Objective To explore the efficacy and safety of endovascular therapy in the treatment of symptomatic M1 stenosis of middle cerebral artery as well as the causes of perioperative complications.Methods Two hundred fifty-six patients with symptomatic M1 stenosis of middle cerebral artery (＞90％) confirmed by TCD,cerebral CT angiography and DSA was treated by endovascular intervention.The success rate,the changes of stenosis,longterm vascular patency rate,in-stent restenosis rate were analyzed.Results endovascular stent was successfully placed in 251 patients with the M1 part of symptomatic middle cerebral artery stenosis and the successful rate was 98.05％.Fifteen patients had complications (5.86％) which caused neurology deficits and deaths.The degree of vascular stenosis was significantly reduced after stenosis (Before vs After:92.26％±2.11％ vs 15.40％±2.60％).The mean mRS and NIHSS scores was decreased significantly.The average follow-up duration was (21.70±0.80) months,249 patients underwent a second DSA and the mean stenosis was (21.70％±0.80％).Twenty-three patients developed instent restenosis (ISR) and ISR rate was 9.24％.Recurrence ischemic stroke and transient ischemic attacks occurred in 5 patients and recurrence rate was 2.01％.Conclusion Endovascular therapy of symptomatic M1 stenosis of middle cerebral artery is safety and efficacy with low complications.The follow-up results reveal good patency rate and excellent prevention of anterior circulation ischemia.

Objective To explore the efficacy,safety and short-term effects of endovascular therapy in the treatment of the symptomatic high-grade basilar artery stenosis.Methods Two hundred thirteen patients with the symptomatic high-grade basilar artery stenosis (＞90％) confirmed by MRA,CTA or DSA was treated by endovascular intervention,the changes of clinical symptoms,the success rate and short-term follow-up results was analyzed.Results Endovascular stent was successfully placed in 209 patients with symptomatic high-grade basilar artery stenosis and the success rate was 98.12％.The degree of vascular stenosis was significantly reduced after stenosis (Before vs After:93.70％±2.51％ vs 11.60％±3.90％).Eight patients had complications (3.76％) including 7 cases of ischemic stroke and 1 case of subarachnoid hemorrhage.The average follow-up duration was 18.70±3.80 months.Two hundred two patients underwent a second DSA and the mean vascular stenosis was (13.80％±4.20％).Five patients developed in-stent restenosis (ISR),of which one was symptomatic.Conclusion Endovascular therapy of the symptomatic high-grade basilar artery stenosis is safety and efficacy.The 1.5 years follow-up results reveal good patency rate and excellent prevention of posterior circulation ischemia.

Objective:To observe the body fluid and cellular immune function of children with cerebral palsy (CP) in the plateau area, as well as the exchanges of these factors during the comprehensive rehabilitation treatment.Methods:A total number of 144 children admitted to Xining Hospital of Traditional Chinese Medicine from June 2018 to October 2019 were selected as the CP group for comprehensive rehabilitation treatment (consecutive courses). The peripheral blood immunoglobulin/complement (IgA, IgG, lgM, C3, C4) level, T lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/CD8+) and neuron-specific enolase (NSE) content was examined in the clinical specimens before and after treatment by using the immunoturbidimetry, flow cytometry, electrochemiluminescence analysis according to the Gross Motor Function Classification System (GMFCS) and Gross Motor Function Test Scale (GMFM-88). Children were divided as the different degrees to evaluate the rehabilitation efficacy. A total number of 50 healthy children taken a health check/physical examinations during the same period were considered as the control group. For statistical Analysis, the χ2 test and independent sample t test were performed. Results:The levels of humoral immune IgG, IgA, IgM, C3 and C4 in CP Group [(6.42±1.05), (0.64±0.13), (0.89±0.13), (0.80±0.08), (0.17±0.03) g/L, respectively] in CP groups′ children were lower than those in the control group [(10.25±0.62), (1.04±0.06), (1.06±0.17), (1.04±0.04), (0.27±0.04) g/L, respectively]. The humoral immune IgG and IgA levels [severe (5.40±0.69) and (0.55±0.09)g/L, moderate (6.63±0.30) and (0.66±0.14)g/L, mild (7.57±0.63) and (0.74±0.09)g/L, P<0.05] were also related to the children with CP of different GMFCS grades. Moreover, the level of T lymphocyte subsets (CD3+,CD4+,CD8+,CD4+/CD8+) in the CP group were not statistically different to that in the control groups children. Receiving the rehabilitation treatment, the levels of serum humoral IgG and IgA in CP Group (7.69±1.14) and (0.79±0.17) g/L were significantly enhanced; whereas the serum NSE (12.82±2.49) μg/L was lower than that before treatment (18.57±3.08) μg/L, and the total score of GMFM-88 (121.35±26.51) was higher than that before treatment (101.04±27.62). The differences were statistically significant ( P<0.05). IgM, C3, C4 and T lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/CD8+) had no significant difference compared with those before treatment ( P>0.05). Conclusions:Children with CP at high altitude have abnormal humoral immune function. IgG and IgA may be related to the severity of CP and neuronal damage. Comprehensive rehabilitation can not only improve the motor function of children with CP, relieve neuronal damage, but also enhance their humoral immunity status.