:Ninety patients with early hypertrophic scar in Luoyang Central Hospital Affiliated to Zhengzhou University from March 2016 to March 2019 were included and randomly divided into study group ( n=30), control group A ( n=30) and control group B ( n=30). The control group A was treated with UFCL, the control group B was treated with TAA, and the study group was treated with UFCL combined with TAA. All three groups were treated for 6 months. The effectiveness of the three groups before and 6 months after treatment was compared, the status of hypertrophic scar was evaluated by Vancouver Scar Scale (VSS), the pain degree before and after treatment was evaluated by Visual Analogue Scale (VAS), and the patients’ satisfaction with the treatment was also evaluated. Results:(1) The study group and the control group were effective in the treatment of early hypertrophic scar, and the effective rate of the study group was higher than that of the control group A and the control group B [93.3%(28/30) vs. 70.0%(21/30) and 66.7%(20/30); all P<0.05]. (2) There was no significant difference in the scores of color, thickness, softness and vascular distribution among the three groups before treatment ( P>0.05). After 6 months of treatment, the scores of the three groups were lower than those before treatment ( P<0.05). The scores of study group were lower than those of control group A and control group B respectively( P<0.05). (3) There was no significant difference in VAS scores among the three groups before treatment ( P>0.05). The VAS scores of the three groups after treatment were lower than those before treatment, and the VAS scores in study group were lower than those in control group A and control group B( P<0.05). (4) After 6 months of treatment, the satisfaction rate of study group was higher than that of control group A and control group B ( P<0.05). Conclusions:UFCL microporous transdermal TAA can effectively treat early hypertrophic scar, reduce the VSS score and VAS score of hypertrophic scar, significantly improve the state of scar hyperplasia, and improve the satisfaction rate of patients, which can be widely used in clinic.

To evaluate the safety and efficacy of mechanical thrombectomy with stent-retriver for anterior circulation small vessel occlusion in patients with acute ischemic stroke (AIS).Methods:From a prospectively collected thrombectomy database of consecutive patients with AIS between January 2017 and November 2018, 311 angiographic images were analyzed to assess small vessel occlusions (A 2 and M 2 segments). Patients were categorized into alteplase with thrombectomy group and thrombectomy alone group. The primary outcome was a favorable outcome (modified Rankin Scale scores 0-2) at 90 days. Secondary outcomes were successful recanalization (modified thrombolysis in cerebral infarction 2b or 3), symptomatic intracranial hemorrhage, and 90-day mortality. Results:Small vessel occlusions were identified in 19 patients, including 14 M 2occlusions, two A 2occlusions, and three M 2+A 2 occlusions. Six patients were in the alteplase with thrombectomy group and 13 patients in the thrombectomy alone group. Favorable outcome was achieved in eight of 19 patients at 90 days. Successful recanalization was achieved in 18 patients (18/19), symptomatic intracranial hemorrhage was observed in one patient (1/19), and death was recorded in five patients (5/19). No statistically significant difference was detected between the two groups with regard to successful recanalization (6/6 in the alteplase with thrombectomy group vs 12/13 in the thrombectomy alone group), symptomatic intracranial hemorrhage (0/6 vs 1/13), favorable outcome (2/6 vs 6/13) and death (1/6 vs 4/13; all P>0.05). Conclusion:As to anterior circulation small vessel occlusions, the combination-therapy within 4.5 hours or mechanical thrombectomy alone in extended time window with perfusion evaluation may be both safe and effective.

This paper explores the relationship between the cardiac volume and time, which is applied to control dynamic heart phantom. We selected 50 patients to collect their cardiac computed tomography angiography (CTA) images, which have 20 points in time series CTA images using retrospective electrocardiograph gating, and measure the volume of four chamber in 20-time points with cardiac function analysis software. Then we grouped patients by gender, age, weight, height, heartbeat, and utilize repeated measurement design to conduct statistical analyses. We proposed structured sparse learning to estimate the mathematic expression of cardiac volume variation. The research indicates that all patients' groups are statistically significant in time factor ( = 0.000); there are interactive effects between time and gender groups in left ventricle ( = 8.597, = 0.006) while no interactive effects in other chambers with the remaining groups; and the different weight groups' volume is statistically significant in right ventricle ( = 9.004, = 0.005) while no statistical significance in other chambers with remaining groups. The accuracy of cardiac volume and time relationship utilizing structured sparse learning is close to the least square method, but the former's expression is more concise and more robust. The number of nonzero basic function of the structured sparse model is just 2.2 percent of that of least square model. Hence, the work provides more the accurate and concise expression of the cardiac for cardiac motion simulation.

Objective To establish an easily reproducible rabbit model of acute pulmonary embolism (APE) with right ventricular dysfunction (RVD).Methods Two gelfoam strips (5 rnm×5 mm× 10 mm) were squeezed and were introduced into the pulmonary arteries of each healthy rabbit (n=12).Pulmonary and systemic hemodynamic function were recorded.All rabbits underwent CT pulmonary angiography (CTPA) and pathological examination after the introduction of APE.Results All gelfoam strips located in the bilateral lower lobe arteries.Compared with baseline mean pulmonary artery pressure (mPAP) ([9.75±1.75] mmHg),mPAP increased to (20.58 ± 5.86) mmHg immediately after embolism (P ＜ 0.001),and then decreased to (18.78 ±4.80) mmHg 1 h after embolism (P＜0.001).Right ventricle/left ventricle diameter ratio (RV/LV) increased from baseline (0.67±0.09) to (1.90±0.28) 45 min after embolism (P＜0.001).Conclusion An easily reproducible rabbit model of APE with RVD are established and may be suitable for study of APE pathophysiology.

Objective The goal of this study is to compare the prognosis of recombinant tissue plasminogen activator (rt-PA) thrombolysis for middle cerebral artery (MCA) occlusion with patients with good and poor cerebral collateral circulation.Methods This retrospective study included 49 patients diagnosed with acute MCA occlusion and treated with rt-PA in the First Affiliated Hospital of Nanjing Medical University between October 1,2014 and February 1,2016.Patients were divided into good collaterals group (n =31) and poor collaterals group (n =18) according to their distribution of leptomeningeal arteries with CTA.Thirty day mortality rate,the incidence of symptomatic intracranial hemorrhage,24h and 30 day Stroke scores with National Institute of Health Stroke Scale (NIHSS) were compared between the two groups.Corrected chi-squared test,Fisher's exact test,or t test was used to statistical analysis as appropriate.Results The 30 day mortality rate of good collaterals group was significantly lower than that of poor collaterals group (0％ vs.16.7％,P ＜ 0.05).There were no significant differences in the incidence of symptomatic intracranial hemorrhage and 24h NIHSS score between the two groups (P ＞ 0.05),however,30 day NIHSS score of good collaterals group was significantly lower than that of poor collaterals group (7.2 ± 3.1 vs.9.6 ± 2.7,P ＜ O.05).Conclusion For patients with MCA occlusion and receiving intravenous thrombolysis,good cerebral collateral circulation may reduce their mortality and improve their clinical outcome after thrombolysis.However,good cerebral collateral circulation does not reduce the risk of symptomatic intracranial hemorrhage in those patients.