BACKGROUND: With the development of neural interventional therapy, the application of covered stents in neural intervention is becoming a topic of general interest.OBJECTIVE: To introduce the structure of stent-graft, and to summary the application of covered stents in clinical treatment of the neural interventional therapy and the shortage of covered stents.RETRIEVAL STRATEGY:The relevant articled were searched for in Pubmed database by researcher of this article with the key words of "stent graft, covered stents, cerebrovascular disease" in English, and with the key words of "covered stent, cerebrovascular disease" in Chinese in VIP database. 223 English and 196 Chinese articles were selected and reviewed primarily. Inclusive criteria: Articles having a close relation with the application of covered stents in neural intervention, especially in cerebrovascular disease, and the latest articles or articles published in authority journals in the same field were chosen. Exclusive criteria: articles with repetitive studies were excluded.LITERATURE EVALUATION: 223 English and 196 Chinese articles were primarily checked by reading titles and abstracts. Among the 31 collected articles, 4 are reviews, 3 are experimental studies and others are clinical studies.DATA SYNTHESIS: Covered stents show special advantages in neural interventional therapy and become a hot spot in present study. There are individual case reports or small group case reports on the application of covered stents in hemorrhagic cerebrovascular disease. It is reported that the covered stent effectively occludes aneurysm, dissecting aneurysm and arteriovenous fistula, keeps patency of the parent artery. The covered stent isolates ulcerated plaque via physical barriers, avoids the abscission of embolus, which can further reduce the development of embolism in percutaneous carotid artery stenting. After releasing covered stents, polytetrafluoroethylene makes the disepiment smooth. Its good biocompatibility reduces thrombosis, and then decreases the incidence of restenosis. Covered stents in vessel for cerebrovascular disease have achieved good effects, but there are some problems in clinic as follows. ①The main shortage of covered stents is to occlude small branch vessels. ②Thrombosis and restenosis occur after covered stenting. ③Covered stents increase the volume of the stent, reduce the compliance and flexibility of the stents, and increase the pushing difficulty and vascular injury. ④Covered stents cannot be used in vessels of less than 4 mm.CONCLUSION: Covered stents for intracranial ischemic and hemorrhagic diseases shows significant outcomes, but there are disadvantages. With the clarification of the related theories and the improvement of new material technology, there will be a brighter future of the application of covered stents for treatment of cerebrovascular diseases.

This report concerns a 4-month-old infant with progressive prominent and redness of his left eye since birth. This report concerns a 4-month-old infant with progressive prominent redness of his left eye since birth. Angiography revealed a congenital pial arteriovenous fistula between the temporal branch of the left posterior cerebral artery and left cavernous sinus through the sphenoparietal sinus, a condition not reported in the literature. The fistula was successfully occluded with two micro-coils by vertebrobasilar approach.
Arteriovenous Fistula/*diagnosis/therapy ; *Cavernous Sinus/radiography ; Embolization, Therapeutic/methods ; Humans ; Infant ; Intracranial Arteriovenous Malformations/*diagnosis/therapy ; Magnetic Resonance Imaging ; Male ; Posterior Cerebral Artery ; Temporal Lobe/blood supply

This paper focuses on the animal experiment of automatic drug delivery based on predictive control for vascular interventional therapy. Improvement of drug delivery system based on predictive control used in simulated experiments was put forward after the presence of time varying parameters and the characteristics of individual differences of animal had been studied. The adaptability of time varying parameters and fault tolerance of the system were also enhanced. Different injection methods were tested on animals. It is proved that higher target blood concentration can be reached while injecting during diastolic than that while injecting during systolic or injecting at a constant speed within the whole cardiac cycle. The results also showed that the improved drug injection system based on predictive control which synchronizes with the cardiac cycle could be applied to clinical trials.
Algorithms ; Animals ; Automation ; Dipyrone ; administration & dosage ; analogs & derivatives ; Forecasting ; Infusion Pumps ; Infusions, Intra-Arterial ; methods ; Pharmaceutical Preparations ; administration & dosage ; Swine

Objective:To study the safety and feasibility of en-bloc lymph node dissection in laparoscopic radical resection for gallbladder cancer(GBC).Methods:The clinical data of 87 patients who underwent laparoscopic radical resection for GBC at Zhejiang Provincial People's Hospital from January 2014 to February 2022 were retrospectively analyzed. There were 26 males and 61 females, aged 67.0 (59.0, 72.0) years old. The patients were divided into the en-bloc dissection group ( n=29) and the non-en-bloc dissection group ( n=58) based on whether en-bloc lymph node dissection was carried out. Differences in general data, tumor characteristics, operation, recurrence and survival were compared between the two groups. Postoperative survival status of these patients was followed-up by telephone. Results:The number of lymph nodes dissected in the en-bloc dissection group was 9.0(8.0, 12.0), which was significantly higher than the 8.0(4.8, 11.0) in the non-en-bloc dissection group ( Z=-2.39, P=0.017). There were no significant differences in age, gender, preoperative blood biochemical indexes, tumor carbohydrate antigen 19-9, tumor stage, nerve and vascular invasion, operation time, intraoperative blood loss, postoperative drainage tube retention time, postoperative hospital stay, and incidences of postoperative complications (biliary fistula, abdominal hemorrhage and abdominal infection) between the two groups (all P>0.05). The median survival was longer in the en-bloc group than in the non-en-bloc group (21 vs. 15 months), and the median relapse-free survival time was 18 months in the en-bloc group compared with 10 months in the non-en-bloc group. However, there were no significant differences in postoperative cumulative survival and recurrence-free survival between the two groups (all P>0.05). Conclusion:En-bloc lymphadenectomy was safe and feasible in laparoscopic radical GBC surgery, with more lymph nodes being removed than the non-en-bloc lymphadenectomy group.

Objective:To compare the early efficacy of proximal femoral bionic nail (PFBN) and proximal femoral nail anti-rotation (PFNA) in the treatment of intertrochanteric fracture in the elderly.Methods:A retrospective cohort study was conducted to analyze the clinical data of 45 elderly patients with intertrochanteric fracture treated at First Affiliated Hospital of Henan Polytechnic University from March 2020 to December 2021, including 13 males and 32 females; aged 70-96 years [(78.6±7.3)years]. According to the AO classification, there were 10 patients with type 31-A1, 16 type 31-A2 and 19 type 31-A3. There were 20 patients treated with PFBN (PFBN group) and 25 with PFNA (PFNA group). The operation time, intraoperaive blood loss, bone healing time, and time to full weight-bearing were compared between the two groups. The tip-apex distance, distance from tail of lag screw to lateral side of intramedllary nail, proximal femoral length and femur neck-shaft angle were compared between the two groups at day 1 postoperatively and at the last follow-up, and their amount of changes between the two time points were also measured. Harris hip score was evaluated at 3, 6 months postoperatively and at the last follow-up. Complications were observed as well.Results:All patients were followed up for 6-21 months [(14.7±3.6)months]. There were no significant differences in operation time, intraoperative blood loss and bone healing time between the two groups (all P>0.05). The time to full weight-bearing was significantly earlier in PFBN group [(7.9±1.2)weeks] than that in PFNA group [(9.1±0.9)weeks] ( P<0.05). At day 1 postoperatively and at last follow-up, the tip-apex distance was (23.4±1.7)mm and (23.3±1.6)mm in PFBN group ( P>0.05), and was (24.5±2.1)mm and (24.3±2.3)mm in PFNA group ( P>0.05); the distance from tail of lag screw to lateral side of intramedllary nail was (8.1±1.1)mm and (11.8±0.9)mm in PFBN group ( P<0.01), and was (7.7±1.0)mm and (12.6±1.6)mm in PFNA group ( P<0.01); the proximal femoral length was (91.3±1.6)mm and (88.5±2.6)mm in PFBN group ( P<0.01), and was (91.4±2.0)mm and (87.6±2.0)mm in PFNA group ( P<0.01); the femur neck-shaft angle was (127.2±2.9)°and (125.7±3.0)° in PFBN group ( P>0.05), and was (128.5±3.0)° and (127.2±3.2)° in PFNA group ( P>0.05). There were no significant differences in the above indicators between the two groups at day 1 postoperatively and at the last follow-up (all P>0.05). The amount of changes in the tip-apex distance and femur neck-shaft angle were (-0.2±0.1)mm and (-1.6±0.7)° in PFBN group, similar with (-0.2±0.2)mm and (-1.5±1.0)° in PFNA group (all P>0.05). However, the amount of changes in the distance from tail of lag screw to lateral side of intramedllary nail and proximal femoral length were (3.6±1.4)mm and (2.7±1.2)mm in PFBN group, significantly lower than (5.2±1.1)mm and (4.0±1.1)mm in PFNA group (all P<0.01). There were no significant differences in Harris hip score between the two groups at 3, 6 months postoperatively or at the last follow-up (all P>0.05). PFBN group had 1 patient with fracture displacement, 2 with compression screw backup and 2 with thigh pain. PFNA group had 1 patient with fracture displacement and 4 with thigh pain. Conclusion:For elderly patients with intertrochanteric fracture, PFBN provides not only earlier full weight-bearing, but also stronger stability of fracture fixation than PFNA.

Objective Using bioinformatics methods to study the immune infiltration mechanism of Primary Sj?gren's syndrome(pSS)and to explore potential target Chinese medicines,which can provide new directions for the clinical treatment of pSS.Methods Gene expression profile microarray dataset of pSS was downloaded from the GEO database,differential genes were screened using R software,and gene ontology(GO)and gene pathway enrichment(KEGG)enrichment analysis was performed on these differential genes.Protein interaction network analysis of differential genes was performed by applying the STRING database,key genes were screened by using Cytoscape,and ELISA for the verification of key genes expression.Immune infiltration and correlation of immune cells in pSS were calculated by CIBERSORT inverse convolution method in 22.Finally,the herbal prediction of key target genes was performed by using the Coremine Medical database.Results A total of 232 differential genes were obtained,of which 207 were up-regulated and 25 were down-regulated.GO was mainly enriched in:leukocyte mediated immunity,lymphocyte mediated immunity,leukocyte cell-cell adhesion,etc;KEGG was mainly enriched in Hematopoietic cell lineage,Primary immunodeficiency,Intestinal immune network for IgA production,Phagosome,Leishmaniasis.Ten key genes were screened:PTPRC,CD19,LCP2,CCR5 and CD69 etc.The hub genes expression in the pSS is the same as that of GSE40611.Immune infiltration showed that memory B cells,T cells CD4 memory activated,and T cells CD4 na?ve were highly expressed in the pSS.Immune cell correlation analysis showed a positive correlation between initial Monocytes and T cells regulatory(Tregs),a positive correlation between Macrophages M1 and B cell na?ve,and a negative correlation between Plasma cells and T cells CD4 memory activated.COREMINE Medical predicted that Ginseng,Panax notoginseng,Tripterygium wilfordii,Burnet,Magnolia,and Strychni may treat pSS.Conclusion The development and progression of pSS are the results of the combined involvement of multiple genes and pathways.Memory B cells,T cells CD4 memory activated,and T cells CD4 na?ve may promote the development of pSS.The predicted Ginseng,Panax notoginseng,Tripterygium wilfordii,Burnet,Magnolia,Strychni may be used as target herbs for the potential treatment of pSS.

Objective:To evaluate the feasibility of abandoning prophylactic abdominal drainage in patients undergoing minimally invasive minor hepatectomy based on a propensity score matching (PSM) study.Methods:Retrospective review of a prospectively collected database of patients undergoing minimally invasive minor hepatectomy from July 2022 to May 2023 at the Department of Hepatopancreatobiliary Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital. A total of 108 patients were enrolled, including 48 males and 60 females, aged (60.8±13.7) years old. According to whether the abdominal drainage tube was prophylactically placed intraoperatively, patients were divided into two groups: the drainage group (with prophylactic placement of abdominal drainage tubes, n=76); the no-drainage group (without prophylactic placement of abdominal drainage tubes, n=32). PSM was used to compare the perioperative data between the groups, including extent of liver resection, intraoperative blood loss, operative time, and postoperative complications. Postoperative survival status within 90 days was followed up through telephone review. Results:Before PSM, the two groups differed significantly on age and the history of hypertension (both P<0.05). After PSM, there were 23 patients in each group. Patients in the two groups showed comparable results regarding the intraoperative parameters including the surgical method, pathological types, the number and maxium diameter of hepatic lesions, the extent and complexity of liver resection, and the duration of hepatic inflow occlusion (all P>0.05). No postoperative intra-abdominal bleeding occurred in either group. The incidences of postoperative complications were comparable between the groups, including fever, bile leakage, incision infection, and abdominal acupuncture for drainage (all P>0.05). After PSM, compared to patients wothout prophylactic abdominal drainage, prophylactic abdominal drainage group showed a decreased white blood cell counts on postoperative day 1 [9.39(6.30, 10.58)×10 12/L vs. 13.19(10.15, 14.90)×10 12 /L, P=0.006] and a shorter length of postoperative hospital stay [4(3, 5) d vs. 5(4, 5) d, P=0.033]. No postoperative death within 90 days occurred in either group. Conclusion:In minimally invasive minor hepatectomy, abandoning prophylactic abdominal drainage could be feasible, which facilitates fast recovery without increasing the incidence of postoperative fever, perihepatic fluid accumulation and postoperative abdominal acupuncture for drainage.