1.Application of different release modes of LVIS stents in wide-neck intracranial aneurysms
Hua CHEN ; Haobo SU ; Liang CHEN ; Liangsheng LUO ; Jianping GU ; Jian ZHANG
Chinese Journal of Cerebrovascular Diseases 2016;(2):82-88
Objective To investigate the safety and short-term efficacy for evaluation of the low-profile visualized intraluminal support device (LVIS stents )compression and lantern release shapes for the treatment of wide-necked intracranial aneurysms. Methods From December 2014 to October 2015,15 patients with intracranial wide-neck aneurysm (16 aneurysms)received LVIS stent treatment, whose stent shapes had shortening changes were analyzed retrospectively. Thecompression mode refers to the length of LVIS stent to be shorter for more than 5 mm than the label release value by operation. Thelantern mode refers to the widened diameter of LVIS stent at the neck of aneurysm. The metal coverage rate in the posterior communicating segment of internal carotid artery after stent compression was calculated, and its safety and efficacy were assessed immediately after procedure and at 3 months after procedure. Results (1 )Using LVIS stent-assisted treatment,16 wide-necked aneurysms were treated,including 8 posterior communicating aneurysms,6 ophthalmic aneurysms,one anterior choroidal artery aneurysm and one M2 bifurcation fusiform aneurysm. The aneurysm neck was 1. 8 to 8. 0 mm (mean 3. 9 ± 1. 7 mm). A total of 15 LVIS stents were implanted (one patient with 2 aneurysms were treated with 1 stent). All the stents were released by using compression mode,and 4 of the patients (4 stents)also used the lantern mode at the same time. (2 ) After LVIS stenting,the Raymond grade Ⅰ embolization was in 10 aneurysms (62.5%),the covered branch arteries were patent immediately after procedure. (3)No perioperative technology-related hemorrhagic and ischemic complications occurred. The success rate of stent implantation was 100%(15/15). (4)The metal coverage rate after stent compression in the internal carotid artery posterior communicating segment was 30. 3%-38. 5%(mean 35. 0 ± 2. 8%). (5)After LVIS stent implantation,15 patients were followed up by whole brain DSA for 3 to 5 months (mean 3. 2 ± 0. 5), 14 aneurysms were cured on imaging (Raymond gradeⅠ),and no aneurysm recurred. All branch arteries covered by the stents did not have vascular occlusion. There was no in-stent restenosis or parent artery occlusion. The total disability rate was 6. 7%(1/15),and no patient died. Conclusions LVIS stents can increase aneurysm neck metal coverage rate and short-term cure rate throughcompression andlantern modes,while does not affect the covered branches. Choosing the appropriate cases for thelanternmode may be beneficial to the short-term protection of the vascular branches at the aneurysm necks.
2.Relationship of TNF-α-308 gene polymorphism with susceptibility and severity of central venous catheter-related sepsis
Liangsheng SU ; Guosen SHEN ; Kai FANG ; Wanjing XU ; Guoqiang CHEN
Chinese Journal of Clinical Infectious Diseases 2018;11(1):36-41
Objective To investigate the relationship of TNF-αgene promoter 308 locus(TNF-α-308)polymorphism with the susceptibility and severity of central venous catheter-related sepsis(CRS). Methods One hundred and five CRS patients admitted in Kaihua People's Hospital from January 2015 to May 2017 were enrolled in the study.According to whether complicated with multiple organ dysfunction syndrome(MODS), they were divided into CRS complicated MODS group(n=34)and CRS non-MODS group(n=71).Meanwhile,210 patients with no catheter-related infection(case control group)and 105 healthy subjects(healthy control group)were also enrolled in the study.Polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP)was used to genotype TNF-α-308, and the relationship of TNF-α-308 polymorphism with the susceptibility and severity of CRS was investigated.SPSS 16.0 was used to analyze the data.Results There were no significant differences in frequencies of GG, GA,AA genotypes and G,A allele of TNF-α-308 among CRS group,case control group and healthy control group(χ2=2.262 and 0.907,both P>0.05).Compared with CRS non-MODS group,case control group and healthy control group, the frequency of GG genotype was significantly lower and the frequencies of genotype GA and AA of TNF-α-308 were significantly higher in CRS MODS group(χ2=8.809,7.700 and 9.220,all P<0.05).Compared with CRS non-MODS group,case control group and healthy control group, the allele frequencies of G were significantly lower and allele frequency of A allele of TNF-α-308 was significantly higher in CRS MODS group(χ2=9.823, 8.624 and 7.654, all P<0.05).There were no significant differences in genotype frequency and allele frequencies of TNF-α-308(χ2=0.852 and 0.975, both P>0.05)among CRS non-MODS group and case control group,healthy control group(χ2=1.022 and 0.535,both P>0.05).The odds ratio of GA +AA genotype and A allele of TNF-α-308 in CRS MODS group were 2.664(95%CI 1.259-5.639)and 2.440(95%CI 1.326-4.490).Conclusion TNF-αgene promoter 308 locus polymorphism is not a predisposing factor for CRS, but may be associated with complication of MODS in CRS patients.