Subclavian artery pseudoaneurysm that induced from central venous catheterization through the internal jugular vein is relatively uncommon. However, the management of subclavian artery pseudoaneurysm remains a challenge because of their non-compressibility of deep locality and relationship to important surrounding anatomy, such as the origin of vertebral artery. In this paper, the authors report a patient with larger iatrogenic subclavian arterial pseudoaneurysm near the origin of vertebral artery, that was treated successfully by endovascular covered stent and coils.

Objective To investigate the clinical efficacy and safety analysis on the different doses of rivaroxaban in treatment of left ventricular apical thrombus.Methods 87 patients with left ventricular apical thrombus were randomly divided into warfarin group (n =21 ),rivaroxaban 1 group (n =22),rivaroxaban 2 group (n =21 )and rivaroxaban 3 group(n =23).Patients in the warfarin group were given the doses of warfarin 2.5mg once daily,and the doses were adjusted according to INR.Patients in the rivaroxaban 1 group were given the doses of rivaroxaban 10mg once daily.Patients in the rivaroxaban 2 group were given the doses of rivaroxaban 20mg once daily.Patients in the rivaroxaban 3 group were given the doses of rivaroxaban 15mg twice daily for 21d,then followed by 20mg once daily. Patients in the four groups were followed up for 3 months.The percent reduction of D -dimmer at taking drug 3d,D -dimmer normal time,left ventricular apical thrombus disappearing time,the number of disappearance and INR compliance rate were recorded.The occurrences of thromboembolic events and bleeding events in the four groups were recorded. Results The percent reduction of D -dimmer at taking drug 3d in the rivaroxaban 1 group,rivaroxaban 2 group and rivaroxaban 3 group were higher than the warfarin group,and the rivaroxaban 3 group were higher than the rivaroxaban 1 group and rivaroxaban 2 group,the D -dimmer normal time and thrombus disappearing time in the rivaroxaban 1 group,rivaroxaban 2 group and rivaroxaban 3 group were lower than the warfarin group,and the rivaroxaban 3 group were lower than the rivaroxaban 1 group and rivaroxaban 2 group,the differences were statistically significant(F =8.443,19.319,35.475,all P <0.05).The numbers of INR compliance in the rivaroxaban 3 group were higher than those in the warfarin group,the differences were statistically significant[18cases(78.3%)vs.9cases(42.9%),χ2 =5.803,P <0.05].There was 1 case of patient appeared minor bleeding in each rivaroxaban 1 group and rivaroxaban 3 group.The occurrence rates of thromboembolic events and bleeding events in the rivaroxaban 1 group,rivaroxaban 2 group and rivaroxaban 3 group were lower than those in the warfarin group,but the differences were not statistically significant(χ2 =0.732,2.357,all P >0.05).Conclusion Rivaroxaban applied to treatment of left ventricular apical thrombus was safe and effective,and without increasing embolism and bleeding events.And treatment plan of the doses of rivaroxaban 15mg twice daily for 21d,then followed by 20mg once daily was superior.

Anticoagulation, which has been used in clinical practice since 1940's, is one of the important measures in the prevention and treatment of cerebrovascular diseases. This article reviews the progress in anticoagulation for ischemic cerebrovascular diseases by introducing a series of large, important, international, randomized controlled clinical trials in the past 20 years (particularly in the recent 10 years).

The changes of skeletal muscle mitochondral monoamine oxidase (MAO) activity in rats fed with low Se grains from a Keshan-disease area were observed. The rats were killed at the time for feeding 30, 60 and 90 days respectiely. The mitochondrium of skeletal muscle was isolated MAO activity was determined with fluorescent methed. The results showed that in low-Se group the mitochondrial MAO activity was significantly decreased only at the time for 90 days feeding however GSH-px activity in red blood cells and Se content in plasma were significantly decreased at all experimental period as compared to Se-supplemented or stock died group.

0.05), although there were more patients with large area anterior infarction and enlarged left ventricle in the DEF group (P

0.05),but incidence of recurrent angina was higher in NHT group(P

0.05).Conclusion Certain changes have been found in mental health of Chinese standby peacekeepers,such as expectancy anxiety,depression,neurasthenia,interpersonal sensitivity etc.

Objective To evaluate the radiation method and resuh of 450 patients received TBI(total body irradiation).Methods Single-dose Measurement was used to mark dose of TLD(thermo luminescence dosimeter).The values of actual dose in body midline were evaluated by calculating and correcting mean dose of incidence and emergence.Radiation methods:In four-field Irradiation.diagonals of fields coinside with the longitudinal axis of the patients,patient in supine and lateral positions received two pairs of parallel opposite radiation.Scheme of TBI came from a preparative radiation about one week before,and this four-field and equal-in-dose(about 10%of TBI)preparative radiation offered US the optimal scheme with aminimal dose non-uniformity by adjusting different dose proportion of supine and lateral position.In small field irradiation,patients received one pair of parallel opposite radiation from lateral side sitting on a special stool with backrest,the stool can be rotated CW or CCW,pedals can be move forward or backward and fixed.In opposite lateral irradiation,similar to four-field irradiation,patients received one pair of horizontal opposite radiation only in supine position.Five of these patients received FTBI(Fractional TBI). Results The average non-uniformity in midline of patients in four-field irradiation group(87 patients).small field irradiation group(91patients)and opposite lateral irradiation group(272 patients)is respectively ±8.1%,±7.4% and ±4.9%. Conclusions It iS a important process for QA and Qc to measure the dose of incidence and emergence real-timely with TLD or semiconductor dosimeter.We can adopt small field irradiation when the field iS not large enough to contain the patient from head to foot,and it showed advantages over four-field irradiation in treatment process and outcomes.We found the uniformity in body midline would be much better in supine position with diagonal＞180 cm than that in four-field irradiation and small field irradiation with diagonal＜110 cm.We compared supine position irradiation with opposite lateral irradiation,only to find which has its strong point.And actually we considered that FTBI treatment booth can be used more often in anterior and posterior parallel fields irradiation,patient semi-sitted,repeatedly received forward and backward radiation. In spit of not possessing radio-biological advantages as FTBI,STBI(Single TBI)is still a practical form of TBI.

Objective To determine the preventive effect of Celecoxib on postoperative adhesion formation and its mechanism. Methods We divided 80 SD rats into 5 groups: Groups A, B, C, H and S. Rats in Groups A, B, C and H received the operation of peritoneum rubbing to promote adhesion formation. Group S underwent sham operation. Rats in Group B were given Celecoxib of 40 mg/(kg·d), those in Group C were also given Celecoxib of 20mg/(kg·d), and those in Group H were given sodium hyaluronate (HA) during the operation. On the 8th and 15th postoperative day, half of the rats were sacrificed, the extent of adhesion formation was assessed and the adhesive peritoneum was subjected to immunohistochemistry with VEGF and CD_(34). Results The extent of postoperative adhesion differed significantly among the five groups (P<0.01). Groups B and C had significantly fewer adhesions than Groups H and A. VEGF was expressed most highly in Group A, followed by Groups H, C and B, and most weakly in Group S. CD34 was expressed most highly in Group A, followed by Groups H, C and B, and most weakly in Group S. Conclusion Celecoxib provides durable inhibition of intra-abdominal adhesions in a murine model compared with HA. The mechanism of preventing intra-abdominal adhesion via inhibiting COX-2 is possibly through down-regulated expression of VEGF and reduced microvascular density.

To meet the cultivation objectives of postgraduate of anesthesiology from TCM colleges, the anesthesiology department carried out reform and exploration on cultivation program.This method has trained professionals of anesthesiology with the features of integrated traditional and western medicine knowledge.