OBJECTIVE To assess the treatment reliability of covered stent for carotid artery blowout after head and neck tumors resection. METHODS Five cases with postoperative rupture of carotid artery invaded by the head and neck tumor were reviewed. They presented with life threatening massive neck or oral bleedings. All of them were treated with self expanding covered stents through intervention therapy approach. RESULTS The covered stent were successfully deployed in the target arteries in all cases,the instant isolation effect was quite satisfactory. After treatment, angiography showed successful occlusion of the pseudoaneurysm, patency of carotid artery lumen, and significant improvement of clinical symptoms without neurologic dysfunction. Following up 2 to 36 months, 3 patients were alive with no disease, two patients died of recurrence. CONCLUSION For the treatment of carotid blowout, endovascular occlusion with covered stent is a minimally-invasive, safe and reliable methods.

Objective To assess the influence between managements in emergency room(ER) andoutcome of severe traumatic brain injury (TBI),in order to provide inference for treatment.Methods A retrospective analysis was performed in severe TBI patients and recorded next indexes.(1) The managements in ER,including endotracheal intubation and oxygenation,fluid resuscitation,and mannitol intake.(2) The vital signs arriving at ICU,including systolic pressure and blood oxygen saturation.(3) Prognostic indicators including inhospital mortality and days during ICU,the scores of Glasgow outcome scale (GOS) at discharge and 6 months after injury.Results In 140 severe TBI patients,65 patients (46.4％) died during ICU.The mortality of patients with endotracheal intubation [65.0％ (39/60)] was significantly higher than that without endotracheal intubation [32.5％(26/80)](P＜ 0.01).The mortality in whether fluid resuscitation and using mannitol had no significant difference [44.7％ (46/103) vs.51.4％ (19/37),49.2％ (31/63) vs.44.2％ (34/77)] (P ＞0.05).In days during ICU,there was no significant difference among the three treatment measures (P＞ 0.05).In GOS grade at discharge and 6 months after injury,the proportion of 4 and 5 grade were 8.3％ (5/60) and 25.0％ (15/60) in patients with endotracheal intubation,while 27.5％ (22/80) and 52.5％ (42/80) in patients without endotraeheal intubation (P ＜ 0.01).In fluid resuscitation and using mannitol patients,there were no significant difference(P ＞ 0.05).Conclusion Treating severe TBI patients in ER,endotracheal intubation should be carefully chosen,fluid resuscitation and mannitol may not be given.

Objective To investigate the effect of early combined functional exercise on lower limb rehabilitation of vessel bridge taken in coronary artery bypass surgery. Methods From January to October 2017,90 patients undergoing coronary artery bypass surgery were randomly divided into control group and experimental group by coin toss, with 45 patients in each group. The control group was given routine nursing care, and the experimental group was given early combined functional exercise (foot dorsiflexion, ring rotation exercise and straight leg raising exercise) on the basis of routine nursing care. The difference of correlation index between two groups was compared. Results In the experimental group, the number of swelling in the thigh, crus and ankle were 20, 25 and 35 respectively; the control group was 32, 35, 43, the difference was statistically significant(χ2=6.55, 5.00, 8.38, P<0.05). The remission of limb swelling in the experimental group was also better than that in the control group(P<0.01). The incidence of limb wound complications: 6 cases in the experimental group, 18 cases in the control group(χ2=11.79,P<0.01));limb muscle strength grade Lovett:experimental group 0 case with grade 3,19 cases with grade 4,26 cases with grade 5,control group 9 cases with grade 3,26 cases with grade 4,10 cases with grade 5, there were significant differences between two groups (χ2=17.20, P<0.05). The limb comfort score,postoperative bed time,postoperative hospital stay was(7.11±1.15)points,(5.28±1.07)d, (11.04±2.01)d in the experimental group and(5.18±1.13)points,(6.97±1.21)d,(12.67±1.59)d in the control group,the differences were significant(t=-8.02,6.97,4.23,P<0.01). Conclusions To carry out early functional exercise can not only take angiogenesis effectively reduce limb swelling rate after coronary artery bypass grafting,relieve the severity of limb swelling,but also can reduce the incidence of incision complications,promote the recovery of limb muscle strength,shorten the postoperative recovery time and postoperative hospitalization time,is worthy of promotion and use in clinical nursing work.