Objective To discuss the feasibility,safety and validity of ViabahnTM self-expanding covered stent in endovascular repair of femoral pseudoaneurysm caused by intravenous drug injection.Methods The clinical data of 9 patients with femoral pseudoaneurysm caused by intravenous drug injection,who were admitted to authors' hospital during the period from April 2014 to April 2015,were retrospectively analyzed.The pseudoaneurysms were located at the common femoral artery in 6 patients and at the superficial femoral artery in 3 patients.Endovascular repair with ViabahnTM self-expanding covered stent was performed in all the 9 patients.The intraoperative angiographic findings,the sizes of the implanted stents,and the manifestations of the angiography performed immediately after stent implantation were recorded,after operation,the patients were kept under close observation to evaluate the improvement of clinical symptoms,the effect of pseudoaneurysm repair,and the occurrence of endoleak,stent infection,in-stent stenosisand fracture of stent.Anti-infection treatment was employed both before and after the stent implantation;after the stent implantation debridement and/or drainage for soft tissue infection area of inguinal region was adopted.Results Successful implantation of ViabahnTM self-expanding covered stent was accomplished in all 9 patients,with a technical success rate of 100％.Angiography performed immediately after stent implantation showed that complete repair of pseudoaneurysm cavity was obtained in all 9 patients,the distal segment of the parent artery was patent,and no endoleak occurred.The patients were followed up for 6-12 months,and limb salvage was successful in all patients,no intermittent claudication or muscular atrophy occurred.CT angiographyreexamination showed that no endoleak,stent infection,stent fracture or in-stent stenosis occurred.Conclusion Under the conditions of adequate anti-infection,local debridement and drainage,the use of ViabahnTM self-expanding covered stent can promptly close the break of femoral pseudoaneurysm to save the patient's life.Because of the excellent qualities,such as flexibility,adhesion and patency,of ViabahnTM self-expanding covered stent,the postoperative occurrence of intermittent claudication,stent fracture and in-stent stenosis can be effectively reduced.It is expected that ViabahnTM self-expanding covered stent may become one of the vascular reconstruction methods for femoral pseudoaneurysm caused by intravenous drug injection,although its long-term curative effect needs to be further observed and verified.

Objective To compare the long-term efficacy of the traditional open surgery (OSP) with the thoracic endovascular aneurysm repair (TEVAR) in the treatment of patients with the complicated Stanford B aortic dissection. Methods The retrospective analysis of the clinical data was conducted in 118 patients (OSP 45 vs. TEVAR 73) with the complicated type B aortic dissection from January 2004 to January 2015. The long-term survival rate was compared between the two groups and the influencing factors of the postoperative survival was analyzed by using the Cox-regression analysis. Results Significant differences in age, sex and operation time were observed between the two groups (P < 0.05, P < 0.01); No significant difference in the benefit of long-term survival was found between the two groups (P > 0.05). The refractory hypertension and preoperative aortic overall diameter > 55 mm were the risk factors for the long-term survival (P = 0.021, OR = 11.1, 95%CI:1.428 ~ 86.372; P = 0.001, OR = 4.5, 95%CI: 1.842 ~ 11.346). Conclusions Compared with OSP, no obvious advantage of TEVAR was shown in the ten-year overall cumulative survival. In view of the influence factors of refractory hypertension and the aortic diameter for the long-term survival , we should pay attention to the blood pressure control and the performance of endovascular repair technology whether pre- or post-operation.

Objective To investigate the value of modified NIHSS and MRI-PC-ASPECTS for the long-term prognosis in posterior circulation ischemic stroke. Methods Seventy eight patients with posterior circulation ischemic stroke were divided into two groups depended on MRS: good outcome group and bad outcome group. General information of patients was collected and vascular risk factors, NIHSS, MRI-PC-ASPECTS of the two groups were compared. Results The scores of admission NIHSS and highest NIHSS of bad outcome group were higher than that of good outcome group. The scores of MRI-PC-ASPECTS, T admission NIHSS (42-admission NIHSS) and T highest NIHSS of bad outcome group were lower than that of good outcome group (P<0.05). The areas under the ROC curves of MRI-PC-ASPECTS+T highest NIHSS, MRI-PC-ASPECTS, T highest NIHSS and T admission NIHSS were 0.907, 0.821, 0.870, 0.744, respectively (P<0.05). Conclusion NIHSS and MRI-PC-ASPECTS can predict the functional prognosis in patients with posterior circulation ischemic stroke.

To explore the mechanism of the absorption of flavonoids from Abelmoschus manihot flowers, in situ intestinal recirculation was performed to study the effect of the absorption at different concentrations and different intestinal regions. To evaluate the conditions of the absorption of six flavonoids from Abelmoschus manihot flowers, the concentrations of Abelmoschus manihot in the perfusion solution were determined by HPLC at predesigned time. And we have investigated the inhibitory effect of six flavonoids from Abelmoschus manihot flowers on P-glycoprotein (P-gp) drug efflux pump. The results demonstrated that the absorption rates of flavonoids from Abelmoschus manihot flowers are not significantly different (P > 0.05) at various drug concentrations, the absorption of flavonoids from Abelmoschus manihot flowers is a first-order process with the passive diffusion mechanism. The absorption rates of each of flavonoids are significantly different. The absorption rate of flavonoid glycoside was lower than that of aglycone; the flavonoids from Abelmoschus manihot flowers could be absorbed in all of the intestinal segments. The best parts of intestine to absorb hyperoside and myricetin are jejunum and duodenum, separately. Verapamil could enhance the absorption of isoquercitrin, hyperoside, myricetin and quercetin-3'-O-glucoside by inhibiting P-glycoprotein (P-gp) drug efflux pump.

Objective To understand the available preventive strategies of unplanned endotracheal extubation (UEX) among adult patients.Methods Twelve nurses were in-depth interviewed and data were processed and analyzed using categorization analysis method.Results Major themes were identified as follows:the incidence rate of UEX,tube fixation,efficacious physical restraint,appropriate sedation and training for younger nurses.Conclusions Nursing leaders should further standardize nursing process related to prevention of UEX,strengthen training for nurses,choose appropriate fixation method for patients and promote physical restraint and sedation care to prevent UEX and improve patient clinical outcomes.

Objective To ivestigate integrative medicine therapy for severe systemic lupus erythematosus.Methods In 2005,we successfully salvaged a severe SLE patient,who was an inpatient from the TCM Rheumatology department of China-Japan relationship hospital.The mainly clinic manifestations included severe pulmonary hypertension,gangrene and pancytopenia.We analyzed this ease.Results By integrative medicine therapy,we successfully salvaged this patient.Conclusion The key points for integrative medicine therapy for severe systemic lupus erythematosus included:1.Using strong measures to control the disease progress,including hormones,immunosuppressive agents; 2.Positive and effective symptomatic treatment aiming at pulmonary hypertension and severe gangrene; 3.Emphasizing the effect of Chinese medicine,using integrative medicine therapy.In sum,in this case,we applied integrative medicine therapy and got very perfect clinic effect at last.

Objective To study the relationship between expression of cyclooxygenase-2 (COX-2) and vas-culax endothelial growth factor (VEGF) with liver sinusnidal capillarization (LSC) of chronic hepatitis B (CHB). Methods We studied liver biopsies from 200 patients with CHB COX-2 ,VEGF immunohistochemical stain were ob-served to accomplish relationship between expression of COX-2,VEGF and LSC. Results LSC occupy above 80% in the group. There were manifestation in mild-LSC (focal) , middle-LSC (sheet-shape) and severe-LSC (widespread). Electron microscope shown the laceration in the endothelium of sinuses and formation of basal lamina and budding for-mation lumen of blood vessel and fat-storing cell convert myofibroblast. Expression of COX-2, VEGF, Co-Ⅳ and retic-ulum, collagen and elastic fibers with mild or severe in LSC is manifest locking relate. Conclusion Increased ex-pression of COX-2 ,VEGF in liver tissue of CHB may facilitate LSC and hepatic fibrosis.

0.05) was found between the dechlorinated water group and the extract of A.philoxeroides group in the activities of LDH and SDH after 12 h or 20 h of exposure.Conclusion The extract of A.philoxeroides rapidly inhibits ChE,and then the activity of Mg2+-ATPase,which may suppress the release and utilization of ATP in the Oncomelania snails and finally causes death of snails.

BACKGROUND:In recent years, neural stem cels are considered to be ideal for the treatment of spinal cord injury, but the proportion of its natural differentiation into neurons in the host body is relatively low, which severely restricts the therapeutic effect on spinal cord injury. OBJECTIVE:To investigate the effect of erythropoietin on the differentiation of neural stem cels in vitro. METHODS:Under sterile condition, neural stem cels from the hippocampus of neonatal Wistar rats were isolated, cultured and identified by immunofluorescencein vitro. The third generation of neural stem cels were randomly divided into 0.5, 5, 50 U/mL erythropoietin groups and control group (with no erythropoietin). RESULTS AND CONCLUSION:Compared with the control group, the differentiation rate of neural stem cels was significantly improved in the 0.5, 5, 50 U/mL erythropoietin groups (P< 0.05); moreover, the differentiation rate of neural stem cels in the 5, 50 U/mL erythropoietin groups was higher than that in the 0.5 U/mL erythropoietin group (P < 0.05). In addition, there was no significant difference between the 5, 50 U/mL erythropoietin groups (P > 0.05). These findings indicate that erythropoietin can effectively induce the differentiation of neural stem cels into neurons in vitro, and moreover, it can significantly improve the differentiation rate of neural stem cels into neurons.

Objective To observe the effects of a rehabilitation robot and body weight supported treadmill training (BWSTT) on the walking ability of hemiplegic patients after stroke.Methods Sixty hemiplegic patients were divided randomly into treatment and control groups (n=30 in each).The treatment group received training assisted by a leg rehabilitation robot for 10-20 min once daily,6 days per week for 8 weeks in addition to conventional treatments and BWSTT.The control group was only given conventional treatments and BWSTT once daily for 8 weeks.Their lower extremity functions,balance and walking ability were assessed with a simplified Fugl-Meyer assessment (FMA) and using the Berg balance scale (BBS) and Functional Ambulation Categories (FACs).Results After training,both groups showed significant improvements in terms of FMA,BBS and FAC results.The treatment group showed significantly better improvements in lower extremity function,balance and walking ability compared with the control group.Conclusions The lower-limb rehabilitation robot and BWSTT could together improve balance and walking ability.