Ultra-early versus delayed coil treatment for ruptured poor-grade aneurysm.

INTRODUCTION: The timing of definitive aneurysm treatment (coiling or clipping) in poor-grade (Hunt-Hess IV or V) subarachnoid haemorrhage (SAH) patients has been a controversial topic. The purpose of this retrospective study was to analyse whether ultra-early coiling of ruptured intracranial aneurysms improves the clinical outcomes of poor-grade SAH patients. METHODS: The records of patients with aneurysmal SAH who were treated with endovascular coiling were retrieved. The patients were classified into two groups: group A (patients coiled within 24 h of SAH) and group B (patients coiled ≥ 24 h after SAH). For each group, the patient demographics, Fisher grade, aneurysm characteristics and clinical outcomes were recorded. Outcomes were measured at 6 months using the modified Rankin Scale (mRS). RESULTS: Thirty-one patients were coiled within 24 h of SAH (group A), and fourteen patients were coiled ≥24 h after SAH (group B). Groups A and B had similar clinical and angiographic characteristics. The clinical outcomes showed that a total of 58.1% of the patients (18 of 31) in group A were independent (mRS 0-2) compared with 21.4% of the patients (3 of 14) in group B (P = .028). Univariate analysis demonstrated that ultra-early coiling (P = .028) proved to be an independent predictor of better clinical outcomes (mRS 0-2). CONCLUSIONS: Ultra-early (<24 h after SAH) coiling of ruptured aneurysms was associated with improved clinical outcomes compared to coiling at ≥24 h in poor-grade SAH patients. Larger, prospective studies are required to adequately assess the outcome differences between these two groups.

Chinese Military Evaluation of a Portable Near-Infrared Detector of Traumatic Intracranial Hematomas.

Introduction: Secondary brain injury is the main cause of mortality from traumatic brain injury (TBI). One hallmark of TBI is intracranial hemorrhage, which occurs in 40-50% of severe TBI cases. Early identification of intracranial hematomas in TBI patients allows early surgical evacuation and can reduce the case fatality rate of TBI. As pre-hospital care is the weakest part of Chinese emergency care, there is an urgent need for a capability to detect brain hematomas early. In China, in addition to preventing injuries and diseases in military staff and in enhancing the military armed forces during war, military medicine participates in actions such as emergency public health crises, natural disasters, emerging conflicts, and anti-terrorist campaigns during peacetime. The purpose of this observational study is to evaluate in the Chinese military general hospital the performance of a near-infrared (NIR)-based portable device, developed for US Military, in the detection of traumatic intracranial hematomas. The endpoint of the study was a description of the test characteristics (sensitivity, specificity, and positive and negative predictive values [NPV]) of the portable NIR-based device in identification of hematomas within its detection limits (volume >3.5 mL and depth <2.5 cm) compared with computed tomography (CT) scans as the gold standard. Materials and Methods: The Infrascanner Model 2000 NIR device (InfraScan, Inc., Philadelphia, PA, USA) was used for hematoma detection in patients sustaining TBI. Data were collected in the People's Liberation Army General Hospital in Beijing using the NIR device at the time of CT scans, which were performed to evaluate suspected TBI. One hundred and twenty seven patients were screened, and 102 patients were included in the per protocol population. Of the 102 patients, 24 were determined by CT scan to have intracranial hemorrhage. The CT scans were read by an independent neuroradiologist who was blinded to the NIR measurements. Results: The NIR device demonstrated sensitivity of 100% (95% confidence intervals [CI] 82.8-100%) and specificity of 93.6% (95%CI 85-97.6%) in detecting intracranial hematomas larger than 3.5 mL in volume and that were less than 2.5 cm from the surface of the brain. Blood contained within scalp hematomas was found to be a major cause of false-positive results with this technology. Conclusion: The study showed that the Infrascanner is a suitable portable device in Chinese population for detecting preoperative intracranial hematomas in remote locations, emergency rooms, and intensive care units. It could aid military medics, physicians, and hospital staff, permitting better triage decisions, earlier treatment, and reducing secondary brain injury caused by acute and delayed hematomas.

[Expression of c-myc mRNA on early restenosis after carotid endarterectomy].

OBJECTIVE: To explore the expression and changes of protooncogene c-myc in early restenosis after carotid endarterectomy (CEA). METHODS: Using New Zealand Rabbits, carotid atherosclerotic stenosis (CASS) model were created. The expression of c-myc in early restenosis after CEA were detected by quantitative real-time polymerase chain reaction (qRT-PCR). RESULTS: In this experiment protooncogene c-myc was analysed at pre-operation, 4 hours and 1 d after CEA by qRT-PCR, and the level of mRNA of c-myc was reached maximum at 4 hours, and decreased following significantly, but still higher than pre-operation. CONCLUSIONS: The activation of protooncogene c-myc may be generator factor of vascular smooth muscle cell proliferation.

[Fertility alteration of male sterile rice line annong S-1 and the expression of fertility related aprt gene].

The thermo-sensitive point and the thermo-sensitive stage for fertility alteration in the thermo-sensitive genic male sterile (TGMS) line Annong S-1 were studied. In nature environment and green house,the leaf, root and young panicle were treated by low and high temperature respectively. In total, 8 treatments were carried out. Results indicated that during the thermo-sensitive stage of fertility alteration, in high temperature environmental conditions, the low temperature treatment in the root did not significantly induce Annong S-1 to be fertile, while the low temperature treatment in young panicle obviously induced Annong S-1 to be fertile. Therefore, the thermo-sensitive point of Annong S-1 is the young panicle. The stage of fertility alteration was also investigated. Results indicated that alteration occurred in the phase from the formation of pollen mother cell to the tetrad of miosis. aprt gene is related the male sterility. The expression of aprt gene in root,young panicle and leaf were investigated by RT-PCR respectively. In young panicle, the expression of aprt gene was greatly down regulated by high temperature, while in root and leaf the expressions have no great changes. These data show that the young panicle is sensitive to temperature change. The result also supported that the young panicle is the thermo-sensitive point of Annong S-1 in the fertility alteration. These conclusions can be used to direct in hybrid rice seed production.

[Genetic mapping of resistant gene to southern corn rust and the tagging analysis on different genetic background].

Southern corn rust (SCR) is a destructive disease in maize. The inbred line Qi319 is highly resistant to southern corn rust. SSR technique was employed to preliminary mapping of the resistance gene. Bulked segregant analysis revealed that two primers, phi 118 and phi 041, amplified polymorphic bands. SSR analysis on populations indicated the two primers were linked to the rust resistance gene, which was mapped on the short arm of chromosome 10. In addition, comparative analysis of the amplification bands among different populations revealed that the amplification products with the same primer in different populations were dissimilar. This result indicates that the genetic background may affect results of gene mapping and tagging. So, it is important to select suitable population to performing molecular marker analysis and gene mapping.