Objective To investigate the application technology and effect of Navien catheter in intracranial aneurysms embolization.Methods The clinical data of 15 patients with intracranial aneurysm treated with Navien catheter in Department of Neurosurgery of Yijishan Hospital Affiliated to Wannan Medical College from March to December 2016 were analyzed retrospectively. The extracranial segments of internal carotid arteries were seriously tortuous in all patients. The coaxial system was used during procedure. Whether the Navien catheter could be smoothly placed into the target artery or not was observed,and the coils or stent-assisted coils were used to embolize the intracranial aneurysms in the corresponding positions. The immediate embolization results were assessed by the Raymond grading. The intraoperative and postoperative complications were observed and the patients were followed up by imaging.Results All 15 patients had abnormal tortuosity of extracranial segments of internal carotid arteries. The Navien catheter was able to smoothly pass through the tortuous vessels and reach the desired position. The stent-assisted coil embolization was used in 9 patients,and the coil embolization was used in 6 patients. The success rate of the coil and stent placement technology was 100%. The stents were all accurately put in place without shift. According to the Raymond grading,the immediate embolization rate of aneurysms showed that 15 patients achieved Raymond gradeⅠ. One case developed internal carotid spasm during the procedure. The patient was improved after giving papaverine. Others did not have intraoperative complications,such as cerebral vasospasm,vascular dissection,in-stent thrombosis,and intraoperative aneurysm rupture. Five patients were followed up for 3 to 6 months with digital subtraction angiography (DSA). There was no recurrence of aneurysm and no in-stent stenosis and shift,No rebleeding or cerebral ischemia was observed.Conclusion Forpatients with severely tortuous in extracranial segments of internal carotid artery,using the Navien catheter may overcome artery tortuosity and other unfavorable factors of the patients and successfully reach the target vessel position,enable the embolization of intracranial aneurysms to be completed successfully.

Objective To investigate the risk factors for influencing recrudescence after endovascular embolization of posterior communicating artery aneurysms.Methods From January 2014 to December 2014,71 consecutive patients (a total of 74 aneurysms) with posterior communicating artery aneurysm treated with endovascular treatment at the Department of Neurosurgery,Yijishan Hosptial of Wannan Medical College were enrolled retrospectively.The aneurysms were calculated as the number of cases (n=74).The aneurysms were divided into two groups according to whether they had recrudescence or not,including recurrent group (n=18) and non-recurrent group (n=56).The differences of the clinical data and aneurysm characteristics between the two groups were compared.Multivariate logistic regression was used to analyze the risk factors for recrudescence after endovascular embolization of posterior communicating artery aneurysms.Results Of the 74 patients with aneurysm,51 were treated with simple coil embolization and 23 were treated with stent-assisted coil embolization.All the coils were released satisfactorily.There were significant difference in the size of aneurysms and Raymond grade between the two groups (all P<0.01).The incidence of aneurysms with daughter cysts (55.6% [10/18] and the rate of non-stent-assisted coil embolization (88.9% [16/18]) in the recurrent group were significantly higher than those in the non-recurrent group (23.2% [13/56],62.5% [35/56]).The difference between the two groups was statistically significant (all P<0.05).There was no significant difference in other aneurysm features between the two groups (all P>0.05).After variable selection,the Raymond grade was referred to Raymond gradeⅠ.Multivariate logistic regression analysis showed that the non-stent-assisted coil embolization (OR,4.789,95%CI 1.207-19.009,P=0.026),Raymond grade Ⅱ (OR,12.326,95%CI 3.838-39.592,P<0.01),Raymond grade Ⅲ (OR,36.884,95%CI 2.892-470.454,P=0.005) were the independent risk factors for recrudescence after embolization of posterior communicating artery aneurysms.Conclusion Non-stent-assisted coil embolization,Raymond Ⅱ and Ⅲ may cause recrudescence of posterior communicating artery aneurysms.

Objective To investigate the feasibility and effectiveness of endovascular treatment of posterior communicating artery aneurysm (PcoAA)in keeping the fetal posterior cerebral artery (FPCA) patency. Methods Form January 2014 to December 2015,14 patients with ruptured PcoAA enrolled retrospectively were treated with endovascular embolization. Six of them were treated with simple coil embolization,3 with stent-assisted coil embolization,3 with double catheter-assisted coil embolization,1 with stent-assisted coil embolization + double catheter technique,and 1 with Y-stent in Yijishan Hospital, Wannan Medical College. The immediate embolization rate of PcoAA (using Raymond grade),prognosis of the patients (the modified Rankin scale score at 6 months after procedure),complications,and imaging follow-up results were analyzed. Results The success rate of coil and stenting was 100% . All the stents were accurately released in place without displacement. The immediate Raymond grading of the aneurysms displayed that Raymond grade Ⅰ was in 8 cases,Raymond grade Ⅱ was in 4 cases,and Raymond grade Ⅲ was in 2 cases. All FPCA were kept patent. A coil protruded into internal carotid artery in one case during the procedure. Others did not have any complications,such as intraoperative cerebral vasospasm,in-stent thrombosis,and rupture. All 14 patients were followed up for 3 -24 months after procedure. Two had recurrence. Both were aneurysms embolized with coils only. No rebleeding and ischemic
complications were observed. The modified Rankin scale scores in 13 cases were 0 -2 at 6 months after procedure,1 was 4. Conclusions Endovascular embolization for the treatment of PcoAA and keeping FPCA patency are safe and feasible. A variety of endovascular treatment modalities are necessary in order to keep FPCA patency.

OBJECTIVE:To provide reference for rational use of second class of psychotropic drugs in the clinic. METHODS:The second class of psychotropic drugs in outpatient department of our hospital during 2012-2015 were analyzed retrospectively in respects of the number of common drugs prescription,distribution of gender/age/disease diagnosis,DDDs and DUI,etc. RE-SULTS:During 2012-2015,second class of psychotropic drugs in outpatient department of our hospital accounted for 25.09%of to-tal prescription amout. The drugs with high use frequency were alprazolam,clonazepam,lorazepam and estazolam,accounting for 93.10% of total prescription amount of second class of psychotropic drugs. The proportion of male to female was 1∶1.50;the pa-tients aged 19-35 years old took up the biggest proportion,accounting for 34.62%. The proportion of schizophrenia prescription was the highest,accounting for 45.17%. DDDs of alprazolam was the highest,being 742 141.67;its DUI was 1.075;DUI of oth-er drugs was lower than 1.0. CONCLUSIONS:The use of second class of psychotropic drugs is basically reasonable in our hospi-tal. Guiding principles of Clinical Application of Psychotropic Drugs should be implemented strictly and continously to avoid abuse of second class of psychotropic drugs.

Objective To analyze the intraoperative and postoperative common complications of Enterprise stent-assisted embolization of intracranial aneurysms and the causes and preventive measures. Methods One hundred forty-three patients with intracranial aneurysm treated with Enterprise stent-assisted embolization at the Department of Neurosurgery,Yijishan Hospital,the First Hospital Affiliated to Wannan Medical College from January 2012 to March 2014 were analyzed retrospectively. The common intraoperative and postoperative complications and its possible causes,as well as the appropriate management were analyzed,and the prognoses were observed. Results A total 143 patients(205 aneurysms)with intracranial aneurysm were enrolled,included 43 with unruptured aneurysm,12 with recurrent aneurysm,and 88 with ruptured aneurysm. A total of 170 Enterprise stents were used. Twenty-two patients (15. 4%)had complications. Among them,2 had intraoperative aneurysm rupture,and they recovered well and discharged after active treatment. Thirteen patients had acute thrombosis,11 of the patients completely restored blood flow immediately after tirofiban and/or urokinase,microcatheter and guidewire-contact thrombolysis. The thrombolysis failed in 1 patient,and the blood flow was slow in 1 patient. Six patients had different degrees of cerebral infarction after procedure,and 1 died (peroperative Hunt-Hess grade Ⅳ). Three patients had vasospasm and they were improved after reducing blood vessel wall irritation and papaverine infusion. The introperative stent guidewire was broken and the stent in place was difficult in 1 case. The last coil packed difficultly during the procedure,and it protruded into the parent artery in 1 case. Two patients had non-aneurysmal hemorrhage after procedure. After conservative treatment,one left unilateral limb muscle strength decline and the other was stable after craniotomy,but leaving aphasia and hemiplegia. Conclusion When using the Enterprise stent-assisted embolization for complex aneurysms,grasping the indications strictly,strengthening the perioperative management and improving the operative skills may reduce or avoid the occurrence of complications.

Objective To study the role of JAK-STAT singal transduction pathway in the interstitial fibrosis of unilateral ureter obstruction (UUO)mice. Methods Mice UUO model was established and the phosphorylation of JAK-STAT was examined at day 1,4,7 and 14 after ligation of the ureter.Mice in the treatment group were treated with daily injection of selective JAK2 inhibitor AG490 starting 2 h before ureter ligation until sacrifice while vehicle alone was given to mice in the model control group.Mice were sacrificed at day 14 after the establishment of model.Renal tubular lesion and interstitial fibrosis were assessed on paraffin section.Immunohistochemistry was used to detect renal macrophage infihration and α-SMA expression.The expression of collagen Ⅲ and MCP-1 mRNA was measured by RT-PCR.Phosphorylation of JAK2and STAT1 was examined by Western blotting. Results JAK2-STAT1 signaling transduction pathway was activated in UUO model.The activation of JAK2-STAT1 was closely correlated with the progression of renal injury,tubular histological lesions and interstitial fibrosis.AG490 treatment significantly inhibited the phosphorylation of JAK2 and STAT1 (P＜0.01).AG490 treatment also significantly reduced tubular lesions[(21.7 ±1.7)% vs (49.4±1.0)%]and interstitial fibrosis(1.0±0.1 vs 2.3±0.2),α-SMA expression(0.9±0.1 vs 2.1±0.2)and maerophage accumulation[(13.3±1.6)cells/HPF vs (34.4±1.0)cells/HPF](all P＜0.01).In addition,AG490 significantly inhibited the expression of collagen Ⅲ and MCP-1 mRNA. Conclusion JAK-STAT signaling plays an important role in renal tubulointerstitial inflammation and fibrosis.

AIM To establish a new bioassay method for estimating the rat angiotensin Ⅰ converting engyme (ACE) activity in vivo by using ramipril (Ram), a ACE inhibitor. METHODS The change in mean arterial pressure induced by angioteuasin Ⅰ (AngⅠ) or bradykinin (BK) was measured before and 1, 24, 48 h after pretreatment with Ram (0 05,0 1 mg?kg -1 ,iv). The ACE activity was expressed by the pressor effect (%)of AngⅠ or the depressor effect (%) of BK. RESULTS The pressor effects of AngⅠ or the supernatant fraction of heart tissue homogenate containing AngⅠ were siginificantly reduced 1 h and 24 h after pretreatment with Ram, but not 48 h after pretreatment with Ram. In comparison of the depressor response of BK vs pressor response of AngⅠ 1 h after pretreatment with Ram,it was shown that the depressor effect of BK is more sensitive than the pressor effect of AngⅠ( P

AIM: To observe the protective effects of shenmai injection on myocardial injury induced by 1,1-dipheyl-2-picryl hydrazyl (DPPH)free radic al in isolated rabbit hearts. METHODS: The isolated rabbit hear ts were perfused in a Langendorff model. Left ventricular pressure (LVP), the fi rst derivative of LVP (+dp/dt max ), left v entricular end-diastolic pressur e (LVEDP) and heart rate (HR) were recorded. Coronary flow (CF) and the activity of creatine kinase (CK) in coronary effluent were measured by timed collection of coronary effluent. RESULTS: Perfusion with DPPH ( 0.25 ?mol?L -1 ) for 10 min caused a significant impairment of cardiac functi on, as shown by a decrease in LVP, +dp/dt ma x and HR and an increase in LV EDP as well as the increased release of CK. After perfusion with DPPH ( 0.25 ?mol?L -1 ) for 10 min, treatment with shenmai injection (1320 or 1 160) for 10 min produced a significant improvement of cardiac function and a d ecrease in the release of CK. CONCLUSION: Shenmai injection prot ects against myocardial injury induced by DDPH free radical in isolated rabbit h earts.

AIM:To investigate the regulatory role of nuclear factor κB (NF-κB) in the expression of interleukin-6 in mesangial cells (MC) induced by interleukin-1β.METHODS:Activation of NF-κB was measured by electrophoresis mobility shift assay (EMSA). RT/PCR and ELISA were used to detect IL-6 mRNA expression and IL-6 production, respectively.RESULTS:rhIL-1β could rapidly stimulate the activation of NF-κB in MC, and increase the expression of IL-6 mRNA and protein. PDTC, one of the inhibitor of NF-κB， could inhibit the expression of IL-6 in mRNA and protein in MC stimulated by rhIL-1β.CONCLUSION:IL-6 expression induced by IL-1β may be regulated by NF-κB in MC, NF-κB may modulate the immune-inflammatory reaction in glomerular disease.

AIM: To investigate the association of gene polymorphism at position 196 of tumor necrosis factor receptor Ⅱ (TNFRⅡ) with systemic lupus erythematosus (SLE) in Chinese, and establish recombinant retroviral vector to analyze the function of the TNFRⅡ 196M/R. METHODS: The genotype at position 196 of TNFRⅡ was determined by PCR-RFLP in 106 SLE patients and 119 healthy controls in china. Human TNFRⅡ196M cDNA were amplified by PCR and cloned into PMD18-T vector. Then, PMD18-TNFRⅡ196R was induced by site-directed mutagenesis. The recombinant T vector, PMD18-TNFRⅡ196M and PMD18-TNFRⅡ196R, were subcloned into retroviral vector PLXSN. Both normal and variant were transfected into rat mesangial cell. The effects of TNF? on production of sTNFRⅡ and IL-6 were study by ELISA. RESULTS: (1) The frequency of TNFRⅡ196R allele was significantly higher than those in controls (35.2% vs 14.3%, P