Since the 1960s,endovascular coil embolization has gradually become another treatment for intracranial aneurysms in addition to craniotomy clipping surgery,and in recent years,it has become the preferred method for many neurologists.However,the complexity of intracranial vascular anatomy and the diversity of intracranial aneurysm make the coil embolization alone unable to meet the needs of all intracranial aneurysms.And then some novel materials and techniques emerged,such as coated coils,balloon-assisted embolization,stent-assisted embolization,and covered stents.The principle of covered stents for the treatment of intracranial aneurysms is to place a kind of stents with bio-physical barriers into the parent arteries,while maintaining the patency of the parent artery,thus isolating aneurysms,leading to thrombogenesis inside and finally curing the lesions while maintaining the patency of parent arteries.It has huge advantage in the treatment of wide-necked,huge,dissecting and pseudo aneurysms without important adjacent branch vessels.This article reviews the application situation and the prospects of development of covered stents in the treatment of intracranial aneurysms.

Ovarian cancer is one of the highest mortality rate of gynecologic malignant tumors. Chemotherapy can improve the survival rate of the traditional ovary. In recent years, PARP [poly(ADP-ribose)polymerase]inhibitors in breast cancer susceptibility gene (breast cancer susceptibility gene, BRCA) mutations in patients with ovarian cancer can significantly improve the disease-free survival, may change the prognosis of patients with ovarian cancer. This part of PARP [poly(ADP-ribose)polymerase] inhibitors, inhibiting the repairment of DNA damage in tumor cell, causing DNA damage accumulation, eventually killing tumor cells.In breast cancer susceptibility gene 1 (breast cancer susceptibility gene1, BRCA1)/BRCA2 mutation patients with ovarian cancer, PARP inhibitors and BRCA mutation of the synthetic lethal effect provides a new direction for the development of anti-cancer drugs. Now, many highly selective and sensitive PARP inhibitors have been developed and applied in clinical trials.Although PARP inhibitor monotherapy can produce a therapeutic effect in BRCA mutation in patients with ovarian cancer, but the clinical application is still used in combination with other chemotherapy or radiotherapy. This review is focused on the recent progress in clinical trials of PARP inhibitors in combination with common chemotherapeutic agents.

BACKGROUND:A high incidence of deep vein thrombosis after total hip replacement does great harm to patients,so it is necessary to look for a safe and effective prevention program after total hip replacement to reduce the harm of deep vein thrombosis.OBJECTIVE:To observe the influence of comprehensive prevention scheme on deep vein thrombosis after total hip replacement.METHODS:102 cases undergoing total hip replacement were randomly divided into observation group and control group with 51 cases in each group.Patients in the observation group received the comprehensive prevention program,which is composed of three interventions: sequential cross combined with low molecular heparin,intermittent pneumatic pressure therapy and continuous femoral nerve block analgesia.In the control group,patients received low-molecular-weight heparin for anticoagulation therapy by the doctor according to his clinical experience,or intermittent pneumatic pressure therapy.The occurrence and distribution of deep vein thrombosis were compared in patients of both groups.At the same time,platelet and hemoglobin were recorded.RESULTS AND CONCLUSION:In the observation group,three patients suffered from deep vein thrombosis with an incidence of 6％.In the control group,11 patients affected deep vein thrombosis,with an incidence of 22％.There were significant differences between the two groups (P＜ 0.05).No significant difference in constituent ratio of the distribution of deep vein thrombosis was detected in the distal vein and proximal vein in patients of both groups (P＞ 0.05).Hemoglobin value was lower at 1 day after surgery compared with that pre-operation in the two groups (P＜0.05).Platelet value was lower at 1 day after surgery compared with that pre-operation in the two groups (P＞0.05).No significant difference in hemoglobin and platelet values was detected between two groups at 1 and 6 days after surgery (P＞ 0.05).Results indicated that the comprehensive prevention program containing the sequential and cross combined with low molecular heparin,intermittent pneumatic pressure therapy and continuous femoral nerve block analgesia can significantly reduce the incidence of deep vein thrombosis,and no serious complications occurred,and the effects are affirmative and reliable.

Objective To study cortactin function in cancer cell endocytosis.Methods We applied cortactin siRNA interference to MDA-Mb-231,a human breast adenocarcinoma cell line in which cortactin was over-expressed,and introduced anti-cortactin immunoreagents into the cells with BioPorter system to interfere with cortactin function in vivo.Capture-ELISA assay was used to measure transferrin uptake.We used immunoblot assay to assess the effect of cortactin knock-down and immunoflurescence microscopy to examine the effect of cortactin down-regulation on transferrin uptake.Results Interference of cortactin function in cells resulted in impairment of transferrin endocytosis.Transferrin fluorescent intensity in cytoplasm in cortactin siRNA treated-cells was significantly reduced in comparison to that of mock-treated cells.Less than 50% of cells subjected to cortactin siRNA treatment had normal transferrin uptake.Endocytosis in MDA-Mb-231 cells introduced with cortactin antibodies was impaired as well,showing a 30%～ 60% reduction in transferrin uptake.Conclusion Crtactin,an actin-binding protein,plays an essential role in cell endocytosis.

Objective To compare the clinical application between peripherally inserted central catheterization(PICC) and subclavian central venous catheterization in severely ill patients.Methods A prospective study was carried out in 80 severely ill patients who had been randomly divided into two groups: receiving either PICC(PICC Group,40 patients) or subclavian central venous catheterization(Subclavian Group,40 patients).The success rate,the puncturing time,and the incidence of adverse reactions in the two groups were observed.Results The rate of successful puncture on one session was higher in the PICC Group(92.5%) than in the Subclavian Group(75.0%)(?2=4.501,P=0.034).And as compared with the Subclavian Group,the PICC Group reported a shorter puncturing time(15.7?5.3 min vs 23.9?6.3 min;t=-6.263,P=0.000) and a lower rate of adverse reactions(10.0% vs 27.5%;?2=4.021,P=0.045).Conclusions Use of peripherally inserted central catheterization is simple and safe to perform,superior to subclavian central venous catheterization.

Objective To study the clinical efficacy and safety of bevacizumab combined with TP chemotherapy in platinum recurrent ovarian cancer.Methods34 patients with platinum sensitive recurrent ovarian cancer were seleted as the objects.All patients were treated with bevacizumab plus paclitaxel and cisplatin.The short-term effects, overall survival(OS), progression free survival(PFS) and incidence of adverse reaction during chemotherapy were observed.ResultsThe patients with CR, PR, SD and PD were 3 cases, 24 cases, 5 cases and 2 cases, respectively.The median PFS and median OS of patiens were 12.7months and 26.2 months, respectively.The incidence of decrease in leukocytes, thrombocytopenia, neutrophils, gastrointestinal reactions, elevated levels of transaminase, hypertension, epistaxis, proteinuria, peripheral neuropathy, mucositis were 73.53%, 20.59%, 67.65%, 82.35%, 47.06%, 14.71%, 5.88%, 17.65%, 29.41% and 17.65%, respectively.ConclusionThe bevacizumab combined with TP chemotherapy in treatment of platinum sensitive recurrent ovarian cancer can better relieve the disease, improve the survival time of the patient, the adverse reaction is controllable, and the safety is good, which has the clinical popularization value.

Background In patients with syphilis,one of the common manifestations is uveitis.However,the lack of understanding on syphilic posterior uveitis may result in misdiagnosis and delayed treatment.Objective This study was to assess ocular clinical features,treatment and prognosis in patients who had latent syphilis and presented with posterior uveitis as the initial symptom.Methods A serial cases-observational study was designed.Twelve patients(19 eyes)who were diagnosed as syphilis from September 2011 to January 2013 were retrospectively analyzed.All patients were characterized by initial posterior uveitis before the final diagnosis.The clinical manifestation,management and prognosis were evaluated and analyzed.All patients were informed of this study and consented with the use of their data for this retrospective study.Results The patients presented with initial clinical signs of acute or chronic posterior uveitis and lacked systemic syphilis symptom.Bilateral posterior uveitis were found in 7 patients and unilateral in 5 patients.The dust-like and grey-white opacification in vitreous was seen by threemirror contact lens in all the patients.Mild hyperemia of the optical disc was found in 10 eyes with the unclear peripapillary boundary.Yellow-white lesions were observed in retinas of 7 eyes and retinal punctuate hemorrhage was in 1 eye.Fundus fluorescein angiography demonstrated fluorescine staining or hyperfluorescence of optic disc in all of the 19 eyes,and fluorescein leakage from vein in 18 eyes,retinal pigment epithelium dye pooling in 6 eyes and cystoid macular edema in 11 eyes.Rapid plasma reagin (RPR) test and treponema pallidum hemagglutination assay (TPHA) were performed and presented positive results in all patients.The visual acuity improved in 19 eyes and partly elevated in 2 eyes following a standard therapy for neurosyphilis was used,including penicillin and/or small doses of glucocorticoid.Conclusions The serological examination for syphilis should be considered for patients with unexplained uveitis.Early diagnosis and prompt treatment are important for the improvement of prognosis in syphilitic posterior uveitis.

Objective To study the alteration of hepatocyte growth factor and c-met in the lungs of rats with pulmonary arterial hypertension and its possible underlying mechanisms.Methods Left pneumonectomy plus monocrotaline injection was used for rat PAH model.Rats were executed after measurement of their pulmonary arterial pressure at 1,2, 3 and 4 weeks after MCT injection.Then the right lung and heart were harvested for further analyses.Expression of HGF and c-met was determined by RT-PCR and Western blot.Expression of eNOS and caspase-3 was analyzed immunohistochemically and intrapulmonary TGF-β and ET-1 was analyzed with ELISA.Results Compared with the normal controls, manifestations of right heart hypertrophy and failure, well-elevated pulmonary arterial pressure were observed 28 days after left lung resection and MCT injection.Pulmonary vascular remodeling (i.e., pulmonary fibrosis, hyperplasia of pulmonary arterial endothelial cells and vascular smooth muscle cells in tunica media, as well as decease of vascular density) was observed.Intrapulmonary HGF expression decreased in a time-dependent manner at both mRNA and protein levels 4 weeks after MCT injection, while c-met stayed unchanged.Immunohistochemically, expression of eNOS was reduced and caspase-3 strengthened.On the contrary, ET-1 and TGF-β were obviously up-regulated(P ＜ 0.01).Conclusion Intrapulmonary HGF expression was obviously downregulated in PAH rats, accompanying with reduction of NO and increase of ET-1 and TGF-β expression, while c-met still unchanged.

Objective To explore a new surgical method for the treatment of refractory fistula after breast augmentation and to improve patients healing efficiently.Methods This paper had collected two groups,a total of 178 cases of injected breast augmentation,who had shown the polyacrylamide hydrogel(PAAG)mixture shift,and caused abdominal fistula.Among them,89 cases further adopt new design in the treatment of fistula by using breast muscle membrane tissue flap and improve the effect of fistula treatment after the removal of fistula.And the other 89 cases were token the pure clean the cavity away caused by the abnormal material shift into the chest and abdominal wall.Results It was observed that PAAG widely distributed in the chest and abdominal wall and formatted the fistula connected mammary gland,axillary,chest abdominal wall.The area of lesions lacuna shrink by 80％ for the group used tissue flap after 2 weeks,but those not with tissue flap shrink by 45％(P＜0.01).At 4th week,all the patients of flap group achieved tissue healed,while the completely heal ratio of control group was only 73％.Compared two groups of healing rate,the group with tissue flap was obviously better than ones only with surgical method.Conclusion It suggests that main reasons for the liquidity bag and huge cavity are PAAG mixture shift into thoracic and abdominal wall and formed chronic fistula and connected the chest and abdominal wall.Local muscle membrane tissue flap can obviously promote the chest and abdominal wall fistula healing.

Objective To establish an accurate method for determining the content of three components in Fufang Buwu Syrup. Methods TLC scanner was selected to detect three components with silica gel G thin layer plate. The sample was separated by using cyclohexane-ethyl acetate-methylenechloride-formic acid (3∶1∶1∶0.2),λS=300 nm. Results The linearity between peak area and ferulic acid was achieved in the range of 0.36-0.84μg, psoralen was achieved in the range of 0.12-0.28 μg, emodin was achieved in the range of 0.01-0.05 μg. The average recovery was 100.7%, 100.8%, 101.0%, and RSD was 1.26%, 1.44%, 1.86%, respectively. Conclusion The method is simple and accurate, which can be used for quality control of Fufang Buwu Syrup.