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.

In this review,the pathogenesis,clinical presentations,diagnosis of occupational asthma(OA)are discussed.The agents that cause OA are more than 300 kinds of high and low molecular-weight substances.The diagnosis of OA is generally established on the basis of a suggestive occupational history,symptoms,abnormal lung function and lab examination.Specific inhalation of bronchial challenge(SIC)comes closest to a gold standard test for some agents causing(sensitizer-induced)OA.

OBJECTIVE:To observe the effect of compound glycyrrhizin on patients with cholelithes combined with ob?structive jaundice.METHODS:The changes of bile drainage and liver function in41patients with choledocholith and obstruc?tive jaundice were observed on1to15days after operation(the trial group).The control group did not receive compound gly?cyrrhizin.RESULTS:The bile drainage of the trial group arrived to stable state3days earlier than that of the control group and color of bile was darker than that of control group;The liver function of trial group was significantly better than that of the control group from the7th day after operation(P

ObjectiveTo explore heart rate variability (HRV),cardiac troponin Ⅰ (cTnI),left ventricular ejection fraction (LVEF) and electrocardiogram (ECG) in order to clarify the function of cardiac autonomic nerve system and the incidence of potential myocardium injury in patients with severe brain injury.MethodsClinical data of 65 patients with severe brain injury admitted between June 2006 and June 2010 were reviewed.For the sake of comparison,patients were divided by different groupings as per different biomarkers or outcomes such as Glasgow coma scale (GCS) 6 - 8 group and GCS 3 - 5 group; cTnl ＞ 0.5 group,0.04 ＜ cTnl ＜ 0.5 group and CTnl ＜ 0.04 group; and survival group and death group.Another 30 healthy subjects were enrolled as control group.Heart rate variability (HRV) was analyzed with both timedomain and frequency domain methods based on data from 24-hour Holter monitoring.The level of serum cardiac troponin Ⅰ was detected. The left ventricular ejection fraction was measured by beside color ultrasonogram.The different relationships between HRV and GCS as well as prognosis,between cTnI and GCS as well as fatality,between cTnI and ECG,and between EF and GCS were analyzed.The computer statistical software SPSS version 13.0 was used for statistical analysis of data.ResultsAll of the 65 patents with severe brain injury were subjected to decrease in HRV.The patients of GCS 6 - 8 group and GCS 3 - 5 group showed significantly lowered HRV in comparison with control group ( P ＜ 0.05 ).The death group showed more obvious decrease in HRV than the survival group ( P ＜ 0.05 ).Fifty-one of the 65 patients had myocardial injury evidenced by increase in cardiac troponin Ⅰ.The patients of cTnl ＞0.5 group and 0.04 ＜cTnI ＜ 0.5 group showed significantly higher fatality compared with cTnI ＜ 0.04 group ( P ＜ 0.05 ).Compared with the GCS 6 ～ 8 group,more patients in the GCS 3 -5 group had abnormal serum CTnl level and lower EF.ConclusionsThere are cardiac autonomic nerve system disorders and different degrees of myocardial injury in patients with severe brain injury,and early intervention is essential to decrease the fatality of severe brain injury.

Along with the development of interventional appliances and proficiency of operational skills,the interventional diagnosis and treatment via hepatic portal vein system have achieved great progress and improvement.However,in order to further exploit the advantages of interventional diagnosis and treatment, the review of the anatomical structures,normal aberrance of portal venous system were needed.Getting familiar with pathologic condition to discover the new interventional appliances and embolic agents,and then in term of conduct the research on a very tough substancial base in a down-to-earth manner were important.

Objective To explore the effect of new labor standards on the intrapartum interventions and delivery outcome for gestational diabetes mellitus primiparas in labor by comparing with materal who were in accordance with the Friedman standards. Methods From May to November 2015, 319 singleton and full-term gestational diabetes mellitus primiparas whose labor treatment was according to new labor standards were selected as observation group. From November 2014 to April 2015, materal in accordance with the Friedman standards were selected as control group, a total of 292 cases, and then progress of labor, the usage of oxytocin, delivery way, postpartum hemorrhage, neonatal hypoglycemia and asphyxia were all observed. Results There was no significant difference between two groups in the rate of postpartum hemorrhage, neonatal hypoglycemia, neonatal asphyxia and neonatal mobidities (P>0.05). The total labor stage, the first labor stage and the second labor stage was (10.73 ± 4.00), (9.97 ± 3.89), (0.60 ± 0.38) h in observation group and (8.86 ± 3.09), (8.19 ± 3.00), (0.53 ± 0.31) h in control group, there was significant difference between two groups (t=18.184, 17.799, 6.798, all P<0.01). The incidence of artificial rupture, the usage of oxytocin, caesarean section was 22.57%(72/319), 16.93%(54/319), 5.64%(198/319) in observation group, and 28.77%(84/292), 22.95%(67/292), 9.59%(28/292) in control group, and there was significant difference between two groups(χ2=3.079, 3.476, 3.410, all P<0.05). The incidence of episiotomy was only 29.47% (94/319) in observation group, significantly less than that in control group, which was 51.37% (150/292), there was significant difference (χ2=30.490, P<0.01). Conclusions For gestational diabetes mellitus primipara, the new labor standards effectively reduce intrapartum interventions, the rate of cesarean sections and episiotomy, and more, less influence on maternal and newborn, which is helpful to promote the maternal reproductive health and natural delivery.

Objective To explore the possible risk factors associated with postoperative lower respiratory infections in the elderly patients with lung carcinoma,and to formulate the appropriate preventive strategies according to the results of the study.Methods From January 2014 to April 2015,182 elderly patients with lung carcinoma who were undergoing surgical treatment in Renji Hospital of Shanghai Jiaotong University were collected.All patients were divided into infection group (n =29) and control group (n =153) according to whether occuring postoperative lower respiratory infections or not.The possible risk factors associated with postoperative lower respiratory infections were analyzed by single factor analysis and multivariable Logistic regression model.Results Single factor analysis showed that the postoperative lower respiratory infections of elderly patients with lung carcinoma were associated with age (t =-3.03,P ＜ 0.05),smoking (x2 =5.69,P =0.02),albumin (t =2.40,P =0.02),forced expiratory volume (FEV) 1.0％ (t =5.85,P ＜ 0.05),lung carcinoma stage (x2 =7.06,P =0.01),small cell lung cancer (x2 =5.09,P =0.02),complication with chronic obstructive pulmonary disease (COPD) (x2 =16.28,P ＜0.01) and complication with coronary heart disease (x2 =10.13,P ＜ 0.01).Multivariable Logistic regression analysis showed that age (OR =1.34,95％CI:1.13-1.59,x2 =11.17,P＜0.01),smoking (OR=12.68,95％ CI:2.06-78.04,x2 =7.50,P=0.01),FEV1.0％ (OR =0.90,95％ CI:0.83-0.97,x2 =7.76,P =0.01),squamous-cell carcinoma (OR =6.88,95％ CI:1.41-33.56,x2 =5.70,P =0.02),complication with COPD (OR =12.44,95％ CI:1.41-109.90,x2 =5.15,P =0.02) and complication with coronary heart disease (OR =10.61,95％ CI:2.25-90.50,x2 =7.18,P =0.01) were independent risk factors for postoperative lower respiratory infections in the elderly patients with lung carcinoma.Conclusion Age,smoking,squamous-cell carcinoma,low value of FEV1.0％,complication with COPD or coronary heart disease can increase the risk of postoperative lower respiratory infections in the elderly patients with lung carcinoma.Comprehensive and effective preventive strategies should be performed to reduce the risk of postoperative respiratory infections.

Objective To evaluate the effects of propofol on glomerular and renal tubular functionsMethods Twenty-five patients without renal disease were randomly assigned to two groups: propofol group(n=13) and enflurane group(n=12), The creatinine, urea nitrogen, uric acid(UA) , ? 2 -microglobulin( ? 2-MG) concentrations in serum and urine were measured before induction of anesthesia, and 1, 2, 3, and 24h after induction Albumin(ALb), immunoglobulin G(IgG), pH, and protein in urine were also examinedResults In both groups , the urine concentrations of ? 2-MG , ALb and IgG were significantly increased following the administrations compared with those before induction of anesthesia (P

Objective To investigate changes in the expression of 5-HT2A receptor mRNA and platelet membrane adhesion molecules in migraineurs during the periods of attack and intermittence therapy by Xinzhengtian Pill (XZTP). To study the interrelation between the expression of 5-HT2A receptor mRNA and platelet membrane adhesion molecules. Methods 68 patients were randomly divided into XZTP (therapy) group and Flunarizine (control) group. The RT-PCR method and the image pattern analysis semiquantitation method were used to determine the 5-HT2A receptor mRNA expression levels in the migraineur groups and the normal control group. Flow cytometry was used to detect the expression of whole blood platelet membrane adhesion molecules in those groups. The interrelation between the expression of 5-HT2A receptor mRNA and adhesion molecules was analysed. Results The total effect have show obvious difference between therapy group and control group. 5-HT2A receptor mRNA in the attack group was higher than that of the intermittence group and the normal group, and XZTP can reduce this expression. The expression of whole blood platelet membrane adhesion molecules had a higher increase during the periods of attack and intermittence, compared with the normal control group and XZTP. The 5-HT2A receptor mRNA expression level in the migraineur groups had a high positive correlation with CD41 and moderate positive correlation with CD62P. Conclusion 5-HT2A receptor mRNA and platelet membrane adhesion molecule expression level during the period of attack was significantly augmented and platelet activation was increased. XZTP maybe restrained the expression of above indexes and resulted in platelet activation reduced.

Apolipoproteins A ; therapeutic use ; Coronary Disease ; drug therapy ; prevention & control ; Humans ; Recombinant Proteins ; therapeutic use