Objective To preliminarily discuss the technical points and clinical efficacy of the pressure cooker technique (PCT)for embolization of intracranial arteriovenous malformation (AVM). Methods From April 2015 to May 2015,7 patients with AVM were treated at the Department of Neurosurgery, Shanghai Deji Hospital. The AVMs of 2 patients were embolized with PCT. (both were Spetzler-Martin gradeⅡ). A sonic and an echelon microcatheter were implanted side by side into the same blood supply artery of an AVM. A coil + α-isobutyl cyanoacrylate (NBCA)plug was formed between the sonic microcatheter tip and the detachable point through the echelon microcatheter in order to prevent Onyx reflux when the glue was injected into a nidus via a sonic microcatheter,achieving the embolization effect of sustained,rapid and high efficient. Results Two patients achieved complete embolization immediately. The symptoms of the patients improved or disappeared within 1 month. The whole brain DSA showed the AVM of one patient did not have recurrence at 4 month after embolization. Two patients did not have any complications or sequelae at the follow-up study. Conclusion PCT can improve the efficiency of embolization. It is suitable for small, medium,superficial,non-major functional area,less feeding artery AVMs,and AVMs with less blood flow in nidus. Its safety and clinical effect still need to be observed with more samples.

Objective To investigate the medium- and long-term effects and safty of Pipeline embolization device ( PED) for the treatment of large and giant intracranial anterior circulation aneurysms. Methods From December 2014 to December 2016,the data of 36 consecutive patients with large and giant aneurysm ( 36 large and giant intracranial anterior circulation aneurysms ) treated with PED in Donglei Brain Doctor Group were analyzed retrospectively. The diameter of the aneurysms was 12 -33 mm, (mean16.6±4.5mm),andthenecksizewas4-10mm(mean6.1±1.5mm).Eightaneurysmswere located in the carotid cavernous sinus segment,22 in the ophthalmic artery segment,5 in the internal carotid artery posterior communicating segment, and 1 in the M1 segment of middle cerebral artery. Seven aneurysms were only treated by PED,28 aneurysms were treated by PED in combination with coil embolization,and 1 aneurysm was treated by double PEDs. The modified Rankin scale ( mRS) score was used to evaluate the prognosis of the patients. Results (1) The clinical prognosis of the patients was followed up by telephone and outpatient department for 6-33 months. Twenty-five patients were followed up by DSA,23 aneurysms (92%) were occluded totally (Raymond gradeⅠ) and 2 (8％) were occluded near totally ( Raymond grade Ⅱ) . ( 2 ) Seven patients were treated with PED alone. Four patients were cured totally after 6 months follow-up,1 was occluded subtotally,2 were not cured;6 were cured in the last follow-up (33 months),and the other aneurysm was gradually reduced;17 of 28 patients treated with PED in combination with coils received DSA follow-up. They were followed up for 6-8 months. All the aneurysms were totally occluded ( Raymond grade Ⅰ) . 1 aneurysm was treated by 2 PEDs, DSA revealed micro-aneurysm-like development at 8 months after procedure. The aneurysms were basically occluded after 15-month follow-up. (3) MRI confirmed after operation that 10 patients had asymptomatic scattered spotted ischemic foci,4 had cerebral parenchymal hemorrhage,1 of them died,1 recovered well after treatment (mRS 1),and the other 2 were asymptomatic cerebral hemorrhage. The occupying effect of 24 cases disappeared, 8 had obvious improvement,and 3 did not have any obvious change. Conclusions The occlusion rate of the treatment of large and giant intracranial aneurysms with PED was high. The results of medium-term follow-up showed that the occlusion rate of PED in combination with coils in the treatment of aneurysms was higher than that of PED alone. The long-term follow-up results showed that the occlusion rate of patients treated with PED alone (including one or more) was gradually increased with time. The safety of the surgery needs to be further confirmed by a large sample study.

Infectious bronchitis in chickens is a serious threat to the global poultry industry.Despite the availability of commercial vaccines,the epidemic has not been effectively controlled.Therefore,the development of novel vaccines may provide new ways to prevent and control this disease.In this study,BLP-S1,a bacterium-like particle displaying the S1 subunit of infectious bronchitis virus on its surface,was constructed using the GEM-PA system.The immunoprotection results showed that BLP-S1 effectively induced the production of specific IgG and sIgA in commercial chickens and provided effective protection against a heterologous strain with a protection rate of up to 90％.This study demonstrated that BLP-S1 has good immunogenicity and immunoprotection,with the poten-tial to develop a novel vaccine against infectious bronchitis.

Objective To evaluate the efficacy and safety of Willis covered stent in the treatment of traumatic carotid cavernous fistulae (tCCF).Methods The imaging and clinical data of 7 patients with tCCF treated with Willis covered stent in Shanghai Punan Hospital from November 2015 to June 2018 were analyzed retrospectively.Results Seven Willis covered stent were used in 7 patients.Immediately after stent release,angiography showed that the fistulae completely disappeared in 6 cases.One patient had a small amount of endoleak,and there was still a small amount of endoleaks after balloon dilatation.It was not further treated.There were no operative complications.During 3-12 months follow-up,no new neurological deficits were found in all patients.Angiographic follow-up of 2 patients showed that the fistulae completely disappeared without recurrence.The internal carotid arteries were patent,no in-stent stenosis and stent displacement.Conclusions Wills covered stent can be used as a treatment for tCCF.Its efficacy is satisfactory and the safety is good.