Objective To investigate the effect of endovascular treatment of vertebral basilar artery dissecting aneurysms. Methods The clinical data of 40 patients with vertebral basilar artery dissecting aneurysm admitted to Beijing Xuanwu Hospital and Haidian hospital,Capital Medical University from August 2013 to September 2014 were analyzed retrospectively. Their clinical symptoms and imaging were followed up. According to the treatment methods,they were divided into either a stent-assisted coil emboliza-tion group (group A;n = 34)or a parent artery occlusion (group B;n = 6),and according to the clinical symptoms and imaging followed-up,the efficacy was assessed at 1 year after procedure. Results The patients were followed up for 1 year after procedure,29 patients (85. 3%)were improved in group A, 1 (2.9%)was stable,and 4 (11. 8%)deteriorated. All the 4 deteriorated patients died of cerebral infarction complications (at 1 week to 6 months after procedure). The 6 patients in group B were improved compared with before procedure. No intracranial hemorrhage and ischemic events occurred. Conclusion Using the stent-assisted coil embolization technique and the parent artery occlusion technique for the treatment of the vertebral basilar artery dissecting aneurysms are relatively safe and effective.

Objective To analyze and compare the demographic characteristics and clinical features of patients with reflux esophagitis (RE) and non-erosive reflux disease (NERD),so as to appraise their different pathogenesis and effective treatment.Methods 127 patients with RE and 80 patients with NERD were enrolled and asked to complete the questionnaires.The general situation,living habits,typical esophageal symptoms,extra esophageal symptoms and the comorbidities were recorded in the two groups.Results There were more male patients in RE group,and more female patients in NERD group (P ＜0.05).There were more patients engaged in mental work in RE group,and NERD group had more physical workers (P ＜ 0.05).Compared with NERD,patients with RE were fatter and had more alcohol consumption (P ＜ 0.05).The proportion of patients with abnormal mental disorders in NERD group was significantly higher than that in RE group (P ＜ 0.05).NERD patients were more likely to incorporate irritable bowel syndrome (IBS) (P ＜ 0.05).RE patients were more likely to suffer from hiatal hernia (P ＜ 0.05).The incidence of anti-acid,chest pain,pharyngeal foreign body symptoms was higher in the NERD group (P ＜ 0.05).Conclusions The demographic characteristics,living habits,mental and psychological factors,esophageal symptoms,extra esophageal symptoms and comorbidities in patients with NERD or RE are different.These results suggest that there are different pathogenesis between RE and NERD.

Objective To study the influence of hierarchical psychological nursing on anxiety, depression, 5-hydroxytryptamine (5-HT) and Galanin (GAL) of patients with gastroesophageal reflux disease. Methods A total of 238 gastroesophageal reflux disease patients were divided into study group( n=119) and control group( n=119) by random number table. Two groups of patients were given the same routine care. Based on this, patients in the control group were given conventional psychological nursing, the study group were given hierarchical psychological nursing. SAS and SDS were used to evaluate the two group patients mental status before and after different mental care. Enzyme linked immunosorbent assay ( ELISA) was used to evaluate the contents of 5-HT and GAL of the two groups.Results After 4 weeks of hierarchical psychological nursing, SAS and SDS scores of the study group were (41.47±9.37) and (42.13±12.36). Those scores of the control group were (45.68±14.81) and (48.15±14.21). The differences were significant (t=2.62,3.49;P<0.05). After 4 weeks of hierarchical psychological nursing, 5-HT and GAL contents of the study group were (166.05±63.66) ng/ml and (23.18±8.74)pg/ml. Those contents of the control group were (146.30±63.75)ng/ml and (25.45± 9.03)pg/ml. The differences were significant (t=2.39,1.97;P<0.05).Conclusions Hierarchical psychological nursing can decrease anxiety and depression of patients with gastroesophageal reflux disease and help the contents of GAL and 5-HT return to normal level gradually. It is worthy of clinical promotion and popularization.