OBJECTIVE:To explore the reasons,occurrence mechanisms,as well as prevention methods for complications following cerebrovascular stent implantation.METHODS:A computer-based online search was performed by the first author.The databases of Medline and CNKI were searched with year's limitation of 1989-2009.According to the inclusive and exclusive criteria,the documents were screened,collected and evaluated from the following aspects:treating progress of cerebrovascular stent implantation;category and biocompatibility of cerebrovascular stent;as well as occurrence and prevention methods for complication following cerebrovascular stent implantation.RESULTS:A series of complications,such as carotid sinus response,hyper-perfusion syndrome,cerebral anglo spasm,bleeding at puncture locus,thrombosis,restenosis,as well as cerebral ischemia,would occur following cerebrovascular stent implantation.The complications were difficult to eliminate,but should be avoided by selecting correct implanting cases,elevating operator's proficiency,enhancing understanding of complications,obeying perioperative management,as well as correctly and in-time treatment.Polymer stent,coating stent,and drug eluting stent presented superior biocompatibility to metal stent,which could prevent restenosis following implantation.CONCLUSION:Cerebrovascular stent implantation is one of the main treatments for cerebrovascular disease.Polymer stent,coating stent,and drug eluting stent exhibit excellent biocompatibility.The complications associate to stent implantation are preventable and remediable via sufficient preoperatively preparation,exactly operation and perioperative management.

Objective To compare the size of ablation lesions created by normal saline enhanced radiofrequency ablation (NS-RFA) and dilute hydrochloric acid enhanced radiofrequency ablation (HCl-RFA), explore their affecting factors, and observe the morphological manifestations of the ablated lesions.Methods NS-RFA and HCl-RFA were performed on 30 excised porcine livers with 9 different combinations of durations (5, 10, 15, and 20 minutes), temperatures (83, 93, 103, and 113 ℃ ) and powers (20, 30,and 40W). For each ablated lesion, the longitudinal and transverse diameters were measured, and volumes calculated. Multifactor analysis of variance was used to analyze the affecting factors of the size of ablated lesions. Macroscopic and microscopic morphological characteristics of lesions were observed. Results ( 1 )NS-RFA lesion volumes under 9 combinations were ( 3.53 ± 0. 34 ), (6. 41 ± 0. 42 ), ( 10. 69 ± 0. 37 ),(11.40±0.51), (3.20±0.23), (6.59 ±0.50), (12.11 ±0.70), (11.12 ±0.52), (11.81 ±0. 64) cm3, respectively. HCl-RFA lesion volumes under 9 combinations were ( 11.97 ± 1. 00), (28.72 ±0.99), (59.45 ±1.33), (105.65 ±2.40), (13.64±0.60), (29.70±0.58), (59.22±1.32),( 57. 22 ± 3.99 ), ( 59. 74 ± 2. 18 )cm3, respectively. The size differences of ablation zones caused by different types of ablation ( F = 948.9 ) ( main factor), durations ( F = 269. 3 ) and temperatures ( F =214. 6) (covariates) were statistically significant (P ＜ 0. 01 ), whereas which caused by power ( F = 0. 2 )(covariate) was not statistically significant (P ＞ 0. 05 ). (2)At gross examination, all ablation lesions were elliptical in cross section and there were three zones in NS-RFA induced lesions and five zones in HCl-RFA induced lesions. At microscopic examination of NS-RFA induced lesions, a small amount of liver cell debris were found at the edge of zone Ⅰ , a few of deformed and ruptured liver cells in zone Ⅱ. The shape of the most of the liver cells in zone Ⅲ was normal. At microscopic examination of HCl-RFA induced lesions, a small amount of liver cell debris were found at the edge of zone Ⅰ , classical coagulation necrosis in zone Ⅱ and Ⅲ, widened hepatic sinusoids lossened junction of hepatocytes and some hepatocytes detached into sinusoids in zones Ⅳ. The liver cells in zone V were normalexcept a small amount of hepatoeytes with pyknosis, karyorrhexis and karyolysis. Condusion Compared with NS-RFA, HCl-RFA can produce lager ablation zones. The duration and temperature were the factors that affected the size of ablation zone. HCl-RFA lesions typically showed coagulation necrosis at microscopical examination.

OBJECTIVETo analyze the etiology, clinical features and prognosis of liver injuries caused by different drugs.

METHODSThe types of suspected drugs related to liver injury, clinical manifestations, liver biochemical parameters, clinical outcomes and other associated data were retrospectively assessed for 140 patients with drug-induced liver injury (DILI). The Roussel Uclaf Causality Assessment Method (RUCAM) was used to assess the causality between drugs and liver injury.

RESULTSThe most prevalent agents inducing DILI were Chinese traditional drugs (62.1%), followed by antipyretic analgesic drugs (10%) and antibiotics (5%). The ratio of male to female patients in the study cohort was 1:1.69, with 71 of the total patients (50.7%) being between the ages of 40 and 60 years-old. The RUCAM scale was not less than 3 points for any of the patients.In general, the clinical manifestations and biochemical results were not specific. The percentages of hepatocellular injury type, cholestatic injury type and mixed injury type were 51.4%, 30.7% and 17.9% respectively. The median age of patients with cholestatic liver injury was 55.6 years, which was older than that of patients with hepatocellular injury (47.1 years) or mixed injury (49.9 years).

CONCLUSIONAlthough antipyretic analgesics and antibiotics are considered as common drugs that can induce DILI, Chinese traditional drugs have emerged as another important group of liver injurious agents. Cholestatic DILI was found to occur more often in elderly patients than in younger patients.

Adult ; Anti-Bacterial Agents ; Chemical and Drug Induced Liver Injury ; Cholestasis ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Prevalence ; Prognosis ; Retrospective Studies