Characteristics of collateral circulation in adult moyamoya disease based on modified Suzuki staging / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the characteristics of collateral circulation in adult moyamoya disease (MMD).</p><p><b>METHODS</b>The clinical data were collected from all adult patients with MMD undergoing digital subtractive angiography (DSA) in our department from 2006 to 2016. Based on the imaging findings, the patients were divided into ischemia group and bleeding group. A double-blind analysis was conducted of the CT or magnetic resonance imaging findings and the severity of the disease was graded using the modified Suzuki score (mSS). We classified the anastomotic networks in MMD into the superficial meningeal type and deep parenchymal type. The superficial meningeal type was further classified into the leptomeningeal and the durocortical networks, and the deep parenchymal networks into subependymal networks and the inner striatal and inner thalamic networks.</p><p><b>RESULTS</b>No significant difference was found in the distribution of mSS scores between the hemorrhage group and the ischemic group (Χ=5.812, v=5, P=0.325), but the posterior communicating artery and internal carotid artery diameter ratio (Pcom/ICA ratio) was significantly greater in the hemorrhage group (t=2.119, v=108, P=0.036). The Pcom/ICA ratio differed significantly among the groups with different mSS scores (f=8.924, P=0.00), higher in groups with mSS scores of 3, 4 and 5. The incidence of anterior choroidal artery dilation differed significantly between hemorrhage and ischemic groups (Χ=11.79, P=0.001). The incidences of durocortical networks (Χ=0.327, P=0.567) and subependymal networks (Χ=0.011, P=0.917) were comparable between hemorrhage group and ischemic groups, but the incidence of leptomeningeal networks (P=0.018) and inner striatal and inner thalamic networks (Χ=7.551, P=0.006) differed significantly between the two groups.</p><p><b>CONCLUSION</b>The collateral circulation vascular system is an important component of cerebral blood flow in MMD patients and varies from patient to patient. Patients with MMD exhibit increased Pcom/ICA ratio with abnormal expansion of the anterior choroidal artery, and the leptomeningeal networks and the inner striatal and inner thalamic networks are independent risk factors for cerebral hemorrhage.</p>

Diagnosis and treatment of traumatic cerebral venous sinus thrombosis / 中华神经医学杂志

Objective To investigate the diagnosis and treatment of intracranial venous sinus thrombosis caused by trauma. Methods The clinical data of 13 patients had definite diagnosis by clinic and imaging, were analyzed retrospectively. Three patients received removal of hematoma and bone flap operation; 2 received anticoagulant therapy in early phase and intravenous thrombolysis; 2 accepted intrasinus interventional catheter-directed thrombolysis; ventriculoperitoneal shunt operation was performed in 1 patient for enjoying sub-optimal effects of conservative treatment; and the other 5 patients with transverse sinus embolism accepted conventional treatment for their symptom-free or having mild symptom. Results Intracranial venous sinus thrombosis caused by trauma was likely to locate in the superior sagittal sinus and transverse sinus; these patients mostly manifested as severe diffuse brain swelling combined with a fractured skull, epidural hematoma or intracerebral hematoma. Ten patients got clinical cure, 2 focal symptom and 1 mild mental retardation. Three days to 6 months after treatment, good results were noted in 8 patients performed DSA and in 5 patients performed MRV. Conclusion Early treatment should be given once the definite diagnosis is made in patients with intracranial venous sinus thrombosis caused by trauma, and anticoagulant and thrombolytic therapy are the main methods.

Temporal and Spatial Expression Pattern of Tenascin in Zebrafish Early Development / 实用儿科临床杂志

Objective To explore the temporal and spatial expression pattern of tenascin-c(tnc) and tenascin-w(tnw) in zebrafish early development,to further explore the role of tenacsin in zebrafish embryo development,and the association between them.Methods Zebrafish embryos at 2 hours post fertilization(hpf),4 hpt,8 hpt,10 hpf,24 hpt,48 hpr,72 hpf and 7 days post fertilization(dpf) were collected to extract RNA for reverse transcription-polymerase chain reaction(RT-PCR) and fix the embryos at different stages for in situ hybridization.Temporal and spatial expression pattern of tnc and tnw on different stages of zebrafish early development was observed.Results tnc and tnw all expressed in zebrafish from 24 hpf to 7 dpf,but did not expressed from 2 hpf to 10 hpf.Tnc expressed at pharyngeal arch,notochord,somite in 24 hpf,then weakly expressed at somite,but highly expressed at otic vesicle,pectoral fin and hindbrain in 48 hpf,and tnc was expressed at hindbrain,pharyngeal and notochord and disappeared at somite and pectoral.tnw expressed at hindbrain,midbrain and otic vesicle in 24 hpf,expressed at somite,notochord,hindbrain,otic vesicle and pharyngeal in 48 hpf.In 72 hpf,tnw expressed weakly at somite and notochord.Conclusions Zebrafish tnc and tnw have special temporal and spatial expression pattern,and share partial overlapping expression pattern.

Significance of Expression of Tenascin-c Gene in Zebrafish Embryo Development Induced by Ethanol / 实用儿科临床杂志

Objective To explore the expression pattern of tenascin-c(tnc)gene in zebrafish embryo abnormal development which was induced by ethanol,and to further understand the function of tnc gene in embryo develepment.Methods Zebrafish were treated with ethanol at different concentration from 100 to 500 mmol/L,and embryos at 24 and 48 hours were collected and fixed,then tnc expression pattern was observed by in situ hybridization and reverse transcriptase-polymerase chain reaction(RT-PCR).Results The result of RT-PCR showed that ethanol at 100 and 200 mmol/L could increase the expression of tnc,while the result of in situ hybridization showed that,while ethanol at 300 mmol/L and above decrease the expression of tnc in presumptive position at 24 hours,and ethanol at 100 mmol/L and above caused increase expression of tnc in zebrafish heart.Conclusions tnc is increased when treated with 100 and 200 mmol/L ethanol and is presented in the abnormal development of hearts of zebrafish,which can promote the normal development of embryos in some degrees.The expression pattern of tnc in pathologic state is highly conserved in all vertebrate,and in adult and embryos as well.