Aim To observe the effect of sodium nitrop russide (SNP)on glial fibrillary acidic protein(GFAP) synthesis in the gerbil hippocampus. Method lmmunofluorescent histochemical staining method was used. Result SNP increased GFAP synthesis in rediatum layer,molecular layer and dentate gyrus.There were not GFAP positive cells in rediatum layer and mol ecular layer.Number of GFAP positive cells related to dose of SNP.Conclu sion SNP increased GFAP synthesis.

Objective To analyze the clinical effects of continuous epidural anesthesia and psychological intervention in painless labor. Methods From June 2016 to December 2016110 cases of maternal treatment in Ningbo city town of dragon longsai hospital as the research object, randomly divided into control group and observation group, control group of women to provide continuous epidural anesthesia, the observation group in continuous epidural anesthesia combined with psychological intervention measures. Results The two groups of pregnant women at different time scales VAS score, duration and other indicators, the data into the SPSS software, given the corresponding analysis and draw conclusions. Results The two groups of pain VAS score had no significant difference, the observation group each time after analgesia VAS score decreased than the control group(P<0.05); the first stage of the observation group was shorter than the control group (P<0.05), there was no significant difference between the 2 groups of second, third labor time. Conclusion Conclusion Epidural anesthesia and psychological intervention combined with painless labor have good analgesic effect and shorten the first stage of labor. .

Objective To evaluate the application of percutaneous suture-mediated closure device (Perclose ProGlide) in patients undergoing percutaneous endovascular aortic procedures.Method From Apr 2011 to Jun 2012,23 patients underwent percutaneous endovascular aortic procedures.The stent delivery system used included one 24Fr,twelve 22Fr,two 20Fr,one 18Fr,two 16Fr,four 14Fr,one 10Fr and four 6Fr.The success rate,complications and the technical feasibility was analyzed.Result The success rate was 93.3％ (28/30),in which two patients were converted to open surgery because of severe stenosis and bleeding of femoral artery.There was no hemorrhage,hematoma,false aneurysm,thrombosis,and serious artery stenosis during the follow-up period ( 8 ± 4 months).Conclusions Percutaneous suture techniques is safe and effective in patients undergoing percutaneous endovascular aortic procedures.Percutaneous suture techniques can be safely used to the branch of aortic arch.

Objective To describe the CSP genotypic profile in clinical isolates of Aspergillus fumigates from different regions of China,and to investigate if there is a difference in antifungal susceptibility among A.fumigates of different CSP genotypes and from different regions.Methods Totally,112 A.fumigates strains clinically isolated from Fujian,Shanghai,Hebei and Beijing were included in this study,and identified according to macro-and micro-morphological characters,growth temperature and β-tubulin sequence.Classic A.fumigatus strains were typed according to CSP gene sequence.The minimal inhibitory concentrations (MICs) of voriconazole,itraconazole and amphotericin B to A.fumigates were determined in accordance with the National Committee for Clinical Laboratory Standards (NCCLS) M38-A protocol.Results All the strains were identified as classic A.fumigates,and fall into 11 CSP genotypes.The most common genotypes were t04A (n =32),t03 (n =17) and t01 (n =24) in all the strains,tl0,t04A and t01 in Fujian,t04A and t01 in Shanghai,t01,t03 and t04A in Hebei,t02,t04A,t01and t03 in Beijing.One A.fumigatus strain was identified as a new CSP type t25 in Fujian,which showed no obvious difference in morphology,growth rate or appropriate growth temperature from the other CSP genotypes of A.fumigatus strains.No statistical difference was found in the susceptibility to amphotericin B,itraconazole or fluconazole among different genotypes of A.fumigates,whereas the MICs of itraconazole were significantly lower in A.fumigates isolates from Fujian than in those from the other three regions.Conclusions The CSP genotypic profile of A.fumigates varies in clinical isolates from different regions.No significant difference is observed in the susceptibility to amphotericin B,itraconazole or fluconazole among different CSP genotypes of A.fumigates,but the susceptibility to itraconazole is somewhat different between A.fumigates strains from different regions.

A vascular closure device (VCD) is a medical apparatus which is used for stopping bleeding at the puncture point after percutaneous vascular puncturing management. According to its principles , these devices can be categorized into active closure device, compression-assisted device and local hemostatic plaster. The use of these devices can shorten the time of hemostasis, the time of limb immobilization, and the time of hospitalization; it can also reduce the damage to the patient, improve patient’s comfort, and reduce the work load of the medical staff as well. But each VCD has its own applicable scope and learning curve , thus it might cause serious complications when it is improperly used. Therefore , in using VCD the interventional physicians should be familiar with the characteristics of each special VCD and have enough knowledge concerning the treatment of the common complications. This paper aims to make a comprehensive review of the closure device manufacturer data and the relevant literatures recently published so as to make a brief introduction of the principle, characteristics, scope of application and practical tips of several common vascular closure devices.

Objective To evaluate the feasibility of endovascular repair for retrograde type A aortic dissection.Method 35 patients of retrograde type A aortic dissection admitted to Peking University People's Hospital from December 2001 to March 2014 were treated with endovascular repair.There were 33 males and 2 females with mean age of 46 ± 9 years.29 were on acute stage,2 on subacute stage and 4 on chronic stage.The entry tear was in the descending thoracic aorta in 32 cases,between the left subclavian artery and the left common carotid artery in one,and between the left common carotid artery and the innominate artery in two.Results Entry closure was achieved in all patients with a covered stent.2 patients died in 30 days postoperatively (5.7％).1 patient with two chimney developed acute renal artery embolized which was infused by false lumin (2.9％).One patient developed transient paraparesis after graft deployment(2.9％).During the follow-up period,the aortic remodeling is perfect,no entry tear was noted in the ascending thoracic aorta.All the endografts for preserving supra-aortic branches were patent.Conclusions The endovascular repair for retrograde type A aortic dissection is feasible and effective.

SUMMARY An involved internal iliac artery is usually embolized when performing endovascular aneu -rysm repair for aortoiliac or isolated iliac artery aneurysm .This can lead to complications such as buttock claudication ,colon ischaemia and erectile dysfunction .Iliac branch device ( IBD ) is an endograft de-signed specifically for iliac bifurcation to preserve internal iliac flow .It was performed with high technical success rates and encouraging mid-term patency .Here we report a case of right iliac aneurysm developed 3 years after endovascular aneurysm repair for an aortoiliac aneurysm , with the patient ’ s left internal ar-tery been sacrificed then .Using a handmade IBD , we excluded the aneurysm without occlusion of the ip-silateral internal iliac artery or any type of endoleak .Both the design and deployment of this IBD are dis-tinctive that we would like to share our experience with all the colleagues .

Objective To evaluate the surgical results for patients with lower-extremity arteriosclerotic occlusive disease. Methods We performed a respective analysis of 358 patients who underwent various consecutive surgical treatments including open artery reconstruction and intervention in our hospital between 2002 and 2007.Results In this study,358 patients(mean age 66 ± 10;293 male,65female)experienced a total of 413 surgical interventions including traditional bypass,interventional surgery and amputation.Postoperatively 310 patients(86.8%)were followed up from 6 months to 64 months.The 1-year,2-year and 3-year primary patency rates of iliac balloon angioplasty and stent placement were significantly higher than that of femoropopliteal balloon angioplasty and stent placement(P＜0.01),but not higher than that of aortoiliac or aortofemoral bypass(all P＞0.05).The 2-year and 3-year primary patency rates of femoropopliteal bypass above knee were significantly higher than that of femoropopliteal bypass below knee(P＜0.01),but that was not the case in 1-year group.There is no statistical difference in 1-year primary patency rates between femoropopliteal balloon angioplasty and distal popliteal balloon angioplasty (P＞0.05).Amputation rate was 8.7%(37/358).Perioperative mortality was 3.9%(14/358).Mortality during follow-up period was 6.4%(23/358).Conclusion A satisfactory result can be obtained in most patients with the lower-extremity arteriosclerotic occlusive disease by using the appropriate surgical treatment.

Objective To evaluate the management of wrong coverage of the left common carotid artery ( CCA ) during interventional treatment of type Ⅲ aortic dissection by stented graft. Methods Coverage of the left CCA occurred in four cases during endovascular repair of type Ⅲ aortic dissection using stented graft. All four cases were male. The ages ranged from 37 to 45 years old with the average of 41. The first case was due to moving proximally of the first stented graft during delivery of one more cuff because of endoleak. Recanalization of the left CCA and subclavian artery ( SA) was acquired through sliding distally of the stented graft with the help of an aortic balloon. Coverage of the left CCA and SA in the second case was due to jumping-forward of stented graft during deploying, we dragged the stented graft distally through the pigtail catheter introduced from the left brachial artery with the help of a trap device. Then, the covered left CCA and SA were recanalized. The 2/3 left CCA was covered because of mislocation of the left CCA for the 3rd case. We recanalized the covered left CCA using chimney technique with the exposure of the left CCA. For the 4th case, half the innominate artery, the left CCA and SA were covered because the performer mistake the stented graft without naked stent as one with proximal naked stent. A bypass of assending aorta to bi-carotid arteries and the left axillary artery was performed using vascular graft one month after the endovascular repair. Result The proximal intimal entry was sealed successfully in all four cases. No endoleak, cerebral infarction and ischemia of the left upper limb occurred. Conclusion In cases of wrong coverage of carotid artery during endovascular repair of type Ⅲ aortic dissection, the CCA must be recanalized as soon as possible through surgical or interventional treatment in order to avoiding cerebral ischemia.

Objective:To compare total percutaneous access using preclose technique with femoral ar-tery cut-down in endovascular aneurysm repair (EVAR)and assess the safety and feasibility of preclose technique.Methods:In the study,81 cases undergoing EVAR from Dec.2011 to Nov.2014 in Peking University People’s Hospital were retrospectively reviewed.Preoperative CT angiography (CTA)showed presence of infrarenal abdominal aortic aneurysm or descending aortic aneurysm in all the cases.The maximum diameter of aneurysm >4.5 cm met the indications for surgical treatment.The conditions of bi-lateral femoral artery and iliac artery CTA showed were good,and there was no moderate or severe steno-sis,nor was there any severe calcification in anterior wall of femoral artery.Not only were the cases fit for percutaneous endovascular aortic aneurysm repair (PEVAR),but also feasible with open endovascular aneurysm repair (OEVAR).According to the intention of the patients about the surgical incision,the ca-ses were divided into group PEVAR and group OEVAR.The data of the general situation,operation time,blood loss,technical success rate,length of hospital stay after procedure and wound complications were analyzed statistically.Results:In the study,44 cases (78 incisions)were enrolled in group PEVAR and 37 cases (65 incisions)in group OEVAR.There was no significant difference between the two groups in age,gender,body mass index (BMI),accompanying diseases,average number of stents and outer diameter of stent delivery system.Average operation time of group PEVAR was less than that of group OEVAR [(119.1 ±102.0)min vs.(163.6 ±61.9)min,P =0.025].The blood loss in group PEVAR was less than that in group OEVAR [(64.7 ±97.0)mL vs.(98.6 ±88.3)mL],but there was no significant difference (P =0.106).There was no difference in the technical success rate (94.9% vs. 95.4%,P =1.000).The average length of hospital stay after procedure was significantly shorter in group PEVAR [(7.8 ±2.8)d vs.(12.3 ±7.2)d,P <0.001].There were 2 cases with subcutaneous hematoma of wound in group PEVAR and 7 cases of wound complications that occurred in group OEVAR including 3 cases with lymphatic leakage,3 cases with lower limb ischemia and 1 case with subcutaneous hematoma.The analysis showed that PEVAR could reduce the wound complications (2.6%vs.10.8%), but there was no significant difference between the two groups (P =0.079).Conclusion:Using preclose technique in EVAR is safe and effective.It can shorten the operation time and length of hospital stay after procedure.