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.

An analysis of typical cases of AIDS infection incurred by blood transfusion suggests that the error-free infection in blood transfusion calls for a social relief mechanism.The authors also made a feasibility analysis of the compensation of medical risk health insurance for such infection,and explored a new way out for resolving the disputes involving medical risk of such infection.

Objective To evaluate the technical method,clinical effect,safety and complication of the endovascular interventional therapy of intracranial A1 segment aneurysms of anterior cerebral artery(ACA).Methods The data of 14 cases with ruptured A1 segment aneurysms received interventional therapy were analyzed retrospectively.All patients were admitted with subarachnoid hem-orrhage (SAH)and classified by Hunt-Hess scale.There were 3 cases of Grade Ⅰ,5 cases of Grade Ⅱ,and 6 cases of Grade Ⅲ. One of fourteen patients was treated by stent implantation alone and 10 patients were treated by coiling alone.The other 3 patients were treated by stent-assisted coiling.Results All the cases were embolized successfully and cured.Angiography immediately after procedure showed Raymond Ⅰ in 1 1 patients,RaymondⅡ in 2 patients and Raymond Ⅲ in 1 patient.In one patient a coil loop was partly left in the parent artery.All of them showed excellent outcome without any serious complication except that one patient suf-fered transient left hemiparesis.Conclusion Endovascular interventional therapy is a safe,effective method in the treatment of the intracranial A1 segment ACA aneurysms.

Objective To study the changes of endothelin-1(ET-1) and calcitonin gene-related peptide(CGRP) in plasma of cerebral vasospasm(CVS) after resection of skull base tumors and the effect of the two factors on cerebral vasospasm. Methods Totally 34 cases were divided into symptomatic cerebral vasospasm group,asymptomatic cerebral vasospasm group and nonvasospasm group after resection of skull base tumors.The blood specimens were obtained from the 34 patients on days 1,3,5,7 and 14 after the resection.The concentration of ET-1 and CGRP was detected by radioimmunoassay;meanwhile,transcranial doppler was recorded.Another 10 normal adult served as control group. Results ① Concentration of ET-1 in plasma elevated from the 1st day after resection of skull base tumors,reaching peak levels on day 5 to day 7,then decreased gradually and nearly recoverd on day 14.Concentration of CGRP in plasma decreased from day 3 after resection of skull base tumors,with the lowest concentration on day 7,then increased gradually and recoverd on day 14.② Concentration of ET-1 in plasma of the three groups was higher than that of normal adult group,while concentration of CGRP of the three groups was lower than that of normal adult group.③ Concentration of ET-1 in plasma in vasospasm groups was higher than that in nonvasospasm group(P