Kinetic changes in virology, specific antibody response and imaging during the clinical course of COVID-19: a descriptive study.

BACKGROUND: To explore the kinetic changes in virology, specific antibody response and imaging during the clinical course of COVID-19. METHODS: This observational study enrolled 20 patients with COVID-19, who were hospitalized between January 20-April 6, 2020, in the two COVID-19 designated hospitals of Zhoushan, Zhejiang and Rushan, Shandong, China, The laboratory findings, imaging, serum response to viral infection, and viral RNA level in the throat and stool samples were assessed from onset to recovery phase in patients with COVID-19. RESULTS: SARS-COV-2 RNA was positive as early as day four. It remained positive until day 55 post-onset in the sputum-throat swabs and became negative in most cases (55%) within 14 days after onset. Lymphocytopenia occurred in 40% (8/20) of patients during the peak infection period and returned to normal at week five. The most severe inflammation in the lungs appeared in week 2 or 3 after onset, and this was completely absorbed between week 6 and 8 in 85.7% of patients. All patients had detectable antibodies to the receptor binding domain (RBD), and 95% of these patients had IgG to viral N proteins. The antibody titer peaked at week four. Anti-S IgM was positive in 7 of 20 patients after week three. CONCLUSIONS: All COVID-19 patients in this study were self-limiting and recovered well though it may take as long as 6-8 weeks. Our findings on the kinetic changes in imaging, serum response to viral infection and viral RNA level may help understand pathogenesis and define clinical course of COVID-19.

Posterior fossa brain arteriovenous malformations : Clinical features and outcomes of endovascular embolization, adjuvant microsurgery and radiosurgery.

BACKGROUND: Posterior fossa brain arteriovenous malformations (PFbAVM) are relatively rare brain disorders but have a high risk of hemorrhage. Endovascular embolization to reduce the lesion size before treatment may improve the outcome of PFbAVM. The purposes of this study were to identify risk factors associated with hemorrhage in PFbAVM and to assess clinical outcomes in patients receiving initial endovascular embolization. MATERIAL AND METHODS: From 1999 to 2013 a total of 63 patients with PFbAVMs were treated (31 males and 32 females, 14.1 % of all AVM cases). A retrospective examination of patient demographics, clinical presentation, angiographic features, treatment modalities, complications and outcomes was carried out. The re-hemorrhage rate, obliteration rate and modified Rankin scale (MRS) were used as measures of outcome. RESULTS: Of the 63 PFbAVM patients 54 (85.7 %) exhibited hemorrhage and 15 had confirmed aneurysms. The cerebellar location (P = 0.007) and deep venous drainage (P = 0.012) were independent predictors of hemorrhage in multivariate analyses. The mean estimated devascularization was 46.9 % (range 10-100 %) in the 20 patients (31.7 %) treated by endovascular embolization. The 16 patients with residual niduses were further treated by radiosurgery, microsurgery or embolization. Complete obliteration was attained in 12 patients (67 %) while 2 (5.7 %) were left with persisting neurological deficits and 1 had a re-hemorrhage 3 years later (annual rate of 4.6 %). Favorable outcome (MRS ≤ 2) was obtained in the 20 patients receiving initial endovascular embolization (P = 0.039 versus preoperative MRS). CONCLUSION: Cerebellar location and deep venous drainage are predictors of hemorrhage in PFbAVM. Adjuvant endovascular embolization is useful and safe for PFbAVM prior to microsurgery or radiosurgery.

Risk factors analysis of mirror aneurysms: A multi-center retrospective study based on clinical and demographic profile of patients.

As a special subgroup of multiple intracranial aneurysms, mirror aneurysms are located bilaterally on the corresponding intracranial arteries. The current study sought to compare the clinical and demographic features of patients harboring mirror aneurysm, and to elucidate the corresponding risk factors. We performed a retrospective cohort study of 2641 intracranial aneurysms patients, who were admitted to our hospitals between January 2005 and June 2014. Patients were subdivided into three groups based on the inclusion criteria: (i) single (n=2250); (ii) non-mirror multiple (n=285); and (iii) mirror aneurysms (n=106). Clinical and demographic files of the three groups were collected and compared, and medical histories including stroke, hyperlipemia, hypertension, hyperglycemia, valvular heart disease were considered as potential risk factors. Potential morphological reasons for mirror cerebral aneurysms rupture, including aneurysms size, irregular walls and cerebral hemispheric dominance, were also compared. Our data showed that the male to female ratio of mirror aneurysms patients was 1:3.61, which was significantly different from that of single aneurysm (1:1.27) and multiple aneurysms (1:2.00). The prevalence of mirror aneurysms in women is higher than that in men (P<0.001). Older patients (especially 60-69 years old) also appear to be more vulnerable to mirror aneurysm than single aneurysm (P<0.001). In 84 mirror aneurysm patients the aneurysms were located on the internal carotid arteries (79.2%), most typically at the PComA or in the Cavernous ICA. Patients with medical history of hyperlipemia appear to have an increased risk of harboring mirror aneurysms. Larger aneurysm size and presence of an irregular aneurysm wall appear to be the morphological factors that predispose for mirror aneurysms rupture.

Synergistic bactericidal activity of chlorhexidine-loaded, silver-decorated mesoporous silica nanoparticles.

Combination of chlorhexidine (CHX) and silver ions could engender synergistic bactericidal effect and improve the bactericidal efficacy. It is highly desired to develop an efficient carrier for the antiseptics codelivery targeting infection foci with acidic microenvironment. In this work, monodisperse mesoporous silica nanoparticle (MSN) nanospheres were successfully developed as an ideal carrier for CHX and nanosilver codelivery through a facile and environmentally friendly method. The CHX-loaded, silver-decorated mesoporous silica nanoparticles (Ag-MSNs@CHX) exhibited a pH-responsive release manner of CHX and silver ions simultaneously, leading to synergistically antibacterial effect against both gram-positive Staphylococcus aureus and gram-negative Escherichia coli. Moreover, the effective antibacterial concentration of Ag-MSNs@CHX showed less cytotoxicity on normal cells. Given their synergistically bactericidal ability and good biocompatibility, these nanoantiseptics might have effective and broad clinical applications for bacterial infections.

Multidisciplinary Care of Unruptured Brain Arteriovenous Malformations to Improve Symptomatic Headache and the Onset, Progression, and Outcomes of Unruptured Brain Arteriovenous Malformations.

BACKGROUND: Symptomatic headaches attributed to unruptured brain arteriovenous malformations (ubAVMs) are very common and affect patients' quality life, but multidisciplinary care of ubAVMs to improve symptomatic headache remains unclear. OBJECTIVE: The objective is to identify the features of symptomatic headaches, and to obtain headache outcomes following multidisciplinary care of ubAVMs, as well as provide background on the natural history of ubAVMs. STUDY DESIGN: The features of symptomatic headaches and headache outcomes were analyzed in a large cohort of cases after multidisciplinary care of ubAVMs. We have also provided information on the natural history of ubAVMs. SETTING: This study was conducted at the Department of Neurosurgery of Zhujiang Hospital where 336 patients from 1998 to 2014 were reviewed by a multidiscipline team. Only 124 patients were eligible. METHODS: The demographics, clinical features, imaging features, and headache details of eligible patients were reviewed. An 11-point pain scale score was used to assess symptomatic headaches before, during, and after treatment. The headache outcomes, death or stroke, and adverse functional outcomes (modified Rankin Scale score = 2, mRS = 2) were assessed following multidisciplinary care of ubAVMs. RESULTS: Twenty-three (56.1%) of 41 patients had migraine-like headaches located in occipital lobe (P < 0.001), while forty (63.5%) of 63 patients had tension-type-like headaches located in frontotemporal lobe (P < 0.001). For patients with tension-type-like or all types of headache, headache improvement differed between the multidisciplinary group and medical group (87.8% vs. 31.8%, P < 0.001; 85.7% vs. 40.7%, P < 0.001). The risk of death or stroke did not differ between multidisciplinary group and medical group (P = 0.393), whereas the risk of adverse functional outcome (mRS = 2) differed significantly by long-time follow-up (23.0% vs.10.0%, P = 0.022). LIMITATIONS: This study provides the initial experience to support multidisciplinary care for ubAVMs to improve symptomatic headaches and patients' quality life, but based on the retrospective study with inherent limitations, larger samples and multi-center trials are needed on this interesting issue. CONCLUSIONS: Occipital ubAVM is more likely to present with migraine-like headache, while frontotemporal ubAVM tends to present with tension-type-like headache. The effectiveness of multidisciplinary care for ubAVM to improve headache has been shown, but the natural history of ubAVM patients with headache remains unclear.Key Words: Unruptured brain arteriovenous malformations, headache, headache improvement, natural history.

Fistula and Infratentorial Location, Characteristics That Contribute to Cerebral Arteriovenous Malformations, Lead to the Formation of Associated Aneurysms in Patients.

OBJECTIVE: Because the formation of associated aneurysms (AAs) related to the characteristics of cerebral artriovenous malformations (cAVMs) is poorly recognized, the purpose of this study was to identify the responsible characteristics of cAVMs related to the formation of AAs and to identify patients with responsible characteristics related to the formation of AAs through the analysis of the outcomes of these patients after treatment. METHODS: This study was performed to analyze the baseline characteristics of patients with cAVMs and AAs. The recurrent AA and residual size of cAVMs were used to evaluate the outcomes of patients after treatment. At the same time, the ROC curve was measured to gauge the relationship between the residual size of cAVMs and recurrent AAs in eligible patients. RESULTS: Fifty (15.0%) patients with cAVMs and AA were confirmed; these patients had twice the hazard of hemorrhage as patients with only isolated cAVMs. An infratentorial location (P < 0.001) and fistula (P = 0.002) were independent predictors of the formation of AAs. After a mean 22.7 months follow-up, 2 patients developed recurrent AAs, and the annual recurrence rate for patients with responsible characteristics was 17.6%, but for all patients was 7.2%. The ROC curve showed that patients, specifically patients with responsible characteristics, the residual size of the cAVM was closely related to recurrent AA (area = 0.89, 95% confidence interval 0.81-0.97, P = 0.023, cut-off value = 82.5%). CONCLUSIONS: Patients with cAVMs and AA who harbor a fistula or an infratentorial location tend to form AAs. To prevent recurrent AAs and decrease the subsequent risk of hemorrhage, complete obliteration of cAVMs or retrograding over 80% size of cAVMs is recommended.

[Evolution of maize climate productivity and its response to climate change in Heilongjiang Province, China.] / é»‘é¾™æ±ŸçœçŽ‰ç±³æ°”å€™ç”Ÿäº§åŠ›æ¼”å˜åŠå ¶å¯¹æ°”å€™å˜åŒ–çš„å“åº”.

Under the background of climate change, revealing the change trend and spatial diffe-rence of maize climate productivity in-depth and understanding the regularity of maize climatic resources utilization can provide scientific basis for the macro-decision of agricultural production in Heilongjiang Province. Based on the 1981-2014 meteorological data of 72 weather stations and the corresponding maize yield data in Heilongjiang Province, by the methods of step by step revisal, spatial interpolation and linear trend analysis, this paper studied the photosynthetic productivity (PP), light-temperature productivity (LTP), and climatic productivity (CP) of spring maize, and their temporal and spatial variation characteristics, main influencing factors and light energy utilization efficiency, and evaluated the maize climate productivities under different climate scenarios in the future. The results showed that during the study period, the mean PP, LTP and CP in Heilongjiang Province were 26558, 19953, 18742 kg·hm-2, respectively. Maize PP, LTP and CP were high in plains and low in mountains, and gradually decreased from southwest to northeast. PP, LTP and CP presented significantly increasing trends, and the increase rates were 378, 723 and 560 kg·hm-2·(10 a)-1, respectively. The increase of radiation and temperature had positive effect on maize production in Heilongjiang Province. The potential productivity of maize presented significant response to climate change. The decrease of solar radiation led to the decline of PP in western Songnen Plain, but the increased temperature compensated the negative effect of solar radiation, so the downward trend of LTP was slowed. The response to climate warming was particularly evident in North and East, and LTP was significantly increased, which was sensitive to the change of precipitation in southwest of Songnen Plain and part of Sanjiang Plain. The average ratio of maize actual yield to its climate productivity was only 24.1%, there was still 75.9% to be developed. In the future, the warm and wet climate would benefit the improvement of maize climate productivity, while the cold and dry climate would make an adverse impact.

Comparison between Solitaire™ AB and Enterprise stent-assisted coiling for intracranial aneurysms.

The aim of the present study was to analyze the feasibility, rate of procedure-related complications and midterm angiographic follow-up outcomes using the Enterprise (EP) and Solitaire™ AB (ST) stents in the stent-assisted coiling of intracranial aneurysms. In total, 81 patients with 90 aneurysms were included in the study, with the aim to treat 43 aneurysms with the EP stent (47.8%) and 47 aneurysms with the ST stent (52.2%). The 90 aneurysms were successfully stented and subsequently coiled; however, in four patients undergoing treatment with the EP stent, the stent was not navigable; thus, treatment with the ST stent was employed (EP, n=39, 43.3%; ST, n=51, 56.7%). Of the 90 aneurysms, 44 cases were ruptured aneurysms, with 74 located in the anterior circulation and 16 located in the posterior circulation. The stenting success rate of the ST stent was significantly higher compared with the EP stent. However, no statistically significant differences were observed with regard to the packing density, complete occlusion, progressive occlusion, recurrence rate, procedure-related complications, in-stent stenosis and stent migration rates between the two groups. In conclusion, the two common medical devices used for intracranial aneurysms are relatively safe and effective for the treatment of intracranial aneurysms. However, due to the higher stenting success rate of the ST stent, this medical devise was demonstrated to be more flexible and feasible compared with the EP stent.

Single-centre comparison of procedural complications, clinical outcome, and angiographic follow-up between coiling and stent-assisted coiling for posterior communicating artery aneurysms.

Aneurysm recurrence is a principle limitation of endovascular coiling procedures, especially in posterior communicating artery aneurysms, with reported recurrence rates of >30%. The adjunctive use of self-expandable stents has revolutionised the treatment of intracranial aneurysms, especially for complex morphologies, wide necks, or unfavourable dome-to-neck ratios. However, there are limited data concerning a direct comparison between simple coiling and stent-assisted coiling in posterior communicating artery aneurysms. This study aimed to compare the durability and outcomes of coiling versus stent-assisted coiling procedures. Imaging data of patients with posterior communicating artery aneurysms treated with coiling or stent-assisted coiling between January 2008 and October 2012 were retrospectively analysed. The initial angiographic results, procedural complications, and clinical outcomes were assessed at discharge. Imaging follow-up was performed with cerebral angiography. Complete aneurysm occlusion was achieved on initial angiography in 23/56 (41.1%) stent and 83/235 (35.3%) non-stent patients. At the latest follow-up (mean follow-up 14.3 ± 10.4 months for stent and 13.2 ± 9.5 months for non-stent patients), aneurysms had recurred in 5/47 (10.6%) stent and 57/203 (28.1%) non-stent patients (p=0.014). Procedural complications occurred in 6/56 (10.7%) stent and 27/235 (11.5%) non-stent aneurysms. No rebleeding occurred during clinical follow-up (mean duration, 46.7 months). Recurrence rates at the latest follow-up were significantly lower in patients undergoing stent-assisted coiling than those undergoing simple coiling. Thus, use of the stent-assisted neck remodelling technique in the treatment of wide-necked posterior communicating artery intracranial aneurysms appears to improve the long-term clinical outcome.

Clinical features and endovascular treatment of intracranial arteriovenous malformations in pediatric patients.

PURPOSE: The purpose of this study was to characterize clinical features and evaluate the clinical outcome of endovascular embolization treatment intracranial arteriovenous malformations in pediatric patients. METHODS: A cohort of children (age ≤ 18 years) with arteriovenous malformations (AVMs) from 2000 to 2012 was included. Predictors studied included patient gender, age, and angioarchitectural features, including AVM location, nidus morphology and size, venous drainage, and associated aneurysms. Treatment method, complications and outcomes were recorded. The features of AVMs were evaluated before the treatment. RESULTS: One hundred twenty-seven children (77 males, mean age 13.2 years) were included; 90/127 (70.9 %) children were presented with hemorrhage. AVM size and deep venous drainage were independently associated with hemorrhage; 66/127 patients (52 %) treated with endovascular embolization. Complete obliteration at the end of all endovascular procedures was achieved in 14/66 patients (21.2 %), with an average of 78 % (range, 20-100 %) volume reduction. A mean of 2.9 (range, 1-9) feeding pedicles was embolized per patient. Overall, nine complications occurred in a total of 123 procedures (7.3 %). There was no procedure-related death in this study population. There was no significant difference between patients with and without complications in terms of AVM grade, demographic characteristics, or embolization features. CONCLUSIONS: AVM size and deep venous drainage were independently associated with hemorrhage in pediatric patients. Endovascular procedure is feasible and safe for pediatric AVMs, and complete embolization can be achieved in small AVMs, while large AVMs can be adequately reduced in size for additional microsurgery or stereotactic radiosurgery.

Chemical stability and degradation mechanisms of ferulic acid (F.A) within various cosmetic formulations.

Ferulic acid (F.A) receives significant interest in the beauty industry with regard to its skin-whitening and anti-oxidant properties. However, its use in cosmetics is limited due to pH- and temperature-related instabilities. In this study, we investigated the stability of F.A in eight different prototype formulae. The results confirmed that in our conditions the stability of F.A is pH- and temperature-related. Additionally, the nature of the solvent dipropylene glycol (DPPG) showed a capacity to stabilize F.A. A series of experiments was further planned for studying the mechanism of degradation of F.A. In a prototype of a cosmetic medium, F.A degrades first through a decarboxylation step, leading to 4-hydroxy-3-methoxystyrene (PVG). Further, F.A and PVG are both involved in an additional reaction, resulting in the trans-conjugation dimer of PVG. The consequences of these results in formulating F.A are discussed.

[Preparation and property of platinum microcoil modified by a copolymer-VEGF conjugate].

OBJECTIVE: To prepare a platinum microcoil coated with polymers and vascular endothelial growth factor (VEGF), and evaluate its surface characteristics and property of sustained VEGF release. METHODS: The surface of the platinum microcoils (GDC) were modified by coating P(DLLA-co-TMC) copolymer and immobilizing heparin on the surface of GDC. VEGF was then loaded onto the surface of GDC and the controlled release of VEGF within GDC was achieved. The morphology was observed by scanning electron microscope, and the sustained release of VEGF was evaluated by enzyme-linked immunosorbent assay (ELISA). RESULTS: Platinum coils were prepared by successive deposition of P(DLLA-co-TMC) copolymer and anionic heparin, and VEGF was immobilized through affinity interaction with heparin. The accumulative release of VEGF increased obviously during the entire testing period without burst release. CONCLUSION: The use of P(DLLA-co-TMC) copolymer allows immobilization of VEGF on the platinum coils for controlled VEGF release, and improves the biological property of the coils.

[Application of virtual imaging technique in diagnosis of intracranial aneurysms].

OBJECTIVE: To investigate the value of virtual imaging technique in diagnosis of intracranial aneurysms. METHODS: Fifty-four cases of 54 intracranial aneurysm diagnosed by three-dimensional CT angiography (3D-CTA) examinations were enrolled in this study. Three-dimensional virtual images of the skull and cerebral vessels were acquired by three-dimensional reconstruction of the original CT images using the surgical planning system, and the location, size and shape of the aneurysms and their anatomical relationship with the adjacent tissues were observed and measured from several angles. All the patients underwent surgical planning and simulated surgical operations using the virtual surgical instruments available in the system. RESULTS: All the 54 cases had successful three-dimensional virtual image reconstruction and the surgical planning operations. The virtual imaging system generated clear and vivid three-dimensional virtual images which clearly visualized the location and size of the aneurysms and their precise anatomical relations to the parent arteries and skull. This virtual reality imaging system also allowed simulation of simple surgical procedures. CONCLUSION: The surgical planning system based on the virtual reality imaging can serve as a useful means to assist the diagnosis and provide precise imaging details of intracranial aneurysms.

Combined application of virtual imaging techniques and three-dimensional computed tomographic angiography in diagnosing intracranial aneurysms.

BACKGROUND: The diagnostic value of virtual imaging combined with three-dimensional computed tomographic angiography (3D-CTA) for intracranial aneurysms has not been fully elucidated yet. This study aimed to evaluate the value of combined application of virtual imaging techniques and 3D-CTA in diagnosing patients with aneurismal subarachnoid hemorrhage (SAH) at the acute stage. METHODS: Eighty patients with non-traumatic SAH received 3D-CTA examinations. The raw CT data of these patients were reconstructed and transferred into the 3D mode through the surgical plan system based on virtual reality (VR) image, and the 3D virtual images of skulls and brain blood vessels were acquired. The location, size and shape of aneurysms and their anatomic relationship with adjacent tissues were measured from many points of view. RESULTS: Seventy-three aneurysms were detected in 68 of the 80 patients, but 2 aneurysms were detected in 2 of the 5 patients who had been found free of aneurysms previously and had received 3D-CTA examinations for a second time one month later. The 3D virtual images produced by the virtual imaging system were clear and vivid, and they could reveal the location and size of the aneurysm and its relations to the parent artery and skull directly. CONCLUSIONS: The imaging of 3D-CTA is convenient, reliable and fast in diagnosing intracranial aneurysms and can be regarded as the first choice for the diagnosis and treatment of ruptured intracranial aneurysms. Combined with the surgical plan system based on the VR image, 3D-CTA may obtain more imaging information about aneurysms.

[Expression of TGFbeta1 and its type I receptors ALK1 and ALK5 mRNA in brain arteriovenous malformation].

OBJECTIVE: To explore the expression of transforming growth factor beta1 (TGFbeta1) and its type I receptors activin-like kinase 1 (ALK1) and ALK5 mRNA in the development of brain arteriovenous malformation (BAVM). METHODS: The mRNA expressions of TGFbeta1, ALK1and ALK5 were detected with semiquantitative RT-PCR in patients with BAVM. RESULTS: The expressions of TGFbeta1 and ALK5 mRNA increased significantly in BAVM, and their relative expression quantity were 0.777-/+0.047 and 0.585-/+0.074, respectively. However, ALK1 mRNA expression declined significantlies with a relative expression of 0.173-/+0.044 in comparison with the control group (0.720-/+0.098, P<0.01). CONCLUSION: The balance of TGFbeta1 and its type I receptors ALK1 and ALK5 mRNA expressions may play important role in the development of BAVM.

[Digital subtraction angiography and preoperative embolization for meningiomas].

OBJECTIVE: To investigate the diagnostic value of digital subtraction angiography (DSA) and the clinical efficacy of preoperative embolization for miningiomas. METHODS: Fifty-eight patients with meningioma were examined by DSA, and preoperative embolization was performed in patients whose miningiomas were supplied predominantly by the external carotid artery (ECA). RESULTS: In 43 patients, the meningiomas was exclusively or predominantly supplied by ECA, and the feeding arteries were embolized with particles of 250-350 microm through catherization of ECA. The blood supply of the tumor in 31 patients was completely blocked, and partial occlusion through embolization was performed in 12 patients. No complications in relation to the embolization occurred. Fifty-three patients underwent total removal of the meningiomas and the others had partial removal 1-7 days following DSA and embolization, with tumor-associated intraoperative hemorrhage of 600 ml on average. CONCLUSION: DSA has important diagnostic value for meningiomas, and preoperative embolization can be safe and effective to reduce bleeding, shorten the operation time and prevent postoperative complications.

[Clinical efficiency of interventional therapy on internal carotid-posterior communicating artery aneurysm].

OBJECTIVE: To evaluate the effect of endovascular embolization of internal carotid-posterior communicating artery (IC-PC) aneurysm. METHODS: 145 patients with IC-PC aneurysms underwent endovascular embolization through the microcatheter under digital subtraction angiography (DSA). Of the 145 cases, 55 patients with 62 aneurysms were embolized by mechanical detachable spiral (MDS) and 90 patients with 106 aneurysms were embolized by Guglielmi detachable coil (GDC) or electrical detachable coil (EDC). RESULTS: 168 aneurysms in 145 patients, 96 of which with 100% embolization, 45 with 95% embolization, 15 with 90% embolization, and 12 with less than 90% embolization, were embolized successfully. During the surgery, aneurysm rupture occurred in 3 cases, cerebral vasospasm in 5, and cerebral infarction in 1 case. 118 cases were cured, 23 improved, and 3 died. 17 patients were followed-up by DSA, 3 aneurysms recurred and 2 were totally embolized with EDC for the second time. CONCLUSION: Endovascular embolization is a safe and effective therapeutic method for IC-PC aneurysm.

[Endovascular embolization for traumatic carotid-cavernous fistula].

OBJECTIVE: To evaluate the choice of approaches, surgical techniques and clinical outcome of endovascular embolization for treating traumatic carotid cavernous fistula (TCCF). METHODS: A retrospective analysis of 119 patients with TCCF was conducted, in whom totally 128 embolizations were performed. In these procedures, the femoral artery approach was adopted in 112 cases, femoral vein approach in 5 cases, and superior ophthalmic vein approach in 2 cases. For the embolization materials, balloons were used in 101 cases, microcoils in 13 cases, both materials in 2 cases, and lyophilized dura mater in 3 cases. After the embolization procedures, 110 patients were followed-up for 3 months to 10 years, and 29 patients reexamined with angiography. RESULTS: Successful embolization for TCCF in a single procedure was achieved in 111 cases, and failure occurred due to balloon leakage in 8 cases, all embolized successfully in a second attempt. The total success rate was 100% in these cases, with a rate of internal carotid artery patency of 90.8% (108/119). No perioperative mortality or complication occurred, nor was TCCF recurrence seen during the follow-up. CONCLUSIONS: In general, TCCF can be successfully treated by balloon embolization via the femoral artery, while microcoil embolization has better performance for small fistula. Embolization can be done through venous approach when the internal carotid artery is ligated or occluded, and no procedure should be performed at the convenient expense of the internal carotid artery. Right choices of the approaches and embolization materials are key to the success of the procedure.

[Protective effect of qi dong yi xin on acute myocardial infarction in dogs].

OBJECTIVE: To observe the protective effects on acute myocardial infarction of QDYX in dog. METHOD: The corconary ciculation and cardial oxygen metabolism, the degree and range of myocardial ischemia, myocardial infarct size, and the changes of the enzymes in serum were determined by using the acute myocardial infarction model of ligation of LAD in the anaesthetized open-chest dogs. RESULT: The coronary resistance and cardial oxygen consumption were decreased and the myocardial blood flow was increased in dogs treated with QDYX of 1.0,2.0 mg.kg-1. The degree and range of myocardial ischemia, myocardial infarct size and the activity of serum CK, LDH were decreased in acute myocardial infarcion dogs treated with QDYX of 1.0,2.0 mg.kg-1. CONCLUSION: QDYX can decrease cardial oxygen consumption in dogs, thus having protective effect on myocardial ischemia.

[Traumatic basilar-cavernous fistula complicated by basilar artery aneurysm: report of one case].

A 19-years-old boy was admitted after brain trauma with subarachnoid hemorrhage, left oculomotor nerve palsy, elevated pressure in the cavernous sinus and intracranial noise. The diagnosis of traumatic basilar-cavernous fistula complicated with basilar artery aneurysm was established by digital subtraction angiography. After endovascular occlusion of the vessels twice using detachable coils, the patient was cured without relapse during the 2-year follow-up. It is at the time being second report globally and the first one in China.