Carotid stenosis is one of the important causes of cerebral infarction. It has been demonstrated that carotid angioplasty and stenting (CAS) can prevent the occurrence of stroke, and its clinical application is continuously increasing. Although CAS is a microinvasive technique, it has some potential complications, such as hemodynamic abnormalities, hyperperfusion syndrome, cerebral infarction, and restenosis. This article reviews the complications of CAS and their management strategies.

Different from Westerners,intracranial atherosclerosis (ICAS) is a main cause for acute ischemic stroke in Eastern population.Studies have shown that ICAS is associated with the risk factors including metabolic syndrome,dyslipidemia,diabetes mellitus,and inflammation.Adiponectin is involved in oxidative stress and glycolipid metabolism,its reduced level is the most important risk factor for metabolic syndrome and the most prominent inflammatory markers.Numerous studies have suggested that adiponectin is associated with cardiovascular diseases,and it is used as a preventive marker.In recent years,the relationship between adiponectin and ICAS has become a hot research topic.This article mainly reviews the roles of adiponectin in ICAS.

The application of intracranial stent-assisted angioplasty has been in controversy.In recent years, the development novel stents, preoperative evaluation, and accumulation of periprocedural management experiences have significantly improved the success rate of this operation.The incidence of complications has decreased significantly. However, the efficacy and safety of intracranial stent-assisted angioplasty are still lack of support from prospective multicenter studies.This article reviews the recent advances in this field.

According Ming dynasty,Qing dynasty established the imperial drug institution(IDI) and set up service offices or pharmacy in several temporary imperial palaces besides office in Forbidden City,which was IDI offices outside Forbidden City.Base on assorting historical information and literature,eld research about historical remains,this article preliminary clari ed the o ces' names and locations of IDI outside Forbidden City.

Objective:To investigate the feasibility,effectiveness and safety in the treatment of symptomatic middle cerebral artery stenosis with stenting.Methods:Twelve patients with middle cerebral artery stenosis were treated with stenting from August 2005 to December 2006.Among these patients,9 were male and 3 were female.The meam(SD)age was 69(5.3)years(range 56 to 81 years).The mean(SD)stenosis degree was 84.2%(3.7)(range 50% to 99%).All patients were successfully treated with balloon-expanded stents.and there was not any severe complications.Results:The rate of residual stenosis after the procedures was≤20%.No cerebral ischemic symptoms recurred in the patients over a 6-to 18-month follow-up period.Conclusions:Endovascular stenting is a safe and effective approach in the treatment of symptomatic middle cerebral artery stenosis,and its short-term effect is significant.

Objective To evaluate and compare 3 kinds of cecocolon urinary reservoir. Methods Penn pouch,indiana pouch or detenial cecocolon reservoir has been performed for 37 patients.The out-come was evaluated by urodynamic and clinically. Results Good continence has been achieved in all patients with an appendiceal continence mechanism.The capacity and intrareservoir pressure of detenial cecocolon was significantly different from penn or indiana pouch 3 months postoperatively (P0.05).The intrareservoir pressure on contraction was lower with penn pouch. Conclusions The penn or modified indiana pouch is better and more ideal as an urinary reservoir whereas the detenial cecocolon pouch is technically simpler.

Objective To construct and identify the Eukaryotic expression vector of RNAi hTRET. Methods The hRERT interference sequence was synthesized by artificial way and was directed cloning to the Eukaryotic expression vector pSilencer 3.1 H1 neo,and was identified by pcr,enzyme cutting,sequencing,determining its concentration and purity. Results We construct the Eukaryotic expression vector of RNAi hTRET successfully. Conclusion Construction of Eukaryotic expression vector of RNAi hTRET established foundation for biological effectiveness of telomere and telomerase in cancer cells.

Objective To evaluate the performance of VITEK-2 compact,VITEK MS and Bruker MS on the identification of Corynebacterium.Methods This was a methodological evaluation study.The 40 Corynebacterium from bioMerieux were i-dentified with the three methods respectively.16S rDNA gene sequencing was conducted as reference method.Made a de-scriptive analysis of the identification ability,time and cost.Resulets The accuracy of species level of the three methods was 95.0%,88.9% and 97.5%.The mean time was 5~6 h,2~3 min and 2~3 min.The cost of consumable was 50~70 yuan, 15~25 yuan and 10~20 yuan.Conclution Three methods with high accuracy can meet the requirement of clinical diagno-sis,and the identification ability of VITEK MS on Corynebacterium amycolatum need to be further improved.

Objective To investigate the risk factors and clinical manifestations of placental abruption, and to analyze the causes of missed diagnosis and misdiagnosis. Methods A retrospective analysis was conducted in 135584 women who delivered in Women′s Hospital, School of Medicine, Zhejiang University from January 2005 to December 2015. The diagnosis of placental abruption was made in 1212 cases. According to the consistency of prenatal and postnatal diagnosis, they were divided into 3 groups.(1) The diagnosis was consistent prenatally and postnatally in 715 cases(58.99%,715/1212) as the diagnosis group.(2)In 312 cases (25.74%,312/1212), the diagnosis was made after birth as the missed diagnosis group.(3)In 185 cases (15.26%,185/1212), the diagnosis was made prenatally but excluded after birth as the misdiagnosis group. The disease classification was made, and the risk factors, clinical manifestations, lab results, the time of termination and perinatal outcomes were recorded in the 3 groups. The reasons of missed diagnosis and misdiagnosis were analyzed. Results (1) In the 1212 cases, the diagnosis of placental abruption was confirmed in 1027 cases, with the incidence of 0.76%(1027/135584). The rate of missed diagnosis was 30.38%(312/1027), and the rate of misdiagnosis was 0.14%(185/134557). (2) There were significant differences in the degree of placental abruption among the 3 groups (P＜0.05). (3)Significant differences were found among the 3 groups regarding the ratio of hypertensive disorders, trauma, induced labor and advanced maternal age (all P＜0.05). (4) There were statistically significant differences among the 3 groups regarding the incidence of vaginal bleeding, persistent abdominal pain and uterine tenderness, bloody amniotic fluid, increased uterine tension and stillbirth (all P＜0.05). (5) There was no significant difference in the rate of abnormal fetal heart rate mornitoring among the 3 groups (P=0.22). The differences were statistically significant among the 3 groups when regarding the incidence of abnormal ultrasound finding and abnormal blood coagulation (P＜0.01), with the highest incidence of abnormal ultrasound in the diagnosis group (68.1%) and the highest incidence of abnormal coagulation in the misdiagnosis group (24.9%). (6)There was statistically significant difference among the 3 groups when comparing the ratio of termination of pregnancy within 24 hours (P=0.01). (7) There were statistically significant differences among the 3 groups when the ratios of postpartum hemorrhage, DIC, neonatal asphyxia and perinatal death were compared (all P＜0.05). The highest incidence of postpartum hemorrhage was in the diagnosis group (17.9%) and the lowest was in the misdiagnosis group (5.4%). The highest incidence of DIC was in the diagnosis group (3.9%) and the lowest was in the misdiagnosis group (0). The highest incidence of neonatal asphyxia was in the diagnosis group (30.6%) and the lowest was in the misdiagnosis group (7.6%). And for perinatal death, the highest incidence was in the diagnosis group (12.6%), the lowest was in the misdiagnosis group (2.2%). Conclusions Placental abruption could be misdiagnosed when depending on risk factors, such as trauma. And it could be missed diagnosis during the induction of labor. Uterine contraction, abnormal fetal heart rate mornitoring, abnormal ultrasound and abnormal coagulation function are important in the diagnosis of placental abruption.

Objective To explore the dynamic changes of D-dimers during pregnancy and early puerperium (within 3 days postpartum). Methods A retrospective study was performed among 8 367 healthy women who had term singleton delivery in Women′s Hospital, School of Medicine, Zhejiang University from January 2007 to December 2014. D-dimers concentrations during pregnancy and early puerprium of all the cases were collected. Data of 21 065 D-dimers tests were assigned to 5 groups according to the time of sampling, including early pregnancy (≤12 gestation weeks), middle pregnancy (12-28 gestation weeks), late pregnancy (>28 gestation weeks), 1 postpartum (within 48 hours postpartum) and 2 postpartum (48-72 hours postpartum). The D-dimers concentrations in different groups were compared. The effect of delivery mode on D-dimers of early pureperium was analyzed. The correlation between D-dimers and the thromboembolic disease was also explored. In this study, Student′s t-test and Wilcoxon rank sum test were used for statistical analysis. D-dimers concentration≤0.5 mg/L was used as the normal range. Results (1) D-dimers concentrations during pregnancy were higher than the non-pregnant women (P<0.01), but there was no statistical difference between early pregnancy and late pregnancy (P=0.820). D-dimers concentration in the 1 postpartum group was higher than that of early pregnancy group or late pregnancy group (P<0.01). But in the 2 postpartum group, it was lower than early pregnancy, late pregnancy and 1 postpartum groups. (2)D-dimers in cesarean section cases was significantly higher than in vaginal delivery cases in each period of pregnancy and early pueprium.(3)The 95%CI of D-dimers in early pregnancy, late pregnancy, 48 hours after vaginal delivery, 48-72 hours after vaginal delivery, ≤48 hours after cesarean section, 48-72 hours after cesarean section were 0.58-8.28, 0.47-11.52, 1.04-9.59, 0.87-5.22, 1.07-11.58 and 1.00-6.23 mg/L, respectively.(4)In 6 cases with thromboembolic disease, D-dimers was 6.89-19.89 mg/L, with the mean value of 13.66 mg/L. It was significantly higher than normal range. In 3 cases, all after cesarean section, with lower extremity vein thrombosis within 48 hours postpartum, the D-dimers concentrations, 9.77, 8.65 and 6.89 mg/L respectively, were in the 95%CI of the study population after cesarean section. Conclusions D-dimers concentration of 0.5 mg/L is not suitable for venous thromboembolism screening during pregnancy. D-dimers concentration in pregnancy and early puerprium is higher than non-pregnancy. It increases in the very early period postpartum and decreases with time. D-dimers should not be a routine screening test to exclude thromboembolic disease in pregnant women without high risk factors and clinical manifestation of thromboembolic disease.