BACKGROUND:Cerebrovascular stent may destroy the vessel walls,which can lead to vascular restenosis.There are different versions about the safety,pathologic pharmacology reasons and clinical effect.OBJECTIVE:To evaluate the safety and short-term effect of endovascular stent implantation for symptomatic artery stenosis.METHODS:Totally 20 patients with total 22 lesions diagnosed symptomatic artery stenosis were treated with endovascular stenting.The vascular stenotic lesions involved middle cerebral artery in 6 cases,internal carotid artery in 6 cases,vertebral artery in 4 cases,basilar artery in 3 cases and vertebro-basilar artery in 3 cases.The length of vascular stenotic lesions was 3-10 mm with the average of 7 mm.Both balloon and self-expandable stents were used in 12 cases with embolus protection device.RESULTS AND CONCLUSION:All of the 22 stents in 20 patients were placed successfully in one time.After stent implantation,the vascular angiography showed that the vessels were reformed obviously with the degree of stenosis no more than 20%.The perfusion in cerebrum was improved in parenchymal phase and the symptom was also improved clearly.At 6-24 months follow-up,20 patients never had cerebral ischemia.With follow-up for 12-24 months in 7 patients,digital subtraction angiography displayed that intima hyperplasia was occurred in stent in one patient with no symptom.The stenotic vascular were unobstructed and no intima hyperplasia by transcranial Doppler examinations.The results demonstrated that endovascular stent implantation is a safe and effective treatment for intracranial symptomatic artery stenosis,while its long-term effect needs further study.

Objective To summarize the experience in nursing patients with gut leak after liver transplantation. Methods Two patients with recurrent gut leakafter liver transplantation underwent surgical repair. The nursing measures included strict observation of postoperative disease, observation of drainage fluid and abdominal signs, early nutritional support, good psychological nursing and health education. Results Gut leak occurred in the two cases again after liver transplantation.One case was treated with repair again and the other with end-stage ileotomy and ileostomy. The patients were discharged after medication and nursing care. Conclusions The close postoperative observation of the disease, observation of drainage fluid and abdominal signs can prompt the discovery of intestinal re-perforation.The early nutritional support plays an important role in the rehabilitation of patients with gut leak after liver transplantation.Mental care and health education can enhance patient's confidence in treatment.

Objective: To explore the related factors for primary hepatic carcinoma (PHC) caused by chronic hepatitis B (CHB) and hepatitis C (CHC). Methods: According to the principle of cross-sectional study, a cluster random sample method was used, a total of 366 chronic hepatitis patients in hospitals were recruited from three provincial tertiary hospitals in Shanxi, Henan and Jilin between July 2016 and October 2016, respectively. Using a self-designed unified questionnaire, face-to-face interviews was conducted on subjects, including sex, age, alcohol consumption, coffee consumption, green tea consumption, fish consumption, smoking, HBV/HCV diagnosis and treatment, diabetes mellitus, family history of PHC (whether PHC in first-degree relatives), etc. Multivariate unconditional logistic regression were performed to identify the related factors for PHC with CHB and CHC. According to the clinical diagnosis the patients were divided into a chronic hepatitis group (not developing to PHC) and a PHC group. Results: Among 366 cases patients, 287 (78.4%) cases were male, 79 cases were female (21.6%), average age was (52.7±9.3) years. 202 cases were chronic hepatitis group, 164 cases were PHC group. Multivariate unconditional logistics regression analysis indicated that alcohol consumption (odds ratio (OR)=2.11, 95%CI: 1.18-3.75), family history of PHC (OR=5.12, 95%CI: 2.60-10.08) were positively correlated with the development of PHC in chronic b, green tea consumption (OR=0.45, 95%CI: 0.23-0.88), antiviral treatment (OR=0.19, 95%CI: 0.11-0.32) were negatively correlated. Alcohol consumption (OR=3.98, 95%CI: 1.14-13.85) was positively correlated with the development of PHC in chronic c, antiviral treatment (OR=0.14, 95%CI: 0.04-0.50) was negatively correlated. Conclusion Alcohol consumption, family history of PHC, green tea consumption and antiviral treatment were the related factors for the development of PHC in chronic hepatitis b. Alcohol consumption and antiviral treatment were the related factors for the development of PHC in chronic hepatitis c.