Deng Q.Q.,Hospital of Shanghai |
Tang J.,Fudan University |
Chen C.,National University of Singapore |
Markus H.,St George's, University of London |
And 6 more authors.
Journal of the Neurological Sciences | Year: 2016
Background Microembolic signals (MESs) are direct markers of unstable large artery atherosclerotic plaques. In a previous study, we found that the number of MESs is associated with stroke recurrence and that clopidogrel plus aspirin more effectively reduce the number of MESs than does aspirin alone. Stroke recurrence is associated with not only the number of MESs but also the size of the MES, which can theoretically be estimated by monitoring the MES intensity via transcranial doppler (TCD). Thus, we compared the effects of clopidogrel and aspirin with aspirin alone on MES intensity using TCD. Methods We recruited 100 patients who experienced acute ischemic stroke or transient ischemic attack (TIA) within 7 days of symptom onset. All patients also had large artery stenosis in the cerebral or carotid arteries and the presence of MES as revealed by TCD. The patients were randomized to receive either aspirin or clopidogrel and aspirin for 7 days. MES monitoring was performed on days 2 and 7. Results Intent-to-treat (ITT) analysis (46 patients in the dual therapy group, 52 patients in the monotherapy group) and per-protocol (PP) analysis (25 patients in the dual therapy group, 31 patients in the monotherapy group) were performed on 98 patients. The primary finding was that the MES intensity was dramatically reduced in the dual therapy group. ITT analysis of the dual therapy group revealed that the MES intensity was 8.04 (0-16) dB before treatment, 0.00 (0-17) dB on day 2, and 0.00 (0 - 12) dB on day 7 (P = 0.000). In the monotherapy group, the MES intensity was 9.00 (0 - 20) dB before treatment, 8.25 (0-17) dB on day 2, and 7.0 (0-18) dB on day 7 (P = 0.577). PP analysis revealed similar results. No severe hemorrhagic complications were detected. The two patients in this study who experienced stroke recurrence were in the monotherapy group. Conclusions Clopidogrel and aspirin more effectively decrease the MES intensity than aspirin alone in patients with large artery stenotic minor stroke or TIA. © 2016 Published by Elsevier B.V.
Liu B.-F.,Shanghai University |
Zhang L.-G.,Tongji University |
Liu Y.-B.,Shanghai University |
Yan N.,Pudong Hospital |
And 5 more authors.
Chinese Medical Journal | Year: 2011
Background Previous clinical and basic research of axial lumbar interbody fusion (AxiaLIF) all focused on the L5/S1. However, there is no data on the feasibility of this approach for the fusion of both L4/5 and L5/S1. This study aimed to explore whether transsacral axial interbody fusion is a candidate for the fusion of both L4/5 and L5/S1. Methods The subjects (n=40) underwent lumbosacral magnetic resonance imaging (MRI). The median sagittal MRI images were analyzed and five measurement markers were defined as follows: the center of the L4/5 disc (A), the center of the L5/S1 disc (B), the anterior margin of the S1/2 space (C), the sacrococcygeal junction (D), and the coccygeal tip (E). The measurement markers were connected each other to produce nine lines (AB, AC, AD, AE, BC, BD, BE, CD and CE) as the reference lines for surgical approaches. The distance between each reference line and the anterior and posterior margins of the L4, L5 and S1 vertebral bodies were measured to determine the safety of the respective approaches. Results Twenty subjects were capable of finding one reference line to fuse both L4/5 and L5/S1 via transsacral axial interbody fusion approach. The surgical approach reference line was AE or CE line. In the other 20 subjects, it was failed to find a reference line which met the safety criteria for fusing both L4/5 and L5/S1. Conclusions About half of subjects were capable of finding a suitable AxiaLIF reference line to fuse both L4/5 and L5/S1. In some subjects, it was difficult to find a suitable AxiaLIF reference line to fuse both L4/5 and L5/S1.
Deng Q.-Q.,Jingan District Central Hospital |
Gao L.-L.,Pudong Hospital |
Fu J.-H.,Pudong Hospital |
Pan D.-H.,Pudong Hospital |
And 4 more authors.
Fudan University Journal of Medical Sciences | Year: 2015
Objective: To explore the prevalence and distribution characteristics of hyperhomocysteinemia (HHcy) of the elderly population in a rural community of Shanghai, and to analyze its related risk factors. Methods: A cross-sectional survey on the level and distribution characteristics of plasma homocysteine (Hcy) was conducted in the elderly (≥60 years) in Datuan community of Shanghai. Multi-factor non-conditional logistic regression was used to analyze the risk factors of Hcy level. Results: A total of 1621 elderly people were enrolled in this study. The plasma Hcy level in the male was higher than that in the female, and the difference was statistically significant [(15.72±9.22) μmol/L vs. (14.08±7.55) μmol/L, P<0.001], while the prevalence of HHcy in the male was higher than that in the female (43.6% vs. 29.5%, P<0.001). The plasma Hcy levels in the different age groups of <70 years, 70-80 years and >80 years were (13.75±5.43), (15.26±9.72) and (15.55±9.12) μmol/L (P=0.001), while the prevalences of HHcy were 23.9%, 40.5% and 46.3%, respectively (P<0.001). The plasma Hcy levels in the groups with and without smoke were (16.14±8.05) and (14.60±8.31) μmol/L (P=0.037), while the prevalences of HHcy were 44.9% and 34.2%, respectively (P=0.011). The plasma Hcy levels in the groups with and without hypertension were (15.24±9.72) and (14.20±6.42) μmol/L (P=0.012), while the prevalences of HHcy were 39.7% and 30.3%, respectively (P<0.001). The Logistic regression showed that gender, age and hypertension were risk factors for HHcy with the odds ratio (OR) of 1.92 (95%CI: 1.46-2.54, P<0.001), 1.89 (95%CI: 1.55-2.29, P<0.001) and 1.57 (95%CI: 1.20-2.05, P=0.001), respectively. Conclusions: Plasma Hcy level had difference in gender and ages in the 1621 elderly population in Datuan Community of Shanghai. The risk factors for HHcy included gender, age and hypertension. © 2015, Editorial Department of Fudan University Journal of Medical Sciences. All right reserved
Yang X.,Shanghai JiaoTong University |
Shen L.,Shanghai JiaoTong University |
Lin Q.S.,Longyan First Hospital |
Li R.,Pudong Hospital |
And 2 more authors.
Journal of Craniofacial Surgery | Year: 2015
We report a case with both traumatic subdural effusion (TSE) and associated hydrocephalus. A collapse of the sinuses is known to be present in some infants with external hydrocephalus, but collapsed sinuses have not been previously described in patients with TSE and associated hydrocephalus. Therefore, a preoperative magnetic resonance imaging venography was performed, with thrombosis in the left transverse and sigmoid sinuses identified. The infant was treated with subdural peritoneostomy. We hypothesized that an occlusive cerebral venous sinus thrombosis may well be the culprit, or an exacerbating factor for TSE associated with hydrocephalus. © 2015 Mutaz B. Habal, MD.
He J.-F.,Pudong Hospital |
Gu G.-M.,Pudong Hospital |
Long D.-H.,Guangzhou University
Chinese Journal of Tissue Engineering Research | Year: 2014
Background: Nerve growth factor (NGF) belongs to a biological macromolecule that is difficult to pass through the blood-brain barrier. However, a retroviral vector carrying exogenous gene can be stably inserted and integrated into the host cell genome, which is suitable for gene therapy. Objective: To study the gene expression of recombinant retroviral vector carrying rat NGF gene in neural stem cells. Methods: The rat NGF gene was inserted into a retroviral vector pLEGFP-N1, which was transferred into packaging cells PT67 by Lipofectamine 2000. The positive clones in virus supernatant were collected by G418 selection and used to infect neural stem cells. After that, the NGF expression was tested by enzyme linked immunosorbent assay and the biological competence by PC12 cells, and then morphological change of neural stem cells and cell typing were examined by fluorescent microscope. Results and Conclusion: The neural stem cells could express extrinsic source NGF protein after the recombinant plasmid was infected into neural stem cells. The PC12 cells increased in the experimental group and stretched out long neurites. And the NGF protein could maintain the neural stem cell survival and stimulate their differentiation. These findings suggest that the neural stem cells carrying extrinsic source NGF gene could express NGF successfully, and the NGF protein induced the survival and differentiation of neural stem cells.
Yan X.,Fudan University |
Yan X.,PLA General Hospital |
Zhang T.,Fudan University |
Wang Z.,Fudan University |
And 6 more authors.
Journal of Genetics and Genomics | Year: 2011
Waardenburg syndrome type II (WS2) is associated with syndromic deafness. A subset of WS2, WS2A, accounting for approximately 15% of patients, is attributed to mutations in the microphthalmia-associated transcription factor (MITF) gene. We examined the genetic basis of WS2 in a large Chinese family. All 9 exons of the MITF gene, the single coding exon (exon 2) of the most common hereditary deafness gene GJB2 and the mitochondrial DNA (mtDNA) 12S rRNA were sequenced. A novel heterozygous mutation c.[742_743delAAinsT;746_747delCA] in exon 8 of the MITF gene co-segregates with WS2 in the family. The MITF mutation results in a premature termination codon and a truncated MITF protein with only 247 of the 419 wild type amino acids. The deaf proband had this MITF gene heterozygous mutation as well as a c.[109G>A]+[235delC] compound heterozygous pathogenic mutation in the GJB2 gene. No pathogenic mutation was found in mtDNA 12S rRNA in this family. Thus, a novel compound heterozygous mutation, c.[742_743delAAinsT;746_747delCA] in MITF exon 8 was the key genetic reason for WS2 in this family, and a digenic effect of MITF and GJB2 genes may contribute to deafness of the proband. © 2011.
Deng Q.,Fudan University |
Zhang Y.,Fudan University |
Ding H.,Fudan University |
Dong Q.,Fudan University |
And 2 more authors.
Journal of Clinical Neuroscience | Year: 2015
We report, to our knowledge, the first patient with brachiocephalic trunk calcified plaque causing the 'salted pretzel sign' and worm-like calcification. Arterial stenosis or occlusion caused by atherosclerosis and thrombosis are responsible for the majority of cases of cerebral infarction. However, there are a number of other causes. Interestingly, these findings were not observed on a CT scan 10 days before the stroke. Acute cerebral infarction with calcifications on unenhanced head CT scans should raise suspicion for disease in the carotid system. Identification of subtle findings of acute ischemic stroke on CT scans is important for early diagnosis and treatment. © 2015 Elsevier Ltd. All rights reserved.
Chen J.-H.,Fudan University |
Min Z.-J.,Pudong Hospital |
Hao H.-K.,Fudan University |
Xiang Y.,Fudan University |
And 2 more authors.
World Chinese Journal of Digestology | Year: 2014
AIM: To investigate the application of laparoscopic resection in the management of colorectal cancer liver metastases. METHODS: Between March 2008 and September 2013, 21 patients underwent laparoscopic resection of colorectal cancer liver metastases at Huashan hospital and Pudong Hospital. Their clinical data were retrospectively analyzed. RESULTS: All laparoscopic resections for colorectal cancer liver metastases were successful with no conversion. There were no severe postoperative complications except one case of bile leakage. The median surgical margin was 12 mm. The overall 1-, 2- and 3-year survival rates were 86%, 67% and 57%, respectively, while the 1-, 2- and 3-year disease-free survival rates were 81%, 62% and 47%, respectively. CONCLUSION: Laparoscopic resection of colorectal cancer liver metastases is safe and effective. © 2014 Baishideng Publishing Group Co., Limited. All rights reserved.
Han D.,Pudong Hospital |
Xiao W.-Z.,Pudong Hospital |
Sha L.,Pudong Hospital |
Zhou X.,Pudong Hospital |
Wei Z.,Pudong Hospital
Chinese Journal of Contemporary Neurology and Neurosurgery | Year: 2014
This paper aims to investigate the curative effect of different treatment approaches for hypertensive basal ganglia hemorrhage at medium amount. The curative effect of different treatment approaches for 226 patients with hypertensive basal ganglia hemorrhage from 20 ml to 40 ml was analyzed. There were 76 cases accepting conservative treatment, 94 burr hole drainage and 56 keyhole approach craniotomy. The patients' life quality was evaluated 3 months after operation. Of fully recovered and mildly disabled patients, 23 patients (30.26% ) were in conservative group, 50 (53.19% ) in burr hole drainage group, and 17 (30.36%) in craniotomy group. Of moderately, severely disabled or dead patients, 53 patients (69.74%) were in conservative group, 44 (46.81%) in burr hole drainage group, and 39 (69.64%) in craniotomy group. The burr hole drainage for treating hypertensive basal ganglia hemorrhage at medium amount had a better outcome than other two methods.
Li C.,Pudong Hospital |
Chen J.,Fudan University |
Zhang J.,Pudong Hospital |
Zou Q.,Pudong Hospital |
And 2 more authors.
Journal of Laparoendoscopic and Advanced Surgical Techniques | Year: 2014
Purpose: We aimed to evaluate a new single-operator mini-endoscope for its performance, feasibility, and safety in the management of biliary and pancreatic diseases. Patients and Methods: A retrospective analysis was conducted of 47 patients (19 men; mean age, 50.3 years) who underwent cholangioscopy with the Polydiagnost (Pfaffenhofen, Germany) Polyscope device via various approaches for diagnosis and treatment of biliary and pancreatic diseases between January 2011 and July 2012. Results: Biliary pancreatic duct endoscopy was performed through a cystic duct, common bile duct, peroral, or sinus tract approach in 21, 9, 11, and 6 patients, respectively. Thirty-two cases with bile duct stones were treated by basket extraction or complete stone fragmentation, 3 cases with tumor were treated by tissue ablation, and 4 cases with stricture were treated by stenting. Seven patients who were diagnosed with suspected stones preoperatively were excluded. No complications and morbidity associated with the use of biliary and pancreatic endoscopy was observed in this study. Conclusions: Cholangioscopy using the Polyscope system is a safe and effective technique for diagnosing or excluding biliary and pancreatic diseases (stone, strictures, or tumor). © 2014, Mary Ann Liebert, Inc.